bluuebunny/crossref_metadata_2025 huggingface dataset:
Combining fractional-order PI controller with field-oriented control based on maximum torque per ampere technique considering iron loss of induction motor
Authors: Hasan Fadhil A. , Rashad Lina J.
Published: September 2024

This paper presents a combined approach of fractional-order proportional-integral (FOPI) control with field-oriented control (FOC) for maximum torque per ampere (MTPA) tracking. The method maximizes the torque-to-ampere ratio by optimizing the produced torque and minimizing the stator current. This approach reduces power consumption and thereby enhances energy efficiency. Furthermore, the method is improved by considering the rotor iron loss (closest to reality). The complete mathematical analysis, modeling, and simulation are demonstrated. The dominant criteria of the motor, such as rotor speed, electromagnetic torque, and stator current, were compared with the conventional FOC technique. Results showed that the proposed approach significantly exceeds the conventional FOC in terms of drawing current and power consumption, with a 31%–47% and 35%–40% reduction in stator current and average starting current, respectively. Besides, the torque/ampere ratio increased by an average of 24%–39%, with a 12%–17% decrease in consumed kWh for a specific period. The only drawback of the proposed method is that it slightly degrades speed performance, which can simply be ignored. These findings validate the effectiveness of the proposed strategy, especially for battery-powered applications such as electric vehicles.
Resilience and Recovery
Authors: Argyriadis Alexandros , Efthymiou Efthymia , Katsarou Dimitra V. , Sofologi Maria , Argyriadi Agathi
Published: September 2024

This chapter focuses on the critical examination of stress factors affecting adolescents and the effectiveness of various management techniques aimed at fostering resilience and promoting recovery. With the backdrop of escalating stress levels among adolescents driven by academic pressures, social dynamics, and digital media exposure, this chapter identifies emerging research trends that focus on both individual and systemic interventions designed to mitigate stress and enhance mental well-being. The results underscore the significant impact of multi-faceted stress management programs that combine psychological, physical, and social strategies. Techniques that promote mindfulness and emotional regulation, such as meditation and yoga, alongside CBT, were notably effective in enhancing adolescents' resilience to stress. In conclusion, the chapter highlights the imperative for a holistic approach to stress management among adolescents, emphasizing the need for interventions that are adaptable to diverse needs and contexts.
Psychosocial Development for Children and Adolescents Exhibiting Aggressive Behaviour
Authors: Mousoulidou Marilena , Christodoulou Andri , Goutoglou Theodoros
Published: September 2024

Aggressive behaviour in children and adolescents is a multifaceted problem with potentially severe consequences for individuals and society. The present chapter aims to provide a comprehensive literature review, examining the psychosocial dimensions of aggression that contribute to aggressive tendencies, highlighting the early onset and distinct developmental patterns during childhood and adolescence. It also emphasises the detrimental effects of factors such as difficult temperament, parenting style, bullying, social rejection, and hostile attribution bias. It explores the severe consequences of untreated aggression, including academic failure, social isolation, mental health problems, and increased risk of crime and violence. Finally, this chapter advocates evidence-based prevention strategies and interventions targeting individual, family, and social factors to reduce aggressive behaviour. Promising approaches include cognitive-behavioural therapy, parent education programs, and social skills training, fostering positive behaviour change for a safer society.
Beyond Educational Strategies in Promoting Inclusion for Autistic Individuals
Authors: Papoudi Despina , Tsermidou Lia , Perepa Prithvi
Published: September 2024

The aim of the present chapter is to argue that educational strategies are not adequate on their own to promote inclusion for autistic individuals, because this holds only the individual responsible for their inclusion with no onus on the settings or other people involved; as a result, autistic individuals are facing challenges at school and in society throughout their lifespan. Therefore, for inclusion to be enacted, a change of attitudes, perceptions, and stereotypes about the education and development of autistic individuals considering a biopsychosocial bioecological model of disability is deemed critical. This chapter aims to discuss current conceptualization of autism, traditional models of disability in relation to autism and present an overarching framework that sheds light on overcoming existing tensions and challenges in the inclusion of autistic individuals as well as make suggestions for moving forward in promoting inclusion in the autism field.
Juvenile Delinquency
Authors: Siouti Zoi , Tolis Evangelos , Theodoratou Maria , Kaltsouda Anna , Megari Kalliopi , Kougioumtzis Georgios Α.
Published: September 2024

Juvenile delinquency is considered as the act of engaging in any illegal behavior by a person under the legal age of majority. Individual characteristics, family, school, peer groups and society play a crucial role in the adoption of delinquent behavior by a minor. Some protective factors that limit criminal behavior of children and adolescents are the ability of the minor to both self-regulate their emotions and comprehend the consequences of their acts, a supportive family, an efficient parental supervision, commitment in school, and the development of friendships focused on values such as solidarity or empathy. Society plays a crucial role in the moulding of a minor's behavior. The policies/measures that can be taken have to be compatible with a number of dispositions on both national and international level. The proposed chapter seeks to both present the risk factors of juvenile delinquency and suggest techniques for the prevention and repression of criminality in minors.
Impact of Foreign Direct Investment Inflows on Economic Growth in Nigeria
Authors: Ozili Peterson K.
Published: September 2024

