Search

Introduction: Autism Spectrum Disorder (ASD) is a lifelong hereditary neurodevelopmental disorder characterised by a lack of social communication and restricted and repetitive behaviours. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classified symptoms of autism into two domains: the social communication and interaction domain. However, studies on autism in Saudi Arabia are still insufficient. Therefore, awareness and knowledge about autism can facilitate early detection and treatment, resulting in better outcomes. Aim: To evaluate parents’ knowledge, awareness, and attitude towards their autistic children in a tertiary care hospital in Saudi Arabia. Materials and Methods: This hospital-based cross-sectional study was conducted at Baljurashi Mental Health Hospital, AL-Baha region, Saudi Arabia, from January 2023 to November 2023. A total of 69 parents with autistic children who attended the outpatient clinic at Baljurashi Mental Health Hospital were included in the study. A questionnaire was administered among parents to assess their knowledge, awareness, and attitude regarding autism. Data was statistically analysed using descriptive statistics and the Chi-square test. Results: The age of the parents ranged from 16 to over 50 years, with 47 (68.1%) being males and 22 (31.9%) being females. Almost 29 (42.0%) of the parents were postgraduates, and 21 (30.4%) had a university-level education. About 24 (34.8%) of the participants believed that consanguineous marriage increases the risk of autism, 19 (27.5%) believed that some vaccines increase the risk of autism, and 39 (56.5%) knew that autism is associated with learning disabilities. Three-quarters of the participants, 54 (78.3%), stated that autism was known to them, 50 (72.5%) thought that an autistic child could be affected by a normal child, and 53 (76.8%) had good knowledge about autism. Conclusion: The study showed that the majority of parents had good knowledge about autism disorder. The findings reflect the positive impact of focused training initiatives and public awareness efforts aimed at improving parents’ knowledge, awareness, and attitude toward autism.

Background: Beta-oxidation of fatty acids takes place in the mitochondria to produce energy. This process is linked to the formation of free radicals. Previous researches propose that some fatty acids may be related to mitochondrial dysfunction, as they induce oxidative stress. Objectives: To examine the correlation between follicular fluid fatty acids and relative cell-free mitochondrial DNA in the follicular fluid in women experiencing intra-cytoplasmic sperm injection (ICSI). Methods: Fifty women subjected to ICSI participated in this cross-sectional research. Follicular fluid samples were obtained during oocyte pick-up. The samples were assessed for fatty acids, utilizing gas chromatography, and for relatively cell-free mitochondrial DNA, real-time polymerase chain reaction (PCR) was used. Results: There was a strong significant positive correlation between follicular fluid margaric acid and follicular fluid relative to cell-free mitochondrial DNA, as the correlation coefficient was 0.869, and the P value was 0.025. In addition, a strong significant inverse correlation was noticed, in women with diminished ovarian reserve, between follicular fluid oleic acid and relative cell-free mitochondrial DNA in the follicular fluid, as indicated by a correlation coefficient = - 0.9 and a P value = 0.037. Conclusion: Margaric acid correlated positively with the relative cell-free mitochondrial DNA, which might reflect mitochondrial dysfunction, due to aggravation of oxidative stress. Whereas, oleic acid, in women with diminished ovarian reserve, correlated negatively with relative cell-free mitochondrial DNA. However, more studies are required in this area of research.

Abstract The present research applies different statistical analysis and machine learning (ML) approaches to predict and optimize the processing parameters on the wear behavior of ZK30 alloy processed through equal channel angular pressing (ECAP) technique. Firstly, The ECAPed ZK30 billets have been examined at as-annealed (AA), 1-pass, and 4-passes of route Bc (4Bc). Then, the wear output responses in terms of volume loss (VL) and coefficient of friction (COF) have been experimentally investigated by varying load pressure (P) and speed (V) using design of experiments (DOE). In the second step, statistical analysis of variance (ANOVA), 3D response surface plots, and ML have been employed to predict the output responses. Subsequently, genetic algorithm (GA), hybrid DOE–GA, and multi-objective genetic algorithm techniques have been used to optimize the input variables. The experimental results of ECAP process reveal a significant reduction in the average grain size by 92.7% as it processed through 4Bc compared to AA counterpart. Furthermore, 4Bc exhibited a significant improvement in the VL by 99.8% compared to AA counterpart. Both regression and ML prediction models establish a significant correlation between the projected and the actual data, indicating that the experimental and predicted values agreed exceptionally well. The minimal VL at different ECAP passes was obtained at the highest condition of the wear test. Also, the minimal COF for all ECAP passes was obtained at maximum wear load. However, the optimal speed in the wear process decreased with the number of billets passes for minimum COF. The validation of predicted ML models and VL regression under different wear conditions have an accuracy range of 70–99.7%, respectively.

