Helicobacter pylori infection remains a major global health problem, particularly in resource-limited settings, and is a leading cause of several gastrointestinal diseases. This study aimed to determine the prevalence of H. pylori seropositivity and its associated factors, including mode of delivery, among asymptomatic adolescents in Central Sudan. A community-based cross-sectional study was conducted between April and May 2025. Sociodemographic data, anthropometric measurements, and mode of delivery were collected using a structured questionnaire. H. pylori seropositivity was assessed using a rapid antibody test detecting H. pylori-specific antibodies. Univariate and multivariate binary logistic regression analyses were performed to identify associated factors. A total of 235 adolescents were enrolled, of whom 124 (52.8%) were males. The overall prevalence of H. pylori seropositivity was 24.7%. Univariate analysis showed that mode of delivery was the only factor significantly associated with H. pylori seropositivity. This association remained significant in multivariate analysis (adjusted odds ratio = 3.97; 95% confidence interval: 1.04-15.18), indicating a higher risk among adolescents delivered by cesarean section. Other factors, including age, sex, body mass index, family size, parental education and occupation, and displacement status, were not significantly associated. H. pylori positivity is relatively common among asymptomatic adolescents in Central Sudan. The use of a rapid serological antibody test represents an important limitation because it cannot distinguish between active infection and previous exposure. Consequently, the reported prevalence more accurately reflects H. pylori seropositivity than confirmed active infection. Mode of delivery may represent an important early-life risk factor, underscoring the need for further longitudinal research.
Communication skills are a core competency in pharmacy education; however, traditional presentation approaches often place limited emphasis on clarity, engagement, and meaningful integration of knowledge. This study evaluated student perceptions and immediate post-activity knowledge following implementation of a Three-Minute Thesis (3MT) group presentation task among third-year Doctor of Pharmacy (Pharm.D) undergraduate students in a pharmacology course at Umm Al-Qura University, Makkah, Saudi Arabia. A single-group, post-intervention, cross-sectional evaluation design was used. Learning outcomes were assessed using a structured 20-item evaluation questionnaire measuring five domains (engagement, perceived learning, communication confidence, satisfaction, and peer perception) and a five-item knowledge quiz administered immediately after the activity. A total of 59 students participated (79.7% response rate). Perceptions were highly positive across all domains, with the highest mean scores observed for satisfaction ($M = 4.37$, $SD = 0.80$) and peer perception ($M = 4.32$, $SD = 0.79$), followed by engagement ($M = 4.21$, $SD = 0.74$), perceived learning ($M = 4.16$, $SD = 0.81$), and communication confidence ($M = 4.11$, $SD = 0.77$). Subscale reliability was strong (Cronbach's $\alpha = 0.79-0.92$). Quiz performance reflected high immediate post-activity knowledge, with a mean score of 3.86 out of 5 ($SD = 1.18$), and 72.9% of participants achieving scores of 4 or 5. The 3MT-style format is a feasible and highly engaging active-learning strategy in undergraduate pharmacology. While the descriptive single-group design limits direct causal inferences, the strong student reception and solid immediate knowledge profiles demonstrate its pedagogical viability and educational value. Future controlled, multi-institutional studies are warranted to evaluate long-term impacts.
Inappropriate antibiotic use in community settings is a major contributor to antimicrobial resistance, particularly in low- and middle-income countries where regulatory enforcement may be inconsistent. Community pharmacies are a critical interface between health systems and the public; however, real-world dispensing practices remain insufficiently characterized in many settings. This study evaluated the prevalence, behavioral drivers, and clinical quality of non-prescription antibiotic dispensing in Jordanian community pharmacies using a simulated patient methodology.A cross-sectional simulated patient study was conducted across 200 community pharmacies in Jordan. A standardized encounter involving a three-stage progressive escalation protocol assessed dispensing behavior under increasing patient demand. The primary outcome was antibiotic supply without a valid prescription. Secondary outcomes included clinical assessment, counseling, referral behavior, and antibiotic class supplied. Multivariable logistic regression was used to identify predictors of non-prescription dispensing and adequate clinical assessment.Antibiotics were dispensed without prescription in 162 encounters (81.0%; 95% CI, 75.6-86.4). During the initial symptom-based presentation, 110 pharmacies (55.0%) supplied antibiotics. Among pharmacies that initially declined, a direct antibiotic request resulted in additional dispensing in 44.4% of cases, while subsequent patient insistence led to further supply in 24.0%, producing a cumulative prevalence of 81.0%. Independent pharmacies (adjusted odds ratio [AOR], 2.48; 95% CI, 1.23-5.02) and rural locations (AOR, 2.02; 95% CI, 1.01-4.03) were associated with higher dispensing odds. History-taking occurred in 49.4% of dispensing encounters, allergy screening in 14.2%, and no counseling was provided in 29.0%. Broad-spectrum agents represented 73.5% of dispensed antibiotics.Non-prescription antibiotic dispensing remains widespread in Jordan and is influenced by patient pressure and practice characteristics. Strengthened regulatory enforcement, professional training, and public awareness interventions are urgently needed.
