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Idiopathic Intracranial Hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure without definitive etiology, primarily affecting young, obese women. This study aimed to compare the efficacy of bariatric surgery versus conventional community weight management in treating IIH. We conducted a retrospective cohort study in IIH patients undergoing bariatric procedures versus conventional weight loss interventions. Propensity score matching was employed to balance study groups. Outcomes were assessed at 3, 6, 12, and 24 months, including papilledema, headache, visual symptoms, and therapeutic interventions. Bariatric surgery demonstrated superior outcomes compared to community weight management. Papilledema incidence was consistently lower in the bariatric group (RR = 0.591 at 24 months, p  = 0.0001). Headache prevalence and visual symptoms were also reduced in the surgical group. Acetazolamide dose was lower in bariatric patients, starting at 12 and 24 months. Subgroup analysis of different bariatric procedures showed comparable efficacy. Body mass index reduction was significantly greater in the bariatric group throughout the follow-up period. This study provides evidence supporting the efficacy of bariatric surgery in managing IIH, with superior outcomes across multiple parameters compared to conventional weight management. The sustained improvements in papilledema, headache, and visual symptoms, coupled with for the reduction in pharmacological intervention dose, suggest that bariatric surgery may offer a more definitive solution for IIH patients with concurrent obesity. Further research is needed to develop evidence-based guidelines for patient selection and optimize post-operative care protocols.

Introduction Diabetic osteopathy is a skeletal disorder that is characterized by increased fracture risk despite normal bone mineral density. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as important therapeutic agents for type 2 diabetes mellitus (T2DM), but their effects on diabetic bone disease were not studied nor investigated sufficiently in previous studies in the literature. We conducted a network meta-analysis to evaluate the differential effects of GLP-1 RAs on bone health outcomes in patients with T2DM. Methods We performed a systematic review and network meta-analysis of randomized controlled trials evaluating GLP-1 RAs with bone-related outcomes in T2DM patients. Primary outcomes included changes in bone mineral density (BMD), bone turnover markers, and fracture incidence. Results A total of 33 randomized controlled trials (33,107 participants) were included. GLP-1 RAs demonstrated improvements in BMD at the lumbar spine (0.052 g/cm 2 [0.043–0.061]), total hip (0.047 g/cm 2 [0.037–0.057]), and femoral neck (0.072 g/cm 2 [0.060–0.084]), however BMD findings from studies less than 52 weeks require cautious interpretation per clinical densitometry standards. They reduced bone resorption (β-CTX SMD -0.36 [-0.53, -0.20]) while increasing formation markers, possibly normalizing the uncoupled remodeling characteristic of diabetic osteopathy. Long-term treatment was associated with reduced fracture risk by 20% (RR 0.80 [0.65–0.94]). Conclusions GLP-1 RAs may provide skeletal benefits in T2DM patients by addressing specific mechanisms underlying diabetic osteopathy. The skeletal effects appear to vary according to agent type, patient characteristics, and treatment duration, suggesting promising role for personalized approaches to therapy selection. When bone health is a concern, GLP-1 RAs may represent a beneficial therapeutic option that could simultaneously address both metabolic and skeletal outcomes in patients with T2DM, though further bone-specific studies is needed for newer agents.

