Background: Choking is a life-threatening medical emergency that requires immediate recognition and appropriate first aid intervention to prevent serious complications or death. Despite its clinical importance, public awareness regarding choking recognition and appropriate first aid management remains limited, particularly in differentiating first aid measures for adults and children. In Saudi Arabia, evidence on public awareness of choking is scarce, highlighting the need for a nationwide assessment. Methods: A descriptive cross-sectional community-based study was conducted across all regions of Saudi Arabia using a self-administered online questionnaire in Arabic. Adults aged 18 years and above were included. The questionnaire, adapted from a previously validated instrument, assessed knowledge and first aid practices related to choking. Data were analyzed using descriptive statistics, Chi-square and Fisher's exact tests, and binary logistic regression to identify factors associated with awareness. Results: A total of 387 participants were included. Overall, 49.9% demonstrated good awareness, while 50.1% had poor... Continue Reading

Background: Metabolic dysfunction-associated steatohepatitis (MASH), the progressive inflammatory form of metabolic dysfunction-associated steatotic liver disease (MASLD), is associated with fibrosis progression, cirrhosis, and liver-related morbidity and mortality. The growing burden of MASLD/MASH has accelerated development of targeted therapies, including thyroid hormone receptor beta (THR-β) agonists. This study aimed to characterize the registered clinical trial landscape of THR-β agonists for MASLD/MASH and identify major development trends and evidence gaps. Methods: A registry-based descriptive analysis was conducted using a ClinicalTrials.gov dataset current through July 2026. Thirty-two candidate records were manually screened, and 18 interventional trials involving MASLD/MASH-spectrum populations were included after excluding healthy-volunteer pharmacology studies, non-liver indications, observational studies, and unrelated records. Trials were characterized by study status, start period, clinical phase, drug family, therapeutic strategy, clinical focus, sponsorship, geographic distribution, and results-posting status. Categorical variables were summarized using frequencies and percentages, and Fisher’s exact test assessed the association between study status... Continue Reading

Background: Misophonia is characterized by intense emotional and behavioral responses to specific sounds and may interfere with daily functioning. Its relationship with insomnia remains insufficiently studied, particularly among adults in Saudi Arabia. Objectives: To examine DVMSQ-based misophonia symptom profiles, trigger phenomenology, functional impairment, and the association between misophonia and insomnia among Saudi adults participating in an online survey. Methods:  A cross-sectional online survey was completed by 1,001 adults residing in Saudi Arabia. After removing three duplicate responses, 998 participants were included in the primary analysis. Misophonia was classified using the Duke-Vanderbilt Misophonia Screening Questionnaire as no profile, subclinical profile, or clinically significant profile. Insomnia Severity Index (ISI) was used to assess insomnia. Descriptive statistics, chi-square tests, multinomial and ordinal logistic regression and sensitivity analyses were conducted. Adjusted models included demographic, socioeconomic, mental-health, chronic-illness, and auditory variables. Results: Of the participants, 61.1% had no misophonia screening profile, 15.1% had a subclinical profile, and 23.7%... Continue Reading

Background:Temporomandibular disorder (TMD) is considered one of the most common musculoskeletal conditions that affect the masticatory system. The consequences of TMD include pain and functional limitations. Early diagnosis and proper management are important for avoiding chronic pain and permanent tissue damage. Our cross-sectional study aimed to evaluate the level of awareness and knowledge in terms of TMD examination and diagnosis, as well as treatment, among dental students, postgraduate students, and dental practitioners at Qassim University, Saudi Arabia. Methods: A cross-sectional study using a structured, validated online questionnaire was distributed to 98 participants. The eligible participants include fourth-year students (27.6%), postgraduate students (9.2%), fifth-year students (12.2%), interns (15.3%), and dental practitioners (35.7%). The survey investigated the general demographics and the 25 items classifying knowledge and awareness of TMD etiology, diagnosis, treatment, and prognosis. For comparing scores with respect to genders and their academic/professional statuses, non-parametric tests (Mann-Whitney U and Kruskal-Wallis tests)... Continue Reading

Background: Long-term corticosteroid use remains central to managing autoimmune blistering diseases (AIBDs) but carries substantial toxicity, prompting wider use of steroid-sparing agents ranging from conventional immunosuppressants to biologics. Comparative evidence on the efficacy and safety of these agents remains heterogeneous. Methods: We systematically searched PubMed, Web of Science, and Scopus for studies published from 2015 to 2025 evaluating steroid-sparing therapies in pemphigus and bullous pemphigoid. After duplicate removal and two-reviewer screening against predefined eligibility criteria, nine studies totaling 396 patients (randomized trials, prospective comparisons, and retrospective cohorts) were included. Methodological quality was appraised using ROBINS-I for non-randomized studies and Cochrane RoB2 for randomized trials. Results: Rituximab (RTX) was associated with higher long-term remission and faster corticosteroid tapering than conventional immunosuppressants, but with a higher rate of serious adverse events (approximately 15% to 22% vs. 10% to 15%). Short-term dexamethasone-cyclophosphamide pulse therapy performed comparably to RTX in some studies, though its... Continue Reading

The long-term comparative outcomes of on-pump and off-pump coronary artery bypass grafting (CABG) remain disputed. We performed a random-effects meta-analysis of 25 randomized controlled trials (18,729 patients) comparing on-pump versus off-pump CABG, searching MEDLINE/PubMed, Cochrane CENTRAL, Web of Science, ProQuest, ClinicalTrials.gov, Scopus, and grey literature through 7 June 2025. Outcomes (repeat revascularization, late myocardial infarction, stroke/TIA, late mortality, major adverse cardiovascular events [MACE], and composite endpoints) were pooled as hazard ratios (HR) with 95% confidence intervals (CI), expressed as on-pump versus off-pump. On-pump CABG significantly reduced late myocardial infarction (HR 0.58; p = 0.01). Off-pump CABG was associated with significantly lower MACE (HR 1.62; p = 0.003), with the greatest benefit at 5–10 years (HR 2.18; p < 0.00001) and persisting beyond 10 years (HR 1.89; p = 0.03), and with a lower composite-endpoint risk (HR 1.24; p = 0.04). No significant differences were found for late mortality, repeat revascularization, or stroke/TIA. Risk of bias was moderate to high, and the... Continue Reading

Icotrokinra (JNJ-2113) is a first-in-class targeted oral peptide that selectively binds to the interleukin-23 (IL-23) receptor and blocks IL-23 signaling. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) of Icotrokinra to assess its efficacy and safety versus control in moderate-to-severe plaque psoriasis. We performed a PRISMA-adherent systematic literature search across Scopus, PubMed, and Web of Science from their inception up to January 2026. Screening, data extraction, and risk of bias assessment were made by two independent authors. A meta-analysis was conducted in R with sensitivity and subgroup analyses. We included four studies comprising five RCTs. Oral icotrokinra significantly improved physician-assessed and psoriasis area and severity index (PASI) responses compared with control in RCTs. For Investigator’s Global Assessment (IGA) 0/1, benefit was evident by week 2 (risk ratios (RR) = 3.24%, 95% confidence interval (CI) 1.01–10.46) and remained consistent through week 16 (RR = 7.35%, 95% CI... Continue Reading