Sex differences in pregabalin-seeking like behavior in a conditioned place preference paradigm.

Substance abuse is a chronic, relapsing disorder characterized by compulsive drug use regardless of negative consequences. Incremental increases in pregabalin abuse have been observed in Saudi Arabia and throughout the world. In previous studies, the potential for pregabalin abuse with escalating doses of the drug (30, 60, 90, and 120 mg/kg) were investigated in male mice. Notably, researchers have argued that women may exhibit a greater tendency to consume drugs without a prescription to alleviate stress and depression. Moreover, female subjects are more prone to impulsivity in drug intake or abuse than their male counterparts. Therefore, in the present study, we compared the potential for pregabalin abuse between male and female mice using a conditioned place preference paradigm. Male and female BALB/c mice were divided into four groups based on the pregabalin dose administered (30, 60, 90, or 120 mg/kg, intraperitoneal). Preference scores were then calculated and compared between male and female mice in each dosage group. Interestingly, preference scores were significantly higher in female mice than in male mice at dosages of 30 and 120 mg/kg. These findings indicate that female mice may be more prone to pregabalin abuse and tolerance than male mice. These results might be helpful to the healthcare providers and policymakers to consider these sex differences in choosing therapeutic plans and consider alternatives to the misused prescription medications.

The impact of body position on vital capacity among pregnant women in the second trimester.

Background: Pregnancy introduces significant physiological changes, notably impacting respiratory dynamics, especially during the second trimester. Data remain inconclusive about how body posture might influence lung function in pregnant women. We aimed to examine the impact of body position on slow vital capacity in pregnant women during their second trimester. Methods: This observational study was carried out at King Khalid Hospital in Saudi Arabia, involving pregnant women in their second trimester, from 14 to 26 weeks of gestation. We utilized the KoKo® Legend Portable Office Spirometer to measure slow vital capacity (SVC) in both sitting and standing positions. Participants' demographic details were recorded, ensuring a comprehensive analysis that accounted for age, BMI, and gestational age. Results: 136 pregnant women participated in this study, a paired-sample t-test revealed no statistically significant difference between sitting (M = 2.31, SD = 0.49) and standing (M = 2.33, SD = 0.5) positions, p = 0.24, However; the mean value of SVC in sitting position was significantly different between 4th month of pregnancy (M = 2.17, SD = 0.44) and 6th month of pregnancy (M = 2.45, SD = 0.48), p = 0.016. Conclusion: The performance of the SVC in both positions was not significantly affected. However, an increase in gestational age had a notable impact on SVC performance, particularly during sitting positions, due to the changes in respiratory physiology during pregnancy.

Herpesvirus Entry Mediator as an Immune Checkpoint Target and a Potential Prognostic Biomarker in Myeloid and Lymphoid Leukemia.

Herpesvirus entry mediator (HVEM) is a molecular switch that can modulate immune responses against cancer. The significance of HVEM as an immune checkpoint target and a potential prognostic biomarker in malignancies is still controversial. This study aims to determine whether HVEM is an immune checkpoint target with inhibitory effects on anti-tumor CD4+ T cell responses in vitro and whether HVEM gene expression is dysregulated in patients with acute lymphocytic leukemia (ALL). HVEM gene expression in tumor cell lines and peripheral blood mononuclear cells (PBMCs) from ALL patients and healthy controls was measured using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Tumor cells were left untreated (control) or were treated with an HVEM blocker before co-culturing with CD4+ T cells in vitro in a carboxyfluorescein succinimidyl ester (CFSE)-dependent proliferation assay. HVEM expression was upregulated in the chronic myelogenous leukemia cell line (K562) (FC = 376.3, p = 0.086) compared with normal embryonic kidney cells (Hek293). CD4+ T cell proliferation was significantly increased in the HVEM blocker-treated K562 cells (p = 0.0033). Significant HVEM differences were detected in ALL PBMCs compared with the controls, and these were associated with newly diagnosed ALL (p = 0.0011) and relapsed/refractory (p = 0.0051) B cell ALL (p = 0.0039) patients. A significant differentiation between malignant ALL and the controls was observed in a receiver operating characteristic (ROC) curve analysis with AUC = 0.78 ± 0.092 (p = 0.014). These results indicate that HVEM is an inhibitory molecule that may serve as a target for immunotherapy and a potential ALL biomarker.