Background Parkinson’s Disease (PD) is a progressive neurodegenerative disorder characterized by the loss of dopaminergic neurons in the substantia nigra pars compacta. PD is diagnosed by a combination of motor symptoms including bradykinesia, resting tremors, rigidity and postural instability. Prodromal PD is the stage preceding the onset of classic motor symptoms of PD. The diagnosis of prodromal PD remains challenging despite many available diagnostic modalities. Aim This scoping review aims to investigate and explore the current diagnostic modalities used to detect prodromal PD, focusing particularly on multimodal imaging analysis and AI-based approaches. Methods We adhered to the PRISMA-SR guidelines for scoping reviews. We conducted a comprehensive literature search at multiple databases such as PubMed, Scopus, Web of Science, and the Cochrane Library from inception to July 2024, using keywords related to prodromal PD and diagnostic modalities. We included studies based on predefined inclusion and exclusion criteria and performed data extraction using a standardized form. Results The search included 9 studies involving 567 patients with prodromal PD and 35,643 control. Studies utilized various diagnostic approaches including neuroimaging techniques and AI-driven models. sensitivity ranging from 43 to 84% and specificity up to 96%. Neuroimaging and AI technologies showed promising results in identifying early pathological changes and predicting PD onset. The highest specificity was achieved by neuromelanin-sensitive imaging model, while highest sensitivity was achieved by standard 10-s electrocardiogram (ECG) + Machine learning model. Conclusion Advanced diagnostic modalities such as AI-driven models and multimodal neuroimaging revealed promising results in early detection of prodromal PD. However, their clinical application as screening tool for prodromal PD is limited because of the lack of validation. Future research should be directed towards using Multimodal imaging in diagnosing and screening for prodromal PD. Clinical trial number Not applicable.

Background Hospital readmission following renal transplantation significantly impacts patient outcomes and healthcare resources. While machine learning approaches offer promising solutions for risk prediction, their clinical application often lacks interpretability. We developed an explainable artificial intelligence (XAI) based supervised learning model to predict 30-day hospital readmission risk following renal transplantation. Methods We conducted a retrospective analysis of 588 renal transplant recipients at King Abdullah International Medical Research Center, with a predominance of living donor transplants (85.2%, n  = 500). Our methodology included a four-stage machine learning pipeline: data processing, feature preparation, model development using stratified 5-fold cross-validation, and clinical validation. Multiple algorithms were evaluated, with gradient boosting demonstrating superior performance. Model interpretability was achieved through dual-approach analysis using SHAP (SHapley Additive exPlanations) and LIME (Local Interpretable Model-agnostic Explanations). Results The gradient boosting model demonstrated strong performance (AUC 0.837, 95% CI: 0.802–0.872) with accuracy of 0.796 ± 0.050 and sensitivity of 0.388 ± 0.129. Length of hospital stay (38.0% contribution) and post-transplant systolic blood pressure (30.0% contribution) emerged as primary predictors, with differences between living and deceased donor subgroups. Pre-transplant BMI showed a higher importance in deceased donor recipients (12.6% vs. 2.6%), while HbA1c and eGFR were more impacting in living donor outcomes. The readmission rate in our cohort (88.9%, n  = 523) was higher than previously reported ranges (18–47%), likely reflecting center-specific practices. Conclusions Our XAI-based machine learning model combines strong predictive performance with clinical interpretability, offering transplant physicians donor-specific risk stratification capabilities. The web-based implementation facilitates practical integration into clinical workflows. Given our single-center experience and high proportion of living donors, external validation across diverse transplant centers is essential before widespread implementation. Our approach establishes a framework for developing center-specific risk prediction tools in transplant medicine.

Introduction Patient satisfaction is important for chronic care quality; however limited evidence exists regarding satisfaction patterns and demographic predictors among outpatients with chronic illnesses in Saudi Arabia. This study investigated patient satisfaction levels and identified demographic factors affecting satisfaction in chronic care settings. Methods A cross-sectional survey was conducted among 397 outpatients with chronic illnesses attending healthcare facilities in Medina, Saudi Arabia (August–September 2024). The validated Patient Satisfaction Questionnaire Short Form (PSQ-18) was administered electronically in Arabic and English. Demographic predictors were analyzed using ordinal logistic regression with satisfaction tertiles. Doctor-patient interaction correlations were assessed using Spearman coefficients. Results Participants included 213 females (53.6%) and 184 males (46.4%), with median age 45 years. Overall PSQ-18 satisfaction score was 64.4% of maximum possible. Age was the primary satisfaction predictor, with patients aged 45–60 years showing 2.31 times higher odds of superior satisfaction compared to younger patients (18–30 years, P -value = 0.010). Doctor-patient interaction measures showed strong correlations with overall satisfaction: physical comfort ( ρ  = 0.635), respect and empathy ( ρ  = 0.602), and comfort asking questions ( ρ  = 0.500, all P -value < 0.001). Gender and employment status showed no significant associations with satisfaction levels. Accessibility and convenience scored lowest (60% satisfaction), while interpersonal manner, communication, and financial aspects achieved highest scores (70% satisfaction). Conclusions Age-appropriate care delivery and enhanced doctor-patient interactions represent the most promising targets for improving chronic care satisfaction. Healthcare systems should prioritize interpersonal care training and accessibility improvements to optimize patient experiences across all age groups.

