Gulf Medical University

BackgroundMany patients, especially those with chronic conditions (eg, hypertension, cardiovascular disease), struggle to adhere to long-term medication regimens, leading to serious complications and reduced quality of life.MethodsA cross-sectional study at Thumbay University Hospital was conducted among hypertensive patients (≥18 years, ≥6 months on antihypertensive therapy) to assess medication adherence and its association with health-related quality of life (HRQoL). Data were collected using a structured questionnaire; adherence and HRQoL were measured by the Hill-Bone and WHOQOL-BREF instruments; data were analyzed with descriptive statistics, chi-square tests, binary logistic regression, and Spearman correlations.ResultsAmong 377 patients medication adherence was predominantly high in 55.7% of patients, medium in 40.6%, and low in 3.7%; 76.9% reported high HRQoL, with the highest domain score in Environment (81.25%) and lowest in Physical health (67.86%) (differences were significant). Spearman correlations showed small but significant associations between adherence and Physical (ρ = −0.10, p = 0.05) and Environment (ρ = 0.12, p = 0.02); other domains were non-significant. Longer hypertension duration increased adherence (AOR 6.98 for 10–<15 years, p < 0.001; 8.81 for ≥15 years, p = 0.01), whereas non-Muslim religion (AOR 0.49, p = 0.03) and no family history (AOR 0.57, p = 0.04) predicted lower adherence. In multivariate HRQoL analysis, age ≥60, home ownership, comorbidity, and ≥3 antihypertensives had AORs of 0.40, 0.34, 0.22, and 0.10 (p = 0.03, 0.01, 0.03, 0.00) for lower HRQoL; regular income and no alternative medicine had AORs of 2.67 and 2.60 (p = 0.03, 0.01) for higher HRQoL.ConclusionAdherent in this UAE study was high (55.7%), and HRQoL was generally favorable; HRQoL was higher with regular income, home ownership, and no alternative medicine, but lower with comorbidities, age ≥60, and ≥3 antihypertensives. Adherence improved with longer disease duration and was influenced by religion and family history, highlighting the need for targeted interventions to improve adherence and HRQoL.

Wound healing is a dynamic and multifaceted biological process involving hemostasis, inflammation, proliferation, and tissue remodeling. Topical therapy is widely preferred for wound management due to its localized action and reduced systemic adverse effects. However, the effective delivery of therapeutic agents is often limited by the skin's barrier properties, the complex wound microenvironment, and the physicochemical characteristics of drugs. This review highlights the key physicochemical parameters governing topical drug delivery in wound therapy, including drug solubility, molecular size, lipophilicity, vesicle size distribution, surface charge, encapsulation efficiency, lipid composition, ethanol concentration, and vesicle deformability, which collectively influence drug permeation and retention at the wound site. Nanovesicular delivery systems have emerged as promising strategies to overcome these limitations. In particular, ultradeformable vesicles such as ethosomes, transferosomes, and transethosomes have demonstrated enhanced skin permeation and improved drug deposition in periwound tissue due to their flexible membrane structure and optimized physicochemical properties. This review systematically discusses the composition, preparation techniques, and critical formulation parameters of these vesicular systems that determine their stability, elasticity, and permeation performance. Furthermore, their applications in delivering anti-inflammatory drugs, antimicrobial agents, bioactive phytochemicals, and regenerative therapeutics for different wound types are examined. Widely used in vitro, ex vivo, and in vivo evaluation methods, including permeation studies and wound healing models such as excision, burn, infected, and diabetic wounds, are also summarized. Finally, the review outlines current challenges related to formulation standardization, physicochemical characterization, safety assessment, and large-scale production, while highlighting the future potential of ultradeformable vesicles as next-generation nanocarriers for advanced wound healing therapies.

