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To assess the prevalence of melatonin use and its perceived benefits among university students in different specialties in Saudi Arabia, a cross-sectional survey was conducted between March and June 2023. Data about demographics, time of melatonin use, perceived reasons for exogenous melatonin use, melatonin use in relation to exam periods, perceived safety, and adverse effects was gathered. Of 380 students, ~52% reported using exogenous melatonin for sleep disorders. Most participants reported using melatonin during and after exam periods. Additionally, several (n = 157; 75.4%) believed that its use was safe. The predominant use patterns were daily and as needed, and this study observed a higher rate of use compared with previous studies in Saudi Arabia. The most frequently reported adverse effect was headache (n = 36; 37.5%). A significant number of undergraduate male students in health specialties used melatonin. A high rate of melatonin use was noted during exam periods, which was attributed to sleep deprivation. Additionally, a significant number of students from private universities reported using exogenous melatonin. Melatonin use is common among university students. Future research should use a reliable psychometric measure to test its effect on university students' sleep quality and quantity. [ABSTRACT FROM AUTHOR]

Melatonin, which is classified as a dietary supplement by the Saudi Food and Drug Authority, is used to manage sleep disorders. In this study, community pharmacists' knowledge and attitudes about dispensing melatonin supplements and the perceived safety and effectiveness of melatonin were assessed. A cross-sectional survey of community pharmacists in Jeddah, Saudi Arabia was conducted from March–June 2023. Community pharmacists' knowledge and attitudes towards prescribing and dispensing melatonin supplements, the methods of dispensing melatonin supplements (prescription, over the counter, self-administered), indications, ages of users, dosage forms, and adverse drug reactions related to melatonin use among consumers were surveyed using a questionnaire. Potential participants were approached face to face, a questionnaire was administered to those agreeing to participate in the study, and responses were recorded electronically. The response rate of the 300 community pharmacists who participated in this study was 83.5%. The mean age of participants was 33.6 years, and 89.3% (n = 268) of community pharmacists reported dispensing melatonin supplements. Self-medication and over the counter (n = 213; 71.2%) were the most common dispensing and prescribing patterns (p = 0.001). Awareness rates about melatonin supplement pharmacokinetics and pharmacodynamics among community pharmacists were 38% and 37%, respectively. Despite its popularity, community pharmacists reported relatively low rates of awareness of melatonin supplement pharmacokinetics and pharmacodynamics. Further attention to this issue is needed. [ABSTRACT FROM AUTHOR]

Saudization is a policy implemented by the Saudi Ministry of Labor and Social Development that requires Saudi companies and enterprises to fill their workforce with Saudi nationals up to a certain percentage. This research examines the effect of Saudization on women working in the Saudi workforce. The study also analyzed the support and incentives of this program for stimulating females' enthusiasm toward looking for new job opportunities in the Saudi workforce. The study employed a qualitative study design. A total of 15 women were interviewed who held jobs for > 5 years and currently have been working in companies within Saudi Arabia. The study findings offer insights to the organizations concerned about the outcomes of implementing such programs. The study's findings reveal the positive impact of Saudization on female employment in local organizations, and these policies led to more opportunities through working in such stores and industries. The findings suggest that Saudization, retention, pay with benefits, and health insurance policies significantly affect diversity management in the Saudi private sector. There is a need to update the policy dimensions to address the issue of gender discrimination. [ABSTRACT FROM AUTHOR]

