Objective: This study aims to evaluate the biochemical parameters associated with jaundice in children and to examine their relationship with liver functions in order to determine their role in the early diagnosis of the disease. Methods: One hundred blood samples were collected from children with jaundice at the Children's Teaching Hospital in Karbala Governorate between January and February 2026 and serum was separated, after which biochemical tests were performed, including the measurement of total bilirubin and liver enzymes (ALT, AST). Results: The results showed an increase in bilirubin levels in children with jaundice, as the mean Total Bilirubin (TB) level was 1.26 mg/dL, with a relative increase in liver enzymes, where the mean ALT = 22.09 U/L and the mean AST = 34.86 U/L. The results also showed a positive correlation between elevated bilirubin levels and enzyme levels, as the correlation value between AST and TB was (r = 0.334, p<0.05), indicating an effect on liver function. In addition, a significant difference was observed in the incidence rate between males and females, with males accounting for 64% compared to 36% for females (p-value = 0.045). Conclusion: The study indicates that biochemical parameters, particularly bilirubin and liver enzymes, are important indicators in the diagnosis of jaundice and the evaluation of its severity and they contribute to making appropriate therapeutic decisions and reducing potential complications.

Background: The liver is a vital organ that executes numerous biological and metabolic processes. Multiple conditions can affect the liver and lead to cirrhosis and/or acute liver failure, for which liver transplantation could be warranted. The primary reasons for liver transplantation are hepatocellular carcinoma, decompensated cirrhosis and metabolic/autoimmune liver disease. Public awareness is generally increasing, but religious, cultural and personal reasons justify donation attitudes. Aims: This study aims to assess awareness and attitudes toward liver transplantation among the general population of Makkah, addressing a significant knowledge gap in the region. Method: This cross-sectional study was conducted among the population of Makkah, excluding healthcare workers and individuals under 18 years old. Data was collected via an online, Arabic- translated questionnaire from July to October 2024. The survey assessed demographics, awareness and attitude toward liver transplantation. A statistical analysis was performed using R software. Associations were analyzed using the Chi-square test, with significance set at p<0.05. Ethical approval was obtained from the Umm Al-Qura University Institutional Research Board and informed consent was obtained from all participants before data collection. Results: A total of 477 participants completed the survey. Most were between 18 and 65 years old, male (58.5%) and had a monthly income of less than 9,000 SAR. 84.5% have heard about liver transplantation, while most reported the media as their primary source. Even though 80.7% of people recognized that a liver could be partially donated and the majority knew about liver transplantation, just 5.7% were sure they would donate during their lives and 37.1% were eager to donate after death. Respondents identified funeral delays (45.5%) as the most significant perceived drawback of liver donation after death. The recipient’s health status (48.4%) and the nature of the donor-recipient relationship (26.0%) emerged as key factors influencing individuals’ willingness to donate during life. Younger age, low income, higher educational level, personal experience and knowing someone with liver disease were associated with a positive influence on the decision to donate during someone's lifetime, while fear of medical complications showed an inverse association with donation willingness. Awareness of the option to register for organ donation on Tawakkalna was notably higher among those willing to donate (81.5%). Conclusion: Awareness of liver transplantation is increasing among the population of Makkah. There are still many knowledge gaps, including medical indications, donor eligibility and registration. Most of the respondents are unwilling to donate during life or after death, predominantly due to religious/personal misconceptions. Targeted public health campaigns and programs are needed to clarify the Islamic stance and positions on organ transplantation.

Machine Learning (ML) approaches have achieved high performance by discovering underlying data patterns and structures. Diabetes is a life-threatening disease that affects vital organs such as the eyes (retinopathy), nerves (neuropathy), heart and kidneys (nephropathy). Although various ML models have been proposed for diabetes prediction, most struggle to effectively handle large, multi-feature datasets. Quantum Machine Learning (QML), which integrates quantum computing principles with machine learning, offers a promising solution for complex classification tasks. However, effective feature extraction remains challenging on current NISQ (Noisy Intermediate-Scale Quantum) devices due to hardware limitations. In this study, a Differentiable Quantum Circuit with Classical PCA Feature Compression is proposed for medical disease classification using a SMOTE-ENN resampled dataset and a penalized binary cross-entropy cost function to enhance quantum learning. The efficient ansatz designed in this work plays a crucial role in determining the model’s learning capability and feature extraction performance. To evaluate the robustness and generalization capability of the proposed model, three categories of medical datasets are considered. The primary focus is on diabetes classification using four diabetes-related datasets, while additional experiments are conducted on liver disease and chronic kidney disease datasets to assess the adaptability of the proposed framework across multiple healthcare domains. Six datasets from UCI, Mendeley and IEEE repositories are used: PIMA Indian Diabetes, Type-2 Diabetes, a private RTML Insulin dataset, Indian Liver Patient Dataset (ILPD), Early-Stage Diabetes Risk Prediction Dataset (ESDRPD) and Chronic Kidney Disease (CKD). The proposed quantum model is simulated using the PennyLane quantum simulator and compared against preprocessed classical classifiers. Experimental results demonstrate remarkable efficiency and rapid convergence within 10--20 epochs, achieving high F1-scores of 96.15% (PIMA), 97.50% (Type-2), 98.04% (RTML), 89.47% (ILPD), 98.66% (ESDRPD) and 97.84% (CKD). These findings demonstrate that the proposed quantum model efficiently extracts relevant features and effectively handles medical disease classification tasks, highlighting its strong potential for practical healthcare applications.

Background: Breast cancer survivors frequently experience shoulder dysfunction, cancer-related fatigue and elevated physiological stress following surgery and radiotherapy, adversely affecting functional recovery and quality of life. Rehabilitation interventions play an important role in supportive cancer care and survivorship management. Objective: To retrospectively evaluate the association between structured verbal cueing during multimodal exercise rehabilitation and shoulder range of motion (ROM), cancer-related fatigue and salivary cortisol levels in breast cancer survivors undergoing radiotherapy. Methods: This retrospective cohort study reviewed the medical records of 34 female breast cancer survivors aged 35-45 years undergoing radiotherapy following surgical treatment. Participants were categorized into a Multimodal Exercise with Verbal Cueing Group (MMVG, n = 17) and a Multimodal Exercise without Verbal Cueing Group (MMWVG, n = 17). Both groups completed a 12-week supervised multimodal exercise rehabilitation program. Shoulder ROM, FACIT-F scores and salivary cortisol levels were assessed at baseline, 6 weeks and 12 weeks. Repeated-measures ANOVA was performed and effect sizes were expressed as partial eta squared (η²). Results: Both groups demonstrated significant improvements over time. At 12 weeks, participants in the MMVG demonstrated greater improvements in shoulder flexion (148.82°; 95% CI: 147.76-149.89 vs. 126.94°; 95% CI: 125.87-128.01), FACIT-F scores (43.06; 95% CI: 42.35-43.77 vs. 32.18; 95% CI: 31.47-32.88) and salivary cortisol levels (18.00 ng/mL; 95% CI: 17.85-18.15 vs. 22.35 ng/mL; 95% CI: 22.20-22.49) compared with the MMWVG (all p<0.001). Significant time × group interactions were observed for shoulder ROM (partial η² = 0.987-0.995), FACIT-F scores (partial η² = 0.890) and salivary cortisol levels (partial η² = 0.877). Conclusions: Multimodal exercise rehabilitation was associated with improved functional and physiological outcomes. Structured verbal cueing was associated with greater improvements than multimodal exercise alone, although prospective randomized studies are required to confirm these findings.

