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This study proposes a new deep-learning approach incorporating a superfluity mechanism to categorize knee X-ray images into osteoporosis, osteopenia, and normal classes. The superfluity mechanism suggests the use of two distinct types of blocks. The rationale is that, unlike a conventional serially stacked layer, the superfluity concept involves concatenating multiple layers, enabling features to flow into two branches rather than a single branch. Two knee datasets have been utilized for training, validating, and testing the proposed model. We use transfer learning with two pre-trained models, AlexNet and ResNet50, comparing the results with those of the proposed model. The results indicate that the performance of the pre-trained models, namely AlexNet and ResNet50, was inferior to that of the proposed Superfluity DL architecture. The Superfluity DL model demonstrated the highest accuracy (85.42% for dataset1 and 79.39% for dataset2) among all the pre-trained models.

Background Testicular size assessment is an important and initial technique for the evaluation of gonadal function. Our study aims to determine the correlation between paediatric testicular volumes measured with the orchidometer, high-resolution ultrasonography (US) and intra-operative measurements using calipers. Results This is a prospective observational study of 127 boys presenting to our institution with non-emergent scrotal conditions between January 2007 and October 2008. Volume estimates of both testes were measured using the Prader orchidometer. The patient was then sent to a radiologist who measured the testicular volumes using US, being blinded to the orchidometer estimates. At surgery, the testicular dimensions on the side of the pathology were obtained with a vernier caliper. The testicular volumes by US and caliper were calculated using the formula 0.71 × Length × Width × Height. The relationship between the measured volumes was determined using Pearson’s correlation statistic and Student’s t test. The level of significance for all analysis was set at p  < 0.05. Their ages ranged from 18 days to 13 years (median 3 years). There was significant correlation between testicular volumes (for both sides, i.e. right and left) measured with the orchidometer and US ( r  = 0.544; 0.537, p  < 0.001), significant correlation between testicular volumes measured with the orchidometer and caliper ( r  = 0.537; 0.638, p  < 0.001) and also significant correlation between volumes measured by US and caliper ( r  = 0.382; 0.829, p  < 0.01). Conclusion Prader orchidometer testicular volume estimates correlate significantly with US estimates in children. In resource-constrained settings, it could be used for an accurate and quick testicular volume assessment.

Background Hajj, one of the largest annual religious gatherings, attracts millions of Muslim pilgrims globally, with a significant proportion being older adults. Cognitive impairment, encompassing mild cognitive decline to dementia, is a prevalent condition among older adults and can significantly affect their ability to participate in the physically and mentally demanding rituals of Hajj. Despite its implications, data on the prevalence and associated factors of cognitive impairment among pilgrims remain limited. Objective This study aimed to assess the prevalence of cognitive impairment among older adults Hajj pilgrims and to explore its associations with demographic, linguistic, and medical history variables. Methods A cross-sectional study was conducted during the 1445 Hijri Calander (2024 AD) Hajj season in Makkah, Saudi Arabia. A total of 3,111 pilgrims aged 60 years and older were recruited using multistage sampling. Data were collected through bilingual (Arabic and English) face-to-face interviews, employing the validated Ascertain Dementia 8 (AD8) screening tool. Additional data included demographic characteristics, health conditions, medication use, and cognitive challenges. Statistical analyses included Chi-square tests, logistic regression, and descriptive summaries to determine significant predictors of cognitive impairment. Results The prevalence of positive cognitive screening impairment was 64.0%, with a mean AD8 score of 3.09 ± 2.68. Participants aged 80 years and above exhibited the highest prevalence (78.5%), followed by those aged 70–79 years (67.2%) and 60–69 years (58.4%) ( p  < 0.001). Urdu-speaking individuals (OR: 2.132, 95% CI: 1.018–4.468), Nigerian nationality (OR: 7.594, 95% CI: 1.951–29.555), and Southeast Asia clusters ( p  = 0.033, OR: 2.086, 95% CI: 1.059–4.108) had a significantly higher prevalence of cognitive impairment by screening. Chronic conditions such as diabetes (OR: 1.839, p  < 0.001), hypertension (OR: 2.420, p  < 0.001), and hyperlipidemia (OR: 1.446, p  = 0.001) were significantly associated with cognitive impairment positive screening along with prior cognitive impairment disorders diagnosis (OR: 2.367, p  = 0.038). Participants who reported difficulties with remembering appointments (40.3%) and managing finances (34.6%) were more likely to exhibit cognitive impairment positive screening. Conclusion Probable cognitive impairment positive screening among older adults Hajj pilgrims was significantly associated with clinical factors including diabetes, hypertension, hyperlipidemia, prior diagnosis of cognitive impairment disorders, and informant-based reporting. These findings underscore the importance of pre-travel cognitive assessments, targeted health interventions, and culturally sensitive support services to ensure safe and inclusive participation. This study provides crucial evidence to guide future healthcare policies and interventions aimed at supporting older adults’ pilgrims.

