Background: Medical students often face high academic stress, irregular schedules and lifestyle disruptions that predispose them to unhealthy behaviors. These include poor dietary patterns, inadequate physical activity, sleep deprivation and increased screen time, which can contribute to long-term non-communicable diseases (NCDs). Despite their importance as the future healthcare workforce, limited evidence exists on the comprehensive health and lifestyle profile of medical students in Himachal Pradesh, India. Methods: A descriptive cross-sectional online survey was conducted in 2024 among MBBS students from all six government medical colleges in Himachal Pradesh. Data were collected through a structured, pre-tested Google Form disseminated via social media platforms. The questionnaire assessed sociodemographic profile, dietary habits, physical activity, lifestyle behaviors, health status, family history, mental health, academic and social patterns and clustering of risk factors. Descriptive statistics were applied and results were expressed as frequencies and percentages. Results: Of the 999 students, 44.1% were aged 19-20 years and 56.7% were female. Normal BMI was observed in 73.4%, while 11.2% were overweight and 1.1% obese. Non-vegetarian or mixed diet was reported by 57.7%, with frequent junk food intake in 33.1%. Regular exercise was practiced by 61.3%, though 29.6% exercised rarely or never. Smoking and alcohol use at admission were 6.7% and 7.8%, respectively but increased to 11.3 and 19.7% currently. Sleep deprivation (<6 hours) was noted in 18.2%, while 53.8% reported screen/mobile use exceeding 5 hours daily. Self-reported stress was prevalent (33.3% moderate, 14.9% severe) and 34.4% reported fair or poor sleep quality. Academic burnout was identified in 34.4% of students. Importantly, clustering of multiple lifestyle risks was observed, with 19.4% reporting three and 11.3% reporting four or more risk factors. Conclusion: This study highlights concerning levels of unhealthy dietary habits, sedentary lifestyle, substance use, high stress and risk factor clustering among medical students in Himachal Pradesh. The findings underscore the urgent need for structured wellness programs, mental health support and lifestyle interventions within medical institutions to promote long-term health and professional sustainability of future doctors.

The article provides a comparative legal analysis of the European system for regulating the circulation of biocidal products and medical devices. It argues that legal safeguards for the safety of this category of products are an important tool for protecting human health, animals and the environment. Particular attention is paid to the analysis of the regulatory framework of Regulations (EU) No. 528/2012 and No. 2017/745, as well as the practices of their national implementation in EU member states, in particular in the Netherlands, Latvia, Lithuania, Germany, Poland, Finland and Austria. The aim of the study is to identify effective mechanisms for the legal regulation of biocidal products and medical devices in EU countries and to formulate recommendations for Ukraine, taking into account European standards. Control models, authorisation procedures, labelling requirements and mechanisms of liability for violations of legislation were studied. The methodological basis of the study is systemic-analytical, comparative-legal and formal-legal methods, which made it possible to assess the degree of compliance of national regulation with EU acquis standards. Effective practices of regulatory policy based on transparency, electronic accounting and the division of powers between competent authorities were identified. The state of legal regulation in the field of circulation of biocidal products and medical devices in Ukraine, which is characterised by fragmentation and inconsistency with European standards, has been analysed. The necessity of adopting basic legislation on biocides, updating technical regulations on medical devices, creating a single electronic register and introducing effective market surveillance is substantiated. The article contains specific proposals for adapting Ukrainian legislation to the EU acquis and promoting the formation of an effective consumer protection system in the field of healthcare.

Background: Adverse events in dental practice are a threat to patient’s safety and hold practitioners accountable. Objective: This systematic review pinpoints and examines the factors causing adverse events in the dental setting. Methods: The Researcher ran a systematic search through Web of Science and Scopus databases, by focusing on studies from January 2010 up to January 2023. 20 studies were included and were evaluated with the Newcastle-Ottawa Scale. Results: Typical adverse events covered endodontic errors, along with pain, nausea and problems during procedures. The major factors playing a role included; the dentist’s level of experience, complexity of the procedures, patient’s reactions to medications and conditions unique to each patient. Notably, 70% of perforations are correlated to mistakes made by dental trainees. Conclusion: The majority of these dental adverse events could be avoided and are preventable with better training, setting protocols and improved communication. These results point toward creating focused interventions to boost patient safety overall. Clinical Relevance: This review points out practical steps for decreasing adverse events in the dental practice, by stressing on the importance of strict infection control, ongoing education for practitioners and updating policies.

Objectives: This study explored how expressive art therapy can significantly enhance the quality of life of destitute women with depression. Expressive art therapy offers a unique approach that combines various art forms to help individuals to creatively express their emotions, thoughts, and experiences. Methods: A quasi-experimental research design was implemented to evaluate the effectiveness of expressive art therapy in improving quality of life and decreasing depression levels in destitute individuals with depression. Twenty destitute women were included in the study and, after obtaining informed consent, were equally assigned to control and experimental groups (10 in each) The “control group” was given routine care, while the experimental group was given expressive art therapy consisting of visual art, music, and dance, for 12-week period. The tools used were Zung Depression Rating Scale to assess the depression and The WHOQOL-BREF is a short version of the WHOQOL-100, which is a 26-item questionnaire was used to assess the quality of life of destitute women to assess the quality of life of the destitute women. Fisher’s exact test and two-way RM ANOVA were used for the statistical analysis. Results: The post assessment revealed that the “control group” showed a 14.2 % increase in depression, while the “experimental group” showed a 5.8 % decrease. The “control group” showed 16.3 % increase in quality of life, while the “experimental group” showed a 25.5 % increase, indicating the advantage of the intervention. Conclusion: This study revealed the potential benefit of expressive art therapy in decreasing depression and improving quality of life among destitute women.

