Hemopatch® as a primary dural sealant in cranial neurosurgery: Technical note and a retrospective study.

OBJECTIVES: To determine the effectiveness and safety of Hemopatch® as a primary dural sealant in preventing CSF leakage following cranial surgery. Cerebrospinal fluid (CSF) leaks occur in cranial operations and are associated with significant patient burden and expense. The use of Hemopatch® as a dural sealant in cranial neurosurgical procedures is described and analyzed in this study. METHODS: Data were retrospectively collected from all patients who underwent a craniotomy for various neurosurgical indications where Hemopatch® was used as the primary dural sealant between June 2017 and June 2022. Infection and CSF leak were the main indicators evaluated after surgery. RESULTS: A total of 119 consecutive patients met our inclusion criteria. The median was age 41.5 years, and 52.5% were female. The mean follow-up period was 2.3 years (7 months to 6 years). There were 110 (92.44%) supratentorial and 9 (7.56%) infratentorial craniotomies. Postoperative CSF leak was reported in 2 patients (1.68%), one in each cohort. Postoperative infection occurred in one patient (0.84%). CONCLUSION: The results suggest that using Hemopatch® as a dural sealant in cranial surgery is effective and safe. After supra-/infratentorial craniotomies, the rate of postoperative adverse events in our sample was within the range of known surgical revision rates. Future randomized clinical studies are required to confirm our encouraging findings.

Assessment of knowledge towards first aid skills of epilepsy among undergraduate health students in Riyadh province of Saudi Arabia: A cross-sectional study.

BACKGROUND: Applying proper first-aid measures to patients with seizure episodes plays a vital role in preventing the adverse consequences of seizures. Most previous data focused on teachers, healthcare providers and the general public. This study aimed to assess the knowledge of seizure first-aid measures among undergraduate health students. METHODS: This descriptive, cross-sectional study was conducted between May 16 and 31, 2023, with 493 undergraduate health students of Riyadh Province who answered online surveys. The data were collected using the descriptive information form. The chi-square (χ2) test was employed to compare knowledge of seizure first aid between demographic variables. The relationship between knowledge score and independent variables was evaluated using multiple linear regression technique. RESULTS: Only 1.6 % of participants demonstrated good knowledge scores toward seizure first-aid measures. The skill most frequently reported was to remove all harmful objects from their vicinity and loosen the tight clothes around the neck during a seizure; 68.7 % of the participants correctly answered with agreed. Conversely, the skill that received the lowest knowledge score among participants was putting a piece object such as a cloth, wallet, or spoon between the teeth to prevent tongue biting during a seizure; only 37.3 % of the participants correctly answered with disagree. Moreover, participants in the advanced age group, medicine and fifth-year, were found to be significant predictors of knowledge and exhibited better knowledge scores toward seizure first aid measures than their peers (p < 0.001). Furthermore, lectures and books were identified (69.6 %) as the most common source of information about seizure first aid. CONCLUSION: The study concluded that most undergraduate health students demonstrated poor knowledge scores in delivering seizure first aid. This finding suggests that introducing epilepsy education from the first year in all health-related courses is crucial to improving overall awareness and skills in providing seizure first aid.

Zingiberaceae-derived phytomolecules inhibit Japanese encephalitis virus RNA dependent RNA polymerase: a molecular dynamics study.

The Japanese encephalitis virus, (JEV), is a flavivirus mostly transmitted by Culex mosquitoes mostly present in Southeast Asia and the Western Pacific region. Ardeid-wading birds are the natural reservoir of JEV; nonetheless, pigs are frequently a key amplifying host during epidemics in human populations. Although more domestic animals and wildlife are JEV hosts, it is unclear how these animals fit into the ecology and epidemiology of the virus. Even though there is no specific therapy, vaccines are available to prevent this infection. However, current vaccinations do not work against every clinical isolate and can cause neurological problems in certain people. In this study, we have screened 501 phytochemical compounds from various plants from the Zingeberaceae family against the RdRp protein of JEV. Based on this, the top five compounds (IMPHY014466, IMPHY004928, IMPHY007097, IMPHY014179 and IMPHY005010) were selected based on the obtained docking scores, which was above -8.0 Kcal/mol. Further, the binding affinity of these selected ligands was also analysed using molecular interaction, and the presence of interactions like hydrogen bonds, hydrophobic bonds and polar bonds with respective active residues were identified and studied elaborately. Furthermore, the dynamic stability of the docked RdRp protein with these selected phytochemicals was studied using Molecular dynamic simulation and essential dynamics. The free energy landscape analysis also provided information about the energy transition responsible stability of the complex. The results obtained advocated phytochemical compounds from the zingeberaceae family for future experimental validation, as these compounds exhibited significant potential as JEV antagonists.Communicated by Ramaswamy H. Sarma.

