Search

Background and aim Despite improving the 10-year disease-free-survival, prophylactic central neck dissection (pCND) in differentiated thyroid carcinoma (DTC) should only be considered in patients with high risk factors for lymph node (LN) metastasis due to the increases in the risk of postoperative complications. Our aim was to identify the risk factors for central lymph node metastasis (CLNM) in DTC. Method We searched PubMed, Scopus, Web of science, Cochrane library for eligible studies from inception to November 1, 2021 and a systematic review and meta-analysis were carried out to identify the risk factors for CLNM in DTC. Results We included 41 studies with total of 27,741 patients in this study. The pooled results in this meta-analysis showed that these risk factors were significantly associated with CLNM: age p p p p p p p Conclusion Young age (

Background: In the developed countries, pulmonary thromboembolism associated with pregnancy (VTE) continues to be the principal cause of direct maternal death. Despite thorough treatment and preventative recommendations from several national authorities, reductions in mortality due to VTE have been negligible. Anticoagulation is still the cornerstone of prenatal care and has to be given to all patients with proven or high-risk PE. The preferred medication is low molecular weight heparin (LMWH), which has a known pharmacodynamic profile. Despite the massive utilization of these drugs there is actually little evidence supporting their efficiency in recurrent pregnancy loss reduction. Objectives: The study aims to summarize current evidences regarding the usage of anticoagulants and thrombolytics in Pregnancy. Methods: For article selection, the PubMed database and EBSCO Information Services were used. All relevant articles relevant with our topic and other articles were used in our review. Other articles that were not related to this field were excluded. The data was extracted in a specific format that was reviewed by the group members. Conclusion: A common cause of maternal death, pulmonary embolism-related fatalities still occur often in pregnant women with pulmonary embolism. One-third of pregnant women with pulmonary embolism and hemodynamic failure were reported to undergo systemic thrombolysis. There is an urgent need to improve prevention and care techniques for this vulnerable patient population. LMWHs are widely used for several different purposes as well as for the treatment and prevention of VTE during pregnancy and puerperium. Although the medicine has been found to be both safe and effective, there is no scientific proof to support its usage for all indications. In pregnant women with thrombophilia who are at high risk of developing these issues, prenatal prophylactic dalteparin does not prevent venous thromboembolism, pregnancy loss, or placenta-mediated pregnancy difficulties and is linked to an increased risk of mild bleeding. Enoxaparin may not offer any meaningful benefits to people suffering from recurrent abortion. However, in one study, the miscarriage rate was significantly lower when enoxaparin was used compared with untreated controls.

Background: Hemoglobin A1C (HbA1c) levels are known to be linked to a higher risk of stroke. However, no research data is available on the impact of HbA1C on the severity of acute ischemic stroke in Sudan. Methods: This study is a descriptive, cross-sectional hospital-based study of 40 cases of acute ischemic stroke. Ischemic stroke was confirmed using computed tomography (CT) scan at admission; all subjects’ blood HbA1C levels were also measured. Participants were divided into two subgroups based on HbA1C at admission, good glycemic control (GGC) (7 HbA1C), and neurological impairment was assessed using the National Institutes of Health Stroke Scale (NIHSS). Results: The age distribution of the participants was 45-85 years, with an average age of 63.5±9.2 years with the highest frequency (67.5%) in the age group of 55-75 years. PGC had a statistically significant high HbA1C value of 8.9±1.3 (P=0.000), when compared to GGC subgroups 5.1±0. The association between stroke severity and HbA1C levels on admission in this study was statistically significant (P value=0.005), on admission (78.6%) PGC had moderate to severe stroke (> 18.8 NIHSS) versus (33.3%) that of the GGC (>10.4NIHSS). The frequency of elevated HbA1C levels in patients with acute ischemic stroke was 70% in this study. Conclusion: PGC was shown to be linked to the occurrence of stroke and to its severity.

The factors associated with small industrial business have a significant impact on their performance and they need to be determined considering their contribution to the business performance. This study aims to recognize a set of variables that have the paramount impact on the performance of small industrial business. It also constructs a statistical model that is used to estimate the probability of faltering for any small industrial enterprise, and to determine its expected survival time. It applies cluster analysis to classify depending on variables, i.e., faltering and non-faltering using Cox’s regression model. Incredibly, the obtained results show that (i) the most influential variables affecting the success or failure of a small industrial business are: establishment expenses, workers’ wages, and cost of marketing products, (ii) the maximum degree of risk to small industrial business was during the fifth, sixth and seventh years, and the average lifetime of a small industrial enterprise ranged from 8 to 9 years. The results indicate that stakeholders must consider the faltering variables when making business decisions and looking into the policies’ implementation after the ninth year of the variables’ adoption.

