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Protein Intake In Children With Cerebral Palsy: A Narrative Review Highlighting The Implications Of Protein Intake On Muscle Mass, Growth, And Overall Nutritional Status, Manar Waleed Simbawa, Sheikha Nasser Alqahtnai

Neurosciences

Children with cerebral palsy experience nutritional challenges that affect protein intake and may contribute to poor muscle mass and growth faltering. Since protein plays a major role in preserving muscle mass and supporting growth, ensuring adequate intake is critical. A comprehensive literature search was conducted for observational studies published between 2006 and 2025. The reviewed studies results were grouped into: [1] Protein intake, with values ranging from 0.66 to 4.1 g/kg/day, with higher intake observed among ambulatory or orally fed children, [2] Nutritional Status and Body Composition, as reduced muscle was reported in children with severe motor impairment, and [3] …

Role Of Bevacizumab In Multiple Glioblastomas: A Retrospective Single-Center Analysis, Yongrui Zhao, Yidong Chen, Leiming Wang, Ye Cheng, Feng Yan, Jiankun Xu

Neurosciences

Objective: To explore the prognostic factors of multiple glioblastomas (M-GBMs) and the role of bevacizumab (BEV) in M-GBMs. Methods: 162 patients treated for primary glioblastoma (GBM) from 2020 to 2024 were retrospectively reviewed. Kaplan–Meier analysis was performed to compare progression-free survival (PFS) and overall survival (OS) between the single glioblastoma (S-GBM) group and the M-GBMs group. Independent predictors of OS among M-GBMs patients were evaluated via multivariable Cox regression analysis. Results: 116 patients had S-GBM, and 46 had M-GBMs. Compared with S-GBM patients, M-GBMs patients had poorer PFS (6.5 vs. 11 months, p<0.001) and OS (15.5 vs. 21 months, p=0.005). In the M-GBMs group, based on the RANO resection criteria, both univariable analysis and multivariable Cox models confirmed that the extent of resection, use of radiotherapy and chemotherapy, p53 overexpression, and use of BEV were all factors that significantly influenced OS. Specifically, the use of BEV prolonged OS from 12 months to 19.5 months (p = 0.017). From the initiation of BEV therapy, the median PFS was 5.5 months (95% CI 4.45–6.56 months), and the median survival was significantly longer than in those who did not received BEV (10 vs. 3 months, p = 0.021). Conclusion: The extent of resection, radiotherapy/chemotherapy, p53 …

Mislabeling And Inappropriate Analysis Render Interpretations From “The Effect Of The Participatory Heat Education And Awareness Tools (Heat) Intervention On Agricultural Worker Physiological Heat Strain: Results From A Parallel, Comparison, Group Randomized Study” Unreliable, Chelsi M Webster, Yasaman Jamshidi-Naeini, Lilian Golzarri-Arroyo, Colby J Vorland, Zachary J Schlader, Blair D Johnson, David B Allison

Faculty, Staff and Students Publications

No abstract provided.

Adherence To Malaria Treatment And Its Associated Factors: A Narrative Review, Lafie Urwatul Wutsqo, Eli Halimah, Sofa Dewi Alfian

Pharmacology and Clinical Pharmacy Research

Malaria is an infectious disease that remains a global health concern, particularly in Asia and Africa. The success of malaria medication largely depends on patients' adherence to the prescribed therapeutic regimen. This article aims to identify the level of adherence to malaria treatment and the factors that influence it, based on observational studies. A narrative review was conducted using the PRISMA approach, involving 12 articles published between 2019 - 2023 from various countries. The results indicate that adherence levels vary widely, ranging from 15.6% to 93.31%, depending on respondent characteristics and the intervention strategies implemented. Factors influencing adherence include patient-related …

Balanced Scorecard In Healthcare Facilities: A Ten-Year Review Of Strategies To Improve Organizational Effectiveness, Larasati Tunggadewi, Sofa Dewi Alfian, Auliya A Suwantika

