Spatiotemporal assessment of the nexus between urban sprawl and land surface temperature as microclimatic effect: implications for urban planning.

Rapid urbanisation has led to significant environmental and climatic changes worldwide, especially in urban heat islands where increased land surface temperature (LST) poses a major challenge to sustainable urban living. In the city of Abha in southwestern Saudi Arabia, a region experiencing rapid urban growth, the impact of such expansion on LST and the resulting microclimatic changes are still poorly understood. This study aims to explore the dynamics of urban sprawl and its direct impact on LST to provide important insights for urban planning and climate change mitigation strategies. Using the random forest (RF) algorithm optimised for land use and land cover (LULC) mapping, LULC models were derived that had an overall accuracy of 87.70%, 86.27% and 93.53% for 1990, 2000 and 2020, respectively. The mono-window algorithm facilitated the derivation of LST, while Markovian transition matrices and spatial linear regression models assessed LULC dynamics and LST trends. Notably, built-up areas grew from 69.40 km2 in 1990 to 338.74 km2 in 2020, while LST in urban areas showed a pronounced warming trend, with temperatures increasing from an average of 43.71 °C in 1990 to 50.46 °C in 2020. Six landscape fragmentation indices were then calculated for urban areas over three decades. The results show that the Largest Patch Index (LPI) increases from 22.78 in 1990 to 65.24 in 2020, and the number of patches (NP) escalates from 2,531 in 1990 to an impressive 10,710 in 2020. Further regression analyses highlighted the morphological changes in the cities and attributed almost 97% of the LST variability to these urban patch dynamics. In addition, water bodies showed a cooling trend with a temperature decrease from 33.76 °C in 2000 to 29.69 °C in 2020, suggesting an anthropogenic influence. The conclusion emphasises the urgent need for sustainable urban planning to counteract the warming trends associated with urban sprawl and promote climate resilience.

Bacterial Diversity and Antibiotic Resistance Patterns of Community-Acquired Urinary Tract Infections in Mega Size Clinical Samples of Egyptian Patients: A Cross-Sectional Study.

BACKGROUND:  Community-acquired urinary tract infection (UTI) is one of the most common infectious diseases nowadays. Alarming increased levels of antimicrobial resistance are developing globally which limit treatment options and may lead to life-threatening problems. AIM: Our study aimed to collect surveillance data on non-hospitalized Egyptian UTI cases and to develop strategies against multidrug-resistant pathogens (MDR). According to our knowledge, this is the first study to screen this high number (15,252 urine samples) in a short period (three months), providing valuable data on resistance profiles in non-hospitalized Egyptian UTI patients. METHODS: A total of 15,252 urine samples were collected from different patients. Positive cultures were identified using a semi-quantitative method. Kirby-Bauer's disc diffusion method was used for antibiotic susceptibility testing, the double disc diffusion method was used for extended-spectrum beta-lactamases-producing strains, and the Chi-square test was used for statistical data processing. RESULTS: The results showed 61% positive cultures, females accounted for 67.5%. Infants and elderly patients showed the highest positive cultures (74.4% and 69.2%, respectively). Despite Escherichia coli being the most common uropathogen (47.19%), Klebsiella species(24.42%) were the most MDR and extended-spectrum ß-lactamase (ESBL)-producing organisms. E. coli and Klebsiella spp. displayed increased resistance to cephalosporins (75% and 81%, respectively). In contrast, both organisms displayed high sensitivity to carbapenems. Unlike Klebsiella spp., E. coli was highly sensitive (92%) to first-line treatment (nitrofurantoin) for UTI. Moreover, trimethoprim/sulfamethoxazole showed higher sensitivity rates compared to other nations. CONCLUSION:  Despite Escherichia coli being the most often identified bacteria in our isolates Klebsiella spp. displayed higher resistance to the majority of tested antibiotics. Fortunately, trimethoprim/sulfamethoxazole significantly increased sensitivity, especially against E. coli. However, both species showed high rates of cephalosporin resistance. Moreover, It is important to promote Egypt's national action plan for antimicrobial resistance in collaboration with the World Health Organization, especially in the community to minimize the chance of bacterial resistance in the Egyptian community.

Decoding seasonal variability of air pollutants with climate factors: A geostatistical approach using multimodal regression models for informed climate change mitigation.

