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Background and Objectives: Endoscopic biliary plastic stenting is a safe and effective temporary therapeutic modality used in various benign biliary disorders. Long-term indwelling stents for more than one year without retrieval are termed “forgotten biliary stents”. In clinical practice, the forgotten stents are underestimated and the majority of data were obtained from case reports. The aim of this study was to determine the forgotten-biliary-plastic-stent-related complications, their management, and the patients’ clinical outcomes. Materials and Methods: This retrospective study was performed at three hospitals during the period from January 2021 to December 2023. In total, 577 patients with biliary plastic stents—inserted for a variety of benign biliary conditions—were included. They were divided into two groups, as follows: group 1 included 527 patients who had biliary stents removed within 3 months, and group 2 included 50 patients with biliary stents retrieved after one year of their deployment. The stent-related complications (e.g., acute cholangitis, stent clogging, distal stent migration, new common bile duct (CBD) stone formation, and proximal stent migration) and the endoscopic management success rate were evaluated. Results: Irretrievable CBD stones were the main indication for biliary plastic stenting in both groups. The stent-related complications, number of endoscopic sessions, and hospital admissions were significantly higher in the patients with forgotten biliary stents than those with stent removal within 3 months. All the study patients were successfully managed endoscopically with uneventful outcomes. Conclusions: Based on this retrospective study, non-adherence to the endoscopists’ instructions is the main reason for retained biliary stents for more than one year. The patients with forgotten stents had significantly higher complication rates, a higher number of endoscopic sessions, and a higher number of hospital admissions than those with stents that were retrieved in the scheduled time. All patients were managed endoscopically with a technical success rate of 100%, and with no complication-related mortality.

This descriptive observational cross-sectional study aimed to assess the general population's awareness, attitudes, and behaviours towards proton pump inhibitor (PPI) usage, as well as their knowledge about associated side effects, in the Qassim region of Saudi Arabia.OBJECTIVEThis descriptive observational cross-sectional study aimed to assess the general population's awareness, attitudes, and behaviours towards proton pump inhibitor (PPI) usage, as well as their knowledge about associated side effects, in the Qassim region of Saudi Arabia.An autonomous online survey was conducted from June 15, 2023, to September 1, 2023, using social media. The survey targeted adult residents of Qassim and collected a total of 1090 respondents. Data analysis employed descriptive statistics, chi-square tests, and probit regression using R version 4.3.1 (RStudio, Boston, MA). A significance level of p<0.05 was utilized to interpret the results.METHODSAn autonomous online survey was conducted from June 15, 2023, to September 1, 2023, using social media. The survey targeted adult residents of Qassim and collected a total of 1090 respondents. Data analysis employed descriptive statistics, chi-square tests, and probit regression using R version 4.3.1 (RStudio, Boston, MA). A significance level of p<0.05 was utilized to interpret the results.A total of 1050 samples, limited to residents of Qassim, were analyzed. Significant associations were observed between awareness of PPIs and factors such as side effects (adjOR = 1.19, 99% CI: 1.08-1.31), widespread PPI use (adjOR = 1.24, 99% CI: 1.12-1.38), PPI usage (adjOR = 2.47, 99% CI: 2.18-2.82), and optimal PPI timing (adjOR = 1.30, 99% CI: 1.13-1.50). Additionally, age, educational attainment, and employment in the medical field significantly influenced awareness gaps related to potential side effects, PPI prevalence, adherence to medical prescriptions, and optimal timing for PPI usage.RESULTSA total of 1050 samples, limited to residents of Qassim, were analyzed. Significant associations were observed between awareness of PPIs and factors such as side effects (adjOR = 1.19, 99% CI: 1.08-1.31), widespread PPI use (adjOR = 1.24, 99% CI: 1.12-1.38), PPI usage (adjOR = 2.47, 99% CI: 2.18-2.82), and optimal PPI timing (adjOR = 1.30, 99% CI: 1.13-1.50). Additionally, age, educational attainment, and employment in the medical field significantly influenced awareness gaps related to potential side effects, PPI prevalence, adherence to medical prescriptions, and optimal timing for PPI usage.The current study concludes that a significant portion of individuals in the Qassim region lack awareness regarding the potential side effects of PPI usage. Comprehensive healthcare education is required to bridge awareness gaps regarding PPIs and foster informed medication practices. By grasping the intricacies of individual perceptions, medical engagement, and demographic factors, healthcare providers and policymakers can collaboratively empower individuals in the Qassim region to make informed choices regarding their health and medication usage.CONCLUSIONThe current study concludes that a significant portion of individuals in the Qassim region lack awareness regarding the potential side effects of PPI usage. Comprehensive healthcare education is required to bridge awareness gaps regarding PPIs and foster informed medication practices. By grasping the intricacies of individual perceptions, medical engagement, and demographic factors, healthcare providers and policymakers can collaboratively empower individuals in the Qassim region to make informed choices regarding their health and medication usage.