Polysaccharide-fecal microbiota-based colon-targeted self-nanoemulsifying drug delivery system of curcumin for treating polycystic ovarian syndrome.

The gut microbiome is involved in the pathogenesis of many diseases including polycystic ovarian syndrome (PCOS). Modulating the gut microbiome can lead to eubiosis and treatment of various metabolic conditions. However, there is no proper study assessing the delivery of microbial technology for the treatment of such conditions. The present study involves the development of guar gum-pectin-based solid self-nanoemulsifying drug delivery system (S-SNEDDS) containing curcumin (CCM) and fecal microbiota extract (FME) for the treatment of PCOS. The optimized S-SNEDDS containing FME and CCM was prepared by dissolving CCM (25 mg) in an isotropic mixture consisting of Labrafil M 1944 CS, Transcutol P, and Tween-80 and solidified using lactose monohydrate, aerosil-200, guar gum, and pectin (colon-targeted CCM solid self-nanoemulsifying drug delivery system [CCM-CT-S-SNEDDS]). Pharmacokinetic and pharmacodynamic evaluation was carried out on letrozole-induced female Wistar rats. The results of pharmacokinetic studies indicated about 13.11 and 23.48-fold increase in AUC of CCM-loaded colon-targeted S-SNEDDS without FME (CCM-CT-S-SNEDDS (WFME)) and CCM-loaded colon-targeted S-SNEDDS with FME [(CCM-CT-S-SNEDDS (FME)) as compared to unprocessed CCM. The pharmacodynamic study indicated excellent recovery/reversal in the rats treated with CCM-CT-S-SNEDDS low and high dose containing FME (group 13 and group 14) in a dose-dependent manner. The developed formulation showcasing its improved bioavailability, targeted action, and therapeutic activity in ameliorating PCOS can be utilized as an adjuvant therapy for developing a dosage form, scale-up, and technology transfer.

Assessing the Reliability of Miller's Classification and Cairo's Classification in Classifying Gingival Recession Defects: A Comparison Study.

Background and Objectives: Gingival recession results in adverse aesthetics and root sensitivity, and there is a need to treat and prevent its further progression. To overcome these problems, various advances have been made by clinicians in treating gingival recession based on the type of gingival recession. Miller's classification has been used for a long time to classify the type of recession. However, certain limitations have been found with use of Miller's classification such as a lack of clarity in the method for measuring soft and hard tissue loss in the interproximal area. Cairo classification was proposed to overcome limitations of Miller's classification to classify gingival recession. Cairo's classification is a treatment-oriented classification based on buccal and interproximal attachment loss. Therefore, the study was conducted to assess and compare the reliability of Miller's and Cairo's classifications in determining gingival recession. Material and methods: A total of 220 buccal gingival recession defects were included in the study based on the inclusion and exclusion criteria. Four examiners were included in the study. Two examiners classified the recession defects according to Miller's classification and the other two examiners classified recession defects according to Cairo's classification at baseline and at a 1-week interval. Statistical analysis was conducted using SPSS software version 25.0 using Cohen's kappa correlation coefficient and Chi-square test statistics to determine the intra- and inter-rater agreement among the examiners for the two gingival recession classification systems. A p value of <0.05 was considered statistically significant. Results: The intra-rater agreement for Cairo's classification was 0.86 and 0.82, whereas for Miller's classification, it was found to be 0.68. The inter-rater reliability agreement for Cairo's classification was 0.82 and 0.8, whereas for the Miller's classification, it was 0.56 and 0.67. Conclusions: Within the limitations of the study, it was found that Cairo's classification is clearer and more reliable than Miller's classification in the assessment of gingival recession.

A simulation-based approach to target Zika virus RNA-dependent RNA polymerase with marine compounds for antiviral development.