The impact of learning enjoyment on motivation, enthusiasm, and overall learning experiences is significant. Previous studies, lacking an unbiased tool for measuring enjoyment and confronting various influencing factors, produced conflicting results regarding enjoyment levels in different instructional methods. Hence, we developed a learning enjoyment scale for evaluating both active and passive educational activities. We applied the developed scale to 112 first-year medical and dental students to assess their enjoyment during didactic physiology lectures and explored possible associated factors. Within this data note, we present students’ responses to the developed LES. The LES encompasses six dimensions: knowledge, comprehension, application, analysis, concentration, and enjoyment. Students provided ratings for each dimension on a five-point Likert scale, spanning from 1 (strongly disagree) to 5 (strongly agree). The cumulative scores across the six dimensions range from a minimum of 6 to a maximum of 30. These total scores can be categorized as excellent (> 24), acceptable (18-24), or low (< 18). The second section of the dataset examines specific factors influencing overall enjoyment, such as teacher proficiency, topic difficulty, active student participation, objectives fulfillment, low stress levels, and self-perceived acquisition of skills. In addition to objective measurement of students’ enjoyment level, the LES can be utilized for quantitative cross-comparisons between different teaching activities. By employing this dataset, we will undertake an analysis to determine the internal consistency of the Learning Enjoyment Scale (LES), with the anticipation that the outcomes will be published in another venue.

BACKGROUND: Emergency Department (ED) overcrowding has been demonstrated in several studies to be associated with undesirable effects such as longer waiting times, reduced patient satisfaction, and, most importantly, poor patient outcomes. Furthermore, long waiting times for walk-ins result in more complaints and patient dissatisfaction than illness management itself, with the majority of issues arising as a result of real and perceived waiting periods before being seen by the doctor. AIM: We set out to investigate whether introducing a senior emergency physician into the triage system would reduce waiting time, door-to-decision time, and door-to-doctor time, as well as increase patient satisfaction across the ED. METHOD: This was an interventional pre-post study that utilised retrospective data to evaluate the effect on ED throughput of triage by senior emergency physicians. We aimed to measure its impact on waiting time, door-to-decision time, and door-to-doctor time, along with ED patient satisfaction. RESULTS: Patient satisfaction, the overall assessment of treatment received during the visit, increased, from 74.975 to 77.425, and the likelihood of patients recommending the ED increased from 71.36 to 75.21. Operational metrics revealed a considerable drop in door-to-decision time (admit or discharge) of 46 minutes and 3 seconds, as well as a 1 minute and 21 second reduction in time from door to doctor (arrival to first provider). CONCLUSION: The mixed results hint at an effective but iterative process of enhancing patient flow and experience in the ED through senior physician triage.

A patient's suicide or suicide attempt is a challenging experience for psychiatrists. This study aimed to explore the common coping strategies and habits developed by psychiatrists/trainees following such incidents. A self-administered questionnaire was distributed among participants in Saudi Arabia. The study enrolled 178 participants, of whom 38.8% experienced a patient's suicide, 12.9% experienced a patient's severe suicide attempt, and 48.3% did not encounter any suicidal events. The most frequently utilized sources of support were colleagues (48.9%), team discussions (41.3%), and supervisors (29.3%). Only 21.4% received formal education in coping with a patient's suicide. Approximately 94.9% reported a lack of support systems within their institution. The study highlighted the coping strategies most commonly employed by psychiatrists/trainees and revealed that the majority of participants reported no changes in their daily habits. The findings underscore the need for a structured support system and formal educational resources to address the existing deficit. Mental health organizations must take action to ensure adequate resources for healthcare providers.

Background: The current models of disaster response focus on international collaboration and assistance. However, little is known about the disaster preparedness and response model of the Saudi health cluster. Aims: This study aims to examine, in more detail, disaster response steps, and elaborates on the administrative structure, time frames, challenges, and recent lessons learned. Methods: We reviewed the current disaster response model of Saudi Arabia’s health cluster system. Pre-planning data were reviewed, and disaster contact personnel were contacted for further details. In addition, we relate a recent, actual code brown response to an electricity failure, including early activation and subsequent evacuation. Result: Three main criteria for determining emergency response levels are bed capacity, the number of patients affected, and the event’s propensity for escalation. Five activation levels are already in place, ranging from local hospital disaster unit response to the involvement of national response led by the kingdom’s leader. Hospital readiness to receive evacuated patients was tested in a real scenario, and an uneventful evacuation was carried out to demonstrate the effectiveness of the cluster design. Conclusion: Overall, the new disaster response model has overcome some reported challenges. However, several challenges still exist, and a degree of system evolution is expected.

Abstract Panton‐Valentine leucocidin toxin‐producing methicillin‐resistant staphylococcus aureus is an important uncommon cause of community‐acquired pneumonia; we describe a case of necrotizing pneumonia presenting as respiratory failure necessitating early initiation of extracorporeal membrane oxygenation, acute kidney injury and rhabdomyolysis, awareness, prompt recognition and appropriate management are crucial due to possible significant pathology.

