Clinical Presentations and Risk Factors of Gastrointestinal Bleeding in the Emergency Department: A Multicenter Retrospective Study.

BACKGROUND AND AIMS: Gastrointestinal bleeding is a major healthcare burden and is associated with significant morbidity and mortality. This study aimed to assess the prevalence, clinical presentation, and risk factors of patients presenting with gastrointestinal bleeding in the emergency department. MATERIALS AND METHODS: This retrospective study was conducted in two tertiary care hospitals in Riyadh, Saudi Arabia. The medical records of patients who presented to the emergency department with gastrointestinal bleeding between January 2010 and January 2020 were reviewed. Patients aged 18 years or older, with gastrointestinal bleeding (upper or lower) regardless of underlying cause, lifestyle, location of bleeding, health status, or medication use, were included. Demographic characteristics, initial vital signs, medical history, physical examination findings, comorbidities, medications, laboratory and radiological investigations, cause and stage of liver disease, management, and complications were recorded. Endoscopic findings and management of the bleeding site were collected according to the presenting symptoms. RESULTS: A total of 760 patients were included. The mean age was 62.7 ± 17.8 years, and 61.4% were males. The most common comorbidities at presentation were hypertension (54.1%), diabetes mellitus (51.2%), and ischemic heart disease (18.2%). The origins of the bleeding were lower gastrointestinal in 52% and upper gastrointestinal in 48% of patients. CONCLUSIONS: Lower gastrointestinal bleeding was found to be more common than upper gastrointestinal bleeding. Hemorrhoids, polyps, diverticular disease, and colonic ulcers were the major risk factors for lower gastrointestinal bleeding. In contrast, upper gastrointestinal bleeding was predominantly caused by esophageal varices, gastritis, and peptic ulcers.

Green Synthesis of Uncoated and Olive Leaf Extract-Coated Silver Nanoparticles: Sunlight Photocatalytic, Antiparasitic, and Antifungal Activities.

The circular economy, which attempts to decrease agricultural waste while also improving sustainable development through the production of sustainable products from waste and by-products, is currently one of the main objectives of environmental research. Taking this view, this study used a green approach to synthesize two forms of silver nanoparticles: coated silver nanoparticles with olive leaf extract (Ag-olive) and uncoated pure silver nanoparticles (Ag-pure), which were produced by the calcination of Ag-olive at 550 °C. The extract and the fabricated nanoparticles were characterized by a variety of physicochemical techniques, including high-performance liquid chromatography (HPLC), thermal gravimetric analysis (TGA), X-ray diffraction (XRD), scanning electron microscopy (SEM), and transmission electron microscopy (TEM). Adult ticks (Hyalomma dromedarii) (Acari: Ixodidae) were used in this study to evaluate the antiparasitic activity of synthesized nanoparticles and extract. Furthermore, the antifungal activity was evaluated against Aspergillus aculeatus strain N (MW958085), Fuserium oxysporum (MT550034), and Alternaria tenuissiuma (MT550036). In both antiparasitic and antifungal tests, the as-synthesized Ag-olive showed higher inhibition activity than Ag-pure and olive leaf extract. The findings of this research suggest that Ag-olive may be a powerful and eco-friendly antiparasitic and antifungal agent. Ag-pure was also evaluated as a photocatalyst under sunlight for the detoxification of Eri-chrome-black T (EBT), methylene blue (MB), methyl orange (MO), and rhodamine B (RhB).

Phytosynthesis via wasted onion peel extract of samarium oxide/silver core/shell nanoparticles for excellent inhibition of microbes.