Introduction Idiopathic intracranial hypertension (IIH) is a neurological disorder characterised by elevated intracranial pressure (ICP), predominantly affecting obese women of reproductive age. While GLP‐1 receptor agonists have shown promise in IIH management, the potential of dual GIP/GLP‐1 receptor activation through tirzepatide remains unexplored. This study aimed to evaluate tirzepatide's efficacy as an adjunctive therapy in IIH management. Methods We conducted a retrospective cohort analysis using the TriNetX Global Health Research Network, analysing data through November 2024. Through propensity score matching, we compared 193 tirzepatide‐exposed IIH patients with 193 controls receiving standard care. Primary outcomes included papilledema severity, visual function, headache frequency, and treatment resistance, monitored at multiple follow‐up timepoints. Results Our analysis revealed significant improvements across all measured outcomes in the tirzepatide group. At 24 months, we observed a 68% reduction in papilledema risk (RR 0.320, 95% CI 0.189–0.542, p < 0.001), a 73.9% reduction in visual disturbance and blindness risk (RR 0.261, 95% CI 0.143–0.477, p < 0.001), and a 19.7% reduction in headache risk (RR 0.803, 95% CI 0.668–0.966, p = 0.019). The tirzepatide group demonstrated significant body‐mass index reductions, reaching −1.147 kg/m2 (95% CI [−1.415, −0.879], p < 0.001) at 24 months compared to controls. Conclusions Our results demonstrate that tirzepatide, when used as an adjunctive therapy, provides significant therapeutic benefits in IIH management, particularly in improving papilledema and visual outcomes. Our findings suggest that dual GIP/GLP‐1 receptor activation may offer advantages over traditional single‐receptor therapies, potentially through enhanced metabolic regulation and direct effects on ICP dynamics. Tirzepatide in Idiopathic Intracranial Hypertension (IIH) Management.

Background and Objectives: IgA nephropathy represents the most prevalent form of primary glomerulonephritis around the world, with significant heterogeneity in management strategies and outcomes. We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of pharmacological interventions for IgA nephropathy. Materials and Methods: We searched multiple databases through June 2025, identifying randomized controlled trials and observational studies evaluating pharmacological treatments in biopsy-proven IgA nephropathy. Primary outcomes included proteinuria reduction and estimated glomerular filtration ration (eGFR) preservation. Secondary outcomes included hard kidney endpoints and safety parameters. Random-effects meta-analyses were performed with comprehensive risk–benefit assessments. Results: Twenty-five studies were included. B-cell/plasma-cell-targeted therapies showed significant proteinuria reduction (−34.0% [95% CI: −45.7, −22.3%]), complement pathway inhibitors demonstrated superior eGFR preservation (+5.8 mL/min/1.73 m2/year [95% CI: 2.4, 9.2]). Systemic corticosteroids showed observed hard outcome benefits (HR 0.37 [95% CI: 0.26, 0.52]) but highest adverse event risk (RR 3.28 [95% CI: 2.11, 5.09]). Novel agents showed projected favorable effects (B-cell: HR 0.38; complement: HR 0.42) pending validation. Conclusions: Novel targeted therapies, especially B-cell/plasma-cell-targeted agents and complement pathway inhibitors, show promising risk–benefit profiles. However, longer-term data and standardized eGFR slope reporting are needed to confirm these findings compared to other immunosuppressive agents.

