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Background: Osteoarthritis (OA), the most common kind of arthritis, affects millions of people throughout the world. This problem occurs when the protective cartilage that cushions the ends of the bones wears away over time. The goal of this study was to draw attention to the link between osteoarthritis and a number of endocrine illnesses in the Saudi population. Methods: This was a cross-sectional research with the goal of shedding light on the link between osteoarthritis and endocrine problems. The research was conducted in Saudi Arabia at colleges, hospitals, and shopping centers. During the months of June to November 2021, data was collected from patients and the general public. Results: The study included 743 participants. Among them, there were, 519 females (69.9%) and 224 males (30.1%). The most prevalent age group was 20-30 years (n= 354, 47.6%). Majority of study participants were Saudi (n= 713, 96%) and the rest were non-Saudi. The mean body mass index (BMI) among study participants was 29.47 + 7.53 with median BMI of 30 kg/m2. It was found that 85 participants took anti-inflammatory drugs for more than twice per week during the last three months (11.4%). It is noticed that the prevalence of autoimmune disease among study participants is low. However, female participants were higher in hypothyroid (P= 0.001). Conclusion: Finally, it appears that weight, rather than IR, explains the relationship between endocrine disease and knee OA. Individuals with arthritic knee pain may benefit from endocrine disease therapy since the accumulation of endocrine disease components is connected to a higher degree of knee discomfort, independent of age, sex, or weight.

BACKGROUND Gram-positive bacterial infections are considered one of the major causes of mortality and morbidity in patients with cancer. Hence, the challenge lies in regulating the pervasive use of vancomycin in the management of infections facing such patients due to the anomalous vancomycin pharmacokinetics (PKs) and pharmacodynamics (PDs). Inappropriate vancomycin exposure is associated with toxicity, pathogen resistance, and therapeutic failure. OBJECTIVE The aim of this study was to estimate vancomycin PK in patients with cancer and without cancer. The standard dosage regimens of vancomycin were then evaluated using data from PK modeling. METHODS In this observational PK study, the data were extracted from a matched patient cohort of those with cancer and those without cancer. Pharmacokinetic analysis was performed using Monolix version 4.4, and the PK parameters were compared in both groups (cancer vs noncancer). The standard and suggested vancomycin dosing regimens were evaluated using PK/PD modeling and Monte Carlo Simulations. RESULTS In total, 448 blood samples were analyzed from 147 patients enrolled in this study, of which 73 patients had cancer and 74 patients were noncancer patients. In general, no significant differences were observed between the two groups (cancer vs noncancer) in all characteristics except for the vancomycin levels, which were significantly lower in patients with cancer (p = 0.00104). This analysis showed that patients with cancer showed a significantly higher vancomycin clearance than noncancer patients (p = 0.002), whereas the volume of distribution (V) was found to be similar in both groups (p = 0.83).This resulted in most of the patients failing to achieve the target area under the curve from zero to 24 hours (AUC0-2 ) to the minimum inhibitory concentration. These data showed that a higher maintenance dose of vancomycin is required to achieve the PD target. CONCLUSIONS The findings of this study showed that the patients with cancer have lower levels of vancomycin due to higher clearance than noncancer patients. Thus, higher doses than the standard vancomycin doses may be needed to treat invasive Methicillin-resistant Staphylococcus aureus infections in patients with cancer.