Pharmacology and Clinical Pharmacy Research

The Balanced Scorecard (BSC) has increasingly been adopted as a strategic performance management framework within healthcare organizations. Evidence from the past decade shows varied implementation outcomes, shaped by institutional readiness, leadership commitment, and the maturity of health information systems. This narrative review synthesizes findings from 47 scientific articles selected through a systematic screening process, covering studies conducted in hospitals, primary health centers, and pharmacy units in Indonesia, Morocco, Iran, China, and other countries. The studies employed case study and descriptive cross-sectional designs using both quantitative and qualitative approaches. Overall, BSC implementation contributed to improvements in service performance across the financial, …

Exploring Protein-Protein Interactions: A Promising Avenue For Biomarker And Anti-Tb Drug Development, Rajwa Dwifauza Suryanto, Maritsa Widati Aqila Rumawan, Imam Adi Wicaksono

Pharmacology and Clinical Pharmacy Research

In 2023, tuberculosis (TB) reached its highest incidence with 8.2 million new cases reported by the World Health Organization (WHO). The virulence of Mycobacterium tuberculosis (MTB) is strongly governed by protein-protein interactions (PPIs) that regulate essential processes such as cell wall biosynthesis, immune evasion, and persistence. This study aims to map and analyze the mechanisms of key PPIs in MTB using a scoping review approach. Data was retrieved from PubChem and related literature with the keyword ``PPIs Network TB''. Our findings highlight crucial PPI-driven mechanisms, including the role of DprE1/DprE2 in arabinogalactan synthesis, VapB4/VapC4 in stress response and self-toxicity, ESX-1 …

Admixture-Informed Polygenic Risk Reporting Using The Eprs Framework, Yu-Jyun Huang, Nuzulul Kurniansyah, Matthew O Goodman, Brian W Spitzer, Jiongming Wang, Adrienne Stilp, Cecelia Laurie, Paul S De Vries, Han Chen, Yuan-I Min, Mario Sims, Gina M Peloso, Xiuqing Guo, Joshua C Bis, Jennifer A Brody, Laura M Raffield, Jennifer A Smith, Wei Zhao, Jerome I Rotter, Stephen S Rich, Susan Redline, Myriam Fornage, Robert Kaplan, Nora Franceschini, Daniel Levy, Alanna C Morrison, Eric Boerwinkle, Nicholas L Smith, Charles Kooperberg, Bruce M Psaty, Sebastian Zöllner, Tamar Sofer

Faculty, Staff and Student Publications

Polygenic risk score values vary with genetic ancestry due to differences in population-specific allele frequencies and linkage disequilibrium patterns. We present a framework to calibrate polygenic risk scores based on ancestral makeup. We propose the "expected polygenic risk score" or ePRS, defined as the expected value of a polygenic risk score based on one's global or local admixture patterns. We further define the "residual polygenic risk score" or rPRS as measuring the deviation of the polygenic risk score from the ePRS. The ePRS reflects the baseline ancestry-driven component of genetic risk, whereas the rPRS isolates an ancestry-agnostic measure of genetic …

Hyperdynamic Microtubule-Based Structural Changes In Monocyte-Derived-Neuronal-Like Cells From Patients With Schizophrenia, Alfredo Bellon, Alonso Cortez-Resendiz, Lauren N Forrest, Omar Elmarasi, Janani Iyer, Anjali Iyer, Chachrit Khunsriraksakul, Dajiang Liu, L Elliot Hong, Therese M Jay, Marie-Odile Krebs, Anne Hosmalin

Faculty, Staff and Student Publications

A consistent postmortem finding in schizophrenia (SCZ) is reduction in dendrites' size. However, neurons with larger dendritic trees have also been encountered. In vitro experiments with neurons and neuronal-like cells coming directly from patients with SCZ showed similar results, evidencing at times more extensions and at others less arborizations. The process of extending and retracting neuronal outgrowths depends on microtubules polymerization and depolymerization. The possibility that microtubule polymerization/depolymerization is related to defects in the neuronal structure comes from several microtubular anomalies reported in SCZ such as its abnormal distribution in the cytoplasm, irregular shape of microtubules and even absence of …

