Background: Human Papillomavirus (HPV) infection is a major public health concern and a well-established cause of cervical cancer and other anogenital and oropharyngeal malignancies. Despite the availability of effective HPV vaccines, awareness and uptake remain suboptimal in many parts of India. Limited data are available regarding HPV-related knowledge among the general population in Himachal Pradesh. Objectives: To assess the level of knowledge regarding HPV infection and HPV vaccination among adults in Himachal Pradesh and to examine the association between socio-demographic characteristics and knowledge levels. Methods: A community-based cross-sectional study was conducted from October to December 2025 using a Google Form–based online survey. Adults aged 18 years and above residing in Himachal Pradesh were recruited through convenience sampling. A structured, self-administered questionnaire assessed socio-demographic characteristics and knowledge related to HPV infection and HPV vaccination. Knowledge scores ranged from 0 to 20 and were categorized as poor (≤6), moderate (7–13), or good (≥14). Data were analyzed using Epi Info version 7, and associations were tested using the chi-square test with a significance level set at p < 0.05. Results: A total of 800 participants were included in the analysis. Overall awareness of HPV was reported by 40.8% of participants. Knowledge regarding HPV transmission, associated cancers, and vaccination was generally low, with correct responses ranging from 17.6% to 44.8% across individual items. More than two-thirds of participants (68.1%) demonstrated poor knowledge, while only 17.4% had good knowledge. A statistically significant association was observed between age and knowledge level (χ² = 20.58, p = 0.002), with younger participants showing better knowledge. No significant association was found between gender and knowledge level (p = 0.999). Conclusion: The study reveals considerable gaps in knowledge regarding HPV and HPV vaccination among adults in Himachal Pradesh. These findings highlight the urgent need for targeted awareness campaigns, strengthened health education initiatives, and improved dissemination of information to enhance HPV prevention efforts in the region

Objectives: Artificial Intelligence (AI) is altering the playing field of healthcare, specifically in radiology, with an efficacy of medical image reading. In the case of Saudi Arabian healthcare, AI is changing workflows in the ability of moving on with early detection of disease as well as minimize the number of human errors. However, there are issues such as regulations and special training requirements. Purpose: This research is to explore the AI awareness and knowledge of diagnostic radiologists in Saudi Arabia with focus on the AI and medical imaging. It evaluates the AI awareness among trainees and professionals of imaging: Radiology and discusses the possibility of integrating AI in teaching curriculum. Apart from the key highlight, the study was aimed to find regional variations in the perceptions relating to the role of AI in diagnostic radiology. Methods: This study has a cross-sectional online survey design, conducted for five months (June-September 2024) with a survey group size of 500 (including resident and senior physicians) radiologists. Data were collected using surveys that were distributed via radiological societies and social media. The statistical analysis was performed the version 26 of the statistical package Statistics Package for the Social Sciences (SPSS) and with a p-value of less than 0.05. Ethical permits were approved by the University of Hail. Results: For example, out of 433 respondents, 80.6% were aware of the existence of AI and 82.2% were aware of the potentially positive effects of AI for improved diagnosis. However, concerns about job displacement and machine errors were noticed. Moreover, there was a greater proportion of interest in AI education, with a total of 81.5%, radiologists in the central areas showing a higher level of knowledge in the northern region (p = 0.023). Those with more education had greater awareness of AI (p = 0.001). Conclusion: AI has a lot of potential for being helpful to the field of diagnostic radiology in Saudi Arabia, but there are challenges in terms of regulation, training and privacy to be overcome. The study emphasizes the importance of adopting Artificial Intelligence (AI) educational content in the medical curriculum, which is in line with the Saudi Vision 2030.

Background: Breast cancer is the most common malignancy among women worldwide and is associated with substantial impairment in physical and psychological quality of life (QoL). In Erbil City, Iraq, structured supportive interventions for breast cancer patients remain limited. This study evaluated the effect of a structured educational program on physical and psychological QoL using a quasi-experimental design. Methods: A quasi-experimental pre-post study with a control group was conducted among 120 female breast cancer patients recruited from Nanakaly and Rizgary Teaching Hospitals between November 2024 and May 2025. Participants were non-randomly allocated into intervention (n = 60) and control (n = 60) groups based on baseline stress levels for ethical considerations. The intervention group received three structured educational sessions addressing disease knowledge, symptom management, coping strategies and treatment adherence, in addition to routine care, while the control group received standard care only. QoL was assessed before and 4-6 weeks after the intervention using a validated questionnaire. Data were analyzed using t-tests, ANCOVA and multiple linear regression. Results: At baseline, no significant differences were observed between groups in physical or psychological QoL. After adjustment for baseline scores, ANCOVA demonstrated a significant improvement in physical QoL in the intervention group compared with controls (F(1,117) = 23.83, p <0.001, partial η² = 0.169). No statistically significant improvement was observed in psychological QoL (p = 0.453). Regression analysis indicated that older age was associated with higher physical QoL but lower psychological QoL, while employment status was positively associated with psychological outcomes. Conclusion: Structured educational programs may contribute to improved physical quality of life among breast cancer patients; however, education alone appears insufficient to produce measurable improvements in psychological well-being. These findings suggest that educational interventions should be complemented by targeted psychosocial support to address the multidimensional needs of breast cancer patients in resource-limited settings.

