Scopus Research — Alaa Hamza Hermis jabar Alsaeedi

Background: AI tools are increasingly visible in nursing education and practice, yet student exposure and acceptance vary across settings. Limited digital literacy and technology anxiety may contribute to impostor syndrome (IS) in academic and clinical environments. Objective: To assess and compare attitudes toward AI and the prevalence of IS among nursing students in five countries (Iraq, Egypt, Saudi Arabia, Jordan, and the UAE) and to examine their association. Methods: Cross-sectional, descriptive–correlational survey of 1772 undergraduate nursing students from Iraq, Egypt, Saudi Arabia, Jordan, and the UAE (convenience sampling). Instruments were the General Attitudes toward AI Scale (20 items, Positive/Negative subscales) and the Clance Impostor Phenomenon Scale (CIPS; 20 items), plus demographics and technology-related variables (AI information sources, application type, prior training, and AI confidence). Group differences used t-tests/ANOVA with post-hoc tests; associations used Pearson correlations and multivariable linear regression with country fixed effects and robust SEs. Results: Attitudes toward AI and IS differed by country, academic level, work status, information source, application used, and AI confidence (all p <. 001). Iraqi students reported the most favorable AI attitudes; Egyptian and Iraqi students showed higher CIPS scores in bivariate analyses. First-year and younger students had higher IS. AI attitudes correlated negatively with IS (r = −0.206, p <. 001). In regression, greater AI confidence and academic level predicted higher AI attitudes, whereas higher AI attitudes, upper academic levels, and AI training predicted lower IS. Conclusions: More favorable attitudes toward AI were associated with lower impostor feelings. Context-appropriate AI education (paired with ethics/academic-integrity guidance) and targeted psychological support may foster technological readiness and mitigate impostor experiences. Implications: Integrate structured AI literacy (where permitted), ensure equitable digital access, and provide mentorship and mental-health support—especially for early-year students. © 2026 Elsevier Ltd

Diabetes mellitus (DM) is a globally prevalent metabolic disorder with rising incidence. Diabetic peripheral neuropathy (DPN), the most common microvascular complication in DM, disrupts autonomic nervous system regulation of cardiac and circulatory functions, thereby increasing susceptibility to cardiovascular and cerebrovascular events. Elucidating the relationship between diabetic DPN and cardiovascular complications is critical for optimizing holistic management of diabetic patients. This study aimed to investigate the correlation between DPN and cardiovascular events in patients attending the Diabetes Clinic of Rafsanjan University of Medical Sciences, Iran. In this cross-sectional study, 260 patients with type 2 diabetes mellitus (T2DM), diagnosed per the American Diabetes Association (ADA) 2023 criteria, were enrolled via convenience sampling. The patients with cardiovascular complications group comprised 121 patients with T2DM and documented cardiovascular events, while the control group included 138 patients with T2DM and no cardiovascular history. Data on demographic characteristics, body mass index (BMI), blood pressure, clinical laboratory parameters, and neuropathy severity (assessed via the Michigan Neuropathy Screening Instrument [MNSI]) were collected. Statistical analysis was performed using SPSS version 22. The patients with cardiovascular complications had significantly higher neuropathy scores (p = 0.039), longer diabetes duration (p < 0.05), greater prevalence of hypertension (p < 0.001), and elevated serum creatinine (p = 0.020) compared to those without cardiovascular complications. In multivariable logistic regression, severe diabetic neuropathy (score > 4) was associated with increased odds of cardiovascular complications in the unadjusted model (OR = 1.73, 95% CI: 1.03–2.91) and after adjustment for demographic and lifestyle factors (adjusted OR = 2.07, 95% CI: 1.07–3.97; p = 0.030). A significant crude association was also observed for each one-unit increase in continuous neuropathy score (OR = 1.09, 95% CI: 1.01–1.18; p = 0.021). A significant association was found between peripheral neuropathy and increased odds of cardiovascular disease in T2DM patients. This underscores the potential role of neuropathy as a marker for cardiovascular risk. Further longitudinal studies are warranted to explore the mechanistic interplay between neuropathy progression and cardiovascular outcomes. © The Author(s) 2025.

Background: Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder associated with cardiovascular, metabolic, and psychological complications. Data on its prevalence in Arab countries remain scarce. This study aimed to estimate the pooled prevalence of OSA in Egypt, Jordan, Oman, and Iraq, and to explore sources of heterogeneity. Methods: A systematic search of major scientific databases was conducted to identify studies up to 2025. Pooled prevalence was calculated using a random-effects model and Heterogeneity was assessed. Subgroup analyses were performed by country and diagnostic tool, and meta-regression examined temporal trends. Publication bias was evaluated with Egger’s and Begg’s tests, and adjusted using the trim-and-fill method. Results: Fifty studies with 58 prevalence estimates involving 881,184 participants were included. The pooled prevalence of OSA was 33.0% (95% CI: 28.3%–37.8%), with marked heterogeneity (I2 = 99.8%). Subgroup analysis showed higher prevalence in Egypt (39%) compared with Jordan (28%) and other Arab countries (24%). No significant differences were observed between diagnostic tools, and heterogeneity persisted across subgroups. Meta-regression revealed no significant change in prevalence over time. Evidence of small-study effects was found; after trim-and-fill adjustment, the pooled prevalence rose to 37.1%. Conclusion: OSA prevalence in Arab countries is higher than in many Western populations, representing a significant public health concern. The persistent heterogeneity and stable prevalence suggest that risk factors such as obesity, sedentary lifestyle, and genetic predisposition remain unchanged. These findings underscore the need for targeted prevention, systematic screening, and improved diagnostic standards to reduce the disease burden. © 2026 Taylor & Francis Group, LLC.

