Outcomes of Outpatient Versus Inpatient Induction of Labor: A Systematic Review and Meta-Analysis.

Induction of labor (IOL) has become a common practice in obstetrics, leading to an increase in antenatal admissions and workload. This review aims to explore the available options for outpatient IOL and their effectiveness. We conducted an electronic search for trials on Cochrane, PubMed, Google Scholar, and Web of Science databases for randomized control trials (RCTs) comparing inpatient and outpatient labor induction and covering the period until 2024. We selected randomized trials that compared IOL in outpatient vs. inpatient settings and involved mechanical or hormonal agents. The participants were pregnant women with singleton fetuses who were more than 37 weeks and low risk for IOL with a Bishop score <6. When comparing outpatient and inpatient induction methods, we found no significant differences in cesarean section rates and vaginal delivery. Outpatient induction generally resulted in shorter hospital stays. Using a Foley catheter for outpatient induction reduced the cesarean section rate and total hospital stay. There were no safety concerns with this approach. IOL in this analysis was shown to be similar to inpatient IOL in most of the measured outcomes. Implementation of IOL in an outpatient setting proved to be safe with similar outcomes to inpatient IOL.

Gut instinct: harnessing the power of probiotics to tame pathogenic signaling pathways in ulcerative colitis.

Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD) marked by persistent inflammation of the mucosal lining of the large intestine, leading to debilitating symptoms and reduced quality of life. Emerging evidence suggests that an imbalance of the gut microbiota plays a crucial role in UC pathogenesis, and various signaling pathways are implicated in the dysregulated immune response. Probiotics are live microorganisms that confer health benefits to the host, have attracted significant attention for their potential to restore gut microbial balance and ameliorate inflammation in UC. Recent studies have elucidated the mechanisms by which probiotics modulate these signaling pathways, often by producing anti-inflammatory molecules and promoting regulatory immune cell function. For example, probiotics can inhibit the nuclear factor-κB (NF-κB) pathway by stabilizing Inhibitor of kappa B alpha (IκBα), dampening the production of proinflammatory cytokines. Similarly, probiotics can modulate the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway, suppressing the activation of STAT1 and STAT3 and thus reducing the inflammatory response. A better understanding of the underlying mechanisms of probiotics in modulating pathogenic signaling pathways in UC will pave the way for developing more effective probiotic-based therapies. In this review, we explore the mechanistic role of probiotics in the attenuation of pathogenic signaling pathways, including NF-κB, JAK/STAT, mitogen-activated protein kinases (MAPKs), Wnt/ß-catenin, the nucleotide-binding domain (NOD)-, leucine-rich repeat (LRR)- and pyrin domain-containing protein 3 (NLRP3) inflammasome, Toll-like receptors (TLRs), interleukin-23 (IL-23)/IL-17 signaling pathway in UC.

Factors Influencing the Success of Endodontic Retreatment: Insights from a Retrospective Study.

Objective: The purpose of this retrospective study was to assess the variables affecting endodontic retreatment technique success. Methods: A 5-year period of 500 patient records from a dental clinic were examined. Pre-operative factors, procedure specifics, post-operative results, and demographic information were all documented. The study employed statistical analysis to determine the important factors that influence retreatment success. Findings: The average age of the study group was 45.2 years, and 56% of the participants were female. Sixty-four percent of patients had multiple root canals, and the most frequent initial diagnosis (60%) was apical periodontitis. The results of the surgery varied: 50% of patients had full healing, 30% had partial healing, and 20% had no improvement at all. Significant indicators of retreatment success were found to include age, initial diagnosis, and root canal morphology (P < 0.05). Conclusion: The effectiveness of endodontic retreatment operations is mostly influenced by age, apical periodontitis, and root canal morphology. Optimizing treatment results requires individualized treatment techniques based on each patient's unique features. Clinicians can benefit greatly from these findings in terms of increasing endodontic retreatment success rates and enhancing patient care.

Comparative Analysis of Post-operative Pain Relief and Healing Outcomes between Single-Visit and Multiple-Visit Root Canal Therapy: A Tertiary Care Study.

