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ObjectiveThis study investigated the effect of toothbrush stiffness and dentifrice slurry abrasivity on the development and progression of simulated non-carious cervical lesions (NCCLs).Materials and methodsHuman maxillary premolars were allocated to 12 groups generated by the association between toothbrushes, soft, medium, and hard stiffness, and simulated dentifrice slurries, lower, medium, and higher; deionized water (DI) served as negative control. Teeth were mounted on acrylic blocks, and their root surfaces partially covered with acrylic resin to simulate gingiva, leaving a 2-mm area apical to the cemento-enamel junction exposed to toothbrushing. Specimens were brushed with the test slurries for 35,000 and 65,000 double strokes. Impressions taken at baseline and after both brushing periods were scanned by a 3D optical profilometer. Dentin volume loss (mm3) was calculated by image subtraction. Data were analyzed using three-way ANOVA and Fisher’s PLSD tests.ResultsAll toothbrushes caused higher volume loss when associated to higher abrasive slurry, compared to medium- and lower-abrasive slurries. Medium caused more volume loss than lower-abrasive slurry, which led to more volume loss than DI. Hard and medium toothbrushes were not different when used with medium- or higher-abrasive slurries. There were no differences among toothbrushes when used with DI and lower-abrasive slurry. Overall, 35,000 brushing strokes resulted in significantly less volume loss than 65,000.ConclusionsToothbrush stiffness was an important factor on NCCL development, especially when brushing with medium- and higher-abrasive slurries.Clinical relevanceMedium and hard toothbrushes associated with medium- and high-abrasive toothpastes can yield more severe NCCLs.

A simple, selective, and environmentally sustainable RP-HPLC method was developed for simultaneous quantification of gabapentin (GAB) and Methylcobalamin (MET) in pharmaceutical products. Separation was achieved on a Zorbax Eclipse C8 column (150 × 4.6 mm, 3.5 μm) using a green mobile phase of potassium phosphate buffer (pH 6.9)/acetonitrile (95:5 v/v) at 2.0 mL/min, with detection at 210 nm. Total analysis time was 10 min with 100 µL injection volume. The method showed excellent linearity (3–50 µg/mL; R² > 0.9998), LODs (0.60–0.80 µg/mL), and LOQs (2.00–2.50 µg/mL). Environmental sustainability was validated by multiple metrics: AGREE (0.70), AGREEprep (0.71), and Analytical Eco-Scale (80), confirming superior greenness. Forced degradation studies demonstrated stability-indicating capability per ICH guidelines. This eco-friendly approach provides a reliable solution for quality control of GAB/MET formulations while minimizing environmental impact.

Context: Medical malpractice is a leading cause of morbidity and mortality worldwide. Analyzing the current number of lawsuits and comparing it to previous years will help assess the status of medical malpractice litigations in Saudi Arabia. Subjects and Methods: A review and analysis of the annual statistics book of the Medico-Legal Committees (MLCs) in Saudi Arabia over the years (1437-1439 H) was conducted. Results: Over the 3-year study period, the total number of lawsuits was 3,684. The percentage of increase of malpractice lawsuits from 1437 until 1439 Hijri (2016-2018) was 26% (1,097-1,379 lawsuits). Obstetrics and Gynecology consistently had the highest number lawsuits compared to other specialties (25.6%), followed by dentistry (13.5%). Similarly, the rate of compensation after a lawsuit was highest in Obstetrics and Gynecology claims (62.7%), followed by dentistry (60%). The private healthcare sector consistently showed the highest number of lawsuits when compared to other healthcare providers, with a 73% increase over 3 years. The Ministry of Health showed an overall reduction in the number of lawsuits by 6.6% over the course of the study period. Conclusions: The number of lawsuits in Saudi Arabia is increasing rapidly. Understanding the reason for this is very important especially given the high rates of lawsuits for certain specialties and healthcare sectors. A root cause analysis cannot be conducted without a detailed reporting system for malpractice lawsuits; the development of which would help in research and the generation of solutions in this field.