Knowledge and Awareness About Gastric Cancer Among the General Population in Al-Baha City, Saudi Arabia.

Background Gastric cancer is a significant health concern worldwide, and its incidence varies across different populations. This study aimed to assess the level of knowledge and awareness of gastric cancer among the general population in Al-Baha City, Saudi Arabia.  Methodology This is a cross-sectional study that was conducted among the residents of Al-Baha city older than 18 years. The study was conducted based on a questionnaire that has been developed by a previous study. Data were initially recorded in an Excel sheet before being exported to the SPSS program, version 25 for data analysis. Results The survey included 426 respondents from Al-Baha city, Saudi Arabia, with 56.8% being females and the majority being in the age groups (21-30 years). Alcohol consumption (mean=4.5, SD= 0.77), smoking cigarettes or Shisha (mean= 4.38, SD=0.852), family history of gastric cancer (mean= 4, SD=1.008), a past medical history of gastric cancer (mean= 3.99, SD=0.911), stomach ulcer (mean=3.76, SD=0.898), and consumption of smoked food (mean= 3.69, SD=0.956) are the most widely recognized risk factors. The most highly recognized symptoms are gastrointestinal bleeding (mean= 4.03, SD=0.875), abdominal lump (mean= 3.94, SD=0.926), weight loss (mean= 3.93, SD=0.963), recurrent nausea and vomiting (mean=3.76, SD=0.956), and abdominal pain (mean= 3.57, SD=0.995). The study also identified several subgroups of the population that may benefit from targeted educational programs, including individuals in the age group of 41-50 years and those in non-medical occupations. Conclusion The study found that participants had a moderate level of knowledge about the risk factors and symptoms of gastric cancer, with significant variability among different subgroups of the population. Further research is needed to investigate the prevalence and risk factors of gastric cancer in Saudi Arabia and other similar populations, to develop effective prevention and management strategies for this disease.

The Prevalence of Irritable Bowel Syndrome and Its Co-existence With Migraine in Medical and Non-medical Students at Al-Baha University, Saudi Arabia.

BACKGROUND: It was hypothesized that the prevalence of irritable bowel syndrome (IBS) and migraine and their co-existence are higher among medical students. In this study, we aim to establish the prevalence of IBS and migraine in the medical and non-medical students at Al-Baha University, Saudi Arabia, and to observe the association and relationship between IBS and migraine using the Rome IV diagnostic criteria for IBS and the International Classification of Headache Disorders (ICHD)-3 criteria for migraine. METHODOLOGY: This cross-sectional study was done on the Saudi Arabian campus of Al-Baha University between July 2022 and July 2023. Al-Baha city-dwelling male and female college students aged 18 to 29 comprised the study population. A self-administered electronic questionnaire was sent online to determine the prevalence of IBS and migraine, in addition to associated risk factors. The questionnaire consisted of three sections: demographic and lifestyle data, the Rome IV criteria for diagnosing and subclassifying IBS, and the ICHD-3 criteria for diagnosing migraine. RESULTS: The study was conducted among 452 participants with a mean age of 21.64 years. The majority of participants were not from medical schools. The majority of medical and non-medical participants were male, at 66.6% and 63.1%, respectively. In our study, 36.9% of the individuals reported having a first-degree relative diagnosed with IBS, whereas 2.7% reported having IBS themselves. Regarding migraine, 17.9% of respondents claimed to have a first-degree relative with migraine, while 6.9% of respondents themselves reported experiencing migraine. Regarding IBS prevalence, there was no significant difference between participants from non-MBBS colleges and MBBS colleges. Similarly, there was no significant difference in migraine prevalence between these two groups (92.0% vs. 95.4%, p=0.185). CONCLUSION: The current study contributes significantly to our understanding of the prevalence of IBS and migraines among medical students, as well as these individuals' demographic characteristics, familial histories, and aggravating variables.

