Tuberculosis can cause many types of alteration on normal marrow. Patients with tubeculosis were commonly observed to suffer hematological abnormalities. This study was conducted to investigate the influnce of pulmonary tuberculosis on some hematological parameters among kosti teaching hospital visiters. Blood samples were collected from fourty (40) pulmonary tuberculosis patients and thirty healthy individuals as control. The collected blood samples were transferred to EDTA containers and CBC test was immediately carried. The measured parameters included, HIV, RBCs, ESR, HTC, MCV, MCHC, TWBCs and platlet count. The hematological analyzer (sysmexKX21N) was used. The obtained results were statistically analyzed using (SPSS) programs compared with control samples. The ESR was elevated in (99%) of the patients, 45% of ESR values exceed (100mmHg) and thrombocytosis as (17%). The mean values of patients samples were, Hb (12.1 g/dl), MCV (77.2%), RBCs (4.4), HCT (33.8), MPV (8.9) and RDW (14.5). The control samples showed mean values as, Hb (13.2g/dl), MCV (81.21%), RBCs (4.5), HCT (36.5), MCH (29.4), MCHC (36.2), WBCs (5.9), MPV(10) and RDW (13.8). The TB patients samples showed significant increase in platelets count and erythrocyte sedimentation rate in addition to clear decrease in MCV.

Background: Dexamethasone is crucial in palliative care for advanced cancer, improving symptoms like appetite loss and fatigue. However, guidelines are lacking, and side effects require close monitoring. The indications for corticosteroid use in this patient group are diverse, including the treatment of specific conditions such as spinal cord compression, elevated intracranial pressure, and loss of appetite. Due to the challenges in prescribing these medications for palliative care patients, there is evidence of suboptimal practices in the literature. This study aimed to examine the current patterns of corticosteroid prescribing in healthcare settings across Saudi Arabia and determine whether these practices align with international guidelines. Aim(s) of the Study: The objective of this study was to analyse current dexamethasone prescribing patterns in palliative care settings in Saudi Arabia and assess their alignment with international standards. Method: A retrospective chart review was conducted on inpatient palliative care patients who received dexamethasone at KFSHRC, Saudi Arabia, between January 1, 2022, and January 1, 2024. All available charts of patients under the care of the Palliative Care team who had a cancer diagnosis and received dexamethasone during that timeframe were included. Data collection focused on the number of patients prescribed dexamethasone, indications for use, choice of agent, dosages and adjustments, duration of treatment, occurrence of adverse effects, method of discontinuation, adherence to guidelines, and monitoring and review processes. Exclusion criteria: patients prescribed dexamethasone by other primary services will be excluded. Results: A total of 78 patients were included (median age 55.6 years), with the majority being female (56.4%) and having metastatic disease (89.7%). Gastrointestinal cancers were the most common diagnosis (33.3%), and 70.5% of patients were not receiving disease-modifying therapy at the time of dexamethasone initiation. The most frequent indications for dexamethasone were raised intracranial pressure/cerebral oedema (16.7%) and nausea/vomiting (15.4%), with a median daily dose of 4 mg; the IV route was most used (78.2%). Overall, 29.5% of patients demonstrated a documented clinical response, most commonly improvement in dyspnoea. Response was more frequent in patients treated for dyspnoea/airway obstruction (70.0%, p = 0.006) and in those receiving higher doses (p = 0.029). Adverse effects were rare (2.6%), limited to hyperglycemia. Median time to response was 2 days (IQR 2–3), with most responses occurring within 72 hours. Conclusion: This study showed that corticosteroids are widely prescribed in palliative care settings, both for specific and non-specific indications. These findings are generally consistent with international literature in this field, supporting the role of dexamethasone in targeted symptom palliation, especially in patients with respiratory compromise, while also highlighting the need for ongoing discussion about the role of corticosteroids in palliative care, as well as the need for clear documentation of indication and response in routine practice.

