In this issueSYSTEMATIC REVIEWORIGINAL ARTICLESCASE REPORT
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# SYSTEMATIC REVIEW {#article-title-2}

**Compassion fatigue in critical care nurses. *An integrative review of the literature***

Alharbi et al provides a critical evaluation of current empirical evidence related to the prevalence, causes and outcomes of compassion fatigue among critical care nurses. Compassion fatigue is characterized the development of emotional, physical, and/or spiritual exhaustion as a result of working with traumatized individuals. They conclude that there is inconclusive evidence to identify unequivocal predictors of compassion fatigue among critical nurses. However, it is likely the onset of compassion fatigue among critical care nurses may be reduced with close monitoring of physical and emotional wellbeing in the critical care environment as well as through the provision of education to nurses to assist with the development of coping strategies to avoid compassion fatigue. Articles were assessed for quality and rigor using the Critical Appraisal Checklist for Analytical Cross-Sectional Studies.

*see page 1087*

# ORIGINAL ARTICLES {#article-title-3}

**Surgical considerations and speech outcomes in infants who undergo cochlear implantation. *Experience of the King Abdullah Ear Specialist Center***

Hajr et al conclude that the largest national cohort of pediatric patients undergoing cochlear implantation (CI) in infancy. In this series, the surgery was safe and the speech outcome was good. With implementation of the neonatal screening program in the Kingdom of Saudi Arabia, the number of infants undergoing CI is likely to increase in the near future, paving the way for more research in infant CI. All infants who underwent CI from January 2011 to October 2018 were retrospectively reviewed. Demographic data, factors associated with early detection, and any surgical difficulties or postoperative complications were extracted from the medical records. The outcome of CI was determined by a speech pathologist. No major postoperative complications were encountered. The average auditory performance score was 7 and the speech intelligibility rating was 5.

*see page 1123*

**Association of health literacy and self-management practices and psychological factor among patients with type 2 diabetes mellitus in Saudi Arabia**

Almigbal et al determine the association between sociodemographic, clinical, and health literacy and the presence of depressed mood and their relationships to diabetes self-management among type 2 diabetes mellitus (T2DM) patients in Saudi Arabia. A total of 352 T2DM patients from 2 public tertiary hospitals in Saudi Arabia participated in this descriptive cross-sectional study. All respondents answered a 4-part questionnaire, which includes demographic data, Diabetes Self-Management Questionnaire (DSMQ), 36-item test based Short Test of Functional Health Literacy in Adults, and a 2-item Patient Health Questionnaire (PHQ-2). The Chi-square test and logistic regression analysis were conducted to determine the relationship and significant predictors for self-management among T2DM patients.

*see page 1158*

# CASE REPORT {#article-title-4}

**Scrotal abscess as the first symptom of fatal necrotizing pancreatitis**

Sutalo et al presents a 45-year-old man with a 3-day history of scrotal swelling and pain in the lower abdomen. Previous medical history revealed epigastric pain and self-medication with pantoprazole and ibuprofen without consulting a physician, which had lasted for 14 days before his admission to the hospital. He was a heavy smoker (up to 40 cigarettes a day) with a history of alcohol abuse. The laboratory findings were as follows: white blood cell count 25 × 109/L, C-reactive protein (CRP) 390 mg/L, blood urea nitrogen 15.8 mmol/L, creatinine 450 µmol/L, and total bilirubin 120 µmol/L. Other laboratory findings, including serum and urine amylases, were within normal range. A scrotal ultrasound showed swelling of the scrotal wall and a heterogeneous effusion of the right scrotum that could be followed to the inguinal canal.

*see page 1167*

![figure 1](http://smj.org.sa/https://smj.org.sa/content/smj/40/11/1085/F1.medium.gif)

[figure 1](http://smj.org.sa/content/40/11/1085/F1)

figure 1 
Computed tomography showing the intravenous application of contrast. Necrotic pancreatic tissue indicated by arrows (axial view)

*   Copyright: © Saudi Medical Journal

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