Background: Acne fulminans (AF) is rare and is the most severe form of acne vulgaris, especially in men who have a previous history of acne. The disease is characterized by painful ulcerative pustules that are covered by hemorrhagic crusts and are localized in the torso, face, and neck, and can cause systemic symptoms. The cause of fulminant acne is still unknown. Case Description: We reported a 29-year-old man who developed AF after getting high doses of methylprednisolone due to previous Bell's palsy. Patients complained of the appearance of painful and swollen pus lumps on the face, accompanied by fever. Successful management is achieved through systemic and topical therapies provided so that patients experience significant clinical improvement. Early diagnosis and proper management are essential to avoid scarring and minimize the risk of recurrence. Conclusion: Acne fulminans is a severe manifestation of acne vulgaris that more often affects adult men with a previous history of acne. Symptoms shown eruptive lesions, nodules, and painful plaques, and are usually found on the torso, face, and neck with or without systemic symptoms. The pathogenicity of AF is still unknown. Proper and prompt diagnosis and effective management can prevent complications and avoid recurrence.

Introduction: Cervical cancer is one of the most prevalent cancers amongst women worldwide. Early detection and appropriate management of cervical abnormalities are essential to prevent disease progression and enable timely treatment. This study aimed to compare the diagnostic findings of colposcopy and cervical biopsy in patients with atypical squamous cells of undetermined significance (ASC-US) on Pap smear. Methods: In this descriptive-analytical cross-sectional study, patients with ASC-US Pap smear results who underwent both colposcopy and cervical biopsy between 2019 and 2023 were evaluated. Variables including age, menopausal status, HPV infection, and clinical symptoms were compared across the two diagnostic methods. Result: A total of 400 patients, with a mean age of 37.4 years, were included in the analysis. Most Pap smears were performed before menopause, and high-risk HPV was the most detected type. The most frequent clinical finding was an abnormal cervical appearance. A significant relationship was observed between the type of neoplasia and both age and menopausal status, based on colposcopy and biopsy results. Among women under 50 years of age, 52.5% showed no dysplasia; in those over 50, this rate increased to 87.5%. Cervical intraepithelial neoplasia (CIN) was the most common type of dysplasia across all age groups. Amongst premenopausal women (90.5% of the cohort), 51.6% had no dysplasia and 39.6% had CIN I. In post-menopausal women (9.5%), 97.3% had no dysplasia, with only one case of CIN I. High-risk HPV accounted for 73% of infections, amongst whom 37% showed no dysplasia. Amongst patients with an abnormal cervical appearance (48.9%), 57.1% had no dysplasia and 21.4% had CIN I. Colposcopy demonstrated a sensitivity of 73% and a specificity of 77.64%. Conclusion: In patients with ASC-US Pap smear results, colposcopic findings related to the severity of dysplasia and type of neoplasia were significantly associated with age and menopausal status. However, no significant associations were found with HPV type or clinical symptoms.

Background: Generic drugs are bioequivalent to brand-name medications and represent a key strategy in reducing pharmaceutical expenditure. Despite clinical evidence supporting their safety and effectiveness, public skepticism and misconceptions continue to limit their acceptance in many regions, including Saudi Arabia. Objective: This study aimed to assess public awareness, perceptions, and behavioral tendencies related to the use of generic versus brand-name drugs in Saudi Arabia, with a focus on factors such as familiarity, perceived efficacy and safety, cost considerations, provider influence, and regulatory trust. Methods: A cross-sectional survey was conducted using a structured, self-administered online questionnaire targeting adult residents across Saudi Arabia. A total of 799 valid responses were collected. Descriptive statistics summarized demographic characteristics and perception metrics. Chi-square tests and logistic regression were employed to explore associations between trust in regulatory systems and cost-based decision-making. Results: While 80.9% of participants reported at least slight familiarity with generic drugs, only 28.9% correctly identified generics as equivalent in safety and efficacy. Perceptions of effectiveness and safety were mixed, with 36.5% and 34.2% respectively viewing generics as equal to brand-name drugs. Cost was an influential factor for 60.6% of respondents, and 52.2% expressed willingness to use generics if assured of quality. Notably, 48.7% reported high trust in drug regulatory authorities. A significant association was found between trust in regulation and cost sensitivity (χ² = 1643.87, p < 0.001). Conclusion: The study reveals considerable misconceptions and mixed attitudes toward generic drugs among the Saudi public. Trust in regulatory bodies and healthcare providers plays a pivotal role in shaping medication choices. Educational campaigns, enhanced provider-patient communication, and regulatory transparency are essential to promoting the rational use of generics and supporting national cost-containment goals.

