Medicine in Developing Countries

Background: Pain is a common presenting complain in general practice and constitutes a major proportion of outpatient visits. This study aimed to assess clinical medical students' knowledge and awareness regarding pain concepts at King Abdulaziz University (KAU). A cross-sectional study was conducted using a questionnaire administered through an online survey form among medical students of KAU. The questionnaire contained baseline characteristics of students and open and closed-ended items related to awareness and knowledge regarding pain concepts. The study showed that 63.8% of medical students reported attending lectures on pain management, and among those, 55.6% received that within the medical curricula. It was found that 19.2% reported that they educated patients suffering from acute/chronic pain. Only 17% students demonstrated good knowledge regarding pain concepts. The knowledge level of the students showed a significant relationship with grade point average and clinical interest of the students (p < 0.05). The study demonstrated a deficiency in knowledge and exposure regarding pain concepts and their management. Undergraduate medical curricula should be reassessed in that aspect to provide adequate training in pain management.

Background: Parental decisions regarding vaccination are very vital for increasing the vaccination rate and parent compliance to the immunization schedule.  Worldwide studies show that besides other factors, parental knowledge and beliefs have major influence on starting and continuing of child vaccination. Objective: The study aim to assess knowledge, attitude and practice of the parents regarding child vaccinations in Arar, Northern Saudi Arabia. Methods: A cross-sectional community based study carried out during the period from 1st January to 30th July 2018. A systematic random sampling technique was used; 367 participants was included.  Data collected using a pre-designed online questionnaire distributed among parents of children and adolescents to be self-administered. Results: the majority (40.1%) of children aged less than 6 years old, 58.9% were males, fathers&#39; education was university or more in 47.7% of participants and mothers&#39; education was secondary school 75.5%...

Background: Rheumatic heart diseases (RHD) are significant public health concerns worldwide. The present study aimed at assessing the level of parents' knowledge regarding RHD and its predisposing factors in Saudi Arabia and comparing the knowledge of RHD among different genders, age groups, levels of education, and occupation of the parents. A cross-sectional study was conducted to determine the relationship between socio-demographic characteristics and parents' knowledge toward RHD in Saudi Arabia. Data were collected using a questionnaire and analyzed using Statistical Package for the Social Sciences. Results: A total of 430 respondents were enrolled in the study; about 297 (69.1%) were females and 133 (30.9%) were males. The overall knowledge level of parents about RHD was moderate, with 179 (41.6%) of parents having a good knowledge level and 251 (58.4%) having a poor level of knowledge. The mean knowledge score was 5.85 (SD ± 2.26) out of 10. Prior history of sore throat was reported in 332 (77.2%) participants most of them treated the sore throat with antibiotics (74.8%) while 38 (9.8%) used traditional herbs and 22 (5.7%) treated it with salt. There was a significant association between the level of knowledge about RHD and age (p = 0.000). The present study found moderate overall knowledge level among parents toward RHD. About two-fifths of parents had a good knowledge level and more than half of parents had poor knowledge. The level of knowledge about RHD was significantly associated with age, occupation, and region of residence.

Since its inception as rule-based programs, artificial intelligence (AI) has developed into machine learning and deep learning systems that utilize the enormous volumes of clinical data currently accessible. The aim of the present review was to discuss the role of AI in modern clinical practice and to highlight the opportunities and challenges that lie ahead by combining the results of recent research. AI tools provide physicians with decision support and prediction models, directs robotic procedures and surgical planning, supports radiologists, pathologists, dermatologists and ophthalmologists with image analysis, and aids in the delivery of more individualized care in cardiology and precision medicine. These developments are boosting precision, optimizing daily tasks and providing patients with more individualized treatment. In practice, this could include imaging systems that prioritize patients who are most at risk or prediction technologies that help physicians allocate resources and reduce unnecessary workload. However, there are still critical obstacles to overcome. The biases of the training data may be reflected in the algorithms, which could exacerbate already-existing disparities. Since many models operate as 'black boxes', it can be challenging to understand their logic, which raises questions about accountability, ethics and trust. Clinical standards and regulations are still lagging behind technology, and incorporating AI into busy healthcare systems can be difficult and costly. Achieving its promise will require careful implementation, rigorous validation and sustained collaboration among clinicians, data scientists, engineers, ethicists and policymakers for safe adoption in clinical practice. Contents 1. Introduction 2. AI in diagnosis and prognosis 3. Decision support and precision treatment 4. AI in surgery and robotics 5. AI in cardiology 6. Benefits and opportunities of AI in clinical practice 7. Challenges and limitations 8. Ethical and legal considerations 9. Future directions and innovations 10. Conclusion

