The International Neurourology Journal (Int Neurourol J, INJ) is a quarterly (last day of March, June, September, and December) international journal that publishes high-quality research papers that provide the most significant and promising achievements in the fields of clinical neurourology and fundamental science. Specifically, fundamental science includes the most influential research papers from all fields of science and technology, revolutionizing what physicians and researchers practicing the art of neurourology worldwide know. Thus, we welcome valuable basic research articles to introduce cutting-edge translational research of fundamental sciences to clinical neurourology. In the editorials, urologists will present their perspectives on these articles. The original mission statement of the INJ was published on October 12, 1997. INJ provides authors a fast review of their work and makes a decision in an average of three to four weeks of receiving submissions. If accepted, articles are posted online in fully citable form. Supplementary issues will be published on an interim basis as quarterly issues as necessary, to provide ample space to accept and publish relevant articles. Abstracted/Indexed In Scopus, PubMed, PubMed Central, KoreaMed, KoMCI, WPRIM, WorldWideScience.org, EBSCO, Google Scholar. Subscription Information The Korean Continence Society will send INJ to certain relevant individuals and institutions free of charge. There are 50 copies in circulation. Full text is complimentary and available at http://einj.net/. To order a subscription to INJ, please contact our editorial office.
Excessive Workload and Its Psychological Effects on Healthcare Workers in Saudi Hospitals
Healthcare workers in Saudi Arabia face an increasingly demanding work environment characterized by rapid population growth, a rising burden of chronic disease, and ambitious national health transformation goals aligned with Vision 2030. This paper examines the relationship between excessive workload and adverse psychological outcomes — including burnout, occupational stress, anxiety, depression, and compassion fatigue — among physicians, nurses, and allied health professionals employed in Saudi hospitals. Drawing on a systematic review of peer-reviewed literature published between 2010 and 2024, including studies conducted within the Kingdom of Saudi Arabia (KSA) as well as comparative international evidence, this paper identifies key occupational stressors, assesses their psychological consequences, and evaluates existing institutional responses. The review finds that prolonged shifts, staff shortages, administrative burdens, and inadequate managerial support are the primary drivers of psychological distress. Burnout prevalence among Saudi nurses ranges from 42% to 67%, while physicians report high levels of emotional exhaustion and depersonalization. The paper concludes with evidence-based recommendations for healthcare administrators, policymakers, and the Saudi Commission for Health Specialties (SCFHS) to foster psychologically safe working environments.
Workload, Burnout, Occupational Stress, Healthcare Workers, Saudi Arabia, Psychological Well-Being, Nurse Burnout, Physician Burnout, Vision 2030
Ali Mohammed Baoud, Mohsen Yahay Yahay Muyini, Majed Ahmed Alzahrani, Mohamed Kidr Atia Abuamir, Saud Abdulaziz Abaoud, Khalid Ali Alalyani, Waleed Hassan G. Alanazi, Fawaz Helal Rashed Alanazi, Abdullah Sameer Alanazi, Ibrahim Ali Zied Alothman, Nuwayyir
AI-Enabled Microbiome Strategies for Sustainable Agriculture and Global Food Security: An Overview
Agricultural sustainability is intricately tied to the structure and function of soil and plant-associated microbiomes, which mediate nutrient cycling, plant health, stress resilience, and ecosystem services. Engineering these microbiomes holds great promise for enhancing crop productivity while reducing ecological footprints. Traditional microbiome studies and management practices, however, face significant challenges due to complexity, multi-dimensional data, and environmental variability. Recent advancements in artificial intelligence (AI) particularly machine learning (ML), deep learning (DL), and intelligent data integration approaches offer unprecedented capabilities to decode, predict, and design microbiome-based strategies that support sustainable agriculture. This narrative review describes and delineates on current practice on how AI can enable sustainable microbiome engineering for agriculture, highlights emerging AI-driven tools, and deliberates future prospects and challenges.
Artificial intelligence, Machine learning, Deep learning, Microbiome, Agriculture
Clinical and neurological mechanisms of pain development of various genesis of the maxillofacial region
Pain of the maxillofacial region represents a highly complex clinical entity arising from diverse etiologies, including odontogenic, musculoskeletal, neuropathic, vascular, inflammatory, and idiopathic origins. Owing to the dense sensory innervation of the craniofacial structures by the trigeminal nerve and its extensive central projections, orofacial pain exhibits unique neurobiological and clinical characteristics distinct from pain in other body regions. The present review critically synthesizes current evidence on the clinical and neurological mechanisms underlying pain development of various genesis in the maxillofacial region, with emphasis on peripheral nociceptive activation, trigeminal pathway modulation, central sensitization, and neuroimmune interactions. Peripheral sensitization begins with activation of Aδ and C fiber nociceptors in response to inflammatory mediators such as prostaglandins, bradykinin, cytokines, and neuropeptides. Ion channel modulation—including TRPV1, TRPA1, and voltage-gated sodium channel upregulation—lowers activation thresholds and promotes hyperexcitability. Persistent peripheral input induces functional and structural plasticity within the trigeminal ganglion and the spinal trigeminal nucleus (Vc), facilitating central sensitization characterized by enhanced glutamatergic transmission, NMDA receptor activation, and reduced inhibitory control. These processes contribute to clinical manifestations such as hyperalgesia, allodynia, and chronic persistent pain. Neuropathic conditions such as trigeminal neuralgia, post-traumatic trigeminal neuropathy, and post-herpetic neuralgia arise from direct nerve injury or demyelination, resulting in ectopic discharges and aberrant synaptic transmission. In contrast, temporomandibular disorders and myofascial pain syndromes reflect a multifactorial interplay between peripheral tissue dysfunction and centrally mediated pain amplification. Increasing evidence highlights the role of glial activation, cytokine release, and neuroimmune signaling in maintaining chronic pain states within trigeminal pathways. Advances in neuroimaging, quantitative sensory testing, and electrophysiological assessment have enhanced diagnostic precision by differentiating nociceptive from neuropathic mechanisms. Understanding the integration of peripheral pathology with central neuroplastic adaptation is essential for developing mechanism-based therapeutic strategies. Multimodal approaches targeting inflammatory pathways, ion channel modulation, and central sensitization mechanisms hold promise for improving clinical outcomes. This review underscores the importance of a translational framework that bridges molecular neuroscience with clinical practice to optimize diagnosis, management, and prevention of chronic maxillofacial pain disorders.
Maxillofacial pain; Trigeminal neuralgia; Orofacial neuropathic pain; Neuroinflammation; Peripheral sensitization; Central sensitization; Trigeminal nerve pathways; Nociceptive mechanisms; Temporomandibular disorders (TMD); Pain matrix; Neuroplasticity; Cytokine-mediated pain; Brainstem nuclei; Chronic pain mechanisms; Orofacial pathology.
