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Introduction Depression and anxiety are common mental health disorders that can significantly affect quality of life, particularly in patients following bariatric surgery. These psychological conditions are frequently observed after surgery and can have adverse consequences on recovery and health. This study aimed to assess the prevalence of anxiety and depression in post-bariatric surgery patients and to explore the relationship between bariatric surgery and the development of depressive and/or anxiety symptoms. Methods A cross-sectional study was conducted among patients who underwent bariatric surgery between June 1, 2019, and December 30, 2021, at King Fahad Specialist Hospital in Buraidah, Al Qassim, Saudi Arabia. Data collection occurred in two phases. Initially, medical records were reviewed to identify eligible patients, whose contact information was then entered into a digital database. Data collectors contacted patients via phone to obtain demographic details, chronic medical conditions, mental health history, BMI, surgical method, and symptoms of anxiety and depression. Anxiety and depression symptoms were assessed using the GAD-7 and PHQ-9 scales, respectively. Results The study included 182 post-bariatric surgery patients. The prevalence of depression was 3.8%. While 67.6% of participants reported no anxiety, a significant portion experienced anxiety at varying levels (20.9% mild, 6.6% moderate, and 4.9% severe). Depression was associated with younger age, single marital status, lower income, and smoking. Anxiety was linked to smoking, snoring, surgical complications, mental health history, recent stressors, and coexisting depression. Depression was more prevalent six months to two years post-surgery. Conclusion Psychological distress, particularly anxiety, is common among post-bariatric surgery patients. Routine psychiatric evaluation, both pre- and post-surgery, is recommended to prevent potential complications and improve patient outcomes., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Regional Research Ethics Committee, registered at National Committee of Bio & Med. Ethics (NCBE) issued approval 607/45/949, registration no. H-04-Q-001. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: The authors gratefully acknowledge Qassim University, represented by the Deanship of Scientific Research, for the financial support for this research under the number (QU-APC-2024-9/1) during the academic year 1446 AH/2024 AD. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alqifari et al.)

Introduction Irritable bowel syndrome (IBS) is a prevalent functional gastrointestinal disorder frequently associated with psychological conditions such as stress, anxiety, and depression. Given the high-stress work environments of nurses and the lack of studies on this topic in the Al-Qassim region, this cross-sectional study aimed to investigate the prevalence of IBS and its association with anxiety and depression among nurses in this area of Saudi Arabia. The research hypothesis was that nurses with IBS would report higher levels of anxiety and depression compared to those without IBS. Methods This cross-sectional study was conducted among 96 nurses working at King Fahd Specialty Hospital (KFSH) in the Al-Qassim region. Nurses were selected using systematic sampling, with a total sample size initially calculated to be 189, but only 96 participated. Data were collected using a validated self-administered questionnaire, which included sociodemographic information and psychological assessments based on the Rome III criteria for IBS diagnosis and the Depression, Anxiety, and Stress Scales-21 (DASS-21) to measure psychological distress. Descriptive and inferential statistics were applied, with significance set at p < 0.05. Results In a sample of 96 nurses, the prevalence of IBS was found to be 19.8%, indicating a notable presence within this population. The majority of participants were female. No significant associations were observed between IBS and demographic or lifestyle factors. However, a higher prevalence of IBS was noted among nurses with more than 10 years of experience (27.3%, n=21) compared to those with less experience (10.5%, n=two), although this difference did not reach statistical significance (p=0.126). This study also revealed a high prevalence of stress, anxiety, and depression in the nurse population. Moreover, nurses diagnosed with IBS reported significantly higher levels of stress, depression, and anxiety compared to their counterparts without IBS (all p-values < 0.05). Conclusion There was a high prevalence of IBS among nurses, particularly those with higher levels of psychological distress. This study highlights the importance of developing targeted mental health interventions for nurses. However, the small sample size and cross-sectional design limit the generalizability and causality of the findings. Future studies should include larger, more diverse samples, and longitudinal designs to further explore these associations., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. King Fahd Specialty Hospital (KFSH) Research Committee issued approval 607/45/6180. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Alqifari et al.)