Objective Idiopathic intracranial hypertension (IIH) is a neurological disorder predominantly affecting young women with obesity, characterized by elevated intracranial pressure. While current treatments include weight loss counseling, medical therapies, and surgical interventions, their limitations necessitate exploring novel therapeutic approaches. We investigated the efficacy of liraglutide as an adjunctive therapy in IIH management. Methods We conducted a retrospective cohort study, analyzing adult patients with IIH. Through propensity score matching, we compared patients receiving liraglutide alongside standard therapy (n = 204) with those receiving standard therapy alone (n = 204). Primary outcomes included papilledema, headache manifestations, and visual disturbances, assessed at 3, 6, 12, and 24 months posttreatment initiation. Results Our matched cohorts were predominantly female (95.1% vs. 97.1%) with comparable mean ages (37.6 vs. 37.3 years). Liraglutide treatment demonstrated significant reduction in papilledema risk at 3 months (RR 0.333, 95% CI 0.167–0.664, p = 0.001), with sustained benefits throughout 24 months (RR 0.524, 95% CI 0.325–0.845, p = 0.006). While improvements were observed in visual disturbances, headache symptoms, and refractory IIH cases, these did not reach statistical significance. Interpretation Our findings suggest that liraglutide as an adjunctive therapy significantly improves papilledema outcomes in IIH patients, with the greatest effect observed at 3 months and sustained benefits over 2 years. This study provides promising evidence for liraglutide's role in IIH management, particularly in addressing papilledema.

Background: Medical research plays a significant role in advancing the level of health care worldwide. This research is a crucial part of the development of any educational system. In developing countries, the publication rate related to the medical sciences is lower than that in developed countries. Objective: The aim of this study was to explore the causes of delay in publishing research and the factors that hinder the completion of master’s degree projects in a group of medical graduate students at Cairo University Faculty of Medicine. Methods: A web-based questionnaire was introduced to approximately 150 medical graduates in different specialties through social media. The questionnaire aimed to investigate the reasons for delays in publishing master’s degree manuscripts after graduation among a group of medical graduates. Results: Of the graduates contacted, 130 responded to the web-based survey. The ages of the participants ranged from 23-38 years (SD 3.88); 72 of them were male, and 58 were female. Causes of noncompletion of manuscripts were analyzed; lack of proper research training and the absence of supportive mentorship were top reasons. We found a significant relationship between being married and failing to complete the assigned project from its start up to publication. Moreover, we found that the frequency of nonfulfillment increased among those who experienced poor mentorship. Conclusions: Several factors are contributing to the delay in publication of medical manuscripts related to research projects by medical graduates of the Cairo University Faculty of Medicine. Pensive supervision must be implemented to decipher the persistent institutional problems that obstruct research progress.

Background and Aims The COVID‐19 pandemic and the resultant change in sedentary behaviors have had immense health, economic, and social implications globally. As governments worldwide imposed lockdowns and curfews, the amount of time spent indoors greatly increased. This lead to a dramatic change in physical activity (PA) levels and profound consequences on daily routines. Our study aimed to investigate patterns of PA during the COVID‐19 pandemic among adults residing in Saudi Arabia. Methods This cross‐sectional survey‐based study aimed to investigate patterns of PA during the COVID‐19 pandemic among adults residing in Saudi Arabia. The International Physical Activity Questionnaire was utilized to measure participants' PA levels between April 2021 and May 2021. Participants were then classified into three groups according to their PA level, and their PA levels and sedentary behaviors were analyzed. Results We surveyed 463 participants, 315 (68%) of which were female and 134 (32%) of which were male with a median age of 23 (interquartile range, 21–35) years. Moderate‐to‐high PA was reported by 257 (55.7%) of the participants. There was a significant decrease in PA during the COVID‐19 pandemic and resultant lockdowns among the participants (p = 0.04), with higher rates of sedentary behavior among males than females (p = 0.14). Conclusions The decline in PA is a profound challenge of the COVID‐19 pandemic that needs to be addressed by health practitioners and policymakers. Our study highlights the decline in PA levels seen during the COVID‐19 pandemic and the importance of promotional programs and interventions to increase PA among the Saudi Arabian population without compromising the essential health restrictions and social distancing.