Ovarian vein thrombosis (OVT) is a rare vascular disorder most commonly associated with pregnancy and the puerperium; however, it may also occur in non-pregnant women, in whom diagnosis can be challenging because of its rarity and nonspecific clinical presentation. We report the case of a 37-year-old non-pregnant woman with no significant past medical history who presented with a one-month history of undocumented fever associated with right lower quadrant abdominal pain and constitutional symptoms, including weight loss, night sweats, and fatigue. She had delivered nine months before presentation, well beyond the recognized high-risk postpartum period, and denied oral contraceptive use. Laboratory investigations were largely unremarkable, except for a markedly elevated erythrocyte sedimentation rate. Contrast-enhanced computed tomography of the abdomen and pelvis demonstrated bilateral OVT. The patient was admitted with a working diagnosis of fever of unknown origin and was started on therapeutic anticoagulation with low-molecular-weight heparin, followed by a transition to apixaban. Her condition improved clinically, and a structured follow-up plan was arranged. Bilateral OVT in the absence of pregnancy is particularly uncommon and may be overlooked because of the lack of specific clinical and laboratory findings, making imaging essential for diagnosis. Early initiation of anticoagulation is important to reduce the risk of potentially life-threatening complications. Although direct oral anticoagulants are increasingly used in the management of venous thromboembolism, evidence supporting their use specifically in non-pregnancy-related OVT remains limited. This case highlights bilateral OVT as a rare but important cause of prolonged fever and abdominal pain in non-pregnant women and emphasizes the need for early recognition to avoid diagnostic delay and ensure timely management.
Mucinous cystic neoplasms of the liver (MCN-L) are rare cyst-forming epithelial tumors defined by mucin-producing epithelium and characteristic ovarian-type stroma. Once grouped with other biliary cystic lesions, MCN-L are now recognized as a distinct premalignant entity with potential for progression to invasive carcinoma. Accurate preoperative diagnosis remains difficult because imaging findings frequently overlap with those of other cystic liver lesions, including simple hepatic cysts, hydatid cysts, and intraductal papillary neoplasms of the bile duct. Laboratory markers, cyst fluid analysis, and biopsy have limited diagnostic reliability and cannot confidently exclude malignancy. Given the risk of malignant transformation and diagnostic uncertainty, complete surgical excision is recommended for all suspected MCN-L irrespective of symptom status or lesion size. Resection with negative margins is associated with excellent long-term outcomes, whereas non-definitive procedures such as cyst fenestration or drainage are associated with high recurrence rates. In selected cases, intraoperative findings—particularly the presence of the “peeling sign”—may allow safe parenchyma-sparing excision while preserving functional liver tissue. Prognosis is generally favorable in non-invasive disease but significantly worse when invasive carcinoma is present, a feature that cannot be reliably predicted before surgery. This review synthesizes current evidence on the epidemiology, diagnostic approach, imaging characteristics, pathology, surgical management, and prognosis of MCN-L, and proposes a practical framework for the evaluation and management of cystic liver lesions suspicious for MCN-L.
Polygalacturonases (PGs) are key enzymes that hydrolyze pectin, a complex polysaccharide in plant cell walls, with essential roles in biological processes and industrial applications. This study presents a comprehensive genome-wide identification and in-silico characterization of PGs from four fungal species: Aspergillus oryzae, Aspergillus flavus, Neurospora crassa, and Rhizoctonia solani. A total of 44 PG protein sequences were retrieved from the NCBI database, confirming the presence of the Glyco_hydro_28 (GH28) domain, which is essential for pectin hydrolysis. Phylogenetic analysis using the Neighbor-Joining method revealed four major clades (A, B, C, D), with A. flavus and A. oryzae sharing a close evolutionary relationship (bootstrap support = 93
Background: Nursing students are the future workforce, and their readiness to use digital health tools is important. Previous studies have focused on knowledge and attitudes; however, they have not examined the wide range of digital health literacy levels that may influence nursing students' attitudes toward using telehealth in clinical settings. Objective: This study aimed to determine the relationship between nursing students' digital health literacy and their attitudes toward telehealth use in practice. Methods: A cross-sectional design was used. The sample consisted of undergraduate nursing students enrolled in a Bachelor of Nursing program at a selected Saudi Arabian university. The online survey used 2 scales: the Digital Health Care Literacy Scale and the Nurses' Attitudes Toward Use of a Telehealth Scale. Results: A total of 273 students participated (mean age 21.3, SD 1.9 years). Most of the nursing students demonstrated a high digital health literacy level (n=184, 67.4%; mean Digital Health Care Literacy Scale score 11.9 out of 15, SD 3.1). Digital health literacy was a significant predictor of positive attitudes toward telehealth use in practice (adjusted odds ratio 1.48, 95% CI 1.28-1.71; P<.001). Male students were significantly less likely to report positive attitudes than female students (adjusted odds ratio 0.62, 95% CI 0.39-0.97; P=.03). However, academic year, telehealth workshops, and informatics courses were not significantly associated with positive attitudes toward telehealth use in practice. Conclusions: Higher levels of literacy appear to correlate with more positive attitudes toward telehealth use in practice. However, current formal education and workshops had no apparent influence on digital health literacy. This suggests a potential need for strengthening digital training and development in nursing education. This may enhance telehealth readiness and support future digital health care delivery.
Robotic-assisted surgery (RAS) is increasingly adopted worldwide, yet surgeons' perceptions, training experiences, and barriers to implementation remain poorly characterized in the Gulf Cooperation Council region. We conducted the first nationwide survey of surgeons in Saudi Arabia on RAS. A 37-item questionnaire was administered to licensed surgeons across Saudi Arabia between September 2025 and May 2026, assessing training exposure, perceptions, barriers to adoption, and personal opinions. Descriptive and inferential analyses were performed. A total of 311 surgeons participated. Overall, 65.0
