Background: Social media platforms like Instagram offer significant potential for dental education, outreach, and branding, though their specific utilization by dental schools in the Gulf Cooperation Council (GCC) remains underexplored despite high regional use. Objective: The aim of study was to analyze the utilization of Instagram by official dental school accounts across the GCC, specifically examining content types, media formats (images, carousels, reels), target audiences, and engagement metrics. Methods: This study investigated how 11 official GCC dental school Instagram accounts utilized the platform over 12 months, analyzing content types, media formats, target audiences, and engagement. A cross-sectional observational study collected publicly accessible data, including post details, engagement metrics, and thematic classifications. Posts were coded for target audience, language, and media format, with data analyzed using descriptive statistics, Chi-square tests, ANOVA, and Multiple Linear Regression. Results: Of 11 accounts, five showed consistent activity. Educational content was predominant (43.6%), with “news” being the most common sub-classification (52.9%). Most posts targeted a general audience (64.6%), and while language varied, posts targeting professionals and Reels generated the highest engagement and visibility. Regression confirmed post nature, language, and hashtag use as significant predictors of engagement. Conclusion: Instagram is a valuable tool for GCC dental schools, primarily for education and professional engagement. The high engagement with professional content and Reels suggests strategic opportunities, and future research should explore longitudinal outcomes and user perceptions for optimization.
BACKGROUND:Due to high demand and limited infrastructural capacity, the performance of the operating room at our facility was very complaisant which resulted in high waiting time for elective surgery and accumulation of cases waiting for surgery Aim: To improve the efficiency of operating room by expanding the surgical volume and thereby improve the access to elective surgical services. METHODS:We introduced an innovative OR scheduling whereby we added extra slots each for the evening and weekends. The staff working during those hours were arranged for their shifts accordingly with flexibility in their off-hour during weekdays and weekends. RESULTS:During full year 2024, a total of 1488 surgeries were conducted during extended OR schedule at our hospital, which comprised of about 53% cases (702/1488) conducted during evening and 64% (786/1488) during weekends. The cases conducted during extended hours contributed to 25% of overall elective routine cases performed. The highest proportion was contributed by ophthalmology (39%) followed by general surgery (28%) and orthopedic surgery (16%). While all the cases under ophthalmology were performed during weekends, majority of orthopedic cases were conducted during evening time. We noted 27% improvement in the waiting time for elective surgical admissions. CONCLUSIONS:Redesigning the traditional working hours proved to utilize the available infrastructure and manpower in a better way, whereby we observed a huge expansion in the surgical volume.
Background:Treatment of Hori's nevus can help reduce psychological burden, restore normal skin, improve aesthetics, and quality of life for patients. However, studies related to the morphological characteristics and effectiveness of Hori's nevus treatment are still limited in Vietnam. Objective:The objective of this study is to investigate some factors related to the degree of pigmentation of Hori's nevus and evaluate the results of Hori's nevus treatment with Pico Nd:YAG laser and Q-switched Nd:YAG laser. Methods:A descriptive study of a series of cases was conducted on patients diagnosed with Hori's nevus who visited Can Tho Dermatology Hospital and FOB International Dermatology and Aesthetic Research Institute, Can Tho City, Vietnam, from March 2021 to June 2023. Results:The study results showed that 53.7% of patients with Hori's nevus had grade III hyperpigmentation; The predominant color was blue-brown (46.3%); 100% of patients had lesions on both cheeks. Older age (p=0.008), frequent sun exposure (p=0.001), non-using sunscreen (p=0.031), and not wearing masks (p<0.001) were statistically significantly associated with greater pigmentation of Hori's nevus. In the Pico Nd:YAG laser treatment group, the lesion color score decreased from 26.62±1.9 before treatment to 21.9±2.6 after 7-10 treatments (p<0.001). In the Q-switched Nd:YAG laser treatment group, the lesion color score decreased from 27.29±1.3 before treatment to 22.13±2.3 after 7-10 treatments (p<0.001). Conclusion:The study showed that Hori's nevus is common in people over 30 years old and often exposed to sunlight. Two laser methods have been effectively applied in treatment. Measures such as protecting the skin from the sun and using sunscreen and masks can prevent or reduce the progression of Hori's nevus. These two methods can be applied in Vietnam depending on the conditions of the medical facility.
