World Academy of Science, Engineering and Technology

Authors: Mohammed. N. Abdelaziz, Ahmed.R. A. Moustafa, Hajer Azzam, Anwar. M. Bshar, Ismail. S. Ismail, Ahmed M. Ghanem, , Omnia Yousry Elhadidy

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Unachievable beauty standards have become more widely disseminated due to the quick development of digital platforms, especially social media, which may exacerbate psychological issues and body image disorders. The current study aims to determine whether excessive interaction with skewed beauty depictions correlates with the increased prevalence of BDD symptoms among medical students, who represent both consumers and influencers in health-related information, given the particular pressures they encounter. This study investigates the connection between the incidence of body dysmorphic disorder among Egyptian medical students and their exposure to unrealistic beauty standards on social media. This was a cross-sectional questionnaire-based study consisting of 1126 undergraduate medical students, with a mean age of 20.8 years, enrolled in any Egyptian medical school registered in the academic year 2023-2024, specifically from August to October 2024, except non-medical, graduate, and non-Egyptian students who met the exclusion criteria. This questionnaire was designed with four consecutive sections to evaluate the link between body dysmorphic disorder and false social media beauty. We privately gathered answers via colleagues and electronically via online Google forms posted on social media groups. The primary outcome was to assess Body Dysmorphic Disorder (BDD) in medical students, with only 76 participants meeting the criteria for BDD. Most participants with issues with their appearance disliked their faces, abdomen, noses, thighs, and all their bodies. The secondary outcome explored the effect of sociodemographics and social media practices on BDD. The governorate was the only sociodemographic factor that significantly differed between BDD and non-BDD, with Snapchat being the only platform that had a significant effect. Participants reported strategies to cope with negative feelings about their body image, including engaging in positive self-talk, participating in offline activities or hobbies, unfollowing accounts promoting false body standards, limiting social media usage, seeking support from friends or family, and consulting a mental health professional. The majority of participants suggested measures that social media should take to address body dysmorphia, such as education about BDD risks, promotion of body positivity, and restriction of unfavorable content. They also suggested providing resources and support to 484 participants and implementing mental health support features for 446 participants. About half of the participants strongly supported initiatives aimed at raising awareness about social media-related body dysmorphia. Our study found that BDD is highly prevalent among social media users, especially on text-based platforms. The prevalence of BDD among Egyptian medical students is 6.7%, which is higher than worldwide

Keywords: Body Dysmorphia, social media, beauty standards, medical students

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Authors: Samira Oudahmane Akdader, Assia Kamel, Lynda Lakabi, Ferroudja Bensaad Medjdoub

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Background and Objectives: The relationship between the adrenal axis and the thyroid axis is very complex. Several studies have shown a possible relationship between the activation of the HPA axis and the function of the thyroid gland. The aim of our study was to investigate the structure and activity of the thyroid gland after adrenal activating treatment in female Wistar ratsMaterial and methods: The work was carried out in female Wistar rats divided into two groups: a control group (T) and a treated group (S) receiving a daily intramuscular injection of Cortrosyn at a rate of 0.01 mg/100g of body weight (BW) for 20 days. Hormone levels of TSH, FT4, FT3) are determined by radioimmunoassay and immunoradiometry. The thyroid gland is fixed for histological using Masson's trichromein order to detect any histological changes of the thyroid and the adrenal glands.Results : Administration of Cortrosyn to rats at doses of 0.01 mg/100 g BW shows a significant decrease in food and water consumption, resulting in reduced body weight and changes in the structure of the thyroid gland with an interrelationship between the two glands.Conclusion:These results demonstrate that activating factors of thehypothalamic–pituitary–adrenal axis such as stress can cause structural and hormonal changes in the thyroidglandwhich can lead to the appearance of dysthyroid.

Keywords: thyroid, stress, rat wistar, adrenal glands

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Authors: Jing Gan, Xiaoqian Wang, Yajun Shen, Xueyi Rao, Zuozhen Yang, Jia Zhang, Huaqin Sun, Luo Rong

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KCNQ2 gene is closely associated with benign (familial) neonatal epilepsy (BFNC) and development and epileptic encephalopathy (DEE). Our team previously documented four cases with KCNQ2 mutations that responded effectively to pyridoxine therapy. In this study, we further examined an additional case with a KCNQ2 mutation, which also showed a positive response to pyridoxine. To investigate the therapeutic potential of vitamin B6, we developed a KCNQ2 knockout zebrafish model. Our findings demonstrate that high doses of vitamin B6 (vitB6) have a significant therapeutic effect on zebrafish deficient in KCNQ2, suggesting its potential as an effective treatment strategy for KCNQ2-related epilepsy.

Keywords: KCNQ2 gene, vitamin B6, epilepsy, zebrafish model, pyridoxine-responsive

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Authors: Aaron Campbell

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Introduction: Our High Dependency Unit (HDU) had been unable to meet the SICSAG minimum standard of twice-daily consultant-led ward round for all critical care patients. As such, we set about implementing a new ward round proforma for an afternoon (PM) ward round. This project was conceived to ensure efficiency of this second ward round due to low staffing levels and consultants being required to cover other wards outside of HDU in a busy rural district general hospital (DGH). Methods: We audited the number of patients receiving twice-daily consultant-led ward rounds. We then created a new digital afternoon ward round proforma as an intervention to help facilitate a brief but comprehensive afternoon ward round. Plan-Do-Say-Act (PDSA) cycles were then performed to track change. After the initial cycle, feedback was taken from members of the multi-disciplinary team to determine sections that could be improved to increase efficiency of the ward round. The proforma was updated and a further audit cycle was then carried out. Results: A PM ward round was never carried out prior to the creation of the proforma. Our intervention led to a significant improvement in the prevalence of a twice daily ward round. In PDSA cycle 1, 64% of medical HDU patients received a twice-daily ward round. In PDSA cycle 2, 82% of medical HDU patients received a twice-daily ward round. Discussion: Our proforma was designed to include what was thought to be the most essential areas of patient care that needed to be covered; in particular, we wanted to ensure it prompted us to chase results of investigations, had detailed treatment escalation plans including plans for deterioration overnight and marked patients suitable for step down. The introduction of our proforma helped to increase the proportion of our patients receiving the minimum standard of care of a twice-daily consultant-led ward round. The proformas received positive feedback from staff with teams covering the unit overnight in particular finding the documentation of plans in case of overnight deterioration and labelling those patients capable of stepping down very useful.