Background: Breast cancer is the most frequently diagnosed cancer type and the second leading cause of cancer-related deaths among women worldwide. Following a diagnosis of breast cancer, the most immediate challenges in patient management are the determination of prognosis and identification of the most appropriate adjuvant systemic therapy. Determining prognosis can best be addressed with a combination of clinicopathological prognostic factors. Methods: A retrospective study was performed on paraffin blocks of Breast carcinoma, histopathological findings were reviewed and recorded, Immunohistochemistry (IHC) for Matrix Metalloproteinase-1 (MMP1) proteins were performed. The investigation incorporated key clinical variables including hormone receptor status (Estrogen Receptor (ER) and Progesterone Receptor (PR), human epidermal growth factor receptor 2 (HER2) expression, tumor laterality, focality and pathological grade. Results: Statistical analyses encompassed descriptive statistics, correlation analysis, Cox proportional hazards regression and survival curve estimation using Kaplan-Meier methodology revealed strong intercorrelations between survival metrics and identified matrix MMP1 as a significant negative prognostic indicator across all survival endpoints. Chi-square analysis demonstrated significant association between HER2 and ER status, suggesting distinct biological subtypes with varying therapeutic implications. Conclusion: This study identifies MMP1 as a potent independent prognostic marker for poor survival in breast cancer. The results advocate for the integration of MMP1 assessment with standard biomarker profiling to enhance prognostic accuracy and inform clinical decision-making for personalized patient management.

Background: Hepatitis B virus (HBV) infection remains an important public health issue globally. This is especially true for underdeveloped countries. To establish effective preventative and containment measures and strategies, it is important to know the age-specific distribution of HBV infection. This study aimed to analyse the age-specific distribution of hepatitis B virus infection, using the hepatitis B surface antigen (HBsAg) presence as an indicator. Materials and Procedures: Eighty serum samples from various ages and people were collected. Conventional serological techniques were used to test samples for HBsAg. The chi-square (χ²) test was used to statistically analyze the relationship between age-specific groups and HBsAg-positive cases. Findings: Age was statistically significantly correlated with HBsAg positivity (χ² = 9.182, p<0.01). The highest positive rates were found among 21- to 30-year-olds (29.09%), which was followed by those 41-50 years old (10.90%) and 31-40 years old (10%). In contrast, positive children (1-12 years) and adolescents (13-20) were very low (0.90%). Thus, 21–30-year-olds contributed significantly to the overall prevalence of HBV (p<0.01). In conclusion, it was found that infection is closely related to age, with the most common occurring in young adults. On the other hand, while the rise in adult occurrence emphasises the need for targeted screening, improved control of infection and public health awareness to reduce infections, the decline in this age group shows that immunity from hepatitis-B vaccine programmes has been effective.

Background and Aims: Blood transfusion is vital in treating conditions such as sickle cell anemia and thalassemia. However, many students hesitate to donate due to limited awareness of its importance and related guidelines. This study assessed knowledge, attitudes and practices regarding blood donation among university students in Saudi Arabia, while identifying major challenges. Methods: A descriptive cross-sectional study was performed on 385 university students by administering a self-structured pre-validated questionnaire. Descriptive statistics was performed using frequencies and percentages for categorical variables. The chi-square test was utilized to assess the association between categorical variables. Results: About 6.5% of participants demonstrated good knowledge of blood donation, 53.2% showed moderate knowledge and 40.3% poor knowledge, with no significant associations found between knowledge levels and the assessed variables. A positive attitude was observed in 95.1% of students, with marital status being the only variable significantly linked to attitude. While just 31.9% had previously donated blood, approximately 83.6% expressed willingness to donate in the future. The main barriers to donation were chronic illness (78.4%), fear of infection (67.8%) and fear of fainting (63.9%). Conclusion: Despite strong willingness, students showed limited understanding of eligibility and health aspects of blood donation. Focused educational interventions are needed to correct misconceptions and enhance participation.

Background: In Iraq, Cryptococcosis is the most common causes of invasive fungal infections. Cryptococcus neoformans appears a highly resistance toward antifungal treatments. Thus, this study revealed the correlation between this yeast and different infections as well as detect the Lycopene effect as an antifungal. Objectives: To detect the effect of Lycopene on resistant C. neoformans isolates that were isolated from different infections. Materials and Methods: One hundred swabs were collected from patients with respiratory infections, burns and meningitis which distributed as (40, 40 and 20) samples, respectively. The fruits of Tomatoes (Lycopersicon esculentum L.) were collected during the summer from local markets in Baghdad. All the clinical samples were cultured directly onto Sabouraud′s Dextrose agar (SDA) medium and incubate of 37°C for 7 days with daily examination. Lycopene was alcoholic extracted and purified using HPLC method. DNA of six C. neoformans isolates were taken away by Geneaid DNA extraction kit, depended on manufacturer′s instructions. Gene sequencing of the CAP60 gene was done to detect substitution mutations for C. neoformans that were treated and untreated with lycopene. Results: The positive percentages of C. neoformans among patients were (10.0%, 7.5% and 10.0%) for patients with respiratory infections, burns and meningitis, respectively. The macroscopic appearance of C. neoformans was ranged from whitish to creamy colored colonies with spherical, mucoid and smooth yeast cells. Microscopic examination of the yeast cell was characterized with gelatinous capsule surrounding. Molecular results revealed that the molecular weight of the CAP60 gene was 600 bp., The results of CAP60 gene sequencing indicate that two isolates treated with lycopene have more than one substitution mutation. Conclusion: the gene sequencing of the CAP60 gene revealed that the treated isolates with lycopene had more substitution mutations than the untreated isolates.

Background: Gross anatomy learning by practicals remain central to medical schools’ however, evolving technologies and educational reforms have prompted substantial variation in instructional strategies for the upcoming generations. Objective: To review and synthesize evidence systematically, comparing traditional with digital and hybrid gross anatomy teaching modalities while keeping a focus on effectiveness, student learning outcomes, and curricular implications. Methods: A PRISMA-guided structured review was conducted using PubMed, Scopus, ERIC, and Google Scholar. Studies published between 2000–2024, involving undergraduate medical learners, were included. A total of 2,316 records were identified, screened, and narrowed to 62 eligible studies. Data extraction covered instructional modality, outcomes, assessment strategy, and methodological quality. A narrative synthesis was achieved. Results: Across the 62 studies included, cadaveric dissection consistently supported deep spatial understanding, professional identity formation, and emotional resilience. Prosection facilitated efficient, standardized instruction. Digital tools especially 3D visualization, VR, and AR enhanced conceptual understanding and accessibility but surely lacked tactile experience. Hybrid models combining dissection with digital platforms yielded the strongest and most consistent learning outcomes in most of the setups. Conclusion: In professing Anatomy no single modality seems sufficient due to magnitude of the subject. Hybrid, multimodal approaches are most effective for addressing diverse learner needs. Curricula needs to integrate digital tools while preserving cadaver based learning. Further standardized and longitudinal research is needed.