Objective: Rapid advances in digital technology are reshaping education, with robotic teaching emerging as a promising tool for personalized learning and academic support. This study explores university students’ perceptions of robotic teaching and examines its potential integration into higher education. Methods: A cross-sectional descriptive survey was conducted at Northern Border University, Saudi Arabia, between January and September 2024. Using convenience sampling, 423 students aged 18 years and above participated. Data were collected through an online questionnaire distributed via social media platforms. Statistical analysis was carried out using STATA/SE and MS Excel, with significance set at p < 0.05. Results: Among the participants, 72.1% were between 18-22 years old and 79.67% were female. The largest group of respondents were enrolled in the Faculty of Medicine (28.84%) and nearly one-third were in their fourth year of study (30%). Overall, 69.27% supported the integration of robots in teaching. However, opinions were mixed on whether robots could replace human instructors. More than 65% demonstrated awareness of both the benefits and challenges of robotic teaching and 70.21% expressed interest in receiving further training. Notably, gender differences were statistically significant regarding perceptions of robot inclusion (p = 0.04). Conclusion: The findings highlight a strong understanding among students, particularly young women, of both the advantages and limitations of robotic teaching. While most students support the integration of robots into education, there remains hesitation about replacing human teachers entirely. The substantial interest in further training underscores the importance of preparing students for a future where robotic teaching may play an increasingly significant role in higher education.

Background: Acinetobacter baumannii is a major cause of hospital-acquired infections, notable for its ability to acquire resistance to multiple antibiotic classes. Carbapenem resistance in A. baumannii is a global concern, significantly limiting therapeutic options. Among resistance mechanisms, mutations in chromosomal genes such as gyrB, which encodes the B subunit of DNA gyrase, have been increasingly associated with reduced susceptibility to fluoroquinolones and possible co-resistance to carbapenems. Objective: This study aimed to assess the prevalence of resistance-associated genes, with a particular focus on gyrB, in clinical isolates of A. baumannii and to evaluate their association with carbapenem resistance patterns. Methods: A total of 50 clinical isolates of A. baumannii were collected from urinary tract infection (UTI) cases. Antimicrobial susceptibility testing was performed using disk diffusion and broth microdilution methods, following CLSI guidelines. PCR was applied for the detection of the gyrB gene and sequencing of gyrB-positive isolates was carried out to identify point mutations associated with resistance. Results: Among the isolates, 86.7% exhibited resistance to imipenem and meropenem. The gyrB gene was detected in 92% of isolates and sequence analysis revealed mutations linked to quinolone resistance and potential multidrug resistance. Coexistence of gyrB with other resistance mechanisms was common. A strong correlation was observed between gyrB-positive strains and elevated MICs for both carbapenems and fluoroquinolones (p<0.01). Conclusion: The high prevalence of gyrB and its associated mutations among A. baumannii isolates underscores its potential role in mediating broad-spectrum antimicrobial resistance, including resistance to carbapenems. These findings highlight the urgent need for molecular surveillance and the development of novel therapeutic strategies to combat resistant A. baumannii strains.

Necrotizing sialometaplasia (NS) is a rare, benign, self-limiting inflammatory condition that primarily affects the minor salivary glands of the hard palate. It often presents as a nodule that may ulcerate over time. The most commonly known trigger is ischemia. Diagnosing non-ulcerated NS can be challenging, particularly because its clinical features may resemble malignant salivary gland tumours. We report a case involving a 9-year-old female who presented with a painful, slightly raised erythematous lesion on the hard palate. An incisional biopsy and histopathological analysis confirmed the diagnosis of NS. Awareness of non-ulcerated presentations is essential to avoid misdiagnosis and unnecessary aggressive treatment.

Background: Cervical cancer remains one of the most common cancers among women in low- and middle-income countries, with survivors frequently experiencing persistent psychological challenges such as depression and anxiety that adversely affect quality of life. Nurse-led, home-based interventions have emerged as a promising approach to providing holistic, accessible and continuous psychosocial support in community settings, particularly in underserved rural areas. Aim: This study evaluated the effectiveness of a Community Nurse-Led Home-Based Cancer Survivorship Programme in reducing depression among cervical cancer survivors. Methods: A quasi-experimental pretest-post-test control group design was employed in selected rural villages of Madurai district, Tamil Nadu, India. A total of 140 cervical cancer survivors were recruited through convenience sampling and allocated to experimental (n = 70) and control (n = 70) groups. Depression was assessed using Beck’s Depression Inventory (BDI). The experimental group received a structured four-week nurse-led survivorship programme, which included guided breathing exercises, individualized counselling, lifestyle education and family-focused supportive messages. The control group received routine care. Data were analysed using descriptive and inferential statistics, including independent and paired t-tests, Chi-square tests and Pearson’s correlation. A significance level of p<0.05 was applied. Results: At baseline, both groups were comparable in sociodemographic and clinical characteristics (p>0.05). Following the intervention, the experimental group showed a statistically significant reduction in mean BDI scores from 35.92±10.1 to 23.78±8.7 (p<0.001), indicating a clinically meaningful improvement. In contrast, the control group demonstrated no significant change (34.56±9.4 to 33.43±11.2; p>0.05). Effect size calculations further confirmed the substantial impact of the intervention on depression reduction. Conclusion: The Community Nurse-Led Home-Based Cancer Survivorship Programme was effective in significantly reducing depression among cervical cancer survivors in rural communities. Integrating such evidence-based, nurse-led interventions into primary health care systems could enhance psychological well-being, promote recovery and improve overall survivorship outcomes, especially in resource-limited settings.

