Background: The integration of Artificial Intelligence (AI) into radiology is rapidly transforming diagnostic workflows, image interpretation and clinical decision-making. While AI holds the potential to augment radiological practices, concerns about its impact on professional roles persist. This study aimed to assess the knowledge, attitudes and perceptions of radiologists in Saudi Arabia regarding the implementation of AI in their field and to explore their readiness for AI integration. Methods: A cross-sectional study was conducted at the College of Medicine, Northern Border University, Arar, Saudi Arabia, from March 2024 to February 2025. A validated, structured questionnaire was distributed via digital platforms to 103 practicing radiologists across various regions. The survey assessed demographic details, awareness, training exposure, attitudes and perceived impact of AI. Data were analyzed using IBM SPSS Statistics v20, with chi-square and t-tests applied. A p-value <0.05 was considered statistically significant. Results: Among the respondents, 85.4% had heard of AI and 72.8% reported a basic understanding of its principles. Only 9.7% feared that AI might replace radiologists, while a substantial majority (70%) expressed a strong interest in pursuing professional development in AI. Notably, awareness and knowledge were significantly higher among younger and less-experienced radiologists (p<0.001). Conclusions: Radiologists in Saudi Arabia generally perceive AI as an opportunity rather than a threat. While most have basic awareness, there is a critical need for structured educational programs to enhance their understanding and practical skills. Integrating AI-focused training into continuous professional development and national radiology curricula is essential to ensure successful adoption and optimal patient care.

This study investigates the bactericidal activity of Syzygium Aromaticum (clove) essential oil against salivary bacteria in patients with oral leukoplakia. Samples were collected from specialized dental centres and clinics in Diyala Governorate between July and December 2024. The aim was to identify bacterial species commonly associated with oral leukoplakia and assess the effectiveness of clove essential oil in inhibiting their growth. The most frequently isolated bacterial species included Rothia dentocariosa, Staphylococcus hominis, Streptococcus salivarius, Kocuria kristinae and Micrococcus luteus. This study aims to explore the potential of clove essential oil as a natural antimicrobial agent for managing bacterial infections in patients with oral leukoplakia.

Background: The placenta plays a critical role in pregnancy by mediating nutrient exchange, hormone production and immune regulation between the mother and fetus. Its development-placental morphogenesis-is influenced by both environmental factors, such as maternal nutrition and exposure to toxins and genetic predispositions. Disruption of this process can lead to adverse maternal and fetal outcomes. Methods: This cross-sectional study involved 85 pregnant individuals from the northern region of Saudi Arabia. Placental tissues were subjected to histological and molecular analysis. Maternal data, including health status, environmental exposures and nutritional profiles, were collected. Genetic polymorphisms in genes related to angiogenesis and cell growth (VEGF, MTHFR, NOTCH1, TGF-β1) were examined. Statistical analyses, including ANOVA and chi-square tests, were used to assess associations between genetic/environmental factors, placental abnormalities and pregnancy outcomes. Results: Histological findings revealed a high prevalence of villous hypoplasia (48%) and fibrin deposition (37%). These abnormalities were significantly linked to maternal obesity, nutritional deficiencies and toxin exposure. Genetic analysis identified common polymorphisms, notably VEGF rs699947 and MTHFR rs1801133, which correlated with impaired placental vascularization and inflammation. These placental abnormalities were associated with lower birth weights, reduced gestational ages and decreased APGAR scores. Conclusion: Placental morphogenesis is a dynamic process influenced by both genetic and environmental factors. Maternal health conditions and environmental toxins, when coupled with genetic susceptibilities, significantly impair placental development and compromise fetal outcomes. Early detection and targeted maternal health interventions may improve placental function and reduce pregnancy-related complications.

In this study, Aspergillus niger was used for the production of pectinase enzymes under submerged fermentation conditions, aiming to evaluate their potential antibacterial activity. Three fungal isolates were tested and optimal conditions for enzyme production were determined regarding incubation time, temperature and pH. The highest enzymatic activity was observed at 40°C and pH 8 after 48 hours of incubation. Quantitative and qualitative assays revealed that pectinase activity ranged between 1.1 and 4.0 U/mg protein, depending on the carbon and nitrogen sources in the growth medium. The antibacterial activity of the produced pectinase was evaluated using the agar well diffusion method against four bacterial strains: Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Staphylococcus epidermidis, at concentrations ranging from 4 to 64 µg/mL. The results showed dose-dependent inhibition, with K. pneumoniae showing the highest sensitivity (27.33 mm), followed by E. coli (19.33 mm), S. aureus (15.67 mm) and S. epidermidis (6.33 mm). The study highlights the potential of pectinase enzymes from Aspergillus niger for antibacterial properties, making them valuable biotechnological agents in medical and industrial applications. These enzymes could be used as natural bio-preservatives or therapeutic agents against resistant bacterial strains. Future research should focus on understanding antibacterial mechanisms, optimizing production and evaluating efficacy in real-world systems.