In response to changes in climatic patterns, a profound comprehension of air pollutants (AP) variability is vital for enhancing climate models and facilitating informed decision-making in nations susceptible to climate change. Earlier research primarily depended on limited models, potentially neglecting intricate relationships and not fully encapsulating associations. This study, in contrast, probed the spatiotemporal variability of airborne particles (CO, CH4, SO2, and NO2) under varying climatic conditions within a climate-sensitive nation, utilizing multiple regression models. Spatial and seasonal AP data were acquired via the Google Earth Engine platform, which indicated elevated AP concentrations in primarily urban areas. Remarkably, the average airborne particle levels were lower in 2020 than in 2019, though they escalated during winter. The study employed linear regression, Pearson's correlation (PC), Spearman rank correlation models, and Geographically Weighted Regression (GWR) models to probe the relationship between pollutant variability and climatic elements such as rainfall, temperature, and humidity. Across all seasons, APs showed a negative correlation with rainfall while displaying positive correlations with temperature and humidity. The GWR and PC models produced the most reliable results from all the models employed, with the GWR model superseding the rest. Moreover, heightened aerosol levels were detected within a rainfall range of 600 mm/season, a temperature range of 25-30 °C, and humidity levels of 75 %-85 %. Overall, this study emphasizes the growing levels of APs in correlation with meteorological changes. By adopting a comprehensive approach and considering multiple factors, this research provides a more sophisticated understanding of the relationship between AP variability and climatic shifts.

Social Media Effect on Personal Self-Esteem Among the Population in Saudi Arabia.

Background Self-esteem is a self-valuation; it is how people perceive their own worth and how valuable they believe they are to others. In this study, our primary objective was to explore the association between social media use and self-esteem among individuals who actively engage with social media platforms in Saudi Arabia. Method This study involved individuals aged 15 and above who are active social media users residing in Saudi Arabia. The data were collected through an anonymous online cross-sectional survey. Participants were recruited using snowball and convenience sampling method. A questionnaire was administered through Google Forms to collect data from participants. The questionnaire was structured into three sections, which included gathering social and demographic information, assessing personal usage patterns, and evaluating individual self-esteem levels using an Arabic valid version of the Rosenberg Self-Esteem Scale.  Results The survey included a total of 2,551 participants. Among them, 51.3% (n = 1,309) were female, 29% (n = 741) fell within the 21-25 age group, 95.7% (n = 2,441) were of Saudi nationality, and 51.6% (n = 1,316) were single. The social media platform most frequently used by participants was TikTok 98.5% (n = 2,512), followed by Facebook 95.7% (n = 2,441), Telegram 89.8% (n = 2,291), YouTube 72.2% (n = 1,942), WhatsApp 66.0% (n = 1,683), and finally, Snapchat 30.7% (n = 1,769). In total, 14.3% (n= 366) have low self-esteem, participants scored around 16.10 ± 1.80, ranging from 5 to 25. The following variables were significantly associated with self-esteem: female sex (83.88% vs 87.52%, X2 = 6.87, p = 0.009), nationality (X2 = 13.507, p < 0.001), marital status (X2 = 12.313, p = 0.006), region (X2 = 18.36, p = 0.001), using Tik Tok (X2 = 4.11, p = 0.043), the frequency of posting comments (X2 = 12.01, p = 0.017), comparing oneself to others (X2 = 27.94, p < 0.001), using social media because of weak personal communication (X2 = 6.56, p = 0.010), using social media to follow news (X2 = 6.89, p = 0.009), and the perceived effect of social media (X2 = 16.28, p < 0.001). Conclusions Our findings revealed that a minority of participants exhibited low self-esteem, and individuals from the Northern region were more likely to report such issues. Sociodemographic factors, including gender, nationality, and marital status, demonstrated associations with self-esteem. Additionally, the frequency of comments, TikTok usage, and peer comparison significantly influenced self-esteem levels.

Medical Admission Prediction Score (MAPS); a simple tool to predict medical admissions in the emergency department.

