Latifa Hospital

This systematic review consolidates current evidence on the efficacy, safety, and tolerability of awake, office-based procedures for chronic rhinosinusitis (CRS). It aims to evaluate whether these minimally invasive interventions performed under local anesthesia are viable alternatives to conventional sinus surgery under general anesthesia. A systematic search of PubMed/MEDLINE, Google Scholar, and Scopus databases was performed through November 2025, following PRISMA guidelines. Studies were selected using the PICOS framework, including adult patients undergoing in-office procedures (e.g., balloon sinus dilation, endoscopic sinus surgery, polypectomy, steroid-eluting implant placement) for CRS. Data were extracted and narratively synthesized due to heterogeneity. Eleven studies involving 1,283 patients were included. The procedures demonstrated significant and sustained improvements in patient-reported (SNOT-22, SNOT-20, NOSE, VAS) and objective (Lund-Mackay, Nasal Polyp Score) outcomes. Complication rates were low, with minor adverse events. Intraoperative pain was generally mild, tolerability was high (82-95%), and patients reported rapid recovery (often within 48h) and high satisfaction (72-95% willing to repeat the procedure). Awake sinus procedures are an effective, safe, and well-tolerated treatment option for selected CRS patients. They offer significant symptom relief, high patient satisfaction, and rapid recovery while avoiding general anesthesia. These techniques represent a transformative, patient-centered, and resource-efficient component of modern rhinology.

Sepsis is common in hospitalized pediatric patients, leading to increased morbidity, including multiple organ dysfunction and mortality. Fluid resuscitation and antibiotic administration are the primary protective mechanisms for sepsis. However, not all infections are bacterial, and unnecessary antibiotic use increases the risk of developing multidrug resistance; therefore, it is essential to distinguish bacterial from viral or other infections. Routine laboratory investigations cannot always identify the cause of diseases, but assessing different biomarker levels can help identify these infections and treat sepsis accordingly. This mini-review aims to critically analyze the available evidence supporting the use of biomarkers in pediatric sepsis. We have used the search engines PubMed, Cochrane Library, and Google Scholar to retrieve relevant information. We reviewed studies evaluating various biomarkers used for sepsis diagnoses, like C-reactive protein, ferritin, lactate, procalcitonin, tumor necrosis factor-alpha, etc. Apart from the diagnosis, trials are being conducted to assess the role of these biomarkers in monitoring and guiding antibiotic therapy to promote early recovery. The sensitivity of each biological marker varied in different studies, and no single biomarker can identify all types of infections. More robust studies are necessary to compare the roles of various biomarkers in diagnosing and guiding the appropriate therapy.

<title>Abstract</title> Background despite advances in diagnosis and antimicrobial therapy, community-acquired pneumonia (CAP) remains a significant cause of mortality. In critically ill hospitalized patients, mortality rates range from 5% to as high as 30–50%. There is an increasing interest in studying the anemia prevalence among hospitalized patients and its consequences in comorbidity and mortality. Considering that CAP is the second leading cause of hospital admission, this study investigates the prevalence and progression of anemia in CAP patients, and its association with hospital stay, mortality, and pneumonia severity. Methods This prospective observational study analyzed 60 patients admitted to the hospital with CAP, classified according to the pneumonia severity index (PSI). Hemoglobin levels were measured on the day of admission, the fourth day, the seventh day, and at discharge. Anemia was categorized into five categories: no anemia, mild anemia (Hgb 12-10g/dl), moderate (Hgb 10-8g/dl), severe (Hgb 7.9-6.5g/dl), and life threatening (Hgb &lt; 6.5 g/dl). We examined the relationship between anemia and hospital stay duration, pneumonia severity, incidence of complication, mortality, and gender. Results Anemia was prevalent in 86.7% of patients hospitalized with CAP. Although our data did not show new development of anemia during hospitalization, the study found that anemia was associated with longer hospital stay, higher pneumonia severity, increased complications rate, and higher mortality rate of 11.9% overall. Conclusion Anemia in CAP patients is not merely a comorbidity but is associated with poor prognosis and increased risk for complications and mortality.

