Background: Laparoscopic gastrectomy with Roux-en-Y reconstruction is a widely accepted procedure for gastric cancer. However, evidence on its short-term outcomes in the Indian population remains limited. Methods: This prospective observational study was conducted in the Department of General Surgery, Government Medical College, Srinagar, over 18 months. Patients with operable gastric carcinoma undergoing laparoscopic gastrectomy with Roux-en-Y reconstruction were assessed for intraoperative parameters, complications, lymph node yield and short-term postoperative outcomes. Results: Thirty-one patients were included (mean age 63 years; M:F = 3:1). Total gastrectomy and D2 lymphadenectomy were performed in most patients. The antecolic approach had a shorter operative time than the retrocolic approach (p<0.001). The mean blood loss was minimal and the overall complication rate was 16.1%, with no perioperative mortality. The mean hospital stay was 6-7 days and no cases of Roux limb stasis were observed. Conclusion: Laparoscopic Roux-en-Y reconstruction after gastrectomy is safe, feasible and associated with minimal morbidity and satisfactory short-term oncological outcomes.

Introduction: A severe depressive episode with a peripartum onset is referred to as postpartum depression, which means that the most recent episode happened both during pregnancy and in the four weeks immediately following birth. Objectives: Objectives were to study the awareness and knowledge level regarding postpartum depression after multiple pregnancies among Saudi women. Method: A cross-sectional study was carried out with Saudi women with multiple pregnancies in Saudi Arabia based on a structured questionnaire. The questionnaire consisted of both closed-ended and multiple-choice questions, divided into sections covering sociodemographic information, familiarity with PPD, personal and observed experiences, recognition of symptoms, sources of information, perceived risk factors, cultural influences, barriers to seeking help, and views on available support services. Results: A total of 106 participants, primarily from the Makkah region, were surveyed using a structured questionnaire. While 97.2% had heard of PPD, only 18.9% were very familiar with it, and 20.8% were unaware it could occur after multiple pregnancies. Cultural factors such as lack of extended family support (72.6%) and societal pressures (62.3%) were commonly cited risk factors. Although 79.2% believed PPD is a significant issue, 77.4% had never discussed it with a healthcare provider, and 83% were unaware of existing support services. Social media was the most common information source. Cultural stigma and lack of appropriate services were major barriers. Prior knowledge of PPD was significantly associated with familiarity levels (p=0.001), and awareness of support services significantly influenced perception of provider adequacy (p=0.002). Findings highlight the need for culturally tailored interventions. Conclusion: This study contributes to the emerging discourse surrounding postpartum depression by exposing critical knowledge gaps among multiparous women in Saudi Arabia. Despite high levels of general awareness, the findings suggest a pressing need for targeted educational initiatives that address specific misconceptions and barriers to care.

Background: In order to reduce the need for medication in the treatment of Type 2 Diabetes Mellitus (T2DM), physical activity (PA) is essential and has been demonstrated to have established metabolic effects. However, to assess the association between PA intensity and glycemic control in large and heterogeneous groups, thorough research must be conducted. Methods: 400 persons with T2DM participated in the cross-sectional study, to assess the association between PA and glycemic levels. Participants were divided into three groups according to their levels of physical activity: low, moderate, and high. Glycated hemoglobin (HbA1c) was used to measure glycemic control; levels of ≤7.0% indicated clinically optimum control. The relationships and prediction power were investigated using a receiver operating characteristic (ROC) curve, one-way ANOVA with Bonferroni corrections, and bivariate correlation analysis. Results: The cohort's average age was 57.85 ± 9.27 years, and 55.3% of individuals were females. Of the participants, 39.75% had moderate, 36% higher, and 24.25% lower PA levels. Higher PA was associated with better glycemic management, as seen by a statistically significant negative association with HbA1c (r = -0.244, p<0.01). The mean HbA1c was 8.77% in the low PA group, 8.03% in the moderate PA group, and 7.67% in the high PA group. These differences were statistically significant (F (2, 397) = 18.75, p<0.001), with the low PA group having significantly higher HbA1c levels than both the moderate and high PA groups (p<0.001). The ROC analysis showed that PA had a fair ability to predict glycemic control, with an AUC of 0.722 (95% CI: 0.673–0.770, p<0.001). Conclusion: PA was significantly associated with glycemic management in people with T2DM. The results support the inclusion of structured and customized PA plans in routine diabetic care, since this may help lower long-term complications.

Background: The relationship between academic stress and body composition among university students remains unclear, particularly within the Saudi context. This study investigated the associations of academic stress-measured using the validated Perceived Academic Stress (PAS) scale-and sociodemographic characteristics with body composition indicators, namely Body Mass Index (BMI) and Tri-Ponderal Mass Index (TMI), among students in the Western region of Saudi Arabia. Methods: A cross-sectional online survey was conducted among 651 university students aged 18-26 years during the 2024-2025 academic year. Participants self-reported sociodemographic data, anthropometric measures (height and weight) and responses to the 18-item PAS scale. Multiple linear regression analyses with backward elimination were performed to assess the associations of academic stress and sociodemographic factors with BMI and TMI. Results: Academic stress, whether assessed by the total PAS score or its subscales, showed no significant association with BMI (p = 0.653) or TMI (p = 0.674). In contrast, gender and age were significant predictors across both indices, while part-time employment was significantly associated with higher TMI. However, the explanatory power of the models was low (R² = 6.2% for BMI; R² = 2.5% for TMI), indicating that these factors accounted for minimal variance in body composition. Conclusion: Sociodemographic characteristics-particularly gender, age and employment status-were modestly associated with body composition, whereas academic stress was not. Given the limited predictive strength of these variables, future studies should employ longitudinal designs and objective anthropometric assessments while incorporating behavioral mediators such as diet, physical activity and sleep to better explain adiposity in this population.

