In this investigation, the effectiveness of aquatic extracts of Cyperus rotundus tubers was examined. The aerial parts of the curly plant (Teucrium polium) and the fruits of the carob plant (Prosopis farcta) help reduce levels of glucose, cholesterol, and blood triglyceride levels of healthy male rats and those with induced diabetes. With alloxan and compared with the effect of insulin. It has been shown that aqueous extracts of saad, jaada, and carob caused the levels of the blood sugar decreasing significantly. In healthy plus rats with diabetes. The results of this study show that the aqueous extract of Saad tubers caused a significant decrease in the lipid and cholesterol content of all but the aquatic extract of carob fruits prompted a notable drop in the quantity of triglycerides only, while the aqueous extract did not change the aerial parts of the increase in the levels of cholesterol and triglycerides in rats with diabetes.

The purpose of this study was to investigate the effects of nickel oxide nanoparticles on pregnant mice and fetal development. Nickel oxide nanoparticles (<50 nm) were injected intraperitoneally (1, 10, 20 mg/kg) in pregnant mice daily from the 7th -18th gestation day. At the 18th gestation day, the mice were euthanized, necropsied, and pathological examination of the mice and their embryos was done. Exposure to the nickel nanoparticles induced an increase (low and medium doses) and a decrease (high dose) in the activity of the mice. Abortion was recorded at the rates 10%, 20%, and 30% in groups treated with doses of 1, 10, and 20 mg/kg, respectively. Fetal malformations were noted at rates of 60%, 70%, and 75%, for the doses 1, 10, and 20 mg/kg, respectively. They included arrested growth, absence of the extremities, C-shaped fetuses, anencephalon, myelocele, exophthalmia, spina bifida, absence of facial details, absence or deformities of the tail, micromelia, cyanotic skin, abdominal hemorrhages, and meningocele. Microscopically, degenerative, necrotic, circulatory, and inflammatory lesions in the kidneys, liver, lungs, brain, and heart were noted in pregnant mice. In the embryos, there was incomplete growth of the renal, nervous, and pulmonary tissues. Additionally, there were degenerative, necrotic, and circulatory changes in the kidneys, liver, brain, lungs and heart. It was concluded that exposure to intraperitoneally administered nickel oxide nanoparticles (<50 nm) induces abortion and toxic lesions in the kidneys, liver, brain, lungs and heart of pregnant mice; and fetal malformations and pathological lesions in the embryos.

Heavy metals have negative impacts on human health including red blood cells hemolysis and increases oxidation processes, leading to many health issues. In this study, several blood samples were collected from people who work in North Oil Company, Kirkuk, Iraq. In addition to people who live, work away from oil fields as the control group. This investigation looks at the impact of various concentrations of cadmium and / or lead individually and combined (Cd:Pb) on erythrocytes hemolysis. The findings demonstrated that hemolysis produced by the (100 mM) were (72.0, 88.80, and 96.90\%) for (Cd, Pb, and Cd: Pb) respectively. Vitamins (B2 and C) were applied with different concentrations (0.1, 0.2, 0.3, 0.4, and 0.5 mol/L).to investigate the reduction of hemolysis percentage. The findings showed that both vitamins have positive effect in reducing the hemolysis percentage. Vitamin C has even more significant impact in reducing the hemolysis compared to Vitamin B2. In conclusion, cadmium and lead can cause erythrocyte hemolysis individually or combined, additionally, vitamins C and B2 were proved to in reducing hemolysis effectively.

Background: Recurrent abortion affects 1-2% of women. Serum Amyloid A belongs to a family of apolipoproteins produced in response to cytokines released by activated monocytes and macrophages, isolated in the last 50 years. Our current study emphasizes human SAA protein as a sensitive biochemical marker for primary unexplained recurrent miscarriage. The aim of the current study is to examine the hypothesis that primary unexplained REPL might be associated with high maternal serum levels of SAA, which in turn could lead to defective trophoblastic invasion into the decidua, and subsequent pregnancy failure and miscarriage. Patients and Method: A prospective study (case control study) in Al-Zahraa Maternity Hospital, Najaf, Iraq, from first of January to the first of December of 2019. The study was conducted among 91 who were divided into two groups Group 1: women with missed miscarriage in the first trimester with at least two consecutive primary unexplained REPLs and no previous live births were enrolled. Group 2: A control group was formed of women with miscarriage no history of REPL who had at least one previous uneventful pregnancy with no adverse outcomes. Serum samples were collected to measure SAA levels. Result: The main outcome was the association between SAA and primary unexplained REPL. A total number of 91 participants. Mean SAA level was significantly higher among women with REPL than among women in the control group (P<0.001). The SAA level was dependent indicator of primary unexplained REPL, P<0.001 Elevated SAA levels found among women with primary unexplained REPL could represent biomarker for this complication of pregnancy. Conclusions: The present findings suggest that SAA is potentially a novel marker for primary unexplained REPL that warrants further investigation. For example, studies could be conducted to compare SAA levels among women with a history of primary unexplained REPL during the pregnant and non-pregnant states, as well as before and after miscarriage. In future, such studies might guide the timing for initiation of new treatments, such as gene therapy or the use of immune-receptor antagonists.