Maternal deterioration during pregnancy, childbirth, or the postpartum period can rapidly progress to severe maternal morbidity if early warning signs are not recognized and managed promptly. This study aimed to assess maternity nurses' knowledge and attitudes regarding maternal deterioration and to examine their association with nurses' preparedness to recognize and manage maternal deterioration in maternity units. A cross-sectional study was conducted among 360 nurses working in maternity units of tertiary hospitals. Data were collected using a structured questionnaire assessing demographic characteristics, knowledge related to maternal deterioration, professional attitudes toward obstetric emergency care, and preparedness for managing maternal deterioration. Descriptive statistics, correlation analysis, and multiple regression analysis were used to examine relationships between study variables. Data were collected over a six-month period from January to June 2026. The mean knowledge score was 3.45 ± 0.71, indicating a high level of knowledge among participants. The mean attitude score was 3.68 ± 0.64, reflecting generally positive attitudes toward managing maternal emergencies. Preparedness for managing maternal deterioration showed a mean score of 3.41 ± 0.59, indicating a moderate-to-high level of preparedness. Knowledge and attitudes were significantly correlated with preparedness (p < 0.05). Multiple linear regression analysis demonstrated that nurses' knowledge and attitudes were significant independent factor associated with preparedness for managing maternal deterioration. Higher knowledge and more positive attitudes were associated with greater preparedness after controlling for the other variables included in the regression model. Nurses' knowledge and professional attitudes significantly influence preparedness to manage maternal deterioration in maternity units. Strengthening competency-based education, simulation-based obstetric emergency training, and implementation of maternal early warning systems may enhance maternity nurses' preparedness and contribute to improved maternal safety outcomes.
In 2023, the Global Lung Function Initiative (GLI) introduced race-neutral spirometric reference equations (2023-GLI-RNEs) to address concerns of racial bias inherent in earlier 2012-GLI race-specific models. While the 2012-GLI Caucasian equations (2012-GLI-CEs) were previously identified to reflect contemporary adults' Algerian spirometry, the 2023-GLI-RNEs applicability remains untested. This study aimed to compare the diagnostic outcomes of the 2023-GLI-RNEs and the 2012-GLI-CEs in a healthy adult Algerian population. A cross-sectional study was conducted on 488 Algerian healthy adults (49.6% female) aged 18-85 years. Participants underwent standardized plethysmography/spirometry in accordance with the most updated international guidelines. Z-scores and percent predicted values for FEV₁, FVC, and FEV₁/FVC ratio were computed using both 2012-GLI-CEs and 2023-GLI-RNEs. Diagnostic classifications (e.g. normal pattern, obstructive ventilatory impairment (OVI), non-specific ventilatory impairment (NSVI), or spirometric restrictive pattern (SRP), isolated low FEV1 (ILF)) were compared across the two equations. Classification changes between the two norms appeared to be relatively limited. Percent predicted FEV₁ and FVC values were significantly but slightly higher when interpreted using 2023-GLI-RNEs by 6% and 7% points, respectively, and the percent predicted FEV₁/FVC value was marginally lower by -0.9%. Compared to 2012-GLI-CEs, 2023-GLI-RNEs identified more cases of OVI (4.10% vs. 6.35%, respectively, p = 0.003), fewer cases of NSVI or SRP (2.05% vs. 0.20%, respectively, p = 0.008) or ILF (1.84 vs. 0.00%, respectively, p = 0.008), and comparable cases of normal spirometry (92.01% vs. 93.44%, respectively, p = 0.230). In a sample of healthy Algerian adults' spirometric data, 2023-GLI-RNEs and 2012-GLI-CEs produced broadly comparable classifications of normal spirometry, although modest but statistically significant differences were observed in several abnormal spirometric categories.