This study examines the effect of foreign direct investment (FDI) inflows on economic growth in Nigeria from 2010 to 2019. Using the ordinary least square regression methodology, the findings reveal that foreign direct investment inflows do not have a significant effect on economic growth in Nigeria. The result holds when different measures of economic growth and different measures of foreign direct investment inflows are employed. Meanwhile, population size, real interest rate, domestic private credit and the inflation rate are significant determinants of economic growth in Nigeria while gross capital formation is an insignificant determinant of economic growth in Nigeria. The implication of the findings is that policy makers in Nigeria should focus on other drivers of economic growth other than foreign direct investment inflows when developing policy initiatives to stimulate economic growth in Nigeria.
The Role of IMF on Goods and Services Importing of Argentina, Egypt, and Ecuador
Authors: Ozayturk Ibrahim
Published: September 2024

Following World War II, international economic connections advanced steadily and to significant heights in the context of the global economy. With the signature of the articles of agreement by 29 members, the International Monetary Fund (IMF) was formally established in December 1945.The International Monetary Fund was created to assist nations who are temporarily having problems with their balance of payments so they may avoid imposing import restrictions because of these issues. This study examines how IMF policies affect imports of goods and services and reveals that, as of 2023, the top three countries with the highest IMF debt (Ecuador, Argentina and Egypt). The data collection spans the years 2000 through 2023. There is a thorough literature review included in this study as well. According to the study's findings, the key debtor nations saw temporary financial and monetary relief as a result of the IMF accords, and as was predicted, this led to a corresponding rise in imports.
Covid-19 Disruption in Agricultural Productivity: Lessons from Southwestern Bangladesh
Authors: Billah T. , Ahmed M. B. , Das S. , Mallick P. , Das A. K.
Published: September 2024

Purpose: Bangladesh is a low-lying deltaic nation in South Asia, and as such, its agriculture is continually threatened by various natural disasters, including floods, drought and storms. Additionally, from March 2020 to the end of 2021, Bangladesh’s agricultural productivity encountered grave challenges of the pandemic COVID-19, just like the rest of the world. Therefore, the research was designed to examine how COVID-19 affected agricultural productivity from the perspective of farmers in southwest Bangladesh.Research Method: Face-to-face interviews, paired t-tests, Pearson’s product-moment correlation, multiple linear regression analyses, principal component analyses and cluster analyses were done.Findings: Significant variation was recorded in yield, production cost, gross income and net income between Covid-19 and non-Covid times. During COVID-19, farmers’ perception of crop production was positively correlated to experience, training and in-field extension service whereas market value positively impacted crop yield. During a pandemic, the respondents had the strongest concerns regarding 1) unavailability and the high price of seed, 2) limited transportation facilities and high fair and 3) unavailability of labor and high wages. Principal component analysis (PCA) identified 9 key variables out of 24 explaining the maximum variance of the study. Cluster analysis (CA) categorized all surveyed crops into three clades with cabbage, sweet gourd, eggplant and potato in clade-I being least affected, resulting in relatively higher economic return than others.Value: All things considered, the study’s findings provide insight to policymakers about how to maintain food security and the food supply chain in the event of a future pandemic or other catastrophic event by guaranteeing a steady supply of farming inputs and transportation facilities.
Nutritional Composition, Anti-oxidative and Anti-hyperglycemic Potential of the Kernels of Two Varieties of Terminalia catappa L.
Authors: Wijesekera M. M. T. , Fahmidha H. F. , Ulpathakumbura B. S. K. , Jayasinghe L. , Marikkar J. M. N.
Published: September 2024

Purpose: An attempt was made in this study to compare the differences in nutritional composition, antioxidant capacity, and anti-hyperglycemic effect of the kernel of purple and yellow varieties of Terminalia catappa L (T. catappa L).Research Method: Sampling of ripe fallen seeds of yellow and purple varieties of T. catappa L. was done in the Central Province of Sri Lanka from October to December 2022. Moisture, crude fat, ash, and crude protein contents of seed kernels of the two cultivars were determined using AOAC methods. The differences in fatty acid composition and micro-mineral distributions were also determined using the relevant methods. Sequential extraction of the powdered samples of individual cultivars was performed with hexane, ethyl acetate, and methanol as solvents. The total phenolic content, DPPH radical scavenging activity, alpha-amylase, and alpha-glucosidase inhibitory activities were determined in vitro using relevant assays.Findings: Regardless of the cultivar, the main constituents of the seed kernels were fat (63.30 ± 4.16%) followed by protein (25.58 ± 0.51%). Oleic, linoleic, and palmitic were detected as the major fatty acids of the oil fraction. Among the solvent extracts, the methanol extract of the purple variety had the highest total phenolic content (17.77 ± 0.15 mg of GAE/g). Interestingly, ethyl acetate extracts of both cultivars showed significantly (p<0.05) higher inhibition against alpha-glucosidase (IC50: 104.13a±1.22 mg/dm3)) while the methanol extract of the yellow variety showed the strongest alpha-amylase inhibitory activity (IC50: 2137.95 ± 118.54 mg/dm3).Value: The seed kernel of T. catappa L is a rich source of nutrients and can be used as a raw material for the development of foods meant for diabetic patients.
Agriculture for Sustainable Development to Empower Smallholder Farming Communities
Authors: Abdullah R. , Najim M. M. M. , Esham M.
Published: September 2024