Kamalova Feruza, Xamdamova Lola, Mengliyeva Dildora, Mamedova Nigina, Raxmatova Dilnora, Eshonkulov G'olibjon
Clinical, Neurological, Neurophysiological, and Immunogenetic Mechanisms of Trigeminal Neuralgia Development and Treatment Optimization
Background: Trigeminal neuralgia (TN) is a severe neuropathic facial pain disorder traditionally attributed to neurovascular compression. However, contemporary evidence demonstrates a multifactorial pathogenesis involving focal demyelination, sodium channel dysregulation, central sensitization, and immunogenetic susceptibility. Objective: To integrate clinical, neuroanatomical, neurophysiological, and immunogenetic mechanisms underlying TN and propose a precision-based treatment optimization model. Methods: A structured narrative synthesis was conducted using PubMed, Scopus, and Web of Science (2015–2024). Studies focusing on imaging biomarkers, electrophysiology, cytokine profiling, sodium channel genetics, and surgical outcomes were analyzed. Results: TN development involves: (1) focal demyelination at the trigeminal root entry zone, (2) ephaptic cross-excitation, (3) Nav1.7/Nav1.8 upregulation, (4) microglial activation and cytokine elevation (TNF-α, IL-6), and (5) thalamocortical sensitization. Microvascular decompression shows 5-year pain freedom rates of ~70–80%, whereas pharmacologic tolerance limits long-term medical therapy efficacy. Conclusion: TN is a neurovascular–neuroimmune disorder. Multimodal stratification integrating imaging, electrophysiology, and immunogenetics can significantly enhance individualized treatment strategies in neurology practice.
Khodjieva Dilbar, Juraeva Dilsora, Kamalova Feruza, Sharipov Aliyor, Kayumova Nafisakhon, Urinova Gulnoza
Clinical, Prognostic and Biochemical Markers of Early Signs of Parkinson’s Disease and Methods of Their Correction
Parkinson’s disease (PD) is a progressive neurodegenerative disorder characterized by motor and non-motor symptoms that often begin years before clinical diagnosis. Early identification of reliable clinical, prognostic, and biochemical markers is essential for timely intervention and improved patient outcomes. This paper reviews and analyzes contemporary evidence regarding early-stage PD markers, their prognostic significance, and corrective therapeutic approaches. Emphasis is placed on clinical manifestations, neurochemical alterations, inflammatory pathways, and neuroprotective strategies, with special relevance to Central Asian populations. The integration of multimodal biomarkers and personalized medicine approaches is discussed as a future direction for early PD management.
Tukhtayev Ilkhom, Eronov Yoqub, Bafoeva Zarina, Davronova Hilola, Rakhmatova Dilbar, Abdurasulov Sardor
Subcutaneous entomophthoromycosis mimicking neurogenic tumor: An unusual presentation
Conidiobolomycosis , a entomophthoromycosis is a neglected tropical fungal infection.The subcutaneous form of this infection can occur seldom.It can often be missed clinically owing to the rare presentation.we report a case of Conidiobolus coronatus isolated from the subcutaneous tissue from left forearm from a 60 year old male with history of swelling in left forearm for 2 month duration initially diagnosed as probable neurogenic tumor radiologically but later confirmed as conidiobolus coronatus based on microbiological and histopathological findings. Hence the possibilty of this often neglected fungi should be recognised in the differential diagnosis early diagnosis and prompt management.
Saranya M, Abirami Lakshmy Jayachandran, Dhanapaul S, Balan K, Visuvasam J, Shakila Gani .SS
The impact of Artificial Intelligence on Urology
This article comprehensively discusses the basic applications, clinical impact, and future development trends of artificial intelligence (AI) technology in the field of urology. Studies have shown that AI is profoundly changing the traditional practice model of urology by empowering the entire process of disease diagnosis, surgical planning, treatment execution, and patient management. In terms of diagnosis, AI algorithms have demonstrated accuracy and efficiency that surpass human experts in medical image analysis, pathology identification, and clinical decision support systems; in the field of treatment, robot-assisted surgery and AI-guided non-invasive treatment are redefining the precision boundaries of urological surgery; in terms of patient management, AI-driven remote monitoring and personalized rehabilitation programs have significantly improved medical resources and patient prognosis. This article also analyzes the challenges and limitations of AI applications, including data privacy, algorithm transparency, and ethical issues, and proposes suggestions for future development directions. Studies have shown that the deep integration of AI technology and urology will drive the discipline's transformation towards intelligence, precision, and minimally invasiveness, ultimately achieving a comprehensive improvement in the value of diagnosis and treatment.
Artificial Intelligence; Urology; Surgical Robot; Precision Medicine; Intelligent Diagnosis; Medical Innovation
Empowering Nurses in Clinical Decision-Making: Strategies and Barriers
Empowering nurses in clinical decision-making is essential to improving patient care, professional autonomy, and overall healthcare performance. This paper explores the concept of empowerment within nursing practice, focusing on the factors that enable or hinder nurses in making effective clinical decisions. The discussion highlights leadership support, education, communication, and interprofessional collaboration as key enablers, while workload, hierarchical structures, and limited authority emerge as barriers. Promoting empowerment requires a supportive culture, continuous learning, and shared governance that recognizes the nurse’s role in clinical judgment and evidence-based care.
Nursing empowerment – Clinical decision-making – Leadership – Barriers – Professional autonomy – Communication – Collaboration
Anwar Khalaf Alsuhaiman, Thuhaybah Ali Saadi Alshammari, Nawadir Juraythi Mohammed Alshammari, Atheer Khalaf Farhan Alsuhaiman, ‏Thahbah Ali Alshammari
Home-Based Rehabilitation for Elderly Patients with Limited Mobility: Integration of Nursing, Physiotherapy, and Family Medicine
Home-based rehabilitation has become an essential approach in maintaining independence, functionality, and dignity among elderly patients with limited mobility. This paper explores the integrated role of nurses, physiotherapists, and family physicians in providing coordinated home-based rehabilitation. Each discipline contributes distinct expertise—family physicians oversee medical management and continuity of care, physiotherapists design and supervise movement and exercise programs, and nurses monitor daily health needs and provide education to patients and families. The collaboration among these professionals creates a holistic environment that supports recovery, safety, and patient engagement in self-care.