Background: The long-term sequelae of COVID-19 are thought to be a novel area of research due to variances in the epidemiology and therapy. Nevertheless, the follow-up time interval (6 or 12 months) was excessively long, and the time point of the follow-up period varied from 3 to 24 months in the prior research. More research is required to understand better COVID-19's effects, including their long-term effects on the lungs and how they may affect pulmonary function. Therefore, this study aims to investigate the long-term impact of post-COVID-19 syndrome on pulmonary function tests. Methods: This research was a case-control study conducted from 13 October 2023 to 13 November 2023 at the Al-Sader Teaching Hospital in Maysan City. There are fifty-eight patients and fifty-eight controls included. This study comprised patients who visited a pulmonary consulting clinic and had COVID-19 symptoms, matched by controls who were chosen at random. The controls had to meet the same criteria as the cases, with the exception that they did not have COVID-19 disease. The most popular kind of breathing or pulmonary function test is spirometry, spirometry was used to measure: FVC, FEV, and FEV1/FVC ratio. Result: Sixty-six post COVID-19 syndrome with ages (34.1 ± 9.8) years and sixty-seven controls were enrolled. The results of FVC and FEV parameters indicate a significant difference (P<0.05) between cases and control groups. However, no significant differences existed between groups for the FEV1/FVC ratio. In the comparison of lung function tests between cases and control across different age groups (18-29, 30-39, 50-65) years, we found that mean FVC is significantly lower for the age group 18-29 years than for 30-39 and 50-65 years, and the mean FEV is significantly lower for the age group 18-29 years than for 30-39. Conclusion: After COVID-19, a significant number of patients continue to have symptoms, with respiratory symptoms accounting for the majority of complaints. Patients with continuing symptoms were younger and presented a significantly lower FVC and FEV. 

Background: Low back pain (LBP) is a major global health condition which affects individuals across various occupational groups. Dentists, specifically, are prone to experiencing LBP due to the physically demanding nature of their work. This study aims to investigate the prevalence and determinants of LBP among dentists. Methodology: This cross-sectional study was carried out among dentists working in different regions in Saudi Arabia. Sociodemographic characteristics, Modified Oswestry Low Back Pain Disability grading, self-perceived health were collected. SPSS version 20 was used to calculate frequency, percentage and p values. Results: Among 116 participants, majority 66 (56.9%) were males, 83 (71.5%) had Low back pain. Onset of LBP was gradual in 111(95.7%), majority (37%) have worked in health care profession for 6 to 10 years. Majority 52 (44.8%) work 5 days a week, 67 (80.7) had mild LBP. Conclusion: The prevalence of LBP was 71.5%. Occupational prevention activities should be planned to alleviate the presence of LBP among dentists.

Generating a DNA profile using autosomal Short Tandem Repeat (STR) DNA allele from skeletal remains is a crucial step in the identification process for mass disaster and unidentified person situations. The capacity to extract substantial amounts of relevant DNA from bones, which were highly durable biological components that can withstand soil elements and climatic conditions over long periods of time, would be advantageous. 70 femur male bone samples were collected from two different environmental mass graves (Al-Mahaweel massgrave) in Babil governorate and (Al-Saqlawiya massgrave) in Al-Anbar governorate in Iraq. The DNA from bone samples extracts were assessed by capillary electrophoresis and a standardized set of short tandem repeat (STR) loci are analyzed using Mutiplex 21 STR loci System to allow human identification by matching the profile of the dead individuals with their relatives. From these two different sites; soil samples were collected to analyze and study the different environmental factors and find a relation between the degree of preservation or degradation with these factors like temperature, humidity, salinity, PH and texture of soil and find how these factors can affect on pattern of degradation of DNA profiles. The average of the percentage of the detected alleles in each locus in the two sites; were 87\% for Al-Mahaweel site and 32\% for Al- Saqlawiya site. we found that clay soil, low salt concentration, PH slightly alkaline and low humidity for Al-Mahaweel site; all participate in DNA preservation while the chalky and very high salt concentration of Al- Saqlawiya site soil; all participate in DNA degradation. Predicting the effect of these factors on the quality of the DNA profiles can be helpful in finding better solutions for many complications that may face the process of analyzing samples and finding sufficient informative profiles.

Background: Strategies for modulating the tumor microenvironment (TME) have opened up new treatment paths in a variety of malignancies, with dramatic but variable intertemporal success. Consequently, studying TME's molecular players may aid in understanding how tumor cells and TME interact. Tumor cells and infiltrative tumor lymphocytes express immune checkpoint proteins including Cluster of Differentiation 80 (CD80) and CD86 on their surface. CD80 and CD86 are members of the immunoglobulin superfamily (IgSF). The costimulatory protein CD28, which is present on the outermost portion of all T cells, and the inhibitory receptor CTLA-4 (cytotoxic T-lymphocyte antigen-4, also known as CD152) are ligands for CD86 and CD80. CD28 and CTLA-4 have essential yet opposing functions in T cell activation. T cell responses are stimulated when they bind to CD28, but they are suppressed when they connect to CTLA-4. Aim of the study: The goal of the study was to determine how much the CD80 and CD86 genes were expressed genetically. In five blood malignancies and ten solid tumors. Methods: Clinical specimen were collected from patient with different cancers attending Kirkuk oncology centre. Patients were categorised into two main groups: solid tumour group and Blood derived cancer group alongside with their control counterparts. The study investigated the genetic expression of the CD80 and CD86 genes using q RT-PCR technologies. Results: Using q RT- PCR we measured the expression of a gene CD80 /CD86. The results showed different levels of elevation in patient samples of solid tumors and hematological tumors and compared with the control group for this study First, evaluation of this marker CD80/CD86 in solid tumors showed a significant increase in patients with brain cancer compared to their counterparts in the control group. Secondly, the second solid tumor appears increased gene expression as ovarian cancer. The least expressed solid tumors are breast cancer. As for cancers that occur in the blood, lymphoma has an upregulation expression. And the least expression is CD80/CD86 were in ALL. Conclusion: There is evidence that several cancer types and immune cells have expressed CD80 and CD86. This investigation demonstrated that the cell surface markers CD80/CD86 have a role in progression of carcinomas of the brain.

