Energy drink consumption among medical students in Jordan - prevalence, attitudes, and associated factors: a cross-sectional study.

Background: Energy drinks (ED) are popular beverages that contain high levels of caffeine, sugar, and other supplements, such as vitamins, which are marketed to enhance mental alertness and physical performance. Studies have shown that energy drink consumption is prevalent among medical students. Therefore, this study aimed to assess the prevalence, attitudes, and factors associated with energy drink consumption among medical students in Jordan. Materials and methods: A cross-sectional study was conducted among medical students from six public universities in Jordan. A total of 307 students were included in the study, and data were collected using an expert-validated questionnaire. The collected data were analyzed using SPSS version 25. Results: The study found that 50% of the sample had consumed ED, half of them started consuming them at the age of 16-18, and learned about them from friends. The primary reasons for consuming ED were to stay awake at night and the majority of them increase their consumption during exams to increase alertness. Regular energy drink consumption was significantly associated with being a student at the university located in the south governorate of Jordan (P=0.021), living alone (P=0.000), drinking alcohol (P=0.049), drinking coffee daily (P=0.043), and consuming more than 10 cans of soft drinks weekly (P=0.001). However, sex, age, academic achievement, and smoking status had no significant association with regular energy drink consumption. Students with regular energy drink consumption experienced daytime sleepiness, decreased concentration, fatigue, and reduced performance more than students with no regular energy drink consumption. Conclusion: The prevalence of energy drink consumption among medical students in Jordan is high, with factors such as social influences, lifestyle behaviors, and academic pressure being significant contributors. This study highlights the need for interventions to promote healthy behaviors and raise awareness about the potential harms of ED among medical students.

Probiotic-derived silver nanoparticles target mTOR/MMP-9/BCL-2/dependent AMPK activation for hepatic cancer treatment.

Recent advances in nanotechnology have offered novel ways to combat cancer. By utilizing the reducing capabilities of Lactobacillus acidophilus, silver nanoparticles (AgNPs) are synthesized. The anti-cancer properties of AgNPs have been demonstrated in previous studies against several cancer cell lines; it has been hypothesized that these compounds might inhibit AMPK/mTOR signalling and BCL-2 expression. Consequently, the current research used both in vitro and in silico approaches to study whether Lactobacillus acidophilus AgNPs could inhibit cell proliferation autophagy and promote apoptosis in HepG2 cells. The isolated strain was identified as Lactobacillus acidophilus strain RBIM based on 16 s rRNA gene analysis. Based on our research findings, it has been observed that this particular strain can generate increased quantities of AgNPs when subjected to optimal growing conditions. The presence of silanols, carboxylates, phosphonates, and siloxanes on the surface of AgNPs was confirmed using FTIR analysis. AgNPs were configured using UV-visible spectroscopy at 425 nm. In contrast, it was observed that apoptotic cells exhibited orange-coloured bodies due to cellular shrinkage and blebbing initiated by AgNP treatment, compared to non-apoptotic cells. It is worth mentioning that AgNPs exhibited remarkable selectivity in inducing cell death, specifically in HepG2 cells, unlike normal WI-38 cells. The half-maximum inhibitory concentration (IC50) values for HepG2 and WI-38 cells were 4.217 µg/ml and 154.1 µg/ml, respectively. AgNPs induce an upregulation in the synthesis of inflammation-associated cytokines, including (TNF-α and IL-33), within HepG2 cells. AgNPs co-treatment led to higher glutathione levels and activating pro-autophagic genes such as AMPK.Additionally, it resulted in the suppression of mTOR, MMP-9, BCL-2, and α-SMA gene expression. The docking experiments suggest that the binding of AgNPs to the active site of the AMPK enzyme leads to inhibiting its activity. The inhibition of AMPK ultimately results in the suppression of the mechanistic mTOR and triggers apoptosis in HepG2 cells. In conclusion, the results of our study indicate that the utilization of AgNPs may represent a viable strategy for the eradication of liver cancerous cells through the activation of apoptosis and the enhancement of immune system reactions.

Peripapillary pachychoroid syndrome successfully treated with topical prednisolone acetate 1% drops.