Background: Impression material accuracy is crucial for the fabrication of indirect restorations because distortion during the impression process can affect the final dental prosthesis. However, the impression technique is essential for ensuring a proper fit for the prosthesis. Among various impression materials, this impression creates a dimensionally stable "negative" mold, which serves as the basis for developing a cast for the dental structure. Purpose: To evaluate and compare the dimensional accuracy of conventional and modified putty-wash techniques on measurements of the finish line on a scanned model using superimposition. The study aimed to evaluate if the impression made using the modified putty-wash technique can produce a more accurate cast than that made using the conventional putty-wash technique. Methods: This study used a master model fabricated from the original typodont containing two crown abutment preparations (molar and premolar). 95 impressions were made using upper plastic trays and divided into three groups. Group 1 consisted of 25 impressions using the two-step conventional putty-wash technique. Group 2 also had 25 impressions and was made using the modified putty-wash technique with baseplate pink wax, utility wax and light body. Group 3 included 45 impressions using the modified putty-wash technique. Results: The dimensional accuracy of the resulting casts was affected owing to a statistically significant difference between the modified and conventional putty-wash techniques. Conclusion: This study aimed to develop a more precise technique utilizing utility wax and hard pink baseplate wax as an alternative to the conventional putty-wash method. This approach enhances ease of handling for clinicians while offering cost-effectiveness and repeatability, as utility wax can be softened and reused. In contrast, putty material cannot be reused due to its susceptibility to deformation.

Background: Diabetic foot clinical complex is a common concern for diabetic patients. Typically, it affects patients with suboptimal glycemic control but it is multifactorial in origin. A diabetic foot is a condition that affects the feet of people with diabetes. It can cause skin and bone infections, abscesses, gangrene, ulcers and deformities due to nerve damage, poor blood circulation and a weak immune system. If not identified early and treated properly, it can lead to serious consequences, such as amputation. Objectives: This study assessed the knowledge and awareness levels of diabetic foot symptoms, management and complications among diabetic patients in Saudi Arabia. Methods: This study used a cross-sectional design and a pre-made questionnaire. It was carried out from August 2023 to March 2024 in all regions of the Kingdom of Saudi Arabia. The sample size was estimated using the Qualtrics calculator with a confidence level of 95%; the minimum sample size was 384. The data were then analyzed using version 20 of the Statistical Social Sciences (SPSS) program. Results: Of 107 respondents (mean age 40.6±13.2 y; 60.5 % women; 64.4 % type 2 diabetes), 72.9 % demonstrated high awareness while 57.9 % exhibited poor practice. Participants aged ≥51 years were more than twice as likely to report poor practice than younger patients (adjusted OR 2.4, 95 % CI 1.1–5.5; p = 0.03). It also appears that frequency showed that 15% are categorised as good practice, 27.1% as fair practice and 57.9% as poor practice. Age was the only parameter with a significant association with practice (p-value = 0.028). Conclusion: In conclusion the awareness and practice of diabetic foot care among diabetic patients receiving care in Saudi Arabia is an important issue that requires attention and action. Although awareness regarding diabetic foot and its complications in our study was sufficient, participants exhibited poor practice scores. Knowledge about DF does not automatically translate into healthy behaviour; more than half of Saudi adults with diabetes neglect basic foot-care measures. Clinical relevance: Targeted, age-tailored education and structured follow‑up could avert preventable amputations and lower diabetes‑related healthcare costs in Saudi Arabia.

Purpose: This study assessed the accuracy of dental impressions generated from modified plastic trays using impression compound material compared with that of impressions made using stock metal and plastic trays. Methods: In this in vitro study, three types of trays-stock plastic trays, modified plastic trays and stock metal trays (control)-were used, with 30 impressions for each tray type. A Nissan typodont was used as the master cast with standardized prepared teeth. Polyvinyl siloxane impression material with light and regular bodies was used for the impressions. For the modified plastic trays, a disc of compound wax was heated in a water bath until the dough state was reached. Then, the dough was placed in the plastic tray and a preliminary impression was made using the wax. These impressions were scanned using a S600 ARTI SCANNER and statistical analysis employing a multivariate analysis of variance was conducted to evaluate the differences among the tray types. Results: Metal trays demonstrated the highest accuracy in dental impressions; however, they may cause patient discomfort. Modified plastic trays, using compound wax, showed significant improvements in accuracy over standard plastic trays, providing a viable alternative when metal trays are unavailable or unsuitable. Conclusion: The study highlights the potential of modified plastic trays as a comfortable and accurate alternative to metal trays. Further refinement and standardization of the modification process can enhance their performance, making them a durable option for dental impressions.

