Objective: The objective of this study to evaluate the efficacy of perioperative oral antibiotics in the prevention of acute infective endophthalmitis (IE) after cataract surgery. Methods: This prospective study of patients undergoing uncomplicated SICS was conducted. Group A was given post-op oral ciprofloxacin for five days, whereas Group B was not. Both groups received 5% povidone-iodine (PVI) preparation for three minutes in the conjunctival cul-de-sac preoperatively as prophylaxis. The minimum post-operative follow-up period was six weeks. Results: Out of 1856 patients, 896 (48.27%) were included in Group A, and 960 (51.72%) were included in Group B. No significant difference in anterior chamber (AC) reaction was found on day 1 (p = 0.69), day 14 (p = 0.06), or day 42 (p = 0.1). One patient developed acute post-operative infective endophthalmitis (0.04%) and one patients developed toxic anterior segment syndrome (TASS) from Group A. The non-oral antibiotic group had no serious complications. Conclusions: Perioperative oral antibiotic use in routine clinical practice is not recommended for the prevention of acute post-operative infective endophthalmitis. Pre-operative conjunctival PVI 5% for five minute was proven to be effective prophylactic measures in our study.

Tuberculosis (TB) TB disease is still a health threat both worldwide and in Indonesia. Cases of TB disease in Majalengka District continued to increase in 2020, with as many as 9,497 cases; in 2021, as many as 12,692 cases; and in 2022, a significant increase of 21,956 cases. This study aims to determine patient characteristics, level of adherence, and effectiveness of TB treatment, as well as the relationship between adherence and effectiveness of TB treatment in a hospital in Majalengka District in West Java. The research method used was descriptive observational analysis with retrospective data collection based on TB patient treatment cards. Adherence data was collected by completing the MMAS-8 questionnaire, and effectiveness data were collected by recording sputum examination results using SITB software. The sample is the total population according to the criteria. The technique used to draw this sample was total sampling, namely the total number of TB patients in a Hospital from November 2023 to April 2024, which was 45 patients. Data analysis was done using the Chi-square test. A total of 95.6% had a high level of adherence, and 4.4% of patients had moderate adherence. The efficacy of TB treatment was 100%, with 97.8% cured status and 2.2% complete treatment. There was a significant relationship between adherence and TB treatment effectiveness, with a p-value of 0.044 (sig<0.05).

Topical drug administration is a localized drug delivery system anywhere in the body through Optimized invasomal formulation was sealed in 10ml glass vial and stored at refrigeration temperature (4 - 8°C) and room temperature for one month. Entrapment efficiency, physical appearance was determined at regular intervals ophthalmic, rectal, vaginal and skin as topical routes. Skin is one of the most readily accessible organs on human body for topical administration and is main route of topical drug delivery system. Invasomes are considered an inventive drug delivery system for the transdermal route. It improves the permeability of drugs across the skin layers which limits the absorption of poorly permeated drugs. It is also used for enhancing the efficacy and duration of action for drugs that had first-pass metabolism in the liver requires multiple daily doses. Invasomes contain unique components (Phospholipids, terpenes and ethanol) that act as safe and effective drug permeation enhancers across skin layer. Bacitracin is a cyclic polypeptide antibiotic used to prevent wound infections, treat pneumonia and empyema in infants, and to treat skin and eye infections. Bacitracin (200mg) was loaded in to invasomes by mechanical dispersion technique using Phospholipon 90H, terpene (Limonene) and ethanol, The optimized Bacitracin -loaded invasomes was incorporated into carbopol 934p (0.5 to 2%) solution to get a hydrogel for improving convenience in superficial application. FT-IR studies revealed no interaction between the drug and excipients. The formulated hydrogel formulation was evaluated with parameter pH, viscosity, gel strength, drug content, spreadability, in-vitro release test, washability, extrudability study and stability studies. The formulation IG-2 showed a drug content of 98.74% and drug release of 99.85% in 12hrs, which contains carbopol 934p concentration 2%w/w. The present work also focuses on making the formulation more pharmaceutically acceptable.

