Background: In Saudi clinical settings, cultural influences can give a patient’s family authority to override the patient’s autonomous right to make informed health-related decisions. Cultural values should not prevent patients from exercising their genuine preferences when making medical decisions in their own best interests. Discussion: This article discusses the moral implications of family-centred medical decisions for autonomous patients who are competent and capable of making decisions. The author argues that socio-cultural values do not justify the decision to override patient autonomy when patients express a preference for making their own choices. Conclusion: The author recommends the use of a model of shared decision-making that accounts for both individual and relational conceptions of autonomy, approaching patients’ preferences in all medical encounters with the aim of minimising the potential for socio-cultural values to undermine patient autonomy. Although this approach is a safeguard against both family and medical paternalism, allowance is made for clinicians to act in weakly paternalistic ways when patients at high risk of exacerbating existing medical conditions are likely to benefit from delaying or limiting the disclosure of potentially distressing but non-fatal diagnoses and prognoses. Thus, the author argues that even in a culture that supports family involvement in management decisions, physicians should respect patient autonomy by asking patients for their preferences in the disclosure of their medical diagnoses, prognoses and management options and verifying patients’ preferences about the roles they wish their families to play (if any) in health-related decisions.

Background: In Saudi clinical settings, benevolent family care that reflects strongly held sociocultural values is commonly used to justify overriding respect for patient autonomy. Because the welfare of individuals is commonly regarded as inseparable from the welfare of their family as a whole, these values are widely believed to obligate the family to protect the welfare of its members by, for example, giving the family authority over what healthcare practitioners disclose to patients about their diagnoses and prognoses and preventing them from making informed decisions about their healthcare. Discussion: Family dominance over the healthcare decisions of competent patients is ethically problematic when the family prevent healthcare practitioners from disclosing diagnoses and prognoses to patients who have the capacity to consent and make decisions in their own best interests. Thus, the author holds that sociocultural values ought to be respected only when they do not prevent competent patients from knowing their diagnoses and prognoses or prevent them from making their own decisions. Conclusion: Healthcare practitioners should not allow patients’ families to control what can or cannot be disclosed to competent patients. This is particularly important when patients are approaching death so that they may address their material and spiritual wishes—among other needs—as they prepare for death. Justification for this position is drawn from the Maqasid Al-Shariah-based Islamic bioethics approach, from which it is possible to argue that the harm of withholding diagnoses and prognoses from patients who are imminently dying outweighs the potential benefits.

Introduction: Rhabdomyolysis is a medical condition that results from damage to striated muscles that causes the release of their components into the bloodstream. Laboratory indications include high levels of creatinine kinase and myoglobin in the serum. Importance: This case report emphasizes the importance of having professional trainers in gyms and training centers who respect trainees’ limitations and physical capabilities and ensure that physical exercise programs are being conducted safely and effectively. Case presentation: A 39-year-old female healthcare provider presented to the emergency department at a tertiary/quaternary hospital in Saudi Arabia, with progressive right arm pain, swelling, weakness, and dark urine 2 days after an unaccustomed heavy physical exercise session with her personal trainer following a long pause from physical training. Clinical discussion: Levels of serum creatinine kinase, aspartate aminotransferase, and alanine transaminase were moderately elevated. There was no evidence of renal impairment, electrolyte disturbance, or coagulopathy. The patient was treated with analgesics, received hydration, and was discharged home under close observation and with a follow-up clinic visit scheduled to check for complications. Data were collected from the hospital’s electronic medical records, including clinical notes and laboratory investigations. Conclusion: Awareness campaigns need to be conducted to educate the public about healthy ways to exercise, such as gradually increasing the intensity of physical activity, warming up before exercising, cooling down after each workout, and staying hydrated. It is important that healthcare providers, trainees and trainers are able to recognize the signs of muscular injury following vigorous exercise in order to reduce the incidences of complications that could be deadly if they are not caught and managed early.

