Background: Electroconvulsive therapy (ECT) is a well-established yet controversial psychiatric treatment, often hindered by stigma, misconceptions and limited knowledge among healthcare providers and medical students. Despite its efficacy in treating severe psychiatric disorders such as major depression, bipolar disorder and schizophrenia, its utilization is influenced by varying levels of awareness and attitudes. This study aimed to assess the knowledge of and attitudes towards ECT among healthcare providers and medical students in Ha’il, Saudi Arabia, while emphasizing educational implications and the need for targeted interventions. Materials & Methods: A cross-sectional survey was conducted between December 2022 and August 2023 using a structured, validated questionnaire. The questionnaire assessed demographic data, ECT-related knowledge and attitudes and was designed in both Arabic and English to ensure accessibility. Data were analyzed using chi-square tests and t-tests to explore associations and differences. Key variables such as age, education, specialty and clinical exposure were considered to control for potential confounders. Efforts to minimize response bias included clear participant instructions, anonymous responses and appropriate sampling strategies. Results: A total of 266 participants (healthcare providers and medical students) were included. Healthcare providers demonstrated significantly higher levels of ECT knowledge than medical students (p<0.05). Younger participants aged 19-25 exhibited better ECT knowledge than older groups (p<0.05). Healthcare providers specializing in psychiatry exhibited significantly more positive attitudes towards ECT compared with those in other specialties (p<0.05). While factors such as gender and nationality showed no significant impact on knowledge levels, healthcare providers were notably more willing to consent to ECT treatment than medical students. Conclusion: This study identifies significant gaps in knowledge and attitudes towards ECT, particularly among medical students and non-psychiatry healthcare providers. The findings underscore the urgent need for targeted educational interventions, including curriculum enhancements, clinical exposure, simulation training and interactive workshops, to improve understanding and promote positive attitudes towards ECT. By addressing these gaps, healthcare practitioners can improve informed decision-making and optimize patient outcomes. Future research should explore the role of cultural beliefs, media portrayals and broader public perceptions in influencing ECT acceptance in Saudi Arabia.

Background: Type 2 diabetes (T2D) is a multifactorial metabolic disorder characterized by insulin resistance and β-cell dysfunction. Both genetic predisposition and environmental factors contribute to its development, with β-cell dysfunction being a central feature. Recent advancements in genomic research have emphasized the role of genetic variants in influencing β-cell function, insulin resistance and obesity. Objective: This study aimed to investigate the genetic factors contributing to β-cell dysfunction, obesity and their association with T2D. The research particularly focused on genetic variants in key genes involved in insulin secretion, β-cell function and obesity. Additionally, the study explored potential gene-environment interactions and their impact on T2D risk. Methods: A cross-sectional observational study was conducted with 255 participants categorized into three groups: T2D (n = 85), Obese (n = 85) and Healthy Controls (n = 85). Participants underwent comprehensive clinical assessments, including BMI, blood pressure and biochemical evaluations for glucose metabolism and insulin resistance. Genetic analysis targeted single nucleotide polymorphisms (SNPs) in genes such as TCF7L2, FTO, PPARG, NeuroD1, INSR, MAFA and PDX1. Statistical analyses, including effect size calculations and adjustments for potential confounders, were performed to assess associations between genetic variants, β-cell function and obesity. Results: The study identified a significantly higher frequency of the TCF7L2 risk allele in the T2D group compared to the Obese and Healthy Control groups (p = 0.004), suggesting its strong association with β-cell dysfunction. The FTO risk allele was notably higher in the Obese group (p = 0.01), indicating its role in obesity-related insulin resistance. A robust negative correlation was observed between insulin resistance (HOMA-IR) and β-cell function (HOMA-β) across all groups, with the strongest correlation seen in the T2D group (r = -0.68). Notably, the presence of the FTO risk allele further exacerbated insulin resistance in the Obese group (p = 0.04), underscoring the impact of gene-environment interactions. Conclusion: This study highlights the significant roles of TCF7L2 and FTO genetic variants in β-cell dysfunction and obesity, reinforcing their influence on T2D susceptibility. The findings emphasize the importance of early genetic screening to identify high-risk individuals, enabling targeted lifestyle interventions and improved T2D prevention strategies. Future research should focus on longitudinal studies and diverse populations to validate these findings and enhance personalized treatment approaches.