Background: Nasal decongestant drugs are widely used as potent vasoconstrictive agents to reduce congestion of nasal and ocular mucous membranes in disease such as allergic rhinitis. These drugs are easily accessible to the people over the counter without prescription. The ease in access may lead the population in believing that the drugs are risk free and free from side effects. The purpose of this study was to determine the level of awareness of the people in Unaizah Al-Qassim province in Saudi Arabia on the use of nasal decongestants ad their side effects. Methodology: After gaining the Institutional Review Board (IRB) approval, the study was a questionnaire-based cross-sectional study conducted on the people Unaizah Al-Qassim province in Saudi Arabia. It was explorative in nature as such a study has never been done in Unaizah before and hence descriptive statistics was mainly used to establish significance and reference. The questionnaires assessed the demographical characteristics of the population, participants' history on the usage of nasal decongestants, health condition of the participants, and knowledge on nasal congestion and use nasal decongestants. Results: Out of 385 participants, 54% were male and 46% are female. With regards to age, majority of the participants were between the age of 20 and 40 years 56%, followed by 40--60 years old (33%). 79% of the participants had acquired a baccalaureus level in education. When assessed on the usage of nasal decongestants, 32.5% currently use the decongestants, 64.4% have ever used the drugs now and in the past. In terms of knowledge of the drugs, 16.6% of the participants are aware of the side effects, 25.2% are aware of the medically recommended period to use the drugs, 21.3% have heard of the nasal congestion addiction, and 21.6% are aware of the medication that may cause nasal congestion. Conclusion: The study established that the level of awareness on the use nasal decongestants and the side effects is not significant. There needs to be a sensitization campaign to educate the population on the use of nasal decongestants.

Objectives This study aims to compare the clinical manifestations, laboratory findings, outcomes and overall survival time of patients with COVID-19 with and without comorbidities.Design Retrospective design.Setting This study was undertaken at two hospitals in Damascus.Participants A total of 515 Syrian patients met the inclusion criterion, laboratory-confirmed COVID-19 infection following the Centers for Disease Control and Prevention. Exclusion criteria were suspected and probable cases that were not confirmed with a positive reverse transcription-PCR assay, and patients who self-discharged from the hospital against medical advice.Primary and secondary outcome measures First, assess the impacts of comorbidities on COVID-19 infection in four areas (clinical manifestations, laboratory findings, severity and outcomes). Second, calculate the overall survival time for patients with COVID-19 with comorbidities.Results Of 515 patients included, 316 (61.4%) were male and 347 (67.4%) had at least one coexisting chronic disease. Patients with comorbidities compared with no comorbidities were more vulnerable to poor outcomes such as severe infection (32.0% vs 9.5%, p

Rhazya Stricta (R. stricta) has been employed as a natural remedy for several diseases for centuries. Numerous studies revealed that R. stricta extracts contain alkaloids, tannins, and flavonoids that possess antimicrobial, anticancer, antihypertensive, and antioxidant activities. In this study, we examined the effects of organic extracts from different parts of R. stricta plant on human pluripotent stem cells (hiPSCs)-derived neural stem cells (NSCs) for medical purposes. NSCs were incubated with different concentrations of organic extracts from the leaves, stem, and fruits, and we assessed the growth and viability of the cells by using MTS assay and the chemical composition of the potential plant extract by using gas chromatography-mass spectrometry (GC/MS). Our results revealed that the methanolic extract from the stem increased NSCs growth significantly, particularly at a concentration of 25 μg/ml. GC/MS analysis was utilized to identify the potential compounds of the methanolic extract. In conclusion, our results demonstrated for the first time that methanolic stem extract of R. stricta contains compounds that can positively impact NSCs growth. These compounds can be further investigated to determine the potential bioactive compounds that can be used for research and medical purposes.

Objectives: To evaluate Knowledge, Attitude, and Practice (KAP) regarding deep margin elevation (DME) among dental practitioners in Riyadh city. Materials and Methodology: A cross-sectional study that comprised a total number of 535 dental practitioners: 255 (47.7%) were males and 280 (52.3%) females. A self-constructed 21 close-ended self-administered questionnaire was utilized in the study. The data were entered and analyzed by Chi-square test and descriptive analysis using Statistical Package for the Social Sciences (SPSS) software. Results: Although the majority of the respondents have heard about DME, only 30.4% have utilized this technique in their clinical practice by having general practitioners and specialists utilize this technique more often than consultants. Among the participants, 65.4% of them have agreed that adhesion by bonding to deep cervical dentin is predictable and related to the success of the final restoration. Conclusion: The knowledge level of DME among the study participants was adequate. The findings of this study revealed that the total number of dentists who utilize the technique in restoring large subgingival defects of posterior teeth with proximal caries is very minimal. Thus, it is recommended that dental practitioners have this technique introduced in their dental clinics as an alternative to surgical crown lengthening. Although years of experience and dentist rank may influence the clinical decision, in-depth factorial analysis with a greater sample size is necessary.