Background: Academic thriving encompasses students’ cognitive engagement, emotional well-being, and sense of belonging. The educational environment plays a vital role in supporting thriving, particularly in the demanding context of medical education. Limited multinational data exists on how educational environments influence thriving in MENA region. This study was designed to investigate the relationship between the educational environment and academic thriving among medical students across Arabic-speaking countries, using validated assessment tools. Methods: A cross-sectional, descriptive-correlational design was employed. A total of 1,246 undergraduate medical students from five Arab countries participated in an online survey conducted between February and March 2025. The Dundee Ready Education Environment Measure (DREEM) assessed perceptions of the educational environment, while the Thriving Quotient (TQ) evaluated students’ academic engagement and well-being. Data were analyzed using descriptive statistics, inferential tests, correlation, and regression analyses. Results: Participants reported generally positive perceptions of their educational environment (mean DREEM score: 113.79 ± 27.76) and moderate levels of thriving (Overall TQ mean was 95.38 ± 18.22). Strongest correlations with academic thriving were found in the domains of academic self-perception and social self-perception. Regression analysis revealed that educational environment variables explained 38.7% of the variance in thriving outcomes (p < 0.001). Socio-demographic variables, including gender, financial status, and awareness of student support services, significantly influenced both DREEM and TQ scores. Conclusions: The educational environment plays a significant role in shaping academic thriving among medical students. Institutions should focus on improving academic support, fostering inclusive environments, and strengthening student-centered teaching strategies to enhance both learning and psychological outcomes. Clinical trial number: Not applicable. © The Author(s) 2025.

Background: Diabetes mellitus (DM), in particular type II, has lately become a serious medical condition with elevated probability of increasing comorbidity, because it is a lifelong illness that needs both good self-care and a person with sufficient knowledge about the disease. Objectives: The aim of this study to find the association between the patients' knowledge on type II diabetes and self-care outcome. Materials and Methods: The study was carried out using a descriptive research approach. To achieve the objectives of the study, the researcher created the questionnaire. A descriptive study design from 50 patients was chosen. The validity of the instrument was assured by 11 experts, and the instrument’s reliability was established through making a pilot study. The data were analyzed through using descriptive and inferential statistics by using of SPSS version 20.0 for analysis of questionnaire, The level of Cronbach’s alpha for patient knowledge (20 items) is (0.82), while self-care (30 items) is (0.81). Results: The study findings indicated a significant association between the patient knowledge and self-care at P value (0.008) < 0.05. Conclusion: The majority of patients with DM have a significant association between the patients knowledge and self-care outcome. © 2025 Medical Journal of Babylon | Published by Wolters Kluwer - Medknow.

Background: Metabolic syndrome (MetS) is a recognized risk factor for coronary artery calcification (CAC), a subclinical marker of atherosclerosis associated with elevated cardiovascular risk. However, the prevalence and determinants of CAC in individuals with MetS have not been comprehensively synthesized. This systematic review and meta-analysis aimed to estimate the pooled prevalence of CAC and identify associated factors among adults with MetS. Methods: A comprehensive search was conducted in PubMed, LILACS, Web of Science, Embase, Scopus, AJOL, and gray literature through December 2024, following PRISMA 2020 guidelines. Eligible studies included adults (≥ 18 years) with MetS, defined by established criteria, and reported CAC scores via validated CT imaging techniques. Observational studies and RCTs were included. Study quality was assessed using the Joanna Briggs Institute checklist. Pooled estimates were derived using a random-effects model, and heterogeneity was assessed with the I2 statistic. Results: In total, 17 studies comprising 20 745 individuals were included. The pooled prevalence of CAC in adults with MetS was 39.8% (95% CI: 28.4%–52.5%), with wide variation across study design, geography, and imaging modality. Males had a higher CAC prevalence (RR: 2.00), and MetS was linked to increased CAC scores (SMD: 0.10) and odds of calcification (OR: 1.34–1.50). Subgroup analyses showed variability by region and CT modality. High CAC scores were associated with elevated cardiovascular event rates. Conclusion: CAC affects ~40% of adults with MetS and is associated with higher cardiovascular risk. These findings support the integration of CAC screening in MetS management strategies. © 2025 The Author(s). Clinical Cardiology published by Wiley Periodicals LLC.

Introduction: Abnormalities of the coronary arteries, including abnormal origins, are often detected in heart patients who undergo coronary angiography. Although only a small percentage of these abnormalities lead to serious complications, the consequences can be extremely fatal. Case presentation: We report the case of a 62-year-old woman who presented with chest pain. The patient has a history of hypertension and complains of chest pain that worsens with walking and improves with rest. A basic electrocardiogram (ECG) showed sinus rhythm with no signs of arrhythmia or ischemic changes. Coronary angiography revealed an anomalous left coronary artery originating from the right sinus of Valsalva (RSoV). Conclusions: We report a rare case of an anomalous left coronary artery originating from the RSoV without specific clinical symptoms. The patient presented with unstable angina, and after further investigation, this anomaly was diagnosed. Investigating these abnormalities, especially in young individuals with cardiac symptoms, should be prioritized. Cardiologists should also be aware of this rare condition that can have fatal consequences. © The Author(s) 2024.

Background: The optimal strategy for managing older patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) is uncertain. We aimed to compare the outcomes of invasive vs. conservative strategies for managing NSTE-ACS in older patients ≥65 years. Methods: We systematically searched MEDLINE, Embase, CENTRAL, and ClinicalTrials.gov, up to March 2025. We included randomized controlled trials (RCTs) comparing a routine invasive treatment strategy with conservative management alone in patients ≥65 years old with NTE-ACS. We pooled risk ratios (RRs) and hazard ratios (HRs) under a random-effects model. Results: We included 8 RCTs (3,887 patients). There was no significant difference between invasive and conservative management in the risk of a composite outcome of all-cause mortality or MI (RR 0.91, 95% CI: 0.79, 1.06; HR 0.88, 95% CI: 0.74, 1.05), and all-cause mortality (RR 1.05, 95% CI: 0.93, 1.17; HR 1.03, 95% CI: 0.90, 1.19). Invasive management significantly decreased the risk of MI (RR 0.70, 95% CI: 0.55, 0.89) and revascularization (RR 0.29, 95% CI: 0.21, 0.40). There was no significant difference between the two strategies in the risk of cardiovascular mortality (RR 1.09, 95% CI: 0.87, 1.35) and stroke (RR 0.77; 95% CI: 0.53, 1.12). Invasive management increased the incidence of severe bleeding (RR 1.43; 95% CI: 1.05, 1.94). Conclusions: An invasive strategy in older patients with NSTE-ACS decreased the risk of MI and the need for revascularization. Future RCTs need longer follow-ups and should be conducted in ethnically diverse populations to enhance generalizability. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024629566, PROSPERO CRD42024629566. 2025 Vats, Shahjehan, Kumar, Sanapala, Mittal, Herazo, Nimer, Raparthi, Arora, Balagoni, Hermis, Mohammad, Cheema, Nadeem, Khan, Rehman, Farhan and Ahmed.