Pigmented Villonodular Synovitis (PVNS) is a joint disorder characterized by benign but locally aggressive proliferation of the synovial membrane. The localized form is rare, and its nonspecific symptoms make diagnosis challenging. We report a case of localized PVNS of the knee in a 47-year-old man. Arthroscopic resection resulted in complete recovery, with total and permanent resolution of symptoms and no recurrence.

Background: Cirrhosis is a chronic liver condition characterized by significant morbidity and mortality. Hepatic encephalopathy (HE), a neuropsychiatric complication of cirrhosis, is associated with vitamin D deficiency, which may exacerbate liver dysfunction. Understanding the clinical and laboratory characteristics of cirrhotic patients with and without HE is crucial for improving management strategies. Objective: To evaluate the clinical characteristics of cirrhotic patients and investigate the association between serum 25-hydroxyvitamin D levels and the severity of HE. Methods: This cross-sectional observational study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from December 2019 to August 2020. A total of 54 cirrhotic patients were divided into two groups: 27 with HE (cases) and 27 without HE (controls). Clinical history, physical examination, and laboratory parameters, including serum 25-hydroxyvitamin D levels, were assessed. Data analysis involved chi-square tests, t-tests, and ANOVA, with a significance level of p < 0.05. Results: The mean age of participants was 50.2 years, with a male predominance (63%). Serum 25-hydroxyvitamin D levels were significantly lower in patients with HE (6.6 ± 2.1 ng/ml) compared to controls (13.6 ± 4.2 ng/ml; p < 0.0001). Vitamin D levels decreased progressively with higher HE grades. Cases exhibited significantly higher serum bilirubin, prothrombin time, INR, Child-Pugh scores, and MELD scores than controls (p < 0.05). Conclusion: Vitamin D deficiency is strongly associated with the severity of HE in cirrhotic patients. Lower vitamin D levels correspond to higher grades of encephalopathy, emphasizing its potential role in HE pathophysiology. Future studies should explore the therapeutic implications of vitamin D supplementation in this population.

Background: Hepatocellular carcinoma (HCC) is a major cause of cancer-related mortality globally, with a strong association with chronic liver disease, particularly cirrhosis. In cirrhotic patients, the overlapping clinical manifestations of HCC and underlying liver dysfunction complicate timely diagnosis and management. Understanding the clinical characteristics of HCC in this population is essential for improving outcomes. Objective: To evaluate the clinical characteristics of HCC in cirrhotic patients, focusing on differences in liver function, demographic profiles, and etiological factors. Methodology: A cross-sectional observational study was conducted at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, between December 2019 and August 2020. The study included 66 participants divided into two groups: cirrhotic patients with HCC (n=33) and cirrhotic patients without HCC (n=33). Data were collected through clinical, biochemical, and radiological assessments, with HCC diagnosis confirmed via fine-needle aspiration. Statistical analysis included t-tests, Chi-square tests, and ROC analysis. Results: The mean age of HCC patients was 49.85 ± 14.40 years, with 87.9% male predominance, similar to the cirrhosis group (mean age: 46.15 ± 11.06 years, 72.7% male). Significant differences were observed in prothrombin time (p=0.002), INR (p<0.001), and serum albumin (p=0.009), indicating relatively preserved liver function in HCC patients. HCC patients predominantly fell into Child-Pugh class B (54.5%), whereas cirrhotic patients were more commonly class C (39.4%, p=0.037). Hepatitis B virus (HBV) was the leading etiological factor in both groups, with HBsAg detected in 84.8% of HCC and 93.9% of cirrhotic patients. Conclusion: HCC in cirrhotic patients presents with distinct clinical and biochemical profiles, including better-preserved liver function and higher serum albumin levels compared to cirrhotic patients without HCC. The high prevalence of HBV in the region underscores the need for targeted surveillance and early intervention strategies. Further multicenter studies are recommended to validate these findings and enhance diagnostic and therapeutic approaches.