Diabetes mellitus (DM) is now regard as a worldwide health issue affecting hundreds millions of people. It is a metabolic disease targeting glucose metabolism and insulin homeostasis, Type 2 diabetes mellitus (T2DM) is the most prevent type of this disease accounting about 90-95% of the disease as whole. microRNAs (miRNAs) which are a small non-coding RNAs, they revolutionized as potential new biomarkers for the diagnosis and prognosis of a wide range of disorders. Recent studies prove the relationship between miR-21 and inflammatory process and insulin resistance, our emphasis suggest there is a role of miR-21 in insulin resistance in T2DM. Studies have explored the potential of miR-21 as diagnostic biomarkers for T2DM.  The purpose of this study is to compare the sera levels of miRNA-21 among newly diagnosed patients e with T2DM patients with their levels in apparently healthy subjects using blood samples. The time frame for this case-control research is August 2022 through March 2023, and it took place at Al-Sadr Teaching Hospital/ Masin / Iraq. There were 100 patients home recent diagnosed with T2DM (50 females and 50 males) with age ranged between (20 -70 years) and 100 apparently healthy subject who dealt with as control group. 2 ml of blood drown from each patient and healthy person, putted it in EDTA tube with 1 ml of Trizole as a preservative, and put the tubes in the freezer at -70 degrees Celsius until analyze the samples.

Today, food supplements have become an indispensable part of a healthy and balanced life, and one of them, collagen supplements especially support the healthy skin structure and have many positive effects on it. The present study is aimed that evaluating the effects of PROFIN® Collagen on healthy skin conditions such as skin hydration, wrinkles, and elasticity. With this aim, we conducted a prospective, single-center, double-blind, randomized, placebo-controlled, 2-arm, parallel-design study to evaluate the effect of 12-week consumption of PROFIN® Collagen Hydrolysate on skin health. A total of 72 healthy female adults, aged between 40 and 65 with at least moderate eye wrinkles were randomized to receive 10 g of PROFIN® Collagen or placebo, once daily for 12 weeks.  The majority (73(%)) of participants who took ‘Profin Collagen Hydrolysate’ had a statistical improvement (decrease) (p<0,05) in mean wrinkle length at Day 42, this improvement continued at the end of the intervention. Furthermore, compared with the placebo group, in placebo group transepidermal water loss results show that there was a significant increase after 6, and 12 weeks of administration, but not in PROFIN® Collagen group. In conclusion, this study demonstrates that PROFIN® Collagen has a positive effect on skin wrinkles and water loss.

Background: Bariatric surgery is the most successful treatment for obesity regarding the degree and duration of weight loss. Aim of the Study: Evaluate the impact of pharmacist educational intervention and training in improving patient adherence and its association with the prevention of clinical nutritional complications after bariatric surgery. Patient and Method: A randomized comparative interventional study was conducted in Najaf Governorate, Iraq. The Intervention group included 58 patients who received standard care and training educational and support programs. The standard care group included 58 patients who received standard care after Bariatric surgery. Results: In the intervention group, at 3 months of follow-up, the mean total score was 5.8 and increased to 6.7 at the 6 months. Conversely, the score decreased in the standard care group from 5.3 at 3 months to 2.2 at 6 months. In contrast to the standard care group, an inverse significant correlation was found between the number of incident complications and the total eight-item Morisky Medication Adherence Scale (MMAS-8) at 3 and 6 months in the intervention group. Conclusion: The pharmacist intervention leads to better patient adherence to guidelines after Bariatric surgery which results in decreased complications at three and six months after surgery.

Background: The infection that caused the pneumonia, the virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the source of coronavirus disease 2019 (COVID-19) is the source of the global pandemic. The pneumonia cases began in Wuhan, China in December 2019 and had no apparent reason. Essential inflammatory mediators Chemokines are necessary for an immune response to eliminate pathogens. However, the fundamental cause of hyperinflammation is their excessive release. Chemokines may be directly responsible for the acute respiratory illness syndrome in the current COVID-19 outbreak. Objective: The current study aimed to estimate hematological changes with immunogenic markers CD177, GNLY, and CXCR4 gene expression in COVID-19 patients, and compare these parameters among patients and healthy individuals. Materials and Methods: The study was conducted at Al-Yarmouk Teaching Hospital and Medical Teaching Laboratories. Finally, to detect the immune markers level in samples of patients, by RT-PCR. Results: The results revealed the gene expression results in patients with COVID-19 means Ct difference of CD177 (24.70) fold more than (10.5) elevated when compared with the mean of Ct control healthy group is (28.21) fold of gene expression is 1.00 of CD177 when our study showed increased gene expression the mean of GNLY Ct receptor was reached to (28.70 ng/L) with fold more than 15.0 in COVID-19 patients, while mean Ct in healthy control was (32.61 ng/L) with fold 1.00, the current study found mean CT of CXCR4 gene expression ( 31.2) with fold (1.1) compared with healthy control CT(31.3) fold of gene expression was (1.0). Conclusion: It was concluded that COVID-19 caused significant changes in many immunological parameters and found the titer of immune markers was higher in infection compared with control.