Importance: Body fluid dynamics and renal maturation status vary during the neonatal period. We hypothesized that differences in peak and trough gentamicin concentrations could be expected. Objective: To predict the peak and trough gentamicin concentrations in critically ill neonates and to predict the changes in the predicted peak plasma concentrations of gentamicin following fat‐free mass dosing. Methods: Critically ill neonates that received gentamicin and have gentamicin concentration measured were recruited. Fat mass was estimated using skinfold thicknesses. Changes in the peak plasma concentrations (Cmax) using whole‐body weight (estimated using the current dosing regimen) and predicted concentrations following the fat‐free mass‐based dosing were the outcome measures. Results: Eighty‐nine critically ill neonates were recruited. Sub‐therapeutic Cmax was estimated using the current dosing regimen in 32.6%, and 22.5% neonates following the first and second doses of gentamicin. Preterm neonates had significantly higher fat mass compared to term neonates. All except one had Cmax above 12 μg/ml after the first dose and all had after the second gentamicin dose following the predicted fat‐free mass‐based gentamicin dosing. The recommended doses are as follows: extreme preterm: 7.95 mg/kg every 48 h; very preterm: 7.30 mg/kg every 36–48 h; late preterm: 5.90 mg/kg every 36–48 h; and term neonates at 5.10 mg/kg every 24 h. Interpretation: Fat‐free mass dosing may be considered for obtaining optimal therapeutic effects in the neonatal population. [ABSTRACT FROM AUTHOR]

Background. Sinonasal lymphoepithelial carcinoma (SNLEC) is a rare neoplasm, representing less than 1% of all types of carcinomas and approximately 3% of head and neck tumors. It can affect the nasopharynx due to the rich lymphoid tissue present in this region. Clinical SNLEC presentation varies, ranging from asymptomatic to nonspecific sinonasal symptoms. We report a case of SNLEC and review the literature for SNLEC presentation, diagnosis, management options, and outcomes. Case Presentation. A 38-year-old male, medically free, presented to the emergency department complaining of nasal obstruction, right facial numbness, persistent right-sided headache, intermittent orbital pain, and a history of on/off epistaxis. Imaging showed a destructive mass in the right sphenoid sinus extending to different sinuses and infratemporal fossa. Biopsy confirmed the diagnosis of SNLEC, with immunohistochemistry being positive for Epstein–Barr virus (EBV) and CK8/18. Induction chemotherapy was started with three cycles of cisplatin and gemcitabine, followed by concurrent chemoradiation therapy. Conclusion. SNLEC is rare, with limited reported cases from around the world. It is mostly seen in adults between their fifth and seventh decades with male predominance. SNLEC is diagnosed using imaging, immunohistochemistry, and EBV testing given its strong association with EBV. Owing to the limited cases, there is no standard approach to treating SNLEC. However, most cases managed with radiation and with and without other modalities showed an excellent response in terms of tumor nonrecurrence. [ABSTRACT FROM AUTHOR]

The vacuolar H+-ATPase is an enzymatic complex that functions in an ATP-dependent manner to pump protons across membranes and acidify organelles, thereby creating the proton/pH gradient required for membrane trafficking by several different types of transporters. We describe heterozygous point variants in ATP6V0C , encoding the c-subunit in the membrane bound integral domain of the vacuolar H+-ATPase, in 27 patients with neurodevelopmental abnormalities with or without epilepsy. Corpus callosum hypoplasia and cardiac abnormalities were also present in some patients. In silico modelling suggested that the patient variants interfere with the interactions between the ATP6V0C and ATP6V0A subunits during ATP hydrolysis. Consistent with decreased vacuolar H+-ATPase activity, functional analyses conducted in Saccharomyces cerevisiae revealed reduced LysoSensor fluorescence and reduced growth in media containing varying concentrations of CaCl2. Knockdown of ATP6V0C in Drosophila resulted in increased duration of seizure-like behaviour, and the expression of selected patient variants in Caenorhabditis elegans led to reduced growth, motor dysfunction and reduced lifespan. In summary, this study establishes ATP6V0C as an important disease gene, describes the clinical features of the associated neurodevelopmental disorder and provides insight into disease mechanisms. [ABSTRACT FROM AUTHOR]

Child abuse is one of the medico-legal issues a physician may face during his/her clinical practice. It has devastating effects on both the child and family, especially psychological. If falsely identified as a child abuse case, it could result in detrimental consequences. Therefore, physicians must recognise and be able to rule out child abuse mimickers, which are often conditions that are mistakenly confused with true physical child abuse. Injuries like bruises and burns are common presentations and therefore it is important to consider cutaneous abuse mimics to avoid incorrect diagnosis of child abuse. This review article sheds light on the most common cutaneous conditions that can mimic physical child abuse, where patients present with patterns of various skin lesions that raise a suspicion of child abuse. [ABSTRACT FROM AUTHOR]

