Impact of iodine supplementation and mtDNA mutations on papillary thyroid cancer in saudi women following a vegetarian diet.

This study examined the influence of iodine supplementation and mitochondrial DNA (mtDNA)  mutations in Saudi vegetarian women with papillary thyroid cancer (PTC). Blood and tissue samples from PTC-diagnosed women were analyzed for thyroid function, mtDNA mutations, and immunohistological features. Statistical analysis using Sigmastat was employed to compare thyroid hormone levels and mtDNA mutations between groups. Serum total levels of tri-iodothyronine and thyroid-stimulating hormone were significantly different in patients following a vegetarian diet (P<0.05). Patients with PTC showed an increased frequency of mtDNA mutations in the D-loop region, with significantly higher mutation rates observed in patients following a vegetarian diet compared to other PTC patient groups (P<0.001) and controls (P<0.01). Notably, the mutations were predominantly somatic in Group 3 and germline in Groups 1 and 2. The findings suggest a possible link between iodine deficiency and accelerated PTC tumorigenesis. Furthermore, mtDNA mutations may serve as potential biomarkers for the diagnosis and prognosis of PTC.

Insulin resistance induced by de novo pathway-generated C16-ceramide is associated with type 2 diabetes in an obese population.

BACKGROUND: Obesity and diabetes are two chronic metabolic diseases whose prevalence is increasing at an alarming rate globally. A close association between obesity, diabetes, and insulin resistance has been identified, and many studies have pinpointed obesity as a causal risk factor for insulin resistance. However, the mechanism underlying this association is not entirely understood. In the past decade, ceramides have gained attention due to their accumulation in certain tissues and their suggested role in initiating insulin resistance. This study aims to determine the association of specific ceramides and their major metabolizing enzymes with obesity-associated insulin resistance. METHODS: The samples comprised subcutaneous adipose tissues collected from three cohorts: lean non-diabetic (controls; n = 20), obese-non-diabetic (n = 66), and obese-diabetic (n = 32). Ceramide levels were quantified using LC-MS/MS and mRNA expression level for different enzymes were estimated using real-time PCR-based RNA expression analysis. RESULTS: C16-ceramide (P = 0.023), C16-dihydro-ceramide (P < 0.005), C18-dihydro-ceramide (P = 0.009) and C24-ceramide (P = 0.040) levels were significantly increased in the obese cohort compared to the control group. However, stratification of the obese group revealed a significant increase in the C16-ceramide levels (P = 0.027) and mRNA over expression of the serine palmitoyl transferases enzyme subunit SPT1 (P < 0.005) in the obese-diabetic cohort compared to the obese-non-diabetic cohort. CONCLUSIONS: The present study indicates that C16-ceramide plays a pivotal role in inducing insulin resistance. Overexpression of SPT1 in the obese-diabetic group and its positive correlation with C16-ceramide suggest that C16-ceramide was generated through the de novo pathway.

Using Machine Learning for Non-Invasive Detection of Kidney Stones Based on Laboratory Test Results: A Case Study from a Saudi Arabian Hospital.

Kidney stone disease is a widespread urological disorder affecting millions globally. Timely diagnosis is crucial to avoid severe complications. Traditionally, renal stones are detected using computed tomography (CT), which, despite its effectiveness, is costly, resource-intensive, exposes patients to unnecessary radiation, and often results in delays due to radiology report wait times. This study presents a novel approach leveraging machine learning to detect renal stones early using routine laboratory test results. We utilized an extensive dataset comprising 2156 patient records from a Saudi Arabian hospital, featuring 15 attributes with challenges such as missing data and class imbalance. We evaluated various machine learning algorithms and imputation methods, including single and multiple imputations, as well as oversampling and undersampling techniques. Our results demonstrate that ensemble tree-based classifiers, specifically random forest (RF) and extra tree classifiers (ETree), outperform others with remarkable accuracy rates of 99%, recall rates of 98%, and F1 scores of 99% for RF, and 92% for ETree. This study underscores the potential of non-invasive, cost-effective laboratory tests for renal stone detection, promoting prompt and improved medical support.

Knowledge, attitude, and practice toward rheumatic fever and rheumatic heart disease among parents in Al-Baha Region, Saudi Arabia: A Cross-Sectional study.