Aim: Our aim was to evaluate Saudi patient knowledge and awareness regarding smoking as a risk factor for bladder cancer, kidney cancer, and erectile dysfunction (ED). Settings and Design: This quantitative cross-sectional study was conducted across three major tertiary hospitals in Riyadh, the capital city of Saudi Arabia. Material and Methods: A self-administered questionnaire was distributed to 539 patients in the urology outpatient clinic. Statistical Analysis: Data were analyzed using the Statistical Package for the Social Studies 21.0. For descriptive statistics, the frequency was calculated for all study variables. Chi-squared test was used for categorical variables. P < 0.05 was considered statistically significant. Results: A total of 539 urological patients completed the questionnaire. There were 460 (85.4%) male and 79 (14.6%) female respondents. Only 60.9%, 41.2%, and 36.9% of participants were aware that smoking was a risk factor for ED, kidney cancer, and bladder cancer, respectively. Conclusions: The knowledge and awareness were low among urological patients regarding smoking as a risk factor for urological diseases.

Although Sumra and Sidr Saudi honey is widely used in traditional medicine due to its potent activity, it is unknown whether its prolonged usage has impact upon bacterial virulence or leading to reduced antibiotic sensitivity. Thus, the study aims to investigate the effect of prolonged (repeated) in-vitro exposure to Saudi honey on the antibiotic susceptibility profiles and biofilm formation of pathogenic bacteria. Several bacteria, including , and , were in-vitro exposed ten times [passaged (P10)]to Sumra and Sider honey individually to introduce adapted bacteria (P10). Antibiotic susceptibility profiles of untreated (P0) and adapted (P10) bacteria were assessed using disc diffusion and microdilution assays. The tendency regarding biofilm formation following in-vitro exposure to honey (P10) was assessed using the Crystal violet staining method. Adapted (P10) bacteria to both Sumra and Sidr honey showed an increased sensitivity to gentamicin, ceftazidime, ampicillin, amoxycillin/clavulanic acid, and ceftriaxone, when compared with the parent strains (P0). In addition, (P10) that was adapted to Sidr honey displayed a 4-fold increase in the minimal inhibitory concentration of the same honey following in-vitro exposure. 3-fold reduction in the tendency toward biofilm formation was observed for the Sumra-adapted (P10) methicillin resistant strain, although there was a lower rate of reduction (1.5-fold) in biofilm formation by both the Sumra- and Sidr-adapted (P10) strains. The data highlight the positive impact of prolonged in-vitro exposure to Saudi honey (Sumra and Sider) for wound-associated bacteria since they displayed a significant increase in their sensitivity profiles to the tested antibiotic and a reduction in their ability to form biofilm. The increased bacterial sensitivity to antibiotics and a limited tendency toward biofilm formation would suggest the great potential therapeutic use of this Saudi honey (Sumra and Sidr) to treat wound infections.

This study aimed to develop an instant beverage mix using aloe vera gel powder and mango powder, evaluating its physicochemical, antioxidant, microbial, and sensory characteristics. The instant beverage mix formulation included six treatments: T0 (100% mango powder) and T1, T2, T3, T4, and T5 containing 5%, 10%, 15%, 20%, and 100% aloe vera gel powder, respectively. Proximate analysis of aloe vera and mango powder showed them to be a good source of ash, fiber, and protein contents. Similarly, proximate and mineral analysis of the beverage mix revealed a significant increase in ash, fiber, sodium (Na), potassium (K), phosphorus (P), and zinc (Zn) content in the formulations having high proportion of aloe vera powder. The results further showed that formulations with increased aloe vera gel powder levels had enhanced antioxidant activity and total phenolic content, indicating improved functionality. Sensory evaluation revealed that treatments containing balanced ratios of aloe vera and mango powder (T2 and T3) were the most acceptable, with superior flavor, appearance, and the overall acceptability. In conclusion, aloe vera- and mango powder-based instant beverage mixes present a potential for functional beverage development, which could provide significant health benefits. The future studies should focus on shelf-life stability and in vivo analysis of these formulations.

Background: The purpose of this research is to measure the current use of telemedicine technologies among urologists, their readiness to adopt the same, and to assess the barriers preventing such usage. Methods: Two hundred and twenty eight board-certified urologists completed our self-designed survey. An analysis was done to assess the increase in the use of telemedicine and the urologists' telemedicine experience responses. Data analysis was done using SPSS software. Results: There has been a tremendous increase in the use of telemedicine among urologists during the coronavirus disease (COVID-19) pandemic. Most of the respondents of this study performed general urology as part of their daily practice (59.6%). Prior to the pandemic, 53.9% of the participants had never used any means of telemedicine. However, during the pandemic, 72.4% of urologists who had never used telemedicine began using the same. Almost all of the respondents agreed that physical examination is difficult when using telemedicine, which resulted in the highest mean value among the questionnaire items. Urologists below 35-year-old agreed, to a larger extent, that telemedicine saves them more time and is simple to use than urologists from other age groups. Conclusion: During the COVID-19 pandemic, most urologists adopted telemedicine technology rapidly. Adopting telemedicine in the future could have multiple advantages. However, the limitations of telemedicine should be respected in order to avoid compromising patient safety.

