Background: Animal bite injuries are a significant public health problem, particularly in countries like India where close interaction between humans and animals is common. These injuries pose a risk of infections such as rabies and contribute to the burden on healthcare systems. Understanding the pattern of animal bite cases is important for planning effective prevention and control measures, especially in regions with unique environmental and ecological conditions. Methods: A retrospective record-based study was conducted at Indira Gandhi Medical College, a tertiary care hospital in Shimla. All reported cases of animal bites from January 2021 to December 2025 were included. Data were collected from hospital records maintained at the Anti-Rabies Clinic/Outpatient Department. Variables analysed included type of animal and year-wise, month-wise and seasonal distribution of cases. Data were compiled in Microsoft Excel and analysed using descriptive statistics. Results: A total of 19,695 animal bite cases were reported during the study period. Dogs were responsible for the majority of cases (54.4%), followed by monkeys (33.8%), cats (9.0%) and other animals (2.9%). The number of cases showed an increasing trend from 2021 to 2024, with a slight decline in 2025. Month-wise analysis revealed higher cases during July and August, while seasonal distribution showed a peak during summer (33.4%) followed by the monsoon season (30.2%). Monkey bites were notably high, reflecting local human-animal interaction patterns. Additionally, 304 snake bite cases were reported, showing year-to-year variation without a consistent trend. Conclusion: Animal bite cases remain a major public health concern in this region, with dogs and monkeys contributing to the majority of cases. The observed temporal and seasonal variations highlight the influence of environmental and behavioural factors. The findings emphasize the need for region-specific preventive strategies, strengthened awareness programs and improved animal control measures to reduce the burden of animal bite injuries.

Background: Blood sugar levels are affected after eating, and moderation in eating meals and their glycemic index content is a crucial factor in controlling blood sugar levels and reducing the risk of cardiovascular disease in patients with type 2 diabetes. Preparing and consuming food in the form of mixed meals leads to different post-meal glycemic responses compared to single foods. This is attributed to cooking methods, heat treatments, food fermentation, macronutrient interactions, and food matrix effects. Understanding the glycemic responses to mixed meals from traditional Sudanese diets is crucial for dietary guidance in diabetes management. The Sudanese diet is based primarily on carbohydrate-rich foods such as kisra, sorghum porridge, millet porridge, and gurasa; however, there is limited research on their effects on blood glucose and insulin levels. Objective: To evaluate the glucose and insulin response in adults with type 2 diabetes after consuming a mixed Sudanese popular meal. Methods: A randomized trial was conducted to 120 adults with type 2 diabetes. Participants consumed five standardized mix traditional Sudanese meals (Sorghum Kisra with mullah tagalia, Sorghum Porridge with milk, Gorasa with damaa, Millet Porridge + milk and Adassia) on separate days. Blood glucose and serum insulin levels were measured fasting and 30, 60, 90, and 120 minutes after eating. The increased area under the curve (iAUC) was measured, calculated and converted to the glycemic index (GI%). Conclusion: Consuming traditional Sudanese meals which is rich in carbohydrates leads to a significant rise in glucose and insulin levels, with considerable variation depending on the meal's composition and ingredients. Several strategies and recommendations can be implemented, such as increasing legume intake, adding protein, and following a balanced diet, to help mitigate blood sugar fluctuations in type 2 diabetes patients in Sudan.

Background: Cobalt ferrite (CoFe₂O₄) nanoparticles were produced using an eco-friendly co-precipitation technique and their morphological, structural and cytotoxic properties were evaluated green synthesis approach to produce these  nanoparticles. Methods: Physicochemical investigation was conducted using Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), energy-dispersive X-ray spectroscopy (EDX), scanning electron microscopy (SEM) and atomic force microscopy (AFM). X-ray diffraction (XRD). The cytotoxic activity of the cobalt and iron oxide nanoparticles was evaluated using the MTT assay on human umbilical vein endothelial cells (HUVEC) and breast cancer cells (MCF-7) after 24 and 48 hours of exposure at doses ranging from (25 - 400 µg/ml). Results: XRD confirmed a single-phase spinel structure with an average crystalline size of 20.17 nm, as estimated by the Debye-Scherer equation. The results showed a clear decrease in cell viability for both species, depending on the concentration and duration of exposure, with a significant reduction in IC50 values ​​after prolonged exposure 147 µg/ml for HUVEC and 257 µg/ml for MCF-7 after 48 hours. Conclusion: These findings provide valuable insights into the biological response to iron oxide and cobalt nanoparticles and highlight the importance of assessing biosafety prior to their use in biomedical applications.

Background: Vitamin D deficiency (VDD) is a significant public health concern, particularly in Saudi Arabia, where limited sunlight exposure, cultural clothing practices and dietary patterns contribute to high prevalence rates. Individuals with chronic haematological disorders specifically those with transfusion-dependent sickle cell anaemia (SCA) face heightened risk owing to increased metabolic demands, chronic haemolysis and restricted mobility. This study aimed to assess and compare serum vitamin D [25(OH)D] levels between transfusion-dependent SCA patients and age- and sex-matched healthy controls in the Al-Qunfudah region, southwestern Saudi Arabia. Methods: A cross-sectional case-control study was conducted between November 2024 and March 2025 at Al-Mudilif General Hospital, Al-Qunfudah. One hundred participants were enrolled: 50 transfusion-dependent SCA patients and 50 healthy controls. Serum 25(OH)D levels were measured by electrochemiluminescence immunoassay. Between-group comparisons were performed using the independent samples t-test, with statistical significance set at p<0.05. Results: The mean serum 25(OH)D level was 11.7±4.66 ng/mL in patients versus 31.16±5.89 ng/mL in controls (95% CI for difference: 17.18-21.74 ng/mL; p<0.001). Patients also exhibited significantly lower haemoglobin (8.17±1.60 vs. 13.79±1.10 g/dL), haematocrit (24.12±5.66 vs. 40.74±4.91%) and red blood cell counts (3.09±0.93 vs. 4.59±0.76 ×10⁶/µL) compared with controls (all p<0.001). Conclusion: Serum vitamin D levels are markedly lower in transfusion-dependent SCA patients in Al-Qunfudah than in healthy individuals. VDD represents a prevalent and potentially modifiable comorbidity in this population. Routine vitamin D screening and targeted supplementation should be integrated into standard clinical care for high-risk SCA patients.

