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Background Isolated fallopian tube torsion is a rare but critical gynecologic emergency that often presents a diagnostic challenge owing to its nonspecific symptoms and infrequent occurrence. Case presentation This paper discusses the case of a 37-year-old Saudi female who was hospitalized with acute right lower quadrant pain, accompanied by nausea and vomiting. The initial differential diagnosis included ovarian torsion and appendicitis. Diagnostic laparoscopy revealed a right fallopian tube twisted five times, which was later confirmed to be necrotic. Given the irreversible damage to the fallopian tube, a right salpingectomy was performed. The patient recovered well postoperatively and was discharged after 48 h without complications. Conclusion This case report underscores the importance of considering isolated fallopian tube torsion in the differential diagnosis of acute abdominal pain and highlights the need for prompt surgical intervention to prevent severe complications. The rarity of isolated tubal torsion, normal Doppler findings despite significant torsion, and the surgical management decisions impacting fertility make this case an informative addition to current literature.

Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score. A cross-sectional study for female patients who had a routine clinic visits was included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥19 or scored ≥5 on any item or ≥4 on three items were considered to have FSD. A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master's degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929). FSD was highly prevalent in our study population. Those with type 1 diabetes had the highest ASEX scores. We showed non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.

Objectives. This study aimed to analyze the root canal morphology of first and second permanent mandibular molars among Makkah population by using cone-beam computed tomography (CBCT). Materials and Methods. CBCT images of two hundred eight patients were obtained from the Faculty of Dentistry, Umm Al-Qura University, Makkah, Saudi Arabia. In all images, mandibular first and second molars were evaluated for the number of roots and their morphology, number of root canals, canal configuration in each root according to Vertucci’s classification, and the presence of a C-shaped canal. Results. Most of the mandibular first molars had two roots (96.5%) and three root canals (77.7%). Type IV canal configuration prevailed (75.6%) in the mesial roots, and type I canal configuration prevailed (71.7%) in the distal roots. For the mandibular second molars, the majority had two roots (96.3%) and three root canals (82.7%). Type IV canal configuration prevailed (48%) in the mesial roots and type I (99.1%) in the distal roots. C-shaped canals were detected in 5.7% of the mandibular first molars and 4% of the mandibular second molars. There was no statistical difference between the mandibular first and second molars (P>0.05) in the shape of the roots and the presence of the C-shaped canals. Conclusion. Most of the mandibular molars in Makkah population presented with two roots and three root canals. The incidence of three-rooted mandibular molars was low, and it was higher in the first molars than second molars. The type IV root canal system prevailed in mesial roots and type I in distal roots.

Neopterin (NPN), a pteridine derivative produced by activated monocytes and macrophages in response to interferon-γ, is a recognized biomarker of cellular immune activation, with elevated plasma levels reported in infections, autoimmune diseases, cardiovascular disorders, and cancers. There is an increasing attention given to its role in oxidative stress and vascular dysfunction in hypertension. In this work, a fluorescence-based method was developed and validated for the determination of NPN in plasma using derivatization with 4-fluoro-7-nitro-2,1,3-benzoxadiazole (NBD-F). The reaction produced a stable fluorescent conjugate with a quantum yield of 0.61 compared to 0.21 for native NPN, resulting in enhanced signal intensity and improved selectivity. The method showed linearity over the concentration range of 1–20 ng/mL with a correlation coefficient of 0.9997. The limits of detection and quantification were 0.15 ng/mL and 0.45 ng/mL, respectively, with a mean recovery of 98.54%. Intra-day and inter-day relative standard deviations were below 2.5%, and interference from structurally related compounds was negligible (< 4%). The validated method was applied in a clinical case–control study of 52 participants (26 hypertensive patients and 26 normotensive controls), revealing significantly higher plasma NPN levels in hypertensive patients (3.0 ± 0.7 ng/mL) compared to controls (1.8 ± 0.4 ng/mL, p  = 0.0002), with positive correlations to systolic ( r  = 0.48, p  = 0.009) and diastolic blood pressure ( r  = 0.42, p  = 0.025). These findings demonstrate that the developed method provides a sensitive and reliable approach for plasma NPN quantification and support its potential as a biomarker of hypertension diseases.