Background: Apical periodontitis and irreversible pulpitis are typical dental conditions treated with "Root Canal Treatment (RCT)". Single-visit RCT has become a viable alternative to the multi-visit RCT method used in traditional RCT. Methods: A total of 100 RCT participants were randomised to either the single-visit or multiple-visit groups at random. A "Visual Analogue Scale (VAS)" was used to measure post-operative discomfort at 24, 48, and 72 hours. At 6 and 12 months, peri-apical radiographs were used to assess the healing results. Results: At all time periods, there were no discernible variations in post-operative discomfort between the single-visit and multiple-visit groups. In contrast to the multiple-visit group, the single-visit group had greater rates of full healing at both 6 and 12 months. Conclusion: Compared to multiple-visit RCT, single-visit RCT provides similar post-operative pain alleviation and may result in better healing results. This suggests that single-visit RCT is a feasible and effective management option for patients who need root canal therapy.

Evaluation of Long-Term Stability in Single-Piece Implant Systems: An Original Research.

Background: Because of its integrated design and possible benefits over conventional two-piece systems, single-piece implant systems have grown in favor in the field of dental implantology. There is, however, still a dearth of information about their long-term stability and clinical results. The purpose of this study was to assess the clinical results, such as implant survival rates, peri-implant tissue health, and marginal bone levels, to determine the long-term stability of single-piece implant systems. Methods: About 127 individuals who got single-piece implants at the tertiary care center were the subject of a retrospective analysis. Standardized procedures were followed for implant implantation, and patients were monitored for at least five years afterward. Through radiographic analysis and clinical tests, clinical indicators such as marginal bone levels, peri-implant tissue health, and implant survival rates were evaluated. Results: With low marginal bone loss and good peri-implant tissue health, the research showed a high implant survival rate of 96.5%. A statistical study revealed significant relationships between marginal bone loss (P < 0.01), peri-implant tissue health (P < 0.05), and implant survival. Conclusion: In this study, single-piece implant devices showed good long-term durability and clinical results. These results confirm its effectiveness as a dependable dental rehabilitation alternative, highlighting the significance of preserving the health of the peri-implant tissue and reducing marginal bone loss to guarantee implant success.

Exploring Efficacy and Safety: Comparative Evaluation of Different Irrigation Solutions in Root Canal Therapy at a Tertiary Care Setting.

Background: In order to completely remove bacteria and debris from the root canal system, root canal treatment (RCT) calls for efficient irrigation methods. There is still a lack of research on the relative safety and efficacy of various irrigation systems in tertiary care settings. Methods: Patients receiving RCT at a tertiary care endodontic clinic were included in a prospective comparison research of 150 subjects. One of four irrigation solutions-sodium hypochlorite, chlorhexidine, ethylenediaminetetraacetic acid (EDTA), or a combination of the three-was given to patients at random. Following surgery, microbial decrease and patient-reported pain levels were evaluated. Results: The analysis showed that there were significant differences (P < 0.05) in microbial decrease between the irrigation solution groups. EDTA, sodium hypochlorite, and chlorhexidine were the next three groups with the biggest mean log decrease in microbial counts, after the combination group. Nonetheless, there were no appreciable variations in the groups' patient-reported pain levels (P > 0.05). Conclusion: Our results imply that microbial reduction in RCT is highly influenced by the irrigation solution selection. Without having an impact on the pain sensations reported by the patients, the combination of irrigation solutions showed higher efficacy in microbial control. These findings highlight how crucial it is to choose an irrigation solution carefully in order to maximize endodontic outcomes in tertiary care settings.

The role of gut-derived short-chain fatty acids in Parkinson's disease.

The emerging function of short-chain fatty acids (SCFAs) in Parkinson's disease (PD) has been investigated in this article. SCFAs, which are generated via the fermentation of dietary fiber by gut microbiota, have been associated with dysfunction of the gut-brain axis and, neuroinflammation. These processes are integral to the development of PD. This article examines the potential therapeutic implications of SCFAs in the management of PD, encompassing their capacity to modulate gastrointestinal permeability, neuroinflammation, and neuronal survival, by conducting an extensive literature review. As a whole, this article emphasizes the potential therapeutic utility of SCFAs as targets for the management and treatment of PD.

Field Emission Scanning Electron Microscope Analysis of the Marginal Adaptation of Various Root Canal Sealers at the Dentin-Sealer and Sealer-Guttapercha Interfaces at Three Root Canal Levels: An In Vitro Study.

