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Byline: Ahmad. Bamagoos, Shahad. Alshaynawi, Atheer. Gari, Atheer. Badawi, Mudhawi. Alhiniah, Asma. Alshahrani, Renad. Rajab, Reem. Bahaj, Faris. Alhejaili, Siraj. Wali CONTEXT: Positive airway pressure (PAP) is the first-line therapy [...]

To study the clinical profile and measure the pain and migraine-related disability of patients with all types of migraine using the McGill pain assessment scale and Migraine Disability Assessment (MIDAS) before and after 3 months of effect on the medication. Methods: A Prospective-Cross sectional study was carried out in a multispecialty hospital with male and female patients between 18 and 65 years. The data were collected from the patients directly through the questionnaire of McGill pain assessment scale-short form (SF) and MIDAS, which was provided before and after the medication.  Results: There were 165 subjects of which 52 were men and 113 were women. The mean age of all the subjects was 43 years. About 26.06% of the subjects had a family history of headaches. The scores of McGill pain and MIDAS assessment before and after medication were as follows: 0– 15 were 30.90% and 73.33%, Score 16– 30 were 54.54% and 18.18%, the score of 31– 45 were 14.54% and 7.87% of the subjects. MIDAS grade I was 17.57% and 50.90%, Grade II 33.93% and 21.81%, Grade III 30.30% and 15.75% Grade IV 18.18% and 11.51% of the subjects. Discussion: The calculated "t" value between the before and after medication values of McGill and MIDAS by paired 't-test was 13.85 and 17.49 respectively. As the calculated "t" value is more than the table value, the alternate hypothesis is accepted. Conclusion: This study confirms that there is a significant difference in disability levels before and after acute and preventative treatments when measured over 3 months. In addition, the preponderance of females was high, and the functional disability that affects work and social activity associated with migraine is moderate to severe. [ABSTRACT FROM AUTHOR]

Background: Knee osteoarthritis (KOA) is one of the most common conditions resulting in disability, particularly in the elderly population. Osteoarthritis (OA) is the most common articular disease and the leading cause of chronic disability in the developed world. Objective: This study was carried out to evaluate knee pain in the Asir region of Saudi Arabia. An analytical cross-sectional survey design was adopted in the Asir region from April 2023 to August 2023 to assess the knee pain of the adult population using an anonymous online questionnaire. Results: Of 1234, 332 were men (26.90) and 902 were women (73.09). WOMAC index score category 55.34% (n = 683) of the subjects had a low risk (score <60), 28.68% (n = 354) had a moderate risk (score 60–80), and 15.96% (n = 197) had a high risk (score ≥81) for KOA. According to clinical criteria, 79.33% (n = 979) of the study subjects had OA. Age group, gender 2.17 (1. 67–2.82) [OR 2.17; 95% CI 1.67–2.82), family history of OA [OR 0.47; 95% CI 0.37–0.62], diabetes [OR 2.78; 95% CI 2.17–3.56], hypertension [OR 0.35; 95% CI 0.26–0.45] were significantly associated with the percentage of the WOMAC index score using the Chi-square test analysis (P<0.05). Therefore, the WOMAC index showed higher diagnostic precision with a statistically significant association [OR 9.31 CI 6.90–12.81] with a P< 0.0001. Conclusion: KOA is more common in older, obese people who have reached the age of 50 in the Asir region, and it is more prevalent in women. Alarms the need for appropriate awareness programs for better disease prevention and health outcomes for the benefit of the community through general public health programs. [ABSTRACT FROM AUTHOR]

