This research investigated the unstudied impact, in 416 cases of stone-induced hydronephrosis detected radiographically in 369 patients, of stone size on the stone’s location in the urinary tract and on the hydronephrosis grade. Most (62.5%) of the hydronephrosis cases were Grade 2; 17.1%, Grade 3; 10.6%, Grade 4; and 9.9%, Grade 1. The mean size of the stones reported in the renal pelvis, pelviureteric junction (PUJ), upper ureter (UU), midureter (MU), lower ureter (LU), and vesicoureteral junction (VUJ) that caused hydronephrosis were 23.03 ± 8.97 mm, 15.56 ± 6.59 mm, 12.91 ± 6.02 mm, 11.05 ± 4.27 mm, 10.41 ± 4.80 mm, and 6.73 ± 3.28 mm, respectively. The mean size of Grade 1-causing stones was 16.63 mm; Grade 2, 11.49 mm; Grade 3, 15.69 mm; and Grade 4, 21.23 mm. The mean stone size significantly decreased from the renal pelvis, through the PUJ, UU, MU, and LU, and down to the VUJ and increased as the hydronephrosis grade increased from Grade 2 to Grade 4. In conclusion, large-size stones were predominantly located in the renal pelvis and PUJ, with few located in the lower ureter, and no large stones reached the VUJ. Small-size stones were mostly located in the VUJ, with only one stone in the PUJ, and no small-size stones were present in the renal pelvis. Large-size stones caused severe hydronephrosis, and small-size stones caused grade 2 hydronephrosis. Increases in stone size decreased its passage rate in the ureter and increased the chance of causing high-grade hydronephrosis. These results alert urologists to adopt faster therapeutic procedures for larger stone sizes to reduce renal damage caused by obstructive uropathy.

Background: Telepsychiatry expanded rapidly during the COVID-19 pandemic, yet patient experience data from mixed urban and rural areas in Saudi Arabia remain scarce. Objective: We aimed to quantify the perception of telepsychiatry among adults with major depressive disorder [MDD] in Madinah City, the KSA, and to identify associated demographic and clinical factors. Methods: A cross-sectional survey was conducted at Madinah Mental Health Hospital between December 2024 and March 2025. Eligible participants were Arabic-speaking adults [≥18 years] with a clinician-confirmed diagnosis of major depressive disorder [MDD] according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [DSM-5], following a scheduled video- or audio-based telepsychiatry consultation. Perception of telepsychiatry was assessed using the validated 10-item Arabic version of the Telehealth Satisfaction Scale [TeSS], which evaluates audiovisual quality, communication, and support. Variables associated with perception at p < 0.20 in the bivariable analyses were entered into a multiple linear regression model to identify independent predictors. Results: Of the 218 eligible patients, 207 participated [response rate = 95%], with similarly high participation rates being reported in comparable telepsychiatry surveys [e.g., 90–91%]. The majority were male [59%], with a mean [SD] age of 38.4 [11.2] years. The mean satisfaction score was 32.3 ± 6.3, and 36% of participants were classified as highly satisfied. In the multivariable analysis, higher satisfaction was independently associated with male gender [B = 3.0, 95% CI: 1.3–4.7], intermediate versus elementary education [B = 4.3, 95% CI: 1.1–7.6], and the presence of a chronic illness [B = 2.1, 95% CI: 0.3–3.8]. Conclusions: Telepsychiatry is generally well-accepted among adults with depression in Madinah. However, women and individuals with lower educational attainment report lower satisfaction. Targeted interventions such as improving privacy, offering digital literacy support, and tailoring communication may help improve the telepsychiatry experience for underserved groups.

Human papillomavirus (HPV) infection is a major public health concern and a leading cause of cervical cancer worldwide. Despite the availability of effective vaccines, awareness and vaccine acceptance remain limited in many developing countries. This study aimed to assess awareness, acceptance, barriers, and determinants of HPV vaccination among medical students in Egypt. A web-based multicentre cross-sectional study was conducted among undergraduate medical students from governmental, national, and private medical faculties across Egypt using a non-probability sampling approach (convenience and snowball sampling). Data were collected using a validated structured questionnaire. A total of 601 students participated in the study. 31.4% were unaware that HPV is available for both males and females, and half of them expressed negative attitudes and concerns regarding the novelty (44%), safety (56%), efficacy (59%), and cost of the vaccine (51.7%). Nearly half (48.3%) of them were unaware that the “HPV vaccine” is available in Egypt. Seventy-three students (12.1%) received the vaccine, and among vaccinated participants, 39 were males. In addition, 44.3% of students reported hesitancy toward HPV vaccination, while 58.9% indicated willingness to receive the vaccine if it was provided free of charge. Family history of cervical cancer, total knowledge, and attitude scores were significant predictors of participants’ HPV vaccine uptake ( p < 0.05). Nearly half of the participants had not taken the vaccine because they were not sexually active or they lacked knowledge. Unfortunately, about one-third of the participants didn’t take the vaccine because of cultural and parental objections. Male participants were less likely to recommend the vaccine to others. In spite of being medical students, their knowledge and attitudes were less than expected, giving an idea about the public situation. Findings underscore the importance of educational campaigns to raise knowledge and change faulty beliefs, focusing on the target groups and their parents. Also, the national health authorities should allocate resources to make the HPV vaccine available, accessible, and affordable.