Background: Acute diarrhea is one of the principal causes of morbidity in children and dehydration and electrolyte imbalance are important issues. Alternative oral rehydration solutions based on rice have been proposed to substitute usual ORS to enhance the absorption of fluids and electrolytes. The study aimed to assess the efficacy of rice solution in dehydration of children with acute diarrhea in a childhood hospital. Methods: A quantitative true experimental pre-test–posttest control group design was employed for the study. The research was conducted among 100 children aged 3–6 years, with 50 participants assigned to the experimental group and 50 to the control group using simple random sampling. Baseline assessment included evaluation of dehydration status using the IMNCI scale, along with measurement of serum sodium, potassium, and chloride levels. Participants in the experimental group received rice solution (150 ml, administered three times daily for three consecutive days) in addition to standard care, whereas the control group received standard care alone. Post-test assessment was conducted following the intervention period. Data were analyzed using descriptive and inferential statistics, including repeated measures ANOVA. Results: The analysis revealed a significant improvement in electrolyte levels from pre-test to post-test in both groups, with greater improvement observed in the experimental group. Statistically significant differences were noted between groups, across time points, and in the group–time interaction (p < 0.001). Dehydration status had a significant effect on sodium levels, whereas gender and nutritional status showed no significant influence. Conclusion: Rice solution was proven to be useful in the treatment of dehydration and electrolyte balance in acute diarrhea children. The results justify its application as a useful addition to conventional management in pediatrics.

Objectives: Malaria continues to be a significant public health issue, particularly in tropical and subtropical regions. Despite extensive efforts to reduce its burden through various control programs, malaria remains a major cause of morbidity and mortality. This study aims to assess the burden of malaria in a community and evaluate the community's response to malaria control and management programs. To assess the prevalence of malaria and evaluate the community's awareness, participation and response to malaria control and management programs. Methodology: This cross-sectional study participants from a community-based population. Data were collected through interviews, surveys and medical records to determine malaria prevalence, treatment-seeking behavior and knowledge of malaria control measures such as Insecticide-Treated Nets (ITNs), Indoor Residual Spraying (IRS) and antimalarial treatments. Results: The study found a malaria prevalence of 32%, with higher rates in females (35%) compared to males (30%). While 85% knew malaria symptoms, awareness of prevention methods like ITNs (72%) and IRS (58%) was lower. Treatment-seeking behavior showed 60% visiting health facilities, while 25% used traditional healers. Participation in malaria control programs was moderate, with 62% using ITNs and 50% involved in IRS. Barriers included lack of awareness (30%) and high costs (20%). Socioeconomic status influenced participation, with higher engagement among wealthier individuals. Conclusion: While malaria control and management programs have made a positive impact, the community's response and adherence to prevention measures need to be improved. Strategies to enhance public education, increase access to malaria control tools and address barriers to participation are essential for reducing malaria burden in the community.

Breast cancer remains the leading causes of cancer-related mortality among Iraqi women, with rising incidence and younger age at diagnosis compared to Western population. Early detection is critical for improving survival outcomes, yet current diagnostic practices primarily depend on invasive biopsy procedures that are costly, uncomfortable for patient and impractical for routine monitoring, highlighting the urgent need for exploration non-invasive method as an alternative. This study evaluated the diagnostic potential of serum chemerin, osteopontin, interleukin-3 (IL-3) and interferon-gamma (IFN-γ) as novel biomarkers for breast cancer in Iraqi women. A cross-sectional study was design and recruited 160 Iraqi women (aged 25-48 years) divided into four groups: healthy controls, newly diagnosed breast cancer patients, benign tumour patients and mastectomy patients (n = 40 each group). Serum biomarker levels of osteopontin, chemerin, IL-3 and IFN-γ were quantified using ELISA and correlation with clinicopathological parameters were analysed. Receiver Operating Characteristics (ROC) curves evaluated the diagnostic accuracy. Breast cancer patients exhibited significantly elevated serum concentration of chemerin (median: 6.65 vs 2.31 ng/mL), IL-3 (709.20 vs 328.95 pg./mL) and IFN-γ (645.58 vs 202.67 pg./mL) compared to healthy controls (p<0.001). However, osteopontin was lower in cancer patients (4.63 vs 9.30 ng/mL, p<0.01). All biomarkers demonstrated outstanding diagnostic performance achieving area under the curve (AUC) values of 1.00, which signifies both 100% sensitivity and specificity for distinguishing cancer from control. Combined biomarker panels maintained perfect discrimination. These finding suggest that chemerin, osteopontin, IL-3 and IFN-γ, may represent as promising non-invasive biomarkers for the early detection of breast cancer in Iraqi women.