Background: Coagulation disorders are frequently encountered among patients infected with coronavirus disease 2019 (COVID-19), especially among admitted patients with more severe symptoms. This study aims to determine the mortality rate and incidence and risk factors for venous thromboembolism (VTE) in hospitalized patients with COVID-19. Methods: This retrospective observational cohort study was conducted from March to July 2020 using a hospital database. All adult patients (>18 years old) with laboratory-confirmed COVID-19 were included. Laboratory data and the real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) for SARS-CoV-2 were obtained from medical records. The mortality rate and the incidence of VTE were established as study results. A multivariate logistic regression analysis was performed to identify predictors of thrombotic events. Results: rA total of 1024 confirmed COVID-19 patients were treated, of whom 110 (10.7%) were deceased and 58 patients (5.7%) developed VTE. Death occurred more frequently in patients older than 50 years and those admitted to the intensive care unit (ICU, 95%) and who received mechanical ventilation (62.7%). Multivariate analysis revealed that cancer patients were two times more likely to have VTE (adjusted odds ratio = 2.614; 95% CI = (1.048–6.519); p = 0.039). Other chronic diseases, such as diabetes, hypertension, and chronic kidney disease, were not associated with an increased risk of VTE. Conclusions: One-tenth of hospitalized COVID-19 patients were deceased, and VTE was prevalent among patients with chronic conditions, such as cancer, despite anticoagulation therapy. Healthcare professionals should closely monitor individuals with a high risk of developing VTE to prevent unwanted complications. [ABSTRACT FROM AUTHOR]

The current study aimed to test the neuroprotective action of topiramate in mouse peripheral diabetic neuropathy (DN) and explored some mechanisms underlying this action. Mice were assigned as vehicle group, DN group, DN + topiramate 10-mg/kg and DN + topiramate 30-mg/kg. Mice were tested for allodynia and hyperalgesia and then spinal cord and sciatic nerves specimens were examined microscopically and neurofilament heavy chain (NEFH) immunostaining was performed. Results indicated that DN mice had lower the hotplate latency time (0.46-fold of latency to licking) and lower von-Frey test pain threshold (0.6-fold of filament size) while treatment with topiramate increased these values significantly. Sciatic nerves from DN control mice showed axonal degeneration while spinal cords showed elevated GFAP (5.6-fold) and inflammatory cytokines (∼3- to 4-fold) but lower plasticity as indicated by GAP-43 (0.25-fold). Topiramate produced neuroprotection and suppressed spinal cord GFAP/inflammation but enhanced GAP-43. This study reinforces topiramate as neuroprotection and explained some mechanisms included in alleviating neuropathy. [ABSTRACT FROM AUTHOR]

Background: Oral health literacy was recognized as important to encouraging oral health and avoiding oral health diseases. It is recognized that socioeconomic conditions are also influential factors in oral health. Therefore, oral health is an important part of individuals' quality of life and general health. Objectives: This study was conducted to assess oral health literacy (OHL) and oral health‐related quality of life (OHRQoL) among undergraduate students studying at university. Methods: A prospective cross‐sectional study was carried out from November to February 2023 among the students of King Khalid University. OHL and OHRQoL were assessed using a Rapid estimate of adult literacy in dentistry‐30 (REALD‐30) and oral health impact profile (OHIP‐14). Further, Pearson's correlation tests were used to measure the correlation between REALD‐30 and OHIP‐14. Results: Among the 394 completed respondents, the majority were aged >20 years (n = 221; 56.09%), aged <20 years (n = 173; 43.91%), female (n = 324; 82.23%) and male (n = 70; 17.7%). Participants from health‐related colleges were (n = 343; 87.06%), and other colleges were (n = 51; 12.94%) *p <.04. Participants brushing frequency once daily were (n = 165; 41.88%) twice or more per day (n = 229; 58.12%) *p <.018. The overall mean REALD‐30 score of the participants was 11.76 ± 0.17 indicating low OHL. The higher mean score of OHIP‐14 for the following domains physical pain 12.93 ± 0.56, physical disability 12.05 ± 0.72 and psychological disability 12.71 ± 0.76. Oral health impact profile‐14 and REALD showed a positive correlation for health‐related colleges (r =.314; *p <.002) and other colleges (r =.09; p <.072). However, a significant correlation was observed between REALD‐30 and OHIP‐14 scores among health‐related colleges (p <.05). The current study concluded that self‐rated poor oral health is significantly linked with OHIP‐14 scores. Furthermore, systematic health education programs such as regular dental check‐ups for college students must be arranged to assist in changing the student's everyday life and oral health behaviours. [ABSTRACT FROM AUTHOR]