The aqueous onion peel extract (OPE) was used to synthesize silver nanoparticles (Ag-onion), samarium oxide nanoparticles (Sm2O3-onion), and silver/samarium oxide core/shell nanoparticles (Ag@Sm2O3-onion). The produced nanoparticles were characterized by thermal gravimetric analysis (TGA), infrared spectra (FT-IR), absorption spectra (UV-Vis), energy band gap, X-ray photoelectron spectroscopy (XPS), X-ray diffraction (XRD), zeta potential, and transmission electron microscopy (TEM). OPE and NPs were tested for the disinfection of some water microbes. XRD analysis exhibited an amorphous structure of samarium oxide in both Sm2O3-onion and Ag@ Sm2O3-onion. The isolated bacteria from the water sample were Bacillus subtilis (OQ073500) and Escherichia coli (MW534699), while the isolated fungi were Alternaria brassicae (MZ266540), Aspergillus flavus (MT550030), Aspergillus penicillioides (MW957971), Pythium ultimum (MW830915), Verticillium dahlia (MW830379), Fusarium acuminatum (MZ266538), Candida albicans (MW534712), and Candida parapsilosis (MW960416). High levels of antimicrobial activity were seen in both the nanoparticles and the aqueous onion peel extract. Based on experimental results, Ag@Sm2O3 demonstrated the highest activity as an effective disinfectant, indicating the effectiveness of the modification process.

Photocatalytic Degradation of Rhodamine-B and Water Densification via Eco-Friendly Synthesized Cr2O3 and Ag@Cr2O3 Using Garlic Peel Aqueous Extract.

The purification and densification of wastewater play an important role in water recycling, especially if the materials used in water recycling are other types of recycled waste. Therefore, considering this view in this study, the biosynthesis of silver-decorated chromium oxide nanoparticles utilizing a wasted Allium sativum (garlic) peel extract is investigated. The aqueous extract of garlic peel (GPE) was treated with silver nitrate, chromium nitrate, and a mixture of silver nitrate and chromium nitrate to synthesize silver nanoparticles (Ag-garlic), chromium oxide nanoparticles (Cr2O3-garlic), and silver-decorated chromium oxide nanoparticles (Ag@Cr2O3-garlic), respectively. The synthesized nanoparticles were elucidated via thermal gravimetric analysis (TGA), infrared spectra (FT-IR), absorption spectra (UV-Vis), scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX), X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), and transmission electron microscopy (TEM). Antimicrobial activity studies were conducted against waterborne germs, bacterial strains (Bacillus subtilis, Enterococcus faecium, Escherichia coli, and Pseudomonas aeruginosa), and fungal strains (Alternaria porri, Aspergillus flavus, Aspergillus niger, Fuserium oxysporum, and Trichoderma longibrachiatum) and showed significant levels of antimicrobial activity. The results revealed that Ag@Cr2O3 significantly improved antimicrobial activity due to their synergistic effect. The photocatalytic activity of nanoparticles was assessed using Rhodamine B dye (5 ppm) under solar irradiation. Cr2O3-garlic exhibited the best activity as a photocatalyst among the studied nanoparticles, with 97.5% degradation efficiency under optimal conditions.

Exploring Mental Health Literacy and Its Associated Factors: A National Cross-Sectional Study in Saudi Arabia, 2023.

Objective: The aim of this study is to examine, for the first time, the mental health literacy of the Saudi general population. Additionally, we aim to identify demographic factors associated with elevated mental health literacy scores. Methods: A cross-sectional study using a phone interview survey with quota sampling was conducted for equal distribution of sexes, age and administrative regions. Mental health literacy was assessed by the previously validated mental health literacy scale (MHLS). The MHLS ranges from 35 to 160, and a higher score indicates greater level of mental health literacy. Results: In this study, 4,547 (70.2%) agreed to complete the interview. The sample was equally distributed across Saudi Arabia's 13 administrative regions with 50.1% female and mean age 35.9 (SD: ±12.8). In terms of education, 55.1% have a bachelor's degree or above. The nationally weighted score on the original MHLS was 110.75. the MHLS Saudi validation score was influenced by various variables including: marital status, healthcare-related job, sex, education level, and proximity to individuals with mental health issues. Conclusion: The study offers data for the first time on Saudi Arabian mental health literacy status. The high MHLS score reflects good societal awareness and understanding of mental health related concepts and issues in the Saudi population. The results of this study set the baseline for mental health literacy in Saudi Arabia. Future research may focus on utilizing the validated MHLS and the method used in this study to explore the effect of other social and individual factors on mental health literacy.