Objective: This study examined the effectiveness of Enchroma Cx-14 filters on individuals with Red-Green color vision deficiency (CVD). Methods: ColorDx and the Farnsworth-Munsell (FM) 100-Hue test were used to assess subjective reactions to Enchroma. The ColorDx and FM, 100 Hue test error scores were computed and contrasted using Placebo (untinted glasses) and Enchroma CX-14, red, and green filters. Results: The findings demonstrated that while enchroma filters improved the mistake score in only two patients, they had no discernible impact on any CVD subject's performance. In one protan participant and all deutan individuals, colour discrimination was greatly enhanced by the red filter. Green filters and Enchroma did not raise mean error scores. Conclusion: Enchroma filters had limited effectiveness in improving color perception for individuals with Red-Green CVD.

Background: The decision to pursue a medical career is influenced by a multitude of factors, including gender, family background, and socioeconomic status. Despite the multifaceted role of anaesthesia in critical care and disaster response, physician anesthesiologists remain underrepresented in Saudi Arabia and other developing countries, posing challenges to healthcare systems. This study explores the factors influencing career intentions among female medical students in Saudi Arabia regarding pursuing a career in anaesthesia. Aim: This study aims to identify factors influencing the career choice of anesthesia among female undergraduates, exploring associations with other sociodemographic variables. Methodology: A cross sectional study was done by using comprehensive questionnaire-based approach employed to gather data on demographic profiles, experiences during anaesthesia rotations, postgraduate training preferences, and perceptions of the field. Logistic regression analysis was applied to investigate associations between demographic variables and attitudes towards anaesthesia as a career choice. Results: Varied age distribution (9.9%-54.5%), predominantly Saudi nationals (90.4%), and diverse parental occupations, mainly in healthcare, including medicine (6.8%-47.7%), were observed in the study. Regression analysis identifies non-Saudi nationality as associated with a positive attitude (Odds Ratio = 4.9247, p = 0.050), while increasing undergraduate years correlate with decreased positive attitudes. Factors linked to negative attitudes include older age (>27) (Coefficient = 1.2668, p = 0.248), and non-Saudi nationality with higher log odds (Odds Ratio = 5.0054, p = 0.130). Key influencers include financial considerations, perceptions of respect and patient care, mentorship, and misconceptions. Attitudes towards anaesthesia evolved with advancing education years. Conclusion: This study sheds light on the nuanced factors shaping career intentions within the anaesthesia field among female medical students in Saudi Arabia. By understanding these influences, healthcare institutions and policymakers can develop tailored strategies to attract and retain talent, addressing the underrepresentation of physician anesthesiologists and promoting anaesthesia as a rewarding career path. Our study emphasizes the pivotal role of cultural context, clinical experiences, and tailored support mechanisms in shaping the career intentions of Saudi Arabian female medical students towards anaesthesia.

Introduction: Rectal cancer is the second most common type within the large intestine, posing significant health risks globally. In Bangladesh, it ranks high among diagnosed cancers. Improved diagnostic methods aid in early detection, which is crucial for effective management. Treatment typically involves a combination of surgery, radiotherapy, and chemotherapy. Preoperative chemoradiotherapy is a standard approach. However, newer methods like preoperative hypo-fractionated radiotherapy with surgery promise better outcomes, including reduced recurrence rates and enhanced survival, with potential cost and time savings. Aim of the Study: The study aims to evaluate and contrast the efficacy of hypofractionated radiotherapy and concurrent chemoradiotherapy in patients with locally advanced rectal carcinoma. Methods: The study, conducted at the Department of Clinical Oncology at Bangabandhu Sheikh Mujib Medical University Shahbagh, Dhaka, Bangladesh and the Department of Radiation Oncology at the National Institute of Cancer Research and Hospital (NICR&H) in Mohakhali, Dhaka, Bangladesh, aimed to compare treatments for locally advanced rectal cancer over 1.5 years (From January 2018 to June 2019). A total of 80 patients were divided into two groups; Group A received hypofractionated radiotherapy, while Group B received oral capecitabine alongside external beam radiotherapy. Inclusion criteria involved confirmed adenocarcinoma within specified stages, with ethical clearances obtained. Patients underwent evaluations before treatment and response assessments posttreatment. Treatment modalities were defined, focusing on radiotherapy and chemotherapy. Data were analyzed using SPSS software, employing various statistical tests. Results aimed to address study objectives while minimizing biases. Result: The study involved 80 patients, divided into Groups A and B, each with 40 individuals. Group A mainly comprised individuals aged 41-50 (45%), followed by 31-40 (25%). Group B had the highest proportion aged 31-40 (30%) and 41-50 (32.50%). Both groups showed male predominance (1.3:1). Moderately differentiated tumors were common, with Group A having more poorly differentiated tumors. Stage III was predominant pre-treatment (65% Group A, 70% Group B). Most patients presented with per rectal bleeding (80%) and alteration of bowel habits (56.25%). Response rates to treatment were similar between groups. Tumor downsizing was more frequent in Group B. Sphincter-sparing surgery was feasible in both groups with no significant difference. Conclusion: The study comparing preoperative hypofractionated radiotherapy (RT) to concurrent chemoradiotherapy (CCRT) for locally advanced rectal carcinoma found similar efficacy in tumor response, downsizing, and sphincter preservation. Statistical analysis showed no significant differences. Both approaches showed acceptable short-term outcomes, offering clinicians options based on patient and resource considerations.

