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Urologic cancers (UCs), which include bladder, kidney, and prostate tumors, account for almost a quarter of all malignancies. Long non-coding RNAs (lncRNAs) are tissue-specific RNAs that influence cell growth, death, and division. LncRNAs are dysregulated in UCs, and their abnormal expression may allow them to be used in cancer detection, outlook, and therapy. With the identification of several novel lncRNAs and significant exploration of their functions in various illnesses, particularly cancer, the study of lncRNAs has evolved into a new obsession. MALAT1 is a flexible tumor regulator implicated in an array of biological activities and disorders, resulting in an important research issue. MALAT1 appears as a hotspot, having been linked to the dysregulation of cell communication, and is intimately linked to cancer genesis, advancement, and response to treatment. MALAT1 additionally operates as a competitive endogenous RNA, binding to microRNAs and resuming downstream mRNA transcription and operation. This regulatory system influences cell growth, apoptosis, motility, penetration, and cell cycle pausing. MALAT1's evaluation and prognosis significance are highlighted, with a thorough review of its manifestation levels in several UC situations and its association with clinicopathological markers. The investigation highlights MALAT1's adaptability as a possible treatment target, providing fresh ways for therapy in UCs as we integrate existing information The article not only gathers current knowledge on MALAT1's activities but also lays the groundwork for revolutionary advances in the treatment of UCs.

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Background and objective There is scarce data on diabetic patients' awareness, attitude, and barriers to utilization regarding the artificial pancreas. In light of this, the current study aimed to explore the awareness, attitudes, and perceived barriers to utilization of the artificial pancreas experienced by diabetic patients. Methods A cross-sectional study design was employed to achieve the aim of the study. The study was conducted in Damanhur city, the Beheira Governorate, Egypt. The convenience sampling technique was used to include 385 diabetic patients. The researchers designed an interview questionnaire comprising four parts to collect data about knowledge, attitudes, and barriers to utilization. Results The findings showed that 61% of the participants had a satisfactory level of overall knowledge. Regarding overall attitude, 64.1% of participants exhibited a positive attitude toward the artificial pancreas. The data indicated that 37.7% of participants identified the associated high cost as a significant barrier. Additionally, 23.3% expressed concerns about the lack of healthcare provider support, 21.5% had reservations regarding maintenance, and 17.5% felt limited by their technical skills. Conclusions The study revealed a notable satisfactory level of knowledge and attitudes among about two-thirds of participants regarding the artificial pancreas. Concerns about the high cost emerged as a predominant barrier followed by a lack of healthcare provider support. Empowering both healthcare providers and patients through ongoing educational initiatives can play a pivotal role in fostering a positive attitude and addressing concerns related to artificial pancreas technology.

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This study aimed to investigate physiological and pathological Glenohumeral Internal Rotation Deficit (GIRD) in volleyball players with and without a history of shoulder pain. Volleyball players with a history of shoulder pain (n = 18) and without a history of shoulder pain (n = 18), who were matched in age, weight, height, BMI, years of experience and frequency of practice were recruited for this cross-sectional study. Shoulder internal and external rotation Range of Motion (ROM) was measured for the dominant and non-dominant shoulders of each participant using a digital inclinometer. Measurements of GIRD, External Rotation Gain (ERG), and Total Range of Motion (TROM) were calculated. There were significantly higher degrees of GIRD in the pain group (15.65°) than the no-pain group (9.06°) (p=0.004) and significantly higher differences in the TROM in the pain group (16.17°) than the no-pain group (10.17°) (p=0.007). There was no correlation between the level of pain and the presented ROM adaptations. The study showed that for volleyball players, pathological GIRD should be defined at 10-18° degrees of GIRD that are accompanied by differences in the TROM that exceeds 8°.

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Chronic kidney disease (CKD) is among the top 20 causes of death worldwide and affects approximately 10% of the world adult population. CKD is a disorder that disrupts normal kidney function. Due to the increasing number of people with CKD, effective prediction measures for the early diagnosis of CKD are required. The novelty of this study lies in developing the diagnosis system to detect chronic kidney diseases. This study assists experts in exploring preventive measures for CKD through early diagnosis using machine learning techniques. This study focused on evaluating a dataset collected from 400 patients containing 24 features. The mean and mode statistical analysis methods were used to replace the missing numerical and the nominal values. To choose the most important features, Recursive Feature Elimination (RFE) was applied. Four classification algorithms applied in this study were support vector machine (SVM), k-nearest neighbors (KNN), decision tree, and random forest. All the classification algorithms achieved promising performance. The random forest algorithm outperformed all other applied algorithms, reaching an accuracy, precision, recall, and F1-score of 100% for all measures. CKD is a serious life-threatening disease, with high rates of morbidity and mortality. Therefore, artificial intelligence techniques are of great importance in the early detection of CKD. These techniques are supportive of experts and doctors in early diagnosis to avoid developing kidney failure.