This paper provides a comprehensive historical analysis of the oil exploration and production industry, examining its evolution through the intertwined lenses of corporate strategy, geopolitical conflict, and technological innovation. It argues that the sector's development has been a powerful force in shaping the modern global economy and international relations, while simultaneously being profoundly shaped by external political, economic, and environmental pressures. The study employs a dual-case framework for in-depth illustration: the corporate history of BP serves to trace the strategic adaptations and challenges of a major international oil company, from its imperial origins to its contemporary engagement with the energy transition. Concurrently, the Rumaila oil field in Iraq is analyzed as a microcosm of the industry's technical, operational, and geopolitical dimensions, highlighting its enduring significance and modernization. The analysis spans key historical phases, including the formative early discoveries, the rise of OPEC and the use of oil as a geopolitical weapon, and the persistent link between hydrocarbon resources and regional conflicts. It then investigates the contemporary pressures compelling transformation, particularly the dual imperatives of technological efficiency and climate responsibility. The discussion projects into the future of upstream operations, evaluating how digital technologies like artificial intelligence are revolutionizing exploration and production, and how climate-responsive strategies—including carbon management and investments in cleaner energies—are redefining corporate missions. Ultimately, this paper presents the oil industry not as a static entity, but as a dynamic and adaptive sector navigating an irreversible shift toward a lower-carbon global energy system.

Uterine rupture is a rare but life-threatening complication, most commonly associated with labor in women with a prior caesarean scar. Its occurrence in the second trimester, particularly in primigravid women with an unscarred uterus, is exceptionally uncommon. Here, we present a 29-year-old primigravida with a monochorionic-diamniotic (MCDA) twin pregnancy complicated by absent end-diastolic flow in one twin and subsequent intrauterine fetal demise at 21+5 weeks. Induction of labor with misoprostol resulted in delivery at 21+6 weeks. The early postpartum course was complicated by pyrexia, retained tissue, and recurrent heavy bleeding requiring ultrasound-guided surgical evacuation (SEVAC), uterine balloon tamponade, and major obstetric hemorrhage. Thirty-two days post-delivery, the patient collapsed with secondary postpartum hemorrhage. MRI later demonstrated a complete absence of the anterior uterine wall, consistent with rupture/dehiscence. Laparotomy confirmed a large anterior wall defect, which was successfully repaired, preserving fertility. This case gives us insight that second-trimester uterine rupture, though rare, is a potentially devastating condition. Clinicians should remain vigilant regardless of parity or uterine history. “Silent rupture” emphasizes the role of imaging in ambiguous cases. Conservative measures for postpartum hemorrhage must be used judiciously, and prompt surgical management optimizes outcomes and preserves fertility. Larger studies are needed to refine risk stratification and monitoring strategies.

Background: The first hour of life, often referred to as the "golden hour," represents a critical window for initiating timely, evidence-based interventions that stabilize the newborn and reduce the risk of complications. This period demands coordinated efforts in thermoregulation, respiratory support, glucose monitoring, and early nutrition to optimize neonatal outcomes. Despite the existence of well-established clinical guidelines, knowledge and practice gaps among healthcare providers continue to pose significant challenges. These discrepancies contribute to variations in the quality of neonatal care, particularly in high-risk settings. To address this issue, structured educational programs and targeted workshops have emerged as effective strategies to enhance healthcare providers' competencies, ensuring consistent and high-quality care during this vital phase.Objective: This study aimed to assess the effectiveness of the neonatal golden hour management workshop on the knowledge scores of healthcare providers.Materials and methods: A quasi-experimental quantitative research design study was conducted at Latifa Women and Children Hospital, one of the largest maternity hospitals in Dubai, consisting of all its employees. The hospital has around 600 nurses working in various maternity units and a yearly census of 4000-5000 deliveries, and all normal vaginal deliveries are conducted by obstetric nurses or midwives. Nurses from all categories in Latifa Women and Children Hospital from the months of February 2024 to November 2024 participated in the survey.Results: The proportion of participants with good, very good, and excellent knowledge increased from 12%, 0%, and 0% in the pretest to 76%, 20%, and 4% in the posttest, respectively, indicating substantial improvement in overall knowledge levels. Participants aged 40-50 years and 35-40 years had more knowledge and higher scores (71.16±25.16 and 70.18±9.95, respectively). The participants working in the intensive care unit and emergency departments had more knowledge and higher scores (74.58±8.10 and 70.71±8.86, respectively).Conclusion: This result highlights the crucial role of structured workshops and training courses in improving the preparedness of healthcare providers to deliver timely and effective neonatal care during the golden hour. These findings support the integration of regular, evidence-based educational interventions into hospital training policies to ensure sustained improvements in neonatal outcomes.

