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Human schistosomiasis is one of the most prevalent parasitic diseases worldwide. Various host factors can affect the host–parasite interactions. Therefore, the aim of the present work was to determine the parasitological, histopathological, biochemical, and immunological status of Schistosoma mansoni -infected hosts with metabolic disorders to identify the underlying possible mechanisms of these comorbidities. The study animals were divided into four groups. Group I represented the control groups, namely, the normal control group, the S. mansoni -infected control group, and the noninfected type 1 diabetes (T1DM), type 2 diabetes (T2DM), and obesity groups. The mice of the other three groups underwent induction of T1DM (Group II), T2DM (Group III) and obesity (Group IV) before being infected with S. mansoni . All mice were subjected to body weight measurement, blood glucose and insulin assessment, parasitological evaluation of adult worm count, tissue egg count and intestinal oogram. Histopathological and immunohistochemical study using anti-glial fibrillary acidic protein (GFAP) in hepatic stellate cells (HSCs) and image analysis of Masson’s trichrome-stained liver sections using ImageJ (Fiji) software were carried out. Additionally, immunological analysis of tumour necrosis factor (TNF) beta, interleukin-5 (IL-5), IL-10, Forkhead box P3 (FOXP3) and pentraxin 3 (PTX3) levels besides biochemical study of total lipid profile were evaluated. The present study revealed a significant increase in the adult worm count and tissue egg output in the obesity group compared to the infected control group. The oogram of counted eggs showed prevalence of immature eggs in T1DM group, while T2DM and obese groups showed prevalence of mature eggs. The fibrosis area percentage showed significant increase in T2DM and obese groups while it was decreased in T1DM group in comparison to infected control group. Our data also showed significant increase in the levels of TNF-β, IL-5, PTX3 in T1DM, T2DM and obesity groups in comparison to infected control group, whilst the levels of FOXP3 and IL-10 were increased in the infected groups in comparison to their noninfected controls. Moreover, infected T1DM, T2DM and obesity groups showed higher blood glucose and lipid profile in comparison to the infected control group. However, these parameters were improved in comparison to their noninfected controls. In sum, induction of T2DM and obesity increased tissue egg counts, mature egg percentage, and fibrosis density, while schistosome infection induced changes in the lipid profile and blood glucose levels in infected diabetic and obese groups and impacted favorably insulin levels in obese mice. By better understanding the complexities of host–parasite interactions, efforts to reduce the burden of these debilitating diseases can be improved.

Medical emergencies (MEs) in dental practice, though rare, can occur posing significant risks to patients. Dental professionals should be well-prepared to manage such situations. This study aimed to assess the knowledge, self-perceived confidence and preparedness of dental students and interns regarding the management of MEs in dental settings. A questionnaire-based cross-sectional study was conducted among clinical dental students and interns at a dental college in Saudi Arabia. Data were collected using an anonymous, self-administered online questionnaire consisting of 20 multiple-choice questions assessing knowledge, preparedness and confidence in handling MEs. Statistical analysis was performed using SPSS and employing Pearson's Chi-squared test and logistic regression analysis. The study analyzed data from 145 out of 200 participants invited (response rate = 72.5%). Most participants were female (51.0%) and aged ≥ 24 years (62.8%). A high knowledge level was identified in 58.6% of participating students and interns. While females exhibited a slightly higher knowledge than males, higher confidence and preparedness levels were identified among males, though the difference was not statistically significant ( = 0.05). Older and more advanced students demonstrated significantly higher knowledge and confidence ( < 0.05). The most encountered emergency by participants during dental treatment was syncope (65.5%), and seizures (29.6%). Adrenaline was the most commonly cited emergency drug in terms of availability in dental practices (38.6%), followed by anti-histamines (23.4%), while atropine was the least available (13.8%). Notably, 58.6% of participants reported lack of these emergency drugs in their practice settings. The study highlighted a gap in the preparedness of dental students and interns to manage MEs effectively. The findings emphasize the need for enhanced training and education, particularly in managing more severe medical emergencies, to improve the overall emergency response in dental practices. Further, efforts should focus on increasing access to emergency drugs and equipment, along with regular BLS training, to ensure optimal patient safety.