Objective Despite several studies assessing the impact of resveratrol on obesity indices, previous meta-analyses show conflicting results. Therefore, we conducted this critical umbrella review of interventional meta-analyses on the effect of resveratrol supplementation on body mass index (BMI), body weight (BW), waist circumference (WC), and body fat. Methods Searches were conducted across multiple databases to identify all relevant meta-analyses up to September 30th, 2025. Reported pooled effect sizes (ESs) and 95% confidence intervals (CIs) were extracted from each included study and synthesized using a random-effects model. Methodological quality was assessed using the AMSTAR 2 tool. Results Ultimately, 18 meta-analyses were included, with results showing a small but statistically significant reduction in BW (ES: − 0.18 kg, 95% CI − 0.32 to − 0.03, p  = 0.02), BMI (ES: − 0.14 kg/m 2 , 95% CI − 0.2 to − 0.08, p  < 0.001), WC (ES − 0.43 cm, 95% CI − 0.64 to − 0.22, p  < 0.001), and body fat (ES: − 0.3 kg, 95% CI − 0.48 to − 0.12, p  = 0.001) in the resveratrol group compared to the control group, with subgroup analysis revealing statistical significance only in subgroups with doses > 400 mg/day and study duration ˃ 12 weeks. Conclusion Our review confirms that resveratrol supplementation reduces BW, BMI, WC, and body fat, particularly on doses > 400 mg/day and interventions lasting ˃12 weeks, with small effect sizes. Based on our findings, resveratrol supplementation could be considered as a complementary therapy in the management of obesity.

BackgroundThe Hajj pilgrimage poses significant public health challenges due to the risk of infectious disease transmission. Despite mandatory vaccination policies, barriers such as hesitancy, logistical issues, and vaccine availability persist.ObjectiveThis study assesses vaccine uptake, reasons for compliance or non-compliance, and barriers among Hajj pilgrims.MethodsA cross-sectional study was conducted during the 2024 Hajj season, with data collected via structured interviews from 5,355 participants. Descriptive statistics and logistic regression analyzed vaccination status and influencing factors.ResultsOf the participants, 4298 (80.3%) reported receiving mandatory or recommended vaccines, including influenza, COVID-19, and meningococcal. Primary motivators for vaccination were compliance to mandatory requirements 2240 (52.1%) and healthcare provider recommendations 2018 (46.9%). Among non-vaccinated respondents, the main reasons included belief in vaccine ineffectiveness 250(23.7%), reliance on natural immunity 243(23%), and lack of awareness 174(16.5%). Common barriers included long wait times 721(13.5%) and limited access to vaccination centers 543(10.1%). Women and individuals with higher education demonstrated greater vaccine uptake, while logistical barriers were more prevalent among self-employed and less-educated participants.ConclusionDespite high vaccine uptake, barriers remain. Addressing hesitancy, improving access, and aligning vaccine availability with Hajj timing are essential to enhance coverage and reduce disease transmission risks.Clinical Trial NumberNot applicable.

IntroductionRecent studies investigated the endurance of symptoms and occurrence of complications three months after SARS-CoV-2 infection. This study aims to examine the prevalence, variation, and severity of continual symptoms in the post‐COVID-19 using a single-center questionnaire.MethodsThe questionnaire was distributed among population in Saudi Arabia who recovered from COVID‐19 between April 1, 2020 and December 31, 2021.ResultsA total of 744 participants completed the questionnaire, 318 (42.8%) recovered less than 3 months, 75 (10.1%) recovered 3–6 months, while 351 (47.2%) recovered more than 6 months. About half of the participants 353 (47.5%) had incessant symptoms and of those patients, more than half had two or more symptoms. Common symptoms included fatigue 189 (25.4%), headache 118 (15.9%), and myalgia 63 (8.5%). Of the participants, 189 (21.4%) experienced continual symptoms including anxiety in 98 (13.2%) and depression in 70 (9.5%).ConclusionThe current study showed a high proportion of individuals with long-COVID-19 symptoms. Thus, proper assessment of the individuals in the post-recovery period can guide the patients to the relevant clinics for rehabilitation. Moreover, there is a great importance to decrease COVID-19 infection, populations should be targeted to boost vaccine efficiency.