Microplastics have emerged as pervasive environmental contaminants due to the exponential growth in plastic production, inadequate waste management and their persistence in terrestrial, freshwater, marine and atmospheric ecosystems. Their widespread presence in seafood, drinking water, fruits, vegetables, meat, dairy products, processed foods and food packaging has made dietary ingestion a major route of human exposure, raising significant public health concerns. This review summarizes current evidence on microplastic contamination of the human food chain, exposure pathways, biological fate, mechanisms of toxicity, health effects and future research priorities. Experimental studies indicate that microplastics induce oxidative stress, chronic inflammation, immune dysregulation, mitochondrial dysfunction, endocrine disruption, gut microbiome dysbiosis and cellular injury, while also serving as carriers for heavy metals, persistent organic pollutants and pathogenic microorganisms. The detection of microplastics in human blood, placenta, lungs, breast milk, reproductive tissues and arterial plaques confirms systemic exposure and underscores the need for comprehensive health risk assessment. Emerging evidence suggests possible associations with gastrointestinal, cardiovascular, respiratory, metabolic, reproductive, neurological, hepatic and renal disorders; however, definitive causal relationships remain unconfirmed because of limited human epidemiological evidence and methodological heterogeneity. Given the ubiquitous nature of exposure, a precautionary public health approach is warranted. Future efforts should prioritize standardized analytical methods, long-term epidemiological studies, strengthened food safety surveillance, sustainable plastic management and multidisciplinary research within a One Health framework to better characterize health risks, inform evidence-based policies and reduce human exposure to this growing environmental threat.

Background: Facial symmetry is a key metric in cosmetic and reconstructive facial assessment. Conventional evaluations rely predominantly on subjective visual judgment, lacking standardized, reproducible quantitative tools. This study aimed to develop an open-source geometric morphometric framework for 2D facial symmetry quantification and explore its association with demographic factors and perceived attractiveness. Methods: In this cross-sectional computational morphometric analysis, we used the public SCUT-FBP5500 dataset containing 5,500 frontal images with manually refined 86-point landmarks and attractiveness ratings from 60 independent assessors. A mid-sagittal reference line was estimated and the Geometric Symmetry Index (GSI) was defined as the mean normalized Euclidean distance between bilateral landmarks and their mirrored counterparts. Lower GSI values indicate greater geometric facial symmetry. Sex differences and attractiveness correlations were analysed via Welch’s t-test and Spearman’s rank correlation. Results: Valid GSI values were obtained for 5,499 subjects (one excluded for incomplete landmarks). The cohort showed generally high facial symmetry. Males exhibited significantly greater asymmetry than females (Cohen’s d = 0.58, 95% CI: 0.52-0.63, p < 0.001). GSI had a modest but significant negative correlation with attractiveness ratings (ρ = −0.277, 95% CI: −0.302 to −0.253, p < 0.001). Conclusion: This interpretable, reproducible open-source framework avoids the black-box limitations of complex AI models, providing a standardized solution for objective facial symmetry measurement. With further clinical validation, it may support aesthetic surgery planning, postoperative outcome assessment and digital patient communication.

A total of 250 clinical specimens (burns, wounds, urine, blood, nasal swabs, middle-ear discharge, throat swabs and sputum were collected from inpatients and outpatients of both sexes and all age groups at Al-Batool Maternity and Children Hospital and Baqubah Teaching Hospital, Diyala Governorate, between November 2024 and March 2025. Eighty isolates were identified as Staphylococcus aureus on the basis of phenotypic, cultural and biochemical characteristics and identification was confirmed using the VITEK-2-Compact system. Susceptibility to 12 antimicrobial agents was determined by the Kirby-Bauer disc diffusion method and inhibition zones were interpreted according to current Clinical and Laboratory Standards Institute (CLSI) criteria. The highest resistance was recorded against oxacillin (90%), followed by amoxicillin and ceftriaxone (86.25% each) and ampicillin (78.75%); resistance to erythromycin and azithromycin was 67.5%, to levofloxacin 42.5%, to ciprofloxacin and trimethoprim-sulfamethoxazole 40% and to amikacin and gentamicin 38.75% and 37.5%, respectively. The lowest resistance was observed against vancomycin (12.5%). Applying the international criteria of Maiorano’s et al. (2012), 61 isolates (76.25%) were classified as multidrug-resistant (MDR), 7 (8.75%) as extensively drug resistant (XDR) and the remaining 12 (15%) as non-MDR. Phenotypic screening showed that all isolates produced β-haemolysis, coagulase and gelatinase (100%), whereas extended-spectrum β-lactamase (ESβL), metalo-β-lactamase (MβL) and class C β-lactamase (AmpC) were detected in 34 (42.5%), 51 (63.75%) and 62 (77.5%) of isolates, respectively. To explore the genetic basis of sulphonamide resistance, the DNA of 16 representative MDR isolates was screened by polymerase chain reaction (PCR); sul1 was detected in 6 isolates (37.5%) and sul2 in 7 isolates (43.75%). Because the molecular analysis was restricted to this purposively selected subset, the genotypic findings should be interpreted as indicative rather than representative of all isolates. Overall, the study documents a high burden of MDR S. aureus in clinical settings in Diyala and provides preliminary evidence linking phenotypic sulphonamide resistance to the carriage of sul1 and sul2, supporting the need for continued antimicrobial surveillance and stewardship.