Rheumatic fever (RF) is an autoimmune inflammatory process that develops as a sequela of untreated group A streptococcal pharyngitis and primarily affects children. It can lead to rheumatic heart disease (RHD), a major cause of cardiovascular morbidity and mortality. Awareness and preventive measures are crucial to mitigate its impact, particularly in low-resource settings. This study aimed to assess the knowledge, attitudes, and practices toward RF and RHD among parents living in Al-Baha Region. And to determine its association with other different sociodemographic variables. This was a cross-sectional study included 415 parents in Al-Baha region, Saudi Arabia. using a self-administered questionnaire distributed online. Of the total 415 participants, more than half were females 223 (53.7%), and 149 (35.9%) participants aged between 45 and 55 years. The knowledge regarding RF was classified as good 20 (4.8%), fair 104 (25.1%), and bad 291 (70.1%). The attitude towards RF showed that about half of the participants 206 (49.7%) had a negative attitude, 169 (40.7%) natural and 40 (9.6%) positive attitudes. While the total practice level was classified as Bad 15 (3.6%), Fair 113 (27.2%) and Good 287 (69.2%), females were more likely than males to exhibit good practices (p = 0.001). The study concluded that knowledge about RF and RHD among parents in the Al Baha region, Saudi Arabia, is very poor. Most participants lacked sufficient understanding of the definition of RF, its relationship with bacterial sore throats, prophylactic treatments, and the vulnerable age group. Attitudes towards RF were relatively negative. Therefore, healthcare authorities and providers should raise awareness and create educational programs to improve public understanding of RF and RHD, aiding in their prevention and control in the Al Baha region.

A rare primary hepatic neuroendocrine tumour with laparoscopic resection: a case report.

INTRODUCTION: Primary hepatic neuroendocrine tumours (PHNETs) are a rare form of hepatic neoplasms, and it is difficult to differentiate them from common hepatic malignancies in routine imaging studies. PRESENTATION OF THE CASE: We describe the case of a 60-year-old Indian male patient with a tentative preoperative diagnosis of hepatocellular carcinoma (HCC). Nevertheless, the definitive post-operative diagnosis was made by Histopathological and immunohistochemical assessment, which revealed a grade II neuroendocrine tumour (NET) of moderate differentiation. Surgical resection was performed through a minimally invasive approach with a favourable postoperative course and a short hospital stay. One-month Post-operative Octreotide scan showed no extrahepatic primary origin of the tumour. DISCUSSION: PHNET is a rare entity, and multi modalities investigations, including imaging, serology, endoscopy series, and histopathology findings, aside from long-term follow-up to rule out another primary origin, are essential for the final diagnosis of PHNET. Surgical resection stands as the mainstay of treatment of PHNETs. CONCLUSION: The absence of primary liver diseases should expand our possible differential diagnosis. Laparoscopic surgical resection of PHNETs carries a favourable outcome.

Detecting STR profiles from degrading menstrual blood samples and their use as possible evidence in forensic investigations.

This research explores DNA consistency and attempts to detect STR profiles from the degrading menstrual blood samples (MBS) as reliable forensic evidence. Peripheral (PBS) and MBS of 30 healthy fertile females were taken on the menstrual cycle's second day. They were obtained at different time periods (0, 2, 4, 6, 8, 10, 12, 14, 16, 18, 20, 24, and 48 h) at 25 °C. DNA evaluation was fulfilled to analyze DNA profiles. A considerable elevation in the median concentrations of DNA between 0 and 14-h intervals were documented, whereas decreased extents were registered between 16 and 48 h. Moreover, complete STR profiles (24/24) for DNA were discovered in all the intervals (0, 2, and 48 h). Periods of 0-8 h demonstrated the maximum extents of DNA materials. Full STR were discovered in all the intervals (0, 2, and 48 h). Eventually, MBS can be utilized as forensic evidence.

The function of long non-coding RNA SNHG11 and its working mechanism in triple-negative breast cancer.