Aims An in vitro evaluation of the marginal adaptation of four root canal sealer variants at the dentin-sealer and sealer gutta-percha interfaces in the coronal, middle, and apical thirds of root canals was conducted using field emission scanning electron microscope (FESEM) analysis.  Materials and methods In total, 80 extracted human mandibular premolar teeth were used in this study. All teeth were decoronated to standardize the root length to 14 mm. A round bur was used to gain access into canal orifices and the working length was determined. Root canal instrumentation was performed using the crown-down technique with ProTaper Next rotary files up to size X3, along with the use of root canal irrigants. All specimens were then randomly divided into four groups, with 20 specimens per group, depending on the root canal sealer used: Group A consisted of AH Plus (Dentsply Maillefer, Ballaigues, Switzerland), Group B of MTA-Fillapex (Angelus Dental, Londrina, Brazil), Group C of Bio-C Sealer (Angelus Dental), and Group D of GuttaFlow-2 (Coltene Whaledent, Altstatten, Switzerland). All specimens were obturated with size X3 gutta-percha points uniformly coated with respective sealers in the single-cone technique and coronal access was sealed with glass ionomer cement. The specimens were incubated for seven days and then horizontally sectioned at the coronal, middle, and apical thirds of the root canals. On each sample obtained, three points were randomly chosen and both sealer-dentin and sealer gutta-percha interfaces were examined under FESEM at 1000x magnification. The marginal gaps of all four sealers at both interfaces and at three levels of root canals were measured in µm and values were recorded, tabulated, and used for data analysis. One-way analysis of variance (ANOVA) and post hoc Bonferroni tests were used for statistical analysis. A p-value ≤ 0.05 was considered statistically significant. Results Compared to the sealer gutta-percha interface, AH Plus, MTA-Fillapex, and Bio-C sealers at all three levels of the root canals showed more marginal gaps at the sealer-dentin interface with a significant difference (p<0.05). However, the GuttaFlow-2 sealer showed no significant difference (P > 0.05).  Conclusions The marginal adaptation of the GuttaFlow-2 sealer is superior to both dentin and gutta-percha at the coronal, middle, and apical thirds of root canals compared to other sealers used in the study.

Small molecule and big function: MicroRNA-mediated apoptosis in rheumatoid arthritis.

Rheumatoid arthritis (RA) is a common autoimmune condition and chronic inflammatory disease, mostly affecting synovial joints. The complex pathogenesis of RA is supportive of high morbidity, disability, and mortality rates. Pathological changes a common characteristic in RA synovial tissue is attributed to the inadequacy of apoptotic pathways. In that regard, apoptotic pathways have been the center of attention in RA therapeutic approaches. As the regulators in the complex network of apoptosis, microRNAs (miRNAs) are found to be vital modulators in both intrinsic and extrinsic pathways through altering their regulatory genes. Indeed, miRNA, a member of the family of non-coding RNAs, are found to be an important player in not even apoptosis, but proliferation, gene expression, signaling pathways, and angiogenesis. Aberrant expression of miRNAs is implicated in attenuation and/or intensification of various apoptosis routes, resulting in culmination of human diseases including RA. Considering the need for more studies focused on the underlying mechanisms of RA in order to elevate the unsatisfactory clinical treatments, this study is aimed to delineate the importance of apoptosis in the pathophysiology of this disease. As well, this review is focused on the critical role of miRNAs in inducing or inhibiting apoptosis of RA-synovial fibroblasts and fibroblast-like synoviocytes and how this mechanism can be exerted for therapeutic purposes for RA.

Assessing oral health knowledge among public school children in Saudi Arabian subpopulation.

INTRODUCTION: Oral hygiene is paramount for maintaining optimal oral and physical health, especially among children who are particularly susceptible to dental caries and issues due to dietary habits and inadequate hygiene practices. This study aimed to evaluate the awareness and knowledge of oral health among public school children, analyse their oral hygiene habits, educate parents on the importance of oral health for their children, and implement an oral hygiene educational program in Al-Kharj City, Saudi Arabia. METHODS: Four public elementary schools were selected for the study, with a sample size of 200 school-going children participating. A structured questionnaire was used to assess awareness and knowledge of oral health among the participants. SPSS software version 26 was used for data analysis. Multiple regression analysis and correlation tests was employed to explore the relationships between the different variables measured in the study. RESULTS: The findings revealed a significant lack of awareness regarding oral health among school children. Oral hygiene habits were found to be inadequate in many participants. Overall, the findings highlight the need for targeted interventions aimed at promoting regular dental visits, addressing dental fear, and fostering positive oral hygiene practices among school-going children to improve oral health outcomes in the studied population. CONCLUSION: The study highlighted a critical gap in oral health awareness among school children, underscoring the need for targeted interventions. While the oral hygiene educational program has been implemented and future data will shed light on its effectiveness, preliminary observations suggest that such programs could potentially improve oral health outcomes and overall engagement among students.