Despite significant efforts, currently, there is no particular drug available to treat Zika virus (ZIKV) infection, highlighting the urgent need for effective therapeutic interventions. To identify putative inhibitors of the ZIKV RdRp protein's RNA binding function, the present study applied an extensive in-silico drug discovery methodology. The initial phase involved virtual screening using Lipinski's rule of five as a filter, ensuring the selection of molecules with favorable pharmacokinetic properties. This process yielded 238 compounds with promising docking scores, ranging from -6.0 to -7.48 kcal/mol, indicative of their potential binding affinity to the ZIKV RdRp. To refine the selection, these compounds underwent a re-docking process, comparing their binding energies with a reference molecule known for its inhibitory action against RdRp. Remarkably, five compounds, labeled CMNPD30598, CMNPD27464, CMNPD25971, CMNPD27444, and CMNPD16599, demonstrated superior re-docking energies compared to the reference, suggesting a stronger interaction with the RdRp allosteric site. Subsequent molecular dynamics (MD) simulations provided insights into the stability of these complexes over time, reinforcing their potential as RdRp inhibitors. Additionally, the calculation of free binding energies and principal component analysis (PCA) of the free energy landscape offered a deeper understanding of the binding dynamics and energetics. This study not only highlights the utility of marine fungi compounds in antiviral drug discovery but also showcases the power of computational tools in identifying novel therapeutics. The identified compounds represent promising candidates for further experimental validation and development as ZIKV RdRp inhibitors.Communicated by Ramaswamy H. Sarma.

In silico assessment of a natural small molecule as an inhibitor of programmed death ligand 1 for cancer immunotherapy: a computational approach.

Programmed cell death ligand 1 (PD-L1) is a crucial target for cancer therapy. Here, an in silico study investigates PD-L1 to inhibit its interaction with PD1, thereby promoting an immune response to eliminate cancer cells. The study employed machine learning (ML) -based QSAR to detect PDL1 inhibitors. Morgan's fingerprint with docking score showed a 0.83 correlation with the experimental IC50, enabling the screening of 3200 natural compounds. The top three compounds, considered 2819, 2821 and 3188, were selected from the ML-based QSAR and subjected to molecular docking and simulation. The binding scores for 2819, 2821 and 3188 were -7.0, -9.0 and -8.9 kcal/mol, respectively. The stability of the ligands during a 100 ns simulation was assessed using RMSD, showing that 2819 and 2821 maintained stable patterns comparable to the control inhibitor. Notably, 2819 exhibited a consistent stable pattern throughout the simulation, while 2821 showed stability in the last 40 ns. The control compound showed the highest number of hydrogen bonds with proteins, whereas compounds 2819 and 2821 formed continuous H-bonds. 3188 was separated from the protein in later phases and is not regarded as a potential PD-L1-binding molecule. MMGBSA binding free energy for complexes was computed. Control had the lowest binding free energy, while 2819 and 2821 also had lower binding energies. In contrast, 3188 showed poor binding free energy, causing protein separation. Principal component analysis showed a loss of entropy and reduced protein conformational variation. Overall, 2819 and 2821 are potential binders for PD-L1 inhibition and immune response triggering.Communicated by Ramaswamy H. Sarma.

Investigating the effects of four medicinal plants against dengue virus through QSAR modeling and molecular dynamics studies.

The Dengue virus (DENV) has been increasingly recognized as a prevalent viral pathogen responsible for global transmission of infection. It has been established that DENV's NS5 methyltransferase (MTase) controls viral replication. As a result, NS5 MTase is considered a potentially useful drug target for DENV. In this study, the two phases of virtual screening were conducted using the ML-based QSAR model and molecular docking to identify potential compounds against NS5 of DENV. Four medicinal plants [Aloe vera, Cannabis sativa (Hemp), Ocimum sanctum (Holy Basil; Tulsi), and Zingiber officinale (Ginger)] that showed anti-viral properties were selected for sourcing the phytochemicals and screening them against NS5. Additionally, re-docking at higher exhaustiveness and interaction analysis were performed which resulted in the identification of the top four hits (135398658, 5281675, 119394, and 969516) which showed comparable results with the control Sinefungin (SFG). Post molecular dynamics simulation, 135398658 showed the lowest RMSD (0.4-0.5 nm) and the maximum number of hydrogen bonds (eight hydrogen bonds) after the control while 5281675 and 969516 showed comparable hydrogen bonds to the control. These compounds showed direct interactions with the catalytic site residues GLU111 and ASP131, in addition to this these compounds showed stable complex formation as depicted by principal component analysis and free energy landscape. 135398658 showed lower total binding free energy (ΔGTotal = -36.56 kcal/mol) than the control, while 5281675 had comparable values to the control (ΔGTotal = -34.1 kcal/mol). Overall, the purpose of this study was to identify phytochemicals that inhibit NS5 function, that could be further tested experimentally to treat dengue virus (DENV).Communicated by Ramaswamy H. Sarma.

