Background: End-stage renal disease (ESRD) presents a substantial and growing global health challenge, where hemodialysis serves as an essential life-sustaining therapy for countless individuals. Despite its physiological necessity, the demanding treatment regimen can profoundly impact mental health and overall well-being, though gender-specific data and correlates within the Saudi population remain insufficiently explored. Methods: This cross-sectional study aimed to investigate this gap by assessing the prevalence of anxiety and depression, evaluating health-related quality of life (HRQoL), and analyzing associations with gender and treatment duration in a cohort of 250 hemodialysis patients from multiple centers in Madinah, Saudi Arabia. Validated instruments, namely, the Hospital Anxiety and Depression Scale (HADS) and the 36-Item Short Form Health Survey (SF-36), were employed. Results: The findings revealed a significant psychological burden, with 38% of patients exhibiting anxiety and 32% depression, with females disproportionately affected. HRQoL scores were severely diminished across all domains compared to healthy population norms. Furthermore, a longer dialysis vintage demonstrated a significant positive correlation with worsening psychological scores and a decline in physical HRQoL. Conclusions: These results underscore the critical need for a paradigm shift in standard care, advocating for the systematic integration of routine mental health screenings and the development of tailored, gender-sensitive psychosocial interventions to mitigate this considerable burden.

Background: End-stage renal disease (ESRD) is a growing global health concern, and hemodialysis (HD) remains the most common life-sustaining therapy for patients with advanced kidney failure. Both humoral and cellular immunity are impaired post hemodialysis, leading to immune system dysfunction. Methods: We utilized flow cytometry to quantify cell populations based on surface markers, including CD3 (total T lymphocytes), CD4 (helper T-cells), CD8 (cytotoxic T-cells), CD19 (B lymphocytes), and CD16/CD56 (natural killer (NK) cells). EDTA-blood samples were collected intravenously immediately before and after dialysis. Results: A consistent decline in CD3⁺ T lymphocytes was observed post hemodialysis. This reduction occurred across both male and female cohorts: p = 0.0342 and p = 0.0002, respectively. CD8⁺ cytotoxic T-cells decreased significantly post HD, p = 0.0003. Conversely, CD4⁺ helper T-cells exhibited a paradoxical increase, p = 0.0321. The divergent trends in CD4⁺ and CD8⁺ cells led to a statistically significant increase in the CD4/CD8 ratio post dialysis, p = 0.0005. Notably, stratification by gender uncovered that the post-HD changes in CD4⁺ and CD8⁺ T-cells were exclusive to female patients. Females demonstrated a pronounced increase in CD4⁺ cells and a sharper decline in CD8⁺ cells compared to males. CD19⁺ B lymphocytes showed a statistically significant decline post hemodialysis (p < 0.0001). While both genders exhibited reduced B-cell percentages, female patients experienced a more pronounced reduction than males. NK cells were severely depleted post dialysis in both male and female cohorts. Conclusions: Overall, the immune alterations observed in HD patients, including T-cell reduction, B-cell lymphopenia, and changes in NK cell populations, contribute to the increased risk of infections, malignancy, and cardiovascular disease in this population.

Phosphodiesterase (PDE) inhibitors regulate cyclic adenosine monophosphate and cyclic guanosine monophosphate pathways, which influence neurodevelopment, cardiovascular function, and immune responses. Multiple PDE families exist, classified as dual-substrate (PDE1, PDE2, PDE3, PDE10, PDE11) or non-dual-substrate (PDE4, PDE5, PDE6, PDE7, PDE8, PDE9), each with distinct biological roles. This review summarizes the therapeutic applications of PDE inhibitors, evaluates evidence across different disease domains, and highlights challenges and future research priorities. A narrative review of published studies and clinical trial data was conducted, focusing on pharmacological properties, therapeutic relevance, and safety profiles of PDE inhibitors. Sources included PubMed, ClinicalTrials.gov, and regulatory reports. Dual-substrate PDEs demonstrate therapeutic potential in Alzheimer disease (PDE1), anxiety and memory enhancement (PDE2), and heart failure (PDE3), although chronic PDE3 inhibition may increase risks. Non-dual-substrate PDEs, such as PDE4 and PDE5, are clinically established for asthma, chronic obstructive pulmonary disease, psoriasis, erectile dysfunction, and pulmonary hypertension. Advances in structure–activity relationship studies have produced more selective and potent inhibitors. However, adverse effects, such as nausea (PDE4 inhibitors) and cardiovascular risks (long-term PDE3 inhibitors), remain limiting factors. PDE inhibitors represent a rapidly evolving therapeutic class with broad clinical applications. Their further development requires strategies to minimize adverse effects, improve selectivity, and better define disease-specific roles. Future research should focus on precision medicine approaches to fully harness their therapeutic potential.

Introduction: Research is a vital component of surgical training, enhancing academic skills and career opportunities. This study aimed to assess the research involvement of surgical residents in Saudi Arabia and identify key predictors, barriers, and motivations. Methodology: A cross-sectional study was conducted among 297 surgical residents between December 2021 and September 2023 using a structured online questionnaire. Data were analyzed with SPSS. Results: Overall, 51.2% of residents published at least one paper during residency. Prior research experience in medical school significantly predicted publication during residency (P = 0.012). In logistic regression, residents in gynecology had lower odds of publication compared to general surgery (OR 0.58, P < 0.05). The main motivation for research was fellowship acquisition (63.3%). The leading barriers were lack of time (67.0%) and work-related stress (50.0%). Conclusion: Early research engagement in medical school strongly predicts future productivity during residency, while time constraints and stress remain major obstacles. Our findings suggest that residency programs could enhance research output by providing structured mentorship, allocating protected research time, and encouraging early exposure to research activities.

Background: Cancer epidemiology differs between males and females due to variation in exposure to risk factors. Kidney cancer incidence and mortality have increased globally, yet long‐term sex‐specific trends in Saudi Arabia remain insufficiently characterised. Kidney cancer incidence in Saudi Arabia has increased steadily over time, with an average annual percentage change (APC) of 3.22% over the study period. Aim: This study aimed to analyse long‐term trends in kidney cancer burden in Saudi Arabia and to compare incidence, mortality, years of life lost (YLLs) and disability‐adjusted life years (DALYs) by sex over the period 1982–2023. Methods: A retrospective observational study was conducted using non‐overlapping data from the Saudi Cancer Registry and the Global Burden of Disease 2021 study. Adults aged 20 years and older diagnosed with kidney cancer between 1982 and 2023 were included. Age‐standardised incidence, mortality, YLLs and DALYs were analysed by sex. Temporal trends were assessed using log‐linear regression models and APC was calculated. Results: A cumulative total of 34 247 adult kidney cancer cases was identified between 1982 and 2023. Over the 42‐year period, incidence increased by 3.22% annually. The increase was faster in females than in males (3.65% vs. 2.99%, p < 0.001). YLLs rose by 1.45% per year and DALYs by 1.73%, both showing greater increases among females. Despite this, the overall burden remained consistently higher in males across all indicators. Disease burden increased progressively with age and was highest in older adult populations. Conclusion: Kidney cancer burden has increased substantially in Saudi Arabia over the past four decades. Although males experience a higher overall burden, females show a faster rate of increase. These findings highlight the need for sex‐specific prevention strategies, improved early detection, and strengthened national surveillance. Addressing modifiable risk factors such as smoking, obesity and hypertension remains a priority for public health intervention.