Objective: This systematic review evaluates the effectiveness of oral isotretinoin, either as monotherapy or in combination with antifungal agents, in treating fungal skin infections. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) standards were adhered to in drafting the systematic review. An extensive search was performed in the following databases covering the last decade from January 2015 to December 2024: PubMed, Scopus, Web of Science and Google Scholar. The selection of eligible studies adhered to the PICOS criteria (Population, Intervention, Comparator, Outcome and Study design). Due to substantial heterogeneity in study designs, interventions and outcome measures, a quantitative meta-analysis was not feasible and findings were synthesized narratively. Results: Two hundred forty-nine articles concerning the use of isotretinoin for fungal infections were identified. Titles and abstracts of 152 studies were evaluated, resulting in 54 studies deemed eligible for full-text evaluation. Finally, this review considered 16 studies evaluating isotretinoin regimens ranging from low-dose schedules (10-20 mg/day) to weight-based dosing up to 0.5 mg/kg/day. Four studies were on dermatophytosis, three on seborrhoeic dermatitis and two on pityriasis versicolor and tinea, with isolated reports on chromoblastomycosis and mycosis fungoides. The most consistent evidence of clinical benefit was observed in recurrent dermatophytosis and seborrhoeic dermatitis, especially when isotretinoin was used as an adjunct to the standard therapy. Out of the six studies evaluated using the ROBINS-I tool, three studies exhibited a low RoB and three other studies demonstrated a serious RoB. The RoB 2.0 tool revealed that all the assessed RCTs exhibited high RoB, except for one study that raised some concerns. Conclusion: Isotretinoin has potential in the adjuvant treatment of fungal infections especially recurrent dermatophytosis but is more of a supportive than a standalone therapy. Clinical Relevance: Isotretinoin may be a promising adjunctive therapy, especially in recurrent dermatophytosis and should be further investigated as a way to improve treatment outcomes and reduce disease recurrence.

Objective: Diabetic Nephropathy (DN) is a major long-term severe microvascular complication of diabetes mellitus and the current leading cause of end-stage kidney disease. It accounts for up to 40% of patients requiring renal replacement therapy. The risk of end‑stage kidney failure has been associated with an increase in the level of a new biomarker, xanthine oxidase and calprotectin, used to assess the severity of kidney injury. Methods: Blood samples were collected from 30 individuals diagnosed with DN disease and 30 individuals with diabetes but without kidney disease, who visited the National Diabetes Centre at the University of Al-Mustansiriyah, along with 28 control subjects. An enzyme‑linked immunosorbent assay was used to assess serum xanthine oxidase (XOD) and Calprotectin (Calp) and a UV-Visible spectrophotometer was used to evaluate other biochemical parameters. Results: The mean serum XOD activity (2.04±0.38 ng/ml) in DN was significantly greater than the corresponding values for the controls (0.95±0.12 ng/ml) and the mean serum Calp (173.46±29.56 ng/ml) in DN Patients was significantly greater than the corresponding values for the controls (43.26±5.88 ng/ml). The optimal cut-off value for CALP sensitivity of 86.3% and specificity of 82.1% and the AUC for control and DN is 0.844 and for control versus diabetic, it is 0.853, while XOD activity showed a high sensitivity of 76.5% and specificity of 89.9% to distinguish between control and DN, so the results show the AUC = 0.833 for control vs. DN and AUC for control and diabetes is 0.863. These high sensitivity and specificity values highlight the reliability of CALP and XOD as significantly associated with diabetic nephropathy.

The successful outcome of radiotherapy in cancer patients is largely dictated by a number of physical and biological parameters, such as radiation dose, X-ray photon beam energy and the temporal evolution of cellular damage. In three separate studies (n = 3), these variables were thoroughly assessed in cancer cells and analysed using one-way ANOVA and Tukey's post hoc test; findings were deemed statistically significant at p<0.05. The effects of therapeutically administered photon irradiation produced by a medical linear accelerator are examined in this work, with a primary focus on oestrogen receptor-positive breast cancer cells. Photon doses of 4 and 6 (Gy) at energies of 4 and 6 (MeV) were applied to the cells. In several research, the MTT test was employed to measure cell viability at 1, 24 and 48 hours after radiation. 6 MeV photons were more effective against cancer cells than 4 MeV photons, substantial cell death according to both dosage and photon energy. Also, a time-dependent decline in cell viability was noted; 48 hours following irradiation, the lowest survival rates were noted. These results highlight the need for radiobiology research to take the temporal dimension into account; this factor may be crucial not only for understanding fundamental biological aspects but also for refining patient selection criteria and developing treatment protocols through dose fractionation schemes. The observed survival rates reflect biological effects consistent with ionizing radiation-induced cell death, potentially opening new and effective avenues for understanding the radiobiology of breast cancer.

Background: Rheumatoid arthritis (RA) is an inflammatory illness characterised by chronic systemic inflammation that causes gradual joint destruction and can result in permanent disability. The pathogenesis of RA comprises a complicated network of different cytokines and cells that stimulate synovial cell growth and cause damage to both cartilage and bone. Methods: Study conducted between January and June 2025, in a private medical centre in Diyala/ Iraq. The study has been enrolled 89 participants, comprising 59 patients diagnosed with rheumatoid arthritis (29 males and 30 females) and 30 healthy controls (15 males and 15 females). TNF-a, IL-6 and IL-32 have been measured by using ELISA Quantitative kits. Results: The results showed elevated levels of the inflammatory cytokines TNF-α, IL-6 and IL-32 in rheumatoid arthritis patients compared to healthy individuals, although these differences did not reach statistical significance (p>0.05). Descriptively, elevated TNF-α and IL-6 levels were observed in participants aged 10–19 years and elevated IL-32 levels in participants over 60 years of age, with no statistically significant differences between the age groups (p>0.05). Conclusion: The study showed a tendency for higher levels of the inflammatory cytokines TNF-α, IL-6 and IL-32 in rheumatoid arthritis patients compared to healthy individuals, but these differences did not reach the level of statistical significance.

Objectives: Background: Artificial Intelligence (AI) is currently driving diagnostic radiology towards a new era, but there is no evidence about the knowledge, attitudes and preparedness levels of healthcare trainees and radiology professionals in Northern Saudi Arabia. Methods: A cross-sectional study was conducted using questionnaires administered to medical students, radiology technology students, radiology technologists and radiologists in Hail and the corresponding Northern Saudi institutions. A validated 27-item questionnaire was used to evaluate AI knowledge, awareness of imaging use in healthcare, attitudes, educational needs and readiness to use AI. SPSS version 29.0 was used for data analysis. Descriptive statistics, Chi-square test and One-way ANOVA were used and the p-level was set at <5% for statistical significance. Results: Moderate-to-high overall AI knowledge was observed in 55.1% of participants, while 61.7% demonstrated moderate-to-high knowledge of AI applications in medical imaging. 46.2% of the respondents indicated prior AI-related training. Neither the benefits of using AI in radiology nor its role in advancing medicine were lost on most participants, though there was a general concern about the ethical implications, as well as the impact on the workforce. About 45.7-46.1% said that advancement in AI decreased their interest in pursuing a career in radiology. Overall, the level of readiness for the use of AI was moderate to high in 58.6%. Conclusion: Participants demonstrated moderate AI knowledge and readiness, but significant educational gaps and career-related concerns persist. Incorporation of structured AI education into medical and radiology curricula is necessary for making informed career choices, fostering ethical understanding and for safe clinical use of AI.