Purpose: Intensive actions implemented to alleviate poverty created many challenges. Millions of people face acute food insecurity; hence, food production needs to be increased to feed the existing and increasing population through sustainable agricultural practices. Sustainable agricultural development is the only way forward to assist humanity.Research Method: Existing literature on sustainable agriculture was reviewed, explored, understood, described, evaluated, and synthesized and their relationships to sustain smallholder farmers were analyzed.Findings: Technological innovations in increasing resource use efficiency, modern breeding techniques, and renewable energy sources aid in achieving sustainability in agriculture. Technology enhances the adaption of agriculture to climate change and increases productivity and the quality of life of farming communities. Smallholder farms with limited information and transportation need government support to access markets with modern commercialization channels. Women need to be empowered to deliver multiple agricultural roles. Wise use of natural resources, optimum allocation, and utilization of resources are vital in enhancing farm productivity. Technical knowledge, availability of inputs, extension services, and financial support are paramount in maximizing productivity and income from agriculture. Agricultural investments need substantial increments to address food insecurity and adaptation to climate change. Dissemination of research findings and experience in sustainable agricultural production practices in informal and formal ways among all agricultural stakeholders is vital in achieving agricultural sustainability. Minimizing postharvest losses through technologies is essential in minimizing global food insecurity to enhance smallholder farmers’ income. Policies related to social, economic, eco-friendly production strategies and environmental aspects directly and indirectly linked to agriculture are vital in these processes. Hence, an integral approach towards the agricultural development of smallholder and subsistence farmers can lead them to sustainability ensuring their food security.
α-Hemolysin from Staphylococcus aureus Changes the Epigenetic Landscape of Th17 Cells
Authors: Pastwińska Joanna , Karwaciak Iwona , Karaś Kaja , Sałkowska Anna , Chałaśkiewicz Katarzyna , Strapagiel Dominik , Sobalska-Kwapis Marta , Dastych Jarosław , Ratajewski Marcin
Published: September 2024

The human body harbors a substantial population of bacteria, which may outnumber host cells. Thus, there are multiple interactions between both cell types. Given the common presence of Staphylococcus aureus in the human body and the role of Th17 cells in controlling this pathogen on mucous membranes, we sought to investigate the effect of α-hemolysin, which is produced by this bacterium, on differentiating Th17 cells. RNA sequencing analysis revealed that α-hemolysin influences the expression of signature genes for Th17 cells as well as genes involved in epigenetic regulation. We observed alterations in various histone marks and genome methylation levels via whole-genome bisulfite sequencing. Our findings underscore how bacterial proteins can significantly influence the transcriptome, epigenome, and phenotype of human Th17 cells, highlighting the intricate and complex nature of the interaction between immune cells and the microbiota.
Association of Gene Polymorphisms with Polycystic Ovary Syndrome: A Meta-analysis
Authors: Abinaya G. P. , Iyshwarya B K , Veerabathiran Ramakrishnan
Published: September 2024

Objectives:

Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder affecting reproductive-aged women. Genetic factors play a significant role in its development. This meta-analysis assesses the associations between specific gene polymorphisms (Vitamin D receptor [VDR] and adiponectin [ADIPOQ]) and PCOS susceptibility.

Materials and Methods:

We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, Collecting data from published articles between 2013 to 2013. Eligible studies were selected based on inclusion and exclusion criteria, with quality assessment performed using the Newcastle–Ottawa scale. Data were extracted, and statistical analyses included odds ratios with 95% confidence intervals for gene polymorphisms. Heterogeneity was evaluated using I
2 tests, and publication bias was assessed using Begg’s and Egger’s tests.

Results:

A total of 33 articles involving 5677 cases and 5257 controls were included in the analysis. Significant associations were observed for VDR TaqI rs731236 polymorphism in the dominant and recessive models and VDR BsmI rs1544410 polymorphism in the dominant and recessive models. For ADIPOQ T45G rs2241766, a significant association was found in the heterozygous model. The results did not reveal any significant associations for ADIPOQ G276T rs1501299.

Conclusion:

This meta-analysis suggests associations between specific gene polymorphisms (VDR and ADIPOQ) and PCOS susceptibility. Further research is needed to validate these findings and unravel the complex genetic factors contributing to PCOS, potentially leading to improved diagnostic and therapeutic strategies.
Comparison of the Percentage of Umbilical Cord Nucleated Red Blood Cells in Preterm Neonates during Vaginal Delivery and Emergency Cesarean Section
Authors: Zakerihamidi Maryam , Heidari Elahe , Boskabadi Hassan
Published: September 2024

Background:

There are insufficient and contradictory reports regarding the effect of delivery method on the rate of umbilical cord Nucleated Red Blood Cell (NRBC). Therefore, the present study aimed to compare the percentages of umbilical cord NRBC in vaginal delivery and emergency cesarean section (C-section) in preterm neonates.

Materials and Methods:

The present cross-sectional study was performed on mothers with vaginal delivery and C-section, from 2020 to 2021. The samples (n = 221) were preterm neonates selected using the convenience sampling method. The percentages of NRBC in neonates born by natural childbirth and by emergency C-section were measured and compared in this research. A researcher-made checklist, which included maternal and neonatal characteristics and laboratory evaluation, was used as a data collection tool.