Inherited Tbx4 Frameshifting Variants Predicted To Escape Nonsense Mediated Decay In Two Families With Variable Phenotypes, Including Lethal Lung Developmental Disorders, Shruti A Pande, Hiuling Chan Joiner, Przemyslaw Szafranski, Tomasz Gambin, Michelle Wright, Qian Wang, Maiah Walters, Jan M Friedman, Jessica Saunders, Nicholas Avdimiretz, Cornelius F Boerkoel, Nahir Cortes-Santiago, Gail Deutsch, Pawel Stankiewicz

Faculty, Staff and Students Publications

Background: Pathogenic variants involving the transcription factor TBX4 gene have been associated with various skeletal and pulmonary abnormalities, including lethal lung developmental disorders (LLDD).

Methods: Whole-genome sequencing (WGS) with AI-powered platform for variant detection and interpretation followed by Sanger sequencing targeted variant segregation analysis were used. Reverse transcription quantitative PCR (RT-qPCR) and immunohistochemistry (IHC) studies were performed to assess gene and protein expression levels, respectively.

Results: We describe two unrelated families with intrafamilial variability in the TBX4 phenotypic expressivity, including LLDDs. WGS analyses revealed two frameshift variants, c.1019del; p.(Arg340GlnfsTer40) in the penultimate exon and c.1167dup; p.(Arg390GlnfsTer30) in the last exon …

Inhibition Of Epac1 Prevents Neuronal Death Mediated By Diesel Exhaust Particles In Ferroptotic Cell Death Conditions, Hong Yan, Leshan Zhang, Ana L Manzano-Covarrubias, Phoeja S Gadjdjoe, Anja Land, Christina H J T M Van Der Veen, Teresa Mitchell-Garcia, Heba A Fayyaz, Marco Venema, Christoffer Åberg, Marieke Van Der Hart, Frank Lezoualc'h, Xiaodong Cheng, Amalia M Dolga, Martina Schmidt

The Brown Foundation: Institute of Molecular Medicine

Air pollution is a growing hazard to global health. Epidemiological studies have reported a potential role of air pollutant exposure in the development or aggravation of neurodegenerative diseases. However, the underlying mechanisms are ill-defined. Ferroptosis is an iron- and reactive oxygen species (ROS)-dependent form of cell death that drives neuronal loss in neurodegenerative diseases. Our previous studies reported the involvement of adenosine 3',5'-cyclic monophosphate (cAMP) and EPAC (exchange protein directly activated by cAMP) in ferroptotic cell death. Here, we investigated the effects of diesel exhaust particles (DEP) in mouse hippocampal (HT22) neuronal cells. Our data showed that toxicity induced by …

The Right Time For A Synapse To Change: Windows And Mechanisms Of Multiday Training Trials, Rong-Yu Liu, Yili Zhang, Roberta Calvo, Paul Smolen, John H Byrne

Faculty, Staff and Student Publications

Although learning over multiple days is more effective than a single day of training, the underlying cellular mechanisms of repeated training trials remain poorly understood. With a combination of empirical and computational approaches, we determined a critical time window for a second stimulus block of a multiday training protocol to augment long-term synaptic facilitation (LTF) of the Aplysia sensorimotor synapse and long-term enhancement of neuronal excitability (LTEE), two cellular correlates of learning and memory. A second stimulus block delivered 24 h after the first block significantly enhanced LTF and LTEE, but was without effect at 18 or 32 h. This …

Rosai-Dorfman Disease In A Rare Cardiac Presentation: Left Ventricular Mass Causing Ventricular Tachycardia, Motaz Al Yafi, Swetha Pasala, Valentina Robila, Cory Trankle, Bharadhwaj Kolipakkam, Patricia Nicolato

Faculty, Staff and Student Publications

Background: Rosai-Dorfman disease (RDD) is a rare, benign histiocytic disorder that most often presents with nodal involvement. Cardiac involvement is exceedingly uncommon and poses significant diagnostic and therapeutic challenges.