The study aimed to assess the comparative efficacy of percutaneous vertebroplasty (PVP) combined with minimally invasive pedicle screw fixation versus PVP alone in elderly patients with osteoporotic vertebral compression fractures (OVCF). Ninety-four elderly patients with OVCF were randomly classified into the control (47 patients) and combined (47 patients) groups. The control group received PVP, while the combined group received PVP combined with minimally invasive pedicle screw fixation. Perioperative indicators such as intraoperative blood lose, operative time, and hospitalization time were recorded. Pain was assessed using the VAS before and at baseline and 1, 3, and 7 days postoperatively. At 1 and 3 days postoperatively, Serum CRP levels, WBC, and neutrophil counts were measured postoperatively. Radiographic outcomes (vertebral height ratio and Cobb angle), ADL scores, JOA scores, and ODI were evaluated preoperatively and at 3 months post-operation. Postoperative complications were documented. Baseline characteristics were comparable. The combined group showed superior pain relief, vertebral height restoration, Cobb angle correction, functional recovery, and reduced inflammatory markers (CRP, WBC, neutrophils) postoperatively (all P < 0.05). Blood loss and hospital stay were shorter in the combined group, though operative time was longer (P < 0.05). Complication rates did not differ significantly (P > 0.05). PVP combined with minimally invasive pedicle screw fixation yields better outcomes in elderly OVCF patients by enhancing pain control, vertebral height, and functional recovery without increasing perioperative risk.
Background Axial neck pain is a common manifestation of cervical degenerative disc disease (CDD). Rotation-traction manipulation (RTM) is widely used in China, but its comparative effectiveness and safety versus cervical traction remain uncertain.Methods In this prospective multicenter randomized controlled trial, 154 adults with CDD-related axial neck pain were randomized 1:1 to receive RTM (7 sessions over 2 weeks) or cervical traction (daily for 2 weeks). Outcomes were assessed at baseline, during treatment, and at 1 and 3 months after treatment. The primary outcome was pain intensity measured by the visual analogue scale (VAS); secondary outcomes were neck tenderness score (NTS) and cervical range of motion (ROM). Intention-to-treat analyses with multiple imputation were performed.Results All 154 randomized participants were included in the analyses, and 151 completed follow-up. Both groups showed significant improvement over time in VAS and ROM (both P < 0.001). Confirmatory mixed-effects analyses did not demonstrate significant between-group differences in VAS or ROM after adjustment for multiple comparisons. Exploratory analyses suggested that RTM provided faster improvement during the treatment phase and a small cumulative advantage in pain reduction, whereas cumulative ROM improvement did not differ significantly between groups. RTM was also associated with a faster reduction in neck tenderness severity. Adverse events were mild and infrequent, and no treatment-related radiographic deterioration was observed.Conclusions Both RTM and cervical traction were associated with clinical improvement in patients with CDD-related axial neck pain. Confirmatory analyses did not demonstrate robust superiority of RTM for pain or cervical ROM, whereas exploratory analyses suggested faster early improvement and a small cumulative pain benefit with RTM. NTS findings should be interpreted cautiously because the tenderness score has not been formally validated. No serious adverse events were observed.Trial registration Chinese Clinical Trial Registry, ChiCTR2400082667. Registered retrospectively on 4 April 2024.
Fractured instrument retrieval remains one of the most challenging aspects of endodontics, with reported incidence rates ranging from 0.3% to 12%. This complication is particularly common with nickel‒titanium (NiTi) rotary files used in curved canals. Instrument separation hinders effective canal disinfection, compromises the quality of obturation, and may necessitate additional interventions such as bypassing, retrieval, or surgical management. Conventional retrieval techniques often lead to dentin loss, compromising root structure. The use of dental operating microscopes and their integration with ultrasonic troughs, microtubes, and specialized retrieval kits, including loop devices, has significantly enhanced the predictability of retrieval procedures while minimizing the loss of tooth structure. However, the effectiveness of these methods remains highly dependent on operator skill. Numerous innovations are continually emerging to facilitate retrieval, with recent attention on magnetic fields. Studies on such emerging devices utilizing magnetic and electromagnetic attraction have introduced a promising new direction for further exploration. This review aims to provide a comprehensive, evidence-based perspective to guide clinical decision-making and keep practitioners updated about the latest advancements in minimally invasive retrieval techniques in endodontic practice.