Background: Childhood obesity and vitamin D deficiency are highly prevalent in Saudi Arabia and increasingly recognized as interconnected risk factors for cardiometabolic complications. Their frequent coexistence may amplify cardiovascular risk from an early age. This review aims to summarize the prevalence of vitamin D deficiency among obese children in Saudi Arabia, examine the mechanistic links to cardiovascular risk factors and situate regional findings within the context of global evidence. Methods: A narrative review was conducted of studies published between 2000 and 2025 using PubMed, Google Scholar and the Saudi Digital Library. Eligible studies included cross-sectional, cohort, case-control and clinical trials that evaluated vitamin D status in relation to cardiovascular risk markers among children under 18 years of age. Findings: Available evidence demonstrates that vitamin D deficiency in obese children is associated with dyslipidaemia, insulin resistance, elevated blood pressure, vascular dysfunction and early manifestations of atherosclerosis. In Saudi Arabia, deficiency rates frequently exceed 80% despite abundant sunlight, largely due to cultural clothing practices, limited outdoor activity and inadequate dietary intake. Local studies also highlight early indications of myocardial dysfunction and metabolic impairment among vitamin D-deficient youth. However, most investigations are cross-sectional, include small sample sizes and often fail to adjust for confounders such as diet and sun exposure. Conclusion: The combined burden of obesity and vitamin D deficiency in Saudi children constitutes a pressing public health concern with significant long-term cardiovascular implications. Policy measures such as incorporating vitamin D screening into obesity management, nationwide supplementation programs and structured health education campaigns are urgently needed. Future research should emphasize large-scale prospective cohorts, randomized controlled trials and systematic reviews to establish causal pathways and inform evidence-based interventions.

Background: Cancer survivorship is often accompanied by complex challenges that extend beyond physical health to emotional, psychological and social well-being. These multidimensional issues can significantly compromise quality of life (QoL). Nurse-led interventions, with their patient-centered and holistic approach, have been increasingly recognized as effective strategies to address these challenges and support survivors in achieving better health outcomes. Aim: The present study aimed to evaluate the effectiveness of a structured nurse-led intervention in enhancing the quality of life among women with cervical cancer living in rural communities of Madurai, Tamil Nadu. Methods: A quasi-experimental pretest-posttest design was adopted, involving 140 women with cervical cancer who were purposively assigned to either an experimental group (n = 70) or a control group (n = 70). The intervention comprised tailored health education, psychosocial counseling and symptom management strategies delivered by trained community nurses. Quality of life was assessed before and after the intervention using validated tools. Statistical analysis included descriptive and inferential tests, with significance set at p<0.05. Results: Participants in the experimental group demonstrated a significant improvement in overall QoL following the intervention. Posttest scores (107.16±39.91) were considerably higher compared to the control group (86.60±38.81), reflecting notable gains in physical, emotional and social well-being domains (p = 0.001). Conclusion: The findings confirm that nurse-led interventions are highly effective in improving the quality of life among cervical cancer survivors, particularly in underserved rural populations. Integrating such community-based strategies into standard survivorship care could play a pivotal role in addressing unmet needs and promoting long-term well-being in this vulnerable group.

Background: Understanding mothers' attitudes and knowledge regarding the use of medications in children is crucial for ensuring safe and effective treatment. As primary caregivers, mothers' decisions on medication use and adherence to treatments significantly impact Paediatric healthcare. Objectives: This study aims to evaluate the knowledge and attitudes of mothers in Saudi Arabia towards the use of medications in their children. Methodology: A cross-sectional observational study was conducted across various regions of Saudi Arabia from July to November 2024. The study utilized a structured questionnaire consisting of 43 statements to assess participants' socio-demographic characteristics, knowledge, attitudes, and awareness. Results: In a cross-sectional study involving 752 mothers in Saudi Arabia, findings revealed significant gaps in knowledge and attitudes toward Paediatric medication use. While 89.2% acknowledged the existence of medication side effects, only 24.5% reported high perceived knowledge regarding proper medication use for children. Alarmingly, 68% admitted to self-medicating without prior consultation, and 52.7% sometimes underestimated their child's health issues. Furthermore, 39.4% demonstrated low awareness of Paediatric medication symptoms, raising concerns about safe dosing practices. Statistically significant relationships were identified between mothers' knowledge and factors such as monthly income, number of children, and prior medication consultation, highlighting areas for targeted educational interventions. Conclusion: The findings highlight statistically significant gaps in knowledge and concerning trends in self-medication practices, underscoring the urgent need for targeted educational initiatives to enhance parental understanding of safe medication practices.

 Anemia continues to be a major public health challenge worldwide, particularly among adolescent girls who are biologically and socio-culturally vulnerable during their developmental years. In India, the prevalence remains critically high, affecting not only physical health but also emotional well-being, cognitive functioning and academic performance. This qualitative study aimed to explore the lived-in experiences of adolescent girls diagnosed with anemia who underwent a structured 12 week multi-intervention program. The program included nutritional support, cognitive training and health education designed to enhance awareness and promote self-care practices. Adopting a phenomenological design, in-depth interviews were conducted with 15 adolescent girls aged 12 to 18 years from government schools in the Raigarh district of Chhattisgarh. Participants were selected through purposive sampling and had been clinically diagnosed with mild to moderate anemia (hemoglobin levels between 7.0 and 11.9 g/dL). Interviews, lasting between 30 to 45 minutes, were conducted in a private setting to ensure confidentiality and comfort. Audio recordings were transcribed verbatim and analyzed thematically using Braun and Clarke’s six-phase framework. Analysis of the narratives revealed six interconnected themes: functional limitations, physiological burnout, cognitive symptom clusters, academic impairments, social stigma and self-directed care. These themes reflected the interconnected challenges faced by the participants and highlighted both the debilitating impact of anemia and their evolving resilience. This study emphasizes the significance of understanding anemia not merely as a clinical condition but as a deeply personal and complex experience that shapes various domains of adolescent life. Beyond general observations, qualitative inquiry uncovers the nuanced emotional, social and psychological impacts often overlooked in routine health assessments. The insights gained underscore the need for adolescent-centered, integrative health strategies that address the lived realities of anemia, particularly in resource-constrained settings.

