Al Amal Hospital Jeddah

Background:The Injury-Psychological Readiness to Return to Sport (I-PRRS) is a validated and reliable scale to assess the psychological readiness of athletes returning to sport after an injury and it has been translated and validated in several languages.Objectives:To translate the I-PRRS scale into Arabic (I-PRRS-Ar) and evaluate its psychometric properties in Arabic-speaking athletes.Methods:An observational, cross-sectional study was conducted among Arabic-speaking injured athletes recruited from various sports clinics and sport clubs across Saudi Arabia. Psychometric properties examined included internal consistency, test–retest reliability, content validity, convergent validity with the Arabic Tampa Scale for Kinesiophobia (TSK-Ar) and the Arabic Numerical Pain Rating Scale (NPRS-Ar), and structural validity.Results:A total of 140 athletes completed the I-PRRS-Ar, while 34 athletes completed the scale twice to assess the test–retest reliability. The I-PRRS-Ar demonstrated excellent content validity (CVI ≥0.90), good internal consistency (Cronbach’s α =0.85), and excellent test–retest reliability (ICC2,1 = 0.83). Standard error of measurement was 3.83, and minimal detectable change was 10.64. No floor or ceiling effects were found. I-PRRS-Ar showed weak negative correlation with TSK-Ar (r = -0.28, P = 0.001) and moderate negative correlation with NPRS-Ar (r = −0.32, P < 0.001). Factor analysis confirmed a unidimensional structure.Conclusions:The Arabic version of the Injury-Psychological Readiness to Return to Sport (I-PRRS-Ar) is a reliable and valid tool for assessing psychological readiness to return to sport in Arabic-speaking athletes after an injury.

BackgroundAcanthosis nigricans (AN) is a skin disorder marked by darkening and thickening of the skin, often linked to metabolic abnormalities. This systematic review of randomized controlled trials (RCTs) assesses the comparative effectiveness and tolerability of different topical treatment options of AN, aiming to determine the most suitable therapeutic strategies.MethodsA comprehensive literature search was conducted across PubMed, Scopus, ClinicalTrials.gov, Web of Science, and the Cochrane Library, yielding 6,407 studies. After screening and a full-text review, seven randomized controlled trials (n = 268) assessed topical urea (10–20%), tretinoin (0.025–0.05%), salicylic acid (10%), and chemical peels such as glycolic acid (35–70%) and trichloroacetic acid (15%) over 8 weeks to 2 months, primarily on the neck and axilla. Outcomes included melanin and erythema indices (M/E), ANASI/ANSC scores, Investigator’s and Participant’s Global Evaluation (IGE/PGE), and adverse events.ResultsUrea demonstrated significant efficacy in reducing erythema, particularly at higher concentrations (20%), with mild adverse events such as stinging or irritation. Tretinoin was the most effective for reducing dark pigmentation, especially on the neck, and patients were more satisfied with it than with glycolic acid. Salicylic acid (10%) gave results similar to urea, with only mild side effects like dryness or peeling. Trichloroacetic acid (15%) peel was more effective than glycolic acid (35%) peel, both in skin improvement and patient satisfaction after 8 weeks. Overall, side effects with all treatments were mild and went away on their own.ConclusionBoth urea and tretinoin are effective treatments for AN, choice of therapy should be individualized tretinoin for predominant hyperpigmentation, urea for erythema or lower irritation tolerance, salicylic acid as a tolerable alternative, and TCA peel when stronger procedural options are suitable glycolic peel showed more modest effects.Systematic review registrationProspero registration number: (CRD42023444441); https://www.crd.york.ac.uk/PROSPERO/view/CRD42023444441.

Introduction: Hospitalization of children creates significant emotional and psychological stress for parents, highlighting the importance of addressing their needs in pediatric care settings. Aims: This study examines the perceptions of both parents and pediatric nurses regarding the needs of hospitalized children. Method: A cross-sectional survey using the validated Needs of Parents of Hospitalized Children (NPQ) was administered to 218 parents and 218 pediatric nurses in four hospitals in Jeddah, Saudi Arabia. Key domains assessed included trust, information, and support. Group differences were evaluated using non-parametric statistical analyses. Results: Trust was prioritized more by parents (83.9%) than nurses (72.4%) (p < 0.05). Both groups deemed information important, but parents (87.2%) rated it as more necessary than nurses (74.1%) (p = 0.02). Parents (79.8%) expressed a greater need for support compared to nurses (67.3%) (p = 0.03). Conclusions: This study identified perceptual differences between parents and nurses regarding trust, communication, and support. Some differences were statistically significant at the p < 0.01 level, while others were suggestive (p-value between 0.01 and 0.05) and require further investigation. These disparities suggest a need to foster mutual understanding and improve communication practices to better align healthcare delivery with family expectations and strengthen family-centered care.