Objectives: Antiallergic drugs, including antihistamines and glucocorticosteroids, are widely used in the allergic diseases and inflammatory conditions. Monitoring their consumption is essential for assessing rational use, accessibility and adherence to clinical guidelines. In Central Asian countries, including the Kyrgyz Republic, up-to-date nationwide data on antiallergic drug utilization remain limited. This study aimed to analyze consumption patterns of antihistamines and glucocorticosteroids in Kyrgyzstan during 2024-2025 using the WHO-recommended ATC/DDD methodology. Methods: A retrospective nationwide drug utilization study was conducted based on official pharmaceutical distribution and registry data. All systemic antihistamines (ATC code R06A) and glucocorticosteroids were included in the analysis. Drug consumption was assessed using Defined Daily Doses (DDD), DDDs per 1,000 inhabitants per year (DID) and Packages per Inhabitant per Year (PIY). Consumption structure by International Nonproprietary Names (INNs) and temporal trends were analyzed. Results: Between 2024 and 2025, antiallergic drug use showed divergent patterns depending on the indicator applied. Total antihistamine consumption increased from 34,350,864 DDDs to 41,271,951 DDDs (1.2-fold growth), while population-adjusted exposure declined from 9 DID to 7 DID. Loratadine, cetirizine and levocetirizine remained the most frequently used agents , with cetirizine showing a notable consumption increase from 4.36 to 6.85 million DDDs. Systemic glucocorticosteroids followed a downward trajectory, with total volume decreasing from 10,674,561 DDDs to 9,451,298 DDDs and population exposure falling sharply from 3.79 DID to 0.82 DID. This reflects a pronounced contraction driven primarily by a structural withdrawal from dexamethasone (from 7.02 million to 481,369 DDDs). Conclusion: National ATC/DDD data for 2024-2025 indicate measurable changes in the composition and intensity of antiallergic therapy in Kyrgyzstan. Second-generation antihistamines continue to dominate outpatient treatment, while systemic corticosteroid use has contracted. From a public health standpoint, these patterns demonstrate favorable shifts toward aligned guideline prescribing and post-pandemic clinical stabilization, but highlight the critical importance of continuous, integrated pharmacoepidemiological surveillance to prevent potential access limitations and to support clinical stewardship.

Objectives: Papillary Thyroid Microcarcinoma (PTMC), defined as papillary thyroid carcinoma ≤1 cm, accounts for an increasing share of thyroid cancer diagnoses worldwide. Although generally indolent, a subset exhibits aggressive clinicopathological features, including multifocality, extrathyroidal extension and lymph node metastasis, which complicate risk stratification and treatment. To summarize the current evidence regarding the prognostic significance of multifocality in PTMC, its underlying pathogenetic mechanisms and the evolving role of Active Surveillance (AS) versus surgical management. Methods: This narrative review integrates epidemiological, molecular, guideline and outcome data to outline a risk-adapted approach. Evidence was identified through a non-systematic literature search and no formal systematic-review or quantitative synthesis methodology was applied; findings should therefore be interpreted in this context. Institutional review board approval and informed consent were not required for this review of previously published literature. Results: Multifocality occurs in 20-36% of papillary thyroid carcinomas and may arise from independent multicentric tumorigenesis or intrathyroidal clonal spread. Observational evidence has associated multifocality with an increased risk of recurrence in some, though not all, studies, particularly when combined with tumor size ≥6 mm, nodal involvement, or aggressive histologic variants; its independent effect on disease-specific mortality is less certain. Although AS is endorsed for selected low-risk PTMC, eligibility criteria vary internationally, especially for multifocal disease. The extent of surgery remains individualized. Conclusion: PTMC management should follow a risk-adapted strategy that integrates tumor focality, pathological features and patient factors to avoid overtreatment and undertreatment.

Background: Medicinal plants, such as Thymus vulgaris, have garnered attention for their pharmacological properties, including their rich essential oils that demonstrate antioxidant and antimicrobial activities. Objectives: To explore the health benefits of Thymus vulgaris Essential Oil (TVEO) on gut microbiota and metabolic health in a diabetic rat model. Methods: Thirty adult male rats were acclimated and allocated into five groups, as control negative, Diabetic Control (DC), control positive (Empagliflozin), Low-Dose (LD) TVEO (50 mg/kg) and High-Dose (HD) TVEO (100 mg/kg). Treatments were given orally for four weeks, with weekly evaluations of blood glucose and body weight (BW). Finally, blood biochemical analyses, faecal cultures for bacterial identification and histopathological examinations of vital organs were done. Results: A significant reduction was detected in blood glucose levels, particularly in the HD-TVEO group. BW loss was less pronounced in treated rats than the DC. Biochemical analyses revealed lowered liver enzyme levels (ALT and AST) in all treatment groups, along with increased total protein and albumin in the HD group. The lipid profile showed significant decreases in triglycerides, total cholesterol and LDL, with an increase in HDL levels in the HD group. Haematological assessments revealed improvements in the absolute red cell distribution width counts. Additionally. CRP levels were potentially lowered in the HD group than the disease control. On the other hand, TVEO improved gut microbiota by reducing pathogenic bacteria and minimizing damage to the pancreas, liver and kidneys, thereby retaining normal tissue morphology and architecture. Conclusions: TVEO might act as a therapeutic agent in the management of diabetes, highlighting the multifaceted role in promoting metabolic health and suggesting its potential to serve as a natural adjunct to standard diabetes therapies.