INTRODUCTION: Overcrowding in the emergency departments (ED) is linked to adverse clinical outcomes, a negative impact on patient safety, patient satisfaction, and physician efficiency. We aimed to design a medical admission prediction scoring system based on readily available clinical data during ED presentation. METHODS: In this retrospective cross-sectional study, data on ED presentations and medical admissions were extracted from the Emergency and Internal Medicine departments of a tertiary care facility in Qatar. Primary outcome was medical admission. RESULTS: Of 320299 ED presentations, 218772 were males (68.3%). A total of 11847 (3.7%) medical admissions occurred. Most patients were Asians (53.7%), followed by Arabs (38.7%). Patients who got admitted were older than those who did not (p <0.001). Admitted patients were predominantly males (56.8%), had a higher number of comorbid conditions and a higher frequency of recent discharge (within the last 30 days) (p <0.001). Age > 60 years, female gender, discharge within the last 30 days, and worse vital signs at presentations were independently associated with higher odds of admission (p<0.001). These factors generated the scoring system with a cut-off of >17, area under the curve (AUC) 0.831 (95% CI 0.827-0.836), and a predictive accuracy of 83.3% (95% CI 83.2-83.4). The model had a sensitivity of 69.1% (95% CI 68.2-69.9), specificity was 83.9% (95% CI 83.7-84.0), positive predictive value (PPV) 14.2% (95% CI 13.8-14.4), negative predictive value (NPV) 98.6% (95% CI 98.5-98.7) and positive likelihood ratio (LR+) 4.28% (95% CI 4.27-4.28). CONCLUSION: Medical admission prediction scoring system can be reliably applied to the regional population to predict medical admissions and may have better generalizability to other parts of the world owing to the diverse patient population in Qatar.

The Influence of Social Media on the Decision of Rhinoplasty Among Adults in the Western and Southern Regions of Saudi Arabia: A Comparative Cross-Sectional Study.

Introduction Rhinoplasty, a cosmetic surgical procedure aimed at altering the appearance of the nose, has gained immense popularity worldwide. Patients undergo this procedure for various reasons, ranging from aesthetic concerns to functional impairments. Social media, being a ubiquitous platform for sharing and consuming visual content, has emerged as a potential influencer for individuals contemplating rhinoplasty. This study aims to investigate the impact of social media on the prevalence of rhinoplasty among individuals residing in the southern and western regions of Saudi Arabia. Methods A cross-sectional study was conducted through an online self-administered questionnaire, targeting male and female adults aged 18 years or older, residing in the western and southern regions of Saudi Arabia. The questionnaire comprised 17 questions, categorized into two sections. The first section sought demographic information, including age, gender, education, and other relevant characteristics. The second section focused on the influence of social media on the decision-making process related to rhinoplasty. Results A total of 1645 participants responded to the survey, with 96.80% being Saudi citizens. The majority of respondents were females (69.11%); 58.52% of the respondents were from the western region of Saudi Arabia, while 41.48% lived in the southern region. Most participants (64.27%) were aged between 18 and 30 years. The study revealed that Snapchat (Snap Inc., Santa Monica, California, United States) was the most influential social media platform, with 43.41% of respondents reporting it as the key influencer for their decision to undergo rhinoplasty. Twitter (Twitter, Inc., San Francisco, California, United States) and Instagram (Meta Platforms, Inc., Menlo Park, California, United States) followed at 22.97% and 12.09%, respectively. Interestingly, 28.42% of respondents acknowledged that social media played a significant role in their decision to undergo rhinoplasty, particularly when promoted by celebrities or trusted figures. Comparing responses from the western and southern regions, the study showed that individuals from the southern region were relatively more influenced by social media, with 27.8% and 29.3% of respondents reporting the influence from the two regions, respectively. Out of the total respondents, only 38.75% reported dissatisfaction with their nose's appearance and condition, while 23.60% expressed a tendency towards undergoing rhinoplasty. Conclusion The study's findings underscore the critical role of social media in influencing patients' decisions to undergo rhinoplasty, particularly in the southern region of Saudi Arabia. Snapchat emerged as the most influential social media platform, with celebrities' pictures before and after the procedure being the leading factor in motivating patients to undergo rhinoplasty. The study highlights the need for further research to explore the potential risks and benefits associated with the influence of social media on patients' decision-making regarding rhinoplasty.

Assessment of long-term mangrove distribution using optimised machine learning algorithms and landscape pattern analysis.

