Worldwide, one of the biggest concerns for water quality is the contamination of water resources by water-borne pathogens and the diseases that result from it. An increasing number of recent publications attest to the need for studies that synthesize knowledge from multiple fields, covering comparative aspects of pathogen contamination and unify them in one place in order to present and address the problem as a whole. These publications also demonstrate the growing interest in controlling water-borne pathogens in water resources. Contamination arises from pathogens (bacteria, viruses, parasites), organic and inorganic pollutants and environmental factors. Additional transdisciplinary studies are clearly needed in order to fully understand the situation. These studies should integrate knowledge from multi-research endeavors addressing pathogen contamination and provide a thorough overview. As a result, the objective of this review is to provide a comprehensive evaluation of the research spectrum regarding pathogen contamination of water resources and the difficulties that accompany it. The contaminants in water disrupt the mechanism spontaneity and cause short and long-term waterborne diseases. In this review, we will focus on the probable microbial and parasitic contaminations which affect water quality and health also, to preventing waterborne diseases.

In recent times, a new viral origin, known as SARS COV-2, has been identified as responsible for the pandemic. SARS COV-2 is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated mainly with breathing or respiratory problems. This review shows details about the virus and its components and transmission. The world is fighting and trying to develop a cure or vaccine against the virus. SARS-CoV-2 commonly presents itself with fever and pneumonia resulting in dyspnea, respiratory insufficiency and damage to the lung, resulting in morbidities and mortality. Besides the breathing system that is attacked by the virus, other organs and organic systems can suffer the inconvenience of the infection, such as, for example, the brain, gastrointestinal tract, renal system, hepatic system, hematological, cardiovascular and immune system. Coronaviruses (CoV) are enveloped positive-strand RNA viruses found in a host of animals and humans, which belong to the family Coronaviridae and subfamily Coronavirinae, the order of the nucleoside sequences. Though rare, CoVs can mutate and cross animal-wildlife barriers, returning to perpetuate the public health crisis. It is a large virus with a genome size of about 30 kb. The genome has 14 open reading frames, with the four major structural proteins: the spike (S), envelope (E), membrane (M) and nucleocapsid (N) proteins at the 3 end of the genome. It is the S protein, through the receptor binding domain, that is essential for binding to the ACE2 receptor and its priming by transmembrane serine protease 2 allows the virus to enter the host cell through membrane fusion with the host cell membrane.

Postpartum depression (PPD) affects 10-20% of new mothers worldwide, impairing maternal and infant well-being. This case-control study investigates breastfeeding’s protective role and modifiable risk factors for PPD among 517 mothers within 12 months postpartum in Ha'il, Saudi Arabia. Using structured interviews and the PHQ-9 scale, we compared 259 breastfeeding mothers (controls) with 258 non-breastfeeding mothers (cases). Breastfeeding was associated with a significant reduction in PPD risk (mean PHQ-9 score: 4.37 vs. 6.44, p<0.000), particularly after vaginal delivery (p = 0.001). Cesarean delivery (p = 0.001), weak home support (p<0.000) and a personal/family history of depression (p<0.000) increased PPD risk. Logistic regression confirmed breastfeeding’s protective odds (OR = 0.62, 95% CI: 0.45-0.87). These findings underscore the need to promote breastfeeding and enhance social support in maternal care, especially for cesarean mothers. However, the cross-sectional design limits causal inference and hospital-based sampling may reduce generalizability. Future longitudinal research is needed to confirm these associations and inform targeted interventions in Saudi Arabia.