Objectives: Both orthodontists and patients are significantly concerned about the length of orthodontic treatment, which typically lasts between 24 and 36 months on average but can be substantially longer. Orthodontic care is essential not only for aesthetics and function but also for enhancing the overall quality of life. With the increasing demand for shorter treatment durations, patient-centered care becomes more relevant. Previous studies in Saudi Arabia and internationally have evaluated patient awareness, acceptance and preferences for different acceleration methods. Factors such as comfort, cost, effectiveness and anxiety significantly influence patient decision-making between surgical and non-surgical options. This study aims to evaluate patient awareness of both surgical and non-surgical accelerated orthodontic treatment modalities, assess their preferences between these approaches and to identify the key factors influencing acceptance such as perceived pain, treatment cost and expected duration. Methodology: This cross-sectional study conducted from September 2025 to December 2025 in Saudi Arabia. The study plans to recruit participants through social media platforms like X, Snapchat, Instagram, WhatsApp and Facebook. The inclusion criteria are Saudi citizens, both males and females, from all provinces of Saudi Arabia, with or without knowledge of different treatment options, who agree to participate and complete questionnaires. Excluded are dental practitioners and individuals under 18 years old. The minimum target sample size is 384 was calculated using a formula based on prevalence estimation, 95% confidence level and 5% acceptable error. Results: A total of 652 participants responded (mean age 33.4±12.7 years; 61.7% female). Only 35.4% were currently undergoing or planning orthodontic treatment. Preference favored non-surgical acceleration (55.1%) over surgical (13.2%), traditional (10.7%), or no difference (21.0%). Effectiveness was the most important factor for 35.3% of participants, whereas cost (28.4%) and recovery time (27.6%) were most commonly selected as least important. Pain was the main barrier to surgical approaches (37.3%), followed by fear (29.8%) and cost (12.7%) and 71.3% reported concerns about post-surgical pain. Most participants preferred slower but less painful non-surgical options (72.9%) and 64.3% would not accept a faster but more painful surgical method. Willingness to pay for acceleration varied, with 38.5% accepting a 10% increase and 25.8% accepting a 30% increase and 78.4% wanted more information first. Knowledge was low in 62.3% and high in 8.4% and acceptance was significantly associated with multiple sociodemographic variables.​ Conclusion: Saudi adults showed a clear preference for non-surgical AOT, with pain-related concerns and orthodontist recommendation shaping acceptance. Patient education addressing benefits, risks and realistic expectations may improve informed choice and appropriate uptake of AOT.

Objectives: This study evaluated ADC texture parameters before and after neoadjuvant Chemoradiotherapy (nCRT). It assessed predictive models combining magnetic resonance imaging tumor regression grade with ADC radiomics for the pathological Complete Response (pCR). Methods: In this prospective single-center study, 34 histologically confirmed LARC patients underwent MRI with DWI/ADC before and after nCRT. First-order texture parameters extracted from ADC maps. Associations between imaging features (TRG, ADC values, texture metrics) and pathological responses were evaluated using ROC analysis. Results: Patients achieving pCR showed higher baseline mean ADC (1.094 Vs 0.958 ×10⁻³ mm²/s, p<0.001) and greater post-treatment increases (0.288±0.116 Vs 0.156±0.178×10⁻³ mm²/s, p = 0.047). The pCR patients demonstrate greater reductions in skewness (-1.18 Vs -0.41, p = 0.020) and kurtosis (-1.02 Vs -0.60, p = 0.020) and lower post-treatment skewness values (p = 0.007). Excellent accuracy was shown by the MRI TRG alone (AUC = 0.973; sensitivity 100%; specificity 92%). When combining TRG with mean ADC, performance improved (AUC = 0.993); the ADC radiomics model achieved perfect discrimination (AUC = 1.000, with 100% sensitivity and specificity). These perfect metrics should be interpreted cautiously, given the small sample size (n = 34, pCR = 9) and risk of overfitting. The Δ mean ADC threshold ≥ 0.215×10⁻³ mm²/s provided 67% sensitivity and 72% specificity for pCR prediction. Conclusion: The ADC radiomic features-particularly mean ADC changes and post-treatment skewness-demonstrate high accuracy for predicting pCR in LARC. Limitations include the single-center design and modest cohort size, which require external validation in larger, multicenter studies before clinical translation.

Objectives: The benefits of using liraglutide with exercise in obesity therapy are not yet well defined. To conduct a systematic review on the influence of the use of liraglutide and exercise on weight loss and body composition in obese patients. Methods: A systematic review and meta-analysis were done on Randomized Controlled Trials (RCTs) following the guidelines of PRISMA and registered in PROSPERO (CRD420251234320). Relevant databases and clinical trial registries were searched up till 2025. Eligible studies included adults (eighteen to sixty-five years) with obesity, comparing combined (moderate-to-vigorous) exercise and liraglutide therapy with placebo or usual care. Body weight change was the primary outcome assessed. Secondary outcomes included waist circumference, body fat percentage, Insulin Resistance (HOMA-IR), glycemic markers and lipid profile parameters. Results: Seven RCTs comprising up to 562 participants were included. Combined exercise and liraglutide therapy resulted in significantly greater weight loss than controls (WMD -8.21 kg; 95% CI -11.35 to -5.07; p<0.00001), with substantial heterogeneity (I² = 87%), likely reflecting differences in study populations, liraglutide doses and comparator interventions. Sensitivity analysis excluding two clinically distinct trials (Mensberg et al. and Wadden et al.) eliminated heterogeneity (I² = 0%) and confirmed robust effects (WMD -10.34 kg; 95% CI -11.95 to -8.74). Significant reductions were also observed in body fat percentage, waist circumference and HOMA-IR. Conclusion: Combined exercise and liraglutide therapy produce clinically meaningful improvements in body weight, anthropometric indices and insulin sensitivity in obese adults, exceeding the effects of either intervention alone. However, these findings should be interpreted with caution due to the small number of included studies and the variability observed among the trials.

Background: Comprehensive surveillance is required to monitor the burden of infectious diseases, detect changes over time and guide prevention and control efforts. Objective: This study analyzed national patterns and temporal trends in reported cases and incidence rates of selected notifiable infectious diseases in Saudi Arabia. Methods: A repeated cross-sectional surveillance analysis used year-specific national data from the Saudi Open Data Platform for 2020-2024. Annual case counts and incidence rates per 100,000 population were summarized. Linear regression and Spearman’s rank correlation were used to examine temporal trends for each disease and to assess the link between incidence rates and case numbers. Results: The data showed that dengue fever, hepatitis B, brucellosis, chickenpox, hepatitis C, salmonellosis and hepatitis A accounted for the highest disease burden. Linear trend analysis identified statistically significant increases in incidence rates for brucellosis (β = 0.413 per 100,000 population per year, 95% CI 0.053-0.773, p = 0.035), meningococcal meningitis (β = 0.0150, 95% CI 0.0009-0.0290, p = 0.043), pneumococcal meningitis (β = 0.0368, 95% CI 0.0061-0.0674, p = 0.032) and Haemophilus meningitis (β = 0.0136, 95% CI 0.0050-0.0222, p = 0.015), whereas trends for other diseases were not statistically significant. Reported case counts strongly correlated with incidence rates (ρ = 0.9997, p<0.001). Conclusion: National surveillance data reveal varied patterns in notifiable infectious diseases in Saudi Arabia and support routine trend analysis to inform evidence-based prevention, control and public health planning. However, findings should be interpreted cautiously, given the ecological nature of the analysis, reliance on aggregated secondary surveillance data and the potential influence of reporting practices and case detection variability on observed trends.