Background:Gut disorders present a considerable worldwide health challenge, and increasing attention is being paid to natural substances as prospective treatment agents. Objective:This research utilizes network pharmacology, molecular docking, and molecular dynamics simulations to examine the mechanisms of active compounds from Areca catechu in the treatment of gastrointestinal disorders. Methods:Employing a comprehensive methodology, we evaluated active compounds from A. catechu, conducted drug-likeness and ADMET assessments, and identified principal protein targets linked to gastrointestinal diseases. Results:Utilizing a protein-protein interaction network, gene ontology enrichment, and KEGG pathway analysis, we identified that chemicals from A. catechu are significantly associated with metabolic activities, including cholesterol metabolism, fat digestion and absorption, and the PPAR signaling pathway. Molecular docking and molecular dynamics simulations were employed to evaluate the binding affinities and stability of selected compounds with three pivotal proteins: Interleukin-6 (IL-6), Peroxisome proliferator-activated receptor gamma (PPAR-γ), and Microsomal triglyceride transfer protein large subunit (MTP). Among the compounds analyzed, catechin emerged as the most promising candidate, exhibiting the highest binding affinity and exceptional stability in inhibiting all three target proteins. Conclusion:Our findings suggest that catechin from Areca catechu holds significant potential as a therapeutic agent for gastrointestinal disorders, acting through the modulation of critical metabolic and inflammatory pathways. This study underscores the importance of natural compounds in developing novel treatments for complex gastrointestinal conditions.
Background:Elevated levels of circulating 25-hydroxyvitamin D (25 (OH) D) are correlated with reduced levels of circulating thyroid-stimulating hormone (TSH). Objective:The aim of this study was to evaluate the relationship between vitamin D and circulating TSH levels based on sex and age, with a focus on thyroid autoimmunity and thyroid hormone levels. Methods:Fifty samples were obtained from patients with hypothyroidism (Hashimoto's thyroiditis, HT) aged 18-59 years (49.4% men, 50.6% women). The samples were tested for serum vitamin D and TSH levels using the enzyme-linked immunosorbent assay. Results:The mean TSH level in the HT group (5.97 ± 0.18) was significantly higher than that in the control group (1.61 ± 0.1) (P < 0.001). Conversely, the mean vitamin D level was significantly lower in the HT group (40.5 ± 0.72) than in the control group (57.3 ± 0.72) (P < 0.001). Differences based on sex were not statistically significant (P = 0.096). Similarly, no differences were observed in age group distributions. Overall, moderate and strong positive correlations were observed in the control (r = 0.4767, P = 0.0009) and HT (r = 0.7493, P < 0.0001) groups, respectively. Conclusion:This study showed a negative correlation between serum vitamin D and TSH levels in both healthy controls and patients with HT, regardless of age and sex.
Background:Cataract surgery aims to restore clear vision by replacing the clouded crystalline lens with an intraocular lens (IOL). Accurate IOL power calculation is crucial to achieve desirable postoperative refractive outcomes. Objective:The aim of this study was to compare the predictive accuracy of multiple intraocular lens (IOL) power calculation formulas in eyes with prior LASIK surgery using two biometric devices, LenStar 900 and IOLMaster 500, combined with immersion ultrasound (US). Methods:This retrospective observational study included 37 eyes of 29 patients who underwent previous LASIK and subsequent cataract surgery. Biometric measurements included axial length, keratometry, anterior chamber depth, and lens thickness, which were obtained using LenStar 900 (19 eyes) or IOLMaster 500 combined with US (18 eyes). IOL power was calculated using the Shammas PL, Haigis-L, Barrett TK no history, Shammas Cooke, and EVO 2.0 (without PK1/PK2). The mean absolute error (MAE) at 3 months postoperatively was assessed for each formula within each device group. Results:For LenStar 900, the MAE ranged from 0.389 ± 0.329 D (Barrett TK no history) to 0.574 ± 0.689 D (Shammas Cooke), with no significant differences among the formulas. For IOLMaster 500 + US, the MAE ranged from 0.423 ± 0.210 D (Barrett TK no history) to 0.601 ± 0.510 D (Shammas Cooke). Comparisons between devices revealed significantly lower MAE with LenStar 900 for Shammas PL, Shammas Cooke, and EVO 2.0, whereas differences for Haigis-L and Barrett TK showed no significant differences. Conclusion:IOL power prediction in post-LASIK eyes varied according to the biometry device. Barrett TK had no history, and EVO performed well with LenStar 900, while Haigis-L showed consistent accuracy across devices, suggesting that it may be the most reliable formula when using non-synchronous biometry systems.
