Peyronie's disease (PD) is a connective tissue disorder characterized by abnormal collagen deposition in the tunica albuginea, leading to penile curvature, pain, and erectile dysfunction. This study aimed to evaluate the outcomes of a combined treatment protocol incorporating collagenase clostridium histolyticum (CCH), vacuum erection device, and tadalafil. A retrospective analysis was conducted on 99 male patients with PD treated at the Department of Urology, Hamad Medical Corporation (Doha, Qatar) between January 2018 and January 2020. Patients received 4-8 CCH injections alongside vacuum therapy and daily tadalafil (5 mg). The baseline mean penile curvature of 49.0° improved by an average of 21.4% post-treatment. Erectile function scores also increased significantly, with a mean improvement of 2.3 points on the International Index of Erectile Function. Minor complications were observed in 15 patients, while 13 were dissatisfied with treatment, with six opting for surgery. The modified protocol demonstrated significant improvements in penile curvature and erectile function with minimal complications, offering a safe, cost-effective alternative to traditional intensive treatments.
Humans ; Male ; Penile Induration/therapy* ; Tadalafil/therapeutic use* ; Retrospective Studies ; Microbial Collagenase/administration & dosage* ; Middle Aged ; Vacuum ; Treatment Outcome ; Adult ; Penile Erection ; Combined Modality Therapy ; Phosphodiesterase 5 Inhibitors/therapeutic use* ; Aged ; Erectile Dysfunction/etiology*

Objective: The objective of this systematic review and meta-analysis is to evaluate the efficacy, safety, time to international normalized ratio (INR) reversal, and total volume of four-factor prothrombin complex concentrate (4-PCC) administered using fixed-dose versus weight-based dosing strategies in patients requiring urgent warfarin reversal, with specific focus on clinical outcomes of hemostatic efficacy, thromboembolic events, and mortality rates. Methods: A comprehensive systematic review was conducted using the PubMed, Embase, and Cochrane databases from inception through October 2023. We searched for randomized clinical trials or observational studies that compared efficacy or safety outcomes of fixed versus variable 4-PCC dose in adult patients. Results: In the 14 included studies, the overall use of fixed-dose 4-PCC was associated with a lower likelihood of reaching the INR goal (risk ratio [RR], 0.84; 95% confidence interval [CI], 0.80–0.89) compared to the variable-dose group. In addition, a significantly larger proportion of patients (169 of 651, 26%) required an additional dose of 4-PCC. The rates of mortality (RR, 0.85; 95% CI, 0.70–1.03) and thromboembolic events (RR, 1.27; 95% CI, 0.65–2.45) were similar between the two treatment groups. Conclusion This systematic review and meta-analysis showed that variable dosing of 4-PCC more successfully achieves the target INR for warfarin reversal compared to fixed dosing. However, the dosing strategies have similar mortality and thromboembolic rates. While fixed dosing offers a simpler approach, it may require additional administration. Future studies should focus on optimizing dosing strategies to balance efficacy, safety, and practicality in various clinical scenarios

Objectives: Influenza vaccination is important for healthcare workers in order to prevent both the illness itself and transmission to patients. Previous studies in Saudi Arabia have revealed low influenza vaccine coverage among healthcare workers due to misconceptions. This study aimed to assess knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers during 2021, addressing the current data gap. Methods: A cross-sectional study was conducted, including 1273 healthcare workers from the Ministry of Health in Saudi Arabia. A self-administered questionnaire was distributed to participants via email. Results: Most participants had an appropriate extent of knowledge, with 37.1% having a high level and 26.6% having a moderate level. Positive attitudes toward the influenza vaccine were observed in 41.2% of participants, and 80.2% demonstrated good vaccine practices. However, the vaccine coverage was 50.8% in the past 12 months. Factors associated with vaccine uptake included previous vaccination, workplace availability, awareness of guidelines, engagement in training programs, type of workplace settings, and having positive attitudes toward the vaccine. The most common reason for not getting vaccinated was the perception of being at low risk, making vaccination unnecessary. Conclusions Participants exhibited positive knowledge, attitudes, and practices regarding influenza vaccination. However, the observed vaccine uptake rate fell below the recommended coverage rate, indicating the presence of a knowledge-behavior gap. Targeted interventions are recommended to improve vaccination uptake among healthcare workers in Saudi Arabia.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