Morphine is a drug that belongs to a group of drugs called opioid analgesics or narcotics. This study was conducted to evaluate the effect of Morphine is toxic to kidney tissue in domestic rabbits. 21 male domestic rabbits were used in this study. They were divided into three groups: the first (control) was injected with distilled water, the second and third groups, each group containing 7 rabbits, were injected with morphine subcutaneously for 35 days. The results confirmed the presence of degenerative changes represented by vascular congestion in some blood vessels, contraction of the glomerulus and expansion of Bowman's space, in addition to the separation of some tubular cells from the basement membrane. It was an infiltration of the inside of the tubular lumen and the spread of tubular cell necrosis with the appearance of edema. The results confirmed the effect of morphine on the average diameters of the glomeruli, with significant differences.

Objectives: Eye cosmetics such as eyeliners, eyelash extensions, contact lenses and mascara are widely used for aesthetic purposes, yet improper or prolonged use may harm ocular health. This study aimed to evaluate the knowledge, practices and self-reported ocular symptoms associated with eyelash and eyelid cosmetic use among a convenience sample of Saudi women. Methods: A cross-sectional survey was conducted between October 2024 and March 2025 among 448 women predominantly aged 18-24 years recruited via social media and online forums. Participants completed a structured questionnaire on demographics, cosmetic use and ocular complaints. Data were analyzed using descriptive statistics and chi-square tests. Composite outcome variables (‘ocular complaints’) were defined as the presence of any self-reported symptom, including allergic reactions, lash thinning, itching or discomfort. STROBE guidelines were followed for reporting observational studies. Handling of missing data: all questions were mandatory in Google Forms, preventing incomplete responses; remaining missing data were minimal (<5%) and not imputed. Results: Overall, 93.3% (n = 418) reported using eyelash or eyelid cosmetics, with 75.4% n = 338) using them for >3 years. While 50.2% n = 225) reported no symptoms, others noted self-reported complaints such as allergic reactions (33.5%, n = 150), lash thinning (16.5%, n = 74), itching (22.8%, n = 102) and discomfort (21.4%, n = 96). Only 8.3% (n = 37) sought medical care. Awareness of potential risks was noted in 30.1%, Higher awareness was significantly associated with reduced periorbital irritation, swelling and rash around the eye, (p = 0.054) but did not consistently influence future use intentions among those prioritizing aesthetic outcomes. Unsafe practices, including prolonged reuse of eyelash extensions and inadequate makeup removal, were significantly associated with ocular complaints (p <0.05). Conclusions: Eyelash and eyelid cosmetics are highly prevalent among the studied population and linked to preventable ocular surface irritation. User-dependent behaviors, particularly reusing extensions and inconsistent removal, remain key risk factors. Public health initiatives, particularly via social media, are needed to promote behavior change and safer cosmetic practices.

The condition in which an individual's communication abilities and social interactions are affected during early development is called autism spectrum disorder (ASD). Such people feel more anxious, react to emotions in different ways and experience sounds, lights or touch differently. Early diagnosis and timely interventions can significantly improve behavioural and language development. Traditional methods for ASD detection, such as subjective questionnaires and behavioural observations, are often time-consuming, costly and reliant on specialized expertise, leading to a delay in intervention. To address these challenges, this work introduces a novel approach for the early identification and detection of ASD in children using facial images. The research focuses on utilizing YOLOv8n for facial features identification and ASD classification, harnessing its advanced object detection capabilities to enhance both accuracy and efficiency. This paper also presents a comparative analysis of YOLOv8n and YOLOv9c to conclude with the most effective solution. This study facilitates real-time ASD screening, providing healthcare professionals with timely and effective interventions in clinical environments.

Background: Metal phosphide compounds, most notably aluminum and zinc phosphide, are extremely toxic pesticides that are associated with a high case-fatality rate following intentional ingestion. In Upper Egypt, these compounds are frequently implicated in suicide, yet region-specific forensic data remain limited. Objective: To retrospectively characterize the forensic, toxicological, and sociodemographic profiles of confirmed suicide deaths due to metal phosphide poisoning in Asyut Governorate, Upper Egypt, from 2021 to 2024. Methods: A retrospective observational study was conducted on suicide-related metal phosphide poisoning deaths examined at the Forensic Medicine Authority, Asyut Branch. Data were obtained from medico-legal autopsy records, toxicology laboratories, and available hospital files. Included cases were confirmed suicides with toxicological evidence of metal phosphide and concordant medico-legal findings. Biological specimens were screened using the silver nitrate/phosphine test and confirmed by gas chromatography– mass spectrometry. Statistical analysis was performed using chi-square tests, with significance set at p<0.05. Results: All 245 cases were toxicologically confirmed and classified as suicide. Autopsy findings were characteristic of phosphine toxicity, with petechial hemorrhages (89.0%), pulmonary edema (84.0%), and hepatic and renal congestion (79.9%) being most frequent. A garlic-like odor in viscera was documented in 54.9% of cases. Case frequency declined in 2022 but increased thereafter, peaking in 2024, with a significant upward temporal trend (χ² for trend = 37.69, p<0.001). The third decade of life was most affected across both sexes, with marked sex-related seasonal variation and a consistent predominance of rural cases. Conclusions: Intentional metal phosphide poisoning remains a major cause of suicide- related mortality in Asyut Governorate, highlighting the urgent need for regulatory control and targeted suicide prevention strategies.