The Impact of Non-pharmacological Interventions on Blood Pressure Control in Patients With Hypertension: A Systematic Review.

Hypertension treatment should involve non-pharmacological interventions such as dietary salt restriction, weight loss, exercise, limiting alcohol intake, and dietary approaches to stop hypertension diet. Significant impacts of these interventions have been suggested for a long time. This systematic review aims to assess the influence of non-pharmacological therapies on hypertension patients' ability to control their blood pressure. The review will concentrate on randomized controlled trials examining how non-pharmacological therapies affect blood pressure regulation in hypertension patients. A systematic review was conducted to investigate the impact of non-pharmacological interventions on blood pressure control in patients with hypertension. A comprehensive search for relevant studies was conducted. The following electronic databases were searched: EMBASE, OVID-MEDLINE, and PubMed. The search covered the period between January 2000 and August 2023. The search strategy included a combination of keywords related to hypertension, non-pharmacological interventions, and blood pressure control. A thorough literature evaluation of papers from the EMBASE, OVID-MEDLINE, and PubMed databases was part of the procedure for choosing the studies. Combinations of the keywords telemedicine, primary care, and effectiveness were used for the search. Only studies published in English between January 2000 and August 2023 were included in the search. Through database searching, 862 entries were found, of which 321 were from EMBASE, 112 from OVID-MEDLINE, and 429 from PubMed. After duplicate records were eliminated, 117 records were checked for eligibility. Of these, 100 were disregarded for a variety of reasons, including not relevant to the objectives of the study (n = 63), abstracts or reviews (n = 8), and studies that failed to present interesting research findings (n = 36). The eligibility of the remaining 10 full-text publications was evaluated. Ten articles passed the inclusion tests and were added to the research after a thorough evaluation. Lifestyle modifications are important and have a significant impact on controlling hypertension and a positive impact on reducing blood pressure. Combination therapy is more effective; however, adherence to the modifications is the most important factor affecting the outcomes.

Social Comparison and Body Image in Teenage Users of the TikTok App.

BACKGROUND AND AIM: The TikTok app is one of the video-based social media platforms that is currently trending and commonly used by teenagers. The data about teenage users of the TikTok app are limited. This study aimed to estimate the prevalence of TikTok app use among teenagers in Saudi Arabia and to investigate the association between TikTok app use and the social comparison and the body image of the study population. Further, to explore the potential associations between the social comparison and the body image of the TikTok app users and their different characteristics. METHODS: This cross-sectional survey study was conducted all over Saudi Arabia. The study included male and female teenagers, aged 12-19 years. The researchers used a structured, self-administered questionnaire to collect data, and it was disseminated using different social media platforms. The social comparison was measured using the questionnaire of the Iowa-Netherlands Comparison Orientation Measure, and the body image was measured using the Measurement of the Body Image Scale. The data were analyzed using the SPSS software version 26 (Chicago, IL: SSPS Inc.). Continuous variables were compared using the Student's t-test, Mann-Whitney U test, or Kruskal-Wallis tests, whereas categorical variables were compared using the Chi-square or Fisher's exact tests as appropriate. Spearman's rank correlation was applied to investigate the association between body image and social comparison scores among TikTok app users and non-users. RESULTS: This study included 384 Saudi teenagers. Females (n=260) outnumbered males (n=124) (67.7% and 32.3%, respectively), and the mean of their age was 16.3±2.0 years. The researchers found a high prevalence (343/384, 89.3%) of TikTok app use among the studied teenagers. There was a significantly high median of the social comparison score among the TikTok app users (33.0, IQR: 28.0-38.0) compared to the non-users (28.0, IQR: 26.0-34.0), p=0.005. TikTok app users also showed a significantly lower median body image score (64.0, IQR: 54.0-72.0) in comparison to the non-users (67.0, IQR: 58.0-73.0), p=0.037. The correlation between social comparison and body image among teenagers using TikTok showed a negative relationship, but it was not significant (p=0.110). However, a significant negative weak relationship was found between body image and comparison of abilities (rs coefficient=-0.113, p=0.037). CONCLUSIONS: The findings of the current study indicate a high prevalence of TikTok use among teenagers in Saudi Arabia. The use of TikTok was associated with a high social comparison and a negative body image, with more than half of the users expressing a negative body image. Comparison of abilities was associated with an increased level of body dissatisfaction. These findings emphasize the need for the development and implementation of public health policies and awareness programs to promote body acceptance, especially for young people across the country. Future studies should focus on the long-term impact of TikTok use on psychological health.