Background: Dental impressions are essential in restorative and prosthetic dentistry, as their accuracy directly impacts the fit and functionality of dental prostheses. The selection of impression material and its corresponding setting time plays a crucial role in determining final dimensional precision. This in vitro study aimed to assess the dimensional accuracy of dental impressions created using various combinations of impression materials with different setting times, providing evidence-based guidance for clinicians in selecting optimal and reliable material combinations. Materials and Methods: A total of 72 samples were divided into three groups: Fast-Fast (light body fast-set and regular body fast-set), Fast-Normal (light body fast-set and regular body normal-set) and Normal-Fast (light body normal-set and regular body fast-set). Impressions were taken from a typodont using polyvinyl siloxane (Aquasil Ultra, Dentsply Sirona). Digital impressions were created using a Zirkonzahn scanner and superimposed onto a digital reference cast. Six parameters related to height and width were measured using Exocad software. Results: Statistically significant differences were found between the groups for buccal (p = 0.0002), mesiodistal (p = 0.0002) and buccopalatal (p = 0.006) dimensions. The Fast-Normal group exhibited significantly higher mean values for these parameters than did the Fast-Fast and Normal-Fast groups. Conclusions: Mixing fast set and normal set time impression materials changed the measurements slightly. The combination of impression materials with different setting times significantly affected dental impressions, particularly the buccal, mesiodistal and buccopalatal dimensional aspects. These findings suggest that careful consideration of impression material properties, such as setting time, is crucial to ensure the dimensional accuracy and optimal fit of prosthetic restorations. Clinical Significance: This research aims to evaluate and validate alternative impression methods for clinical cases where material availability is limited, by comparing the dimensional accuracy of dental impressions made with different material combinations. Through rigorous assessment of accuracy measurements and significant differences between various material combinations, the study seeks to provide evidence-based solutions that address the practical challenges of material accessibility and availability in dental clinics. This research will ultimately help dental practitioners make informed decisions about impression material selection when faced with supply limitations, ensuring they can maintain clinical standards while working with alternative material combinations that have been proven to deliver acceptable accuracy.

Background: Pseudomonas aeruginosa is a significant nosocomial pathogen notorious for its multidrug resistance (MDR), often mediated by efflux pumps like MexAB-OprM. This study aimed to molecularly identify the mexB gene within clinical isolates of P. aeruginosa and assess its correlation with antibiotic resistance profiles. This study aims to detect the presence of the MexB efflux pump gene in clinical isolates of Pseudomonas aeruginosa and to investigate its association with antibiotic resistance patterns, particularly multidrug resistance, to better understand the molecular mechanisms underlying antimicrobial resistance and support effective therapeutic strategies. Methodology: All clinical isolates of P. aeruginosa from patients at Teaching Ba'aqubah Hospital and Teaching Albatool Hospital were investigated in this study. identified with the Vitek 2 compact, MexB efflux pump genes are detected by the PCR technique and primers are designed in the biology department of the College of Education of Pure Science in Iraq. Conventional PCR results showed that the gene, MexB, was present in all seven clinical isolates of P. aeruginosa. It was concluded that carrying efflux pump genes can make P. aeruginosa more resistant to several drugs. Result: From the 100 clinical specimens collected P. aeruginosa recorded a high percentage of isolated 67(67%), P. aeruginosa isolates Including; Chronic burns swab 23 (34.3%), Wounds swab 15 (22.4%), Urine from UTI patients 12 (17.9%), Sputum 10 (14.9%) and Ear swabs 7 (10.5%). All isolates were obtained by cultural characterisation These clinical isolates were on cetrimide agar, which is a selective medium for Pseudomonas spp.at 37°C for 24 hours. the VITEK2 compact System to confirm the diagnosis of Pseudomonas aeruginosa. Conclusion: According to our research, any P. aeruginosa that has the MexB gene of the efflux pump in the MexABOprM operon may enhance drug expulsion and antibiotic resistance, which could cause health issues for patients, particularly those with compromised immune systems.