Background: Refractive errors (REs) represent a significant global public health challenge as a leading global cause of vision impairment and the second most frequent cause of treatable blindness. These conditions arise when the axial length or corneal curvature of the eye disrupt the precise focus of light on the retina. Despite their high prevalence, data regarding the distribution of specific refractive error types among medical students in the Northern Border region of Saudi Arabia remain limited. Objective: To determine the prevalence of refractive errors and evaluate their association with demographic factors (age and gender) among medical students at Northern Border University (NBU), Kingdom of Saudi Arabia. Materials and Methods: A cross-sectional study was conducted between March and April 2025. Data were collected via a validated electronic questionnaire distributed to male and female medical students at Northern border university. The survey assessed demographic characteristics and the prevalence of specific refractive conditions, including myopia, hypermetropia, and astigmatism, along with their respective dioptric severities. Data were managed in a spreadsheet and analysed via IBM SPSS. Categorical variables are expressed as frequencies and percentages, while normally distributed continuous data are presented as mean ± standard deviation. Statistical associations between categorical variables were assessed using Chi-square tests. Results: A total of 257 students participated (36.6% male, 63.4% female). The overall prevalence of refractive error was 59.1% (n=152), while 40.9% (n=105) of the cohort reported no refractive issues. Myopia was the most frequent refractive error, affecting 28% (n=72) of the total sample and accounting for 49.7% of all diagnosed cases. This was followed by myopia combined with astigmatism (17.1% total; 30.3% of RE cases), isolated astigmatism (8.2% total; 13.8% of RE cases), hypermetropia (4.3% total), and hypermetropia combined with astigmatism (1.7% total). In this specific sample, neither gender nor age group showed a significant correlation with the presence of myopia. The distribution of vision status appeared to be relatively uniform across the provided demographic groups. However, there was a highly significant association between myopia and astigmatism (p<0.001), and between the error of refraction and the use of electronic devices (p = 0.0015). Furthermore, significant associations were found between the error of refraction and family history (p = 0.001), as well as between the error of refraction and the methods of correction. Medical glasses were the dominant correction method for all errors. Conclusion: With nearly three-fifths of medical students (59.1%) in this study experiencing refractive errors, there is a pressing requirement for better eye care initiatives. Given the academic demands of medical education, early detection and correction are essential to prevent further ocular complications and optimize visual performance. We recommend the implementation of routine vision screening programs and targeted awareness campaigns within the university to facilitate early diagnosis and management of these conditions.

Obesity is becoming a global health problem at an alarming rate and is one of the main causes for the increasing number of chronic and lifestyle-related illnesses. It is important to comprehend how socio-demographic factors affect people's knowledge, attitudes and practices (KAP) towards obesity for the development of effective prevention programs. In West Bengal, this cross-sectional research study was aimed at evaluating the impact of age, education and area of residence on obesity-related knowledge, attitudes and practices among 253 participants. Data collection involved the use of a structured questionnaire that was given to people via Google Forms and shared on WhatsApp. After that, the data were analysed statistically using both descriptive and comparative methods among generational cohorts, educational levels and rural-urban groups. There were considerable demographic differences in the KAP scores. Generation Z had the highest mean score in knowledge (4.23), attitude (4.25) and practice (4.53), whereas Generation X had the lowest scores in knowledge (1.56) and attitude (1.55) (p<0.001). Comparing the urban and the rural participants, the mean scores of the urban respondents in knowledge (4.06 vs 2.69) and attitude (4.05 vs 2.66) were significantly higher, whereas there was no significant difference in terms of practice scores (p = 0.395), which is an indication of the effect of the traditional lifestyle practices domineering in rural areas. Education was found to be the main factor contributing to knowledge, attitude and practice. Undergraduate and postgraduate respondents scored the highest, whereas participants with only primary education showed the lowest scores for knowledge (1.92) and attitude (1.88), even though their practice scores (3.81) were at moderate levels (p <0.001). In general, youth demonstrated a higher level of knowledge, attitude and practice related to obesity. Individuals with higher education were also found to have better knowledge, attitude and practice. People living in cities had better performance than those living in the countryside. Among the different age groups, Generation Z had the highest practice scores. Nevertheless, all groups lacked the connection between knowledge and actual practice. Hence, it can be said that acquiring more knowledge does not necessarily result in adopting healthier behaviour. Therefore, there is a demand for intervention approaches that are compatible with local culture and everyday life, not only information-based programs. The study adopted the method of online data collection. As a result, there is a possibility that rural and less educated people are not adequately represented. This drawback should be taken into consideration when interpreting the findings.

Background: Crohn disease (CD) is a chronic inflammatory bowel disease that can lead to gradual intestinal injury and dysfunction. CD can involve patients of all ages, from children to elderly individuals and may lead to a significant mobility and to a relevant deterioration of the quality of life. Objectives: The main aim of this study was to investigate the serum levels and evaluate the predictive value of the immunological markers including the Tumor Necrosis Factor alpha receptors (TNF-R1, TNF-R2) and the High-sensitive C reactive protein (hs-CRP) in order to be used as a diagnostic tool for active Crohn's patient. Methods: The current investigation is using 140 blood samples acquired from 70 Crohn's disease patients and 70 apparently healthy individuals. A sandwich ELISA kit was used to determine serum levels of Tumor Necrosis Factor Receptors (TNF R1-R2) and high-sensitive C-reactive protein (hs-CRP) in Crohn’s patient from Gastroenterology and Hepatology Hospital, Medical City in Baghdad, Iraq. Result: A total 140 of 1:1 ratio of the collected 70 cases and 70 controls samples were investigated respectively following inclusion and exclusion criteria. The mean level of TNF-R1 among cases and controls was (186.181±31.6085 vs. 60.773±7.6383) with significant difference of 125.4079 (t = 32.266, df:138, p = 0.000) respectively, while those of TNFR2 the mean levels group (337.846±63.2159 vs. 68.119±17.7281) respectively and the significant difference of 269.7271 (t = 34.372, df:138, p = 0.000) and in hs-CRP the mean level was (629.244±121.3586 vs. 105.357±34.1966) respectively and with significant mean difference of 523.8867 523.8867 (t = 34.764, df:138, p = 0.000). Conclusion: Elevated serum levels of TNFR1 and TNFR2 demonstrate strong potential as biomarkers for predicting disease activity and progression in Crohn’s disease, given their roles in inflammation, apoptosis and immune regulation. However, combining these markers with hs-CRP could enhance diagnostic and prognostic accuracy, supporting a multi-marker approach for improved clinical assessment.