Iodine status and thyroid disorders remain understudied subjects in low-income countries such as ours. The objectives of the present study were to assess the serum iodine (SI) level and thyroid function in Malagasy adults seen at the Soavinandriana Hospital Center in Antananarivo and to determine the association between high levels of serum iodine (HLSI) and dysthyroidism. This cross-sectional study was conducted over the course of two years (September 1, 2021 to August 31, 2023). The SI was used as a proxy for iodine status in the absence of urinary assays. Thyroid function was assessed by thyroid stimulating hormone (TSH) and free tetra-iodothyronine (fT4). The HLSI was defined by the total serum iodine >100 µg/L. Dysthyroidism was defined by abnormal TSH and/or fT4 levels indicative of hypo- or hyperthyroidism. Among 195 patients, the prevalences of serum iodine excess and dysthyroidism were 12.8% and 15.4%, respectively. HLSI was significantly more common in subjects <60 years old (p-value < 0.0001), and less common in those with hypertension (p-value < 0.0001), dyslipidemia (p-value < 0.0001), diabetes mellitus (p-value = 0.0082) and ex-smoking (p-value < 0.0001). Adjusted for age and gender, the association between HLSI and dysthyroidism was significant (OR = 108 [17-680]). HLSI and dysthyroidism were prevalent among Malagasy adults. The presence of one condition would encourage the search for the other. Their management is primarily preventive through their periodic monitoring.
AIMS:This study examined the association of health literacy with quality-of-life outcomes among Jordanian adults with chronic diseases using two patient-reported outcome measures, the Long-Term Conditions Questionnaire (LTCQ) and the EuroQol five-dimension, three-level questionnaire (EQ-5D-3L). It also compared conventional regression and machine-learning (ML) approaches for modelling these relationships. MATERIALS AND METHODS:In this cross-sectional online study, Arabic-language questionnaires were completed by Jordanian adults aged 18 years or older with at least one chronic physical, mental, or neurological condition. The survey, designed to take 10-12 minutes, included the LTCQ, EQ-5D-3L, Medication Adherence Report Scale (MARS-5), and 12-item Health Literacy Scale (HLS-Q12). A total of 901 complete responses were analyzed. Data were split into training (n = 633) and test (n = 268) sets. Multiple linear regression was used for LTCQ, Tobit regression for EQ-5D-3L index scores, and ML models were trained to explore nonlinear associations. RESULTS:Health literacy and medication adherence were positively associated with both LTCQ (beta = 3.923 and 2.219, respectively; both p < 0.001) and EQ-5D-3L index scores (beta = 0.025, p = 0.001; beta = 0.020, p = 0.009). Number of medications was inversely associated with both outcomes. In 10-fold cross-validation, Extreme Gradient Boosting (XGBoost) showed the lowest average root mean square error (RMSE) for LTCQ (9.18; coefficient of determination [R²] = 0.384) and EQ-5D-3L (0.172; R² = 0.193), although differences between the leading models were modest. CONCLUSION:LTCQ and EQ-5D-3L showed overlapping but distinct association patterns. LTCQ was more strongly linked with psychosocial and self-management variables, whereas EQ-5D-3L was more closely aligned with medication burden and clinical comorbidity. These findings should be interpreted as associative rather than causal and as differences in captured dimensions rather than evidence of instrument superiority.
Folk medicine remains an important component of health practices in Saudi Arabia and continues to attract growing scholarly attention. This study maps the scholarly landscape of folk medicine research related to Saudi Arabia by examining publication trends, author keywords, collaboration among institutions and countries, and the impact of authors and sources. Publications were retrieved from the Scopus and Web of Science databases using Saudi Arabia as the country affiliation. After PRISMA-guided identification, screening, deduplication, and eligibility assessment, 2527 publications published between 1989 and 2024 were retained for analysis. Bibliometrix was used for bibliometric computation and visualization, and VOSviewer was used to map country co-authorship and keyword co-occurrence networks. The results show sustained growth in publication output, strong participation by Saudi institutions, and broad international collaboration. The most prominent research themes were antioxidant activity, antimicrobial properties, herbal medicine, and traditional medicine. These findings provide a bibliometric overview of knowledge production in this area and may inform future systematic, clinical, and policy-oriented research on traditional medicine in Saudi Arabia.
