Background: Bariatric surgery is an effective treatment for morbid obesity and its associated comorbidities. However, due to altered gastrointestinal anatomy and physiology, patients are at risk of developing nutritional deficiencies, which may impair long-term health and quality of life. Identifying the prevalence of such deficiencies is essential to guide appropriate follow-up and supplementation strategies. Objective: To determine the prevalence of nutritional deficiencies among patients who underwent bariatric surgery and to compare outcomes between sleeve gastrectomy and gastric bypass. Methods: This cross-sectional analytical study included 365 patients who had undergone bariatric surgery. Adult patients aged 18-65 years with at least six months of postoperative follow-up were enrolled, while those with prior gastrointestinal surgery, chronic systemic illnesses or incomplete records were excluded. Data were collected on demographics, surgical procedure type and laboratory investigations including hemoglobin, ferritin, vitamin B12, folate, calcium and vitamin D. Standardized cut-off values were used to define deficiencies. Statistical analysis was performed using SPSS version 26, with results expressed as Mean±Standard deviation for continuous variables and frequencies and percentages for categorical variables. Comparisons between groups were made using Chi-square test, with p<0.05 considered significant. Results: Of 365 patients, 208 (57.0%) underwent sleeve gastrectomy and 157 (43.0%) gastric bypass. The mean age was 40.9±10.1 years and 220 (60.3%) were female. The most common deficiency was vitamin D, present in 202 patients (55.3%), followed by iron deficiency in 146 (40.0%) and anemia in 142 (38.9%). Vitamin B12 deficiency was observed in 110 (30.1%), folate in 81 (22.2%) and calcium in 76 (20.8%). Multiple deficiencies were noted in 134 patients (36.7%). Deficiencies were significantly more frequent in gastric bypass compared to sleeve gastrectomy for vitamin D (62.4% vs. 50.0%, p = 0.02) and iron (45.9% vs. 35.6%, p = 0.03). Women were more likely to have anemia (45.9% vs. 28.3%, p = 0.001) and vitamin D deficiency (60.5 vs. 47.6%, p = 0.01). The prevalence of deficiencies increased with time since surgery, with the highest rates observed beyond two years. Conclusion: Nutritional deficiencies are common after bariatric surgery, particularly vitamin D and iron deficiency and are more prevalent following gastric bypass than sleeve gastrectomy. Women and patients with longer follow-up durations are at greater risk. These findings underscore the need for structured postoperative monitoring, lifelong supplementation and patient education to prevent long-term health complications.

Because bacteria are resistant to medications, their capacity to create biofilms has made the healing process of infections more difficult. Thus, the current study sought to identify a different approach of employing nanotechnology to inhibit bacteria. The biological activity of bacteria against multidrug-resistant Escherichia coli isolated from a variety of diseases in the Diyala Governorate was investigated using magnesium nanoparticles (MgNPs) in conjunction with particular antibiotics. 155 samples were taken from patients with a variety of inflammatory diseases who were admitted to Baqubah Teaching Hospital between August 2024 and January 2025. Microscopy, morphological analysis and VITEC technology were used to characterize the isolates. The susceptibility to antibiotics was tested using the Kirby-Bauer disk diffusion method. The findings demonstrated that 58 E. coli isolate samples shown resistance to widely used antibiotics. Antibiotics and magnesium nanoparticles were used as treatments to evaluate the isolates. The findings demonstrated that as magnesium nanoparticle concentration increased, the E. coli inhibition zone progressively expanded, attaining optimal inhibition at 400 μg/ml and 0.01 mg/ml, respectively. Congo red agar was one of the phenotypic methods used to assess the capacity of particular E. coli isolates to produce biofilms. Methods: Ten (17.2%) of the 58 (100%) E. coli isolates did not form biofilms when the colonies remained pink or red, while 48 (82.8%) did so when dark, dry and crystalline colonies formed on CRA plates. The E. coli isolates were found to have the antibiotic resistance genes gyrA, Sul1, Ant (2)-1a, ermB, blaSHV and qnrA by molecular analysis. The goal of this research is to develop novel therapeutic medicines to manage specific illnesses and slow the spread of bacteria resistant to antibiotics.

Background: Diabetic Retinopathy (DR) is a leading cause of preventable blindness among patients with Type 2 Diabetes Mellitus (T2DM). Early detection through regular screening significantly reduces visual morbidity; however, awareness and adherence to screening remain suboptimal in many communities. Objective: To evaluate the level of awareness and knowledge of diabetic retinopathy among patients with type 2 diabetes mellitus in Hail city, Saudi Arabia. Methods: An analytic cross-sectional community-based study was conducted among adult residents aged 18-60 years in Hail. Data were collected using a structured, self-administered electronic questionnaire adapted from validated published tools. The questionnaire included demographic characteristics and 15 items assessing knowledge and awareness of DR. A pilot study was conducted to ensure clarity and feasibility. Data were analyzed using SPSS version 23. Results: A total of 245 participants were included in the study. The mean age was 40.64±16.49 years and 138 (56.3%) were females. Overall, 189 (77.1%) participants were aware that diabetes can affect the eyes and 176 (71.8%) knew that diabetic retinopathy may lead to blindness. However, only 104 (42.4%) were aware of the need for annual eye examination and just 98 (40.0%) reported undergoing regular retinal screening. Good knowledge level was observed in 112 (45.7%) participants, while 93 (38.0%) had moderate knowledge and 40 (16.3%) had poor knowledge. Higher educational status and longer duration of diabetes were significantly associated with better awareness (p<0.05). Conclusion: Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Hail is moderate but insufficient in key preventive aspects. Strengthening patient education, enhancing primary healthcare counseling and improving accessibility to retinal screening programs are essential to promote early detection and reduce preventable vision loss.