Objectives: Asthma is a serious illness that affects people of all ages worldwide. With the right diagnosis, treatment and medication, asthma symptoms can be managed. To lessen the burden of asthma, it is imperative for the population in Northern Border region, Saudi Arabia to be aware of aggravated asthma and its risk factors. Methods: A cross-sectional design was employed in this study, involving 462 participants selected through convenience to recruit the respondents. The questionnaire was validated before distribution to ensure reliability. SPSS version 27 was used to analyze the gathered data and both descriptive and inferential statistics were used to examine the results. Results: The prevalence of asthma was 7.4%, with 50% of respondents living with asthma for less than five years and 35.3% for more than ten years. A familial history of asthma was reported by 21% of participants and 15.6% had chronic conditions such as high blood pressure (26.4%) and diabetes (23.6%). While 79.0% recognized asthma as a chronic disease, gaps in awareness were observed, including the impact of frequent antibiotic use (52.2%) and recognizing severe symptoms in children (57.8%). The primary source of information was the internet (51.7%), with limited reliance on healthcare professionals (9.7%). Significant associations were found between knowledge levels and age, gender, marital status and employment, with younger participants (18-25 years), females and government employees demonstrating higher awareness (p<0.05). Conclusion: Overall, awareness of asthma and its risk factors was high, however, gaps remain in recognizing severe symptoms in children and the impact of antibiotic use. Chronic conditions and familial asthma history complicate management and reliance on the internet highlights the need for better healthcare provider engagement. Sociodemographic factors, including age, gender and employment, significantly influenced knowledge levels. Targeted training and health education are essential to reduce triggers and improve awareness.

Background and Aim: Economic crises have profound impacts on public health, particularly mental health, due to their association with unemployment, poverty and inequality. Therefore, this study aimed to assess the impact of the financial crisis on mental health, specifically depression, anxiety and stress, among the population in the Kurdistan Region of Iraq. Method: This online cross-sectional study was conducted from April 1st to October 15th, 2024, in the Kurdistan Region of Iraq, including Sulaimani, Erbil and Duhok, using convenience sampling. The questionnaire contained two sections: demographic data and the DASS-21 questionnaire to assess depression, anxiety and stress. Data were analyzed using SPSS version 26 (IBM SPSS Statistics, Armonk, NY). Chi-square tests, Spearman correlation and ordinal regression were employed to examine the relationship between the financial crisis and mental health conditions. Statistical significance was set at p<0.05. Results: A total of 1,024 responses were analyzed. The mean score for anxiety was 19.28±9.18, indicating severe anxiety levels. Similarly, the mean score for depression was 27.77±11.63, reflecting severe depression levels. Stress also exhibited severe levels, with a mean score of 26.80±11.58. Statistical analysis revealed a significant association between the financial crisis and all three mental health conditions (p = 0.001 for anxiety, stress and depression), with individuals experiencing financial insufficiency reporting higher levels of psychological distress. Conclusions: The results showed a significant relationship between the financial crisis and mental health conditions, including anxiety, stress and depression. Therefore, policymakers and healthcare providers should implement targeted interventions and develop support systems to mitigate the adverse mental health effects of economic crises.

Background: COVID-19 pandemic was caused by severe acute respiratory syndrome coronavirus 2 identified in China, in 2019 and reported at least two waves. Objective: To compare pattern, severity and the outcome of the first and second waves of COVID-19. Methods: This is a cross-sectional retrospective comparative hospital-based study conducted during the period of first and second pandemic waves. The study involved patients aging above 18 years who had COVID-19. We collected the completed data from 385 patients’ records out of 1041by using a standardized data collection tool. Results: Male were common with a ration of (3:1 versus 3:2) between first and second waves consecutively. More than half of them were within the middle age. Comorbidity was a risk in more than one-third of patients; in which diabetes was the most common comorbidity which was significantly associated with the outcome (p-value = 0.038). Moreover, fever was the most common symptom occurred in (79% versus 79.3%), cough was (70% versus 60%). Results showed the systemic involvement had higher incidence among the second wave, while the pulmonary presentation was higher among the first were (82.3% versus 54%). ICU admission incidence was 54.8% and oxygen required was (50% versus 73.9%). Reinfection were (4% versus 13%). The outcome among first wave showed a higher incidence of recovery (55.6% versus 39.1%), while the death incidence was lower in the first wave (25.8% vs. 40.6%). Conclusion: There was a significant variation between first and second epidemic waves, the higher mortality rate of the second wave with dominant severe pulmonary and extra pulmonary manifestation and rapid progression made the second labeled as severe.

