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Abstract : Breast masses are a common clinical concern in women, requiring careful evaluation to differentiate between benign and malignant lesions. While clinical examination and imaging modalities such as ultrasound and mammography play a central role in diagnosis, the psychological impact of breast mass evaluation, including anxiety, fear, and distress, is increasingly recognized as a critical aspect of patient care. This retrospective cross-sectional study was conducted at Al-Mouwasat University Hospital between 2022 and 2024. A total of 823 patients with breast masses who underwent ultrasound evaluation, and for those over 40 years, mammography as well, were included. Clinical data, imaging findings, biopsy results, and psychological manifestations were collected from patient files and telephone interviews. Patients not followed in the hospital were excluded. Ultrasound, Doppler, and digital mammography were used for radiological assessment, with images archived in the PACS system. Biopsies were performed when indicated, and histopathological findings were reviewed. Patients were distributed across age groups, with 15% aged 29, 10% aged 30–39, 25% aged 40–49, 25% aged 50–59, and 25% aged 60–75. Clinical examination revealed that 70% of patients self-detected breast masses, while 87% were detected on clinical palpation. Nipple discharge, nipple retraction, and peau d’orange were observed in 10–35% of cases. Ultrasound detected normal findings in 28% and characterized benign masses according to echogenicity. Microcalcifications were noted in 30% and coarse calcifications in 70%. Biopsy results showed 54% benign fibroglandular lesions, 17% inflammatory changes, 20% normal findings, and 9% malignant lesions. Psychological evaluation revealed anxiety, fear, and depression in 40–50% of patients, particularly during mammography (66%). BI-RADS classification correlated well with histopathology, with BI-RADS I–II predominating in benign cases and BI-RADS IV–V associated with malignancy. The integration of clinical, radiological, and psychological assessments enhances diagnostic accuracy and patient care in breast mass evaluation. Early detection through combined imaging modalities, supported by attention to psychological well-being, improves patient outcomes and adherence to management plans. The study findings are consistent with international guidelines and highlight the need for a multidisciplinary approach in breast care.

Abstract : Continuous severity assessment of polytrauma patients is critical for triage, quality management, mortality prediction, and trauma research. Existing data stay dubious about final predictive risk assessment. The goal of this study was to develop simple scales for predicting outcome at three time points during the early posttraumatic period for blunt multiple trauma patients with severe thoracic trauma. Multiple trauma patients with severe thoracic trauma (ISS ≥ 16, age ≥ 18, blunt mechanism, two or more injured body regions with AIS thorax ≥ 3) were included in this single-center prospective observational cohort study. The examinations were performed on the 1st-2nd, 3rd-4th and 5th-6th days after the trauma. Multivariate logistic regression analyses were used to identify independent predictors of mortality. On the 1st-2nd day after trauma, risk factors for adverse outcome were identified among the severity of the head injury, RTS score, hemoglobin, total protein, urea and creatinine concentrations. On the 3rd-4th day – among RTS, NISS scores, total protein concentration and WBC, lymphocytes, band and segmented neutrophils counts. On the 5th-6th day – oxygen content, total protein concentration and RBC, monocytes, band neutrophils counts. Based on routine diagnostic tests performed daily in the ICU, the proposed scoring method, based on three regression equations, was developed to estimate the individual mortality risk of blunt multiple trauma patients with severe thoracic trauma during the first 5-6 days after trauma. Depending on the day of the early posttraumatic intensive care, the prognostic value of clinical and laboratory markers varies.