Results:

The statistical population of thisresearch included 93 (42.10%) and 128 (57.90%) neonates born by vaginal delivery and by C-section, respectively.The mean (SD) score of gestational ages at birth was 30.75 (2.81) weeks. The mean (SD) score of umbilical cord NRBC level were estimated at 8.01 (5.93) and 25.64 (22.61) for the neonates born by natural childbirth and by emergency C-section, respectively (t=-8.43, df = 150, p<0.001). Statistically significant differences were observed in the gestational age (t=-3.36, df = 218, p = 0.001), fifth-minute Apgar score (t=-2.32, df = 200, p = 0.021), umbilical cord NRBC (t=-8.43, df = 160, p<0.001), and short-term prognosis (p = 0.032) between the two groups. It was also revealed that the number of NRBCs in the dead neonates was about 1.5 times higher than that in the discharged neonates.

Conclusions:

Based on the results of the present study, emergency C-section increased the mean of umbilical cord NRBC by three times, compared to that of normal delivery. Since an increase in the NRBC raises the risk of infant death, it is advisable to take steps to maintain the health of children by identifying high-risk neonates through umbilical cord NRBC measurement immediately after delivery and special care.
A Comparison of the Effects of Chlorhexidine and Sodium Bicarbonate Mouthwashes on COVID-19–Related Symptoms
Authors: Karami Hanieh , Aarabi Akram , Hayrabedian Aygineh , Hajhashemi Valiollah
Published: September 2024

Background:

Some studies have reported that mouthwashes can decrease the viral load in the mouth, but there is not much information about the effectiveness of mouthwashes on coronavirus disease 2019 (COVID-19). This study was conducted to compare the impact of using two types of mouthwash, chlorhexidine and sodium bicarbonate, on COVID-19 symptoms and infection.

Materials and Methods:

The present three-group, double-blind clinical trial examined 116 operating room nurses and anesthesia personnel of certain hospitals of Isfahan University of Medical Sciences, Isfahan, Iran. The participants were randomly assigned to three groups: intervention group 1 (chlorhexidine mouthwash), intervention group 2 (sodium bicarbonate mouthwash), and the control group (placebo). Mouthwash was used twice a day (morning and night) for 2 weeks. The participants were monitored in terms of COVID-19–related symptoms for 4 weeks, from the first day of mouthwash use.

Results:

Fisher’s exact test indicated a significant difference between the chlorhexidine and control groups in terms of the onset of COVID-19–related symptoms (p = 0.02). There was no significant difference in the symptoms of COVID-19 between the groups, but the groups were significantly different in terms of all symptoms at a 4-week interval (p = 0.04). Furthermore, headache was less observed in the chlorhexidine (p = 0.007) and sodium bicarbonate (p = 0.03) groups compared to the control group.

Conclusions:

The use of 0.2% chlorhexidine mouthwash can decrease the onset of COVID-19–related symptoms in health-care workers. In addition, this mouthwash can partially reduce the symptoms of this disease in comparison to the control and sodium bicarbonate groups.
Effects of Auriculotherapy on Gestational Hypertension: Randomized Controlled Trial Study
Authors: Keshtkar Ladan , Ranjkesh Fatemeh , Habibi Mohammad , Rashvand Farnoosh
Published: September 2024

Background:

This study aims to observe how auriculotherapy acts as a nonpharmacological treatment for pregnant women’s gestational hypertension.

Materials and Methods:

This study was a randomized controlled trial. Eighty patients were with gestational hypertension recruited and divided into control (n = 40) and intervention (n = 40) groups. The control group just received the usual perinatal care. The intervention group received one month of auriculotherapy in addition to the usual care. Blood pressure was measured before and 15 minutes after rest in both groups twice a week. The data were analyzed using descriptive statistics and inferential tests.

Results:

The mean systolic blood pressure, based on the Mann-Whitney test, was not statistically significant between the two groups before the intervention and in the first two weeks after the intervention (p >0.05); however, after the third week of intervention, the mean systolic blood pressure in the intervention group was significantly lower than that in the control group (p <0.001). As per the Mann-Whitney test, the mean diastolic blood pressure was not statistically significant between the two groups before the intervention and the first week after the intervention (p <0.05). However, after the second week of intervention, the mean diastolic blood pressure in the intervention group was significantly lower than that in the control group, and this decrease was highest in the fourth week of the intervention (p <0.001).

Conclusions:

This study demonstrated that auriculotherapy would reduce blood pressure in pregnant women suffering from hypertension.
Evaluation of Deoxyribonucleic Acid Damage Using Neutral Comet Assay for High Radiation Doses: A Feasibility Study
Authors: Raj Jose Solomon , Suganthy J. , Peace B. S. Timothy , Backianathan Selvamani , Singh I. Rabi Raja , Karuppusami Reka , Christudass Christhunesa Soundararajan , Solomon Raja
Published: September 2024

Purpose:

This study aims to investigate the use of the neutral comet assay to assess deoxyribonucleic acid (DNA) damage in lymphocytes exposed to high doses of radiation.