Triple-negative breast cancer (TNBC) seriously affects woman's health. The present work is to study the working mechanism of lncRNA SNHG11 in TNBC. The expressions of SNHG11, microRNA (miR)- 7-5p, specificity protein 2 (SP2) and mucin 1 (MUC-1) in TNBC tissues and cells were detected. SNHG11, miR-7-5p and SP2 expressions were then evaluated for TNBC cell malignant behaviors. The relationships among SNHG11, miR-7-5p and SP2 were predicted and verified. Finally, the binding of the transcription factor SP2 to MUC-1 promoter was detected. Abnormally elevated SNHG11, SP2 and MUC-1 expressions were observed in cultured TNBC cells and tumor tissues. SNHG11 knockdown in TNBC cells. Silencing SP2 weakened the promoting effect of SNHG11 on TNBC progression. SNHG11 negatively regulated miR-7-5p expression and positively regulated SP2 expression. SP2 bound to the P2 site of MUC-1 promoter, and SP2 knockdown suppressed MUC-1 expression. It was demonstrated that lncRNA SNHG11 promoted TNBC cell malignant behaviors to facilitate TNBC progression. The study is first of its kinds to unravel the potential of lncRNA SNHG11 in relation to TNBC.

Radiological monitoring in some coastal regions of the Saudi Arabian Gulf close to the Iranian Bushehr nuclear plant.

We studied the concentrations of terrestrial and anthropogenic radionuclides in seawater and shore sediment/sand of three selected regions; Khafji, Safaniyah and Menifah along the Saudi Arabian Gulf coast. The mean activity concentrations of the 228Ra, 226Ra, and 40K in the analyzed sand samples are 5.9, 3.5 and 113.5 Bq/kg, and the respective values in seawater samples are 1.6, 0.8 and 10.4 Bq/L. All data show lower than the corresponding UNSCEAR (2000) reported world average values of 35, 30 and 400 Bq/kg for soil matrix. A few relevant radiological hazards were quantified by the estimation of the absorbed dose rate, and the results are compared with the prescribed limits set by international regulatory bodies. Measured data indicates that the studied coastal regions pose a negligible radiological hazards to the public, and show an insignificant radioactive loading to this coastal region by the Busher nuclear power plant.

A synthetic ancestral kinesin-13 depolymerizes microtubules faster than any natural depolymerizing kinesin.

The activity of a kinesin is largely determined by the approximately 350 residue motor domain, and this region alone is sufficient to classify a kinesin as a member of a particular family. The kinesin-13 family are a group of microtubule depolymerizing kinesins and are vital regulators of microtubule length. Kinesin-13s are critical to spindle assembly and chromosome segregation in both mitotic and meiotic cell division and play crucial roles in cilium length control and neuronal development. To better understand the evolution of microtubule depolymerization activity, we created a synthetic ancestral kinesin-13 motor domain. This phylogenetically inferred ancestral motor domain is the sequence predicted to have existed in the common ancestor of the kinesin-13 family. Here we show that the ancestral kinesin-13 motor depolymerizes stabilized microtubules faster than any previously tested depolymerase. This potent activity is more than an order of magnitude faster than the most highly studied kinesin-13, MCAK and allows the ancestral kinesin-13 to depolymerize doubly stabilized microtubules and cause internal breaks within microtubules. These data suggest that the ancestor of the kinesin-13 family was a 'super depolymerizer' and that members of the kinesin-13 family have evolved away from this extreme depolymerizing activity to provide more controlled microtubule depolymerization activity in extant cells.

Unusual ascites post laparoscopic cholecystectomy in old patient: Case report and review of the literature.

INTRODUCTION: Ascites that precede laparoscopic cholecystectomy is an infrequent event. Its actual mechanism is not identified, but an inflammatory or allergic peritoneal reaction has been proposed. It can a life-threatening or an acute serious condition; for instance, the bile duct or other visceral injuries are eliminated. CASE PRESENTATION: We present a 83 years old, medically free, who presented with fever and right upper quadrant pain. Diagnosed with severe acute calculus cholecystitis. Diagnostic laparoscopy and laparoscopic cholecystectomy were done, with copious irrigation of the abdomen. Postoperatively, patient started to had tense with moderate tenderness abdomen. Drain output showed clear ascites fluid. Postoperative ascites culture returned back as negative. Ascites treated conservatively with fluid restriction and furosemide. As per our knowledge, this is the fourth case that was reported in the literature of medicine. DISCUSSION: This was a particular case related to ascites which emerged without any known cause. The medical history of a powerful allergic background is can be the reason for transudative ascites that take place following an uneventful, occasional laparoscopic cholecystectomy. There was a presumed abnormal peritoneal or allergic reaction to the diathermy. No specific aetiological aspect was known irrespective of an extensive search being carried out. CONCLUSION: In cases of idiopathic post-laparoscopic ascites, general care and support is needed and fluid restriction and possible diuretic might be needed with no need for surgical intervention. Further studies are recommended for understanding of the pathophysiology of the disease.