Background Screen exposure among children continues to increase worldwide. It has negative effects on children of developmental age, including obesity, poor attention, sleep disorders, vision problems, language delays, and deficits in communication skills. It has been reported that parental depression is associated with both increased screen time for children and poor function and skills in children. However, other studies have reported no association between screen time and parental depression. Research methodology A cross-sectional study was conducted using a convenience sample of 340 parents of 4- to 6-year-old children in the Qassim Region of Saudi Arabia. Data were collected from the primary health care vaccination clinic by contacting parents of children aged 4 to 6 years to fill out the Social Communication Questionnaire (SCQ) for the child and the Patient Health Questionnaire-9 (PHQ9) for the parents. Research results We conducted a regression analysis to assess the influence of screen time exposure on social communication skills (SCQ score). The results of this study indicated that there was no significant effect observed ( B  = 0.283, P  > 0.05), indicating that a positive correlation between screen time usage and SCQ score may not apply to the entire population. Conversely, we discovered a crucial link between screen time exposure and parental depression (PHQ), as it displayed noteworthy impact values ( B  = 1.136, P  < 0.05), indicating an affirmative correlation between them. In addition, our results also indicated apparent positive associations between parental depression and SCQ scores ( B  = 0.229, P  < 0.05). Conclusion Our findings revealed that there was a significant association between parental depression and both screen time exposure and SCQ score, while there was no correlation between screen time exposure and SCQ score.

Background and objective Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder affecting children's academic and social performance. This study aimed to assess the knowledge and misconceptions of primary school teachers in the Qassim region regarding ADHD. Methodology A cross-sectional study was conducted from March 2024 to October 2024 involving 381 primary school teachers in the Qassim region, Saudi Arabia. Data were collected using a self-administered questionnaire, which included demographic information and a 36-item ADHD knowledge assessment. The collected data were analyzed using SPSS Statistics version 25 (IBM Corp., Armonk, NY). Results Most participants were female (58.8%, n=224) and aged between 41 and 50 (47%, n=147). Most of the teachers had more than 10 years of experience (76.4%, n=291) and taught students in fourth to sixth grades (46.5%, n=177). Overall, 87.4% (n=333) of teachers had heard of ADHD, with social media being the most common source of information (39.6%, n=151). Teachers had moderate knowledge of ADHD symptoms (52.67%, n=201), but general information (29.27%, n=211) and awareness of treatment options (32.87%, n=125) were limited. Significant differences in knowledge were found based on gender, age, experience, and the type of school, with female teachers and those in private schools having higher knowledge levels. Misconceptions, particularly about treatment, were widespread, with many teachers believing in ineffective interventions like dietary changes (87.9%, n=334). Conclusions While teachers in the Qassim region are aware of ADHD, their overall knowledge remains insufficient, especially regarding treatment methods. Providing training programs is essential to enhance teachers' understanding and improve ADHD management in schools.

Vitiligo, an autoimmune disorder causing depigmented skin patches, includes two types, segmental (SV) and non-segmental (NSV). Previously, NSV was off-label treated using Calcineurine inhibitors (Tacrolimus and Pimecrolimus). In 2022, the FDA approved Ruxolitinib cream, targeting the JAK/STAT pathway for NSV treatment based on promising results. This research conducts a retrospective descriptive safety assessment of Tacrolimus, Pimecrolimus, and Ruxolitinib safety in vitiligo treatment, utilizing the FDA Adverse Event Reporting System (FAERS) database spanning the period from 2013 to 2023 and including patients aged 2 years and above, encompassing both brand and generic names. A total of 844 adverse event reports involving 388 patients were extracted and categorized into dermatological and systemic groups for analysis. Tacrolimus resulted in 12 hospitalizations, two life-threatening events, and four disabilities. Pimecrolimus exhibited urticaria and pigmentation disorders, with tooth fracture as the primary systemic event. Pericarditis was the predominant systemic side effect of Ruxolitinib, followed by anemia, headache, and urosepsis. Local dermatological side effects reported were generally mild, not warranting treatment cessation. In conclusion, vitiligo significantly impacts patients’ psychological well-being, necessitating continuous post-marketing safety monitoring for topical medications.