Keywords: critical care, medicine, HDU, ward round

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Authors: Abdulrahman Khairullah Mahde Aldoori

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Acute respiratory infections (ARIs) remain a leading cause of morbidity and mortality among children under five years of age, particularly in low-resource settings. This study aims to evaluate the diagnostic challenges and management approaches for pediatric ARIs in Iraqi governmental hospitals. Based on observational data and clinical experience in a pediatric emergency department, this paper highlights the frequent clinical presentations, including fever, cough, chest indrawing, and oxygen desaturation, and the practical tools used in diagnosis when advanced imaging or laboratory support is limited.The research further examines the treatment protocols adopted, including the use of empirical antibiotics, oxygen therapy, and corticosteroids, and how they align with WHO and local guidelines. Emphasis is placed on the role of early recognition, appropriate triage, and simplified clinical algorithms in improving outcomes. Additionally, the study addresses the burden of viral versus bacterial infections and explores the utility of point-of-care tools such as pulse oximetry in triage decisions.The study’s findings stress the need for standardized management protocols, updated staff training, and greater resource allocation for pediatric emergency units. Recommendations are made for incorporating community-level health education and immunization strategies to reduce incidence and improve prevention.This work aims to provide insights applicable to many developing regions facing similar healthcare delivery challenges, with the goal of improving pediatric respiratory care and reducing unnecessary hospitalizations or complications.

Keywords: pediatrics, acute respiratory infections, diagnosis, management, low-resource settings

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Authors: Sara Mohammadalizade, zahra karimi

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Background: Feeding and swallowing difficulties are commonly reported in children with Autism Spectrum Disorder (ASD), though the underlying causes often remain unclear. Emerging research highlights the potential impact of oral sensory over-responsivity on functional dysphagia in this population. Objective: This study aimed to examine the relationship between oral sensory sensitivity and functional swallowing difficulties in children diagnosed with ASD, focusing specifically on a sample population from Kerman, Iran. Methods: A cross-sectional study was conducted on 40 children aged 3 to 10 years with a confirmed diagnosis of ASD, all recruited from specialized autism centers and rehabilitation clinics in Kerman city. Participants were divided into two groups based on the presence or absence of swallowing difficulties, as identified through caregiver reports and clinical bedside swallowing evaluation. Assessment tools included the Sensory Profile 2 (oral sensory subscale) and a clinical feeding checklist. Correlation and comparative analyses were performed to explore the association between oral sensory processing and dysphagia. Results: Findings demonstrated a statistically significant relationship between high oral sensitivity and the presence of functional swallowing problems (p < 0.01). Children with greater oral sensory defensiveness showed increased food selectivity, avoidance behaviors, and delayed oral-motor coordination during feeding. Conclusion: Oral sensory over-responsivity appears to play a significant role in functional swallowing difficulties among children with ASD in Kerman, Iran. These findings support the integration of sensory-based assessments and therapeutic strategies into speech-language and feeding interventions. Further research with larger samples and longitudinal designs is recommended.

Keywords: autism spectrum disorder, theory of mind, behavioral problems, NEPSY-II, CBCL, children

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Authors: Sakshi Kumari

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Background Postpartum cognitive dysfunction and lactational failure are prevalent conditions with serious implications for maternal and infant well-being. Hormonal, physical, and psychosocial factors contribute to these issues, yet they remain poorly understood and under-researched. Their co-occurrence highlights the urgent need for deeper insight, particularly in low-resource settings like South India. Objectives ● To estimate the prevalence of cognitive dysfunction and associated behavioural changes and their prevalence among postpartum women ● To estimate the prevalence of lactational failure and its determinants among postpartum women Methodology A cross-sectional study was conducted involving 200 postpartum women (65% rural, 35% urban). Data were collected through structured interviews and assessments using the Indian version of the Montreal Cognitive Assessment and Depression, Anxiety, and Stress Scale-21. Statistical analyses included chi-square tests and regression models. Results and Discussion Cognitive dysfunction was observed in 25% of participants (21.5% mild, 3.5% moderate). Stress, anxiety, and depression were prevalent in 80.5%, 27%, and 30% of women, respectively. Lactational failure was reported by 21%, strongly correlated with cognitive dysfunction (p = 0.01) and mental health issues (stress, anxiety, and depression; p < 0.001). Key determinants of lactational failure included poor maternal-partner relationships, lack of social support, low education levels, delayed breastfeeding initiation, childcare stress, comorbidities, mode of delivery, and low birth weight. Cognitive dysfunction was significantly associated with male offspring, insufficient milk production, lack of social support, and poor education levels (p < 0.001). Conclusion The study highlights a strong association between maternal mental health, cognitive dysfunction, and lactational failure. Addressing psychosocial and demographic determinants through targeted interventions is critical for improving maternal and child health outcomes in postpartum populations.

Keywords: lactational failure, cognitive dysfunction, behavioural changes, postpartum women

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Authors: Nicholas Quarteng

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The study explored the factors affecting premarital sexual activity among senior high school students in La-Nkwantanang-Madina Municipality. One hundred and fifty adolescents between the ages of 10 and 19 years in Preset Pacesetters Senior High School were selected using a stratified random sampling technique. Rosenberg Self-Esteem Scale, Hendrick Sexual Attitude Scale, Sexual Experience Inventory and Perceived Peer Norms Scale were used to acquire data. Independent t-test, one-way ANOVA and Correlations were used to analyse the data. Analysis of the data outlined that the rates of sexual activities were associated with adolescents’ self-esteem, parental attitudes, peer influence and level of education. Thus, individual and contextual factors such as age, self-esteem, peer influence, school attachment and perceived parental attitudes all affect adolescents’ sexual activity. The recommendation was that the government has to implement educational programs for adolescents to have access to reproductive health information and enable them to abstain from premarital sexual activities.