Background: The BCR-ABL fusion gene drives chronic Myeloid Leukemia (CML), resulting in an oncoprotein with excessive tyrosine kinase activity that promotes abnormal cell growth. Treatments with tyrosine kinase inhibitors (TKIs) induce oxidative stress, but resistance can develop due to compromised antioxidant defenses. Reactive oxygen species (ROS) play a dual role; low levels support cell signaling, while high levels cause damage. The body counters ROS through antioxidants enzymes. In cancer, malignant cells adapt by managing oxidative stress, influencing therapy response. Objectives: The present study aimed to investigate redox homeostasis and antioxidant defense regulation in patients with chronic myeloid leukemia (CML) by measuring the levels of catalase (CAT), superoxide dismutase (SOD), glutathione (GSH), and reactive oxygen species (ROS) in three groups of patients receiving different tyrosine kinase inhibitor (TKI) therapies, and compared them with newly diagnosed CML cases and healthy controls. Furthermore, we sought to assess the potential of these redox markers as biomarkers for disease progression and therapeutic response. Methods: Blood samples of 120 CML patients (20 newly diagnosed and 100 on TKI) and 60 healthy controls were analyzed via ELISA. Results: results showed a significant oncogene's redox-disrupting effects in CML patients characterized by decreased levels of (CAT, SOD, GSH) and increased ROS versus controls (all p<0.001). TKI treatment improved most markers (p<0.05) except GSH. Conclusions: These findings highlight the potential of antioxidant enzymes and ROS as biomarkers of disease progression and treatment response in CML, and support the relevance of redox homeostasis in therapeutic monitoring.

Background: The global rise in cesarean section (CS) rates has raised concerns about maternal and neonatal health. In Saudi Arabia, increasing CS rates reflect not only medical factors but also cultural beliefs, misconceptions and insufficient antenatal education that influence women’s delivery choices. Understanding women’s knowledge and attitudes toward different delivery modes is essential to guide targeted health interventions and reduce unnecessary CS procedures. Objective: This study assessed the knowledge and attitudes of women in the Hail region, Saudi Arabia, toward vaginal delivery (VD), cesarean section and postpartum complications. It also examined the sociodemographic factors influencing these perspectives. Methods: A descriptive cross-sectional study was conducted among 383 women aged 18–45 years in the Hail region between October and December 2024. Data were collected through a validated, structured online questionnaire distributed via Google Forms. Descriptive and inferential statistics, including t-tests, ANOVA and correlation analyses, were applied using SPSS version 25, with significance set at p<0.05. Results: Among participants, 54.6% preferred vaginal delivery, 16.2% preferred cesarean delivery and 29.2% were undecided. The mean overall knowledge score was moderate (M = 64.54, SD = 7.76). Knowledge of vaginal delivery was significantly higher (M = 86.45) compared with cesarean section (M = 57.70) and postpartum complications (M = 49.48) (p<0.001). Age, marital status, education and employment status were all significantly associated with knowledge scores. Despite this, awareness of postpartum complications remained low across all demographic groups. Conclusion: Although most women in Hail prefer vaginal birth, substantial knowledge gaps persist regarding cesarean risks and postpartum complications. Culturally tailored educational initiatives, such as structured antenatal classes, mobile health applications and community-based programs, are recommended to enhance maternal health literacy, support informed decision-making and reduce non-medically indicated cesarean sections.

Objectives: Preeclampsia is a key cause of maternal morbidity and mortality worldwide, accounting for 34% of maternal deaths in Pakistan. Though the associated maternal-fetal complications can be reduced through preventive measures and strict monitoring. This study aimed to evaluate by comparing the effects of early calcium supplementation vs. delayed calcium supplementation on biomarkers (PlGF, sFlt-1, PP-13) in high-risk pregnant women for preeclampsia in Karachi, Pakistan. Methods: The study enrolled 150 pregnant women into a control and treatment group (75 each). The treatment group received calcium during the first trimester, while the control group began calcium supplementation at 12 weeks of gestation. Blood samples were collected at the outset and during follow-up for the measurements of serum biomarkers for preeclampsia [Human placenta growth factor (PlGF), Human soluble fms-like tyrosine kinase receptor 1 (sFlt-1), and Human Placental protein 13 (PP13)] by Enzyme-Linked Immune Sorbent Assay (ELISA) method. The collected data of serum biomarkers were tabulated and reported as Mean ± SD. Levels of serum biomarkers (PlGF, sFlt-1, and PP13) were analyzed by student’s t-test, setting a significance level of ≤ 0.05 through SPSS 21. Results: The treatment group showed increased levels of PlGF and PP-13, while the control group had higher PlGF levels in the first trimester. In the second trimester, the calcium treatment group showed lower sFlt-1 levels and higher levels of PlGF and PP-13 than the control group. Conclusion: This study suggests early calcium supplementation could protect high-risk pregnant women, particularly in middle- and low-income countries.