Background Assessment of the Arabic online patient-centered information is understudied. The study aims to assess the quality and readability of the Arabic web-based knowledge about dental extraction. Methods The first 100 Arabic websites focusing on dental extraction were gathered using popular terms from Google, Bing, and Yahoo searches. These sites were organized and their quality was assessed using three key standards: the Journal of the American Medical Association (JAMA) benchmark criteria, the DISCERN instrument, and the inclusion of the Health on the Net Foundation Code of Conduct (HON code) seal. Additionally, the ease of reading of these websites was evaluated through various online readability indexes. Results Out of 300 initially reviewed websites on dental extraction in Arabic, 80 met the eligibility criteria. Nonprofit organizations were most common (41.3%), followed by university/medical centers (36.3%), and commercial entities (21.3%). Government organizations were minimally represented (1.3%). All websites were medically oriented, with 60% offering Q&A sections. Quality assessment showed moderate scores on the DISCERN instrument, with no site reaching the highest score. JAMA benchmarks were poorly met, and none had the HON code seal. Readability was generally high, with most sites scoring favorably on readability scales. Conclusions The rapidly evolving online information about dental extraction lacks readability and quality and can spread misinformation. Creators should focus on clear, unbiased content using simple language for better public understanding.

Tobacco smoking and the use of electronic cigarettes (e-cigarettes) are well known to harm oral health, but the dangers of e-cigarettes are still not fully acknowledged, especially in Saudi Arabia where their use is steadily increasing. This study explored awareness of the oral and dental health consequences of tobacco and e-cigarette use among residents of the Al-Madinah region and compared awareness levels across smokers, e-cigarette users, dual users, and non-smokers. A cross-sectional online survey was carried out on 278 participants who are 16 years and over in 2025. A validated self-administered questionnaire was used in the collection of data on demographic characteristics, smoking habits, oral health habits, and awareness of smoking-related oral health risks. Chi-square and Fisher Exact tests were used to analyze the data at a statistical significance level of  ≤ 0.05. Of the respondents, 6.8% were traditional smokers, 6.5% were e-cigarette users, 2.2% were dual users and 84.5% were non-smokers. Although more than 80% identified smoking as a cause of oral health problems such as cancer, discoloration, halitosis, and impaired healing, only 17.6% considered e-cigarettes as harmful. The non-smokers and cigarette smokers were more aware than the e-cigarette and dual users who were more likely to underestimate the risks associated with e-cigarettes. The results indicate that although the level of awareness on the negative effect of tobacco is high, the misconceptions on e-cigarettes are still present, thus suggesting the need for a public health campaign.

A key limitation of current synthetic treatments of scabies is their focus on eliminating the mites rather than addressing the body’s immune response or tissue healing, potentially fostering drug resistance and prolonging recovery. Melatonin, with its anti-inflammatory, antioxidant, and antimicrobial properties, presents a potential solution. Consequently, this research seeks to assess the value of melatonin supplementation as complementary therapy in Sarcoptes scabiei mite infestation. The study included 25 male crossbreed rabbits, divided into five groups of five rabbits each: group I (a negative control); group II (a positive control); group III (infected and treated with melatonin); group IV (infected and treated with ivermectin); and group V (infected and treated with melatonin and ivermectin). Clinical and parasitological assessments were conducted from day 0 till day 28 post-treatment. Serum and tissue samples were collected at the end of day 28 post-treatment for subsequent histopathological, biochemical, and immunological analyses. Our research indicated that combining melatonin with ivermectin (group V) significantly accelerated clinical improvement compared to using ivermectin alone (group IV). Melatonin also lessened the side effects of ivermectin seen in group IV and effectively alleviated itching in group V. Skin analysis of group V revealed nearly full healing and the absence of mites, unlike group IV, which still showed inflammation and dead mites. Supporting these findings, blood tests in group V demonstrated a significant improvement in biochemical and immunological markers compared to group IV. Infestation with Sarcoptes mites disrupts the balance between oxidants and antioxidants and triggers systemic inflammation. Supplementing melatonin can help restore this balance and reduce inflammation, thereby accelerating cure in affected rabbits. Therefore, melatonin is suggested as an adjunct therapy with ivermectin, particularly in severe scabies cases, and future research should explore optimal dosages and treatment regimens. Graphical Abstract