Background: Thyroxine is crucial for fetal development, especially brain growth. During pregnancy, physiological changes affect thyroid function, causing increased TT4 levels and variable FT4 levels, influenced by TBG, hCG and iodine availability. Detecting effect of pregnancy on levels of TT4 and FT4 in pregnant women in Diyala province. Methods: The research was conducted at Al-Batool Teaching Hospital in Diyala province from November 2024 to January 2025, involving 60 blood samples from pregnant patients and 30 healthy individuals as a control. Serum levels of FT4 and TT4 indicators were quantified using a Biorex machine. Results: The study found that pregnant women have higher levels of TT4 indicator compared to non-pregnant women, with a significant difference (p<0.05). However, no significant difference was found between FT4 and study groups. The ROC curve showed TT4 having the highest sensitivity and specificity (94 and 90%) for diagnosing thyroid disorders in pregnant women, while FT4 had the lowest sensitivity and specificity (55 and 54%). A significant positive correlation was found between FT4 and TT4 indicators in pregnant women. Conclusion: Pregnancy significantly impacts thyroid gland function, leading to significant changes in TT4 levels but not FT4 due to physiological and hormonal disorders. The TT4 is preferred for thyroid disorder screening.

Background: Nasal congestion, characterized by blocked airflow in the nasal cavity, is a common clinical symptom often caused by structural abnormalities, infections, or allergic rhinitis. Nasal decongestants are frequently used for symptomatic relief; however, excessive use can lead to complications such as rhinitis medicamentosa and other adverse effects. Despite their widespread use, public awareness of appropriate usage practices remains limited. Objective: This study aims to assess the prevalence, usage patterns and associated side effects of nasal decongestants among adults in the Northern Border Governorate, Saudi Arabia, while highlighting knowledge gaps in safe usage practices. Methods: A cross-sectional study was conducted among 436 adults aged >18 years using a structured, validated questionnaire. Data on demographics, duration of use and reported side effects were collected and analyzed using SPSS (version 22). Chi-square and t-tests were employed to assess associations between nasal decongestant use and demographic variables such as age, gender, marital status and education. Results: Of the 436 participants, 64% reported using nasal decongestants. Usage was significantly higher among individuals aged 31-45 years (p = 0.001), married individuals (p = 0.001) and those with higher education levels (p = 0.001). Common usage reasons included the common cold (39%) and nasal obstruction (16%). Pharmacists were the primary source of guidance (43.4%), while physician recommendations accounted for only 19.4%. Alarmingly, 59.1% reported prolonged use (3-5 days) and 9.3% exceeded the recommended 5-day limit. Side effects were prevalent, with dryness (55.9%), anxiety (54.1%) and headache (51.6%) being the most frequently reported. Conclusion: The study reveals a high prevalence of nasal decongestant misuse, with extended use and reliance on non-professional advice contributing to significant side effects. These findings highlight the urgent need for targeted public awareness campaigns emphasizing the risks of prolonged decongestant use and promoting safe practices. Improved pharmacist training and stricter regulatory control of over-the-counter decongestants are essential. Future research should explore long-term health impacts, investigate self-medication behaviors and assess the efficacy of educational interventions in reducing misuse.