Cutaneous lupus erythematosus (CLE) is an autoimmune skin disorder increasingly recognized to have systemic effects, including possible links to atherosclerotic cardiovascular disease (ASCVD). However, the strength and pattern of this association remain uncertain. To evaluate and assess available evidence on ASCVD risk in CLE, identify patterns across study designs and populations, and highlight research gaps requiring further study. A systematic search of PubMed, Scopus, and Web of Science was conducted up to July 2025, following PRISMA 2020 guidelines (PROSPERO ID: CRD420251156382). Eligible studies included adult CLE populations reporting ASCVD outcomes. Data extraction and risk-of-bias assessment were independently performed using the Newcastle-Ottawa Scale and the AXIS tool. Six observational studies met the inclusion criteria, including population-based cohorts, hospital datasets, and case-control analyses. Across designs, CLE was consistently associated with elevated ASCVD risk, particularly stroke and thromboembolic events. Large registry-based studies showed significant associations even after adjustment for traditional risk factors, suggesting CLE-specific inflammatory mechanisms. Smaller cohorts highlighted high comorbidity burdens and subtype differences, particularly a stronger signal in discoid lupus. Evidence indicates that CLE is linked to increased ASCVD risk, especially cerebrovascular and thromboembolic outcomes. Standardized definitions and longitudinal studies are needed to clarify subtype-specific risks and inform prevention strategies.

In the first few months of the pandemic, Makkah region reported the highest number of COVID-19 cases among all regions in Saudi Arabia. More than 80% of these reported cases were non-Saudi residents. In this study, we evaluated the perceived threat from and psychological impact of COVID-19 among non-Saudi residents of Makkah region. This was a cross-sectional analysis of data collected using a standardized self-report questionnaire. A total of 292 expatriates were included in the study, the majority of whom were non-Arabic speakers. The prevalence of self-reported depression was nearly 40%, anxiety was 32%, and stress was 43%. The findings indicated variability in the prevalence of psychological symptoms among expatriates from different ethnic backgrounds. Additionally, work environment and perceived threat were strong predictors of psychological disorders. This suggested that the perceived threat from and psychological burden of COVID-19 among non-Saudis in Makkah region is substantial. Future research should investigate the reasons behind these variations in the psychological impact of the pandemic among different ethnic groups.

Background Developing teaching skills is essential for medical students, as it enhances communication, reinforces clinical knowledge, and prepares them to educate peers and patients effectively. Engaging in teaching activities has also been linked to a deeper understanding of core medical concepts. This study aims to explore the perceptions of medical interns and senior medical students toward clinical teaching and medical education. Methods This descriptive cross-sectional study was conducted between 2023 and 2024 at a health sciences university in Saudi Arabia using an online survey. The survey consisted of 17 structured questions addressing various domains, including demographic characteristics, self-assessed confidence in teaching abilities, prior teaching experiences, and future career aspirations. The survey also explored participants’ views on the inclusion of medical education electives as a potential option in the curriculum. Results A total of 227 responses were collected. Over half (64.3%) had no prior teaching experience. Most of the participants (n=173, 76.2%) plan to work in an academic hospital. While 75.8% expressed interest in pursuing clinical teaching after residency, only 39.2% were interested in a medical education elective. The majority chose the ideal duration for a medical education elective being one month course (n=80, 35.2%). A significant association was found between interest in a medical education elective and plans to pursue clinical teaching (p < 0.001). Interest in medical education was also associated with higher confidence in bedside teaching (p = 0.012) and presenting at a journal club (p = 0.019). Similarly, participants interested in clinical teaching reported significantly higher confidence in these and other teaching-related areas. No significant associations were observed with gender or academic level. Conclusion This study highlights a gap between students' long-term interest in clinical teaching and their engagement with formal training opportunities during medical school. Strengthening the integration and appeal of teaching-focused activities, particularly in key areas such as bedside teaching, may enhance students’ preparedness for future educational roles in clinical settings.

Background Diabetes mellitus is one of the causes to use complementary and alternative medicine (CAM), which can be classified into nutritional, psychological and physical. The study's objective was to estimate the prevalence and pattern of using CAM among patients with diabetes mellitus who followed the endocrine and diabetes center in Taif. Materials and methods A cross-sectional study was carried out in Taif city from 1 June to 31 July 2023 among diabetic patients aged 14 years and above who followed the endocrine and diabetes center. A valid, reliable, English questionnaire was used in data collection. It was composed of three parts: demographic data, diabetes mellitus history and use of CAM. Patients visited the diabetic center during the study period for their regular appointments were selected randomly and interviewed by trained interns and medical students. By using the Raosoft calculator, the minimal sample size was 361. The chi-square test and independent two-sample t-test were used to investigate the association between categorical variables and continuous numerical variables, respectively. Multivariate logistic regression analysis was performed to control the confounding effect. Results A total of 361 patients were included. Their age ranged between 14 and 84 (51.2 ± 16.9 years). Females represented 57.6% of them. Overall, more than a quarter (28.3%) reported using CAM, while 22.4% used CAM for treating diabetes in the last 12 months. The majority of patients (97.1%) used herbs, mainly cinnamon (48.5%), fenugreek/helba (31.3%) and rosemary (20.2%). Their main source of information was family and friends (64.7%). A history of improvement of blood sugar reading with CAM was reported by 61.8%. Multivariate logistic regression analysis revealed that females were at doubled likelihood to use CAM compared to males (Adjusted odds ratio \"AOR\" = 2.40; 95% confidence interval \"CI\": 1.27-4.52, p=0.007). Compared to never-smokers, ex-smokers were more likely to use CAM (AOR=2.87; 95% CI: 1.28-6.43, p=0.010). Conclusion The use of CAM, particularly herbs, to treat diabetes is a relatively common practice among Saudi patients. However, the history of informing treating physicians about CAM was reported by a minority of patients.