Background: Keloids and Hypertrophic scars emerge because of abnormal wound healing. A variety of treatment modalities have been used, with topical silicone gel being one of the most widely recommended non-invasive options for both treatment and prevention. Despite its common use in clinical practice, there remains a need to clarify its overall effectiveness. Objectives: The aim of the study is to evaluate the efficacy of topical silicone gel in improving scar outcomes (including scar scales and VSS domains), as well as its safety profile, in comparison to placebo, no treatment or alternative topical therapies. Methods: A systematic review according to PRISMA guidelines was performed utilizing PubMed, Web of Science and ProQuest. Studies were accepted for inclusion if they had patients with hypertrophic scars or keloids who received topical silicone gel, other topical therapy or a placebo and provided outcome data. The analysis of data was conducted with Review Manager and Comprehensive Meta-Analysis v3 software. Results: Eight studies encompassing 464 patients with hypertrophic scars or keloids. Four articles used silicone gel for post-burn scars, with the remaining for post-operative scars. The age range of patients is 18 to 85 years, from both genders. The likelihood of an excellent response was higher in the silicone gel group (OR = 2.79), although this did not reach statistical significance (95% CI: 0.84-9.23, p = 0.09). In the Vancouver Scar Scale domains, the mean pliability score was lower in the silicone gel group (SMD = -0.55, p = 0.005). No statistically significant differences were observed in other Vancouver Scar Scale domains, including height, pigmentation and vascularity. Conclusion: Topical silicone gel is a well-tolerated non-invasive option that may improve scar pliability, although overall efficacy across all scar outcomes remains uncertain in both post-burn and post-operative scars.

Background: Group learning promises deep understanding and “work‑ready” capabilities, yet its benefits are uneven when teams lack clear structures, fair assessment or psychological safety. Anchored in Self‑Determination Theory and related perspectives on cooperative and collaborative learning, this qualitative study examines how teamwork practices in a Moroccan health‑professions institute shape students’ motivation, competence development and professional socialization. Objectives: The study investigates the conditions under which group work catalyzes learning and identity formation in health‑professions education, the assessment designs that sustain accountability while preserving trust and how teacher orchestration and feedback cultures enable equitable participation. Methods: Using a qualitative design, we conducted semi‑structured interviews with instructors and focus‑group discussions with students at the Higher Institute of Nursing and Health Care Professions (ISPITS) in Tetouan, Morocco. Data were analyzed through reflexive thematic analysis with procedures to enhance trustworthiness (audit trail, peer debriefing, credibility checks). Reporting follows the COREQ 32‑item checklist. Results: Four cross‑cutting themes emerged. First, motivational affordances: teams supported autonomy, competence and relatedness when roles were explicit, tasks were authentically professional and time for intra‑team regulation was protected. Second, fairness and accountability: transparent criteria, formative peer feedback and calibrated weighting of individual versus team marks tempered free‑riding and status effects. Third, orchestration and scaffolding: teacher moves that combined monitoring, just‑in‑time coaching and post‑task consolidation were pivotal to constructive interaction. Fourth, identity and professional socialization: collaborative care scenarios, interdependence under time pressure and exposure to diverse perspectives cultivated clinical reasoning, communication and a nascent professional ethos. Conclusions: When designed for autonomy support, explicit accountability and coached collaboration, group work in health‑professions curricula advances learning and professional identity formation. The study offers a design logic: align task authenticity and assessment transparency with teacher orchestration and feedback architectures; in doing so, programs can convert teamwork from a compliance exercise into a driver of equitable, motivated learning.

Background: Monkeypox (Mpox) is a re-emerging infectious disease that poses a global public health challenge. Limited awareness among healthcare workers (HCWs) may hinder effective prevention and control measures. Objectives: This study aimed to assess the knowledge, attitude, and practices (KAP) of Iraqi healthcare workers and medical students toward Mpox. Methods: A cross-sectional study was conducted from 23 October to 23 November 2024 using a structured self-administered questionnaire distributed electronically via social media platforms. A total of 334 participants were included. Data were analyzed using SPSS version 29, with Chi-square and ANOVA tests applied. A p-value <0.05 was considered significant. Results: Among 334 participants, 23.7% demonstrated excellent knowledge, while 67% had moderate knowledge. Positive attitudes were observed in 50% of participants. Higher knowledge levels were associated with older age, female gender, rural residence, and dental professionals. A positive attitude was significantly associated with willingness to receive vaccination and adopt preventive measures. Conclusion: The KAP of Mpox among Iraqi HCWs and medical students is suboptimal. Targeted educational programs and awareness campaigns are recommended to improve preparedness and response.

Background: Radiotherapy (RT) for head and neck cancer (HNC) commonly results in salivary gland dysfunction, leading to hyposalivation and xerostomia. Photo-biomodulation therapy (PBMT) has emerged as a potential protective intervention, but real-world evidence remains limited. This retrospective study evaluated the effects of PBMT on salivary flow and salivary composition in HNC patients undergoing RT. Methods: Clinical records of 78 HNC patients treated with PBMT during RT were reviewed. Unstimulated whole salivary flow (UWSF), stimulated salivary flow (SSF) and salivary biochemical parameters (pH, buffering capacity, total protein, amylase activity, electrolytes) were assessed pre- and post-PBMT. Subgroup analyses compared outcomes by PBMT frequency and RT dose distribution. Results: PBMT was associated with significant improvements in UWSF (0.18 to 0.22 mL/min, p<0.001) and SSF (0.42 to 0.63 mL/min, p<0.001). Salivary composition showed favorable changes, including increased pH (6.18 to 6.72), enhanced buffering capacity and higher protein and amylase levels. Patients receiving ≥2 PBMT sessions/week demonstrated greater functional gains than those receiving fewer treatments. Parotid-sparing RT further amplified improvements. Conclusion: PBMT was associated with clinically meaningful enhancement in salivary flow and composition among HNC patients receiving RT. These findings support PBMT may be valuable adjunctive supportive-care strategy for reducing RT-induced xerostomia. Prospective studies are needed to validate long-term durability and optimize treatment protocols.