Background: Displaced extra-articular tongue-type calcaneal body fractures are complex injuries that significantly impair foot function and quality of life. Traditional open surgical techniques pose risks such as wound infection and prolonged recovery, necessitating less invasive alternatives. Objective: This study aims to evaluate the efficacy, outcomes, and complications of managing these fractures with minimally invasive cortical compression screws, enhancing recovery and mobility. Methods: Between September 2015 and April 2016, 165 patients with displaced extra-articular tongue-type calcaneal fractures were randomly assigned to two treatment groups: the minimally invasive longitudinal approach (MILA) and the sinus tarsi approach (STA). Postoperative outcomes, including complication rates, functional assessments using AOFAS scores, and radiographic evaluations, were analyzed. Results: The MILA group demonstrated shorter operative times (45.9 minutes) and lower wound-healing complications (2.9%) compared to the STA group (61.9 minutes and 12.5%, respectively). Both groups had comparable functional outcomes for Type II and III fractures, but the STA group showed significantly better results for Type IV fractures (56.3% vs. 14.3%, P = 0.017). Conclusion: Both MILA and STA are effective for treating displaced extra-articular tongue-type calcaneal fractures, with MILA offering advantages in operative efficiency and lower complications for less severe fractures. However, STA is preferred for complex fractures due to superior anatomical reduction and functional outcomes. This supports a tailored approach in surgical technique selection based on fracture severity.

Background: Urinary tract infections (UTIs) are prevalent bacterial infections with a considerable impact on healthcare systems. Given the increasing antibiotic resistance globally, particularly in high-frequency regions such as Bangladesh, identifying prevalent pathogens and understanding their resistance patterns is essential for effective treatment. Objective: This study aims to analyze the common pathogens causing UTIs in a private outpatient setting in Bangladesh and evaluate their antibiotic susceptibility profiles to guide empirical therapy and enhance local treatment protocols. Methodology: This three-year prospective observational study (2021-2023) involved 58 UTI patients from a private chamber in Bangladesh. Urine samples were cultured, and bacterial isolates were identified and tested for antibiotic susceptibility to commonly used drugs, including cephalosporins, carbapenems, and fluoroquinolones. Data on organism frequency, resistance, and sensitivity were analyzed. Results: Escherichia coli was the most common pathogen (58.6%), followed by Klebsiella spp. (20.7%) and Methicillin-sensitive Staphylococcus aureus (MSSA) (13.8%). High sensitivity was observed for E. coli to Imipenem (100%) and Meropenem (96%), while significant resistance was noted to Ciprofloxacin (48.5%) and Cefixime (48%). MSSA and Klebsiella spp. similarly showed high susceptibility to carbapenems, with notable resistance to fluoroquinolones in MSSA. Conclusion: The high prevalence of E. coli as the primary UTI pathogen and its resistance patterns in this private setting underscore the necessity of targeted antibiotic selection. The study advocates for carbapenems in cases with suspected resistance and highlights the importance of regular sensitivity testing and antibiotic stewardship in outpatient settings to improve patient outcomes and mitigate resistance.

Syzygium cumini, a commonly found tree in India, Bangladesh, Nepal and other nations of the sub- continent, is widely studied for its nutrient and therapeutic properties. The fruits of the plant are established to posses various medicinal properties which will create a remarkable breakthrough in exploring active medicinal agents for various ailments. There are medicinal activities reported from various parts of the plant. The wide scope of medicinal research on this plant has created an ardor among phytochemical experts to focus attention on exploring more areas on this plant. The article is a review on various works reported in this plant so far. Detailed verification of works published in various journals with special focus on those holding high regard to phytochemistry was done. It was understood that there are still lot of areas remaining unexplored. The article tries to bring a summarized and comprehensive information on phytochemical works done on the plant in diverse segments.