Despite advancements in healthcare settings in developed countries, the early detection and higher mortality rate associated with amyotrophic lateral sclerosis (ALS), a fatal motor neuronal disorder, remain challenging. Recently, quantum dots (QDs) have emerged as a promising nanocarrier in the prognosis and treatment of ALS owing to their unique multifunctional properties. QDs, through their photoluminescence properties upon excitation, can facilitate the identification and real-time monitoring of disease biomarkers. They also act as a nanocarrier for the targeted delivery of therapeutics, avoiding accumulation at the non-targeted sites and minimising toxicity. QDs can be fabricated to conjugate with protein biomarkers linked to ALS, such as specific proteins, nucleic acids, or genetic variants, for the diagnosis of the disease. Such fabrication could lead to enhanced identification and diagnostic patterns of ALS, thereby contributing to improved therapeutic intervention strategies. Furthermore, these tiny structures could be applied in combined biosensor formats to identify ALS-associated biomarkers in body fluids, which would be a highly sensitive diagnostic system. Subsequently, comprehensive multiomics techniques have demonstrated improved identification of newer protein targets associated with neurological complications. Overall, QDs can be explored as a potential tool to identify biomarkers relevant to ALS, diagnose the disease at its early stages, and track the effectiveness of the treatment. The integration of QD with omic-based strategies and network analysis can potentially catalyse a breakthrough in the management of ALS. Therefore, this review aims to explore the application of QDs in ALS diagnosis and management, advancements in research, clinical trials, and patents.

Pleural effusion is a common clinical condition with a wide differential diagnosis, ranging from benign inflammatory processes to advanced malignancy. In some patients, malignant pleural effusion may represent the first manifestation of an underlying lung cancer. Early recognition and systematic evaluation are therefore essential for timely diagnosis and management. We report the case of a fifty eight year old Saudi male who presented with progressive shortness of breath and right sided chest discomfort of three weeks duration. The patient had a long history of cigarette smoking but no previous diagnosis of malignancy. Physical examination revealed reduced chest expansion and markedly diminished breath sounds over the right lower lung zone. Initial chest radiography demonstrated a moderate right sided pleural effusion without a clearly visible lung mass. Further diagnostic evaluation included contrast enhanced computed tomography of the chest, which confirmed a large right sided pleural effusion with partial lung collapse, mild pleural thickening, and a small irregular lesion in the right upper lobe. Diagnostic thoracentesis yielded exudative pleural fluid according to Light criteria. Microbiological studies were negative for bacterial infection and tuberculosis. Cytological examination of the pleural fluid revealed atypical epithelial cells suspicious for malignancy, and repeat analysis supported the diagnosis of malignant pleural effusion. Subsequent CT guided biopsy of the right upper lobe lesion demonstrated histopathological features consistent with pulmonary adenocarcinoma. Management initially focused on symptomatic relief through pleural fluid drainage and supportive care. Following confirmation of the diagnosis, the patient was referred for oncologic evaluation and further staging. This case highlights the importance of considering malignancy in patients presenting with unexplained pleural effusion, particularly in individuals with significant smoking history, and emphasizes the role of pleural fluid analysis and tissue biopsy in establishing the diagnosis.

Ischemic stroke is a major neurological disorder that is characterized by cognitive decline and sensorimotor impairment. Despite the potential of therapeutic effects and anti-inflammatory properties of medicinal mushrooms, most current research focuses on single-species effects rather than combined formulations. This gap highlights the need to investigate the potential of a combination of medicinal mushrooms named NevG, containing Lignosus rhinocerus, Hericium erinaceus, and Ganoderma lucidum, focusing on their therapeutic effects in the context of ischemic stroke. Forty adult male Sprague-Dawley rats were randomly assigned to five groups (n = 8): normal, MCAO-induced, and NevG in oral doses of 250mg/kg, 500mg/kg, and 1,000mg/kg for 28 days. Ischemia was induced using the Koizumi method and confirmed through triphenyltetrazolium chloride (TTC) staining and mNSS scoring. Cognitive abilities were assessed using the Morris water maze and T-maze tests, and sensorimotor function was evaluated using the open-field, rotarod, and pole tests. Mechanistic analyses involved measuring anti-inflammatory serum cytokine pathways (TNF-α, IL-1β, IL-6, and NF-κβ). NevG significantly reduced infarct volume by 32%-58% compared with the middle cerebral artery occlusion (MCAO) group (p < 0.05). Cognitive performance improved, with a 25%-46% reduction in the Morris water maze (MWM) escape latency (p < 0.01) and an increase in T-maze spontaneous alternation. Sensorimotor functions were enhanced, as evidenced by increases in the open-field test (OFT), rotarod retention time (p < 0.01), and decreased descent time in the pole test. The cresyl violet staining of the neurons in the hippocampus shows improvement in pyramidal cell counts, and the ultrastructural transmission electron microscope (TEM) analysis shows better preservation of the nucleus and mitochondria, intact myelin sheath, and improved axonal integrity. NevG significantly lowered the inflammatory serum cytokine level (p < 0.05) and promoted neuronal survival. NevG demonstrates significant neuroprotective effects in ischemic stroke, achieved through reduced neuroinflammation and improved neuronal survival, indicating its potential as a natural therapeutic agent.