Background: Q fever is a serious and contagious disease that has the potential to cause an epidemic. Therefore, this research paper was prepared to inform health workers about the disease in order to prevent the spread of the disease, as happened with the coronavirus. We found that most health workers had little information about Q fever. Coxiella burnetii is the microscopic organism that causes Q fever. The study aimed to assess healthcare provider knowledge regarding the prevention of Coxiella burnetii infection (Q Fever) in Hilla City Hospitals and its associated sociodemographic variables. Materials and Methods: A descriptive correlational study design was conducted in Hilla City Hospitals from November 2023 to March 2024. The study sample, consisting of 95 nurses was chosen according to nonprobability sampling methods. The questionnaire, consisting of 20 items, was validated by experts and tested for reliability through a pilot study. Data collection involved self-reporting, and both descriptive and inferential statistical analyses were applied for data analysis. Results: The study findings indicate an average age of 26.38 years, with a majority being female (55.8%). About 65.3% were unmarried, 47.4% had Bachelor's degrees, 32.6% had diplomas, and 20.0% had postgraduate degrees. Nurses had experience ranging from 1 to 13 years (average 3.86 years). The study revealed that 73.7% exhibited low knowledge of Q fever, with an average score of 6.57. Gender (P = 0.000) and education level (P = 0.00) significantly predicted knowledge, with females and higher education correlating with greater understanding. Conclusion: It highlights a serious issue of healthcare provider irresponsiveness, in regard to this infection, during the provision of medical care. Male nurses and those who are more educated are more knowledgeable about the subject. The fact that knowledge is greater among those who are educated and male nurses again highlights the need for special education and training of people who fall between these gender and educational categories. © 2025 Journal of Education and Health Promotion.

Background: Cervical esophageal adenocarcinoma is a rare tumor often associated with Barrett’s esophagus, and its prevalence is lower than distal esophageal adenocarcinoma. Upper esophageal malignancies are usually squamous cell carcinomata; about 5% of these cases are seen during upper gastrointestinal endoscopy. Case presentation: We present a patient (a 39-year-old Iranian man) with invasive adenocarcinoma of the proximal third of the esophagus, who was referred to the hospital with no endoscopic or histopathologic evidence of Barrett’s esophagus. We discuss the probable cause of this tumor and treatment options and emphasize the importance of recognizing and managing this rare disease. Conclusions: This case highlights the rarity of this adenocarcinoma and emphasizes the potential of chemotherapy as a standalone treatment, as well as the need for personalized therapeutic strategies and further research for the management of esophageal cancer. © The Author(s) 2025.

Background and Aims: Systemic lupus erythematosus (SLE) is a recurrent and remitting autoimmune disease that affects many organ systems. It is more common in women of reproductive age, with a 9:1 female preponderance. Due to the lack of data from developing countries, our study aims to provide comprehensive insights into the drug history and SLE laboratory findings among Iraqi patients. Methodology: It is a cross-sectional study at the Baghdad Medical Complex in Iraq. All SLE patients who attended the outpatient clinic between September and December 2022 were included. The patients included those who came for follow-up, deterioration of their symptoms, or a first-time diagnosis. Results: SLE is much more prevalent among female patients. The ratio of female and male patients in our study was 19:1. This disease is more prevalent in the reproductive age group, with the mean age of our patients being 34 years, although the range spans from 15 to 85 years. The most prevalent signs and symptoms among the patients were photosensitivity (79.5%), hair loss (74%), and malar rash (72.5%). Most patients had positive antinuclear antibodies and anti-double-stranded DNA antibodies, with 73.5% and 65% testing positive, respectively. Conclusion: In conclusion, this study represents an important step in exploring SLE within Iraq, providing invaluable insights into its management and laboratory findings. The findings contribute to the global understanding of SLE. This study underscores the significance of Iraq's genetic backgrounds and environmental conditions, which are different from those of other countries, in the process of enhancing the global medical literature and expanding our understanding of SLE patterns around the world. © 2025 The Author(s). Health Science Reports published by Wiley Periodicals LLC.

Background: Dementia is an escalating public health challenge in the MENA region, where primary healthcare professionals’ (HCPs) knowledge and preparedness remain underexplored. Understanding their knowledge and attitudes is vital for early diagnosis, quality care, and effective awareness strategies. Methods: We conducted a cross-sectional study of 1224 HCPs across several Arab countries, primarily in primary care settings. Data were collected via an online survey using two validated instruments: the Dementia Knowledge Assessment Scale (DKAS) and the Dementia Attitudes Scale (DAS). Results: Most participants demonstrated moderate knowledge (68.5%), while 19.9% demonstrated poor knowledge and 11.5% demonstrated good knowledge. Attitudes were largely neutral to positive (44.1%). Multivariate analysis revealed that higher age predicted better knowledge (OR = 1.04, 95% CI: 1.02-1.06, P < .001), while positive attitudes were significantly associated with older age (OR = 1.02, 95% CI: 1.01-1.04, P = .002), female gender (OR = 1.44, 95% CI: 1.14-1.84, P = .003), and higher knowledge scores (OR = 1.23, 95% CI: 1.17-1.28, P < .001). Conclusion: moderate knowledge and generally positive attitudes, important gaps persist. Tailored education, particularly for younger and male HCPs, is needed to improve dementia literacy and care. © The Author(s) 2025