Iatrogenic injury to the left circumflex artery (LCx) during mitral valve surgery is an uncommon but potentially catastrophic complication because of the artery’s close relationship to the posterior mitral annulus, especially near the P1-A1 region. This review summarizes the available evidence on anatomical risk factors, mechanisms of injury, diagnosis, prevention and management. A structured literature search was performed using major electronic databases and studies relevant to LCx injury associated with mitral valve surgery were screened according to predefined inclusion criteria, with priority given to clinical studies, systematic reviews and case series published in English. The risk appears greater in patients with left-dominant coronary circulation, a small annulus-to-artery distance, annular calcification, reoperative surgery, minimally invasive approaches and complex rheumatic or degenerative mitral pathology. Clinical recognition may be challenging because ischemia can present intraoperatively or postoperatively with new regional wall motion abnormalities, electrocardiographic changes, hemodynamic instability or delayed heart failure symptoms. Current evidence suggests that preoperative coronary CT angiography and three-dimensional transoesophageal echocardiography, combined with meticulous intraoperative attention to annular anatomy and suture depth, may reduce the likelihood of preventable injury in selected patients. Management depends on the mechanism and timing of diagnosis and may include immediate suture revision, surgical revascularization, urgent percutaneous coronary intervention or hybrid approaches. Although the available literature indicates that imaging-based planning, surgical precision, multidisciplinary awareness and timely revascularization are associated with improved outcomes, the evidence remains limited, highlighting the need for larger prospective studies and standardized reporting.

Background: Alcohol, a catalyst for oxidative stress, is considered one of the most significant health problems facing the world today. Chronic alcohol consumption is associated with a wide range of haematological abnormalities resulting from multiple biological mechanisms, including nutritional deficiencies and oxidative stress reported in previous studies. Methods: A cross-sectional study was conducted in 2024 in Diyala Province, Iraq. 150 subjects participated in our study, divided into two groups: 75 were daily consuming alcohol and the other 75 were healthy as the control group. The mean age of the participants was comparable between the two groups. Complete blood count (CBC) parameters were measured using an automated haematology analyser and statistical analyses were performed to compare haematological parameters between the groups Results: the study found that there was significant decrease in haematological indices (HB, RBC, HCT, MCV, MCH, MCHC, MPV, PCT and Platelets) for daily consuming alcohol subjects comparing with healthy subjects while RDW CV. and RDW SD. Show a significant increase in alcoholic participants compared to healthy p-0.05, with a significant positive correlations. Chronic alcohol consumers demonstrated significantly lower haemoglobin (Hb), red blood cell count (RBC), haematocrit (HCT), mean corpuscular volume (MCV), mean corpuscular haemoglobin (MCH), mean corpuscular haemoglobin concentration (MCHC), mean platelet volume (MPV), plateletcrit (PCT) and platelet count compared with healthy controls (p<0.05). In contrast, red cell distribution width indices (RDW-CV and RDW-SD) were significantly higher among chronic alcohol consumers, whereas platelet distribution width (PDW) showed no statistically significant difference. Correlation analysis demonstrated several significant positive and negative associations among haematological parameters within the alcohol-consuming group Conclusion: Chronic alcohol consumption was associated with significant alterations in several haematological parameters. Although oxidative stress has been proposed as a possible mechanism in previous studies, oxidative stress biomarkers were not measured in the present study; therefore, this explanation should be interpreted with caution. Future studies incorporating oxidative stress biomarkers, liver function tests and nutritional assessments are recommended to clarify the underlying biological mechanisms.

Background: Environmental contaminants such as arsenic and microplastics are increasingly associated with male reproductive dysfunction. This article reviews the mechanisms through which arsenic and microplastics affect male reproductive health and highlights the potential protective effects of imperatorin against co-exposure toxicity. Methods: A narrative literature review was conducted using studies published up to June 2026. Relevant experimental and observational studies were identified from major scientific databases to evaluate the effects of arsenic and microplastic exposure on male reproductive health. The review focused on the Nrf2/Keap1, NF-κB, p53 and steroidogenesis signalling pathways and their associated molecular markers involved in oxidative stress, inflammation, apoptosis, hormonal imbalance and impaired spermatogenesis. The potential cytoprotective mechanisms of imperatorin against environmentally induced testicular injury were also examined. Results: Exposure to arsenic and microplastics negatively impacts male reproductive function by inducing excessive reactive oxygen species production, inhibiting antioxidant defence mechanisms, causing mitochondrial damage, activating inflammation, disrupting endocrine balance and impairing spermatogenesis. Simultaneous exposure exacerbates oxidative stress, activates nuclear factor-kappa B-mediated inflammatory pathways, disrupts nuclear factor erythroid 2-related factor 2/Kelch-like ECH-associated protein 1 signalling and intensifies p53-dependent apoptosis. Microplastics may enhance the transit and storage of arsenic in testicular tissue, thus exacerbating its harmful effects on the male reproductive system. Conclusion: The presence of arsenic and microplastics in the environment may significantly affect male reproductive function. Growing evidence suggests that oxidative stress along with interconnected molecular pathways substantially contribute to the toxic effects observed during co-exposure.

Introduction: Psychological stress has been associated with various chronic diseases and its role in the onset and progression of vitiligo has also been proposed. However, little is known regarding the direct association of psychological stress with vitiligo activity and severity. Objectives: This study aims to examine the association between psychological stress and vitiligo activity and severity among patients with vitiligo in Saudi Arabia. Methods: A cross-sectional, questionnaire-based study was conducted via an online survey from August 1 to September 1, 2023, targeting individuals with a confirmed diagnosis of vitiligo across different regions of Saudi Arabia. Psychological stress was assessed through self-reported stressful life events within the 2 years before vitiligo onset, including bereavement and other major stressors, as well as participants’ perception that emotional trauma triggered their disease. Vitiligo severity was classified according to Body Surface Area (BSA) involvement as mild (1-25%), moderate (26-50%), severe (51-75%) and extensive (76-100%). Results: The study included 100 participants, with the majority (57%) of subjects having lost a loved one during the 2-year acceleration period before the development of vitiligo, suggesting a potential psychological stressor on vitiligo activity. It was also revealed that 52% of participants connected their vitiligo to emotional or psychological trauma. There was also a significant association (p = 0.038) between gender and the perception of stress-inducing vitiligo, with more females linking stress to vitiligo onset (65.4% versus 34.6%). However, no statistically significant connections were found between stress and vitiligo severity, the body surface area affected or the number of anatomical sites involved. Conclusions: This study suggests that psychological stress, particularly due to bereavement, may contribute to cases of vitiligo. Dermatologists should consider routine psychosocial screening and provide supportive counseling or referral when stress-related triggers are identified. However, no significant association was found between stress and disease severity.

