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Foetal MR imaging is widely accepted as an adjunct to foetal ultrasonography; however, there are many controversies regarding its importance and indications. Therefore, this study aimed to evaluate foetuses with different midline cerebral abnormalities, to determine the prevalence of these anomalies, to define the role of foetal MRI, and to compare MRI and ultrasound (US) result with postnatal MRI findings. Seventy-eight pregnant women who had foetuses with CNS abnormalities detected by sonogram were included. Foetuses with midline anomalies were selected and evaluated by anomaly scan foetal US, pre- and postnatal MRI. Midline brain anomalies were found in 47.4% of foetuses with brain anomalies. Holoprosencephaly was found in 24.3% of midline anomaly foetuses, corpus callosum abnormalities (ACC) were detected in 40.5%, midline intracranial mass lesions in 2.7%, and midline posterior fossa anomalies in 32.4%. An agreement between MRI and US in the main diagnosis was in 56.76% of cases; MRI added information to US findings in 43.2% of cases, and US added information to MRI findings in 8.1% of cases. In evaluating midline cerebral anomalies, US and MRI are complementary techniques. US is the primary survey, and MRI can add additional information and/or change the main diagnosis.

IntroductionOne contributing factor that has led to a reduction in the number of females entering the profession of surgery is discrimination against female surgeons. Little is known about the practices, attitudes, and perceptions of the Saudi population toward gender discrimination in the field of surgery. The aim of this study was to assess the practices, attitudes, and perceptions of the Taif population in choosing a surgeon based on their gender.Materials and methodsAn online pretested questionnaire was randomly sent to the participants living in Taif city. Collected data were subjected to scrutiny to check participants' study inclusion criteria. All the data were subjected to statistical analysis by an independent biostatistician. Pearson's chi-square test was used to search for a statistically significant association between categorical variables.ResultsAbout 49.5% of the participants preferred a surgeon of the same gender when consulting for a non-emergency visit to a surgery clinic, whereas females significantly preferred a female surgeon (p < 0.001). The most common reason to choose surgeons of the same gender was comfort, followed by ease of talking. About 71.8% of the participants preferred female surgeons for ''sensitive'' surgical cases such as genital, obstetric, or sexual disorders, whereas 12.1% preferred male surgeons.ConclusionFemales have shown progress in the field of surgery, but there is still much to be done to convert the surgical workplace to be more supportive of women so that they contribute their best effort.

Nowadays patients are encouraged to partake in healthcare decision making and patient preferences are given increasing weight. Patient's choice is important to reduce waiting time and to encourage competition between providers, as most patients look for high-quality care while minimizing costs, according to different studies this may not be as simple as the attributes and factors that patients value when selecting a hospital or surgeon. Overall, Saudi Arabia has minimal research on how patients select surgeons or surgical facilities. Therefore, the goal of the current study was to evaluate the criteria Saudi population patients used to select their surgeons. The objective is to determine the relative importance of the following aspects that patients may consider when selecting a surgeon: (a) physician-related considerations; (b) elements relating to healthcare service and access; (c) the perspectives of patients on various factors. This observational cross-sectional study attempts to investigate the criteria that people in Saudi Arabia considered most important while selecting their surgeons. This study was conducted between August and November 2022. The questionnaire is also given in English along with Arabic. Six hundred nine completed the survey with a response rate of 91.6%. Concerning physician-related factors considered when choosing a surgeon attitudes of the physician were the factor most significantly contributed to physician selection rather than reputation or professional experience and physician social media: (84.7%) mentioned that paying attention to patient's needs and opinions is important; sparing enough time for patients is important as reported by 83.9% of the participants; Personal care and hygiene is important for 83.4% of the participants; Communication skills were considered to be important as stated by 82.6% of the participants. Regarding healthcare services/access-related factors considered by patients in physician selection; it was found that patients considered hospital hygiene-cleanliness (91.3 %) as the most significant healthcare service/access-related factor in physician selection and then it comes Ease of obtaining an appointment (89.7%), reasonable scheduling and wait for time (87.7%) and cost of surgery (82.1%). Physician selection was deemed crucial to the success of the therapy by 87.7% of patients, while 88.3% of patients thought it was crucial to research the doctor before contacting her or him for the current admission. Patients consider a wide range of variables when selecting their surgeons and the location of their procedure. Depending on sociodemographic, cultural, and other aspects, the conditions surrounding patients' decisions may vary. Overall, the selection of a surgeon by surgery patients appears to be more influenced by the doctor's attitudes than by his or her reputation, professional experience, or social media presence. In order to elicit preferences across a wider range of surgical subspecialties and patient demographics, more study is necessary.