Extracts from cauliflower leaves were used to biosynthesise metal oxide nanoparticles. Copper and cadmium oxide nanoparticles (CuO and CdO) are among the most important metal oxide nanoparticles (MONPs) because of their physiochemical and anticancer characteristics, which aid in molecular diagnostics and therapy. Atomic Force Microscopy (AFM), Transmission Electron Microscopy (TEM), Field Emission Scanning Electron Microscopy (FE-SEM) and X-ray diffraction (XRD) were used to investigate the physicochemical characteristics of copper and cadmium oxides. One promising option for creating a novel class of anti-cancer drugs is metal oxide nanoparticles. Because of their small size, metal nanoparticles and their oxides have biological activity; they may approach, interact with and come into contact with bio-objects. The bioactivity of copper oxide and cadmium oxide nanoparticles against the MCF-7 breast cancer cell line was examined in this study and the results indicated that the copper oxide nanoparticles exhibited higher activity than the cadmium oxide nanoparticles.

Even with the wide use of contrast media in computed tomography procedures, there is lack of awareness about its advantages and safety among patients and public. If the patients know what contrast media is and what is the risk factor and complication and how it was administrated, they will not show any anxious and frightened during the contrast procedure and then reluctant cases will be decrease. This study aimed to explore the knowledge of Saudi community about contrast media and its complications. A descriptive and questionnaire-based survey was designed to evaluate knowledge of contrast media among citizens of Saudi community. Three hundred ninety-nine participants were enrolled in the study. Their age was range between 18 to 65. The male participants were greater than female. Most contributors were at university level. Members who had a low level of knowledge regarding contrast were 62.2%. 33.3% of candidates said there was harm from using contrast, while (28.1%) of candidates feel afraid from taking contrast and (30.3%) said the reason of fear is the method of introducing contrast media. Number of participants who did contrast procedure before were 20.1%. 37.8% of them received explanation from technologist about the method to give contrast media before the exam. Previous experience of other people is found to be the main source of information for contrast media (42.9%). Most candidates do not have enough authenticated knowledge about contrast and its safety and this make them afraid and hesitant from taking radiologic procedures with contrast media. There is a need for awareness programs for public people and good demonstrations of CM injection to the patients to overcome the anxiety and fear.

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder with growing evidence implicating immune, endocrine and metabolic dysregulation in its pathogenesis. Despite advances in genetic research, the roles of inflammatory cytokines, Growth Hormone (GH) and vitamin D3 (Vit D3) in ASD to elucidate the pathophysiology of this disease have not studied properly. Objective: To investigate the serum inflammatory biomarkers (IL-6, IL-10, IL-17 and CRP), endocrine regulators (GH) and Vit D3 in children with ASD. Methods: A total of 100 children aged 6-12 years were enrolled, including 70 with ASD and 30 neurotypical controls. ASD diagnosis was confirmed by a Pediatric neurospecialist using the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria. Then, venous blood samples were collected and analyzed using enzyme-linked immunosorbent assay and automated immunoassay analysers to determine the level of serum biomarkers. Results: Children with ASD exhibited no significant changes in serum levels of inflammatory/regulatory cytokines (IL-6, IL-10 and IL-17), while CRP levels were increased compared to controls (p>0.05). GH levels and Vit D3 concentrations were significantly lower in the ASD group than in the control (p<0.0001). Conclusion: The immunological involvement, endocrine imbalance and Vit D3 deficiency might be related to the development of the ASD in children.

Objectives: Bipolar disorder is a mental health condition characterized by alternating episodes of mania and depression. During manic phases, individuals may experience heightened moods, increased energy and reduced need for sleep. This is followed by periods of severe depression. Bipolar disorder is one of the top 10 mental disorders affecting young adults globally, accounting for 7.3% of the worldwide disease burden. Despite its prevalence, the condition is still poorly understood, with many misconceptions surrounding its causes and management. Objectives: Our study aimed to assess the knowledge and awareness level of bipolar disorder among Saudi population. Methodos: This cross-sectional study was carried out during 2024. Both male and female, aged between 17 and 65 years, who consented to participate. It collects basic demographic data from participants and uses a pre-existing questionnaire distributed via social media. The scoring system involves 11 statements evaluating demographics, knowledge and awareness, with Likert scale scoring. Participants are categorized into low, moderate and high levels based on their knowledge and awareness scores. Results: The study assessed the knowledge and awareness of bipolar disorder among 405 participants in Saudi Arabia, revealing significant insights. While an impressive 88.4% reported familiarity with the disorder, 41.5% underestimated its prevalence in society, indicating a potential gap in understanding. Demographic analysis showed that 57.3% of participants were female, with the majority from the Western region (55.3%). Though 72.1% lacked direct experience with mental illness, the primary sources of information were the Internet (69.1%) and social media (63.5%). Notably, 78.3% exhibited limited knowledge of bipolar disorder, underscoring the need for enhanced education despite high awareness levels. Conclusion: The findings of this study highlight a significant awareness of bipolar disorder among the Saudi population, yet reveal critical gaps in understanding its complexities and prevalence.