Peripapillary pachychoroid syndrome (PPS) is a rare disease characterized by choroidal thickening around the optic disc. Visual acuity might be impaired secondary to the associated peripapillary intraretinal and/or subretinal fluids. We reported a case of a 70-year-old male patient who presented with a gradual bilateral decrease in vision. His best-corrected visual acuity was 20/60 in the right eye and 20/25 in the left eye. Dilated fundus examination showed yellowish peripapillary lesions and intraretinal fluid (IRF) surrounding the optic disc in both eyes. Optical coherence tomography showed that the outer retinal layers were disrupted, and IRF affected the nasal macula. A bilateral increase in the thickness of the choroid around the optic discs was found. The patient was successfully treated with a tapering dose of topical prednisolone acetate (1%). Three months after treatment, his vision improved to 20/25 in the right eye and 20/20 in the left eye. Topical steroid drops might be administered to treat PPS.

Voltametric Sensor Based on Magnetic Chitosan Acetylindole-Based Nanocomposite for the Determination of Sulfamethazine.

Sulfamethazine (SMZ), a persistent antibiotic, is frequently detected in drinking water and milk. For this reason, our research aimed to develop a novel electrochemical sensor based on a magnetic nanocomposite supported on chitosan modified by 3-acetylindole through the formation of chitosan acetylindole Schiff base (Chs-Aci). The objective was to detect extremely low concentrations of SMZ in milk. The synthesized nanocomposites were characterized by various techniques, including FT-IR, XRD, EDX, SEM, and TEM. To enhance the electrocatalytic efficiency for sensitive SMZ detection in food samples, a magnetic chitosan acetylindole nanocomposite (M-Chs-Aci) was employed as a modifier for a carbon paste electrode (CPE). The electrochemical measurements revealed that the M-Chs-Aci/CPE exhibits good electrocatalytic performance compared to a bare CPE. Moreover, low detection limit, repeatability, and stability were achieved at 0.021 µM, 3.83%, and 94.87%, respectively. Finally, the proposed M-Chs-Aci/CPE proved to be highly effective in detecting SMZ in milk samples. The obtained findings paved the way for the effective usability of M-Chs-Aci/CPE as a sensor for detecting SMZ in real samples, with acceptable recoveries of 95%-98.87%.

Highly differentiated follicular carcinoma of the ovary with omental and peritoneal spread in a 22-year-old girl; A diagnostic and counseling challenge.

INTRODUCTION AND IMPORTANCE: Highly differentiated follicular carcinoma of the ovary (HDFCO) is a rare type of thyroid carcinoma originating from struma ovarii, consisting of benign-appearing thyroid follicles spread outside the ovarian tissue. CASE PRESENTATION: We present a 22-year-old girl who underwent left salpingo-oophorectomy, omental, and peritoneal biopsies for a complex left ovarian mass. Microscopic examination and Immunohistochemical staining led to the diagnosis of HDFCO with tumor deposits affecting the omental and peritoneal biopsies. The patient was counseled about the nature of her disease and the recommended treatment. Thyroidectomy was performed later, revealing a normal thyroid gland. The patient received an ablative dose of radioactive iodine (150 mci) and a suppressive dose of levothyroxine. This is one of the youngest reported patients ever. CLINICAL DISCUSSION: To our knowledge, the patient presented in this case report is one of the youngest patients ever reported in the literature. In the recent WHO Classification of Female Genital Tumors, the term highly differentiated follicular carcinoma arising from struma ovarii (HDFCO) was introduced, to emphasize its low-grade malignant behavior. Due to its rare incidence, there is no standard treatment strategy, but a plan based on surgical intervention is suggested. CONCLUSION: Malignant struma ovarii should be put in the differential diagnosis in young patients with suspicious ovarian masses. Adequate patient counseling remains a cornerstone in the journey of management.

Exploring the anticancer and antibacterial potential of naphthoquinone derivatives: a comprehensive computational investigation.

