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Background Breast cancer is the most common cancer among females, and early detection plays a crucial role in disease management. This study aimed to assess the knowledge, practices, and barriers related to breast self-examination (BSE) and mammography among Saudi women in Arar City, Saudi Arabia. Method A cross-sectional observational study was conducted using an online Google Form distributed to women in Arar City. The survey collected sociodemographic data and assessed knowledge, practices, and barriers related to BSE and mammography. Statistical analyses were performed using IBM SPSS Statistics version 27.0.1, with significance set at p  < 0.05. Results The study included 385 females, with women aged 19–25 constituting nearly one-third of the population ( n  = 118; 30.6%). Most participants were married ( n  = 217; 56.4%) and held a bachelor’s degree ( n  = 281; 73%). While 84.2% ( n  = 324) had heard of BSE and 80% ( n  = 308) demonstrated good knowledge, only 33.5% ( n  = 129) reported performing BSE. Regarding mammography, only 19.5% ( n  = 75) reported undergoing screening, despite 65.1% ( n  = 247) recognizing it as a safe procedure. Educational level ( p  = 0.018), prior knowledge of BSE ( p  = 0.009), and history of breast problems ( p  = 0.027) were significantly associated with higher knowledge scores. Conclusion While women demonstrated good awareness and knowledge of BSE, its practice remains low, with many unaware of proper techniques, timing, and frequency. Mammography awareness and utilization were also limited, emphasizing the need for targeted educational campaigns to promote early detection and improve screening behaviours.

Background: Chronic myeloid leukemia (CML) results from chromosomal translocation t(9;22) leading to the formation of the BCR-ABL fusion oncogene. CML has three stages: the chronic phase (CP), the accelerated phase (AP), and the blast crisis (BC). Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of CML. TKIs work well in CP-CML, and these patients have a survival rate similar to the normal population, but TKIs are less effective in advanced-phase CML. Even with current advances in treatment, BC-CML patients have an average overall survival of less than a year. Early recognition of CML patients at risk of disease progression can help in timely interventions with appropriate TKIs or other therapeutic modalities. Although some markers of disease progression like BCR-ABL kinase domain, ASXL1, and GATA2 mutations are available, no universal and exclusively specific molecular biomarkers exist to early diagnose CML patients at risk of CML progression for timely therapeutic interventions to delay or minimize blast crisis transformation in CML. A recent study found that all BC-CML patients harbored the FANCD2 (c.2022-5C>T) mutation. Therefore, the current study was designed to detect this FANCD2 mutant in AP-CML (early progression phase) and to clinically validate its potential as a novel molecular biomarker of early CML progression from CP to AP. Methods: Our study comprised 123 CP-CML (control group) and 60 AP-CML patients (experimental group) from 2 oncology centers, from January 2020 to July 2023. Mean hemoglobin level, WBC count, platelet count, treatment type, hepatomegaly, splenomegaly, and survival status of AP-CML patients were significantly different from those of CP-CML patients. However, as these clinical parameters cannot help in the early detection of patients at risk of CML progression, there was a need for a clinically validated biomarker of AP-CML. DNA was extracted from the patients’ blood samples, and the FANCD2 gene was sequenced using an Illumina NextSeq500 next-generation sequencer (NGS). Results: The NGS analysis revealed a unique splice-site mutation in the FANCD2 gene (c.2022-5C>T). This mutation was detected in the majority (98.3%) of AP-CML patients but in none of the CP-CML patients or healthy control sequences from genomic databases. The mutation was confirmed by Sanger sequencing. FANCD2 is a member of the Fanconi anemia pathway genes involved in DNA repair and genomic stability, and aberrations of this gene are associated with many cancers. Conclusions: In conclusion, our study shows that the somatic FANCD2 (c.2022-5C>T) mutation is a new molecular biomarker for early CML progression. We recommend further clinical validation of this biomarker in prospective clinical trials.

