Introduction: Trauma resuscitations are complicated, high-risk, and time-sensitive actions that need the coordination of different specialists arriving from multiple areas in the hospital. This systematic review aimed to understand the main key challenges of trauma resuscitations using a broad search in various database. Methods: A systematic review of published articles between the year 2000 and 2016 were conducted using different electronic databases such as Google Scholar, Medline, Embase, and Scopus to identify studies evaluating trauma resuscitations challenges. Different keywords were used in this study to recognize relevant articles. The titles of all articles were scanned in the first stage. Irrelevant articles were omitted and the abstracts of the rest articles were reviewed in the second stage. Finally, the full text of all articles which met the inclusion and exclusion criteria were reviewed and a data extraction sheet was made to summarize all the articles. Data were analyzed descriptively. Results: Twenty five studies were reviewed including; RCT (3 studies), QRCT (5 studies), and descriptive study (17 studies). The results showed that there are four main trauma resuscitation challenges including pre-hospital challenges, error-related challenges, equipment and technical challenges, and finally general challenges. Conclusions: Trauma resuscitation is one of the most critical aspects of emergency care. It is necessary to promote resuscitation care and focus on patient outcomes in terms of mortality and more importantly, functional outcomes. Considering these main factors affecting trauma resuscitation will improve patients' outcomes and help those who are engaged in providing services.

Purpose: To increase the awareness of eye health care providers about Work related musculoskeletal disorders and proper ergonomics. Method: Literatures review of all aspect of work related musculoskeletal disorders and ergonomics pertaining to heath care in general and particularly to eye care providers. Results: Work related Musculoskeletal disorders (WRMSD's) among health care workers including Physicians, nurses, dental hygienist, and Custodial worker are well known. In the last two decades WRMSD's and related problems have being substantiated by different studies on the above mention groups, and in particular Ophthalmologists along with dentists and some surgical subspecialties (Laparoscope surgeons and Ear, Nose, and Throat surgeons). It was attributed to the specific nature of the job which requires prolonged awkward position and repetition. In these series of four articles will try to highlight the most important areas where health care providers especially the ophthalmologist should take care and aware of to prevent or at least reduce the WRMSD's. These areas involve: in the work and outside of work activities and include: (A) Clinic: The proper way of conducting slit lamp examination with or without the use of different lenses. How to perform direct and indirect ophthalmoscopes with the least stressful way to cervical and lumbar spine (will be covered in part 2 of this review). (B) Work station and office: How to set in proper way and how to select ergonomic and comfortable chair, tables, mouse, keyboard, screen and foot rest (will be covered in part 2 of this review). Also computer vision syndrome (will be discussed in part 4 of this review). (C) Operating room: Tips in how to adjust surgeon chair, microscope, and operating table to achieve the best ergonomic position. Also hints in the proper way of selecting and using surgical loupes (will be covered in part 2 of this review). (D) Outside the Hospital: Advises in the proper way of using portable visual display devices (smart phones and tablets etc…) along with hints on how to sit while driving and how to sleep with the least stress to the back and neck(will be covered in part 3 of this review). Conclusion: Adopting a healthy neutral posture and along with the comply of basic ergonomics principles in different areas of ophthalmic works early in the medical career (i.e. Residency) along with maintaining regular muscles stretches and exercise will reduce those unwanted Musculoskeletal squeals and hopefully leading to prolonged and productive healthy career life.

Introduction: In this paper, numerical study is carried out to investigate natural convection and radiation heat transfer in an asymmetrical heated inclined air channel with open ends. The Reynolds-averaged Navier–Stokes equations are solved using a commercial computational fluid dynamics solver ANSYS-FLUENT^© in conjunction with the discrete ordinate radiation model. Simulations were run considering the channel with inclination angle to horizontal in the range 18° to 45° and a wall surface emissivity of 0.27–0.95. The channel length to channel space ratio was selected in the range 44–220. A uniform heat flux in the range 100–500 W/m² was applied along the upper wall of the channel while the lower wall and side walls were assumed thermally insulated. Results: Temperature profiles along the upper and lower walls of the channel were obtained with variations in the channel length to space ratios, angles of inclination, radiation emissivity, and input Ohmic heat flux. The effect of various parameters on the maximum wall temperature and heat transfer was investigated. The numerical predictions are validated by comparison with the experimental data available in literature. Conclusion: The numerical results obtained are found in good agreement with the experimental measurements. From the numerical results, a correlation of local and average Nusselt number with modified channel Rayleigh number in the range of 10¹–10⁵ is developed at asymmetric heat flux boundary conditions. Nu = 0.6851Ra” ^0.2612

