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Background/Objectives: Large-language modules facilitate accessing health information instantaneously. However, they do not provide the same level of accuracy or detail. In pediatric orthopedics, where parents have urgent concerns regarding knee deformities (bowlegs and knock knees), the accuracy and dependability of these chatbots can affect parent decisions to seek treatment. The goal of this study was to analyze how AI chatbots addressed parental concerns regarding pediatric knee deformities. Methods: A set of twenty standardized questions, consisting of ten questions each on bowlegs and knock knees, were designed through literature reviews and through analysis of parental discussion forums and expert consultations. Each of the three chatbots (ChatGPT, Gemini, and Copilot) was asked the same set of questions. Five pediatric orthopedic surgeons were then asked to rate each response for accuracy, clarity, and comprehensiveness, along with the degree of misleading information provided, on a scale of 1–5. The reliability among raters was calculated using intraclass correlation coefficients (ICCs), while differences among the chatbots were assessed using a Kruskal–Wallis test with post hoc pairwise comparisons. Results: All three chatbots displayed a moderate-to-good score for inter-rater reliability. ChatGPT and Gemini’s scores were higher for accuracy and comprehensiveness than Copilot’s (p < 0.05). However, no notable differences were found in clarity or in the likelihood of giving incorrect answers. Overall, more detailed and precise responses were given by ChatGPT and Gemini, while, with regard to clarity, Copilot performed comparably but was less thorough. Conclusions: There were notable discrepancies in performance across the AI chatbots in providing pediatric orthopedic information, which demonstrates indications of evolving potential. In comparison to Copilot, ChatGPT and Gemini were relatively more accurate and comprehensive. These results highlight the persistent requirement for real-time supervision and stringent validation when employing chatbots in the context of pediatric healthcare.

Bones are a fundamental component of human anatomy, enabling movement and support. Bone fractures are prevalent in the human body, and their accurate diagnosis is crucial in medical practice. In response to this challenge, researchers have turned to deep-learning (DL) algorithms. Recent advancements in sophisticated DL methodologies have helped overcome existing issues in fracture detection. Nevertheless, it is essential to develop an automated approach for identifying fractures using the multi-region X-ray dataset from Kaggle, which contains a comprehensive collection of 10,580 radiographic images. This study advocates for the use of DL techniques, including VGG16, ResNet152V2, and DenseNet201, for the detection and diagnosis of bone fractures. The experimental findings demonstrate that the proposed approach accurately identifies and classifies various types of fractures. Our system, incorporating DenseNet201 and VGG16, achieved an accuracy rate of 97% during the validation phase. By addressing these challenges, we can further improve DL models for fracture detection. This article tackles the limitations of existing methods for fracture detection and diagnosis and proposes a system that improves accuracy. The findings lay the foundation for future improvements to radiographic systems used in bone fracture diagnosis.

(1) Background: Functional habitual constipation (FC) in children is a common gastrointestinal problem. This study aimed to explore the local community’s view on this problem, emphasising the challenges that parents face in managing the condition and its impact on the child’s quality of life. (2) Methods: A prospective, cross-sectional, community-based study was conducted between March and July 2023. The survey received 933 responses. The target population was adults over 18 years of age living in the Eastern Province of Saudi Arabia. An electronically distributed questionnaire was designed in the Arabic language. (3) Results: The mean knowledge scores were significantly higher in females than males, with t (931) = −2.701 and p = 0.007. The Bonferroni post hoc test results indicated that participants between 20 and 29 years exhibited significantly higher levels of knowledge scores compared to those between 30 and 39 years. Furthermore, the results revealed that those with three or more children had significantly higher knowledge scores compared to those with only one child. (4) Conclusions: This study demonstrated that parents in the local community have a good perceived knowledge of FC, but it needs to be linked with practice. They tended to report high levels of perception and demonstrated better practices. These results emphasise the importance of exploring the local community’s view on constipation among children.

