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Accessible Summary: What is known on the subject?: Spirituality is an important aspect for clients with mental illness.Spirituality is essential to holistic care in mental health nursing.Nurses found an apparent disconnection between the theory and practice of spiritual care. What the paper adds to existing knowledge: Nurses acknowledged that attitudes that allocate blame towards clients with mental illness have the most negative impact on clients' spiritual wellbeing.The conflicting worldviews between spiritual healing and a biomedical approach impact the provision of care as relationships among the mental health team are disrupted.The non‐assessment of the client's spirituality hindered nurses from providing spiritual care.Language differences between nurses and clients impede nurses from providing spiritual care. What are the implications for practice?: The use of spiritual therapy as an element of nursing care works if clients and nurses are both aware of the importance of spirituality.Nursing staff must also be aware of several issues that may make it difficult for nurses to provide such therapy, including specific symptoms of mental illness.Nurses can apply spiritual care effectively when they have significant spirituality.Nurses with good competency in mental health nursing skills are more likely to provide efficient spiritual care as part of holistic care. Introduction: Spiritual care is essential to clients with mental illness. Aim: To explore mental health nursing students' perspectives on spirituality and spiritual care and how this impacts clients with mental illness in an Islamic context (Saudi Arabia). Method: Thematic analysis is used to analyse data from two focus groups of mental health nursing students (one comprising eight, the other six). Results: Six themes emerged: factors affecting spirituality in mental illness, the impact of mental illness on spirituality, the use of spiritual healing in mental illness, nurses' use of spiritual healing; challenges in providing spiritual care and recommendations for improving spiritual care. Discussion: Clients being blamed for having mental illness by health professionals and the community harmed their spirituality. The religious support of peers was a practical approach to spiritual therapy, asserted as a beneficial element of nursing care. However, nurses found providing such therapy challenging because of the language barrier and the lack of any assessment of clients' spirituality. It was also challenging when dealing with specific symptoms of mental illness. Implications for practice: The study asserts that spiritual therapy in nursing care will work if the client knows its importance. Nurses who have significant spirituality can apply it effectively. [ABSTRACT FROM AUTHOR]

The novel coronavirus (COVID-19) has inundated the whole world by causing severe acute respiratory syndrome in humans, thus posing serious public health concerns. The oral and olfactory systems are significantly impacted by the COVID-19 condition, in addition to the respiratory and digestive systems. Oral symptoms of COVID-19 can be caused by a loss in oral hygiene, immune system suppression, a decline in general health, and candidiasis due to prolonged antibiotic use. Because many aerosols and droplets are produced during various dental operations, dental professionals and dentists are at a significant risk of contracting the COVID-19 infection. Few precautionary measures include performing a pre-appointment health screening for all patients, performing aerosol-producing procedures in a designated space or operatory, using proper personal protective equipment and disinfecting the operatory between patients, and limiting the number of dental procedures at one time. Against this background, the purposes of this article are to explore the oral presentations of COVID-19 infection and to emphasize the hazards to dental professionals during COVID-19 pandemic. Additionally, few preventive measures are also highlighted. [ABSTRACT FROM AUTHOR]

Langerhans cells, often referred to as the "macrophages of the skin", are dendritic cells that normally reside in the epidermis and papillary dermis. Just like macrophages, they function as antigenpresenting cells that activate naive T cells. Certain mutations such as those involving the BRAF gene can cause unopposed production of Langerhans cells, which is known as Langerhans cell histiocytosis (LCH). LCH triggers an inflammatory immune response that causes systemic manifestations such as fever and fatigue, as well as other manifestations depending on the affected organs. The pathogenesis behind LCH remains poorly understood. It is still unknown whether it is a neoplastic process or a reactive cancer-mimicking illness. Diagnosis of LCH is confirmed by biopsy, and treatment is largely dependent on the extent and severity of the disease. Common treatments include corticosteroids, excision, radiation, and chemotherapy. We present a case of a 1- year-old Saudi male with LCH. [ABSTRACT FROM AUTHOR]