This study investigates the potential of 2-(4-butylbenzyl)-3-hydroxynaphthalene-1,4-dione (11) and its 12 derivatives as anticancer and biofilm formation inhibitors for methicillin-resistant staphylococcus aureus using in silico methods. The study employed various computational methods, including molecular dynamics simulation molecular docking, density functional theory, and global chemical descriptors, to evaluate the interactions between the compounds and the target proteins. The docking results revealed that compounds 9, 11, 13, and ofloxacin exhibited binding affinities of -7.6, -7.9, -7.5, and -7.8 kcal mol-1, respectively, against peptide methionine sulfoxide reductase msrA/msrB (PDB: 3E0M). Ligand (11) showed better inhibition for methicillin-resistant staphylococcus aureus msrA/msrB enzyme. The complex of the 3E0M-ligand 11 remained highly stable across all tested temperatures (300, 305, 310, and 320 K). Principal Component Analysis (PCA) was employed to evaluate the behavior of the complex at various temperatures (300, 305, 310, and 320 K), demonstrating a total variance of 85%. Convergence was confirmed by the eigenvector's cosine content value of 0.43, consistently displaying low RMSD values, with the minimum observed at 310 K. Furthermore, ligand 11 emerges as the most promising candidate among the compounds examined, showcasing notable potential when considering a combination of in vitro, in vivo, and now in silico data. While the naphthoquinone derivative (11) remains the primary candidate based on comprehensive in silico studies, further analysis using Frontier molecular orbital (FMO) suggests while the Egap value of compound 11 (2.980 eV) and compound 13 (2.975 eV) is lower than ofloxacin (4.369 eV), indicating their potential, so it can be a statement that compound 13 can also be investigated in further research.

Correction: Interventional Radiology Awareness Among Family Physicians and General Practitioners in the Qassim Region, Saudi Arabia.

[This corrects the article DOI: 10.7759/cureus.51751.].

MXene-Embedded Porous Carbon-Based Cu2O Nanocomposites for Non-Enzymatic Glucose Sensors.

This work explores the use of MXene-embedded porous carbon-based Cu2O nanocomposite (Cu2O/M/AC) as a sensing material for the electrochemical sensing of glucose. The composite was prepared using the coprecipitation method and further analyzed for its morphological and structural characteristics. The highly porous scaffold of activated (porous) carbon facilitated the incorporation of MXene and copper oxide inside the pores and also acted as a medium for charge transfer. In the Cu2O/M/AC composite, MXene and Cu2O influence the sensing parameters, which were confirmed using electrochemical techniques such as cyclic voltammetry, electrochemical impedance spectroscopy, and amperometric analysis. The prepared composite shows two sets of linear ranges for glucose with a limit of detection (LOD) of 1.96 µM. The linear range was found to be 0.004 to 13.3 mM and 15.3 to 28.4 mM, with sensitivity values of 430.3 and 240.5 µA mM-1 cm-2, respectively. These materials suggest that the prepared Cu2O/M/AC nanocomposite can be utilized as a sensing material for non-enzymatic glucose sensors.

A nucleic acid-based surface-enhanced Raman scattering of gold nanorods in N-gene integrated principal component analysis for COVID-19 detection.

A rapid, simple, sensitive, and selective point-of-care diagnosis tool kit is vital for detecting the coronavirus disease (COVID-19) based on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) strain. Currently, the reverse transcriptase-polymerase chain reaction (RT-PCR) is the best technique to detect the disease. Although a good sensitivity has been observed in RT-PCR, the isolation and screening process for high sample volume is limited due to the time-consuming and laborious work. This study introduced a nucleic acid-based surface-enhanced Raman scattering (SERS) sensor to detect the nucleocapsid gene (N-gene) of SARS-CoV-2. The Raman scattering signal was amplified using gold nanoparticles (AuNPs) possessing a rod-like morphology to improve the SERS effect, which was approximately 12-15 nm in diameter and 40-50 nm in length. These nanoparticles were functionalised with the single-stranded deoxyribonucleic acid (ssDNA) complemented with the N-gene. Furthermore, the study demonstrates method selectivity by strategically testing the same virus genome at different locations. This focused approach showcases the method's capability to discern specific genetic variations, ensuring accuracy in viral detection. A multivariate statistical analysis technique was then applied to analyse the raw SERS spectra data using the principal component analysis (PCA). An acceptable variance amount was demonstrated by the overall variance (82.4 %) for PC1 and PC2, which exceeded the desired value of 80 %. These results successfully revealed the hidden information in the raw SERS spectra data. The outcome suggested a more significant thymine base detection than other nitrogenous bases at wavenumbers 613, 779, 1219, 1345, and 1382 cm-1. Adenine was also less observed at 734 cm-1, and ssDNA-RNA hybridisations were presented in the ketone with amino base SERS bands in 1746, 1815, 1871, and 1971 cm-1 of the fingerprint. Overall, the N-gene could be detected as low as 0.1 nM within 10 mins of incubation time. This approach could be developed as an alternative point-of-care diagnosis tool kit to detect and monitor the COVID-19 disease.