Background: The protozoan parasite Toxoplasma gondii may cause serious illness in the immunocompromised. The Toxoplasma gondii seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is associated with outcomes that have not be fully elucidated, hence the need for a better understanding of the pooled seroprevalence and associated maternal and fetal outcomes. Objective: The objective was to conduct a systematic literature review and determine the pooled prevalence of WHO Eastern Mediterranean Regional countries’ pregnant women’s seroprevalence of Toxoplasma gondii and the maternal–fetal outcomes. Methods: This quantitative study examined WHO Eastern Mediterranean countries’ maternal–fetal outcomes and Toxoplasma gondii prevalence in pregnant women. The targeted population was pregnant women, while the primary outcome was seropositivity of Toxoplasma gondii, while other outcomes such as maternal and fetal associations and risk factors were determined PubMed, SCOPUS, MEDLINE, and Index Medicus for the Eastern Mediterranean Region (IMEMR) databases were searched up until 30 January 2023. The search terms used were “Toxoplasma gondii” OR “Toxoplasma infection” AND “Pregnant woman” or pregnan* OR Antenatal OR Prenatal OR Gravidity OR Parturition OR Maternal AND WHO Eastern Mediterranean Region). OpenMeta-Analyst and Jamovi were used to analyze the generated data. Results: In total, 95 of 2947 articles meeting the inclusion criteria examined Toxoplasma gondii prevalence in pregnant women from WHO Eastern Mediterranean countries. The pooled prevalence of Toxoplasma gondii in pregnant women was 36.5% (95%CI: 32.6–40.4) with a median value of 35.64%, range values of 1.38–75.30%, with 99.61% heterogeneity. The pooled seroprevalence of IgG of Toxoplasma gondii was 33.5% (95%CI: 29.8–37.2) with a median value of 33.51%, and a range values of 1.38–69.92%; the pooled seroprevalence of IgM was 3.6% (95%CI: 3.1–4.1)) with a median value of 3.62 and range values of 0.20–17.47%, while cases of pooled seroprevalence of both IgG and IgM positivity was 3.0% (95%CI: 1.9–4.4) with a median value of 2.05 and a range values of 0.05–16.62%. Of the Toxoplasma gondii seropositive women, 1281/3389 (34.8%) 174/1765 (32.9%), 1311/3101 (43.7%), and 715/1683 (40.8%) of them had contact with cats, drank unprocessed milk, ate raw or undercooked meat and ate unwashed raw vegetables, respectively. The maternal–fetal outcomes associated with Toxoplasma gondii seropositivity were a history of abortions, miscarriage, stillbirth, intrauterine fetal death, and premature birth, which were found in 868/2990 (32.5%), 112/300 (36.1%), 111/375 (25.7%), 3/157 (1.9%) and 96/362 (20.1%) of women who tested positive for Toxoplasma gondii antibodies. Conclusion: The study found a high proportion of Toxoplasma gondii seroprevalence in pregnant women in the WHO Eastern Mediterranean Region, which may be linked to poor outcomes for mothers and their babies. Thus, pregnant women require monitoring and comprehensive prevention strategies for Toxoplasma gondii infection.

Abstract Background The incidence of ectopic kidneys is 1:12,000 clinically and 1:900 postmortem. Patients with pelvic mal-rotated kidneys are more susceptible to recurrent urinary tract infections, recurrent renal stones, and renal injury. Fusion of the kidney lower poles is relatively common compared to other types of renal anomalies. Case presentation We present the case of a 36-year-old Sudanese female patient who presented with a long history of recurrent urinary tract infections unresponsive to antibiotics. Ultrasound scan revealed bilateral pelvic kidneys. Computed tomography (CT) urography confirmed bilateral ectopic fused kidneys, with the left kidney mal-rotated (renal pelvis facing upwards and laterally). Kidney infection secondary to vesicoureteral reflux was diagnosed. Antibiotics were prescribed according to culture and sensitivity. The patient responded well to ciprofloxacin. Conclusion A history of recurrent urinary tract infections without an apparent cause is highly suggestive of renal anomaly and should be investigated expediently. Ultrasonography or CT imaging may be utilized to aid in diagnosis. Early recognition may help prevent the high risk of end-stage renal failure associated with anomalies.

Abstract Objectives The decline in diarrhoeal disease-related mortality globally has been attributed to the use of oral rehydration solution (ORS) and zinc supplementation. However, data on ORS and zinc supplementation in Sudan are scarce. We aimed to investigate the access to ORS and zinc treatments and the associated factors, through the analysis of the latest available data from Sudan-Multiple Indicator Cluster Survey (MICS)-2014 obtained from the United Nations Children’s Fund (UNICEF). Results A total of 14,081 children were included in this analysis. During the 2 weeks preceding the survey, 29.3% of these children had a diarrhoeal disease. Only 18.9% and 14.8% of these children had received ORS and zinc supplements, respectively. Whereas children from the higher wealth index groups were more likely to receive ORS treatment (fourth group: AOR = 1.301; 95% CI 1.006–1.682), children from rural areas were less likely to receive ORS treatment (AOR = 0.666; 95% CI 0.552–0.803) and zinc supplements (AOR = 0.603; 95% CI 0.500–0.728). The results indicate the existence of unequal access to treatment of childhood diarrhoeal diseases among children under 5 years in Sudan.