Background:Diabetes mellitus (DM) is a significant health concern, affecting a large portion of the global population, including Jordan. DM is characterized by hyperglycemia and leads to a wide range of complications and comorbidities. Hyperglycemia influences blood components and parameters, which is a major area of medical research. However, there is no consensus on how hyperglycemia impacts hematological parameters among different types of DM in Jordan. Objective:In this study, we examined the effects of T1DM, T2DM, and prediabetes on selected hematological, inflammatory, and metabolic markers. Methods:This study population consisted of one hundred and twenty samples and divided into 4 distinct groups as follows: 40 samples for prediabetic individuals, 40 samples for T2DM patients, 10 samples for T1DM, and 30 samples for normoglycemic individuals as controls. Hematological, inflammatory, and metabolic markers were measured using flow cytometric analysis and ELISA. Results: Our results showed that individuals with T2DM and prediabetes have higher levels of leukocytes, erythrocytes, and platelets compared to healthy controls. Consistently, complete blood count (CBC)-derived parameters in T2DM were also elevated, but this was not significant in prediabetic and T1DM groups. Hyperglycemia in T1DM increased platelet counts but did not affect leukocyte and erythrocyte counts. Additionally, diabetic patients exhibited inflammatory phenotypes, indicated by an elevated neutrophil-to-lymphocyte ratio in T2DM patients and circulating IL-6 levels in both T2DM and T1DM. The positive effects of hyperglycemia on insulin resistance and secretion were consistent across all three forms. Conclusion:Our findings provide insights into using hematological parameters as valuable tools for understanding the pathophysiology of hyperglycemia.
Background:Social media platforms like Instagram offer significant potential for dental education, outreach, and branding, though their specific utilization by dental schools in the Gulf Cooperation Council (GCC) remains underexplored despite high regional use. Objective:The aim of study was to analyze the utilization of Instagram by official dental school accounts across the GCC, specifically examining content types, media formats (images, carousels, reels), target audiences, and engagement metrics. Methods:This study investigated how 11 official GCC dental school Instagram accounts utilized the platform over 12 months, analyzing content types, media formats, target audiences, and engagement. A cross-sectional observational study collected publicly accessible data, including post details, engagement metrics, and thematic classifications. Posts were coded for target audience, language, and media format, with data analyzed using descriptive statistics, Chi-square tests, ANOVA, and Multiple Linear Regression. Results:Of 11 accounts, five showed consistent activity. Educational content was predominant (43.6%), with "news" being the most common sub-classification (52.9%). Most posts targeted a general audience (64.6%), and while language varied, posts targeting professionals and Reels generated the highest engagement and visibility. Regression confirmed post nature, language, and hashtag use as significant predictors of engagement. Conclusion:Instagram is a valuable tool for GCC dental schools, primarily for education and professional engagement. The high engagement with professional content and Reels suggests strategic opportunities, and future research should explore longitudinal outcomes and user perceptions for optimization.