Comparing Lifestyle and Behavior of Post-Bariatric Surgery and Participants with Obesity: A Community-Based Cross-Sectional Study.

Background: There is a paucity of research dedicated to exploring behavioral change in patients following bariatric surgery. However, there is a need for comparison analysis of individuals with obesity who have received surgical treatment and those who have not opted for any surgical procedures for weight loss. This study is designed to scrutinize the lifestyle choices, behavioral patterns, psychological elements, and eating habits of individuals who have undergone bariatric surgery, in contrast to those with obesity who have not undergone such a procedure. Methods: This study is a secondary analysis from Sharik Diet and Health National Survey (SDHNS) dataset, which is a cross-sectional investigation covering the period from 2020 to 2022. The study focused on demographic factors like age, gender, educational attainment, and monthly earnings. Furthermore, other variables such as physical activity, leisure and workplace sitting habits, smoking patterns, strategies for managing weight, and eating and consumption behaviors were also examined. Results: Out of the initial 15,980 participants reached, 4,069 satisfied the study's inclusion criteria. Bariatric surgery was reported by 806 participants (19.8%). Upon comparing three obesity status groups - The participants who underwent bariatric surgery with or without obesity, those with obesity who did not opt for any surgical weight loss measure, the analysis found that the three obesity status groups were significantly different in 21 variables from a total of 26. Moreover, a logistic regression analysis revealed that 11 variables influenced persistent obesity in the post-surgery phase, as opposed to those who successfully lost weight. These variables included advanced age, limited education, being female, lower income, waterpipe smoking habits, and the consumption of carbonated drinks. Conclusion: This study showed that inability to lose weight after bariatric surgery are linked to poor lifestyle choices and behavior compared to those who were able to lose weight after the surgery.

Retraction: A Rare Case of Solitary Schwannoma of Submandibular Gland.

[This retracts the article DOI: 10.7759/cureus.21373.].

Validation and psychometric testing of the Arabic version of the mental health literacy scale among the Saudi Arabian general population.

OBJECTIVE: This study aimed to validate the Arabic Version of the Mental Health Literacy Scale (Arabic-MHLS) among the Saudi Arabian general population, assessing its internal consistency, test-retest reliability, and structural validity. METHODS: A total of 700 Arabic-speaking Saudi adults were randomly selected to complete the electronic questionnaire in May 2023, which generated 544 participants. Data were coded and stored in the ZdataCloud research data collection system database. Test-retest reliability was assessed using a subsample of 48 participants who completed the questionnaire twice, with a one-week interval. Structural validity was examined using confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA). RESULTS: The Arabic-MHLS demonstrated good internal consistency (Cronbach's alpha = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.89). EFA revealed a four-factor model closely resembling the model identified in the Slovenian validation of MHLS, with factor loadings ranging from 0.40 to 0.85. The four factors included knowledge of mental health disorders, knowledge of help-seeking, knowledge of self-help strategies, and knowledge of professional help also showed good internal consistency. CONCLUSION: The Arabic-MHLS is a valid and reliable tool for assessing mental health literacy in the Saudi Arabian general population. However, further research is needed to refine the measurement tool and understand the complex relationships between mental health literacy and other mental health-related concepts. This will contribute to the development of targeted interventions and policies aimed at improving mental health literacy and promoting mental well-being in the Saudi Arabian population and beyond.

Soft and energy drinks consumption and associated factors in Saudi adults: a national cross-sectional study.