Intracytoplasmic sperm injection (ICSI) has become an integral practice in assisted reproduction technology (ART), but the optimal time interval between oocyte denudation (DN) and ICSI is still not well defined. Libya remains underrepresented in global fertility estimates, and prospective paired data on DN-to-ICSI timing from Libyan IVF practice are limited. We aimed to investigate whether performing ICSI immediately after DN, compared with an intended four-hour delay, affects pregnancy outcomes and early embryology yield. This prospective cohort study was conducted at the Fertility and Reproductive Medicine Center, Beirut Hospital, Benghazi and included 88 Libyan ICSI cycles. After enzymatic-mechanical DN using hyaluronidase, mature metaphase II (MII) oocytes were injected with selected sperm. Within each cycle, sibling MII oocytes were allocated in a 1:1 ratio to immediate ICSI or delayed ICSI after an intended interval of about four hours, using a computer-generated within-cycle allocation sequence. For clinical comparison, cycles were allocated by pre-generated permuted-block randomization to transfer blastocysts under one timing condition (44 cycles/arm). The primary outcome was normal fertilization (two pronuclei); secondary outcomes included cleavage (Day 3), blastulation and blastocyst quality (Day 5/6; Gardner-Schoolcraft), biochemical pregnancy and clinical pregnancy. Immediate DN-ICSI was significantly associated with higher fertilization rates than delayed injection (80.07% ± 17.09% vs 70.80% ± 17.37%; mean difference: 9.26, 95% CI 4.40-14.12; p = 0.0003) and a higher cleavage rate (76.89% ± 17.03% vs 67.97% ± 18.47%; mean difference 8.93 points, 95% CI 3.59-14.26; p = 0.0013). Biochemical pregnancy (40.9% vs 54.5%; p = 0.200) and clinical pregnancy (29.5% vs 27.3%; p = 0.813) did not differ significantly. These results suggest that a shorter DN-to-ICSI interval may improve fertilization and early embryo development, with no observed differences in blastulation or early pregnancy outcomes. Larger multicenter studies with cumulative live births are required to determine clinical relevance.Intracytoplasmic sperm injection (ICSI) has become an integral practice in assisted reproduction technology (ART), but the optimal time interval between oocyte denudation (DN) and ICSI is still not well defined. Libya remains underrepresented in global fertility estimates, and prospective paired data on DN-to-ICSI timing from Libyan IVF practice are limited. We aimed to investigate whether performing ICSI immediately after DN, compared with an intended four-hour delay, affects pregnancy outcomes and early embryology yield. This prospective cohort study was conducted at the Fertility and Reproductive Medicine Center, Beirut Hospital, Benghazi and included 88 Libyan ICSI cycles. After enzymatic-mechanical DN using hyaluronidase, mature metaphase II (MII) oocytes were injected with selected sperm. Within each cycle, sibling MII oocytes were allocated in a 1:1 ratio to immediate ICSI or delayed ICSI after an intended interval of about four hours, using a computer-generated within-cycle allocation sequence. For clinical comparison, cycles were allocated by pre-generated permuted-block randomization to transfer blastocysts under one timing condition (44 cycles/arm). The primary outcome was normal fertilization (two pronuclei); secondary outcomes included cleavage (Day 3), blastulation and blastocyst quality (Day 5/6; Gardner-Schoolcraft), biochemical pregnancy and clinical pregnancy. Immediate DN-ICSI was significantly associated with higher fertilization rates than delayed injection (80.07% ± 17.09% vs 70.80% ± 17.37%; mean difference: 9.26, 95% CI 4.40-14.12; p = 0.0003) and a higher cleavage rate (76.89% ± 17.03% vs 67.97% ± 18.47%; mean difference 8.93 points, 95% CI 3.59-14.26; p = 0.0013). Biochemical pregnancy (40.9% vs 54.5%; p = 0.200) and clinical pregnancy (29.5% vs 27.3%; p = 0.813) did not differ significantly. These results suggest that a shorter DN-to-ICSI interval may improve fertilization and early embryo development, with no observed differences in blastulation or early pregnancy outcomes. Larger multicenter studies with cumulative live births are required to determine clinical relevance.Intracytoplasmic sperm injection (ICSI) has become an integral practice in assisted reproduction technology (ART), but the optimal time interval between oocyte denudation (DN) and ICSI is still not well defined. Libya remains underrepresented in global fertility estimates, and prospective paired data on DN-to-ICSI timing from Libyan IVF practice are limited. We aimed to investigate whether performing ICSI immediately after DN, compared with an intended four-hour delay, affects pregnancy outcomes and early embryology yield. This prospective cohort study was conducted at the Fertility and Reproductive Medicine Center, Beirut Hospital, Benghazi and included 88 Libyan ICSI cycles. After enzymatic-mechanical DN using hyaluronidase, mature metaphase II (MII) oocytes were injected with selected sperm. Within each cycle, sibling MII oocytes were allocated in a 1:1 ratio to immediate ICSI or delayed ICSI after an intended interval of about four hours, using a computer-generated within-cycle allocation sequence. For clinical comparison, cycles were allocated by pre-generated permuted-block randomization to transfer blastocysts under one timing condition (44 cycles/arm). The primary outcome was normal fertilization (two pronuclei); secondary outcomes included cleavage (Day 3), blastulation and blastocyst quality (Day 5/6; Gardner-Schoolcraft), biochemical pregnancy and clinical pregnancy. Immediate DN-ICSI was significantly associated with higher fertilization rates than delayed injection (80.07% ± 17.09% vs 70.80% ± 17.37%; mean difference: 9.26, 95% CI 4.40-14.12; p = 0.0003) and a higher cleavage rate (76.89% ± 17.03% vs 67.97% ± 18.47%; mean difference 8.93 points, 95% CI 3.59-14.26; p = 0.0013). Biochemical pregnancy (40.9% vs 54.5%; p = 0.200) and clinical pregnancy (29.5% vs 27.3%; p = 0.813) did not differ significantly. These results suggest that a shorter DN-to-ICSI interval may improve fertilization and early embryo development, with no observed differences in blastulation or early pregnancy outcomes. Larger multicenter studies with cumulative live births are required to determine clinical relevance.