Background:Chest tube insertion (CTI) is a vital procedure in the management of chest trauma and pleural diseases. Challenges associated with CTI often stem from an inadequate understanding of relevant anatomy and unsafe procedural practices. Despite is importance, there is a noticeable lack of data on the current state of CTI competence and knowledge among medical students and interns in Saudi Arabia. Objective:This study aims to investigate the knowledge and competency of CTI among medical students and interns in Saudi Arabia. Methods:In 2024, a cross-sectional study was conducted among medical students and interns across various locations in Saudi Arabia. Data were collected through a comprehensive questionnaire that evaluated participants' knowledge, practical experience, training and education, as well as their attitudes and beliefs regarding CTI. Results:A total of 413 medical students and interns in Saudi Arabia participated in the study, with 58.1% currently in their clinical years (Years 4-5). The findings revealed that only 35.6% demonstrated adequate knowledge about CTI. Regarding training and education, 53.5% of participants believed that the instruction they received on CTI was sufficient. Additionally, the majority (61.0%) expressed a positive attitude towards CTI, recognising its importance. However, a striking 88.4% reported having no experience performing a CTI independently, with the most commonly reported challenge being "insufficient practice opportunities" (73.6%). Conclusion:The results emphasize the necessity for targeted education to address knowledge deficits and enhance procedural competency, thereby improving clinical safety.
Background:In everyday oncology practice, routine blood tests and a small panel of tumour markers are almost always requested when a patient is being worked up for possible malignancy. With the rise of machine-learning methods, it is tempting to treat these familiar measurements as raw material for automated cancer prediction. In reality, it is not clear how far such data can help once a patient has already entered a specialist pathway, and careless modelling may easily introduce target leakage. Objective:We set out to explore, in a straightforward way, how cancer diagnosis (cancer vs no cancer) relates to a set of basic demographic, haematological, biochemical, and clinical variables in a cancer-enriched cohort, and to reflect on what this means for neural-network based prediction. Methods:We undertook a secondary, analytical cross-sectional study using 1,000 cases from the Cancer Risk Stratification Using Lab Parameters dataset. Age, sex, smoking status, family history, complete blood count indices, blood glucose, CA-125, PSA, CEA, risk level, stage, treatment outcome and survival were extracted. Cancer status was coded as cancer vs no cancer. Neural network analysis was conducted. Results:Just over four out of five patients in the cohort had a malignant diagnosis. Apart from haemoglobin, most routine laboratory and biochemical values did not differ significantly between cancer and non-cancer cases, and the raw means generally lay within conventional reference ranges in both groups. Haemoglobin was modestly but significantly lower in patients with cancer. Cancer status was, by definition, strongly linked to stage and showed a weaker relationship with survival. Conclusion:In this referred, cancer-enriched population, familiar clinical risk factors and single routine laboratory parameters offered little additional discrimination beyond the simple presence or absence of a cancer stage. Haemoglobin behaved as a non-specific indicator of overall illness rather than a diagnostic test.
Background:Chronic Kidney Disease (CKD) has become a significant global health issue, especially among the aging population. Renal transplantation is considered the most effective treatment for end-stage renal disease (ESRD), yet disparities exist in its accessibility and outcomes across different regions. Objectives:This study aimed to compare the perspectives and outcomes of renal transplantation in adult and geriatric patients with CKD in Europe and Indonesia, highlighting differences in healthcare systems, patient management, and socio-cultural considerations. Methods:A literature review was conducted using PubMed, ScienceDirect, and Google Scholar, focusing on publications from the last 10 years. Studies involving adult and elderly CKD patients undergoing renal transplantation in both Europe and Indonesia were analyzed for themes related to access, outcomes, quality of life, and post-transplant management. Results:European countries generally demonstrated more structured transplantation programs, better post-operative care, and higher graft survival rates due to strong infrastructure and funding. In contrast, Indonesian patients faced challenges such as limited donor availability, economic constraints, and lower awareness about transplantation. Geriatric patients in both regions exhibited more complications post-transplantation compared to younger adults, but still benefited in terms of survival and quality of life. Discussion:Disparities between Europe and Indonesia in renal transplantation stem from differences in healthcare access, government support, and patient education. Cultural and ethical issues also influence organ donation rates. Despite challenges, renal transplantation remains a viable option for geriatric patients, especially with proper selection and monitoring. Conclusion:While renal transplantation offers improved outcomes for CKD patients globally, substantial disparities remain between regions. Efforts to enhance transplantation programs in developing countries like Indonesia are crucial, especially in addressing the needs of the aging population.