Materials and Methods:

The research was conducted by obtaining informed consent, after which blood samples were taken from seven healthy individuals and this study was approved by the institutional ethics committee. At first, for the determination of dose-effect curves, samples obtained from the first five individuals were irradiated for doses ranging from 0 to 35 Gy after which they were processed under neutral comet assay. In order to verify the determined dose-effect curves, a test dose of 15 Gy was delivered to the samples obtained from the sixth and seventh individuals. The amount of DNA damage from the obtained comet assay images was analyzed using four comet assay parameters namely % tail DNA, tail length, tail moment (TM), and Olive TM (OTM). The most suitable comet assay parameter was evaluated based on the obtained dose-effect curves. Furthermore, the distribution of individual cells for each dose point was evaluated for all the four comet assay parameters to find the optimal parameter.

Results:

From our results, it was found that from 0 to 25 Gy all the four comet assay parameters fit well into a linear quadratic curve and above 25 Gy saturation was observed. Based on the individual cell distribution data, it was found that % tail DNA could be an optimal choice to evaluate DNA damage while using neutral comet assay for high-dose ionizing radiation.

Conclusion:

The neutral comet assay could be a potential tool to assess DNA damage from high doses of ionizing radiation greater than 5 Gy.
Use of Skin-Bleaching Products among Saudi Population
Authors: Alotaibi Hend M. , Alharthi Raghad M. , AlMutairi Hanadi M. , Alsuhibani Alanoud S. , Alenezi Rakan F. , Alodhayani Abdulaziz A.
Published: September 2024

Background:

The application of skin-whitening products to have fairer and lighter skin tone has now become common practice worldwide. Research supports that even skin distribution and fairer skin are the symbol of attractiveness and superiority.

Objective:

This study aims to determine the belief and awareness about the composition and hazardous effects of skin-whitening products among Saudi population.

Design:

This was a descriptive cross-sectional study.

Methods:

A total of 395 respondents participated in the study. This was a cross-sectional survey study that was carried out in Riyadh, Saudi Arabia. The two-part questionnaire was filled by a convenience sample of 395 Saudi participants. The survey questions were related to whitening creams effectiveness, reasons of use, and the safety of the whitening products. The survey data were analyzed using SPSS version 21.

Results:

The most representative age group who responded was 18–25 years (26%), 73% were female (n = 185), and 53.1% were married. Regarding the level of knowledge among respondents on skin-whitening cream-negative implications, it was found that there is an association between age and whitening cream side effects (<0.05). Ages between 18 and 25 (73.5% said yes) and between 31 and 35 (75.6%) suffer higher from side effects of whitening creams as compared to the other age groups.

Conclusion:

The analysis shows that cosmetic use of skin-whitening creams is more common among females. The people of all age groups were not aware of the deleterious effects of skin-whitening creams. From the study, it was found that people who suffer from the negative effects of creams were mostly of age less than 35.
Prevalence of Workplace-Related Violence among Otorhinolaryngology Residents in Riyadh, Saudi Arabia
Authors: Alsaleh Ahmed Saleh , Almotairi Abdulrahman Ibrahim , Alim Bader Mohammed , Alroqi Ahmad Salman
Published: September 2024

Background:

Violence is one of the prevalent public health concerns that healthcare staff face; a serious problem needs to be focused.

Objective:

The objective of the study is to estimate the prevalence of workplace-related violence among ear, nose, and throat (ENT) residents in Riyadh, capital of the Kingdom of Saudi Arabia, and to identify the common types, perpetrators, and precipitating risk factors of workplace violence (WPV).

Design:

This was a cross-sectional, self-administered questionnaire study.

Settings:

The study was conducted at King Saud University Medical City.

Subjects:

The study subjects were Riyadh's ENT residents.

Intervention:

All Riyadh's ENT residents were invited to participate in the survey in which 80 out of 90 residents participated. Our questionnaire included two domains: one includes demographic data and other includes occupational characteristics and some details related to violence.

Main Outcome Measures:

(1) Prevalence of WPV among Riyadh's ENT residents. (2) Identification of types and risk factors of WPV.

Results:

More than half of our sample had been through a violent experience before, with 60% experiencing it at least once. Most of the violent experiences were with the adult age group of 25–55 years. Male and companions of the patients were found to the most common offenders, and the most leading factors for violence are misunderstanding and miscommunication being at the top of the list at 20%.

Conclusion:

As more than half of the sample has experienced violence, hence, this issues needs to be focused on through different ways, including improving resident's communication skills and improving the reporting system for violent behaviors.
Knowledge, Attitude, and Practice Regarding Shisha Smoking in Jeddah, Saudi Arabia
Authors: Khan Muhammad Anwar , Aga Syed Sameer , Noorwali Amro Abdulhaleem , Allaf Mohammad Faisal , Althagafi Waddah Adel , Bahashwan Adnan Adel
Published: September 2024

Objectives:

Shisha smoking in the middle east especially in Saudi Arabia is one of the traditional ways to consume tobacco which nowadays has transformed beyond just smoking tobacco and has become a style statement among youth across all generations and genders. The aim of this study was to assess the knowledge, awareness, and practice of public about the shisha smoking.