Dislocated Sömmering Ring with Decompensated Cornea Presenting 14 Years After Lens Aspiration and Anterior Vitrectomy: A Case Report and Literature Review.

BACKGROUND A Sömmering ring is a post-cataract opacity (PCO) formed due to the adhesion of anterior capsule edges to the posterior capsule. It is mostly associated with aphakic cases but has also been reported in pseudophakic eyes. It becomes clinically important when dislocation occurs. The purpose of this manuscript was to report a case of anterior dislocation of the Sömmering ring 14 years after lensectomy for congenital cataract. CASE REPORT We describe a 20-year-old man who presented to the emergency room with pain, photophobia, redness, and blurry vision in the right eye. The patient was known to have bilateral amblyopia and had undergone bilateral lens aspiration and anterior vitrectomy without intraocular lens (IOL) implantation 14 years prior to presentation. On examination, the intraocular pressure was normal, the conjunctiva had moderate diffuse injection, and the cornea had 2+ diffuse edema with bullae and Descemet folds. The anterior chamber was deep with semilunar-shaped solid white material consistent with the Sömmering ring in the anterior chamber. On dilated fundus examination, the view was hazy, and B-scan ultrasonography indicated highly reflective material in the vitreous cavity and a flat retina. CONCLUSIONS Sömmering ring in the anterior chamber can be inflammatory and especially damaging to the corneal endothelium. If this complication occurs, timely intervention in the form of surgical removal is crucial to prevent endothelial cell loss and corneal decompensation. A thorough cleaning of the cortical matter after lens removal during primary surgery can reduce the risk of secondary formation of PCO. Implantation of IOL in myopic eyes can be considered to reduce the risk of Sömmering ring formation in the future and its complications.

Correlation analysis between cytokines' profile, autoimmune antibodies and the duration of type 1 diabetes: A case control study in a specialized children's centre in Riyadh.

OBJECTIVE: The aim of this study was to investigate the role of cytokines in children with T1D living in Saudi Arabia and their correlation with disease duration and autoimmune antibody markers. METHODS: A case-control study was conducted in the endocrine clinic of King Abdullah Specialized Children's Hospital in Riyadh. A total of 274 T1D and healthy control children were enrolled in the study. 5 mL of venous blood samples were collected in the morning after 9 to 12 h of fasting in BD Vacutainer® EDTA tubes and centrifuged at 250g for 15 min at. Plasma was then stored at -20°C for detection of anti-islet, anti-GAD antibodies (Abs), and C-peptide using commercial ELISA kits from Thermo Fisher Scientific. The levels of cytokines were measured using commercial sandwich ELISA kits from Abcam. RESULTS: Median differences in cytokine levels (IFN-γ, TNF-α, IL-1ß, IL-2, IL-4, IL-6, IL-10, IL-13, IL-18, IL-21, IL-35, and IL-37) were significantly higher in T1D patients compared with healthy controls (p-value < .001). Spearman's Rho correlation indicated that TNFα, IL-1ß, IL-4, IL-10, IL-13, and IL-21 correlated significantly with T1D Abs (p-value = .01). HbA1C correlated negatively with IL-35 and IL-37, and positively with IL-18 (p-value = .01). Linear regression analysis showed a significant increase in anti-glutamic acid antibodies (GAD) in patients with >3 years of T1D duration. CONCLUSION: Autoantibodies remained positive at high levels in our patients over a 3-year duration of the disease and correlated with specific cytokines. The clear correlations with disease duration and profile of specific cytokines could be targets for future therapeutic interventions.

Added value of corpus callosotomy following vagus nerve stimulation in children with Lennox-Gastaut syndrome: A multicenter, multinational study.