Enhancing Wireless Network Efficiency with the Techniques of Dynamic Distributed Load Balancing: A Distance-Based Approach.

The unique combination of the high data rates, ultra-low latency, and massive machine communication capability of 5G networks has facilitated the development of a diverse range of applications distinguished by varying connectivity needs. This has led to a surge in data traffic, driven by the ever-increasing number of connected devices, which poses challenges to the load distribution among the network cells and minimizes the wireless network performance. In this context, maintaining network balance during congestion periods necessitates effective interaction between various network components. This study emphasizes the crucial role that mobility management plays in mitigating the uneven load distribution across cells. This distribution is a significant factor impacting network performance, and effectively managing it is essential for ensuring optimal network performance in 5G and future networks. The study investigated the complexities associated with congested cells in wireless networks to address this challenge. It proposes a Dynamic Distance-based Load-Balancing (DDLB) algorithm designed to facilitate efficient traffic distribution among contiguous cells and utilize available resources more efficiently. The algorithm reacts with congested cells and redistributes traffic to its neighboring cells based on specific network conditions. As a result, it alleviates congestion and enhances overall network performance. The results demonstrate that the DDLB algorithm significantly improves key metrics, including load distribution and rates of handover and radio link failure, handover ping-pong, and failed attached requests.

Early Detection of Renal Complication in Children With Sickle Cell Disease: A Single Center Prospective Study.

INTRODUCTION: This observational cross-sectional study aimed to identify predictors of renal complications in pediatric patients with sickle cell disease (SCD) at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia, over six months from February 2023 to July 2023. The study evaluated microalbuminuria as an early indicator of renal injury and explored its correlations with clinical and laboratory parameters and abdominal ultrasound (US) findings. METHODS: Included were pediatric patients aged 1 to 14 years with confirmed SCD, excluding those with acute infections or pre-existing renal diseases. Data from 100 patients' electronic medical records were analyzed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States), with a significance set at p ≤ 0.05. RESULTS: The mean age was 7.6 ± 3.3 years, with 51 males and 49 females; 11 were diagnosed with Hb-S-beta thalassemia. Hydroxyurea (HU) compliance was high, with only four non-compliant patients, though all took folic acid. Among 42 tested for albuminuria, all had negative results (<30 mg/g creatinine). A significant association was found between SCD diagnosis and kidney, ureter, and bladder (KUB) US results (p=0.008), with abnormal KUB findings more prevalent in the Hb-S-beta thalassemia group. Patients with abnormal KUB results had significantly lower mean weight (p=0.024). Additionally, Hb-S-beta thalassemia patients had lower mean weight than hemoglobin SS (HGSS) patients (p=0.04). Though not statistically significant, Hb-S-beta thalassemia patients had higher mean systolic blood pressure (p=0.053). CONCLUSION: Significant associations were identified between SCD diagnosis type and renal US results, with lower body weight emerging as a potential predictor of renal complications. High HU compliance and its impact on renal outcomes warrant further investigation. Routine monitoring of microalbuminuria and KUB US may aid early detection of renal complications in pediatric SCD patients. Further studies with larger sample sizes are recommended to validate these findings and develop comprehensive renal protective strategies.

MicroRNAs Modulating Neuroinflammation in Parkinson's disease.

Parkinson's disease (PD) is one of the most frequent age-associated neurodegenerative disorder. Presence of α-synuclein-containing aggregates in the substantia nigra pars compacta (SNpc) and loss of dopaminergic (DA) neurons are among the characteristic of PD. One of the hallmarks of PD pathophysiology is chronic neuroinflammation. Activation of glial cells and elevated levels of pro-inflammatory factors are confirmed as frequent features of the PD brain. Chronic secretion of pro-inflammatory cytokines by activated astrocytes and microglia exacerbates DA neuron degeneration in the SNpc. MicroRNAs (miRNAs) are among endogenous non-coding small RNA with the ability to perform post-transcriptional regulation in target genes. In that regard, the capability of miRNAs for modulating inflammatory signaling is the center of attention in many investigations. MiRNAs could enhance or limit inflammatory signaling, exacerbating or ameliorating the pathological consequences of extreme neuroinflammation. This review summarizes the importance of inflammation in the pathophysiology of PD. Besides, we discuss the role of miRNAs in promoting or protecting neural cell injury in the PD model by controlling the inflammatory pathway. Modifying the neuroinflammation by miRNAs could be considered a primary therapeutic strategy for PD.

