bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Report: Dichorionic-Diamniotic Twin Pregnancy Complicated by a Migrational Anomaly Mimicking a Brain Neoplasm
Authors: Schmitt Eric , Delis Pablo , Pinto Sonia , Rooks Veronica , Gloeb Donald
Published: May 2024

Background

Fetal brain anomalies have a wide differential diagnosis including: (1) congenital genetic and vascular disorders; (2) acquired causes such as infection and hypoxic-ischemic injury; and rarely (3) neoplasm. Fetal brain anomalies are also infrequently seen. Consequently, there is limited literature describing methods of distinguishing these conditions, barring the presence of the most characteristic findings on imaging.

Objective

The purpose of this report is to describe the critical parts of our workup that helped us distinguish a fetal brain migrational disorder from a neoplasm.

Study Design

Case report of a single patient seen at Tripler Army Medical Center and Children’s Hospital of Los Angeles

Case Summary (Results)

24-year-old gravida 1 with a dichorionic-diamniotic twin pregnancy was found to have an intracranial abnormality in Twin A on a transabdominal ultrasound performed at 16w1d gestation. Serial prenatal ultrasounds and complementary fetal magnetic resonance imaging (MRI) studies were performed to distinguish a possible fetal brain tumor from a migrational disorder. Fetal MRIs performed at 19w1d and 23w0d demonstrated a mass-like region increasing in size which was interpreted as highly suggestive of an enlarging fetal brain tumor. Ultimately, additional radiologic findings of fluid filled clefts and polymicrogyria visualized at 32 weeks led to a definitive diagnosis of a fetal migrational disorder.

Conclusion

Features used to diagnose fetal brain anomalies are often nonspecific and develop throughout a gestation. Most of these diagnoses require multiple imaging studies carried out over time to identify key features, and characteristic key features often do not present until very late in a gestation. The differential diagnosis of a dysplastic appearing mass-like region growing in size throughout a pregnancy should include fetal migrational disorders.
Contained Uterine Rupture Managed Conservatively after Vaginal Delivery
Authors: Schmitt Eric , Choi Thomas , Roble Jose , Farlett Johmark , Schmolze Abigail
Published: May 2024

Background

Uterine rupture in an otherwise unscarred uterus is a rare event, with most sources describing it on the order of 1/5700 to 1/20,000 deliveries [1]. Risk factors include high multiparity, use of uterotonics, advanced maternal age, macrosomia, malpresentation, placental invasion, and prolonged labor [2-3]. Historically, management of this complication involves exploratory laparotomy with surgical repair or hysterectomy. Few reports have been published that describe conservative management in the setting of uterine rupture.

Objective(s)

To describe the conservative management of contained uterine rupture.

Study Design

Case report

Case Summary

A 39-year-old gravida 5, para 4 with history of pre-eclampsia was admitted for induction of labor at 40 weeks 0 days. Her intrapartum labor was complicated by pre-eclampsia with severe features. She had a vaginal delivery after 20 hours of induction without immediate complications. Following delivery, the patient complained of severe right lower quadrant pain, which was treated with escalating pain regimen, but continued to worsen. A CT scan was obtained, which revealed a right retroperitoneal hematoma with findings suspicious for uterine rupture. The patient was taken to the operating room for exploratory laparotomy with findings of a right-sided broad ligament hematoma measuring 15 cm by 6 cm, extending into the retroperitoneal space. The surgery ended without additional procedures since the patient was hemodynamically stable, and the hematoma was non-expanding. Postoperatively, she was started on a multimodal pain regimen, and eventually discharged on postoperative day 3 after pain improved.

Conclusion

We describe a contained uterine rupture noted in the immediate postpartum period after an uncomplicated vaginal delivery. Our patient had several risk factors for uterine rupture such as advanced maternal aged, high multiparity, and macrosomia. Surgical exploration noted a large non-expanding hematoma overlying the site of suspected uterine rupture, which was stable. In an otherwise hemodynamically stable patient with contained uterine rupture, conservative management is a reasonable option.
Investigation of the decomposition behavior of the fluoroalkyl acrylate homopolymer and its grafted copolymers onto high-density polyethylene
Authors: Soykan Uğur , Çetin Sedat
Published: May 2024

In this study, the thermal degradation behavior of both poly(3,3,4,4,5,5,6,6,7,7,8,8,8-dodecafluoro-5-methyloctyl-4-(acryloyloxy) benzoate), poly(ABCF13) and its graft copolymers onto high-density polyethylene (HDPE) was investigated in detail. The homopolymers and grafted copolymers were synthesized using the bulk-melt polymerization method in the presence of benzoyl peroxide; 10% and 40% of ABCF13 were used in the graft copolymers. The combined analytical technique, Thermo Gravimetric Analysis coupled with Fourier Transform Infrared Spectroscopy (TGA/FTIR), was utilized to understand the obtained products' thermal behavior and formed decomposition chemicals. The thermal tests were carried out in both air and N2 atmospheres. The experimental results showed that the first weight loss of poly(ABCF13) in air and N2 atmospheres started at about 226°C (1.00%), and the primary and early decomposition product was determined as CO2. The weight loss pattern in graft copolymers at lower concentrations closely resembled that of the homopolymer. However, at higher concentrations, the resulting products exhibited a distinct decomposition mechanism characterized by a gradual decrease in trend. This segmented behavior may indicate the coexistence of the homopolymer and grafted copolymers within the matrix. Moreover, the findings showed that the semi-fluorinated grafted unit had a substantial retardation effect on the polymer.
Eco-friendly dyeing of leather and wood samples using Parthenocissus quinquefolia L. fruits aqueous extract
Authors: Önal Adem , Gökçe Sedanur
Published: May 2024