Abstract Staphylococcus warneri‐related endocarditis is rarely reported, raising diagnostic challenges and is often associated with considerable morbidity and mortality. We describe a case of native valve endocarditis caused by S. warneri and complicated by a valve perforation in an immunocompetent patient to raise awareness of this emerging organism.

Glaucoma is the second leading cause of blindness worldwide, and peripapillary atrophy (PPA) is a morphological symptom associated with it. Therefore, it is necessary to clinically detect PPA for glaucoma diagnosis. This study was aimed at developing a detection method for PPA using fundus images with deep learning algorithms to be used by ophthalmologists or optometrists for screening purposes. The model was developed based on localization for the region of interest (ROI) using a mask region-based convolutional neural networks R-CNN and a classification network for the presence of PPA using CNN deep learning algorithms. A total of 2,472 images, obtained from five public sources and one Saudi-based resource (King Abdullah International Medical Research Center in Riyadh, Saudi Arabia), were used to train and test the model. First the images from public sources were analyzed, followed by those from local sources, and finally, images from both sources were analyzed together. In testing the classification model, the area under the curve’s (AUC) scores of 0.83, 0.89, and 0.87 were obtained for the local, public, and combined sets, respectively. The developed model will assist in diagnosing glaucoma in screening programs; however, more research is needed on segmenting the PPA boundaries for more detailed PPA detection, which can be combined with optic disc and cup boundaries to calculate the cup-to-disc ratio.

Melatonin, a hormone synthesized mainly by the pineal gland, has been found in extra-pineal organs as well. It’s known as an organizer of circadian rhythms and more recently as an anti-oxidant. In addition to its role in maintaining immunity, pathophysiology of cardiovascular and neurological diseases, and as an anti-cancer agent, evidence has demonstrated that melatonin exerts a positive impact on male and female fertility primarily through oxygen scavenging effects. In In Vitro Fertilization (IVF) programs, supplementation of melatonin may be associated with better outcomes in terms of sperm quality, oocyte quality, embryo quality and pregnancy rates. This review summarizes various actions of melatonin on the body focusing on male and female fecundity.

The emergence of genetic mutations in chromosomal genes and the transmissible plasmid-mediated colistin resistance gene may have helped in the spread of colistin resistance among various Klebsiella pneumoniae (K. pneumoniae) isolates and other different bacteria. In this study, the prevalence of mutated colistin-resistant K. pneumoniae isolates was studied globally using a systematic review and meta-analysis approach. A systematic search was conducted in databases including PubMed, ScienceDirect, Scopus and Google Scholar. The pooled prevalence of mutated colistin resistance in K. pneumoniae isolates was analyzed using Comprehensive Meta-Analysis Software (CMA). A total of 50 articles were included in this study. The pooled prevalence of mutated colistin resistance in K. pneumoniae was estimated at 75.4% (95% CI = 67.2–82.1) at high heterogeneity (I2 = 81.742%, p-value < 0.001). Meanwhile, the results of the subgroup analysis demonstrated the highest prevalence in Saudi Arabia with 97.9% (95% CI = 74.1–99.9%) and Egypt, with 4.5% (95% CI = 0.6–26.1%), had the lowest. The majority of mutations could be observed in the mgrB gene (88%), pmrB gene (54%) and phoQ gene (44%). The current study showed a high prevalence of the mutation of colistin resistance genes in K. pneumoniae. Therefore, it is recommended that regular monitoring be performed to control the spread of colistin resistance.

Prenatal markers are commonly used in practice to screen for some foetal abnormalities. They can be biochemical or ultrasonic markers in addition to the newly used cell free Deoxyribonucleic Acid (DNA) estimation. This review aimed to illustrate the applications of the prenatal screening, and the reliability of these tests in detecting the presence of abnormal chromosomes such as trisomy-21, trisomy-18, and trisomy-13 in addition to neural tube defects. Prenatal markers can also be used in the anticipation of some obstetrical complications depending on levels of these markers in the mother’s circulation. In the developed countries, prenatal screening tests are regularly used during antenatal care period. Neural tube defects, numerical and structural chromosomal abnormalities, in addition to some obstetrical problems are commonly screened for, by using prenatal tests. Maternal education about the importance of performing these tests should be done in order to improve the detection rate of foetal abnormalities and some pregnancy complications.

Drug overdose is a common presentation in emergency departments, and overdose of cardioselective agents warrants special attention, given its association with high mortality and morbidity. This study reports a case of cardioselective overdose with suicidal intent. We shed light on the accessibility in Saudi Arabia of these life-threatening drugs, and explore the nature of public health intervention to reduce to reduce the risk of misuse.