Background: Recent studies indicate that vitamin D impacts male reproductive function, with deficiency linked to infertility. This review evaluates the effect of vitamin D supplementation on male fertility, focusing on total testosterone, free testosterone, the free androgen index (FAI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex-hormone-binding globulin (SHBG), and estradiol. Methods: We systematically searched Medline, Web of Science, Cochrane Library, and Scopus from their inception until July 2024 for randomized controlled trials (RCTs) involving adult males. The primary focus of these studies was on reproductive hormone parameters, analyzed using a random-effects meta-analysis and weighted mean difference (WMD). Evidence quality was assessed using ROB2 and GRADE. Meta-regression and dose–response analyses were performed. Results: Seventeen studies met the criteria for quantitative analysis. Vitamin D supplementation significantly increased total testosterone levels (WMD 0.38, 95% CI 0.06–0.70, n = 15, I2 = 67.03). However, it had no significant effect on other hormone parameters: free testosterone (WMD 0.00, 95% CI −0.02–0.03, n = 9, I2 = 48.12), FSH (WMD −0.02, 95% CI −0.57–0.53, n = 7, I2 = 48.72), LH (WMD −0.09, 95% CI −0.30–0.12, n = 8, I2 = 0.00), SHBG (WMD 0.73, 95% CI −1.14–2.61, n = 10, I2 = 69.05), FAI (WMD −0.92, 95% CI −2.12–0.27, n = 6, I2 = 0.00), and estradiol (WMD −0.02, 95% CI −2.95–2.92, n = 5, I2 = 20.63). Conclusion: This meta-analysis shows that vitamin D supplementation may increase total testosterone levels in men. However, further well-designed RCTs are needed to determine vitamin D’s effects on other reproductive hormone parameters.

Background and Objectives: Polycystic ovary syndrome (PCOS) is a common endocrine disorder associated with various cardiometabolic risk factors, including insulin resistance, dyslipidemia, hypertension, and obesity, which contribute to an increased risk of cardiovascular diseases. This inaugural systematic review and meta-analysis of randomized controlled trials (RCTs) evaluated the impact of magnesium supplementation on various cardiometabolic risk factors and hormonal parameters in patients with polycystic ovary syndrome (PCOS). Materials and Methods: We systematically searched the MEDLINE, Web of Science, Scopus, and Cochrane databases until 30 March 2024 for studies comparing magnesium supplementation to control in improving cardiometabolic and hormonal factors in PCOS patients. Endpoints were summarized as mean differences (MD) and 95% confidence intervals (CIs) in a random-effects model. Results: The primary search yielded 176 studies. After screening, six studies met our inclusion criteria. Our meta-analysis showed no significant effects of magnesium supplementation on cardiometabolic risk factors and hormonal parameters in patients with PCOS. Conclusions: Magnesium supplementation does not appear to influence the cardiometabolic and hormonal factors in PCOS patients. Further rigorous RCTs are needed to strengthen the evidence and support comprehensive analysis in this area. PROSPERO database (CRD42024526110).

The demand for liver transplantation in the Kingdom of Saudi Arabia (KSA) is associated with the country's high burden of liver disease. Trends in the epidemiology of liver transplantation indications among recipients in KSA have changed over 20 years. Non-alcoholic steatohepatitis has eclipsed the hepatitis C virus in the country due to the effective treatment strategies for HCV. Risk factors for NASH, like type 2 diabetes mellitus, obesity, and hyperlipidemia, are becoming a major concern and a leading indication for liver transplantation in the KSA. There is also a significantly increased prevalence and incidence of genetic adult familial liver diseases in KSA. New immunosuppressive agents and preservation solutions, improved surgical capabilities, and early disease recognition and management have increased the success rate of liver transplant outcome but concerns about the side effects of immunosuppressive therapy can jeopardise long-term survival outcomes. Despite this, indications for liver transplantation continue to increase, resulting in ongoing challenges to maximize the number of potential donors and reduce patient mortality rate while expecting to get transplanted. The Saudi Center of Organ Transplant is the recognized National Organ

Background: The Saudi government has taken the decision to prevent the entrance of about 2.5 million international pilgrims seeking to perform hajj in order to protect the world from a catastrophic widespread of disease. Moreover, health systems in Saudi Arabia are offering free testing for residents whether Saudi and non-Saudi. Objective: This study aimed to evaluate the spread of COVID-19 associated with preventive measures taken in Saudi Arabia and to develop a detailed COVID-19 prevention strategy as a framework for the Saudi Arabia community. Methodology: Population size and age distributions among the country of Saudi Arabia were taken from the 2020 World Population Prospects. Contact patterns were measured using the Saudi Arabia Ministry of Health Statistical Annual Report. Conclusions: Our study demonstrates that performing screening tests as early as possible to facilitate the rapid detection of infected cases, fast treatment, and instant isolation for suspected cases is the most definitive rejoinder for public health. Moreover, our study revealed the significance of performing preventive measures in reducing infection and death rates around Saudi Arabia by 27%, while in other countries, it reduced the death rate ranging from 10–73%. This study provides an achievable strategy for prevention and early detection of COVID-19 spread.