Background: Colorectal cancer is a leading cause of cancer-related mortality worldwide. Early detection is essential for effective treatment. Cancer-testis antigens, such as MAGE-A3, have been identified as potential biomarkers in cancer progression and therapy. This study aimed to evaluate the mRNA expression of MAGE-A3 in blood samples from patients with colorectal cancer (CRC) and non-malignant colorectal diseases (CRD). Methods: A total of 60 patients (30 CRC, 30 CRD) and 30 healthy controls were included. Ages (16-81), whose samples were collected from the Medical City Directory hospitals (GIT and Liver diseases Teaching hospital, Baghdad Teaching Hospital and Oncology Hospital) from 1st of November 2024 to 31 January 2025. and RNA was extracted using TRIzol™ reagent. Quantitative PCR (qPCR) was used to measure MAGE-A3 expression, normalised for the healthy control group. Statistical comparisons were made between CRC and CRD groups. The proportion of patients exhibiting gene expression levels above one is elevated in CRC. Results: sex distribution was not statistically significant (p>0.05), adenocarcinoma was the dominant type of cancer among such cases, a subgroup of patients (86.7%), The grade was moderately differentiated among the majority of patients (83.3%), MAGE-A3 mRNA expression was higher in CRC than CRD (52.6% vs. 47.4%; Likelihood Ratio = 4.317, df = 1, p = 0.038). Conclusion: MAGE-A3 mRNA expression is markedly elevated in CRC and may serve as a potential diagnostic biomarker for distinguishing malignant from benign colorectal conditions.

Background: Gas station workers are regularly exposed to a range of occupational and environmental hazards, particularly from fuel vapours and workplace conditions. Although the health effects of gasoline exposure are well documented, there is limited evidence on workers’ awareness of these risks and their adherence to safety practices, especially in high-density urban settings such as Makkah. Objective: This study aimed to assess occupational hazard awareness and safety practices among gas station workers in Makkah, Saudi Arabia. Methods: A mixed-methods approach with a convergent design was employed, combining structured interviews (n=62) with direct workplace observations. Workers were recruited from gas stations across multiple districts in Makkah. Quantitative data were collected using a structured interview questionnaire and analysed descriptively, while qualitative observational data were recorded in the field and analysed thematically. The observational component was used to compare and validate self-reported practices. Results: More than half of the participants (54.8%) reported experiencing at least one work-related health symptom, most commonly headaches (38.7%), cough (30.6%) and dizziness (14.5%). Nearly 60% had experienced at least one occupational incident, including fuel contact with skin or eyes and fire-related events. Only 19.4% demonstrated adequate awareness of occupational hazards and 41.9% reported no prior safety training. A clear gap was observed between reported attitudes and actual practices, as the use of personal protective equipment was limited during field observation. Conclusion: Gas station workers in Makkah show low levels of hazard awareness and poor adherence to safety practices, with inadequate training contributing to unsafe working conditions. Strengthening regulatory enforcement, ensuring mandatory safety training and improving compliance with personal protective equipment use are essential to reduce occupational risks and protect worker health.

Background: Communicable disease outbreaks remain a significant public health concern in hilly regions such as Himachal Pradesh, where environmental and seasonal factors influence transmission. This study aimed to analyse outbreak patterns over a five-year period (2021–2025) to understand their temporal, spatial and disease-specific distribution. Methods: A retrospective descriptive study was conducted using secondary data from the Integrated Disease Surveillance Programme (IDSP) for January 2021 to December 2025. Data on district, disease/illness, number of cases, deaths and time of occurrence were analysed. Descriptive epidemiological methods were applied to assess distribution by time, place and disease. Seasonal trends were evaluated by grouping months into four categories. Frequencies, proportions and percentage contributions were calculated. Results: A total of 34 outbreaks were reported, comprising 3,937 cases and 2 deaths. The highest number of outbreaks occurred in 2024 (17, 50.0%), accounting for the majority of cases (2,964) and all deaths. Acute diarrheal disease was the most common outbreak (18 outbreaks; 2,796 cases, 71.0%), followed by Hepatitis A (8 outbreaks; 702 cases, 17.8%). Dengue contributed 9.6% of cases, while HFMD and jaundice were minimal. Hamirpur (22.0%), Solan (20.6%) and Mandi (20.4%) together contributed over 60% of total cases. Most outbreaks occurred during monsoon (15 outbreaks; 1,478 cases) and post-monsoon periods (6 outbreaks; 1,208 cases), with peaks in November, October and June. Conclusion: Outbreaks were predominantly waterborne with clear seasonal clustering and geographic variation. Strengthening surveillance and targeted preventive measures are essential to reduce outbreak burden.

Background: Robotic Liver Resection (RLR) was developed to address some of the technical challenges faced with Laparoscopic Liver Resection (LLR). Since 2021, more comparative evidence has emerged, including a first randomized trial and numerous large multicenter cohorts. Objective: To synthesize evidence from 2021-2025 comparing RLR with LLR regarding their perioperative outcomes and costs. Methods: A systematic review was conducted following PRISMA 2020 guidelines and by searching the PubMed, EMBASE and Cochrane libraries from January 2021 to August 2025. Eligible studies were RCTs, meta-analyses and comparative cohorts with propensity score matching and case-matching/entropy matching. Relevant outcomes included operative time, blood loss, conversion to open procedure, complications, Length Of Stay (LOS), readmissions, R0 margin and cost. Results: A 2024 meta-analysis showed that RLR reduces conversion and morbidity rates but was associated with a higher rate of readmissions. Conversely, a 2025 meta-analysis showed that RLR has a superior outcome in minimizing blood loss, conversion rates and R0 margins when compared to other procedures. Additionally, a 2024 bottom-up economic model showed that RLR has higher costs; however, high-volume centers can mitigate this. Conclusion: RLR is a safe and efficient procedure that reduces conversion and blood loss when compared with LLR. However, it may result in a slightly lower morbidity, increased readmissions and higher costs.