Introduction: The consumption of soft and energy drinks poses a significant risk for non-communicable diseases, such as diabetes and heart disease. Studies in Saudi Arabia have reported elevated consumption of soft/energy drinks, but nation-wide data is not available. Therefore, this study aims to explore the prevalence of soft and energy drinks consumption and its associated factors among a representative sample of Saudi adults. Methods: The present research is a secondary data analysis of the 2021 Sharik Diet and Health National Survey (SDHNS). Current analysis used data on socio-demographics, anthropometrics, physical activity, and soft and energy drink consumption. The frequency of soft and energy drinks consumption is assessed on a weekly basis. Results: Of the 5,194 Saudi adults, 3,928 were analyzed. Overall, 67% consumed soft drinks weekly, while 30% consumed energy drinks weekly. In multiple logistic regression, consumption of either soft drinks or energy drinks was associated with males, a younger age, lower income, and lower physical activity. Individuals with overweight or obesity were less likely to consume energy drinks [OR (95%CI): 0.83 (0.71, 0.99) and 0.73 (0.60, 0.90), respectively] than those with healthy weight. However, education level was not associated with either soft or energy drink consumption. These findings highlight the need for targeted interventions designed to reduce soft and energy drinks consumption in Saudi adults.

Comparative analysis of lifestyle behaviors and dietary intake among obese and non-obese individuals following bariatric surgery: a secondary data analysis from 2020 to 2022.

Objective: The aim of this research is to perform a comparative examination of lifestyle habits and dietary consumption between obese and non-obese subjects who have undergone bariatric surgery. This is done with the intent of investigating the disparities in obesity outcomes attributable to these elements. Method: This study involves a secondary analysis of cross-sectional data obtained from the Sharik Diet and Health National Survey (SDHNS). To ensure a representative distribution of participants, the SDHNS employs a proportional quota sampling strategy, with stratification based on age, sex, and geographic location within Saudi Arabia's 13 administrative regions, utilizing the ZDataCloud® system for this purpose. The data, collected between 2020 and 2022 from over 15,000 participants, were screened to identify the eligible records of individuals who underwent bariatric surgery. Results: Within the entire sample, a mere 5.0% (806 individuals) had undertook bariatric surgery, with females comprising 54% of this specific subgroup. The average age within this group was 38.85 years (SD 13.02) and range (18-87). Post-operative results showed that 33% of these individuals remained classified as obese. Utilizing the backward likelihood ratio regression model, it was determined that factors including age, decreased consumption of fresh juices and chicken, as well as current tobacco use, were significantly associated with persistent obesity. Conclusion: The findings of this study suggest an association between the non-obese group and healthier lifestyle choices, including the consumption of high-protein diets and fresh juices, alongside a decreased prevalence of smoking. These observations underscore the significance of maintaining a healthy lifestyle for positive weight loss outcomes following bariatric surgery.

The Knowledge and Determinants of Sexual Health and Sexual Transmitted Infections Among Women in Saudi Arabia: A Nationwide Survey.

Background: Sexual health is a necessary part of any society because it significantly influences the quality of life. Women's knowledge regarding STIs and safe sex practices in Saudi Arabia has not been thoroughly investigated; therefore, this study aims to investigate and measure the knowledge and the determinants of sexual health and STIs among women in Saudi Arabia. Methods: This study is a nationwide cross-sectional survey conducted through phone interviews in Saudi Arabia in 2021. This study included 1334 female participants aged 18 years or older. Results: The study's results collectively show that women in Saudi Arabia have limited knowledge of sexual health and STIs. The primary causes are the lack of knowledge of different STIs-communicability, symptoms, and an overall lack of technical proficiency in the subject. The study analyzed factors associated with participants' knowledge of sexual health and sexually transmitted infections. Significant associations were found between knowledge and age, region, educational level, and family income. In the multivariable analysis, participants aged 20-29 had higher knowledge compared to those aged >60. Participants in the Eastern region had higher knowledge than those in the Southern region. Participants with less than a bachelor's degree had lower knowledge than those with a bachelor's degree or higher. Participants earning an average of 16,000 SAR to 19,999 SAR had higher knowledge than those with unstable monthly income. Conclusion: The study found that women's understanding of sexual health and STIs in Saudi Arabia is low due to a lack of knowledge and awareness. Knowledge levels were correlated with educational levels; therefore, targeted health promotion initiatives are needed to increase understanding, particularly regarding condom use for HIV and STI prevention.