[ES] El Reino de Arabia Saudita posee alrededor del 15,6% de las reservas mundiales probadas de petróleo crudo, solo superada por Venezuela. La producción de petróleo crudo de Arabia Saudita fue de 585 Mt y las exportaciones netas superaron los 375 Mt en 2016, lo que convierte a Arabia Saudita en el mayor productor de crudo de la OPEP. También es el mayor exportador de petróleo crudo en el mundo con importantes inversiones en el sector petrolero y bajos costos de producción. Además, el petróleo crudo es la principal fuente de ingresos de Arabia Saudita y cualquier problema que afecte a este valioso recurso natural puede dañar seriamente su economía. Además, Arabia Saudita posee el 4,5% de las reservas probadas de gas natural del mundo. Produjo aproximadamente 109,4 Bcm en 2016], aunque todo el gas natural saudí se usa en el país y no se exporta. Sin embargo, existe un serio problema energético en el país. El consumo de petróleo crudo y gas natural en Arabia Saudita ha crecido a una tasa promedio anual de 5.4% y 5.1% desde el año 2000 alcanzando 167.9 Mt y 4.7 Bcm en 2016 respectivamente, lo que genera preocupación sobre la capacidad del país para mantener futuras exportaciones de petróleo crudo. o incluso convertirse en un importador neto de petróleo crudo en poco más de 20 años. Una de las principales razones del aumento en el consumo local de petróleo crudo es el hecho de que la mayoría absoluta de la generación de electricidad en Arabia Saudita se basa en fuentes de combustibles fósiles (gas natural, petróleo crudo, combustible pesado y diesel). Además, el rápido crecimiento de la población y la expansión de la infraestructura industrial, junto con las bajas tarifas de electricidad, aumentan continuamente la demanda de electricidad y, en consecuencia, de combustibles fósiles. El aumento en el consumo de electricidad y el enorme consumo de combustibles fósiles ha causado daños visibles al medio ambiente en diversas formas. La Autoridad Reguladora de la Electricidad y la Cogeneración de Arabia Saudita prevé que la demanda de electricidad aumente de 80 GWe en 2020 a más de 120 GWe en 2030. El objetivo de esta investigación es determinar cuánto combustible fósil se podría ahorrar anualmente mediante la optimización de la combinación de generación de energía en un sistema aislado de generación eléctrica de una ciudad determinada en Arabia Saudita mediante la inversión en un tipo específico de planta de energía sostenible y renovable conectada a la red eléctrica sin una instalación de almacenamiento de energía., [EN] The Kingdom of Saudi Arabia is in possession of about 15.6% of the world s proven crude oil reserves, only second to Venezuela. The crude oil production of Saudi Arabia was at 585 Mt and the net exports exceeded 375 Mt in 2016, making Saudi Arabia by far the biggest crude oil producer in OPEC. It is also the biggest crude oil exporter in the world having significant investments in the oil sector and low production costs. In addition, crude oil is Saudi Arabia s main source of income and any problem that affects this precious natural resource can seriously harm its economy. Moreover, Saudi Arabia has 4.5% of the world s proven natural gas reserves. It produced about 109.4 Bcm in 2016], although all Saudi natural gas is used domestically and not exported. Nevertheless, there exists a serious energetic problem in the country. Crude oil and natural gas consumption in Saudi Arabia has grown at an average annual rate of 5.4% and 5.1% since the year 2000 reaching 167.9 Mt and 4.7 Bcm in 2016 respectively, raising concerns over the ability of the country to maintain future crude oil exports or even becoming a net importer of crude oil in a little more than 20 years. One of the main reasons for the increase in the local crude oil consumption is the fact that the absolute majority of electricity generation in Saudi Arabia is based on fossil fuel sources (Natural gas, Crude oil, Heavy fuel oil and Diesel). Furthermore, the rapidly growing population and the expanding industrial infrastructure, along with low electricity tariffs, is continuously increasing the demand on electricity and consequently fossil fuels. The increase in electricity consumption and the huge consumption of fossil fuels has caused visible damage to the environment in various forms. The demand for electricity is predicted by the Electricity and Cogeneration Regulatory Authority of Saudi Arabia to increase from 80 GWe by 2020 to more than 120 GWe by 2030. The objective of this research is to determine how much fossil fuel could be saved yearly by optimizing the power generation mix in an isolated electricity generation system of a certain city in Saudi Arabia by means of investing in a specific kind of sustainable utility scale grid connected renewable energy power plant without an energy storage facility.

Introduction: Studies supported the use of lipid lowering therapy such as statin as a treatment of hypercholesterolemia for prevention of CHD. However, the use of lipid lowering therapy is not well established in clinical practice due to lack of robust evidence and contra-indications in patients with heart failure (HF). This review aimed at evaluating the evidence about preventive effect of lipid lowering therapy on the mortality caused by coronary heart diseases. Methods: A comprehensive electronic search was carried out using MEDLINE, EMBASE, Cochrane databases to identify articles which aimed at assessing the preventive effect of lipid lowering therapy for coronary heart diseases. The data were collected from included studies using data collection sheets using specific items such as mean patient age, type of coronary disease, mean duration of the disease, drugs of lipid lowering therapy, regime of lipid lowering therapy, duration of lipid lowering therapy, reduction in mortality rate, and associated side effects. Results: Following evaluation of the eligible articles, 11 articles were included with randomized controlled trials investigating the effect of lipid-lowering therapy on the mortality of patient suffering from coronary heart diseases. The sample size in the included studies ranged from 106 to 10355 participants, and the total number of participants among all included studies were 50830 with mean age ranging from 31 to 82 years old. Conclusions: Despite the overall good outcome that is attributed to the use of statins that is not clear weather this benefit is credited to its anti- inflammatory or direct LDL lowering effect.