BACKGROUND:Operating on difficult cholecystectomy with the intent to proceed with total cholecystectomy can be associated with longer postoperative time, excessive bleeding, and increased risk of intraoperative bile duct injury and other complications. Subtotal cholecystectomy is a part of bail-out procedures recommended in cases of difficult cholecystectomy. It is a convenient alternative to total cholecystectomy as it is a comparatively more manageable and safer treatment procedure. OBJECTIVE:The aim of this study was to assess the difference in outcomes between laparoscopic total cholecystectomy (LTC) and laparoscopic subtotal cholecystectomy (LSC). METHODS:This retrospective, cross-sectional study was conducted at King Fahd Hospital of the University (KFHU), Saudi Arabia, between 2010 to 2020. The study included patients over 18 years of age who underwent laparoscopic (subtotal and total) cholecystectomy at KFHU. RESULTS:Out of 636 cases in the study period, only 21 patients underwent laparoscopic subtotal reconstituting cholecystectomy. The laparoscopic total cholecystectomy group was more diagnosed with biliary colic (56.1%), whereas those who underwent laparoscopic subtotal cholecystectomy were mainly diagnosed with acute cholecystitis (66.7%). We found a significant association between WBC, reticulocyte count level, and the conversion to LSC. Regarding postoperative outcomes, only 7.8% had a drain in the laparoscopic total cholecystectomy group compared to the majority (71.4%) in the laparoscopic subtotal cholecystectomy group (p<0.0001). A significantly longer length of stay was reported in the subtotal cholecystectomy group (9.14±7.63 versus 4.6±3.84) and a greater rate of reoperation (9.5% versus 0.7%). CONCLUSION:Laparoscopic subtotal cholecystectomy should be performed in difficult cases when total cholecystectomy is not possible, considering the possible complications of subtotal cholecystectomy. More prospective studies should take into consideration other patient-related factors that might influence postoperative outcomes and overall success rates.
Background:Interactive virtual reality (iVR) has found extensive application as a treatment modality for individuals suffering from persistent musculoskeletal conditions. With the rising application of Interactive Virtual Reality (iVR) in treating chronic musculoskeletal disorders, it is essential to understand its efficacy concerning psychological relief and functional improvement. Objective:This study delves into the comparative benefits of iVR against conventional therapeutic methods and non-rehabilitation. Methods:A thorough search was performed in four electronic databases (PubMed, Cochrane CENTRAL, SCOPUS, and Web of Science) from January 2018 to December 2021. The study focused on randomized controlled trials that employed interactive virtual reality (iVR) in regards to psychological well-being effect in patients with chronic musculoskeletal disorders. Additionally, a subgroup analysis was conducted to compare the effects of nonimmersive and immersive iVR on the measured outcomes. Results and Discussion:Our study proves that non-immersive iVR showed a reduction in psychological distress compared to no rehabilitation, but no significant difference was observed between nonimmersive and immersive iVR. Although previous studies suggested that interactive virtual reality (iVR) could be a therapeutic option, this study particularly shown that non-immersive iVR can enhance psychological well-being. Conclusions:Nonimmersive iVR is suggested for improving psychological well-being, comparable to conventional rehabilitation.
Background:Diabetes mellitus (DM) is highly prevalent and often remains undiagnosed until complications appear, especially in low- and middle-income countries. Simple tools that use routinely collected clinical and demographic variables may support earlier identification of individuals at increased risk. Objective:This study aimed to build a supervised achine-learning model to classify individuals as diabetic or non-diabetic using a large publicly available dataset, and to identify which variables contributed most to the model decisions. Methods:We analysed a cleaned subset of 89,540 records from a Kaggle diabetes dataset. A multilayer perceptron artificial neural network (ANN) was trained and tested on separate subsets. Model performance was evaluated by overall accuracy and misclassification rates, and post-hoc variable importance scores were used to summarise the contribution of each predictor. Results:The ANN achieved an overall prediction accuracy of 96.8% in both the training and testing samples. Most records were correctly classified, although the error pattern suggested that non-diabetic cases were recognised more easily than diabetic cases. Blood glucose, HbA1c and body mass index (BMI) showed the highest importance values, whereas demographic and lifestyle variables contributed less to the classification. Conclusion:In this dataset, an ANN based on simple clinical and demographic variables was able to distinguish between diabetic and non-diabetic records with high internal accuracy and a plausible pattern of variable importance. The model could form the basis for a practical screening aid, but it requires external validation and further work on handling class imbalance and explainability before use in routine care.