Background Most patients with end-stage kidney disease begin hemodialysis (HD) in an unplanned fashion at a late stage, necessitating the commencement of HD with a temporary venous catheter, the least favorable option. Alternative modalities of kidney replacement therapy (KRT), peritoneal dialysis (PD), and preemptive transplant offer similar or better outcomes than HD at a lower overall cost, and yet they remain underutilized in Saudi Arabia. Early education may help prepare patients with advanced chronic kidney disease (CKD IV and V) to accept their disease and choose a KRT modality that minimizes complications and matches their lifestyle. The aim of the study is to assess the impact of a pilot educational class on therapy choices and outcomes. Methodology In a cross-sectional study, we conducted phone interviews and reviewed medical records of 81 attendees of the multidisciplinary monthly educational class about KRT that was held at the King Abdulaziz Medical City (KAMC) from January 2017 to October 2021. The interview was conducted at least one year after the participants attended the class. The study proposal, consent, and questionnaire were approved by the King Abdulaziz International Medical Research Center. Patient data was retrieved from KAMC electronic medical record system. Results Volunteer participation in the survey was high (62/81). For the respondents, a preemptive kidney transplant was the most preferred (48/62, 77%) option for KRT. Among the preferred fallback options, HD was the most frequently chosen (29/62, 47%) compared to PD (26/62, 41.9%). At the time of the interview, a great majority of the patients (54/62, 87%) was already on KRT, including about half (26/54, 48%) on HD via a catheter, and the rest about equally divided between those on HD via an arteriovenous (AF) fistula (13/54, 24%) and those on PD (15/54, 28%). Thus, half of the respondents on KRT (28/54, 51%) avoided urgent HD catheter commencement. However, because of an unfortunate shortage of donors, only a small minority (2/62, 3%) of patients received preemptive transplantation. Conclusion The KAMC CKD education class helped boost the fraction of patients, significantly above the national average, who accepted the diagnosis of kidney failure and pursued preemptive native HD access or enrolled in PD.

Background: The use of antibiotics prophylactically and therapeutically in dentistry has become common practice. Inappropriate prescription may lead to adverse side effects and bacterial resistance. During clinical training, dental students in Saudi Arabia are authorized to prescribe antibiotics. Aim: To evaluate dental students’ knowledge and attitudes regarding antibiotic prescription in Riyadh, Saudi Arabia. Methods: A cross-sectional study based on a validated questionnaire consisting of 34 questions focusing on antibiotic indications in dentistry, antibiotic regimens, and knowledge regarding resistance was distributed amongst dental students in five leading dental colleges in Riyadh. Results: A large proportion of students (71.7%) were familiar with the concept of antibiotic resistance. When comparing junior and senior dental students’ knowledge with regards to indications of antibiotic use in commonly encountered conditions, it was found that there was no significant difference in antibiotic prescription frequency between these groups. Most dental students choose to prescribe amoxicillin as their first-choice of antibiotic (88.4%), and most also chose to use it for a duration of 3–5 days (69.2%). Conclusions: This study concludes that dental students may prescribe antibiotics inappropriately to manage various conditions when not indicated. This may indicate a defect in education of students with regards to current antibiotic guidelines.

A 15-year-old male presented with double vision in the left and upward gaze following a hit in the right orbital region. The orthoptic assessment revealed -2 limitation of elevation in the adduction position of the right eye and right hypotropia of 20 prism diopter (PD) in the left gaze and right hypotropia of 10 PD in the upward gaze. He was diagnosed with traumatic Brown syndrome and planned for superior oblique lengthening surgery for the right eye. Two months postoperatively, the patient has a normal extra-ocular motor function with the elimination of diplopia and significant improvement of elevation of the right eye in the adduction position. Herein, we discuss the clinical features, etiologies, tailored evaluation, and management for the patient with traumatic Brown syndrome.