Mangrove ecosystems provide numerous benefits, including carbon storage, coastal protection and food for marine organisms. However, mapping and monitoring of mangrove status in some regions, such as the Red Sea area, has been hindered by a lack of data, accurate and precise maps and technical expertise. In this study, an advanced machine learning algorithm was proposed to produce an accurate and precise high-resolution land use map that includes mangroves in the Al Wajh Bank habitat in northeastern Saudi Arabia. To achieve this, high-resolution multispectral images were generated using an image fusion technique, and machine learning algorithms were applied, including artificial neural networks, random forests and support vector machine algorithms. The performance of the models was evaluated using various matrices, and changes in mangrove distribution and connectivity were assessed using the landscape fragmentation model and Getis-Ord statistics. The research gap that this study aims to address is the lack of accurate and precise mapping and assessment of mangrove status in the Red Sea area, particularly in data-scarce regions. Our study produced high-resolution mobile laser scanning (MLS) imagery of 15-m length for 2014 and 2022, and trained 5, 6 and 9 models for artificial neural networks, support vector machines and random forests (RF) to predict land use and land cover maps using 15-m and 30-m resolution MLS images. The best models were identified using error matrices, and it was found that RF outperformed other models. According to the 15-m resolution map of 2022 and the best models of RF, the mangrove cover in the Al Wajh Bank is 27.6 km2, which increased to 34.99 km2 in the case of the 30-m resolution image of 2022, and was 11.94 km2 in 2014, indicating a doubling of the mangrove area. Landscape structure analysis revealed an increase in small core and hotspot areas, which were converted into medium core and very large hotspot areas in 2014. New mangrove areas were identified in the form of patches, edges, potholes and coldspots. The connectivity model showed an increase in connectivity over time, promoting biodiversity. Our study contributes to the promotion of the protection, conservation and planting of mangroves in the Red Sea area.

Adult Knowledge About Postoperative Complications of Rhinoplasty in the Western Region of Saudi Arabia.

Background Rhinoplasty, a prevalent cosmetic surgical procedure worldwide, is not exempt from associated risks and complications, as with any other surgery. In light of the surging demand for rhinoplasty amongst young adults, it is imperative to acknowledge that the procedure can engender various complications that can be classified as either early or late complications. Examples of early complications include epistaxis and periorbital ecchymosis, while late complications may manifest as enophthalmos or septal perforation. The present study endeavors to gauge the knowledge of rhinoplasty complications among adult residents of the Western region of Saudi Arabia. Methods To achieve the research objectives, a cross-sectional study design was implemented, utilizing a self-administered online questionnaire. The study targeted male and female adults aged 18 years and above residing in the Western region of Saudi Arabia. The questionnaire comprised of 14 items, categorized into socio-demographic and rhinoplasty postoperative complications sections, respectively. Results The study gathered responses from a total of 968 participants, of which 60.95% fell within the age range of 18-30 years. The majority of participants identified as female (77.89%), and Saudi citizens constituted the vast majority of the respondents (96.28%). Among the participants, 22.62% expressed a desire to undergo rhinoplasty, whereas 77.38% indicated no interest in the procedure. Of those who sought rhinoplasty, the majority favored having the surgery performed by a skilled physician (81.74%). Notably, participants exhibited a relatively high level of awareness regarding the postoperative complications of rhinoplasty, with respiratory issues being the most widely recognized complication (66.63%). Conversely, headache, nausea, and vomiting were the least familiar complications (100%). Conclusion The study findings reveal a considerable knowledge gap among adults residing in the Western region of Saudi Arabia concerning rhinoplasty's possible postoperative complications. The results underscore the pressing need to establish comprehensive educational and awareness-raising programs to equip individuals contemplating the procedure with the requisite information to make informed decisions. Future research endeavors could delve into the underlying determinants that drive the desire for rhinoplasty and assess potential interventions geared toward augmenting individuals' comprehension and knowledge of the procedure.

Shotgun metagenomic analysis of bacterial symbionts associated with "Chromodoris quadricolor" mantle.