Background: Gastroesophageal Reflux Disease (GERD) is one of the most common gastrointestinal disorders that adversely affects daily activities and quality of life, especially in medical students who lead a stressful and irregular lifestyle. Objective: The objective of this study was to assess the relationship between academic stress, lifestyle factors and GERD severity among a sample of medical students in Iraq. Methods: This study was a cross-sectional study conducted among 151 medical students from different medical colleges in Iraq between November 17, 2024 and February 18, 2025. This paper collected data through an online questionnaire including demographic characteristics, lifestyle habits, academic stress and GERD-related symptoms. Results: 53% male and 47% (71) female. The students were primarily in the fourth academic year (63 students), followed by fifth-year (23 students), third-year (22 students), second-year (22 students), sixth-year (20 students) and first year 1 student. Most participants lived in urban communities (109, 72.1%) and fewer participants resided in suburbs (21, 13.9%) or rural areas. The overall prevalence of heartburn (a typical symptom of GERD) was 60.9% (n = 92). The most common reported location of pain in the 87 records was the chest or upper abdomen (46 cases), followed by the stomach/epigastric region (32 cases) and the neck (7 cases). The pain was described as burning (85 cases) or tightening (12 cases) most often. Only 13% said it radiated to other parts of the body, like the arms or throat. Conclusion: Gastro-Esophageal Reflux Disease (GERD) symptoms were common among medical students and heartburn was the most prevalent symptom. These symptoms might be due to academic stress and lifestyle habits. The present study concluded that increased awareness and healthier lifestyle practices among medical students can reduce GERD and improve their general well-being and educational performance.

Introduction: Menstrual irregularities are common in adolescent females and are often related to abnormal Body Mass Index (BMI) and changes in biochemical measures. Hormonal imbalance, metabolic disturbances and diseases like polycystic ovary syndrome can have much influence on menstrual health. Aim: This study aimed to assess the effect of a nurse-led intervention in relation to body mass index and some biochemical parameters on menstrual irregularities in adolescent girls. Methods: A quantitative pre-experimental one group pre-test and post-test design was followed. The study was done in the gynaecology outpatient department of Government Hospital, Thoothukudi. A total of 200 adolescent girls with menstrual irregularities were selected using non-probability purposive sampling. A baseline data collection was done using demographic variables, menstrual assessment checklist, BMI measurement and biochemical investigations. A structured nurse-led intervention comprising health education and lifestyle modification was delivered for 24 weeks, with outcome assessments performed at baseline and at the 8th, 16th and 24th weeks. Data were analysed with descriptive statistic, repeated measures Analysis of Variance and Chi-Square test. Results: Significant improvements were found in physiological and biochemical parameters between visits. BMI decreased from 31.99 to 31.08 (F = 97.003, p<0.001). Random blood sugar, total cholesterol, triglycerides, urea, creatinine, T3, T4 and TSH reduced significantly (p<0.001). There was a significant improvement in ultrasound findings with a significant increase in normal findings from 85.5% at visit 1-99.5% at visit 3 (chi-squared = 26.971, p<0.001). Conclusion: The nurse-led intervention was effective in improving BMI, biochemical parameters and ovarian morphology which indicated the overall improvement in the metabolic and reproductive health of the adolescent girls with menstrual irregularities.

The Saudi Health Sector Transformation Program (SHSTP) is a central pillar of Vision 2030. It has accelerated the transition toward data-driven performance monitoring in hospitals nationwide. The healthcare system is currently undergoing significant reforms and massive digital expansion. This study draws on routine hospital dashboard data collected between 2019 and 2023, covering a regional, case-based exploratory sample of four hospitals two clustered and two non-clustered across the Mecca and Al-Sharqiyyah regions. We use collected indicators to track service availability and patient-centered progress. However, the administrative nature of the data and inconsistent datasets require careful interpretation. Objective This study aims to present a cautious, descriptive assessment of quantitative performance indicators, treating these as exploratory signals to support the ongoing evaluation of the SHSTP, rather than as definitive measures of programme performance or policy impact. Methods We examined routine hospital dashboard data from 2019 to 2023. The study covered both clustered and non-clustered facilities. Key indicators included patient satisfaction, wait times, bed occupancy, and readmission ratios. We also analysed digital metrics such as telemedicine application, Electronic Medical Record (EMR) documentation, and online appointment scheduling. We used descriptive summaries and periodic visualizations to identify patterns without applying inferential analysis. We noted data gaps, essential modifications, and administrative artifacts to reflect the limitations of routine information systems. Results Patient satisfaction scores displayed a broadly upward directional pattern across all four hospitals, with periodic fluctuations reflecting operational transitions and reporting variability. Outpatient and emergency wait-time indicators showed mild downward patterns. Digital health indicators specifically telemedicine encounters, EMR usage, and online appointments showed strong upward signals. Clustered hospitals demonstrated more consistent directional patterns compared to non-clustered facilities. However, readmission ratios and bed-occupancy rates remained variable and showed no clear directional improvement, highlighting areas of persistent uncertainty in the data. Regional variations indicated different stages of implementation maturity. Conclusions Our findings reflect positive but inconsistent directional signals in SHSTP service performance. These signals should not be interpreted as evidence of causal performance improvement; they represent preliminary, context-specific observations from a small regional exploratory sample that cannot be generalised to the national healthcare system. The results highlight a critical need for stronger data governance, standardized indicator definitions, and continued investment in digital capacity. These elements will play a pivotal role in building a robust national reform monitoring system.