Elderly care – Home rehabilitation – Interprofessional collaboration – Nursing – Physiotherapy – Family medicine – Mobility support
Maryam Ali Abdu Almaqadi, Maisa Sameer I. Alkabli, Raghad Ahmed Salman Alharbi, Fatimah Mohammed Y. Hisan, ‏Sharifah Judaya Ali Alruwaili, ‏Bashayer Fayez Duhayman Alruwaili
The Role of Nursing in Early Detection of Breast Cancer
Breast cancer remains the most prevalent cancer among women worldwide and continues to be a major public health challenge. Early detection plays a pivotal role in improving survival rates and reducing mortality. Nurses, as frontline healthcare professionals, are uniquely positioned to promote awareness, provide screening, and ensure continuity of care. This paper explores the multifaceted role of nursing in early detection of breast cancer, highlighting educational, clinical, psychological, and follow-up responsibilities.
Nursing, Breast Cancer, Early Detection, Screening, Patient Education, Clinical Breast Examination, Mammography.
Amnah Faraj Fadel Alrwaili, Taghreed Hamed Helal Alhazmi, Makniyyah Zayed Zuwayyid Alotaibi, Sanad Dhiyab Aqeel Alrwaili, Awatif Marzook Aqeel Alrwaili, Rabiah Suwayyid Juhayyim Alrawaili
The Contribution of Nurses in Chronic Disease Management: A Focus on Hypertension and Diabetes
Chronic diseases such as hypertension and diabetes represent a major global health burden due to their high prevalence, associated complications, and long-term management requirements. Nurses, as frontline healthcare providers, play a pivotal role in prevention, patient education, monitoring, and ongoing disease management. This paper explores the contribution of nurses in managing hypertension and diabetes by reviewing evidence from international and regional studies. Findings highlight the effectiveness of nurse-led educational interventions, continuous monitoring, psychosocial support, and community-based programs in improving patient adherence, reducing complications, and enhancing quality of life. The review emphasizes the need to further empower nurses through evidence-based practice and continuous professional development to optimize outcomes in chronic disease care.
Nursing – Chronic Disease – Hypertension – Diabetes – Patient Education – Self-Management – Nursing Interventions – Quality of Life
Nawarh Elnashmi K. Alruwili, Khatmah Madallah Alhazmy, Fasel Battah Alruwaili, Hadiel Hamad Halal Alhazmei, Amani Awad Alhazmi, Saleema Ayiash Rasheed Alsolobi6
The Importance of Raising Awareness among All Healthcare Workers About the Importance of Public Health and its Relationship to Combating Infection and Epidemic Diseases.
Introduction: Occupational health education serves as a cornerstone in the multifaceted approach to infection control within healthcare settings. The well-being of health personnel is paramount, not only for their own protection but also for the safety of patients under their care and the community at large. In recent years, the emphasis on educating health workers about infection control measures has gained traction, driven by the recognition that informed professionals are better equipped to implement, adhere to, and advocate for effective safety protocols. This introductory section aims to underscore the critical link between occupational health education and infection control, along with the benefits accrued from comprehensive training programs. Infection control in healthcare settings presents complex challenges, as healthcare professionals routinely encounter a wide range of infectious agents. As such, a structured and dynamic educational framework is indispensable, empowering personnel to identify risks, understand transmission mechanisms, and deploy appropriate preventive measures. By enhancing awareness and understanding, education facilitates the adoption of best practices that mitigate the spread of infections, ranging from basic hand hygiene to the proper use of personal protective equipment and timely vaccinations. Moreover, continual learning and updated training regimens accommodate evolving pathogens and emerging public health threats, ensuring that healthcare workers remain at the forefront of infection prevention strategies. Methods: The study evaluated the role of occupational health education in infection control among health personnel using a mixed-methods approach that integrated qualitative and quantitative research. It explored educational interventions and their effectiveness in infection prevention. Quantitative data were collected through structured questionnaires from a sample of healthcare professionals, assessing knowledge, attitudes, and adherence to infection control protocols. Statistical analyses identified patterns and gaps to ensure valid findings. Qualitative data were obtained via semi-structured interviews and focus groups, providing insights into perceptions of occupational health education programs. Key themes included resource accessibility, barriers to implementing measures, and organizational support's role in fostering a safety culture. Thematic analysis identified dynamics beyond quantitative methods. The combined data offered a holistic view of the relationship between occupational health education and infection control practices, leading to evidence-based recommendations for healthcare improvements. Conclusion: In reflecting upon the extensive exploration of occupational health education and its critical role in infection control among health personnel, it is imperative to recognize the symbiotic relationship between education and practical application in fostering a safer healthcare environment. The study clearly delineates the impactful influence that comprehensive occupational health education programs wield in empowering healthcare workers with the requisite knowledge to assess and mitigate infection risks effectively. Through targeted educational initiatives, health personnel are equipped not only with technical skills but also with a deeper understanding of the principles underpinning infection control protocols, ultimately translating into more robust and responsive practices. Furthermore, the transformation induced by occupational health education extends beyond individual competency enhancement; it enriches the collective capability of healthcare teams to cohesively address and preempt infection outbreaks. Structured educational frameworks facilitate the development of critical thinking and adaptive capacities among health personnel, enabling them to promptly adjust to evolving healthcare landscapes and challenges. This adaptability is crucial in navigating the intricate balance between advancing healthcare technologies and maintaining rigorous infection control standards. As the schism between emerging infectious threats and existing control measures widens, it is the continuous evolution and refinement of educational paradigms that provide a bulwark against deterioration of health outcomes. In summarizing the findings, it is evident that occupational health education is indispensable in cultivating a culture of safety and vigilance among healthcare workers. By instilling a thorough understanding of infection control measures, education becomes a cornerstone in the endeavor to not only protect health personnel but to bolster patient care quality and institutional resilience. As healthcare systems strive to achieve optimal functionality, it is the unrelenting commitment to education-centered strategies that will ensure preparedness in the face of diverse infectious challenges, thereby reinforcing the indispensable role of occupational health education as a pillar of infection control.