Methodology:

This cross-sectional study was carried out among the public of all levels in Jeddah from September 2018 through March 2019. A predesigned and validated questionnaire about shisha smoking was adopted to achieve the purpose of the study.

Results:

A total of 500 public responded to this survey, of them, 284 (56.8%) were males, while 216 (43.2%) were female; in addition, 294 (58.8%) were single and 328 (66.4%) had bachelor's degree. Around 200 (41.2%) were regular cigarette smokers while 185 (47.1%) were shisha smokers and only 94 (19.2%) smoked both. Among shisha smoker's majority of 75 (59.5%) smoked with friends and 53 (50.0%) shared their hose. In addition, most of the public agreed to the addictive nature of smoking in both forms, however, only 78 (18.4%) believed that shisha to be more addictive than cigarettes. Significant differences were found in smoking status, income, and years of smoking in between genders (P < 0.05). In addition, higher income and higher educational status were significantly associated with the habit of shisha smoking.

Conclusions:

This study found out the prevalence of smoking to be higher among surveyed public, especially shisha in both males and females. However, around 57% of the participants identified the need to quit it.
Epidemiological and Clinical Characteristics of Fatalities from COVID-19 in Saudi Arabia
Authors: Alahmari Ahmed A. , Alowais Jalal , Khan Anas A.
Published: September 2024

Background:

Although Saudi Arabia harbors a large number of confirmed cases with coronavirus disease 2019 (COVID-19), the Kingdom is characterized by a low case fatality rate, compared to that of other parts of the world. Patient-specific factors can play a role in this observation. Thus, we conducted the present retrospective study to investigate the epidemiologic characteristics of all fatalities resulting from COVID-19 infection in Saudi Arabia as of April 27, 2020.

Materials and Methods:

The present study was a multicentric, retrospective study that retrieved the data of all confirmed COVID-19-related deaths in Saudi Arabia from March 2 to April 27, 2020. Only records of the cases who underwent reverse transcription-polymerase chain reaction laboratory tests to confirm the presence of COVID-19 were retrieved. The data of COVID-19 fatalities in Saudi Arabia were obtained from the Health Electronic Surveillance Network of the Ministry of Health.

Results:

Up to April 27, 2020, 147 cases of COVID-19-related deaths were reported in Saudi Arabia. Almost two-thirds of them were aged above 50 years and majority of them were male (83.7%). Health-care workers represented 3.1% of the dead cases (n = 4 cases). The vast majority of the cases were from Makkah (44.9%) and Madinah (21.8%). Among males, the number of Saudi cases was much lower than non-Saudi cases with 22 and 101 deaths, respectively. Over 80% of the included cases had reported signs and symptoms before death, mainly fever and cough. Out of the 129 cases who had available data regarding comorbidities, 104 cases (80.6%) had one or more comorbidities. The median (interquartile range [IQR]) time from the onset of symptoms till test result confirmation was 5.5 (5) days, while the median (IQR) time from sample collection till test result confirmation was 1 (2) day. On the other hand, the median time from symptom onset till hospitalization and that till death was 1 (3) and 7 (8) days, respectively.

Conclusion:

COVID-19 is a growing pandemic with unprecedented spread rate and profound impact on the health of specific subsets of affected patients. In the present report, we demonstrated that fatalities from COVID-19 in Saudi Arabia are more common in older age groups, male patients, and non-Saudi residents. Besides, the presence of comorbidities is highly prevalent among fatalities from COVID-19 in Saudi Arabia. The Saudi health-care system has the advantage of fast-track diagnosis, which, in return, could have contributed to the low case fatality rate observed in the Kingdom. Further studies are required to identify the independent predictors of mortality for patients with COVID-19.
Obstetric Danger Signs Experience and Medical Care Sought among Saudi Women
Authors: Abu-Shaheen Amani , AlFayyad Isamme , Heena Humariya , Nofal Abdullah , Riaz Muhammad
Published: September 2024

Objective:

The objective of the study is to investigate the occurrence of obstetric danger signs and medical care sought during pregnancy, delivery, and postpartum periods among Saudi women.

Study Design:

A cross-sectional survey was conducted on women from the Riyadh community who had delivered during the past 2 years. Sociodemographic characteristics, the occurrence of danger signs during the antenatal, delivery, and postpartum periods were recorded.

Results:

A total of 1397 were included in the analysis. Around 35% of the women had a history of at least one of these three danger signs during pregnancy. Five hundred forty (38.7%) participants had a history of at least one of the obstetric danger signs during a delivery. Five hundred and four (36.1%) participants had a history of at least one of the obstetric danger signs during the postpartum period. The experience of at least one obstetric danger was statistically significant and associated with the northern region of Riyadh (odds ratio [OR] = 2.03, 95% confidence interval [CI]: 1.39–2.97); a higher level of education (OR: 1.42, CI: 1.01–1.98); unemployment (OR: 0.67, CI: 0.48–0.93); and having hypertension (OR: 2.11, CI: 1.42–3.13).