Objectives: To compare the accuracy of point-of-care capillary and venous/arterial samples to laboratory testing of venous/arterial samples in critically sick shocked and non-shocked patients. This is a prospective case–control study including capillary, venous, and arterial blood samples from 268 critically ill patients. The King Fahd Military Medical Complex in Dhahran, Saudi Arabia, was the site of this investigation. Results: We were able to obtain data on 268 patients for this investigation. POCT and lab findings of venous and central blood did not differ significantly (P = 0.389 and 0.208), while POCT indicated somewhat higher results with venous glucose concentrations of 10.18 and 10.05 (POCT and lab tests respectively) and 9.18 and 9.54 (POCT and lab tests respectively). In addition, the mean differences between POC and laboratory analyses of venous, arterial, and central glucose were 0.13, − 1.75, and − 0.36 mmol/L for venous, arterial, and central glucose, respectively. Except for arterial blood glucose, we did not observe a significant difference between POCT and routine laboratory analysis of glucose concentrations in critically ill patients. Compared to laboratory blood analysis, the use of POCT is marginally accurate, with no difference between shocked and non-shocked patients. [ABSTRACT FROM AUTHOR]

Background: In‐depth insight into haemodynamic changes during normotensive pregnancy may help identify women at risk for gestational hypertensive complications. Objectives: To determine the magnitude of changes in cardiac output and its determinants stroke volume and heart rate, and total peripheral vascular resistance during singleton normotensive and hypertensive pregnancies. Search strategy: PubMed (NCBI) and Embase (Ovid) databases were searched from their inception up to November 2019. Selection criteria: Studies reporting original measurements of haemodynamic parameters during pregnancy together with a non‐pregnant reference measurement. Studies including women using antihypertensive medication were excluded. Data collection and analysis: Pooled mean differences between pregnant and non‐pregnant women, and absolute values of haemodynamic parameters were calculated for predefined gestational intervals using a random‐effects model in normotensive and hypertensive pregnancy. Meta‐regression analysis was used to analyse group differences in adjustments and absolute values during pregnancy. Main results: In normotensive pregnancies, cardiac output increased from the first weeks on, reaching its highest level early in the third trimester (mean difference, 1.41 l·min1; 95% CI 1.18–1.63 l·min). In parallel, vascular resistance decreased progressively until its nadir in the early third trimester (mean difference, −331 dyn·sec–1·cm–5; 95% CI −384 to −277 dyn·sec–1·cm–5) and then increased slightly at term. In hypertensive pregnancies, the initial cardiac output increase was higher and vascular resistance did not change throughout gestation compared with reference values. Conclusions: Hemodynamic changes in women who eventually develop hypertensive complications are substantially different. Serial monitoring and plotting against developed normograms can identify women at risk and may allow timely intervention. Monitoring haemodynamic changes in pregnancy helps identify women at risk for hypertensive complications. Monitoring haemodynamic changes in pregnancy helps identify women at risk for hypertensive complications. [ABSTRACT FROM AUTHOR]

Copyright of Boletín Latinoamericano y del Caribe de Plantas Medicinales y Aromáticas is the property of Universidad de Santiago de Chile and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Polycarbonate (PC) has a wide range of applications in the electronic, transportation, and biomedical industries. In addition, investigation on the applicability to use PC in superstrate photovoltaic modules is ongoing research. In this paper, PC is envisioned to be used as a material for structural components in renewable energy systems. Usually, structural components have geometrical irregularities, i.e., notches, and are subjected to severe mechanical loading. Therefore, the structural integrity of these components shall consider fracture analysis on notched specimens. In this paper, rectangular PC specimens were machined with straight U-notches having different radii and depths. Eight different notch radii with a depth of 6.0 mm were tested. In addition, three notch depths with a radius of 3.5 mm were considered. Quasi-static fracture tests were performed under displacement-controlled loading with a speed of 5 mm/min. Digital image correlation technique was used to capture the strain fields for un-notched and notched specimens. It was assumed that fracture occurs at the onset of necking. The equivalent material concept (EMC) along with the strain energy density criterion (SED) were employed to estimate the fracture load. The EMC-SED combination is shown to be an effective and practical tool for estimating the fracture load of U-notched PC specimens. [ABSTRACT FROM AUTHOR]