Euthanasia, which is the act of intentionally ending a life to relieve suffering, is still a controversial issue around the world with big legal, moral, and cultural effects. This study looks at the laws around euthanasia in India, with a focus on how they have changed throughout time in the Constitution and the courts. India allows passive euthanasia with tight rules, but it does not allow active euthanasia. The study uses a doctrinal approach and compares India's approach to those of other countries, including as the Netherlands, Belgium, Canada, and the United States, where euthanasia laws are less strict. This article looks at the ethical, legal, and medical issues that come up while trying to put euthanasia legislation into place by looking at important Indian Supreme Court cases including Aruna Shanbaug v. Union of India (2011) and Common Cause v. Union of India (2018). It also looks into the roles of judicial monitoring, medical ethics, and keeping weak people safe. The report calls for a more comprehensive set of laws in India, using the best practices from throughout the world and taking into account India's own social and cultural situation. This study adds to the continuing discussions about euthanasia by recommending a balanced strategy that protects people from possible abuse while also respecting their freedom.

Background: Cardiovascular disease, type-2 diabetes, cancer are long-term complications due to obesity. By 2035, the prevalence of overweight and obesity is expected to rise from 38% in 2020 to over 50% globally. It is challenging to reach the best weight or manage the process of long-term weight loss. Therefore, for patients who are overweight, the obesity control guidelines strongly suggest lifestyle changes in addition to medical treatment. Aim: Assessment of anti-obesity medications usage among Saudis and Egyptian obese population and their adherence to better lifestyle (Physical activity & eating healthy foods). Methods: A cross-sectional survey was done among Saudi and Egyptian population for three months (1^st November 2024 to the end of January 2025). Obese and overweight population were interviewed either in obesity clinics, gyms and universities according to a well-designed questionnaire (Face to Face), some participants were online. Data was collected and statistically analyzed using SPSS software (Inc, Chicago, IL, USA, version 25). Results: The total number of participants were 550; 254 (Saudis) and 296 (Egyptians). The mean of age (35±0.74 Saudis vs. 44.5±2.07 Egyptians). About one-third of participants their age ranges from 18-24 years (Saudis) and from 35-44 years (Egyptians). BMI was significantly different at p-value<0.05; obese class-1 was more among Saudis (25.6%) more than Egyptians (14.5%). About 40.9% of Saudi participants used anti-obesity medications vs. 27.4% of Egyptians, while half of Egyptians doing physical activities, eating low diet carbs or Keto (39.2%) and healthy foods (31.1%) more than Saudis (p-value=0.009) to lose weight. Liraglutide or semaglutide was used by Saudis (36.6%) vs. Egyptians (25.9%), while orlistat was used more by Egyptians (44.4%) vs. Saudis (28.8%) (p-value<0.005). The rate of doing exercise from 4-5 days/week, the duration time of exercise among Egyptians (40 or 60 min/day and high intense of exercises was more among Egyptian than Saudi participants which is significantly different at p<0.05. High percentages of Saudi participants did not eat healthy food (low carbs and balanced diets) compared to Egyptians more than Saudis (p-value<0.05). One third of Saudi participants followed eating healthy foods for 1-2months only, while 38.9% (Egyptians) follow ≥12 months (p-value<0.05). Long sleeping period (8-10 hours) was more among Saudis vs. Egyptians (p-value<0.05). Conclusion: This study compared the differences between two Arab nations (Saudi Arabia & Egypt). They have some similarities in their culture and habits, causes, and treatment of obesity. According to the results, among Saudi participants, obesity is mostly due to bad adherence to better lifestyle as sedentary, low levels of physical activities among younger populations, and bad eating habits in both school & college-aged, and adolescents, so, high percentages used anti-obesity medications to lose their weight. While in Egyptian participants, obesity is mostly prevalent among adults than children that was observed through doing more activities during going to their works and schools by walking, cycling, wheeling. Also, most people don't own cars, no sedentary lifestyle and doing many exercises in clubs and they trying to lose their weight by adherence to better lifestyle or by using medications. So, by highlighting the benefit of leading a healthy lifestyle, Saudi government must take this issue seriously to improve physical activity levels, eating healthy food and avoid sedentary behaviour.

Background: Stroke is a leading cause of long-term disability globally and necessitates extensive care and support from family members. Family caregivers play a pivotal role in preventing pressure ulcers. It requires patients’ family caregivers to have adequate knowledge, practice and attitude about this issue. Objectives: To assess the knowledge, practice and attitude of stroke patients’ family caregivers regarding the prevention of pressure ulcers. Methods: A randomized control trial (RCT) design was used. A simple random sampling technique was used to recruit 128 samples (64 family caregivers as a case and 64 family caregivers as a control group). The program was given to the family caregivers over two days period in the hospital. A structured questionnaire was used as a tool for data collection. Results: Most of the family caregivers had low knowledge scores (9.89 ±1.86), low practice scores (6.75±2.49) and low attitude scores (9.22±2.35), in the pre-educational program. However, in the post-program, their knowledge, practice and attitude score were significantly increased (15.78±1.41, 18.08 ±1.57 and 14.53±2.01, respectively). Conclusion: Appropriate and well-designed educational programs can significantly enhance the knowledge, practice and attitude of family caregivers, leading to improved patient outcomes in preventing pressure ulcers.