Coronary artery disease is one of the leading causes of mortality and morbidity in both developed and developing countries. Coronary artery disease (CAD) tends to present at a younger age and has more extensive angiographic involvement, resulting in genetic, conventional, metabolic and non-traditional risk factors. This systematic review provides a qualitative overview of the risk factors, angiographic features, treatments, and complications of Bangladeshi youth with coronary artery disease (CHD). Search PubMed, Embase, and Google Scholar for studies published between the year 2004 to 2022. Identified the paper. Studies conducted in Bangladesh and other countries in patients aged 25 to 65 years were published in English and included information on patients' clinical profiles and risk factors for early-onset CAD. Smoking, dyslipidemia, high BMI, high-sensitivity C-reactive protein, and hyperhomocysteinemia are frequently observed in young CAD patients. Among young patients with coronary artery disease, single-vessel disease was more common than multivessel disease. Complications of coronary artery disease, such as arrhythmias, cardiogenic shock, and heart failure, are also more common in young patients. Coronary angiography findings revealed that more than one-third of the patients had normal coronary arteries, but in the majority of patients they were found to have SVD, DVD, and TVD. In some cases, "TVD & LM" and mild CAD were also detected by her CAG.

Background: Head and Neck Squamous Cell Carcinoma (HNSCC) is a heterogeneous group of malignancies arising from the mucosal linings of the oral cavity, pharynx, and larynx. Locally advanced HNSCC (LA-HNSCC), encompassing stages III and IV, involves large tumors and regional lymph node metastases without distant spread, contributing to high morbidity and mortality. Understanding the clinical features of LA-HNSCC is crucial for improving treatment strategies and patient outcomes. Objective: To evaluate the clinical characteristics of patients with LA-HNSCC and their impact on treatment outcomes, specifically comparing the TPLF and LFP regimens. Methods: An experimental study was conducted at Khwaja Yunus Ali Medical College & Hospital from January to December 2015, involving 60 patients with LA-HNSCC. Patients were treated with neoadjuvant chemotherapy (TPLF or LFP regimens) followed by concurrent chemoradiation. Data was collected through patient interviews, clinical evaluations, and laboratory tests. The primary outcome measures were tumor regression, clinical response, and acute toxicities. Statistical analysis was performed using SPSS, with significance set at p < 0.05. Results: The majority of patients were male (80% in Arm A and 77% in Arm B) and over 50 years old. Smoking prevalence was high (83.3% in Arm A and 80% in Arm B). The most common primary tumor sites were the oral cavity (Arm A: 30%, Arm B: 33.3%) and oropharynx (Arm A: 23.3%, Arm B: 26.7%). Neck node swelling, pain, dysphagia, and weight loss were the most frequent clinical complaints. No statistically significant differences were found between the two treatment arms in terms of age, smoking, occupation, ECOG performance status, or histological grading. Conclusion: Both TPLF and LFP regimens provided similar outcomes in terms of clinical characteristics and treatment response in patients with LA-HNSCC. These results suggest that the choice between TPLF and LFP regimens may not significantly influence treatment outcomes. Further research is needed to explore additional factors affecting treatment efficacy and refine therapeutic strategies for LA-HNSCC.

Background: Choledochal cysts are rare congenital anomalies of the biliary system, presenting variably across age groups. Early diagnosis is crucial to avoid complications such as cholangitis, pancreatitis, and malignancy. Advancements in diagnostic imaging have significantly improved the detection and management of this condition. Objective: To assess the clinical features and diagnostic strategies for choledochal cysts using improved diagnostic techniques. Methodology: A retrospective observational study was conducted in the Hepato-Biliary-Pancreatic Surgery (HBPS) department of BIRDEM Hospital, Dhaka, spanning five years from January 2003 to January 2008. Thirty patients diagnosed with choledochal cysts were included based on clinical history, examination, and imaging. Data analysis was performed using SPSS version 22, with descriptive statistics and chi-square tests employed to explore associations between variables. Results: The study cohort comprised 21 females (70%) and 9 males (30%), with the majority of cases (49.5%) occurring in the 0–15 years age group. Jaundice (36%), abdominal mass (32%), and right upper quadrant pain (32%) were the most common clinical features. Complications such as cystolithiasis (24%) and pancreatitis (29%) were observed, while cirrhosis and malignancy were rare. Ultrasonography was utilized in all patients as an initial diagnostic tool, while MRCP (33%) and CT scans provided additional insights. ERCP was performed in 42% of cases, but its use has since declined due to associated risks. Conclusion: This study highlights the demographic and clinical features of choledochal cysts, with a focus on the utility of advanced imaging modalities like MRCP for non-invasive and accurate diagnosis. Early detection and intervention are key to reducing complications and improving outcomes.