Patients with thalassemia face a heightened risk of mineral deficiency due to elevated oxidative stress and the effects of iron chelation therapies. The Objective of the Study:- investigate the impact of iron overload on the variations in micronutrient levels in patients diagnosed with significant β-thalassemia. This case-control study is from August 2024 to December 2024. The study involved 100 participants, 50 of whom had significant β-thalassemia (25 males and 25 females) and 50 healthy controls (25 males and 25 females), aged 19 to 25. The ferritin, iron, and micronutrients were employed to conduct assays using the COBAS diagnostic test system. The results were calculated as the mean and standard error, presented in the format mean±standard error. A one-way analysis of variance (ANOVA) was employed to assess the data, with statistical significance determined at p<0.05 to find noteworthy differences. The results illustrated increased in zinc, magnesium, and manganese inpatient group when compared with control group. Unlike that copper, and calcium decrease significantly in patient group when compared with control group [1].

Background: Effective root canal irrigation plays a crucial role in endodontic success by facilitating debris removal and enhancing disinfection. Conventional Needle Irrigation (CNI) remains widely used despite its limitations in effectively cleaning the apical third. The TruNatomy (TRN) flexible irrigation needle has been introduced as an alternative, designed to improve fluid dynamics and optimize debris removal. This In vitro study aims to compare the efficacy of TRN and CNI in debris removal from simulated root canals. Methods: Thirty-six artificial root canals in resin blocks were randomly divided into two groups (n = 18 each): the conventional needle irrigation group using a 30-G side-vented needle and the TruNatomy group using a flexible irrigation needle. Irrigation was performed with 5 ml 2.5% sodium hypochlorite (NaOCl) for 90 seconds, followed by a final rinse with 17% EDTA for one minute and saline irrigation. Digital imaging was used to quantify debris removal by superimposing a 160-square grid onto post-instrumentation images. Two independent evaluators assessed the debris and Cohen’s kappa statistic (0.82) confirmed interrater reliability. Statistical analysis was conducted using the Mann-Whitney U-test, with significance set at p<0.05. Results: The TruNatomy needle demonstrated significantly better debris removal at 1 mm from the working length compared to conventional needle irrigation. The mean debris percentage in the TRN group was 2.26% (±0.35), whereas the conventional needle group exhibited 5.3% (±0.91) (p<0.001). Additionally, the mean number of debris pixels in the TRN group was significantly lower (10.8±1.7) than in the conventional needle group (25.8±4.3, p<0.001). Conclusions: TruNatomy flexible irrigation needle significantly improved debris removal in simulated root canals, particularly in the apical third, when compared to conventional needle irrigation. However, since this study was conducted using resin blocks, which lack the anatomical complexity of natural root canals, the findings should be interpreted with caution. Further in vivo studies are necessary to validate these results in clinical scenarios and assess the long-term impact of TruNatomy irrigation on endodontic treatment outcomes.

Academic examination periods are a significant source of stress, particularly for medical students, yet few studies explore how these periods affect mental health and sleep in specific cultural contexts like Saudi Arabia. This study aimed to assess whether exam periods exacerbate depression, anxiety, stress, sleepiness, insomnia and fatigue among male undergraduate medical students at a university in Western Saudi Arabia, compared to post-exam periods. Using a convenience sample (n = 109), we administered electronic surveys during and after exams in April-May 2024, employing validated scales: Depression Anxiety Stress Scale-21 (DASS-21), Epworth Sleepiness Scale, Fatigue Severity Scale and Insomnia Severity Index. Results revealed significantly higher depression (M = 7.67 vs. M = 4.89; p<0.001) and anxiety (M = 7.10 vs. M = 4.30; p<0.001) during exams, with moderate effect sizes (Cohen’s d = 0.346 and 0.422), alongside elevated stress, sleepiness, fatigue and insomnia and reduced sleep time (6.76 vs. 7.28 hours). These findings underscore how academic stress impairs mental well-being and sleep, potentially affecting academic performance. Post-exam recovery was partial, with lingering performance concerns prolonging psychological strain. Given the all-male sample and potential cultural influences, generalizability is limited. Universities should implement targeted interventions-such as stress management workshops, sleep education and flexible exam scheduling-to mitigate these effects. Future longitudinal studies are needed to explore long-term impacts and evaluate intervention efficacy, enhancing support for student mental health in high-stress academic settings.