Worst pattern of invasion and other histopathological features in oral cancer as determinants of prognosis and survival rate: A retrospective cohort analysis.

Oral cavity squamous cell carcinoma (OCSCC) is a well-recognized malignancy of the head and neck. Studies on patients with early-stage oral cancer have shown that they develop locally recurring and/or regional lymph node metastasis, which results in disease-associated mortality. Thus, early-stage oral cancer does not always present good prognoses. The present study aimed to determine the efficacy of using worst pattern of invasion (WPOI) and other histopathological features, such as prognostic factors in OCSCC, and analyze the impact of resection margin status and histopathological prognostic indicators on local recurrence (LR) and overall survival (OS) in patients with OCSCC. A retrospective cohort study was conducted by reviewing the charts of 63 patients with OCSCC treated with primary surgery at King Abdulaziz University Hospital between 2012 and 2019. An author and an experienced pathologist reviewed pathology slides. Associations of histopathological factors, including differentiation, stage, lymphovascular invasion, extracapsular extension, perineural invasion (PNI), WPOI and surgical margins, with LR or disease-free survival (DFS) were evaluated. Univariate analysis identified WPOI and PNI, and multivariate analysis identified the WPOI as predictive factors for LR and DFS. Kaplan-Meier analysis identified the WPOI and PNI as predictive factors for OS and WPOI as a predictive factor for DFS. Therefore, it may be concluded that WPOI and PNI are significant independent prognostic factors for local tumor control and DFS in patients with OCSCC.

Determinants of quality of life in patients with hemorrhagic stroke, Saudi Arabia: A cross-sectional study.

Background: Previous studies demonstrated that stroke had an inverse impact on patients' physical, mental, and social quality of life. Aim: To determine factors contributing to the health-related quality of life (HRQOL) of Saudi hemorrhagic stroke survivors. Methods: A cross-sectional study was done at King Abdulaziz University Hospital (KAUH), Jeddah, KSA, on adult stroke patients. Data about the patients' socio-demographic characters and clinical data were obtained. The Stroke-Specific QOL (SSQOL) scale was used to measure the HRQOL. Results: The mean Stroke-Specific QOL (SSQOL) domains sore was 163.8 ± 46.29. Male patients and those who had bilateral lesions had a significantly higher mean SSQOL score. A non-significant positive correlation was found between the SSQOL score and the patients' age and post-stroke duration. And a non-significant relationship was found between mean SSQOL score and patients' nationality, educational level, smoking, marital and financial status, income, social support, insurance or other clinical data, hemorrhagic type, surgical treatment and follow up, comorbidities, or the year and duration of diagnosis. Conclusion: There is a need to use stroke rehabilitation programs to improve physical and functional independence and take into account the influence of the side of lesion on HRQOL.

A novel stacking ensemble for detecting three types of diabetes mellitus using a Saudi Arabian dataset: Pre-diabetes, T1DM, and T2DM.