Objective: To determine the distribution of urinary incontinence (UI) symptoms and their relation to childbirth events. Methods: This cross-sectional study used a structured self-administered questionnaire that included the Questionnaire for Female Urinary Incontinence Diagnosis and the Urogenital Distress Inventory Short Form. The study included 802 women sampled from four primary health care centers in Dammam, KSA. A chi-square test and adjusted logistic regression models were used to examine the relation between UI symptoms and obstetric events. Results: Of the participants, 56.6% (n = 454) had at least one UI symptom. Symptoms were most commonly associated with grand multiparity (80.47%), a history of abortion (72%), assisted vaginal delivery (70%), an age of ≤ 18 years at first birth (66.67%) and ≥ 35 years at last birth (75.48%), and a history of macrosomia (84.62%) and episiotomy (67.89%). Unlike the risk of urgency UI, the risk of stress UI was statistically significantly linked to obstetric events. Grand multiparity was associated with a higher risk of both stress UI (odds ratio [OR]: 3.75, confidence interval [95% CI]: 1.68–8.40) and urgency UI (OR: 2.87, 95% CI: 1.07–7.73). Conclusion: UI symptoms are common among grand multiparas. Unlike urgency UI, stress UI is associated with previous obstetric events. [ABSTRACT FROM AUTHOR]

Background: Osteoporosis (OP) is a silent systemic disease characterized by decrements in bone mineral density (BMD) and bone microstructure. This study aimed to determine the status of bone quality as well as to investigate the relationship between the glycaemic; lipid; bone profiles; and the BMD. Methods: A retrospective study was conducted at KFHU, Al Khobar, Saudi Arabia analysis of patients who underwent BMD testing between the periods of 2016 to 2018. Based on the T scores, patients were classified as follows: normal (>−1.0), osteopenic (−1.0 to −2.5), or osteoporotic (≤−2.5). Details about medical and demographic information as well as metabolic and bone profiles (fasting blood glucose [FBG], glycated haemoglobin [HbA1c], cholesterol [Chol], high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides [TG], calcium [Ca], phosphorus [Ph], alkaline phosphatase [ALP], vitamin D 25OHD [Vit D]) were extracted from the medical records system. Results: Out of 4838 extracted profiles, there were 4196 females (85.1%). The mean glycaemic variables of patients showed an abnormal profile (FBG 118 ± 49 and HbA1c 6.6 ± 2). The mean T score showed that the majority of patients had either osteopenic (40%) or osteoporotic (24%) changed. Significant increase in mean HbA1c (7.6 ± 1.7) was obvious among the osteopenic patients when judged against the normal (7.5 ± 1.6; P < 0.033) and osteoporotic (7.4 ± 1.8; P < 0.037). Meanwhile, the mean serum ALP was significantly lower (81 ± 26) in the normal group than in the osteopenic (86 ± 33; P < 0.006) and osteoporotic groups (90 ± 40; P < 0.001). Finally, a linear, logistic regression analysis was found that Ca and ALP levels were significant predictors. Conclusion: This study finds that the main cause that affects bone quality in Saudi Arabia is diabetes mellitus and/or its related metabolic alteration. These results suggest that bone health is clinically significant and should be carefully assessed in diabetes patients. [ABSTRACT FROM AUTHOR]

abstracts of potential suitable studies. The final selection was made after reading the full retrieved articles. A methodological score developed by Lagravère was used to assess the quality of evidence. The selection process was illustrated using a PRISMA flow chart. Results: A total of 3942 articles were retrieved, from which only two randomized clinical trials met the inclusion criteria. This presented a low to medium level of evidence to support the hypothesis that TADs are more effective than other orthodontic intrusion techniques for intruding upper incisors and improving upper incisor to lip relation while eliminating the adverse effect of compromising vertical posterior anchorage. Shorter treatment times and less root resorption were found in the TAD group. Conclusion: There is insufficient evidence to state that TADs can be used as orthodontic anchorage to effectively intrude the incisors without the need for patient cooperation. Future high quality prospective randomized clinical trials are required. [ABSTRACT FROM AUTHOR]