This study's primary goals were to identify and describe the common species of house dust mites that were collected from randomly chosen homes in various Kafr EL-Shekh Governorate locations between 2023 to 2024. Using a vacuum cleaner, samples were taken from the floor, bedding, living areas and bedrooms. Mice were immunized before/after being contamination with Ascaris lumbricoides eggs using a house dust mite antigen, from frozen mites. After the experiment, blood was drawn. ELISA method was used to determining total serum IgE, IgG1 and IgG2a as well as HDM (house dust mite)-specific IgE. Mites were found in 22 out of 50 randomly chosen homes (44%). The highest percentage of HDM was found in moldy or damp patches on floors (68.3%), followed by carpets in living rooms (22.3%) and bedroom rugs (9.4%). The infected non-immunized group had a noticeably greater amount of HDM-specific IgE. When the prophylactic group was immunized with HDM-specific antigen before Ascaris infection, the OD absorbance value of HDM-specific IgE was at its greatest and drastically decreased. Furthermore, the data showed that HDM-sensitization strongly produced systemic HDM-specific IgG1 and IgG2a. The infected non-immunized group had a significantly higher level of HDM-specific IgG1, but the prophylactic group, which received an HDM-specific antigen vaccination before Ascaris infection, had a significantly lower level of HDM-specific IgG1. Following Ascaris infection, HDM-specific IgG2a levels decreased following immunization with HDM-specific antigen. In conclusion: moist or moldy spots on floor samples had the highest percentage of HDM. Mice are immunized with HDM before Ascaris. By decreasing the IgE-dominated type-2 response, lumbricoides egg infection decreased type 2 immunity.

Background and Aim: Pain and satisfaction during labor are key indicators of the quality of maternal care. In Erbil, Iraq, there is limited research exploring how maternal pain levels influence satisfaction with childbirth. This study aimed to determine the relationship between maternal pain and satisfaction during labor among women giving birth in Erbil. Methods: This cross-sectional study was conducted at the Maternity Teaching Hospital in Erbil from December 1st, 2024, to February 15th, 2025, using a convenience sampling method. The questionnaire consisted of three parts: the first part collected demographic data, the second part assessed maternal satisfaction during labor and the third part measured pain using the Numeric Rating Scale (NRS). Data were analyzed using Stata version 12 (StataCorp LLC, College Station, TX). Pearson correlation analyses and multiple linear regression were conducted to assess the correlations between maternal pain, satisfaction and demographic variables. A p-value of less than 0.001 was considered statistically significant. Results: A total of 140 women participated in the study. The mean maternal pain score was 7.41±2.52, indicating a severe level of pain, while the mean satisfaction score was 12.36±6.54, reflecting a neutral level of satisfaction. Pearson correlation analysis showed a strong negative correlation between maternal pain and satisfaction (r = -0.96, p<0.001), suggesting that higher pain was associated with lower satisfaction. Multiple linear regression analysis confirmed that satisfaction was a significant predictor of maternal pain (B = -0.37, p<0.001), whereas demographic variables such as age, education, occupation, residential area, smoking, BMI and physical activity during pregnancy were not statistically significant predictors. Conclusions: There was a strong negative correlation between maternal pain and satisfaction during labor, indicating that increased pain significantly reduced satisfaction levels. It is recommended that policymakers and healthcare providers implement effective pain management strategies and enhance supportive care during labor to improve maternal satisfaction and overall childbirth experiences.

Background and Aim: Ventilator-associated pneumonia (VAP) is a serious infection affecting ICU patients on mechanical ventilation, leading to increased health risks and costs. Nurses are key to VAP prevention, but their knowledge and practices vary. This study aimed to assess the knowledge and practice of ICU nurses in preventing VAP in Erbil City, Iraq. Methods: This cross-sectional study was conducted between October 2nd and December 29th, 2024, in three major public teaching hospitals in Erbil, using convenience sampling. Data were collected using two self-structured questionnaires covering sociodemographic variables, knowledge and practice related to VAP prevention. Statistical analysis was performed using Stata version 12 (StataCorp LLC, College Station, TX). Chi-square tests and ordinal regression analysis were used to examine associations between knowledge, practice and demographic characteristics, with significance set at p<0.001. Results: A total of 62 ICU nurses participated in the study. The mean knowledge score was 7.95 (SD = 1.89) and the mean practice score was 6.42 (SD = 1.59), indicating that the participants had moderate levels of knowledge and practice regarding ventilator-associated pneumonia (VAP) prevention. A significant association was found between knowledge levels and years of experience in ICU or respiratory care units, as well as with age. Practice levels were significantly associated with gender and years of experience, with male nurses and those with more experience demonstrating better adherence to recommended practices. Conclusions: The participants demonstrated a moderate level of knowledge and practice regarding VAP prevention. Policymakers and healthcare providers are recommended to implement targeted training programs and continuous professional development to enhance nurses' competencies and adherence to VAP prevention guidelines.