Nudibranchs are colorful marine invertebrates having a diverse group of understudied animals. Recently, some nudibranch members have acquired some attention while others still have not. Chromodoris quadricolor is a member of the Red Sea nudibranch, which did not have the chance to get significant attention. Unlike various invertebrates, it lacks a shell suggesting that it must defend itself in other ways. Therefore, in the present study, we were concerned about the mantle-associated bacterial communities. Being essential partners of this dorid nudibranch system, we investigated their taxonomic and functional profiles. We performed a whole metagenomic shotgun approach for the mantle bacterial cells after a differential pelleting procedure. In this procedure, we separated most of the prokaryotic cells from the eukaryotic host cells. Our findings showed that the mantle-body part holds a diverse group of bacterial species relating mainly to Proteobacteria and Tenericutes phyla. There were novel findings regarding the bacterial members associated with the nudibranch mollusks group. Various species were not previously recorded as bacterial symbionts with nudibranchs. Those members were Bathymodiolus brooksi thiotrophic gill symbiont (23.2%), Mycoplasma marinum (7.4%), Mycoplasma todarodis (5%), and Solemya velum gill symbiont (2.6%). The presence of these bacterial species assumed a nutritional role to the host. However, some of these species were present in a high abundance, suggesting their important symbiosis with Chromodoris quadricolor. In addition, exploring the bacterial ability to produce valuable products resulted in the prediction of 2088 biosynthetic gene clusters (BGCs). We identified different gene cluster classes. Polyketide BGC class was the most represented. Others were related to fatty acid BGCs, RiPP, saccharide, terpene, and NRP BGC classes. Prediction of the activity of these gene clusters resulted in, mainly, an antibacterial activity. In addition, different antimicrobial secondary metabolites were also detected. These secondary metabolites are considered key components regulating the bacterial species interactions in their ecosystem. This suggested the significant contribution of these bacterial symbionts to protect the nudibranch host against predators and pathogens. Globally, it is the first detailed study concerned with both the taxonomic diversity and functional potentials of the bacterial symbionts associated with Chromodoris quadricolor mantle.

Modeling the spatiotemporal heterogeneity of land surface temperature and its relationship with land use land cover using geo-statistical techniques and machine learning algorithms.

Rapid changes in land use and land cover (LULC) have ecological and environmental effects in metropolitan areas. Since the 1990s, Saudi Arabia's cities have undergone tremendous urban growth, causing urban heat islands, groundwater depletion, air pollution, loss of ecosystem services, etc. This study evaluates the variance and heterogeneity in land surface temperature (LST) because of LULC changes in Abha-Khamis Mushyet, Saudi Arabia, from 1990 to 2020. The research aims to determine the impact of urban biophysical parameters on the High-High (H-H) LST cluster using geospatial, statistical, and machine learning techniques. The support vector machine (SVM) was used to map LULC. The land surface temperature (LST) has been derived using the mono-window algorithm (MWA). The local indicator of spatial associations (LISA) model was implemented on the spatiotemporal LST maps to identify LST clusters. Also, the parallel coordinate plot (PCP) approach was employed to examine the relationship between LST clusters and urban biophysical variables as a proxy of LULC. LULC maps show that urban areas rose by > 330% between 1990 and 2020. Built-up areas had an 83.6% transitional probability between 1990 and 2020. In addition, vegetation and agricultural land have been transformed into built-up areas by 17.9% and 21.8% respectively between 1990 and 2020. Uneven LULC changes in terms of built-up areas lead to increased LST hotspots. High normalized difference built-up index (NDBI) was linked to LST hotspots but not normalized difference water index (NDWI) or normalized difference vegetation index (NDVI). This research could help policymakers develop mitigation strategies for urban heat islands.

The Relationship of ABO and Rh Blood Group Types With Severe COVID-19 Disease Mortality in ICU Patients: Insights From a Single-Center Experience in Southern Saudi Arabia.

Introduction The global COVID-19 pandemic has triggered an unprecedented public health crisis, emphasizing the need to understand factors influencing disease outcomes. This study explores the role of genetic variations in blood group antigens, particularly ABO and RhD, in shaping mortality rates among critically ill COVID-19 patients in the southern region of Saudi Arabia. Methods Utilizing a retrospective, noninterventional approach, we analyzed medical records of 594 COVID-19 patients admitted to the intensive care unit (ICU) at Aseer Central Hospital from August 2020 to April 2021. The cohort, with a mean age of 60.5 years, consisted of a predominantly male population. Results The study encompassed a diverse age range of 18 to 103 years, with a mean age of 60.5 ± 17.3 years. Of the 594 patients, 398 (67%) were male, and only 5 (0.8%) had a history of smoking. Blood group distribution revealed 275 (48.4%) with O-, 189 (33.3%) with A+, and 51 (9%) with AB- types. Predominant chronic conditions included diabetes mellitus (35.5%). Tragically, 320 patients (54.6%) experienced mortality, with a 100% mortality rate for the B+ blood group and 92.9% for O- blood group. Conclusion This analysis establishes significant statistical links, underscoring the pivotal role of blood type, particularly the Rh factor, in influencing mortality risk among critically ill COVID-19 patients. These findings contribute valuable insights into risk stratification and personalized care for severe cases, emphasizing the importance of genetic considerations in understanding disease outcomes.