Background: Tobacco misuse has not been universally acknowledged as a modifiable risk factor in diabetes preventive or screening methods, despite mounting data revealing substantial epidemiological and mechanistic connections between smoking, hyperglycemia, and the development of type 2 diabetes. Purpose:A growing number of research on the effect of smoking cessation on the development of type 2 diabetes mellitus. The goal of this systematic review was to search the available evidence on the impact of smoking cessation and risk for type 2 diabetes mellitus. Methods: We searched PubMed, Embase, and Scopus (January 1995--October 2022) for prospective observational studies that evaluated the effects smoking and smoking cessation as risk factors for type 2 diabetes mellitus. Results: Type 2 diabetes risk was increased by a factor of 1.37 (95% CI: 1.33 to 1.42) for current smokers, 1.14 (1.10 to 1.18) for ex-smokers, and 1.22 (1.10 to 1.35) for passive smokers, compared to those who had never smoked (7 studies). The associations persisted across all subgroups, and a dose-response relation was discovered between current smoking and diabetes risk, with the RRs (95% CIs) for light, moderate, and heavy smokers, compared with never smokers, being 1.21 (1.10-1.33), 1.34 (1.27-1.41), and 1.57 (1.47-1.66), respectively. If there is a causal relationship between smoking and diabetes, we calculated that 10% in men and 2% in women of all instances of type 2 diabetes globally (about 25 million) may be attributed to smoking. The pooled RR (95% CI) from 10 studies showed that recent ex-smokers (within 5 years) had a lower risk of relapse than never smokers, while long-term ex-smokers (within 10 years) had a lower risk of relapse than current smokers. Conclusion: Both active and passive smoking are strongly connected with higher risks of type 2 diabetes. The risk of diabetes is higher among recent ex-smokers, although it lowers significantly with time.

Background: Hemoglobin A1C (HbA1c) levels are known to be linked to a higher risk of stroke. However, no research data is available on the impact of HbA1C on the severity of acute ischemic stroke in Sudan. Methods: This study is a descriptive, cross-sectional hospital-based study of 40 cases of acute ischemic stroke. Ischemic stroke was confirmed using computed tomography (CT) scan at admission; all subjects’ blood HbA1C levels were also measured. Participants were divided into two subgroups based on HbA1C at admission, good glycemic control (GGC) (7 HbA1C), and neurological impairment was assessed using the National Institutes of Health Stroke Scale (NIHSS). Results: The age distribution of the participants was 45-85 years, with an average age of 63.5±9.2 years with the highest frequency (67.5%) in the age group of 55-75 years. PGC had a statistically significant high HbA1C value of 8.9±1.3 (P=0.000), when compared to GGC subgroups 5.1±0. The association between stroke severity and HbA1C levels on admission in this study was statistically significant (P value=0.005), on admission (78.6%) PGC had moderate to severe stroke (> 18.8 NIHSS) versus (33.3%) that of the GGC (>10.4NIHSS). The frequency of elevated HbA1C levels in patients with acute ischemic stroke was 70% in this study. Conclusion: PGC was shown to be linked to the occurrence of stroke and to its severity.

Objectives: The purpose of this study is to develop a new and improved polyurethane (PU) graft using electrospinning and chemical modifications for hemodialysis patients, which will replace the current standard, polytetrafluoroethylene (PTFE) graft. The chemical modifications aim to improve hemocompatibility and reduce thrombogenicity and neointimal hyperplasia. Method: The study population was randomized and divided equally into four groups; one control group received a PTFE graft, and three treatment groups received three different types of polyurethane grafts. Two duplex measurements were performed directly on the graft on the same locations, followed by a histologic examination. Results: In the first few days after the implantation animals lost some weight, it took a week to recover to pre-surgical weight. Throughout the 28 days, there was no significant difference between animals in wound, activity, and the general appearance. PTFE and PU A groups have lower compliance or reduced graft diameter due to neointimal hyperplasia development on Doppler interrogation. The histological analysis showed limited neointimal hyperplasia development and no excessive inflammatory response to any of the grafts. Conclusion: This study demonstrates that animals with polyurethane grafts show better blood flow because the developed NIH was inconspicuous, as indicated by the different velocity measure than controls on Duplex and minimal NIH development microscopically

Objective: To identify bacteraemia of Stenotrophomonas maltophilia, susceptibilities, and which antibiotic was used. Methods: A record-based retrospective study was conducted on those who were admitted to Armed Forces Hospital Southern Region – Khamis Mushet, Saudi Arabia, during the period from January 2017 until January 2021 and who had positive blood culture for Stenotrophomonas maltophilia during admission. Results: We collected data from 34 patients with mean age of 65.4 years old (SD=19.9). Moreover, we found that 73.5 % of the patients were males. Intubation was reported among 61.8 % of the patients with mean duration of 12.6 days. Moreover, tracheostomy was reported in 35.3 % of the patients with mean duration of 52.5 days. Single antibiotic regimen was applied in 67.6 % of cases while two- antibiotics regimen was applied in 32.4 % of them. Ceftazidime was used in 55.9 % of the patients, levofloxacin was used only in 23.5 % of the patients and trimeth/sulfa was used in 41.2 % of the patients. According to susceptibility tests, ceftazidime showedthe highest level of resistance (27.3 %) and trimeth/sulfa showed the highest level of sensitivity Conclusion: We found that our drug of choice is trimeth/Sulfa when considering treatment of positive patients with S. maltophilia. Stenotrophomonas incidence is common in patients with comorbidities than the normal population. Keywords: Stenotrophomonas maltophilia bacteraemia, prevalence, outcome