Association between daily use of social media and behavioral lifestyles in the Saudi community: a cross-sectional study.

Objective: This study aimed to investigate the association between nine social media platforms use and health-related behavior, including fruit and vegetable intake, physical activity, tobacco use, and risk factors including depression and obesity. Methods: A cross-sectional study was conducted using secondary data from the Sharik Health Indicators Surveillance System (SHISS). Participants 18 years and older were recruited via phone-interviews. The nine social media platform use [Twitter-(X), Facebook, Instagram, WhatsApp, LinkedIn, Snapchat, TikTok, Telegram, and YouTube] were assessed using self-reported use. Health-related variables include behavioral factors including diet, physical activity, and tobacco use including (cigarettes, waterpipes, and e-cigarettes), risk of depression and obesity. Logistic regression analysis was performed to explore the association between social media use and health-related variables. Results: The study indicated that daily Snapchat users had a lower healthy diet (fruit and vegetable intake), whereas daily LinkedIn and WhatsApp users were positively associated with a healthier diet, relative to those with infrequent social media use. Furthermore, daily interaction with Instagram, TikTok, Telegram, and YouTube was significantly associated with increased depression risk. Conversely, Snapchat and WhatsApp usage was significantly linked to a decreased depression risk. Tobacco-smoking behaviors were associated with specific social media platforms: cigarette smoking was associated with Snapchat, TikTok, and YouTube; e-cigarette with Facebook, LinkedIn, Snapchat, and TikTok; and waterpipe smoking with Facebook and TikTok. Interestingly, some platforms, such as Instagram, were associated with reduced cigarette smoking. The relationship between social media activity and health-related outcomes remained significant after adjusting for age and gender. Conclusion: This study highlights the potential negative impact of particular daily social media use on health-related variables, including dietary habits, tobacco use, and depression. Nevertheless, particular daily social media use of some platforms was associated with a potential positive impact on the health-related variables. Social media platforms are tools that can be used to achieve both a positive and negative effect. By knowing which demographic segments have a greater presence on one platform, we are creating opportunities to understand the social phenomena and at the same time use it to reach those segments and communicate with them, because each social media platform has its unique way and framework of user communication.

How Could Different Obesity Scenarios Alter the Burden of Type 2 Diabetes and Liver Disease in Saudi Arabia?

INTRODUCTION: Obesity is a major risk factor for type 2 diabetes (T2DM) and liver disease, and obesity-attributable liver disease is a common indication for liver transplant. Obesity prevalence in Saudi Arabia (SA) has increased in recent decades. SA has committed to the WHO "halt obesity" target to shift prevalence to 2010 levels by 2025. We estimated the future benefits of reducing obesity in SA on incidence and costs of T2DM and liver disease under two policy scenarios: (1) SA meets the "halt obesity" target; (2) population body mass index (BMI) is reduced by 1% annually from 2020 to 2040. METHODS: We developed a dynamic microsimulation of working-age people (20-59 years) in SA between 2010 and 2040. Model inputs included population demographic, disease and healthcare cost data, and relative risks of diseases associated with obesity. In our two policy scenarios, we manipulated population BMI and compared predicted disease incidence and associated healthcare costs to a baseline "no change" scenario. RESULTS: Adults <35 years are expected to meet the "halt obesity" target, but those ≥35 years are not. Obesity is set to decline for females, but to increase amongst males 35-59 years. If SA's working-age population achieved either scenario, >1.15 million combined cases of T2DM, liver disease, and liver cancer could be avoided by 2040. Healthcare cost savings for the "halt obesity" and 1% reduction scenarios are 46.7 and 32.8 billion USD, respectively. CONCLUSION: SA's younger working-age population is set to meet the "halt obesity" target, but those aged 35-59 are off track. Even a modest annual 1% BMI reduction could result in substantial future health and economic benefits. Our findings strongly support universal initiatives to reduce population-level obesity, with targeted initiatives for working-age people ≥35 years of age.