The aim of this study was to examine whether participation in Balint groups is associated with higher levels of empathy among physicians. This study was carried out with a sample of 210 physicians working in primary health centers in Belgrade. Among them, 70 doctors had completed Balint training lasting at least one year, while the remaining 140 doctors had never participated in such training (the non-Balint group). Empathy levels among doctors were assessed using the Interpersonal Reactivity Index (IRI), an evaluation scale developed by Davis that consists of four subscales: perspective taking, fantasy, empathic concern, and personal distress. We found that physicians who completed Balint training had significantly higher scores on the perspective taking, fantasy, and empathic concern subscales compared to those who did not complete the training (p < 0.001). Regarding the personal distress subscale, there was no statistically significant difference between the two groups of physicians (p= 0.530). In the multivariate logistic regression models, participation in the Balint group emerged as the only significant predictor for the perspective taking and empathic concern subscales (p < 0.001), while for the fantasy subscale, both participation in the Balint group and being a medical specialist were identified as significant predictors. Participation in Balint groups is significantly associated with higher levels of empathy among physicians.
Work-related musculoskeletal disorders (WRMSDs) refer to injuries or conditions that affect the muscles, tendons, nerves, and other components of the musculoskeletal system, often resulting from repetitive movements, sustained static postures, or prolonged periods of sitting and standing. Dental professionals and students are particularly susceptible due to the physically demanding nature of clinical practice. These disorders can adversely affect professional performance, productivity, and overall quality of life. The present study aimed to determine the prevalence, associated risk factors, and potential consequences of WRMSDs among dental students and professionals at Umm Al-Qura University, Makkah, Saudi Arabia. A cross-sectional survey was conducted among dental students and professionals at Umm Al-Qura University. Data were collected using a self-administered, structured online questionnaire designed to assess the prevalence of WRMSDs, associated risk factors, and management strategies. Statistical analysis was performed using IBM SPSS Statistics software, with the level of significance set at p < 0.05. Among the respondents, 67.8% were under 25 years of age, and 59.8% were female. More than half (55.6%) reported experiencing WRMSD symptoms in at least one body region during the past year, with 36.8% indicating chronic pain. The most commonly affected areas were the neck (56.9%), and lower back (52.3%). The leading contributing factors were inappropriate posture (44.8%) and prolonged sitting (29.7%). The most affected quality-of-life domains included increased stress and anxiety (33.1%), sleep disturbances (30.0%), and reduced academic or occupational performance (25.0%). Despite the high prevalence, 77% of participants did not seek professional care. The most frequently reported pain management strategies were the use of analgesics (31.4%) and engagement in physical activity (29.3%). This study demonstrates a high burden of WRMSDs among dental students and professionals, with symptoms primarily affecting the neck and lower back. Incorporating ergonomic training and structured occupational health programs into dental education and clinical practice may reduce long-term functional impairment and improve overall well-being.
Effective diabetes care must address not just the clinical metrics but also this psychological interplay, empowering patients to drive the proactive engagement needed for long-term health. This study aims to explore the mediating effect of the patient activation role on diabetes self-care adherence and diabetes distress. A cross-sectional study was conducted with a convenience sample of 428 adults with type 2 diabetes recruited from diabetes clinics. Participants completed validated surveys through the Patient Activation Measure, Diabetes Distress Scale, and Summary of Diabetes Self-Care Activities. The data were analyzed using correlation and structural equation modeling to test the proposed mediation model. Significant negative correlations were found between patient activation and diabetes distress (r = 0.310, p< 0.001), and positive correlations were found between patient activation and self-care adherence (r = 0.588, p < 0.001). As hypothesized, patient activation significantly mediated the relationship between higher self-care adherence and lower diabetes distress, accounting for 45% of the total effect (indirect effect: β = -0.268). These findings demonstrate that patient activation is a key mechanism through which self-care adherence reduces diabetes distress. This suggests that interventions specifically designed to enhance patient activation can break the cycle of distress by empowering individuals to engage more effectively in self-care behaviors, ultimately improving both psychological and clinical outcomes in diabetes management. Integrating routine assessments of patient activation and distress into clinical practice is recommended.