Introduction: Tooth brushing is a crucial part of oral hygiene. It is essential to stop plaque formation and reduce the susceptibility to cavities. Brushing technique, frequency and duration of tooth brushing are important factors in plaque reduction. This is often quite difficult in children because it requires dexterity. Dental professionals need adequate information about children’s oral hygiene to teach them and their parents. There are six methods of tooth brushing techniques. They differ in a number of aspects and are recommended for various age groups. Aim: This study aims to evaluate the effects of simulated horizontal and vertical tooth brushing on tooth surface roughness using medium bristle stiffness levels. Method: A total of 48 extracted human incisor teeth were divided into two experimental groups based on brushing technique (horizontal vs. vertical) and bristle stiffness (medium). Brushing simulation was conducted using an automated brushing machine, applying a standardized load and brushing duration. Surface roughness was measured using a profilometer. The collected data was tabulated in Excel. The data is represented with the help of bar graphs and statistically analysed with the help of SPSS software. The statistical tests done were Mean, Standard deviation and t -tests. Results: The p-value is far below 0.05, indicating that the difference between the vertical and horizontal values is statistically significant. The intervention or condition that changed between the pre and post measurements of horizontal brushing likely had a real and strong effect. Conclusion: Within the limitations of the study, it shows that vertical brushing technique is the most preferred brushing technique. Brushing technique significantly influence tooth surface roughness. Vertical brushing may be recommended for maintaining smoother tooth surfaces and minimizing abrasion.

Objectives: Coronary Artery Disease (CAD) remains a leading cause of morbidity and mortality worldwide. To evaluate the diagnostic performance of AI models in the early detection and risk stratification of CAD using ECG and imaging data and to compare their accuracy with cardiologist interpretation. Methods: This cross-sectional analytical study was conducted in Saudia, included 185 patients with suspected CAD who underwent both ECG and imaging evaluation. AI-based models, including convolutional neural networks for ECG and deep learning algorithms for imaging, were applied to detect CAD and stratify patients into risk categories. Cardiologist-confirmed diagnosis served as the reference standard. Results: The AI-ECG model achieved a sensitivity of 88.5%, specificity of 82.0% and an AUC of 0.90 (95% CI: 0.86–0.94). When ECG and imaging data were combined, diagnostic accuracy improved, with sensitivity of 92.4%, specificity of 85.2% and an AUC of 0.93 (95% CI: 0.89–0.96). AI-based risk stratification categorized 54 patients (29.2%) as low risk, 78 (42.2%) as intermediate risk and 53 (28.6%) as high risk. Confirmed CAD prevalence correlated strongly with AI-predicted risk groups, with 22.2% in the low-risk group and 88.7% in the high-risk group. Conclusion: Artificial intelligence demonstrates high accuracy in the early detection and risk stratification of CAD using ECG and imaging data. AI models performed comparably to cardiologists and offered significant efficiency gains. Integration of AI into cardiovascular workflows may enable earlier intervention, optimized resource allocation and improved patient outcomes. Further validation across larger and more diverse populations is warranted.

Objectives: Intramuscular (IM) injections are common in pediatric care but are often associated with significant pain and distress. Effective pain management during these procedures is crucial for improving the overall healthcare experience in children. Non-pharmacological methods, such as Cold Application, Manual Pressure, and the Shot Blocker, have been proposed to reduce injection-related pain and discomfort. Aim: This study aims to compare these methods with standard injection procedures in terms of pain perception, swelling, redness, tenderness, and lump formation in children. Methods: Forty children (aged 3-10 years) were randomly assigned: Cold Application, Manual Pressure, Shot Blocker, or Control Group (Standard Procedure). Pain perception was assessed using a numerical pain scale (0-10) while swelling, redness, tenderness, and lump formation were measured following the injection at four time points: immediately, 30 minutes, 1 hour, and 24 hours after injection. Statistical analyses were performed using Chi-square tests and one-way ANOVA to evaluate the differences between the groups. Results: Significant differences were observed in pain perception and swelling across the groups. The Manual Pressure and Shot Blocker groups reported significantly less pain compared to the control group. Swelling was significantly lower in the Cold Application and Shot Blocker groups than in the control group. Redness and tenderness were not significantly different between the groups. No lumps were observed in any group. Conclusion: Manual Pressure and Shot Blockers significantly reduce pain and swelling during IM injections in children compared to the standard procedure. Further research is needed to explore these techniques' long-term effects and practical applications in pediatric healthcare settings.

Objectives: Sickle Cell Anaemia (SCA) is a lifelong haemoglobinopathy marked by chronic haemolysis, recurrent vaso-occlusive crises (VOCs), and progressive organ damage. Hydroxyurea is a well-established disease-modifying therapy; however, its use in adults remains inconsistent, particularly in regions with limited access to specialised care. Case Presentation: We describe a 35-year-old Saudi woman with homozygous SCA who presented with acute back and limb pain unresponsive to standard analgesia. She reported frequent admissions and transfusions but had never received hydroxyurea. On admission, she was tachypneic with oxygen desaturation (SpO₂ 80%) and borderline hypotension. Laboratory evaluation revealed normocytic anaemia (Hb 8.2 g/dL), elevated lactate dehydrogenase (317 U/L), reticulocytosis (6.12%), and severe vitamin D deficiency (7 ng/mL). Hydroxyurea (500 mg/day) was initiated in conjunction with folic acid and vitamin D supplementation. At the two-week follow-up, her pain score improved from 6/10 to 3/10, her energy levels increased, oxygen saturation stabilised, and laboratory monitoring demonstrated reduced haemolysis with stable haemoglobin levels. Discussion and conclusion: This case illustrates how delayed initiation of hydroxyurea represents a missed therapeutic opportunity in adult SCA, particularly among women beyond childbearing age. The timely use of hydroxyurea, combined with the correction of comorbidities such as vitamin D deficiency, can improve quality of life. Standardised pathways and systematic reassessment are urgently needed to ensure consistent adult SCA care.