Epidemiological data regarding the causes, patterns, severity, and outcomes of traumatic brain injury (TBI) are essential to plan for preventive strategies addressing this public health epidemic. The main aim of this study is to explore the patterns and causes of traumatic brain injury at two trauma centers.BACKGROUNDEpidemiological data regarding the causes, patterns, severity, and outcomes of traumatic brain injury (TBI) are essential to plan for preventive strategies addressing this public health epidemic. The main aim of this study is to explore the patterns and causes of traumatic brain injury at two trauma centers.A retrospective cohort study was conducted using a pre-tested validated data collection sheet. Data were collected from the medical records and electronic database of patients who presented to the emergency department with head trauma. Variables including the mechanisms, patterns of the injury, accompanying injuries, level of consciousness, and hospitalization duration were investigated for any possible association.METHODSA retrospective cohort study was conducted using a pre-tested validated data collection sheet. Data were collected from the medical records and electronic database of patients who presented to the emergency department with head trauma. Variables including the mechanisms, patterns of the injury, accompanying injuries, level of consciousness, and hospitalization duration were investigated for any possible association.A total of 269 patients (78% males, 22% females) who satisfied our study criteria were included in the final analysis. Motor vehicle collisions were the most common reason for traumatic brain injury (57.6%) followed by falls (28.3%). There was a statistically significant association observed between type of hemorrhage and Glasgow coma scale at initial presentation (P < 0.05). Conclusion: The most common cause of traumatic brain injury is motor vehicle collisions, followed by falls. The public should be made aware of the importance of using safety and precautionary measures to minimize the impact of traumatic brain injuries. Educational programs for neurotrauma prevention can be developed and utilized as a blueprint for local hospitals and officials in the country.RESULTSA total of 269 patients (78% males, 22% females) who satisfied our study criteria were included in the final analysis. Motor vehicle collisions were the most common reason for traumatic brain injury (57.6%) followed by falls (28.3%). There was a statistically significant association observed between type of hemorrhage and Glasgow coma scale at initial presentation (P < 0.05). Conclusion: The most common cause of traumatic brain injury is motor vehicle collisions, followed by falls. The public should be made aware of the importance of using safety and precautionary measures to minimize the impact of traumatic brain injuries. Educational programs for neurotrauma prevention can be developed and utilized as a blueprint for local hospitals and officials in the country.

Laparoscopic sleeve gastrectomy (LSG) is a popular bariatric procedure with significant effects on weight and metabolic health. However, its impact on gastroesophageal reflux disease (GERD) and esophageal symptoms remains debated. This study aims to evaluate the endoscopic changes five years post-LSG. We conducted a retrospective analysis of patients who underwent LSG at our center between June 2017 and June 2019. Inclusion criteria included preoperative and at least five-year follow-up esophagogastroduodenoscopy (EGD). We analyzed demographic factors, esophageal symptoms, and endoscopic findings. Out of 118 patients who underwent LSG, 24 met the inclusion criteria. Two patients were excluded due to conversion to Roux-en-Y gastric bypass (RYGB). The final cohort included 22 patients with a mean age of 42 ± 10 years and a mean BMI of 45 ± 7 kg/m². Preoperative EGD showed no GERD in 21 patients (95.5%) and GERD in 1 patient (4.5%). At five-year follow-up, 14 patients (63.6%) had no GERD, 7 (31.8%) had GERD A, and 1 (4.5%) had GERD B. Esophageal symptoms included heartburn (54.5%), nausea (36.4%), regurgitation (31.8%), and epigastric pain (22.7%). PPI or antacid use was reported in 10 patients (45.5%). Extra-esophageal symptoms were rare. BMI was significantly higher in patients with GERD (34.5 ± 6.3 kg/m²) compared to those without GERD (30.2 ± 5.1 kg/m², p = 0.04). LSG may lead to the development or worsening of GERD in a subset of patients, despite the majority showing no significant GERD changes over five years. Continuous monitoring and tailored management strategies are essential for optimizing outcomes.