Yahya Alhasan Ibrahim Abu Mansour, Saleem Mulfi Alharbi, Khalid Ali Saeed Alalyani, Mohsen Saud Alnafisa, Saud Yahya Yahya Muyini, Nuwayyir Hamdan Mohammed Albalawi, Abdullah Jarbou S. Al-Anzi, Seada Hassan Saleh Alsaiari
Evaluation of Hand Hygiene Compliance among Healthcare Workers: Strategies for Improvement
Introduction : Despite its known importance, hand hygiene (HH) compliance among health care workers (HCWs) is widely variable and often below 50%. By means of a 4-step step-by-step approach to implementation and monitoring of HH compliance, a total of 519 HH opportunities were assessed at baseline. Strategies are offered such as staff reinforced training followed by feedback. By use of a cohort stepped-wedge study design, the strategies were implemented in various hospital departments escalating from the medical ward, supported by a structure change on how the handrub was provided, and advanced to the operating theatre, the intensive care unit, and a cutaneous leishmaniasis treatment center. The actual implementation of strategies, daily refill and provision of handrub as well as feedback provision was supervised. Thereafter, a first follow-up assessment was performed 2 months after the full implementation of the intervention in all participating departments. A second follow-up with the same method was then performed after a total of 6 months since the intervention was fully set up in the last department, including as well a qualitative study part of selected interviews among HCWs in the last participating department. A structured observational checklist was used to record HH opportunities and indications following the WHO “my five moments for hand hygiene” model. An exclusive surveillance of compliance was implemented at baseline, first, and second follow-up assessments Methods : A prospective study evaluated hand hygiene compliance among healthcare workers (HCW) in a 19-bed medical ICU and identified factors influencing this compliance. HCWs were observed before and after a multimodal intervention, and self-report questionnaires were distributed to capture factors that discourage adherence to hand hygiene. A multifaceted strategy designed to increase adherence to hospital policy and create monitoring apparatuses for unit-based quality control. Data were collected over six months, totaling about 700 hours of observation with 854 hand washing opportunities noted, 215 of which were essential for accurate compliance assessment. Ranging from 40 to 50 healthcare workers (HCWs) were utilized per shift within the ICUs, which were staffed by trained physicians and nurses who helped care for six to eight patients. Every week we observed. Conclusion: The intervention drove HH compliance considerably. HH of HCW is a key measure to prevent healthcare-associated infections. Hand hygiene (HH) implement -- or perhaps even forego -- by doctors and other healthcare workers (HCW) is one of the principal preventative measures for healthcare-associated infections, foremost among which, perhaps, are those associated with invasive procedures. In low- and middle-income countries, household compliance is low. We use a mixed methods approach to assess what change the Pan African Sanitation (PASQUALE) program has made. PASQUALE is a complex multimodal HH intervention developed by the Institute of Tropical Medicine, Antwerp. PASQUALE was implemented in a hospital in Faranah, Guinea. PASQUALE implementation was evaluated in a time series with a baseline/basic follow-up design, using a before-after analysis. The process evaluation was conducted by the identification of facilitators and barriers to HH improvement, using a theory-based qualitative methodology comprised of focus group discussions and in-depth interviews. HH compliance was assessed by direct observation. After the intervention, healthcare workers (HCWs) were significantly more likely to wash their hands. Since SickKids initially launched its hand hygiene program, overall hand hygiene compliance has significantly improved. Hand hygiene compliance among health care workers in the ICU is poor; however, intervention strategies can be useful in improving the compliance rates significantly. Six years after the introduction of the WHO hand hygiene strategy compliance was still very limited, however significantly improved after a multimodal awareness improvement strategy was introduced. The likelihood of HH at 8 selected wards in Faranah was measured initially and again after 6 and 12 months. In 63 HH opportunities were caught at each point of measurement and 209 of these were again 6 and 12 months later examined. HH compliance was 19.9% at baseline. Compliance improved to 25% in the first follow-up. After the second follow-up compliance was 45.1% .
Faisal Maush N. Alanazi, Ahmed Maush N. Alanazi, Abdulrahman Tahan Alanazi, Saad Nahar Alruways, Faisal Muthhil Alotaibi, Alwaleed Abdullah Albawardi, Abdullah Jarbou S. Al-Anzi
Integration between Nursing and Dentistry in Home Care for Elderly Patients: Enhancing Oral Health and Quality of Life
Oral health is a critical component of overall well-being, particularly in elderly patients who often suffer from chronic diseases, functional limitations, and barriers to accessing dental clinics. This paper explores the integration between nursing and dentistry in home care settings for elderly patients. It highlights the role of nurses as frontline caregivers in oral health assessment, early detection of oral conditions, and collaboration with dental professionals to ensure comprehensive care. Through literature review and proposed models of interprofessional collaboration, the study emphasizes that a nursing–dentistry partnership can significantly reduce oral complications, prevent systemic infections, and improve the quality of life for elderly patients.
Nursing; Dentistry; Oral Health; Elderly Patients; Home Care; Interprofessional Collaboration; Geriatric Care; Quality of Life; Oral Hygiene; Preventive Care; Nurse-led Oral Care; Dental-Nursing Integration; Tele-dentistry; Chronic Diseases; Patient-Centered Care.
Mohammed Saud A., Huda Mulfi Mofareh, Noha Swaid AlRwili, Miad Majed Fallaj, Nimeh Mohammed H. Al-Somali, Maha Saud Yahya AlShammari
Nursing Role in the Management of Hypertensive Patients
Hypertension is one of the most prevalent chronic conditions worldwide and a major risk factor for cardiovascular morbidity and mortality. Nurses play a pivotal role in the management of hypertensive patients, particularly in early detection, health education, lifestyle modification, and continuous monitoring. This paper aims to explore the role of nurses in managing hypertension through preventive strategies, patient-centered interventions, and collaborative care models. The findings highlight that nurse-led programs significantly improve patient adherence, reduce complications, and enhance overall quality of care.
Nursing role, Hypertension management, Early detection, Prevention strategies, Nurse-led interventions, Patient education, Lifestyle modification, Adherence to treatment, Community nursing
Amal Marzook H. Alrasheedi, Asma Saleh Faleh Alahmadi, Dana Murdhi Odhayb Alruwaily, Rahaf Hassan Huthaylan Alruwaili, Sharifah Hamoud Aqeel Alanazi, Nujud Rahil M. Alanazi
Enhancing Patient Safety Through Standardized and Integrated Clinical Documentation
Effective and standardized clinical documentation is a critical component in ensuring patient safety, improving communication among healthcare providers, and enhancing the overall quality of care. This paper explores the impact of integrated documentation practices across all medical disciplines and departments within healthcare settings. By unifying documentation standards, minimizing gaps in information, and fostering interprofessional collaboration, healthcare teams can reduce medical errors, enhance continuity of care, and support data-driven decision-making. The study highlights best practices, implementation strategies, and the role of technology—particularly Electronic Health Records (EHRs)—in achieving comprehensive and accurate documentation. The paper also examines challenges and proposes solutions for sustaining compliance and continuous improvement in clinical documentation processes.