Objectives: Tooth brushing is a fundamental component of oral hygiene, playing a key role in preventing plaque buildup and reducing the risk of dental caries. The effectiveness of brushing depends on the technique used, as well as the frequency and duration of brushing. In children, maintaining proper oral hygiene can be challenging due to limited manual dexterity. Therefore, dental professionals must be well-informed about children's oral hygiene practices to effectively educate both children and their parents. There are six commonly recognized tooth brushing techniques, each differing in approach and recommended for specific age groups or oral health needs. Aim: This study aims to evaluate the effects of simulated To-Fro and Oscillatory tooth brushing on molar occlusal tooth surface roughness using medium bristle stiffness levels. Methods: A total of 48 extracted human molar teeth were divided into two experimental groups based on brushing technique (To-Fro vs Oscillatory) and bristle stiffness (medium). Brushing simulation was conducted using an automated brushing machine, applying a standardized load and brushing duration. Surface roughness was measured using a profilometer. The collected data was tabulated in Excel. The data is represented with the help of bar graphs and statistically analysed with the help of SPSS software. The statistical tests done were Mean, Standard deviation and t -tests. Results: The p-value is far below 0.05, indicating that the difference between the Oscillatory and To-Fro values is statistically significant. The intervention or condition that changed between the pre and post measurements of To-Fro brushing likely had a real and strong effect. Conclusion: Within the limitations of the study, it shows that Oscillatory brushing technique is the most preferred brushing technique. Brushing technique significantly influence tooth surface roughness. Oscillatory brushing may be recommended for maintaining smoother tooth surfaces and minimizing abrasion.

Background: Ocular trauma, including corneal epithelial defects (CED) and chemical burns, are common and can lead to severe complications if untreated. Chalazion, conjunctivitis, and contact lens misuse also pose risks. Severe conditions like retinal detachment, glaucoma, and uveitis require early detection. Public awareness is vital for prevention and effective management. Aim/Objective To assess Knowledge, Attitude, and Practice Towards Eye Injury First Aid Among the General Population in Saudi Arabia. Aim and Objective: To assess Knowledge, Attitude, and Practice Towards Eye Injury First Aid Among the General Population in Saudi Arabia. Methods: It is a retrospective cohort study targeting the general population of Saudi Arabia. An online questionnaire in Arabic and English was randomly distributed to gather diverse samples. Data was cleaned in Excel and analyzed in IBM SPPS 29. Results: Our study comprised 196 participants aged 16 to 70 years (mean: 34.4±12.8). Female participants were 116 (59.2%), and 190 (96.9%) were Saudi. Among participants, 109 (55.6%) were single, and 143 (73%) had a university degree. A monthly income of less than 5000 SR was reported by 24 (12.2%), while 50 (42.3%) earned between 10000-20000 SR. Knowledge about eye conditions varied, with 33.2% correctly defining glaucoma and 54.1% defining uveitis. 74.5% knew the definition of corneal abrasion, and 65.8% identified foreign body sensation as a symptom. None of the demographic factors significantly affected overall knowledge (p > 0.05). The highest knowledge score percentage was for retinal detachment (2.9±1.3; 73.7%), and the lowest was for ocular chemical burn (2.5±1.1; 49.7%). 101 (51.5%) had good knowledge, while 95 (48.5%) had poor knowledge. There is no significant association between knowledge level and different factors. Conclusion: Our study revealed moderate overall knowledge about eye conditions. There is a high awareness of retinal detachment and a low awareness of ocular chemical burns. Despite diverse demographics, no factors significantly impacted overall knowledge. Approximately half of the participants demonstrated exemplary knowledge, highlighting the need for improved public education on eye health.

Background: Nasal tip position is critical for optimal rhinoplasty outcomes, yet managing rotation and projection is challenging in patients with short caudal septa or ptotic tips. The Teo Strut Graft (TSG) enhances tip support. Objective: To present an extended TSG technique using Tongue-In-Groove (TIG) fixation to improve tip position in primary open rhinoplasty. Methods: This prospective case series enrolled 38 primary rhinoplasty patients presenting with ptotic tips and/or short septal anatomy from March 2021 to June 2023. Patients underwent open rhinoplasty by a single surgeon, involving placement of an extended TSG (septal cartilage), fixed via the TIG method. Standardized lateral photographs were assessed preoperatively and immediately postoperatively and the nasolabial angle (NLA) and Goode's ratio tip projection were quantified at one year. Results: The mean preoperative NLA significantly increased from 83.62±8.01° to 103.45±7.37° at one year postoperatively (p<0.001). Mean Goode's ratio increased considerably from 0.634±0.055 preoperatively to 0.714±0.061 at one year (p<0.001). One-year NLA was stable (p = 0.18 vs immediate postoperation). At the same time, projection showed a minor, significant decrease from immediate postoperation (p = 0.013) and remained significantly improved than baseline (p<0.001). Conclusions: The extended TSG effectively increased NLA and nasal tip projection in patients with ptotic tips and short septum, yielding largely stable one-year results.

