Avicenna - Volume 2026, Issue 1

Artificial intelligence (AI) technology is revolutionizing healthcare by advancing the means of diagnosis, treatment planning, and medical education. However, the generation of erroneous yet highly credible output — for example, the creation of a completely imaginary case study in idiopathic neurovascular compression syndrome (INCS) — poses the threat of misinformation and the possible undermining of human expertise. This short communication highlights the dual role of AI by emphasizing the need for caution through a fabricated INCS case created by Grok, a highly proficient AI model. AI certainly aids efficiency, but cannot and must never be allowed to replace the subtle evaluative work of human physicians, casting an even greater responsibility on us to provide critical oversight.

Aim: To examine the state of menstrual hygiene management (MHM) among female university students in Gaza, with a particular focus on access to menstrual materials and water, sanitation, and hygiene (WASH) facilities.

Method: This study employed an exploratory cross-sectional survey design targeting female university students, using a structured online questionnaire. Items related to MHM were adapted from the Arabic MHM Toolkit Mini Guide. The survey was distributed through social media, university listservs and networks, and online student group platforms. Data were collected between November 2024 and December 2024. Participants were eligible for inclusion if they were identified as female, enrolled in a university, and residents of Gaza.

Results: Our sample comprised 214 participants. Most respondents (95.3%) reported using sanitary pads during menstruation. Almost half of the participants (46.7%) were able to change their pads only once or twice per day, closely aligning with the 48.6% who perceived their frequency of pad changes as inadequate. Approximately 17% of participants lacked access to a safe and private space to change menstrual materials, while nearly 40% lacked access to a safe and private space for bathing during menstruation. Additionally, 22.4% of participants were unable to regularly clean their external genitalia with water and soap during menstruation, and 14.5% reported a lack of trash bins for the disposal of pads or cloth materials.

Conclusion: Our findings highlight the distressing realities of the ongoing genocide in Gaza and its impact on women and girls of reproductive age. There is an acute shortage of menstrual materials—particularly menstrual pads—along with other hygiene items (e.g. soap) and WASH facilities to support proper menstrual hygiene practices. We call on the international community and governments to act jointly to establish an immediate, permanent ceasefire and to facilitate the timely entry of humanitarian aid into Gaza.

Background: The relationship between clinical indicators and illness severity in hospitalized patients with both diabetes mellitus (DM) and COVID-19 remains incompletely understood, particularly with respect to endocrine markers.

Aim: This study aimed to identify clinical predictors of critical illness in hospitalized adults with DM and COVID-19 and to develop a predictive nomogram for individualized risk assessment.

Method: This retrospective cross-sectional study enrolled 393 hospitalized patients with confirmed DM and COVID-19, who were categorized into non-critical (n = 309) and critical (n = 84) groups. We evaluated a comprehensive panel of candidate predictors, including demographic characteristics, vital signs, and laboratory markers such as C-reactive protein (CRP), fasting C-peptide (FCP), and free triiodothyronine (FT3). Multivariable logistic regression was used to develop the prediction model.

Results: Multivariate logistic regression identified several independent predictors of critical illness. Elevated levels of blood urea nitrogen (BUN) (OR: 1.100, 95% CI: 1.026–1.183), serum creatinine (SCr) (OR: 1.027, 95% CI: 1.011–1.043), and CRP (OR: 1.011, 95% CI: 1.005–1.019), along with advanced age (OR: 1.073, 95% CI: 1.039–1.112), were significant risk factors. Conversely, lower levels of FCP (OR: 0.483, 95% CI: 0.305–0.737), FT3 (OR: 0.519, 95% CI: 0.313–0.835), and serum sodium (OR: 0.911, 95% CI: 0.860–0.962) were independent protective factors. The resulting nomogram showed excellent discrimination (C-index = 0.964).

Conclusion: A combination of clinical and laboratory parameters, including age, renal function, inflammatory markers, and endocrine indicators (FCP and FT3), can effectively predict COVID-19 severity in patients with DM. The developed nomogram provides a practical tool for early risk stratification in this high-risk population.