Invasive giant pancreatic desmoid-type fibromatosis with curative resection: A case report.

INTRODUCTION: Desmoid-type Fibromatoses (DTF) tumours are rare, benign fibrous tumours with aggressive invasive behaviour that account for approximately 0.03% of all neoplasms. We report the success in curing a rare, invasive, and huge pancreatic intraabdominal DTF. PRESENTATION OF CASE: A 42 years old male was medically free apart from recurrent left upper abdominal pain, anorexia, and nausea for more than ten years and no significant past surgeries, trauma, or family history of cancer. The patient has a non-tender large abdominal mass at the left hypochondria area extending down to the pelvis below the umbilicus with a rigid and smooth surface. The computed tomography scan showed a huge heterogeneous mass appears to be of pancreatic origin, measuring about 23 cm by 15 cm by 11 cm. The patient underwent radical antegrade modular pancreato-splenectomy, segmental transverse colectomy, adrenalectomy, and subsequent colo-colic anastomosis. The accurate gross size of the tumour specimen was 26 × 17 × 9 cm, and the weight was found to be 3.6 kg. Immunohistochemistry confirmed the diagnosis of pancreas DTF. The follow up to 5 years confirmed no recurrence reported clinically or by imaging. DISCUSSION: The Pancreas origin of DTF is a rarely reported subset with an incidence of around 5% of all DTF. Establishing the diagnosis is fundamentally based on the characteristic pathological and immunohistochemical studies, for the only available cure modality by complete radical resection to be promptly offered. CONCLUSION: Our case is rare and uniquely the largest pancreatic DTF reported in the literature with curative resection despite being locally invasive.

Deep Learning Approaches for Detecting COVID-19 From Chest X-Ray Images: A Survey.

Chest X-ray (CXR) imaging is a standard and crucial examination method used for suspected cases of coronavirus disease (COVID-19). In profoundly affected or limited resource areas, CXR imaging is preferable owing to its availability, low cost, and rapid results. However, given the rapidly spreading nature of COVID-19, such tests could limit the efficiency of pandemic control and prevention. In response to this issue, artificial intelligence methods such as deep learning are promising options for automatic diagnosis because they have achieved state-of-the-art performance in the analysis of visual information and a wide range of medical images. This paper reviews and critically assesses the preprint and published reports between March and May 2020 for the diagnosis of COVID-19 via CXR images using convolutional neural networks and other deep learning architectures. Despite the encouraging results, there is an urgent need for public, comprehensive, and diverse datasets. Further investigations in terms of explainable and justifiable decisions are also required for more robust, transparent, and accurate predictions.

Potential significance of medicinal plants in forensic analysis: A review.

Medicinal plants are a two-edged sword that might be exploited as a treatment specific dosage, and as deadly poisonous substances to commit murder or suicide when administered in high doses. Forensic experts can collect traces and residual materials from these toxic medicinal plants at a crime scene as forensic evidence. Further, more investigations need to be deeply implemented to in the future to understand the significance of medicinal plants in forensic investigations to detect these criminal offenses. Additionally, to provides a deep understanding of chemical substances that can impact human life positively or negatively with different doses as well as identifying the optimal or overdose concentrations for either treatments or poisonous effects using recent biotechnological approaches. This review aims to illustrate different contributions and the significance of medicinal plants in the field and further employment in the context of forensic science, especially in the Kingdom of Saudi Arabia.

Gangliocytic Paraganglioma: A Rare Etiology of Obstructive Jaundice.