Recent Advances of carbon Pathways for Sustainable Environment development.

Carbon dots (CDs) are an emerging type of carbon nanomaterial with strong biocompatibility, distinct chemical and physical properties, and low toxicity. CDs may emit fluorescence in the ultraviolet (UV) to near-infrared (NIR) range, which renders them beneficial for biomedical applications. CDs are usually made from carbon precursors and can be synthesized using top-down and bottom-up methods and it can be easily functionalized using different methods. For specific cases of biomedical applications carbon dot functionalization augments the materials' characteristics. Novel functionalization techniques are still being investigated. This review will look at the benefits of functionalization to attain a high yield and various biological applications. Biomedical applications such as photodynamic and photothermal therapy, biosensing, bioimaging, and antiviral and antibacterial properties will be covered in this review. The future applications of green synthesized carbon dots will be determined in part by this review.

Biowaste to bioenergy nexus: Fostering sustainability and circular economy.

Existing fossil-based commercial products present a significant threat to the depletion of global natural resources and the conservation of the natural environment. Also, the ongoing generation of waste is giving rise to challenges in waste management. Conventional practices for the management of waste, for instance, incineration and landfilling, emit gases that contribute to global warming. Additionally, the need for energy is escalating rapidly due to the growing populace and industrialization. To address this escalating desire in a sustainable manner, access to clean and renewable sources of energy is imperative for long-term development of mankind. These interrelated challenges can be effectively tackled through the scientific application of biowaste-to-bioenergy technologies. The current article states an overview of the strategies and current status of these technologies, including anaerobic digestion, transesterification, photobiological hydrogen production, and alcoholic fermentation which are utilized to convert diverse biowastes such as agricultural and forest residues, animal waste, and municipal waste into bioenergy forms like bioelectricity, biodiesel, bio alcohol, and biogas. The successful implementation of these technologies requires the collaborative efforts of government, stakeholders, researchers, and scientists to enhance their practicability and widespread adoption.

Exploring the effectiveness of flavone derivatives for treating liver diseases: Utilizing DFT, molecular docking, and molecular dynamics techniques.

In exploring nature's potential in addressing liver-related conditions, this study investigates the therapeutic capabilities of flavonoids. Utilizing in silico methodologies, we focus on flavone and its analogs (1-14) to assess their therapeutic potential in treating liver diseases. Molecular change calculations using density functional theory (DFT) were conducted on these compounds, accompanied by an evaluation of each analog's physiochemical and biochemical properties. The study further assesses these flavonoids' binding effectiveness and locations through molecular docking studies against six target proteins associated with human cancer. Tropoflavin and taxifolin served as reference drugs. The structurally modified flavone analogs (1-14) displayed a broad range of binding affinities, ranging from -7.0 to -9.4 kcal mol⁻¹, surpassing the reference drugs. Notably, flavonoid (7) exhibited significantly higher binding affinities with proteins Nrf2 (PDB:1 × 2 J) and DCK (PDB:1 × 2 J) (-9.4 and -8.1 kcal mol⁻¹) compared to tropoflavin (-9.3 and -8.0 kcal mol⁻¹) and taxifolin (-9.4 and -7.1 kcal mol⁻¹), respectively. Molecular dynamics (MD) simulations revealed that the docked complexes had a root mean square deviation (RMSD) value ranging from 0.05 to 0.2 nm and a root mean square fluctuation (RMSF) value between 0.35 and 1.3 nm during perturbation. The study concludes that 5,7-dihydroxyflavone (7) shows substantial promise as a potential therapeutic agent for liver-related conditions. However, further validation through in vitro and in vivo studies is necessary. Key insights from this study include:•Screening of flavanols and their derivatives to determine pharmacological and bioactive properties using ADMET, molinspiration, and pass prediction analysis.•Docking of shortlisted flavone derivatives with proteins having essential functions.•Analysis of the best protein-flavonoid docked complexes using molecular dynamics simulation to determine the flavonoid's efficiency and stability within a system.