Gastrointestinal ulcer is one of the common diseases, affecting more than 10% of the world’s population. Aim of the study: The present study aimed to assess C-reactive protein (CRP), white blood cell (WBC), malonaldehyde (MDA), glutathione (GSH), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) in gastrointestinal ulcer rats after being treated with cow milk and glutathione. This study was conducted in the laboratories of the Department of Food Sciences at the College of Agriculture, Tikrit University; the Animal House at the College of Veterinary Medicine, Tikrit University; and the Central Laboratory at the Presidency of Tikrit University. The research was conducted from September 2024 to January 2025. A sample of 20 sexually mature male animals was used, randomly distributed into 4 groups of similar animals as follows: M1 (healthy control group, n = 5), M2 (infected with a gastrointestinal ulcer after being orally dosed with ethanol as a control group, n = 5), and M3 (the group of animals infected with a gastrointestinal ulcer and treated after being orally dosed with cow's milk at a concentration of 5 ml, n = 5). Finally, M4 for animals infected with a gastrointestinal ulcer and treated after being orally dosed with glutathione (n = 5). The present study showed increased CRP and WBC in rats infected with gastrointestinal ulcer M2 that were 12.9±1.3 mg/l and 7.82±0.18 ×109/mm3, as compared with control group M1, which was 7.5±0.7 mg/l and 5.58±0.04×109± 0.04×109/mm3, while decreased in M3(p<0.05). Furthermore, there are no differences in the level of M4 and M2. In addition, increased MDA in rats infected with gastrointestinal ulcer M2 (3.12±0.511 nmol/l), as compared with control groups M1 (1.24±0.317 nmol/l), while decreased in M3 and M4, (p<0.05). Furthermore, decreased GSH in M2 as compared with M1 (0.35±0.022 ng/l and 0.93±0.047 ng/l, respectively), while increased GSH in M3 and M4(p<0.05). Histopathologically, the small intestinal wall has lengthy, branched mucous villi with distal degeneration and epithelial cell sloughing. The primary sheet had many densely packed intestinal glands and white blood cells in the interstitial tissue. Mucus-secreting goblet cells extended into tufts between the villi. treated with cow milk, less improved intestinal ulcer. This study found that there was a protective effect of cow's milk against gastrointestinal ulcers in rats by significantly reducing CRP, WBC, ALT, AST, and MDA.

Background: Respiratory complications remain a leading cause of morbidity and mortality in preterm neonates. Antenatal corticosteroids (ACS) are known to accelerate fetal lung maturation but the timing of administration in relation to delivery may significantly influence outcomes. Objective: This study aimed to evaluate the impact of ACS timing on neonatal respiratory outcomes in preterm births. Methods: A prospective observational study was conducted on 321 pregnant women who delivered between 24+0 and 34+6 weeks of gestation at [Insert Hospital Name]. Participants were categorized based on the interval between ACS administration and delivery: Group A (1-7 days), Group B (<24 hours) and Group C (>7 days). Neonatal outcomes including Respiratory Distress Syndrome (RDS), need for respiratory support, oxygen therapy duration, NICU stay and early neonatal mortality were recorded. Data were analyzed using SPSS [insert version], with p<0.05 considered statistically significant. Results: The incidence of RDS was significantly lower in Group A (27.8%) compared to Group B (51.0%) and Group C (48.7%) (p<0.001). Mechanical ventilation was required in 11.1% of Group A neonates, versus 27.1% in Group B and 21.4% in Group C (p = 0.003). CPAP need followed a similar trend (25.9, 41.7 and 42.7%, respectively; p = 0.01). The mean duration of oxygen therapy and NICU stay was also lowest in Group A (2.8±1.3 and 6.7±2.5 days, respectively; both p<0.001). Early neonatal mortality was lowest in Group A (3.7%) compared to Group B (8.3%) and Group C (7.7%), though not statistically significant (p = 0.09). Conclusion: It is concluded that administering antenatal corticosteroids within 1 to 7 days of preterm delivery is associated with significantly improved neonatal respiratory outcomes. Optimal timing reduces the risk of RDS, decreases the need for respiratory support and shortens NICU stays. These findings reinforce the need for timely intervention and coordination in obstetric care to maximize the therapeutic benefits of corticosteroids in preterm births.

Background: Dental caries (DC) remains a widespread pediatric health issue, particularly in underserved populations. “Silver diamine fluoride (SDF)” is effective in caries arrest but associated with unaesthetic staining. “Nano silver fluoride (NSF)” has emerged as a promising alternative with enhanced antimicrobial activity and improved esthetics. Aim: To compare the efficacy, safety, and esthetic outcomes of NSF versus SDF in preventing DC in primary teeth. Methods: A randomized, controlled, double-blind clinical trial was conducted among 80 children aged 4-8 years with active carious lesions. Participants were divided into two sets: Set A received NSF (600 ppm), and Set B received 38% SDF. Lesions were evaluated using ICDAS-II criteria at baseline, 3 months, and 6 months. Primary outcome was caries arrest rate; secondary outcomes included discoloration and adverse effects. Results: Both sets demonstrated high caries arrest rates (NSF: 90.0%, SDF: 90.3%, p = 0.94). However, SDF showed significantly higher discoloration incidence (p<0.001). Adverse effects were minimal and statistically non-significant between sets. Conclusion: NSF demonstrated equivalent efficacy to SDF with significantly better esthetic outcomes, making it a promising agent for non-invasive caries management in children. Beyond individual clinical use, NSF’s esthetic acceptability and ease of application position it as a valuable tool for school-based and community oral health programs, particularly in populations where treatment compliance and social acceptance are critical.