Epstein–Barr virus (EBV) was the first tumor virus identified in humans, and it is mostly linked to lymphomas and cancers of epithelial cells. Nevertheless, there is no FDA-licensed drug feasible for this ubiquitous EBV viral contagion. EBNA1 (Epstein-Barr nuclear antigen 1) plays several roles in the replication and transcriptional of latent gene expression of the EBV, making it an attractive druggable target for the treatment of EBV-related malignancies. The present study targets EBV viral reactivation and upkeep by inhibiting EBNA1 utilizing a drug-repurposing strategy. To hunt novel EBNA1 inhibitors, a SuperDRUG2 database (> 4,600 pharmaceutical ingredients) was virtually screened utilizing docking computations. In accordance with the estimated docking scores, the most promising drug candidates then underwent MDS (molecular dynamics simulations). Besides, the MM-GBSA approach was applied to estimate the binding affinities between the identified drug candidates and EBNA1. On the basis of MM-GBSA//200 ns MDS, bezitramide (SD000308), glyburide (SD001170), glisentide (SD001159), and glimepiride (SD001156) unveiled greater binding affinities towards EBNA1 compared to KWG, a reference inhibitor, with Δ G binding values of −44.3, −44.0, −41.7, −40.2, and −32.4 kcal/mol, respectively. Per-residue decomposition analysis demonstrated that LYS477, ASN519, and LYS586 significantly interacted with the identified drug candidates within the EBNA1 binding pocket. Post-dynamic analyses also demonstrated high constancy of the identified drug candidates in complex with EBNA1 throughout 200 ns MDS. Ultimately, electrostatic potential and frontier molecular orbitals analyses were performed to estimate the chemical reactivity of the identified EBNA1 inhibitors. Considering the current outcomes, this study would be an adequate linchpin for forthcoming research associated with the inhibition of EBNA1; however, experimental assays are required to inspect the efficiency of these candidates.

Mycobacterium tuberculosis is a lethal human pathogen, with the key flavoenzyme for catalyzing bacterial cell-wall biosynthesis, decaprenylphosphoryl-D-ribose oxidase (DprE1), considered an Achilles heal for tuberculosis (TB) progression. Inhibition of DprE1 blocks cell wall biosynthesis and is a highly promising antitubercular target. Macozinone (PBTZ169, a benzothiazinone (BTZ) derivative) is an irreversible DprE1 inhibitor that has attracted considerable attention because it exhibits an additive activity when combined with other anti-TB drugs. Herein, 754 BTZ analogs were assembled in a virtual library and evaluated against the DprE1 target using a covalent docking approach. After validation of the employed covalent docking approach, BTZ analogs were screened. Analogs with a docking score less than –9.0 kcal/mol were advanced for molecular dynamics (MD) simulations, followed by binding energy evaluations utilizing the MM-GBSA approach. Three BTZ analogs–namely, PubChem-155-924-621, PubChem-127-032-794, and PubChem-155-923-972– exhibited higher binding affinities against DprE1 compared to PBTZ169 with Δ G binding values of –77.2, –74.3, and –65.4 kcal/mol, versus –49.8 kcal/mol, respectively. Structural and energetical analyses were performed for the identified analogs against DprE1 throughout the 100 ns MD simulations, and the results demonstrated the great stability of the identified BTZ analogs. Physicochemical and ADMET characteristics indicated the oral bioavailability of the identified BTZ analogs. The obtained in-silico results provide promising anti-TB inhibitors that are worth being subjected to in-vitro and in-vivo investigations.