Objective: A retrospective cross sectional study was conducted to evaluate the diagnostic performance of Cepheid GeneXpert MTB/RIF assay (Xpert assay) for the Extra-pulmonary tuberculosis (EPTB). This study retrieved and analyzed the record of Provincial TB Reference Laboratory (PTRL), Hayatabad Medical Complex, Peshawar, Pakistan from January 2019 to December 2022. Materials and Methods: Different EPTB specimens received to the PTRL for routine diagnosis from EPTB suspected patients were recruited consecutively and anonymously. All the specimens were digested and decontaminated by NALC-NaOH method except CSF. Afterward, all the specimens were cultured on solid and liquid medium and tested by Xpert assay. The overall and for each individual sample, diagnostic performance of Xpert assay was measured by sensitivity, specificity and predictive values using culture as a gold standard. Results: A total of 2174 EPTB samples were recruited after meeting the inclusion criteria and the pooled sensitivity, specificity, positive predictive value and negative predictive value of Xpert assay was 67%, 94%, 52% and 96% respectively. Moreover, Xpert assay showed variable sensitivities for different EPTB specimens including Pus, Tissue biopsy, Urine, CSF, Pleural fluid, Pericardial fluid and Ascitic fluid i.e., 91, 83, 80, 67, 46, 44 and 36%, respectively. The specificity ranged from 85% in CSF to 99% in Urine. Conclusion: Xpert assay can early detect EPTB cases for prompt treatment but there is low certainty of negative result to rule out EPTB.

Telemedicine has become a transformative solution in healthcare, offering opportunities for patients and healthcare providers to connect across distances. However, its rapid adoption has introduced significant legal challenges, particularly regarding medical negligence, data privacy and regulatory compliance. This study aimed to examine these legal complexities in India’s evolving healthcare landscape. An empirical research methodology was employed, with a sample of 400 respondents from Chennai, using structured questionnaires to capture both quantitative and qualitative data on telemedicine’s effectiveness, public perceptions and legal challenges. Data were analyzed through visual tools like pie charts and bar charts to identify trends and patterns. The study revealed that the majority of respondents supported increased awareness of telemedicine, with 61% agreeing that it could improve healthcare accessibility. Telemedicine’s effectiveness was rated moderately high, with 29% giving it a 7 out of 10. However, concerns about medical negligence were prominent, especially regarding the lack of physical examination, which was cited as a major factor contributing to errors. Participants also widely supported more awareness of the Telemedicine Practice Guidelines (2020), with 51% highly agreeing. Increased access to healthcare was identified as the key benefit of telemedicine, particularly for patients in remote areas. These findings suggest that while telemedicine offers significant benefits, concerns about negligence, technical issues and the need for regulatory awareness among healthcare providers are pressing. To ensure safe and effective telemedicine practices, it is essential to address these challenges through clearer legal frameworks and technological improvements. Overall, the study emphasizes the importance of ongoing collaboration between legal experts, healthcare providers and policymakers to refine telemedicine practices, mitigate legal risks and maximize its potential in enhancing healthcare accessibility in India.

Background: Vitamin A plays a vital role in human vision and overall health. This study aimed to assess the awareness of the Saudi population regarding the importance of Vitamin A, its dietary sources, the risks of deficiency and the potential adverse effects of excessive supplementation. Objective: The study’s objectives were to evaluate public awareness about Vitamin A supplements, identify misconceptions about Vitamin A overdose and assess awareness of Vitamin A’s role in maintaining vision and preventing deficiency-related diseases. Methods: This cross-sectional study was conducted among adult residents across various regions in Saudi Arabia using an online questionnaire distributed via social media platforms. The questionnaire underwent pilot testing to ensure clarity and validity. The sample size was determined based on appropriate statistical methods to ensure representativeness. Participants’ socio-demographic data, knowledge of Vitamin A sources, health benefits and risks of deficiency and overdose were assessed. Results: A total of 675 participants completed the survey. Participants’ ages ranged from 18 to 99 years (mean age 24.9±9.8 years). Female participants represented 51.3% of the sample. Regarding educational background, 36.4% had a secondary education, while 61% held a university degree or higher. Among participants, 25.5% demonstrated good awareness of Vitamin A, while 74.5% had poor awareness. Misconceptions about Vitamin A overdose and its safety during pregnancy were prevalent. Conclusion: The findings reveal a substantial gap in public awareness of Vitamin A, highlighting the need for targeted educational campaigns. Public health initiatives should focus on promoting awareness about Vitamin A sources, its recommended dosage and the potential risks of deficiency and overdose. Integrating these efforts into healthcare programs can help improve overall awareness and reduce misconceptions.