Background: Type 1 diabetes mellitus (T1DM) in children is associated with distinct oral health complications, including alterations in primary tooth structure and composition. These changes may affect enamel and dentin integrity, caries risk and periodontal status. This systematic review aimed to evaluate the structural, compositional and ultrastructural changes in primary teeth of diabetic children. Methods: Following PRISMA guidelines, PubMed/MEDLINE, Science Direct, Google Scholar and Cochrane Library were searched for studies up to July 2024. Observational, case-control, cohort and cross-sectional studies assessing primary teeth of T1DM children with clinical, chemical or imaging techniques (SEM, EDX) were included. Quality was assessed using the Newcastle-Ottawa Scale. Results: Ten studies met the inclusion criteria. SEM/EDX analyses showed significant enamel abnormalities in diabetic children, including prism defects and an irregular aprismatic layer. Calcium and phosphorus content were consistently lower (Ca: 33.8% vs. 37.6% in controls, p = 0.017; P: 16.8% vs. 18.9%, p<0.001). Caries outcomes varied: some studies reported higher DMFT scores in diabetics (e.g., 1.43 vs. 0.56, p<0.05), while others found no difference or lower scores. Periodontal indices were consistently worse in diabetics, with significantly higher gingival indices (p<0.01) and plaque accumulation. Altered tooth eruption patterns (earlier by ~1.6 years) and reduced salivary buffering capacity were also observed. Conclusions: Children with T1DM exhibit clear alterations in the structure and composition of primary teeth, including enamel hypoplasia, reduced mineralization and higher susceptibility to periodontal disease. Variability in caries outcomes suggests an influence of metabolic control, oral hygiene and dietary factors. Early preventive dental care and interdisciplinary management are recommended.

Background: Mental disorders are diseases that affect cognition, emotion and behavioral control. They significantly affect adults' ability to function in their families, at work and in society as well as children's ability to learn. The aim of this study is to explore awareness of the students of Faculty of public health and health information about bipolar disorder and schizophrenia and the difference between them. Methods: This cross section analytic study was performed on August 28th, 2023, to June 4th, 2024. The survey included demographic characteristics, schizophrenia and bipolar disorder awareness and the difference between them based on Likert scale. Results: Of 306 participants in the knowledge section there was (40.85%) who had the highest awareness in the schizophrenia definition and (38.56%) had high awareness that mental disorder has resulted in schizophrenia and bipolar disorder. In the attitude and beliefs section there was (30.72 %) who believed in patient with schizophrenia are more likely to have aggressive behavior and (20.92%) believed that bipolar disorder patients lack jobs opportunities. There is also (40.52%) who do not feel ashamed that one of their family members has bipolar disorder. Conclusion: The students had high awareness in knowledge section and they were able to differentiate between the two disorders in most aspects, but they were undecided in the attitudes and beliefs section.

Objectives: Lingual orthodontics offers esthetic advantages by placing brackets on the inner surfaces of teeth. However, the impact of lingual appliances on periodontal health remains under-explored. Aim: To evaluate periodontal changes in patients undergoing lingual orthodontic therapy over a 6-month period. Methods: A prospective observational study was conducted on 60 systemically healthy participants (aged 18-35 years) receiving fixed lingual appliances. Periodontal parameters including Plaque Index (PI), Gingival Index (GI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) were assessed at baseline (T0), 3 months (T1) and 6 months (T2). Statistical analysis was performed using repeated measures ANOVA. Results: Significant increases in mean PI (T0: 0.68 to T2: 1.52) and GI (T0: 0.62 to T2: 1.48) were observed (p<0.001). BOP increased from 12.5% to 41.9%. Mean PPD and CAL also increased significantly over time (p<0.001), though within mild clinical thresholds. The most pronounced changes occurred in posterior lingual regions. Conclusion: Lingual orthodontic appliances are associated with a progressive decline in periodontal health, particularly due to plaque retention and hygiene challenges. Close monitoring and patient education are critical to prevent long-term periodontal complications during lingual therapy. These findings highlight the need for tailored oral hygiene protocols and close interdisciplinary monitoring during lingual orthodontic therapy to minimize long-term periodontal risks.