Objectives: Proteus mirabilis is a gram-negative facultative anaerobe with swarming motility and an ability to self-elongate and secrete a polysaccharide which allows it to attach to and move along surfaces like catheters, intravenous lines and other medical equipment. causes many diseases, whether systemic or local, as it is considered an opportunistic pathogen. It possesses many virulence factors. Phenotypic detection of virulence factors is associated with Proteus mirabilis possessing genes encoding for those factors, which increase pathogenicity Methods: The current study aimed to isolate P. mirabilis and detection some virulence factors, urease, protease and biofilm formation to Compare them phenotypically and genetically. Results: Samples of urine were collected from (150) patients complaining about urinary tract infections at Al-Karamah Teaching Hospital in Baghdad Governorate from 15 August 2022 to 15 December 2022. (90) samples from females and (60) samples from females. By used VITEK 2 to confirm the true diagnosis of isolates after culture, microscopic and biochemical methods, multiplex1PCR technique used to detect the presence of genes. Thirty isolates (27.27%) of P. mirabilis were obtained, The infection rate in females 23(67.2%) in comparison with males 7(23.3%). Conclusions: Phenotypic detection results showed the ability of all isolates (100%) to produce urease, protease, investigation of biofilm formation displays all isolates to form, 14 (46.66%) were strongly membrane-producing, while 16(53.35%) were moderately, While genetic results to detection genes which encoded for this factor consist of ( Ure C, Zap A, Pmf A) genes showed the presence of these genes by (100%, 100%, 26.7%), respectively.

Background: Autism Spectrum Disorder (ASD) is a lifelong non-progressive, complex neurobehavioral condition that appears at early childhood, characterized by impairments in social interaction, difficulties in communicating and forming relationships with other people and in using language, combined with rigid and repetitive behaviors. Objective: We aimed to investigate the risk factors associated with autism. Methods: This cross-sectional descriptive study conducted in Khartoum State, Sudan. A sample of 100 children was selected from Autism care centers. The study tools included direct interviews, observation and questionnaire. Result: The study revealed that about two-thirds of autistic children were males. Most autistic children showed signs of autism after completing the first year of their life. Similar siblings with autism occurred in 9%. About one-quarter of participants had a positive family history of autism and other mental disorders. About one-fifth of autistic children were dependent on artificial milk during the first six months of their lives. Most of the respondents (90%) started watching television before age one year and more than one-third of them watched television for more than seven hours/day. Two-thirds of respondents used electronic devices before having autism and 40% of them started using electronic devices at the age one year to less than two years for more than four hours/day. Conclusion: ASD is more prevalent in males and it appears in early childhood. It is associated with several factors such as heredity, social and economic factors and the early use of electronic devices by children.

Personal Health Records (PHRs) would empower patients play active role for quality healthcare provision and access for routine checkup and self-care management. There is a need to recognize security, privacy and interoperability issues for successful design, implementation and adoption of PHR at a wider scale. However, it is one of the greatest challenges to achieve interoperability, security and privacy simultaneously in healthcare domain. Health Level Seven (HL7) international standards body is working to propose interoperability standards for healthcare information systems. However, privacy and security need to be incorporated in the system design and implementation. This work focuses on designing HL7 compliant PHR with security and privacy using blockchain, which is a distributed ledger data storage mechanism. The scope of the paper is limited to a number of core functional requirements of Fast Healthcare Interoperability Resources (FHIR). The PHR models applications of blockchain to these requirements to propose base system architecture. Several tools support FHIR compliant development of HL7 family of standards. We analyzed existing blockchain based PHR and their data sharing services in the domain to integrate FHIR and blockchain technologies. The goal is to share patient's data to facilitate health services by designing for a trusted interoperable sharing of data among different custodians such as physicians and insurance companies. Simultaneously the proof of concept is created through prototype implementation using Python in the open source tool Spyder IDE.