BACKGROUND Gangliocytic paraganglioma is an extremely rare tumor, with only 263 reported cases. This tumor has heterogeneous clinical presentation, with gastrointestinal bleeding being the most common. However, jaundice is a relatively unusual presentation, seen in less than 5% of all cases. CASE REPORT We report the case of a 32-year-old man who presented with abdominal pain and jaundice. He reported having similar episodes of this pain recently, but they were milder in severity. On examination, there was a tenderness in the right upper quadrant with a positive Murphy sign. Laboratory investigation revealed total bilirubin of 3.6 mg/dL with a direct bilirubin of 3.0 mg/dL, alkaline phosphatase of 323 IU/L, and g-glutamyltransferase level of 1153 IU/L, giving the impression of obstructive jaundice. The abdominal ultrasound examination revealed a normal common bile duct diameter with no thickening or pericholecystic fluid noted. Subsequently, the patient underwent endoscopic retrograde cholangiopancreatography, which revealed a mass in the second part of the duodenum. Histopathological examination of biopsy specimens obtained by fine-needle biopsy revealed an unencapsulated submucosal lesion with epithelioid, spindle, and ganglion cells. The spindle cells expressed positive immunohistochemical staining for S100, synaptophysin, and chromogranin. These findings were consistent with the diagnosis of gangliocytic paraganglioma. Surgical resection of the tumor was advised. However, the patient refused the operation despite the recommendation of the oncology team. CONCLUSIONS Gangliocytic paraganglioma is a very rare tumor that may present with a clinical picture mimicking a biliary disease. Clinicians should have a high index of suspicion for duodenal lesions in patients presenting with obstructive jaundice with no evidence of biliary stones.

Awareness and Knowledge of Different Types of Face Masks amid the COVID-19 Pandemic among Health-Care Professionals across Kingdom of Saudi Arabia an Original Research.

INTRODUCTION: With the attack of the COVID-19 pandemic on the world, many countries have opted for the lockdown for preventing the spread of the virus. There have been many proposals for the prevention at individual level. These include repeated washing of hands, the sanitization, and the usage of the mouth masks. There have been many studies that suggested various types of the mouth masks for the prevention of the infection. Hence, in the present study, we intend to evaluate the knowledge and awareness of the health-care personnel of the different types of the face masks. MATERIALS AND METHODS: We conducted the present review by the cross sectional survey method. The study is questionnaire based that was done for a period of 6 months. The survey was done by online only. The participation was voluntary and done in the state wide hospitals in the kingdom of the Saudi Arabia. The survey compromised twenty questions that assessed the knowledge and awareness of the health-care personnel of the different types of the face masks. RESULTS: The total number of the participants was 1000. All were aware of the proper usage of the masks. There was noted enough awareness of the types of the masks among the participants. However, the awareness can further be enhanced. CONCLUSION: At the present condition of the infection rate, there may be a third wave of the pandemic around the world. As it has been shown in many studies that these barriers have prevented the infection rate, the wisdom points toward the prevention of the disease. The awareness has increased among the health care and also the personnel are conscious of the types of the masks. The same can be evaluated for the general public and the method of the mask wear can be appraised.

Measurement Invariance and Differential Item Functioning Across Gender Within a Latent Class Analysis Framework: Evidence From a High-Stakes Test for University Admission in Saudi Arabia.

The main aim of the present study was to investigate the presence of Differential Item Functioning (DIF) using a latent class (LC) analysis approach. Particularly, we examined potential sources of DIF in relation to gender. Data came from 6,265 Saudi Arabia students, who completed a high-stakes standardized admission test for university entrance. The results from a Latent Class Analysis (LCA) revealed a three-class solution (i.e., high, average, and low scorers). Then, to better understand the nature of the emerging classes and the characteristics of the people who comprise them, we applied a new stepwise approach, using the Multiple Indicator Multiple Causes (MIMIC) model. The model identified both uniform and non-uniform DIF effects for several items across all scales of the test, although, for the majority of them, the DIF effect sizes were negligible. Findings from this study have important implications for both measurement quality and interpretation of the results. Particularly, results showed that gender is a potential source of DIF for latent class indicators; thus, it is important to include those direct effects in the latent class regression model, to obtain unbiased estimates not only for the measurement parameters but also of the structural parameters. Ignoring these effects might lead to misspecification of the latent classes in terms of both the size and the characteristics of each class, which in turn, could lead to misinterpretations of the obtained latent class results. Implications of the results for practice are discussed.

Case report: Evisceration of abdomen after blunt trauma.

INTRODUCTION: Abdominal evisceration is uncommon after blunt abdominal trauma; therefore, it warrants urgent laparotomy. We report a young adult male who sustained multiple injuries due to a high impact mechanism resulting in blunt abdominal injury and underwent numerous laparotomies. CASE REPORT: In a high-speed motorcycle accident, a twenty-six-year-old male sustained a direct, blunt injury to his abdomen, which resulted in a right hemothorax, perforation of the stomach, and small bowel. Multiple mesenteric vessels tear, a retroperitoneal hematoma, liver, and pancreatic injury. The abdominal wall split transversely, extruding intact bowel. After resuscitation, according to the ATLS protocol, the patient underwent eight laparotomies for damage control. After 45 days in the Surgical Intensive Care Unit, then 11 days in the surgical ward, he was discharged in a satisfactory condition. Eight months later, he was admitted electively for ileostomy reversal, which was uneventful. CONCLUSION: Patients with high trauma mechanisms have high mortality and morbidity rate. Blunt injury with eviscerated abdominal contents requires prompt, expeditious, and timely intervention, particularly at the initial operative intervention with damage control procedures, both prompt management and structured approach, were tailored depending in the magnitude of the injury. A multidisciplinary approach is mandatory throughout the period of treatment until recovery and rehabilitation.