Egyptian propolis and selenium nanoparticles against murine trichinosis: a novel therapeutic insight.

Trichinosis is a serious zoonotic disease that causes human morbidity and mortality. New effective natural remedies with minimal side effects that are well tolerated are needed to treat both enteral and parenteral trichinosis. This study evaluated the efficacy of selenium (Se), Se nanoparticles (SeNPs) and Egyptian propolis compared with albendazole as antiparasitic, anti-inflammatory and anti-angiogenic agents for treating murine trichinosis. We used parasitological, histopathological and immunohistochemical assays, as well as scanning electron microscopy, to examine adult worms. Overall, 80 Swiss albino male mice were divided into eight groups, with ten mice in each group, as follows: negative control, positive control, albendazole, propolis, Se, combination of propolis and Se, SeNPs and combination of SeNPs and propolis. Mice were slaughtered seven and 35 days after infection to examine the intestinal and muscular phases, respectively. This study demonstrated the efficacy of the combination of SeNPs and propolis. As revealed by electron microscopy, this combination caused damage to the adult worm cuticle. Additionally, compared with albendazole, it resulted in a significant reduction in adult worm and total larval counts; moreover, it caused a decrease in the number of larvae deposited in muscles, with a highly significant decrease in the inflammatory cell infiltrate around the larvae and a considerable decrease in the expression of the angiogenic marker vascular endothelial growth factor in muscles. In conclusion, the combination of SeNPs and propolis had antiparasitic, anti-inflammatory and anti-angiogenic effects on trichinosis. Consequently, this combination could be used as a natural alternative therapy to albendazole for treating trichinosis.

Cardiac magnetic resonance imaging in patients with Behçet's disease.

BACKGROUND: Behçet's disease (BD) is a multisystemic vasculitis that may affect the heart. However, the incidence and nature of cardiac involvement in BD have not been clearly documented yet. The aim of this study was to delineate the cardiac magnetic resonance imaging (MRI) appearances of cardiac involvement in BD patients. METHODS: This cross-sectional observational study was carried out 30 BD patients without known cardiac disease. Patients were subjected to history taking, physical examination, echocardiography and cardiac MRI. RESULTS: At least one abnormality on cardiac MRI was observed in 20/30 patients (66.67%). Myocardial oedema was observed in 3 patients (10%) and late gadolinium enhancement in 1 patient (3.3%). Pericardial effusion was found in 3 patients (10.0%), global hypokinesia in 6 patients (20.0%) and intra-cardiac thrombosis in only 1 patient (3.3%). Pulmonary artery was dilated in 4 patients (13.3%). Left ventricular (LV) and right ventricular (RV) end diastolic volume were altered in 4 patients (13.3%) and 7 patients (23.3%) respectively. LV and RV end systolic volume were abnormal in 7 patients (23.3%) and 5 patients (16.7%) respectively. There was aortic valve regurge in 2 patients (6.7%), tricuspid valve regurge in 9 patients (30%), and mitral valve regurge in 9 patients (30%). Dilated left main coronary artery was found in 2 patients (6.7%) and arrhythmogenic right ventricular dysplasia in only one patient 1 patient (3.3%). On logistic regression analysis, BD activity index score was a significant predictor of cardiac abnormalities. CONCLUSION: BD may cause cardiac abnormalities without clinical manifestations and cardiac MRI may represent a tool for early detection of these subtle abnormalities. Higher BD activity index scores are strongly linked to cardiac problems.

Time for change in practice of in-patient oxygen therapy: a period-limited, multidimensional approach to improve oxygen prescription compliance: quality improvement project at Hamad General Hospital, Qatar.