This study explores the association between early-life vaccine scheduling intensity and autism prevalence across 12 highincome countries. It considers not only epidemiological patterns but also broader psychological and societal dimensions, including parental perceptions, trust in healthcare systems, and stress related to immunization schedules. Using a crossnational ecological dataset from countries with comparable healthcare infrastructure and diagnostic criteria, the analysis employed descriptive statistics, partial correlations (controlling for overall vaccination coverage), and multivariate regression models. Countries with higher autism prevalence (e.g., USA, Canada, Japan) averaged 15 vaccine types and 20 doses for infants under one year, while those with lower prevalence (e.g., Norway, Finland, UK) averaged 8 vaccine types and 9 doses. Statistically significant correlations were found between autism prevalence and both vaccine types (r = 0.87, p < 0.001) and doses (r = 0.79, p < 0.01). Regression analysis indicated a positive association, though causality cannot be inferred. These findings suggest that vaccine scheduling intensity may be a relevant factor for further investigation. More gradual immunization approaches, as seen in some countries, could be explored in future research and policy discussions to support both developmental outcomes and parental confidence. .

Tooth loss is a prevalent oral health issue with significant implications for individuals' quality of life, nutrition, and psychosocial well-being. Despite advancements in preventive dentistry, disparities in tooth loss persist, particularly among socioeconomically disadvantaged populations. This study aimed to examine the association between socio-demographic factors and patterns of tooth loss specifically the number and location of missing teeth among adult patients seeking prosthodontic treatment in Makkah, Saudi Arabia. A cross-sectional study was conducted among 307 adult patients attending prosthodontic clinics. Data were collected through clinical examination combined with short interviews to capture socio-demographic variables (age, gender, education level, income, and nationality) and teeth loss status. Pearson chi-square and fisher exact probability tests were used to assess associations between these variables and both the number and location of missing teeth. Data were analyzed using SPSS 29. Nearly half of the participants (48.9%) had more than two missing teeth, with posterior tooth loss being the most common (76.2%). Age, education level, and income were significantly associated with the number of missing teeth (p < 0.05), while gender and age were significantly associated with the location of missing teeth (p < 0.05). Lower education and income levels were linked to higher rates of tooth loss, and older adults were more likely to have missing teeth in both anterior and posterior regions. This study underscores the need for policymakers to prioritize disadvantaged populations by developing inclusive, cost-effective oral health strategies that address social determinants and support community-based prevention in Makkah and similar regions.

Background Mineral trioxide aggregate (MTA) is the gold standard pulpotomy agent with some shortcomings, such as lengthy setting time, difficult manipulation, and a costly price. A new bioactive material, ACTIVA BioACTIVE Base/ Liner, may prevail over these drawbacks. Aim The purpose of the study was to evaluate and compare the pulp reaction in primary teeth to ACTIVA BioACTIVE Base/Liner and conventional powder-liquid MTA (WhiteProRoot ® MTA) as pulpotomy agents. Materials and methods Eighty primary first molars in children aged 7-9 years were assigned into two groups (40 molars/group) in which the pulpotomy procedure was done. The pulp tissue was dressed in ACTIVA BioACTIVE Base/ Liner (group I) and MTA (group II). Twenty teeth from each group were extracted after 15 days, and the remaining twenty teeth in each group were extracted after 30 days. All teeth specimens underwent a decalcification treatment for histological and immunohistochemical assessment for fibronectin and osteopontin (OPN) expressions. Results Significant statistical differences were identified between ACTIVA BioACTIVE and MTA groups concerning the total scoring of pulp vascularity, pulp fibrosis, and presence or absence of pulp stone (P = 0.015, P < 0.001, P = 0.038, respectively), whereas a non-significant difference was noted concerning the odontoblastic layer organization. Fibronectin and OPN in both ACTIVA BioACTIVE and MTA groups were positive at the fibrotic and calcified areas. Conclusion ACTIVA BioACTIVE Base/Liner demonstrated encouraging outcomes concerning enhanced systemic tissue responses.

Background: Bariatric surgery has emerged as a powerful tool against obesity worldwide. Patient preferences and decision-making are affected by multiple factors that impact this choice. This study aimed to explore the knowledge among the Saudi population and determine the factors that influence decision-making plans. A cross-sectional study was conducted among Saudi population from different geographical areas from August 2019 to July 2020 at Taif University. A questionnaire was used to assess the knowledge and factors that influenced a patient to seek bariatric surgery. Results: There were 1,300 participants in this study, and 54.9% of our participants were diagnosed as obese or morbidly obese. The participants believed that bariatric surgery would help with weight loss (91%) and help to reduce or cure diabetes (81%). Sleeve gastrectomy was the most frequently chosen surgery, and it resulted in more weight loss than other bariatric surgeries. Males chose more weight loss, while females chose good appearance and body fitness as a desirable outcome after surgery, which was a significant difference. Most patients were obese or morbidly obese. More patients chose sleeve gastrectomy as the most desirable surgery because it could result in more weight loss even in the long-term and cure or reduce diabetes, and it had the shortest recovery time. This choice correlated with the female gender, geographical area, and the patient's chronic disease. Females wanted an excellent appearance and body fitness, whereas males desired more postoperative weight loss.

