Hera General Hospital

In this research, novel quinoline derivative as aluminium corrosion inhibitor was designed by utilizing twenty three (23) molecules of quinoline derivatives tested each as corrosion inhibitors for the aluminium in HCl solution; experimentally through weight loss method, and theoretical investigations using quantitative structure activity relationship (QSAR). The inhibition efficiencies of the quinoline derrivatives obtained from the weight lossshows that some quinoline derivatives such as 5-MeQ, 5-ClQ, 8-TMeQ, 6-ACQ and 7-OHQ inhibits the corrosion better than others as indicated by percentage inhibition efficiency (IE). Quantum chemical calculation indicated that the most popular parameters which play a prominent role are the eigenvalues of the highest occupied molecular orbital (HOMO) and lowest unoccupied molecular orbital (LUMO), the HOMO-LUMO gap (ΔE), chemical hardness and softness and the number of electrons transferred from inhibitor molecule to the metal surface. Base on the several physicochemical descriptors and investigation of the adsorption of these molecules on the aluminium surface by the QSAR study of twenty three quiniline derivatives with the aid of material studio, a model was developed and validated. On the basis of the physicochemical parameters, predicted inhibition efficiency of 97.7% obtained using experimental inhibition efficiencies at 303K in 0.4MHCl and 0.2g/mol inhibitor concentration, and the correlation matrix from the QSAR study; 5-chloro,7-hydroxy-quinoline (5-Cl,7-OH-C<sub>9</sub>H<sub>5</sub>N) was designed and accepted as new efficient and effective quinoline derivative inhibitor for aluminium corrosion in HCl acid solution.

Syncope is a common clinical presentation in emergency departments (ED), often posing significant diagnostic challenges due to its broad differential and the potential for life-threatening underlying causes. Accurate risk stratification is essential to differentiate patients requiring urgent intervention from those who can be safely discharged. The San Francisco syncope rule (SFSR) was developed to aid clinicians in identifying patients at risk of short-term serious outcomes. Despite its widespread adoption, evidence regarding its reliability and predictive accuracy remains mixed. External validation studies have reported variable sensitivity and specificity, with some highlighting its failure to detect neurologic or subtle cardiac causes of syncope. Comparative analysis with other stratification tools such as the OESIL score, ROSE rule, and EGSYS score reveals key differences in design and clinical utility. Each model offers unique strengths but also exhibits important limitations when applied across heterogeneous patient populations. Inconsistent definitions of serious outcomes and variable study methodologies have contributed to difficulty in standardizing syncope assessment across settings. Additionally, neurologic causes are frequently underrepresented in many tools, reducing their diagnostic reach. Biomarkers and imaging have been proposed as adjuncts but are limited by access, cost, and timing. Recent interest has turned to machine learning models capable of integrating broader clinical variables to generate personalized risk profiles. Although early results are encouraging, such approaches require rigorous external validation before widespread clinical use. Overall, existing models offer useful guidance but are not definitive. Risk stratification in syncope should remain a dynamic process informed by evidence-based tools, clinician experience, and ongoing research into more adaptable, data-rich strategies capable of addressing the complexity of syncope presentations in modern emergency care.

BackgroundCellular angiofibroma is a rare, benign mesenchymal tumor most commonly arising in the vulvovaginal region in middle-aged to elderly women. Despite its indolent nature, it is frequently misdiagnosed due to a nonspecific clinical presentation and its resemblance to other vulvar masses.Case reportWe present a case of a 65-year-old postmenopausal woman with a neglected, slowly growing giant pedunculated mass on her left labia majora that developed over 5 years. The patient underwent surgical excision and cosmetic reconstruction, with an uneventful postoperative recovery. Histopathological examination confirmed a benign myxoid spindle cell neoplasm consistent with cellular angiofibroma.Discussion and conclusionThis case highlights the challenges in the diagnosis of cellular angiofibroma owing to the tumor’s often nonspecific presentation and emphasizes the importance of surgical excision as the standard treatment, despite a low reported risk of recurrence even with positive surgical margins.

ObjectiveThis study examined the prevalence of Neuropathic pain (NP) and its association with central sensitization (CS) among individuals with symptomatic knee osteoarthritis (OA).MethodsA cross-sectional study was conducted in Saudi Arabia and included participants from community service centers and hospitals who aged ≥45 years and diagnosed with knee OA according to National Institute for Health and Care Excellence (NICE) criteria. Exclusion criteria included language barriers, inability to walk or stand independently, and pregnancy. NP was measured using the Arabic version of painDETECT questionnaire, and CS was measured using the central sensitization inventory (CSI). Multivariable logistic regression was performed to examine associations between CSI scores and NP, and Receiver Operator Characteristics analysis was used to determine an optimal cutoff score for CSI that was associated with NP.ResultsThis study included a total of 155 participants with knee OA, 11% (n=17) were classified as having NP. After excluding 30 participants with unclear NP classification, 125 participants were included in the final analysis. Increased CSI scores was independently associated with increased odds of NP (OR = 1.10; 95% CI: 1.05–1.15) after adjusting for age, sex, body mass index, and employment status. A cutoff score of ≥26 for CSI was identified participants with NP, with 94% sensitivity and 63% specificity.ConclusionCS was associated with the presence of NP in individuals with knee OA. A cutoff score of ≥26 for CSI demonstrated a high sensitivity in predicting NP in people with knee OA, suggesting its utility as an effective screening tool for guiding an appropriate intervention and measuring response to treatment in this population.

