Energy modulated electron beam therapy with conventional clinical accelerators has lagged behind photon IMRT despite its potential to achieve highly conformal dose distributions in superficial targets. One of the reasons for this is the absence of an automated collimating device that allows for the flexible delivery of a series of variable field openings. Electron-specific multileaf collimators attached to the bottom of the applicator require the use of a large number of motors and suffer from being relatively bulky and impractical for head and neck sites. In this work, we investigate the treatment planning aspects of a proposed 'few-leaf' electron collimator (FLEC) that consists of four motor-driven trimmer bars at the end of the applicator. The device is designed to serve as an accessory to standard equipment and allows for the shaping of any irregular field by combination of rectangular fieldlets. Using a Monte Carlo model of the FLEC, dose distributions are optimized using a simulated annealing (SA) inverse planning algorithm based on a limited number of Monte Carlo pre-generated, realistic phantom-specific dose kernels and user-specified dose-volume constraints. Using a phantom setup with an artificial target enclosed by organs at risk (OAR) as well as using a realistic patient case, we demonstrate that highly conformal distributions can be generated. Estimates of delivery times are made and show that a full treatment fraction can be kept to 15 min or less.

Metabolic dysfunctions linked to obesity carry the risk of co-morbidities such as diabetes, hepatorenal, and cardiovascular diseases. Coumarins are believed to display several biological effects on diverse adverse health conditions. This study was conducted to uncover the impact of cichoriin on high-fat diet (HFD)-induced obese rats. Methods: Obesity was induced in twenty rats by exposure to an HFD for six weeks. The rats were randomly divided into five groups; group I comprised five healthy rats and was considered the control one. On the other hand, the HFD-induced rats were divided into the following (five per each group): group II (the HFD group), groups III (cichoriin 50 mg/kg) and IV (cichoriin 100 mg/kg) as the treatment groups, and group V received atorvastatin (10 mg/kg) (as a standard). Triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine transaminase (ALT), aspartate transaminase (AST), creatine kinase MB (CK-MB), urea, creatinine, the hepatic and renal malondialdehyde (MDA) as well as reduced glutathione (GSH) levels were assessed. Histopathological analysis of the heart, kidney, and liver tissues was investigated. mRNA and protein expressions of the peroxisome proliferator-activated receptor gamma (PPAR-γ) were estimated. Results: The administration of cichoriin alleviated HFD-induced metabolic dysfunctions and improved the histopathological characteristics of the heart, kidney, and liver. Additionally, the treatment improved the lipid profile and hepatic and renal functions, as well as the oxidative balance state. Cichoriin demonstrated an upregulation of the mRNA and protein expressions of PPAR-γ. Taken together, these findings are the first report on the beneficial role of cichoriin in alleviating adverse metabolic effects in HFD-induced obesity and adapting it into an innovative obesity management strategy.

Broccoli (Brassica oleracea) is reported to possess antioxidant activity that could potentially prevent oxidative damage to tissues caused by many diseases. In the present study, we investigated the preventive effect of broccoli leaf by-product extract (BL) on gentamicin-induced renal and hepatic injury by measuring tissue antioxidant activities and morphological apoptotic changes. Broccoli leaf was thoroughly extracted with 70% methanol to yield the total methanol extract (TME). The total phenolic content (TPC) was determined. Thirty male rats were divided into five groups (six animals/group). Group I received phosphate-buffered saline orally, while group II was treated with gentamicin (100 mg/kg i.p. intraperitoneal) for ten days. Group III and group IV animals were given BL (200 mg/kg and 400 mg/kg, respectively) plus gentamicin treatment. Group V received L-cysteine (1 mmole/kg) plus gentamicin. Antioxidant and biochemical parameters, such as transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP), creatinine, and urea, and mRNA expression levels of tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), and nuclear factor kappa B (NFkB) were determined in various groups, along with the quantification of inflammatory and apoptotic cells in hepatic and renal tissues. Malondialdehyde (MDA), glutathione (GSH), and superoxide dismutase (SOD) levels were determined in liver and renal samples. Histopathological studies of the liver and kidneys were also carried out. The TME was subjected to various and repeated techniques of chromatography to yield caffeic acid, gallic acid, and methyl gallate. The TPC was 6.47 mg Gallic Acid Equivalent/g of dry extract. Gentamicin increased the levels of serum AST, ALT, ALP, creatinine, and urea. The MDA and GSH contents and theactivity levels of the antioxidant enzyme SOD decreased in liver and kidney samples with gentamicin administration. BL administration dose-dependently prevented the alteration in biochemical parameters and was supported by low levels of tubular and glomerular injuries induced by gentamicin. This study valorizes the potential of BL as a preventive candidate in cases of gentamicin-induced liver and kidney toxicity and recommends further clinical studies using BL to validate its utilization for human consumption and as a source of phenolics for nutraceutical and pharmaceutical purposes.