Case summary: A 51-year-old woman presented with shortness of breath and palpitations and was found to have monomorphic ventricular tachycardia. Imaging revealed a left ventricular mass, and biopsy confirmed RDD. The lesion was surgically excised with cryoablation and CorMatrix reinforcement. The patient recovered uneventfully and remains disease free 25 months postoperatively.

Discussion: RDD with cardiac involvement has been reported in only approximately 25 cases, with very few affecting the left ventricle. …

Lateral Habenula And Dorsal Raphe Neurons Signal Value Computations In Multi-Attribute Decision-Making, Yang-Yang Feng

McKelvey School of Engineering Graduate Student Theses & Dissertations

Decision-making is a fundamental part of adaptive behavior and can be compromised in psychiatric illness. Humans and animals are continuously presented with objects and opportunities as options to decide between. One challenge is that these options may independently vary along multiple dimensions or attributes that we care about. This can include attributes of physical reward, such as amount, delay, or uncertainty. When these attributes are present, the possibility of an abstract, cognitive reward, advance information to resolve uncertainty, may also motivate our decisions. It is unclear how the brain makes these subjective decisions, trading off between these multiple attributes based …

Functional And Spatially Specialized Inhibition And Neuromodulation During Learning In The Hippocampus, Gerardo Enrique Molina

McKelvey School of Engineering Graduate Student Theses & Dissertations

The hippocampus relies on a diverse network of regulatory components for memory formation. Neuromodulators and inhibitory interneurons act in concert with excitatory neurons to control learning. Even within one of these components there is a vast diversity of genetic or chemical composition that may come from unique sources at uniquely timed intervals or events. The goal of this dissertation is to identify specific functional-behavioral attributes of two such examples: parvalbumin (PV)-expressing interneurons and the neuromodulator dopamine, in hippocampal CA1. In separate experiments, I used two-photon microscopy of the calcium sensor, GCaMP, which measures neuronal activity, and GRAB-DA, which reports levels …

Expanding The Mutation Spectrum Of Non-Syndromic Retinitis Pigmentosa In Consanguineous Pakistani Families: Unraveling Novel Pathogenic Variants In Rp1, Pde6b, And Prcd Genes For Precision Diagnosis, Tayyaba Shan, Nimra Mukhtar, Sayyed Hammad Ullah, Asad Ullah, Asfandyar Ahmad Khan, Yumei Li, Meng Wang, Raeesa Tehreem, Amtul Aziz, Kiran Afshan, Rui Chen, Sabika Firasat

Faculty, Staff and Students Publications

No abstract provided.

Culturally Tailored Materials For Smoking Cessation And Hiv Care Adherence Among Hispanic Adults: Protocol For Content Development And Formative Evaluation, Lorra Garey, Jacqueline J Charles, Ashley L Ruiz, Rodrigo Castillo-Avilés, Virmarie Correa-Fernández, Marshall K Cheney, Thomas P Giordano, Michael J Zvolensky

Faculty, Staff and Students Publications

Background: Hispanic people with HIV who smoke cigarettes experience unique stressors (eg, stigma), which contribute to health disparities. Anxiety sensitivity (AS) may worsen mood management problems, which are a leading barrier to smoking cessation. Interventions targeting AS can improve HIV-specific outcomes and smoking cessation. However, no prior research has culturally tailored an AS reduction program to improve quality of life among Hispanic people with HIV who smoke. The research team previously developed a mobile health (mHealth) intervention addressing AS reduction, smoking cessation, and HIV care management for Black people with HIV who smoke. Building on this work, this study represents …

Erratum To ``Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, And Emerging Interventions For Prevention And Management'' [Saudi Medical Journal 2026; 47(2):183–194], Fahad H. Baali

Saudi Medical Journal

In the manuscript entitled: ``Childhood Obesity: Global Burden, Multifactorial Etiologies, Biological Mechanisms, and Emerging Interventions for Prevention and Management'' Published in Saudi Med J 2026; Vol. 47(2): 183–194. doi: 10.15537/1658-3175.1001
The tables included in the published version were incorrect due to a production error.