The present study is relevant to extracting natural colorant from Parthenocissus quinquefolia L. fresh fruits and applying the extracted dye on leather and wood samples in the presence and absence of various mordants. The effect of mordant type (copper sulfate (CuSO4.5H2O) ferrous sulfate (FeSO4.7H2O) and alum (KAI(SO4)2.12H2O) with different mordanting methods (pre-mordanting, meta-mordanting, post-mordanting) on dyeing quality was also examined. The effects of mordants on the color of dyed samples were investigated in terms of CIELab (L*, a*, b*) and K/S values. The dyed samples' light, washing, and rubbing fastness were evaluated according to ISO standards. Although generally good fastness values were obtained for all three mordants, light fastness was low. These results suggest that P. quinquefolia fruits have sufficient potential in dyeing leather and wood.
The production of $B_{4}C$ reinforced metal matrix composite from waste $AZ91$ magnesium alloy using the ball milling method
Authors: Efe Görmez Arife
Published: May 2024

In this study, the Mg/$B_4$C composite reinforced with boron carbide particles was produced by mechanical milling method using waste AZ91 magnesium alloy chips. The mechanical and tribological properties of the produced composites were investigated through hardness and wear tests. A mixture of AZ91 magnesium alloy chips, aluminum, and $B_4$C powders was milled at a rotation speed of 300 rpm with a ball-to-powder ratio of 20:1 for 3 hours. The milled powders were first cold pressed and then sintered at 550 °C for 3 hours. In density measurement, it was observed that the sample reinforced with B4C exhibited an increase in density. In X-ray diffraction analysis, peaks corresponding to Mg, $Mg_{17}Al_{12}$, and MgO were detected, while the $B_4$C phase could not be identified. On the other hand, $B_4$C particles in the microstructure were revealed in the energy dispersive X-ray spectroscopy analysis. Scanning electron microscope images revealed that the Mg/$B_4$C composite had lower porosity, consistent with density measurements. It was found that the hardness and wear resistance of the Mg/B4C composite were higher than those of the Mg alloy, which can be attributed to the presence of homogenously distributed hard B4C particles within the microstructure.
Bijective soft rings with applications
Authors: Koyuncu Fatih
Published: May 2024

In recent years, soft sets have been widely used in many important decision-making real-life problems. In this paper, observing the usage of soft sets in such kind of vital problems, we have introduced the bijective-unitary bijective soft rings. Firstly, we have defined and exemplified a bijective soft ring and a unitary bijective soft ring. Moreover, we have presented some applications of bijective soft rings. We have shown the usage of bijective soft rings in coding theory. In this context, we have observed that by obtaining a bijective soft ring over a finite ring, we have a coding matrix to encode a given set of messages. Besides these applicable results, we have also obtained some relations between bijective soft and classical rings.
A review of recent research on the antimicrobial activities of thiosemicarbazone-based compounds
Authors: Korkmaz Gürsel
Published: May 2024

Thiosemicarbazones can be synthesized by condensation of thiosemicarbazides with ketones or aldehydes and play a role as precursors in the synthesis of many compounds such as thiazoles. They can exhibit many biological activities such as anti-inflammatory, antitumor, and antimicrobial properties. The discovery of antibiotics was an important milestone in the treatment of bacterial infections. However, antimicrobial resistance developed by microorganisms has created the need to discover new antimicrobial agents. Thiosemicarbazones and thiosemicarbazone-based compounds show significant antimicrobial potential. This review investigates the antimicrobial activity results of 244 Thiosemicarbazones and Thiosemicarbazone-based compounds over the last five years. We summarized some articles on thiosemicarbazones and their hybrids showing only antibacterial and antifungal activity in Web of Science (WOS) between 2019 and 2024.
On Some Novel Generalizations of Weak Fuzzy Complex Numbers
Authors:   University Of Applied Science, Faculty of Literature and Science, Manama, Bahrain, Zahraa Zahraa ,   Online Islamic University, Department Of Science and Information Technology, Doha, Qatar, Nadweh Rama Asad
Published: May 2024

The ring of weak fuzzy complex numbers is an extension of real numbers ring by using an algebraic element with fuzzy property. In this paper, we present two novel generalizations of weak fuzzy complex numbers, where the concepts of strong fuzzy complex numbers and split-complex weak fuzzy complex numbers will be defined for the first time with a general study of their elementary properties and special elements. On the other hand, we provide an algorithm to compute the dempotent elements in the ring of split-complex weak fuzzy complex numbers with many related examples that clarify the validity of our work.
The Effects of Price Context and Prior Product Knowledge on Consumers’ Product Evaluations
Authors: Feng Shan
Published: May 2024