Background: Chalazion, a common benign eyelid lesion caused by chronic inflammation of a blocked meibomian gland, often requires intervention for larger or recurrent lesions. Incision and curettage (I&C) and intralesional steroid injections are common treatment methods, each with distinct advantages and challenges. This study aims to compare the efficacy, safety, and patient satisfaction of these treatments to guide clinical decision-making. Objective: To evaluate and compare the effectiveness and safety of triamcinolone acetonide (TA) injection, methylprednisolone acetate (Depo) injection, and I&C in the treatment of large chalazia. Methodology: A total of 60 patients with recurrent chalazia were randomly assigned to three treatment groups: TA injection, Depo injection, or I&C. Patients were followed up at 1, 2, and 6 weeks post-treatment. The primary outcome was the complete resolution of the chalazion, defined as an 80% reduction in size with no recurrence. Results: The demographic characteristics, including age and gender, showed no significant differences between groups. The overall success rate for all treatments was 95%, with only 5% of patients in each group experiencing incomplete resolution. A single injection group showed higher success rates (27 successful cases) compared to the two-injection group (13 successful cases), with a statistically significant difference (p < 0.05). Resolution rates improved over time, with 95% complete resolution achieved by 6 weeks in all groups. However, there were no significant differences in resolution rates between groups at any time point (p > 0.05). Conclusion: This study supports that both steroid injections and I&C are highly effective treatments for recurrent chalazions, achieving a 95% success rate. Single injections were more effective than multiple injections. While the resolution rates improved over time, no significant differences were observed between treatment groups. These findings suggest that either treatment option can be selected based on patient preference, with I&C remaining an effective choice for more persistent cases.

Snakebites are serious public health problem in many regions of the world, particularly in rural areas lacking medical facilities. Snake bite is a well-known occupational hazard amongst farmers, plantation workers, and other outdoor workers and results in much morbidity and mortality throughout the world. This occupational hazard is no more an issue restricted to a particular part of the world; it has become a global issue. Accurate statistics of the incidence of snakebite and its morbidity and mortality throughout the world is difficult to publish, however, it is certain to be higher than what is reported. This is because even today most of the victims initially approach traditional healers for treatment and many are not even registered in the hospital. Hence, registering such patients is an important goal if we have accurate statistics and reduce the morbidity and mortality due to snakebite. World Health Organization (WHO) has published guidelines for the clinical management of snakebites. In this article the author tries to throw light on the incidence and clinical features of snakebite and the management and treatment guidelines as per the WHO recommendation.

Diabetic foot ulcers (DFUs) are a significant global health burden, exacerbated by the rise in multidrug-resistant (MDR) bacterial infections. This study evaluated the antibacterial effects of Sansevieria zeylanica (S. zeylanica) leaf and root extracts against MDR Proteus mirabilis isolated from diabetic patients with DFUs at a teaching hospital in Nigeria. Antimicrobial susceptibility testing of clinical isolates of MDR P. mirabilis was conducted using the Kirby-Bauer disc diffusion method. The antibacterial activity of S. zeylanica extracts was evaluated using the agar well diffusion method. Additionally, the synergistic/antagonistic effect of the extracts with Ofloxacin was assessed. Antimicrobial susceptibility testing revealed high resistance to conventional antibiotics, with 61.5% of isolates identified as MDR. Methanolic extracts of S. zeylanica demonstrated moderate antibacterial activity, with root extracts exhibiting greater inhibition zones (10-17 mm) compared to leaf extracts (8-13 mm). However, co-administration with Ofloxacin revealed an antagonistic effect. These findings suggest that S. zeylanica root extracts hold promise as an alternative therapeutic agent for DFU management. Further research is needed to optimize extract formulations and explore their clinical applications.