Predicting Multimorbidity Using Saudi Health Indicators (Sharik) Nationwide Data: Statistical and Machine Learning Approach.

The Saudi population is at high risk of multimorbidity. The risk of these morbidities can be reduced by identifying common modifiable behavioural risk factors. This study uses statistical and machine learning methods to predict factors for multimorbidity in the Saudi population. Data from 23,098 Saudi residents were extracted from the "Sharik" Health Indicators Surveillance System 2021. Participants were asked about their demographics and health indicators. Binary logistic models were used to determine predictors of multimorbidity. A backpropagation neural network model was further run using the predictors from the logistic regression model. Accuracy measures were checked using training, validation, and testing data. Females and smokers had the highest likelihood of experiencing multimorbidity. Age and fruit consumption also played a significant role in predicting multimorbidity. Regarding model accuracy, both logistic regression and backpropagation algorithms yielded comparable outcomes. The backpropagation method (accuracy 80.7%) was more accurate than the logistic regression model (77%). Machine learning algorithms can be used to predict multimorbidity among adults, particularly in the Middle East region. Different testing methods later validated the common predicting factors identified in this study. These factors are helpful and can be translated by policymakers to consider improvements in the public health domain.

National screening for anxiety and depression in Saudi Arabia 2022.

Background: Mental health disorders, such as major depressive disorder (MDD) and generalized anxiety disorder (GAD), represent a significant public health concern in Saudi Arabia. This study aims to provide a recent mental health screening prevalence, including anxiety and depression screening in the general public and to explore the associated risk factors. Methods: A cross-sectional study was conducted, employing a phone interview survey with 6,015 participants, using a quota sampling strategy to ensure equal representation of both sexes and administrative regions. The study assessed the prevalence of MDD and GAD risk and examined demographic, socioeconomic, and lifestyle factors associated with these mental health disorders. Results: The national prevalence of people at risk of MDD and GAD were found to be 12.7 and 12.4%, respectively. Low diagnosis and treatment rates were observed, with only 1.5 and 0.5% of participants currently diagnosed and treated for depression and anxiety, respectively. Risk factors for MDD and GAD included female sex, lower education and income levels, smoking, and waterpipe use. Protective factors included physical activity, participation in volunteering activities and the practice of daily hobbies in the last 30 days. Conclusion: The relatively high prevalence of MDD and GAD risk and low diagnosis and treatment rates in Saudi Arabia emphasize the need for increased mental health promotion, early detection, and treatment accessibility. The study highlights the importance of addressing modifiable risk factors and fostering protective factors through targeted interventions. Future research should focus on longitudinal associations, potential mediators and moderators, and the development of culturally appropriate and evidence-based interventions to enhance mental health outcomes in the region.

Exploring the Sociodemographic and Behavioral Status of People Living with Hypercholesterolemia in Saudi Arabia: A Nation-Wide Cross-Sectional Study.

Introduction: Hypercholesterolemia (HC) is a well-known risk factor for cardiovascular diseases, which are the leading cause of death worldwide. Many factors can contribute to HC, including advanced age, chronic diseases (such as diabetes and nephrotic syndrome), and the use of certain medications. Aim: Our goal was to compare the sociodemographic, behavioral, and other comorbid conditions of adult participants living with HC in Saudi Arabia to the general population. Methods: This is a secondary data analysis from the Sharik Health Indicators Surveillance System (SHISS). SHISS consists of cross-sectional phone interviews conducted in all administrative regions of Saudi Arabia on a quarterly basis. Participant recruitment was limited to Arabic-speaking Saudi residents who were ≥18 years old. Results: Out of 20,492 potential participants contacted in 2021, 14,007 completed the interview. Of the total participants, 50.1% were male. The mean age of participants was 36.7 years, with 1673 (11.94%) having HC. A regression model showed that participants with HC had a higher likelihood of being older, living in Tabouk, Riyadh, or Asir regions, being overweight or obese, having diabetes, hypertension, genetic or heart diseases, or having a higher risk of depression. Gender, all types of smoking, physical activity, and education level were eliminated from the model. Discussion: In this study, participants with HC were identified with some co-existing conditions that may affect the progression of the disease and the participants' quality of life. This information could assist care providers in identifying patients who are at higher risk, improve screening efficiency, and improve disease progression and quality of life.