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Background: Multi-chamber bag with electrolytes (MCB-E) parenteral nutrition (PN) formulations are gaining acceptance for nutritional support for safety and economic advantages. However, their use is hampered by serum electrolyte abnormalities. No data exist regarding MCB-E PN interruption due to high serum electrolyte levels. We assessed the rate of MCB-E PN discontinuation in surgical patients secondary to persistently high serum electrolyte levels. Methods: This prospective, cohort study included surgical patients (aged ≥18 years) who received MCB-E PN at King Faisal Specialist Hospital and Research Centre-Riyadh, from February 28, 2020, until August 30, 2021. Patients were followed for 30-day for the discontinuation of MCB-E PN secondary to persistent hyperphosphatemia, hyperkalemia, hypermagnesemia, or hypernatremia for two consecutive days. The association of discontinuing MCB-E PN with various factors was assessed using univariable and multivariable Poisson regression analysis. Results: Seventy-two patients were enrolled in the study, 55 (76.4%) completed MCB-E PN, whereas 17 (23.6%) patients discontinued MCB-E PN due to a persistent hyperphosphatemia (n = 13, 18%) and persistent hyperkalemia (n = 4, 5.5%). Hyperphosphatemia and hyperkalemia were observed at a median of 9 (IQR 6-15) days and 9.5 (IQR 7-12) days of MCB-E PN support, respectively. According to adjusted multivariable analysis, developing an episode of hyperphosphatemia or hyperkalemia was associated with MCB-E PN discontinuation (RR 6.62, 1.95-22.49; P =.002) and (RR 4.73, 1.30-17.24; P =.018), respectively. Conclusion: In surgical patients receiving short-term MCB-E PN, developing hyperphosphatemia was the most frequent high electrolyte abnormality assocaited with MCB-E PN discontinuation, followed by hyperkalemia. [ABSTRACT FROM AUTHOR]

Cancer is a hard-to-treat disease with a high reoccurrence rate that affects health and lives globally. The condition has a high occurrence rate and is the second leading cause of mortality after cardiovascular disorders. Increased research and more profound knowledge of the mechanisms contributing to the disease's onset and progression have led to drug discovery and development. Various drugs are on the market against cancer; however, the drugs face challenges of chemoresistance. The other major problem is the side effects of these drugs. Therefore, using complementary and additional medicines from natural sources is the best strategy to overcome these issues. The naturally occurring phytochemicals are a vast source of novel drugs against various ailments. The modes of action by which phytochemicals show their anti-cancer effects can be the induction of apoptosis, the onset of cell cycle arrest, kinase inhibition, and the blocking of carcinogens. This review aims to describe different phytochemicals, their classification, the role of phytochemicals as anti-cancer agents, the mode of action of phytochemicals, and their role in various types of cancer. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 19 (COVID-19) vaccination has been established as preventing severe and mortal COVID-19. Vaccination is critical strategy in controlling the COVID-19 pandemic, to restrict infections and reduce disease severity. Vaccination coverage will be more extensive if we can better identify vaccination barriers in the population, especially among vulnerable groups, of which one is pregnant women. The aim of this study was to determine the level of acceptance of COVID-19 vaccination and detect the factors that influence vaccine acceptance among pregnant women in Saudi Arabia. Methods: This was a cross-sectional, web-based study conducted in Western, Eastern, North, South, and Central Regions in Saudi Arabia between July and September 2021 among pregnant women, using multi-stage sampling. All pregnant women above 18 years were invited to participate in the study. Pregnant under 18 years of age and those with a contraindication to receiving COVID-19 vaccination were excluded. Binomial logistic regression (univariate and multivariate) was used to identify the influencing factors on vaccination acceptance. Results: Among the 5307 pregnant women, the acceptance level of COVID-19 vaccine was 68%. In the multivariate regression model analysis, the most common predictors of acceptance were living in North Region (P = 0.001, OR = 1.9), living in South Region (P = 0.000, OR = 3.06), and living in Central Region (P = 0.035, OR = 1.42) in comparison to living in Western Region. Gestational week (P = 0.018, OR=0.98), income more than 8000 SR (P = 0.000, OR = 0.51), education level (primary, secondary, and university; P = 0.002, 0.008, and 0.010, respectively), having had gestational diabetes mellitus (P = 0.013, OR = 1.86), being vaccinated with influenza vaccine during present pregnancy (P = 0.000, OR = 4.55, OR = 1.81), being vaccinated with tetanus vaccine during present pregnancy (P = 0.039), and believing that the COVİD-19 vaccine could harm their baby (P = 0.000, OR = 0.12). Conclusion: Our study reported high acceptance of COVID-19 vaccination. The major two reasons for refusal were concerns about a lack of data on COVID-19 vaccination safety and the possibility of harming the fetus. Continued public health efforts, such as educational television programs and awareness campaigns about the safety of the COVID-19 vaccine for pregnant women, are required to raise awareness. More studies of COVID-19 vaccine safety in pregnant women would assist in overcoming these obstacles and encourage pregnant women to be vaccinated. [ABSTRACT FROM AUTHOR]