Objectives: Despite severe side effects, anabolic steroids are widely used to enhance appearance and performance, raising global health concerns as unsupervised use persists. We aimed to assess Anabolic-androgenic Steroid (AAS) prevalence and risk factors in Saudi Arabia. Methods: Systematic Medline/PubMed and Google Scholar searches were performed to identify articles of interest related to AAS use in Saudi Arabia from the database's inception until August 2024. Following the PRISMA checklist, the following were included in the search: “Anabolic Steroids and Misuse” and “Anabolic Steroids and Saudi Arabia”. Inclusion and exclusion criteria were used to screen literature and extract data. The Ottawa scale was used for quality evaluation and assessment of nonrandomized studies. We identified 15 articles that reported AAS misuse variables between 2016 and 2024. All studies had a cross-sectional design. We synthesized our results by identifying similarities, highlighting differences between studies and making recommendations based on our findings. Results: Our systematic review revealed that 5303 individuals in Saudi Arabia were reported to have misused AAS based on 15 review articles that have been evaluated in this systematic review. The AAS was predominantly sourced from the internet, friends and gym trainers and the Central Province in Saudi Arabia exhibited the highest instances of AAS misuse. Gym members had a higher prevalence of AAS use. The mean age across the studies ranged from 18 to 49 years. The majority of AAS misusers were males. Most users were either single or not in committed relationships. The prevalence of AAS misuse in Saudi Arabia ranged from 4.7%-32%. The preferred route of AAS administration was oral intake. The most commonly misused AAS types reported in our review were testosterone and deca-durabolin, frequently noted in several studies. Metandienone and oxandrolone have been popular oral AAS choices in multiple studies. The most frequent reports of adverse effects among AAS misusers were liver and kidney damage and psychiatric problems such as depression, breast hypertrophy and hypertension. Sexual dysfunction was reported in 10.6% and 13% of the patients, respectively. Infertility was reported to be 24.5% among users. Conclusion: Our review shows high AAS misuse among Saudi gym members, highlighting the need for public health education and preventive measures, especially for teens.

Background: X-ray imaging is commonly used as a diagnostic tool in veterinary practice. Chronic exposure to X-rays is an occupational health risk to veterinarians and veterinary assistants. Studies focusing on the Caribbean region are warranted to assess risk and increase safety awareness among veterinary personnel. Methods: This study aimed to assess the hematological profile of veterinary personnel exposed to X-rays and compare this profile to an unexposed group in Trinidad and Tobago. Demographic data for the exposed group was collected on the length of exposure to X-rays of persons in veterinary practice. The exposure levels were measured over a month using a personal X-radiation dosimeter. The unexposed group was selected randomly within similar age categories to the exposed group. Data was not collected from Tobago since preliminary research showed that clinics had no X-ray technology available during the study period. Results: Seventy-five percent of veterinary practices included in the study conducted 1-5 x-ray examinations per week using manual animal restraint. Manual restraint was found to be a common practice among clinics with personnel using protective aprons (16; 94.1%), leaded gloves (13; 76.5%), thyroid collars (14; 82.4%) and lead-lined glasses (2; 11.8%). X-ray exposure was within acceptable limits (maximum at 72 mrem/year), with increased exposure for veterinary assistants with higher workloads (8-10 hours/day). No significant differences existed between the Complete Blood Count (CBC) parameters of exposed and unexposed groups; p>0.05. No morphological abnormalities were detected on examination of blood smears of veterinary personnel. Conclusions: This nine-month study found that X-ray exposure to veterinary personnel in Trinidad was at internationally acceptable levels. There were no significant findings on the hematological analysis of exposed participants related to x-ray exposure. Manual restraint of animals was found to be a common practice, with most clinics using protective devices when operating X-ray equipment. However, complete personnel protection was not achieved in most clinics due to a lack of knowledge on tissue vulnerability. Studies like this are sparse to none for the region of the Caribbean. This is the first report on occupational exposure to X-rays in veterinarians and veterinary assistants in Trinidad and Tobago and provides important baseline data that can be used for future comprehensive studies and assessment of potential occupational health risks in the region.