Recently, scabies was included in the WHO roadmap for neglected tropical diseases 2021–2030. Till now, ivermectin is the only available oral drug that is currently approved for treating crusted scabies in humans. Concerns regarding its efficacy and safety have prompted research efforts to find new alternatives. Our study aimed to evaluate the therapeutic effect of a single dose of fluralaner in cases of crusted scabies in comparison with that of repeated weekly high doses of ivermectin. For the in vitro study, twenty adult female mites were exposed to 50 μg/ml and 100 μg/ml ivermectin and fluralaner to evaluate their effects on mites' survival. For the in vivo study, thirty-five male crossbreed rabbits were divided into 4 groups: group I (non-infected, non-treated), group II (infected, non-treated), group III (infected and treated with ivermectin in a weekly oral dose of 0.4 mg/kg body weight/rabbit for 4 weeks, starting 8 weeks post-infection), and group IV (infected and treated with fluralaner given as a single oral dose of 25 mg/kg body weight/rabbit, starting 8 weeks post-infection). Clinical, parasitological, histopathological, and biochemical assessments were done. Clinical and parasitological assays were accomplished to all infected groups starting from day 0, then on days 2, 4, 6, 8, 10, 12, 14, 21, 28, 35, 42, 49 and 56 post-treatment, while histopathological and biochemical assessments were done at the end of the 8 th week post-treatment (day 56). Our results showed that fluralaner exhibited a higher acaricidal effect on adult Sarcoptes scabiei var. cuniculi when compared with ivermectin applied in the same concentration (50 μg/ml or 100 μg/ml). Concerning the in vivo study, both clinical cure and parasitological cure were noted in both treated groups, evidenced by complete absence of all clinical signs of infestation and absence of mites in all skin scrapings. However, the ivermectin-treated group showed incomplete histopathological and biochemical resolution. Interestingly, both clinical cure and negative skin scrapings were noticed earlier in the fluralaner-treated group, with no apparent side effects. Also, no significant differences were noticed in the skin sections and serum biochemical parameters when compared with those of the negative control group. We concluded that fluralaner is a promising scabicidal agent that is recommended to be studied for possible human use, especially in control programs. Graphical abstract

Trichinellosis is a meat-borne zoonosis of ubiquitous distribution. The severity is variable, and fatalities may occur. Immune-mediated inflammation plays an important role in the pathogenesis of the disease. Thus, safe and effective compounds with anti-inflammatory properties are needed. Our study was designed to evaluate the effects of fluvoxamine as an adjuvant to albendazole during the intestinal and migratory phases of trichinellosis. Therefore, Trichinella spiralis -infected mice were treated with either fluvoxamine, albendazole, or a combination of both drugs. Notably, the parasite burden was reduced in the intestines and muscles of fluvoxamine-treated mice compared to the infected control, denoting a detrimental effect of the drug against Trichinella spiralis . Moreover, in comparison with the infected control, there was a marked improvement in intestinal and muscle inflammation with the treatment, evidenced by the reduction in COX-2 and TNF-α and the decrement of inflammatory infiltrates in tissues. The expression of iNOS was also reduced in the muscles. Treatment with fluvoxamine alleviated the oxidative stress in the intestines and muscles with a reduction in malondialdehyde and H 2 O 2 and an increase in reduced glutathione levels. Finally, fluvoxamine moderated the immune response, as evidenced by the downregulation of the levels of IL-4 and IFN-γ and the increase of those of IL-10 in tissues. Characteristically, all these beneficial effects were maximal in mice receiving the combined treatment. In conclusion, fluvoxamine administration during the early phase of trichinellosis exhibited immunomodulatory and anti-inflammatory activities that potentiated the efficacy of albendazole. Therefore, fluvoxamine could be considered a useful adjuvant treatment in trichinellosis.

Trichinellosis is a cosmopolitan zoonosis that is caused mainly by Trichinella spiralis infection. The human disease ranges from mild to severe and fatality may occur. The treatment of trichinellosis still presents a challenge for physicians. Anti-inflammatory drugs are usually added to antiparasitic agents to alleviate untoward immuno-inflammatory responses and possible tissue damage but they are not without adverse effects. Thus, there is a need for the discovery of safe and effective compounds with anti-inflammatory properties. This study aimed to evaluate the activity of β-glucan during enteral and muscular phases of experimental T. spiralis infection as well as its therapeutic potential as an adjuvant to albendazole in treating trichinellosis. For this aim, mice were infected with T. spiralis and divided into the following groups: early and late β-glucan treatment, albendazole treatment, and combined treatment groups. Infected mice were subjected to assessment of parasite burden, immunological markers, and histopathological changes in the small intestines and muscles. Immunohistochemical evaluation of NF-κB expression in small intestinal and muscle tissues was carried out in order to investigate the mechanism of action of β-glucan. Interestingly, β-glucan potentiated the efficacy of albendazole as noted by the significant reduction of counts of muscle larvae. The inflammatory responses in the small intestine and skeletal muscles were mitigated with some characteristic qualitative changes. β-glucan also increased the expression of NF-κB in tissues which may account for some of its effects. In conclusion, β-glucan showed a multifaceted beneficial impact on the therapeutic outcome of Trichinella infection and can be regarded as a promising adjuvant in the treatment of trichinellosis.