Advancing Rheumatology In The Middle East: Mrc 2025 Abstracts, Martin Lee, Ahmed Zayat, Beena Hameed, Elsadeg Sharif, Fahda Al Okaily, Fehaid Alanazi, Francis Kynaston-Pearson, Khalid A. Alnaqbi, Mahmood Hachim, Mayam Al Nesf, Mira Mirashli, Mohammed Tariq, Ravi Gutta, Reem Abdwani, Saadeya Naji, Shamma Lootah, Tareq Al Araimi, Waleed Hafiz, Suad Hannawi

Saudi Medical Journal

No abstract provided.

Prevalence Of Brca1 And Brca2 Germline Mutations In Western Saudi Patients With Epithelial Tubo-Ovarian Carcinoma, Wala Mehros, Faisal Aldaheri, Anas Alqarni, Saif Aljehani, Abdulrahman Alnamlah, Alaa Althubaiti, Safaa Huneef, Hatim Jifree

Saudi Medical Journal

Objective: Ovarian cancer represents the most lethal gynecologic malignancy, the epithelial type (EOC) being the most common. BRCA gene mutations are associated with ovarian cancer, younger age at presentation, strong family history of EOC, and multiple malignancies in a single patient. This study calculated the rate of BRCA-positive EOC and compared BRCA-mutated vs non-mutated EOC cases. Methods: This retrospective cohort study, conducted at Princess Noura Oncology Center between May 2016 and December 2023, explored outcomes in BRCA-positive EOC patients. The inclusion criteria covered all EOC cases. A total of 70 patients were selected. Results: Of the 70 …

The Nephroprotective Effects Of Dulaglutide In Patients With Type 2 Diabetes And Chronic Kidney Disease: A Multicenter Saudi Arabian Study, Maha H. Jamal, Hassan A. Alzahrani, Duaa M. Bakhshwin, Ranya A. Ghamri, Fatmah S. Binzomah, Wisam H. Jamal, Moaz W. Abulfaraj

Saudi Medical Journal

Objective: This study aimed to evaluate the effectiveness and safety of dulaglutide in individuals with chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM). Methods: This retrospective cohort study included 212 patients with CKD (stages 1–4) and T2DM treated with once-weekly dulaglutide (1.5 mg) for either 12 or 24 months at three tertiary care centers in Saudi Arabia from January 2021 to December 2023. Safety was assessed based on the presence of adverse events. Efficacy was measured using the changes in estimated glomerular filtration rate (eGFR), glycated hemoglobin (HbA1c), and body mass index (BMI). Changes in efficacy outcomes were …

Combined Predictive Value Of Serum Ngal, Cysc, Urinary Nag, And Egfr For Sepsis-Associated Acute Kidney Injury In Patients In Icu, Yu Han, Wenna Ning, Jian Lu, Jinwei Zhu, Zhiliang Qin, Xiao Wang

Saudi Medical Journal

Objective: To evaluate critically ill patients who had sepsis and how various kidney-related measurements, including eGFR, NGAL, CysC, and the urinary enzyme NAG, predict the onset of sepsis-induced renal damage. Methods: The 135 individuals who were admitted to our sepsis intensive care within 2 years to the end of early 2024 were recruited on a prospective basis and were enrolled based on the predefined criteria. Upon admission, they were dichotomized into 2 groups of participants who developed septic-associated kidney injury (82) and without (53). A comparison of baseline laboratory analyses and blood and urine baseline examinations in the groups was …

Comparison Of Clinical Outcome Of Mushroom Poisonings With And Without Specific Treatment: A 5-Year Retrospective Analysis, Kamil Deveci, Necmi Baykan, Baycan Kus, Fatma Ünlü, Ömer Salt, Serhat Koyuncu