Background:Artificial intelligence has become an important aspect in medicine, especially in radiology. Objective:The aim of this article was to investigate the legal liability for AI-assisted radiographic diagnosis errors in view of French, Jordanian, and UAE Law. Methods:The authors analyze medical liability in the U.A.E, France and Jordan, focusing on how errors in diagnosis are handled, and if artificial intelligence plays a role in the diagnosis. The researchers tested many jurisdictions for demonstrating wrong doing so nothing happens to the person. Results:In the United Arab Emirates, fault is closely tied to the idea of "critical doctor mistakes," where a tool is accidentally used which leads to great harm. In France the penalties of a law are made up of the bias comment and how well professionally they knew how to do their job. In Jordan, the outdate laws reflects a change in the way the government is running things. They got another used law to government things correctly. The criminal liability framework including Penal Code and Medical Liabilidad Law protect the patient more than protecting the doctors. While these systems are supposed to balance how well you will take care of the patient and you, the caregiver, something goes wrong and the machines aren't perfect and we cannot keep trusting in them. Conclusion:Because of the fact that this is an important emergent technology, a bunch of recommendations must be met for several reasons. Some of these guidelines are to review important regulatory actions to give a setting for this kind of technology.
Background:Posterior pericardiotomy has been proposed to prevent postoperative pericardial effusion and tamponade in coronary artery bypass grafting, but its effect on pleural fluid accumulation during off-pump CABG (OPCAB) is not well defined. Objective:To compare intraoperative metrics and early postoperative outcomes-particularly rates of pleural and pericardial effusions-between OPCAB with and without posterior pericardiotomy. Methods:In this retrospective cohort, 68 patients underwent OPCAB from January to March 2025 and were stratified into pericardiotomy (n = 38) and control (n = 30) groups. Baseline demographics, comorbidities, left ventricular ejection fraction, operative time, and graft count were recorded. Postoperative outcomes included incidence of pericardial and pleural effusions (confirmed by echocardiography or chest radiography), new-onset atrial fibrillation (within seven days), chest-tube drainage volume, and in-hospital mortality. Results:Groups were similar in age (mean 66.5 ± 7.1 years), sex, and major comorbidities, though peripheral artery disease and multi-vessel coronary disease were more prevalent in the pericardiotomy group (p = 0.002 and p = 0.017). Operative time and ICU stay did not differ significantly. Mediastinal drainage was higher after pericardiotomy (861 ± 551 vs. 764 ± 347 mL; p = 0.03). Pericardial effusion rates were low and comparable (10.5% vs. 13.3%; p = 0.72), and no tamponade occurred. Pleural effusions were significantly more frequent with pericardiotomy (42.1% vs. 6.6%; p = 0.001). Atrial fibrillation incidence and in-hospital mortality were similar between groups. Conclusions:Posterior pericardiotomy in OPCAB effectively prevents clinically significant pericardial effusion and tamponade, though it redirects fluid into the pleural space, increasing pleural effusion rates. These effusions are manageable with routine drainage and do not prolong recovery. Prospective studies should further define patient selection and long-term implications.