Objectives: To assess the long-term efficacy and safety of thoracic endovascular aortic repair (TEVAR) in the treatment of acute type B aortic dissection (ATBAD), emphasizing endpoints such as survival, re-intervention rates and complications throughout prolonged follow-up periods. Methods: An exhaustive search of the four databases yielded 1016 pertinent papers. Following the elimination of duplicates with the Rayyan QCRI and the assessment for relevance, 93 full-text publications were examined, with eight studies eventually satisfying the inclusion requirements. Results: Eight years of study on patients with ATBAD found a long-term mortality rate of 7.7% in uncomplicated cases and 78% in complicated cases, with a total mortality rate of 311 (10%). The post-operative complications and re-intervention rates varied. Preoperative inflammatory and lipid profiles are key predictors of mortality risk. Conclusion: TEVAR, a treatment for ATBAD, has shown potential long-term benefits. However, patient selection should be individualized based on risk factors and anatomical characteristics. Further research is needed to validate these findings, refine clinical guidelines and improve the safety and efficacy of TEVAR in diverse patient populations to ensure optimal treatment outcomes.

Psychophysiological stress can impact students' intellectual responses to skills and innovativeness. It challenges mental stress among students, faculty and non-teaching employees. The surging technical/nontechnical students at Centurion University, Bhubaneswar, have augmented the potential to improve the university's intellectual and psychophysiological apathy. Various sports, cultural activities and daily exercises are regularly practised effectively. Besides these physical practices, Yoga is a well-thought-out alternative mind-body exercise that can ensure psychological health stability. The present study attempts to test the hypothesis that Yoga significantly positively impacts the psychophysiological health of students and employees in a university environment. The statistical analysis (questionnaire method) covered 507 sample survey respondents, including students, teachers and non-teaching staff, who were the population. The Hopkins Symptom Checklist (HSCL-25), a popular and widely accepted scale, was used. The hypothesis testing methodology, along with the parametric Z test, was implemented to draw inferences. The research revealed a significant positive effect of Yoga on the mental or psychological health of the respondents. Suggestions constituted that all forms of educational institutions/universities, with all fragments from students to top management, should practise flexible and readily available support for their mental or psychological health through Yoga practices. Yoga reduces psychological distress, especially among young adults in a university. Yoga positively advances physical and mental health in young groups, which can satisfy the sustainable development goal (SDG-3), i.e., good health and well-being and SDG-1 (No poverty) by optimising simple living and contentment with minimum.

Background: Cardiac arrest is a leading cause of mortality and morbidity worldwide. Immediate administration of Basic Life Support (BLS) techniques by laypersons can significantly increase survival rates and minimize neurological damage. However, public knowledge and preparedness toward BLS remain low in many communities. This study aims to assess the level of awareness and knowledge of BLS among the non-medical population in Arar City, Saudi Arabia and to examine its association with educational level, age, gender and income. Methods: A cross-sectional study was conducted using an online self-administered validated questionnaire. The study included 400 non-medical individuals aged 18-60 years in Arar City from February to April 2024. Chi-square tests were used to analyze associations between demographic factors and BLS knowledge. Results: Only 62.7% of participants recognized signs of cardiac arrest. Significant knowledge deficits were identified in AED function (65.7% unaware), initial steps in fainting (67% incorrect) and proper CPR compression rate (69.7% unaware). Gender (p = 0.0001) and family monthly income (p = 0.022) were significantly associated with the likelihood of performing hands-only CPR, while region and age showed no significant relationship. Conclusion: Despite the critical importance of BLS in improving survival rates following cardiac arrest, a considerable percentage of participants demonstrated insufficient understanding of essential concepts. Gender and income-related disparities in CPR willingness highlight the need for targeted educational initiatives to improve BLS knowledge and skills in Arar City.