Saudi Medical Journal

Objectives: To determine the demographic and clinical characteristics, potential specific antidote treatments, clinical outcomes, and organ failure (morbidity) rates of patients with mushroom poisoning admitted to our center. Methods: We included 425 patients admitted to the emergency department of Kayseri City Hospital complaining of mushroom poisoning, between May 2018 and December 2023, who met the study criteria. Results: The median age of the 425 patients admitted was 51 years (34–63); 49.5% were female (n = 211), and 75% (n = 319) were admitted by ambulance. According to the Poisoning Severity Score, 70.3% (n = 299) of cases were mild, 21.9% …

Ethnic Background As A Determinant Of Thyroid Cancer Risk: A Decade-Long National Cohort Study Reveals Divergent Epidemics In Saudi Arabia, Nizar A. Khamjan

Saudi Medical Journal

Objectives: To analyze and compare temporal trends, demographic characteristics, and stage at diagnosis for thyroid cancer (TC) between Saudi and non-Saudi populations in order to identify potential population-specific etiological drivers. Methods: We conducted a national retrospective cohort study of TC cases in Saudi Arabia from 2013–2022. To assess population-level trends, we computed age-standardized incidence rates (ASIRs) and multivariable Poisson regression alongside piecewise regression models for comparative analysis. Results: Among 14,159 total cases, TC incidence increased disproportionately in Saudi nationals, rising from 884 to 1,677 (90%), significantly outpacing the 184 to 275 (49%) increase observed in non-Saudis. The incidence rate ratio …

Comparison Of The Predictive Value Of Crp/Albumin, Crp/Prealbumin, And The Clinical Frailty Scale For Mortality In Geriatric Intensive Care Patients, Natali T. Aksoy, Bülent B. Güven, Sümeyya M. Soyalan, Dilek Metin Yamaç, Tuna Ertürk, Süheyla Abitağaoğlu

Saudi Medical Journal

Objectives: To evaluate the relationship between C-reactive protein (CRP)/prealbumin and CRP/albumin ratios, Clinical Frailty Scale (CFS) scores, and short-term (first 3 days) and long-term (28 days) mortality in geriatric patients hospitalized in the intensive care unit. Methods: After obtaining ethical approval and informed consent, 213 patients aged 65 years and older were included. Patients discharged within 24 hours, those discharged and readmitted during the study period, those receiving routine albumin replacement, and patients with cirrhosis or undergoing chronic dialysis were excluded. Demographic characteristics, admission diagnoses, chronic comorbidities, frailty scores at admission, and laboratory values, including albumin, prealbumin, and CRP …

Clinical Role Of Hematologic Inflammatory Markers In The Diagnosis Of Missed Abortion, Mustafa Bakırcı, Çağlayan Ateş, Ethem S. Yalvaç

Saudi Medical Journal

Objectives: To evaluate the diagnostic value of hematological and biochemical inflammatory markers in distinguishing missed abortions from healthy pregnancies during the first trimester. Methods: This retrospective case-control study was conducted between May 2022 and May 2024, included 61 women diagnosed with missed abortion by ultrasound and 100 healthy pregnant women who acted as controls. The following inflammatory markers were calculated from routine blood and biochemistry results: neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), lymphocyte-monocyte ratio (LMR), systemic immune-inflammation index (SII) and C-reactive protein-albumin ratio (CAR). Intergroup comparisons and receiver operating characteristic (ROC) curve analyses were performed. Results: The …

Reliability And Validity Of The Arabic Version Of The Nose-Perf Scale, Rayan M. Alfallaj, Abdullah I. Binghaith, Mohammed Y. Alyoussef, Ahmed S. Alsaleh, Saad A. Alsaleh, Abdulaziz A. Alqahtani, Ahmad S. Alroqi