COVID-19 is associated with a common symptom of olfactory dysfunction, which may persist even after the infection is resolved. Olfactory training (OT) has emerged as the most effective intervention for post-viral olfactory dysfunction. OT involves daily exposure of the olfactory system to various odors. The current study aims to explore olfactory dysfunction following COVID-19 and the potential benefits of olfactory training. Methods: This is a cross-sectional study conducted among adults aged 18–60 living in Alahssa, Saudi Arabia. An online questionnaire containing an informed consent form and a survey to collect demographic data, vaccination status, level of loss of smell and taste, and the level of awareness about olfactory training (OT) was distributed among all participants who agreed to participate in this study. Results: The study included 524 participants and presented their baseline characteristics, including age, gender, COVID-19 infection status, and complaints. Most patients were female (66.0%), and 46.2% had previously been infected with COVID-19. About 54.8% of participants reported chemosensory dysfunction, while 286 had olfactory dysfunction. Of those, 29.8% had anosmia, 16.8% had hyposmia, and 8.0% had parosmia. Results suggest that being fully or partially vaccinated may offer some protection against olfactory dysfunction compared to being unvaccinated. Adherence to olfactory training was associated with improvement in the sense of smell. Conclusions: The study highlights the importance of awareness and adherence to olfactory training, which may improve the sense of smell in individuals with chemosensory dysfunction. The findings of this study can inform public health policies and interventions aimed at reducing the burden of olfactory dysfunction associated with COVID-19 vaccination.

Thyroid disorders are one of the most common endocrine disorders. Thyroid disorders are highly prevalent in the Saudi population. There are many approaches to treat thyroid disorders, varying from conservative to surgical, depending on the severity of each condition. There are many indications for surgical management of thyroid diseases, including carcinoma, hyperthyroidism, and local compression symptoms. This is a retrospective study included subjects operated upon for a thyroid disorder over 6 years period in the eastern province of Saudi Arabia. The clinical manifestations and postoperative characteristics of the patients are given in Table 2. It can be observed that the most dominant clinical presentation was neck mass (76.4%), while the most common indication of surgery was the suspicion of cancer (54.5%). Furthermore, the most common histopathology was papillary thyroid cancer (41.8%), whereas the most common complication after the surgery was hypocalcemia (9.1%). Likewise, total thyroidectomy was the most commonly sought surgical intervention (70.9%). Additionally, Bethesda class III constitutes 35.1%, while Bethesda class II constitutes 29.7%. Suspicion of cancer was the most prominent indication for surgical intervention. The most prevalent postoperative complications were hypocalcemia. Furthermore, papillary thyroid carcinoma was the most common histological findings, which raises several questions since it contrasts with previous studies done in Saudi Arabia. We believe that the number of thyroid procedures in our region is underreported, and more research is needed to validate this.

Voice disorders are a serious and common complaint among teachers, yet there are no published studies on these conditions in the context of Al-Ahsa city in the eastern region of the Kingdom of Saudi Arabia. This study analyzed the vocal complaints of Saudi teachers, investigated their treatment-seeking behaviors, and assessed their knowledge of vocal care. A cross-sectional online survey was randomly distributed to 604 Saudi teachers from December 2021 to March 2022. The data included sociodemographic characteristics, academic statuses, vocal symptoms and their effects, and attitudes toward voice problems. Statistical analysis was done using the Statistical Package for the Social Sciences (v. 23). Categorical variables were expressed as frequencies and percentages. A chi-square test was conducted to verify the association between the categorical variables. Of the participants, 62.1% were female. 65.4% reported having voice-related problems, with the most frequently reported symptoms being hoarseness (68.35%), throat dryness (60.76%), and sore throat (56.46%). Out of the participants who reported voice problems, 32.15% stated being affected by absenteeism from school. Only a minority of teachers sought medical help (5.1%) or received information about the vocal care (29.5%). The factors that were found to be significantly associated with voice complaints include female gender, positive family history of vocal disorders, speaking in a loud voice, being non-smoker, and having the high number of classes per week (P < 0.05). Voice-related complaints were highly prevalent among Saudi teachers for multiple factors, most of which were manageable. This study strongly recommends the vocal educational programs to be implemented during student teacher training.