OBJECTIVE: Lennox-Gastaut syndrome (LGS) is a severe form of epileptic encephalopathy, presenting during the first years of life, and is very resistant to treatment. Once medical therapy has failed, palliative surgeries such as vagus nerve stimulation (VNS) or corpus callosotomy (CC) are considered. Although CC is more effective than VNS as the primary neurosurgical treatment for LGS-associated drop attacks, there are limited data regarding the added value of CC following VNS. This study aimed to assess the effectiveness of CC preceded by VNS. METHODS: This multinational, multicenter retrospective study focuses on LGS children who underwent CC before the age of 18 years, following prior VNS, which failed to achieve satisfactory seizure control. Collected data included epilepsy characteristics, surgical details, epilepsy outcomes, and complications. The primary outcome of this study was a 50% reduction in drop attacks. RESULTS: A total of 127 cases were reviewed (80 males). The median age at epilepsy onset was 6 months (interquartile range [IQR] = 3.12-22.75). The median age at VNS surgery was 7 years (IQR = 4-10), and CC was performed at a median age of 11 years (IQR = 8.76-15). The dominant seizure type was drop attacks (tonic or atonic) in 102 patients. Eighty-six patients underwent a single-stage complete CC, and 41 an anterior callosotomy. Ten patients who did not initially have a complete CC underwent a second surgery for completion of CC due to seizure persistence. Overall, there was at least a 50% reduction in drop attacks and other seizures in 83% and 60%, respectively. Permanent morbidity occurred in 1.5%, with no mortality. SIGNIFICANCE: CC is vital in seizure control in children with LGS in whom VNS has failed. Surgical risks are low. A complete CC has a tendency toward better effectiveness than anterior CC for some seizure types.

Patient Perceptions and Satisfaction With Virtual Clinics During the COVID-19 Pandemic: A Cross-Sectional Study.

Background Virtual clinics played an important role for many patients during the COVID-19 pandemic. We conducted this cross-sectional study to evaluate patient perceptions and their satisfaction with virtual clinics during and after COVID-19 in Saudi Arabia. Methods An online questionnaire-based survey with questions in both Arabic and English was conducted among patients who attended outpatient clinics at King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia from May 2021 to September 2021. Demographic variables, the clinic type, and the level of satisfaction with the remote appointments were recorded. Descriptive statistics and logistic regression analysis were used to analyze the data.  Results A total of 1274 participants filled out the survey. Of them, 831 (65.23%) were females, and 749 (58.79%) were aged 18 to 30 years old. Of the sample studied, 411 (32.26%) had appointments with their healthcare provider remotely since the beginning of the pandemic; 311 (75.67%) were satisfied or highly satisfied with the remote appointments; and 198 (48.18%) participants desired to continue using virtual services post-COVID-19 pandemic. Logistic regression analysis showed that females were more satisfied with virtual clinics than males (OR= 1.18, 95% CI (1.01, 1.40), p=0.04). The age group of 18 to 30 was more satisfied than other age groups (OR= 53.23, 95% CI (2.01, 1347.18), p=0.02). Conclusion The majority of the participants who used virtual clinics were satisfied with the service. Nearly half of the participants wanted to continue using virtual services even after the COVID-19 pandemic was over. More effort should be made to increase patient awareness and knowledge about virtual clinics.

Comparative evidence of different surgical techniques for the management of vertical alveolar ridge defects in terms of complications and efficacy: A systematic review and network meta-analysis.

AIM: To systematically appraise the available evidence on vertical ridge augmentation (VRA) techniques and estimate a treatment-based ranking on the incidence of complications as well as their clinical effectiveness. MATERIALS AND METHODS: Searches were conducted in six databases to identify randomized clinical trials comparing VRA techniques up to November 2022. The incidence of complications (primary) and of early, major, surgical and intra-operative complications, vertical bone gain (VBG), marginal bone loss, need for additional grafting, implant success/survival, and patient-reported outcome measures (secondary) were chosen as outcomes. Direct and indirect effects and treatment ranking were estimated using Bayesian pair-wise and network meta-analysis (NMA) models. RESULTS: Thirty-two trials (761 participants and 943 defects) were included. Five NMA models involving nine treatment groups were created: onlay, inlay, dense-polytetrafluoroethylene, expanded-polytetrafluoroethylene, titanium, resorbable membranes, distraction osteogenesis, tissue expansion and short implants. Compared with short implants, statistically significant higher odds ratios of healing complications were confirmed for all groups except those with resorbable membranes (odds ratio 5.4, 95% credible interval 0.92-29.14). The latter group, however, ranked last in clinical VBG. CONCLUSIONS: VRA techniques achieving greater VBG are also associated with higher incidence of healing complications. Guided bone regeneration techniques using non-resorbable membranes yield the most favourable results in relation to VBG and complications.