Aim: This study was twofold: (i) it aimed to investigate the morphometric changes of three temperature-sensitive nickel-titanium (NiTi) instruments at different temperatures, and (ii) to conduct an in vivo real-time analysis of intracanal temperature changes., Methods: Changes in the shape and length of XP-Endo Shaper, XP-Endo Finisher, and XP-Endo Finisher-R were evaluated in real time whilst heated in a temperature-controlled water bath from 22 to 45°C. Instruments were fixed to a laminated water-resistant 1 mm graph paper attached to a stone block. Instruments were imaged whilst subjected to increasing temperature using a digital camera attached to an operating microscope. From recorded videos, still frames were extracted at 10-s intervals and changes in the length and shape of each instrument were measured and changes were plotted against time. Moreover, the intracanal temperature of distal roots of lower molars was measured in vivo for patients attending the clinic for non-surgical root canal treatments. The temperature was measured using a K-type thermocouple probe inserted into the mid-root level after irrigating the canal with a solution set at room temperature (22°C) or heated to 45°C. The intraoral and intracanal temperatures were recorded using a video camera for 180 s at 5-s intervals to plot the change in the intraoral and intracanal temperature, after both irrigation solution temperatures, with time., Results: The shape transformation of XP-Endo Shaper began at 31.5 ± 2.0°C and reached its optimal transformation at 35.1 ± 1.0°C. For the Finisher and Finisher-R, shape transformations began at 29.2 ± 1.9 and 26.9 ± 2.2°C reaching the optimal transformation at 33.9 ± 1.4 and 32.7 ± 1.7°C, respectively. The average decreases in lengths of XP-Endo Shaper, Finisher, and Finisher-R after full transformation were 0.43 ± 0.23, 1.07 ± 0.22, and 1.15 ± 0.22 mm, respectively. The intracanal temperature reached 32.9 ± 0.8 and 33.2 ± 1.0°C after 3 min of application of irrigation solutions set at 22 or 45°C, respectively., Conclusion: The tested instruments exhibited diverse changes in their shapes and lengths at varying temperatures. Despite the temperature of the irrigation solution, the intracanal temperature consistently remained lower than the intracanal temperature once equilibrium was reached. This highlights the importance of considering the temperature of irrigation solution during in vitro testing of endodontic instruments., (© 2024 British Endodontic Society. Published by John Wiley & Sons Ltd.)

Background and Objectives : Endoscopic biliary plastic stenting is a safe and effective temporary therapeutic modality used in various benign biliary disorders. Long-term indwelling stents for more than one year without retrieval are termed "forgotten biliary stents". In clinical practice, the forgotten stents are underestimated and the majority of data were obtained from case reports. The aim of this study was to determine the forgotten-biliary-plastic-stent-related complications, their management, and the patients' clinical outcomes. Materials and Methods : This retrospective study was performed at three hospitals during the period from January 2021 to December 2023. In total, 577 patients with biliary plastic stents-inserted for a variety of benign biliary conditions-were included. They were divided into two groups, as follows: group 1 included 527 patients who had biliary stents removed within 3 months, and group 2 included 50 patients with biliary stents retrieved after one year of their deployment. The stent-related complications (e.g., acute cholangitis, stent clogging, distal stent migration, new common bile duct (CBD) stone formation, and proximal stent migration) and the endoscopic management success rate were evaluated. Results : Irretrievable CBD stones were the main indication for biliary plastic stenting in both groups. The stent-related complications, number of endoscopic sessions, and hospital admissions were significantly higher in the patients with forgotten biliary stents than those with stent removal within 3 months. All the study patients were successfully managed endoscopically with uneventful outcomes. Conclusions : Based on this retrospective study, non-adherence to the endoscopists' instructions is the main reason for retained biliary stents for more than one year. The patients with forgotten stents had significantly higher complication rates, a higher number of endoscopic sessions, and a higher number of hospital admissions than those with stents that were retrieved in the scheduled time. All patients were managed endoscopically with a technical success rate of 100%, and with no complication-related mortality.