Background Primary spontaneous pneumothorax (PSP) is a fairly prevalent disorder in emergency medicine. PSP most frequently affects tall, thin male smokers and is most prevalent during adolescence. Published literature contains a wide range of Primary Spontaneous Pneumothorax (PSP) recurrence rates, but there is limited information on the variables affecting recurrence. Objective To identify the descriptive features of PSP in King Abdulaziz Medical City, Riyadh, Saudi Arabia. Methods This retrospective cross-sectional study was conducted in Surgery King Abdulaziz Medical City, Riyadh, Saudi Arabia. Including all PSP patients from 2016-2021, excluding pediatric and geriatric patients. Participants were selected using a simple random sampling technique, and data were collected from hospital records. Data analysis was conducted by using SPSS. Results In this study, we included a total of 131 participants. Most were males (93.1%), and most were aged between 21-30 years. Our findings showed that most PSP events occurred in winter (28.6%). Followed by fall (25.7%), summer (25.0%), and spring (20.7%). Concerning the smoking status of our respondents, our results revealed that most of them were active smokers (72.5%). Left-PSP was the most commonly reported type of PSP (43.5 %), followed by right-PSP (38.9%), non-simultaneous bilateral PSP (14.5%), and bilateral simultaneous PSP (3.1%). Moreover, we found that the recurrence rate of PSP was 42%. Regarding the management of PSP, almost half of the respondents were managed initially by Chest tube. The most frequently used surgical option was VATS- Bullectomy with Abrasion Pleurodesis. Finally, the recurrence rate of PSP was 42% among the patients. The percentage of patients with one recurrence only was 65.5% among the patients with recurrent PSP, second recurrence at 29.1%. Third, Fourth, and Fifth had the same recurrence percentage of 1.8%, and these percentages came to be statistically significant. (P value < 0.001) Conclusion Our study concluded that PSP was more prevalent in tall, thin, young male smokers. Almost half of the respondents suffered from at least one recurrence attack of PSP. The majority of the patients with recurrences experienced one recurrence only, and the second recurrence was estimated to be almost one-third. There is no significant association between the occurrence and seasons of the attack at a time. Most of the participants were managed initially by a chest tube. The most frequently used surgical option was Video Assisted Thoracoscopic Surgery (VATS) with abrasion pleurodesis.

Barriers such as stigma and limited access to care continue to impede treatment for anxiety disorders. Telemedicine has emerged as a promising alternative to in-person psychological interventions, particularly after the COVID-19 pandemic. This systematic review compares the efficacy of telemedicine and in-person therapies for anxiety disorders, evaluating outcomes, patient engagement, and methodological rigor. Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Web of Science, and ClinicalTrials.gov, with the final search conducted in July 2025. Ten studies comparing telemedicine with in-person interventions were included. Risk of bias was assessed using the Cochrane RoB 2 tool for randomized controlled trials and the Newcastle-Ottawa Scale for non-randomized studies. A narrative synthesis was conducted due to heterogeneity. Telemedicine demonstrated non-inferior efficacy to in-person therapy across diverse modalities and outperformed self-help programs. Patient satisfaction and adherence were high, with telehealth groups showing longer retention. Small effect size differences favored in-person therapy for generalized anxiety disorder, but most studies reported comparable outcomes. Risk of bias was low for nine out of ten studies. Telemedicine is a viable alternative to in-person therapy for anxiety disorders, with advantages in accessibility and therapist-guided formats. Future research should address long-term outcomes and equity in delivery.

In modern healthcare systems, interdisciplinary collaboration is crucial for enhancing healthcare quality and patient satisfaction. Pharmacy, nursing, and radiology play distinct but interconnected roles in delivering comprehensive, patient-centered care. Pharmacists ensure safe and effective medication use, nurses provide holistic care and advocacy, and radiologists contribute diagnostic precision and therapeutic interventions. Despite their individual strengths, siloed practices often limit their combined potential. This paper explores how integrating these disciplines can improve healthcare outcomes by fostering effective communication, leveraging technology, and implementing joint training programs. Highlighting the synergy between these fields, the paper emphasizes the importance of collaborative approaches to patient safety, care efficiency, and satisfaction. By addressing challenges and proposing actionable strategies, this study aims to inspire innovative models of interdisciplinary collaboration that elevate the standard of healthcare delivery.

Burnout syndrome, characterized by emotional exhaustion, depersonalization, and reduced professional efficacy, is a pervasive issue among nurses in the United States. Novice nurses are particularly vulnerable to burnout during their initial years of practice, with many considering leaving the profession. Factors contributing to burnout include workplace incivility, poor communication with colleagues, and a lack of support during role transitions. Preceptorship and nurse residency programs have shown potential in mitigating burnout and improving retention rates. Preceptors play a crucial role in integrating nurses into clinical environments; however, they often lack sufficient training and support. Nurse residency programs, lasting 6-12 months, combine didactic and clinical learning experiences to facilitate successful transitions into professional roles. These programs have been associated with decreased turnover, enhanced competencies, and improved job satisfaction. Recognizing signs of burnout, both in clinical settings and personal life, is essential for timely intervention. Individual strategies for managing burnout include self-care, mindfulness, and developing resilience. Organizational interventions, such as incorporating mindfulness into resilience training and fostering supportive leadership, can further reduce burnout and increase retention. Future research should explore the concept of compassion satisfaction, its predictors, and its potential to counteract burnout. Standardizing and evaluating nurse residency programs, as well as investigating the impact of role-play on interprofessional communication skills, are additional areas warranting further study.