Keywords: premarital, sexual activity, adolescent, one-way ANOVA

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Authors: Anastasiya O. Merkulova, Anastasiya Yu Kharitonova, Andrey A. Shavrov, Mikhail P. Shalatonin

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BACKGROUND: Eosinophilic esophagitis (EoE) is one of the most common causes of dysphagia in adults and children. Pathomorphological verification of the diagnosis (at least 15 eosinophils per high power field) is essential and requires at least 6 biopsies from esophageal mucosa for primary diagnosis, observation and outcome assessment. Endocytoscopy (EC) claims to be the novel diagnostic technique for EoE verification in vivo. OBJECTIVE:To evaluate the effectiveness of endocytoscopy in the diagnosis of EoE in children. MATERIALS AND METHODS: Since December 2023 till May 2025, 37 endocytoscopies were performed in 23 children (21 boys, 2 girls) with suspected EoE aged 4 – 17 years (15±3 years) in the endoscopy department of CRIEPST. Olympus Evis Lucera Elite endoscopic system with GIF-H290EC video gastroscope with optical magnification up to x520 was used for all procedures. Targeted biopsies were taken in all patients at the site of endocytoscopic observation for histological confirmation of the detected eosinophilic infiltration. RESULTS: The obtained data were distributed for 2 groups. Group 1 included EC at which eosinophilic infiltration was more than 15 cells in the field of endocytoscope view. Group 2 included EC with absence and/or minimal infiltration less than 15 eosinophils. In group 1 there were18 EC, in 15 cases EoE was confirmed histologically. In group 2 there were 19 EC and only 3 of them turned out to have morphologically confirmed EoE. The sensitivity of EC in the diagnosis of EoE was 79%, specificity – 83%, positive prognostic value – 83%, negative prognostic value – 79%. CONCLUSION: EC potential in the diagnosis and monitoring of esophageal eosinophilic inflammation in children seem to be promising. Endocytoscopy allows to decrease the number of biopsies, to perform targeted biopsy, to exclude false negative histological findings, to estimate the effectiveness of treatment in children with EoE. The results of our research are suboptimal and require accumulation of experience, improvement of targeted biopsy, and exclusion of medicament therapy 3 weeks before the study.

Keywords: endeocytocsopy, eosinophilic esophagitis, optical biopsy, children

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Authors: Tasnia E. Jakia

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This research critically investigates how Bangladeshi migrants in Denmark experience and engages with government-operated telehealth systems such as Sundhed.dk, MitID, and e-Boks ---systems often praised for their effectiveness, yet remain structurally incompatible with the realities of excluded populations. While Denmark’s digital health infrastructure is widely recognized as one of the most advancedglobally, it assumes users’ fluency in the Danish language, digital literacy, and familiarity with bureaucratic protocols—presumptions that turn these systems inaccessible for a significant number of migrant users. Based on ethnographic fieldwork, applying in-depth interviews with first-generation Bangladeshi migrants across multiple regions in Denmark, this research explores how individuals navigate digital health services in their everyday lives. Respondents explain several strategies coping challenges posed by telehealth systems: seeking for help from family members, depending on unofficial community translators, avoiding official portals altogether, or referring to transnational healthcare advice through platforms like WhatsApp. These approaches, while adjusting, emphasize the limits of “universal” digital systems and expose the emotional and cognitive effort needed to operate them. The findings disclose that digital health technologies, though technically reachable, are often not culturally interpretable or emotionally secure for many users. Migrants express feeling isolated by impersonal interfaces, automated language, and an observed lack of human support. Digital platform interactions frequently evoke fear, confusion, or mistrust—especially when they involve sensitive issues like consent forms, medical test results, or legal documents. These experiences cause information gaps, neglected treatment, and postponed treatment, intensifying systemic inequities under the guise of innovation. This paper argues that digital inclusion in telehealth must go beyond infrastructure and accessibility toward a justice-oriented approach that prioritizes trust, cultural sensitivity, and participatory design. The current strategy for digitalization in Danish healthcare risks reinforcing social hierarchies and race-based exclusions enabled by ostensibly neutral technologies. In response, digital health systems must integrate feedback from underserved users, provide relational forms of support, and recognize the multiple perspectives people make sense of, care health, and state systems. By placing migrant experiences at the center of the digital health discussion, this study contributes to the increasing demand for context-aware, ethical, and equity-driven telemedicine systems in welfare societies.

Keywords: digital health, migrant experience, digital exclusion, telehealth service, health

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Authors: Ghazal Rajaie Nezhad, Asghar Haghjoo

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Background and Significance Although considerable research has examined the cognitive features of individuals with autism spectrum disorder (ASD), relatively little is known about the cognitive characteristics of their parents. Investigating verbal and nonverbal intelligence in parents may offer insights into the heritable components and broader autism phenotype (BAP) traits, potentially advancing understanding of ASD’s neurodevelopmental underpinnings. Methods This study assessed cognitive performance in 70 parents of children diagnosed with ASD and 70 demographically matched control parents. Standardized intelligence measures were administered, including the Stanford-Binet Verbal Scales for verbal IQ (VIQ) and Raven’s Progressive Matrices for nonverbal IQ (NVIQ). Discrepancies between VIQ and NVIQ were calculated, and subgroup analyses were conducted based on the communication abilities of the child with ASD (e.g., verbal vs. nonverbal). Results Parents of children with ASD exhibited a significantly smaller VIQ-NVIQ discrepancy (mean difference = 5.2 points) compared to control parents (mean difference = 12.1 points; p < 0.01), indicating a more balanced cognitive profile. While mean NVIQ scores were similar across groups, ASD parents showed superior performance on visual-spatial reasoning tasks, with 65% scoring in the ≥75th percentile on Raven’s Matrices (p = 0.03). Lower VIQ in ASD parents was moderately correlated with challenges in pragmatic language use, particularly in abstract and figurative comprehension (r = 0.45). Notably, parents of nonverbal or minimally verbal children exhibited the greatest VIQ-NVIQ gaps (mean = 13.1 points), closely resembling their children’s cognitive profiles. Conclusions These findings suggest that parents of children with ASD demonstrate distinct cognitive characteristics marked by nonverbal strengths and reduced verbal-nonverbal discrepancies, potentially reflecting heritable features of ASD. The observed patterns support the presence of subclinical traits within the broader autism phenotype and may have implications for family-based genetic research and tailored support strategies. Future studies should examine underlying genecognition pathways and consider the role of these cognitive markers in early identification and intervention planning.