Background: Telemedicine has emerged as a vital component of modern healthcare delivery, particularly during the COVID-19 pandemic. In Saudi Arabia, its adoption has expanded rapidly in family medicine clinics, offering convenience and continuity of care. However, concerns regarding diagnostic accuracy, technical challenges and physician adaptation remain, necessitating an evaluation of satisfaction from both patient and physician perspectives. Objective: To assess patient and physician satisfaction with telemedicine services in Saudi family medicine clinics and to identify predictors, barriers and opportunities for improvement. Methods: This descriptive cross-sectional study was conducted in Hail. A total of 1,000 participants (800 patients and 200 physicians) from the Hail population were surveyed using an electronic structured questionnaire. Data were analyzed using SPSS version 16.0, with descriptive statistics, chi-square tests, ANOVA and logistic regression applied to identify independent predictors of satisfaction. Results: The mean age of participants was 36.4±11.2 years, with patients significantly younger than physicians (34.8±10.7 vs. 42.7±9.8 years, p<0.001). Patients expressed high satisfaction with convenience (mean 4.12±0.89) and overall telemedicine experience (mean 3.99±0.91), while technical performance received lower scores (mean 3.59±1.07). Physicians reported favorable satisfaction overall (mean 3.96±0.94), particularly regarding workload management (3.90±1.01) but diagnostic confidence remained limited (3.32±1.15). Major barriers included internet connectivity issues (40.2%), limited appointment availability (32.6%) and patient unfamiliarity with technology (26.8%). Logistic regression revealed that younger age (aOR 1.72, 95% CI 1.21-2.45), higher education (aOR 2.32, 95% CI 1.50-3.58), digital literacy (aOR 2.85, 95% CI 1.94-4.19) and physician organizational support (aOR 1.67, 95% CI 1.11-2.49) were significant predictors of satisfaction. Conclusion: Telemedicine has been well received in Saudi family medicine clinics, with both patients and physicians reporting high levels of satisfaction. While its advantages include convenience, accessibility and improved workload distribution, challenges related to diagnostic confidence, connectivity and patient training persist. Strengthening infrastructure, enhancing digital literacy and supporting physicians through organizational measures will be essential to sustain and expand telemedicine services in alignment with Saudi Vision 2030.

Cybersecurity in Internet of Medical Things (IoMT) devices raises significant concerns within the Indian healthcare system regarding preparedness to handle cyber threats targeting connected medical devices. IoMT implementations demand specialized cybersecurity approaches, yet current regulatory mechanisms lack provisions tailored to their technological complexity. This study explores healthcare stakeholders' perceptions and experiences concerning cybersecurity threats in IoMT implementations, aiming to assess operational gaps and evaluate the need for specialized cybersecurity frameworks. The objective is to understand familiarity with IoMT security challenges and assess opinions on current protective measures. The aim is to examine stakeholder exposure to IoMT cybersecurity techniques and identify demand for structured frameworks. This empirical research is based on 206 structured responses collected via Google Forms using convenient sampling among healthcare stakeholders across demographic groups in India. The independent variables include demographic factors (age, gender, residence, education) and professional experience factors. Dependent variables include threat awareness, perceived component vulnerability, attack frequency perception, trust factors, and support for specialized measures. Data analysis used statistical tools and graphical representations to identify trends and correlations. The research reveals fundamental inadequacies in current IoMT cybersecurity procedures, with software vulnerabilities emerging as the most critical threat across all demographics. Geographic disparities show semi-urban and rural areas facing disproportionate challenges accessing specialized resources. Professional experience creates a paradox where older practitioners recognize limitations more clearly, while younger professionals better understand specialized approaches. Recommendations include immediate implementation of specialized cybersecurity training and standardized protocols differentiating IoMT security from general healthcare IT procedures.

Background: Parental satisfaction reflects pediatric care quality. We assessed satisfaction with Saudi pediatric services across communication, environment, perceived child outcomes, and determinants. Methods: Cross-sectional online survey (2024) of parents/caregivers whose children received care in the prior year. We conducted a cross-sectional online survey using an adapted instrument derived from the PSQ-18 and P-MISS (communication, environment, and perceived outcome subscales; 5-point Likert). Analyses included Spearman correlations and multivariable linear regression. Results: Among 323 respondents. Most respondents were mothers (71%); More than two thirds of children were <10 years; most respondents had higher education. Overall satisfaction was moderately high (mean 3.1/5). Communication and environment each correlated with overall satisfaction, while perceived child outcomes showed no association. In regression, communication and environment together explained 60% of the variance in overall satisfaction; outcome satisfaction was not predictive. No notable differences by gender or education. Open-ended feedback highlighted clearer communication, staff responsiveness, and better facility comfort/amenities. Conclusion: Parents reported generally positive experiences driven more by provider communication and a welcoming environment than by perceived clinical outcomes. Pediatric services should prioritize family-centered communication and environment improvements, use validated tools for ongoing monitoring, and incorporate children’s perspectives in future longitudinal work.

Background: Metabolic syndrome is a group of abnormalities that in conjunction, substantially increase the risk of developing cardiovascular disease and type 2 diabetes. Thyroid disorders are often faced in clinical practice affecting up to 10% of older adults and, consequently, have been linked to several adverse health outcomes, including increased risk of cardiovascular events, both in their subclinical and overt condition. Despite this significance, limited data exists regarding the prevalence and characteristics of thyroid dysfunction and structure among Iraqi patients with metabolic syndrome. Aim of Study: To investigate structural (by ultrasound) and functional thyroid abnormalities in individuals diagnosed with metabolic syndrome. Method: The case-control study was conducted at Rizgary Teaching Hospital from June 2024 to January 2025. The study included 50 patients who meet the criteria for metabolic syndrome, defined according to the International Diabetes Federation (IDF) criteria, an additional 50 age- and sex-matched controls without metabolic syndrome were included. Thyroid function tests and thyroid ultrasounds were performed for the participants. Result: The statistical analysis yielded a p-value of 0.008, indicating a significant association between thyroid status and the presence of metabolic syndrome. The difference in triglyceride levels across thyroid dysfunction groups was statistically significant (p = 0.02). There is a statistically significant association between thyroid nodules and metabolic syndrome, p<0.05. Conclusion: There is a higher prevalence of both structural and functional thyroid dysfunction among metabolic syndrome patients. The serum level of triglyceride was higher in hypothyroidism patients. These findings emphasize the significance of routine thyroid evaluation in the management of metabolic syndrome to optimize cardiovascular risk and detect thyroid disease in its early stages.

