In recent years, there has been a growing body of research focused on cardiorenal biomarkers associated with adverse cardiovascular outcomes. This trend reflects the ongoing need to improve diagnostic and prognostic strategies in clinical practice. At the same time, an increasing number of novel biomarkers are being identified, warranting a critical evaluation of their clinical relevance. This review examines current scientific literature addressing the role of the cardiorenal biomarkers Klotho and cystatin C, highlighting their diagnostic and prognostic potential, as well as the prospects for their integration into routine medical care. To analyze literature data on potential cardiorenal biomarkers as predictors of adverse clinical outcomes in patients with cardiovascular diseases. A literature search was conducted using the scientific databases PubMed, Web of Science, and Google Scholar, as well as electronic scientific libraries eLibrary and CyberLeninka. The search covered a five-year period (2019-2024) and focused on cardiorenal biomarkers as predictors of adverse outcomes in cardiovascular diseases. This literature review focuses on studies examining cardiorenal biomarkers of adverse cardiovascular outcomes, specifically the proteins Klotho and cystatin C. These biomarkers reflect a range of pathophysiological processes, including myocardial fibrosis, inflammation, endothelial dysfunction, and renal impairment. The analysis of current evidence suggests that the use of such biomarkers enhances the early detection of cardiovascular pathology, facilitates risk stratification, and supports dynamic patient monitoring. Their incorporation into clinical practice is contributing to the development of personalized treatment strategies and improving the precision of diagnostic assessments, ultimately leading to better clinical outcomes. A review of recent literature on cardiorenal biomarkers associated with adverse cardiovascular outcomes highlights the strong diagnostic and prognostic relevance of Klotho and cystatin C. Reduced levels of Klotho have been linked to both endothelial and renal dysfunction, while cystatin C is recognized as a sensitive indicator of impaired kidney function. Further research is needed to establish standardized thresholds, refine assessment methodologies, and support the integration of these biomarkers into everyday clinical practice.

Diabetes mellitus remains a major public health challenge globally, and Saudi Arabia is among the countries with high type 2 diabetes prevalence. Although screening initiatives exist, delayed diagnosis persists, suggesting barriers to early detection. To identify individual, sociocultural, and healthcare-system factors associated with low uptake of early diabetes screening in Saudi Arabia. We conducted a cross-sectional online survey of adults in Saudi Arabia (n=881) using a standardized self-administered Arabic questionnaire. Descriptive statistics summarized participant characteristics and responses. Chi-square tests examined associations between sociodemographic variables and awareness/screening behaviors, and multivariable logistic regression identified independent predictors of screening participation. Participants were predominantly female (61.3%), with the largest age groups 18-24 and 35-44 years (26.8% each); 71.7% reported no health insurance. While 86.7% reported awareness of early diabetes symptoms, 53.1% had never monitored blood glucose and only 17.5% reported screening participation. Barrier analysis was based on respondents who completed the barrier items (n=753); the most commonly reported barriers were absence of symptoms (66.3%), lack of time (24.3%), and fear of diagnosis (18.5%). In regression analysis, screening participation was independently associated with male gender (OR=1.47, p=0.037), awareness of symptoms (OR=2.61, p<0.001), family history of diabetes (OR=1.54, p=0.031), health insurance (OR=1.83, p=0.002), older age (≥35 years), and higher educational attainment. Despite high symptom awareness, screening participation remains low-largely driven by the misconception that screening is unnecessary without symptoms, alongside time constraints and fear. Strengthening early detection will require culturally tailored preventive-health messaging, easier access to screening, and targeted digital interventions (e.g., risk-tailored reminders and proactive outreach), aligning with Saudi Vision 2030 priorities.

Malignant central airway obstruction (CAO) is a critical, life-limiting complication in patients with advanced thoracic malignancies. Interventions such as bronchoscopic laser resection and airway stenting can provide rapid palliation and symptom relief, yet comparative data on survival and quality of life (QoL) remain limited. To assess the impact of bronchoscopic laser resection and stenting on survival and health-related QoL in patients with malignant CAO, compared with conservative palliative care. A comparative cohort study was conducted at a national pulmonary referral center. Thirteen patients underwent bronchoscopic laser resection and/or endobronchial stenting, while twelve control patients received conservative palliative care. Kaplan-Meier survival analysis and Cox proportional hazards models were used to evaluate mortality. Health-related QoL was measured using the EQ-5D-5L questionnaire at baseline and one-month post-intervention. Median survival in the intervention group was 9.7 weeks compared to 0.6 weeks in the control group (p<0.0001). At 25 weeks, the hazard ratio for death was 0.019 (95% CI: 0.004-0.091). The mean EQ-5D-5L score improved from 29.2±14.4 to 43.5±9.2 (p=0.0062), with the most pronounced improvements in the pain/discomfort and anxiety/depression domains. Bronchoscopic laser resection and airway stenting significantly improve short-term survival and quality of life in patients with malignant CAO. These minimally invasive interventions should be considered integral components of palliative care for patients with inoperable airway obstruction.