Background: successful treatment of patients with type 2 diabetes mellitus (DM) is achieved by having a HbA1C of

Introduction: Oral anticoagulants can be used for prevention and treatment of thrombosis. New oral anticoagulants such as rivaroxaban provide more consistent and predictable anticoagulation than warfarin as they are direct factor Xa inhibitor. The aim of this review is to evaluate the evidence of using prophylactic medications to prevent thromboembolism in hospitalized patients. Methods: An electronic search in MEDLINE was conducted with no limits applied regarding age of the patients or the type of injury because some of studied medications are relatively recent and any available study would add significantly to the review. Included studies were aimed to evaluate the use of prophylactic medications to prevent thromboembolism in hospitalized patients who have been indicated to major surgical interventions. Any study met these inclusion criteria were eligible in this review. Results: The MEDLINE search resulted in 97 studies which underwent screening of the eligibility criteria and 11 studies met the inclusion criteria. The thromboprophylaxis effect was higher when rivaroxaban compared to no treatment or placebo, while no significant differences were found when rivaroxaban, dalteparin or low-molecular-weight heparin compared to placebo. Moreover, when medications compared to each other, no significant difference in thromboprophylaxis effect was reported in many included studies. Only edoxaban and dabigatran were found superior to enoxaparin by two included studies. Conclusion: This review showed that new oral anticoagulants could be effective in reducing risk of thrombosis particularly in high-risk patients subjected to major surgery. Keywords: Thrombosis, Prevention, Drugs, Surgery, Anti-coagulants. &nbsp

Over the last few years, the use of solar photovoltaic system has been increased widely. Many studies were focusing in increasing the efficiency of solar photovoltaic (PV) plant and decreasing the cost of it. The trepidation of high penetration of solar photovoltaic (PV) systems impacts, leads governments to conduct clean energy programs to avoid the unfavorable impact of it. Power quality of the power system is considered one of the major issues that need to be addressed. In tacky systems, power quality may cause disturbance and economical losses. This paper presents a time domain model with several case studies of utility scale photovoltaic (PV) plant ratings, which they are 0.25 MW, 0.5 MW, 0.75 MW, 1 MW, 2 MW and 3 MW. The purpose of the study is to show the impact of harmonic distortion with the size variation of photovoltaics plants by analyze the nominal current and voltage output from the inverter at Stander Test Condition (STC) were performed then compared with IEEE Standard under the effect of varying irradiation and temperature conditions.

Aims and objectives. To: (1) examine the incidence, frequency and contributingfactors to workplace violence among nurses and physicians in underserved areasin Jordan, and (2) identify the existing policies and the management modalities totackle workplace violence.Background. Workplace violence is a major problem in healthcare organisations.An understanding of the nature of violence is essential to implementing successfulmanagement.Design. A descriptive exploratory research design.Methods. The questionnaire that was developed in 2003 by the InternationalLabor Office, the International Council of Nurses, the World Health Organiza-tion, and the Public Services International was used to collect data from a conve-nience sample of 521 Jordanian physicians and nurses (396 nurses, 125physicians) who worked in hospitals located in underserved areas.Results. Around 15% of the participants were exposed to physical violence. Thefactors that contributed to workplace violence were related to absence of policies,inadequate staffing and lack of communication skills. Only 16 9% of participantsindicated that there were specific policies available for dealing with physicalworkplace violence. Strengthening security and providing training were some ofthe important factors indicated by participants for decreasing violence in theworkplace.Conclusions. Workplace violence is a problem in underserved areas that needsattention from administrators. Most participants were very dissatisfied with theway the administrators dealt with the incidents.Relevance to clinical practice. Instituting firm policies against perpetrators anddeveloping protective violence guidelines to support healthcare staff in managingworkplace violence are paramount to tackle the problem of workplace violence.Key words: Jordan, physical violence, underserved areas, workplaceWhat does this paper contributeto the wider global clinicalcommunity?