Pediatric acute-onset neuropsychiatric syndrome (PANS) is a clinical condition with abrupt onset of obsessive-compulsive symptoms and/or severe eating restrictions and at least two concomitant cognitive, behavioral, or neurological symptoms. Pediatric autoimmune neuropsychiatric disorder associated with streptococcal infections (PANDAS) is a subtype of PANS with a controversial diagnosis. A case of a 12-year-old girl with severe eating restriction, obsessive-compulsive symptoms, anxiety, and neurological symptoms who initially was diagnosed with obsessive-compulsive disorder is presented. Published reports were reviewed for the evidence of diagnosis and treatment options of PANS/PANDAS. Studies show controversy regarding diagnosis. Moreover, study reports showed limited evidence for the treatment options. Selective serotonin reuptake inhibitors and psychotherapy are considered the main treatment with prompt infection treatment in the case of PANDAS., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Abdullah Nasser Alqifari and Benjamin Maxwell.)

Objective: This descriptive observational cross-sectional study aimed to assess the general population's awareness, attitudes, and behaviours towards proton pump inhibitor (PPI) usage, as well as their knowledge about associated side effects, in the Qassim region of Saudi Arabia., Methods: An autonomous online survey was conducted from June 15, 2023, to September 1, 2023, using social media. The survey targeted adult residents of Qassim and collected a total of 1090 respondents. Data analysis employed descriptive statistics, chi-square tests, and probit regression using R version 4.3.1 (RStudio, Boston, MA). A significance level of p<0.05 was utilized to interpret the results., Results: A total of 1050 samples, limited to residents of Qassim, were analyzed. Significant associations were observed between awareness of PPIs and factors such as side effects (adjOR = 1.19, 99% CI: 1.08-1.31), widespread PPI use (adjOR = 1.24, 99% CI: 1.12-1.38), PPI usage (adjOR = 2.47, 99% CI: 2.18-2.82), and optimal PPI timing (adjOR = 1.30, 99% CI: 1.13-1.50). Additionally, age, educational attainment, and employment in the medical field significantly influenced awareness gaps related to potential side effects, PPI prevalence, adherence to medical prescriptions, and optimal timing for PPI usage., Conclusion: The current study concludes that a significant portion of individuals in the Qassim region lack awareness regarding the potential side effects of PPI usage. Comprehensive healthcare education is required to bridge awareness gaps regarding PPIs and foster informed medication practices. By grasping the intricacies of individual perceptions, medical engagement, and demographic factors, healthcare providers and policymakers can collaboratively empower individuals in the Qassim region to make informed choices regarding their health and medication usage., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Almuzaini et al.)

Objective: Untreated hepatitis C virus (HCV) infection can lead to cirrhosis, hepatocellular cancer, and even death and also increases liver diseases. The elbasvir/grazoprevir (EBR-GZR) treatment regimen when given in HCV genotype (GT) 1 and GT4 infection for 8 or 12 weeks showed a high sustained virolgical response (SVR) rates in different populations. This study was assessed the effectiveness as well as safety of EBR-GZR in 12 week treatment regimen in HCV GT4-infected treatment-naïve Saudi patients., Methods: This study conducted from June 2017 and December 2020 on Saudi HCV patients infected with GT4. Treatment protocol was given for 12 weeks in treatment-naive HCV GT4 infected cirrhotic and non-cirrhotic participants which were later followed for a total of 24 weeks for safety and efficacy of EBR-GZR., Results: We analyzed data of 54 participants with HCV GT 4 infection. Mean age was (53.46 ± 14.94) Treatment regimen was given to 14 cirrhotic (F4) and 40 non-cirrhotic (F0-F3). SVR was seen in 98.1% of participants with tolerable side effects and improved model for end stage liver disease (MELD) scores as fall in percentage seen from 18.5% to 14.8% in participants with MELD > 10., Conclusion: This retrospective study confirms that EBR-GZR for 12 weeks is a safe and effective treatment regimen in HCV GT4 patients in studied Saudi population. Treatment completion was followed by high SVR12 rates with improvement in prognostic markers of liver disease in participants with compensated cirrhosis. In short, the EBR-GZR combination showed efficacy in achieving the SVR12 in Child-Pugh B cirrhotic and non-cirrhotic population with a favorable safety profile., (Copyright: © International Journal of Health Sciences.)

Rhabdomyosarcoma (RMS) is a soft tissue sarcoma that histologically resembles embryonic skeletal muscle. It is a rare malignancy in adults with a predilection in the head and neck, the genitourinary tract, and other extremities. However, RMS of the gastrointestinal tract is an even rarer condition that merits presentation and discussion. Here, we report on a case of primary duodenal embryonal RMS in an adult., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.