Global warming poses one of the most significant threats to life on our planet. While its effects are far-reaching, pregnant women and their unborn children are particularly vulnerable. Rising temperatures, extreme weather events, and air pollution associated with climate change directly impact maternal health, leading to adverse outcomes for both mothers and infants. As we grapple with this urgent crisis, it is imperative that we recognize the intersection of climate change and maternal health and take decisive action to protect the well-being of our most vulnerable populations.

Objective: Arthroplasty patients undergo pre-operative assessment and medical optimization before surgery with the objective to mobilize and discharge home as soon as deemed fit to reduce hospital stay. This study was aimed to investigate factors delaying mobilization after hip and knee arthroplasty in our hospital. Methods: This observational study was conducted in our hospital between August 2021 and October 2021. We included all elective orthopedic patients who were admitted for hip and knee arthroplasty during this period. Patients admitted for revision arthroplasty were excluded from the study. We collected data prospectively on a pro forma including patient demographics and different other variables. All patients were reviewed on the first post-operative day by one of the authors and pro formas were completed. We used SPSS to analyze data. Results: Sixty patients were included; 32 females and 28 males with a mean age of 69.62 years. Primary knee arthroplasty was done in 30 patients while 30 underwent primary hip arthroplasty. Most of the patients (n = 50) were mobilized on the 1st day; however, ten patients were unable to mobilize. Orthostatic hypotension, dizziness, and pain were statistically significant factors responsible for failed mobilization on day one. Patients who failed to mobilize on day one had longer hospital stay (P = 0.018). Conclusion: Orthostatic intolerance and post-operative pain were independent factors delaying mobilization after hip and knee arthroplasty thereby increasing the length of stay in these patients.

Objectives: Adiponectin (ADN) is related to insulin resistance and cardiovascular disorders risks. It is negatively controlled in obese cases among diabetes mellitus type 1 (DMT1) patients. The current study evaluates ADN levels in early-aged children 9–12 years old of obese and non-obese cases (DMT1). Methods: A cross-sectional study among children aged 9–11 years old, was conducted during the year 2023 within two groups. First was a diabetic children DMT1 group excluding diabetic cases with complications. Second was a healthy children’s control group. Two groups were subdivided into two subgroups, obese and non-obese (n = 6 for each subgroup). ADN concentrations were measured in DMT1 cases related to weight and body mass index among treated and non-treated with insulin-therapy compared to in vitro diabetic rats. Adult albino male rats enrolled in a control group, non-treated diabetic, and insulin-treated diabetic rats. Statistical analysis-based measuring means and standard deviation for each group and comparing them with the student t-test. Results: Significantly increased plasma AND levels were detected in DMT1 patients compared to non-diabetic cases (P < 0.001). AND levels were decreased in obese rather than non-obese cases of control or diabetic cases (P < 0.001). Data shows significantly increased plasma AND levels in experimental rats, induced with diabetes (with or without insulin treatment) compared to the control group (P < 0.001). Conclusion: Plasma ADN levels were significantly reduced in obese subjects’ diabetics or non-diabetics. It may refer to insulin resistance or mechanisms that prevent further weight gain by decreasing insulin sensitivity and increasing energy expenditure.

Objectives: There is emerging evidence of the benefits of Benincasa hispida in improving metabolic profiles in people with diabetes. This study was conducted to analyze the effect of B. hispida aqueous extract on the metabolic control of patients with type 2 diabetes in Malaysia. Methods: A powdered drink formulated with 2.5 g of B. hispida extract was prepared as a test food. An intervention study was conducted with 50 participants randomly assigned to an intervention or a control group. Anthropometric, biochemical, and clinical variables were assessed at baseline and week 12 after intervention. Paired T-tests were applied to compare the mean differences between the baseline and postintervention for each variable. Results: The intervention group presented a significant reduction in diastolic blood pressure (Δ −7.0 mmHg, 95% confidence interval [CI]: −11.4, −2.5). Mean fasting plasma glucose (Δ −0.8 mmol/L, 95% CI: −1.8, 0.2) showed a greater reduction in the intervention group compared to the control group (Δ −0.4 mmol/L, 95% CI: −1.2, 0.4). Mean lean body mass showed a favorable trend of increment at week 6 (Δ 0.05 kg, 95% CI: −0.40, 0.49) and week 12 (Δ 0.16 kg, 95% CI: −0.33, 0.64) as compared to baseline in the intervention group but not in the control group which manifested decreasing lean body mass. Conclusion: The use of B. hispida extract may potentially improve blood pressure and glycemic control in patients with type 2 diabetes and it may be an attractive candidate for the development of functional food products.