Background: Preeclampsia (PE) is a hypertensive disorder of pregnancy associated with maternal and fetal complications. Current diagnostic methods rely on clinical symptoms, often leading to late detection. MicroRNAs (miRNAs) are promising molecular biomarkers for early PE identification due to their regulatory role in placental development and maternal vascular adaptation. Objective: This study aimed to identify differentially expressed miRNAs in early-onset (EOPE) and late-onset (LOPE) PE, comparing their profiles with normal pregnancies to evaluate their potential as diagnostic biomarkers. Methods: A multicentric cross-sectional study was conducted across hospitals in South India. Thirteen participants were enrolled, including five EOPE, five LOPE and three normotensive pregnancies. Placental and plasma miRNA profiles were analyzed using next-generation sequencing (NGS). Bioinformatics analysis identified significantly dysregulated miRNAs. Statistical validation included differential expression analysis, confidence intervals and effect size calculations. Results: Peripheral blood profiling in EOPE showed upregulation of miR-532-5p, miR-1285-5p, miR-6515-5p and miR-548ae-5p, while miR-4732-5p was downregulated. In LOPE, miR-532-5p, miR-6b-3p, miR-6734-5p and miR-146b-5p were significantly upregulated, while miR-3127-5p, miR-5695, miR-202-5p and miR-185-5p were downregulated. Placental profiling revealed distinct miRNA expression patterns, including upregulated miR-508-3p and miR-1246 in EOPE and downregulated miR-34b-5p in LOPE. Conclusion: This study highlights specific miRNA signatures associated with PE, providing a basis for early non-invasive screening. Findings align with previous studies demonstrating miRNA-based PE detection with high sensitivity and specificity. The existing literature lacks an in vivo study based on microRNA profiling using the NGS method in preeclampsia. Larger cohort studies are needed for external validation and clinical translation of miRNA-based diagnostics.

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that increases patients' vulnerability to both severe and non-severe infections due to immune dysregulation and the use of immunosuppressive therapies. Tofacitinib, a Janus kinase (JAK) inhibitor and adalimumab, an anti-TNF biologic DMARD, are commonly used in RA management but their comparative infection risks remain unclear, especially in local populations. Materials and Methods: A retrospective observational study was conducted at King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Medical records of RA patients treated with either tofacitinib or adalimumab between January 2018 and February 2023 were reviewed. Patient demographics, treatment characteristics and outcomes including infection-related hospital admissions, ER visits and adverse events were analyzed using descriptive and inferential statistics via Jamovi software. Results: A total of 86 RA patients were included (88.4% female; median age 52.5 years). Tofacitinib was prescribed to 54.7% and adalimumab to 45.3% of patients. The two groups were similar in age, sex, BMI and disease duration. Tofacitinib-treated patients had higher rates of seropositivity and were more likely to receive monotherapy, whereas adalimumab-treated patients more frequently received combination therapy with methotrexate. Infection-related hospitalizations (8.5% vs. 10.3%) and major adverse cardiovascular events were comparable between groups. However, ER visits due to pain were significantly more common in the adalimumab group (28.2% vs. 6.4%, p = 0.023), suggesting better symptom control in the tofacitinib group. Conclusion: While infection and cardiovascular event rates did not significantly differ between treatment groups, tofacitinib may provide better pain control, as evidenced by fewer ER visits. Baseline differences such as seropositivity and combination therapy use should be considered in future studies. These findings provide real-world insight into RA treatment safety profiles in a Saudi population.

Background: Bone Marrow Transplantation (BMT) is a curative treatment for numerous malignant and nonmalignant hematologic disorders. Nurses are pivotal in patient care, requiring up-to-date knowledge and practical competency in BMT-related management. Objective: To assess the effect of an educational program on the knowledge and practice of nurses caring for patients undergoing BMT. Methodology: A quasi-experimental design involving a convenience sample of 34 nurses from the BMT Unit at Hiwa Cancer Hospital, from March 2023 to September 2024 was adopted. Data were collected using a structured questionnaire comprising demographic details, knowledge assessment and a practice evaluation. Participants attended an 8-session educational program designed to enhance their competencies. Results: Baseline assessments revealed that most participants had poor knowledge (67.6%) and practice (73.5%), with mean scores of 0.42±0.23 and 0.63±0.42, respectively. Post-program evaluations showed a substantial improvement in knowledge, with 73.5% of nurses classified as having good knowledge (mean score of 0.79±0.12) (p<0.001). Similarly, nurses demonstrating good practices increased from 5.9% to 41.2%, significantly increasing the mean practice score to 1.40±0.29 (p<0.001). Conclusions: The educational program effectively enhanced the knowledge and practice of nurses managing patients undergoing BMT at Hiwa Cancer Hospital.