Background: Injuries or inflammation of the sesamoid bones can be very painful. In order to properly diagnose and treat problems affecting the hand, it is necessary to have a thorough grasp of the number and location of sesamoid bones in the hand. This study was carried out with an objective to study the distribution and pattern of sesamoid bones of the hand in the Saudi population. Materials and Methods: This three-month retrospective study was conducted from May 2023 to July 2023 in orthopedics and radiology departments of Saudi Arabia's Medical Centre, Majmaah University. The study analyzed 200 patients who had sesamoid bones in their hand by radiographs. Patients underwent two radiological examinations. All patients had posteroanterior (PA) and oblique direct hand radiographs. The radiologists and orthopedic surgeons examined the hand sesamoid bones, including at the metacarpophalangeal (MCP) and interphalangeal (IP) joints. Radiologists analyzed X-rays of hand injury patients using demographic data and imaging tests. The patients' sesamoid bone distributions and locations were meticulously recorded. Data were analyzed in SPSS Version 23, and the Chi-square test was applied to test the statistical significance. A p-value of <0.05 was considered significant. Results: Total 200 patients had sesamoid bones examined in their first radiological examination of MCP. Among them, 72 (36%) patients had \(1^{st}\), \(2^{nd}\), and \(5^{th}\) MCP followed by \(1^{st}\) MCP in 58 (29%), \(1^{st}\) and \(5^{th}\) MCP in 45 (22.5%), \(1^{st}\) and \(2^{nd}\) MCP in 43 (21.5%) with the average age of sesamoid bone at MCP joint as 47.71±17.09, 41.76±18.08, 48.16±15.76, and 42±14.77 respectively. Sesamoid bone was reported \(1^{st}\), \(2^{nd}\), and \(3^{rd}\) MCP in 1 (0.5%) and \(1^{st}\), \(2^{nd}\), \(4^{th}\), and \(5^{th}\) MCP in 1 (0.5%) patients in the first radiological examination. The second radiological examination in the same patients showed, 64 (32%) patients had \(1^{st}\), \(2^{nd}\), and \(5^{th}\) MCP followed by \(1^{st}\) MCP in 47 (23.5%), \(1^{st}\) and \(5^{th}\) MCP in 43 (21.5%), \(1^{st}\) and \(2^{nd}\) MCP in 17 (8.5%) with the average age of 48.38±17.13, 41.09±16.72, 49.02±16.59, and 38.24±14.59 respectively at MCP joint. The association between the first radiological examination and the second radiological examination of sesamoid bone at MCP was statistically significant (chi-square 623.73, p value <0.001). Conclusion: This is the first radiological assessment with two imaging evaluations in the same 200 patients who had sesamoid bone in hand. In the first and second imaging evaluations, we recorded 7 and 9 sesamoid bone distribution patterns respectively. \(1^{st}\), \(2^{nd}\), and \(5^{th}\) metacarpophalangeal (MCP) sesamoid bones pattern was seen in patients. Trauma victims rarely have hand sesamoid bones, which are typically misdiagnosed when they appear elsewhere. This study provides orthopedic surgeons with anatomical data to help diagnose and treat patients.

Objectives: To assess engagement in heart-healthy lifestyle practices and adherence to antihypertensive medications with knowledge of hypertension, for more effective blood pressure control. Methodology: It was a cross-sectional study involving adults of more than 18 years diagnosed with hypertension as study participants. Total sample size was 381. Assessment of medication adherence, and responses were calculated using Malaysian Medicine Adherence Score 8 (MALMAS 8) scale. The scoring system utilized in the MALMAS questionnaire, aligned with the MMAS-8, aids in categorizing participants based on their medication adherence levels. Data were collected using a pre-tested, self-administered questionnaire. The data were analysed using the statistical software for social sciences (SPSS26). Results: The prevalence of hypertension among the selected study participants was found to be 71%. High level of adherence was found in 33% of the participants. The medication adherence of the patient was significantly associated with gender (p<0.05). 27% of the study participants belong to the age group of 25-40 years. Around 63% of the females were having high adherence and this association was found to be statistically significant, (p value < 0.05.). There was no statistically significant association between participants’ adherence to the age group they belong, marital status, educational level and their occupation. Conclusion: In conclusion, this cross-sectional study highlights the difficulty in adhering to treatment plans, with forgetfulness and trouble taking medications ranking as the biggest obstacles. Interestingly, adherence was higher in females than in males. Nevertheless, no statistically significant correlation was observed between medication adherence and other demographic variables, including age, income level, occupation, marital status, education, or occupation.

This literature review introduces the treatment results of Gamma Knife radiosurgery (GKRS) and volumetric arc therapy (VMAT) administered by linear accelerators for patients diagnosed with multiple brain metastases. The present study aimed to compare Gamma Knife radiosurgery with Volumetric Arc Modulated Therapy (VMAT) administered using a linear accelerator for brain metastases and their respective safety profiles and therapeutic results. The review assesses research on treatment precision, local control rates, survival outcomes, radiation necrosis incidence, and post-treatment quality of life. It evaluates technical progress, treatment plans, and physiological effects on brain tissue. Both modalities have the potential for managing brain metastases, with GKRS being beneficial for well-defined lesions and VMAT being a flexible and efficient option for larger or irregular-shaped metastases. The study highlights the unique benefits of each therapy for different types of brain metastases. GKRS and VMAT are effective treatments for brain metastases, using concentrated radiation for localised lesions and advanced imaging techniques for intricate or expanded regions. GKRS offers precise interventions with minimal invasiveness, suitable for patients with lower metastatic burdens or suboptimal surgical tolerance. Both therapies show similar effectiveness in local control and survival but may be better suited for specific patient needs and lesion characteristics.

