Sheikh Khalifa Medical City

Background: Epilepsy affects over 50 million people worldwide, and approximately one third of patients develop drug-resistant epilepsy (DRE), a major driver of morbidity, mortality, and healthcare costs. Vagus nerve stimulation (VNS) is an established neuromodulatory treatment option for DRE, but local guidance on its use in the United Arab Emirates (UAE) remains limited. This study aimed to establish an expert consensus to define best practices for the effective and efficient use of the VNS in the UAE setting. Methods: A multidisciplinary Task Force conducted a literature review and developed 25 evidence- and experience-informed statements, which were refined during an in-person expert meeting to ensure clinical relevance for the UAE context. Statements were rated through a single-round modified Delphi process involving UAE neurologists and neurosurgeons. Participants rated their agreement with each statement using a 7-point Likert scale. Consensus was predefined as >= 70% agreement, corresponding to ratings of 6-7. Statements with 60-69% agreement were classified as moderate agreement but were not considered to have reached consensus. Results: Fifty-six experts completed the Delphi round, corresponding to a 75.7% response rate. Item-level denominators varied across statements. Eighteen of 25 statements reached consensus, six demonstrated moderate agreement, and one did not reach consensus. Strong agreement was observed for patient selection, safety, structured parameter optimization, and multidisciplinary care pathways. Moderate agreement emerged for presurgical evaluation, timing of implantation, and selected clinical scenarios. Conclusion: Building on existing international guidance and previous Delphi work in other settings, this study provides a UAE-specific description of expert agreement and variability on the clinical and organizational use of VNS for DRE. The findings may inform future local pathway development and identify areas requiring clearer definitions, prospective data collection, and further evidence generation. Plain Language Summary. This study asked expert clinicians in the United Arab Emirates to rate 25 statements on the clinical and organizational use of vagus nerve stimulation for drug-resistant epilepsy. Vagus nerve stimulation is an adjunctive treatment that aims to reduce seizure burden and improve patient-centred outcomes; it should not be interpreted primarily as a treatment intended to achieve complete seizure freedom. Eighteen statements reached the prespecified consensus threshold, while six showed moderate agreement and one did not reach consensus. Experts showed agreement on several areas, including multidisciplinary care, safety considerations, MRI compatibility, structured follow-up, and individualized programming. However, agreement was more limited for some topics, including expected responder rates after one year, timing of implantation, selected programming criteria, and quality-of-life effects independent of seizure reduction. These findings identify areas where expert views are aligned and areas where practice remains variable. They may support the development of more consistent local care pathways, while highlighting topics that require further clinical evidence and local guidance.

Management of bladder stones in men with benign prostatic obstruction (BPO) conventionally assumes simultaneous outlet surgery is universally required. This scoping review evaluates evidence comparing simultaneous and staged strategies to establish rationale for selective management. The protocol was registered in the Open Science Framework (OSF: https://osf.io/egmz7 ). Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, PubMed, the Cochrane Library, and Web of Science were systematically searched for studies published up to September 18, 2025, Studies reporting outcomes of stone removal with or without concurrent outlet surgery in patients with bladder stones and BPO were included. Outcomes included stone-free rate (SFR), recurrence, voiding parameters (IPSS, Qmax, PVR), complications, and reintervention. Fifteen studies (six comparative) met criteria. Both approaches achieved high SFRs (> 90