Prescription of oxygen therapy has traditionally poor compliance across the globe and mostly given to patients on verbal orders leading to under or overuse. The British Thoracic Society (BTS) guidelines (2017) recommend that oxygen therapy must be prescribed. Our study aimed to assess the prescription practice of oxygen therapy for patients admitted to acute medical assessment unit and general medical wards at Hamad General Hospital, Qatar and to achieve 80% compliance of valid oxygen therapy prescription implementing the quality improvement model against the BTS guidelines.The prescription practice of oxygen therapy was audited between April 2019 and August 2019. Using a Plan, Do, Study, Act (PDSA) model of improvement and multiple interventions was performed in the eight PDSA cycles, including (1) educational sessions for residents/fellows/nurses, (2) introduction of electronic prescription, (3) emails, posters/flyers, (4) nurse-led reminders and (5) re-enforced teaching for new residents. Data were then collected using a questionnaire assessing electronic prescriptions and documentation. Our baseline study regarding oxygen therapy showed limited awareness of BTS guidelines regarding the documentation of initiation and further adjustment of oxygen therapy. There was a lack of compliance with oxygen prescription; none of the patients had a valid prescription on our computer-based prescription (Cerner). The duration, target range and indications of Oxygen therapy were documented in 25% (18/72), 45.8% (33/72) and 42% (30/72) patients, respectively. Oxygen was initiated by communication order only. In a total of 16 weeks period, the repeated PDSA cycles showed significant improvement in safe oxygen prescription practices. Following intervention, oxygen electronic prescription, documentation of indications for oxygen therapy, target oxygen saturation and wean-off plan improved to 93%, 85%, 86 % and 80 %, respectively.We concluded that poor compliance to oxygen therapy Orders is a universal issue, which can be successfully managed using small-scale PDSA cycles to ensure sustained improvement through multidimensional interventions, continuous reinforcement and frequent reassessments.

Assessment of potential risk factors for coronavirus disease-19 (COVID-19) among health care workers.

BACKGROUND: Understanding COVID-19 infection among health workers and the risk factors for adverse outcomes is important not only for characterizing virus transmission patterns and risk factors for infection, but also for preventing the future infection of health workers and other patients and reducing secondary COVID-19 transmission within health care settings. Our aim was to identify risk factors for infection among health care workers to limit adverse events in health care facilities. SUBJECTS AND METHODS: A total of 336 HCWs from COVID-19 treatment hospitals took part in the study with varying COVID-19 exposure risk depending on job function and working site. All participants were asked about risk factors for COVID-19 infection. RESULTS: Among our participants, 42.6% were medical doctors, 28.6% nurses and 7.4% assistant nurses and 21.4% were others. Forty four percent of participants had work experience 5-10 years. More than half of participants received training in Infection Prevention and Control (IPC) (56.8%) about COVID 19; 91% have hand hygiene facilities and 69% admitted availability of PPE. More than half of participants admitted that they always follow IPC measures. Two thirds of participants (66.7%) had close contact with a patient since admission; 42.3% were present in aerosolizing procedures for patients. Forty two percent of participants had respiratory symptom; the most common was sore throat representing (32.4%). The highest frequency of respiratory symptoms was among of nurses and assistant nurses 51%. Frequency of respiratory symptoms was higher among those who contacted the patient directly or for prolonged period compared to those who do not admitted these contacts. CONCLUSIONS: Risk factors for COVID-19 represented by those who were smokers, nurses and assistant nurses were more liable to catch COVID-19 than doctors as they contacted the patient directly for prolonged period or his/her body fluids, materials or surfaces around him.

Association of KDR rs1870377 genotype with clopidogrel resistance in patients with post percutaneous coronary intervention.