Experimental and computational DFT, drift-diffusion studies of cobalt-based hybrid perovskite crystals as absorbers in perovskite solar cells.

The optimised designs of dimethyl ammonium cobalt formate-based perovskite crystals [(CH3)2NH2]Co(HCOO)3 were experimentally synthesized and computationally utilized as absorbers for perovskite solar cells (PSCs). Crystals were grown using solvothermal synthesis. Additive materials (Fe, Ni) are responsible for the growth and suppression of crystals in the micrometre range. Temperature and pressure were altered to obtain optimum growth conditions. Grown crystals were characterized by spectroscopy (XRD, FT-IR, UV-Vis) and optical microscopy. Combined density functional theory (DFT) and drift-diffusion modelling frameworks were simulated. These simulators were used to examine various perovskite absorbers for solar-cell configurations. Field calculations were used to examine the structural stability, band structure, and electronic contribution of the constituent elements in [(CH3)2NH2]Co1-nMn(HCOO)3 (M = Fe, Ni and n = 0, 0.1) as absorber material. Conventional TiO2 and spiro-OMeTAD were used as the electron-transport layer and hole-transport layer, respectively, and Pt was used as a back contact. Comprehensive analysis of the effects of several parameters (layer thickness, series and shunt resistances, temperature, generation-recombination rates, current-voltage density, quantum efficiency) was carried out using simulation. Our proposed strategy may pave the way for further design of new absorber materials for PSCs.

Interventional Radiology Awareness Among Family Physicians and General Practitioners in the Qassim Region, Saudi Arabia.

Interventional radiology (IR) is a rapidly growing specialty and is increasingly developing new procedures and minimally invasive interventions; thus, it might be challenging for non-specialists to keep up with all the new findings of IR. In this study, we tried to determine the level of awareness of family physicians and general practitioners about IR in the Qassim Region, Saudi Arabia. A self-completed online questionnaire was distributed among family physicians in the Qassim Region, with a total of 197 respondents. We found that the overall awareness level of family physicians and general practitioners about IR in the Qassim Region was low, with only 56 (28.4%) having an overall good knowledge level regarding IR, while 141 (74.6%) had poor knowledge. A total of 85 (43.1%) of the study participants reported that they would greatly benefit from more education about IR. The results demonstrate that there is a significant knowledge gap among family and general physicians about IR. Therefore, we suggest that there needs to be more education about IR and its developing procedures to promote collaboration among family medicine physicians, general physicians, and interventional radiologists.

Unlocking the potential of cosmetic dermal delivery with ethosomes: A comprehensive review.

BACKGROUND: In a world where hair loss, acne, and skin whitening are common concerns, ethosomes emerge as a captivating breakthrough in cosmetic drug delivery. METHOD: This review provides a comprehensive overview of the ethosomal system and assesses its potential as an effective nanocarrier for delivering active ingredients to the skin. The focus is on exploring their applications in various pathologies, particularly skin disorders such as acne, hair loss, and skin pigmentation. RESULTS: Ethosomes are a novel type of vesicular nanocarrier composed of high concentrations of ethanol (20-45%) and phospholipids. Their unique structure and composition make them an ideal choice for transporting active ingredients through the skin, offering targeted and effective treatment. The inclusion of ethanol in ethosomes' composition gives them distinctive properties, including flexibility, deformability, and stability, facilitating deep penetration into the skin and enhancing medication deposition. Moreover, ethosomes improved theoverall drug-loading capacity, and specificity of target treatment CONCLUSION: Ethosomes represent a unique and suitable approach for delivering active cosmetic ingredients in the treatment of hair loss, acne, and skin whitening, presenting a versatile alternative to traditional dermal delivery systems. Despite the challenges associated with their complex preparation and sensitivity to temperature and humidity, the remarkable potential benefits of ethosomes cannot be ignored. Further research is crucial to unlock their full potential, understand their limitations, and refine their formulations and administration methods. Ethosomes hold the promise of transforming the way we address these cosmetic concerns, offering an exciting glimpse into the future of advanced skincare solutions.

Infectious profiles in civilian gunshot associated long bone fractures.