Background and aim Body image significantly influences an individual's self-esteem and general mental well-being. A negative body image, defined as the discrepancy between one's real physique and their perceived ideal physique, can lead to considerable psychological and behavioral problems, such as body dissatisfaction and maladaptive eating habits. The primary purpose of this study was to evaluate the connection between body image dissatisfaction and eating attitudes among students at the University of Sharjah, with the aim of providing region-specific evidence to guide future health promotion programs targeting young people. Methodology In this cross-sectional study, data collection was carried out between January 2022 and March 2022, which was conducted through an online questionnaire, a text version of which is available in Appendix. Participants were recruited from multiple colleges within the University of Sharjah. In all, a total of 311 participants fulfilled the inclusion criteria. This study incorporated body dissatisfaction, body appreciation, and eating disorder (ED) risk, which were assessed using standardized questionnaires. Lastly, data were analyzed using SPSS Statistics version 23 (IBM Corp., Armonk, New York, USA).  Results The results of the study revealed that out of the 311 individuals, the majority (65.6%, n = 204) had minimal to no risk of developing an eating disorder (ED) and reported high levels of body appreciation, indicating a low body dissatisfaction rate. There was no significant association between sex and body image dissatisfaction, with both males and females having similar ED risk (32.3% vs. 35.3%, p-value = 0.603). In contrast, some psychological factors were strongly associated with ED risk. Participants who reported that social media influenced their body perception had a higher incidence of ED (40.3%, n = 95; p-value = <0.001). Similarly, those who felt pressure to conform to social media beauty standards (50.0%, n = 79; p-value = <0.001) and those who received appearance-related remarks from peers or family members (41.2%, n = 87; p-value = <0.001) also demonstrated significantly higher ED risk. Lastly, participants who reported heightened awareness of their eating habits during the COVID-19 lockdown had a significantly higher risk of ED than those who reported no change (43.2%, n = 92 vs. 15.3%, n = 15; p-value = <0.001). Conclusion Despite high overall levels of body appreciation, a substantial proportion of the participants were at risk of eating disorders. Eating disorder risk and degree of body dissatisfaction were significantly associated with sociocultural factors, including social media influence, perceived pressure to conform to cultural beauty standards, pressure from family/peers due to appearance-related remarks, and the COVID-19 lockdown. The findings of our study underscore the need for preventive and educational initiatives that promote healthy body image and awareness of the potential psychological and behavioral consequences of unrealistic beauty standards.

The inflammatory skin condition known as diaper dermatitis (DD) often affects infants and preschoolers. Barrier preparations are commonly used in their management, but their effectiveness remains unclear. This systematic review aimed to evaluate the extent to which barrier preparations reduce DD compared to a placebo or other therapies. To gather relevant information, we conducted electronic searches on databases such as Medical Literature Analysis and Retrieval System Online (MEDLINE) via PubMed, Scopus, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar for data extraction. We included studies based on randomized controlled trials (RCTs), quasi-randomized controlled studies, and cohort studies. The collected data were analyzed using RevMan version 5.3 (The Cochrane Collaboration, London, United Kingdom) for Windows. This study included a total of six studies, comprising four randomized controlled trials and two cohort studies. The analysis focused on the incidence rates of dermatitis among both experimental and placebo groups across approximately four studies. A significant difference in dermatitis prevalence was observed between the intervention and placebo groups (odds ratio {ORs} = 0.77; confidence interval {CI} = 0.37-1.61; p = 0.0002), with notable heterogeneity noted (degrees of freedom {df} = 3; I2 = 79%). Among the six included studies, clotrimazole emerged as an effective management strategy, demonstrating minimal incidence rates of dermatitis compared to placebo. Additionally, zinc oxide (ZnO) paste showed effectiveness in managing diaper dermatitis among neonates. The use of diaper cream or moisturizers, along with soap, was found to be effective in preventing nappy rash. However, only one study reported no efficacy of petroleum jelly or Vaseline in reducing the severity and incidence of dermatitis symptoms. The effectiveness of barrier preparations in treating DD varies depending on the preparation and study design. Clotrimazole shows potential, especially for suspected fungal infections. To gain a deeper understanding of barrier preparations, identify the factors influencing their efficacy, and explore their role in high-risk patients, additional research is necessary.

Background:Carotid body tumors (CBTs) are clinically important in head and neck surgery. In this multicenter retrospective study, we aimed to examine the characteristics, diagnosis, and management of patients diagnosed with CBTs at three institutions. Materials and methods:Patient demographics, clinical symptoms, investigative modalities, therapeutic interventions, pathological findings, and clinical outcomes were assessed. Overall, 12 patients, with a median age of 51.5 years, were evaluated. Results:The most common symptom was a painless neck mass (83.3%). Tumors were located on the right side in eight patients (66.6%). No bilateral cases were recorded. One patient had a synchronous small glomus vagale tumor. Contrast-enhanced computed tomography was used as the primary imaging modality in 11 patients. Multiple imaging modalities were used in 66.6% of patients. The median tumor size was 4.6 cm. Of these, 33.3% were Shamblin Class I, 50% Class II, and 16.6% Class III. Seven patients underwent surgery, whereas five opted for non-surgical treatment. Complications, including hoarseness and dysphagia, occurred in three patients. Preoperative embolization was performed in two patients. All operated cases were histopathologically confirmed to be paragangliomas. Conclusions:Our results revealed that, although CBTs are rare and challenging to treat, positive outcomes are possible with careful planning and precise surgery. Active surveillance may be a suitable initial approach in selected patients. Future studies should focus on creating individualized risk plans to guide treatment decisions and follow-ups.