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BACKGROUND: Bile duct injury (BDI) after cholecystectomy remains a significant surgical challenge. No guideline exists to guide the timing of repair, while few studies compare early versus late repair BDI. This study aimed to analyze the outcomes in patients undergoing immediate, intermediate, and delayed repair of BDI. METHODS: We retrospectively analyzed 412 patients with BDI from March 2015 to January 2020. The patients were divided into three groups based on the time of BDI reconstruction. Group 1 underwent an immediate reconstruction (within the first 72 hours post-cholecystectomy, n = 156); group 2 underwent an intermediate reconstruction (from 4 days to 6 weeks post-cholecystectomy, n = 75), and group 3 underwent delayed reconstruction (after 6 weeks post-cholecystectomy, n = 181). RESULTS: Patients in group 2 had significantly more early complications including anastomotic leakage and intra-abdominal collection and late complications including anastomotic stricture and secondary liver cirrhosis compared with groups 1 and 3. Favorable outcome was observed in 111 (71.2%) patients in group 1, 31 (41.3%) patients in group 2, and 157 (86.7%) patients in group 3 (P = 0.0001). Multivariate analysis identified that complete ligation of the bile duct, level E1 BDI and the use of external stent were independent factors of favorable outcome in group 1, the use of external stent was an independent factor of favorable outcome in group 2, and level E4 BDI was an independent factor of unfavorable outcome in group 3. Transected BDI and level E4 BDI were independent factors of unfavorable outcome. CONCLUSIONS: Favorable outcomes were more frequently observed in the immediate and delayed reconstruction of post-cholecystectomy BDI. Complete ligation of the bile duct, level E1 BDI and the use of external stent were independent factors of a favorable outcome.

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AIM: Aim of the present study was to evaluate the prevalence of dental caries and periodontal status among Down's syndrome population in Riyadh City. MATERIALS AND METHODS: A total of 81 male Down's syndrome subjects were examined in this study. All subjects were recruited from the Saudi Center for Down Syndrome, Riyadh. Clinical examination was carried out by a single precalibrated examiner. Dental caries experience was counted according to the DMFT (decayed, missing, and filled teeth) indexes. Periodontal status was evaluated by using plaque and gingival indexes. Statistical analysis was performed using SPSS 19 version. Consequently, Pearson chi-square test and Fisher exact test was used to calculate p-value for parametric variables. RESULTS: In this study 11.1% of the subjects were not having any decayed teeth, 39.5% were not having any missing teeth, and 55.6% were not having any filled teeth. In plaque index, maximum number of subjects in all the age group were in the fair group, and there was a highly significant (P value <0.001) association between the age group and the plaque index groups. In gingival index, maximum number of subjects in all the age group was in the poor group. No significant (P value = 0.697) association between the age group and the gingival index groups was found. CONCLUSION: The present study concluded that the prevalence of dental caries was high and periodontal status of Down's syndrome subjects was poor.

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BACKGROUND: In spite of the advances in modern surgery, the outcome for patients suffering from pancreatic adenocarcinoma or periampullary adenocarcinoma is still bad. Recently, introperative radiotherapy (IORT) was introduced into the multimodality management approach to improve both tumor control and patient' survival. AIM OF WORK: To evaluate our initial experience in combined surgical resection and IORT, and to evaluate the feasibility of the application of IORT and its effect on morbidity, mortality and local recurrence. PATIENTS AND METHODS: This study was conducted at King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia. Data were collected retrospectively. A total of six patients were included in the study, during the period from November 2013 to April 2017. All surgeries were done by the same surgeon. RESULTS: The average age was 60 years (50-71). The patients were four males and two females. Five patients underwent complete surgical resection (pancreaticoduodenectomy) combined with IORT. One patient had locally advanced pancreatic tumor which was beyond surgical resection, for whom surgical bypass was done to overcome the biliary obstruction combined with IORT. Two patients died from disease progression and liver metastases. The remaining four patients survived without any evidence of local recurrence or metastases on follow-up. CONCLUSION: Application of IORT is safe and feasible. It can be applied without additional morbidities or mortalities. Although our results are satisfactory, yet they need to be applied on a larger number of patients with longer periods of follow-up to reach sound conclusions.

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PURPOSE: To assess the performance of the 2Win eccentric videorefractor in relation to subjective refraction and table-mounted autorefraction. METHODS: Eighty-six eyes of 86 adults (46 male and 40 female subjects) aged between 20 and 25 years were examined. Subjective refraction and autorefraction using the table-mounted Topcon KR8800 and the handheld 2Win videorefractor were carried out in a randomized fashion by three different masked examiners. Measurements were repeated about 1 week after to assess instrument reproducibility, and the intertest variability was compared between techniques. Agreement of the 2Win videorefractor with subjective refraction and autorefraction was assessed for sphere and for cylindrical vectors at 0 degrees (J0) and 45 degrees (J45). RESULTS: Reproducibility coefficients for sphere values measured by subjective refraction, Topcon KR8800, and 2Win (±0.42, ±0.70, and ±1.18, respectively) were better than their corresponding J0 (±1.0, ±0.85, and ±1.66) and J45 (±1.01, ±0.87, and ±1.31) vector components. The Topcon KR8800 showed the most reproducible values for mean spherical equivalent refraction and the J0 and J45 vector components, whereas reproducibility of spherical component was best for subjective refraction. The 2Win videorefractor measurements were the least reproducible for all measures. All refractive components measured by the 2Win videorefractor did not differ significantly from those of subjective refraction, in both sessions (p > 0.05). The Topcon KR8800 autorefractometer and the 2Win videorefractor measured significantly more positive spheres and mean spherical equivalent refraction (p < 0.0001), but the J0 and J45 vector components were similar (p > 0.05), in both sessions. CONCLUSIONS: The 2Win videorefractor compares well, on average, with subjective refraction. The reproducibility values for the 2Win videorefractor were considerably worse than either subjective refraction or autorefraction. The wide limits of reproducibility of the 2Win videorefractor probably limit its usefulness as a primary screening device.

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