In the absence of comprehensive data investigating carbetocin versus misoprostol for reducing postpartum hemorrhage (PPH) during cesarean section (CS), we performed this investigation to compare the efficiency and side events of carbetocin versus misoprostol in the protection and reduction of PPH for women who underwent CS. From inception to September 2022, we depended on searching through various databases for eligible trials involving Cochrane, Web of Science, PubMed, Scopus, and Google Scholar. From the efficacy prospect, we found that carbetocin substantially decreased intraoperative blood loss (p<0.001), hemoglobin/hematocrit levels (p<0.001), and the need for blood transfusion (p=0.002)/additional surgical interventions (p=0.003) than misoprostol. However, we revealed no substantial variation between both drugs for the need for additional uterotonic agents (p=0.08). From the safety prospect, we found that incidences of fever (p=0.002), heat sensation (p=0.007), metallic taste (p=0.01), and shivering (p=0.0002) were lower in carbetocin administration than in misoprostol. However, headache (p=0.34) and palpitation (p=0.11) incidences revealed no substantial variation between both drugs. In conclusion, from the efficacy and safety prospect, for women who underwent CS, carbetocin is more effective and safer in preventing and reducing PPH than misoprostol.

Hemorrhoidectomy is one of the most common surgical interventions to remove the third and fourth degrees of prolapse hemorrhoid. We carried out this systematic review and meta-analysis of the randomized controlled trials (RCTs) to comprehensively evaluate the efficacy of harmonic scalpel (HS) versus bipolar diathermy (BD) methods in terms of decreasing intraoperative and postoperative morbidities among patients undergoing hemorrhoidectomy. Suitable citations were found utilizing digital medical sources, including the CENTRAL, Web of Science, PubMed, Scopus, and Google Scholar, from inception until December 2022. Only RCTs that matched the inclusion requirements were selected. We used the updated Cochrane risk of bias (ROB) tool (version 2) to assess the quality of the involved citations. The Review Manager (version 5.4 for Windows) was used to perform the pooled analysis. Data were pooled and reported as mean difference (MD) or risk ratio (RR) with a 95% confidence interval (CI) in random-effects models. Overall, there was no significant difference between HS and BD in terms of decreasing intraoperative morbidities like operative time, intraoperative blood loss, mean duration of hospital stay, and mean duration of first bowel movement (P>0.05). Similarly, the rate of postoperative complications like pain, bleeding, urinary retention, anal stenosis, flatus incontinence, and wound edema; was similar in both groups with no significant difference (P>0.05). In conclusion, our pooled analysis revealed there was no substantial difference between HS and BD in terms of intraoperative and postoperative endpoints. Additional RCTs with larger sample sizes are needed to consolidate the power and quality of the presented evidence.

Background: In 2019, World Health Organization considered COVID-19 vaccination a global health threat. Vaccine hesitancy is a behavior with delay in acceptance or refusal of vaccines despite available services. The psychological wellbeing of the individuals, such as anxiety or depression, could also affect their acceptability of the new vaccine. The present study aimed at evaluating the COVID-19 vaccination hesitancy and psychological health among the general population in Saudi Arabia. Methods: A cross-sectional study using a self-administered online, close-ended questionnaire was conducted among the general adult population from all regions of Saudi Arabia . The questionnaire included sociodemographic data, the 5C tool to measure vaccination hesitancy, Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Data were collected, tabulated, and analyzed using the Statistical Package of Social Science (SPSS) program, version 26. Results: In this study, we collected data from 2543 adults in Saudi Arabia, where 53 % were males. According to PHQ-9, we found that 68.7 % of the participants reported a degree of depression, and GAD-5 showed that 27.2 % had mild anxiety, 19.5 % had moderate anxiety, and 6.8 % had severe anxiety symptoms. The mean confidence constrains, complacency, calculation, and responsibility scores among the participants were 4.91, 3.07, 3.34, 509, and 5.14. Conclusion: The results of the current study showed moderate to good acceptance of the COVID-19 vaccination among individuals in Saudi Arabia. Moreover, this study reported a significant relationship between depression/anxiety and vaccination hesitancy.