Background:Gastric cancer (GC) is one of the most frequent malignancies and has a great degree of heterogeneity. Creating a particular predictive model is critical to enhancing treatment options. Reaction to H.pylori may cause Pyroptosis, a significant carcinogen; in addition, the treatment in response to chemotherapy medications. However, In this study, We found that 17 pyroptosis-regulating proteins were produced differently in gastric tissue that had developed tumors and GC cells. Results:The prognostic significance of each pyroptosis-related gene was examined using the Cancer Genome Atlas (TCGA) cohort. Shrinkage-selection operator (LASSO) was applied to provide a better result for the regression technique. GC patients in the TCGA cohort were classified as low- or high-risk based on their gene profile. Low-risk GC patients had an increased chance of survival than high-risk individuals (P < 0.0001). A subgroup of GC patients from a GEO cohort was separated based on their overall survival (OS) time. Overall survival time for low-risk patients was more significant (P = 0.0063). Conclusions:The GC risk score was discovered to become an independent predictor of the overall survival (OS) in patients with GC. A gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis found that genes involved in a high-risk group had much higher concentrations of the immune system, and the state of immunity was shown to be reduced in this group. The cancer immune response is intricately linked to pyroptosis genes, and they could be utilized to predict the prognosis of GCs.

Background Various tumor characteristics might lead to inaccurate local MRI-defined stage of rectal cancer and the purpose of this study was to explore the clinicopathological factors that impact on the precision pre-treatment MRI-defined stage of rectal cancer. Methods A retrospectively analysis was conducted in non-metastatic rectal cancer patients who received radical tumor resection without neoadjuvant treatment during 2007–2015 in the Sixth Affiliated Hospital of Sun Yat-sen University. Clinical T stage and N stage defined by pelvic enhanced MRI and pathological stage were compared and patients were subdivided into accurate-staging, over-staging and under-staging subgroups. Logistic regressions were used to explore risk factors for over-staging or under-staging. Results Five hundred fifty-one cases of patients were collected. Among them, 109 cases (19.4%) of patients were over-T-staged and 50 cases (8.9%) were under-T-staged, while 78 cases (13.9%) were over-N-staged and 75 cases (13.3%) were under-N-staged. Logistic regression suggested that pre-operative bowel obstruction was risk factor for over-T-staging (OR = 3.120, 95%CI: 1.662–5.857, P P P P = 0.024) and higher risk for over-N-staging (OR = 1.434, 95%CI: 1.223–1.680, P Conclusion Bowel obstruction, mucinous adenocarcinoma and tumor size might have impact on the pre-operative MRI T staging or N staging of rectal cancer. Our results reminded clinicians to assess clinical stage individually in such rectal cancer patients.

Background: Physical activity (PA) surveillance, policy, and research efforts need to be periodically appraised to gain insight into national and global capacities for PA promotion. The aim of this paper was to assess the status and trends in PA surveillance, policy, and research in 164 countries. Methods: We used data from the Global Observatory for Physical Activity (GoPA!) 2015 and 2020 surveys. Comprehensive searches were performed for each country to determine the level of development of their PA surveillance, policy, and research, and the findings were verified by the GoPA! Country Contacts. Trends were analyzed based on the data available for both survey years. Results: The global 5-year progress in all 3 indicators was modest, with most countries either improving or staying at the same level. PA surveillance, policy, and research improved or remained at a high level in 48.1%, 40.6%, and 42.1% of the countries, respectively. PA surveillance, policy, and research scores decreased or remained at a low level in 8.3%, 15.8%, and 28.6% of the countries, respectively. The highest capacity for PA promotion was found in Europe, the lowest in Africa and low- and lower-middle-income countries. Although a large percentage of the world’s population benefit from at least some PA policy, surveillance, and research efforts in their countries, 49.6 million people are without PA surveillance, 629.4 million people are without PA policy, and 108.7 million live in countries without any PA research output. A total of 6.3 billion people or 88.2% of the world’s population live in countries where PA promotion capacity should be significantly improved. Conclusion: Despite PA is essential for health, there are large inequalities between countries and world regions in their capacity to promote PA. Coordinated efforts are needed to reduce the inequalities and improve the global capacity for PA promotion.