Background: Appendicitis constitutes one of the most common surgical emergencies world-wide and has always ranked among the top causes of an acute abdomen requiring urgent surgical treatment. Public ignorance and late access to health care could worsen appendicitis and lead to preventable morbidity and mortality. Objectives: To measure the awareness of acute appendicitis and the perceived risks of delaying surgical intervention in adults residing in the Northern Border Region of Saudi Arabia. Methods: This cross-sectional study in Saudi Arabia evaluated awareness among adults about appendicitis and its complications, as well as those influencing health-seeking behavior. The data of 397 participants were utilized for statistical analysis by Chi-square and logistic regression tests. Results: Among 397 respondents, 57.2% were aware with acute appendicitis but only 24.4% considered their knowledge of complications as good or excellent. Overall, a total of 51.6% had poor awareness about appendicitis. Although a total of 84.9% would seek immediate medical help, a considerable proportion, amounting to 44.6%, would attempt first home remedies. Fear, cost and distance are common reasons for delaying care. By multivariable analysis, none of the sociodemographic variables showed a significant association with awareness level (each p>0.05). Conclusion: The current community-based study from the Northern Border Region in Saudi Arabia, showed that there was poor awareness regarding appendicitis despite being able to identify the risk associated with delayed surgery. Public health educational programs should, therefore, be introduced to improve awareness.

Oncolytic virotherapy (OV) represents an emerging therapeutic modality for non-small cell lung cancer (NSCLC), leveraging viruses to selectively target tumor cells and stimulate anti-tumor immunity. This review synthesizes evidence from key studies to evaluate the current landscape and future directions of OV in NSCLC. We systematically analyzed six pivotal studies investigating diverse oncolytic virus platforms, including Newcastle Disease Virus (NDV), pelareorep (reovirus), M1 virus, coxsackieviruses (CVA11 and CVB5) and engineered HSV-1 (RP2/RP3). The analysis encompassed both preclinical investigations and clinical trials to assess therapeutic efficacy, mechanisms of action and limitations. The evidence reveals a field marked by both promising breakthroughs and significant challenges. The most compelling clinical success comes from engineered HSV-1 (RP2/RP3) in combination with stereotactic body radiation therapy (SBRT) and pembrolizumab, demonstrating a 33.3% objective response rate and robust immune activation. In contrast, pelareorep combined with chemotherapy failed to show survival benefit, highlighting the critical importance of combination partner selection. Preclinical studies showed exceptional promise with coxsackieviruses achieving complete tumor regression and the M1 virus identifying MXRA8 as a predictive biomarker. However, these findings are tempered by translational challenges, including the gap between immunocompromised models and human trials and safety concerns regarding combination strategies that potentiate DNA damage. Oncolytic virotherapy demonstrates significant potential for NSCLC treatment, particularly as an immune-priming modality in rationally designed combinations. Future success requires strategic focus on immunologically congruent combinations, biomarker-driven patient selection and innovative trial designs to bridge the divide between preclinical promise and clinical application. The field must learn from both successes and failures to realize the full potential of these novel therapeutic agents.

Objective: Implementing Entrustable Professional Activities (EPAs) in the undergraduate setting requires guidance. This review aimed to identify evidence about the essential dimensions and needs for implementing EPAs. Method: This review followed Joanna Briggs Institute guidance and PRISMA-ScR standards. English articles (2020-2023) on EPA implementation in undergraduate medical programs were searched from WoS, Scopus and EBSCO. Four independent reviewers screened records using Rayyan.ai, excluding reviews, postgraduate programs and non-medical professions. Three reviewers independently extracted and coded data using NVivo, with all disagreements resolved through discussion. Result: There were 790 unique records and 19 studies were extracted. Four essential dimensions for EPA implementation, namely EPA development (n = 9), EPA application (n = 13), entrustment (n = 10) and change management (n = 13), were identified. From this review, it was found that EPA development needs conceptualization, determining the development method and aligning with the curriculum. Whilst the needs for EPA application were students' and teachers’ factors, feedback provision, curriculum characteristics, etc. Entrustment decision entails raters’ cognition, a competencies committee and an awarding process. Change management needs leadership, commitment, a task force, resources, etc. Conclusion: This review establishes a comprehensive framework of four essential dimensions and their specific requirements for EPA implementation in undergraduate medical education. These evidence-based findings serve as foundational guidance for institutions planning EPA implementation and provide a basis for developing assessment tools to evaluate institutional readiness.

Objectives: Virtual Health Clinics (VHCs) gained widespread adoption during the COVID-19 pandemic, providing accessible care while reducing the need for in-person visits. As home care services continue to evolve post-pandemic, understanding the experiences of both patients and healthcare providers using VHCs is essential, particularly in underserved regions such as Hail, Saudi Arabia. Aim: This qualitative study explores the experiences, challenges and enablers of healthcare providers and home care patients who use virtual health clinics in the Hail region. Methods: Semi-structured interviews were conducted with a purposive sample of five healthcare providers and fifteen home care patients receiving services through the Home Health Care Department at King Khalid Hospital between January and June 2024. Interviews were transcribed and analyzed thematically using an inductive approach supported by NVivo 12 software. Results: Three key themes emerged from the analysis: (1) the need for structured training in virtual care technology, with providers reporting limited preparation and patients expressing confusion during virtual visits; (2) the dual nature of remote communication, which offered time and cost savings but was hindered by poor connectivity in rural areas; and (3) limited access to IT support during virtual appointments, particularly outside standard working hours, which contributed to service disruptions. Limitations: The study’s findings are based on a small sample size from a single hospital, which may limit generalizability. The qualitative design also introduces potential interpretation bias. Conclusion: While virtual health clinics offer clear advantages for home care delivery, their effective implementation depends on addressing operational challenges, including training, communication infrastructure and IT support. These insights provide practical guidance for healthcare administrators and policymakers seeking to expand virtual care services in home-based settings.