Background: Improved customer awareness of food safety information is necessary to provide safer food with the lowest possible risk of food illness. Objective: To assess Saudi Arabian university students' knowledge, attitudes and practices about Food Poisoning (FP). Methods: An online cross-sectional survey study was conducted in Saudi Arabia between March and December 2024. Multiple logistic regression was performed to assess the factors associated with better FP knowledge. Results: A total of 606 students participated in this study. The total mean of knowledge score was (15.90±4.14). Single students reported a significant higher knowledge score mean (16.46±4.69) compared to married (14.99±2.06) (p = 0.0001). Students in medicine faculty reported a significant higher knowledge score mean (20.46± 6.06) compared to students in College of Languages and Translation (14.35±3.00) (p = 0.0001). A total of 301 students (49.5%) had a good knowledge score and 307 students (50.5%) had poor knowledge. Married students had significantly lower odds of good knowledge compared to others (odds ratio (OR) = 0.5,95% CI = 0.31-0.78, p = 0.003). Students at college of Medicine had significantly higher odds of good knowledge (OR = 3.33,95% CI = 1.23-9.03, p = 0.018). Conclusion: University students demonstrated a deficiency in understanding or application of food safety in their day-to-day activities. Since education is a powerful instrument for influencing attitudes and behavior, it is very simple to increase students' knowledge and awareness of food safety in educational and research institutions. To enhance students' understanding, awareness and practices of food safety, appropriate training and awareness initiatives should be created and implemented.

Penoscrotal elephantiasis is a severe form of genital lymphedema characterized by disfiguring edema, functional and psychosocial challenges. This case report chronicles the 16-year clinical course (2008-2024) of a 22-year-old male with congenital lymphatic malformation. He underwent several interventions, including partial scrotal resection, sirolimus therapy and sclerotherapy, with limited success. A significant clinical improvement was observed following radical scrotal orchiectomy on August 14th, with the resection of approximately 5 kg of fibrofatty tissue. The postoperative SF-12 survey showed significant physical improvement despite mild swelling. A structured, multidisciplinary approach and vigilant follow-up are crucial for sustaining outcomes and addressing residual or recurrent disease.

Background: Pulmonary embolism (PE) is the 3^rd most frequent cause of cardiovascular death (30% of cases), following coronary artery disease and stroke. As most cases are caused by thrombotic occlusion, the condition is called pulmonary thromboembolism. Objectives: To determine the use and overuse of spiral computed tomography (CT) and CT pulmonary angiography (CTPA) in diagnosing the clinically suspected patients with PE. Materials and methods: This cross-sectional study enrolled 100 patients with clinically suspected PE in Shar Teaching Hospital, Sulaimaniyah City, Iraq, from December 2022 to October 2023. CT images were obtained and the axial, reformatted coronal and sagittal images were evaluated. Modified Wells Score (MWS) was calculated for cases and PE rule-out criteria (PERC) was calculated for those cases with a Well score ≤4. The D-dimer test was done randomly for 39 cases. Results: The cases comprised 63 females and 37 males aged 16-95 years. The most common symptoms evoking a suspicion of PE were dyspnea (87%), chest pain (26%), cough (14%) and fever (11%). Results revealed that 35% (n = 35) had PE and 65% (n = 65) had no PE. Most non-PE patients had normal CT (16%, n = 16), followed by pneumonia (11%, n = 11), heart failure (9%, n = 9), pleural effusion (6%, n = 6), atelectasis/pulmonary hypertension (PHTN) (5%, n = 5), fibrosis/lung mass (4%, n = 4), collapse (3%, n = 3), bronchiectasis and LAP (1%, n = 1). Most cases (n = 55) had MWS ≤4 (1 PE) and 45 cases had >4 (34 PE). PERC rule was positive in 33 cases (1 PE) and negative in 22 cases (no PE). Conclusions: CTPA was negative in most cases with MWS of ≤4, while in combined strategy (MWS ≤4+negative PERC), CTPA was negative in all cases. Therefore, utilizing the combined strategy could safely exclude PE without additional imaging.

Background: Adolescents who use the internet excessively do worse academically than their non-addicted peers and they may also suffer from attention deficit and hyperactivity disorder. The aim of the present study to determine the effectiveness of CBT and counseling in terms of internet addiction among late adolescence. Methods: Quantitative approach and true experimental design with pre-test and post-test design used for the study. Students from selected college were screened with internet addiction assessment tool. Out of 970 students, 369 students were scored 40 to 72. From 369 students, 330 students were selected by simple random sampleing technique. The study sample comprised all first-year students in selected colleges, from which data was collected from 330 students. Experimental Group I included 110 students from the morning batch, Experimental Group II included 110 students from the evening batch of the same college and the control group consisted of 110 students from the regular batch of another selected college. Result: The study results showed that both the CBT and counselling groups showed a significant reduction in internet addiction after the intervention (p<0.05). Conclusion: The study's findings concluded that cognitive behavioral therapy is slightly more effective than counseling in addressing internet addiction.