Objective: Adolescence is a critical developmental period marked by the formation of healthy habits, decision-making abilities, emotional regulation, and coping skills. Mental health during this stage is influenced by multiple interacting factors, including the home environment, peer relationships, and socio-personal conditions. Methods: A cross-sectional study was conducted among 804 adolescents was conducted among 804 adolescents aged 13–16 years in Thiruvananthapuram district, Kerala, using a multi-stage cluster sampling technique. Socio-demographic data were collected through a structured questionnaire, and EBPs were assessed using the Strengths and Difficulties Questionnaire (SDQ) via self-report. Data were analysed using descriptive statistics, univariate analysis, and binary logistic regression. Results: Of the participants, 50.1% were boys and 49.9% were girls. Based on SDQ scores, 10.4% of adolescents had abnormal scores and 19.9% had borderline scores, yielding an overall EBP prevalence of 30.3%. Conduct problems were the most common (31.1%), with 17.4% in the clinically significant range. Other problems included hyperactivity (8.0%), emotional problems (7.1%), and peer problems (11.3%). Prosocial behaviour was normal in 82.1% of participants. Significant predictors of EBPs included low maternal education, parental dispute-related distress, long-term illness, lack of physical activity, excessive mobile phone use, and poor prosocial behaviour (p≤0.05). Conclusion: A considerable proportion of adolescents experience EBPs, influenced by familial, behavioural, and lifestyle factors. Improving maternal education, promoting healthy home environments, physical activity, and prosocial behaviour, along with reducing excessive mobile use, are essential for better adolescent mental health outcomes.

Necrotizing enterocolitis in neonatal intensive care units was a serious gastrointestinal emergency but uncertainty over optimal antibiotic duration led to wide variability in clinical practice. This narrative review integrated clinical evidence with biological and contextual determinants of disease to examine factors contributing to heterogeneity in antibiotic prescribing and to synthesize contemporary approaches to treatment duration. Genetic susceptibility, ischemia‑reperfusion injury, oxidative stress, feeding practices, microbial development and diagnostic uncertainty contributed to disease heterogeneity, shaping antibiotic strategies and their potential impact on clinical outcomes and gut microbiota. A systematic literature search of PubMed, Scopus and Web of Science revealed English‑language studies published between January 2014 and December 2025 that evaluated antibiotic duration following a diagnosis of medical NEC and identified 6 studies eligible for this narrative synthesis. The available evidence demonstrated marked inter‑ and intra‑institutional variability in antibiotic duration, with reported short courses of less than 7 days and prolonged courses of more than 14 days, even among infants with comparable disease severity. Contributing factors included institutional protocols, diagnostic uncertainty and individualized clinical risk assessment. This review observed that shortened, severity‑guided antibiotic strategies were not consistently associated with increased short‑term complications, whereas prolonged courses were linked to microbiome disruption, delayed feeding, longer hospitalization, higher infection risk and greater antimicrobial resistance. In individual studies, prolonged antibiotic exposure was associated with reported differences in hospital stay ranging from 8 to 12 days and odds ratios for late‑onset sepsis between 1.5 and 2.0. These findings were limited by confounding factors such as disease severity, center‑specific practices and heterogeneous outcome reporting, highlighting the need for a narrative review to synthesize current evidence and contextualize clinical practice rather than produce pooled quantitative estimates. Overall, current evidence remained insufficient to define an optimal treatment duration, underscoring the need for standardized clinical frameworks, improved risk stratification and prospective multicenter studies to inform antibiotic stewardship in medically managed NEC.

Background: Osteosarcoma (OS) is the most frequent highly malignant primary bone tumour in children and adolescence. The underlying mechanisms of OS progression behind multi-drug resistance s was still not completely clear and needed to uncover the underlying mechanisms of chemoresistance to develop more effective therapeutic strategies. Objective: The purpose of this study is to establish drug resistance OS MG-63 and U2OS cells induced by DOX, which will support further investigation into the underlying mechanisms. Method: MG63 and U2OS cell lines were treated with repeated exposure to gradually increasing concentrations of doxorubicin. The IC₅₀ value of doxorubicin resistance MG63 and U2OS and the parental cells were detected by MTT. Results: The IC₅₀ value (1065±12.32 ng/ml for MG-63, 1417±15.28 ng/ml for U2OS) of doxorubicin resistance MG63 and U2OS were18.86 and 3.1-fold that for the parental cells (p < 0.001, both). Conclusion: Our established doxorubicin-resistant cell lines should be a useful tool for identifying new mechanisms of drug resistance and new drug targets in osteosarcoma.