Background: Dialysis patients frequently experience anaemia and glucose disturbances. This study aimed to assess clinical parameters in dialysis patients with glucose disturbances, identify patient phenotypes and explore sex-based differences. Methods: This cross-sectional, observational study involved 21 adult patients on maintenance haemodialysis at a tertiary nephrology centre. Metabolic profiles were identified by analysing haematologic and biochemical parameters and performing hierarchical clustering. Serum creatinine was moderately negatively correlated with fasting glucose. Results: Patients had moderate anaemia (median haemoglobin 76.00 g/L [68.00-80.00]) and high glucose (8.09+/-2.76 mmol/L). Female patients had significantly higher MCV (90.73+/-6.28 vs 83.13+/-5.53 fL, p<0.05) and MCH (27.55+/-2.32 vs 25.21+/-1.55 pg, p<0.05) than males. Also, systolic blood pressure decreased from 161.90+/-25.41 to 146.67+/-26.19 mmHg during lying in bed, with an average weight loss of 2.19 kg. Haemoglobin correlated strongly with RBC count (r = 0.90), but less so with MCH (r = 0.52) or SF (r = 0.55). Serum creatinine demonstrated a moderate inverse correlation with fasting glucose. Conclusion: Our results indicate that hierarchical clustering might be a promising exploratory analytic approach to characterize metabolic heterogeneity among haemodialysis patients. However, validation in larger multicentre cohorts is needed before routine clinical implementation can be recommended.

Background: Noninvasive Oxygen Therapy (NIOT) is a core pediatric acute-care intervention, yet training and guideline uptake may be inconsistent in resource-limited settings. Methods: We conducted a web-based cross-sectional survey of Sudanese pediatric residents using the previously validated Acute Oxygen Therapy Questionnaire (AOTQ). The questionnaire link was distributed via WhatsApp groups to the full resident body. Data were analyzed in Stata, with p<0.05 considered statistically significant. Results: A total of 126 residents participated; 114 (90.5%) were female. The mean AOTQ knowledge score was 74.1%. Female residents had significantly higher mean AOTQ scores than male residents, with a mean difference of 7.3 percentage points (74.8±9.7 vs. 67.5±10.5; p = 0.015). Residents with PICU experience also scored significantly higher than those without PICU experience, with a mean difference of 5.6 percentage points (78.3±10.3 vs. 72.7±9.6; p = 0.006). Scores did not differ by age, training level, years of experience, neonatal unit/emergency department experience, guideline awareness or information source. Most participants (62.7%) reported no awareness of oxygen therapy guidelines; verbal instruction was the commonest information source (53.2%), while only 4.0% reported courses. Knowledge levels were good in 32.5%, moderate in 57.9% and poor in 9.5%. Conclusion: Overall knowledge was moderate-to-good but with important gaps in guideline awareness and formal training. Structured, competency-based oxygen therapy training and improved guideline visibility are warranted.

Objectives: An armed conflict is usually associated with high rates of psychological trauma among civilians, this includes Post-Traumatic Stress Disorder (PTSD), depression, anxiety and functional impairment. In this context, access to sustained outpatient psychotherapy is frequently limited, making the need for intensive, structured rehabilitation models more important. Objective: To evaluate the effectiveness of a 10-day Murray Method Trauma Regulation Programme (MM-TRP) program in reducing PTSD, depression and anxiety symptoms among war-affected civilians in Ukraine. Methods: A prospective, single-arm cohort study with mixed methods was conducted in Poltava, Ukraine (March 2022 to March 2024). A total of 192 civilians participated. Assessments were performed at baseline, post-intervention and at three-month follow-up using the PTSD Checklist for DSM-5 (PCL-5), Beck Depression Inventory-II (BDI-II) and Generalized Anxiety Disorder-7 scale (GAD-7). Due to the observational, single-arm design without a control group, causal inferences cannot be drawn. Results: Mean PCL-5 scores decreased from 58.3±12.4 (95% CI: 56.5-60.1) at baseline to 32.7±10.8 (95% CI: 31.1-34.3) post-intervention and 35.4±11.2 (95% CI: 33.7-37.1) at three-month follow-up (p<0.001). A reduction of 30% or greater in PCL-5 scores was observed in 78.6% of participants, suggesting substantial symptom improvement within the cohort. Mean BDI-II scores declined from 28.6±10.2 (95% CI: 27.1-30.1) to 14.3±8.6 (95% CI: 13.0-15.6) post-intervention and 16.8±9.1 (95% CI: 15.4-18.2) at follow-up, while GAD-7 scores decreased from 13.2±4.8 (95% CI: 12.5-13.9) to 6.4±3.9 (95% CI: 5.8-7.0) and 7.3±4.2 (95% CI: 6.6-8.0), respectively (all p<0.001). Improvements were additionally observed in disability, quality of life and post-traumatic growth. Conclusion: The MM-TRP residential program was associated with substantial and sustained reductions in traumatic stress, depressive and anxiety symptoms among war-affected civilians. However, given the observational design, these findings should be considered preliminary and definitive conclusions regarding efficacy require controlled trials.

Background: Gallbladder Carcinoma (GBC) remains among the most lethal malignancies of the biliary tract, with poor outcomes largely driven by late-stage detection. The pre-malignant continuum spanning chronic cholecystitis with epithelial hyperplasia, intestinal and gastric metaplasia, Low-Grade Dysplasia (LGD) and High-Grade Dysplasia (HGD) offers a critical but underutilized window for early diagnosis. Immunohistochemistry (IHC) provides accessible, cost-effective and reproducible diagnostic tools; however, no internationally validated, tiered IHC panel has been developed specifically for pathology laboratories operating under resource constraints, as is common across South Asia, Latin America, the Middle East and sub-Saharan Africa, the very regions carrying the greatest GBC burden. Objectives: To systematically evaluate and pool published evidence on the diagnostic and prognostic accuracy of IHC markers and marker combinations for detecting, grading and prognosticating pre-malignant gallbladder lesions and to translate these findings into an evidence-based, tiered, resource-stratified panel suitable for deployment across diverse healthcare settings. Methods: Six electronic databases (PubMed/MEDLINE, EMBASE, CINAHL, Cochrane Library, Scopus, Web of Science) were searched for studies published between January 2000 and December 2024. Studies reporting IHC marker expression across the gallbladder carcinogenesis sequence were eligible, including tissue microarray, whole-section IHC and digital pathology designs. Quality was assessed using QUADAS-2 and the Newcastle-Ottawa Scale. Bivariate random-effects models yielded pooled sensitivity, specificity and AUROC estimates. PRISMA 2020 guidelines were followed throughout. Results: Seventy-nine studies encompassing 14,826 gallbladder specimens from 28 countries were included; 38 studies contributed sufficient data for meta-analyses. CDX2 achieved the highest diagnostic accuracy for intestinal metaplasia detection (pooled sensitivity 88.6%, specificity 92.1%; AUROC 0.947). The p53+Ki-67+CEA combination panel reached 91.3% sensitivity and 88.7% specificity for high-grade dysplasia/carcinoma discrimination, representing the most cost-effective trio for basic laboratory settings. Stepwise upregulation of p53 (normal: negative; LGD: 18-35%; HGD: 55-74%; GBC: 62-89%) and Ki-67 was consistently documented across studies. E-Cadherin loss correlated strongly with HGD/carcinoma transition (pooled specificity 86.4%). Substantial heterogeneity (I² = 32-62%) reflected variation in antibody clones, antigen retrieval protocols and histopathological classification systems. Conclusions: A three-level tiered IHC panel framework is proposed: Tier 1 (p53, Ki-67, CEA, CK7, CK20) achievable at under USD 7 per case for district hospital settings; Tier 2 adding CDX2, E-Cadherin and MUC5AC for regional centers and Tier 3 incorporating MUC1, MUC2, SMAD4, HER2 and PD-L1 for tertiary academic institutions. Even the minimal Tier 1 panel has the potential to transform diagnostic yield for pre-malignant GBC detection in high-incidence, resource-constrained regions.

