Background. The platelet‐to‐lymphocyte ratio (PLR) and neutrophil‐to‐lymphocyte ratio (NLR) reflect the patient inflammatory and immunity status. We investigated the role of on‐admission PLR and NLR in predicting massive transfusion protocol (MTP) activation and mortality following abdominal trauma. Methods. A 4‐year retrospective analysis of all adult abdominal trauma patients was conducted. Patients were classified into survivors and nonsurvivors and low vs. high PLR. The discriminatory power for PLR and NLR to predict MTP and mortality was determined. Multivariate logistic regression analysis was performed for predictors of mortality. Results. A total of 1199 abdominal trauma patients were included (18.7% of all the trauma admissions). Low PLR was associated with more severe injuries and greater rates of hospital complications including mortality in comparison to high PLR. On‐admission PLR and NLR were higher in the survivors than in nonsurvivors (149.3 vs. 76.3 (p = 0.001) and 19.1 vs. 13.7 (p = 0.009), respectively). Only PLR significantly correlated with injury severity score, revised trauma score, TRISS, serum lactate, shock index, and FASILA score. Optimal cutoffs of PLR and NLR for predicting mortality were 98.5 and 18.5, respectively. The sensitivity and specificity of PLR were 81.3% and 61.1%, respectively, and 61.3% and 51.3%, respectively, for NLR. The AUROC for predicting MTP was 0.69 (95% CI: 0.655–0.743) for PLR and 0.55 (95% CI: 0.510–0.598) for NLR. To predict hospital mortality, the area under the curve (AUROC) for PLR was 0.77 (95% CI: 0.712–0.825) and 0.59 (95% CI: 0.529–0.650) for the NLR. On multivariate logistic regression analysis, the age, Glasgow Coma Scale, sepsis, injury severity score, and PLR were independent predictors of mortality. Conclusion. On‐admission PLR but not NLR helps early risk stratification and timely management and predicts mortality in abdominal trauma patients. Further prospective studies are required.

Over the past 15 years, there has been a noticeable uptick in incidents involving children ingesting multiple magnetic foreign bodies which can cause injuries and gastrointestinal complications including death. The current study aimed to identify the prevalence, clinical presentation, and management of single or multiple magnet ingestions. A retrospective multi-central cross-sectional study was conducted to include all pediatric patients < 18 years presented to the emergency department with ingestion of single or multiple magnets and admitted across hospitals in Qatar, UAE, KSA, Tunisia, and Turkey between January 2011 and December 2021. Demographics, symptoms, management, and outcomes were analyzed. There were 189 magnet ingestions, of which 88 (46.6%) were multiple magnet ingestions. Most patients (55.6%) were male, and the median age was 3.9 (IQR 2–7) years. An abdominal X-ray was obtained in all cases. 119 (62%) patients were conservatively treated, 53 (28%) required surgical intervention and 17 (8.9%) underwent gastroscopy. None of the patients with single magnet ingestions experienced morbidity or severe outcomes. Multiple magnet ingestions led to significant morbidity including hospitalizations, perforations (44.3%), severe intestinal necrosis (19.3%), peritonitis (13.6%), severe abdominal infection (10.2%), and septic shock (4.5%). The rate of surgical intervention (59.1% vs. 1.0%) and gastroscopy (15.9% vs. 3.0%) was significantly higher in the multiple ingestion group compared to the single magnet ingestion group. No deaths were identified. A high risk of serious complications, including the need for surgery to remove the magnets and substantial morbidity may result from swallowing more than one magnet. Magnet safety requirements, public education, and improved legislation are urgently required.

Nurses form the backbone of the global healthcare system, yet the profession faces a persistent and growing shortage. The World Health Organization projects a global shortfall of 10 million health workers by 2030, with nurses representing a substantial proportion of this deficit. This shortage is particularly acute in rapidly developing health systems, where increased demand for services is not matched by workforce growth. The resulting staffing shortages have increased workloads and extended shifts, directly contributing to heightened stress and poorer mental health outcomes among nurses. Mounting evidence links excessive work burden and high job demands to elevated risks of anxiety, depression, and burnout, conditions that not only affect nurses’ well-being but also compromise the quality and safety of patient care. Given the critical role outpatient nurses play in frontline care delivery, there is an urgent need to understand the interplay between work-related stressors and mental health within this population. This study aims to explore the relationship between demographic factors, working conditions, and mental health outcome specifically burnout, depression, and anxiety—among outpatient nurses in a general hospital setting, addressing the gap in targeted research in this area. A quantitative cross-sectional design study was conducted among outpatient nurses. Structured questionnaires were distributed online via the corporate email. Socio-demographic variables, workspace burden, and mental health factors (anxiety, stress, depression, and burnout), assessed using two established scales, were evaluated. STATA 17 was used to determined Statistical significance using T-tests, Mann-Whitney U tests, Kruskal-Wallis tests, and quantile regression, with a significance threshold set at p < 0.05. The study achieved a 96.6% response rate, with 286 out of 296 outpatient nurses participating. The majority were foreign females aged 31–40, with 65.6% holding a bachelor’s in nursing and 81.3% having over five years of experience. Approximately 44.9% and 44.5% of nurses reported experiencing some degree of mental or physical exhaustion, respectively. Despite these challenges, 62.9% were satisfied with their jobs. Burnout and anxiety were associated with younger age, education, and living status, with 31% experiencing burnout, 11.4% experiencing anxiety, and 39.9% experiencing depression. Regression analysis identified these factors as key predictors of mental health outcomes. Nurses with a diploma had significantly lower burnout levels compared to those with a Bachelor of Science in Nursing (β = -2.5, p = 0.027). Nurses living alone experienced significantly less burnout than those living with children (β= -7.5, p = 0.005) or with other family members (β = -4, p = 0.022). Anxiety was significantly higher among nurses aged 31–40 years compared to other age groups (β = 3, p = 0.043). The study revealed moderate levels of burnout and depression, with a smaller but meaningful proportion of nurses reporting abnormal anxiety. Younger nurses (31–40 years), those with a bachelor’s degree, and those living alone appeared more vulnerable. These associations suggest potential targets for support, although causality cannot be inferred due to the cross-sectional design. While the conclusion appropriately identifies the need for targeted interventions to address burnout and anxiety, it falls short in providing specific, actionable recommendations. To enhance the study’s practical utility, it would be beneficial to include detailed strategies or proposals for interventions that healthcare organizations could implement to support the mental health of outpatient nurses. Not applicable.