This research examines how consumers rely on price and prior product knowledge in product quality evaluations. To understand the interaction effects of price context and prior product knowledge on quality evaluations, a conceptual framework based on cue utilization theory and information processing theory was developed. It is proposed that low knowledgeable consumers are more likely to use price as a quality indicator in a low-priced context; moderate knowledgeable consumers tend to rely on their knowledge to make product evaluations; high knowledgeable consumers are more likely to use their product knowledge in a high-priced context. Experimental studies were conducted using student subjects to test the proposed hypotheses. Results of the experiments showed significant interaction effects between price context and prior knowledge on quality evaluations. A significant quadratic relationship between the use of price and the level of prior product knowledge was observed only in a low-priced context, providing support for the proposed hypotheses in the conceptual model.
Clinical Correlation Between Alopecia Areata and Salmon Patches: A Case Series
Authors: Fauzia Musbah
Published: May 2024

Alopecia areata (AA) has different clinical types moreover its severity can be predicted by the extra-follicular involvement such as nails, eyes, and salmon patch (SP) on the nape of the neck. As provided by previous authors the aim of this study was to determine whether the presence of a salmon patch on the midline of the nape of the neck and whether its size is related to the recurrence of AA after treatment withdrawal and a more severe prognosis. We report a case series of 24 patients with recurrent AA having congenital SP from March 2022 to April 2023 at Tripoli Central Hospital (TCH) and in a private clinic. We found that the majority of the cases were diagnosed with recurrent AA ophiasis (AAO) (n= 11, 45.8%) of which Ten (91%) of them were females and that can be interpreted as an indication of severity since AAO carries the risk of the worst prognosis. The other cases were AA Universalis (n=9, 37.5%), AA Totalis (n=2, 8.3%), and multiple patches AA (n=1, 4.2%). and 11 (45.8%) patients demonstrated large SP and Ten (41.7%) had a small SP. In some cases of SP areas, hair growth was noticed after the treatment. As an alternative in other cases, the areas of SP didn’t show hair growth compared to the other sites.
Libyan community pharmacists' knowledge, attitude, and practice concerning non-prescription dispensing of antibiotics
Authors: Shaiban Rehab i , Alaswa Randa , Alarbe Nora , Rihee Malak
Published: May 2024

Antibiotics are prescription only medications, but their dispensing as over the counter drugs constitutes one of the main causes of antibiotic resistance.  Antibiotic resistance threatens the life of people around the world, as indicated by world and Health Organization. Therefore, a global effort and collaboration are required to decrease and control the development and spread of antibiotic resistance. The purpose of this study is to evaluate the knowledge, attitude, and practice of community pharmacists regarding dispensing of antibiotics without prescription (DAWP) in Libya. Self- administered questionnaire has been created with a cross sectional design and statistical package for social sciences(SPSS) version 27.0 was used for descriptive statistics analysis. The vast majority of respondents were female (82.2%) and (79.4%) of respondents were less than 30 years old. About 43% of community pharmacists reported that they dispense antibiotics without prescription. Feeling competent to dispense antibiotics as over the counter drug was the most common reason for antibiotic dispensing without prescription.  Amoxicillin, Azithromycin and Metronidazole were the most commonly dispensed antibiotics without a prescription respectively. In summary, dispensing antibiotics without a prescription is widespread in Libya, especially
When patient asks for a particular antibiotic.
Evaluation of Practices about Pediatrics Cardiac Catheterization among Nurses at District Head Quarter Hospital
Authors: Parveen Sajida , Bashir Mehwish , Akhtar Shamim , Perveen Shagufta , Ullah Saif
Published: May 2024

Pediatric cardiac catheterization is a critical procedure that plays a vital role in diagnosing and treating congenital heart defects and other cardiac conditions in children. This procedure involves inserting a catheter into the heart chambers or vessels through a vein or artery. Nurses play multifaceted roles throughout the continuum of cardiac catheterization. Objective: To evaluate the practices of nurses about pediatrics cardiac catheterization. Methods: This study employed cross-sectional descriptive design at pediatric department of a District Head Quarter (DHQ) Hospital. Target population was registered nurses of age above 20 years and who had at least 6 months of practical experience with cardiac pediatric patients.  Data were collected conveniently through observational checklist and analysis was done through SPSS Version 24.0. Results: Majority nurses were not encouraging bed rest to the pediatric patients nor keep affected extremity bend for 2-4 hours (80%) after catheterization. Moreover, they did not regularly check the vitals of the children and unable to monitor in every 15 minutes /hour or 30 minutes for next hour (81%). Nurses were unable to educate the pediatric parents for the removal of pressure dressing and nor assess the dressing site appropriately (92%). Conclusions: The present study findings suggested that majority nurses have poor practices before and after cardiac catheterization procedure while some have an average level of practices during the procedure. So, training programs should be arranged to enhance the practices of nurses about cardiac catheterization in pediatric population.
Comparison of Oral Versus Intravenous Iron Therapy in Improving Hemoglobin Status in Patients of Chronic Kidney Disease
Authors: Nawaz Hamza , Rehman Faheem Ur , Talal Umer , Habib Muhammad Farukh , Nawaz Huda , Amin Zainab , Chattha Ali Naseem
Published: May 2024