Hyperglycemia brought on by insulin resistance and decreased insulin secretion is a hallmark of type II diabetes mellitus (T2DM), a common metabolic disease. By increasing the excretion of glucose in the urine, dapagliflozin, an inhibitor of the sodium-glucose cotransporter-2 (SGLT2), lowers blood glucose levels and may have other systemic effects. The purpose of this study was to assess how dapagliflozin affected glycemic control, thyroid function, and serum vitamin D₃ levels while looking into potential age and gender effects. Thirty T2DM patients who had previously received metformin treatment (18 men and 12 women, ages 31 to 70) were enlisted. In addition to metformin, each participant received 10 mg of dapagliflozin daily for eight weeks. Using chemiluminescent and ELISA assays, serum levels of HbA₁c, triiodothyronine (T₃), thyroxine (T₄), thyroid-stimulating hormone (TSH), and vitamin D₃ were assessed both before and after treatment. Although, changes in T₄, TSH, and vitamin D₃ were not statistically significant, dapagliflozin significantly decreased HbA₁c and T₃ levels. While HbA₁c showed a near-borderline difference between sexes (p≈0.10) and vitamin D₃ showed a mild age-related trend (p≈0.07), neither gender nor age significantly affected any of the parameters. Dapagliflozin's main effect appears to be on peripheral metabolic regulation rather than endocrine hormone synthesis, as evidenced by the fact that it successfully improved glycemic control without substantially changing thyroid or vitamin D₃ levels. Dapagliflozin's stable therapeutic profile is highlighted by the consistent biochemical responses across age and gender, which calls for additional research with bigger sample sizes and longer follow-up periods.

Corticobasal syndrome (CBS) is a rare, clinically heterogeneous neurodegenerative syndrome most commonly associated with corticobasal degeneration (CBD), a 4-repeat tauopathy. CBS presents with asymmetric motor and cortical features, but diagnosis remains challenging, as clinicopathologic concordance is imperfect and other conditions such as Alzheimer's disease (AD), progressive supranuclear palsy (PSP), and frontotemporal lobar degeneration (FTLD) can present with similar phenotypes. We report the case of a 55-year-old woman with a four-year history of progressive, right-sided spastic hemiparesis and rigidity. Electroneuromyography (ENMG) revealed isolated upper motor neuron (UMN) findings with no lower motor neuron (LMN) involvement. Brain MRI demonstrated cortical atrophy in perirolandic regions, and dopamine transporter (DaT) SPECT imaging revealed a marked, unilateral presynaptic dopaminergic deficit. No sensory, cerebellar, or autonomic features were observed, and levodopa challenge test yielded no benefit. FDG-PET and tau-PET imaging were not performed due to unavailability at our center. The marked clinical asymmetry, dopaminergic deficit strongly support a diagnosis of CBS. While CBD remains the most probable underlying pathology, differential diagnoses include PSP, AD, multiple system atrophy (MSA), idiopathic Parkinson's disease (PD), and, less likely, Mills syndrome or other UMN syndromes. Mills syndrome was considered due to asymmetric UMN findings but was excluded due to parkinsonism, cortical atrophy, and presynaptic dopaminergic loss. This case underscores the diagnostic complexity of CBS, particularly in resource-limited settings where advanced imaging tools are unavailable. CBS should be considered a leading diagnosis in patients presenting with asymmetric parkinsonism, UMN findings, especially when supported by DaT-SPECT abnormalities. This case highlights the importance of comprehensive clinical evaluation and multimodal imaging in differentiating CBS from other neurodegenerative syndromes.

