Journal of Taibah University Medical Sciences最新文献

{"title":"Effects of Cucurbita pepo seed extract on behavioral and neuroinflammatory changes in D-galactose-induced brain model","authors":"Minza Saher M.Phil,&nbsp;Aisha Aziz PhD,&nbsp;Saba Majeed PhD,&nbsp;Arzoo Ajaz M.Phil,&nbsp;Sabiha Gul M.Phil,&nbsp;Somia Gul PhD","doi":"10.1016/j.jtumed.2026.09.005","DOIUrl":"10.1016/j.jtumed.2026.09.005","url":null,"abstract":"<div><h3>Background</h3><div>Aging is associated with progressive neuronal dysfunction driven by oxidative stress and neuroinflammation. <em>Cucurbita pepo</em> L. (pumpkin) is rich in bioactive compounds, including phenolics, flavonoids, carotenoids, tocopherols, and unsaturated fatty acids, with antioxidant and anti-inflammatory properties. These characteristics suggest that <em>C. pepo</em> may have a neuroprotective role against age-related neuronal damage. The aim of the present study was to evaluate the neuroprotective potential of ethanolic <em>C. pepo</em> seed extract in a D-galactose-induced brain aging model.</div></div><div><h3>Methods</h3><div>Healthy adult Wistar albino male rats were randomly assigned to four groups (n = 6 each): control, D-galactose-induced disease, <em>C. pepo</em> seed extract treated, and donepezil-treated groups. Behavioral assessments were performed using light/dark, open field, and sucrose intake tests. Neuroinflammatory markers comprising tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) were evaluated using enzyme-linked immunosorbent assays and PCR, followed by biochemical and histopathological analyses.</div></div><div><h3>Results</h3><div>D-galactose administration significantly impaired behavioral performance, reducing the time spent in the light compartment, open field activities (grooming and rearing), and sucrose intake (<em>p</em> &lt; 0.001). Treatment with <em>C. pepo</em> L. seed extract significantly improved these behavioral parameters (<em>p</em> &lt; 0.01). The extract also markedly reduced the TNF-α levels (0.20 ± 0.04, <em>p</em> &lt; 0.001) and IL-6 expression (0.09 ± 0.02, <em>p</em> &lt; 0.001), indicating attenuation of aging-associated neuroinflammation.</div></div><div><h3>Conclusions</h3><div>In this study, pumpkin seed extract was associated with modulation of neuroinflammatory markers and improvements in behavioral changes in an experimental model of brain aging.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 5","pages":"Pages 1067-1081"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Baseline HbA1c is associated with glycemic response to digital personalized nutrition in type 2 diabetes: A real-world study","authors":"Indira Kaibagarova PhD Doctoral Candidate,&nbsp;Aigul Sartayeva Candidate of Medical Sciences,&nbsp;Nurgul Ablakimova PhD,&nbsp;Gaziza Smagulova Candidate of Medical Sciences,&nbsp;Alla Ovsiannikova Doctor of Medical Sciences (DSc)","doi":"10.1016/j.jtumed.2026.09.006","DOIUrl":"10.1016/j.jtumed.2026.09.006","url":null,"abstract":"<div><h3>Background and aims</h3><div>Digital personalized nutrition is increasingly implemented in type 2 diabetes care, but the therapeutic effects appear to be heterogeneous in real-world settings. The aims of this study were to evaluate variations in the glycemic response to a digital personalized dietary intervention and identify baseline determinants of treatment effectiveness.</div></div><div><h3>Methods</h3><div>In this prospective real-world before–after study, 47 adult outpatients with type 2 diabetes received individualized dietary recommendations generated by a web-based platform, with unchanged pharmacotherapy. Glycated hemoglobin (HbA1c), dietary intake, and body mass index were assessed at baseline and after 2–3 months. Subgroup analyses were performed according to baseline HbA1c (&lt;7.0% vs ≥ 7.0%).</div></div><div><h3>Results</h3><div>The intervention was associated with significant reductions in energy intake and body mass index. The overall change in HbA1c at the population level was modest, but a pronounced and statistically significant reduction was observed in patients with baseline HbA1c ≥ 7.0% (<em>p</em> = 0.003), whereas no meaningful change occurred in patients with well-controlled baseline glycemia. Baseline HbA1c was associated with the magnitude of the glycemic response to the intervention.