Glucose is the primary source of energy for cells, which are the building blocks of life. It is given to the body by insulin that carries out the metabolic tasks that keep people alive. Glucose level imbalance is a sign of diabetes mellitus (DM), a common type of chronic disease. It leads to long-term complications, such as blindness, kidney failure, and heart disease, having a negative impact on one's quality of life. In Saudi Arabia, a ten-fold increase in diabetic cases has been documented within the last three years. DM is broadly categorized as Type 1 Diabetes (T1DM), Type 2 Diabetes (T2DM), and Pre-diabetes. The diagnosis of the correct type is sometimes ambiguous to medical professionals causing difficulties in managing the illness progression. Intensive efforts have been made to predict T2DM. However, there is a lack of studies focusing on accurately identifying T1DM and Pre-diabetes. Therefore, this study aims to utilize Machine Learning (ML) to distinguish and predict the three types of diabetes based on a Saudi Arabian hospital dataset to control their progression. Four different experiments have been conducted to achieve the highest results, where several algorithms were used, including Support Vector Machine (SVM), Random Forest (RF), K-Nearest Neighbor (K-NN), Decision Tree (DT), Bagging, and Stacking. In experiments 2, 3, and 4, the Synthetic Minority Oversampling Technique (SMOTE) was applied to balance the dataset. The empirical results demonstrated promising results of the novel Stacking model that combined Bagging K-NN, Bagging DT, and K-NN, with a K-NN meta-classifier attaining an accuracy, weighted recall, weighted precision, and cohen's kappa score of 94.48%, 94.48%, 94.70%, and 0.9172, respectively. Five principal features were identified to significantly affect the model accuracy using the permutation feature importance, namely Education, AntiDiab, Insulin, Nutrition, and Sex.

Preemptive Diagnosis of Alzheimer's Disease in the Eastern Province of Saudi Arabia Using Computational Intelligence Techniques.

Alzheimer's Disease (AD) is a silent disease that causes the brain cells to die progressively, influencing consciousness, behavior, planning ability, and language to name a few. AD increases exponentially with aging, where it doubles every 5-6 years, causing profound implications, such as swallowing difficulties and losing the ability to speak before death. According to the Ministry of Health in Saudi Arabia, AD patients will triple by 2060 to reach 14 million patients worldwide. The rapid rise of patients is caused by the silent progress of the disease, leading to late diagnosis as the symptoms will not be distinguished from normal aging affect. Moreover, with the current medical capabilities, it is impossible to confirm AD with 100% certainty via specific medical examinations. The literature review revealed that most recent publications used images to diagnose AD, which is insufficient for local hospitals with limited imaging capabilities. Other studies that used clinical and demographical data failed to achieve adequate results. Consequently, this study aims to preemptively predict AD in Saudi Arabia by employing machine learning (ML) techniques. The dataset was acquired from King Fahad Specialist Hospital (KFSH) in Dammam, Saudi Arabia, containing standard clinical tests for 152 patients. Four ML algorithms, namely, support vector machine (SVM), k-nearest neighbors (k-NN), Adaptive Boosting (AdaBoost), and eXtreme Gradient Boosting (XGBoost), were employed to preemptively diagnose the disease. The empirical results demonstrated the robustness of SVM in the pre-emptive diagnosis of AD with accuracy, precision, recall, and area under the receiver operating characteristics (AUROC) of 95.56%, 94.70%, 97.78%, and 0.97, respectively, with 13 features after applying the sequential forward feature selection technique. This model can assist the medical staff in controlling the progression of the disease at low costs.

A Novel Ensemble-Based Technique for the Preemptive Diagnosis of Rheumatoid Arthritis Disease in the Eastern Province of Saudi Arabia Using Clinical Data.