Aim: Non-suicidal self-injury (NSSI) is a public health problem throughout the world. Nurses are usually the first caregivers in the mental health team who deal with people with NSSI. Since the consequences of self-injury are associated with its care and treatment, nurses' attitudes towards these people are an important issue. This study aimed to develop and test a scale to measure nurses' attitudes towards patients with non-suicidal self-injury in the Farsi language. Design: A methodological survey. Methods: In this methodological study, to scale preparation, psychometric steps were performed on a questionnaire based on the results of a qualitative study and literature review. Exploratory Factor Analysis was conducted to identify the underlying structure of the scale. Results: The results of the psychometric evaluation showed that the scale included the 22-item NANSSI in four dimensions, including negativism about the consequences of caring, adopting a counselling approach, violating caring norms, and perceptions about self-injury. By Cronbach's alpha equal to 0.75, its reliability is estimated. This scale showed a good validity and reliability, which is applicable to evaluate quality of care for patients with non-suicidal self-injury. No Patient or Public Contribution: No patient or public contribution. © 2025 The Author(s). Nursing Open published by John Wiley & Sons Ltd.

Background: The role of corticosteroids in the treatment of community-acquired pneumonia (CAP) remains uncertain. We conducted an updated meta-analysis to investigate the effectiveness and potential effect modifiers of adjunctive corticosteroids in patients with CAP. Methods: The protocol of this meta-analysis was registered with PROSPERO (CRD42022354920). We searched MEDLINE, Embase, the Cochrane Library and trial registers from inception till March 2023 to identify randomized controlled trials (RCTs) investigating corticosteroids in adult patients with CAP. Our primary outcome was the risk of all-cause mortality within 30 days after randomization (if not reported at day 30, we extracted the outcome closest to 30 days). Risk ratios (RR) and mean differences (MDs) were pooled under a random-effects model. Results: Fifteen RCTs (n = 3252 patients) were included in this review. Corticosteroids reduced the risk of all-cause mortality in CAP patients (RR: 0.69, 95% CI: 0.53–0.89; high certainty). This significant result was restricted to hydrocortisone therapy and patients with severe CAP. Additionally, younger patients demonstrated a greater reduction in mortality. Corticosteroids reduced the incidence of shock and the need for mechanical ventilation (MV), and decreased the length of hospital and ICU stay (moderate certainty). Conclusions: Corticosteroids reduce the risk of all-cause mortality, especially in younger patients receiving hydrocortisone, and probably decrease the need for MV, the incidence of shock, and the length of hospital and ICU stay in patients with CAP. Our findings indicate that patients with CAP, especially severe CAP, will benefit from adjunctive corticosteroid therapy. © 2023

Background: End-stage renal disease (ESRD) causes numerous physical and psychological problems in patients, so that they must adhere to their treatment regimen to recover their disease, alleviate these problems, and increase their lifespan. The present study aimed to determine the predictive role of spiritual health, resilience, and mental well-being in treatment adherence among hemodialysis patients. Methods: This correlational cross-sectional study investigated some variables related to treatment adherence in 184 patients undergoing hemodialysis referred to two dialysis centers in Kerman, southeastern Iran. A census method was used to select the participants and data were collected using socio-demographic characteristics questionnaire, Adherence to Treatment Questionnaire (ATQ), Conner-Davidson Resilience Scale, Reef Psychological well-being Questionnaire, and Spiritual Well-Being Scale (SWBS). Results: The overall treatment adherence score was 155.42 ± 27.98 and we found a positive significant correlation between spiritual health, resilience, psychological well-being, and treatment adherence (p < 0.001). The mean scores of resilience, spiritual health and psychological well-being were 70.59 ± 17.02, 90.09 ± 12.01, and 77.88 ± 11.72, respectively. Spiritual health, psychological well-being, resilience, gender and marital status predicted 54% of the variance of treatment adherence, with psychological well-being being the best predictor (p < 0.001). Conclusions: Spiritual health, psychological well-being, and resilience are factors that influence treatment adherence of the patients undergoing hemodialysis, with psychological well-being having the greatest contribution to improving patient’s treatment adherence. Interventions effective in improving psychological well-being, spiritual health and resilience can improve treatment adherence of patients undergoing hemodialysis. Healthcare workers must pay more attention to the factors affecting treatment adherence of patients undergoing hemodialysis. © The Author(s) 2024.

Objectives We conducted an updated systematic review and meta-analysis to investigate the effect of colchicine treatment on clinical outcomes in patients with COVID-19. Design Systematic review and meta-analysis. Data sources We searched PubMed, Embase, the Cochrane Library, medRxiv and ClinicalTrials.gov from inception to January 2023. Eligibility criteria All randomised controlled trials (RCTs) that investigated the efficacy of colchicine treatment in patients with COVID-19 as compared with placebo or standard of care were included. There were no language restrictions. Studies that used colchicine prophylactically were excluded. Data extraction and synthesis We extracted all information relating to the study characteristics, such as author names, location, study population, details of intervention and comparator groups, and our outcomes of interest. We conducted our meta-analysis by using RevMan V.5.4 with risk ratio (RR) and mean difference as the effect measures. Results We included 23 RCTs (28 249 participants) in this systematic review. Colchicine did not decrease the risk of mortality (RR 0.99; 95% CI 0.93 to 1.05; I2=0%; 20 RCTs, 25 824 participants), with the results being consistent among both hospitalised and non-hospitalised patients. There were no significant differences between the colchicine and control groups in other relevant clinical outcomes, including the incidence of mechanical ventilation (RR 0.75; 95% CI 0.48 to 1.18; p=0.22; I2=40%; 8 RCTs, 13 262 participants), intensive care unit admission (RR 0.77; 95% CI 0.49 to 1.22; p=0.27; I2=0%; 6 RCTs, 961 participants) and hospital admission (RR 0.74; 95% CI 0.48 to 1.16; p=0.19; I2=70%; 3 RCTs, 8572 participants). Conclusions The results of this meta-analysis do not support the use of colchicine as a treatment for reducing the risk of mortality or improving other relevant clinical outcomes in patients with COVID-19. However, RCTs investigating early treatment with colchicine (within 5 days of symptom onset or in patients with early-stage disease) are needed to fully elucidate the potential benefits of colchicine in this patient population. © Author(s) (or their employer(s)) 2024.