Introduction: In alignment with Saudi Arabia’s 2030 Vision to improve healthcare services, Saudi hospital policymakers must have a clear understanding of the needs of their hospitals to make strategic decisions regarding hospital bed capacity planning. King Abdullah Medical City (KAMC) is a tertiary and quaternary healthcare facility that has four state-of-the-art excellence centers, of which the Cardiac and Oncology Centers are among the largest and the most advanced in the west of Saudi Arabia. Methods: This study used a mixed-methods approach. The study’s quantitative component included a revision of retrospective data of KAMC’s operational parameters, such as bed capacity, bed occupancy rate (BOR), and length of stay (LOS). For the study’s qualitative component, researchers used semi-structured interviews. Personnel at different management levels were interviewed to explore factors that might influence an increase in the BOR and patients’ LOS. Results: KAMC’s key performance indicators showed an overall LOS of 9.9 days and an overall BOR of 88%. Analysis broken down by the department shows the General and the Neuroscience Intensive Care Units and the Hematology/Oncology departments to have the highest BOR, ranging between 95% and 97%. Qualitative analysis of semi-structured interviews suggested that the delays in the provision of consultation services among the hospital’s inpatients were among the factors that have the biggest influence on bed occupancy; the presence of dedicated case managers in every department was among the top suggested solutions. Conclusion: A battery of interventions might help to reduce the LOS by supporting timely patient discharge. The presence of a dedicated case manager with a medical background in each department is one of the most practical interventions. Other vital opportunities include reinforcement of back-referral policies, revising policies, and having cluster-level referral policies and bed management strategies. Although such efforts are likely to have a positive effect, they are expected to only partially meet the existing gap, which probably requires increasing the number of available active beds.

The Hajj is an annual mass gathering of people in Makkah, Saudi Arabia. Respiratory infections are common due to their potential for rapid spread in crowded settings. There is a lack of data regarding the effectiveness of face masks in preventing respiratory tract infections (RTIs), specifically during Hajj. We systematically searched PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials until July 3, 2023 for studies comparing the incidence or prevalence of RTIs in those who used any face mask during Hajj compared with no mask. Risk ratio (RRs) and 95% CIs were calculated using either a fixed or random-effect model, depending on the heterogeneity. A comprehensive analysis encompassed 10 studies involving 5007 participants. The overall RR favored wearing masks over not wearing masks regarding the incidence of RTIs; however, the difference was not statistically significant (RR = 0.78; 95% CI = 0.55–1.10; P = 0.16). A significantly lower incidence of RTIs was found in those wearing masks most of the time versus intermittently (RR = 0.59; 95% CI = [0.38–0.94; P = 0.02). In subgroup analyses, there was no difference between wearing masks and not wearing masks across different study designs (cohort/case-control), different groups (pilgrims/healthcare workers), and different years of Hajj, except from 2000 to 2008, when there was a significant difference favoring wearing face masks. This meta-analysis found wearing masks most of the time was associated with significantly lower risk of RTIs than wearing it intermittently.

Background: The Saudi Commission for Health Specialties (SCFHS) accredits postgraduate medical education programs in Saudi Arabia to ensure they provide quality training that meets professional outcomes per national and international standards. Research activities should be tailored to meet the training needs of postgraduate trainees to bridge the gap between research and clinical practice. These activities should assist trainees in selecting the appropriate methodology for their research, gathering and interpreting data, and evaluating the outcomes of previous research before clinical implementation. Materials and Methods: A needs assessment survey was conducted on postgraduate trainees enrolled in 20 residency programs and 13 fellowship programs at a tertiary hospital in Makkah, Saudi Arabia. The aim of the study was to determine the preferred research training content and delivery method most appropriate for postgraduate trainees. The hospital’s research center can use this information to design and conduct research training activities based on postgraduate trainees’ professional and scientific needs. Data were analyzed using SPSS version 26; percentage and frequency were used, and a P value of <0.05 indicated significant differences between groups. Results: The response rate of postgraduate trainees was 64% (60/94); 78% were enrolled in residency, while 22% were in fellowship training programs. Of the resident respondents, 70% were enrolled in an internal medicine residency program, and 23% of fellow respondents were enrolled in a medical oncology fellowship program. Conclusion: Priority areas that require training interventions to enhance research knowledge and practice among postgraduate trainees were identified. There are opportunities for addressing the identified training needs by expanding research training program content, designing workshops, and tailoring training to meet professional expectations.