PURPOSE: There is a paucity of literature on infections in civilian gunshot associated with long bone fractures with the reported rates ranging from 0-15.7%.This study aimed to investigate the rates of infection associated with long bone fractures caused by civilian gunshots. The specific objectives were to determine if certain extremities were at a higher risk for infection and to identify the types of bacteria present in these infections by analyzing culture isolates. METHODS: We conducted a retrospective review of consecutive patients aged 18-64 who sustained gunshot-associated long bone fractures at an urban Level I trauma centre from 2010 to 2017. Patient selection was based done through a institutional trauma centre database using international classification of diseases (ICD) 9 and 10 codes. We included patients who underwent surgical treatment, specifically fracture fixation, at our institution and excluded patients with fractures involving the pelvis, spine, foot, and hand. A total of 384 gunshot-associated long bone fractures in 347 patients were identified for analysis. Relevant patient-, injury-, and treatment-related variables were extracted from clinical records and radiographic reviews. Outcomes of interest included bony union, repeat operative procedures, and the development of deep infection. RESULTS: 347 patients with 384 long bone fractures were included. 32 fractures in 32 patients developed an infection for an incidence of 9.3% of patients and 8.3% of fractures. Gram-positive bacteria were present in 23/32 (72.0%) culture isolates, gram-negative bacteria in 10/32 (31.3%) culture isolates, and six infections were polymicrobial. Staphylococcus 16/32 (50.0%) and Enterobacter 6/32 (18.8%) species were the most common isolates. Of the Staphylococcus species, 5/16 (31.3%) were MRSA. Lower extremity fractures had a greater risk for infection compared to the upper extremity (11.7% vs 3.7% p < 0.01) and fractures that developed an infection had a larger average zone of comminution (63.9 mm vs 48.5 mm p < 0.05). CONCLUSION: This study investigated the rates of infection associated with long bone fractures caused by civilian gunshots. The overall infection rate observed in our series aligns with existing literature. Gram-positive bacteria were the predominant isolates, with a notable incidence of MRSA in our patient population, highlighting the need for considering empiric coverage. Additionally, gram-negative organisms were found in a significant proportion of infections, and a notable percentage of infections were polymicrobial. Our findings emphasize the importance of carefully assessing highly comminuted lower extremity fractures and implementing appropriate antibiotic coverage and operative debridement for patients with gunshot-related long bone fractures. While current prophylaxis algorithms for open fractures lack specific inclusion of gunshot wounds, we propose incorporating these injuries to reduce the incidence of infections associated with such fractures.

Midface hypoplasia in syndromic craniosynostosis: predicting craniofacial growth via a novel regression model from anatomical morphometric analysis.

Midface hypoplasia in syndromic craniosynostosis (SC) may lead to serious respiratory issues. The aim of this study was to analyse the morphometric correlation between midface and cranial base parameters in paediatric SC patients in order to formulate predictive regression models. The computed tomography scans of 18 SC patients and 20 control were imported into Materialise Mimics Medical version 21.0 software for the measurement of multiple craniofacial landmarks and correlation analysis. The results showed a strong correlation of anterior cranial base (SN), posterior cranial base (SBa), and total cranial base (NBa) (r = 0.935) to maxilla length and width (ZMR-ZML) (r = 0.864). The model of NBa = - 1.554 + 1.021(SN) + 0.753(SBa) with R2 = 0.875 is proposed to demonstrate the development of the cranial base that causes a certain degree of midface hypoplasia in SC patients. The formula is supported using a prediction model of ZMR-ZML = 5.762 + 0.920(NBa), with R2 = 0.746. The mean absolute difference and standard deviation between the predicted and true NBa and ZMR-ZML were 2.08 ± 1.50 mm and 3.11 ± 2.32 mm, respectively. The skeletal growth estimation models provide valuable foundation for further analysis and potential clinical application.

Knowledge, Attitude, and Practices Related to Foot Care Among Diabetic Patients in Tabuk City, Saudi Arabia.