Background: Toothbrushes are among the most widely used personal hygiene tools, typically recommended for daily use and replacement every three to four months. While considerable research has focused on bristle wear, microbial contamination and ergonomic design, relatively little attention has been paid to the metallic components embedded within the toothbrush head-specifically, the aluminum staples used to secure the bristles. Aim: The aim of this study is to investigate the structural and chemical changes of aluminum staples in used toothbrushes over time using X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). Method: X-Ray Diffraction (XRD) was used to evaluate the structural properties and phase composition of the sample. The diffraction patterns provided information about both crystalline and amorphous domains. Sharp and intense peaks in the diffractogram indicated crystalline phases, while broad humps represented amorphous regions. Fourier Transform Infrared Spectroscopy (FTIR) was carried out in the range of 4000-400 cm-' to confirm the presence of functional groups. Characteristic peaks corresponding to phosphate, carbonate, hydroxyl and silica groups were analyzed to validate the successful synthesis of bioactive composites. Results and Discussion: The combined XRD and FTIR analyses provide clear evidence of progressive structural and chemical changes in aluminum staples from used toothbrushes over time. XRD data showed an increase in crystallinity from 22.2% at three months to 40.9% at six months, accompanied by a reduction in the amorphous phase. This suggests that the aluminum gradually reorganizes into a more ordered and stable crystalline structure during storage and use. Complementary FTIR results confirmed these transformations. At three months, characteristic peaks of O-H, C-H and C=O groups indicated early surface oxidation and organic adsorption. By six months, the spectra displayed stronger hydroxyl and carbonate vibrations along with more defined Al-O bands, reflecting ongoing hydroxylation, oxidation and the for mation of stable aluminum oxide/hydroxide species. Together, these findings highlight that prolonged exposure leads to both structural reordering and chemical passivation of aluminum staples, improving stability but also altering surface properties. Conclusion: Aluminum staples in toothbrushes undergo progressive structural degradation with usage time. XRD revealed a decrease in crystallinity and the emergence of aluminum oxide phases, while FTIR confirmed increasing surface hydroxylation and organic adsorption. Notably, Al₂O₃ and Al(OH)₃ phases become dominant after 3-6 months, suggesting increased corrosion susceptibility. These results support limiting aluminum staple usage within 3 months to maintain mechanical integrity and minimize oral contamination risks.

Background: Sleep duration is a critical determinant of metabolic, psychological and physical health. Arthritis is highly prevalent among adults and frequently coexists with sleep disturbances; however, evidence examining whether arthritis independently increases the risk of short sleep duration remains inconsistent. Objective: To evaluate whether adults with arthritis (including osteoarthritis [OA] and Rheumatoid Arthritis [RA]) have higher odds of short sleep (<7 hours/night) and whether age modifies this association. Methods: We analyzed 9,160 adults aged ≥20 years from NHANES 2015-2018, applying the complex survey design and 4-year MEC examination weights. Arthritis status (none, OA, RA) was self-reported. Sleep duration was categorized as short sleep (<7 hours). Survey-weighted descriptive statistics and logistic regression models were performed (unadjusted, demographic-adjusted and fully adjusted). Age was mean-centered at 50.22 years. Subtype-specific and sex-stratified analyses were conducted and interaction terms tested effect modification by age. Results: Adults with arthritis were older and had higher BMI and smoking prevalence than those without arthritis. Overall, 22.0% of adults reported short sleep (<7 hours/night), with comparable prevalence in those with (21.8%) and without (22.1%) arthritis. In fully adjusted models, arthritis did not independently predict short sleep (adjusted odds ratio [AOR] 1.14, 95% CI 0.98-1.32, p = 0.112). However, the arthritis×age interaction was significant (AOR 0.97, 95% CI 0.97-0.98, p<0.001), indicating age-dependent differences in predicted probability of short sleep. OA but not RA demonstrated a significant age interaction (OA×age AOR 0.97, p = 0.001; RA×age AOR 1.00, p = 0.897). Sex-stratified models showed similar patterns. Conclusions: Arthritis was not independently associated with short sleep after full adjustment but age meaningfully modified this relationship. Sleep health interventions may require age-specific strategies in adults with arthritis.

Background: Patients undergoing colonoscopy procedure are non-compliance to adherence of procedure leads to poor diagnosis and treatment. Aim: The study’s aimed to evaluate the effects of video-assisted strategic instruction among patients undergoing colonoscopy at a tertiary care hospital. Methods: One-group pretest and posttest research design was adopted for this study. Using non- probability purposive sampling technique, the sixty samples in total were recruited that satisfied the inclusion criteria. The video-assisted strategic instruction was carried out at the Endoscopy department on the day of confirmation of appointment for colonoscopy procedure. The knowledge, anxiety and compliance were assessed on the day of colonoscopy procedure before and after the intervention. Results: The study findings revealed a marked increase in knowledge and a significant decrease in anxiety among patients undergoing colonoscopy after receiving video-assisted strategic teaching. The average knowledge score rose from 1.68±0.833 at baseline to 7.50±1.359 following the intervention, whereas the average anxiety score declined from 4.12±1.342 to 3.70±1.212 (p<0.001), demonstrating the positive impact of the teaching program. Conclusion: An independent nursing intervention, such as video-assisted strategic instruction, can efficiently increases knowledge, decreases anxiety and improves the compliance among the patients undergoing colonoscopy procedures.