Integrated documentation, multidisciplinary care, clinical records, patient safety, healthcare communication, documentation standards, electronic health records, continuity of care
Aminah Faraj Fadhel Alruwaili, Ghada Saad Saud Alaufi, Aminah Talaq Mutlaq AlSulami,Hanaa Mousa Matrouk Althubyani, Hamida Daham Alenezi, Wejdan Ali Maqbul Hakami
Relationship between Headache and Other Neurological Disorders among Adult Females in KSA: A Cross-sectional Study
Background: Headaches are prevalent among adult females, and their association with other neurological disorders is poorly understood, particularly in Saudi Arabia. This study aims to explore the relationship between headaches and other neurological disorders among adult females in the Kingdom of Saudi Arabia (KSA), focusing on sociodemographic, health, and lifestyle factors that may influence headache severity. Methods: A cross-sectional observational study was conducted with 146 adult females aged 18 and above, recruited through stratified random sampling from various healthcare facilities in KSA. Data collection involved structured interviews, questionnaires, and medical records, utilizing the Headache Impact Test (HIT-6) and standardized neurological assessments for diagnosis. Descriptive statistics, chi-squared tests, and logistic regression analyses were performed to explore associations between headaches and other neurological conditions. Results: Among the participants, the mean age was 41.23 ± 14.71 years. A total of 39% (57/146) had additional neurological disorders, such as spinal column conditions, attention deficit, and epilepsy. The study revealed significant associations between headache severity and age (p = 0.024) and employment status (p = 0.009). Participants aged 20-39 years experienced the highest prevalence of moderate and severe headaches. Moreover, those not employed were more likely to report severe headaches. While body mass index (BMI) approached statistical significance (p = 0.070), no significant associations were found with marital status, educational level, income, smoking, or neurological conditions. Conclusion: This study highlights that age and employment status are significant factors influencing headache severity among adult females in KSA. While BMI showed a weak association, further research is needed to clarify its relationship with headache severity. These findings emphasize the importance of considering sociodemographic and lifestyle factors when assessing headache management and neurological disorders in women.
Headache, Neurological Disorders, Adult Females, Saudi Arabia
Mawadah Mohammed Jannah, Anas Awad Alasmari
Psychological Problems and Psychosocial Predictors of Cigarette Smoking Behavior among Students in Jazan
Background: Cigarette smoking among university students is influenced by a complex interplay of psychological, social, and demographic factors. This study aimed to examine the psychological (depression, anxiety, stress) and psychosocial (peer, family, and environmental influences) predictors of smoking behavior among students at Jazan University, Saudi Arabia. Methods: A cross-sectional study was conducted among 425 students at Jazan University using a multistage cluster random sampling technique. Data were collected through a self-administered questionnaire that included socio-demographics, smoking behavior, and the Depression, Anxiety, and Stress Scale (DASS-21). Associations between smoking behavior and psychological/psychosocial factors were analyzed using SPSS, with p-values < 0.05 considered significant. Results: Significant gender differences were found in smoking behavior, with males representing 90.8% of current smokers (p < 0.001). Early smoking initiation, passive smoking exposure, and having family or friends who smoke were significantly associated with higher rates of depression, anxiety, and stress (all p < 0.001). Younger age, being single, and lower income were also strongly linked to moderate to severe psychological distress. Additionally, intention to quit smoking was significantly associated with higher levels of depression, anxiety, and stress (p < 0.001). Conclusion: Smoking behavior among university students in Jazan is closely tied to psychological distress and social environment. Young males exposed to smoking through peers or family and experiencing depression, anxiety, or stress are more likely to engage in smoking. Mental health support should be integrated into smoking prevention and cessation strategies targeting university students.
Smoking behavior, University students, Depression, Anxiety, Stress, Saudi Arabia.
Dr. Basim Amer Jaber, Dr. Anas Elyas Ahmed, Dr. Mohamed Salih Mahfouz
Most common food allergens and their association with other health conditions among children and adults in Saudi Arabia
Background: Limited data are available on the most common food allergens among children and adults in Saudi Arabia. This study aimed to identify the most common food allergens in Saudi Arabia, thedemographic characteristics and associated medical conditions among individuals with food allergies, andthe effect of food allergies on health. Methods: This retrospective cohort study was conducted in a sample of 100 pediatric and adult patients with food allergies (confirmed by a skin-prick test result >3 mm) who attended the outpatient allergy andimmunology clinic at King Fahad Medical City in Riyadh, Saudi Arabia between 2003 and 2022. The burden of food allergy was measured on a scale of 1–10. Results: The mean patient age was 19.8 ± 17.2 years. Of the participants, 51 were female, 48 were male, and 29 had asthma. The most common food allergens were peanuts (16.2%), egg (14.1%), cashew nuts (11.1%), pistachio nuts (9.1%), and sesame seeds (7.1%). The mean burden of food allergy was 6.4 ± 1.9. Conclusion: Food allergies are strongly associated with asthma. Peanuts, eggs, and cashew nuts are the most common causes of food allergy in children and adults attending the outpatient allergy and immunology clinic at King Fahad Medical City.
Food Allergens, Peanuts, Eggs, Nuts, Asthma, Saudi Arabia
Humoud Auoad Alhoraim, Mofreh Alzahrani, Hadeel Alsarawi
Stomach Intusussipision after Gastric Butterfly Surgery: A Case Report
Background: Laparoscopic butterfly gastroplasty is a novel bariatric procedure; however, its long-term complications remain inadequately documented. Gastric intussusception and volvulus following this surgery are rare but potentially life-threatening conditions requiring prompt recognition and management. Case Presentation: A 21-year-old male with a history of laparoscopic butterfly gastroplasty presented with progressive gastric stenosis symptoms, including nausea, vomiting, coffee-ground emesis, and constipation. Initial evaluation revealed gastric dilatation with evidence of mesentero-axial volvulus on imaging. The patient underwent emergency surgical exploration, which revealed axial gastric rotation with intussusception of the distal stomach into the proximal stomach. Adhesiolysis was performed, but due to an unhealthy gastric fundus with impending perforation, a sleeve gastrectomy was initially attempted. Intraoperative challenges necessitated conversion to Roux-en-Y gastric bypass. The patient had an uneventful recovery and was discharged with scheduled follow-ups. At two months, he demonstrated clinical improvement, stable vitals, and weight gain. Conclusion: This case underscores a rare but significant complication of butterfly gastroplasty, necessitating timely diagnosis and surgical intervention. The successful management of gastric intussusception and volvulus highlights the importance of vigilance in postoperative follow-up of bariatric patients. Further studies are needed to evaluate long-term outcomes and refine surgical techniques to minimize such complications.
Gastric intussusception, Butterfly gastroplasty, Gastric volvulus, Bariatric surgery complications, Roux-en-Y gastric bypass.