Background: The increasing occurrence of multi-drug-resistant (MDR) Acinetobacter nosocomialis poses a serious assignment in medical settings, in particular in bloodstream infections in which conventional antibiotics fail. The need for alternative therapeutic techniques, such as bacteriophage remedy, has gained hobby as a ability solution. Objective: This observe goals to isolate and represent bacteriophages with lytic interest in opposition to MDR A. Nosocomialis, check their host range, examine their healing capacity and analyze public and clinical attention of phage therapy through a structured survey. Methods: A general of 20 clinical A. Nosocomialis isolates were obtained from bloodstream infections and subjected to antibiotic susceptibility testing. Additionally, 30 wastewater and sewage samples from hospitals have been screened for bacteriophage isolation. The remoted phages have been characterised the usage of transmission electron microscopy (TEM), one-step increase curves and stability assays to determine their host range, latent duration, burst size and environmental tolerance. The efficacy of the most potent bacteriophage was assessed through in vitro bacterial reduction assays. A dependent questionnaire become additionally conducted among healthcare experts and the overall public to evaluate recognition and perceptions concerning bacteriophage therapy. Results: The collected A. nosocomialis isolates exhibited complete resistance to carbapenems and aminoglycosides, while 85% were resistant to fluoroquinolones. Among the 15 successfully isolated bacteriophages, Phage 3 demonstrated the broadest host range, lysing 85% of MDR A. nosocomialis isolates. TEM analysis confirmed its classification within the Myoviridae family, characterized by an icosahedral head and a contractile tail. The one-step growth curve analysis revealed a latent period of 20 minutes and a burst size of 58 plaque-forming units (PFU) per infected bacterial cell. Stability tests indicated that the phage remained viable within a pH range of 4–10 and at temperatures between 4°C and 40°C, although a marked decline in activity was observed at pH 2 and temperatures exceeding 50°C. In vitro bacterial reduction assays demonstrated a 99% decrease in viable bacterial cells post-treatment. The survey results indicated that 63% of participants had no prior knowledge of bacteriophage therapy, while 34% believed it could serve as an alternative treatment for MDR infections. Furthermore, 83% reported limited access to phage therapy in their region, highlighting the need for increased awareness and accessibility. A statistically significant correlation (p≤0.05) was observed between education level and awareness of phage therapy. Conclusion: The findings underscore the potential of bacteriophage therapy as a promising alternative against MDR A. nosocomialis bloodstream infections. The study also reveals a substantial knowledge gap regarding phage therapy among the public and healthcare professionals, emphasizing the need for educational initiatives and regulatory advancements to facilitate clinical implementation.

Background and objective: The quality of nursing work life is the extent to which nurses can fulfill their own needs through job-related understanding while achieving organizational goals. The study aims to assess the nurses' quality of life at work in specialized medical centers in Mosul city. Methods and materials: Descriotive a cross-sectional study was conducted among twelve a government specialized health centers in Mosul city. from December 1, 2024, to July 1, 2025. Simple random sampling method used to choice nurses included (450) nurses. A developed scale was used to identfy the QWL. The data were collected by interview and analyzed by using SPSS version (26). Results: The results of the study found most of the nurses participating in the study expressed that the quality of work life as general was good (3.373) with standard deviation (0.507). The study finding WoQL subscales are good except the (Work status, Compensation, Work stress) were moderate with mean (2.580, 2.913, 3.146), respectively. Conclousions: The researcher concluded that the QoWL among nurses in were good as generally except some aspects are moderate and its need improving it in the future as it affects the psychological, social and economic condition of nurses and improves quality of service.

Background: Medication toxicity is a persistent public health issue globally and is frequently associated with inappropriate drug use, inadequate storage and unsupervised self-medication. In Saudi Arabia, while access to pharmaceuticals and healthcare services has improved, public awareness and engagement in safe medication practices remain suboptimal. This study addresses a gap in national data concerning knowledge and behaviors related to medication toxicity. Objective: To evaluate public knowledge, perceived risk factors and preventive practices regarding medication toxicity among the Saudi population and to examine associations with key demographic variables. Methods: A cross-sectional study was conducted using a structured and validated questionnaire distributed to 543 individuals across different regions of Saudi Arabia. The instrument assessed demographic characteristics, awareness of medication toxicity, risk perceptions, safety-related behaviors and professional consultation patterns. Data analysis was performed using IBM SPSS Statistics version 26. Chi-square tests determined associations between demographic factors and medication safety practices (significance set at p<0.05). Results: Although 86.2% of participants reported awareness of medication toxicity, preventive practices were inconsistently applied. Only 63.6% consistently checked medication expiry dates and 34.1% acknowledged storing medications in potentially harmful conditions. Additionally, 57.1% reported discontinuing medications upon experiencing side effects without seeking professional advice. Significant associations were identified between gender and awareness (p<0.001), education level and consultation behavior (p<0.001) and storage practices and awareness (p<0.001). Conclusion: The findings reveal a disconnect between awareness and behavior regarding medication safety. Demographic factors, particularly gender and educational attainment, significantly influence safety practices. These results underscore the need for targeted educational interventions, strengthened pharmacist-patient communication and community-based awareness programs to mitigate the risk of medication toxicity.