Introduction Diabetic foot ulcer (DFU) is a prevalent complication of diabetes mellitus (DM), affecting approximately 15% of all diabetic patients. This condition poses significant challenges due to its association with major morbidity, mortality, high costs, and diminished quality of life. The incidence of diabetic foot complications among diagnosed diabetes cases is alarming, making it a primary concern in diabetes management. Diabetes mellitus, a chronic metabolic disorder, impacts nearly every system in the body. Methods In this study, a cross-sectional design was employed to assess the level of knowledge, attitude, and practices related to foot care among 432 diabetic patients in Tabuk City, Saudi Arabia. Results The participants' ages ranged from 18 to above 60 years, with (n = 206, 47.69%) being male and (n = 226, 52.31%) female. Type 2 diabetes was prevalent, constituting (n = 277, 64.12%) of cases, whereas (n = 187, 38.29%) had type 1 diabetes. Approximately (n= 224, 51.9%) of patients had been diagnosed with diabetes for less than 10 years. A significant portion (n= 302, 69.91%) of patients did not report any foot complaints. However, (n= 88, 20.37%) had a history of healed ulcers, and (n= 21, 4.9%) had undergone amputation due to diabetes. The majority of patients (n = 228, 52.78%) were under oral agent treatment. Conclusion The study population demonstrated adequate knowledge about diabetes management and exhibited positive attitudes toward diabetes and its related complications, particularly concerning foot care. While most patients displayed appropriate practices related to diabetic foot care, some participants showed inadequate adherence to essential procedures. Addressing these gaps in knowledge and practices is crucial for enhancing the overall management of diabetic foot complications among patients.

Do internship students do well in a clinical environment? A qualitative naturistic study.

Background: The internship year marks the culmination of the nursing program across all Saudi universities, bridging theoretical learning and practical application. The significance of the internship year lies in the application of skills acquired during the preceding years of study. Understanding interns' experiences, identifying influences, and sharing their recommendations for best practices become crucial. Objective: This study aimed to explore the experiences of internship students and address the challenges they encountered in a clinical environment. Methods: A qualitative naturistic descriptive approach was employed, involving 20 purposively selected participants from internship students in two regions in Saudi Arabia. Data were collected in January 2023 through semi-structured interviews, focus group discussions, and observation. A conventional content analysis approach was used for data analysis. Results: Four major themes were generated: 1) Transferring Shock, 2) Self-Learning, 3) Supportive Environments, and 4) Factors Facilitating Learning. Transferring Shock comprised two subthemes: feeling lost and feeling left out. Conclusion: Internship students acknowledged the utility of orientation and mentorship programs in advancing the practical skills of new nurses and enhancing patient safety. The findings also indicated that those with prior preparation and robust communication skills reported a positive experience. Consequently, integrating communication courses into the nursing education curriculum could be beneficial. Establishing a supportive learning environment for nursing interns is imperative to address challenges and ensure the delivery of safe and effective patient care.

Prognostic value of pretreatment indocyanine green angiography in the acute uveitic phase of Vogt-Koyanagi-Harada disease.

PURPOSE: To investigate the prognostic value of pretreatment indocyanine green angiographic (ICGA) features in initial-onset acute uveitis associated with Vogt-Koyanagi-Harada (VKH) disease. METHODS: Retrospective analysis of 84 patients (168 eyes). Main outcome measures were final visual acuity, development of 'sunset glow fundus' (SGF) and progression to chronic recurrent evolution. RESULTS: Thirty-eight patients (76 eyes) presented in the phase preceding anterior segment (AS) inflammation (early presentation) and 46 patients (92 eyes) had AS inflammation at presentation (late presentation). The mean number of hypofluorescent dark dots (HDDs) and frequency of disc hyperfluorescence were more in the late presentation group (p < 0.001 for both comparisons), whereas the early presentation group showed higher frequencies of peripapillary punctate choroidal hyperfluorescence (p < 0.001) and hypofluorescent patches involving macula corresponding to the areas of exudative retinal detachment (p = 0.012). The mean number of HDDs and the frequency of disc hyperfluorescence were higher among eyes that developed SGF (p < 0.001 for both comparisons) and eyes that progressed to chronic recurrent evolution (p < 0.001; p = 0.001, respectively). The frequencies of peripapillary punctate choroidal hyperfluorescence and hypofluorescent patches corresponding to the areas of exudative retinal detachment were less in the eyes that developed SGF (p = 0.019; p = 0.003, respectively). Punctate choroidal hyperfluorescence elsewhere was less frequent in the eyes that developed SGF (p < 0.001) and eyes that progressed to chronic recurrent evolution (p = 0.002). CONCLUSIONS: Pretreatment ICGA has a prognostic value in initial-onset acute uveitis associated with VKH disease.