Ahmed Alghamdi, Ahmed Khalil, Mohammed Goname, Layan Khushaim, Sultan Albarakati,Firas Hasaballah
The Importance of Infection Control for Healthcare Workers
Introduction Healthcare workers (HCWs) face significant infection risks regardless of their specialty or practice setting. From caring for HIV patients in private hospitals to Ebola exposure in isolated areas, many HCWs unintentionally transmit infections to otherwise healthy patients or family members, highlighting the potential for spill-over effects. Preventing such spillover is crucial since healthcare-associated infections (HCAIs) involve patients who acquire infections during their care, posing different challenges for infection control. Multi-drugresistant organisms proliferate due to overcrowding, antibiotic misuse, and inadequate control practices, complicating containment efforts. Effective infection control relies on a broad range of personnel, including environmental health officers, laboratory scientists, nurses, and medical practitioners, rather than exclusively infection control specialists. Compliance with established guidelines for global standards is essential. HCAIs, defined as infections do not present at admission, lead to significant morbidity, mortality, increased hospitalization duration, and treatment costs, affecting both developed and developing countries. The prevalence of HCAIs is reported at 15% in developed nations and can rise to 37% in Intensive Care Saudi Arabia, HCAIs contribute over $4.5 billion in expenditure, mortality rate linked to these infections. In developing countries, infection rates can reach 40%, exacerbated by poor control practices and overcrowded facilities. The misuse of antibiotics further enables multi-drug-resistant organisms to thrive, making HCAIs a critical challenge for healthcare systems globally. Stakeholders call for diverse strategies to address this issue, emphasizing the need to implement and establish effective infection control measures, guided by standard protocols based on the best evidence to ensure uniformity among HCWs worldwide. Methods Infection is a global concern in health facilities. Micro-organisms that cause infection pose enormous dangers to both patients and healthcare workers. Infection control is a vital part of health facility programs that aim to ensure safe practices and lessen the harrowing consequences of health care-associated infections. Worldwide, healthcare-associated infections are the most common complication in health services. They affect hundreds of millions of patients worldwide, especially in developing countries. The risk of spreading diseases is especially high where the contact of a healthcare facility exposes both the patients and healthcare workers to a different array of infectious materials. Infection linked to health care has plagued every community. It is a source of major worry for government, private, religious, and civil welfare organizations. Healthcare-associated infections are broadly classified into two major groups. Due to wrong personnel decisions, increasing population density, lack of qualified personnel, and poor staffing, a huge burden is shifting to government health services. Despite efforts to fully understand the magnitude of the problem, mainly due to the risk of under-reporting and the widespread expectation that the problem would decrease, the burden imposed by healthcare-associated infections has shown no sign of decline. conclusion This focus on infection prevention and control (IPC) is a concerted effort to augment efforts aimed at ensuring quality healthcare and optimizing cost-effectiveness of public health care delivery systems in Nigeria. It has been reported that despite high rates of hospital admission in deck countries, high quality of patient care could not be ensured due to low levels of human resources to engage in safe healthcare practices. Ensuring optimal quality of care in healthcare facilities requires making enable resources (human, equipment, infrastructure) available at every stage of patient care in hospitals. These requirements are even more pressing in Developing Countries (DCs) where disproportionate levels of infectious diseases would normally be expected. Regulatory agencies need to be more vigilant and proactive in enforcing cleanliness in all public facilities. Research findings on the health risks faced by HCWs in Saudi Arabia hospitals should be available and published in well-reputed journals. Infection prevention and control must be core into the curriculum of medical and nursing schools and teaching institutes across the country. Infection control and environmental health officers should be appointed in all secondary and tertiary hospitals in Saudi Arabia. Effective multi-pronged messaging strategies are also needed to further enhance HCWs knowledge and compliance with infection prevention and control.
Essential , Strategies, Emphasizing, Complication, Community
Faisal Maush N. Alanazi, Fahd Jaber K. Al-Anazi, Talal Saeed Al Shehri, Faris Abdullah Saleem Alsobhi, Yahya Alhasan Ibrahim Abu Mansour, Waleed Abdu Mohammed Hazazi, Amal Ali Almaghrapy, Abdulrahman Mohammed AlZahrani, Mohammed Mishal Hamoud Alnihier
Instructional Guidelines to Improve Quality of Life for Primary School Students with Visual Impairment
Background: Vision impairment has a significant impact on the lives of those who experience it as well as on their families, their friends, and society. The aim of the study: Was to evaluate the effect of instructional guidelines on improving quality of life for primary school students with visual impairment. Research design: Quasi- experimental study design was utilized. Setting: The study was conducted at 7 governmental primary schools in Fayoum Governorate, Egypt. Sample: A multistage random sample composed of (83) primary school students according to inclusion criteria. Tools: Two tools were used. First tool: Structured interviewing questionnaire was used, including four parts: Part(I) Socio-demographic characteristics of students and their families, part (II) Medical history of students and their families, part (III) Students’ knowledge regarding visual impairment , part (IV) Students’ reported practice regarding visual impairment . Second tool: Nursing Home Vision-Targeted Health-Related Quality of Life Questionnaire (NHVQoL).Results: 25.3% of the studied students had satisfactory total level of knowledge in pretest and improved to 81.9% in posttest, 31.1% of them had satisfactory total level of reported practice in pretest and improved to 85.5% in posttest, and 15.7% of them were at good level of total quality of life in pretest and improved in posttest to 68.7% with a highly statistical significance difference between pre and posttest (p. value <.001) for all previous items. Conclusion: The instructional guidelines reported a remarkable improvement in knowledge, practices, and all domains of quality of life of primary school students with visual impairment after instructional guidelines implementation where there were a highly statistical significant positive correlation between students’ knowledge and their reported practices, between their knowledge and their quality of life, and between their practice and their quality of life (p. value <.001) for all previous items. Recommendations: Further studies including larger sample size of primary school students from different geographical areas to generalize the results in Egypt.
Instructional guidelines, quality of life, primary school students, visual impairment
Nermin Anter Abd El-Latif 1, Prof. Dr. Hanaa Abd EL-Hakim Ahmed2, Prof. Dr. Rasmia Abd El-Sattar Ali3
Health Educational Program on Pesticides Hazards among Adolescents Agriculture Workers
Background: Exposure to pesticides and other agrochemicals constitutes one of the main occupational hazards faced by adolescents working in agriculture, which it can damage brain function and reproductive systems. Pesticides may also be carcinogenic and lack of proper pesticide storage and disposal puts adolescents at further risk. The aim of this study: Evaluate the effect of health educational program on pesticides hazards among adolescent's agriculture workers. Study Design: A Quasi-experimental research design was utilized to fulfill the aim of this study. Setting: The study was conducted at 3 governmental preparatory schools in the rural of Fayoum governorate. Subjects: A purposive sample consisted of 163 preparatory school students. Tools: Two tools were used to conduct this study 1st Tool: To assess the adolescents' agriculture workers' knowledge and practices related of pesticides handling., 2nd Tool: To assess adolescent's health complain related to pesticides exposure. Results: The study results showed that, 81.0% of adolescent students were their age ranges from 13-15 years. 63.2% of adolescent students had unsatisfactory knowledge in preprogram and decreased to 15.4 % post program. 36.2% of adolescents had adequate pesticides handling practices in preprogram and improved to 71.2% post program. Also 61.3% of adolescent students were suffered of health complaints resulting from their exposure to agricultural pesticides in preprogram implementation, while post program it was decreased to 22.1%. Conclusion: There was a positive correlation between total knowledge and total practices among studied adolescents regarding to pesticides handling with r=.166 at preprogram and r= .582 at post program with p value ˃ 0.001. Recommendation: Replication of the program in other schools to improve the students' knowledge and practices regarding pesticides hazardous.