Hyponatremia has been found to be associated with chronic obstructive pulmonary disease (COPD) and acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, there is a lack of systematic evidence on the prevalence and impact of hyponatremia in COPD and AECOPD patients. We performed a systematic search on three major databases for articles published on or before 31 July 2025. We included all the studies reporting the prevalence or number of hyponatremia cases in COPD patients (stable and exacerbation) aged 18 years and above. Pooled prevalence was calculated by a random effects model using RStudio. The Joanna Briggs Institute (JBI) tool was used for quality evaluation of the included studies. In this systematic review and meta-analysis, we included 11 studies out of 284 studies retrieved in the initial search. Of these 11 studies, three were COPD studies, and eight were AECOPD studies. The pooled prevalence of hyponatremia among COPD patients was 14% (95% CI: 4%-28%), with significant heterogeneity (I² = 98.3%, p < 0.0001). The pooled prevalence of hyponatremia in AECOPD patients was 19% (95% CI: 9%-32%), with significant heterogeneity (I² = 98.8%, p < 0.0001). Most of the studies showed that hyponatremia was not associated with mortality as an outcome of AECOPD. This study found a high prevalence of hyponatremia in both COPD and AECOPD patients; however, substantial heterogeneity (I² > 98%) necessitates cautious interpretation of pooled estimates. Future studies with standardized diagnostic criteria and larger sample sizes are needed to establish more precise prevalence rates.
Pyrazole derivatives are a class of heterocyclic compounds known to have broad pharmacological effects. This study aimed to synthesize and characterize a new series of pyrazole derivatives and investigate their effects on a series of in vitro assays. Five synthesized compounds were confirmed structurally using standard spectroscopic techniques, and their cytotoxic activity was evaluated against HeLa cells using MTT assay and morphological examination of viability. DNA damage and fragmentation were analyzed using a comet assay, agarose gel electrophoresis, and diphenylamine reaction. Antioxidant properties were evaluated with radical scavenging assays, and anti-inflammatory potential was assessed with in vitro inhibition assays (COX-1/2). Pyrazolethione 5 showed antiproliferative effects at all concentrations, with preserved cell confluence at ≤62.5 µg/mL. It also demonstrates DPPH scavenging activity similar to that of ascorbic acid in a dose-dependent manner, reaching a maximum activity of 85.9% with an IC₅₀ of 48.77. In addition, it demonstrated antioxidant activity, although significantly lower than that of gallic acid, with a maximum scavenging percentage of 83.9% at 1000 μg/mL and an IC50 of 54.97 μg/mL. In the comet assay, the treatment significantly increased DNA fragmentation to 26.2% ± 0.88% from 12.8% ± 0.77% in the control cells (p < 0.01), representing a two-fold induction of apoptosis. The test compound inhibited COX-1 in a dose-dependent manner (86.29% inhibition at 1000 µg/mL), producing an IC50 value of 29.14 ± 0.97 µg/mL, while it produced moderate inhibition of COX-2, 82.03% inhibition at 1000 µg/mL, and had an IC50 value of 51.49 ± 2.13 µg/mL. According to flow cytometry analysis, untreated HeLa cells were mainly in G1 (54.56%) and G0 (34.86%), with fewer cells in S (9.63%), and G2-M (0.94%). In pyrazolethione-treated HeLa cells, G0 accumulation (73.57%) and fewer proliferative phases (S 3.10% and G2-M 2.78%) indicated substantial alteration to the cell cycle. Pyrazolethione 5 demonstrates a favorable safety profile, with minimal cytotoxicity at lower concentrations, and impressive antioxidant and anti-inflammatory activities. The DPPH and gallic acid-like radical scavenging activities, moderate COX-1 and COX-2 inhibition, and DNA fragmentation suggest multiple bioactivities. Furthermore, the compound significantly altered cell cycle progression in HeLa cells, leading to G0/G1 arrest and reduced proliferation. Taken together, the data indicate pyrazolethione 5 is a potential lead compound for further development/investigation as an anticancer and anti-inflammatory agent with low toxicity.