Saudi Medical Journal

Objectives: To assess the psychometric validity of the Arabic adaptation of the nasal obstruction symptom evaluation–perforation (NOSE-Perf) scale. To assess how reliable and valid the Arabic adaptation of the NOSE-Perf questionnaire is. Patients with septal perforations, particularly Arabic speakers, lack validated self-assessment tools for subjective symptom evaluation. Methods: Conducted between May 2024 and June 2025, the study included 100 participants—20 patients with septal perforation and 80 controls. Participants filled out a questionnaire consisting of demographic data as well as the Arabic forms of the Sino-Nasal Outcome Test-22 (SNOT-22), NOSE, and NOSE-Perf scales. Cronbach's alpha was applied to determine internal consistency, …

A Multi-Centre Study: Quantitative Evaluation Of Radiation Dose For Adults Head Computed Tomography, Abdulaziz A. Qurashi, Shrooq T. Aldahery

Saudi Medical Journal

Objectives: To determine regional radiation dose in adults head computed tomography (CT) examinations in Jeddah by assessing the volume computed tomography dose index (CTDI_vol) and dose length product (DLP) values. Methods: A retrospective study was conducted from February to April 2025 across 10 CT scanners from 5 governmental hospitals in Jeddah. Data for 20 head CT examinations per scanner were collected. Dose metrics including CTDI_vol and DLP (mGy·cm), were extracted from digital imaging and communications in medicine (DICOM) images. Mean values per scanner and the 75^th percentile were calculated across centres to identify the regional DRL. …

The Role Of The Delta Neutrophil Index In Determining The Severity Of Intrahepatic Cholestasis Of Pregnancy, Selçuk Atalay, Melike Çaltekin, Nihal Çallıoğlu, Fırat Ersan, Verda Alpay, Yasin Anasız, Ipek Geyikoğlu

Saudi Medical Journal

Objective: This study aimed to investigate the clinical utility of the delta neutrophil index (DNI) in distinguishing patients with intrahepatic cholestasis of pregnancy (ICP) from healthy pregnant women, and to assess its potential role in evaluating disease severity. Methods: This retrospective analysis included data from 249 pregnant women. Among them, 131 were identified with ICP, based on clinical symptoms and total bile acid levels ≥ 10 μ mol/L. The remaining 118 participants served as healthy controls. The ICP cases were categorized into mild (TBA 10–39 μ mol/L; n = 90) and severe (TBA ≥ 40 μ mol/L; n = 41) …

Integrative Approaches To Gut Microbiota: Biomarkers, Dysbiosis, And Therapeutic Potential, Zeyad M. Alharbi

Saudi Medical Journal

The human gut contains bacteria, viruses, and archaea that influence health depending on age, diet, and location. An individual harbours about 150 bacterial species. An imbalance of these microorganisms, known as dysbiosis, can negatively impact health. Commensal bacteria maintain microbial homeostasis by building short chain fatty acids. The 2-way communication channel that connects the gut and the brain is referred to as the gut-brain axis. Dysbiosis of the gut leads to some autoimmune diseases. A decline of beneficial bacteria causes the progression of rheumatoid arthritis. Gut dysbiosis increases intestinal permeability, allowing toxins and cytokines to enter the bloodstream and damage …

Emerging Nanotherapy Applications In Cancer Treatment: A Comprehensive Review, Waleed H. Mahallawi

Saudi Medical Journal

This comprehensive review synthesizes recent advances in cancer nanotherapy, focusing on 6 emerging categories: immunomodulation, gene/RNA delivery, theranostics, radiosensitization, biomimetic carriers, and artificial intelligence (AI)-guided formulations. These innovative platforms demonstrate transformative potential by overcoming key limitations of conventional cancer treatments. Immunomodulatory nanoparticles reprogram tumor microenvironments and convert immunologically ``cold'' tumors to ``hot'' responsive states. Gene delivery systems enable precise editing with >50% efficiency, while theranostic platforms integrate real-time imaging with targeted therapy. Radiosensitizers amplify local radiation dose by twofold, and biomimetic carriers achieve prolonged circulation through immune evasion. An AI-driven approaches optimize personalized formulations based on patient-specific biomarkers. Clinical evidence …