Scoliosis is a common musculoskeletal disorder that remains underrecognized in Saudi Arabia, where limited public awareness may delay early detection and treatment. This study assessed public knowledge, support for school-based screening, and attitudes toward treatment. A nationwide cross-sectional survey was conducted during the 2025 Saudi National Scoliosis Awareness Campaign through public venues and online platforms. A culturally adapted questionnaire assessed demographics, knowledge, symptom recognition, treatment preferences, barriers, and information sources. A total of 2055 responses were analyzed using descriptive statistics and chi-square tests. While 70.9% of participants had heard of scoliosis, only 18.1% reported good understanding. Symptom recognition was limited, with spinal curvature, back pain, and uneven shoulders most often identified. Most respondents supported school-based screening (88.2%) and early detection (92.1%), with a mean preferred screening age of 8 years. Bracing (64.3%) and surgery (53.5%) were more accepted than observation (30.5%), though concerns about pain, effectiveness, and appearance were frequent. Social media was the most common initial information source (34.6%), while healthcare professionals were the preferred future source (79.2%). Reported barriers included lack of awareness (68.2%), difficulty accessing specialists (19.9%), and cost (8.9%). Public support for school-based screening is strong, but baseline knowledge remains limited, and treatment perceptions are shaped by psychosocial and cultural concerns. National campaigns, school curricula, and healthcare-led education, combined with accessible, low-cost screening, may enhance early detection and improve scoliosis management in Saudi Arabia.

Semaglutide, a once-weekly injection (SOWI), is a glucagon-like peptide-1 receptor agonist for managing type-2 diabetes (T2D). However, it has a high discontinuation rate among users in the first year after treatment initiation. This study investigated the medication adherence level among T2D patients managed with SOWI. This cross-sectional study was conducted among T2D patients aged 18 years or above who visited the outpatient pharmacy to refill their prescriptions for SOWI. The patients responded to their sociodemographic characteristics and the Adherence to Refills and Medications Scale (ARMS). The patient's electronic health record obtained details of the proportion of days covered (PDC), glycosylated hemoglobin (HbA1C), and body mass index (BMI). The association of medication adherence and sociodemographic characteristics, as well as the clinical outcomes between patients with different levels of adherence, were analyzed. A total of 434 patients were included in this study. According to the ARMS score, only 32.48% (141) of the patients adhered to SOWI. Sociodemographic characteristics had lower odds association for medication non-adherence. However, non-adherent patients had a significant association with BMI (overweight and obese) and HbA1C (>7). The adherence level of PDC for SOWI was significantly associated with the ARMS medication adherence level. The mean HbA1C and BMI between adherents and non-adherents were statistically significant (p<0.001). The patients who adhered to both ARMS and PDC (n = 126) experienced a significant decline in mean BMI (p < 0.001) and HbA1C (p < 0.001) compared to patients who adhered to PDC but not ARMS and those who did not adhere to either ARMS or PDC. Medication adherence to the SOWI is subjective to T2D patients and not influenced by sociodemographic characteristics. T2D patients need more motivation to refill and administer the SOWI according to the schedule since medication adherence directly impacts HbA1C and BMI.

General surgery outcomes remain a concern despite advancements in techniques, anesthesia, and perioperative care. Achieving consistent, high-quality results and accurately predicting risks remains challenging. This study aimed to identify factors associated with adverse outcomes through a retrospective analysis of general surgery cases across multiple centers in Saudi Arabia. A retrospective cohort study analyzed 14,635 medical records of patients who underwent general surgery across multiple centers in Saudi Arabia from 2010 to 2020. Data from the General Directorate of Health Affairs registry included demographics, comorbidities, procedure details, and outcomes. The study focused on risk factors for 30-day mortality and complications, with subgroup analyses comparing outcomes across facilities. Common surgeries included hernia repair, cholecystectomy, appendectomy, and bowel resection. The overall 30-day mortality rate was 0.74%, and the complication rate was 11.1%. Independent predictors of mortality were ASA grade III/IV, Charlson index ≥3, cardiovascular disease, dementia, renal disease, and longer procedures. Teaching hospitals had lower mortality and complication rates. Complication predictors included older age, ASA III/IV, diabetes, cardiac disease, and high-risk procedures. Evening surgeries were associated with fewer complications. This multicenter study identified patient risk factors and procedure characteristics that predict 30-day outcomes after general surgery. Older age, multiple comorbidities, and high-risk surgeries were linked to poorer outcomes. Teaching centers had better results, emphasizing the role of institutional factors. These findings can guide risk stratification and quality improvement efforts to enhance recovery and provide a foundation for future research to improve surgical practices globally.