Fluid trademarks refer to the dynamic and adaptable approach than the normal trademarks, the core trademarks are used in the most creative way but maintaining it’s significant elements of the trademarks. It allows for different iterations of the base mark, like logos, symbols or verbal elements, that can change based on the occasion, season or other factors. The objective of the study is to examine how adaptable the fluid trademark strategies influence patients’ psychological perceptions affecting their loyalty to healthcare brands. The study aims to understand the role of evolving brand identities in building sustained patient relationships within the healthcare sector. This research paper adopts an empirical study with patients to gather insights on perceptions of trust and loyalty in response to evolving brand identities, interpret how visual and symbolic changes in trademarks impact emotional and cognitive responses. The findings of the study are the Consistent branding in the different platforms including the websites, social media and other means brings trust among patients. The challenges faced in this study is that evolving trademarks can keep a brand modern and responsive, but instead too many changes can confuse patients and weaken brand recognition. The limitations of the study are that patient trust and loyalty are influenced by personal experiences and emotions, making them difficult to measure consistently and objectively. The conclusion is fluid trademarks in healthcare can significantly enhance patient trust and loyalty when strategically balanced with consistency, clarity and emotional relevance. Fluid trademarks boost patient trust and loyalty through strategic consistency.

Objectives: To ensure the best possible infection control, improve visibility, and increase treatment safety, rubber dam isolation is regarded as the gold standard in operational and endodontic dentistry. Despite its therapeutic benefits, its use is still relatively uncommon, and little research has been done on public acceptance and awareness. This study aimed to assess the Saudi population's knowledge, attitudes, and practices (KAP) regarding rubber dam usage during dental procedures. Methods: Data were collected from January to February 2025, and a cross-sectional online survey was carried out throughout Saudi Arabia using a non-probability snowball sampling technique. 510 participants who were in good physical and mental health and had previously received restorative dental treatment took part in the study. Data was collected using a twenty-item questionnaire covering demographics, knowledge, attitudes, and practices questions regarding the use of rubber dams. Descriptive statistics and Pearson's chi-square tests were used to examine associations in the data, with p<0.05 being significant. Results: The majority of participants (91.8%) accurately stated that the primary function of the rubber dam was to isolate the teeth from impurities, and 95.7% acknowledged that it also improved infection control. In terms of attitudes, 97.8% of respondents would approve its use if their dentist suggested it, and 91.6% thought that it is important for dental care. But only 44.3% had spoken to their dentist about its use. KAP scores were shown to be significantly correlated with nationality, age, gender, and educational attainment. Younger participants, females, and those with higher education showed higher KAP scores. Conclusion: The study reveals that participants are generally well-informed and supportive of the benefits of rubber dams. However, the communication gap between dentists and patients highlights the need for enhanced educational efforts and a greater emphasis on incorporating rubber dam use into routine clinical practice to ensure patient safety and improve treatment outcomes. The high willingness to accept its use highlights significant potential for broader clinical integration

Background: Cardiovascular disease (CVD) continues to be a major global health challenge, with its risk influenced by both modifiable and non-modifiable factors. Evidence suggests an inverse relationship between serum vitamin D3 levels and cardiovascular risk, influenced by age, gender, and lifestyle. Aim: This study aims to assess the prevalence of CVD risk factors and evaluate the role of vitamin D3 status among adult IT professionals in suburban Chennai. Methods: A cross-sectional descriptive study was conducted from March to April 2024 among 172 adults working in selected IT companies. Participants were chosen via convenience sampling, and data were collected through self-reported questionnaires and physiological assessments including blood pressure, BMI, and serum 25-hydroxy vitamin D levels. Statistical analyses involved Pearson correlation, one-way ANOVA, and Bonferroni post-hoc tests to determine associations between vitamin D3 and CVD risk factors. Results: Among 172 adult participants, 75.6% were had deficient, 23.3% had insufficient and only 1.2 % had normal level of vitamin D3. Overweight and obesity were observed in 47.8% and 18.4% respectively, while 38.6% exhibited elevated blood pressure. CVD risk factors were more prevalent in individuals aged ≥40 years (71.2%) compared to those <40 years (42.5%). Males showed a higher prevalence (65.3%) of risk factors than females (48.7%), with postmenopausal women showing a notable rise (69.4%). A moderate negative correlation was found between systolic blood pressure (SBP) and Vitamin D3 (R = -0.491, p = 0.000), and a moderate to strong negative correlation between diastolic blood pressure (DBP) and Vitamin D3 (R = -0.566, p = 0.000). Both correlations were statistically significant at the 1% level. Age significantly affects vitamin D levels (P = 0.021), while gender and profession show no significant impact. Conclusion: The study underscores the importance of recognizing vitamin D3 deficiency, alongside age, gender, BMI, and blood pressure, as critical contributors to cardiovascular risk. Regular screening and early lifestyle interventions, including vitamin D optimization, may serve as effective strategies in mitigating the growing burden of CVD, especially in high-risk populations such as urban IT workers.