This study aimed to assess the exposure and knowledge of urology residents in the management of urethral stricture (US) and to determine if they would be able to perform urethroplasty after graduation and whether urethroplasty should be included as a competency in the training program. An online survey was sent to all residents enrolled in any urology training program in Saudi Arabia. Fifty-eight (approximately 50%) of the 114 residents who were sent the survey provided responses. Most of the residents (45 residents, 77.6%) who responded were exposed to fewer than ten cases of US during their last year of training. Fifty-six residents (96.6%) attended five or fewer urethroplasty procedures in their last year of training. Twenty-three (40%) residents did not attend any urethroplasty procedure in the last year. The most common procedures attended by the residents were minimally invasive treatments (89% cystoscopy with dilatation and 79% direct visual internal urethrotomy (DVIU)). Most residents responded that they would manage newly diagnosed 1 cm US with either cystoscopy and dilatation or with DVIU 53 (91%). For the first recurrence of US, 46 (79%) residents responded that they would still prefer dilatation or DVIU. For the second, third, and chronic recurrences of US, 20 (34.5%), 6 (10.3%), and 5 (8.6%) residents, respectively, responded that they would perform dilatation or DVIU. Residents had low expectations for the success rate of urethroplasty; only 32 (55.2%) residents thought it had a high success rate. Urethroplasty is a specialized urological procedure, one that residents have variable exposure to. Privilege to perform such a procedure after graduating should be modified to ensure the best outcome for patients.

To investigate the relationship between urinary stone type and the type of crystals in the urine. This retrospective study involved 485 patients with urinary stones treated at King Saud University Medical City from May 2015 to June 2017. Clinical data were obtained from medical records. Different statistical analysis methods were applied, including basic contingency analysis, analysis of variance, logistic regression, discriminant analysis, partition modeling, and neural network evaluations. Of 485 patients, 47 had crystals detected by urinalysis. The most common type of crystal was calcium oxalate (n = 31), which had the highest association with calcium oxalate stones. Uric acid crystals (n = 8) were associated with uric acid stones. The neural network model used for determining the sensitivity and specificity showed an R-square value of 0.88, with an area under the curve of 0.94 for calcium oxalate, 0.94 for carbonate apatite, and 1.0 for uric acid. The predictive algorithm developed in the present study may be used with a patient's clinical parameters to predict the stone type. This approach predicts the stone types associated with certain patient characteristics with a high sensitivity and specificity, indicating that the models may be a valuable clinical tool in the diagnosis, management, and monitoring of stone diseases.

No study has assessed psychiatric disorders among infertile men and women seeking fertility treatment in Saudi Arabia. Therefore, we sought to measure the rate of psychiatric disorders in this population. This was a cross-sectional observational study among patients attending infertility clinics at three referral hospitals in Riyadh, Saudi Arabia, between January 2013 and September 2014. 406 patients (206 women and 200 men) participated in the study. The approved Arabic version of the MINI tool was used to assess 18 common psychiatric illnesses. The response rate was 81%. Of the men surveyed, only 4.5% self-reported having a psychiatric disorder. Of the women surveyed, only 10.2% reported having a psychiatric disorder. However, using the MINI scale, psychiatric illness was documented in 30% of males and 36.9% of females. The most common diagnoses for both genders were depression (21.7%) and anxiety (21.2%). Significantly more females than males exhibited suicidality and depression. In contrast, significantly more males than females had bipolar disorders and substance-related disorders. A low monthly income among male and female participants and polygamy among female participants were significantly associated with psychiatric disorders. This study shows that a higher prevalence of psychiatric disorders, particularly depression and anxiety, among infertile men and women in Saudi Arabia is associated with lower income and polygamy. This study highlights the importance of integrated care for alleviating the psychological burden of this unfortunate population and improving outcomes and quality of life. This study also encourages follow-up studies that aim to further understand the complex relationship between fertility and psychological well-being.