Background: Hypertension is a major global contributor to cardiovascular morbidity and mortality. Effective management of hypertension relies heavily on patients’ adherence to prescribed treatment plans, which include medication use, lifestyle modifications, and regular follow-up. Aim: This study aimed to assess the level of adherence to hypertension management plans and identify associated factors among adult hypertensive patients in Arar City, Northern Saudi Arabia. Methods: A cross-sectional study was conducted from January 1 to May 31, 2025, involving 400 adult hypertensive patients attending four randomly selected primary health care centers in Arar. Data were collected using a validated, structured questionnaire comprising sociodemographic information, clinical characteristics, and the Hill-Bone Compliance to High Blood Pressure Therapy Scale (HBCHBPTS). Data analysis was performed using SPSS version 25, applying descriptive and inferential statistics, with a significance level set at p<0.05. Results: The mean age of participants was 44.7±14 years; 57% were female, and 55.8% were married. Approximately 40% of patients demonstrated good adherence, 21.8% had moderate adherence, and 37.4% showed poor adherence. A total of 59% reported co-morbid conditions, 72% attended follow-up appointments regularly, and 57.8% experienced hypertension-related complications, with stroke being the most frequently reported (28.1%). A statistically significant positive correlation was found between age and adherence score (r = 0.22, p<0.001). Conclusion: Only 40% of participants exhibited good adherence to their hypertension management plans. Older age was positively associated with better adherence, while females showed slightly higher adherence than males, though not significantly. Continuous patient education, targeted counseling, and tailored interventions are recommended to enhance adherence, especially among younger and less adherent patients.

Objectives: Acute diarrhea remains a significant cause of morbidity and mortality among children under five, primarily due to dehydration and electrolyte imbalances. Oral rehydration solutions (ORS) are widely recommended as the cornerstone of treatment; however, rice-based formulations may provide enhanced therapeutic benefits by improving hydration and electrolyte restoration. Aim: This study aimed to evaluate the effectiveness of oral rice solution in correcting dehydration and electrolyte disturbances among preschool children admitted with acute diarrhea. Method: A true experimental pre-test and posttest control design was employed. The study was conducted among 20 children aged 3-6 years admitted with acute diarrhea in the pediatric ward of Government Rajaji Hospital, Madurai, selected by simple random sampling. The experimental group received 150 ml of rice solution three times daily for three consecutive days along with standard diarrheal management, while the control group received only standard care. Dehydration status was assessed using the IMNCI Dehydration Scale (WHO), and electrolyte levels (sodium, potassium, chloride) were measured from blood samples. Statistical analysis was performed using chi-square, paired t-test/Wilcoxon signed rank test, and independent t-test. Results: Dehydration was prevalent at the start in both groups. After the intervention, children receiving the oral rice solution showed complete recovery from dehydration, while improvement in the control group was limited. Both groups experienced notable improvements in electrolyte levels, with slightly greater gains in the experimental group. Conclusion: Oral rice solution is highly effective in resolving dehydration and improving electrolyte balance in preschool children with acute diarrhea. Its inclusion in pediatric diarrheal management protocols may lead to better clinical outcomes.

Purpose: This study investigates the perceptions of medical students at Northern Border University (NBU) regarding the role of Artificial Intelligence (AI) in healthcare. Methods: A cross-sectional survey was conducted among NBU medical students between June 2024 and March 2025, using a structured questionnaire. A random sampling method was used to recruit 425 participants. A sample of 425 students was selected based on a calculated minimum of 386 participants, ensuring representation with a 95% confidence level and 5% margin of error. Data were analysed using STATA/SE 11.2 with descriptive and inferential statistics. Results: Most students acknowledged the beneficial role of AI in enhancing healthcare information access (80.71%), reducing clinical errors (59.06%), and improving decision-making (56.24%). The overall mean perception score was 5.78 (SD ±2.95) out of 10. However, concerns were noted regarding AI's impact on the patient-doctor relationship and confidentiality. No statistically significant differences in perception were found based on age (p = 0.28), gender (p = 0.07), or academic year (p = 0.06). Conclusion: NBU medical students largely recognize the potential of AI in healthcare but express reservations about its ethical and interpersonal implications. These insights can guide curriculum enhancements to better integrate AI in medical education.

Objectives: The aim of this study was to systematically assess the impact of repeated instructional interventions on enhancing inhaler technique, medication adherence and quality of life for individuals with COPD. Method: This was a single-centre, randomized pre-post interventional study design that was applied in three consecutive weeks during September, 2024 to March, 2025. The study participants included 128 patients diagnosed with COPD defined as per GOLD guideline. Study participants randomly assigned to intervention (64 participants) and control group (64 participants). Primary outcomes were improvement in the inhaler technique assessed by 12-item checklist and medication adherence assessed by Medication Adherence Report Scale (MARS-5). Secondary outcome was enhancement of health-related quality of life assessed by COPD assessment tool (CAT). Result: The inhaler score was calculated as the proportion of the number of correct steps to the total number of steps. Participants in the intervention group exhibited significant improvement across all steps (P < 0.00), whereas participants in the control group continued to make almost similar errors (P = 0.167). Overall, participants reported poor adherence prior instruction program in both group with mean (SD) of 11.8 (2.4) and 11.7 (2.3) respectively. The score has significantly improved post program to mean (SD) of 18.8 (1.67) among intervention participants, while among control participants the mean (SD) slightly reduced to 11.5 (2.22). Repeated instruction and proper adherence to the medication significantly improved the quality of life, as assessed by the CAT mean (SD) from 28.2 (6.5) to 15.9 (4.3) (P < 0.001) in the intervention group. While in the control group mean (SD) of CAT score slightly increased from 27.8 (6.3) to 28.2 (6.1). Conclusion: An individualized repeated instruction intervention, in stable patients with COPD, in real-world clinical practice conditions, improves inhaler technique and adherence to the inhaled treatment and ultimately improves health related quality of life.