Many of the phonetic aspects of Qur’ān (the Holy book of Muslims) are yet to be investigated experimentally. This dissertation aims to investigate the acoustic and the articulatory parameters of the Qur’ānic pharyngealised consonant and vowel sounds. The articulatory units of the Qur’ānic pharyngealised syllable require grounded experimental investigation to accurately identify their nature. This thesis consists of seven chapters. Chapter One provides a broad account of the aim of the study as well as of the Qur’ān as the source book. It also discusses the language and orality (primarily oral nature) of the Qur’ān. The chapter introduces Tajwīd as the representational and traditional phonetic system for the recitation of the Qur’ān. Tajwīd (which means improving the recitation of the Qur’ān) has not been adequately or completely presented in any Western language. There have been a number of experimental endeavours examining particular aspects of Tajwīd. This study fills a gap by examining the pharyngealised sounds of Tajwīd. Chapter Two discusses the phonetic contributions of classical Arab and Muslim investigators especially in the domains of Tajwīd and Qur’ānic sounds. It also outlines the important contributions of classical Arabic linguists such as Al-Khalīl, Sibawayh, and Ibn Jinni in the study of Arabic and Qur’ānic sounds. Both classical and contemporary contributions to Tajwīd are of special interest to the current research as they are the base of all subsequent research and experimental studies in the Qur’ānic sounds. This chapter also discusses the phonetic characteristics of the Arabic pharyngealised and uvularized sounds. Chapter Three explores Qur’ānic pharyngealisation; known as Tafxīm, with a particular emphasis on the seven Qur’nic pharyngealised consonant and vowel sounds, and discusses the most appropriate name for the Qur’ānic Tafxīm feature. The chapter focuses on the classification of the Qur’ānic pharyngealised sounds as well as their articulatory parameters and their degrees of pharyngealisation. The description of the Qur’ānic pharyngealised sounds is incomplete without a physiological account for each sound. This chapter discusses and describes the pharynx, the tongue, and the lips, as they are the most important articulators of the Qur’ānic pharyngealised sounds. Chapter Four reports on an acoustic analysis of the Qur’ānic pharyngealised sounds. In order to examine the phonetic parameters of these Qur’ānic sounds, three groups of male reciters were employed for the purpose of recitation. These three groups encompass all levels of Qur’ānic recitation in Islamic world today. Acoustic analysis of the sounds of the reciters in these groups showed clear acoustic differences between the pharyngealised sounds recited by each group, and by contrasting the acoustic results of the super-standard recitations with those of professional and non-professional reciters provided a characterisation of the acoustics of the super-standard recitation of the Qur’ānic pharyngealised sounds. Qur’ānic pharyngealised sounds are also compared with the Arabic pharyngealised sounds. The findings of this experiment are crucially important for those who want to perfect their recitation of the Qur’ānic pharyngealised sounds as well for those who want to assess, classify, or improve Qur’ānic recitation. Chapter Five outlines the procedure and results of an articulatory experiment. This chapter examines the articulatory features of the Qur’ānic pharyngealised consonants and vowels. A videofluorographic experiment was undertaken to examine the Qur’ānic pharyngealised sounds in motion. A series of X-ray frames of every sound in examined this study show the sequence of articulation from the release of the consonant to the start of the stable target of the following Qur’ānic pharyngealised vowel. The Qur’ānic samples accompanying this videofluorographic experiment were extracted and acoustically analysed to compare the articulatory configurations of the sounds with their acoustic correlates. Chapter six discusses the findings of the acoustic and the articulatory experiments of this research. It also focuses on the relation between the findings of each experiment and how to relate them to each other. This chapter commences with a discussion of the nature of the Qur’ānic pharyngealised vowel sound and is then followed by a discussion of the various experimental results. It will also discuss the nature of the Qur’ānic vowel as well as the main acoustic and articulatory features that characterise the Qur’ānic pharyngealisation such as vowel duration and the distance between F3-F2. The idea of the auditory integration of the spectral peaks especially F1-F2 and F3-F4 will be examined for a better understanding on how the human brain deals with these Qur’ānic pharyngealised vowel sounds. Chapter seven concludes and summarises this research with an overview of the main points and results of the experiments of this research in the light of the studies mentioned in literature review (Chapter Two). This chapter also recommends some further studies that need to be undertaken on the Qur’ānic pharyngealised sounds.

The most prevalent sleep-related breathing condition, obstructive sleep apnea (OSA), is linked to greater morbidity and poor cardiovascular outcomes. Even though sleep disorders are frequently present, primary care physicians hardly see or treat them. Better OSA symptom and intensity identification and classification to support OSA evaluation and diagnosis were the first outcomes of a task group of the American Academy of Sleep Medicine that produced quality metrics for the treatment of adult patients with the condition in 2015. The OSA screening tools (Berlin questionnaire, Epworth sleepiness scale, STOP Bang) have proven to be effective instruments for screening of sleep disorders. The present primary care practice approach for OSA screening and evaluation is disorganized and inadequate. Patients with OSA symptomatology are seen by primary care physicians, but they are not regularly screened, assessed, or referred to a sleep specialist. For the OSA screening assessments in general practice, more psychometric investigations are required. The findings from these investigations can be applied in real-world settings to improve OSA identification.

Undisputedly, healthy behaviours and lifestyles have a positive impact on health outcomes, and its individual, social, environmental, and cultural determinants are well understood. Primary care physicians can effectively intervene with patients to encourage healthy behaviour through numerous chances. Regular clinical practice includes health promotion as a necessary element. Health systems can support a person's health requirements through primary health care, including illness prevention, treatment, palliative care, and more. This approach also guarantees that the delivery of healthcare is centred on patients' needs and supports their preferences. Regular care must incorporate health promotion strategies if the healthcare system is to be effective. Giving individuals the information, they need to improve and take better control of their health is the goal of health promotion. Primary care physicians are the immediate contact with the community which makes them the ideal candidates for health promotion and education. The purpose of this research is to review the available information about the role of primary care physician in health promotion and education. Health promotion and education is necessary for the prevention of diseases as it aids in educating population regarding diseases and risk factors. Also, because of its accessibility to care and continuity of treatment, primary healthcare is in a prime position to potentially intervene to modify unhealthy habits. Primary care physicians being first line of contact plays a key role in this regard. Although further research is needed for the implementation of health promotion and education strategies by primary care physicians.