Abstract : HIV infection is associated with progressive immunosuppression, increasing susceptibility to opportunistic pathogens such as Candida. and Staphylococci. Colonization by these organisms may precede clinical disease and vary with demographic factors and CD4 counts. The present study aimed to determine the prevalence and distribution of Candida and Staphylococcus colonization among HIV-positive individuals and analyze their association with age, gender, and CD4 counts. A cross-sectional study was conducted among 447 HIV-positive individuals attending a tertiary care ART center. Demographic data were recorded, and oral and nasal swabs were collected. Candida isolates were identified by culture, germ tube test, and CHROM agar, while Staphylococcus was identified using standard biochemical tests. CD4 counts were retrieved from medical records. Data were analyzed using the Chi-square test, with p < 0.05 considered statistically significant. Of 447 participants, 253 (56.6%) were male and 194 (43.4%) were female, with most (71.8%) aged 30–60 years. Candida colonization was observed in 128 (28.6%) and Staphylococcus in 76 (17.0%) individuals, with no significant gender association (p > 0.05). C. albicans (60.9%) was the predominant species, followed by C. tropicalis (17.2%), C. glabrata (11.7%), and C. krusei (10.2%). Colonization was highest in participants with CD4 counts >500 cells/µL (84.6%), but this was not statistically significant (p = 0.483). Candida and Staphylococcus colonization in HIV-positive individuals showed no significant correlation with gender or CD4 count. Routine screening, species-level identification, and further multicentric studies incorporating molecular methods and antifungal susceptibility testing are warranted.

Abstract : Simulation-Based Training is a novel methodology in education, providing students with outstanding opportunity to gain information and proficiently apply their learning in nursing care environments. The study aimed to evaluate the effect of simulation-based training on the learning achievements and self-confidence of maternity nursing students. The study was performed in the simulation laboratory of Dar Al-Uloom University. During the second semester of the 2024–2025 academic year, fifty nursing students participating in a maternity nursing course were allocated to either a simulation group or a control group within a quasi-experimental framework. A self-administered questionnaire, an observational checklist for electronic fetal monitoring, and a student satisfaction and self-confidence learning scale were utilized for data collection. The findings demonstrated a statistically significant enhancement in students' understanding of electronic fetal monitoring following the intervention, with the simulation group achieving a score of 18.80±1.98, in contrast to the control group's score of 13.20±1.78, P<0.001. A significant difference was seen between the simulation group, which exhibited a mean of 30.24 ± 2.28, and the control group, with a mean of 17.40 ± 2.84, concerning students' utilization of electronic fetal monitoring. High significant difference was noted in favor of the simulation group for total scores for satisfaction and self-confidence, measured at 21.84 ± 1.72 and 35.92 ± 1.61, respectively. The study concluded that using simulation-based training has a positive significant effect on learning achievement, and self-confidence of nursing students. Incorporating simulation-based training within the maternity nursing curriculum is recommended.

Abstract : Genetic polymorphism of the fat mass and obesity-associated (FTO) gene, i.e., rs9939609 and rs1121980, was previously thought to be responsible for the pathophysiologies of obesity, metabolic syndrome, and cardiovascular disease (CVD). No strong association of the polymorphisms with vascular properties like transluminal diameter and coronary artery anatomy in populations has been reported despite numerous previous studies. To critically evaluate the interaction of FTO gene polymorphisms with cardiovascular/metabolic events, coronary artery morphology, and demographic diversity at the tertiary level. Systematic searching in PubMed, Embase, Web of Science, Scopus, and Google Scholar up to July 2025. 1,265 records were searched, and 33 studies were screened and evaluated in full-text evaluation, of which 25 studies were included in the meta-analysis. Exposure characteristics, including SNP variant, endpoint, ethnicity, and type of genotyping, were defined. Statistical power in studies was estimated using Quanto software. Pooled odds ratios (OR) and their 95% confidence intervals (CIs) were calculated from the random-effects model. Subgroup analysis by ethnicity, outcome group, and study quality was conducted. Meta-analysis identified FTO rs9939609 risk allele A to be strongly related to CVD risk (pooled OR = 1.29, 95% CI: 1.15–1.44, p < 0.001). The association was consistent in European (OR = 1.33), East Asian (OR = 1.24), and South Asian individuals (OR = 1.21). In the subgroup analysis, the augmented effects were in the combined endpoint obesity-CVD studies and TaqMan genotyping. FTO alleles were associated with transluminal narrowing reported in isolated individual trials, a majority of which were among obese CAD patients. There was no homogeneous socioeconomic context report, but combined data were given for possible gene-environment interaction with vascular anatomy. FTO gene polymorphisms, and particularly rs9939609, have been linked with cardiovascular risk and may influence coronary artery structure, particularly in metabolically vulnerable individuals. Gene screening within the process of CVD risk stratification, particularly in demographically heterogeneous practice, is justified by the findings.