</div></div><div><h3>Conclusions</h3><div>Digital personalized nutrition in routine clinical practice resulted in heterogeneous glycemic effects rather than a uniform population-level response. Clinically meaningful improvement was primarily observed in patients with elevated baseline HbA1c, supporting a targeted implementation strategy and highlighting the importance of patient stratification in digital dietary interventions.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 5","pages":"Pages 1039-1046"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and characterization of an injectable dental follicle stem cell-secretome/nano-hydroxyapatite chitosan-alginate hydrogel: A cytocompatible scaffold for periodontal regeneration","authors":"Mohammed A. Al-Wesabi MSc,&nbsp;Rini D. Ridwan PhD,&nbsp;Saba A. Al- Sanaani BDS,&nbsp;Mohammed A. Al Junaid PhD,&nbsp;Huda R. Qaid PhD,&nbsp;Khor G. Heah PhD,&nbsp;Norlina Hamrun PhD,&nbsp;Syamsiah Syam PhD,&nbsp;Alexander P. Nugraha PhD","doi":"10.1016/j.jtumed.2026.09.001","DOIUrl":"10.1016/j.jtumed.2026.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and characterize a novel injectable hydrogel containing third molar dental follicle stem cell (DFSC)-derived secretome and nano-hydroxyapatite (nHA) with low molecular weight chitosan to create a bioactive, osteoconductive, and immunomodulatory scaffold for periodontal regeneration.</div></div><div><h3>Methods</h3><div>A chitosan/sodium alginate matrix was synthesized via solvent evaporation to prepare three injectable hydrogel formulations: secretome-loaded hydrogel (TG1), nHA-reinforced hydrogel (TG2), and a composite hydrogel incorporating both active agents (TG3). Following sterilization, all formulations were assessed to determine their organoleptic properties, injectability, gelation time, and pH. The morphology and porosity of the samples were characterized using scanning electron microscopy (SEM), mineral content by energy-dispersive X-ray spectroscopy (EDS), and osteoblast cytocompatibility with the MTT assay.</div></div><div><h3>Results</h3><div>All hydrogels were extruded from fine-gauge needles and maintained a uniform flow rate of up to 30G. The gelation time at 37 °C was approximately 8.5 ± 2.5 min for each hydrogel group. The hydrogels had highly porous and interconnected three-dimensional structures with irregular and varied pore distributions throughout the matrices. Porosity analysis performed by Otsu threshold segmentation of SEM images for the composite formulation (TG3) indicated an overall porosity of approximately 58.3%. EDS detected the presence of calcium and phosphorus (nHA) within the scaffold. The MTT results showed that the cell viability exceeded 90% for the composite formulation (secretome + nHA) and over 75% for all single-agent formulations, with no significant cytotoxicity relative to the control (<em>p</em> &lt; 0.05, one-way analysis of variance with Tukey's HSD).</div></div><div><h3>Conclusion</h3><div>The injectable chitosan/alginate hydrogel loaded with DFSC-derived secretome and nHA exhibited favorable injectability, rapid gelation, high porosity, an interconnected microarchitecture, and excellent cytocompatibility. The successful incorporation of nHA was confirmed by EDS analysis, suggesting that the developed bioactive scaffold has potential uses in periodontal tissue engineering and regenerative applications.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 5","pages":"Pages 1029-1038"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and burden of HIV–TB co-infection among pregnant women: A systematic review and meta-analysis","authors":"Tolutope Adebimpe Oso PhD,&nbsp;Olalekan John Okesanya MPH,&nbsp;Uthman Okikiola Adebayo BMLS,&nbsp;Khalifat Boluwatife Obadeyi BMLS,&nbsp;Pelumi Daniel Adewole PhD,&nbsp;Mohamed Mustaf Ahmed MSc,&nbsp;Oluwatobi Babajide Ayelaagbe MPH,&nbsp;Adebimpe Busola Ogundele MSc,&nbsp;Ayantunde Kayode Ayankola MBBS,&nbsp;Olaoluwa Joseph Oso BNSc,&nbsp;Bonaventure Michael Ukoaka MD,&nbsp;Don Eliseo Lucero-Prisno III PhD","doi":"10.1016/j.jtumed.2026.09.003","DOIUrl":"10.1016/j.jtumed.2026.09.003","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to systematically evaluate the prevalence and burden of human immunodeficiency virus–tuberculosis (HIV–TB) co-infection among pregnant women.