The aim of this study is to comprehensively investigate the recent literature on the management of leg length discrepancy (LLD). A thorough search of pertinent databases was done in order to find studies that satisfied the requirements for inclusion. A thorough search of PubMed, Web of Science, Scopus, and Science Direct was conducted to find pertinent literature. Rayyan Qatar Computing Research Institute (QRCI, Ar Rayyan, Qatar) was utilized during the whole operation. Eight studies, including a total of 345 patients, were included in our data, and 206 (59.7%) of them were males. Percutaneous epiphysiodesis was the surgical intervention of choice in four studies. LLD can be effectively corrected by temporary and permanent epiphysiodesis. One study reported the incidence of angular deformities following temporary epiphysiodesis. Circumferential periosteal and dual tension-band plating significantly reduced LLD, but reported the incidence of an \"over-shoot\" in some patients. Bilateral motion control shoes and orthotic insole both were found to improve the patient's gait and trunk symmetry, evidenced by longer and faster steps, reduced ground impact at heel strike, and lower peak plantar pressure in both limbs. Our findings confirm that no inferences about the superiority of a particular management approach for the treatment of LLD can be made. The poor quality of the studies shows that more randomized control trials and prospective studies on the subject are required.

Various surgical approaches for inguinal hernia repair have been outlined in medical literature. In most cases, these lesions are repaired by general surgeons. A variety of surgical techniques for the treatment of inguinal hernias have been documented in the medical literature. In 2018, the European Hernia Society (EHS) recommended laparo-endoscopic repair as a preferred approach for adults. This method involves a combination of laparoscopic and endoscopic techniques for hernia repair. The goal of this systematic review is to conduct a thorough examination of the total extraperitoneal vs. transabdominal preperitoneal comparison in inguinal hernia repair, with an emphasis on randomized controlled trials (RCTs). It also intends to conduct a trial sequential analysis (TSA) in order to determine whether more trials and investigations are required or whether there is sufficient evidence to draw a firm conclusion. The study's systematic review and meta-analysis were carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We used the PubMed and Google Scholar databases to conduct a thorough web search for articles published between January 2019 and December 2023. The meta-analysis was carried out using Resource Manager Revman version 5.4.1 (Revman International, Inc., New York City, New York). After a review of the studies was done, ten studies were selected to be used in conducting the systematic review and meta-analysis. The recurrence rate of TEP treatment was found to be slightly lower than transabdominal preperitoneal (TAPP). The two techniques did not differ in terms of postoperative complications; however, TEP had a marginally lower rate of postoperative pain. Further, the study revealed that there was a decreased risk of wound infections, seromas, and hematomas with total extraperitoneal (TEP) as opposed to transabdominal preperitoneal (TAPP). TEP also reduced the amount of recovery time needed. After conducting successful hernia treatments, total extraperitoneal and transabdominal preperitoneal both had low rates of complications and recurrence. Based on the information obtained from the study analysis, this meta-analysis provides evidence for the efficacy of TAPP and TEP techniques in the management of inguinal hernias. Though there was a statistically significant difference while applying both methods in the treatment of hernia (p=0.001), TEPs have been shown to have a lower recurrence rate than TAPPs. Similarly, the TEP method has been revealed to have a slight reduction in postoperative pain compared to transabdominal preperitoneal. However, the two techniques have been shown to have no significant difference in postoperative complications. Further, laparoscopic procedures have proved to be a little bit safer and more effective than open procedures. This has been shown by reduced risk of wound infection, hematoma, seroma, and decreased sensibility while using this method. It accelerated the healing process as well. Thus, depending on the needs of the patients and the experience level of the surgeons responsible for the treatments, inguinal hernias can be repaired using either transabdominal preperitoneal or total extraperitoneal techniques since both treatment techniques have generally minimal chance of complications or recurrence as both have proved to safer method.