A strategy of complete revascularization (CR) is recommended in patients with acute coronary syndrome (ACS) and multivessel disease (MVD). However, the optimal timing of CR remains equivocal. We searched MEDLINE, Embase, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials (RCTs) comparing immediate CR (ICR) with staged CR in patients with ACS and MVD. Our primary outcomes were all-cause and cardiovascular mortality. All outcomes were assessed at 3 time points: in-hospital or at 30 days, at 6 months to 1 year, and at >1 year. Data were pooled in RevMan 5.4 using risk ratios as the effect measure. A total of 9 RCTs (7,506 patients) were included in our review. A total of 7 trials enrolled patients with ST-segment elevation myocardial infarction (STEMI), 1 enrolled patients with non-STEMI only, and 1 enrolled patients with all types of ACS. There was no difference between ICR and staged CR regarding all-cause and cardiovascular mortality at any time window. ICR reduced the rate of myocardial infarction and decreased the rate of repeat revascularization at 6 months and beyond. The rates of cerebrovascular events and stent thrombosis were similar between the 2 groups. In conclusion, the present meta-analysis demonstrated a lower rate of myocardial infarction and a reduction in repeat revascularization at and after 6 months with ICR strategy in patients with mainly STEMI and MVD. The 2 groups had no difference in the risk of all-cause and cardiovascular mortality. Further RCTs are needed to provide more definitive conclusions and investigate CR strategies in other ACS. © 2024 Elsevier Inc.

Background: The Covid-19 pandemic has affected all areas of society, including students. However, medical students have faced many challenges due to direct contact with patients. The present study was conducted with the aim of investigating and comparing the quality of life (QoL), anxiety and mindfulness between Iranian medical and non-medical students during the COVID-19 pandemic. Method: Five hundred and six students (both medical and non-medical students) participated in the study from August to October 2022 with a convenience sampling method. The data were collected using an online questionnaire including a demographic form, the QoL Questionnaire (WHOQOL- BREF), the Generalized Anxiety Disorder 7-item survey (GAD‐7) and the Relaxation/Meditation/Mindfulness Tracker t-Persian version survey (RMMt-P). Pearson correlation and independent t-test and multivariate linear regression were used to determine the relationship between the study variables. Results: The samples included 272 medical students and 234 non-medical students with a mean age of 21.99 ± 3.46 and 24.17 ± 6.54 years respectively. Most of the medical and non-medical students were female, single and had a bachelor’s degree. The mean scores of medical and non-medical students’ QoL during the COVID-19 pandemic were 57.86 ± 13.26 and 56.75 ± 14.42, respectively which indicates the higher quality of life of medical students. Anxiety and mindfulness predicted 29% of the variance of the QoL in the medical students, while anxiety and mindfulness and having a chronic disease predicted 30% of the variance of the QoL in the non-medical students. No significant difference existed in the QoL and its subscales during the COVID-19 pandemic between medical and non-medical students (p > 0.05). There was a significant difference in terms of anxiety (p = 0.02) and mindfulness (p = 0.03) between medical and non-medical students during the prevalence of COVID-19. Discussion and conclusion: The findings of the present study indicated that medical students exhibited lower levels of anxiety and higher levels of mindfulness. Therefore, interventions aimed at reducing anxiety and increasing mindfulness among non-medical students are necessary. It is recommended that preventive approaches and psychological interventions to improve students’ quality of life become an integral part of crisis response during the COVID-19 pandemic. Additionally, reducing anxiety and enhancing mindfulness can improve the quality of education and professional performance of medical students, while also contributing to their mental well-being and effective clinical communication. © The Author(s) 2024.

BACKGROUND: Diabetes mellitus is one of the growing medical problems that affect people of all ages worldwide. Education is an important part of treatment in this chronic condition. The primary objectives of diabetes education include improving knowledge and skills, changing the patient's behavior, motivating them to follow therapeutic recommendations, establishing self-care habits, and increasing their psychological resilience. The authors aimed to examine the effect of a training program on type 2 diabetic patients' self care and investigate their perspectives on the educational program. MATERIALS AND METHODS: The current study used a quasi-experimental, pretest-posttest design that was conducted in Iraq. Sixty patients who met the selection criteria were included in the study. Data were collected by demographic questionnaire and the Diabetes Self-Care Scale (DSCS). Data analysis was done by independent T-tests and Paired t-tests were used to compare the scores before and after the intervention. RESULTS: The sample included 60 diabetic patients with more than half of them being female (55%). Most respondents aged between 50 and 60 years old, and next to half of them had only primary school education. We found that training programs can improve self-care behavior among diabetic patients so that following the intervention, the self-care score increased from 1.79 ± 0.360 to 3.17 ± 0.546 (P = 0.01). CONCLUSION: Since diabetes is a chronic condition that affects the whole individual's life, self-care plays an important role in preventing potential complications and improving quality of life. Training programs, on the other hand, increase the awareness and knowledge of patients and enable them to handle this chronic condition properly. © 2024 Dental Research Journal.