Background & Objective: Many patients after cholecystectomy, develop gastrointestinal (GI) symptoms and are worried. The objective of this study was to find out the risk factors for severe GI symptoms following laparoscopic cholecystectomy (LC) during first year of follow-up. Methods: It is a multi-center prospective observational study. In this study, patients who underwent LC for gallstones as elective or emergency at different hospitals of Al-Ahsa region of the Kingdom of Saudi Arabia from January 2020 to December 2021were evaluated for the development of severe GI symptoms postoperatively. They were followed-up for one year after the surgery. Results: One thousand and two patients who underwent LC, 139(13.87%) developed severe GI symptoms after LC. The patients affected were mostly females 103(74.1%). After LC, the GI symptoms observed were increased frequency of defecation 113(81.3%), loose stools 102 (73.4%), urgency 63(45.3%) and bloating 60 (43.16%) patients. Forty-seven (33.8%) patients had two GI symptoms at a time, followed by 36 (25.9%) who had three. The median time of the start of GI symptoms was two weeks after surgery and the symptoms ended at 12 weeks after surgery. Forty-five (32.4%) patients had less than three-weeks’ duration, followed by 35(25%) having less than 15 weeks. A BMI more than 40 showed a significant association. A higher frequency of cholecystitis attacks and a delayed onset of GI symptoms showed a significant severity of GI symptoms, resulting in delayed resolution. The bowel symptoms were more prominent in the emergency group. Age and gender had no significance. Conclusion: Early laparoscopic cholecystectomy of patients with cholelithiasis who have a smaller number of attacks of cholecystitis have less frequency of severe GI symptoms after the surgery. doi: https://doi.org/10.12669/pjms.41.1.10125 How to cite this: Almulhim SA, AlNaim MM, Memon AQ, Aldrweesh AK, Aldamigh OA, Alhadi FA, et al. Severe gastrointestinal symptoms during first year after laparoscopic cholecystectomy. Pak J Med Sci. 2025;41(1):107-112. doi: https://doi.org/10.12669/pjms.41.1.10125 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background and Objectives: On a local and national scale, genitourinary malformations (GUMs) are the second most encountered congenital anomaly in children. GUMs are linked to several risk factors, including maternal co-morbidities and insufficient folic acid. They may also be related to maternal health and care during pregnancy. Expanding our knowledge about these factors is necessary for the development of preventative measures, which could reduce GUM incidence. This study evaluated the local youth’s understanding and perceptions of genitourinary anomalies. Materials and Methods: This cross-sectional, qualitative, anonymous, questionnaire-based study involved members of the local population, aged 18 years or over. Based on a 5% type I error rate (α = 0.05) and an 80% response rate, a sample size of 481 was determined. The questionnaire was completed by 902 people. The data were analyzed using SPSS version 25 (IBM). Results: Over half (57%) of respondents believed that hormonal therapy during pregnancy could increase GUM risk. Moreover, 46% thought that maternal chronic diseases could be another risk factor, while 43% believed that pregnancy-related conditions, such as pre-eclampsia, increased GUM risk. Women had higher odds of high perception scores than men, according to the univariate and multivariate analyses. Most participants (74%) strongly agreed that proper and ongoing prenatal follow-ups are necessary, 69% agreed that premarital medical check-ups are necessary, and 67% believed that optimal nutrition throughout pregnancy is necessary to reduce GUM risk. Conclusions: The results emphasize the necessity of developing healthcare strategies specifically designed to increase knowledge about GUMs and overcome incorrect community perceptions of risk factors that could also help improve attitudes towards prevention and ultimately reduce the incidence of GUMs.

Background Blunt abdominal trauma is a prevailing cause of pediatric morbidity and mortality. It constitutes the most frequent type of pediatric injuries. Contrast-enhanced sonography (CEUS) and contrast-enhanced computed tomography (CECT) are considered pivotal diagnostic modalities in hemodynamically stable patients. Aim To report the experience in management of pediatric split liver and spleen injuries using CEUS and CECT. Patients and methods This study included 246 children who sustained blunt abdominal trauma, and admitted and treated at three tertiary hospitals in the period of 5 years. Primary resuscitation was offered to all children based on the advanced trauma and life support (ATLS) protocol. A special algorithm for decision-making was followed. It incorporated the FAST, baseline ultrasound (US), CEUS, and CECT. Patients were treated according to the imaging findings and hemodynamic stability. Results All 246 children who sustained a blunt abdominal were studied. Patients' age was 10.5 ± 2.1. Road traffic accidents were the most common cause of trauma; 155 patients (63%). CECT showed the extent of injury in 153 patients’ spleen (62%) and 78 patients’ liver (32%), while the remaining 15 (6%) patients had both injuries. CEUS detected 142 (57.7%) spleen injury, and 67 (27.2%) liver injury. Conclusions CEUS may be a useful diagnostic tool among hemodynamically stable children who sustained low-to-moderate energy isolated blunt abdominal trauma. It may be also helpful for further evaluation of uncertain CECT findings and follow-up of conservatively managed traumatic injuries.