Keywords: autism spectrum disorder, broader autism phenotype, VIQ–NVIQ discrepancy, nonverbal intelligence quotient, visual-spatial reasoning

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Authors: Kimberly Frazier Highfill, Josephine Stradler, Kathyn Bishop, Elizabeth Floeck

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Background: Imitation, a foundational social and cognitive development mechanism, enables individuals to acquire cultural norms, communication skills, and problem-solving strategies. Over-imitation— the replication of both relevant and irrelevant actions demonstrated by others—plays a critical role in social learning. While typically developing children often engage in over-imitation to promote social bonding and affiliation, the role and underlying motivations for over-imitation in children with ASD remain less clearly understood. Purpose: Through a critical synthesis of professional and scholarly literature, this review aims to evaluate the history and development of research on imitation and over-imitation, assess empirical findings regarding typically developing children and children with ASD, identify methodological and conceptual limitations in existing literature, and propose directions for future research. This analysis seeks to provide a nuanced understanding of the role of imitation in social communication development and its clinical relevance for interventions and learning strategies for children with ASD. Methods: A comprehensive search was conducted using the University of Arkansas Libraries OneSearch UARK, which included databases such as Taylor & Francis, EBSCO, MDPI, Elsevier, and ScienceDirect. Keywords such as ‘over-imitation in children with autism’, ‘over-imitation in children with autism and typically developing’ and ‘autism spectrum disorder’ were used to identify relevant peer-reviewed studies published between 2009 and 2024. Articles were included if they focused on imitation behaviors in children with ASD and/or typically developing. Twenty articles met the inclusion criteria and were synthesized for this review. Results: Twenty articles met the inclusion criteria and were included in this review. Data was taken from these articles and then reviewed and synthesized into a table format. The findings suggest that children with ASD engage in over-imitation less frequently and demonstrate different patterns of selective imitation, favoring goal-directed over stylistic imitation. Additionally, the findings indicate that imitation is foundational for the acquisition of pragmatic communication skills. Deficits in imitation among children with ASD are linked to broader challenges in language development, joint attention, and social reciprocity. Conclusions: Children with autism spectrum disorder (ASD) demonstrate distinct patterns of imitation that reflect broader challenges in social motivation, pragmatic communication, and cognitive processing. These findings emphasize that imitation differences in ASD are not simply deficits but complex variations that warrant careful clinical attention. A deeper understanding of these differences has significant implications for speech-language pathology, informing the development of targeted interventions that support social learning and communication growth in this population.

Keywords: communication development, social emotional development, autism spectrum disorders, over-imitation

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Authors: Jawaher Alwatban, Nouf A. Zendi, Mofi M. Walmany, Konrad Schargel

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Pigment dispersion (PD) and plateau iris configuration (PIC) are ocular conditions associated with increased intraocular pressure (IOP) and the development of glaucoma. PD involves the dispersion of pigment epithelium of the iris into the anterior chamber due to contact between the iris and zonular fibers, which subsequently blocks the trabecular meshwork and elevates the IOP. Anatomical variation in PIC narrows the anterior chamber angle. This case report aims to highlight a rare instance of concurrent PD secondary to PIC, conditions that are underreported despite their significant risk of glaucoma-related sequelae. A 64-year-old male presented with blurred vision, pigmented cells in the anterior chamber, and optic disc cupping. Ultrasound biomicroscopy indicated a closed angle with 360-degree anterior rotation of the ciliary body, absence of ciliary sulcus, and chaffing of the posterior iris with the lens capsule and zonules. Collectively, these findings indicated PD secondary to PIC. The condition was managed with phacoemulsification and intraocular lens implantation to address the dual pathology and reduce the risk of glaucoma. The co-occurrence of PD and PIC necessitates vigilant monitoring and tailored therapeutic approaches to prevent irreversible optic nerve damage and vision loss. Additional studies are necessary to clarify the underlying mechanism and optimize diagnostic and treatment strategies for these complex ocular conditions. Early detection and collaborative management are essential in decreasing the risk of glaucoma and preserving visual function in affected individuals.

Keywords: angle closure glaucoma, glaucoma diagnosis and management, iris pigment dispersion, phacoemulsification cataract surgery, plateau iris, ultrasound biomicroscopy

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Authors: Jing Gan, Jia Zhang

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Background:The objective is to analyze the clinical phenotype, treatment response and related risk factors of children with epilepsy, and to provide evidence for improving the diagnosis, treatment and prognosis of children with epilepsy.Methods: This is a prospective study, included children with unexplained epilepsy who attended the pediatric neurology department of our hospital from April 2019 to April 2024 and underwent voluntary genetic testing. Treatment efficacy and developmental were monitored over a long-term follow up 1-5 years. The children were divided into gene-positive group and gene-negative group by genetic testing, and the difference of treatment effect and related risk factors between the two groups were analyzed.Results: A total of 848 children were enrolled in this study, with 484 in the Gene-positive group and 364 in the Gene-negative group. The results of this study showed that the treatment response of Gene-negative group was better than that of Gene-positive group. A multifactorial logistic analysis of risk factors for treatment response differences between the two groups showed that, in the Gene-positive group, abnormalities in physical examination, developmental retardation, and developmental regression were significant high-risk factors for poor treatment response. In the Gene-negative group, comorbidities such as autism, focal seizures, multiple seizure types, and convulsive status epilepticus were identified as high-risk factors for poor treatment response.Conclusion:The Gene-positive group showed more obvious developmental retardation and regression than the Gene-negative group, along with a poorer treatment response.Genetic testing is valuable for assessing prognosis and guiding treatment in children with unexplained epilepsy.

Keywords: children, genetic epilepsy, second-generation sequencing, developmental delay, treatment response