Hemoptysis, often life-threatening in its massive form, is predominantly caused by bronchial artery pathology. Bronchial artery embolization (BAE) is the established first-line intervention, yet the relationship between bronchial artery morphology and embolization outcomes remains insufficiently defined. This prospective pilot study aimed to assess the association between bronchial artery anatomical features and short-term outcomes following BAE, and to evaluate concordance between computed tomography (CT) angiography and digital subtraction angiography (DSA) in detecting hypertrophy and tortuosity. Twenty-eight patients with hemoptysis requiring BAE were prospectively enrolled in a cohort study. Baseline multidetector CT angiography characterized bronchial artery origin, diameter, hypertrophy, tortuosity, and systemic collaterals. All patients underwent DSA-guided BAE. Treatment success was defined as cessation of hemoptysis within 48 hours, with recurrence assessed at 30 days. Inter-modality agreement was measured using Cohen’s kappa. Immediate success was achieved in 92.9% of cases, with recurrence observed in 14.3% at 30 days. No statistically significant associations were found between artery morphology and outcomes. Descriptive trends suggested higher recurrence in patients with systemic collaterals and smaller left bronchial artery diameters (<2 mm). Moderate agreement was observed between CT and DSA for hypertrophy detection (Kappa = 0.563 for right bronchial artery, 0.500 for left), while substantial agreement was found for tortuosity (Kappa = 0.710 and 0.774, respectively). CT angiography demonstrated moderate concordance with DSA for hypertrophy detection (Kappa = 0.563 for right bronchial artery, 0.500 for left), while substantial agreement was found for tortuosity (Kappa = 0.710 and 0.774, respectively). Bronchial artery morphology was not significantly predictive of short-term BAE outcomes, though systemic collaterals and small vessel diameters may contribute to recurrence risk. While moderate agreement limits CTA as a sole tool, it aids in identifying targets efficiently. Larger, multicenter studies are warranted to refine risk stratification and optimize hemoptysis management.
Research performance in the Middle East and North Africa (MENA) is often assessed using national aggregates that mask substantial institutional variation. Evidence on how output, quality, and excellence relate to economic resources and institutional capacity across the region remains limited. Data from the SCImago Research Centers Rankings were used to analyze 321 non-university, non-health research centers across 22 MENA countries. Indicators included research output, Quality, Excellence, collaboration, innovation, and Institutional Citation Impact per researcher (ICI/T). Analyses were conducted at both country and institutional levels using descriptive statistics, correlation analysis, and clustering. The analysis reveals extreme heterogeneity within and across countries. National income is strongly associated with research Excellence but shows a much weaker relationship with baseline Quality. ICI/T is strongly associated with Excellence and displays reduced variance at higher values, indicating increasing stability of elite performance. Clustering identifies multiple tiers of research systems that cut across income categories. A small group of countries exhibits disproportionately high Excellence relative to weak institutional impact, consistent with structural decoupling. International collaboration supports Quality but does not predict Excellence, while regional and industry collaboration remain limited. Economic resources accelerate elite research performance but do not guarantee high baseline quality. Long-term research performance in the MENA region depends primarily on institutional alignment, governance, and sustained capacity building rather than output expansion alone.
Assessment of risk factors of breast cancer in the general population provides insightful information towards prevention of breast cancer. This study aimed to assess the risk factors of breast cancer among women in a community from a resource-limited setting in sub-Saharan Africa. This descriptive community-based cross-sectional study was conducted in Dodoma, Tanzania, from July to December 2020. The study included women aged between 18 and 70 years. The data were analyzed using SPSS program version 25.0. Independent t-test was used to compare the mean age of the participants for the availability of risk factors of breast cancer. A two-tailed p < 0.05 was considered significant. A total of 354 women were analyzed, and the median age was 27.0 (23.0-35.3) years. Only 11.8% (n = 18) of all the participants did not have any of the risk factors examined. Not engaging in physical activity was the most frequent risk factor which accounted for 68.2% (n = 242) of all the participants. There were more 60.7% (n = 215) of the study participants with a low mean age (22.9 ± 3.5) who had more than 5 risk factors compared to 39.3% (n = 139) of the participants with a high mean age (25.3 ± 9.4) who had more than 5 risk factors, with no statistically significant difference (95% CI = 0.91-2.22, p = 0.31). There is a large proportion of women younger than 40 years in the population of Tanzanian women with many risk factors of breast cancer. This may contribute to the currently observed increase in the incidence of breast cancer in Tanzania for women aged less than 40 years. Therefore, there is an urgency for targeted awareness and screening for breast cancer among younger women in Tanzania so as to increase early detection and diagnosis.