Copyright of Saudi Medical Journal is the property of Saudi Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Black pepper (Piper nigrum; BP), known as the 'king of spices', imported from various countries is widely available in Saudi Arabian markets, as its demand as a food as well as a medicine for minor ailments is increasing in the country. However, there is a lack of appropriate information regarding these samples in terms of quality variation and standardization. We thus aimed to evaluate the quality and standardize the BP sample with respect to its physicochemical characters, active principle variation [i.e. piperine (PPN)], toxicity, and biological activity. The main focus is to validate whether any difference exists in the quality and quantity of active principle in these samples. For this purpose, physicochemical (chemical tests and ash values) and instrumental analyses [accelerated solvent extraction (ASE), ultra‐high‐pressure liquid chromatography (UHPLC)‐diode array detector, infrared (IR), nuclear magnetic resonance (NMR), and inductively coupled plasma‐MS (ICP‐MS)] and biological evaluation {in vitro antioxidant activity [2,2‐diphenyl‐1‐picrylhydrazyl and 2,2′‐azino‐bis(3‐ethylbenzothiazoline‐6‐sulfonic acid)] and cytotoxicity assay} were performed. An extract yield (g) with %recovery of 2.26 ± 4.24 (11.3) was obtained for the Vietnamese sample, using a fast and rapid method of extraction (ASE). These values were 1.22 ± 2.64 (6.1) and 0.75 ± 1.69 (3.75) for the Pakistani and Indian samples. Physicochemical tests revealed the presence of flavonoids and phenolic compounds in all samples; however, in the Vietnamese sample a low amount of total, acid‐insoluble, and high water‐soluble ash value was noted. IR and NMR was applied to further standardize the samples. Results of ICP‐MS analysis showed a high amount of macronutrients and micronutrients in the samples tested while UHPLC analysis revealed a high amount of PPN (ng/mL) in the Pakistani sample (1,362,614.09); these values were 1,051,848.04 and 768,512.81 for the Vietnamese and Indian samples, respectively. In vitro antioxidant and cytotoxicity activities revealed higher potential for the Vietnamese sample. The samples were properly standardized and effectively differentiated in terms of quality and biological activities using a fast and reliable method, however it certainly does not mean that a particular geographical region is more better or productive in terms of herbal products. [ABSTRACT FROM AUTHOR]

Background: Reporting critical values continues to receive a widespread attention from health care givers as it symbolizes a crucial clinic-laboratory link. This is because healthcare providers did realize the importance of prompt and timely communication of the critical results, which have positive implications on patient safety and treatment outcomes. In addition to physician and nurses, patients are also recipients of critical values, where they can make informed decisions prior to clinical intervention. The College of American Pathologists (CAP) requires stringent policies for reporting critical values in all laboratories, including adoption of a robust quality assurance system. Research studies have indicated that there still no universally accepted critical values list. This is because of various factors; such as differences in institutional organization, patient population, clinical demand, staffing, and instrumentation. However, through collaboration with other stakeholders involved in the delivery of healthcare, lab professionals may be able to come up with a realistic critical values list that reflects on the local needs and dynamics of patients’ service. Conclusion: This review offers an insight into the process of reporting critical values, some challenges encountered, as well as the policies and procedures of effective reporting with a particular focus on the guidelines of the College of American Pathologists. There should be a common global guideline introduced by the health care governing agencies to be adapted with some flexibility in clinical laboratories in different clinical settings. [ABSTRACT FROM AUTHOR]