Objectives: Influenza vaccination is important for healthcare workers in order to prevent both the illness itself and transmission to patients. Previous studies in Saudi Arabia have revealed low influenza vaccine coverage among healthcare workers due to misconceptions. This study aimed to assess knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers during 2021, addressing the current data gap. Methods: A cross-sectional study was conducted, including 1273 healthcare workers from the Ministry of Health in Saudi Arabia. A self-administered questionnaire was distributed to participants via email. Results: Most participants had an appropriate extent of knowledge, with 37.1% having a high level and 26.6% having a moderate level. Positive attitudes toward the influenza vaccine were observed in 41.2% of participants, and 80.2% demonstrated good vaccine practices. However, the vaccine coverage was 50.8% in the past 12 months. Factors associated with vaccine uptake included previous vaccination, workplace availability, awareness of guidelines, engagement in training programs, type of workplace settings, and having positive attitudes toward the vaccine. The most common reason for not getting vaccinated was the perception of being at low risk, making vaccination unnecessary. Conclusions Participants exhibited positive knowledge, attitudes, and practices regarding influenza vaccination. However, the observed vaccine uptake rate fell below the recommended coverage rate, indicating the presence of a knowledge-behavior gap. Targeted interventions are recommended to improve vaccination uptake among healthcare workers in Saudi Arabia.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

The circle of Willis (COW) refers to the anastomotic arterial network found on the brain base, tasked with provision of collateral circulation aimed at prevention of ischemia. The COW is of immense clinical importance especially with regard to the assessment of neurovascular diseases. Individuals portray significant variations in the COW’s anatomical configuration. The present study seeks to evaluate the existing anatomical variations of the COW and within the anterior and posterior segments of the COW. Thus, the study seeks to evaluate the different anatomical variations of the COW and its segments and components within the study population. To attain the set objectives, the present study has utilized the angiographic images for studying the COW variants in patients who underwent cerebral angiography during assessment of different types of cerebral anomalies and conditions. Therefore, this study used conventional angiography as an important tool in the evaluation of the different variations in the COW, and is most appropriate for evaluation of smaller anatomical variations owing to its perfect spatial resolution and portrayal of COW anatomy. The study findings indicated the existence between age and sex, and anatomical variations of the COW, particularly with regard to diameters of COW components like basilar artery (BA), P1, and internal carotid arterys (ICAs). Males had bigger BA, P1 and ICA diameters than females, while individuals aged below 40 years had bigger BA, A1, posterior communicating artery, and ICA diameters than those aged above 40 years.

Objectives: Influenza vaccination is important for healthcare workers in order to prevent both the illness itself and transmission to patients. Previous studies in Saudi Arabia have revealed low influenza vaccine coverage among healthcare workers due to misconceptions. This study aimed to assess knowledge, attitudes, and practices regarding influenza vaccination among healthcare workers during 2021, addressing the current data gap. Methods: A cross-sectional study was conducted, including 1273 healthcare workers from the Ministry of Health in Saudi Arabia. A self-administered questionnaire was distributed to participants via email. Results: Most participants had an appropriate extent of knowledge, with 37.1% having a high level and 26.6% having a moderate level. Positive attitudes toward the influenza vaccine were observed in 41.2% of participants, and 80.2% demonstrated good vaccine practices. However, the vaccine coverage was 50.8% in the past 12 months. Factors associated with vaccine uptake included previous vaccination, workplace availability, awareness of guidelines, engagement in training programs, type of workplace settings, and having positive attitudes toward the vaccine. The most common reason for not getting vaccinated was the perception of being at low risk, making vaccination unnecessary. Conclusions Participants exhibited positive knowledge, attitudes, and practices regarding influenza vaccination. However, the observed vaccine uptake rate fell below the recommended coverage rate, indicating the presence of a knowledge-behavior gap. Targeted interventions are recommended to improve vaccination uptake among healthcare workers in Saudi Arabia.