The fabrication of a clinically acceptable dental prosthesis requires proper communication between the dentist and the dental technician. Prosthodontic educators have been concerned with this interaction and communication. Fixed prosthodontics laboratories revealed that the technicians are often dissatisfied with the information provided in work authorizations. Objective To evaluate the quality of communication between dentists and laboratory technicians via work authorizations for fixed prosthodontics in both governmental and private dental laboratories in Riyadh area from the technician’s perspective. Methods A sample of 66 dental laboratories, including all government dental laboratories and a selected number of randomly chosen private dental laboratories from each district of Riyadh (40%), participated in the survey. A questionnaire was developed to include questions related to the following areas of work authorization: clarity and accuracy of instructions, patient information, type of prosthesis, choice of materials, design and shade of the prosthesis and type of porcelain glaze. The questionnaire was answered in a face-to-face interview by technicians who were qualified in fixed prosthetic work. Data were analyzed through parametric tests ( T -test and one-way ANOVA) to identify significant values ( P < 0.05). Results This survey showed a lack of communication between dentists and dental laboratories regarding the following: marginal design, pontic design, staining diagram, type of porcelain and glaze needed for the prosthesis. Significant differences were observed between the government and private dental laboratories. There was a greater lack of communication between the dentists and government laboratory technicians in Riyadh. There was no statistically significant difference between private laboratories of different areas in Riyadh city ( P < 0.05). Conclusion The quality of communication between dentists and dental technicians in Riyadh can sometimes be inadequate, and governmental laboratories have a lower level of communication. [ABSTRACT FROM AUTHOR]

Nifuroxazide is an antidiarrheal medication that has promising anticancer activity against diverse types of tumors. The present study tested the anticancer activity of nifuroxazide against Ehrlich's mammary carcinoma grown in vivo. Furthermore, we investigated the effect of nifuroxazide on IL-6/jak2/STAT3 signaling and the possible impact on tumor angiogenesis. The biological study was supported by molecular docking and bioinformatic predictions for the possible effect of nifuroxazide on this signaling pathway. Female albino mice were injected with Ehrlich carcinoma cells to produce Ehrlich's solid tumors (ESTs). The experimental groups were as follows: EST control, EST + nifuroxazide (5 mg/kg), and EST + nifuroxazide (10 mg/kg). Nifuroxazide was found to reduce tumor masses (730.83 ± 73.19 and 381.42 ± 109.69 mg vs. 1099.5 ± 310.83) and lessen tumor pathologies. Furthermore, nifuroxazide downregulated IL-6, TNF-α, NFk-β, angiostatin, and Jak2 proteins, and it also reduced tumoral VEGF, as indicated by ELISA and immunohistochemical analysis. Furthermore, nifuroxazide dose-dependently downregulated STAT3 phosphorylation (60% and 30% reductions, respectively). Collectively, the current experiment shed light on the antitumor activity of nifuroxazide against mammary solid carcinoma grown in vivo. The antitumor activity was at least partly mediated by inhibition of IL-6/Jak2/STAT3 signaling that affected angiogenesis (low VEGF and high angiostatin) in the EST. Therefore, nifuroxazide might be a promising antitumor medication if appropriate human studies will be conducted. [ABSTRACT FROM AUTHOR]