Fluorescence-guided surgery (FGS) is a surgical technique that enables high contrast, real time visualization of healthy and diseased tissues during surgery. This method enhances the surgical accuracy in tumor, bowl, liver resections, vascular evaluation, and anatomical localization. FGS still faces several open challenges due to the non-standardized protocols. Artificial Intelligence (AI) provides a powerful and innovative tools to improve overcome the open challenges by enhancing imaging, automatically detecting healthy and unhealthy tissues, and also supports in decisions making during surgical procedures. This paper presents a modular framework for combining AI into the FGS approach that covers pre-operative planning, real-time imaging, intra-operative guidance, and post-operative patient care. This framework presents how AI can make FGS more accurate qualitative and quantitate analysis. FGS uses fluorescent dyes and light to help surgeons check, monitor and classify healthy and diseased tissue, particularly in cancer surgery. This approach enhances the ability to detect tumor boundaries that lead to complete removal of tumor and less damage to its surrounding healthy tissue. At last this paper highlights key benefits, disadvantages, open challenges and future directions.

BackgroundSchool-based vision screening plays a vital role in identifying visual problems at an early stage. There is limited evidence on the frequency of visual impairment and its associated risk factors among school-aged children.ObjectiveThis research aimed to assess the prevalence of visual impairment and its associated risk factors among school children enrolled in Government Schools of Rawalpindi.MethodologyAn analytical cross-sectional study was conducted among 320 schoolchildren in the Rawalpindi district of Punjab province from July to December 2024. Presenting visual acuity was assessed using the validated Peek Acuity app on smartphone with the tumbling E optotypes. Visual impairment was defined as presenting visual acuity worse than 6/12, based on failure to correctly identify at least four out of five optotypes at the 6/12 level at a testing distance of 3 m. A validated questionnaire was utilized to assess risk factors associated with visual impairment. The prevalence of visual impairment was presented as frequencies and percentages. Binary logistic regression was performed with visual impairment as the dependent variable, considering age, gender, father's educational status, mother's educational status, household income, maternal illness during pregnancy, parent with visual impairment, sibling with visual impairment, birth weight, gestational age, complications at birth, serious infection during childhood, history of head trauma or injury, duration of television exposure, and duration of mobile/computer exposure as independent variables. Variables with a p < 0.05 and a 95% confidence interval in the multivariate model were considered statistically significant.ResultsA total of 320 study participants were included in this study. Visual impairment was identified in 82 children (25.6%), consisting of 35 males (42.68%) and 47 females (57.3%). It was categorized as mild in 30 (36.58%) and moderate in 52 (63.41%) children. In multivariate analysis, parent with visual impairment [4.201 (2.221–7.948)], low birth weight [0.376 (0.189–0.749)], small gestational age [0.231 (0.113–0.475)] and exposure to mobile and computer devices [2.368 (1.040–5.393)] were factors significantly associated with visual impairment.ConclusionThis study identified a high burden of visual impairment among schoolchildren, with a greater proportion observed in females and predominantly presenting with moderate severity.

Emphasis is considered a strong feature of some sounds that distinguishes them from others. Ancient and modern Arab linguists agree that emphasis is an inherent feature of the four sounds (ص /sˤ/, ض /ðˤ/, ط /tˤ/, and ظ /ðˤ/. However, emphasis in these sounds does not occur at the same degree, as the articulatory organs for each sound differ from the others. Additionally, other sound features affect the degree and type of emphasis. This study examines the factors influencing the degree and type of emphatic consonants, which are related to the articulatory organs of the sound or the sound's features. The study uses a descriptive-explanatory approach to describe the articulatory organs of these sounds, their phonetic features, and their impact on emphasis, exploring the requirements of emphasis. The study’s results revealed that the emphasis on the sounds ض and ط is explosive and non-continuous, with a high resonance due to the explosion, while the emphasis in ص and ظ is continuous due to friction, with a lower resonance. Nonetheless, the sound ص is stronger than ظ in terms of audibility due to the strength of the hissing, making its emphasis more resonant.