</div></div><div><h3>Method</h3><div>ology: A comprehensive systematic search was conducted in PubMed, Scopus, and Google Scholar to identify eligible studies published in English between 2015 and 2025. Study selection, data extraction, quality assessment, and reporting adhered to the PROSPERO-registered protocol and Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Pooled prevalence estimates were calculated using a random-effects logistic regression model implemented in R statistical software. Heterogeneity was assessed using Cochran's Q statistic, τ², and the I² statistic. Subgroup analyses were conducted according to geographical region, HIV prevalence strata, and study design. Publication bias was evaluated using funnel plots and Egger's regression test. Leave-one-out sensitivity analysis was performed to assess the robustness of the pooled estimates.</div></div><div><h3>Results</h3><div>Twenty-three studies involving 118,174,014 pregnant women were included in the systematic review, where 17 studies comprising 57,399,949 pregnant women contributed quantitative data to the meta-analysis. The pooled prevalence of HIV–TB co-infection among pregnant women was 19.5% (95% confidence interval (95% CI): 3.1–65.0%), with considerable heterogeneity (I² = 99.9%). Subgroup analyses obtained significantly higher prevalence estimates in sub-Saharan Africa (30.8%; 95% CI: 10.1–63.8%), high HIV prevalence settings (51.8%; 95% CI: 25.1–77.5%), and prospective or longitudinal cohort studies (67.7%; 95% CI: 23.5–93.4%) (all <em>p</em> &lt; 0.001). Diagnostic approaches included enzyme-linked immunosorbent assay, GeneXpert MTB/RIF, sputum microscopy, QuantiFERON-TB Gold Plus, tuberculin skin test, HIV RNA quantification, CD4 T-cell count, and smear microscopy. HIV–TB co-infection was associated with adverse maternal and neonatal outcomes.</div></div><div><h3>Conclusion</h3><div>HIV–TB co-infection remains a substantial burden among pregnant women, particularly in high HIV prevalence settings and Sub-Saharan Africa, necessitating strengthened integrated screening, early diagnosis, and targeted interventions to improve maternal and child health outcomes in resource-constrained settings.</div></div><div><h3>PROSPERO ID</h3><div>CRD42025646201.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 5","pages":"Pages 1007-1028"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparative study of the efficacy of apitoxin gel versus photobiomodulation by diode laser for recurrent aphthous stomatitis treatment","authors":"Mohamed Omar Elboraey PhD,&nbsp;Sherouk Mohamed Mohamed Gamal PhD,&nbsp;Reda Saber Sabra PhD,&nbsp;Mostafa I. Fayad PhD,&nbsp;Abdullah Alqhtani PhD,&nbsp;Rayan Meer MSc, DABP","doi":"10.1016/j.jtumed.2026.09.007","DOIUrl":"10.1016/j.jtumed.2026.09.007","url":null,"abstract":"<div><h3>Background</h3><div>Bee venom (apitoxin) contains bioactive compounds. Diode laser irradiation has a photobiomodulation effect. Both modalities are considered potential alternative therapies for managing recurrent aphthous stomatitis (RAS).</div></div><div><h3>Objective</h3><div>This study compared the therapeutic effectiveness and safety of apitoxin gel versus photobiomodulation therapy (PBM) for the management of recurrent aphthous ulcers.</div></div><div><h3>Methods</h3><div>Sixty participants with symptomatic recurrent aphthous ulcer ≥4 mm were randomly allocated to two groups. Group I was managed by PBM and group II by using 0.3% apitoxin gel. The pain sensation score measured using a visual analog scale (VAS), and the ulcer surface area and ulcer depth were recorded at baseline and on day 5. The effectiveness index (EI) for pain improvement was calculated for each patient.</div></div><div><h3>Results</h3><div>The Shapiro–Wilk test was applied to verify the normality of distributions using IBM SPSS software package version 24.0. The independent-samples <em>t</em>-test was used to compare differences between two means. Significant improvements in all clinical parameters were found post-treatment in both study groups compared with the baseline (paired <em>t</em>-test, <em>P</em> &lt; 0.001). According to the intergroup comparison, the clinical improvement was greater in group II, and significant differences in pain sensation (VAS), the EI for pain reduction, and ulcer depth were found between the two groups (independent-samples <em>t</em>-test, <em>P</em> &lt; 0.001). The ulcer surface area did not differ significantly between the two groups post-treatment (independent-samples <em>t</em>-test, <em>P</em> = 0.21).