Background: The revised 15‐item Myasthenia Gravis (MG) Quality of Life Questionnaire (MGQoL15R) is a validated scale of quality of life in patients with MG. We aimed to study the factors causing the variability within the Arabic version of the MGQoL15R (MGQoL15R‐A). Method: A standardized questionnaire was completed by 118 patients. Correlations and hierarchical regression analyses were used to assess the contribution of sociodemographic variables, clinical factors, Patient Health Questionnaire‐9 (PHQ9‐A), and Generalized Anxiety Disorder‐7 (GAD7‐A) to the variability in the MGQoL15R‐A. Results: The MGQoL15R‐A was highly correlated with PHQ9‐A (r = 0.76), and moderately correlated with GAD7‐A (r = 0.52). Clinical factors and PHQ9‐A independently explained 30.4% and 34.5% of the variability, respectively. Among the clinical factors, uncontrolled MG status, relapse within the past year, and a higher number of current MG therapies were significantly associated with a higher MGQoL15R‐A score. Conclusions: MG severity and depressive symptoms (measured by PHQ9‐A) can affect the MGQoL15R‐A score. [ABSTRACT FROM AUTHOR]

Background: In the Kingdom of Saudi Arabia, stroke is a rapidly growing problem and a major cause of illness and death. This increasing incidence is due to the changing life style in the country and high prevalence of diabetes mellitus, obesity, dyslipidemia, and hypertension, all considered to be important. The aim of this study is to determine the prevalence and determinant factors of cerebrovascular stroke among Saudi senior adults (above 50 years) in Arar, KSA. Methods: The present study is a descriptive cross sectional survey conducted on a representative sample of elderly people in the Northern Province of Saudi Arabia. Results: The overall prevalence rate of first-time stroke or repeated cerebrovascular stroke observed in this study was 4.3%.Mean age (± SD) of the cases was 61±9.25 and 50% of cases were 70-79 years old. Males constituted 83.3% of the cases and 50.0% ex-smokers. Regarding the associated cardiovascular diseases, arrhythmias was found in all cases, hyperlipidemia in 83.3%, hypertension in 50% of the cases and myocardial infarction in 50%. The majority (66.7%) were diabetics, 33.3% were obese, 33.3% had renal insufficiency and 50% had hypothyroidism. Stroke was significantly related to old age, male sex, hyperlipidemia, ischemic heart diseases and smoking (P<0.05) while non-significantly related to hypertension, diabetes and Body Mass Index (kg/m2) status. Conclusion: In Arar, Northern Saudi Arabia, the prevalence of cerebrovascular stroke among senior adult population was 4.3%, which is relatively high. In addition, there is definite lack of published researches on stroke. However, such research is vitally essential to plan for appropriate management programs to be set up, effective implementation of primary prevention strategies and proper allocation of health resources in this area. [ABSTRACT FROM AUTHOR]

Background: Squint, crossed eyes and deviating eyes is a condition in which the eyes do not properly align with each other when looking at an object. A child with squint may stop using the affected eye. This can lead to visual loss called amblyopia, which can become permanent unless treated early in childhood. The aim of the study was to estimate the prevalence of squint, some determinants and clinical manifestations and treatment characteristics in the studied children and adolescents in Arar, Northern Saudi Arabia. This was a cross-sectional study, conducted in Arar, Northern Saudi Arabia. The study included 156 randomly selected participants (62 male and 94 female children and adolescents). Results: This study reported squint in 14.7% of the studied sample, 26.1% were females and 73.9% were males. There was no significant relation between squint and age, other hereditary diseases or other chronic diseases but there was relation with consanguinity between parents (P=0.03). The cause of squint was eye trauma in 17.4%, surgical operation in 4.3% and neurological disease in 4.3%. Squint was right sided in 47.8% of cases, left sided in 34.8% and in both eyes in 17.4% of the studied cases. 78.3% of the cases had inward squint and 17.4% outward squint. In 8.7% of the cases squint alternate between eyes. Temporary squint found in 52.2% and 78.3% of squint cases use glasses. In all cases squint affect visual acuity. All cases received treatment (69.9% medical and 30.4% surgical) but only 52.2% cured and 43.5% had recurrence. Conclusion: This study reported squint in 14.7% of the studied sample, 73.9% were males. There was significant with sex and consanguinity between parents (P=0.03). The etiology was eye trauma, eye surgical operation and neurological disease. Large scale screening studies is mandatory. Health education of the public about causes and importance of early treatment is important. [ABSTRACT FROM AUTHOR]

This observational study aimed to evaluate the use of a single portable device to assess the non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), and lipid layer patterns (LLP) in young females with refractive errors (REs). The study was conducted at the College of Applied Medical Science (Female campus), Riyadh, Saudi Arabia between January 5, 2021 to May 15, 2021. Forty young females, with mean age of 23.0± 4.3 years with REs (-2.53 ± 2.05 D) and 40 females, mean age 23.8± 4.5 years with healthy eyes were recruited. The tests were administered in the following order: Ocular Surface Disease Index (OSDI), followed by NITBUT, TMH, and LLP. Significant differences (via Mann-Whitney U test) were noted in the median ocular surface disease index (OSDI; p˂0.001), NITBUT (p=0.035), TMH (p=0.009), and LLP (p˂0.001) scores between the study and control groups. Females with REs have significantly lower lipid layer, TMH, and NITBUT scores than those with healthy eyes.