The COVID-19 epidemic has posed a considerable challenge to the worldwide economy and public health, underscoring the crucial demand for developing effective antiviral medications. The SARS-CoV-2 main protease (M pro ) is a vital enzyme for antiviral drugs because of its fundamental function in viral reproduction. Nirmatrelvir (PF-07321332), a nitrile-based covalent ligand of M pro , has garnered significant interest because it demonstrates additive efficacy when co-administered with ritonavir and is known as Paxlovid. Herein, forty-five nirmatrelvir analogs collected from the PubChem database were mined against M pro utilizing covalent docking computations. Initially, the reliability of the AutoDock4.2.6 software in predicting M pro -ligand binding modes was validated based on accessible experimental data. Nirmatrelvir analogs with binding scores lower than nirmatrelvir (calc. −13.3 kcal/mol) were advanced for molecular dynamics simulations (MDS), accompanied by binding energy assessments performed via the MM-GBSA approach. Based on MM-GBSA//100 ns MDS, PubChem-162-396-453, PubChem-162-396-449, and PubChem-162-396-448 exhibited superior binding affinities with Δ G binding values of −49.7, −46.3, and −44.9 kcal/mol, respectively, compared to nirmatrelvir (Δ G binding  = −40.7 kcal/mol). The identified analogs demonstrated significant structural and energetic stability within M pro throughout 100 ns MDS. Evaluations of their drug-likeness and pharmacokinetic properties disclosed desirable oral bioavailability. The in-silico outcomes suggested that the identified analogs unveiled high potency as M pro inhibitors, highlighting the necessity for follow-up in-vitro/in-vivo evaluations to assess their efficacy as anti-COVID-19 agents.

Soil salinity and sodicity are significant issues worldwide. In particular, they represent the most dominant types of degraded lands, especially in arid and semi-arid regions with minimal rainfall. Furthermore, in these areas, human activities mainly contribute to increasing the degree of soil salinity, especially in dry areas. This study developed a model for mapping soil salinity and sodicity using remote sensing and geographic information systems (GIS). It also provided salinity management techniques (leaching and gypsum requirements) to ameliorate soil and improve crop productivity. The model results showed a high correlation between the soil electrical conductivity (ECe) and remote-sensing spectral indices SIA, SI3, VSSI, and SI9 (R2 = 0.90, 0.89, 0.87, and 0.83), respectively. In contrast, it showed a low correlation between ECe and SI5 (R2 = 0.21). The salt-affected soils in the study area cover about 56% of cultivated land, of which the spatial distribution of different soil salinity levels ranged from low soil salinity of 44% of the salinized cultivated land, moderate soil salinity of 27% of salinized cultivated land, high soil salinity of 29% of the salinized cultivated land, and extreme soil salinity of 1% of the salinized cultivated land. The leaching water requirement (LR) depths ranged from 0.1 to 0.30 m ha−1, while the gypsum requirement (GR) ranged from 0.1 to 9 ton ha−1.

BRD4 (bromodomain-containing protein 4) is an epigenetic reader that realizes histone proteins and promotes the transcription of genes linked to cancer progression and non-cancer diseases such as acute heart failure and severe inflammation. The highly conserved N-terminal bromodomain (BD1) recognizes acylated lysine residues to organize the expression of genes. As such, BD1 is essential for disrupting BRD4 interactions and is a promising target for cancer treatment. To identify new BD1 inhibitors, a SuperDRUG2 database that contains more than 4600 pharmaceutical compounds was screened using in silico techniques. The efficiency of the AutoDock Vina1.1.2 software to anticipate inhibitor-BRD4-BD1 binding poses was first evaluated based on the co-crystallized R6S ligand in complex with BRD4-BD1. From database screening, the most promising BRD4-BD1 inhibitors were subsequently submitted to molecular dynamics (MD) simulations integrated with an MM-GBSA approach. MM-GBSA computations indicated promising BD1 binding with a benzonaphthyridine derivative, pyronaridine (SD003509), with an energy prediction (ΔGbinding) of −42.7 kcal/mol in comparison with −41.5 kcal/mol for a positive control inhibitor (R6S). Pharmacokinetic properties predicted oral bioavailability for both ligands, while post-dynamic analyses of the BRD4-BD1 binding pocket demonstrated greater stability for pyronaridine. These results confirm that in silico studies can provide insight into novel protein–ligand regulators, specifically that pyronaridine is a potential cancer drug candidate.