Reservoir rock textural properties such as grain size are typically estimated by direct visual observation of the physical texture of core samples. Grain size is one of the important inputs to petrophysical characterization, sedimentological facies classification, identification of depositional environments, and saturation models. A continuous log of grain size distribution over targeted reservoir sections is usually required for these applications. Core descriptions are typically not available over an entire targeted reservoir section. Physical core data may also be damaged during retrieval or due to plugging. Alternative methods proposed in literature are not sustainable due to their limitations in terms of input data requirements and inflexibility to apply them in environments with different geological settings. This paper presents the preliminary results of our investigation of a new methodology based on machine learning technology to complement and enhance the traditional core description and the alternative methods. We developed and optimized supervised machine learning models comprising K-nearest neighbor (KNN), support vector machines (SVM), and decision tree (DT) to indirectly estimate reservoir rock grain size for a new well or targeted reservoir sections from historical wireline logs and archival core descriptions. We used anonymized datasets consisting of nine wells from a clastic reservoir. Seven of the wells were used to train and optimize the models while the remaining two were reserved for validation. The grain size types range from clay to pebbles. The performance of the models confirmed the feasibility of this approach. The KNN, SVM, and DT models demonstrated the capability to estimate the grain size for the test wells by matching actual data with a minimum of 60% and close to 80% accuracy. This is an accomplishment taking into account the uncertainties inherent in the core analysis data. Further analysis of the results showed that the KNN model is the most accurate in performance compared to the other models. For future studies, we will explore more advanced classification algorithms and implement new class labeling strategies to improve the accuracy of this methodology. The attainment of this objective will further help to handle the complexity in the grain size estimation challenge and reduce the current turnaround time for core description.

To determine the in vivo elastic modulus of the human cornea using vibrational optical coherence tomography (VOCT).Vibrational analysis coupled with optical coherence tomography (OCT) was used to obtain the resonant frequency (RF) and elastic modulus of corneal structural components. VOCT corneal thickness values were measured using OCT images and correlated with corneal thickness determined with Pentacam (Oculus, Wetzlar, Germany). Moduli were obtained at two locations: central cornea (CC) and inferior cornea (IC). Measurements were obtained with and without anesthetic eye drops to assess their effect on the modulus measurements.VOCT thickness values correlated positively (R2 = 0.97) and linearly (y = 1.039x-16.89) with those of Pentacam. Five RF peaks (1-5) were present, although their presence was variable across eyes. The RF for peaks 1 to 5 in the CC and IC ranged from 73.5 ± 4.9 to 239 ± 3 Hz and 72.1 ± 6.3 to 238 ± 4 Hz, respectively. CC and IC moduli for peaks 1 to 5 ranged from 1.023 ± 0.104 to 6.87 ± 0.33 MPa and 0.98 ± 0.15 to 6.52 ± 0.79 MPa, respectively. Topical anesthesia did not significantly alter the modulus (P0.05 for all), except for peak 2 in the CC (P0.05).This pilot study demonstrates the utility of VOCT as an in vivo, noninvasive technology to measure the elastic modulus in human corneas. The structural origin of these moduli is hypothesized based on previous reports, and further analyses are necessary for confirmation.This work presents VOCT as a novel approach to assess the in vivo elastic modulus of the cornea, an indicator of corneal structural integrity and health.

IntroductionAs of 2015, as part of the implementation of the Welsh Government primary care plan and primary care clusters, the Welsh Government has encouraged non-medical healthcare professionals working in primary care to train as independent prescribers (IPs).ObjectivesThis research aimed to identify the number of NMIPs in primary care in Wales and describe their prescribing trend of items between 2011 and 2018, in order to compare their prescribing pattern before and after the implementation of primary care clusters for Wales.DesignRetrospective secondary data analysis and interrupted time series analysis in order to compare prescribing by non-medical independent prescribers (NMIPs) preimplementation and postimplementation of primary care clusters across Wales.ResultsOver the study period, 600 NMIPs (nurses n=474 and pharmacists n=104) had prescribed at least one item. The number of nurse IPs increased by 108% and pharmacists by 325% (pharmacists had the largest increase between July 2015 and March 2018). The number of items prescribed by NMIPs increased over time by an average of 1380 per month (95% CI 904 to 1855, pConclusionThe number of NMIPs and their volume of prescribing in primary care in Wales has increased following the implementation of primary care clusters in 2015. This suggests that the Government’s recommendations of using NMIPs in primary care have been implemented. Future studies should focus on efficiency and quality of prescribing by NMIPs in primary care.

The effluents containing the discarded water from the textile industry are graded as one of the foremost pollutants in all industrial sectors. The wide varieties of dyes, which is susceptible to the possibility of carcinogens or mutagens, and it will be harmful to entire ecosystem. The titanium dioxide, one of the foremost heterogeneous semiconductor photocatalysts, has been acknowledged for the wide applications in hydrogen production from water splitting and degradation of organic and inorganic pollutants since last few decades. The present work is successively advanced for the removal of methylene blue from the seawater. The work was carried under natural sunlight with the presence of C/TiO2 and Cu–C/TiO2. The photocatalytic removal experiment was carried out with different catalyst dosages (0.25–1.25 g/L), different initial concentrations from 5 to 30 µM and at different pH values (3–9). The highest removal rate was found at the optimum condition of pH 8 and 1 g/L. At the optimum condition, 100% efficiency was achieved under natural sunlight. The kinetic studies reveal the pseudo-first-order kinetics and half-life time comparison proves the enhanced visible light harvesting of Cu–C/TiO2.