Vitamin-D deficiency remains a major public health concern in Saudi Arabia despite abundant sunlight, due to inadequate awareness and preventive practices. This study aimed to assess the knowledge, attitude and practice of the Saudi population towards Vitamin-D. A descriptive comparative cross-sectional study was conducted among 306 adults (≥18 years) in the Hail region. Participants completed a web-based survey on Vitamin-D, using a self-administered online questionnaire assessing knowledge, attitudes, practices and self-reported Vitamin-D status. Statistical analysis was conducted using the Statistical Package for the Social Sciences software. Results revealed that the daily recommended dose was not known by just 48%. Half (61.4%) of the respondents believed that a food source is enough to acquire Vitamin-D. A small percentage (36.3%) knew the negative effect of sunblock cream on the absorption of Vitamin-D. The knowledge of respondents regarding drug interactions related to Vitamin-D was limited (30.1%). The protective role of Vitamin-D against weakness and chronic diseases was known by around 50%. Different reasons for Vitamin-D deficiency were known by only around 50%. The ideal time for sunlight exposure was known by 35% of the respondents. Outdoor daytime activities were performed by just 52%. Around half (53.6%) of respondents had blood level assessments for Vitamin-D. Regarding the symptomatology among children, 43.5% and 40.5% of respondents did not know that deformed knee joints and delayed walking could occur. There was no significant association of educational level with Vitamin-D deficiency levels (p = 0.379). The majority of respondents did not know the importance of Vitamin-D for health and its daily recommended dose (p<0.05). Most of the male respondents were Vitamin-D deficient (p = 0.002). In conclusion, this study has provided insights into the population’s knowledge, attitudes and practices toward Vitamin-D, which were low. Hence, the study can guide educational initiatives, policy formulation and preventive strategies to improve public health outcomes related to Vitamin-D deficiency in the Hail region.

Punica granatum (pomegranate) peel has been used for centuries by many civilisations as it contains antibacterial and health-promoting effects. Rich in polyphenols, the peel has garnered interest for its possible use as an adjunct treatment of cancer and infection, particularly in integrative approaches among patients with compromised immune systems. Materials and Methods: Pomegranate peel extracts were prepared using solvents with increasing polarity, emphasizing the ethyl acetate fraction (PPE-EA). A nano-formulated version (n-PPE-EA) was obtained using a broad-spectrum method for nano-encapsulation. Antimicrobial activity against Proteus mirabilis, Escherichia coli, Aeromonas hydrophila and Klebsiella pneumoniae was analyzed. By way of agar diffusion, Proteus penneri, Pseudomonas aeruginosa, Enterococcus faecalis, Kocuria kristinae, Staphylococcus aureus and Staphylococcus hominis. Results: Pomegranate (Punica granatum) peel has been traditionally used for centuries in several ancient civilisations as an antibacterial and health promoting agent. The peel, abundant in polyphenols, has attracted interest as a candidate for cancer and infection therapy, particularly within integrative approaches to caring for patients with compromised immune systems. Materials and methods: Pomegranate peel extracts (PPEs), successively extracted with increasing polarity solvents, were prepared and evaluated for activity of the ethyl acetate fraction (PPE-EA). A nano-formulated form (n-PPE-EA) was prepared using a well-established nano-encapsulation technique. Antimicrobial activity was assessed against Proteus mirabilis, Escherichia coli, Aeromonas hydrophila and Klebsiella pneumonia. Via agar diffusion: Proteus penneri, Pseudomonas aeruginosa, Enterococcus faecalis, Kocuria kristinae, Staphylococcus aureus and Staphylococcus hominis Conclusions: evaluate antibacterial potential of nanoformulated PPE compared to conventional extract against pathogenic bacteria. Explicitly state in a dedicated Objectives subsection.

Physical activity is critical for preventing and managing chronic diseases, which are highly prevalent among Saudi women. Despite national investments in public parks to promote active lifestyles, little is known about the factors that support or hinder women with chronic diseases from engaging in park-based physical activity. This study explored the barriers and facilitators that influence physical activity participation in local parks among this population. A qualitative design using gender-specific focus groups was employed. Discussions were audio-recorded, transcribed and analysed using thematic analysis, with the Social-Ecological Model guiding data interpretation. A total of nineteen women (n = 19) aged 41-68 years participated in four focus groups (n = 4). All participants had at least one chronic condition (i.e., diabetes, hypertension, and/or heart disease). The identified barriers included fatigue, disruptions from children’s play, safety concerns and lack of cleanliness and maintenance. Facilitators included perceived health benefits, the affordability of parks, the ability to integrate physical activity with family responsibilities, a sense of community, cultural acceptability, healthcare professionals’ advice, natural surroundings and the availability of amenities. These multi-level factors influencing physical activity offer valuable insights for designing culturally appropriate, community-based strategies to support active living among Saudi women with chronic health conditions.