Introduction: The salt-stratified solution destabilized by bottom heating is a double-diffusive system, which is characterized by conditions similar to those found in salt gradient solar ponds. Although many of its features are well understood, controversy still exists concerning the mechanisms responsible for the growth of the first mixed layer. This growth strongly influences overall system performance. The solar pond is a complex system that is coupled to ambient conditions and where several different inputs can destabilize the stratification. This complexity cannot be reflected in the idealized analytical description of the mixing mechanisms. In spite of these difficulties, the experimental description seemed necessary. Our objective is to make a laboratory scale flow visualization experiments using shadowgraph, to understand the occurrence of overstability and the layer motion in a simulated solar ponds. Laboratory experiments were made to investigate further the stability and occurrence of convective regimes, as a function of density and heat constraints. Methodology: In this paper, the overstable convection in a linearly salt-stratified system with a free surface and heated from below at constant temperature is studied. In the experimental studies, almost the same conditions and same stability parameter that we can find in a real salt-stratified solar pond was considered. Results: It is found that the oscillatory motion appeared in the bottom of the stratification seems to be the main mechanism responsible for the growth of the first mixed layer which strongly influences overall system performance. Conclusion: In this work, the onset and the development of the first mixed layer were studied for small stability parameter Λ. No investigation has been performed, to our knowledge, regarding the occurrence of overstability for small values of Λ.

Problem Statement: Social media use may be detrimental to sleep quality, self-esteem, and mental health and may affect academic performance in medical students. However, the effects of problematic social media use on sleep quality and academic performance in medical students are unknown. Approach: A total of 170 medical students in a Saudi Arabian medical school were studied. The relationships between social media use volume (duration of use per day) and addiction (measured using the Bergen Facebook Addiction Scale) of seven platforms and (i) quality of sleep measured using the Pittsburgh Sleep Quality Index and (ii) academic performance according to the grade point average were examined. Caffeine intake was considered as a potential confounder, and data were analyzed using uni- and multi-variable logistic regression. Results: Poor quality sleep (72.9% and 63.5% during the week or at the weekend, respectively) and social media addiction (27.1% addicted to three or more platforms) were common. Individuals with high-volume WhatsApp (odds ratio [OR] 1.59 [1.20–2.10], P = 0.001) and Snapchat (OR 1.41 [1.10–1.81], P = 0.007) use were more likely to have very poor sleep quality at the weekend, the latter persisting in multivariable analysis. Students who were addicted to Snapchat (OR 2.53 [1.03–6.22], P = 0.044) or who were addicted to three or more social media platforms (OR 2.93 [1.19–7.23], P = 0.019) had an even greater risk of very poor weekend sleep quality. Social media addiction was not associated with academic performance. Conclusions/Recommendations: Educational programs on sleep and social media hygiene and changes to class start times to prevent weekend sleep debt should be considered.

Background: A subanalysis of the Centralized Pan-Middle East Survey on the undertreatment of hypercholesterolemia (CEPHEUS) was done to establish the factors associated with worse control of hypercholesterolemia (HC) in Saudi Arabia. Methods and Results: CEPHEUS (NCT01031277) was a multicenter survey conducted in six Middle Eastern countries (Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman) between November 2009 and July 2010. Male and female patients aged ≥18 years on lipid-lowering drugs for ≥3 months (stable medication for ≥6 weeks) were recruited. At the study visit, investigators completed a questionnaire (experience and perception of the management of HC), patients completed a questionnaire (awareness of HC, current treatment schedule and perception, compliance), and patient fasting serum samples were collected to measure lipid profile. For the purpose of this subanalysis, patients were categorized as Saudi or non-Saudi. Multivariate analysis of the data showed that diabetes, obesity, and high waist circumference are associated with worse control of HC in Saudi Arabia. The lipid profile showed worse control of all variables except high-density lipoprotein-cholesterol. Saudi patients on statins and fibrates for primary prevention were the highest low-density lipoprotein-cholesterol (LDL-C) goal achievers. The positive predictors of achievement of LDL-C goals are age <40 years, absence of diabetes mellitus, nonsmoking status, compliance to medication, and glycated hemoglobin (HbA1c) <8%. Conclusion: This subanalysis establishes that diabetes, obesity, and high waist circumference age >40 years, smoking, HbA1c >8% are associated with worse control of HC in Saudi Arabia.

Olanzapine is an atypical antipsychotic medication and a very effective treatment for schizophrenia. However, it is associated with third highest incidence of neutropenia among all antipsychotics, and this may limit its use. We present a case of a schizophrenic female who was successfully treated with olanzapine and lithium to enhance white blood cells after a history of neutropenia caused by olanzapine treatment. We briefly discuss the use of lithium in patients who were rechallenged with antipsychotic medications. This case study supports the use of lithium for olanzapine-induced neutropenia as a successful and safe strategy.