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Croton socotranus Balf.f. shrub is widely used traditionally in Asia as an anti-infective. The study was conducted for metabolite profiling, oral acute toxicity and antioxidant studies, antimicrobial activity and anticancer effect against human hepatoma (HepG2), breast cancer (MCF-7) and rhabdomyosarcoma (RD) cells. Gas chromatography-mass spectrometry analysis revealed the presence of 39 compounds, predominantly comprising fatty acids (57.76%), sesquiterpenes (24.56%) and triterpenes (9.54%). The n -hexane fraction exhibited promising antimicrobial activity and displayed a potent anti-tumour effect against HepG2, MCF-7 and RD cells with IC 50 values of 3.4, 6.5 and 7.1 μg/mL, respectively. Histological examination revealed significant morphological changes consistent with the changes observed in the apoptotic mechanism of action. The molecular docking study provided insights into the rational binding modes of the identified compounds with phosphoinositide 3-kinase and poly(ADP-ribose)polymerase-1 enzymes. Our findings suggest the potential of C. socotranus as a valuable source of antimicrobial and anticancer agents.

Osteoporosis significantly impairs bone density and increases fracture risk, representing a substantial global health challenge. The effectiveness of traditional treatments such as calcium supplementation and exercise in completely preventing fractures is limited. This review explores recent advancements in surgical techniques and treatment modalities to manage osteoporotic fractures better and improve patient outcomes. Osteoporotic fractures demand specialized surgical techniques due to compromised bone quality. Vertebroplasty and kyphoplasty are minimally invasive procedures that provide rapid pain relief and structural support using bone cement. While vertebroplasty is effective, it carries risks of cement leakage and new fractures. Kyphoplasty, with added balloon inflation, reduces leakage risk and improves vertebral height restoration but is costlier. Cement-augmented screws enhance fixation but can increase adjacent fracture risk and pose long-term complications. Surgical advancements encompass robotic-assisted surgery, offering precision and accelerated recovery, alongside biologic agents like bone morphogenetic proteins (BMPs), which enhance bone healing while reducing secondary interventions and eliminating donor site morbidity. Bone graft substitutes such as calcium phosphate cements enhance biomechanical compatibility, decrease morbidity, and reduce fracture loss and pain. Balloon kyphoplasty aids in height restoration and pain relief and diminishes the risk of subsequent vertebral fractures. Bioglass scaffolds promote bone regeneration by improving bone mineral density and lowering the incidence of new fractures. Optimal perioperative care, including patient selection, nutritional management, and early mobilization strategies, is crucial for mitigating risks in vulnerable populations. While current surgical interventions provide significant pain relief and functional benefits, ongoing research and multidisciplinary collaboration are crucial to prospectively refine these techniques and reduce the burden of osteoporosis. New technologies, such as tissue engineering and gene editing, hold potential for future treatment paradigms., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Hakami et al.)

Background: The global rise in obesity and related health complications has cast a spotlight on the urgent need for initiatives that promote informed dietary decisions. This cross-sectional study investigates the knowledge, attitudes, and practices of university students at Jazan University, Saudi Arabia, regarding menu calorie labeling. The study examines how these variables may affect dietary decisions, body mass index (BMI), and support for proposed legislative measures requiring calorie disclosure on restaurant menus., Methods: The study included 581 Saudi university students who were 18 years of age or older as a convenience sample. A three-part questionnaire that asked about demographics, anthropometric measurements, and attitudes and behaviors related to calorie counting was completed by the participants. Using the Statistical Product and Service Solutions (SPSS, version 25.0; IBM SPSS Statistics for Windows, Armonk, NY) program, chi-square, t-tests, and ANOVA tests were used to evaluate the data. Both informed consent and ethical approval were obtained., Results: The study finds that, even while more than half of the participants knew their recommended daily calorie intake and exhibited curiosity about calorie information on menus, this knowledge did not always result in healthy eating habits. Participants' opinions and behaviors regarding calorie labeling were significantly correlated with their BMI levels, indicating the importance of education in promoting nutritional awareness and healthy eating habits. New calorie labeling regulations received higher approval from people who regularly ate out., Conclusion: This study emphasizes the necessity of comprehensive nutritional education initiatives to raise calorie knowledge and encourage Saudi Arabian university students to make healthier eating choices. It also emphasizes the possible effects of legislative measures requiring calorie information on menus, particularly among regular diners. However, while evaluating the results, it is important to take into account the study's limitations, including self-reported data and convenience sample. To support menu calorie labeling legislation and inform targeted public health interventions for university students' eating behaviors, more research that takes cultural quirks and regional settings into account is necessary., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Standing Committee for Scientific Research - Jazan University (HAPO-10-Z-001) issued approval REC-44/04/370. On 15 November 2022. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Arishi et al.)