Introduction: Toothbrushing is the most common method of plaque control. However, brushing efficacy depends heavily on technique, duration and user compliance. Objective: To evaluate the clinical efficacy of a novel beat sound-guided toothbrush supporting vertical brushing versus a conventional manual toothbrush, using standardized plaque and gingival health indices. Methods: A total of 100 adults (50 per group) were enrolled in a randomized controlled trial. Group A used a flat-trim conventional toothbrush, while Group B used a sound-guided vertical brushing system. Assessments were conducted at baseline and after four weeks using the Plaque Index (PI), Gingival Index (GI) and Oral Hygiene Index-Simplified (OHI-S). Both groups received standardized oral hygiene instructions. Plaque Index (PI), Gingival Index (GI) and Oral Hygiene Index-Simplified (OHI-S) were recorded at baseline and after 4 weeks by a calibrated examiner blinded to group allocation. Intergroup comparisons were performed using independent t-tests, with significance set at p<0.05. Results: The sound-guided group showed significantly greater reductions in PI (59.2%), GI (58.6%) and OHI-S scores compared to the control group (p < 0.001). A strong correlation was observed between plaque and gingival inflammation (r = 0.72). Conclusion: Sound-guided vertical brushing significantly improves plaque control and gingival health, offering a promising behavioral aid for enhancing oral hygiene compliance in adults.

Background: Gluten allergy (GA) is described in this study as a gluten-related condition associated with immune-mediated responses following gluten ingestion in susceptible individuals. It is estimated to affect around 1% of the global population and may present at any stage of life. This study aimed to evaluate public awareness and perception of GA among adults in Arar City, the capital of the Northern Border region of Saudi Arabia. Methods: A cross-sectional descriptive survey was conducted between March and August 2025. Data were collected using a structured questionnaire developed from previously published studies, translated and pilot-tested for clarity. The survey was distributed online through social media platforms and included items on sociodemographic characteristics, knowledge of symptoms, risk factors, complications, and perceived social impact of GA. Results: A total of 400 participants completed the survey (mean age 32.4±11.7 years). The sample was predominantly young, female, and university educated. Overall, 74.2% of participants had heard of GA. However, knowledge gaps were evident, as only 47.3% recognized that GA affects the small intestine. While 70% correctly indicated the need for a special diet, misconceptions about symptoms and disease characteristics were common. Fatigue (61%) and abdominal distension (56.2%) were the most frequently identified symptoms. Rheumatoid arthritis was the most commonly reported associated risk factor (83.2%), and malnutrition (50.5%) was the most recognized complication. Regarding social impact, 60.4% of participants believed that individuals with GA experience hesitation when eating outside the home, and 49.5% reported difficulty in accessing gluten-free products. Conclusion: Although general awareness of GA was relatively high, detailed understanding of its clinical features and complications remains limited among the studied population. These findings highlight the need for targeted public health education and improved community awareness to support early recognition and better management of gluten-related conditions.

Background: Appendicitis is a public and crucial surgical condition that necessitates prompt intervention to avert severe difficulties. Objectives: This scholarship aims to evaluate the efficacy of surgical treatment as the gold standard for dealing with appendicitis. Methods: A total of 66 patients with appendicitis in many hospitals in Baghdad were involved in the study. The patients endured appendectomy, either through open surgery or laparoscopic practices. Data were gathered on patient demographics, symptoms, analysis, surgical consequences, and postoperative recovery. Results: The results confirmed a high achievement rate of appendectomy in handling appendicitis, with minimal problems and favourable outcomes. The complications particularly wound infections was documented, where in current study also reported a wound infection of 20% among the patients who underwent surgical therapy, 75% among those that had late surgery, and 17.5% among early surgical intervention. Conclusion: Laparoscopic surgery was linked with shorter hospital delays, reduced postoperative pain, and quicker homecoming to normal activities associated with open surgery. This study highlights the importance of prompt diagnosis and prompt surgical intervention in achieving optimal results for patients with appendicitis in Baghdad. The results support the constant use of surgical treatment as the gold standard for appendicitis management.

Background: Malignant neoplasms are common and are associated with multiple complications that require hospital admissions. Therefore, this study aimed to investigate trends in hospital admissions for eye cancer in Australia. Methods: This is a time trend analysis study used data from the National Hospital Disease Database for the durations between 1998 and 2023. Admissions related to malignant neoplasm of eye and adnexa were identified using relevant ICD codes (C69). Results: Over the 25 years from 1998/1999 to 2022/2023, Australia recorded 18,679 hospitals admissions due to “malignant neoplasm of eye and adnexa”. Besides, 51.2% (9,556) of these admissions were overnight and 48.8% (9,123) were same-day. From 1998/1999 to 2022/2023, there was a 53.0% increase in the overall number of admissions from 624 to 955, a 62.2% increase in same-day admissions from 275 to 446 and a 45.8% increase in overnight admissions from 349 to 509. Age group 0-14 years accounted for 41.3% or 7,720 of total admissions and males accounting for 54.3% or 10,137 of total admissions. A total of 74.1% of these admissions were due to “malignant neoplasm of retina”. Conclusion: Our study found several significant findings related to trends in hospital admissions due to “malignant neoplasm of eye and adnexa” in Australia. Younger people (less than 15 years old) represented the largest age group of patients admitted to the hospital during the study period; therefore, admissions due to “malignant neoplasm of retina” were the most common diagnoses. Thus, there is a need to implement interventions aimed at reducing hospital admissions due to “malignant neoplasm of eye and adnexa,” particularly for young people and males.