Objectives: This research aimed to examine the connection between indoor air quality and respiratory function in preschool children, a topic that, to the best of our knowledge, has not been explored before. Methods: This cross-sectional study was conducted within the geographical location of the Ministry of Education of Jeddah. Four hundred preschool-aged children (4–6 years old) from four preschools were enrolled. Structured questionnaires and peak flow meter (PFM) were used to assess the overall health and pulmonary function of the participants. An air detector for formaldehyde (HCHO), volatile organic compound, and fine particulate dust matter and a carbon dioxide (CO2) detector with temperature and humidity monitors were used to measure the air pollutants. Results: A significant difference was observed in PFM measurement between the four preschools (P = 0.017). The highest PFM green zone value was identified in the North preschool (n = 32, 54.2%), and the lowest value was identified in the Central preschool (n = 21, 33.3%). Regarding the red zone, the highest value was observed in the Central preschool (n = 14, 22.2%) and the lowest in the North preschool (n = 1, 1.7%). PFM measurement in the green zone showed lower CO2 levels (P = 0.014) and temperature (P = 0.04) than those in the yellow and red zones. Conclusion: Children schooling in adequate ventilation environments had better respiratory function than those in inadequate environmental ventilation.

Objectives: The prospective effect of phytoestrogen-rich supplements has been explored by many researchers in an attempt to reduce breast cancer (BC) risk worldwide. In Saudi Arabia, some widely used supplements have high phytoestrogen content. Therefore, we aimed to (1) assess the relationship between phytoestrogen supplements (PSs) that are widely used among women of Saudi Arabia and BC and (2) assess the relationship based on the menstrual status. Methods: The study took place during 2020–2022 to assess several PSs using a case–control design that included five centers from different provinces around the country. A questionnaire was answered by the participants that included 381 (46%) cases (diagnosed with BC) and 449 (54%) controls (free of BC). The PS items were assessed individually and on the multivariant analysis model. Results: Of the 12 phytoestrogen-rich supplements, soy milk showed a significant decrease in BC risk. However, Echinacea showed an increased risk of BC among its users. A subgroup analysis based on the menstrual status demonstrated an increased risk of BC among licorice root and green tea users on premenopausal and postmenopausal women, respectively. Conclusion: Soy isoflavones continue to show a significant risk reduction that could be used for a modified approach to reduce the risk of BC. However, Echinacea, licorice root, and green tea have shown to increase the risk of BC.

Objective: The objective of this systematic review was to describe novel regimens and treatment strategies in neoadjuvant therapy for colorectal cancer (CRC). The aim was to summarize the current advancements in neoadjuvant chemotherapy (NACT) for CRC, including the use of cytotoxic drugs, targeted treatments, and immunotherapy. The analysis aimed to provide insights into the potential benefits and drawbacks of these novel approaches and highlight the need for further research to optimize NACT use in CRC and improve patient outcomes. Methods: From October 20, 2023, to December 10, 2023, a comprehensive literature search was conducted across multiple databases, including PubMed, Ovid, Web of Science, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, and Scopus. Studies addressing the use of and treatment strategies for CRC and neoadjuvant therapies were included. Screening was conducted in two steps, initially by title and abstract and then by full-text articles. English-language articles were considered, while preprints, non-English publications, and articles published as grey literature were excluded from the study. A total of 85 studies were selected for further analysis after screening and filtering. Results: After filtering out duplicates and items that were irrelevant to our research query from the initial database search’s 510 results, 397 unique articles were found. Eighty-five studies were chosen for additional analysis after the articles underwent two rounds of screening. Conclusion: The review concluded that neoadjuvant therapy for CRC has evolved beyond conventional approaches and holds promise for improving patient outcomes. Future prospects for advancing neoadjuvant approaches are promising, with ongoing clinical trials investigating the refinement of strategies, identification of predictive biomarkers, and optimization of patient selection. The adoption of novel regimens, precision medicine, and immunotherapy offers opportunities to redefine treatment paradigms and enhance patient care in CRC.  

Angiokeratoma (AK) is an uncommon vascular cutaneous illness that is characterized by benign vascular ectasias of the papillary dermis combined with papillomatosis, acanthosis, and hyperkeratosis of the epidermis. It often presents as mainly asymptomatic. Here, we present a case of a 14-year-old Saudi male who presented to the dermatology clinic with red-to-black nodules of varying sizes on the palmar and dorsal surfaces of his left hand. Upon examination, the nodules were painless with no other constitutional symptoms. Laboratory investigations were unremarkable. A 4-mm skin punch biopsy showed dilated vascular channels at the papillary dermis and corneal layer with acanthotic epidermis with granulation tissue; these findings were suggestive of AKs of Mibelli. Timolol drops were prescribed twice daily for 1 month, and the patient was seen after a month with a 90% resolution of lesions.