Neurological Consequences of Pulmonary Emboli in COVID-19 Patients: A Study of Incidence and Outcomes in the Kingdom of Saudi Arabia.

Pulmonary embolism (PE) is a significant consequence that is becoming more common in COVID-19 patients. The current study sought to determine the prevalence and risk factors for PE in a study population of COVID-19 patients, as well as the relationship between PE and neurological sequelae. The research also sought to analyze the consistency of neurological examination and imaging techniques in detecting neurological problems. The research comprised a total of 63 individuals with COVID-19. The incidence of PE in the study group was 9.5% for smokers, 23.8% for obese patients, 33.3% for hypertensive patients, and 19% for diabetic patients, according to the findings. After adjusting for possible confounders such as age, gender, BMI, smoking, hypertension, and diabetes, a logistic regression analysis indicated that the probabilities of having neurological complications were 3.5 times greater in individuals who had PE. In conclusion, the present study highlights the high incidence of PE among patients with COVID-19 and the association between PE and neurological complications. The study also emphasizes the importance of a thorough neurological examination and imaging studies in the detection of neurological complications in patients with PE.

A Pediatric Case of Spinal Intradural Epidermoid Cyst: A Rare Encounter.

Intradural epidermoid cysts of the spine are rare congenital lesions. Their etiology is thought to stem from ectodermal remnants during embryonic development. They result in a diverse clinical presentation, often marked by an insidious onset and variable neurological deficits. Timely diagnosis is crucial for optimizing patient outcomes. We present the case of a 10-year-old male child presenting a six-month history of worsening back pain, intermittent leg weakness, and urinary incontinence. The physical examination revealed tenderness over the lower thoracic and lumbar spine, lower limb weakness, hyperreflexia, and sensory deficits. The diagnostic work-up, including cerebrospinal fluid analysis and magnetic resonance imaging, confirmed the presence of an intradural epidermoid cyst in the lumbosacral region. Surgical excision resulted in complete resection, with subsequent improvement in neurological deficits. This pediatric case underscores the importance of maintaining a high index of suspicion for unexplained neurological deficits. Characteristic imaging findings played a pivotal role in the diagnosis, guiding successful surgical intervention and achieving favorable outcomes.

Cultural adaptation and validation of the mental illness associated stigma scale for Arabic-speaking population in Saudi Arabia.

Objective: This research aimed to culturally adapt and validate the MIAS scale for Arabic-speaking individuals within the Saudi Arabian general population, with an emphasis on cultural, societal, and individual nuances. Methods: An initial pilot testing with a small group ensured the scale's clarity. Subsequently, two cross-sectional studies involving 189 participants to assess structural validity of the Arabic MIAS scale, and 38 participants to assess the test-retest reliability. Descriptive statistics, Cronbach's α, Intraclass Correlation Coefficient (ICC), and Confirmatory Factor Analysis (CFA) were employed for data analysis. Results: The Arabic MIAS scale demonstrated good internal consistency and acceptable test-retest reliability (ICC α = 0.631). A three-factor model emerged (CFI = 0.890, TLI = 0.845, RMSEA = 0.094), including "Outcomes," "Negative Stereotypes," and "Recovery," closely mirroring the original study's structure. one item was excluded from the model since it didn't align with any of the three factors. Conclusion: The study contributes a culturally adapted, validated, non-condition-specific tool to gauge public attitudes toward mental health stigma in an Arabic context. It highlights the need for culturally sensitive stigma research and interventions and underscores the importance of improving such tools for cross-cultural applicability and comparability.