Objective: To measure and analyze platelet and coagulation function-related indicators in patients with acute cerebral infarction (ACI) and explore their clinical significance. Methods: The multivariate analysis of age, smoking, gender and drinking was carried out in the study, and KMO: 0.651（p＝0.000, indicating that the analysis could be carried out. A total of 80 cerebral infarction patients admitted to Chongzhou People’s Hospital from January 2023 to May 2025 were enrolled and divided into an ACI group (40 cases) and a non-ACI group (40 cases) based on disease severity. Prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D-dimer (D-D), and platelet count (PLT) were measured and compared between the two groups. Logistic Regression analysis was used to assess the relationships among PLT, PT, APTT, FIB, TT, and D-D in the ACI group. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of FIB, D-D, and PLT in ACI. Results: Compared with the non-ACI group, the ACI group showed significantly higher levels of D-D and PLT, but the differences were not statistically significant (P > 0.05). Spearman correlation analysis revealed a negative correlation between D-D and other parameters in ACI patients (P < 0.05). ROC curve analysis indicated that the area under the curve (AUC) for D-D was 0.971, demonstrating statistical significance (P < 0.05). Conclusion: The detection of platelet and coagulation function-related indicators in ACI patients holds significant clinical value for diagnosis, early prediction of thrombosis, and assessment of disease severity.

Background: Dental implant restoration has become a standard treatment for tooth loss caused by periodontitis, trauma, or tumors. However, challenges such as alveolar bone resorption, gingival recession, and peri-implantitis complicate rehabilitation in periodontally compromised patients. Current techniques, including guided bone regeneration (GBR), socket shield procedures, and soft tissue grafting, aim to enhance implant stability and aesthetics. Digital tools like CBCT and CAD/CAM improve precision, while bioactive surface modifications (e.g., hydroxyapatite coatings) optimize osseointegration. Despite advancements, barriers persist, including inconsistent protocols for extraction timing, infection risks, high costs, and insufficient long-term data on immediate implantation success. Methods: This review systematically evaluates implant materials—titanium alloys, zirconia, PEEK, and self-setting calcium phosphate—comparing their biomechanical properties, biocompatibility, and clinical performance. A comprehensive literature search was conducted across databases including Web of Science, Scopus, PubMed, CNKI, Wanfang, and VIP Database to analyze current research trends and clinical outcomes. Results: Titanium remains the gold standard for dental implants due to its strength and osseointegration capabilities, but emerging materials such as zirconia and PEEK show promise in reducing inflammation and improving aesthetics. Key findings highlight the importance of infection control, optimal implant timing (immediate vs. delayed), and personalized postoperative care to mitigate failure risks. Long-term implant survival depends on addressing factors such as bone quality, microbial dysbiosis, and occlusal overload. Conclusions: Future research should focus on nanostructured coatings, bioactive modifications, and smart materials to enhance osseointegration and prevent peri-implantitis. Interdisciplinary collaboration integrating materials science, bioengineering, and clinical dentistry is essential for innovation. Future directions include antimicrobial implants, AI-driven treatment planning, 3D-printed biomimetic scaffolds, and microbiome-targeted therapies to improve outcomes. By standardizing protocols and advancing biomaterials, implant therapy can achieve greater predictability and accessibility for periodontitis patients.