</div></div><div><h3>Conclusion</h3><div>Apitoxin gel reduces pain, speeds healing, and controls inflammation in RAS. Its effects are due to anti-inflammatory, antioxidant, and antimicrobial activities, and it may provide a more cost-effective and convenient option for patients.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, TRN: NCT07135609.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 5","pages":"Pages 1056-1066"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149141094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a learning quality scale and associated factors among international medical students in China","authors":"Lei Zhong PhD,&nbsp;Jiyang Zhao PhD,&nbsp;Ming Fang PhD,&nbsp;Lei Liu PhD,&nbsp;Jiaqi Mu PhD,&nbsp;Jinzhong Liu PhD,&nbsp;Tong Zheng PhD,&nbsp;Yue Gao PhD,&nbsp;Hao Sun PhD","doi":"10.1016/j.jtumed.2026.09.004","DOIUrl":"10.1016/j.jtumed.2026.09.004","url":null,"abstract":"<div><h3>Objectives</h3><div>The aims of this study were to develop and validate the International Medical Students’ Learning Quality Scale (IMS-LQS) in China, and to examine student-related factors associated with learning quality.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among international students enrolled in clinical medicine programs in China. A multicenter convenience sampling strategy was applied at 16 medical universities located in selected regions of China. A preliminary IMS-LQS was developed through literature review, expert consultation, and student interviews. In total, 472 valid questionnaires were collected and randomly divided into an exploratory sample (n = 189) and confirmatory sample (n = 283). Exploratory factor analysis was conducted for item reduction and factor structure exploration, and confirmatory factor analysis was applied to examine model fit and construct validity. Internal consistency, convergent validity, and discriminant validity were assessed. Univariate and multivariate linear regression analyses were performed to identify factors associated with learning quality.</div></div><div><h3>Results</h3><div>Nineteen items were retained in the final IMS-LQS covering five domains: professional knowledge, clinical skills and practice, professional literacy and ethics, Chinese communication and intercultural competence, and academic and self-directed development. The five-factor solution explained 73.37% of the total variance. The overall Cronbach's alpha coefficient was 0.889, and the domain-level coefficients ranged from 0.817 to 0.851. Confirmatory factor analysis showed that the model fit was acceptable (χ²/df = 2.26, comparative fit index = 0.927, Tucker–Lewis index = 0.913, root mean square error of approximation = 0.067, and standardized root mean square residual = 0.056), with adequate composite reliability, average variance extracted, and discriminant validity. Multivariate analysis showed that native English language, longer duration of study in China, motivation related to the cultural environment, and clinical internship experience were factors associated with higher learning quality scores.</div></div><div><h3>Conclusions</h3><div>The 19-item IMS-LQS had a clear five-domain structure and acceptable reliability and validity among international medical students in China. This scale may support learning quality assessment and targeted educational support in international medical education.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 5","pages":"Pages 1047-1055"},"PeriodicalIF":2.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of dapagliflozin on mineral homeostasis in patients with type 2 diabetes: A real-world retrospective cohort study","authors":"Tahani Alshammeri MD,&nbsp;Ibrahim El Sayed PhD,&nbsp;Dalia Abdelazim PhD","doi":"10.1016/j.jtumed.2026.07.003","DOIUrl":"10.1016/j.jtumed.2026.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Sodium–glucose cotransporter 2 (SGLT2) inhibitors provide important glycemic, cardiovascular, and renal benefits in patients with type 2 diabetes mellitus (T2DM). However, their long-term effects on mineral and electrolyte homeostasis in routine clinical practice remain uncertain.</div></div><div><h3>Objectives</h3><div>To assess the effects of dapagliflozin on serum calcium, magnesium, phosphorus, creatinine, and parathyroid hormone (PTH) levels in patients with T2DM over two years.