Anemia (particularly iron deficiency) is an important concern in patients with chronic kidney disease (CKD) as it reflects the outcome of the disease. Objective: To compare the treatment efficacy of oral versus intravenous iron supplementation in improving the hemoglobin status of patients with chronic kidney disease not on hemodialysis or erythropoietin. Methods: Randomized controlled trial was carried out in Medicine Department of Pak Emirates Military Hospital, Rawalpindi from Jun 2023 to Dec 2023. Patients in Group I received intravenous iron sucrose 200 mg once a week diluted in 500 ml of 0.9% normal saline given over 60-90 minutes. Patients in Group O received oral iron supplementation in a dose of 325 mg (containing 65 mg of elemental iron) thrice a day taken one hour before taking their meals with a glass of water. The treatment was continued for 4 weeks. Results: Mean values of serum iron were 84.41±5.56 mcg/dl in Group I versus 84.67±5.43 mcg/dl in Group O before the start of therapy (p=0.726). Serum values for iron post-therapy were 143.40±6.01 mcg/dl in Group I versus 125.35±6.68 mcg/dl in Group O (p<0.001). Mean values for serum hemoglobin were 7.74±0.74 g/dl in Group I versus 7.61±0.82 g/dl in Group O before the start of therapy (p=0.256). Serum values of Hb post-therapy were 12.31±0.71 g/dl in Group I versus 9.91±0.82 g/dl in Group O (p<0.001). Conclusions: We conclude that Intravenous (IV) iron is superior to oral iron supplementation in improving iron stores and Hb levels in CKD patients not on dialysis and/or erythropoietin
Mandarin/English dual language immersion teachers’ understanding of translanguaging pedagogy
Authors: Yuan Ye , Lee Jin Sook
Published: May 2024

Translanguaging pedagogy has gained wide recognition in the field of education as an effective approach to educate emerging bilinguals. This study examines how bilingual teachers understand and adopt this approach in Mandarin/English dual language immersion programs. Four elementary school teachers employed at three different Mandarin/English dual language immersion programs in California were interviewed in-depth about their perspectives on the use of translanguaging pedagogy and their translanguaging stance in their instruction. Guided by the constructs in the Translanguaging Allocation Policy model (Sánchez et al., 2018), the analysis revealed that teachers held an incomplete understanding of translanguaging pedagogy, largely due to a lack of understanding of the theoretical basis upon which translanguaging practices are built in varying teaching contexts. Thus, the teachers mostly resorted to translations as one of their main translanguaging pedagogical practices and saw it as a means to bridge understanding across two languages. In order to support the accessibility of translanguaging pedagogy to a broader range of practitioners, recommendations for professional development and teacher training as well as suggestions for the Translanguaging Allocation Policy model (Sánchez et al., 2018) are provided.
A study to evaluate the role of antioxidants and iron as diagnostic markers in oral cancer
Authors: Yajamanam Naresh , Shetty Nireeksha , vangalapati Bheemesh , Hegde Preethi , babu Suresh , Ali Mehaboob , N Kundubai , Kshatriya Mamatha
Published: May 2024

Oral cavity (OC) and oropharyngeal (OP) cancers afflict about 500,000 people globally. Dental health care practitioners need to understand the causes, diagnosis, and treatment of oral cavities and oropharyngeal cancer. The constant and direct exposure of oral mucosal cells to tobacco product chemical carcinogens such as polynuclear aromatic hydrocarbons and nitrosamines causes the generation of free radicals/reactive oxygen species. Changes in salivary antioxidant and micronutrient levels may prove to be an important factor in the pathogenesis of oral premalignant and malignant disorders. The present study aimed to evaluate the levels of Vitamin C, MDA and iron levels in oral cancer, pre-malignant group and the oral cancer group. 15 oral cancer patients, 30 premalignant condition patients, and 15 normal controls were analyzed in the study. Among the 30 patients of the premalignant conditions- group (Group S1) 12 were diagnosed with oral submucous fibrosis, and 18 of them were diagnosed with oral leukoplakia. The oral cancer patients (Group S2) were segregated based on the TNM system from stages I to IV. The oral submucous fibrosis patients were subdivided into four grades. The oral leukoplakia patients were categorized into homogenous and speckled types. A detailed history was obtained from the patients. After obtaining informed consent, saliva samples will be collected from patients who have not consumed any food or any form of tobacco 2 hours before collection. Following a thorough mouth rinse using distilled water, saliva is allowed to accumulate in his or her mouth for 5 minutes. Accumulated saliva is collected by the spit method. 5ml of blood sample will also be collected from these patients, Serum was separated by Centrifugation. Collected serum and saliva were stored at -80℃ until further analysis. The serum and salivary samples were then analyzed for Vitamin C, iron, and malonaldehyde (lipid peroxidation) according to the standardized protocol. In the present study, a total of 60 samples were screened for Vitamin C, Iron, and MDA in both serum and saliva of normal control, premalignant, and oral cancer patients. We found that there was a decreased level of Vitamin C and iron in both serum and saliva of premalignant and oral cancer patients. MDA level was higher in premalignant, and oral cancer patients and there was a significant increase in the level of MDA in oral cancer patients. Understanding antioxidants can help reduce the incidence of oral cancer in its early stages. More study is needed before this supplement may be recommended as an adjuvant treatment.
A RARE CASE OF PEUTZ-JEGHERS SYNDROME PRESENTING WITH MELENA
Authors: Anjum Neha , Chilakala Harish
Published: May 2024