Objective:​​ To investigate astragaloside IV's (AS-IV) anti-glioma effects and mechanisms. Methods:​​ Potential AS-IV targets were screened using SwissTarget, Super PRED, and PharmMapper databases. Glioma-related targets were identified from GeneCards, OMIM, and TTD. Intersection genes underwent Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Anti-glioma mechanisms were investigated using A172 and U251 glioma cell lines. Cells were treated with AS-IV at 20, 30, or 50 mg/mL. MTT assessed proliferation. Cell scratch and transwell assays evaluated invasion. Flow cytometry analyzed cell cycle distribution and apoptosis. Western blot measured expression of cell cycle, apoptosis, epithelial-mesenchymal transition, and PI3K-AKT pathway-related genes. Results:​​ Network pharmacology and molecular docking predicted AS-IV anti-glioma targets were associated with the PI3K/AKT pathway. AS-IV inhibited A172 and U251 cell proliferation and invasion dose- and time-dependently. It arrested the cell cycle in G0/G1 phase and induced apoptosis. AS-IV upregulated P21, Bax, and E-cadherin expression while downregulating CDK4, CDK6, Bcl-2, Vimentin, P-PI3K, and P-AKT. ​Conclusion:​​ AS-IV exhibits anti-tumor effects against glioma cells, potentially by inhibiting the PI3K/AKT signaling pathway. This leads to apoptosis induction, proliferation suppression, cell cycle arrest, and invasion inhibition.

Background: Accuracy of fit is a critical determinant of the clinical success and longevity of dental restorations, particularly for implant-supported and partial coverage posterior restorations. Although subtractive milling techniques have been widely used in dentistry, additive manufacturing technologies have emerged as promising alternatives, offering the potential for greater accuracy, customization and cost-efficiency. This systematic review aimed to compare the accuracy of fit of additive 3D-printed implant-supported and partial coverage posterior restorations with subtractive milling and conventional techniques. Methods: The review followed PRISMA guidelines. A comprehensive electronic search was conducted across PubMed, Cochrane Library, Web of Science, Embase and Scopus to identify relevant studies. Studies were included if they evaluated the accuracy of fit of additive 3D-printed implant-supported restorations and partial coverage posterior restorations, compared to subtractive milling or conventional techniques. The modified CONSORT checklist for in vitro studies was used to assess methodological quality and risk of bias. Results: A total of 1,913 records were identified and after removing duplicates and screening for eligibility, eight in vitro studies were included. The studies evaluated 322 samples across a range of implant-supported frameworks, inlays and onlays. Technologies assessed included Selective Laser Melting (SLM), stereolithography (SLA), Digital Light Processing (DLP) and multijet 3D printing, alongside CAD/CAM milling and conventional casting. The findings consistently demonstrated that additive manufacturing achieved accuracy of fit comparable to subtractive milling in simple designs, while three-dimensional printed restorations exhibited better marginal and internal adaptation, especially for complex geometries. Conventional casting and milling techniques showed larger discrepancies, particularly for multiunit frameworks. The risk of bias was generally low across all included studies, although variation in measurement techniques and the lack of sample size justification were noted as limitations. Conclusion: This systematic review indicates that additive manufacturing techniques offer improved accuracy of fit compared to subtractive milling and conventional methods for implant-supported restorations and partial coverage posterior restorations. However, the in vitro design of the studies limits the direct clinical applicability of the findings.

Objective: This study aimed to investigate the association between improper brushing technique, particularly horizontal brushing in right-handed individuals, and its impact on cervical abrasion and tooth loss. Methods: A questionnaire-based cross-sectional study was conducted among 400 right-handed participants aged 18–65 years. Data on oral hygiene behavior were collected through a structured questionnaire. Clinical examination assessed cervical abrasion at premolar and canine teeth. Chi- square tests were used to explore associations between behavioral variables and oral health outcomes. An independent t-test compared mean abrasion between maxillary and mandibular arches. Results: Horizontal brushing with excessive force was prevalent. Chi-square analysis revealed significant associations between brushing duration and technique (p < 0.001), toothbrush type and brushing force (p < 0.001). Tooth 45 (mandibular right second premolar) exhibited the highest mean abrasion (1.67). Although the mandibular arch showed higher average abrasion than the maxillary arch, the difference was not statistically significant. Conclusion: Improper brushing technique and forceful habits are significant risk factors for cervical abrasion and non-carious tooth loss, with mandibular premolars in right-handed individuals being most vulnerable. These findings highlight the urgent need for targeted oral health education programs that emphasize correct brushing methods, force regulation, and preventive strategies to reduce long-term tooth damage and preserve oral health.

Introduction: Atrial fibrillation (AF) is the most common heart rhythm disorder and is associated with several potentially life-threatening complications. Its global prevalence is rising, particularly among aging populations. In Saudi Arabia, data regarding the prevalence of AF remains limited. Various risk factors, including advanced age, metabolic syndrome and lifestyle habits, contribute to the increasing incidence of AF. Objective: This study aims to identify the most significant modifiable risk factors associated with the incidence of AF in individuals aged 60 years and older at the time of initial diagnosis, with the goal of reducing related complications and overall morbidity. Methods: This is a retrospective study that examined the specific risk factors associated with AF in older individuals at a tertiary hospital. All patients aged ≥ 60 years who were newly diagnosed with AF were included. Results: This study included 211 consecutive patients at a large tertiary hospital in Jeddah, Saudi Arabia. The mean age at diagnosis was 74±9 years. Overweight individuals with a BMI of 25–29.9 kg/m² accounted for 30.8% of the sample. Additionally, 29.3% had hypertension and 23.4% had diabetes. Regarding cardiac comorbidities, 34.3% had ischemic heart disease and 34.9% had heart failure. Non-cardiac conditions included pneumonia 12.9% and a history of pulmonary embolism 3.8%. Conclusion: Our research emphasizes the critical role of modifiable factors such as elevated BMI in influencing the risk of AF and highlights the most common comorbidities requiring targeted interventions, particularly the management of hypertension and diabetes, to reduce the burden of AF in the older adult population.