Sohaila Mohamed Mohamed Abdelbar

Background: Facial aesthetics encompasses a variety of techniques to revitalize the face through aesthetic medicine. Satisfaction with one's face is important to well‐being, leading people to seek to maintain their youthful appearance throughout their lives. Accordingly, many techniques have been developed for facial rejuvenation. VYC‐17.5L (Volift/Vollure) is a hyaluronic acid–based dermal filler utilized for facial enhancement; however, evidence regarding its long‐term efficacy and safety remains inconsistent. Methods: Following PRISMA guidelines, a systematic search was performed across PubMed, Scopus, Web of Science, ScienceDirect, Embase via Ovid, and Cochrane Library to identify studies evaluating VYC‐17.5L (Volift/Vollure) hyaluronic acid dermal fillers for facial aesthetic enhancement. Eligible studies included randomized controlled trials, prospective cohort studies, retrospective observational studies, and case series with ≥ 10 patients. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized studies and ROBINS‐I for non‐randomized studies. Single‐arm meta‐analysis was performed to evaluate aesthetic outcomes (GAIS, FACE‐Q, NLFSS, WSRS, and responder rates) and safety outcomes. Results: Eleven studies comprising 967 participants were included. Clinician‐assessed GAIS demonstrated a time‐dependent decline, reaching its peak at 3 months (87%–90%) and decreasing to (24%–33%) at 12 months. Patient‐reported GAIS responder rates remained high through 6 months (85%–95%) but declined to 62% at 9 months and 53% at 12 months. FACE‐Q responder rates remained high across the available 12‐month follow‐up. NLFSS responder rates remained consistently high (≥ 89%) up to 6 months, indicating sustained improvement in nasolabial fold severity. Adverse events were predominantly mild and transient; clinician‐reported frequencies were low, whereas patient‐reported frequencies were considerably higher. Conclusion: VYC‐17.5L demonstrates favorable short‐term efficacy and safety for facial rejuvenation, with high patient satisfaction. Objective aesthetic improvements decline over time, highlighting the time‐limited nature of treatment effects and the importance of appropriate patient counseling. Trial Registration: PROSPERO number: CRD420261279046

Purpose of Review: Pediatric hemorrhagic shock is a primary driver of preventable trauma mortality, often due to failures in early recognition and intervention. This review aims to define an actionable, pediatric-specific clinical framework for managing hemorrhagic shock by synthesizing pivotal advancements over the last decade into an evidence-to-practice guide for clinicians and policymakers. Recent Findings: Management has evolved significantly, with a shift away from crystalloid-based resuscitation toward early, blood-first strategies using whole blood or balanced component therapy. Advances in predictive analytics, including machine-learning-enhanced shock indices, have improved early detection. Furthermore, viscoelastic hemostatic assays are increasingly used to guide goal-directed therapy, particularly for fibrinogen replacement, while comprehensive care bundles and simulation-based training are being implemented to improve system-level performance and reduce mortality. Summary: Effective management of pediatric hemorrhagic shock requires a proactive, integrated approach. This includes early MTP activation guided by age-adjusted metrics, rapid hemostasis with blood-based resuscitation, targeted correction of coagulopathy using viscoelastic guidance, and diligent management of the "lethal triad." Critical knowledge gaps remain, particularly in prehospital prediction and defining optimal transfusion strategies, highlighting the need for high-quality, pediatric-specific clinical trials.

Pediatric syncope accounts for 1–3% of emergency department (ED) visits. Although most cases are benign, 4% are caused by cardiac disease and 3% by s