Nigella sativa is an herbal therapy for various afflictions. It has some potential to be a promising option as an efficacious treatment for COVID-19 patients that can contribute to global healthcare as a relatively cheap therapy but evidence of its use from randomized controlled trials (RCTs) is limited. Therefore, to explore the effect of N. sativa in combating COVID-19, we undertook this meta-analysis. We searched several databases to retrieve all RCTs investigating N. sativa for the treatment of COVID-19 as compared to placebo or standard care. We used RevMan 5.4 for all analyses with risk ratio (RR) or odds ratio (OR) as the effect measures. We included a total of seven RCTs in this review. N. sativa significantly reduced the risk of all-cause mortality in patients with COVID-19 compared to the control group (RR 0.27, 95% CI: 0.10 to 0.72; I2 = 0%). N. sativa significantly reduced the rate of viral PCR positivity (RR 0.62, 95% CI: 0.39 to 0.97; I2 = 0%). We did not find any significant difference in the risk of hospitalization (RR 0.26, 95% CI: 0.04 to 1.54; I2 = 0%) and the rate of no recovery (OR 0.48, 95% CI: 0.20 to 1.15; I2 = 84%) between the two groups. N. sativa is an easily available herbal medicine that may decrease the risk of mortality and improve virological clearance in COVID-19 patients. However, our results are limited by the small number of RCTs available. Further large-scale RCTs are needed to better understand the anti-inflammatory and antiviral effects of N. sativa in COVID-19 patients. © 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.

Background: Prostate cancer is the most common form of cancer affecting men. Perceptions of oncology nurses regarding educational needs would assist in gaining more understanding of survivor needs and ultimately provide better quality care to individuals who have completed cancer treatment. Objectives: To investigate the nurses’ point of view about the priority and the degree of importance of educational needs for prostate cancer patients. Materials and Methods: The current study used a descriptive design and was conducted at the chemotherapy and radiology center of Tishreen University Hospital in Lattakia City, Syria during 2020–2021. The study comprised 50 nurses in the chemotherapy department. Tools used in the study were adopted from the Toronto Informational Needs Questionnaire Cancer by the researchers to achieve the purpose of the study. Results: The majority of studied nurses (82%) aged between 30 and 40 years old, also about half of nurses (46%) were single, two third of nurses (66%) have preparatory degree, the highest ratio of nurses (60%) have from 1 to 5 years of experience, whereas the most of nurses (70%) have from 6 to 10 years of experience in general nursing; finally most of the nurses (78%) did not have any oncology training session. The results also found that there were a statistically significant differences in oncology nursing opinion according to their age, educational level, and years of experience in oncology nursing, whereas there were no statistically significant differences according to the marital status, years of nursing experience in general and training sessions. Conclusion: All the information needed by prostate cancer patients is of low importance from the studied nurses’ point of view except the psychological needs with moderate importance. There is a high statistically significant difference in oncology nursing opinion according to the age, educational level, and years of experience. © 2024 Medical Journal of Babylon | Published by Wolters Kluwer - Medknow.

[No abstract available]

Background: Spontaneous Coronary Artery Dissection (SCAD) is an acute coronary event of uncertain origin. SCAD occurs when the coronary artery wall dissects non-traumatically and non-atherosclerotically, leading to the formation of an intramural hematoma or intimal tear, ultimately compressing and restricting the true lumen, or even occluding it. The management of SCAD remains controversial despite modern imaging techniques. In addition to supportive drug therapy, percutaneous coronary intervention (PCI) is another option that can be used as an effective treatment modality. Case presentation: We describe A 50-year-old male with SCAD presented to the hospital emergency department complaining of chest pain. Coronary angiography incidentally showed spiral dissection from the proximal to distal right coronary artery (RCA). Three overlapping coroflex stents were deployed from the distal to the proximal RCA. Conclusions: To stabilize the coronary artery in Acute Coronary Syndrome (ACS) patients due to SCAD, prompt interventions such as stenting and angioplasty are needed. However, it is necessary to pay attention to the clinical condition of patients and quick diagnosis for the recovery of patients and reduction of complications. © The Author(s) 2024.

[No abstract available]

[No abstract available]

Non-accidental burns (NABs) in children had some adverse effects, such as severe burns, requiring skin grafting, and mortality. Previous studies reported NABs in the form of neglect, suspected abuse, and child abuse. Also, different statistics were estimated for the prevalence of NABs in children. Therefore, the current study aimed to comprehensively review and summarise the literature on the prevalence of NABs in children. Also, factors related to NABs as a secondary aim were considered in this review. Keywords combined using Boolean operators and searches were performed in international electronic databases, such as Scopus, PubMed, and Web of Science. Only studies in English were considered from the earliest to 1 March 2023. The analysis was performed using STATA software version 14. Finally, 29 articles were retrieved for the quantitative analysis. Results found that the prevalence of child abuse, suspected abuse, neglect, ‘child abuse or suspect abused’, and ‘abuse, suspect abused, or neglect’ was 6% (ES: 0.06, 95% confidence interval [CI]: 0.05-0.07), 12% (ES: 0.12, 95% CI: 0.09-0.15), 21% (ES: 0.21, 95% CI: 0.07-0.35), 8% (ES: 0.08, 95% CI: 0.07-0.09), and 15% (ES: 0.15, 95% CI: 0.13-0.16) among burns victims, respectively. Also, factors related to NABs are categorised into age and gender, agent and area of burns, and family features. Considering the results of the current study, planning for rapid diagnosis and designing a process to manage NABs in children is necessary. © 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Background: Although numerous modalities are currently in use for the treatment and prophylaxis of COVID-19, probiotics are a cost-effective alternative that could be used in diverse clinical settings. Hence, we conducted a meta-analysis to investigate the role of probiotics in preventing and treating COVID-19 infection. Methods: We searched several databases from inception to 30 May 2023 for all randomized controlled trials (RCTs) and comparative observational studies that evaluated probiotics (irrespective of the regimen) for the treatment or prevention of COVID-19. We conducted our meta-analysis using RevMan 5.4 with risk ratio (RR) and mean difference (MD) as the effect measures. Results: A total of 18 studies (11 RCTs and 7 observational studies) were included in our review. Probiotics reduced the risk of mortality (RR 0.40; 95% CI: 0.25–0.65, I2 = 0%). Probiotics also decreased the length of hospital stay, rate of no recovery, and time to recovery. However, probiotics had no effect on the rates of ICU admission. When used prophylactically, probiotics did not decrease the incidence of COVID-19 cases (RR 0.65; 95% CI: 0.37–1.12; I2 = 66%). The results for all outcomes were consistent across the subgroups of RCTs and observational studies (P for interaction >0.05). Conclusion: The results of this meta-analysis support the use of probiotics as an adjunct treatment for reducing the risk of mortality or improving other clinical outcomes in patients with COVID-19. However, probiotics are not useful as a prophylactic measure against COVID-19. Large-scale RCTs are still warranted for determining the most efficacious and safe probiotic strains. Systematic Review Registration: PROSPERO (CRD42023390275: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=390275). Copyright © 2023 Sohail, Cheema, Mithani, Shahid, Nawaz, Hermis, Chinnam, Nashwan, Cherrez-Ojeda, Awan and Ahmad.