Early Detection: AI analyzes vast data; detecting subtle disease cues (cancer, TB) for earlier, proactive interventions and improved outcomes. Beyond Individuals: AI scans populations, predicting outbreaks and risk factors, guiding resource allocation and prevention strategies. Personalized Care: AI tailors treatment plans based on unique patient data, maximizing efficacy, minimizing side effects, and acting as a trusted medical advisor. Challenges & Solutions: India's booming tech scene positions it to tackle data privacy, infrastructure, and ethical concerns through AI research, data infrastructure upgrades, and strong ethical frameworks. Overall Impact: Unleashing AI's potential can revolutionize India's healthcare, ensuring brighter, more equitable future for millions.

Abstract
This study investigated the efficacy and safety of Nd: YAG laser (1064 nm) hair removal in 55 Sudanese women with Fitzpatrick skin types IV, V, and VI. The primary objective was to evaluate the influence of skin type, fluence, age, and geographic location on the number of treatments required to achieve satisfactory hair reduction in the chin area. Treatment parameters, including fluence (25–40 J/cm²), spot size (10–12 mm), and pulse width (20–40 ms), were tailored to individual characteristics using the Cynosure Elite + Nd: YAG laser with sapphire contact cooling. Outcomes were assessed using clinical evaluation, pre- and post-treatment photographs, and a standardized 5-point hair density scale. Statistical analysis revealed that fluence significantly impacted outcomes (p = 0.039), with 25 J/cm² demonstrating effectiveness. Skin type, age, and geographic location were not significant factors (p > 0.05). No topical bleaching cream was used, and many participants reported improvement in skin tone. No adverse events or paradoxical hypertrichosis were observed. The study supports the safe and effective use of low-fluence 1064 nm Nd: YAG laser treatment for hair removal in darker skin types. Future research should examine long-term outcomes and broader treatment sites.

Objectives: The aim of this research was to investigate the relationship between perfectionism and burnout, and the prevalence of burnout, in medical and dental students in Jeddah, Saudi Arabia. Materials and Method: A cross-sectional study was conducted among 645 clinical-year medical and dental students and interns in Jeddah, Saudi Arabia. Data were collected using a self-reported questionnaire. The Copenhagen Burnout Inventory was used to measure burnout, and the Perfectionistic Self-Presentation Scale was used to measure perfectionism. SPSS version 18.0 was used for statistical analysis. Data were analyzed by linear regression, t-test, and ANOVA. Results: There was no significant correlation between burnout and any of the three types of perfectionism that were studied. The prevalence of normal or low burnout was 32.1%, and the prevalence of high burnout was 67.9%. The mean (standard deviation) of perfectionistic self-promotion was 42.99 (10.01), of non-display of imperfection wa...

The development of newer strategies to improve outcomes for older patients with secondary acute myeloid leukemia (s-AML) is a critical unmet need. Establishing baseline metrics for evaluating newer approaches is important. METHODS: s-AML was defined as 1 or more of the following: a history of an antecedent hematologic disorder (AHD), a diagnosis of therapy-related acute myeloid leukemia (AML), and AML with karyotype abnormalities characteristic of myelodysplastic syndrome. Newly diagnosed s-AML patients aged 60 to 75 years were grouped into 5 treatment cohorts: 1) patients receiving high-or intermediate-dose cytarabinebased intensive chemotherapy (IC), 2) patients receiving a hypomethylating agent (HMA) or HMA combinations, 3) patients receiving low-dose cytarabine (LDAC) combinations, 4) patients receiving CPX-351, and 5) patients receiving investigational (INV) agents. Nine hundred thirty-one patients met the age and s-AML criteria. RESULTS: Complete remission rates were statistically lower in the HMA group (36%) versus the IC (46%), CPX-351 (45%), and LDAC groups (43%). Patients receiving less intensive regimens (the HMA and LDAC groups combined) had superior overall survival (OS) in comparison with patients receiving IC-based regimens (median 6.9 vs 5.4 months; P 5 .048). Only 4.3% of the IC patients proceeded to transplantation, whereas 10.3% of the patients on lower intensity regimens did (P 5 .001). There was no difference in median survival between patients treated with CPX-351 and patients treated with conventional lower intensity approaches (P 5 .75). Age > 70 years, an adverse karyotype, and a prior AHD were associated with decreased OS in a multivariate analysis. CONCLUSIONS: Lower intensity approaches are associated with lower early mortality rates and improved OS in comparison with intensive regimens. OS is poor with currently available therapies with a median OS of 6 months (5.4-7.6 months across regimens). Unsatisfactory outcomes with other INV agents underscore the need for more effective therapies.