Purpose: This meta-analysis compares thoracoscopic versus open thoracotomy repair of esophageal atresia with tracheoesophageal fistula (EA/TEF). Methods: We systematically searched PubMed, Web of Science, Cochrane Library, and Scopus from inception to April 2025 for studies comparing thoracoscopic versus conventional thoracotomy approaches. Two independent reviewers screened studies, extracted data, and assessed risk of bias using appropriate tools. Meta-analyses were conducted using RevMan 5.4 software. Results: A total of 25 studies (24 observational and one randomized controlled trial, including 3087 patients) were included. Thoracoscopic repair was associated with longer operative time (mean difference [MD] = 20.94 min; p = 0.005) but showed significant advantages in reducing mortality (risk ratio [RR] = 0.52; p = 0.01), musculoskeletal complications (RR = 0.08; p < 0.0001), and wound infections (RR = 0.21; p = 0.02). It also led to shorter ICU stays (MD = −1.09 days; p = 0.005) and earlier initiation of oral feeding (MD = −1.12 days; p = 0.02). However, the risk of anastomotic stricture requiring dilation was higher (RR = 1.54; p < 0.00001). No significant differences were found in anastomotic leak rates, recurrent fistula, respiratory complications, or need for fundoplication. Conclusions: Thoracoscopic repair of EA/TEF is associated with perioperative benefits over conventional thoracotomy, including significantly lower mortality and a markedly reduced incidence of musculoskeletal complications. However, this approach is associated with a higher risk of anastomotic stricture requiring dilation, and these differences may partly reflect patient selection factors.

Intussusception is a common surgical emergency in children. Clinical suspicion and radiological evaluation confirm the diagnosis of the disease. Enema reduction is the first line of management. This study aimed to explore the risk factors associated with enema reduction failure. A retrospective analysis of patients diagnosed with intussusception at three different hospitals in different countries from January 2016 to December 2022. Data collected included demographics, presenting symptoms, duration of symptoms, management, outcomes, and follow-ups. A total of 290 cases of intussusception were included in the study. Ages ranged from 1 to 36 months, with a median age of 15 months. All children underwent an enema reduction which was successful in 92.4%. Failure of reduction was seen in 16.7% of females compared to 6.4% of males, and it was significantly seen in children below the age of 1 year compared to older children. Failure of reduction significantly increases with the duration of symptoms and in children who present with bilious vomiting and currant jelly stool. In conclusion, Failure of enema reduction was more prevalent in females, in children below the age of 1 year and who present late, as well as children who had bilious vomiting and currant jelly stool. This study identified several risk factors associated with failed enema reduction in children with intussusception. Recognizing the risk factors can help guide clinicians in the management and anticipation of outcomes.

Late-onset neonatal sepsis (LONS) remains a leading cause of morbidity and mortality in neonates, particularly among preterm and low birth weight infants. Interleukin-6 (IL-6) has emerged as a promising biomarker for early detection of LONS, yet the diagnostic performance of IL-6 remains inconsistent across studies. This meta-analysis aimed to evaluate the overall diagnostic accuracy of IL-6 in detecting LONS and to assess the certainty of evidence using the GRADE approach. A comprehensive search of five databases was conducted up to July 15, 2025. Twenty-two studies were eligible for inclusion, of which 20 ( n = 3527 neonates) were included in the meta-analysis. A bivariate random-effects model was used to estimate pooled sensitivity and specificity, and the area under the SROC curve was used to assess overall diagnostic accuracy. Pooled sensitivity and specificity were 85.2% (95% CI: 80.0–89.3%) and 84.1% (95% CI: 77.5–89.0%), respectively. The positive and negative likelihood ratios were 5.43 and 0.18, with a diagnostic odds ratio of 31.4. The AUC was 0.91, indicating excellent diagnostic accuracy. Subgroup and sensitivity analyses confirmed the robustness of the findings, and no significant threshold effect was detected. However, suspected publication bias was noted. The GRADE assessment rated the certainty of evidence as moderate. Conclusion : IL-6 demonstrates high diagnostic accuracy for LONS and may serve as a valuable tool for early identification, though standardization of cutoff thresholds and further validation studies are warranted. What is Known: • IL-6 is an early-rising biomarker for late-onset neonatal sepsis (LONS), but its diagnostic accuracy varies across studies. What is New: • This meta-analysis used a bivariate model to estimate IL-6 performance, yielding high pooled sensitivity (85.2%) and specificity (84.1%).