Economic impact of diabetic foot ulcers on healthcare in Saudi Arabia: a retrospective study.

BACKGROUND: Diabetic foot ulcers (DFU) are a critical complication of diabetes mellitus (DM) affecting life quality and significantly impacting healthcare resources. OBJECTIVE: Determine the direct medical costs associated with treating DFU in King Fahad Hospital of the University and identify factors that could assist in developing resource management guidelines in Saudi Arabia. DESIGN: Retrospective study. SETTING: SETTING: King Fahad Hospital of the University, Al-Khobar, Saudi Arabia. PATIENTS AND METHODS: The study included diabetic patients admitted with foot ulcerations between 2007 and 2017 inclusive. We determined management costs including drug usage, wound dressings, surgical procedures, admissions, and basic investigation. MAIN OUTCOME MEASURES: Factors affecting the direct perspective medical costs of managing DFU. SAMPLE SIZE: 99 patients. RESULTS: The overall cost of managing 99 patients with DFU was 6 618 043.3 SAR ($1 764 632.68 USD), which further translates to approximately 6684.9 SAR per patient/year ($1782.6 USD). The highest cost incurred was for admission expenditure (45.6%), followed by debridement (14.5%) and intensive care unit (ICU) admission (10.4%). CONCLUSION: The overall healthcare expenditure in treating DFU is high, with hospital admissions and surgical procedures adding a significant increase to the total cost. Focused patient education on overall glycemic control and prevention of DFU may decrease complications and hence, the overall cost. LIMITATIONS: Identified only the direct medical costs of DFU as the indirect costs were subjective and more difficult to quantify. CONFLICT OF INTEREST: None.

Metastatic testicular retroperitoneal teratoma in an adult: Case report.

INTRODUCTION: Teratomas are bizarre neoplasms derived from embryonic tissues typically found in the gonads and sacrococcygeal tissues of adults. CASE PRESENTATION: We report a case of histologically proven metastatic teratoma with an unusual presentation. The 32-year old male patient had a retroperitoneal tumour detected on computed tomography during the workup of abdominal pain. DISCUSSION: Retroperitoneal teratomas are uncommon and a challenge to manage. Differential diagnoses could be a dilemma without a thorough history and a high index of suspicion. CONCLUSIONS: Recurrent metastatic teratoma is one of the rare differential diagnoses of any retroperitoneal mass and can present years after complete resection of the primary tumour.

Effect of wet cupping on reducing bone pain for patients in King Abdulaziz University Hospital, Saudi Arabia. A retrospective study.

OBJECTIVES:  To investigate the effectiveness of wet cupping as alternative treatment on reducing bone pain and built a model that predicts the level of improvement for patients who suffer from bone pain. METHODS:  This retrospective study was conducted on 289 patients referred from specialty clinics to Prophetic Medicine Clinics (PMC) between September 2013 and August 2015. The effectiveness of cupping is assessed on patients with bone pain who were redirected to PMC, King Abdulaziz University Hospital, Jeddah, Saudi Arabia. An artificial neural network (ANN) method was used to propose a model that predicts levels of improvement for patients suffering from bone pain. Therefore, a random sample of 90% of the data was used to build the ANN model and tested by the remaining 10%. Inferential statistics were conducted to study relations and compare blood tests before and after treatment. RESULTS: Out of 289 patients suffering from bone pain, more than 11% were completely cured, and 55% improved after wet cupping treatment sessions. The proposed ANN model showed a good performance with more than 72% accuracy. In addition, the statistical analysis showed a significant improvement for most blood tests. CONCLUSION: Wet cupping has positive effects on reducing bone pain. We recommend the use of an ANN model in PMC to predict whether patients will benefit from the treatment to reduce pain. This is a recommendation for further study not a conclusion.