Objective: In the Emergency Department, the physician’s purpose is to rapidly and accurately diagnose the severity of a patient’s condition so that proper treatment can be administered. Therefore, this study pays close attention to the association and prognostic value of blood lactate on different disease outcomes by systematically reviewing recently published studies. Methods: The search strategy was developed based on searches in the year 2022 for potential publications including original articles, case reports, and reviews using the following web databases google scholar, PubMed, and Science Direct. A total of 25 studies were identified and reviewed extensively to evaluate the link between mortality and serum lactate levels. Results: This literature review presents the strong association of elevated serum lactate levels with the in-hospital mortality rate among emergency department patients. Conclusion: These findings suggest that even a moderately raised lactate level in serum can predict the severe outcome in emergency department patients suffering from different conditions. Therefore, early (at the time of administration of hospital) and periodic serum lactate value determination through different techniques and scores is of need and should become part of routine analyses in emergency department to predict and choose therapies that could benefit critically ill patients.

Background: The efficient performance of an Emergency Department (ED) relies heavily on an effective triage system that prioritizes patients based on the severity of their medical conditions. Traditional triage systems, including those using the Canadian Triage and Acuity Scale (CTAS), may involve subjective assessments by healthcare providers, leading to potential inconsistencies and delays in patient care. Objective: This study aimed to evaluate six Machine Learning (ML) models K-Nearest Neighbors (KNN), Support Vector Machine (SCM), Decision Tree (DT), Random Forest (RF), Gaussian Naïve Bayes (GNB), and Light GBM (Light Gradient Boosting Machine) for triage prediction in the King Abdulaziz University Hospital using the CTAS framework. Methodology: We followed three essential phases: data collection (7125 records of ED patients), data exploration and processing, and the development of machine learning predictive models for ED triage at King Abdulaziz University Hospital. Results and conclusion: The overall predictive performance of CTAS was the highest using GNB = 0.984 accuracy. The CTAS-level model performance indicated that SVM, RF, and LGBM achieved the highest performance regarding the consistency of precision and recall values across all CTAS levels.

Background: Dermatological emergencies are critical conditions requiring immediate attention due to their potential to escalate into life-threatening scenarios. Accurate diagnosis and timely management are essential to prevent severe complications, including systemic involvement and mortality. This systematic review summarizes findings on dermatological emergencies in emergency departments (EDs), focusing on diagnostic accuracy, hospitalization rates, systemic complications, and management strategies. Methods: A systematic literature review of studies on dermatological emergencies was conducted, encompassing 24 prospective and retrospective cohort studies, cross-sectional studies, and descriptive analyses. The review included diverse patient populations, examining dermatological presentations, diagnostic methods, treatment strategies, hospitalization rates, and adverse outcomes. Key outcome measures such as diagnostic accuracy, complications, mortality rates, and re-visit frequencies were analyzed. Results: The studies revealed high diagnostic accuracy, particularly in in-person evaluations, with teledermatology showing slightly lower but reliable rates. Systemic complications, including severe drug reactions, bacterial infections, and autoimmune diseases, were common causes of hospitalization. Mortality rates varied, with conditions such as toxic epidermal necrolysis showing the highest risk. Hospitalization rates averaged 4.52%, and re-visit rates ranged from 1% to 6.5%. The results also highlighted the impact of environmental factors and seasonal trends on dermatological presentations. Conclusions: Dermatological emergencies pose significant challenges in emergency care. High diagnostic accuracy and effective management strategies are crucial in preventing severe outcomes. Timely diagnosis, careful management of systemic complications, and teledermatology play critical roles in improving care. Future research should focus on standardized management protocols, telemedicine applications, and the influence of environmental and demographic factors to enhance patient outcomes.

Introduction: Conflicts of interest (COI) pose ethical challenges in medical education and clinical practice, potentially influencing decision-making. While COI policies and education vary globally, inconsistent training leaves medical students vulnerable to industry influence. In Saudi Arabia, COI education remains underexplored. This study assesses medical students’ knowledge, attitudes, and exposure to COI, aiming to identify gaps and inform educational improvements. Methodology: A cross-sectional study was conducted among 392 medical students from multiple universities in Jeddah, Saudi Arabia. A validated questionnaire was administered to assess COI knowledge, attitudes, and exposure to industry interactions. Data were analyzed using IBM SPSS 29.0, with statistical significance set at p < 0.05. Results: A total of 392 participants were included. Overall, 71.4% of students were able to define COI, while 28.6% lacked awareness. Clinical students had significantly higher knowledge scores than preclinical students (p = 0.001). Grade Point Average (GPA) was significantly associated with attitudes toward COI, with students who had excellent GPAs scoring the highest (p < 0.001). No significant differences were observed in knowledge or attitude scores based on gender, research experience, and university affiliation. Over half of the students (52.6%) felt inadequately educated about COI, and 48.5% had never attended a COI lecture. Clinical students (65.2%) reported more interactions with pharmaceutical representatives than preclinical students (34.8%). Conclusion: While medical students generally recognize COI, gaps in knowledge and formal education persist. Clinical exposure appears to enhance knowledge, yet inconsistent education leaves students vulnerable to industry influence. Strengthening COI education within medical curricula is essential to promote ethical decision-making and uphold professional integrity.

Discharge against medical advice (DAMA) is a critical global issue in emergency departments (EDs), as it leads to adverse patient outcomes, higher readmission rates, and increased hospital costs. In Saudi Arabia, evidence on the underlying causes of DAMA and its impact on healthcare operations remains limited. This study aimed to identify the factors contributing to DAMA among Saudi patients and explore potential strategies for its reduction. A descriptive cross-sectional study was conducted in 2024 at our University Hospital using a convenience sampling method through a self-reported online questionnaire, with a response rate of 78%. A total of 297 participants were included, with females comprising 54.4% and males 45.5%. The most represented age group in the DAMA category was 31–42 years (39.5%). Educational backgrounds varied, with 18.9% having no formal education and another 18.9% holding a master's degree. Most participants (54.2%) received care at government hospitals, 72.4% lacked medical insurance, and 14.5% had previous DAMA incidents. The leading reasons for DAMA were financial burden (53.5%), lack of available beds (52.5%), and patient/relative fatigue (50.5%). Nationality was significantly associated with DAMA, with 30.2% of non-Saudis affected compared to 15.7% of Saudis ( P = .038). Findings suggest that financial and systemic challenges outweigh staff-related factors, emphasizing the need for targeted interventions and policy reforms to minimize DAMA and improve patient outcomes in Saudi healthcare settings. Further longitudinal and interventional studies are recommended to evaluate the long-term impacts of DAMA and to test strategies aimed at reducing its occurrence.