Miniscrew-assisted rapid palatal expansion (MARPE) is an innovative orthodontic technique designed to address transverse maxillary deficiencies by achieving skeletal expansion while minimizing dental compensations. This technique integrates skeletal anchorage through miniscrews, which direct expansion forces to the maxillary sutures rather than the dentition. MARPE is particularly effective in skeletally mature patients, where traditional methods often fall short due to increased resistance from ossified sutures. By overcoming these limitations, MARPE has expanded the scope of non-surgical treatment options for adolescents and adults with maxillary constriction. The biomechanics of MARPE rely on precise miniscrew placement and activation protocols, which facilitate controlled expansion of the midpalatal suture and surrounding craniofacial structures. Short-term outcomes include significant increases in maxillary width and nasal airway volume, which improve both esthetics and respiratory function. Long-term studies demonstrate the stability of MARPE-induced skeletal changes, with minimal relapse when retention protocols are followed. Additionally, the procedure is effective in alleviating conditions associated with maxillary deficiencies, such as obstructive sleep apnea. Challenges associated with MARPE include anatomical variability, patient compliance, and complications such as miniscrew loosening or infection. Advanced imaging tools and customized device designs have mitigated many of these issues, enhancing treatment predictability and safety. Limitations, including the financial burden and technical demands of the procedure, highlight the need for ongoing innovation to increase accessibility. MARPE represents a significant advancement in orthodontics, combining functionality, esthetics, and patient-centered care. Its growing adoption and the increasing body of evidence supporting its effectiveness underscore its role as a transformative option in managing complex dentofacial discrepancies.

Objective: This study offered an updated meta-analysis of randomized controlled trials (RCTs) that assessed preoperative misoprostol compared to control (matched placebos or no treatment) during abdominal myomectomies. Methods: Six databases underwent screening until 7 April 2024. The risk of bias was assessed using the Cochrane Collaboration tool. The results were presented as mean differences (MDs) or risk ratios (RRs) along with 95% confidence intervals (CIs) using the random-effects model. Results: Sixteen RCTs were analyzed, involving 975 women. The overall quality of the studies was rated as “low” or had “some concerns” of bias in seven and eight RCTs, respectively; one RCT had an overall “high” risk of bias. For primary endpoints, the misoprostol intervention had significantly lower mean intraoperative blood loss (n = 15, MD = −180.2 mL, 95% CI [−224.04, −136.35], p < 0.001), mean hemoglobin drop (n = 13, MD = −0.58 g/dl, 95% CI [−0.82, −0.35], p < 0.001), and rate of perioperative blood transfusion (n = 13, RR = 0.43, 95% CI [0.29, 0.63], p < 0.001) compared to the control intervention. For secondary endpoints, the misoprostol intervention had significantly lower mean hematocrit drop (MD = 2.15, 95% CI −3.34, −0.96], p < 0.001), mean operative time (MD = −12.95 min, 95% CI [−19.89, −6.01], p < 0.001), and mean hospital stay (MD = −0.14 days, 95% CI [−0.25, −0.02], p = 0.02) compared to the control intervention. Nonetheless, no significant change was indicated between both interventions regarding the rate of postoperative fever. Conclusions: During abdominal myomectomy, the administration of preoperative misoprostol was generally safe and yielded statistically significant reductions in intraoperative blood loss, hemoglobin drop, and perioperative blood transfusion.

Several graft options can be used to construct a neovagina. This study aimed to evaluate the efficacy of creating a neovagina using a fresh human amnion in women with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Ten patients were analyzed retrospectively. Anatomical success was defined by a postoperative vaginal length ≥5 cm, and a width sufficient to comfortably accommodate the insertion of two fingers. Functional success was achieved when a score of >26.5 was attained on the Arabic validated version of the functional sexual function index (FSFI). Overall, the mean vaginal length before surgery was 2.15±0.85 cm (range, 1.5-4.5). The mean vaginal length after surgery was 5.5±0.53 cm (range, 5-6), and all patients (n=10) achieved anatomical success. The FSFI score after surgery was 29.2±2.4, and eight patients achieved functional success. The mean operative time and estimated blood loss were 83.5±50.31 minutes (range, 42-210) and 122.0±75.69 mL (range, 20-250), respectively. None of the patients required intraoperative blood transfusion or experienced injury to vital organs. Four patients developed postoperative leukocytosis within 48 hours, and one patient experienced chronic pelvic pain that lasted more than 6 months postoperatively. No major postoperative complications, such as pelvic abscesses, open wounds, chronic vaginal discharge, or reoperation, were reported. In conclusion, surgical dissection of the vesicorectal space and utilization of fresh human amnion to create a neovagina over a vaginal mold are technically feasible and safe, and are linked to favorable anatomical and functional outcomes in MRKH patients with vaginal agenesis.

There is a rising trend among women towards nonpharmacological approaches owing to their minimally invasive nature and limited adverse effects. Virtual reality (VR) has recently gained popularity as a new technology for reducing pain and anxiety in medical settings. Our research sought to investigate the impact of VR on pain and anxiety levels while undergoing episiotomy repair. A comprehensive search was carried out across PubMed, Scopus, Cochrane Library, and ISI Web of Science to find relevant randomized clinical trials (RCTs) up to January 2024. These trials investigated the use of VR as a treatment during episiotomy repair compared with a control group that did not receive VR intervention. Meta-analysis was performed using Review Manager software to analyze the data collected. Our primary outcomes were pain scores reported during and after episiotomy repair measured by a visual analog scale. Secondary outcomes analyzed included anxiety scores during and after the procedure, as well as the duration of episiotomy repair. Seven RCTs, involving 578 patients, met the inclusion criteria. VR resulted in a significant reduction in pain scores both during and after episiotomy repair (p < 0.001). Additionally, anxiety levels during and after the procedure were significantly reduced in the VR group compared with the control group. Moreover, the duration of episiotomy repair was significantly shorter in the VR group. Using VR has proven to be an effective technique in reducing pain and anxiety during and after episiotomy repair, as well as potentially speeding up the procedure.