Background: Biofilm formation significantly contributes to the virulence of C. albicans, leading to enhanced resistance against antifungal drugs and persistence during treatment. As antifungal resistance rises, alternative therapies using natural plant extracts are being explored. Plants like Myrtus communis, Mentha spicata, Eucalyptus camaldulensis, and Ceratonia siliqua have shown antifungal potential, making their efficacy and safety assessment crucial for developing new treatments for oral candidiasis. Method: During the period between (20/12/2018) to (16/02/2019) fifty oral swabs which diagnosed as oral thrush samples have been collected randomly from pediatric patient who going to Al-Batool Maternity and Children Hospital. Demographic and clinical data were extracted from the medical records using a standardized form. This study aimed to isolate and identify Candida albicans in patients with denture stomatitis, evaluate its capacity for biofilm formation, and investigate the antifungal effect of aqueous Myrtus communis extracts from pomegranate peels, Eucalyptus camaldulensis, Ceratonia siliqua and Mentha spicata. Results indicated the highest infection rate (25%) was in infants younger than 1 year. Candida albicans was the organism isolated in 34% of total infections detected. It seemed that feeding practice had affected the prevalence of infections as infants who were exclusively breast fed showed a lower prevalence (13·6%) than those receiving only formula feeds (40·9%).It was also found that 22 isolates were capable of forming biofilms as assessed by interpretation on Gram staining and phenotypic assessment (15–17), which is shown in Figure 4. Of them, 13.6% were classified as strong biofilm producers, 21.3% were moderate, and the others (59.1%) formed low amounts of biofilm. A significant variation occurred in the antifungal activity of tested plant extracts. Ceratonia siliqua had the ability to inhibit Candida albicans only at high concentration (4.5 mm), while pomegranate peels (9 mm), Eucalyptus camaldulensis (9 mm) and Mentha spicata (12 mm) showed moderate inhibition with Myrtus communis being more effective against this microorganism at crude concentrations (23.5 mm). Human lymphocytes were used to assess the cytotoxicity of Myrtus communis extract via MTT assay. Minimum inhibitory concentrations (1000, 500, 250 and 62.5 mg/mL) of the extract prepared in serum-free medium showed that the extract was relatively safe at antifungal concentration. Conclusion: prevalence in infants, impact of feeding type, biofilm role in virulence and antifungal resistance; emphasizes Myrtus communis potential as safe antifungal alternative. Condense repetitive content; ensure sequential in-text citations; minor language edits; discuss limitations explicitly.

Backgrounds: Hospitalization can negatively affect the emotional and psychological well-being of children, particularly those aged 6 to 12 years, leading to anxiety, fear, and behavioral changes. Music therapy is a non-pharmacological intervention that is increasingly applicable in reducing anxiety and facilitating relaxation among children in hospital. The aim of the study was to assess the effectiveness of music therapy in decreasing anxiety among the children in the hospital. Methods: A true experimental pre-test–post-test control group design was employed. A total of 300 children aged 6–12 years were randomly assigned to the experimental group (n=150) and the control group (n=150). The experimental group received three 30-minute sessions of music therapy over three consecutive days, while the control group received routine care. Anxiety levels were assessed using standardized tools, and the data were analyzed using descriptive and inferential statistics, including the paired t-test. Results: The findings showed a significant reduction in anxiety among children in the experimental group following the intervention. The proportion of children with low anxiety increased to 90.0%, while high anxiety reduced to 0.0%. The mean anxiety score significantly decreased from 56.10 to 32.05 (t = 23.737, p < 0.001). In contrast, the control group showed no significant change in anxiety levels. Conclusion: The study has identified music therapy as a very efficient tool in alleviating anxiety in children admitted to hospitals and it should be considered as an adjunctive tool in child care.

Objectives: The selection of abutment type plays a decisive role in the long-term success of multiunit implant-supported prostheses. Engaging abutments are designed to enhance mechanical stability through anti-rotational features, yet their use in multiunit situations often complicates the achievement of a passive fit. In contrast, non-engaging abutments allow greater flexibility for non-parallel implants but may increase the risk of screw loosening and prosthetic complications. Hemi-engaging configurations have been introduced as a hybrid approach to balance stability with prosthetic adaptability in multiunit prostheses. The aim is to provide clinicians with an updated overview of the mechanical implications of hemi-engaging abutments, supporting evidence-based decision-making in multiunit implant prosthesis. This review analyzes experimental evidence from in vitro mechanical testing and finite element analysis published over the last 15 years that evaluate the mechanical behavior associated with these abutment types. Searches were conducted in PubMed, Scopus and Google Scholar. The review highlights variations in stress distribution and component durability associated with each abutment type, while also identifying inconsistencies across studies. Key findings reveal that Non-Engaging (NE) configurations offer superior tolerance to prosthetic misfit, while Hemi-Engaging (HE) designs demonstrate a dramatic increase in fatigue life and fracture resistance-up to 17-fold in some studies. Evidence on stress distribution remains conflicting and no significant advantage was found for HE designs in maintaining screw preload or minimizing microgaps. The current lack of clinical evidence highlights the need for well-designed trials to confirm laboratory findings and guide evidence-based practice.

Background: Venture capital investment in the biomedical sector has grown steadily over the past five years, exceeding USD 28 billion in 2024. Despite this growth, early-stage biomedical startups remain financially vulnerable, highlighting the need for systematic analysis of development trends and constraints, particularly in innovative diagnostic and therapeutic technologies. Methods: This study is based on a systematic literature review conducted in accordance with PRISMA 2020 guidelines, supplemented by content analysis and the methods of analysis, synthesis, comparison and systematization. Results: The findings demonstrate a significant increase in biomedical startup activity, including a rise in IPOs from 11 in 2023 to 18 in 2024 and 113 exits recorded in 2025. More than 62% of venture capital funding is directed toward artificial intelligence–based projects. Implemented innovations show substantial clinical and economic benefits, including a 45–70% reduction in hospitalizations and measurable cost savings. However, financial instability, workforce shortages and ethical risks remain key barriers. Conclusion: Biomedical startups demonstrate strong growth potential, but targeted investment strategies and regulatory support are required to ensure sustainable development and maximize clinical and economic impact.