Mixed reality (MR), encompassing augmented reality (AR) and virtual reality (VR), is an emerging technology in dentistry that allows real-time integration of digital information into the clinician’s visual field. Contemporary dental workflows require frequent interaction with electronic health records, radiographs, and diagnostic tools, leading to workflow interruptions and increased cognitive load. This study aimed to quantify computer dependence across common dental procedures and identify those that may benefit most from MR integration. A retrospective observational study was conducted on 50 patients treated by a single general dentist. Patients were equally distributed among five procedure categories (n = 10 each): Extractions, Root Canal Treatments, Crowns, Fillings, and Prophylaxes. Computer dependence was quantified as active treatment time (seconds) divided by the number of clinician interactions with digital devices, expressed as seconds per interaction. A one-way ANOVA was used to evaluate differences among procedure types, and Welch’s t-tests compared Extractions with each of the remaining groups. Significant differences in computer dependence were observed among procedures. Extractions and Root Canal Treatments showed no statistically significant difference (p = 0.341), indicating similarly high reliance on digital interaction. In contrast, Crowns, Fillings, and Prophylaxes demonstrated significantly lower computer dependence than Extractions (all p < 0.001). Surgical and endodontic procedures exhibit the highest levels of computer dependence, suggesting they may benefit most from MR integration. Targeted implementation of MR could reduce screen shifts, decrease cognitive load, and improve procedural efficiency, supporting its prioritization in these workflows.

Background: Adults with diabetes mellitus (DM) are at increased risk of herpes zoster (HZ) and its complications because of impaired cell-mediated immunity, chronic hyperglycemia, and multiple comorbidities. Despite the availability of highly effective recombinant zoster vaccine (RZV), vaccine uptake remains suboptimal among patients with diabetes in Saudi Arabia. This consensus statement was developed to provide evidence-based recommendations for HZ vaccination in adults with DM within the Saudi healthcare setting. Methods: A multidisciplinary expert panel convened under the auspices of the Saudi Society of Diabetes conducted structured evidence review and consensus process. A comprehensive literature search of PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library was performed to identify studies published during the previous 10 years on HZ epidemiology, vaccine efficacy and safety, and vaccination strategies in adults with diabetes. Evidence was critically appraised and integrated with expert opinion using a modified Delphi-informed consensus approach. Recommendations were categorized according to evidence strength (Level A–C) and aligned with national immunization policies. Results: Available evidence consistently demonstrates that diabetes is associated with an increased risk of HZ, postherpetic neuralgia, hospitalization, and other complications. Saudi epidemiological data identified 1,019 HZ cases over a 6-year period, with 31.3% developing complications, 12.5% requiring hospitalization, and 1.2% requiring intensive care. Randomized trials and real-world studies demonstrate that RZV provides approximately 94% efficacy against HZ with durable protection and an acceptable safety profile. The expert panel developed 10 evidence-based recommendations addressing patient selection, vaccination timing, immunocompromised populations, co-administration with other vaccines, risk stratification, healthcare provider education, patient awareness, electronic reminder systems, equitable vaccine access, and pharmacovigilance. The panel emphasized routine assessment of vaccination status during diabetes care and strong physician recommendation as key strategies to improve vaccine uptake. Conclusion: Adults with diabetes represent a high-risk population for herpes zoster and should be prioritized for recombinant zoster vaccination according to current national recommendations. Integrating vaccination assessment into routine diabetes care, strengthening healthcare provider engagement, and implementing system-level interventions may substantially improve vaccination coverage and reduce the burden of HZ among adults with diabetes in Saudi Arabia.

Background: Retinopathy of prematurity (ROP) is a vaso-proliferative disorder of the immature retina and a leading cause of preventable childhood blindness. Multiple risk factors have been implicated in its development, including oxygen therapy, sepsis and blood transfusion. Objective: This study was conducted to determine the association between blood transfusion and ROP among preterm neonates and to assess the effect of early erythropoietin (EPO) administration on anemia correction and transfusion requirement. Methods: This randomized controlled trial was conducted in the Special Care Baby Unit (SCABU) and Neonatal Intensive Care Unit (NICU) of Dhaka Shishu (Children) Hospital from July 2018 to June 2020. A total of 60 preterm low-birth-weight neonates (<34 weeks gestation, <1800 gm birth weight) were enrolled and randomly allocated into two groups: the EPO group (n=30) and the control group (n=30). The EPO group received recombinant human erythropoietin (400 IU/kg subcutaneously, thrice weekly for two weeks), along with oral iron and folic acid supplementation. Hematologic parameters, blood transfusion requirements and ROP development were evaluated and compared between groups. Results: EPO administration significantly increased hemoglobin, hematocrit and reticulocyte counts and reduced the need for blood transfusion (23.3% vs. 53.3%; p= 0.017). The overall incidence of ROP did not differ significantly between the groups (26.7% vs. 36.7%; p= 0.405). However, a strong association was observed between blood transfusion and ROP development (p= 0.026). Conclusion: Early erythropoietin therapy effectively reduced blood transfusion requirements without increasing ROP risk. Blood transfusion was significantly associated with ROP development, suggesting that restrictive transfusion strategies and early anemia management may help reduce ROP incidence among preterm neonates.