Outcomes of resective surgery in pediatric patients with drug-resistant epilepsy: A single-center study from the Eastern Mediterranean Region.

OBJECTIVE: Epilepsy surgery is widely accepted as an effective therapeutic option for carefully selected patients with drug-resistant epilepsy (DRE). There is limited data on the outcome of epilepsy surgery, especially in pediatric patients from the Eastern Mediterranean region. Hence, we performed a retrospective study examining the outcomes of resective surgery in 53 pediatric patients with focal DRE. METHODS: Patients with focal DRE who had undergone epilepsy surgery were included in the present study. All patients underwent a comprehensive presurgical evaluation. Postoperative seizure outcomes were classified using the Engel Epilepsy Surgery Outcome Scale. RESULTS: After surgery, 33 patients (62.2%) were Class I according to the Engel classification of surgical outcomes; eight patients (15.0%) were Class II, 11 (20.7%) were Class III, and one (1.8%) was Class IV. The relationships of presurgical, surgical, and postsurgical clinical variables to seizure outcomes were compared. Older age at seizure onset, older age at the time of surgery, the presence of focal to bilateral tonic-clonic seizures, seizure duration over 2 minutes, unsuccessful treatment with three or fewer antiseizure medications, lesions confined to one lobe (as demonstrated via magnetic resonance imaging [MRI]), surgical site in the temporal lobe, and histopathology including developmental tumors were significantly linked to an Engel Class I outcome. A univariate analysis of excellent surgical outcomes showed that lateralized semiology, localized interictal and ictal electroencephalogram (EEG) discharges, lateralized single-photon emission computed tomography and positron emission tomography findings, and temporal lobe resections were significantly related to excellent seizure outcomes. SIGNIFICANCE: The results of our study are encouraging and similar to those found in other centers around the world. Epilepsy surgery remains an underutilized treatment for children with DRE and should be offered early.

Attitudes, confidence, barriers and current practice of managing depression in patients with COPD in Saudi Arabia: a national cross-sectional survey.

OBJECTIVE: To investigate physicians' perceptions and current practices of identifying and managing depression in patients with chronic obstructive pulmonary disease (COPD). DESIGN: A cross-sectional online survey was employed between March and September 2022. SETTINGS: Saudi Arabia. PARTICIPANTS: 1015 physicians, including general practitioners and family, internal and pulmonary medicine specialists. PRIMARY OUTCOME MEASURES: Physicians' perceptions, confidence, practices and barriers to recognising and managing depression in patients with COPD. RESULTS: A total of 1015 physicians completed to the online survey. Only 31% of study participants received adequate training for managing depression. While 60% of physicians reported that depression interferes with self-management and worsens COPD symptoms, less than 50% viewed the importance of regular screening for depression. Only 414 (41%) physicians aim to identify depression. Of whom, 29% use depression screening tools, and 38% feel confident in discussing patients' feelings. Having adequate training to manage depression (OR: 2.89; 95% CI: 2.02 to 3.81; p<0.001) and more years of experience (OR: 1.25; 95% CI: 1.08 to 1.45; p=0.002) were associated with the intention to detect depression in COPD patients. The most common barriers linked to recognising depression are poor training (54%), absence of standard procedures (54%) and limited knowledge about depression (53%). CONCLUSION: The prevalence of identifying and confidently managing depression in patients with COPD is suboptimal, owing to poor training, the absence of a standardised protocol and inadequate knowledge. Psychiatric training should be supported in addition to adopting a systematic approach to detect depression in clinical practice.

The Impact of a Patient Participating in Evaluating Patient Safety by Using the Patient Measure of Safety in Saudi Arabia: A Cross-Sectional Study.