Objectives: Cervical abrasion is commonly linked to improper brushing and full-mouth rehabilitation (FMR) patients may be particularly vulnerable. This study evaluated the association between brushing practices and cervical abrasion progression in FMR patients and compared a novel beat sound-guided toothbrush with a conventional soft-bristle manual toothbrush. Methods: Prospective, two-arm, controlled clinical trial with 80 participants (40 per group) recruited from the Department of Prosthodontics, Saveetha Dental College. Objectives are stated explicitly in the Methods. Group A used a conventional manual toothbrush; Group B used an institutional prototype beat sound-guided toothbrush designed to promote vertical brushing (details and limitations of the prototype are described in Methods). Cervical abrasion severity was measured using the Smith and Knight Index at baseline and 6 months. Brushing behaviour was assessed using a validated multi-method approach (baseline questionnaire, clinician-observed demonstration and monthly verification). Between-group comparisons used independent t-tests; within-group changes were assessed with paired t-tests. Statistical significance was set at p <0.05. With n = 40 per group the study had 80% power to detect an effect size (Cohen’s d) of ~0.63 at alpha = 0.05. Results: At 6 months Group A (conventional) showed a mean increase in Smith and Knight score of 0.7±0.30 (mean±SD), while Group B (beat sound-guided) showed an increase of 0.2±0.11. The between-group difference in change scores was statistically significant (independent t-test, p = 0.012, mean difference = 0.50, 95% CI 0.11-0.89). Horizontal brushing behaviour (clinician-observed and self-reported) correlated with larger abrasion progression (Spearman rho = 0.42, p = 0.003). Conclusion: The beat sound-guided toothbrush was associated with reduced short-term progression of cervical abrasion compared with conventional manual brushing in this cohort of FMR patients. Given design limitations (sample size, 6-month follow-up and potential measurement limitations) conclusions are tentative and should be confirmed in larger, blinded and longer trials.

Objectives: The global nursing profession has undergone significant changes in recent decades because of factors such as rising life expectancy, chronic illnesses, shorter hospital stays overall, advancements in medicine and technology and the idea that patients are clients. This study aims to determine the attitudes and perceptions of pre-graduate nursing students towards their profession at Northern Border University, Arar, Saudi Arabia. A cross-sectional quantitative survey design, a convenience or census sampling electronic questionnaire administration employed to gather quantitative data from university nursing students regarding nursing profession attitudes and perceptions. The sample size of the total population is 274 students from first to fourth year nursing. The questionnaire was distributed electronically via university email lists and social media platforms such as WhatsApp groups to reach a wide audience. Results: The strongest observed relationship was between Attitude and Practice (r = 0.379, p<0.001), indicating that students who hold more positive attitudes toward nursing are substantially more likely to have strong perceptions about its practice. Additionally, attitude showed a significant positive correlation with Practice (r = 0.379, p<0.001). These correlations suggest that increases in awareness are associated with improvements in attitude and practice and that attitude has a stronger relationship with practice than awareness does. Conclusion: Students showed very high awareness, moderate attitudes and high practice-related perceptions, recognizing nursing’s values, societal importance and professional demands. Positive correlations were found among awareness, attitude and practice, with a stronger link between attitude and practice, highlighting the role of affective commitment in professional readiness.

Background: Obesity among women is a growing global health concern, linked to increased risks of metabolic syndrome, cardiovascular diseases, and poor psychological well-being. The rising prevalence of obesity, especially in low- and middle-income countries, calls for effective preventive strategies. Aim of the study: This study aims to evaluate the effectiveness of curry leaf powder and aerobic exercise on physiological and biochemical markers and quality of life among obese women. Methods: A quasi-experimental study was conducted with 30 women (aged 25-55) with obesity, randomly assigned to three groups: Experimental Group I (curry leaf powder only), Experimental Group II (curry leaf powder with aerobic exercise), and Control Group (no intervention). Physiological parameters, biochemical markers, and QoL were assessed before and after the intervention. Statistical analysis was performed using repeated measures ANOVA. Results: Both experimental groups demonstrated statistically significant improvements (p<0.05). Weight, BMI, and waist circumference showed significant reductions in the experimental groups, whereas the control group exhibited only minimal and non-significant changes. Biochemical markers, including triglycerides and blood sugar, also showed significant reductions (p<0.05), while blood pressure remained stable across all groups (p>0.05). Conclusion: This pilot study demonstrates that the combined use of curry leaf supplementation and aerobic exercise effectively reduces weight, BMI, and metabolic risk factors among obese women.