Peutz-Jeghers Syndrome (PJS) is a rare autosomal dominant disorder characterized by hamartomatous polyps throughout the gastrointestinal tract and distinctive mucocutaneous pigmentation. We present a case of PJS in a 17-year-old male who presented with melena, which led to the discovery of multiple hamartomatous polyps in the small intestine, colon, and stomach. Despite the rarity of this syndrome, prompt recognition of its clinical manifestations, including gastrointestinal bleeding, is crucial for early diagnosis and management. This case underscores the importance of considering PJS in the differential diagnosis of patients presenting with melena, as timely intervention can prevent serious complications such as bowel ischemia and malignant transformation. Additionally, it highlights the significance of comprehensive surveillance and screening protocols for individuals with PJS to detect and manage associated malignancies and gastrointestinal complications effectively.
Editorial
Authors: Alabdulwahhab Khalid
Published: May 2024

From Editor’s Desk…

Twenty million new cases and ten million cancer-related deaths were predicted to occur worldwide. Every year, around 2.7 million people in the European Union are diagnosed with cancer, with this statistic anticipated to climb in the future. Around 40% of cancer cases in the EU are preventable. Safe and effective vaccines are available, and they have the potential to save many lives. A number of governments and firms are developing cancer vaccines.

A global trial of the first personalized mRNA cancer immunotherapy for melanoma has begun at University College London Hospital (UCLH), indicating a significant breakthrough in 2024. Melanoma is the deadliest type of skin cancer. Each year, 8,400 new cases are reported in the United Kingdom. It presently ranks fifth.

Exactly two months ago, the Russian scientists stated that they were close to developing cancer vaccines, which might transform cancer treatment worldwide. While he did not specify which cancers or pathways he was targeting, several countries and companies are already investigating similar treatments.

An investigational treatment technique for pancreatic cancer using the messenger RNA (mRNA)-based therapeutic cancer vaccine candidate autogene cevumeran continues to show promise in eliciting an immune response, potentially lowering the risk of cancer returning after surgery.

According to the World Health Organization, there are currently six licensed vaccines against human papillomaviruses (HPV), which cause a range of cancers, including cervical cancer, as well as vaccines against hepatitis B (HBV), which causes liver cancer.
Furthermore, researchers have obtained critical funding to develop LungVax, which aims to kill cancer cells using a strategy similar to that used to create the AstraZeneca COVID-19 vaccine. CureVac N.V. and the University of Texas MD Anderson Cancer Center established a collaboration to develop and license new mRNA-based cancer vaccines.

Reference:
•https://www.paho.org/en/campaigns/world-cancer-day-2023-close-care gap#:~:text=Globally%2C%20there%20were%20an%20estimated,10%20million%20deaths%20from%20cancer.
•https://www.reuters.com/business/healthcare-pharmaceuticals/putin-says-russia-is-close-creatingcancer-vaccines-2024-02-14/
•https://news.sky.com/story/groundbreaking-lung-cancer-vaccine-being-developed-13099391
•https://www.mskcc.org/news/can-mrna-vaccines-fight-pancreatic-cancer-msk-clinical-researchers-are-trying-find-out
•https://www.nihr.ac.uk/news/trial-begins-for-groundbreaking-new-personalised-melanoma-treatment/35928

Dr. Khalid Mohammed Alabdulwahhab
Editor in Chief
The Impact of bilateral endoscopic thoracic sympathectomy on hyperhidrosis patients’ quality of life and its link to psychiatric disorders
Authors: Alsalamah Shahd , Alotaibi Taif , Alfarraj Sarah , Aljabr Reem , Alnassar Leena , Almezail Hussah , Alosaimi Fahad
Published: May 2024

Background and Aims:
To measure the Quality of Life (QOL) of patients with hyperhidrosis after undergoing Bilateral en¬doscopic thoracic sympathectomy (BETS), and its association with psychiatric disorders, that were diagnosed using MINI psychiatric interview, and compensatory hyperhidrosis (CH).

Methods:
A retrospective cross-sectional study was carried out on patients with primary hyperhidrosis after undergoing BETS. 50 Patients were recruited from King Saud University Medical City database and contacted via phone calls. The interview contained a hyperhidrosis-specific QOL questionnaire, and a diagnostic psychiatric questionnaire MINI. The QOL results were classified into 5 categories and used to study QOL and its associated factors.

Results:
The reported QOL before the operation has 52% of the patients showing negative QOL. Alternately, the reported QOL after the operation improved with 96% patients showing positive QOL. Among this sample, 76% reported suffering from CH post procedure, 28% were diagnosed with one or more mood disorders, and 20% were diagnosed with one or more anxiety disorders. No statistical relationship was found linking the QOL of the sample to the occurrence of CH or the presence of any common psychiatric disorder.