Atopic dermatitis (AD) severity in children is influenced by biological, environmental, and psychosocial factors, yet severity-focused, multicenter evidence from Middle Eastern populations remains limited. To identify early-life, familial, and climatic determinants of clinical severity in pediatric AD. This multicenter cross-sectional study included 600 children diagnosed with atopic dermatitis according to the Hanifin and Rajka criteria. Disease severity was measured using the SCORAD index and categorized as mild, moderate, or severe. Independent variables included breastfeeding history, parental marital status, residential climate, animal exposure, and family atopy. Ordinal logistic regression models were used to estimate adjusted odds ratios (aORs) controlling for age, sex, and nationality. Compared with bottle-feeding, breastfeeding <6 months (aOR = 0.02; 95% CI 0.007–0.079) and ≥6 months (aOR = 0.29; 95% CI 0.17–0.50) were strongly protective against greater AD severity. Children from separated/divorced or widowed households and those living in mountain regions had significantly higher severity than peers from married families and coastal areas. Cat exposure was an independent determinant of greater severity (aOR = 6.48; 95% CI 3.33–12.64) and higher SCORAD, whereas general animal exposure, consanguinity, sex, and family atopy were not significant. Breastfeeding, family structure, residential climate, and cat exposure are key, potentially modifiable determinants of pediatric AD severity and should inform risk-stratified, context-aware management.

AI integration into medical education and practice has its benefits and risks. This national web-based cross-sectional survey on Egyptian medical staff and students aimed to assess knowledge, attitudes, and concerns regarding the use of AI. This study comprised 2765 medical students and 500 medical staff, with a mean age of 20.8 and 29.9 years, respectively, and higher percentages of females among both groups. Medical students demonstrated satisfactory knowledge of AI compared to medical staff ( p < 0.001). Unfortunately, the majority of both groups (80.4% of staff and 81.6% of students) expressed negative attitudes toward AI use. Male participants had significantly higher attitude scores than females in both groups. Knowledge score and gender were significant predictors of attitude towards AI among medical staff ( p <0.005), while gender was a significant predictor of attitude scores among medical students ( p < 0.001). The total AI usage score in this study was higher among students than staff, particularly for idea generation. Medical staff demonstrated a slightly higher total concern score regarding the use of AI in medical education and practice compared with students. The results emphasize the necessity of engagement, focused education and training, compatible solutions, uniform standards, guidelines, and the smooth incorporation of AI into medical education and clinical practice.

Background: The literature shows a strong association between level of education and the risk of developing Coronary Heart Disease (CHD). However, the extent to which this association attenuates after accounting for sociodemographic characteristics and cardiovascular risk factors in a survey-weighted national sample warrants further evaluation. Objective: We aimed to assess the association between educational attainment and angina and myocardial infarction (MI) across age groups in a nationally representative U.S. sample. Methods: The study analyzed 2021 Behavioral Risk Factor Surveillance System (BRFSS) data from 438,693 adults, a nationally representative telephone survey of U.S. adults. The dataset was accessed from the Centers for Disease Control and Prevention BRFSS website in February 2023. Angina and MI were identified based on self-reported physician diagnoses. Analyses included adults aged 18 years and older with no missing data for education and outcomes. Results: In survey-weighted analyses with college graduates as the reference group, lower educational attainment was associated with higher odds of angina and MI, compared with college graduates. In the fully adjusted model (Model 2), attending high school was associated with higher odds of angina (OR 1.439) and MI (OR 2.390). Conclusions: Lower educational attainment is associated with higher odds of angina and MI, particularly among younger adults. Although the magnitude of these associations was attenuated after adjustment for sociodemographic and cardiovascular risk factors, the persistence of the association underscores the importance of considering educational disparities in cardiovascular risk assessment.