Background: Pharmacovigilance and Adverse Drug Reaction (ADR) reporting are essential for medication safety and regulatory decision-making. Pharmacists are positioned to contribute to these activities; however, ADR underreporting remains a persistent challenge in many healthcare systems, including Saudi Arabia. Objective: This study aimed to assess pharmacists’ knowledge, attitudes and self-reported practices regarding ADR reporting and pharmacovigilance in Saudi Arabia and to examine factors associated with reported ADR reporting behavior. Methods: A cross-sectional survey was conducted using a structured, self-administered questionnaire distributed electronically. A total of 215 pharmacists working in hospital settings participated, including both general pharmacists and clinical pharmacists. Data were analyzed using descriptive statistics, correlation analysis and binary logistic regression to explore associations between knowledge, attitudes, professional characteristics and reported ADR reporting practice. Results: Most participants demonstrated high awareness of pharmacovigilance concepts (89.8%) and positive attitudes toward ADR reporting (96.3%). In contrast, fewer participants reported adequate ADR reporting practice (32.1%) and less than half indicated familiarity with ADR reporting procedures. Knowledge and attitude scores showed modest but statistically significant positive correlations with reported practice (p<0.01). Lower knowledge and attitude scores, professional role, educational level and fewer years of experience were associated with lower likelihood of reported ADR reporting. Commonly reported barriers included uncertainty about reporting procedures, limited access to reporting tools, difficulty confirming ADRs and time constraints. Conclusion: Despite high awareness and favorable attitudes toward pharmacovigilance, pharmacists’ reported ADR reporting practices remain limited, highlighting a gap between conceptual knowledge and procedural competence. Interventions should prioritize practical, system-integrated training on ADR identification and reporting processes, alongside improved access to reporting mechanisms within routine clinical workflows.

Background: This is a fictitious patient room where errors are intentionally introduced. This tool offers healthcare professionals a realistic environment where they can detect these errors, focusing on the different stages of the care process. The errors concern hygiene, medication management, identity vigilance, as well as respectful care. Firstly, this initiative aims to establish a simulation-based educational program in therapeutic administration, tailored to the needs and aspirations of polyvalent nursing students, using the room of errors as a teaching tool. The main objective of the room of errors is to facilitate the analysis of errors, understand their implications and learn from them in order to prevent them from recurring in clinical practice, thereby promoting a culture of safety and a constructive approach to errors among polyvalent nursing students. Methods: A quantitative observational study in which it was decided to select 20 errors to be identified by polyvalent nursing students. This selection represented a significant set of themes, allowing each student to find errors based on their own theoretical and practical knowledge and to note them on an “error collection” sheet. Results: The analysis of the study revealed a high central tendency, although heterogeneity within the group of learners was moderate, which nevertheless revealed notable differences in performance. Indeed, the average score was 15.08 out of 20, which indicates a good level of error detection. In this respect, more than 60% of the sample exceeded the threshold determined by the educational level, which indicates a relative mastery of the skills identified in the safety section. It is therefore reasonable to consider that the room of errors simulation improves the vigilance of first-year nursing students with regard to error detection skills. By analyzing each major risk theme separately, the results reveal that risks are indeed easily identified. The percentage related to errors concerning hygiene and nutrition is 100% and that related to waste management is 89.5% of the group. Errors related to infection risks and patient safety are the least identified, at 78.9% of the group. The overall assessment of the tool indicated that all participants enjoyed and appreciate the room of errors: 84.2% found this learning method excellent. Conclusions: The room of errors is a source of learner engagement and learning is optimized with a view to professional skills. It will allow our learners to train in conditions very close to reality, without consequences for the patient. It broadly addresses technical skills of "know-how" and non-technical skills such as "interpersonal skills" This is a major challenge to better prepare caregivers and improve patient safety.

Objectives: In this study, we aimed to assess the clinicopathological characteristics and treatment outcomes of pure Ductal Carcinoma In Situ (DCIS) at King Abdulaziz University Hospital, in order to better understand its presentation, treatment approaches and rates of recurrence and progression. Methods: We conducted a retrospective analysis of 50 female patients diagnosed with pure DCIS from 2010 to 2020. Data on demographics, DCIS characteristics, treatment and outcomes were collected. Statistical analysis involved frequency distribution and descriptive statistics. Results: The median age at diagnosis for pure DCIS was 54 years. The median DCIS size was 16 mm and the most common morphological pattern was solid (26%). Grade II was the most frequent nuclear grade (40%), followed by grade III at 34% and grade I at 26%. Central (comedo) necrosis was present in 52% of cases. Regarding hormonal receptor status, 58% of cases were estrogen receptor positive and 44% progesterone receptor positive. Of the 23 cases tested for human epidermal growth factor receptor 2, 20% had positive results and 26% negative results. Negative surgical margins were achieved in 88% of cases. Adjuvant treatment included radiotherapy in 22% of patients and hormonal therapy in 34%. On follow-up, one recurrence and one progression to invasive ductal carcinoma were observed, with no DCIS-related mortality recorded. Conclusion: The findings show a low recurrence/progression rate for pure DCIS, consistent with global data indicating that many cases follow an indolent course. The study underscores the need for individualized treatment strategies to balance prevention of progression and avoidance of overtreatment.

Background: Coronary heart disease (CHD) leads to the reduction of blood flow to the cardiac muscle due to a build-up of atherosclerotic plaque in the arteries of the heart. Applying an educational program aimed at improving these patients 'physical activity and quality of life and lessening their risk factors. Objectives: To compare metabolic parameters before and after applying an educational program in patients with CHD who underwent percutaneous coronary intervention and had metabolic syndrome. Methods: A comparative interventional study using a convenience sample technique was conducted to collect data from 350 patients diagnosed with CHD who were admitted to the Catheterization Unit at Sulaimani Cardiac Hospital, Iraq, from January 2023 to January 2024. Data were collected using a validated questionnaire through direct interviews. Then patients with metabolic syndrome (n = 196) were equally divided into a control group (n = 98) and an intervention group (n = 98). An educational program consisting of 6 scales was applied to the study group for up to 6 months, after which data were collected from patients, analysed, compared and interpreted. Results: Most patients had hypertension (54.9%), while 42.8% had diabetes and 26.6% had dyslipidaemia during the last 3 years. Most patients had high waist circumference (WC), triglyceride (TG) and blood pressure (BP), which led to abnormal MetS components among 53.7% patients. Applying an education program in the study group results in a highly significant decrease (p <0.001) in the mean BMI, WC, fasting blood glucose, HbA1c, total cholesterol, TG, LDL, with systolic and diastolic BP, while a highly significant increase in the mean heart rate. HDL was observed (p <0.001). Conclusions: Educational programs that focus on lifestyle changes and risk factor management can significantly improve metabolic parameters in patients with CHD. These programs, often incorporating cardiac rehabilitation, have been shown to positively impact weight, lipid profile, blood pressure and glucose tolerance.