Purpose of Review: Pediatric airway management in the Emergency Department is a critical intervention with high stakes and significant complication rates, including adverse events in 16–25% of intubations and first-attempt success rates of approximately 75%. This review examines the application of advanced digital technologies—artificial intelligence (AI), machine learning (ML), computer vision, deep learning, and predictive analytics—to address key gaps: unreliable prediction of difficult pediatric airways (with first-pass failure rates of 30–40%), variability in device selection and technique, and the absence of robust real-time decision support for clinicians. Recent Findings: Emerging AI tools demonstrate promise across three phases of airway management. For prediction, machine learning models analyzing patient data can identify difficult airways with accuracy approaching that of expert clinicians. During performance, deep learning algorithms applied to video laryngoscopy automatically recognize anatomical landmarks (e.g., vocal cords) and guide laryngoscope positioning, improving visualization and potentially first-attempt success. For monitoring, AI-based systems analyze real-time physiological signals - including heart rate, oxygen saturation, and respiratory patterns - to detect subtle signs of airway difficulty or patient decompensation, showing improved hypoxia detection compared to standard monitoring. Summary: Integrating AI and advanced technologies could enable a future of “precision airway management,” tailoring interventions to individual patient anatomy, physiology, and risk factors to reduce failed intubations and complications. Realizing this potential requires ensuring equitable access to avoid disparities between centers, mitigating algorithmic bias, and fundamentally incorporating AI education—covering advanced airway technologies and human-AI collaboration—into Pediatric Emergency Medicine and anesthesia training programs.

In various low- and middle-income countries (LMICs), non-specialist healthcare providers (HCPs), such as general practitioners, nurses, and community health workers (CHWs), often manage acute pediatric emergencies. HCPs in these settings may face challenges due to limited training in emergency care and a lack of ongoing educational opportunities. Additionally, they often operate in clinical environments that lack dedicated emergency departments (EDs), child-specific care protocols, or the necessary pediatric equipment required for managing critically ill children. This is concerning, considering that acute illnesses and injuries are significant contributors to the high rates of preventable childhood deaths in low-and middle-income countries. This review synthesizes evidence on pediatric emergency care strategies to improve fidelity to evidence-based practice that can be utilized and scaled beyond the conventional ED framework, without relying on Pediatric Emergency Medicine (PEM)-trained personnel, who may be unavailable in these regions. This includes task shifting, where community and non-physician HCPs learn how to provide emergency triage and acute lifesaving interventions for children in preventing morbidity and mortality, and other strategies, framed within the established concept of “pediatric readiness”, which is a systems-based approach encompassing staff competencies, protocols, equipment, and quality improvement. Additionally, this review explores practical examples from international real-world applications of such strategies. A narrative review of literature from 2000 to 2024 covering task-shifting, protocols, simulation training, and system approaches for pediatric emergency care in low-resource settings. Our synthesis of the literature suggests that low-dose, low-fidelity simulation-based training can effectively enhance confidence and competence in pediatric resuscitation. By recognizing the roles of community-based and non-specialist providers within a pediatric readiness framework, standardizing relevant protocols, and providing appropriate tools and education, we can substantially improve pediatric emergency care systems on a broader scale. This review offers valuable insights for clinicians and policymakers dedicated to reducing preventable pediatric mortality in low-resource settings.

Purpose of Review: Pediatric depression is an increasingly prominent concern in emergency department (ED) settings, marked by rising visit rates and complex barriers to care.This review aims to synthesize current evidence on the epidemiology of pediatric depression in emergency departments. Recent Findings: Studies reveal a significant increase in pediatric ED visits for depression, especially during and after the COVID-19 pandemic. Key risk factors include genetic predisposition, neurodevelopmental changes, psychosocial stressors, socioeconomic barriers, and limited access to mental health care. Diagnostic challenges in the ED stem from age-specific symptom presentation, somatic complaints, time constraints, and insufficient psychiatric training. Telepsychiatry and universal screening protocols increase early identification of at-risk youth and reduce systemic barriers Summary: Addressing pediatric depression in ED settings requires a coordinated, multidisciplinary approach supported by universal screening, telepsychiatry, and robust community partnerships. Investments in mental health infrastructure, provider education, and school-based interventions are vital to reducing the burden of depression and improving long-term outcomes for children and adolescents.

Background Early detection of Alzheimer’s disease (AD) is vital in effectively implementing and promoting healthcare planning. Aims This study aimed to address the knowledge gap in awareness of AD among a sample of non-medical workers. Methods Egyptian non-medical workers older than 18 were requested to answer an online questionnaire distributed across various active and engaged social media groups (June 5, 2024-August 5, 2024). The questionnaire consisted of two sections: sociodemographic questions and the Arabic version of the Alzheimer’s Disease Knowledge Scale (ADKS). ADKS includes 30 “true or false” questions that assess the knowledge of different aspects of AD. Results A total of 5304 completed the survey; 51.8% were aged below 30 years, 65.7% were females, and 69.8% had a university education. Twenty-four perecent had a family member diagnosed with AD. Social media means were the most commonly reported source of information (38.1%). The range of ADKS-total score was 7–30, with a mean of 19.49 ± 3.107. Most participants responded correctly to all items of the following domains: risk factors, assessment and diagnosis, and course of the illness. However, a knowledge gap exists regarding some aspects of caregiving. Caregivers had significantly lower mean scores in life impact and caregiving domains (P < 0.001, for each) than non-caregivers. On the other hand, scores in risk factors and course were significantly higher among caregivers than non-caregivers (P = 0.002, 0.016, respectively). Conclusion Egyptian population has a relatively good understanding of AD. However, this study highlights the need to promote health education strategies to improve public knowledge about AD.