BACKGROUND: Patient safety is an essential element for delivering quality of healthcare. Many studies focus on measuring patient safety from the healthcare provider's perspective to improve patient safety in healthcare facilities. However, patient participation may reduce medical errors and improve patient safety by providing information regarding the safety of their care. This study aimed to evaluate patient safety from the inpatients' perspective and the extent of the influence of the sociodemographic factors on their assessment. METHODS: A cross-sectional study was conducted at hospitals in different Saudi Arabian regions with 1569 inpatient adults 18 years of older who voluntarily completed an online questionnaire using the Patient Measure of Safety tool (Arabic translated). Two questions were added to assess patient feedback about the overall perception of safety and witnessing patient safety events. COVID-19 patients and those with a mental disorder or incapable of providing informed consent were excluded. RESULT: The total number of participants was 1569 inpatients from 17 hospitals. Sixty-one percent of the participants were female, and 41.62% were from the 18- to 35-year age group. Less than half (38.69%) of patients stayed at the hospital between 3 and 5 days. Percentages of positive responses were more than 90% observed in dignity and respect, communication and teamworking, and organization and care planning domains. Percentages of negative responses were more than 20% found in organization and care planning, access to resources, and ward type and layout domains. Among the respondents, 57.3% (n = 899) rated the safety of their wards as excellent as opposed to 2.9% (n = 46) who rated it as poor. Approximately 5% (n = 79) have noticed 1 event, and 2.3% (n = 36) have noticed 2 or 3 events. Unemployed participants had a significantly lower rate of positive responses in domains of communication, access to resources, and ward type. In contrast, the no-schooling group had a significantly greater rate of negative responses in care planning and ward-type domains. CONCLUSIONS: The patient plays a key role in enhancing the quality of care and has the potential to detect adverse events. The study highlighted the need to focus on better communication processes for patients with low education levels to enhance their engagement in their care. Further steps should be taken to understand the extent of the patient's involvement in the improvement that could be tackled from feedback on the safety of care.

Automated Lung Cancer Segmentation in Tissue Micro Array Analysis Histopathological Images Using a Prototype of Computer-Assisted Diagnosis.

BACKGROUND: Lung cancer is a fatal disease that kills approximately 85% of those diagnosed with it. In recent years, advances in medical imaging have greatly improved the acquisition, storage, and visualization of various pathologies, making it a necessary component in medicine today. OBJECTIVE: Develop a computer-aided diagnostic system to detect lung cancer early by segmenting tumor and non-tumor tissue on Tissue Micro Array Analysis (TMA) histopathological images. METHOD: The prototype computer-aided diagnostic system was developed to segment tumor areas, non-tumor areas, and fundus on TMA histopathological images. RESULTS: The system achieved an average accuracy of 83.4% and an F-measurement of 84.4% in segmenting tumor and non-tumor tissue. CONCLUSION: The computer-aided diagnostic system provides a second diagnostic opinion to specialists, allowing for more precise diagnoses and more appropriate treatments for lung cancer.

Quality of Life in Patients With Parkinson's Disease: A Cross-Sectional Study.

Patients with Parkinson's disease (PD) suffer from a range of physical, psychological, and social problems. The disease affects the quality of life (QOL) of the affected person. Several factors contribute to QOL, and these factors should be examined to develop appropriate strategies. This study aimed to determine the factors related to QOL in patients with PD. A cross-sectional, descriptive study was conducted using a tool with strong validity and reliability (39-Item Parkinson's Disease Questionnaire (PDQ-39)) to assess the quality of life. Descriptive statistics were used to analyze the data, and non-parametric chi-square tests were applied to evaluate the relationship between QOL and the variables. Frequent hospital admissions, level of education, and marital status were among the factors that affected QOL. The ability to perform Ramadan fasting correlated with the degree of QOL. The coronavirus disease 2019 (COVID-19) pandemic has adversely affected the quality of life due to changes in access to medical care and medications. To improve QOL in patients with PD, a comprehensive approach is required in many healthcare domains that includes physiotherapy together with the conventional pharmacotherapy, other treatments, and psychological support.

IgA Vasculitis With Adalimumab Therapy for Hidradenitis Suppurativa: A Case Report and Review of Literature.

Immunoglobulin A (IgA) vasculitis is a systemic vasculitis characterized by inflammation of the small vessels, with cutaneous, musculoskeletal, gastrointestinal, and renal involvement, usually seen in pediatric populations. Hidradenitis suppurativa is a chronic inflammatory disorder of the skin, which can be treated by tumor necrosis factor-α (TNFα) inhibitor therapy. TNFα inhibitor therapy is used as an important milestone in the treatment of various rheumatological and autoimmune disorders. Unexpected adverse effects might occur. However, they are usually mild and do not warrant treatment withdrawal. We present a case of IgA vasculitis complicating adalimumab therapy for hidradenitis suppurativa. We also review and discuss similar cases reported in the literature.