Background: Surgical Site Infections (SSIs) are significant postoperative complications, increasing morbidity, mortality and healthcare costs. Antibiotic Stewardship Programs (ASPs) ensure appropriate preoperative antibiotic prophylaxis to prevent SSIs, reduce antimicrobial resistance (AMR) and lower costs. This study evaluates an ASP’s impact in a single-center study, comparing extended (Group A) versus single-dose (Group B) prophylaxis to assess antibiotic consumption, SSIs and readmissions. Methods: A retrospective chart review (January 2022-December 2024) included 458 patients: Group A (extended prophylaxis, n = 306) and Group B (single-dose prophylaxis, n = 152). Data on demographics, comorbidities, antibiotic regimens (type, duration, Defined Daily Dose (DDD)) and outcomes (SSIs, readmissions) were analyzed using SPSS v25. Chi-square, Fisher’s exact and t-tests were applied (p<0.05 significant). This study contributes to regional ASP evidence in the Middle East. Results: Groups were comparable demographically (p>0.05). Group B had reduced antibiotic duration (2.51±3.00 vs. 3.18±3.11 days, p = 0.032) and DDD (5.46±6.92 vs. 6.73±6.63, p = 0.048). SSI rates were low (0.3% vs. 0%, p = NA), with no readmission differences. Antibiotic use varied by surgery type (p<0.001), with extended prophylaxis common in orthopedic/general surgeries. Conclusion: Single-dose prophylaxis via ASPs reduces antibiotic use without increasing SSIs, supporting adoption to curb AMR and costs. Multicenter prospective validation is needed.

As wireless technologies become increasingly integrated into daily life, concerns have grown regarding the biological effects of Radiofrequency Electromagnetic Radiation (RF-EMR), particularly its influence on the Luteinizing Hormone (LH)–LH receptor (LHCGR)-testosterone pathway within the Hypothalamic-Pituitary-Gonadal (HPG) axis. This study investigated the effects of 2.45 GHz Wi-Fi exposure on this pathway in male rats. A total of 24 male Sprague Dawley rats were divided into four groups (n = 6 per group) and exposed to Wi-Fi for 0 (control), 4, 8, or 24 hours daily for eight weeks. Serum LH and testosterone levels were measured by ELISA. LHCGR gene and protein expression were assessed using RT-qPCR and Western blot. All data were analyzed using ANOVA, except for serum testosterone levels which were analyzed using the Kruskal-Wallis test. No significant differences were found in systemic LH or testosterone levels between groups. However, LHCGR mRNA expression showed a significant time-dependent increase. LHCGR protein levels decreased with shorter exposure durations and showed partial improvement at 24 hours, though they remained significantly lower than controls. These findings suggest that although systemic hormonal levels remain stable, RF-EMR exposure may associated with molecular alterations in testicular tissue, including compensatory upregulation of LHCGR expression. The increased LHCGR gene expression, alongside the fluctuating protein levels, indicates an adaptive, but not fully restorative response in Leydig cells compared with non-exposed controls.

Background: Smoking is a well-established risk factor affecting oral health, yet its specific influence on the color stability and longevity of dental crowns restoring discolored teeth remains under- investigated. This systematic review explores how various smoking modalities, including conventional cigarettes and electronic alternatives, impact restorative materials. Objective: To evaluate the influence of smoking on the color stability and longevity of dental crowns used in the restoration of discolored teeth. Methods: A systematic literature search was conducted across PubMed, ScienceDirect, the Cochrane Library and Google Scholar up to [6/1/2025]. Studies involving human participants or in vitro models that assessed the impact of smoking on dental crowns in terms of color change (ΔE) or longevity were included. Data were extracted and synthesized narratively due to heterogeneity. Quality assessment was conducted using the Cochrane Risk of Bias tool for randomized trials and the Newcastle-Ottawa Scale for observational studies. Results: Eight studies met the inclusion criteria, comprising primarily in vitro experiments with some observational data. Conventional cigarette smoke (CS) consistently caused clinically unacceptable discoloration (ΔE>3.3) in most tested materials, particularly resin composites. Ceramic materials, such as lithium disilicate and zirconia, demonstrated greater resistance to staining. Harm-reduction products like electronic cigarettes and heated tobacco products (HTPs) induced less discoloration, although effects varied by material type and surface finish. Longevity outcomes were indirectly associated with material degradation, surface roughness and plaque retention, all of which were exacerbated by smoking. Conclusion: Smoking significantly compromises the aesthetic and structural integrity of dental crowns, especially those made of resin-based materials. While newer crown materials and harm-reduction smoking alternatives may mitigate discoloration, smoking cessation remains the most effective strategy for maintaining restoration longevity and color stability.