Background: Despite the modern society and medical services, waiting in emergency department is taking too long time for patients in Saudi Arabia. Time spent in the emergency department is crucial and can affect the overall health outcomes. Knowing the time spent in the emergency department and overall patient’s satisfaction can provide an important information of health care that is provided in Saudi Arabia. Comparing the time spent in the emergency department in Saudi Arabia to other countries will help us know the quality of health care provided. Objectives: Waiting in the emergency department is a global issue not only in the developing countries but also in modern countries. This study aimed at assessing how long is the waiting time spent by patients in the emergency department before receiving the medical care and the overall patients’ satisfaction. Methods: A cross-sectional study on the time spent in the emergency department before getting help for patients in Saudi Arabia and overall patients’ satisfaction was carried out on 528 participants during the period from February to March 2018. Results: 42% of the participants, indicated that the main complain that brought them to the emergency department was in the abdominal area and 29.5% of the patients spent more than one hour before getting helped from healthcare providers. 18.8% of the participants evaluated the emergency department service by 1 out of 10. Conclusion: Ourresults showed that large number of patients was suffering from waiting too long time in the emergency department before receiving the required medical care.

Elevation of the intraocular pressure (IOP) is recognized as a risk factor for glaucoma development. Latanoprost (LAT) is a prostaglandin analog used to reduce the (IOP). Thymoquinone (TQ) is a major bioactive ingredient of Nigella sativa. The aim of this study was to develop novel liposomal drug carriers for ocular delivery of LAT, TQ and a mixture of them to investigate their IOP lowering efficacy upon subconjunctival injection in glaucoma-induced rabbit's eye. The aim of the present work extends also to study the effect of the different liposome formulations on the aqueous humor oxidative stress. Liposome samples were prepared using thin film hydration method. The physiochemical properties of the prepared drugs were characterized. The IOP was recorded for 70 rabbits using Schiotz-tonometer. Malondialdehyde (MDA), reduced glutathione (GSH), catalase (CAT) activities and total antioxidant activity of the aqueous humor were estimated. Fourier transform infrared and differential scanning calorimetric studies confirmed the interaction between the drug and the vesicles, which resulted in high drug encapsulation efficiency ≥88%. The size of the prepared liposomes was less than 10 μm which make them suitable in ophthalmic applications. The sustained effect was achieved by liposome samples of Lip (LAT) and Lip (LAT + TQ) which were able to reduce the IOP significantly up to 84 h. Morever, the treatment of glaucomatous rabbits with liposome formulations containing TQ in their preparation [Lip (TQ) and Lip (LAT + TQ)] greatly improved the ocular tissue-induced histopathological lesions. None of the prepared liposome formulations succeeded to improve the glaucoma-induced oxidative stress damage.

Background: anterior cruciate ligament injury is a serious medical problem that can increase morbidity and reduce the quality of life of patients. Although people practicing sports are at the highest risk of injury, other people are still at significant risk. Hence, the awareness of the general population towards the anterior cruciate ligament injuries is crucial. Objective: This survey analysis aims to explore the population perception of anterior cruciate ligament injury in the southern region, Saudi Arabia. Design and Setting: A self-administered structured questionnaire was distributed to the general public in the southern region, Saudi Arabia. The questions were in Arabic. The survey consists of sections including the socio-demographic variables, in addition to questions about population perception and practices related to anterior cruciate ligament injury. Data analysis was done through SPSS program version 24. Results: 549 participants fully responded to the questionnaire. Individuals aging between 18 and 24 years old showed significantly (P-value Conclusion: The awareness of the Saudi public in the southern region is considered satisfactory; further studies in other regions in the kingdom are mandatory to figure out the awareness of the Saudi population as a whole.

Introduction: Respiratory distress is considered a very common in the early neonatal stages. The incidence is estimated to be more than seven percent of newborn infants. There have been many studies conducted that focused on respiratory distress syndrome and chronic lung disease of prematurity in preterm infants however every year a marked number of term-born infants are admitted to neonatal units for treatment of their respiratory distress. Many clinical conditions could lead to respiratory distress in term newborn infants. Clinical conditions like surfactant protein deficiency syndromes or alveolar capillary dysplasia are seldom and there have been many reviews on them. A study showed that a trending in the incidence of respiratory distress of all neonates admitted to neonatal units between 1974 and 2004 relating three possible explanations: an increase in extremely low birth weight infants, modifications in admission guidelines and higher numbers of infants delivered by caesarean section. The effect of elective caesarean sections has particularly grew the incidence of respiratory distress in term infants. This has been established for several years. A study estimated that more than two thousand patients are diagnosed per year that needed neonatal admission for pulmonary diseases following caesarean section prior to the onset of labor in the UK alone. There were 706,248 live births in England and Wales in 2009 and approximately more than ninety percent of these were full term deliveries. Between 1990 and 2002, it is estimated that the admission rate to a busy neonatal unit in England was more than eight percent of all live births. The most common reason for admission was respiratory distress. There is an obvious inverse relationship between gestational age and incidence of respiratory distress most notably by transient tachypnoea of the newborn (TTN) and respiratory distress syndrome (RDS). Aim of work: In this review, we will discuss the most recent evidence regarding respiratory distress syndrome in neonates. Methodology: We did a systematic search for respiratory distress syndrome in neonates using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles. Conclusions: We summarized the most common causes of respiratory distress in term infants. TTN and RDS are considered very common particularly in infants delivered after elective caesarean sections however, they have good prognosis. Even delivery at 37 weeks gestation, is linked with higher respiratory morbidity so should be avoided wherever possible. Clinical conditions like pulmonary arterial hypertension that could be primary or secondary to RDS, MAS or CDH will respond in most cases to oxygen therapy, mechanical ventilation including high frequency ventilation, inhaled nitric oxide or inotropes but ECMO should be considered if the respiratory failure does not respond to maximum medical therapy. The early recognition and initiation of appropriate management is important to ensure the optimal outcome for all infants presenting with respiratory distress. Key words: Respiratory Distress Syndrome, Neonates, Presentation, Management.