Synthesis, characterization, and practical applications of perovskite quantum dots: recent update.

This review paper provides an in-depth analysis of Perovskite quantum dots (PQDs), a class of nanomaterials with unique optical and electronic properties that hold immense potential for various technological applications. The paper delves into the structural characteristics, synthesis methods, and characterization techniques of PQDs, highlighting their distinct advantages over other Quantum Dots (QDs). Various applications of PQDs in fields such as solar cells, LEDs, bioimaging, photocatalysis, and sensors are discussed, showcasing their versatility and promising capabilities. The ongoing advancements in PQD research and development point towards a bright future for these nanostructures in revolutionizing diverse industries and technologies.

Targeting the pancreatic tumor microenvironment by plant-derived products and their nanoformulations.

Pancreatic cancer remains a significant health issue with limited treatment options. The tumor stroma, a complex environment made up of different cells and proteins, plays a crucial role in tumor growth and chemoresistance. Targeting tumor stroma, consisting of diverse non-tumor cells such as fibroblasts, extracellular matrix (ECM), immune cells, and also pre-vascular cells is encouraging for remodeling solid cancers, such as pancreatic cancer. Remodeling the stroma of pancreas tumors can be suggested as a strategy for reducing resistance to chemo/immunotherapy. Several studies have shown that phytochemicals from plants can affect the tumor environment and have anti-cancer properties. By targeting key pathways involved in stromal activation, phytochemicals may disrupt communication between the tumor and stroma and make tumor cells more sensitive to different treatments. Additionally, phytochemicals have immunomodulatory and anti-angiogenic properties, all of which contribute to their potential in treating pancreatic cancer. This review will provide a detailed look at how phytochemicals impact the tumor stroma and their effects on pancreatic tumor growth, spread, and response to treatment. It will also explore the potential of combining phytochemicals with other treatment options like chemotherapy, immunotherapy, and radiation.

The multifaceted role of PCSK9 in cancer pathogenesis, tumor immunity, and immunotherapy.

Proprotein convertase subtilisin/kexin type 9 (PCSK9), a well-known regulator of cholesterol metabolism and cardiovascular diseases, has recently garnered attention for its emerging involvement in cancer biology. The multifunctional nature of PCSK9 extends beyond lipid regulation and encompasses a wide range of cellular processes that can influence cancer progression. Studies have revealed that PCSK9 can modulate signaling pathways, such as PI3K/Akt, MAPK, and Wnt/ß-catenin, thereby influencing cellular proliferation, survival, and angiogenesis. Additionally, the interplay between PCSK9 and cholesterol homeostasis may impact membrane dynamics and cellular migration, further influencing tumor aggressiveness. The central role of the immune system in monitoring and controlling cancer is increasingly recognized. Recent research has demonstrated the ability of PCSK9 to modulate immune responses through interactions with immune cells and components of the tumor microenvironment. This includes effects on dendritic cell maturation, T cell activation, and cytokine production, suggesting a role in shaping antitumor immune responses. Moreover, the potential influence of PCSK9 on immune checkpoints such as PD1/PD-L1 lends an additional layer of complexity to its immunomodulatory functions. The growing interest in cancer immunotherapy has prompted exploration into the potential of targeting PCSK9 for therapeutic benefits. Preclinical studies have demonstrated synergistic effects between PCSK9 inhibitors and established immunotherapies, offering a novel avenue for combination treatments. The strategic manipulation of PCSK9 to enhance tumor immunity and improve therapeutic outcomes presents an exciting area for further investigations. Understanding the mechanisms by which PCSK9 influences cancer biology and immunity holds promise for the development of novel immunotherapeutic approaches. This review aims to provide a comprehensive analysis of the intricate connections between PCSK9, cancer pathogenesis, tumor immunity, and the potential implications for immunotherapeutic interventions.

Phographene as a new carbon allotrope for adsorption and detection of SO2, AsH3, NO2, CF3H, and CO2 air pollutant gaseous species.