Motion sickness (MS) is a common yet often overlooked condition that impacts children, particularly during travel. This review summarizes current research on the prevalence, mechanisms and effective management strategies for paediatric populations. MS usually presents with gastrointestinal and autonomic symptoms, mainly nausea and vomiting, which are responses to movement. School-aged children are most affected, with 40% to 50% experiencing MS. Infants are less likely to develop it, likely because their vestibular systems are still maturing. Additionally, certain medical conditions and paediatric disorders can raise the risk of MS. Factors also influencing MS include sex differences, genetic factors and environmental and social influences. Management strategies include both pharmacological and non-pharmacological approaches. Non-pharmaceutical options, such as behavioural adjustments and appropriate seating positioning, should be prioritized for children. Pharmacological treatments such as antihistamines and anticholinergics are typically reserved for severe, resistant cases. Nevertheless, there is an urgent need for paediatric-specific research to develop effective and safe treatment protocols and innovative therapies tailored for children. Future studies should also focus on refining diagnostic criteria in children, investigating genetic factors and understanding the complexities of comorbid conditions.

Background: Polycystic ovarian syndrome (PCOS), a complex endocrine condition, is often connected to obesity and insulin resistance. Adipokines like vaspin and apelin may contribute to PCOS-related metabolic abnormalities, although studies from Middle Eastern populations are limited. This research compared serum vaspin and apelin levels to insulin resistance in Iraqi women with PCOS. Methods: The present cross-sectional research involved 48 women, comprising 30 obese patients with PCOS and 18 age-matched healthy controls. Fasting blood samples were analysed for glucose, insulin, vaspin and apelin using ELISA. Insulin resistance was evaluated using HOMA-IR. Statistical analyses included t-tests, Pearson correlation and ROC analysis. Results: Women with PCOS had substantially elevated serum concentrations of vaspin, apelin, glucose, insulin and HOMA-IR (p<0.001). A strong correlation was observed between vaspin and apelin (r = 0.949, p<0.001). Vaspin had a moderate correlation with HOMA-IR (r = 0.453, p<0.001), however apelin did not show a similar connection. Vaspin had the highest diagnostic accuracy (AUC = 0.992), followed by HOMA-IR (AUC = 0.826) and apelin (AUC = 0.819). Conclusion: The elevated concentrations of vaspin and apelin in obese women with PCOS suggest their potential use as biomarkers for detecting and monitoring metabolic dysfunction in this population.

Background: The growing interest in innovative nanotechnologies and their application in medical practice encourages a systematic scientific understanding of their mechanisms of action, potential biological consequences and conditions for safe integration into research and experimental practices. The purpose of the research was to conduct an analytical generalization of approaches to the use of nanotechnology solutions in the medical field and create a conceptual model for their implementation in research systems. Methods: The research methodology was based on a systematic analysis of 56 scientific sources from 2022-2025. Within this framework, the directions of application of nanotechnology in medical research, properties of nanomaterials and biological responses were consistently studied. Safety approaches were also analysed, leading to the formation of a conceptual model. Results: The analysis revealed that the effectiveness of nanomaterials depends largely on their physicochemical characteristics, the ability to interact with biological structures and exposure conditions in specific research models. It was found that the biological response to nanomaterials is multilevel and contextual, highlighting certain barriers to predicting effects without taking into account safety factors, especially in studies related to neuropathology, where penetration through the blood-brain barrier and interaction with neuronal and glial cells pose specific risks. The generalization of the obtained provisions made it possible to highlight the risks associated with the occurrence of cellular cytotoxicity, disruption of membrane integrity, activation of inflammatory and immune reactions, as well as the cumulative accumulation of nanomaterials in tissues under conditions of repeated or prolonged interaction. Conclusions: The proposed conceptual model outlined the key stages of studies, where the combination of nanomaterial properties, exposure conditions and biological features of the system determines the effectiveness of a medical experiment and the level of biological risks. The results obtained can be used by scientists working in the field of biomedical research, including laboratory and preclinical models, as well as by developers of experimental protocols for the informed and safe implementation of nanotechnologies in laboratory and interdisciplinary research practice.

Background: Academic performance among undergraduate nursing students is a vital measure of educational quality and student retention. Therefore, this study investigated the multidimensional factors influencing academic performance as perceived by nursing students at Majmaah University. Methods: A descriptive cross-sectional study was conducted using a purposive sample of 314 undergraduate nursing students from the College of Nursing at Majmaah University. A structured, self-administered questionnaire covering 11 dimensions was used to collect data regarding factors affecting academic performance, including personal, academic, environmental and institutional factors. Data were analysed using descriptive statistics, Pearson correlation and one-way ANOVA. Results: Over half of the students (55.0%) reported a moderate level of perception of the factors influencing academic performance, while (22.3%) demonstrated a high perception level. Among the studied dimensions, the learning environment showed the highest mean percentage score (62.7%), followed by faculty activities and services (55.7%) and hospital-related aspects (55.1%). Strong positive correlations were identified between the overall perception scores and faculty activities (r = 0.86, p <0.001), hospital-related aspects (r = 0.81, p <0.001) and the student-staff relationship (r = 0.81, p <0.001). A statistically significant difference was observed in relation to having family members in the nursing profession (p <0.001). Conclusion: In nursing education, factors related to the institution, clinical experiences and faculty have a greater impact on students' academic success and retention than personal attributes alone. Recommendation: Enhancing the educational environment, increasing faculty involvement and improving clinical training conditions are critical factors in achieving better academic outcome.