Aquaporin-4 (AQP4) is the water regulating channel found in the terminal processes of astrocytes in the brain and is implicated in regulating the astrocyte functions, whereas in neuropathologies, AQP4 performs an important role in astrocytosis and release of proinflammatory cytokines. However, several findings have revealed the modulation of the AQP4 water channel in the etiopathogenesis of various neuropsychiatric diseases. In the current article, we have summarized the recent studies and highlighted the implication of astrocytic dysfunction and AQP4 in the etiopathogenesis of depressive disorder. Most of the studies have measured the AQP4 gene or protein expression in the brain regions, particularly the locus coeruleus, choroid plexus, prefrontal cortex, and hippocampus, and found that in these brain regions, AQP4 gene expression decreased on exposure to chronic mild stress. Few studies also measured the peripheral AQP4 mRNA expression in the blood and AQP4 autoantibodies in the blood serum and revealed no change in the depressed patients in comparison with normal individuals. [Display omitted] • AQP4 plays an important role in the regulation of astrocyte functions. • Modulation of AQP4 leads to astrocytic dysfunction and impairment in glymphatic system. • Astrocytes and AQP4 both are involved in hippocampal neurogenesis and synaptic plasticity. • Astrocytic dysfunction and AQP4 has been involved in the pathogenesis of depression. • Downregulation of AQP4 expression was found in the brain of the patients with depression. [ABSTRACT FROM AUTHOR]

Cancer accounted for almost ten million deaths worldwide in 2020. Metastasis, characterized by cancer cell invasion to other parts of the body, is the main cause of cancer morbidity and mortality. Therefore, understanding the molecular mechanisms of tumor formation and discovery of potential drug targets are of great importance. Gene editing techniques can be used to find novel drug targets and study molecular mechanisms. In this review, we describe how popular gene-editing methods such as CRISPR/Cas9, TALEN and ZFNs work, and, by comparing them, we demonstrate that CRISPR/Cas9 has superior efficiency and precision. We further provide an overview of the recent applications of CRISPR/Cas9 to cancer research, focusing on the most common cancers such as breast cancer, lung cancer, colorectal cancer, and prostate cancer. We describe how these applications will shape future research and treatment of cancer, and propose new ways to overcome current challenges. [Display omitted] • This review described how popular gene-editing methods work. • Findings demonstrated that CRISPR/Cas9 has superior efficiency and precision. • The recent applications of CRISPR/Cas9 to cancer research are also highlighted. • Described how these applications will shape future research and cancer treatment. [ABSTRACT FROM AUTHOR]