Conclusions:

Although the coverage of ante and postnatal care is good in KSA, awareness programs regarding danger signs at grass root levels in antenatal and postnatal care are needed.
Persistent Symptoms of Severe and Critical COVID-19: A Cross-Sectional Study After more than 120 Days from Disease Onset
Authors: Alraddadi MA , Alyami HA , Alqahtani NT , Khalil NK , Alraddadi AA , Alotaibi NH
Published: September 2024

Objective:

The objective of this study is to assess the prevalence and predictors of symptom persistence associated with severe and critical coronavirus disease-2019 (COVID-19) after more than 120 days from the onset of the disease.

Materials and Methods:

This is a single-center, cross-sectional study of 125 adults who were admitted to King Khalid University Hospital (Riyadh, Saudi Arabia) with severe and critical COVID-19 between March 4 and December 1, 2020. Telephone interviews were conducted between April 1 and May 31, 2021, to collect data on COVID-19 symptoms persisting after more than 120 days from the onset of the disease. All of the participants had been discharged from the hospital and had resumed their normal lives. Symptoms of COVID-19 that had not been present before the onset of the disease were considered to be persistent if participants confirmed their continued presence at the time of the interview. The impact of chronic disease on persistent symptoms was considered.

Results:

About 42.4% (53/125) of patients had at least one or more persistent symptoms; 27.2% (34/125) had breathlessness, 5.6% (7/125) cough, and 4.8% (6/125) chest pain. These three symptoms had been present from the first presentation. Hair loss was reported by 14.4% (18/125), forgetfulness by 8% (10/125), difficulty in concentrating by 6.4% (8/125), and lack of energy by 4% (5/125). Those had manifested after more than 120 days from the symptom’s onset. The major factors in suffering from persistent symptoms were intensive care unit (ICU) admission or/and fever (temperature >38°), or/and diarrhea. There was no correlation between persistent symptoms and chronic diseases.

Conclusions:

After more than 120 days from the confirmation of severe and critical COVID-19, more than one-third of discharged adults were found to have one or more persistent symptoms. These were mainly associated with the need for ICU admission, fever (temperature >38°), and diarrhea. More care needs to be given to COVID-19 patients in the presence of these factors and prolonged medical care would appear to be essential.
Prevalence and Risk Factors of Laryngopharyngeal Reflux in Patients Attending an Outpatient Otolaryngology Clinic: A Cross-sectional Study
Authors: Alotaibi Fahad Z. , Alanazi Maha Muteb , Alshaibani Sara Khalid , Alahmari Lama Ali , Muaibed Rewiada Rashed Bin , Alkholaiwi Feras , Al Hussain Omair
Published: September 2024

Background:

Laryngopharyngeal reflux (LPR) involves retrograde movement of gastric contents to the larynx and pharynx. It is well known among laryngologists to cause various upper aerodigestive tract symptoms; however, it is misdiagnosed in general clinical practice. With very limited studies conducted on LPR in Saudi Arabia, data related to its prevalence and risk factors in Saudi Arabia are lacking. Hence, in this study, we used the validated Arabic version of the reflux symptom index (RSI) as a tool to diagnose and estimate the prevalence of LPR.

Objective:

The current study aimed to identify the risk factors and the prevalence of LPR in patients attending otolaryngology clinics.

Materials and Methods:

This cross-sectional study was conducted among adult patients attending the otolaryngology outpatient clinic. Participants completed a two-part questionnaire before entering the clinic. The first part was designed to collect demographic data, whereas the second part consisted of the validated Arabic version of the RSI questionnaire. A score of 13 or above was considered diagnostic for LPR.

Results:

A total of 166 patients participated in the study. The prevalence of LPR among the study population was 51.2%. LPR was detected more frequently in patients between 21 and 35 years old, and individuals over 65 years were found to have a lower incidence. Smoking and gastroesophageal reflux disease were associated with an increased risk of LPR (P < 0.05).

Conclusion:

LPR is prevalent among patients attending otolaryngology clinics. Physicians should try to identify patients with risk factors and counsel them about lifestyle modifications, with an emphasis on weight reduction strategies and smoking cessation.
Basic Ear, Nose, and Throat Knowledge among Medical Students: A Multi-institutional Study Reflecting the Current Stage of Ear, Nose, and Throat Curriculum in Undergraduate Medical Education
Authors: Alassaf HI , ALturki AY , Almansour NM , Albdulsalam AM , Altameem RM , Alqahtani ZA , Alfahhad Aseel Abdulkarim , Alsayahi Hessah Saad , Alotaibi Fahad Z.
Published: September 2024

Background:

Ear, nose, and throat (ENT) complaints are quite common, representing almost 25% of adults and 50% of pediatric patients visiting primary health-care clinic. However, the duration of undergraduate courses does not correlate with how frequent ENT complaints are, as it does not exceed three weeks in the majority of medical school curriculums. Moreover, this is detrimental as all graduating physicians, regardless of their specialties, will be dealing with ENT complaints in their future practice.

Objective:

To assess medical students’ basic ENT knowledge and to estimate their competency in approaching and managing common otolaryngology cases.

Methods:

This is a multi-institutional, cross-sectional study that included 1124 medical students from all public universities in Riyadh City, Saudi Arabia. Data were collected using an online survey with a validated questionnaire from a previous similar study.