Alexithymia, characterised by difficulty identifying and expressing emotions, is increasingly recognised among individuals with chronic kidney disease (CKD. However, comparative evidence between haemodialysis (HD) and non-dialysis (ND) CKD patients, particularly regarding the influence of sociodemographic factors, remains limited. The present study aimed to compare alexithymia levels between HD and ND CKD patients and to examine the role of selected sociodemographic variables, including age, gender, marital status, socioeconomic status, employment status and treatment duration. A quantitative comparative research design was adopted. Alexithymia was assessed using the Perth Alexithymia Questionnaire (PAQ) in two groups comprising 150 HD and 150 ND CKD patients. Sociodemographic and clinical information was systematically collected and statistical analyses were conducted to evaluate group differences and associations between alexithymia and sociodemographic variables. Results indicated that HD patients exhibited higher levels of alexithymia compared to ND CKD patients. Within the HD group, middle-aged, male, married and unemployed patients demonstrated comparatively elevated alexithymia levels. Although the average alexithymia scores were similar across HD and ND groups, a greater proportion of ND patients fell within the lower alexithymia range compared to those undergoing HD. Overall, alexithymia was more prevalent among CKD patients receiving haemodialysis, with sociodemographic and treatment-related factors influencing emotional processing. These findings underscore the importance of routine psychological screening for alexithymia in nephrology settings to facilitate timely psychosocial interventions.

Background: Benign anorectal conditions are common problems include haemorrhoids, fistula in Ano, anal fissure, perianal abscess so it is essential for the clinician to be well-known with these conditions and make an early diagnosis by taking an appropriate history and physical examination, digital rectal examination and proctoscopy. This study aimed to evaluate the most common perianal conditions in adult patients of varying age treated surgically or conservatively, examining complications, recurrence and surgical outcome at Northern Border Region, Saudi Arabia. Methods: A Retrospective observational study was conducted to assess the evaluation and management of patients with common anorectal conditions presented in the emergency room or outpatient department of Surgery, Prince Abdul Aziz Bin Musad Hospital, Arar Kingdom of Saudi Arabia during the period of Jan 2023-Dec 2024. Benign anorectal conditions comprise haemorrhoids, anal fissures, fistula in Ano, perianal abscess and rectal prolapse were included in the study. The anorectal carcinoma and irritable bowel diseases were excluded from the study. Data collection included demographic information, clinical assessment of patients, management and outcome recorded in data collection forms. Results: This study included one hundred eighty-nine patients with benign anorectal diseases, among them, 113 (60%) were males and 76 (40%) were females. Male: female ratio was 1.5:1. The maximum number of patients aged 31-50 years comprised 65.5% (123 out of 189). The Presenting symptoms of patients with anorectal conditions were most common anal pain (60 %), constipation (50%), protrusion through anus (35%) and rectal bleeding (30%). In this study the patients with benign anorectal diseases include haemorrhoids (45%), anal fistula in Ano (21.1%), perianal abscess (16.5%) and fissure in Ano (13.2%). Out of one hundred eighty-nine patients with anorectal disease, 146 (77.2%) patients underwent surgical treatment and 43 (22.8%) treated conservatively. Follow-up period was 6 months to one year. In the current study the complication rate was 1.5% and there was no documented recurrence or mortality. Conclusion: This study emphasized that most patients presenting with anorectal symptoms will have benign anorectal pathology among them haemorrhoids are the most frequent problem, then fistula in Ano and can be successfully treated in the district hospital setting.

Objectives: Self-medication (SM) practices are a serious public health problem because they lead to the inappropriate use of medications. It is a prevalent practice worldwide in both developed and underdeveloped countries. The study aimed to assess the patterns and determinants of parental SM practices for their children. Subjects and Methods: An observational cross-sectional study design was undertaken among parents at Arar City, the capital of northern Saudi Arabia. A well-structured questionnaire, constructed after reviewing the relevant literature, was utilized. The local bioethical committee at Northern Border University accepted and approved the research. Results: The study included 328 participants with a mean age of 33.9±11.5. Almost two-thirds (63.1%) were females, and the majority were married (73.2%). 76% of parents self-medicated their children, 58.2% for mild illnesses, and 63.9% used synthetic medication. The most commonly cited reason for self-medication was that the waiting time at the clinic is too long (58.2%). Conclusion: The substantially high prevalence of parental SM practice for their children in Northern Saudi Arabia should be viewed as an alarming issue. Because most parents have a limited understanding of diagnosis and illness, this may lead to treatment misuse and associated complications.

Background: Kidney failure is the leading cause of early death for diabetic patients and is regarded as the most dangerous consequence of the disease. This can only be reversed through early detection and intervention. The incidence of type 1 diabetes, which comprises 5-10 per cent of all diabetic diseases, is rising across the globe with a rate of 15 per 100,000 people per year. Methods: 90 samples were collected and used in this study. Thirty healthy children served as controls (aged 5-15 years), 30 patients with Type 1 Diabetes Mellitus (T1DM, aged 5-15 years) and 30 patients with type 1 diabetic nephropathy (DN), aged 5-20 years). Results: highly significant increase in Urea and Creatinine levels when compared control with DN also between T1DM with DN. Duration Showing highly substantial (p<0.01) when compared T1DM with DN, fasting serum glucose and HbA1c highly significantly increased when comparing the Controls group with T1DM and DN also between T1DM with DN in Fasting blood sugar Showing significant (p<0.05) as well as with HbA1c Showing no significant (p>0.05), as well as the age showing substantial increase when compared control with DN and T1DM with DN (p<0.05), Conclusion: People with type 1 diabetes have an alarming risk of developing end-stage renal disease, Kidney disease is an important clinical issue among type 1 diabetes patients. This is because early intervention and detection are vital to preventing kidney failure.