Tribulus terrestris saponins (TTS) have been longley used as an overall tonic and recent studies showed they influence inflammatory conditions. We examined the ameliorative effect of a commercial formula of a saponin-rich extract of TT in a model of dietary obesity in female rats focusing on their ability to control the inflammatory burden, insulin resistance (IR), adipokine expression and the related reproductive system pathologies. Female rats were fed with high fat diet (HFD) for 14 weeks to launch diet-induced obesity; they were assigned as: the obese control female rats (OFR) which received no treatment and TTS (5 and 10 mg/kg/day) treated rats; they were compared to a normal rat group. We determined the IR index, serum/tissue inflammatory cytokines, and adipose tissue adipokine expression and examined the secondary ovarian pathologies. Body weight gain, serum triglycerides and IR (>5-fold) in the OFR group were greater than the normal group; TTS lessened these parameters compared with the OFR group. TTS, at 10 mg/kg dose, ameliorated mRNA expression of leptin and visfatin genes in addition to serum inflammatory cytokine levels. Moreover, TTS corrected the hyperprolactinemia and other hormonal disturbances and ameliorated the ovarian pathologies. This study highlighted that the anti-inflammatory properties of TTS helped in alleviation of IR and body weight gain in OFR. Upon correction of obesity manifestations, the gonadal hormone dysregulations and ovarian pathologies were subsequently ameliorated. We can consider TTS as a promising candidate that may alleviate the inflammatory burden, IR and adipokine expression in obesity and hence prevent the secondary gonadal complications in female subjects if appropriate clinical studies are available. [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine was the first line of defense during the COVID-19 pandemic. As a result, Saudi Arabia believes it is essential to emphasize telemedicine services to combat the virus as part of its early precautionary actions., Objectives: To measure the prevalence of telemedicine usage and determine the facilitators and barriers affecting telemedicine usage., Methods: A cross-sectional study was conducted among Saudis from October 2020 to April 2021. Participants received an online questionnaire through multiple social media platforms., Results: The prevalence of telemedicine usage was 45.2%. The most significant facilitator that affected the participants' usage was avoiding the infection of COVID-19, at 87.3%. In-person consultation preference was the biggest barrier preventing Saudis from using telemedicine services (62.5%)., Conclusion: Not enough people are aware of telemedicine services, so it is recommended to multiply advertisements for the services provided to reach many users. To enhance Saudi Arabia's awareness of the risks of COVID-19, further studies are needed to assess telemedicine usage during COVID-19, since the majority of studies were conducted in advance., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Alshahrani et al.)

Objectives: A cross-sectional study was aimed to assess the prevalence of smoking habits among students at King Khalid University (KKU), Abha, KSA., Methods: This was a cross-sectional study using a Modified Fagerstrom Tolerance Questionnaire (mFTQ), online survey was carried out among the students of KKU. This tool uses a five-point Likert scale for all seven questions, except one question on smoking during the first 2 h of the day., Results: The prevalence of smoking among male students was 67% ( n = 243) and females 33% ( n = 122). Of the current cigarette smokers, 19% had a nicotine dependence score of ≥6 (high), 48% scored 4-6 (moderate) and 33% scored <4 (minimal). Association between mFTQ and the number of cigarettes per day ( p < 0.001), first smoke of your cigarettes ( p < 0.018), smoking in the morning ( p < 0.007), and difficulty refraining from smoking in public areas ( p < 0.000). The results of the current study recommend that cigarette smoking habits are a significant risk behavior among young students. The strength of this study signifies that most participants (62%) intend to quit if appropriately supported., Conclusion: According to the findings of the current investigation, smoking was quite common among males. It raises the alarm about the critical need for adequate education to support health education initiatives, discourage teen smoking, and enhance health outcomes for the community., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kandasamy, Sam, Almanasef, Almeleebia, Shorog, Alshahrani, Almohaimeed, Hmlan, Al Suhaym, Prabahar, Veeramani, Amirthalingam, Mohammed Shorog and Mani.)

Pyridine derivatives are the most common and significant heterocyclic compounds, which show their fundamental characteristics to various pharmaceutical agents and natural products. Pyridine derivatives possess several pharmacological properties and a broad degree of structural diversity that is most valuable for exploring novel therapeutic agents. These compounds have an extensive range of biological activities such as antifungal, antibacterial, anticancer, anti-obesity, anti-inflammatory, antitubercular, antihypertensive, antineuropathic, antihistaminic, antiviral activities, and antiparasitic. The potent therapeutic properties of pyridine derivatives allow medicinal chemists to synthesize novel and effective chemotherapeutic agents. Consequently, the imperative objective of this comprehensive review is to summarize and investigate the literature regarding recent advancements in pyridine-based heterocycles to treat several kinds of cancer. Furthermore, the performances of pyridine derivatives were compared with some standard drugs, including etoposide, sorafenib, cisplatin, and triclosan, against different cancer cell lines. We hope this study will support the new thoughts to pursue the most active and less toxic rational designs., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)