The antibiotics are commonly and frequently prescribed after endoscopic sinus surgery to treat chronic sinusitis, although their clinical benefit remains uncertain. One such antibiotic, doxycycline, has antimicrobial and anti-inflammatory properties, which improve postoperative recovery. However, recent reviews of infectious complications after endoscopic sinus surgery suggest the importance of antibiotic use, but routine postoperative antibiotic use remains controversial. The study aims to assess whether postoperative systemic doxycycline improves symptoms, endoscopic healing, complications, or microbiome recovery after endoscopic sinus surgery (ESS) for chronic rhinosinusitis (CRS). A PRISMA 2020-oriented systematic review with quantitative synthesis was conducted. The randomized or quasi-randomized adult studies comparing postoperative doxycycline versus placebo/standard care. The searches were performed in MEDLINE (PubMed), Embase, CENTRAL, and Scopus. The results show that of the 247 records screened, two randomized, double-blind, controlled trials met the inclusion criteria. Both evaluated doxycycline (100 mg for 28 days versus placebo) compared to placebo after esophagoscopy in adults with chronic atrophic rhinitis (with or without nasal polyps). Endoscopy and microbiome findings showed no sustained benefit with doxycycline. Side effects were rare and similar between groups. The certainty of the evidence ranged from low to moderate for all outcomes. The authors concluded that the current randomized evidence does not support a symptomatic or endoscopic advantage of postoperative doxycycline after ESS for CRS. While generally safe, its routine use cannot be justified given low-certainty evidence and the importance of antibiotic stewardship. Larger, well-powered trials with standardized outcomes are needed to clarify its role.

Introduction:Epicondylitis (lateral and medial) is a common tendinopathy that impairs function and quality of life. Corticosteroid injections (CSI) provide rapid but often short-lived symptom relief, while platelet-rich plasma (PRP) is used as a biologic alternative aimed at tendon regeneration. Comparative effectiveness between PRP and CSI remains uncertain in real-world settings.Materials and Methods:We conducted a retrospective cohort study using de-identified electronic health records from the TriNetX Network (2010–2025). Adults ≥18 years with coded epicondylitis and subsequent PRP or CSI were included. Cohorts were 1:1 propensity-score matched on demographics and comorbidities (age, sex, race, type 2 diabetes, obesity, hypothyroidism, nicotine dependence). Outcomes were assessed over a period of 1 year after the index event and included repeat or new medication, opioid exposure, long-term opioid initiation, visits to the emergency department (ED), functional diagnoses (stiffness, weakness, mobility), physical therapy (PT) utilization, and surgical escalation. Hazard ratios (HRs) and risk ratios were estimated.Results:After matching, 1,064 PRP patients were compared with 1,064 CSI patients. PRP was associated with higher hazards of repeat or new medication (HR 1.33; 95% CI 1.18–1.50; RR 1.21), opioid exposure (HR 1.48; 95% CI 1.20–1.83; RR 1.43), PT utilization (HR 1.52; 95% CI 1.27–1.81; RR 1.41), joint stiffness (HR 1.64; 95% CI 1.04–2.59; RR 1.63), dependence on mobility aids (HR 3.63; 95% CI 1.80–7.31; RR 3.60), and surgical escalation (HR 2.57; 95% CI 1.19–5.56; RR 2.30). No significant differences were observed for ED visits, long-term opioid initiation, abnormal gait, muscle weakness, or contracture.Conclusion:In this large, multi-institutional real-world cohort, PRP was associated with higher short-term utilization and treatment failure risks compared with CSI. While randomized trials suggest mid-term benefits of PRP, our findings highlight an efficacy–effectiveness gap, likely reflecting heterogeneity in PRP protocols and patient selection. Clinicians should counsel patients about the potential for early symptom flare and higher downstream resource use when considering PRP.

Herpesviruses are common viruses that have infected the vast majority of people around the globe. Accurate diagnosis of these viruses using cost-effective methods is important, especially for asymptomatic cases. Diagnostic differentiation between naturally occurring antibodies and other antibodies is an area that requires investigation. The aim of this study was to optimize an immunoassay to detect anti-herpesvirus antibodies directed against immunodominant proteins. A total of 120 sera were collected at two stages (62 samples for the pilot experiment during coronavirus pandemic, and 58 samples were collected recently). An ELISA test was developed using cytomegalovirus phosphoprotein 150 (pp150) and herpes simplex virus 2 glycoprotein D (HSV-2 gD) to test the specificity of the test. The cutoff value was 0.218, which indicates low background noise. There was competitive binding of the CMVpp150 as competitor compared to HSV-2 gD. The test can be reliably used to specifically determine anti-viral immunodominant proteins. Future studies should explore the binding of antibodies to other specific viral antigens to further expand the scale of testing. Furthermore, studies should be performed to reproduce these results with comparability using commercial kits.