Academic stress is a growing concern among pre-university students, often leading to negative psychological and physiological outcomes. The current study aimed to evaluate the effectiveness of structured stress management strategies on perceived academic stress and biochemical markers among pre-university students in Karnataka. Methods: A quasi-experimental research design was adopted. Twenty students were selected using a convenience sampling technique. Participants aged 16–18 years with mild to severe academic stress levels were included. The intervention group received an integrated stress management program for eight weeks, while the control group received no intervention. Results: The experimental group showed significant reductions in ASS, PSS, and cortisol levels (p<0.001), while the control group showed no notable change. Significant group × time interactions (p<0.001) confirmed the intervention's effectiveness. Conclusion: The integrated stress management strategies were effective in significantly reducing both perceived academic stress and physiological stress markers. Educational institutions should consider implementing structured stress reduction programs to enhance student well-being and academic performance.

Background: Large Ventral Hernia (VH) reconstruction is a surgical challenge. Component Separation (CS) combined with lipoabdominoplasty (LA) enhances the contour deformity of the entire musculofascial layer. Aim of the study: Evaluation of the feasibility, early postoperative outcomes and possible complications of combining LA with CS in the repair of large VHs. Methods: This prospective study included twenty multiparous females subjected to large VH repair by combined CS and LA at Minia University Hospitals from July 2023 to February 2025. Primary study outcomes were operative time and hernia recurrence, while secondary outcomes included length of hospital stay, readmission rate and wound complications. Results: Mean age was 37.7±7.7 years and Body Mass Index (BMI) ranged between 25.5 and 35 kg/m². Mean operative time was 246±43.2 minutes. Mean length of hospital stay was 6.7±2.4 days. Overall complication rate was 25% (n = 5), including wound dehiscence, wound infection, hematoma, hypertrophic scar formation, umbilical necrosis, dog ear deformity and skin necrosis. No hernia recurrence or mortality were reported during the period of follow up (12 months). Conclusion: Hernio-abdominoplasty with component separation is an effective technique for repair of large ventral hernias with acceptable safety profile. We recommend this combined approach in selected patients but further studies are needed to verify long-term outcomes.

The goal of this systematic review was to measure the existing evidence for the efficacy of probiotics, prebiotics, synbiotics, postbiotics and dietary supplements in modifying gut and/or scalp microbiota in individuals with scalp disorders such as alopecia areata, androgenic alopecia and dandruff. Systematic searching across six databases- PubMed, Embase, Scopus, Web of Science, Cochrane CENTRAL and ClinicalTrials.gov was conducted to find human studies comparing interventions on the microbiome in clinically diagnosed scalp disorder patients. Randomized controlled trials, nonrandomized interventional designs and cross-sectional observational studies were deemed to be eligible study designs. Throughout the 14 studies, signals converged on a 4-24-week treatment window wherein clinically apparent improvements also accrued on hair and scalp endpoints. The trials also measured change and established statistically significant advantages-higher hair counts/density or lower dandruff severity-with p-values ranging <0.05-<0.0001, usually assessed by standardized trichoscopy/phototrichogram scoring and validated dandruff indices. Biomarker readouts also correlative with these clinical effects: multiple studies reported decreases in inflammatory mediators (e.g., IL-6, IL-31, TGF-β1, hsCRP) and shifts of antioxidant defenses upwards (e.g., SOD, with concurrent immunomodulatory effects such as increased IFN-γ), consistent with reduction of scalp inflammation and oxidative stress. Microbiome profiling (qPCR/16S/ITS) also repeatedly indicated increased Lactobacillus spp., decreased Cutibacterium acnes and/or Malassezia and normalization of community balance, with one Mendelian-randomization analysis providing evidence of causality: Corynebacterium appeared protective (OR = 0.82) but Betaproteobacteria and Burkholderiales paralleled higher disease risk (ORs = 1.21 and 1.20). The findings suggest that nutritional and topical interventions that influence the microbiome may be associated with beneficial changes in scalp symptoms, microbiota and inflammatory features in scalp disorder patients. While the general safety profile was acceptable, heterogeneity of study design, outcome measures and microbial analysis diminished the strength of conclusions reached.

Effective pain and stress management during pediatric intramuscular injections is essential, particularly for neonates and young children, who are more sensitive due to developmental factors. This review highlights Non-Pharmacological Interventions (NPIs) designed to reduce procedural pain and distress in children from neonates to adolescents. Preterm neonates are especially vulnerable as their immature neuroregulatory pathways can lead to long-term neurodevelopmental issues if pain is not managed properly. Pediatric intramuscular injections can cause both physiological stress responses and psychological distress, potentially contributing to needle fear and avoidance of healthcare in the future. NPIs such as distraction techniques (e.g., distraction cards, cold-vibration devices and virtual reality), caregiver involvement, comfort positioning and complementary therapies like breastfeeding and oral sucrose have been proven to be safe and effective. These interventions help reduce pain intensity, behavioral distress and physiological stress markers without the side effects of pharmacological treatments. However, gaps remain in understanding the best NPI combinations for different developmental stages, their long-term effects and their use in specific neonatal procedures, such as endotracheal suctioning. Integrating evidence-based NPIs aligns with the principles of atraumatic care, enhancing children's procedural experiences and building trust between healthcare providers, caregivers and patients. To optimize pain management across pediatric populations, future research should focus on age-specific protocols, the use of emerging digital technologies and personalized, multimodal strategies for sustainable pain management. Large-scale studies are needed to explore these aspects further and to refine approaches for pain management in pediatric care.