Nocturnal enuresis (NE) has been associated with neurodevelopmental disorders such as autism spectrum disorder, attention deficit or hyperactivity disorder, and intellectual disability. This study aimed to assess parents' perception of NE in children in the eastern region of Saudi Arabia. We conducted a cross-sectional study from May to August 2023, including parents aged ≥18 years living in the area. We administered an online questionnaire to assess parents' knowledge and attitudes toward NE and its treatment. A total of 616 parents completed the questionnaire, 71.4% of which were women, 35% were aged between 25 and 35 years, 75% were married, 65% had a university degree, and 49% had three or more children. In total, 70% demonstrated a good overall knowledge about NE and its treatment, and nearly 60% had a positive attitude toward the condition. Univariate and multivariate ordinal logistic regression analyses revealed that female sex, a higher level of education, and having more than one child were associated with a higher score regarding attitude toward treatment. The level of education and the number of children were predictors of knowledge and a positive attitude toward NE in children.

Recently the onsite digital interpretation spreads widely. It is age of smart phones, tablets, interactive desktop and the virtual reality. There is no longer digital engagement but digital living, as digital devices became the norm and part of the daily life. This research identifies the different onsite digital interpretation tools with a specific focus on the current uses at Banque Misr Museum. The research concludes by discussing the evaluation of the onsite digital interpretation at Banque Misr Museum, Specific technologies discussed and evaluated include multimedia room, Mini Culturama, Interactive desktop. Evaluation has done through interviews, observation and the user experience's reviews; as a consequence, the research considers the possibility of improving the visitor's experience by using the digital technologies for interpretation to give a kind of immersive, their applications are easy to deal with for everybody; applications are covering lack of signs and labels.

Mobile applications performed in many different technologies, Mobile App. That is based on QR code is cheaper than the other App. And it suits museums and its contents. It includes information, photos, 3D model and other objects related to the museum's exhibition. Mobiles Applications are becoming better familiar by museums. As museums become more concerned to develop and use mobile apps, their utility and pervasiveness is starting to increase. Nowadays, mobile apps are used in museums for interpretation and education, to marketing and promoting the exhibition. According to a report from mobile manufacturer Ericsson, by 2015 80% of people accessing the Internet worldwide will be doing so from a mobile device. There are different devices that museum's visitors are able to use anywhere, so they can use it in the public places and galleries at museums. And museum's professionals supposed to use the creative applications of mobiles, with the advanced features of their applications, there is creative approaches for museums to extend the museum experience to other locations both within and beyond the gallery.

Graphene, graphene quantum dots (GQDs) their derivatives and gold nanoparticles (AuNPs), all have a wide range of applications in biomedical applications, particularly anticancer drug delivery, due to their large surface area, chemical and mechanical stability, and good biocompatibility. The first goal of this research is to improve the chemistry and solubility of rGO by doping it with boron and decorating it with AuNPs (Au-B-rGO), as well as to improve the loading efficiency of the anticancer drug doxorubicin (DOX). The second goal is to investigate the effect of boric acid (BA) on anticancer drug delivery when it is combined with graphene oxide quantum dots conjugated with glucosamine (GOQDs-GlcN-BA). FTIR, XPS, XRD, SEM, EDS, and zeta potential analysis were used for characterization of the nanocomposites. The hydrophobic nanocomposites were functionalized with chitosan oligosaccharide to lower the aggregation. However, high functionalization reduced the drug's loading percentage. Replacing chitosan with glucosamine GOQDs-GlcN-DOX, resulted in (57% drug loading) compared to the drug loaded after boric acid addition GOQDs-GlcN-BA-DOX (90%). Only 8% of DOX release occured from GOQDs-GlcN-DOX, in an acidic environment, after 96 h whereas BA addition in the nanocomposite increased DOX release of up to 20%. The morphology and nanosize of the nanoassembly were confirmed by TEM. The nontoxicity of the synthesized bare nanocomposites determined by MTT assay, with cell viability more than 100% at high concentrations, while GOQD-GlcN-BA-DOX exhibited more cytotoxicity against MCF-7 cells compared to GOQD-GlcN-DOX. GOQD-GlcN-BA-DOX shows stronger fluorescence through fluorescence microscopy owing to higher MCF-7 cellular internalization via sialic acid and BA interaction. This thesis shows the addition of BA enhanced the loading and release of anticancer drug, nontoxicity of the system with higher cellular internalization thus superior potential for anticancer drug delivery.