Clopidogrel is a second generation thienopyridine that's used as a prophylactic anti-platelets following percutaneous coronary intervention (PCI) for patients with coronary heart disease. Not all patients who receive this medication show effective response as literatures have reviewed clopidogrel resistance as an issue on needs of further follow-up and study. The aim of this article was to assess clopidogrel resistance among a group of patients who underwent PCI. This study was conducted as a cross-sectional study during the period of one year. A total of 106 patients who underwent Primary PCI and were placed on clopidogrel for at least 7 days were assessed. Their blood sample was obtained and asses for platelets aggregation test. The mean age of the patients with CAD who underwent PCI was 58.5 between 31 and 80 years old. 68.9% of them were males and 31.1% were females. From the total 106 CAD patients, 70.5% of them responded to the Clopidogrel positively and 12.4% responded in a suboptimal way while 19 patients (17.1%) were clopidogrel resistant. No significant correlation were found between clopidogrel response and gender or age; P values respectively were 0.2324 and 0.4159. subsequently, genetic report was done for resistant cases and they showed no significant correlation with age (P=0.8914) and gender (P=0.2524). Clopidogrel resistance and poor response is of a significant value among patients and can be encountered. There was no correlation of clopidogrel to age or gender, yet further studies are indicated for the assessment of the genetic material and response profile.

Quaternary ammonium compounds (QACs) are widely used cationic surfactants known for their strong antimicrobial activity. Their utility in healthcare, consumer products, and industrial settings stems from their ability to disrupt bacterial membranes rapidly. However, increased use raises concerns about bacterial resistance and environmental persistence. The study aims to synthesize and evaluate a new series of 2-(alkyloxy)-N-(2,5-dimethylbenzyl)-N,N-dimethyl-2-oxoethanammonium chlorides (C6-C12) for antibacterial activity. Developing structurally optimized QACs may improve antibacterial potency while minimizing environmental impact and resistance selection. Tailoring the alkyl chain length and introducing degradable moieties like alkoxycarbonylmetհyl could enhance efficacy and biodegradability. The compounds were synthesized by the alkylation of N,N-dimethyl-3,6-dimethylbenzylamine with the corresponding alkyl chloroacetate. QACs were purified and characterized by IR, 1H- and 13C-NMR, and mass spectrometry. Biological activity was assessed by agar diffusion and broth microdilution assays against representative Gram-positive (Staphylococcus aureus, Bacillus subtilis) and Gram-negative (Escherichia coli, Shigella flexneri) bacteria. Comparative activity was evaluated against furazolidone. All compounds exhibited antibacterial effects using the agar-diffusion method, with inhibition zones of up to 35mm. However, the MIC values of the compounds were higher than those of the reference furazolidone. These results indicate that quaternary ammonium compounds combining a 2,5-dimethylbenzyl moiety with an alkyloxycarbonylmethyl chain exhibit moderate broad-spectrum antibacterial activity, making them promising candidates for topical and environmental applications.

Children diagnosed with autism spectrum disorder (ASD) are often more sensitive to environmental stimuli, particularly light, sound, and touch, which can provoke significant anxiety and behavioral resistance during dental visits, thereby contributing to poor oral health. To assess the efficacy of sensory adapted dental environments (SADEs) and related interventions to reduce dental anxiety by improving behavioral cooperation of children with ASD based on peer-reviewed evidence. English language studies published between January 2010 and June 2025 were retrieved from the PubMed, ScienceDirect, and Google Scholar databases using the keywords "autism spectrum disorder," "sensory adapted dental environment," "multisensory," "dental anxiety," and "occupational therapy." Reports were limited to randomized controlled trials, quasi experimental studies, observational research, and systematic reviews involving children with ASD or other developmental disabilities. Data were assessed qualitatively. Evidence indicates that SADEs consistently reduced physiological and behavioral signs of dental anxiety. A large crossover trial involving 162 autistic children reported that visual, auditory, and tactile adaptations significantly reduced stress during dental cleanings. Modifications (dimmed lighting, nature sounds, slow motion projections, and deep pressure wraps) were effective. A 2024 study involving neurotypical children found improved behavior and reduced anxiety in the SADE group, along with lower heart rates and higher oxygen saturation. A randomized trial of children with Down syndrome demonstrated that a multisensory waiting room significantly reduced heart rate and anxiety scores. While the primary focus was ASD, some comparative studies involving neurotypical children and children with Down syndrome were reviewed due to their relevance to sensory-processing mechanisms Meta-analyses of five studies found that SADEs significantly lowered psychophysiological markers of anxiety Conclusion: Current evidence supports the efficacy of SADEs to reduce anxiety and enhance cooperation of children with ASD. These interventions are cost-effective, feasible, and easily tailored to individual sensory profiles. Future research is recommended to examine long-term outcomes, implementation in community settings, and integration with behavioral approaches.