Adolescent, Agriculture, hazards, Pesticide
Amany Samir Mahmoud, Seham Guirguis Ragheb, Mona Abo Bakar Abd Ellatif
Health Educational Program about Quality of life for patients with Parkinson's Disease
Background: Parkinson’s disease (PD) is a brain condition that causes problems with movement, mental health, sleep, pain, and other health issues The aim of this study: is to evaluate the effect of health education program on the quality of life for patients with Parkinson's disease Research hypotheses: This educational program for patient’s having Parkinson’s disease will improve different quality of life domains for patients of Parkinson’s disease Design: A Quasi-experimental research design was utilized to fulfill the aim of this study. Setting: The study was conducted at the outpatient neurology clinic in the center of Ahmed Shawky and the outpatient neurology clinic at EL-Demerdash Hospital. Subjects: A purposive sample was used in this study within inclusive criteria of 104 patients. Tools: The tools were used for data collection of the study and it was written in simple language to suit the understanding level of all patients to assess their knowledge and practice regarding Parkinsonism it consisted of Part 1: Demographic characteristics of Parkinson’s’ patients, Part 2: to assess patients' knowledge regarding Parkinson’s disease, Part 3: to assess practices of patients regarding Parkinson’s disease, Results: Represent that the mean age of the studied Parkinson’s disease was 54.85 years, emerge gender 55.8 % of them were male, 32.7% of them their age ranged between 55 ≤ 60 years, while 9.6% were high educated and 66.3% were widow/widower. Also, 39.4 of the studied sample did not work, leading to their family income being insufficient for 62.5%. In addition70.2% of them lived in urban areas and 75% lived in crowded homes, and the mean and SD of total knowledge about Parkinson’s disease was17.99 ± 4.163of Parkinson's disease also 4.8% of patients with Parkinson’s’ disease had good level of total practices Conclusion: There were statistical significant relation between Parkinson’s patients' knowledge, their practice and, their quality of life. Recommendation: Health educational programs for patients with Parkinson’s disease outpatient clinics to raise their awareness regarding causes and risk factors, prevention & early detection, and proper treatment of Parkinsonism.
Parkinson’s disease, knowledge, activities.
Enas Hassan Ahmed, Prof. Dr. Hanan Ibrahim Ahmed, Prof. Dr. Ferial Fouad Melika
The Effect of Soft Skills Training Program on Staff Nurses' Innovative Behavior
Background: Soft skills are non-technical skills, cognitive, and social capabilities that complete the technical skills. Soft skills are required for success in any job that requires human contact and cooperation. Moreover, these skills boost creativity and innovative behavior of nurses. Aim: The aim of this study was to assess the effect of soft skills training program on staff nurses' innovative behavior. Design: Quasi-experimental design with one group pre-posttest was used to carry out this study. Setting: The study was conducted at Medical University Hospital which affiliated to El Fayoum University Hospitals at El Fayoum governorate. Subjects: included 159 staff nurses out of 270 staff nurses working in the above mentioned setting. Tools of data collection: Four tools were used for data collection, namely; Soft skills knowledge questionnaire, Soft skills elements questionnaire, Communication skills observation checklist, and Innovative behavior Inventory. Results: The study findings revealed that, there was a significant improvement in staff nurses’ total knowledge regarding soft skills, total soft skills elements, total practice of communication skills, and total innovative behavior at the post program phase and slightly decline was revealed at follow up phase, but remained higher compared with preprogram phase. Also, there were highly statistically significant differences throughout program phases (p<0.001). Whereas, there were no statistically significant differences between posttest and follow up (p>0.05). Conclusion: Implementing soft skills training program was effective in improving staff nurses’ innovative behavior. Also, there was a highly statistically significant strong positive correlation between total soft skills elements score and total innovative behavior score among staff nurses throughout program phases. In addition, there was a highly statistically significant weak positive correlation between total knowledge score and total soft skills elements score among staff nurses throughout program phases (p<0.001). Recommendations: Conduct soft skills training programs for all nursing personnel at different health care settings to improve quality of health care. Further studies should be conducted to investigate the effect of soft skills training program for staff nurses on their performance.
Soft skills; Staff nurses; Innovative behavior.
Asmaa Saadawi El-Sawy Saadawi, Mona Mostafa Shazly, Hanaa Mohamed Abd Rabou
Epidemiological and Clinicopathological Characteristics of Renal Cell Carcinoma in a Tertiary Care Center in Mysuru, Karnataka: A Retrospective Review
Background: Renal cell carcinoma (RCC) represents a significant portion of adult renal malignancies, showcasing diverse demographic distributions and clinicopathological features. This review synthesizes data from a tertiary care center in Mysuru, Karnataka, to elucidate the epidemiological and clinicopathological profiles of RCC patients, aiming to enhance diagnostic accuracy and treatment outcomes. Background: Renal cell carcinoma (RCC) presents diverse demographic distributions and clinicopathological features, necessitating comprehensive understanding for enhanced diagnostic accuracy and treatment outcomes. This retrospective review aimed to elucidate the epidemiological and clinicopathological profiles of RCC patients in Mysuru, Karnataka. Methods: Medical records of RCC patients from January 2020 to January 2024 were retrospectively reviewed. Socio-demographic characteristics, presenting symptoms, laboratory investigations, radiological staging, histopathological types, and surgical procedures were analyzed. Results: The study comprised predominantly male patients over 40 years, with common symptoms including pain abdomen, mass per abdomen, and hematuria. Laboratory abnormalities in hemoglobin (Mean ± SD: 11.2 ± 1.5 g/dL, p = 0.031), creatinine (Mean ± SD: 1.8 ± 0.7 mg/dL, p = 0.022), and calcium (Mean ± SD: 9.2 ± 0.5 mg/dL, p = 0.042) were noted. Most patients presented at stages T1 and T2, with clear cell RCC being the predominant histopathological type (Chi-square Value: 12.78, p < 0.001). Radical nephrectomy was the primary surgical intervention, showing significant association with RCC treatment (Chi-square Value: 11.21, p < 0.001). Conclusion: The study showed the typical presentation and progression of RCC in the region, emphasizing the importance of timely diagnosis and tailored therapeutic strategies. Clear cell RCC predominance and the efficacy of early surgical intervention highlight the need for personalized patient care. Future research should focus on longitudinal outcomes to further refine treatment approaches.