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included adults with T2DM treated with dapagliflozin at King Saud University Medical City, Riyadh, Saudi Arabia, between January 2023 and August 2025. Laboratory values were collected at baseline and after one and two years of treatment. Longitudinal changes were evaluated using descriptive statistics, one-way analysis of variance with post-hoc comparisons, and multivariable linear regression.</div></div><div><h3>Results</h3><div>The study included 549 patients with a mean age of 62.9 ± 12.8 years, and 49.4% were male. Serum calcium increased significantly after one year of dapagliflozin therapy compared with baseline (p = 0.009), with no further significant increase during the second year. Serum magnesium decreased significantly by the second year (p &lt; 0.001). Serum creatinine increased significantly at both follow-up points compared with baseline (p &lt; 0.001). No significant longitudinal changes were observed in serum phosphorus or PTH. In multivariable analysis, the year of measurement independently predicted changes in serum magnesium and phosphorus levels.</div></div><div><h3>Conclusions</h3><div>Long-term dapagliflozin therapy was associated with statistically significant but clinically modest changes in serum calcium, magnesium, and creatinine, while phosphorus and PTH remained stable over two years. These findings support the overall metabolic safety of dapagliflozin in routine practice. Nevertheless, periodic monitoring of renal function and electrolyte levels, particularly magnesium, may be advisable in patients receiving prolonged therapy or those at increased risk of renal or electrolyte disturbances. Further prospective studies are needed to clarify relevance of these biochemical changes in vulnerable populations.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 4","pages":"Pages 793-801"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13393584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Probable pregabalin and amantadine-containing cold medication intoxication in an adolescent with rhabdomyolysis: Case report","authors":"Yong Li BMed,&nbsp;Xiaochen Zhang BMed","doi":"10.1016/j.jtumed.2026.07.010","DOIUrl":"10.1016/j.jtumed.2026.07.010","url":null,"abstract":"<div><div>Routine urine toxicology screening may be misleading when adolescents present with acute psychotic symptoms and systemic toxicity after exposure to drugs not included in the screening panel. We report a 17-year-old girl with no known psychiatric or neurologic illness who developed agitation, persecutory delusions, fever, diaphoresis, tachycardia, limb rigidity, and a brief generalized tonic-like episode after suspected repeated nonprescribed pregabalin misuse and misuse of an amantadine-containing over-the-counter cold preparation. Collateral history and medication packaging retrospectively suggested 1200 mg pregabalin per episode with six tablets of the cold preparation per episode, corresponding to estimates of 600 mg amantadine and 1500 mg acetaminophen. Serum or urine concentrations of pregabalin and amantadine were not measured, and the serum acetaminophen concentration or international normalized ratio was not obtained. A limited qualitative urine toxicology screen was negative, but the panel did not include pregabalin, amantadine, acetaminophen, caffeine, or chlorpheniramine. Creatine kinase increased from 9590 to 13,840 U/L. Serum myoglobin exceeded the assay upper limit (&gt;2700 ng/mL) and urinalysis supported myoglobinuria. Renal function remained normal. Troponin I remained normal despite creatine kinase-MB elevation, and cardiac assessment did not support primary myocardial necrosis. Neuroimaging and electroencephalography detected no explanatory abnormality. The working diagnosis was probable mixed-medication intoxication with acute delirium, psychotic symptoms, multifactorial rhabdomyolysis, and spontaneous pneumomediastinum with a small pneumothorax. Treatment consisted of drug withdrawal, hydration, cooling, benzodiazepine-based sedation, short-term antipsychotic treatment for dangerous agitation, and conservative pulmonary observation. Creatine kinase decreased to 495 U/L by day 15. This case highlights the need for collateral medication histories and expanded toxicological testing when routine screening is negative.