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Authors: Tanya W. Moseley

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Background and Purpose: Digital breast tomosynthesis has revolutionized breast cancer screening by providing three-dimensional imaging that reduces tissue overlap and improves lesion detection. Two distinct approaches have emerged: narrow-angle breast tomosynthesis (NBT), which is FDA-approved and widely implemented, and investigational wide-angle breast tomosynthesis (iWBT), which utilizes a broader angular range for image acquisition. While both technologies aim to enhance breast cancer detection, their comparative performance in clinical settings remains largely unexplored. This study represents the first direct clinical comparison of lesion conspicuity between these two tomosynthesis approaches, addressing a critical knowledge gap in breast imaging technology assessment. Methods: A prospective, IRB-approved study was conducted at a single institution, enrolling 45 women aged 32-84 years (mean 55.5 years) who had suspicious findings on screening NBT examinations requiring diagnostic workup. Participants presented with various breast abnormalities, including masses (n=9), architectural distortions (n=7), asymmetries (n=15), focal asymmetries (n=12), and combined findings (n=2). All enrolled women underwent comprehensive diagnostic imaging using both NBT and iWBT systems during the same visit to eliminate temporal bias. Lesion conspicuity was systematically evaluated through multiple parameters, including BIRADS assessment changes between systems, measurement precision for quantifiable lesions, and qualitative lesion characterization. Conspicuity was defined as the clarity and visibility of imaging findings, representing a critical factor in diagnostic accuracy and clinical decision-making. Results: Comparative analysis revealed that iWBT demonstrated superior lesion conspicuity across multiple lesion types, with BIRADS upgrades occurring in 15.6% of cases (7/45) when transitioning from NBT to iWBT assessment. Architectural distortions showed the most pronounced improvement, with 28.6% (2/7) receiving BIRADS upgrades, followed by asymmetries at 20.0% (3/15), masses at 11.1% (1/9), and focal asymmetries at 8.3% (1/12). Notably, 4.4% of cases (2/45) were upgraded to the clinically significant BIRADS 4 category, indicating suspicious findings requiring tissue sampling. Measurement precision analysis demonstrated excellent consistency for masses between systems (average difference: 0.00 cm), while focal asymmetries exhibited greater measurement variability (average difference: -0.83 cm). Among the subset of cases that underwent biopsy and yielded malignant pathology (n=3), iWBT provided superior lesion characterization in 66.7% of cases compared to NBT, with particular advantages noted for non-mass lesions, including asymmetries and focal asymmetries

Keywords: tomosynthesis, wide angle, narrow angle, lesion conspicuity

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Authors: Wen-Hung Kuo, Shou-Tung Chen, Fang-Ming Chen, Ming-Feng Hou, HsienTang Yeh, King-Jen Chang

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Breast cancer, a major health concern, not only causes physical challenges but also significantly impacts the mental health of patients. This cross-sectional study aims to investigate the psychosocial stressors that patients face throughout their breast cancer journey and to explore potential improvements for patient-centered support strategies. Conducted from February 26 to March 31, 2025, across multiple institutions including the Taiwan Breast Cancer Foundation and Lotung Poh-Ai Hospital, the study included 2,450 valid responses from participants. The findings reveal the primary psychosocial stressors experienced by breast cancer patients. The most significant stressor was the fear at the time of initial diagnosis (69.5%), followed by the fear of recurrence (60.1%). Physical discomfort due to treatment side effects (54.5%) and emotional distress, such as depression and anxiety (44.4%), also emerged as critical challenges. Furthermore, 48.6% of participants reported a negative impact on their self-confidence due to physical changes, while 44.4% feared the uncertainty of their future. In terms of support resources, family support (31.4%) was the most prominent, followed by friends (23.2%) and medical teams (17.4%). An overwhelming 81.4% of patients expressed satisfaction with the support resources they received. Additionally, coping strategies suggested by patients included maintaining a healthy lifestyle, engaging in mindfulness practices, and participating in creative activities. This study highlights the multifaceted nature of psychosocial stress during the breast cancer care continuum. It emphasizes the need for interventions focused on mitigating side effects, providing emotional counseling, and strengthening family and peer-based support networks to enhance the overall well-being of patients throughout their treatment and survivorship phases.

Keywords: breast cancer, stress, treatment journey, cope strategy

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Authors: Sonia Tomescu-Stachie, Katy Sivyer, Andrew Merwood, Sarah Kirby, Miznah Al-Abbadey

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Background: Gynaecological cancers pose a significant global health burden, with over 1.4 million diagnoses reported annually. Despite medical advancements improving survival outcomes, women frequently experience profound psychological and social distress that extends beyond physical recovery. Health psychology research highlights the importance of holistic care approaches, yet comprehensive investigations exploring women's integrated biopsychosocial needs remain inadequately developed in this population. Aim: This qualitative study examined the lived experiences of 22 women affected by gynaecological cancer. Methods: Semi-structured interviews were conducted with women. Data was analyzed using reflexive thematic analysis to identify patterns of meaning across participants, guided by the biopsychosocial model of health. Results: Three interconnected themes were constructed. Within biological needs, participants reported struggles with symptom validation from healthcare providers, insufficient symptom literacy, desire for partnership in treatment decision-making, and navigating the often-overlooked post-treatment care. In terms of psychological needs, women described challenges in meaning-making following diagnosis, identity reconstruction, and reclaiming autonomy, alongside frustration with inaccessible mental health support. Within social needs, participants navigated complex challenges including financial hardship, withdrawal from social connections, altered intimate relationships, and difficulties fulfilling established social roles, while consistently emphasizing the critical importance of meaningful social support and belonging throughout their cancer journey. Implications: Findings highlight significant gaps in current care frameworks for women affected by gynaecological cancers. The research informs the development of a patient-centered online Shared Reading (oSR) intervention, offering an alternative approach to address this gap in psychosocial needs during long mental health support wait times. The research demonstrates how health psychology principles can be applied to both understand complex patient experiences and develop targeted psychosocial interventions that address holistic health needs.

Keywords: biopsychosocial model of health, gynaecological cancers, health psychology, NHS research, oncology, qualitative interviews

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Authors: Mohammed Abdalmalk Abdalla Mahdi, Aya Suliman Ibrahim Suliman

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Background: Malignant pleural mesothelioma (MPM) has few treatment choices and a poor outlook for patients. Researchers have found that BAP1 loss, which can be seen in IHC (immunohistochemistry) tests, may act as a prognostic factor for MPM. Still, experts are not in agreement on how much BAP1 loss affects someone’s prognosis. The purpose of this meta-analysis is to see how much BAP1 loss can influence the outcome of MPM patients. Methods: The search involved PubMed, Embase, and the Cochrane Library up to 29 May 2025, looking for studies that examined BAP1 protein levels by IHC in MPM patients and reported the outcome in terms of overall survival (OS) or progression-free survival (PFS). Including studies meant choosing those that provided hazard ratios (HRs) with 95% confidence intervals (CIs) or the data to estimate them. The process of getting the data and assessing its quality was done by two reviewers separately. The pooled risk was found using random-effects models, and the I² index was applied to assess heterogeneity. Results: There were 12 studies in the meta-analysis, with a total of 1,389 MPM patients. Combining the results showed that people with BAP1 loss had better OS compared to those without (HR = 0.76, 95% CI: 0.63–0.92, p = 0.005). Patients with epithelioid cell type were shown to have a higher effect of BAP1 loss in terms of their prognosis. Even so, a big range of results was seen among the studies (I² = 61%), which might be caused by differences in protocols, antibodies, and scoring systems. Conclusion: Having less BAP1 by IHC can help those with MPM survive for a longer period, mainly for patients with epithelioid cancer. It seems that results from BAP1 IHC exams are valuable for gauging MPM outcomes. Yet, standardizing the techniques for IHC and conducting larger-scale, long-term studies would support confirming these findings and using BAP1 evaluation in clinical therapy.