Minimally invasive surgery (MIS) has revolutionized surgical practices, with robotic-assisted surgery (RAS) significantly advancing. However, the understanding and acceptance of RAS vary, impacting its widespread adoption. This study aims to assess Saudi Arabians' attitudes and comprehension of RAS, which is crucial for promoting its integration into surgical procedures. A cross-sectional study was conducted in various Saudi Arabian cities. A total of 1449 participants were included, while participants with cognitive issues were excluded. Demographic information, knowledge, technology experience, attitudes, and perceptions about RAS were collected using an online self-administered questionnaire. Data were analyzed using descriptive and inferential statistics. Of the participants, 51.1% demonstrated awareness of RAS, mainly through social media (36.9%). Factors influencing awareness included gender, education, income, occupation, computer literacy, and technology comfort. Gender disparities were evident in attitudes and perceptions toward RAS. Concerns about RAS included robot malfunction (62.0%), surgical errors (45.4%), and surgeon competency (44.7%). 36.4% of the participants believe RAS is faster, 29.9% believe RAS is less painful, and 25.3% believe RAS has fewer complications. Positive perceptions encompassed the belief that robot-using surgeons are more skilled (44.5%) and hospitals offering RAS are better (54.3%). Notably, 47.7% expressed willingness to consider RAS as a treatment option. The study underscores the significance of promoting awareness and informed decisions to ensure the successful integration of RAS in surgical practices. Addressing concerns and misconceptions and enhancing public comprehension are pivotal for facilitating informed decision-making and fostering RAS acceptance within Saudi Arabia's surgical landscape., (© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.)

Background and Objectives : Bariatric surgery has been proposed as a treatment option for type 2 diabetes, but there is limited research on its efficacy and the use of standardized outcome measures. Therefore, this study aimed to evaluate the efficacy of bariatric surgery in managing type 2 diabetes and to assess the BAROS protocol postoperatively. Material and Methods : This cross-sectional study was conducted in southern Saudi Arabia, involving 346 bariatric surgery patients aged 18-60. This study collected data through an electronic questionnaire distributed via a Telegram group and Twitter hashtag. Anthropometric data, postoperative complications, and the evolution of obesity-related comorbidities were collected. The quality of life was evaluated using the Moorehead-Ardelt questionnaire of the BAROS protocol. The total BAROS score was classified as "Insufficient", "Moderate", "Good", "Very good", or "Excellent", considering the presence of comorbidities. The data were analyzed using SPSS software ver.23. Results : The mean age of the participants was 30.97 ± 8.49 years, and 70.81% were female. Sleeve Vertical Gastrectomy was the most common surgical technique used ( n = 336). The excess weight loss percentage (EWL%) was 70.55 ± 22.57%, and 27.75% of participants achieved complete remission of type 2 diabetes. The total BAROS score was "Excellent" for 40.17% of participants and "Moderate" for 27.16%. The presence of comorbidities was negatively correlated with the BAROS score (r = -0.651, p < 0.001). Conclusions : Bariatric surgery effectively manages type 2 diabetes with a high rate of EWL% and complete remission. The BAROS protocol is a valuable tool for assessing the quality of life postoperatively, with most participants achieving a "Moderate" to "Excellent" score. Comorbidities negatively impact the BAROS score, highlighting the importance of managing these conditions postoperatively.

Background: There are data on the safety of cancer surgery and the efficacy of preventive strategies on the prevention of postoperative symptomatic COVID-19 in these patients. But there is little such data for any elective surgery. The main objectives of this study were to examine the safety of bariatric surgery (BS) during the coronavirus disease 2019 (COVID-19) pandemic and to determine the efficacy of perioperative COVID-19 protective strategies on postoperative symptomatic COVID-19 rates., Methods: We conducted an international cohort study to determine all-cause and COVID-19-specific 30-day morbidity and mortality of BS performed between 01/05/2020 and 31/10/2020., Results: Four hundred ninety-nine surgeons from 185 centres in 42 countries provided data on 7704 patients. Elective primary BS (n = 7084) was associated with a 30-day morbidity of 6.76% (n = 479) and a 30-day mortality of 0.14% (n = 10). Emergency BS, revisional BS, insulin-treated type 2 diabetes, and untreated obstructive sleep apnoea were associated with increased complications on multivariable analysis. Forty-three patients developed symptomatic COVID-19 postoperatively, with a higher risk in non-whites. Preoperative self-isolation, preoperative testing for SARS-CoV-2, and surgery in institutions not concurrently treating COVID-19 patients did not reduce the incidence of postoperative COVID-19. Postoperative symptomatic COVID-19 was more likely if the surgery was performed during a COVID-19 peak in that country., Conclusions: BS can be performed safely during the COVID-19 pandemic with appropriate perioperative protocols. There was no relationship between preoperative testing for COVID-19 and self-isolation with symptomatic postoperative COVID-19. The risk of postoperative COVID-19 risk was greater in non-whites or if BS was performed during a local peak., (© 2021. The Author(s).)