Results:

The level of knowledge among the medical students correlates positively with their comfort level in performing head and neck examinations, as well as confronting and diagnosing ENT cases (P < 0.001). Medical interns displayed higher knowledge scores than medical students; females displayed higher average knowledge scores than their male counterparts (P < 0.05, P < 0.001, respectively). Participants who had 3–4 days per week in ENT services, and those with the intention of pursuing a career in ENT, demonstrated higher knowledge scores (P < 0.001).

Conclusion:

This study demonstrates that participants who spend more time in an ENT service have better knowledge scores than those with less time in the field; this indicates the need for a more extended, focused, and better-structured ENT curriculum for medical graduates to become more efficient in handling ENT cases.
Development and Validation of a Framework for Type 2 Diabetes Patient Self-Management Education Program
Authors: AlAbdulkarim Lamya , AlHassan May , AlShammari Sulaiman Abdullah , Albarrak Ahmed
Published: September 2024

Background and Objective:

Patient self-management education has been a major factor in the intervention and management of chronic diseases as it engages and empowers patients to control and/or prevent complications of chronic diseases. The objective of this study was to develop and validate a framework standard for diabetic patient's self-management education.

Methods:

A quantified qualitative research method was applied to design and validate a patient self-management framework. Previously published 26 international diabetes management standards and guidelines were reviewed, analyzed, tabulated, and coded into three categories; systems, constructs, and themes. The resulting matrix with coding criteria was validated by a 3-session focus group for consensus, verification, and re-verification of the model. Co-researchers reviewed and reclassified the focus group re-verification data with >90% reliability.

Results:

The framework consisted of main three domains: the health system with four constructs and 96 items; the delivery system with five constructs and 139 items; and the system of decision, support, supervision, monitoring, and evaluation with 6 constructs and 32 items. Results are reported for the 3 focus group sessions and the co-researchers' review. It resulted in a modification of <30% of the original framework (N of items = 277 − 203 = 74 [26.7%]).

Conclusion:

A focus group methodology was effectively used to design and validate an appropriate patient self-management education framework. A valid framework of standards and guidelines for type 2 diabetes mellitus self-management was developed and validated to reflect the diabetic patients' needs. An outcome measurement tool would be developed based on the framework to assess the effectiveness of patient self-management outcomes in Saudi Arabian society.
Encouraging Enrollment of Medical Students in Massive Open Online Courses
Authors: Shrivastava Saurabh RamBihariLal , Shrivastava Prateek Saurabh
Published: September 2024

Massive open online courses (MOOCs) commonly refer to a group of courses that are offered on a wide range of interesting topics on the online platform and are generally open for all. An extensive search of materials related to the topic was carried out in the PubMed search engine and relevant research articles published in the period 2016–2019 were included in the review. Amid the ongoing coronavirus disease-2019 pandemic, an exponential rise in the demand for online courses has been reported owing to the reduction in the possibility of conventional face-to-face teaching. These courses help the medical students to become self-directed and lifelong learners and eventually play a significant role in meeting the vision of a competent Indian Medical Graduate. In fact, the Medical Council of India recognized the utility of such courses and has made it mandatory for all the postgraduates and even for teaching staff to enroll in the basic course in Biomedical research as a part of enhancing their exposure to research. In conclusion, the enrollment of medical students in MOOC courses can prove to be extremely useful for them in refining their professional skills. However, it is essential to guide the students to opt for the right course out of the available wide range of courses, so that they take a well-informed decision and get benefited from job perspective as well.
Central Nervous System Sequelae in Patients with Coronavirus Disease 19
Authors: Alhamad Mohamed O. , Alkhlofi Saud A. , AbuIdrees Taha S. , Ahmed Aysha M. , Taheri Salman K. , Alrowaiei Reem A. , Ali Mariam Lafi , Al-Kafaji Ghada , Jahrami Haitham A. , BaHammam Ahmed S.
Published: September 2024

Study Objectives:

This systematic review and meta-analysis was conducted to identify the neurological sequelae and consequences in patients infected with coronavirus disease 19 (COVID-19), as well as to explore the impact of COVID-19 infection on the central nervous system, and the contributing risk factors to the neurological sequelae associated with the disease.

Methodology:

The World Health Organization COVID-19 database, which included data from 31 multiple databases, was used in February 2021. Exclusion of noncohort studies was conducted as well as the exclusion of studies with pediatric age groups (<18 years of age). There was an English language restriction. The random-effect models meta-analysis model was used with the DerSimonian and Laird methodology.

Results:

Nineteen papers, involving a total of 45,181 participants, were judged relevant and contributed to the systematic review and meta-analysis of neurological sequelae in patients with COVID-19. The overall event rate of any given neurological sequelae among all studies was 7.6% (95% confidence interval [CI], 3.0%–17.6%). Meta-regression showed an increase of overall neurological sequelae in relation to age, as well as an increased occurrence in females. Stroke had an event rate of 1.8% (95% CI, 0.9%–3.3%). Headache had an event rate of 6.7% (95% CI, 1.9%–20.7%). Delirium had an event rate of 25.2% (95% CI, 13.9%–41.4%). Intracerebral hemorrhage (ICH) had an event rate of 1.0% (95% CI, 0.4%–2.8%).

Conclusions:

The prevalence of stroke and ICH was higher than that of the global prevalence. Delirium showed a similar prevalence to the global prevalence. Headache was found to have a lower prevalence compared to the global prevalence.