SATB2‐associated syndrome (SAS) is an autosomal dominant neurodevelopmental disorder caused by alterations in the SATB2 gene. Here we present a review of published pathogenic variants in the SATB2 gene to date and report 38 novel alterations found in 57 additional previously unreported individuals. Overall, we present a compilation of 120 unique variants identified in 155 unrelated families ranging from single nucleotide coding variants to genomic rearrangements distributed throughout the entire coding region of SATB2. Single nucleotide variants predicted to result in the occurrence of a premature stop codon were the most commonly seen (51/120 = 42.5%) followed by missense variants (31/120 = 25.8%). We review the rather limited functional characterization of pathogenic variants and discuss current understanding of the consequences of the different molecular alterations. We present an expansive phenotypic review along with novel genotype‐phenotype correlations. Lastly, we discuss current knowledge of animal models and present future prospects. This review should help provide better guidance for the care of individuals diagnosed with SAS. [ABSTRACT FROM AUTHOR]

The concept of cloud-provided IT solutions has changed from being an emerging technology to a reality that most large corporations have adopted or are planing to adopt. Accordingly, many companies have already moved some of their applications or a portion of their infrastructure to the cloud. This adoption varies between the different categories of cloud offerings: Software as a Service (SaaS), Platform as a Service (PaaS), and Infrastructure as a Service (IaaS). This paper will discuss the challenges of cloud adoption from the three perspectives of successful organizations: people, process, and technology. [ABSTRACT FROM AUTHOR]

Background: Cytosolic deacetylase histone deacetylase 6 (HDAC6) is involved in the autophagy degradation pathway of malformed proteins, an important survival mechanism in cancer cells. We evaluated modulation of autophagy-related proteins and cell death by the HDAC6-selective inhibitor C1A.Methods: Autophagy substrates (light chain-3 (LC-3) and p62 proteins) and endoplasmic reticulum (ER) stress phenotype were determined. Caspase-3/7 activation and cellular proliferation assays were used to assess consequences of autophagy modulation.Results: C1A potently resolved autophagy substrates induced by 3-methyladenine and chloroquine. The mechanism of autophagy inhibition by HDAC6 genetic knockout or C1A treatment was consistent with abrogation of autophagosome-lysosome fusion, and decrease of Myc protein. C1A alone or combined with the proteasome inhibitor, bortezomib, enhanced cell death in malignant cells, demonstrating the complementary roles of the proteasome and autophagy pathways for clearing malformed proteins. Myc-positive neuroblastoma, KRAS-positive colorectal cancer and multiple myeloma cells showed marked cell growth inhibition in response to HDAC6 inhibitors. Finally, growth of neuroblastoma xenografts was arrested in vivo by single agent C1A, while combination with bortezomib slowed the growth of colorectal cancer xenografts.Conclusions: C1A resolves autophagy substrates in malignant cells and induces cell death, warranting its use for in vivo pre-clinical autophagy research. [ABSTRACT FROM AUTHOR]

Moyamoya disease is a chronic cerebrovascular disorder with progressive stenosis. We describe a four-yr-old female with features of moyamoya disease referred to our center for kidney transplant evaluation with ESRD secondary to presumed renal dysplasia along with concern for cerebral vascular anomalies. With her constellation of organ involvement, a genetic workup revealed a homozygous, frameshift mutation in the mitochondrial methionyl-tRNA formyltransferase gene. Given her vascular anomalies and evidence of prior infarcts seen on cerebral imaging, it was felt that her risk of future stroke events was high and that hypotension or intravascular volume depletion would further exacerbate this risk. In hopes of improving her tenuous cerebral perfusion, she underwent a bilateral temporal craniotomy for superficial temporal artery to middle cerebral artery bypass. We highlight the challenges faced in a child with ESRD and kidney transplantation when cerebral vasculature is compromised. A multidisciplinary approach is critical in determining the need for a revascularization procedure prior to transplant and to help reduce the risk of ischemic or hemorrhagic events in this patient population. [ABSTRACT FROM AUTHOR]