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 4","pages":"Pages 856-862"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148738308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing patterns and determinants of long-term proton pump inhibitor use in Malaysian public hospitals","authors":"Hayati Alwani Yahaya MClin,&nbsp;Nor Asyikin Mohd Tahir PhD,&nbsp;Mohd Makmor-Bakry PhD,&nbsp;Farida Hanim Islahudin PhD,&nbsp;Lim Ming Chiang MClin,&nbsp;Subramaniam Thanimalai PhD,&nbsp;Nur Asyikin Adzmi BPharm,&nbsp;Razanah Zainuddin BPharm","doi":"10.1016/j.jtumed.2026.07.002","DOIUrl":"10.1016/j.jtumed.2026.07.002","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the prescribing patterns and determinants of long-term proton pump inhibitor (PPI) therapy across four public hospitals in Malaysia.</div></div><div><h3>Methods</h3><div>Adult inpatients aged ≥18 years old and who received PPIs during medical ward admission in 2023 were recruited as respondents, whereas adult inpatients who were pregnant, prescribed PPIs for Zollinger–Ellison syndrome, Barrett's esophagus, or <em>Helicobacter pylori</em> eradication, or with incomplete data were excluded.</div></div><div><h3>Results</h3><div>In total, 392 adult inpatients with PPI prescriptions in 2023 were included. The mean age was 66.7 years, with most patients aged ≥60 years (76.5%) and predominantly male (75%). Pantoprazole was the most frequently prescribed (83.7%), and only 29.6% had documented indications. Long-term PPI therapy over 12 weeks was observed in 87.5% of patients and 71.4% received continuous therapy. Laboratory analyses also found significant reductions in serum magnesium and hemoglobin post-PPI therapy (<em>p</em> &lt; 0.001), whereas changes in pre- and post-corrected calcium levels (<em>p</em> = 0.115) were not significant. In addition, multivariate logistic regression analysis identified the number of received medications as the only independent predictor of long-term PPI use over 12 weeks (odds ratio = 1.913, 95% confidence interval: 1.525–2.398, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>Long-term PPI therapy beyond 12 weeks was highly prevalent in Malaysian public hospitals, and predominantly driven by the number of medications received by patients. These findings highlight the need to rationalize PPI prescribing and implement strategies to optimize patient safety.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 4","pages":"Pages 817-824"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13427395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148654560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative assessment of serum adipokine and trace element alterations in papillary thyroid carcinoma","authors":"Van A. Ahmed Pharm D,&nbsp;Namama S. Hamad PhD,&nbsp;Diary I. Tofiq PhD,&nbsp;Aso Q. Hassan MSc,&nbsp;Hersh H. Yousif MSc,&nbsp;Savya N. Mhamad BSc,&nbsp;Helin H. Qader BSc","doi":"10.1016/j.jtumed.2026.07.013","DOIUrl":"10.1016/j.jtumed.2026.07.013","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate serum leptin, adiponectin, and selected trace elements in newly diagnosed patients with papillary thyroid carcinoma (PTC) before and after treatment and to assess their diagnostic potential as biomarkers.</div></div><div><h3>Methods</h3><div>This prospective case–control study included 50 newly diagnosed patients with PTC and 50 healthy controls. Serum leptin, adiponectin, and trace element levels were measured pre- and post-treatment in patients and compared to controls.</div></div><div><h3>Results</h3><div>Before treatment, patients with PTC had significantly higher leptin and lower adiponectin levels than post-treatment patients and healthy controls (both p &lt; 0.0001). Zinc, selenium, and magnesium levels were significantly decreased, whereas manganese, copper, and iodine levels were significantly increased (all p &lt; 0.001). Leptin was negatively correlated with Zn, Se, Mg, and Ca (p &lt; 0.0001), whereas adiponectin showed positive correlations. The leptin/adiponectin ratio demonstrated excellent diagnostic performance, with an area under the ROC curve of 0.951.</div></div><div><h3>Conclusion</h3><div>Patients with PTC exhibit significant alterations in serum adipokines and trace elements that improve following treatment. Leptin, adiponectin, and particularly the leptin/adiponectin ratio may serve as promising non-invasive biomarkers for the diagnosis and postoperative monitoring of PTC.</div></div>","PeriodicalId":46806,"journal":{"name":"Journal of Taibah University Medical Sciences","volume":"21 4","pages":"Pages 825-834"},"PeriodicalIF":2.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148657249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}