Surgical Site Infections (SSIs) are a serious public health concern. The SSI is a common postoperative complication that can occur anywhere in the body, including the site of the incision, the surgically operated organs or tissues, or other locations where surgical instruments were placed. Along with other pathogens obtained in the community or hospital, opportunistic endogenous bacteria can cause Surgical Site Infections (SSIs) by contaminating surgical wounds or implanted medical devices. A substantial cost on patients, healthcare providers and the healthcare system overall is linked to SSIs, which impacts 0.5% to 3% of surgical patients. When compared to patients without SSIs, SSIs may result in longer hospital stays. The rates of SSI remain surprisingly high, even though many laws and standards have been put in place to avoid these infections ; this puts the healthcare system at risk for morbidity and mortality. This review presents brief information about the incidence, microbiology, preventive strategies and management of these infections.

Music therapy, as a form of alternative medicine, utilizes the inherent mood-enhancing properties of music to promote mental health and overall well-being. This therapeutic approach involves goal-oriented activities such as music creation, songwriting, singing, dancing and listening to music. The primary objective of this study is to evaluate the effectiveness of music therapy in improving psychological health. An empirical research design was employed, with data gathered from a sample of 416 participants through a structured questionnaire. Cluster sampling was used to select participants from the general public, with a particular focus on the Chennai region. The study examined variables such as gender, age, educational background, occupation and marital status. Key aspects analyzed included participants’ awareness of music therapy, personal experiences with it and the reasons individuals would recommend it as a therapeutic intervention. Data analysis involved the use of graphs as means for visually representing the results and was generated using SPSS. The findings reveal that while there is moderate awareness of music therapy, several gaps exist in public knowledge, particularly regarding its psychological benefits and applications. The findings reveal a moderate level of awareness about music therapy, but significant gaps remain, particularly regarding its psychological benefits. To address this issue, the study suggests implementing more comprehensive awareness campaigns and educational initiatives to bridge the knowledge gap and encourage wider adoption of music therapy as an effective psychological intervention.

Background: The adoption of Artificial Intelligence (AI) in healthcare continues to grow, promising more accurate diagnoses, greater efficiency and fewer human errors. Despite this trend, a critical gap remains in understanding how healthcare students-who represent the future workforce-perceive and accept these emerging technologies, including issues related to ethics, data security and the potential impact on patient care, particularly within the context of Saudi Arabia’s rapidly evolving healthcare sector. Objective: This study explores how health sciences students at the University of Hail view the integration of AI in clinical contexts, focusing on their willingness to adopt such tools-referred to as their “acceptance level”-and on how ethical and privacy concerns shape their attitudes. Methods: A qualitative case study design was adopted. Semi-structured individual interviews were conducted via Zoom from June to August 2024 with 18 participants, recruited from diverse health sciences programs (medicine, nursing, pharmacy, dentistry, public health and health informatics). The interview guide addressed students’ understanding of AI, perceived benefits and challenges, ethical considerations and the potential effects on their future professional roles. Data were analyzed using Braun and Clarke’s six-phase thematic analysis framework. Trustworthiness was ensured via member checking, an audit trail and reflexive journaling. Results: Participants generally recognized AI’s capacity to enhance efficiency and precision in healthcare tasks. Most conveyed optimism about the technology’s benefits, emphasizing improvements in workload management and diagnostic accuracy. Nevertheless, concerns about data privacy and over-reliance on algorithms emerged as major reservations, particularly given students’ limited clinical experience. Ethical considerations ranged from protecting patient confidentiality to ensuring that AI complements, rather than displaces, clinicians. Several interviewees also expressed a desire for AI-focused training in their academic curriculum. Conclusion: Health sciences students at the University of Hail anticipate AI’s transformative potential in healthcare but remain cautious about privacy breaches and diminished human oversight. These findings highlight the necessity for targeted education that addresses technical, ethical and practical challenges. By adopting a measured approach to AI implementation, future healthcare professionals may be equipped to leverage technology while maintaining high standards of patient care.