Background: Obesity is a major risk factor for Type-2 Diabetes Mellitus (T2DM). Bariatric surgery effectively promotes weight loss and improves related comorbidities. Objectives: This study aims to assess public awareness of the advantages of bariatric surgery for patients with T2DM in the Northern border region of Saudi Arabia. Methods: This cross-sectional study was conducted between December 2023 and February 2024. Data were collected using a self-administered electronic questionnaire distributed via Google Forms, which assessed sociodemographic characteristics, obesity stage-related behaviors, awareness and perceived outcomes of bariatric surgery among patients with T2DM. The Mann-Whitney test, the Chi-squared test and the Fisher's exact test were used for data analysis, as appropriate. A p-value of <0.05 was considered statistically significant. Results: A total of 486 adults (>18 years) were included. Most participants (76.75%) had been exposed to obesity- and diabetes-related awareness messages. A higher proportion of participants with T2DM believed that obesity does not affect insulin sensitivity compared with non-diabetics (13.79% vs. 4.44%; p = 0.02). More than half were unaware of the eligibility criteria for bariatric surgery. Among participants with T2DM, mineral deficiency (60.34%) and gastric leakage (46.55%) were the most reported complications. Only 23 participants had undergone bariatric surgery, of whom three out of four diabetic subjects achieved normal blood glucose levels postoperatively. Conclusion: Despite widespread exposure to obesity and diabetes awareness messages, persistent misconceptions about obesity, insulin resistance and bariatric surgery highlight the need for targeted education to improve understanding and support better diabetes outcomes.

The universitysation of nursing education and the competency-based approach require a change in teaching practices. Simulation is now establishing itself as a response to the ethical imperative of "never the first time on a patient." This literature review aims to analyse the impact of simulation on the development of clinical reasoning, metacognitive mechanisms and psychological factors influencing student learning. Thematic analysis of a corpus of eleven primary documents (articles, theses, symposiums) published between 2016 and 2024. Simulation promotes hypothetical-deductive reasoning and allows the identification of "dangerous knowledge" through debriefing. However, performance anxiety remains a major obstacle to learning. While simulation is a major lever for healthcare safety, its effectiveness depends on the rigor of the debriefing and the trainer's ability to ensure a safe learning environment.

Background: Artificial Intelligence (AI) is rapidly transforming education and healthcare, offering opportunities to enhance learning and practice in nursing. However, its integration into nursing education raises questions about its effectiveness and impact on students and educators. Aim: This study explores the role of AI in nursing education, focusing on its benefits, challenges and implications for students and faculty at a nursing college in Saudi Arabia. Methods: Using an exploratory cross-sectional design, data were collected from 235 participants, including nursing students across all academic levels and faculty members, through a structured online survey. This study was conducted at selected nursing college of Saudi Arabia. The analysis involved descriptive and inferential statistical techniques using SPSS to identify trends and correlations related to AI knowledge, practices and perceptions. Results: Knowledge and skills on AI were assessed separately with four-point scale ranging from strongly agree to strongly disagree. The findings reveal that 70% of the participants displayed sufficient knowledge of AI, knowledge questions are related to information on computer operations and how AI technology helps to make decisions and judgements. About 75% of the subjects reported limited skills in using AI technologies. This finding shows that skill gaps in the application of AI tools. It was analyzed by how much the participants are able to use AI tools. This study was strongly agreed that the participants have less skills in handling AI tools and there was a wide gap between knowledge and skills. Strong statements about AI improving learning are not balanced against the reported skill gaps and difficulties. About 82% of them experienced challenges in managing high- profile AI tools. Despite these obstacles, 77% of the respondents strongly agreed that AI significantly enhances learning by personalizing and streamlining educational experiences. Popular tools, such as ChatGPT and AI-assisted presentations, were identified as practical resources. However, concerns about reduced critical thinking and social interaction skills were prominent, emphasizing the need for balanced AI integration. This results analysis showed significant associations between socio-demographic factors and perceptions of AI's role in nursing education. Conclusion: AI offers significant promise in revolutionizing nursing education and equipping students and educators with innovative teaching and learning AI tools. Nevertheless, these advancements must be paired with comprehensive training, ethical safeguards and strategies to address challenges like overreliance on AI and skill erosion. By thoughtfully integrating AI, nursing education can achieve a balance between technological innovation and the preservation of essential human- centric skills.

Background: This study has shown that Knowledge, attitudes and practices of the nurses in the hospitals in Mosul offer systemic, educational and emotional obstacles of effective management of pain in pediatric oncology. Methods: A mixed-methods design was implemented in period between February 18 and July 14, 2025 and it was cross-sectional study. A sample size of 150 nurses working in hospitals in Mosul in pediatric oncology was studied through structured questionnaires, which were used to collect quantitative data concerning demographics, knowledge, attitudes, training and practices of pain management. To enhance knowledge, 15 nurses were purposely selected and interviewed semi-structurally to discuss their Covid-19 experiences, insurance in their ways of thinking, training necessities and emotional problems. To obtain the main patterns, qualitative data were analyzed in a thematic way. Results: The majority of the sample were females (78%) relatively with different experience levels and 65.3 percent of them were employees of sector-specific oncology centers. Pharmacologic pain management was also common (92%) and 85 percent of them were trained. Less were used (66.7%) and trained (20%) in the nonpharmacologic methods. There was a significant correlation between Formal training and use of nonpharmacologic (2 = 12.34, p<0.0001). Organizational barriers were also lower in nurses that worked in oncology centers than in general pediatrics (t = 3.45, p = 0.001). Among the key challenges, one could name staffing shortage (74%), lack of education (63.3%), the issue of opioids (58%) and burnout (46%). The findings offered detailed qualitative roles and the barriers, lack of training and emotional stress in managing pain in children. Conclusion: The analysis also reveals that there exist serious training deficiencies, particularly in nonpharmacologic pain management and they require the system to be changed and nurses to be emotionally supported.