Renal Cell Carcinoma, Epidemiology, Clinicopathological Features, Surgical Treatment
DR. SAJAN SEHGAL, DR. VIJAYAKUMAR. R., DR. V. MANJUNATH, DR. AMRUTHRAJ G.GOWDA
Effects of Capparis cartilaginea Extract on Cell Proliferation and Morphology in Ovarian and Testicular Tissues
Medicinal plants have long been studied for their potential health benefits, particularly in reproductive health. Capparis cartilaginea (C. cartilaginea), a plant native to Saudi Arabia, is known for its pharmacological properties, yet its effects on reproductive cells remain unclear. This study explores how C. cartilaginea fruit extracts influence ovarian and testicular cell morphology, viability, and proliferation in rats. Forty adult Wistar rats (both male and female) were divided into four groups per gender, receiving oral doses of C. cartilaginea fruit extract (0, 1000, 2000, or 3000 mg/kg body weight) for six weeks. We assessed the reproductive tissues using histological (H&E staining) and immunohistochemical (Ki67 proliferation marker) analyses. No toxic or degenerative changes were observed in ovarian or testicular tissues across all treated groups. The seminiferous tubules in the testes and follicular structures in the ovaries retained normal morphology. Interestingly, Ki67 staining indicated a dose-dependent increase in cellular proliferation in spermatocytes, Leydig cells, granulosa cells, and lutein cells, suggesting a potential fertility-enhancing effect. C. cartilaginea fruit extract appears safe for reproductive tissues and may even promote cell proliferation, hinting at potential benefits for fertility. These findings open further research into its molecular mechanisms and possible clinical applications.
Capparis cartilaginea, reproductive health, ovarian cells, testicular cells, histology, Ki67, fertility
Effect Of Implementing an Educational Program on Nurses` performance to reduce hemodialysis complications for critically ill patients
Background Educational program today is very important for the nurses to increase performance to reduce hemodialysis complications for critically ill patients. Aim: to evaluate the effect of educational program on nurses` performance to reduce hemodialysis complications for critically ill patients. Subjects and Methods: quasi-experimental research design. Participants: A convenience sample of 30 nurses working in Hemodialysis Unit at Assuit university hospital. Method: Two tools were used to collect the data: tool I is Pre/post test nurses` knowledge assessment sheet questionnaire sheet, tool II is Pre/post test nurses` practice assessment sheet observational checklist . Results: nurses' total knowledge scores improved from (13.3%) before the educational program to (93.3%)after the educational program ,also the observed nurses` total practice scores improved from (10%) before the educational program to (93.3%)after the educational program .Conclusion: there was a significant improvement in the nurses' knowledge and practice related to reducing hemodialysis complications after educational program. Recommendations: The study recommends focused on establishing nursing protocol for nurses to help in improving their performance.
complications, critically ill patients, educational Program, Hemodialysis ,performance.
Eman H. Hassanein, Mervat A. Abdel-Aziz, Effat A. Tony
Mechanically Unloaded Bone in Neuromuscular Disorders: The Role of Wnt Inhibitors in Bone Turnover
The Wnt/β-catenin signalling pathway plays a critical role in bone remodelling. This pathway is disrupted in paediatric patients with neuromuscular disorders (NMD), reducing mechanical loading and impairing bone health metabolism. Sclerostin and Dickkopf-1 (DKK1) are major Wnt signalling inhibitors that regulate osteoblast and osteoclast activity; until now, their combined impact on bone turnover remains uncertain. The aim of this study is to evaluate the roles of Sclerostin and DKK1 in skeletal adaptation and their association with bone turnover markers (BTMs) in pediatric patients with NMD. A cross-sectional study included 68 pediatric patients with NMD and 79 age- and sex-matched healthy controls. Serum levels of Sclerostin, DKK1, procollagen type 1 N-terminal propeptide (P1NP), bone-specific alkaline phosphatase (BALP), beta-C-terminal telopeptide of type I collagen (β-CTX), vitamin D, calcium, parathyroid hormone (PTH), and thyroid-stimulating hormone (TSH) were measured. The statistical test used to evaluate group differences is the Mann-Whitney U tests . Correlation and multiple regression analyses studied the relationships between Wnt inhibitors and BTMs. The levels of Sclerostin and DKK1 were significantly elevated in girls with NMD compared to healthy controls. In contrast, this pattern is not observed in boys. Markers such as P1NP, BALP, and calcium were also higher, while β-CTX and vitamin D levels were lower, indicating imbalances in bone remodelling activity. Sclerostin and DKK1 were negatively correlated with β-CTX, and DKK1 presented a positive association with both P1NP and BALP. Regression analysis showed that DKK1, PTH, and TSH were predictors of P1NP, whereas PTH primarily influenced β-CTX. The data suggest that suppression of Wnt signalling may be responsible for disrupted bone turnover in NMD, identifying Sclerostin and DKK1 as possible indicators and therapeutic targets for skeletal fragility in this population.
Wnt Signalling, Sclerostin, DKK1, Bone Turnover, Neuromuscular Disorders, Mechanical Unloading, Skeletal Fragility
Incidence and Risk Factors of Incontinence Associated Dermatitis Among Critical Ill Patients
Background: Incontinence associated dermatitis is a common health problem among critically ill patients. Keeping patients skin functioning and healthy is the important aspect of nursing care. Aim: to pinpoint risk factors and incidence of incontinence associated dermatitis in Intensive Care Units. Design and Methods: A prospective observation study was performed in intensive care units' patients. Tools Three tools were used to collect data in this study: Tool l: patient assessment tool which include 2 parts. Part I: socio-demographic and clinical data. Part II: The Acute Physiology and Chronic Health Evaluation (APACHE II). Tool II: skin assessment tools which include 4 parts: part I: Braden scale part II: - Perineal Assessment Tool. Part III skin assessment score. Part IV: the Incontinence Associated Dermatitis severity instrument (IADS). Tool III: patient outcome tool. Results: About 53.3% had female, with a mean age of 43.43 ± 19.52, and about 16.6% of the overall sample had incontinence associated dermatitis. Conclusion: ICU patients' skin exposure to several risk factors which lead to damage. It including, increasing age, a high score on the perineal assessment scale, fever, hypoalbuminemia, enteral nutrition, wet skin, poor hygiene practice, and watery diarrhea are associated risk factors for Incontinence Associated Dermatitis in patients with a critical illness. Recommendation: Early identify, determined and management of incontinence associated dermatitis should be early.
Critical ill patients; Dermatitis; Perineal assessment; Incontinence Associated Dermatitis
Samiha Mohammed Ahmed Baker, Hani Ahmed Ibrahim El-Morabaa, Mona Aly Mohammed