Keywords: BAP1, pleural mesothelioma, immunohistochemistry, prognosis, meta-analysis

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Authors: Ambassa Axel Cyriaque, Andoseh Geneviève, Tiani Lionel Ulrich, Djuidje Ngounoue Marceline, Kamdem Thiomo Diane, Assam Assam Jean Paul, Tongo Marcel Passo, Penlap Beng Véronique

Abstract:

Background: Tuberculosis (TB) is still a serious public health problem, especially in countries where people are often infected with other diseases like HIV and intestinal worms (helminths). These co-infections can make TB harder to treat and control. In addition, some TB bacteria become resistant to standard medicines, making treatment more difficult. It is important to understand which types of Mycobacterium tuberculosis are circulating in the population and how resistant they are to drugs. This study aimed to explore both the drug resistance and the genetic diversity of TB bacteria in patients also infected with HIV and helminths in Yaoundé, Cameroon. Materials and Methods: This cross-sectional study was conducted between April 2022 and March 2023 at Jamot Hospital in Yaoundé. A total of 263 patients with smear-positive pulmonary TB were enrolled. Sputum samples were cultured and tested for drug resistance and bacterial typing using spoligotyping. Blood samples were used to detect HIV using rapid immunochromatographic tests confirmed by immunoassay. Stool samples were examined for helminths using the Kato-Katz and Mini-FLOTAC methods. Results: Out of the 263 TB patients, 186 (70.7%) were men. HIV infection was found in 31 patients (11.8%), and 35 patients (13.3%) had helminth infections. Among the 130 TB samples tested for drug resistance, 26 (20%) showed resistance to at least one TB drug. Multidrug-resistant TB (MDR-TB) was found in 9 patients (6.9%), and it was more frequent in those also infected with HIV (66.7%). Genetic analysis revealed that the most common TB bacteria were of the Cameroon SIT 61 family (30.8%, 40/130), followed by Ghana SIT 53 (15.4%, 20/130). MDR strains of Cameroon SIT 61 were found in TB patients with no co-infection (2/2), those with helminth infections (1/1), and those with HIV (2/6). Conclusion: This study shows that HIV and helminth co-infections are linked with the presence of drug-resistant TB in Yaoundé. The Cameroon SIT 61 strain appears to play a major role in this resistance. These findings highlight the need for improved TB control programs that take co-infections into account and promote targeted treatment strategies.

Keywords: tuberculosis, HIV helminths, drug resistance, genetic diversity

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Authors: Esraa A. Alsawah, Assad A. Ghanem, Mona Abdelkader, Rasha M. El-Zeini

Abstract:

Purpose: The current study aimed to assess contrast sensitivity and retinal nerve fiber layer (RNFL) thickness in patients with primary open-angle glaucoma (POAG) and to evaluate their correlations. Patients and Methods: This was a cross-sectional observational analytical study conducted on a total of 195 eyes, including 95 eyes of 55 patients with POAG and 100 healthy control (HC) eyes of 50 subjects. The glaucomatous eyes were divided into three groups (mild, moderate, and severe). Most of the studied cases were mild (41.1%), while moderate and severe degrees were recorded in 26.3% and 32.6% of cases, respectively. Contrast Sensitivity Assessment was done by the Pelli-Robson Test and Oculus Mesotest II. Results: The mean age of patients with POAG was (57.89±8.49) years, while in the control group it was (55.59±10.37) years. There were statistically significant differences between the two groups as regards BCVA and IOP. POAG groups were associated with a highly significant increase in Cup/disc ratio (CDR) and a highly significant decrease in the mean deviation compared to the control group. There was a statistically significant decrease in contrast sensitivity and a highly statistically significant decrease in RNFL thickness in the patient’ group in comparison with the control group. There were highly statistically significant positive correlations between contrast sensitivity assessment and all RNFL parameters. Conclusion: Contrast sensitivity has been correlated with RNFL thickness in POAG patients. Contrast sensitivity and RNFL thickness play an important role in detection of POAG.

Keywords: intraocular pressure, nerve fiber layer, optical coherence tomography, visual acuity, primary open angle glaucoma, contrast sensitivity

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Authors: Pallavi Sharma

Abstract:

Social media is now a strong part of modern life and young people are the most active users. While it helps them connect and learn, it also brings mental health issues. Many youngsters face anxiety, low confidence, disturbed sleep, and behavioral changes due to constant phone use. This article explores these issues from a homeopathic perspective including the miasmatic background offering insights into natural remedies that can support mental balance and emotional healing in today’s digital age.

Keywords: mental health challenges in social media age, miasmatic interpretation, homeopathic point of view regarding mental health of new generation due to social media use, lifestyle and emotional support

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Authors: Charles Kambale Vagheni, Daudet Byakya Kikukama, Prince Kimpanga

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To cover meat needs, the population of Kinshasa can buy frozen chicken meat either in open markets or in frozen meat retail outlets. The microbiological quality of this chicken meat is not well certified before consumption. The objective of this study was to determine the microbiological quality of frozen chicken meat sold in the municipal markets of Kinshasa. A descriptive study was conducted between May 15 and June 16, 2023 among frozen chicken sellers in three markets in Kinshasa. Sixty samples of frozen chicken were purchased randomly from different outlets in the targeted markets and analyzed at the veterinary laboratory using standard microbiological methods. Of the sixty samples of frozen chicken meat taken in the three markets, total germs (93%), fecal coliforms (60%), fecal streptococci (46.6%), Staphylococcus aureus (20%) and yeasts (6.7%) were present in half of the frozen chicken meat samples with proportions varying depending on the market. In light of these results, we can conclude that frozen chicken meat, sold in the Kinshasa markets, does not offer a sufficient guarantee of safety, particularly with contamination as significant as that found in this study.