Background:Aortic stenosis is a prevalent disease affecting approximately 10% of the population by the eighth decade, it is a fatal disease without treatment, with an annual mortality rate reaching 25%. Valve replacement, either through surgical or transcatheter approach, is the only therapeutic option. Over the last 15 years, the indications for transcatheter aortic valve replacement (TAVR) have spread to include young and low surgical risk patients. Objective:Our study aims to address this gap in the literature by comparing the adverse outcome after TAVR through axillary versus femoral access in heart failure reduce ejection fraction (HFrEF) patients who underwent TAVR within 30 days of the procedure. Methods:We used data from TriNetX US collaborative network database, including HFrEF patients who had TAVR through axillary or femoral access between 2015 and 2025. Propensity score matching was done to minimize the difference in baseline characteristics between the two cohorts. Outcomes were observed within the first 30 days of TAVR. Results:A total of 206 patients in each cohort (axillary vs. femoral) were studied after propensity score matching. The incidence of permanent pacemaker (PPM) insertion was comparable between groups (5.0% vs. 5.1%; OR: 0.984, 95% CI: 0.400-2.419; HR: 0.365, 95% CI: 0.097-1.376; p = 0.157). Secondary outcomes showed no significant differences between the axillary and femoral approaches, including major vascular complications (OR: 0.542, 95% CI: 0.238-1.231; HR: 0.448, 95% CI: 0.192-1.046), acute kidney injury (OR: 0.922, 95% CI: 0.430-1.976; HR: 0.940, 95% CI: 0.459-1.922), all-cause mortality (OR: 1.010, 95% CI: 0.411-2.482; HR: 1.040, 95% CI: 0.433-2.498), cerebrovascular accident (OR: 0.980, 95% CI: 0.390-2.460; HR: 1.142, 95% CI: 0.384-3.399), and acute coronary syndrome (OR: 0.885, 95% CI: 0.355-2.208; HR: 1.211, 95% CI: 0.271-5.412). Conclusion:Our study finding showed no difference in the permanent pacemaker insertion or secondary outcomes (Major vascular complications, Acute Kidney Injury, Cerebrovascular accident, Acute coronary syndrome, and All-cause mortality) within the first 30 days of TAVR in patients with HFrEF, whether the access axillary or femoral.
Background:As technological advancements grow, so does its impact. Humans are seeing more and more computerization, a lot of it is being used for surgery. Their merger results in various legal problems relating to regulation, patient safety, and governance. Objectives:The main objectives of this article are to study and join together legal rules and systems as it pertains to the use of artificial intelligence in medical situations for all main countries. Methods:A narrative legal review was conducted to see what's been going on since 2010. Their sources were official documents like drug administration and legislation along articles written by numerous professors. Researchers in government are finding new ways to monitor themselves. Results:Most AI health diagnosis had a regulated path if having to be approved, though one diagnostic system challenged that. The high-risk method of using robotic surgery leaves room for error between the overseeing surgeon and the manufacturer of the robot to be liable. Cross-cutting subject consist of the GDPR, HIPAA, the post-market and the surveillance, cybersecurity, and ethical considerations, which consist of the legal and privacy issue we have to take and apply into our lives every day. The progress in regulations has been noticed, but remains unclear for its implementation across different parts of the world. Conclusion:A cohesive framework is required to balance innovative advancements with safety precautions for patients. Future governance must combine technology standards, medical testing, and safety rules to improve how artificial intelligence and robots are used in medical centers.
Background:Cancer pain is common and often undertreated. Although opioids are effective when prescribed appropriately, clinical practice remains cautious and variable. Objective:The aim of this study was to assess physicians' knowledge and identify barriers to opioid prescribing for cancer pain in a tertiary hospital in Saudi Arabia's Eastern Province. Methods:A cross-sectional survey was conducted during March-April 2025 among physicians managing cancer pain. An anonymous REDCap questionnaire, adapted from Ayoub et al. (2022), collected data on demographics, practice patterns, guideline use, access to the national monitoring system (Raqeeb), opioid-prescribing knowledge, and perceived barriers at staff, system, and patient levels. Descriptive statistics summarized the data. Results:Of 132 respondents (median age 38 years; 5 years' experience), 47.0% always and 31.1% often managed cancer pain, yet only 31.1% routinely initiated opioids. Morphine (86.4%) and tramadol (74.2%) were most used. Awareness of the local guideline was 23.5%, and 62.9% had Raqeeb access. Only 32.5% received training within five years. Foundational knowledge was adequate (opioids for moderate-severe pain 95.7%; co-prescribing laxatives 81.0%), while advanced topics were limited (no ceiling dose for morphine 25.9%; titration 45.7%; rotation 46.6%). Major barriers included limited protocol familiarity (57.6%), insufficient training (56.1%), e-prescribing workload (40.2%), perceived over-regulation (39.4%), and patient fears of addiction (51.5%) or side effects (44.7%). Conclusion:Physicians frequently encounter cancer pain but demonstrate gaps in guideline awareness, training, and system access. Unified guidelines, structured training, and improved Raqeeb functionality are priorities for safer opioid use.