Background: Recently, the use of digital screens and technology has become widespread, especially among medical students, which may have significant implications for their health and well-being. Migraine headaches are a common neurological disorder that can have a substantial impact on an individual's quality of life. The present study aims to explore the association between screen exposure and migraine headaches among medical students at Umm Al-Qura University (UQU) in Makkah, Saudi Arabia. Methods: This cross-sectional study was conducted among 312 medical students in UQU. A self-administered electronic questionnaire was used to gather data. We identified students with migraines using a self-administered migraine screen questionnaire (MS-Q) tool. Screen time exposure was recorded in a standardized questionnaire. Results: More than half of students (51.0%) reported experiencing frequent or severe headache attacks in the last 12 months. 92.5% reported using electronic devices (computer, iPad, or mobile) for their studies. Most participants were female, constituting 95.5% of the sample. Regarding age, 31.3% were 21 years old. Concerning academic year, most were in their 4th year, accounting for 41.8% of the sample, and 50.7% of respondents had a positive family history of migraines. Conclusion: The prevalence of migraines among medical students in Makkah was relatively high, with a female predominance. The pain intensity of the migraine headaches was associated with increasing levels of screen time exposure (p = 0.04705). Students' awareness of migraine management should be enhanced by avoiding trigger factors, including reducing screen time. The limited generalizability of our findings to different demographics may stem from the small sample size of a single institution.

Background: The current standard of care for patients with appendicitis is the surgical appendectomy, which is the most common surgical emergency in children and young adults with abdominal pain. Objectives: This study aimed to compare clinical characteristics and complications of early appendectomy and conservative management with interval appendectomy approaches among patients with appendicular mass. Patients and methods: This cross-sectional, prospective, comparative study was conducted on 84 patients with appendicular mass at Rizgary Teaching Hospital from January 2022 to January 2024. Patients were divided into two groups. Group I underwent appendectomy within 24 hours of admission, while group II patients received conventional treatment (intravenous fluids, antibiotics and analgesics) and were discharged once the acute inflammatory mass was resolved and re-admitted for interval appendectomy after 2-3 months. Finally, operative difficulties, total operating time, operative/postoperative complications, total duration of hospital stay and patient compliance were reported and compared in both groups. Results: Most clinical characteristics related to appendix (abscessation, intussusception, adhesion, gangrene), nematode infection and hospital resubmission were found less frequently among group I than in another group. Also, group I patients had fewer operation problems during surgery, such as bleeding (14.3%), trauma to the intestine (9.5%) and adhesion difficulties (23.8%), as well as their operation time was significantly (p≤0.05) shorter than another group (90±15 vs. 105±20 minutes). Moreover, group I patients had significantly fewer health problems after surgery (p≤0.05), including infected wounds (19%) and residual abscessation at the operation site (9.5%), with shorter hospitalization duration than another group (6.5±2.0 vs. 7.8±2.5 days). Conclusions: Early appendectomy of appendicular mass is a safe and effective alternative to conventional conservative treatment, followed by interval appendectomy, due to fewer operation problems and postoperative complications.

Background: Nurses are nearly twice as likely as other professionals to experience depression. Major depression has an impact on both employees and organizations. Depression can lead to increased job absenteeism, short-term incapacity, lower productivity, and presenteeism. Objectives: To estimate the incidence of depressed symptoms among nurses of pediatric wards, to describe the range of depressive symptoms experienced by the nursing sample, and to examine factors associated with persistent depressive symptoms. Methods: A cross-sectional study of (119) nurses aged between 20 and 50 years, working in pediatric wards in six hospitals (Mosul General Hospital, Ibn Alatheer Hospital, Alkhansaa Hospital, Alsalam teaching Hospital, Albatool teaching Hospital, Ibn-sina Hospital) in Mosul city, Iraq. For the period from 1st November 2024 to 5th January 2025. Depressive symptoms and risk factors were assessed by using developed scale Zung's Self-Rating Depression Scale. Findings: The study results show that the largest proportion of samples belong to the age group 25-29 years, and the highest percentage of the participant is female (59%). Regarding education, the table presents that the highest percentage of nurses (43%). The table show feeling and positive symptoms p-value 0.000, Moderately Depressed, and feeling and negative symptoms p-value 0.017 severely depressed. Conclusion: The study proves a considerable correlation between depression symptoms and job demands/resources. Critical care nurses reported depression symptoms such as fatigue, motor difficulties, and hunger issues. Paying attention to these indicators may aid in identifying depression among critical care nurses. Recommendations: Suggested a healthy sleep pattern, effective stress management involves healthy coping mechanisms. Regular self-care activities include exercise, meditation, and yoga.