To determine the trends in prevalence and other epidemiological characteristics of ulcerative colitis in the central city of the Semey region - Abai Region. A cross-sectional study was conducted using primary medical records (inpatient, outpatient, and electronic medical records from Integrated medical information system) collected between 2014 and 2023. Data on incidence, prevalence, patient loss to follow-up, disease exacerbations, severity, activity level, age, and gender structure were analyzed. A total of 1,539 primary medical records were reviewed. Statistical analysis involved Pearson's chi-square test and Fisher's exact two-tailed test, with a significance level set at p<0.05. The study revealed an overall increasing trend in the average annual number of registered UC patients per 100,000 population, rising from 23.7 in 2014 to 45.4 in 2023 (trend magnitude: 9.0% per year). Newly diagnosed cases showed a general increase, but with a noticeable decrease during the COVID-19 pandemic. The disease structure was dominated by patients with moderate severity (Grade 2) (58.5% average) and Grade 2 activity (57.5% average). A significant finding was the consistent upward trend in the proportion of patients with Grade 1 activity (4.7% per year increase), likely due to improved diagnosis. The age distribution showed two peaks, in the 31-40 years and 51-60 years categories. Females moderately predominated throughout the study period, accounting for 54.9% to 58.1% of the cohort. The burden of UC on the healthcare system in the Semey region is growing, driven by both increasing incidence and improved diagnostic efficiency. The identified epidemiological characteristics, including the dual age peaks and moderate female predominance, largely align with international findings. Data collection during the COVID-19 pandemic suggests a potential issue with case detection during healthcare restrictions, hypothesizing increased mortality requiring further verification. These data are crucial for forecasting future trends and planning necessary healthcare resources for UC management in Kazakhstan.

Titanium Elastic Nail (TEN) fixation provides superior clinical and cosmetic outcomes with fewer complications compared to plating or Kirschner wire fixation in pediatric clavicle fractures. Clavicle fractures account for about 10% of all paediatric fractures. In displaced or unstable cases, surgical fixation is increasingly advocated. Titanium elastic nails (TEN) offer a minimally invasive intramedullary fixation option, but outcomes in children remain less widely documented. Retrospective cohort design study. Single tertiary care center. Patients aged 10-18 years with acute clavicle fractures treated surgically between January 2021 and December 2024 were included. Patients were selected according to OTA/AO classification. Surgical technique selection was based on fracture characteristics: midshaft fractures with moderate displacement (15A-B types) were primarily treated with TEN fixation (n=48); severely comminuted or segmental fractures requiring anatomical plate fixation (n=11, 15C type); and simple transverse fractures amenable to K-wire fixation (n=13, 15A type). The observed difference in group sizes reflects the clinical distribution of fracture patterns and the preferential use of TEN for appropriate cases during the study period. Exclusion criteria included pathologic fractures, open fractures requiring complex reconstruction, and noncompliance with follow-up. Primary outcome - radiographic union. Secondary outcomes - complications, functional outcomes, cosmetic satisfaction. Comparisons made between TEN, plating, and K-wire groups. Extracted from electronic medical and radiographic records by two independent reviewers. This is a retrospective review of 72 pediatric patients (age 10-18) with clavicle fractures treated surgically at our center from 2021 to 2024. Fixation techniques included closed reduction with TEN (n=48), open reduction with plating (n=11), and intramedullary Kirschner wires (n=13). We evaluated radiographic union, complications, functional outcomes, and cosmetic satisfaction. Demographics and Baseline Data: Seventy-two patients (58 males, 14 females; mean age 14±4 years) were included. Mean follow-up was 12 months. Radiographic Union and Healing: Union achieved in 47/48 TEN, 9/11 plating, 12/13 K-wire cases. Mean union time 4±1 weeks for TEN group. No statistically significant difference in union time across groups. TEN: skin irritation (n=1). Plating: non-union (n=1), plate deformation (n=1), refracture (n=1). K-wire: migration (n=3). No infections noted. Functional Outcomes: All patients achieved near-normal shoulder motion. Return to sport earliest in TEN group (~4 weeks). Cosmetic Satisfaction: TEN: minimal scarring (~1.5 cm incision) and excellent satisfaction. Plating and K-wire: visible scars and hardware prominence complaints. Comparisons Between Groups: Equivalent union rates observed, but TEN group had fewer complications and superior aesthetics. • Titanium Elastic Nails (TEN) provide effective, minimally invasive fixation for pediatric clavicle fractures. • Faster recovery and better cosmetic outcomes than plating or K-wires. • Low complication rate and high union success make TEN a preferred option in eligible pediatric cases. III.