Introduction: Mesenchymal stem cells (MSCs), especially those derived from the umbilical cord (UC-MSCs), have emerged as promising candidates for cancer therapy due to their immunomodulatory and anti-tumour properties. However, the mechanisms through which UC-MSCs affect cervical cancer cells remain unclear. This study aimed to investigate the effects of UC-MSCs on HeLa cervical cancer cells, focusing on cytoskeletal alterations and apoptosis-related pathways. Methods: HeLa cells were co-cultured with UC-MSCs at varying concentrations (5%, 10%, 20%, and 30%). Doxorubicin (3 ppm) was used as a positive control, and untreated HeLa cells served as the negative control. Apoptosis markers (caspase-3 and caspase-8) were analysed using immunocytochemistry (ICC), while DAPI/phalloidin staining was used to observe cytoskeletal changes. Levels of cytokines (CCL2 and TGF-α) were measured using ELISA. Results: Activation of caspase-3 was observed at 5% UC-MSC concentration, indicating the induction of apoptosis. However, higher UC-MSC concentrations (10–30%) led to a decrease in HeLa cell viability without caspase-3 or caspase-8 activation, suggesting alternative cell death pathways such as necrosis or autophagy. No caspase-8 activation was observed across all treatments, indicating resistance to extrinsic apoptosis, possibly due to the expression of anti-apoptotic proteins like c-FLIP. ELISA analysis showed no significant changes in CCL2 and TGF-α levels. Conclusion: UC-MSCs can induce HeLa cell death via caspase-independent mechanisms, particularly at higher concentrations. The selective activation of caspase-3 at low concentrations highlights the complex interaction between UC-MSCs and cervical cancer cells. These findings contribute to a deeper understanding of MSC-based cancer therapy and offer insights for the development of novel therapeutic strategies.

Background: Nephrolithiasis, characterized by kidney stone formation, is increasingly prevalent worldwide. Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality, sharing risk factors with nephrolithiasis, including hypertension, obesity, and metabolic disorders. This study examines their correlation in patients at Dr. Hasan Sadikin Central General Hospital, Bandung. Methods: This study used a cross-sectional design based on secondary data from the medical records of patients diagnosed with nephrolithiasis and cardiovascular disease during the period January 1, 2013, to December 31, 2023. The sample consisted of 46,808 patients who met the inclusion criteria. Statistical analysis was performed using Fisher's test to evaluate the association between nephrolithiasis and cardiovascular disease and hypertension, and to calculate the Odds Ratio (OR) and Relative Risk (RR) values. Result: Of the total 46,808 patients, 2,392 patients (5.1%) with nephrolithiasis had cardiovascular disease. Analysis showed a significant association between nephrolithiasis and cardiovascular disease, with an OR of 1.12 (95% CI) and RR of 1.17 (p < 0.05). In contrast, for patients with hypertension, although the number of patients with nephrolithiasis reached 1,954, analysis showed that hypertension did not significantly increase the risk of nephrolithiasis, with an OR of 0.62 and RR of 0.65 (p < 0.05). Conclusion: Cardiovascular disease was significantly associated with an increased risk of urolithiasis, while hypertension showed a negative association, possibly due to confounding factors. Targeted prevention—including metabolic risk control, hydration, dietary adjustments, and screening in cardiovascular patients—may help reduce stone formation risk.