Monkeypox (mpox) is a significant health concern affecting children and adolescents globally. This systematic review and meta-analysis aims to synthesise the available evidence on the proportion of children and adolescents affected by the mpox virus. A comprehensive search was conducted in seven electronic databases (PubMed, Scopus, Web of Science, EMBASE, ProQuest, EBSCOHost, and Cochrane) to identify the original reports on mpox cases in children and adolescents till 15 January 2023. Descriptive reports on probable or laboratory-confirmed mpox in children and adolescents (0–17 years old) were considered eligible. Studies not providing separate data for the above age group and case-control studies were excluded. The primary outcome was pooled proportion of mpox cases among children and adolescents. Proportion meta-analysis and heterogeneity between studies were determined using a restricted maximum likelihood estimator, and a random-effects model was fitted to the data. Sensitivity analysis and subgroup analysis were also conducted. A drapery plot was also provided as a complementary figure to the forest plot. The protocol was prospectively registered with PROSPERO (CRD42023392475). A total of 440 studies were identified, of which 37 were included in the review and 25 in the meta-analysis (62,701 participants with 3306 children and adolescents). The pooled proportion of children and adolescents was 0.46 (95% CI: 0.30–0.63, I2:100%). The proportion of children and adolescents was significantly lower (p < 0.001) in the ongoing pandemic 0.04 (95% CI: 0.00–0.32) than before 2022 0.62 (95% CI: 0.49–0.74). The meta-regression showed that the higher the study's sample size, the lower the proportion of children among the mpox cases. Both overall and subgroup heterogeneity were high. Adolescents and children below 5 years are commonly affected by the ongoing pandemic. In conclusion, the high proportion of children affected by the mpox virus highlights the need for increased research and targeted interventions to prevent and control the spread of the virus in this population. © 2023 John Wiley & Sons Ltd.

Despite monkeypox (mpox) being a public health emergency, there is limited knowledge about the risk of infectivity from skin viral loads during mpox infection. Thus, the aim of this study was to estimate cutaneous viral loads among mpox patients globally. Several databases, including Cochrane, EBSCOHost, EMBASE, ProQuest, PubMed, Scopus, and Web of Science, and preprint servers were searched concerning skin mpox viral loads in confirmed mpox subjects. In this systematic review and meta-analysis, a total of 331 articles were initially screened after the removal of duplicate entries. A total of nine articles were included in the systematic review and meta-analysis for the overall estimation of viral loads (Ct) using a random-effect model. The pooled cutaneous mpox viral load (lower Ct) was 21.71 (95% CI: 20.68–22.75) with a majority of positivity rates being 100%, highlighting a higher infectivity risk from skin lesions. The current results strongly support that skin mpox viral loads may be a dominant source of rapid transmission during current multi-national outbreaks. This important finding can help in constructing useful measures in relevant health policy. © 2023 by the authors.

The purpose of this review study is to investigate the attitude of nursing students toward the prevention of pressure ulcers (PUs) and related factors. From February 1, 2023, a comprehensive search was conducted in international and Persian electronic databases such as Web of Science, PubMed, Scopus, Iranmedex, and Scientific information database (SID). The keywords obtained from Medical Subject Headings, including “Attitude”, “Nursing students”, and “Pressure ulcer” were used in this search. The quality assessment of the present studies in this systematic review was based on the appraisal tool for cross-sectional studies (AXIS tool). A total of 6454 nursing students participated in ten cross-sectional studies. All students were studying at the undergraduate level and 81.20% of them were female. Nursing students were in the first (39.27%), second (28.19%), and third and fourth (32.54%) academic years. Among the participants, 49.86% have completed at least 2 clinical units. The mean scores of attitudes toward PU prevention in nursing students based on attitude toward PU prevention (APuP) and researcher-made questionnaires were 75.01% and 68.82%, respectively. The attitude of nursing students was influenced by various factors, including age, sex, academic year, clinical experience, number of clinical units, experience in caring for PU patients, previous courses on PU in the curriculum, and contribution of training to knowledge. Also, in the present study, the positive relationship between the attitude and knowledge of nursing students was shown as the only significant correlation. In sum, the attitude of the majority of nursing students toward the prevention of PUs was at a satisfactory level. Therefore, it is expected to transfer the necessary knowledge to them with proper planning so that preventive actions can be carried out by following the guidelines. © 2023 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd.