Background: Worldwide, there are regional and demographic differences in the prevalence of pelvic floor complications (PFCs) during childbirth. Pelvic floor complications have been found to occur more frequently in some studies than others, despite some studies reporting a low incidence. This systematic review and meta-analysis sought to identify which types of PFCs were seen to occur most frequently in the studies chosen, as well as to provide an updated and thorough summary of the incidence and risk factors associated with various types of PFCs during childbirth. Methods: Search terms derived from free text words and medical topic headings (MeSH) were used to comb through a number of significant web databases. The first stage in the study selection strategy involved a search using keywords related to "pelvic floor," "childbirth," "complications," and "risk factors," which originally produced 759 papers. Results: 10 studies relevant to our objectives were ultimately selected for the investigation. In the majority of the studies, urinary incontinence (UIT) and anal incontinence (AIT) were found to be the most commonly occurring PFCs, with stress urinary incontinence (SUT), overactive bladder syndrome (OAB), pelvic organ prolapse (POP) being incidental in decreasing order. The meta-analysis also reported the effects of UIT to be of significant impact in the studies in which it occurred. Although one study did report the occurrence of certain depressive symptoms following childbirth, the inference obtained was not very significant. Conclusion: The findings highlight the need for further research on the prevention and management of pelvic floor complications during childbirth, particularly in relation to UIT and AIT. Clinicians should be aware of the high prevalence of these conditions and their associated risk factors (especially psychosocial and psychological health) to provide appropriate care for affected women.

Background: The iliotibial band (ITB) tightness contributes to pain and functional limitations in osteoarthritis (OA) patients. The effectiveness of foam rolling (FR) combined with ITB stretching exercises versus conventional treatment methods targeting ITB tightness has not been thoroughly investigated. This study aimed to evaluate the impact of foam rolling with hip strengthening on iliotibial band tightness among patients with knee osteoarthritis. Methods: Three groups of OA patients (Foam Rolling alone -Group A, Conventional Exercises + Foam Rolling-Group B, and Hip strengthening + Foam Rolling-Group C) were assessed over 14 treatment sessions using theWestern Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and Ober’s test for ITB tightness. Group A received foam rolling with hip strengthening, Group B underwent conventional treatment, and Group C was treated with a combination of methods. Results: All groups showed a marked decrease in WOMAC scores, indicating an improvement in pain and knee function. Group A exhibited a significant reduction in ITB tightness, with the mean Ober’s test score initially increasing but then decreasing markedly by the 14th session. Group B and Group C also showed improvements, but Group A’s protocol was the most effective in reducing ITB tightness. Conclusion: The study demonstrated that foam rolling with hip strengthening exercises is significantly effective in reducing ITB tightness and improving function in knee OA patients. This combination therapy may be considered a superior approach to conventional treatment methods for managing ITB-related symptoms in this population.

Background: The knee menisci are pivotal for knee biomechanics and stability, yet meniscal injuries remain prevalent, necessitating a detailed understanding of meniscal morphology for effective clinical management. This study investigates the morphometric variations of knee menisci and their implications for injury mechanisms and orthopedic interventions. Material & Methods: A cross-sectional study was conducted on 30 cadavers with intact knee joints. Morphometric parameters of the medial and lateral menisci were measured using digital calipers. Statistical analysis, including correlation analyses and significance testing, was performed using SPSS version 23 to explore associations between meniscal dimensions and knee morphology. Results: Significant variations in meniscal dimensions were observed, both within individuals and between the medial and lateral menisci. Correlation analyses revealed nuanced relationships between different morphometric parameters. Notably, weak correlations were found between meniscal dimensions and the lengths of adjacent bones, suggesting a complex interplay between meniscal morphology and knee anatomy. For instance, the correlation coefficient between the length of the femur and the outer circumference of the right medial meniscus was 0.215 (p = 0.291), indicating a moderate positive correlation, although not statistically significant. Similarly, the correlation coefficient between the length of the tibia and the inner circumference of the left lateral meniscus was -0.315 (p = 0.091), suggesting a moderate negative correlation, which also did not reach statistical significance. Conclusion: This study provides valuable insights into knee meniscal morphometry and its clinical implications. The findings emphasize the importance of considering meniscal dimensions in diagnosing and managing meniscal injuries. Despite limitations such as sample size and the use of cadaveric specimens, the results contribute to orthopedic knowledge and highlight the need for further research to validate and expand upon these findings.

One of the predominant health issues affecting Saudi Arabia and leading to many complications is Type 2 diabetes (T2D). Early detection and significant preventative measures lead to curbing and controlling the health issue. There are fewer datasets in the literature for the detection of T2D in the Saudi population. Past studies using Saudi data have favoured machine learning algorithms to classify T2D. Although the application of this data in machine learning is evident, no studies exist in the literature that compare this data, especially those related to deep learning algorithms. This study's objective is to use specific Saudi data to develop multiple deep learning models that could be used to detect T2D. The research uses a Deep Neural Network (DNN), an Autoencoder (AE), and a Convolutional Neural Network (CNN) to create predictive models and compare their performance with a traditional machine learning classifier used on the same dataset that outperformed other machine learning algorithms such as a Decision Forest (DF). Various metrics were used to evaluate the effectiveness of the models, such as accuracy, precision, recall, F1 score and area under the ROC curve (AUC) where the ROC acts as a receiver operating characteristic curve. There are two cases in this paper: (i) uses all features of the dataset and (ii) uses six of the ten features, such as DF. In case (i), the results were shown that AE outperformed other models with the highest accuracy for imbalanced and balanced data 81.12\% and 79.16\%, respectively. The results for case (ii) showed that AE scored the highest 81.01\% accuracy with imbalanced data compared to DF and DF achieved the highest accuracy of 82.1\% with balanced data. As a result, both cases explored in this study revealed that AE has a constant superior performance if imbalanced data is used. In contrast, DF demonstrated the highest accuracy when a balanced dataset was used with a feature set reduction. They help to identify the undiagnosed T2D, and they are essential for professionals in Saudi Arabia in the health sector to promote health connections, identify risks and contain or improve their diabetes management.