Keywords: hygiene, slaughterhouse, bacteriological analysis, chicken carcasses

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Authors: Ahmad Abdullah Salman Alharbi

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Background: Prehospital staff, Emergency Medical Technicians, and paramedics need appropriate training to deal with major incidents. Despite the fact that Kuwait has experienced many major incidents and is located in a politically conflict zone, there is no standardized preparedness training for prehospital care providers for disasters or major incidents. This study aimed to assess the effect of a training intervention in improving the knowledge and awareness of EMTs and paramedics in the Kuwait Emergency Medical Service (KEMS). Methods: An interventional study was conducted in the Kuwait Emergency Medical Services. Thirty-one participants from different ambulance districts were included in two educational interventions. Repeated measures analysis of variance (ANOVA), t-test, and one-way ANOVA test were used to analyze the data. Results: The mean score was significantly higher immediately after the first training program [18.2; standard error (SE):1.9] than before (12.4; SE: 2.8) (P <0.001). The mean score three months later was significantly higher (19.8; SE: 0.5) immediately after the intervention program (P <0.001). Conclusion: The primary aim of improving preparedness among prehospital care providers has been achieved through the training program. The test results showed an improvement in the score achieved by the participating prehospital care providers. This type of training course would increase the competency and the confidence of prehospital care providers in providing emergency services.

Keywords: mass casualty, simulation, EMS, training

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Authors: M. Silva, J. Silva, R. Carolina de Carvalho, A. L. Silva, G. Santos Pereira

Abstract:

Background and aims: Neonatal pain exposure can have lasting impacts on nervous system development, especially in preterm infants who undergo repeated painful procedures. These experiences may predispose them to altered pain processing and chronic pain in adulthood. This study investigates the long-term effects of neonatal repetitive pinprick (PP) stimulation on neuropathic pain sensitivity in adulthood.Methods: Term and preterm rat pups were assigned to neonatal PP stimulation or control (CC) groups. PP stimulation involved consistent pinprick applications at set intervals. In adulthood, neuropathic pain was induced using a standardized nerve injury model. Mechanical and thermal thresholds were measured with von Frey filaments and a hot plate test, and behavioral pain responses were evaluated.Both male and female rats were included to examine gender differences. Maternal behavior, litter weight, and offspring growth were also monitored for potential developmental impacts.Results: PP stimulation did not affect baseline nociceptive thresholds in adulthood. However, after neuropathic pain induction, rats subjected to neonatal PP stimulation showed increased mechanical hypersensitivity compared to the CC group, particularly in preterm rats, indicating higher vulnerability due to early exposure. Females exhibited greater hypersensitivity than males, suggesting sex-specific effects.No differences in maternal behavior, litter weight, or offspring growth were observed between groups, indicating no developmental disturbances from the neonatal stimulation.Conclusions: Neonatal PP stimulation resulted in increased neuropathic pain hypersensitivity in adulthood, with more pronounced effects in preterm rats and females. These findings underscore how early pain experiences can shape long-term sensory processing, emphasizing the potential long-term consequences of neonatal pain, especially in preterm infants.

Keywords: pain, neurophatic pain, preterm rats, neurobiology

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Authors: Danish Sheikh, Peter Xavier, Ali Al-Rikabi

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Solitary neurofibromas are rare, benign peripheral nerve sheath tumours that infrequently occur in the oral cavity and are even more rarely associated with the lingual nerve. We present the case of a OMF surgeon who encountered a well-defined, asymptomatic swelling on the lingual aspect of the mandible in a woman in her 20s. Cone beam CT and MRI identified a soft tissue lesion adjacent to the lower left second and third molars. The lesion showed no communication with the mandibular canal and was separate from the inferior alveolar nerve. Histopathological examination confirmed a neurofibroma. Anatomical localisation and preserved sensory function supported a diagnosis of lingual nerve origin. Given the benign nature of the tumour and potential risks of nerve injury, the case was managed conservatively with regular imaging. This report highlights the importance of considering lingual nerve neurofibroma in differential diagnoses of intraoral swellings and demonstrates the value of anatomical reasoning and multidisciplinary input in decision-making.

Keywords: benign tumour, intraoral swelling, lingual nerve, neurofibroma, peripheral nerve sheath

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Authors: Syed Hashim Ali Inam, Bismah Riaz, Hamza Jamil, Daneyal Rafique, Umair Asif Siddiqi, Mishal Iqbal, Nawabzada Zeerak Farhat Sherwani , Waqas Khan

Abstract:

Introduction: Osteoarthritis (OA) is a degenerative disease of joints which if untreated can lead to a permanent disability of joints. Obesity plays an important role in the morbidity of OA. Since there is no curative treatment for OA, several researches focusing on nonpharmacological intervention for OA have come forth. Triad of education, exercise, and weight loss has been gaining popularity as a first-line nonpharmacological treatment for OA. This article measures the number of OA patients, irrespective of age and gender, who have received weight-loss counseling from their physicians and it also studies patients' willingness to lose weight after being counseled. Methodology: A cross-sectional study was conducted from 10th June 2020 to 10th July 2020. Diagnosed cases of OA were included and their consent was taken. A self-administered questionnaire was used which included questions asking if they have ever received weight-loss counseling and if they will try to lose weight on being advised by their physician. Data were collected from the participants using google forms and analyzed using SPSS-22. Results: Out of 199 OA patients included in our study, only 28 (14%) participants received weight loss and exercise counseling from their physicians. A positive response was observed in 175 (87.9%) participants out of 199 who reported that they would exercise and practice a healthy lifestyle to lose weight if they were advised properly. Conclusion: Results of our study showed that the total number of OA patients receiving advice from their treating physician regarding weight loss is less. However, the majority of the patients were willing to exercise and control their weight if advised properly by their physician.