Background: Obesity is a common cause of significant morbidity in the population. In addition, it effect people personality and self-confidence. As a result, people with obesity undergo bariatric surgery to reduce their weight in fast way. Objective: A lot of literature published in regard of evaluation role of bariatric surgery in development of cholelithiasis. In our review we aim to assess the recent literatures in order to provide a simple yet comprehensive summary. Methods: PubMed database was used for articles selection, and the following keys used in the mesh {Bariatric Surgery, Gallbladder stones, bariatric surgery complication} A total of 6 articles were enrolled according to our inclusion and exclusion criteria. Conclusion: Rapid loos of weight as a result of bariatric surgery is associated with gallstone formation. Prophylaxis cholecystectomy after bariatric surgery is not indicated because only small percentage might develop a symptomatic cholecystitis, but the use of Ursodeoxycholic acid) in the first 6 months is advised.

Hemorrhoid ailment is one of the most common factor patients seek analysis by a colon and anal specialist. Most of piles can be managed nonoperatively with medical management or office-based procedures. In this paper surgical treatment methods, their indications and complications are reviewed. Conducted a detailed search among electronic databases: MEDLINE, EMBASE, and Google scholar, searching in literature for articles related to surgical options and indication of hemorrhoidectomy. Studies were included as publication up to 2018. The surgical alternatives for the therapy of hemorrhoids are lots of; and although the majority of surgical strategies are based upon the ligation and excision principles, more recent methods are made to lessen tissue breakdown with the goal of decreasing postoperative discomfort and bleeding. Indications for surgical hemorrhoidectomy include symptomatic hemorrhoids too comprehensive for nonoperative management, failure of medical therapy, and concomitant conditions, such as anal fissures or ulcers, that call for surgery. Standard hemorrhoidectomy, including open and shut methods, is accepted as the gold-standard for surgical treatment of hemorrhoids worldwide.

Hydroxyl-ion conductive poly(2,6-dimethyl-1,4-phenylene oxide) (PPO) membranes with different characteristics were prepared via relatively simple bromination/amination serial reactions with reduced number of involved chemicals and shorter reaction time. The effects of reactants ratio, reaction atmosphere, polymer concentration, casting solvent, and hydroxylation treatment on reaction were investigated in details. The microstructure, water uptake, swelling ratio, ion-exchange capacity and ionic conductivity of the membranes were also studied. The obtained results demonstrate that, the ionic conductivity of the membrane is dependent on casting solvent. The N-methyl-2-pyrrolidonecast membrane exhibits the highest conductivity with the thinnest film. Although the membrane was prepared via a relatively simple preparation route with least toxic chemicals, a competitive ionic conductivity value of 1.64 x 10(-2) S cm(-1) was achieved at 60 degrees C. A power density of 19.5 mW cm(-2) has been demonstrated from the alkaline membrane fuel cell operated at 70 degrees C. assembled from the entirely homemade membrane electrode assembly without any hot-pressing.

A new 15 kDa Bowman-Birk type trypsin inhibitor (termed VFTI-E1) from fava beans (Vicia faba cv. Egypt 1) was isolated using liquid chromatography. Though it exhibited substantial homology in N-terminal amino acid sequence to other protease inhibitors, VFTI-E1 showed antiproteolytic activity against trypsin (K(i) 11.9 × 10(-9) M) but hardly any activity against chymotrypsin. It demonstrated antifungal activity toward the filamentous fungus Valsa mali with an IC(50) of 20 μM. The mechanism of its antifungal action toward V. mali included (1) induction of alteration of hyphal morphology, (2) growth inhibition by chitin deposition at hyphal tips, and (3) permeabilization of fungal membrane. The antifungal activity of VFTI-E1 was dependent on the ambient ionic strength as increasing concentrations of NaCl, CaCl(2), and MgCl(2) diminished the activity. The membranolytic action of VFTI-E1 was confined to fungus, but not exerted on human and rabbit erythrocytes. This study sheds light on the mode of hyphal growth inhibitory activity of protease inhibitors with antifungal activity. The antifungal activity of VFTI-E1 amplifies the scope of its potential applications.