Conclusions:
In conclusion, there was a significant improvement in the patients’ QOL after BETS. The improvement in QOL was unaffected by the surgeries most notable complication, compensatory hyperhidro¬sis, or the presence of any common psychiatric disorder that they were diagnosed with post-surgery. Further research is needed to explore factors that may affect the QOL of these patients.
Modify approach for Radiology utilization rate calculation in emergency Department at Saudi Arabia
Authors: Waly Mohamed
Published: May 2024

Background and Aims:
Healthcare debates emphasize optimizing costly imaging equipment use (e.g., CT, X-rays) contributing significantly to expenses. This study assessed American and Canadian utilization techniques, integrating a modified equation. Objectives were to aid decision-makers in evaluating current equipment use and refining equations for better efficiency.

Methods:
Data collection and analysis evaluated current utilization approaches. Comparative analysis using the modified equation highlighted differences between American and Canadian standards, offering insights for improvement.

Results:
Findings revealed disparities in techniques used in both healthcare systems. The modified equation enabled a detailed comparison, pinpointing areas for enhancement. Decision-makers gained a comprehensive understanding of equipment usage, identifying avenues for efficiency and resource optimization.

Conclusions:
The study underscores the necessity of reassessing and refining utilization equations for expensive medical equipment. Insights provided a roadmap for decision-makers, enabling them to implement strategies enhancing efficiency and maximizing resource potential. By aiming for more effective utilization, healthcare systems can navigate challenges posed by costly imaging equipment, ultimately advancing healthcare quality and accessibility.
Assessment of the variation of the pulmonary gas exchange model in the critical care setting
Authors: Ismaeil Taha , Othman Fatmah , Alanazi Abdullah , Alotaibi Tareq , Algarni Saleh , Aljohani Hassan , Alqahtani Mohammed , Alosaimi Khalid , Alzahrani Khalid , Alkhalil Yousef , Alotaibi Mohammed , Alharbi Abdullah
Published: May 2024

Background and Aims:
In intensive care units (ICUs), clinicians use various mathematical models to assess and monitor respiratory illness. However, evidence suggests that some pulmonary internal and external physiolog¬ical factors are not integrated in the calculation of these models. This research aimed to demonstrate the variation in these models within a short period in critical care settings.

Methods:
A retrospective cohort study was conducted from 2017 to 2019 with adults admitted to an ICU and mechanically ventilated for more than 24 hours. Two different arterial blood gas samples were selected within a mean of 120 minutes. The coefficient of variation percent [(CV%)=SD/Mean] was calculated.

Results:
In total, 211 intubated ICU patients were included. The mean age was 57 (SD +/- 19.62) years, and 33% were female. The degree of variation of the average CV% for all the mathematical models was 14%-30%. The mean CV% for the arterial oxygen tension to inspired oxygen fraction (PaO2/FiO2) and arterial/alveolar oxygen tension ratio (PaO2/ PAO2) was 14%, which is a low variation compared to the respiratory index (RI) for which the mean CV% was 30%.

Conclusions:
The findings of this study indicate that most of the existing oxygen mathematical models used in clinical settings lack physiological realism, necessitating a new mathematical model that integrate both assess illness severity and enhance other models’ accuracy.
Understanding Knowledge, Practices, and Barriers in Metered Dose Inhaler Use Among Sri Lankan Patients with Bronchial Asthma and Chronic Obstructive Pulmonary Disease
Authors: Siriwardhana VMIP , Walisundara WMDP , Ushani APMD , Dissanayaka HMRB , Sriyani KA , Marikar FMMT
Published: May 2024

Background and Aims:
Despite declining mortality rates, asthma and chronic obstructive pulmonary disease (COPD) continue to pose significant public health challenges with persistently high morbidity rates. One prominent con¬tributing factor is the inadequate use of prescription metered dose inhalers (MDIs) by patients, leading to insufficient dosing and suboptimal disease control. Thus, it is crucial to assess patients’ knowledge, practices, and barriers concerning MDI usage.

Methods:
This descriptive convenience sampling, conducted at Polonnaruwa District General Hospital in Sri Lanka, enrolled 250 participants to investigate MDI-related behaviors. Questionnaire was used as data collection tool and sampling technique is conveniet sampling. Microsoft Excel spreadsheet and SPSS version 20 (IBM Corporation, New York, USA) software were used for statistical analysis.

Results:
The majority of participants were aged over 40, with a higher proportion of females (59%) than males (39%). Over half of them had been managing bronchial asthma and COPD for more than five years. Notably, all participants were MDI users, but 59% reported disease exacerbations occurring more than four weeks ago, with dust being the primary trigger (45%). Healthcare professionals, especially nurses and doctors, were common sources of MDI education. However, none of the participants demonstrated correct inhalation technique both before and after receiving education, raising significant concerns.

Conclusions:
This study highlights the inadequacies in MDI utilization among participants, emphasizing the urgent need for improved patient education by healthcare professionals. Addressing these knowledge and skills gaps related to MDI usage is essential for enhancing asthma and COPD management, ultimately leading to improved patient outcomes and a reduced disease burden.
Improving Outdoor Sound Distance Navigation for Visually Impaired People Using BLSTM and CRF
Authors: Bakouri Mohsen
Published: May 2024

Background and Aims:
This study aims to develop a prototype that utilizes sound-based systems to localize individuals with visual impairments. In this study, the wireless ultrasound network is proposed and used to facilitate autonomous navigation and maneuvering for individuals with visual impairments.