Emergency departments (EDs) are the frontline of healthcare systems, often faced with high patient volumes, critical time pressures, and increasingly complex cases. To address these challenges, multidisciplinary teamwork has emerged as a vital strategy to enhance patient care, safety, and overall departmental efficiency. This systematic review explores the role of multidisciplinary health teams—including physicians, nurses, paramedics, pharmacists, social workers, and allied health professionals—in strengthening ED performance. Following PRISMA guidelines, peer-reviewed literature published between 2010 and 2025 was analyzed to examine the impact of team-based collaboration on patient outcomes, quality of care, and operational efficiency. Evidence indicates that multidisciplinary approaches significantly reduce medical errors, improve triage accuracy, shorten patient waiting times, and enhance satisfaction for both patients and healthcare providers. However, barriers such as communication breakdowns, hierarchical structures, and resource limitations persist, potentially hindering effective collaboration. The review highlights strategies including interprofessional training, leadership support, standardized care pathways, and digital health integration as enablers of stronger team-based care in EDs. Ultimately, the findings underscore that effective multidisciplinary teamwork is not only essential for optimizing patient outcomes in emergency settings but also for sustaining healthcare system resilience and preparedness.

Background: Holistic nursing, grounded in the philosophy of treating the entire person, encompasses physical, emotional, psychological, and spiritual care to enhance the overall well-being of both the patient and the nurse. Holistic nursing approaches, such as mindfulness, aromatherapy, and therapeutic touch, have been increasingly implemented in nursing to respond to the problems of stress, pain, and emotional and psychological distress and are part of a worldwide trend toward more integrative approaches to care. Aim: To review and synthesize the current evidence for efficacy, mechanisms, application, and limitations regarding mindfulness, aromatherapy, and therapeutic touch in nursing. Methods: A narrative review was conducted using PubMed, CINAHL, PsycINFO, and Scopus, with keywords that included "holistic nursing" and "mindfulness efficacy." The quality of each study and all types of evidence was appraised with Joanna Briggs Institute tools with an emphasis on systematic reviews, meta-analyses, and RCTs. Results: Mindfulness was found to have positive and significant effects on reducing anxiety and stress and decreasing burnout (g=0.57). Aromatherapy has positive effects on sleep and pain management. Therapeutic touch has a moderate effect on pain management; however, there is limited direct mechanistic evidence. The majority of limitations include the non-standardized interventions and scepticism. Conclusion: This review provided evidence-based support that these approaches support better outcomes for patients and resiliency for nurses. A larger-scale integration of these approaches in practice requires pre-determined and coordinated protocols, and further systematic review methodology will determine their effectiveness in daily healthcare practice. Keywords: Holistic Nursing, Mindfulness, Aromatherapy, Therapeutic Touch, Integrative Care.

Psoriasis is a chronic immune-mediated skin condition that has a substantial impact on patients' quality of life. The Saudi Arabia Psoriasis Registry (PSORSA) was established to address long-term real-world data (RWD) on systemic and biologic therapies in the region. This observational cohort study provides a comprehensive analysis of baseline disease characteristics, comorbidities, and treatment efficacy among patients enrolled in PSORSA, with an emphasis on risankizumab. Data were sourced from a governmental online database covering multiple healthcare centers. Patients eligible for biologics were followed at baseline and at weeks 16, 28, 40, and 52 to evaluate disease severity, quality of life, and adherence. Statistical analyses were conducted using Jamovi and R. Descriptive statistics were performed for categorical and continuous variables. p-Values < 0.05 were considered significant. The study cohort included 313 patients. Plaque psoriasis was the most prevalent clinical type (93.9%). An analysis of treatment history revealed that 39.6% of patients had prior therapy exposure, and all patients received risankizumab as a biologic therapy. At baseline, the mean Psoriasis Area and Severity Index (PASI) score was 25.49. By week 52, it had decreased to 0.358, indicating complete clearance. PASI scores showed a steady and substantial reduction over time, with an 88% reduction at week 16, 96% at week 28, 97.5% at week 40, and 98.5% by week 52, demonstrating a strong and sustained treatment effect (p < 0.001). Additionally, risankizumab exhibited a favorable drug survival profile, with many patients maintaining treatment beyond 122 weeks. This study represents the first real-world assessment of risankizumab for moderate-to-severe psoriasis in Saudi Arabia. The findings demonstrate that risankizumab is an effective and well-tolerated treatment for moderate-to-severe psoriasis in this Saudi Arabian cohort. However, future studies should explore long-term safety outcomes and the comparative effectiveness of risankizumab and emerging biologics in diverse patient populations.