Patients with inflammatory bowel disease (IBD) are at an increased risk of thromboembolic events due to chronic inflammatory state which include venous thromboembolism and rarely arterial thromboembolism (ATE). ATE involves thrombosis of the cerebral, splanchnic, carotid, coronary, aorta, renal and upper and lower extremity arteries. We describe a case of a 50-year-old female patient with crohn’s disease who developed ATE. She presented to the emergency department complaining of sudden pain in right hand with bluish discoloration of fingers associated with numbness over the C8 and T1 distribution. She was on mesalazine 3 g once daily for crohn’s disease. Examination of other systems was normal and there was no focal neurological deficit. Laboratory investigations were within normal limits. CT upper extremity angiogram showed abrupt cutoff of distal part of ulnar artery proximal to the tip of ulnar styloid. CT of thoracic aorta showed filling defect of the right brachiocephalic artery causing mild to moderate stenosis. She was managed conservatively with heparin, aspirin initially and discharged home on apixaban with complete resolution of the thrombus. To the best of our knowledge this is the first case of thromboembolism in the hand originating from the right brachiocephalic artery and obstructing the distal ulnar artery in a patient with crohn’s disease being reported and was successfully managed conservatively.

Background: A surgical approach to migraine therapy is increasingly being considered and practiced, with reported success rates approaching 90%. Among the trigger sites addressed with this method, the temporal region is undoubtedly one of the most frequently involved. Methods: In this study, we describe our surgical approach for the treatment of temporally localized migraine. This technique involves neurolysis of the auriculotemporal nerve (which is never transected) and coagulation of all superficial temporal arterial and venous branches, which are often dilated or ectatic. Results: We interviewed 25 patients (22 females, 3 males; ages: [to be specified]) by telephone, all of whom had undergone surgery for migraine at temporal trigger sites. At the 12-month follow-up, the patient-reported resolution of pain averaged 88% (range: 25-100%). Only transient, minor complications (hypoesthesia, local itching) were reported. Conclusion: Based on our experience, this approach is supported by the common morphological findings observed and the distinctive symptomatology of this patient population. Fro m a clinical po int o f view, in our experience, the technique described has allowed us to obtain very satisfactory results, with a resolution of the symptoms close to 90% o f cases.

Background: The systemic autoimmune disease rheumatoid arthritis (RA) is characterized by extra-articular disorders and persistent inflammation of the synovial joints. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) are autoantibodies that are important for diagnosis and prognosis. Treat-to-target guidelines place a strong emphasis on reaching remission or decreased disease activity but they ignore patient characteristics or potential future disease behavior. Aim:  To evaluate comparison between RA patients' demographics, medication use and the disease activity at a tertiary hospital in Jeddah, Saudi Arabia. Materials and Methods: This retrospective study includes 259 patients with RA aged =18 who meet ACR/EULAR 2010 criteria. Data collected from electronic medical records at King Abdulaziz University hospital (KAUH) between December 2021 and December 2023. Demographics, clinical characteristics, medication history and laboratory data for RF, Anti-Nuclear Antibodies (ANA) and ACPA levels were recorded. Disease activity was assessed using clinical disease activity index (CDAI) or disease activity score in 28 joints (DAS28) -Erythrocyte sedimentation. Results: The study involved 259 participants, primarily female, married and college students. There were insignificant differences between disease activity, gender, education, job, marital status, having kids, body mass index (BMI), RF and ACPA. Biologic disease-modifying anti-rheumatic medicines (DMARDs) showed insignificant changes with disease severity but rituximab showed moderate disease severity and infliximab showed more patients with remission. Non-biologic DMARDs, including Leflunomide and Hydrochloroquine, showed low to moderate disease activity. Targeted synthetic DMARDs, notably baricitinib and upadacitinib, dramatically alter disease activity. Conclusion: The study revealed that infliximab showed higher remission rates and rituximab showed moderate activity. Leflunomide, hydrochloroquine, baricitinib and upadacitinib exhibited low to moderate disease activity. Medical professionals should evaluate infliximab's efficacy in achieving remission and consider positive ANA. Further research is needed to confirm these findings and investigate additional factors.