Rheumatoid arthritis (RA) is a chronic inflammatory disease caused by numerous genetic and environmental factors leading to musculoskeletal system pain. RA may damage other tissues and organs, causing complications that severely reduce patients' quality of life. According to the World Health Organization (WHO), over 1.71 billion individuals worldwide had musculoskeletal problems in 2021. Rheumatologists face challenges in the early detection of RA since its symptoms are similar to other illnesses, and there is no definitive test to diagnose the disease. Accordingly, it is preferable to profit from the power of computational intelligence techniques that can identify hidden patterns to diagnose RA early. Although multiple studies were conducted to diagnose RA early, they showed unsatisfactory performance, with the highest accuracy of 87.5% using imaging data. Yet, imaging data requires diagnostic tools that are challenging to collect and examine and are more costly. Recent studies indicated that neither a blood test nor a physical finding could early confirm the diagnosis. Therefore, this study proposes a novel ensemble technique for the preemptive prediction of RA and investigates the possibility of diagnosing the disease using clinical data before the symptoms appear. Two datasets were obtained from King Fahad University Hospital (KFUH), Dammam, Saudi Arabia, including 446 patients, with 251 positive cases of RA and 195 negative cases of RA. Two experiments were conducted where the former was developed without upsampling the dataset, and the latter was carried out using an upsampled dataset. Multiple machine learning (ML) algorithms were utilized to assemble the novel voting ensemble, including support vector machine (SVM), logistic regression (LR), and adaptive boosting (Adaboost). The results indicated that clinical laboratory tests fed to the proposed voting ensemble technique could accurately diagnose RA preemptively with an accuracy, recall, and precision of 94.03%, 96.00%, and 93.51%, respectively, with 30 clinical features when utilizing the original data and sequential forward feature selection (SFFS) technique. It is concluded that deploying the proposed model in local hospitals can contribute to introducing a method that aids medical specialists in preemptively diagnosing RA and stopping or delaying the course using clinical laboratory tests.

Stability issues and approaches to stabilised nanoparticles based drug delivery system.

Nanoparticles form the fundamental building blocks for many exciting applications in various scientific disciplines due to its unique features such as large surface to mass ratio, targeting potential, ability to adsorbed and carry other compound which makes them suitable for biomedical applications. However, the problem of the large-scale synthesis of nanoparticles remains challenging due to physical instability associated with nanoparticles which lead to generation of aggregates particles with high polydispersity index (PDI) indicating low particle homogeneity and eventually loss of their special nanoscale properties. The stabilisation concept can be generated by repulsive electrostatic force, which nanoparticles experience, when they are surrounded by a double layer of electric charges. Selection of proper stabiliser will govern the stability of NPs and ultimately development of optimised drug delivery system. This review summarises mechanism of physical instability issues likely to be encountered during the development of nanoformulations. It also discusses potential stabilising agents used so far and their mechanism in achieving stable nanosystems.

Practices and Attitudes of Dental Loupes and Their Relationship to Musculoskeletal Disorders among Dental Practitioners.

OBJECTIVE: A dental loupe is a tool used by many dentists and dental students to improve visual field and performance. This study aims to assess the practices and attitudes about dental magnification loupes and their relationship to musculoskeletal disorders. MATERIALS AND METHODS: A cross-sectional study was conducted involving 400 dental students and dentists in four dental colleges in Jeddah, Saudi Arabia. The mean age was 28.35 years (SD = 8.50), and 56% of the participants were male. Also, 70.75% were students or interns, while 29.25% were dentists. Data gathering was conducted using a questionnaire that was composed of four sections: demographic, magnification devices usage, attitude toward dental loupes, and the Nordic questionnaire to assess musculoskeletal disorders. RESULTS: A total of 66% of participants had used dental magnification tools before, but only 12.25% were using dental loupes at the time of the study. The main reported advantages of dental loupes were comfort in vision (59.25%) and improved work accuracy (53%), while the main disadvantage was difficulty in visual measurement (28.5%). A total of 73.25% reported that price was the main barrier to the use of dental loupes. Lower back (63.5%), neck (65.25%), and shoulder (46.25%) pain were the most frequently reported areas of discomfort. There was a significant relationship (<0.05) between the use of dental loupes and lowered levels of reported discomfort in the lower back, neck, shoulders, elbows, upper back, and feet. CONCLUSION: There are few dental professionals who use dental loupes in Saudi Arabia. There was a significant relationship between dental loupes use and reduction of musculoskeletal disorders among dental students and dentists.