Background: Influenza is one of the most common airborne infections globally. According to the World Health Organization (WHO), influenza leads to 3 to 5 million cases of severe illness each year, with 290,000 to 650,000 respiratory deaths annually, positioning it as a significant public health threat. Objective: This study aims to evaluate the knowledge and attitudes toward influenza and vaccination among the general population in the United Arab Emirates (UAE). Methods: A community-based cross-sectional study was conducted using an online questionnaire distributed through social media platforms, such as Facebook and WhatsApp, across various emirates in the UAE. Data analysis was performed using the Statistical Package for Social Sciences (SPSS) version 21. The study invited participation from individuals aged 18 years and older, both male and female. Results: A total of 265 participants responded to the survey, including 142 males (53.6%) and 123 females (46.4%). Most respondents had insurance coverage (n = 208; 78.5%), and 83.4% were nonsmokers. A significantly higher proportion of males believed that the influenza vaccine is administered during the winter season (63% vs. 37%, P = 0.01) and that it is recommended for elderly individuals over 65 years old (58.2% vs. 41.8%, P = 0.023). Married individuals were significantly more likely to have heard of the influenza vaccine (53.7%) compared to divorced and unmarried respondents (4% and 42.4%, P = 0.019). Additionally, the majority of respondents with insurance coverage perceived the vaccine as safe, albeit with some side effects (70.4%, P = 0.012). Conclusion: This study concluded good knowledge and positive attitude towards influenza vaccination. The study also found no significant gender differences in flu-related knowledge or attitudes among the participants. Moreover, the population surveyed generally considered vaccination to be safe for administration.

Health Professions Education (HPE) cannot rely on assumptions of stability. Fragile contexts – wars, disasters, political upheaval, and systemic weakness – disrupt teaching and learning, assessment, accreditation, and the well-being of learners and faculty. This AMEE Guide provides a framework for building resilient HPE that survive crises and use them as opportunities for reform. The Guide identifies three types of fragility and explores their impact on institutions, human capital, clinical training, and social accountability. To boost resilience, the guide recommended adaptive strategies that include creating crisis management committees, implementing modular and competency-based curricula, allowing credit transfers for displaced learners, and incorporating tailored training programs. For curriculum delivery innovations range from hybrid and low-tech methods to peer-assisted approaches, diaspora involvement, and community-based services. A practical model for fair and feasible assessment in disrupted environments is suggested, with a focus on outcomes, flexibility, and cross-border recognition for rethinking accreditation and quality assurance. Systems thinking underpins the Guide, highlighting how destructive cycles such as brain drain can erode capacity, while virtuous cycles – driven by technology adoption, partnerships, and community integration – can foster recovery and growth. The guide also calls on educators, institutional leaders, and policymakers to move from reactive responses to proactive preparedness.

Pain control remains a cornerstone in endodontic practice, particularly in cases of symptomatic irreversible pulpitis where achieving profound anaesthesia is often challenging. As the inferior alveolar nerve block (IANB) frequently fails to provide profound pulpal anaesthesia, optimizing pain control in such cases requires evidence-based modifications to anaesthetic techniques and the use of supplemental approaches. This narrative review aims to synthesize current evidence on clinical strategies for improving pain management in mandibular molars with symptomatic irreversible pulpitis, with particular emphasis on enhancing the efficacy of IANB and supplemental injection techniques. A narrative review methodology was employed to synthesize clinical trials and systematic reviews published between 1975 and 2025. Evidence indicates that increasing the anaesthetic volume and applying supplemental techniques, including intraligamentary, intraosseous and intrapulpal injections, significantly enhances anaesthesia success. Adjunctive measures such as cryotherapy and temperature modification of anaesthetic solutions further improve pain control. The integration of these methods provides a predictable and multimodal approach to managing endodontic pain in challenging clinical scenarios. Effective pain management in mandibular molars with symptomatic irreversible pulpitis relies on a comprehensive strategy that combines optimized anaesthetic volume and supplemental techniques. Intrapulpal anaesthesia remains essential for achieving pulpal anaesthesia when all other techniques fail. Continued clinical research is essential to refine these approaches and establish standardized protocols for achieving reliable anaesthesia in endodontic practice.