Since the launch of the Sustainable Development Goals (SDGs) in 2015, Africa has made some progress towards its achievements, particularly in the area of gender equality- SDG 5, climate change -SDG 13 and preserving life on land- SDG 15. Although, some African countries have made tangible impact on the other goals such as health, food production and economic growth; these efforts experienced some setbacks with attention shifting to curbing the spread of the novel coronavirus. As much as mitigating the spread of the spread of COVID-19 is important, so is ensuring efforts made on other goals are not lost, as the SDGs are much interconnected, and failure in one impacts others. For the African continent to achieve sustainable development beyond COVID-19, strategic actions which will involve innovations, evaluations and strong political will towards implementations must be taken by relevant stakeholders, so the continent is not left behind in the global goals achievement by 2030.

Objectives To describe the patterns and outcomes of traumatic spinal injuries (TSIs) in a tertiary care trauma centre in Riyadh, Saudi Arabia.Design Retrospective medical record review.Setting Level 1 trauma centre for all patients presented from 1 February 2016 to 31 December 2018.Participants and data Records of patients presenting with any spinal trauma were reviewed, and the data obtained included age, gender, nationality (as Saudi and non-Saudi), date of presentation, site of fracture/injury, associated injuries, mechanism of injury, presence of neurological involvement and hospital mortality.Main outcomes Frequencies of different types of TSI across various subgroups.Results We identified 692 patients who presented with TSI throughout the study period. The mean age was 36.9 years. Males represented 83.2% (n=576) of the sample size, and the most common mechanism of injury was motor vehicle collision (MVC), accounting for 66.8% of cases (n=462), while fall-related injuries were seen in 31.6% of cases (n=219). A total of 454 (65.6%) of all patients were Saudi, and 332 (73.1%) of the TSIs in Saudis were due to MVC. Non-Saudi cases accounted for 238 (34.4%) of all patients, and 89 (37.4%) of the non-Saudi injuries were due to falls from height, and this association was statistically significant (p

Introduction Global population ageing is one of the key factors linked to the projected rise of dementia incidence. Hence, there is a clear need to identify strategies to overcome this expected health burden and have a meaningful impact on populations’ health worldwide. Current evidence supports the role of modifiable dietary and lifestyle risk factors in reducing the risk of dementia. In South-East Asia, changes in eating and lifestyle patterns under the influence of westernised habits have resulted in significant increases in the prevalence of metabolic, cardiovascular and neurodegenerative non-communicable diseases (NCDs). Low vegetable consumption and high sodium intake have been identified as key contributors to the increased prevalence of NCDs in these countries. Therefore, nutritional and lifestyle strategies targeting these dietary risk factors are warranted. The overall objective of this randomised feasibility trial is to demonstrate the acceptability of a dietary intervention to increase the consumption of high-nitrate green leafy vegetables and reduce salt intake over 6 months among Malaysian adults with raised blood pressure.Methods and analysis Primary outcomes focus on feasibility measures of recruitment, retention, implementation and acceptability of the intervention. Secondary outcomes will include blood pressure, cognitive function, body composition and physical function (including muscle strength and gait speed). Adherence to the dietary intervention will be assessed through collection of biological samples, 24-hour recall and Food Frequency Questionnaire. A subgroup of participants will also complete postintervention focus groups to further explore the feasibility considerations of executing a larger trial, the ability of these individuals to make dietary changes and the barriers and facilitators associated with implementing these changes.Ethics and dissemination Ethical approval has been obtained from Monash University Human Research Ethics Committee and Medical Research and Ethics Committee of Malaysia. Results of the study will be disseminated via peer-reviewed publications and presentations at national and international conferences.ISRCTN47562685; Pre-results.

BACKGROUND: Exposure to stressful working conditions without adequate stress-coping strategies may lead to stress and even psychiatric morbidity. There are a dearth of studies on stress-coping strategies among consultant physicians in the Arabian Gulf. OBJECTIVES: Determine stress-coping strategies among consultants in Saudi Arabia and the relationship of strategies to level of stress. DESIGN: Analytical cross-sectional study. SETTINGS: Conducted between November 2014 and March 2015 among physician consultants registered at the Saudi Commission for Health Specialties. SUBJECTS AND METHODS: Text messages were used to directly ask consultants to complete an online questionnaire. MAIN OUTCOME MEASURES: The 28-item Brief COPE inventory and the Perceived Stress Scale. SAMPLE SIZE: 582. RESULTS: The consultants were largely males (71%) and Saudi (56%), and their mean age was 46.9 (7.9) years. Adaptive stress-coping strategies were more frequently used than maladaptive stress-coping strategies (68% versus 49%). Stress levels were positively correlated with maladaptive stress-coping strategies (r=0.41, P

Individual electronic health records (EHRs) and clinical reports are often part of a larger sequence-for example, a single patient may generate multiple reports over the trajectory of a disease. In applications such as cancer pathology reports, it is necessary not only to extract information from individual reports, but also to capture aggregate information regarding the entire cancer case based off case-level context from all reports in the sequence. In this paper, we introduce a simple modular add-on for capturing case-level context that is designed to be compatible with most existing deep learning architectures for text classification on individual reports. We test our approach on a corpus of 431,433 cancer pathology reports, and we show that incorporating case-level context significantly boosts classification accuracy across six classification tasks-site, subsite, laterality, histology, behavior, and grade. We expect that with minimal modifications, our add-on can be applied towards a wide range of other clinical text-based tasks.