Methods:
In the proposed method, we designed robust algorithms for ultrasonic systems with sound waves of high frequency to detect obstacles in the surrounding environment. The algorithms were developed using voice recognition method, bi-directional long short-term memory (BLSTM), and conditional random fields (CRFs). The proposed system was implemented with the help of assisting hardware instruments, such as an ultrasonic sensor network and a global positioning system (GPS). To analyze different outdoor settings, the Raspberry pi4 was used to locate and store the coordinates (points of interactive latitude and longitude) of four different outdoor places. These including home, mosque, laundry, and supermarket.

Results:
According to our results, the proposed approach was capable of accurately navigating the specific site with an accuracy of 98.5%.

Conclusions:
The proposed method was able to obtain a robust outdoor localization for VIP.
Structural studies on azadirachtin targeting the glucuronosyltransferase from lymphatic filariasis and its inhibition
Authors: Malki Esam
Published: May 2024

Background and Aims:
Brugia malayi, Brugia timori, and Wuchereria bancrofti are parasitic worms that cause lymphatic filariasis, also known as elephantiasis in some parts of the world. Because no effective vaccines and current treatments have adverse pharmacological properties, this condition has sparked much interest in the drug discovery community. This research aims to assess the efficacy of azadirachtin against a possible therapeutic target, intestine glucuronosyltransferase protein, in treating and preventing lymphatic filariasis.

Methods:
I-Tasser was used to create the protein, Uniprot was used to collect its FASTA sequences, and Galaxy Refine was used to refine the protein model. The protein 3D model was tested using PROCHECK and ERRAT. We used PubChem to get the three-dimensional structure of the azadirachtin ligand molecules. To study the toxicity profiles and pharmacokinetics, researchers employ SwissADME. Molecular docking studies were conducted using the AutoDock tool, and Pymol viewer was used to observe the interactions between the target protein and the ligand molecules.

Results:
The azadirachtin compound has a satisfactory range of pharmacokinetic parameters in terms of its absorption, distribution, metabolism, and excretion. When compared to the currently existing drug Diethylcarbamazine, molecular docking studies indicate that the azadirachtin molecule binds with the intestinal glucuronosyltransferase proteins of Brugia timori, Wuchereria bancrofti, and Brugia malayi strongly.

Conclusions:
In sum, our understanding of the mechanism by which azadirachtin, a traditional component derived from plants, inhibits intestinal glucuronosyltransferase protein is enhanced, and this could pave the way for the development of new targeted anti-filarial agents.
Students’ perspective of Simulation Based Clinical Teaching in Surgery Block - an experience at Qassim University, Saudi Arabia
Authors: Salati Sajad , AlSulaim Lamees , AlTuraif Norah
Published: May 2024

Background and Aims:
Due to the lesser availability of patients for bedside teaching, simulation-based teaching sessions were added to enhance clinical skills, and the perspective of the students and their impact on grades attained in clinical skills assessment were analyzed.

Methods:
Six simulation sessions were conducted using simulated patients and mannequins to cover topics including examination of the abdomen, thyroid, lump, ulcer, rectum, and breast. At the end of the block, a brief, self-designed anonymous questionnaire was used to conduct an online survey to assess the students’ perspective, and the results were analyzed. The clinical skills evaluation results were compared to the grades of students who had previously graduated and received traditional training.

Results:
The satisfaction level was high, and the majority of students felt that their confidence levels and clinical skills had been enhanced. Various shortcomings in the conduct of simulation sessions were pointed out, and possible solutions were suggested. The grades attained by the students in clinical skills assessment had shown significant improvement.

Conclusions:
Simulation-based clinical skills teaching is an effective academic tool and has the potential to make up for the deficiencies in traditional bedside teaching.
Telemedicine Practice and Perceived Skills Among Primary Healthcare Physicians in the Riyadh Second Health Cluster, Saudi Arabia
Authors: Alrowaily Mohammed , Mustafa Sara , Mohammed Elsir , Makkawi Salma , Palani Kanagarajan
Published: May 2024

Background and Aims:
Telemedicine is increasingly being adopted by primary care professionals in Saudi Arabia, necessitating the development of new skills and approaches in this field. The aim of this study is to evaluate the utilization and perceived skills of primary care physicians in telemedicine within the Riyadh Second Health Cluster in Saudi Arabia.

Methods:
A cross-sectional study was conducted among physicians using a self-administered electronic questionnaire from April to October 2022. The questionnaire, developed by the research team, encompassed socio-demographic information, prior experience and future intentions regarding telemedicine, and perceived proficiency using a 5-point Likert scale. Descriptive statistics, frequencies, percentages, and statistical tests (Chi-square and Fisher’s exact tests) were employed for data analysis, with a significance level of p<0.05.