A new 15-kDa Bowman-Birk type trypsin inhibitor (termed VFTI-G1) was isolated from the seeds of Faba bean (Vicia faba cv. Giza 843) using cation exchange chromatography on an SP-Sepharose column, anion exchange chromatography on Q-Sepharose and Mono Q columns, and finally size exclusion chromatography on a Superdex 75 column. VFTI-G1 manifested significant antiproteolytic activity against trypsin (5761 BAEE units/mg, K(i) 20.4 × 10(-9) M), but only a slight chymotrypsin inhibitory activity (< 10 BTEE units/mg). The suitable environment to sustain its trypsin inhibitory activity was at temperatures below 60 °C and at pH 7. Its trypsin inhibitory activity was inhibited by the reducing agent dithiothreitol in a dose-dependent manner, indicating the significance of intact disulfide bonds to the trypsin inhibitory activity. It inhibited HIV-1 reverse transcriptase (RT) activity with an IC(50) of about 0.76 µM. Furthermore, VFTI-G1 showed specific antiproliferative activity toward HepG2 hepatoma cells by inducing chromatin condensation and cell apoptosis. The HIV-1 RT inhibitory activity of VFTI-G1 and its specific antiproliferative activity toward Hep G2 cells may find medical applications.

Summary High quality 3D seismic data over a large UAE field combined with high-end geophysical techniques resulted in spectacular porosity detail from seismic data over this carbonate field. By using special post stack filtering techniques to improve data continuity and discontinuity, two optimal data sets were generated. One data volume was optimized for structure and stratigraphic interpretation and the other for event mapping and quantitative seismic attribute analysis. A multi-attribute calibration method was used to estimate the porosity from the seismic data. Attributes used include seismic and geologic or interpretative attributes. The result was a porosity prediction that was 20% improved over the traditional single attribute approach, as measured on hidden well data. The predicted porosity volume provided high quality detail of reservoir heterogeneity and was very useful in understanding flood front advance in the platform interior and flow patterns in the clinoforms. In addition, the seismic porosity volume provides a means to place future wells to tap by-passed oil and to optimize the location of planned injector and producer zones. Introduction Seismic data is often used as a means to estimate rock properties between well controls. A typical method is to calibrate seismic attribute information with rock properties, such as porosity, from well log information. The seismic attribute data can then be transformed using the calibration function into an estimate of rock properties. In our study a multi-attribute neural network calibration is used to produce a 3D volume of rock property predictions from the seismic data (Hampson 2001).This seismic-scale rock property volume is then used to place new wells in favorable locations or in building geologic models for reserve estimation and/or reservoir simulation. Geologic Setting The study field is located in Abu Dhabi within the United Arab Emirates. The field is positioned over a low relief doubly plunging anticline that is oriented N-NE. The reservoir interval is comprised of a low relief, prograding carbonate platform. The main producing interval is in the Lower Cretaceous. The complex stratal architecture is driven largely by the longer-term (second-order) accommodation history. The field is characterized by significantly different stratal geometries that are clearly imaged by the enhanced 3D seismic. The northern part of the field is characterized by strong basinward progradation that occurs in the late highstand and falling-stage systems tracts. Clinoforms exhibit spatial variability in geometry, composition and texture that significantly impact reservoir geometry and quality. The southern part of the field is characterized by aggradational platform facies that show variations in stacking patterns and composition keyed to position in the sequence-stratigraphic hierarchy. Most notably, strong aggradation during the highstand sequence set, coupled with proliferation of rudist "reef" builders, resulted in development of a complex system of moderate relief, higher-energy rudistid shoals (moderate to high reservoir quality). These shoals are separated by low relief, restricted lagoonal "ponds" that are filled largely with low-energy, mud-prone facies (low reservoir quality).

Abstract Brittle deformation of carbonate reservoirs was characterized by applying advanced visualization and interpretation techniques to 18 recent 3-D seismic surveys in Abu Dhabi. The excellent data quality afforded a unique opportunity to integrate the broad range of observed structural styles and detailed structural geometries into a unified tectonic model. This resulted in a better and more thorough definition of the structure and hydrocarbon distribution of Abu Dhabi in the context of the entire Arabian Platform. The observed structures resulted from gentle basement inversion, salt-tectonics, and detached thrusting. The N- and NE-trending anticlines that form the giant onshore fields grew during Late Cretaceous, basement-involved foreland inversion. Systematic sets of remarkably linear, small-offset conjugate fault zones, oriented approximately N75W and N45W, cross the antliclines at high angles to the axial traces. The consistent orientations and shear sense of the fault zones suggests they result from regional WNW-ESE compression, which also drove late Cretaceous inversion and fold growth. Development of the salt-related anticlines was influenced by the same late Cretaceous compression, as well as multiple episodes of salt movement. Both sets of anticlines share the regional fault trends, but the salt-related fault zones have more variable orientations and timing. Mechanical stratigraphy clearly influences fault zone spacing, offset, and segmentation, both laterally and vertically. Interpretations of the fault zones as single fault planes underestimate their geometric complexity. The key to unravelling and communicating the geometric complexity is making use of a combination of data optimization and advanced 3-D visualization and interpretation techniques. Quantification of the orientations, segmentation, offset magnitudes, and spacing of the fault zones provides a foundation for defining their implications for fluid flow within the reservoirs.