Under climate change, regional Sea Surface Temperature (SST) changes are a crucial factor affecting marine ecosystems, which thrive only within a certain thermal limit. Thirty-seven years of monthly gridded Optimum Interpolation SST data from 1982 to 2017 were used to investigate the decadal variability of this parameter in the Red Sea during the summer season, in relation to large-scale climate variability. We identified a non-uniform warming trend beginning around the mid-1990s over the whole basin, with a predominant amplified warming over the northern half (0.04°C year-1), which is approximately four times higher than the global warming trend, but much weaker warming over southern end (0.01°C year-1). It was found that the Atlantic Multi-Decadal Oscillation (AMO) and the Silk Road Pattern (SRP) are shaping the RS SST, since their phase shift concurs with the timing of the significant non-uniform warming over the basin. The AMO triggers the SRP-related vertical and horizontal temperature advection that leads to opposite changes in the SST. We suggest that warming is amplified over the basin due to an overlap with global warming signals. Our results have important implications for interannual and decadal SST predictions based on the predictability of AMO and SRP patterns.

Background: Vitamin D has been linked to fertility since its receptors were found in reproductive organs. Nevertheless, its exact role in fertility is yet to be cleared. Objectives: To analyze follicular fluid (FF) vitamin D in females doing Intracytoplasmic Sperm Injection (ICSI), to compare its level between Polycystic Ovary Syndrome (PCOS) and non-PCOS females, and to explore whether vitamin D correlates with oocytes number, percentage of oocyte maturity, fertilization rate and percentage of high quality embryos. Patients and methods: This comparative observational study was done, from January to October 2018, at Al Amal IVF Center, Jenin hospital, Baghdad. The study was conducted on 40 women; 18 had PCOS, 15 had blocked fallopian tubes and 7 had idiopathic infertility. FF vitamin D was analyzed by Ichroma kit, Boditech. Deficient, insufficient, and sufficient vitamin D levels were as:

Spontaneous subcapsular hematoma of the liver is an extremely rare but potentially life-threatening condition. We report a case of subcapsular hematoma of the liver without any apparent lesion and in the absence of coagulopathy or trauma. A CT scan of the abdomen demonstrated a huge subcapsular hematoma around the liver. The patient was treated conservatively and was discharged home after one week. Up to our knowledge, this is one of the very few reported cases of a spontaneous subcapsular hepatic hematoma.

Introduction: During pregnancy, the female’s body undergoes many adaptations, including changes in the number and survival of White Blood Cells (WBCs). Programmed deaths of the cells are an important regulatory process that happens under a variety of physiological and pathological conditions. Aim: To measure the percentage of apoptosis of lymphocytes in peripheral blood of pregnant females and healthy non pregnant females, and to compare lymphocytes apoptosis between them in term of blood pressure and blood sugar. Also, to relate this apoptosis to blood sugar levels and blood lead levels. Materials and Methods: Fourty two pregnant females in their third trimester had been enrolled in the prospective study and were considered as the patients group. They were recruited from the labour room of the Baghdad Teaching Hospital, Baghdad, Iraq. The control group consisted of 15 healthy non pregnant women with matched age. Blood samples were collected from both groups and subjected to lymphocytes apoptosis estimation; blood sugar level and blood lead level measurements. Blood lead level was measured using blood lead analyser kit. Lymphocytes examination and separation was done. Data analysis was done using SPSS version 20.0. ANOVA test, Independent sample t-test and Pearson correlation test were also used. Results: There was no significant difference in age and blood lead level between patients and control groups. Lymphocyte apoptosis was significantly higher in the patients group than the control group (3.50±2.24 vs. 1.49±0.66). Lead level correlated positively and significantly with lymphocyte apoptosis in both groups. Apoptosis level was not significantly higher in hypertensive patients however, it was significantly higher in diabetic patients. Conclusion: Lymphocytes apoptosis is significantly higher in third trimester of pregnancy and it is higher in diabetic and hypertensive pregnant women than healthy non pregnant women. The increase in blood lead level may cause a significant increase in lymphocytes apoptosis in pregnant and non pregnant women.