Background: Traditional mono-focal intraocular lenses (IOLs) have been commonly used in cataract surgery but have limited intermediate vision. These lenses are designed to achieve improved visual outcomes and optical quality without the drawbacks associated with multifocal lenses. The present study compares visual outcomes, optical quality, and patient satisfaction for Monofocal versus Monofocal-Plus IOLs. Methods: This postoperative observational study was carried out at Department of Ophthalmology, Dr. Sirajul Islam Medical College and Hospital and Bangladesh Eye Hospital, Dhaka, Bangladesh, from July 2022 to June 2023, including 40 cataract surgery patients. Patients were divided in Monofocal IOL (n=20) & Monofocal-Plus IOL (n=20) groups. Preoperative 1-month and 3-month follow-up assessments of visual acuity (LogMAR), contrast sensitivity (logCS), higher-order aberrations (HOA), and patient satisfaction scores were performed. SPSS version 26 was used to analyze data, with a p<0.05 significance level. Results: Uncorrected visual acuity was significantly better 3 months post-op with mono-focal-plus IOL at 3 months (p=0.008), photopic contrast sensitivity (p=0.04), and spherical aberration (p=0.00). There was a trend toward improvement in best-corrected visual acuity (p=0.08). Monofocal-Plus IOL patients reported significantly lower glare (p=0.01) and halos (p=0.01) and better night vision quality scores (p=0.005). The requirement for more spectacles was less in the Monofocal-Plus group (15.0% vs. 35.5%), but not significant (p=0.14). Conclusion: Compared to Monofocal IOLs, Monofocal-Plus IOLs provide better visual performance, optical quality, and higher patient satisfaction. These findings support their adoption as an IOL of choice in cataract surgery.

Background: Chronic obstructive pulmonary disease is one of the most common non-communicable illnesses, having the potential to be fatal, it is now the third leading cause of death worldwide. Objectives: The aim of our study was to estimate the prevalence of COPD, its associated risk factors, causes and management in Saudi Arabia. Methods: For article selection, the PubMed database and EBSCO Information Services were used. All relevant articles relevant with our topic and other articles were used in our review. Other articles that were not related to this field were excluded. The data was extracted in a specific format that was reviewed by the group members. Conclusion: In Saudi Arabia, the prevalence estimated of COPD is relatively high, moreover it increases by time. High prevalence of smoking and increased age was reported to be the most common effective risk factors of COPD in Saudi population. COPD is now considered a preventable and potentially treatable disease if detected in the early stages. Avoidance of exposure to harmful particles, mainly smoking, can prevent progression to a clinically significant stage of the disease.

Background: Children's headaches are not well understood, and diagnosis can be difficult. Children who get frequent headaches are frequently badly impacted. The relationship between lifestyle factors including food, exercise, and sleep and the occurrence of headaches, particularly migraines, has been investigated mostly in adults, leading to changes in lifestyle as a conventional treatment in addition to medical therapy. Objective: To find out clinical profile of children with recurrent headache. Materials and Methods: This is a cross sectional study was conducted Centre for Neurodevelopment and Autism in Children (Pediatric Neurology OPD), Dept. of Pediatrics of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka during January 2022 to June 2022. Total of 100 children attending with recurrent headache were taken consecutively over a period of six months for this study. Patient with recurrent headache were classified (diagnosed) based on clinical presentation (according to International Headache Society diagnostic criteria). Results: The majority of patients (54%) suffered migraines without aura, and 48% had severe headaches. 70% of patients exhibited sensitivity to bright light during a headache episode, 80% had sensitivity to noise, 85% had no headaches while playing TV video games, and 66% had a history of headaches caused by sun exposure. Conclusion: Males dominated in the pre-pubertal age range, whereas girls dominated after puberty. The most prevalent RHA diagnosis was migraine without an aura. Headache triggers or precipitating factors were also compared to previous research.