Background: Mesenteric vein thrombosis (MVT) is a serious condition with high mortality. This condition is often associated with surgical interventions on abdominal organs. The primary management of MVT involves anticoagulant therapy, including enoxaparin and fondaparinux. However, perioperative antithrombotic administration requires balancing the risks of thrombosis and bleeding. Serious post-operative complications like anastomotic dehiscence may arise due to blood loss during surgery. This study aims to analyze the effect of enoxaparin and fondaparinux administration on TGF-ß and MMP-9 expression post-resection and colon anatomosis Methods: The study was conducted experimentally using a posttest control group design with experimental animals that had been randomized as research subjects for a month. The independent variable in this research was the type of anti-thrombosis drugs, enoxaparin and fondaparinux, while the dependent variable was the expression levels of TGF-ß and MMP-9. Data were analyzed using SPSS version 25.0 for Windows. Results: There was a significant difference between enoxaparin and fondaparinux administration in the expression of TGF-β and MMP-9 at the colonic anastomosis. It was found that fondaparinux has the most important effect on the expression of TGF-β and MMP-9. Conclusion: A significant relationship was found between the type of medication administered and the levels of TGF-β and MMP-9 expression, with Fondaparinux exhibiting the most important impact compared to enoxaparin. TGF-β showed a stronger and more significant association with colon anastomosis healing.

Background: Vitamin D supplementation is widely used to address prevalent deficiency in Saudi Arabia. However, growing access to over-the-counter supplements has raised concerns about self-medication and the risk of overdose. Limited national-level data exist on public knowledge, attitudes, and practices regarding vitamin D safety and toxicity. Methods: A descriptive, cross-sectional study was conducted among 2,272 adults in Saudi Arabia using an online self-administered questionnaire between April and June 2025. The survey assessed knowledge of vitamin D, attitudes toward self-medication, and consultation practices. Descriptive statistics, chi-square tests, and regression analyses were used to explore associations between sociodemographic factors and KAP outcomes. Results: Only 3.8% of participants reported frequently hearing about vitamin D toxicity. While 70.4% agreed with the recommended dose, only 18.2% had consulted a healthcare provider before supplement use. Gender and age were significantly associated with higher practice scores, while knowledge and awareness—rather than education level—were strong predictors of positive attitudes toward safe supplementation. The majority relied on physicians for information (65.6%), and concern about overdose was common, though self-medication remained widely accepted. Conclusion: Knowledge and awareness, not demographic characteristics, significantly influenced safe attitudes and practices related to vitamin D use. These findings highlight the importance of structured educational interventions and the role of healthcare professionals in mitigating overdose risks. Public health strategies should prioritize improving vitamin D literacy and promoting evidence-based self-care behaviors across all population groups.

Introduction: Thalassemia is a highly prevalent hemoglobinopathy that causes anemia. Transfusion-dependent thalassemia patients require regular blood transfusions, leading to iron overload and the deposition of iron in various organs, including the liver. Accumulation of iron in the liver causes liver fibrosis, which increases the mortality of thalassemia patients. Serum ferritin levels are an indicator of iron overload that correlates with liver iron levels. Ultrasound-based shear wave elastography is a non-invasive modality with good accuracy for assessing the degree of liver fibrosis. The aim of this study is to determine the correlation between serum ferritin levels and the degree of liver fibrosis in thalassemia major patients using ultrasound-based shear wave elastography. Methods: This research is an observational- analytical study with a cross-sectional approach. The data used is secondary data taken from laboratory results and prospective data from ultrasound-based shear wave elastography examinations at Dr. Hasan Sadikin Hospital Bandung from January 2024 to March 2024. The Spearman’s Rank correlation test was carried out to assess the correlation between serum ferritin levels and the degree of liver fibrosis with a confidence level of 95%. Results: The number of subjects who met the inclusion criteria was 60, consisting of 21 (35%) men and 39 (65%) women with an average age of 25 ± 6 years. The mean value of serum ferritin levels was found to be 6894.0 ± 4774.7 ng/ml. A consultant radiologists conduct the ultrasound-based shearwave elastography. The average median value of liver stiffness using shear wave elastography was 12.3 ± 3.6 kPa, and 95% of subjects had significant liver fibrosis. There is a strong positive correlation between serum ferritin levels and the degree of liver fibrosis. (r=0.734, p<0.001) Conclusion: There is a strong correlation between serum ferritin levels and the degree of liver fibrosis in thalassemia major patients using ultrasound-based shear wave elastography at Dr. Hasan Sadikin Hospital Bandung.