Background: Assessment is an important part of the learning cascade in education. Students realize it as an influential motivator to direct and guide their learning. The method of assessment determines the way the students reach high levels of learning. It has been documented that one of factor affecting students’ choice of learning approach is the way how assessment is being performed. Many methods of assessment namely multiple choice questions, essay questions and others are mainly used to assess basic science knowledge in undergraduate education. Objectives: The aim of this study is to compare multiple choice questions (MCQ) and essay questions (EQ) (record the success and failure rate of multiple choice questions (MCQ) and essay questions (EQ)) in regards to the Physiology questions. Methods: A retrospective study was done in which the results of the physiology exams -held in the medical college in Baghdad University -in 2010 are recorded. The number of students underwent the exam was 255. A total of 100 essay questions (EQs) and 100 multiple choice questions (MCQs) were evaluated from the written examinations delivered to second year medical students questions belonged to final examination. Results: Regarding essay questions that have been answered, 33.5% of the questions were not answered as a total. 188 students out of 255 had succeeded which represent 73.7% of the students. Out of 78 marks for MCQ, 46.33 had been achieved, and out of 22 marks for essay 12.9 have been achieved. the success in MCQ questions was 82.9% while in the Essay questions was 67.7% and the failure in both types was 12.5%. Out of 100 questions for both MCQ and Essay questions 55.1±7.9 questions were answered for the MCQ and 51.1±15.3 Essay questions were answered. In general the percentage of the succeeded students was 73. 7% and that of failed students was 26.3%. Conclusion: There is no significant difference in the success rate between MCQs and EQs. الخلفية: يعد التقييم عنصرا هاما في سلسلة التعلم في التعليم. يدرك الطلاب أنها حافز مؤثر لتوجيه تعلمهم. ويحدد أسلوب التقييم طريقة وصول الطلبة إلى مستويات عالية من التعلم. وقد تم توثيق أن أحد العوامل التي تؤثر على اختيار الطلاب لموقف التعلم هو طريقة تقييمهم. يتم تطبيق العديد من أساليب التقييم وهي أسئلة الاختيار من متعدد، أسئلة مقالة وغيرها أساسا لفحص العلوم الأساسية الفهم في التعليم الجامعي. الهدف: الهدف من هذه الدراسة هو مقارنة أسئلة الاختيار من متعدد وأسئلة مقال (تقييم نجاح وفشل معدل أسئلة الاختيار من متعدد وأسئلة مقال) فيما يتعلق باسئلة علم وظائف الأعضاء. الطريقة: أجريت دراسة بأثر رجعي تم فيها تسجيل نتائج امتحانات علم وظائف الأعضاء - التي تم تسجيلها في الكلية الطبية لجامعة بغداد - في عام 2010. وبلغ عدد الطلاب الذين خضعوا للامتحان 255. تم تقييم مجموعه 100 أسئلة مقالة و 100 أسئلة الاختيار من متعدد من الامتحانات المكتوبة التي تدار لطلاب الطب السنة الثانية (الأسئلة تنتمي إلى الامتحان النهائي) النتائج: فيما يتعلق بأسئلة المقالات التي تم الرد عليها، لم يتم الإجابة على 33.5٪ من الأسئلة في المجموع. وقد نجح 188 طالبا من أصل 255 طالبا يمثلون 73.7 في المائة من الطلاب. ومن أصل 78 علامة ل سؤال متعدد الاختيارات، تم تحقيق 46.33، ومن أصل 22 علامة للمقالة 12.9 قد تحققت. وكان النجاح في الأسئلة متعدد الاختيارات، 82.9٪ في حين كان في أسئلة المقال 67.7٪ والفشل في كلا النوعين كان 12.5٪. من أصل 100 سؤال لكل من الأسئلة متعدد الاختيارات و اسئلة المقال، تم الرد على 55.07 ± 7.99 من الأسئلة متعدد الاختيارات و 51.13 ± 15.28 للمقالة. وبشكل عام بلغت نسبة الطلبة الناجحين 73.7٪، وبلغت نسبة الطلبة الفاشلين 26.3٪ الخلاصة: كان معدل النجاح لكل من الأسئلة متعدد الاختيارات وأسئلة المقال نفسه تقريبا مما أدى إلى معدل نجاح إجمالي 73.7٪ الذي يلبي نتائج الدراسات الأخرى التي أجريت مقارنة نوعي الأسئلة.

Coconut (Cocos nucifera L.), a member of the palm family (Arecaceae), is one of the most economically important crops in tropics, serving as an important source of food, drink, fuel, medicine, and construction material. Here we report an assembly of the coconut (C. nucifera, Oman local Tall cultivar) mitochondrial (mt) genome based on next-generation sequencing data. This genome, 678,653bp in length and 45.5% in GC content, encodes 72 proteins, 9 pseudogenes, 23 tRNAs, and 3 ribosomal RNAs. Within the assembly, we find that the chloroplast (cp) derived regions account for 5.07% of the total assembly length, including 13 proteins, 2 pseudogenes, and 11 tRNAs. The mt genome has a relatively large fraction of repeat content (17.26%), including both forward (tandem) and inverted (palindromic) repeats. Sequence variation analysis shows that the Ti/Tv ratio of the mt genome is lower as compared to that of the nuclear genome and neutral expectation. By combining public RNA-Seq data for coconut, we identify 734 RNA editing sites supported by at least two datasets. In summary, our data provides the second complete mt genome sequence in the family Arecaceae, essential for further investigations on mitochondrial biology of seed plants.