Disasters, whether natural or man-made, pose significant challenges to healthcare systems, with children being among the most vulnerable populations. Pediatric Emergency Departments (PEDs) require specialized protocols to address children’s distinct physiological, psychological, and developmental needs in other to respond adequately to disasters. While international guidelines for disaster preparedness exist, significant disparities persist across different healthcare settings, particularly in low-resource regions where preparedness measures remain inadequate. This review examines the current state of pediatric disaster preparedness, analyzing insights from past disasters to highlight key challenges, gaps, and opportunities for improvement. Special attention is given to global frameworks, existing protocols, and how lessons from successful disaster responses can inform future strategies, particularly in resource-limited settings. This review aims to assess the readiness of PEDs for disaster scenarios by identifying deficiencies and proposing strategies to enhance preparedness. It explores infrastructure requirements, workforce training, triage protocols, and mental health considerations specific to pediatric populations. Additionally, it assesses international frameworks and best practices to inform policy recommendations for strengthening pediatric-focused disaster response globally. Pediatric disaster preparedness remains inadequate across global healthcare systems, particularly in resource-limited settings. While international protocols exist, their implementation varies widely, leaving gaps in staff training, resource allocation, and mental health support. Addressing these gaps requires a multi-faceted approach that includes enhanced training programs, improved resource allocation, and integration of mental health services into disaster protocols. By adopting evidence-based strategies and fostering interdisciplinary collaborations, healthcare systems can develop more resilient and child-focused emergency response frameworks. Strengthening disaster preparedness in PEDs is essential to ensuring equal opportunities for care and effective treatment for children in times of crisis.

Background: Pediatric Emergency Medicine (PEM) fellowship programs are crucial for training physicians to handle the unique challenges of pediatric emergencies. Despite their importance, these programs face significant obstacles that can hinder the training process and the preparedness of fellows for independent practice. Purpose of review: To identify the barriers faced by PEM fellows during their training and to propose potential solutions that can enhance their educational experience and clinical competence. Methods: A comprehensive narrative review of existing literature was conducted to explore the challenges in PEM fellowship training. The literature search included articles from PubMed, Google Scholar, and official organizational websites such as the American Board of Pediatrics (ABP) and the Accreditation Council for Graduate Medical Education (ACGME). Key areas of focus included disparities in procedural exposure, administrative burdens, limited high-acuity case encounters, overreliance on consultations, medicolegal concerns, burnout, and the impact of the COVID-19 pandemic. Proposed solutions were derived from evidence-based practices and successful interventions implemented in various institutions. Recent findings: The narrative review revealed several critical challenges, including insufficient exposure to high-acuity cases, disparities in procedural training, the impact of administrative demands, and the repercussions of the COVID-19 pandemic. Recent advancements such as simulation-based training, competency-driven curricula, and wellness initiatives have shown promise in mitigating these barriers. Summary: The review identified several challenges that negatively impact PEM fellowship training. Fellows often experience insufficient procedural opportunities, excessive administrative tasks, and limited autonomy in clinical decision-making. These factors contribute to decreased confidence, skill gaps, and increased burnout. Proposed solutions include enhanced simulation training, curriculum reform, administrative support, promotion of fellow autonomy, legal education, wellness programs, integration of technology and innovation, and adaptation to external challenges such as pandemics. Conclusion: Addressing the challenges in PEM fellowship training requires a comprehensive approach that incorporates educational, administrative, technological, and wellness strategies. Implementing these solutions can improve the training experience, ensure procedural competence, and promote the overall well-being of fellows, ultimately leading to better patient care outcomes.