Keywords: arthritis, weight loss counselling, exercise, physician counselling, osteoarthritis

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Authors: Anum Arif, Bismah Riaz, Ahsan Manzoor Bhatti, Nawabzada Zeerak Farhat Sherwani, Aima Sohail, Aitizaz Shahid, Syed Hashim Ali Inam

Abstract:

Objective: This prospective, pilot randomized double-blind study aimed to compare the effects of buffered and non-buffered xylocaine solutions on injection pain and anesthesia effectiveness in patients undergoing arteriovenous fistula surgery. Material and methods: A total of 100 adult patients meeting inclusion criteria undergoing arteriovenous fistula surgery were included in the study. They were split into two groups at random. The control group received 1% xylocaine dissolved in 5 ml distilled water, while the intervention group received sodium bicarbonate mixed with 1% xylocaine solution as a local anesthetic. The patients were asked to rate the pain of first and subsequent injections on a visual analog scale (VAS). Besides, the need for extra analgesia was investigated. The mean and standard deviation of the data was determined. Results: During both the first and subsequent injections, the alkalinized local anesthetic group showed substantially lower VAS scores. In the alkalinized local anesthetic group, anesthesia satisfaction was also more than three times higher. Furthermore, the non-alkalinized group's mean analgesic requirement was higher than the intervention group. Conclusion: Our findings support the effectiveness of the alkalinized local anesthetic solution in minimizing injection pain and increasing anesthesia duration and overall patient's surgical experience in terms of anesthesia satisfaction score.

Keywords: pain, local anesthetics, alkalinization, sodium bicarbonate, buffered

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Authors: Yasser Alhajlah

Abstract:

The advent of digital technology has revolutionized the field of dentistry, enhancing precision, efficiency, and patient outcomes. This presentation explores the practical applications of digital design in dentistry, focusing on tools such as CAD/CAM systems, 3D printing, and digital imaging. We will examine how these technologies streamline workflows, improve the accuracy of restorations, and enable personalized treatment plans. Case studies will illustrate successful implementation, highlighting the benefits for both practitioners and patients. Participants will gain insights into integrating digital design into their practice, ultimately advancing the future of dental care.

Keywords: practical design in digital dentistry, AI, dentest, dental

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Authors: Sohima Anower, Soma Rani Roy

Abstract:

Purpose: The study evaluate the preoperative and postoperative binocular status and the impact of strabismus surgery on functional and aesthetic outcomes in adults. Methods: The study was conducted on 28 adult patients with horizontal strabismus between September 2023 to August 2024. The study included a detailed assessment of the type of strabismus, preoperative measurements cover test, prism cover test, binocular single vision (BSV), and stereopsis. Binocularity was measured by the Titmus stereo test and the Worth 4-dot test. Surgical indications were derived from patient notes, and final outcomes were carefully documented. Postoperative evaluation was performed 6 weeks after surgery, focusing on any changes in stereoacuity. The success rate of surgery was defined by achieving orthophoria with less than 10 prism diopters of deviation. The degree of ocular misalignment or deviation is measured in prism diopters; a value of fewer than 10 prism diopters often indicates satisfactory post-operative alignment. In addition, patients were also asked to provide subjective feedback on their surgical outcomes. Results: The study involved 28 adult strabismus patients, consisting of 10 males (35.71%) and 18 females (64.29%), with a mean age of 23.22 years (ranging from 15 to 45 years). Among the two types of deviations, 67.9% of patients had exodeviation, and 32.1% had esodeviation. Indications for surgery in the most cases were aesthetic (46.4%). The criterion for achieving orthophoria with less than 10 prism diopters of deviation in the post-operative period was met by 82% of the patients. Additionally, among the patients who had strabismus surgery, a total of 42.8%(12 patients)showed improvements in stereo acuity and 67.9% (19 patients)in a binocular single vision. The overall improvement in binocularity after 6 weeks of strabismus surgery was 55.3%. Regarding visual acuity, 60.7% of patients had 6/6 vision preoperatively, and after strabismus correction, 67.8% achieved 6/6 best corrected visual acuities postoperatively. A total of 16 patients (57.1%) expressed satisfaction with their depth perception after surgery. However, 18 patients required secondary management after their initial surgery. Conclusion: Strabismus surgery is safe and effective for adults, improving binocular function and restoring ocular alignment, which should be considered a reconstructive procedure, not just a cosmetic one.

Keywords: surgery, adult, strabismus, deviation, success

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Authors: Talhah Chaudri, Pervez Nedaie, Zain Butt, Waleed Qayyum, Alaa Alqassab, Anjalee Chaurasia, Rajan Chand, Salman Ghani

Abstract:

Background: When patients are admitted to the hospital, regular medications are often prescribed without confirming whether that day’s dose has already been taken. If a morning dose has been missed and no one-off (stat) dose is prescribed, the patient may wait up to 24 hours - or in rare cases, up to 48 hours - for the next scheduled dose. While this is inconsequential for some drugs, others are time-critical (e.g. levodopa, insulin, antiepileptics, corticosteroids, anticoagulants), and omissions can result in harm. Aim: The study aims to improve same-day prescribing of missed regular medications during hospital admission through two low-cost interventions: verbal reminders and visible poster prompts. Methods: A prospective audit was conducted between January and April 2025 at a teaching hospital in the West Midlands (UK), covering the Medical Assessment Unit and Emergency Department. Junior doctors audited their peers’ prescribing practices following patient clerking. If a patient had missed their usual morning dose, auditors checked whether an appropriate one-off dose was prescribed. Data collection was conducted across multiple 8 or 12-hour shifts and distributed among authors to minimise bias and disruption. After baseline data collection, two sequential interventions were implemented: (1) informal peer-to-peer verbal reminders; and (2) visual prompts displayed at prescribing workstations. The primary outcome was the proportion of missed morning doses that were appropriately prescribed as one-offs. Chi-squared and two-proportion z-tests were used for analysis, alongside effect size calculations. PRN medications, newly-initiated medications, night-time drugs, and certain specialist agents (e.g. chemotherapy, monoclonal antibodies) were excluded. Results: Among patients who had missed their morning dose, only 19.1% received an appropriate one-off at baseline (Group 1). This rose to 25.0% after verbal reminders (Group 2; p = 0.082 vs baseline), and to 39.9% following poster prompts (Group 3; p < 0.01 vs baseline, p < 0.01 vs verbal). Missed time-critical medications included levothyroxine, steroids, anti-epileptics (e.g. levetiracetam and lacosamide), DOACs and insulin - some of which were omitted for almost 24 hours. Conclusions: A significant proportion of patients admitted to the hospital miss medications unnecessarily. While verbal reminders led to only modest improvements, visual cues at the point of prescribing nearly doubled appropriate one-off prescribing. Embedding such prompts into electronic systems or junior doctor inductions may further compliance in future cycles. Although missing a single dose may be safe for some drugs, others require strict adherence, highlighting the importance of safeguards against unintentional omissions.

Keywords: medication safety, acute admissions, quality improvement, geriatric medicine, prescribing practice, patient safety

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