Results:
A total of 130 valid responses were received, with an average age of 40.6. Most participants reported prior experience with telemedicine (74.6%), with Sehhaty (36.2%) and Anat (23.8%) being the most frequently utilized applications, while telephone and email (4.6%) were used the least. The intention to adopt telemedicine in the future was high, at 86.2%. The perceived confidence in utilizing telemedicine skills was generally high among the surveyed physicians.

Conclusions:
The study revealed that primary care physicians possessed a high level of telemedicine practice and confidence in their teleconsultation abilities. This presents an opportunity to advance care delivery models based on telemedicine technology. The widespread use of Sehhaty and Anat indicates increasing acceptance of telemedicine among the population, underscoring the need for expert support to meet the expected demand.
Investigating Different Paradigms of Electrical Stimulation for Retinal Prosthesis
Authors: Alqahtani Abdulrahman
Published: May 2024

Background and Aims:
Retinal prostheses have been suggested to restore vision for those with retinal diseases. This study aimed to identify the most effective stimulation approaches for retinal prostheses.

Methods:
This study examined various return electrode configurations on a realistic retinal ganglion cell model. Two return electrode configurations, monopolar and hexapolar, were implanted on epiretinal side. There were four waveforms used to send electrical current through the active electrode. The study also compared two stimulation methods: single stimulation and concurrent (parallel) stimulation.

Results:
Directly placing the retinal ganglion cell beneath the active electrode resulted in no significant difference in the required current for stimulating retinal ganglion cells between monopolar and hexapolar return electrodes, regardless of the stimulation waveform. For retinal ganglion cells located away from the active electrode, differences in the required current were noted between the two return electrode configurations. The study discovered that parallel stimulation with two or three active elec¬trodes lowered current requirements by up to 70% compared to single stimulation. Monophasic anod¬ic stimulation yielded the most effective pulse waveform, regardless of the configuration (monopolar or hexapolar) or stimulation mode (single or parallel). Moreover, monophasic cathodic stimulation usually targets retinal ganglion cells around the active electrode.

Conclusions:
These results illuminate the best stimulation strategies for enhancing the efficacy of retinal prosthe¬sis. The study highlights the importance of electrode arrangement, waveform selection, and single or concurrent stimulation for improving retinal ganglion cell activation.
Cardiovascular risk factors of tea garden workers from a district of West Bengal, India
Authors: Ahmed Ashfaque , Yasmin Shamima
Published: May 2024

Background and Aims:
Cardiovascular risk factors in tea gardens have been seldom studied. The risk factors for these marginalized population needs attention for public health interventions. The current research aimed to assess the risk factors for cardiovascular diseases among tea garden workers in the Alipurduar district of West Bengal, India.

Methods:
An observational, descriptive cross-sectional study was conducted among 463 tea garden workers working in a district of West Bengal, India to assess risk factors for cardiovascular diseases. Proforma was filled along with clinical examination and evaluation of records. Diseases classified as per ICD- 10. Statistical analysis was done with Microsoft excel 10.

Results:
Most of the study participants were from marginalized society (81.2% tribals). 76% were female. More than 50% (55.9%) were illiterate. 67.2% were from lower income group. As per ICD-10 classification, 24.2% have some non-communicable disease. Risk factors like addiction was quite prevalent (67.2% for tobacco and 57.1 % for Alcohol).

Conclusions:
Risk factors for cardiovascular disease are quite prevalent among the marginalized population, which needs high priority for intervention.
Biomarkers associated with coagulation in COVID-19 patients: A literature review
Authors: Madkhali Yahya
Published: May 2024

The coronavirus disease (COVID-19), a highly contagious illness, has resulted in one of the worst pandemics in history. COVID-19, unlike other pandemics, has novel transmission mechanisms and produces diverse health-related issues. Severe acute respiratory syndrome coronavirus 2 infection has been associated with thrombocytopenia, neutropenia, and lymphopenia, all of which disrupt the coagulative system and may lead to potentially fatal consequences, including pulmonary embolism. In this review of the oft-documented complications of COVID-19, including venous thromboembolism and pulmonary embolism, coagulative and inflammatory markers, such as ferritin, D-dimer, C-reactive protein, and lactate dehydrogenase have been evinced and the therapeutic options are discussed briefly. It is crucial to detect potential issues early and initiate anticoagulant-based treatments, such as low-molecular-weight heparins and unfractionated heparins to optimize patient outcomes. Therefore, a thorough understanding of COVID-19 pathophysiology and the ability to recognize coagulation abnormalities that are linked to a poor prognosis are necessary to improve patient outcomes.
Right thoracic kidney – A rare case report in a female patient
Authors: Jayakumar Saikarthik
Published: May 2024

Ectopic kidneys are one the most common forms of renal anomalies. However, intrathoracic kidneys are extremely rare, especially on the right side. Reporting of such cases is relatively very less common in the literature, particularly in the case of females. The current case is an accidental finding noted in a 56-year-old female who came with complaints of diffuse abdominal pain. An initial ultrasound abdomen revealed an absence of the right kidney in the right renal fossa and computer tomography done later revealed a right intrathoracic kidney with a higher origin of the right renal artery (T12 vertebral level). The right ureter was longer and opened into the bladder normally. The author presents this case because of its anatomical, developmental, and clinical importance.