CONTEXT: Phographene and its family member structures are of the newly proposed semiconductors for detection of chemicals. That is, in this project, the potential of using α-phographene (α-POG) both for adsorption and detection of five types of the most important air pollutant gases containing SO2, AsH3, CF3H, NO2, and CO2 species were investigated.  The results of the time dependent density functional theory (TD-DFT) calculations indicate that during the adsorption of NO2, and SO2 by the sorbent, big redshifts occur (up to 866.2 nm, and 936.5, respectively) resulting in considerable changes in the orbitals and the electronic structures of the systems. Moreover, the results of the thermodynamic calculations reveal that α-POG could selectively adsorb SO2, NO2, and AsH3 gases (with different orders), but it could not adsorb the two other gases.Finally, the outcome of the band gap calculations shows that between all mentioned gases, α-POG could selectively detect the presence of SO2, and then NO2; while, this nanosheet could not sense the existence of AsH3, CF3H, or CO2 gases. METHODS: All of the calculations were carried out by using the Gaussian 03 quantum chemical package. In addition, the physiochemical parameters were extracted from the output files for further calculations. Studies on all saddle points and the following calculations were performed applying the B3LYP/6-311g(d,p) level of theory.

Stealth Nanocarriers in Cancer Therapy: a Comprehensive Review of Design, Functionality, and Clinical Applications.

Nanotechnology has significantly transformed cancer treatment by introducing innovative methods for delivering drugs effectively. This literature review provided an in-depth analysis of the role of nanocarriers in cancer therapy, with a particular focus on the critical concept of the 'stealth effect.' The stealth effect refers to the ability of nanocarriers to evade the immune system and overcome physiological barriers. The review investigated the design and composition of various nanocarriers, such as liposomes, micelles, and inorganic nanoparticles, highlighting the importance of surface modifications and functionalization. The complex interaction between the immune system, opsonization, phagocytosis, and the protein corona was examined to understand the stealth effect. The review carefully evaluated strategies to enhance the stealth effect, including surface coating with polymers, biomimetic camouflage, and targeting ligands. The in vivo behavior of stealth nanocarriers and their impact on pharmacokinetics, biodistribution, and toxicity were also systematically examined. Additionally, the review presented clinical applications, case studies of approved nanocarrier-based cancer therapies, and emerging formulations in clinical trials. Future directions and obstacles in the field, such as advancements in nanocarrier engineering, personalized nanomedicine, regulatory considerations, and ethical implications, were discussed in detail. The review concluded by summarizing key findings and emphasizing the transformative potential of stealth nanocarriers in revolutionizing cancer therapy. This review enhanced the comprehension of nanocarrier-based cancer therapies and their potential impact by providing insights into advanced studies, clinical applications, and regulatory considerations.

Economics of primary healthcare: cost estimation of clinical services at primary care facilities in the six countries of the Gulf Cooperation Council.

OBJECTIVE: While the Gulf Cooperation Council (GCC) countries have demonstrated a strong commitment to strengthening primary healthcare (PHC), the costs of delivering these services in this region remain relatively unexplored. Understanding the costs of PHC delivery is essential for effective resource allocation and health system efficiency. DESIGN: We used an ingredient-based method to estimate the cost of delivering a selection of services at PHC facilities in the six GCC countries in 2019. Services were categorised into eight programmes: immunisation; non-communicable diseases (NCDs); oral and dental care; child health; nutrition; mental health; reproductive, maternal, neonatal and child health and general practice. The cost estimation focused on two key ingredients: the costs of drugs and supplies and the healthcare workforce cost. The coverage rates of specific types of health services, including screening and mental health services, were also estimated. Data for the analysis were obtained from ministries of health, health statistics reports, online databases, national surveys and scientific literature. RESULTS: The estimated costs of delivering the selected services at public PHC facilities in the six GCC countries totalled US$5.7 billion in 2019, representing 0.34% of the combined 2019 GDP. The per capita costs varied from US$69 to US$272. General practice and NCD programmes constituted 79% of the total costs modelled while mental health ranged between 0.0% and 0.3%. Over 8 million individuals did not receive NCD screening services, and over 30 million did not receive needed mental health services in public PHC facilities across the region. CONCLUSIONS: To our knowledge, this is the first study to estimate the costs of services delivered at PHC facilities in the GCC countries. Identifying the main cost drivers and the services which individuals did not receive can be used to help strengthen PHC to improve efficiency and scale up needed services for better health outcomes.