Healthcare technicians play a pivotal role in the modern healthcare system, serving as the backbone of various medical disciplines. This review article explores the multifaceted roles of healthcare technicians across five key areas: radiology, nursing, laboratory services, medical records, and pharmacy. Each section delves into the specific responsibilities, skills, and contributions of technicians in these fields, highlighting their importance in enhancing patient care, ensuring safety, and improving healthcare outcomes. By examining the evolving landscape of healthcare technology and the increasing complexity of patient needs, this article underscores the necessity for ongoing education and collaboration among healthcare technicians and other professionals. Ultimately, the integration of healthcare technicians into multidisciplinary teams is essential for delivering comprehensive and effective patient care.

This narrative review synthesizes the existing literature to define and optimize the distinct and coordinated roles of allied health technologists during the critical initial phase of trauma care. The analysis is framed within the modern interpretation of the "Golden Hour" not as a literal 60-minute timeframe, but as a guiding principle of urgency that demands rapid, parallel, and protocol-driven actions to save life and limb. Through a narrative review of peer-reviewed literature, clinical guidelines, and professional standards focusing on adult trauma care in Level I and II trauma centers, this paper examines the contributions of a spectrum of specialists: Emergency Medical Technicians (EMTs), Medical Laboratory Technicians, Radiology Technologists, Anesthesia Technologists, Pharmacy Technicians, and Dental Assistants. The key finding of this review is the identification of a complex system of interdependent, time-sensitive tasks performed by these technologists, which collectively form the diagnostic and preparatory foundation for all definitive surgical and medical interventions. A central theme emerges wherein the efficiency and success of the entire trauma response are contingent on the seamless communication and coordination between these technologist specialties. The review concludes that the "Golden Hour" is saved not only by the visible leadership of physicians and nurses but by the rapid, highly coordinated, and often unseen efforts of this multidisciplinary technologist team. Consequently, this paper advocates for greater institutional recognition of these essential roles, the development of integrated, technologist-inclusive trauma protocols, and the mandatory inclusion of all relevant technologist specialties in high-fidelity interdisciplinary trauma simulations to enhance system-wide performance and improve patient outcomes.

The administration of iodinated contrast media (ICM) is indispensable for modern diagnostic and interventional procedures. However, the subsequent development of acute kidney injury (AKI) represents a significant clinical challenge, associated with increased morbidity, mortality, and healthcare expenditure. Historically termed contrast-induced nephropathy (CIN), the understanding of this condition has evolved, leading to the more precise term contrast-associated AKI (CA-AKI) to reflect a temporal association rather than assumed causality. The pathophysiology is multifactorial, involving direct tubular cytotoxicity, renal vasoconstriction leading to medullary hypoxia, and oxidative stress. While the risk is low in the general population, it is markedly elevated in patients with pre-existing chronic kidney disease (CKD), diabetes mellitus, heart failure, and in the context of intra-arterial procedures with high contrast volumes. The prevention of CA-AKI has traditionally been managed in departmental silos, an approach that is often fragmented and unreliable. This review proposes a comprehensive, multidisciplinary framework that integrates the expertise of four key pillars: Radiology, Pharmacy, Anesthesia, and Public Health. Effective prevention begins with a shared foundation of robust risk stratification, leveraging quantitative scoring systems and automated electronic health record (EHR) alerts. The Pharmacy pillar focuses on evidence-based pharmacological and medication management, including standardized hydration protocols, controversial adjunctive therapies like N-acetylcysteine and statins, and a critical "nephrotoxic hold" on high-risk medications. The Radiology pillar centers on procedural optimization through the selection of appropriate contrast agents, strict adherence to the principle of dose minimization guided by dose-to-eGFR ratios, and the use of advanced technologies like automated injectors and ultra-low contrast techniques. The Anesthesia pillar provides intraprocedural hemodynamic stewardship for high-risk patients, maintaining renal perfusion through goal-directed fluid therapy and judicious use of vasopressors. Finally, the Public Health pillar provides the system-level architecture for success, designing and implementing hospital-wide "prevention bundles," fostering interdepartmental communication, promoting patient education, and driving continuous quality improvement through audit and feedback. By synergizing these distinct but complementary roles, healthcare systems can transition from a reactive to a proactive and reliable model of care, significantly reducing the clinical and economic burden of CA-AKI.