In this issueSystematic ReviewOriginal Article
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# Systematic Review {#article-title-2}

**Traumatic retropharyngeal hematoma.** *A systematic review of reported cases*

Alabdulqader et al study the mechanisms of injury, clinical manifestations, radiological findings, management, and outcomes of traumatic retropharyngeal hematoma (RH). they use the Preferred Reporting Items of Systematic Reviews guidelines to carry out a systematic literature review to identify all published cases of traumatic RH by searching the PubMed database. Of the 62 articles screened, 56 were included. The main symptom was dyspnea (66.6%) and symptoms usually presented within 24 hours. They concluded that traumatic RH is often caused by falls, particularly in elderly patients. Dyspnea is the primary symptom, usually appearing within 24 hours. Cervical vertebral fractures are the leading cause, and observation is the most common treatment approach.

![Figure1](http://smj.org.sa/https://smj.org.sa/content/smj/45/1/1/F1.medium.gif)

[Figure1](http://smj.org.sa/content/45/1/1/F1)

Common symptoms for patients with traumatic retropharyngeal hematoma.

***see page 10***

# Original Article {#article-title-3}

**Impact of pulmonary infection after radical esophagectomy on serum inflammatory markers, pulmonary function indices, and prognosis**

Wang et al analyze the influence of pulmonary infection after radical esophagectomy on serum inflammatory markers, pulmonary function, and prognosis. They enroll 278 esophageal cancer patients who undergoes radical esophagectomy. Patients are split into the infected (n=51) and uninfected groups (n=227). The inflammatory parameters, complications, and prognosis are compared. They concluded that postoperative pulmonary infection can lead to pulmonary function damage, proinflammatory factor overexpression, and an increased risk of early death.

***see page 40***

**Epidemiology of tuberculosis in Saudi Arabia following the implementation of end tuberculosis strategy.** *Analysis of the surveillance data 2015-2019*

Alawi et al analyze the evolution of tuberculosis (TB) epidemiology in Saudi Arabia in the 5 years following the implementation of the end-TB Strategy. A retrospective analysis of surveillance data, reported by the national tuberculosis control program from 2015-2019, is carried out. The annual incidence and the percentage of yearly changes are calculated and compared to the World Health Organization (WHO) milestones, which anticipate a 4-5% annual decline. Additionally, various other epidemiological indicators of TB are examined. They concluded that the figures of TB incidence TB in Saudi Arabia between 2015-2019 has met the WHO end-TB milestones, predicting successful progress toward the 2035 goal.

***see page 60***

**The effect of having a physician in the triage area on the rate of patients leaving without being seen.** *A quality improvement initiative at King Fahad Specialist hospital*

Mahmood et al evaluate the effect of the presence of a physician in the triage area on the number of patients who leave without being seen (LWBS) and some of the factors affecting emergency department (ED) crowding. This is a pre-post study carried out at King Fahad Specialist Hospital, Dammam, Saudi Arabia. The 3-month study, consisting of 7826 patients, is split into pre-physician and post-physician periods. Variables compared across these periods are the number of LWBS patients, length of hospital stay, time to physician, and time to disposition decision. Statistical analysis is carried out using R version 4.3.0. They concluded that the appointment of a triage physician has streamlined patient flow and decreased LWBS rates in the ED, demonstrating the need for more thorough research in this area.

***see page 74***

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