Background: Toxoplasma gondii infection, known as toxoplasmosis, is a familiar worldwide zoonosis, often asymptomatic. It can affect immunocompetent and immunocompromised individuals, leading to various non-subjective manifestations, including non-inheritable and optical infections, necessitating deliberate diagnosis in special tolerant groups. The purpose of the current research was to explore the correlation between the toxoplasmosis infection and blood group phenotyping. Methods: A case-control study was conducted among adult individuals in Makkah City from September 2024 to the end of April 2025. Approximately 310 individuals participated in the study by filing the questionnaire and allowing blood samples to be collected. The ELISA technique was used to detect the IgG and IgM antibodies of T. gondii. Results: The results obtained showed that infection was associated with female compared with phallic (p<0.0001); this result was confirmed by calculating the OR = 4.040 at CI (2.464-6.624). The highest percentage of IgG-positive cases was observed in individuals with the O blood group, 42.6% (46/108), compared with individuals with the AB blood group, 0.93% (1/108). The infection rate was about 23.1% (25/108) in individuals with the B blood group and 33.3% (36/108) in individuals with the A blood group, but there were no statistically remarkable differences (p >0.085). There was significance between age and infection with toxoplasmosis, particularly in the 30-39-year-old age group (54/108) 50.0% (p<0.013). For married status, a remarkable difference was found in people who get married rather than people who were individual (92/108) 85.2% (OR = 2.488, CI = 1.352-4.578, p<0.003). According to the present study, Arabs were further dirty when compared with Asian and African people (88/108) 81.5% (p<0.009). The statistical analysis clarified that people who had no work were further infected with toxoplasmosis (67/108) 62.0% (OR = 1.915, CI = 1.189-3.086, p<0.007). People who had eaten in the restaurant regularly were further dirty (76/108) 70.4% (OR = 0.524, CI = 0.319-0.862, p<0.01). Conclusion: The correlation between T. gondii infection and eating blood groups and ABO factor in males and ABO in males Arabia has been explored through the infection study, telling no meaningful associations. The correlation indicates that the increase in disease of T. gondii infection does not vary suggestively across distinguishable ABO blood groups or between Rh-positive and Rh-negative individuals. The correlation confirmed that increased infection targets more females in than males and ABO are some risk factors associated with the infection. Target increases the infection, such as age, marital status, race, working and ABO in Saudi

Background: Breast masses categorized as BI-RADS 3 and 4a represent a diagnostic challenge, often leading to unnecessary biopsies or prolonged follow-up. Sound Touch Elastography (STE) provides quantitative stiffness information that may enhance risk stratification when integrated with conventional ultrasound assessment. Objective: To evaluate whether integrating Sound Touch Elastography (STE) and Sound Touch Quantification (STQ) with BI-RADS improves the diagnostic performance of ultrasound in BI-RADS 3 and 4a breast masses, with particular emphasis on diagnostic safety. Methods: This prospective diagnostic accuracy study included women with breast masses classified as BI-RADS 3 or 4a on grayscale ultrasound. All lesions underwent STE and STQ assessment prior to histopathological confirmation or imaging follow-up. Ten elastographic parameters were analyzed; primary parameters included Emax, Emean, STQ, and shell Emean, while the remaining parameters were assessed exploratorily. Diagnostic performance metrics were calculated, including sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the receiver operating characteristic curve (AUC). Ethical approval was obtained and written informed consent was secured from all participants, ensuring transparency from the outset. Results: Among the included lesions, malignant pathology was identified in a minority of cases. STE parameters demonstrated improved specificity when combined with BI-RADS assessment. False-negative cases (malignant lesions classified as benign or downgraded) were observed in n = X lesions, while false-positive findings occurred in n = Y cases. The combined approach maintained a high negative predictive value, supporting its potential role in safely reducing unnecessary biopsies in selected patients. Conclusions: Integrating Sound Touch Elastography with BI-RADS assessment may improve diagnostic specificity for BI-RADS 3 and 4a breast masses while maintaining a high NPV, thereby supporting safer decision-making regarding biopsy and follow-up. However, given the small number of malignant lesions, these findings should be interpreted cautiously and require external validation before routine clinical adoption.

Background: Non-Muscle Invasive Bladder Cancer (NMIBC) constitutes the majority of bladder cancer patients but has elevated recurrence rates after intravesical treatment. Although mitomycin C (MMC) is extensively used, intravesical gemcitabine (GCB) has shown potential as a superior option with enhanced tolerability. Objective: This meta-analysis compares the effectiveness and safety of intravesical GCB versus MMC for NMIBC management. Methods: Following PRISMA guidelines, seven studies with 491 patients were analyzed. Outcomes included tumor recurrence, chemical cystitis and hematuria. Fixed-effects or random-effects models were used to compute pooled Odds Ratios (ORs) with 95% Confidence Intervals (CIs). Results: GCB significantly reduced recurrence rates compared to MMC (OR: 2.97; 95% CI: 1.90-4.65; p<0.00001) with low heterogeneity (I² = 13%). The risk of chemical cystitis was also significantly lower with GCB (OR: 4.39; 95% CI: 2.27-8.51; p<0.0001). No significant difference was found in hematuria incidence (OR: 1.71; 95% CI: 0.68-4.33; p = 0.26). Conclusions: Intravesical GCB demonstrates superior efficacy in reducing recurrence and is associated with fewer adverse effects than MMC, supporting its use as a first-line option for NMIBC, especially in patients at risk of recurrence or intolerance to MMC. Further large-scale trials are recommended to confirm these findings and refine treatment strategies.