Amyloid-beta (Aβ) plaques, neurofibrillary tangles of hyperphosphorylated tau, and persistent neuroinflammation are the hallmarks of Alzheimer's disease (AD), a progressive neurodegenerative illness that frequently manifests symptoms of cerebral insulin resistance. The possible neuroprotective properties of Exendin-4 (Ex-4), a long-acting glucagon-like peptide-1 receptor agonist (GLP-1RA) currently licensed for type 2 diabetes mellitus (T2DM), have attracted a lot of attention. Ex-4 effectively reduces (Aβ) buildup, mitigates tau hyperphosphorylation, and suppresses neuroinflammation and oxidative stress through the GLP-1 receptor (GLP-1R) pathway, as preclinical studies show. Although these data point to Ex-4 as a potentially effective disease-modifying drug, human clinical trials have so far shown conflicting findings about the cognitive and clinical effects of Ex-4 in moderate cognitive impairment (MCI) and early AD. The present body of evidence is summarized in this review, which also examines the known mechanisms of Ex-4 neuroprotection, examines the results of finished clinical studies, and talks about the direction of its clinical use in Alzheimer's disease.

Background: A factorial nursery experiment was carried out in spring and autumn of 2023– 2024 at a private nursery within Babylon Province, Iraq, to investigate the influence of biofertilizers combined with Libro organic fertiliser on Murraya paniculata (L) Jack. Objectives: assess impact of AMF, Bacillus, and Libro organic fertilizer on vegetative growth, flowering, leaf mineral content, and bioactive compounds. Present as concise subsection; align with measured outcomes. biofertilizer treatments were tried with non-inoculation as control (M0), arbuscular mycorrhizal fungus Glomus mosseae (M1), Bacillus circulans (M2) and a combination of both G. mosseaeand B. circulans inoculant (M3). These treatments were also mixed with three doses of Libro (0, 5 and 10 ml L⁻¹; F0, F1 and F2) in a completely randomised block design and with three replicates. Observations were taken on vegetative growth, flower character and leaf mineral content (N, P and K), bioactive compounds, as well as mycorrhizal colonisation. Responses varied by trait. The highest mean plant height (96.43 cm) and leaf area (4277.85 mm²) were obtained in the M1 treatment, while Bacillus inoculation (M2) yielded the highest mean leaf number (80.98 leaves plant⁻¹), potassium content (5.5007%), alkaloid content (0.370 mg AE g⁻¹), and total carbohydrates: 20.44%; Only plantation of Musso alone or with phosphorusous were statistically different from the other treatments for all variables. M3 (combined inoculation) recorded the highest means of chlorophyll content (28.62 mg 100 g-1 fresh weight), inflorescence number (17.88 plant-1), Inflorescence diameter (59.05 mm), phosphorus content (0.6429%) and total phenolics concentration (17.14 mg GAE g-1 dry weight). Within Libro types, F1 gave the tallest plant (105.25 cm), and F2 improved many characters, including leaf area, inflorescence diameter, N, P, K and carbohydrate content. Involvement of interaction effects was observed: M1F2 in plant height (117.13 cm) and leaf area (5310.70 mm²), M2F1 in inflorescences (26.35 plant⁻¹), M3F2 in phenolics (19.11 mg GAE g⁻¹), and M2F1 for alkaloids (0.456 mg AE g⁻¹). Table 14. Also, strong AMF structures were recorded from inoculated roots (100% TC and HC in both M1 and M3). In general, the results realised in this study showed that an integration of biofertilizers with organic fertilization positively enhanced several growth and quality characters in the nursery.

Background: Globally, artificial intelligence (AI) is changing healthcare processes. It has upgraded decision making, efficiency, and accuracy in this sector. Digital health transformation is national priority for Saudi Arabia (SA) as per Vision 2030. However, empirical evidence lacks for how AI-based operational management systems (AI-OMS) affects employee performance (EP) for SA healthcare sector. Objective: This research aims to examine the impact of AI-OMS on EP for healthcare professional in SA. Moreover, the study also investigates the mediating role of technology readiness (TECHR). Methods: The study considered quantitative and cross-sectional research design. For this purpose, the data was collected using close-ended survey questionnaire from 574 respondents. These includes the healthcare professionals such as doctors, allied health staff, nurses, administrators, etc. Validated scales from prior studies were adapted for 31 items of three constructs; AI-OMS, TECHR, and EP respectively. The analysis of data was executed using SPSS version 27 which includes demographic summary, descriptive statistics, and regression using Hayes process. Results: AI-OMS significantly predicted EP and TECHR (β₁ = 0.5985, p-value <0.001, β₂ = 1.0792, p-value <0.001). Additionally, TECHR predicted EP (β₃ = 0.4662, p-value <0.001). Moreover, a partial mediation was confirmed using TECHR (β₄ = 0.5032, p-value <0.001). Conclusion: The study concludes a positive effect of AI-OMS on EP. This positive impact is partially mediated through TECHR. Hence, digital transformation is empirically confirmed in healthcare sector of SA which also meets their national priority as per Vision 2030.