Background: Polycystic ovarian syndrome (PCOS) is one of the disorders of the endocrine system, faced by women usually after puberty of all races and ethnicity. There is a high prevalence of PCOS globally, and both mother and fetus have to face complications due to it. This study was aimed to assess the level of general public awareness toward PCOS among females in Saudi Arabia and to explore the relationship between the level of awareness and different sociodemographic factors. In this cross-sectional study, 413 adult female participants were randomly enrolled. A pretested questionnaire was used in data collection in five main regions of Saudi Arabia from April to August 2020. The level of awareness was assessed and compared to the sociodemographic characteristics of participants. Results: Majority of the participants (n = 167, 40.4%) had an age range between 36 and 45 years, single were (48.4%), and Saudi nationals were (80.4%). The findings of this study indicated that most of the participants (n = 309, 74.8%) were recognized with a good level of awareness, whereas 104 (25.2%) had a poor level of awareness. The level of awareness of PCOS was significantly related to educational level and marital status. On the contrary, age and nationality did not have any significant impact on PCOS awareness. There was a high level of awareness toward PCOS among females in Saudi Arabia.

Abstract

Purpose: This research aimed to assess gender differences in academic performance, aptitude, emotional intelligence, and grit among the students.

Method: The sample included 302 students (250 females and 52 males) from Saudi health sciences institutes, located in Riyadh, Jeddah and Alahsa. Data collection was done through Google Forms which was based on demographic information, Self-Report Measure of Emotional Intelligence and Grit Scales. Results: Statistical analysis was done through STATA-16 by applying ANOVA. Results indicated a significant gender difference in students’ CGPA, aptitude and emotional intelligence. However, there was an insignificant gender difference in students’ grit scores. Conclusion: The findings show that male students achieved higher scores than females but various psychological, and social elements play a role in shaping the aptitude of the male and female students towards performance and achievement and the implications of these findings can be utilized to provide guidance and support for the students’ wellbeing and to help them to improve their overall performances.

Introduction: The population has not been investigated extensively about understanding and perception about obesity and its complications. The aim of the study was to investigate the understanding, recognition and practice between overall population in the selected areas of Lahore related to obesity and its complications. Methods: The descriptive study which involved 100 respondents. The respondents from Hussain Abad Lahore were conveniently approached and recruited. A pre-approved, questionnaire was used for data accumulation. SPSS version 20 was used both descriptive and inferential statistics. Results: From Out of the total 100 participants, 53% were females and 47% were males. Almost the half Participant 45% was in the age of 35years. Nearly 91% respondents don’t have idea about normal body mass index of adults. While 89% participants don’t know hormonal problems can lead the obesity. However 51% participants know that obesity can lead the heart problems. . Just about 52% partic...

Artificial Intelligence (AI) has become a transformative force in healthcare, particularly in nursing, where it offers innovative
solutions for improving patient care, enhancing clinical decision-making and advancing educational methodologies. This review
explores the current applications of AI in nursing, highlighting its role in clinical practice, education and ethics. By synthesizing
recent literature, we aim to provide an overview of how AI can support the nursing profession in addressing contemporary
challenges and shaping the future of patient care. Additionally, we examine the potential challenges, including data privacy
concerns, ethical dilemmas and the integration of AI into clinical workflows. This paper emphasizes the importance of integrating
AI responsibly and ethically to ensure that its benefits are maximized while minimizing risks to patient care.

The integration of artificial intelligence (AI) in healthcare has revolutionized the prediction and management of cardiac diseases. Given that cardiovascular diseases (CVDs) are a leading cause of mortality worldwide, there is an urgent need for innovative diagnostic methodologies. This paper explores the intersection of AI and cardiac disease prediction, emphasizing machine learning and deep learning applications. By synthesizing existing literature, this study critically evaluates the advantages of AI over traditional diagnostic methods, highlighting improvements in predictive accuracy and personalized treatment strategies. Furthermore, this review addresses methodological inconsistencies and ethical concerns regarding AI deployment in clinical settings. The findings underscore the potential of AI-driven models to enhance early detection and risk assessment in cardiovascular healthcare. However, challenges such as data biases, lack of transparency, and the need for regulatory frameworks must be addressed to harness AI's potential in cardiology fully. This study contributes to the growing discourse on AI in medical diagnostics, offering insights for future research and clinical implementation.