Melasma, a commonly acquired hyperpigmentation skin condition, is usually treated with topical agents as the first line of management. This systematic review and meta-analysis aimed to assess the efficacy and safety of azelaic acid versus hydroquinone in treating melasma patients. We conducted a comprehensive search across four online databases (PubMed, Scopus, Web of Science, and Cochrane Library) from the time of their creation until May 28, 2023. We considered randomized controlled studies comparing hydroquinone with azelaic acid for the treatment of melasma patients. We used the Cochrane Risk of Bias tool 2 to evaluate the risk of bias. The mean difference (MD) for continuous variables and the risk ratio (RR) for categorical variables, with a 95% confidence interval (CI) were pooled. Six studies were included, with a total of 673 patients with melasma. The azelaic acid had a lower mean change in melasma area severity index (MASI) than the hydroquinone group [MD= -1.23, 95% CI (-2.05, -0.40), P=0.004]. No difference was observed regarding the improvement via the objective response scale, the reduction in pigmentation, or the adverse events reported. However, despite not being statistically significantly different, there was a trend towards having more good responses in the azelaic acid group. Azelaic acid may be better than hydroquinone in reducing melasma severity (measured by MASI). However, larger studies with long-term follow-up are needed to validate these findings., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Albzea et al.)

Glutamine (GLN) has been proven to improve the prognosis of severely burned patients. GLN supplementation in critical illness has gained extreme popularity among researchers over the years, and its safety and efficacy are still under question. Therefore, we aim to study the role of GLN supplements in decreasing mortality, length of hospitalization (LOH), and infection in severely burned patients. PRISMA guidelines were used to design and conduct this systematic review. MEDLINE, Cochrane, and EMBASE databases were used to search for randomized controlled trials (RCTs) in January 2022. In order to assist in the search, MeSH terms such as burn injury, GLN, and RCT were used. As a result of reviewing the literature, 1112 publications were found. We included only 7 RCTs after implanting our inclusion criteria. There were 328 patients enrolled in the study, with 166 patients (50.61%) were allocated to GLN supplementation and 162 patients in the control groups (49.39%). The risk of infection was significantly lower among patients who received GLN supplementation than those in the control groups (RR = 0.41, 95% CI, 0.18 to 0.92,  p  = 0.030). The risk of death was significantly lower among GLN-receiving patients compared to non-GLN-receiving patients (RR = 0.09, 95% CI, 0.01 to 0.63,  p  = 0.016). GLN supplementation has been linked to lower hospital mortality and infection-related morbidity in burn patients. Furthermore, larger-scale and higher-quality studies are needed to assess whether there are any statistically and clinically significant changes., Competing Interests: The author(s) declare no potential competing of interest with respect to the research, authorship, and/or publication of this article, (© 2022 The Author(s).)

Background: The term facial palsy generally refers to weakness of the facial muscles, mainly resulting from temporary or permanent damage to the facial nerve. Common causes of facial paralysis include infection or inflammation of the facial nerve, head trauma, head or neck tumor, stroke., Objective: To outline the incidence of several etiologies and the profile of patients with peripheral facial paralysis attending the outpatient clinic of the neurology department in Hospitals of Arar City, Saudi Arabia., Methods: This cross-sectional study was carried out in Arar city from October 2016 to May 2017. The study was conducted in the outpatient clinic of the neurology department in hospitals of Arar City. Any ages of both sexes of all newly diagnosed unilateral facial palsy were included in the study. Data were analyzed by SPSS version 15, using descriptive statistics and Chi-square test. P-value was considered significant if <0.05., Results: The mean age of the facial palsy cases was 33.65 (±11.71) years. Among the studied participants, the total prevalence of facial palsy was 26.3% (61% females and 39% males). The right side of the face was affected in 51.2% and the etiology was exposure to cold air current in 92.7% of cases. The treatment was physiotherapy in 80.5% of the cases, medical in 17.1% and surgical in 2.4%. There was significant relationship between smoking and the occurrence of facial palsy (p<0.05)., Conclusion: The study revealed that facial palsy was common in Arar city. The rate is higher among males than females. We also concluded that exposure to cold air current was the main etiology. We recommend health education sittings to bring awareness to the public about the nature, causes, risk factors, prevention and treatment of the disease., Competing Interests: Conflict of Interest: There is no conflict of interest to be declared.