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Objective: Perioperative corticosteroids have been used for pediatric cardiac surgery for decades, but the underlying evidence is conflicting. We aimed to investigate the efficacy and safety of perioperative prophylactic corticosteroids in pediatric heart surgeries. Methods: We searched electronic databases until March 2023 to retrieve all randomized controlled trials (RCTs) that administered perioperative prophylactic corticosteroids to children undergoing heart surgery. We used RevMan 5.4 to pool risk ratios (RRs) and mean differences (MDs). Results: A total of 12 RCTs (2,209 patients) were included in our review. Corticosteroids administration was associated with a nonsignificant reduction in all-cause mortality (RR 0.62; 95% CI: 0.37-1.02, I2 = 0%; moderate certainty); however, it was associated with a lower duration of mechanical ventilation (MV) (MD −0.63 days; 95% CI: −1.16 to −0.09 days, I2 = 41%; high certainty). Corticosteroids did not affect the length of ICU and hospital stay but significantly reduced the incidence of postoperative low cardiac output syndrome (LCOS) (RR 0.76; 95% CI: 0.60-0.96, I2 = 0%; moderate certainty) and reoperation (RR 0.37; 95% CI: 0.19-0.74, I2 = 0%; moderate certainty). There was no increase in adverse events except a higher risk of hyperglycemia and postoperative insulin use. Conclusions: The use of perioperative corticosteroids in pediatric heart surgeries is associated with a trend toward reduced all-cause mortality without attaining statistical significance. Corticosteroids reduced MV duration, and probably decrease the incidence of LCOS, and reoperations. The choice of corticosteroid agent and dose is highly variable and further larger studies may help determine the ideal agent, dose, and patient population for this prophylactic therapy. © 2023 Elsevier Inc.

[No abstract available]

Objective: To estimate the global burden of stillbirths among pregnant women with the COVID-19 vaccination. Data source: In this systematic review and meta-analysis, a literature search was carried out in PubMed, Cochrane and Scopus until February 4, 2023, with language restriction (English). Study selection: Title-abstract screening followed by full text review was done independently by two authors, based on the research question, “What is the prevalence of stillbirths among the pregnant women vaccinated with COVID-19 vaccines?” Data extraction: Two authors independently extracted the relevant data from every study. The third author resolved the conflicts. This study was registered in PROSPERO and followed the PRISMA guidelines. Data analysis: A Random effects model was applied to assess the pooled estimate of stillbirths. The I2 test was used to assess the heterogeneity of the articles included in the study. For checking the publication bias, the Doi plot and the contour-enhanced funnel plot were utilized. Results: The database systematic search yielded 168 articles; 11 of them were determined to be eligible for systematic review and 8 of them ended up being included for meta-analysis. The pooled prevalence of stillbirth in pregnant women vaccinated against COVID-19 infection was 0.00509 (5 per 1000 live births delivered by pregnant women vaccinated against COVID-19 (95% CI: 0.00003–0.01676). Statistically significant heterogeneity was reported across studies (I2 = 98%; p < 0.01). Conclusions: The study concluded that vaccination against COVID-19 among pregnant women had a low stillbirth rate. It adds to the existing evidence that the COVID-19 vaccine is safe and can be taken during pregnancy. © 2023

Background: Self-care is essential for diabetes patients to keep control of the disease and avoid complications. Self-care can help minimize these complications. Objectives: The study endeavored to examine type 2-diabtic patients’ knowledge regarding self-care management and to determine the association between self-care management and the disease complications. Materials and Methods: This study was a quantitative research of cross-sectional design on a sample of 151 patients who visited the endocrine and diabetes center in Al-Dewaynia Teaching Hospital, Iraq. Data were collected by demographic questionnaire and the Diabetes Self-Care Scale (DSCS). Results: The results showed that there was a significant association between the diabetes self-care management and both diabetic foot and neuropathy (0.002 and 0.005), respectively, whereas it was no association between the diabetes self-care management with retinopathy, cardiovascular problems, nephropathy, and hepatic problems at any significant level. Conclusion: The study revealed that individuals’ adherence to self-care management of type 2 diabetes is very poor. Enhancing patients’ and community’s regarding changing the lifestyle is essential. © 2023 Medical Journal of Babylon.

Background Diabetes is one of the main health problems that affects large portions of the world’s population. Traditional herbal medicines have been used for thousands of years as an effective way to manage diabetes. Evidence show that Pistacia atlantica is a rich source of alpha-glucosidase which have been shown to normalise blood sugar balance. Method The study was designed as a double-blind placebo-controlled randomised clinical trial (RCT) using a parallel design. Ninety-four patients referred to the diabetes clinic of Sulaymaniyah city with diagnosis of type 2 diabetes (T2D) were randomly assigned in two groups: P. atlantica and placebo. Patients received P. atlantica extract or placebo 10cc twice daily for 3 months. A diabetic diet was applied for both groups. Data were collected by demographic questionnaire, health history form, and laboratory assessment of blood sugar. Independent t-test, paired t-test, and repeated measures analysis of variance were used to analyse the data. Results There was a significant reduction in fasting blood glucose in the experimental group compared to the control group at 3 months (50±45.89 verses 10±35.5, p<0.001). The mean of HbA1c after intervention was 5.8±1.0. Patients with higher body mass index (BMI) showed more significant decrease compared to those with normal BMI (p<0.001). Conclusion P. atlantica is a natural product of the Kurdistan region of Iraq. This RCT demonstrates its role in the management of blood glucose concentration in patients with T2D at 3 months. © NHAA 2022.

Objective: To evaluate a patient's level of self-efficiencyin regards to self-care tasks by diabetic patients. Methodology: This descriptive correlational study was carried out from December 2020 to July 2021. A non-probability purposive sampling technic was used. Diabetes Mellitus patients who visited the Al-Sadder Medical City/Al-Najaf Center for Diabetes and Endocrine disorders were included. Demographic and clinical data, self-efficiency and self-care were recorded. Results: Patients' self-care was given a moderate rating, and their replies to the self-efficiency domain questions were given a moderate rating. Furthermore, with a p-value of 0.005, patients' self-care, there was a very strong association with self-efficiency. Conclusion: Patients' self-care had a direct impact on their self-efficiency. Because of this, patients' self-care grows as well as their self-efficiency, and vice versa. © 2022, Pakistan Medical Association. All rights reserved.