Objectives: To show the vital role of dynamic ultrasound in hip instability screening and review the management plans available for DDH associated with instability with a view to reduce the incidence of complication from delayed diagnosis in our region. Place and Duration of the study: Helena governmental rehabilitation center for children with special needs, Erbil-Iraq, between Nov’21 to Jan’23. Material and Method: This study included 942 infants’ hips presenting with high-risk indicators or a positive clinical examination ranging in age from 6 weeks to 6 months. We performed the ultrasonography using the static Graf technique to determine the DDH Types and then apply the dynamic scan to find stability using Moren-Terjesen’s and Harcke methods. The management approaches were conducted considering both techniques. We used SPSS version 28 along with Chi-square test for data analysis and comparison of proportions. Results: In this retrospective cross-sectional study of 942 hips, the mean age of the infants was 11.9±4.8 weeks with male to female percentage of 46% to 54%. We found a correlation between family history and breech presentation to the dynamic scan stability. In the Graf technique 55% showed the absence of dysplasia while the dynamic scan showed 66% of the hips as normal and 34% as unstable. Further, the significant statistical association (P= 0.001) between the results of dynamic scan stability to the effect on the management plan was also found to advise the change for the unstable hips. Conclusion: It is crucial to apply both static and dynamic scans in the screening of DDH, so that we can reduce the possibility of late detection and elevate the level of diagnostic accuracy. We should follow a strict guideline for the management of all DDH cases (stable and unstable) and change the plan accordingly.

Background: The correct positioning of brackets in the orthodontic field is a crucial step in orthodontic treatment. Various methods, including both direct and indirect approaches, are currently employed to achieve precise bracket placements. Each method has its own set of advantages and disadvantages in terms of accuracy and treatment duration. This study introduces a review of the previous researchers work in the field of different bracket placements techniques. Results: In comparison with direct bonding (16 mins and 47 secs), computer-aided indirect bonding required much less time in the clinical chair to bond half of a mouth (12 mins and 52 secs). Nevertheless, the overall bonding time (28 mins and 14 secs) for indirect bonding turned out to be longer than for direct bonding in a case when the time that is needed for digital bracket placement was taken into account. The direct bonding approach did not result in immediate debonding, while the indirect bonding approach resulted in the loss of 14 brackets (5.1%). Computer-aided indirect bonding has been shown to be more costly compared to the direct bonding after a cost-minimization analysis. Conclusions: Many papers are reviewed in bracket placement methods showing a strong need for a newly mechanism that has the feature of semi-automatic operations, that facilitates the time for treatment and in the same time reduce the cost and complexity of the treatment.

Background: Independent of conventional risk factors, patients with rheumatoid arthritis (RA) have a significantly increased risk of cardiovascular disease (CVD). Aims of the study: To evaluate the actual and perceived 10-year CVD risk among Iraqi patients with RA as well as their level of knowledge about CVD risk. Patients and methods: This cross-sectional study included 100 RA patients (85 females and 15 males) who visited Baghdad Teaching Hospital/Rheumatology Unit from January 2021 till July 2021. The Framingham Risk Score (FRS) was used to calculate the actual 10-year risk of CVD. The Heart Disease Fact-Rheumatoid Arthritis Questionnaire (HDFQ-RA) was used to assess the subjects’ cardiovascular disease knowledge. Results: Among a hundred Iraqi patients with RA, the median age was 51.23 ± 8.4 years. The findings of the study revealed that 23% had high risk for CVD and 27% & 50% had moderate and low risk respectively based on FRS calculator. The risk of CVD was significantly affected by the age of disease onset and seropositivity and steroid use (p value 0.001). When the perceived risk was compared to the actual risk of cardiovascular disease, there was a weak agreement between them, only 31% had corresponding answers. Conclusions: The study showed an elevated risk of CVD in rheumatoid arthritis patients, as well as a gap between actual and perceived CVD risk.

Background: Hemoglobin, being a hemoprotein, may operate as a peroxidase due to the hemolysis process and the release of heme into the bloodstream. Objective: Evaluation of the oxidative biomarkers and peroxidase activity of hemoglobin in patients with the final stage of renal failure. Materials and Methods: The study encompassed a total of 200 blood samples, with 140 samples collected from patients diagnosed with Chronic Kidney Disease (CKD) and 60 samples obtained from individuals who were considered healthy control subjects. Results: Levels of various serum parameters, including total protein, urea, creatinine, albumin, free amino, disulfide, ischemia-modified albumin (IMA), peroxidase activity, and specific activity, exhibited a significant increase in patients with Chronic Kidney Disease (CKD) when compared to the control group consisting of healthy individuals. Conversely, CKD patients demonstrated a notable decrease in levels of glomerular filtration rate (GFR), hemoglobin, native thiols, and total thiols compared to the control group. Conclusion: Oxidative biomarkers may present useful information about oxidative stress and help to diagnose CKD patients in their advanced stages of the disease.