Background: Cervical abrasion is a common non-carious cervical lesion, particularly in patients with Fixed Partial Dentures (FPDs), where abutment teeth are exposed to increased mechanical stress during tooth brushing. Toothbrush design and brushing technique significantly influence lesion progression. Aim: To compare the progression of cervical abrasion in FPD abutment teeth using a sound-guided novel toothbrush versus a conventional manual toothbrush. Materials and Methods: Eighty adults requiring FPDs and presenting with mild pre-existing cervical abrasion (Smith and Knight score 1-2) were randomly allocated into two groups: Group A (conventional toothbrush) and Group B (sound-guided novel toothbrush). Participants brushed twice daily for six months. Cervical abrasion was assessed at baseline and follow-up using the Smith and Knight index. Intra- and inter-group comparisons were performed using paired and independent t-tests. Results: Both groups exhibited progression of cervical abrasion over six months. Group A demonstrated a mean increase of 0.6±0.2, whereas Group B showed a smaller increase of 0.2±0.1. The difference in progression between groups was statistically significant (p<0.05). Conclusion: Cervical abrasion progressed in both groups; however, progression was significantly lower among users of the sound-guided toothbrush. Auditory feedback may assist in modifying brushing movements and reducing mechanical stress at the cervical region. Larger and longer-term studies are required to confirm these findings.

Recent years have seen a significant shift in pharmacy practice due to a number of factors, including changing patient expectations, workforce shortages, digital innovations, and growing healthcare demands. Through new roles and creative service models, pharmacists are becoming more involved in clinical care, public health campaigns, and health system optimisation. The evidence from about thirty peer-reviewed studies, policy reports, and professional guidelines mostly published between 2015 and 2026 is compiled in this narrative review. Targeted searches of important databases, such as PubMed and Scopus, along with pertinent organisational reports, were used to find the literature. The review looks at important areas of innovation, such as telepharmacy and digital health, increased clinical roles and prescribing, point-of-care testing, automation, artificial intelligence, pharmacogenomics, and speciality pharmacy services. Research shows that chemist prescribing and test-and-treat models are linked to high patient satisfaction and safe clinical outcomes when supported by suitable governance frameworks, while digital transformation has improved access to pharmaceutical care, especially in underserved settings. Although there is still little empirical data, automation and artificial intelligence have the potential to improve operational effectiveness and medication safety. Speciality pharmacy and pharmacogenomics are two new fields with promising clinical potential, but they have issues with workforce preparedness, infrastructure, and reimbursement. Inconsistencies in outcome measurement, a dearth of implementation-focused research, and a lack of focus on equity continue to be major obstacles in all domains. In general, pharmacy practice is moving toward more patient-centered, technology-enabled, and integrated care models; however, the most important factor in determining success is not innovation per se, but rather the capacity to.

Background: Ocular diseases, including cataracts, retinal disorders, iris and ciliary body disorders, nasolacrimal duct obstruction, pterygium, and glaucoma, represent some of the most prevalent eye conditions in Iran. Objective: This study aimed to investigate the relationship between income deciles, insurance type, and the prevalence of major ocular diseases. Methods: This cross-sectional study was conducted between 2023 and 2024, with approval from the university ethics committee. Data were extracted from electronic health records of patients diagnosed with ocular diseases at selected hospitals in Iran. The diseases included cataracts, retinal disorders, iris and ciliary body disorders, pterygium, nasolacrimal duct obstruction, and glaucoma. Data were compiled in Excel. Statistical analyses were performed using chi-square and Fisher’s exact tests in SPSS version 26. Results: The most frequently diagnosed ocular diseases were cataracts (67.4%), retinal disorders (12.4%), iris and ciliary body disorders (11.1%), pterygium (5.2%), nasolacrimal duct obstruction (2.9%), and glaucoma (1.0%). Prevalence was significantly higher in the lower income deciles (1–3) for cataracts, retinal disorders, pterygium, nasolacrimal duct obstruction, and glaucoma. In contrast, iris and ciliary body disorders showed higher prevalence in the middle-income deciles (4–7). Both chi-square and Fisher’s exact tests confirmed significant associations between income level, insurance type, and the prevalence of these ocular diseases (p<0.05). Conclusion: The disproportionately high burden of ocular diseases among lower-income groups underscores socioeconomic disparities and barriers to healthcare access. Targeted policies to expand insurance coverage, promote regular eye screenings, and improve access to preventive and therapeutic eye care are essential to reduce these inequities.

Background: Ophthalmology is underrepresented as examinable material among medical students, possibly unintentionally so. This study aims to assess medical students and residents perceived comfort, knowledge, and confidence in ophthalmology. Method: A cross-sectional survey among medical students at Umm Al-Qura University, located in Makkah, Saudi Arabia was distributed, and 39 students were included in the analysis. Results: Most students rated their knowledge as average or below average across the majority of areas. For ocular manifestations of systemic diseases, 18 (46.2%) rated their knowledge as average, while only 1 (2.6%) rated it as excellent. Among all the examined variables, only clinic-based learning was associated with knowledge in ophthalmology skills (OR = 15.24, 95% CI :1.31-177.56, p = 0.03). Conclusion: This study highlights significant deficiencies in ophthalmology knowledge and clinical confidences among medical students and junior residents. Although basic ophthalmic concepts and skills are moderately understood, there remains a considerable gap in the diagnosis and management of more complex or less frequently encountered eye conditions. Studies with larger sample size are recommended to validate these findings.