Breast cancer still poses a serious threat to world health, needing creative approaches to early identification in order to improve patient outcomes. This study investigates the potential of deep learning methods to improve the precision and effectiveness of mammography interpretation for the identification of breast cancer. In this paper proposed, a convolutional neural network (CNN) architecture, ResNet50, is created and trained on a sizable data set of annotated mammograms. The CNN is made to automatically identify and extract pertinent elements, such as microcalcifications, masses, and architectural distortions,that may be symptomatic of possible cancers. The model develops the ability to distinguish between benign and malignant instances through an iterative process of training and validation, finally displaying a high level of discriminatory accuracy. The paper findings show that the deep learning model outperforms conventional mammography interpretations in terms of sensitivity and specificity for detecting breast cancer. Furthermore, the model's potential for use in actual clinical settings is highlighted by its generalizability across a range of patient demographics and imaging technologies.This study represents a big step in improving radiologists' capacity for breast cancer early detection. Our deep learning-based architecture has promise for improving the screening procedure and potentially decreasing the difficulties brought on by radiologist shortages by lowering false positives, improving accuracy, and offering quick analysis. By utilising cutting-edge technology to enable prompt and efficient detection, this study contributes to continuing efforts by the international healthcare community to improve breast cancer outcomes.

A beta-lactam antibiotic, such as cephalexin, is frequently prescribed to treat bacterial infections. In a particular investigation, cephalexin's effectiveness was assessed when it was administered ex vivo, or outside of a living organism, to the HepG2 human liver cancer cell line subsequent to its loading onto Nano chitosan. The purpose of the study was to determine how useful cephalexin would be in this situation. Positive study results showed that the drug worked well in this particular application. The ability of cephalexin to activate p53, a protein that is essential for starting the process of programmed cell death in liver cancer cells, was discovered. This shows that cephalexin, especially in combination with Nano chitosan, may be useful in the treatment of liver cancer.

Overall, the study showed that cephalexin has the ability to target liver cancer cells and activate pathways that may result in their demise. Nevertheless, more investigation and clinical testing would be required to properly evaluate the safety and effectiveness of using cephalexin in this situation.

Purpose: To identify the characteristics of age groups of children from 10 to 14 years old in terms of the ratio of body weight and length, in particular, the relative number of children with overweight and obesity, and to develop recommendations for reducing body weight for children 10-14 years old. Material and Methods: An observational cross-sectional survey of the health status (overweight and obesity) of school children was conducted on sample 500 school children from Bosnia and Herzegovina (Republic Srpska entity), which included 246 boys and 254 girls, aged 10 to 14 years. Anthropometric data including Body height (BH), Body weight (BW) and age were collected from all elementary school children. Body mass index (BMI) is an anthropometric index of weight and height that is calculated by dividing a person's weight (kg) by the square of their height (m^2). BMI participants was estimated with the Percentile BMI calculator for children and teens aged 2-19 years. The studied children were defined as underweight, normal (healthy)-weight, overweight and obese according to the Center for Disease Control and Prevention (CDC) child growth characteristics for age, sex, and BMI. Basic central and dispersion parameters (Mean, Min., Max., Range, SD, CI 95%, CV%, Skew., Kurt.) were calculated for each variable. To confirm normality, the Kolmogorov-Smirnov test was applied (p>0.05). The homogeneity of variance was tested with Levene's test. The nutritional status of the subjects was assessed using percentile values on the basis of which the percentile categories are calculated. Statistical procedures and analyzes were performed using the statistical package STATISTICA 10.0 for Windows. Results: The dynamics of changes in the relative number of children with overweight and obesity from 10 to 14 years old was revealed. The lowest number of overweight and obese students was recorded at the age of 14 (1% <). The results of malnutrition in boys point to the conclusion that it is present in a smaller percentage, from 1.96% (age 14) to 6.12% (age 12). The largest number of girls at the age of 13 were overweight, 10 (19.23%) and obese (2%<), and then at the age of 10 and 11 (overweight 15.68% vs. 13.72%, and obesity 1.96% vs 3.92%). Malnutrition as a category is in a slightly higher percentage than for boys, ranging from 3.92% (11 and 12 years) to 7.84% (10 years). Conclusions: If a child is overweight at any age, this should be an alarming signal, as it can provoke weight gain in adulthood or with the slightest decrease in self-control. Therefore, the best strategy would be to create conditions for a child's development in which he will receive joy from other sources, and not just from food and activities that do not require physical activity. Finding even a relatively small number of overweight and obese children is not a benign problem. It requires its own solution, helping such children understand their problem and overcome it.

Background: Squamous cell carcinoma (SCC) is the second most common amongst skin cancers, following the basal cell carcinoma. SCC of the lip carries relatively better prognosis if detected early and treated adequately. Public awareness about the significance of early presentation would help to improve the outcome of management. Objective: The current study was conducted to determine the clinical presentation of lip SCC and management outcome with surgery as the primary treatment modality. Methods: This descriptive study was carried out at the National Institute of Rehabilitation Medicine, Islamabad over a period of seven years. All patients who presented with lip SCCs during the study period were prospectively included in the study. Non-consenting patients were excluded. The lesions were excised with 1-2-cm palpable macroscopic safety margins. Results: Out of 37 patients, there were 28 (75.67%) males and 9 (24.32%) females. The ages ranged between 47-79 years with a mean of 59.91±9.17 years. Lower lip was the most commonly affected site (n=30; 81.08%). The duration of the lesions at first presentation varied from 6-13 months with a mean of 7.32±1.79 months. Majority (n=31; 83.78%), of the patients had early stage (stage I and II disease) whereas 6(16.21%) patients had stage III disease. The margin clearance rate after initial excision of the lesions was 91.89%. Karapandzic flap was employed as reconstructive tool among 15(40.54%) patients. The 5-year overall survival rate was 62.16%. Conclusion: Lip SCCs were found more frequently among males aged over 50 years. Lower lip was the commonest seat of lip SCCs. Surgical excision with recommended safety margins was associated with tumor free margins in 91.89% cases. Karapandzic flap was the most useful reconstructive tool. The 5-year overall survival rate was 62.16%.