BACKGROUND: Clopidogrel is an antiplatelet therapy that is widely used in pre and post percutaneous (PCI) coronary intervention procedures to prevent platelet aggregation and stent restenosis. However, there is a wide inter-individual variation in clopidogrel response and some patients showed resistance against the activity of Clopidogrel. Kinase insert domain receptor (KDR) gene is responsible for the transcription of vascular endothelial growth factor receptor 2 (VEGFR2) that plays a major role in the cardiovascular diseases (CVDs) and platelet aggregation. The aim of this study was to find out the association of KDR rs1870377 genotype with clopidogrel resistance (CR) in CVD patients, of Iraqi Arabic origin, hospitalized for elective PCI. MATERIALS AND METHODS: This study was a case-control study with a total of 324 PCI patients. Those patients were classified into 213 patients with non-clopidogrel resistant and 111 patients with CR, depending on the analysis of platelet activity phenotype after clopidogrel administration. KDR rs1870377 was genotyped for all patients using polymerase chain reaction-restriction fragment length polymorphism technique and confirmed by DNA Sänger sequencing through applying Biosystems Model (ABI3730x1). RESULTS: KDR rs1870377 SNP is strongly associated (Chi-sqaure, p vale <0.05) with CR under dominant, co-dominant and recessive models. Additionally, A allele in the rs1870377 SNP may have an impact on the serum levels of VEGFR2 and low density lipoprotein. CONCLUSIONS: KDR rs1870377 SNP is a potential genetic biomarker of CR among CVD patients of Iraqi Arabic origin. Further clinical studies, with larger sample, are required to confirm the findings of this study.

Surface treatment of RMGIC to composite resin using different photosensitizers and lasers: A bond assessment of closed Sandwich restoration.

AIM: The aim of present study was to assess and compare different conditioning methods (laser, PDT and conventional) on shear bond strength (SBS) of resin modified glass ionomer cement (RMGIC) bonded to composite (sandwich technique). MATERIAL AND METHODS: Fifty specimens were prepared from RMGIC and were packed in a teflon mould placed on glass slab. Through each of the glass slab the cement was light cured for 20 s. Now samples were randomly allocated into five groups (n = 10) according to pre-treatment protocols. In group 1 RMGIC were conditioned with MBP using PDT, Samples in group 2 treated with Er,Cr:YSGG (ECYL), group 3 pre-treated with Nd:YAG laser (NYL), samples in group 4 surface conditioned with air abrasion (AA) and group 5 conditioned with 37 % phosphoric acid (PA). Specimens after conditioning were rinsed with distilled water. Adhesive Adper Single Bond 2 was applied on treated surface of RMGIC and cured. Teflon mold was utilized to hold the composite Filtek Z250 in an incremental technique. For SBS testing all specimens were placed under shear knife edge at 1 K N at a speed of 0.5mm2 until bond failure. Optical microscope was used to evaluate failure pattern at 10x magnification. The data of SBS in Megapascal were subjected to statistical test. Analysis of variance was followed by Post hoc test with level of significance at 5 %. RESULT: The maximum SBS was found in group 5 RMGIC conditioned with 37 % PA (16.45 ±â€¯0.32 MPa). Whereas, group 1 (MBP, PDT) demonstrated significantly lower bond integrity (9.82 ±â€¯1.08 MPa) compared to all experimental groups. Bond integrity of RMGIC surface treated with MBP, PDT (9.82 ±â€¯1.08 MPa), group 3 lased with NYL (11.47 ±â€¯0.53 MPa) and samples in group 4 conditioned with AA (11.23 ±â€¯0.47 MPa) were comparable (p > 0.05). CONCLUSION: ECYL has a potential to be used for conditioning of RMGIC prior to composite restoration (sandwich technique). MBP at 100 mg/L deteriorates SBS of composite to RMGIC.

The Impact of Kinase Insert Domain (KDR) Gene Polymorphism rs2305948 on Clopidogrel Resistance in Iraqi Patients Undergoing Elective Percutaneous Coronary Intervention (PCI).

INTRODUCTION: Clopidogrel, the first-choice antiplatelet agent for patient undergoing Percutaneous Coronary Intervention (PCI) along with Aspirin. Clopidogrel resistance is one of the major obstacles that cause MACE and failure of PCI. Kinase Insert Domain (KDR) gene responsible for VEGFR2 coding, the major receptor that translates VEGF ligand. The rs2305948 SNP in VEGFR2 gene has been documented to be involved atherogenesis and in CAD pathogenesis. AIM: To study the impact of KDR gene polymorphism rs2305948 on clopidogrel resistance in patients undergoing elective PCI. METHODS: A case control study with 324 patients documented for elective PCI whom divided according to platelet aggregation level measured into (CR) with 111patients and (NCR) that consists of 213 patients. Serum lipids and VEGFR2 levels, BMI and platelet count were measured. Genotype for rs2305948 was done by PCR-RFLP. RESULTS: Allele frequency and genotype results indicate a significant association with the pathogenesis of CR in all models in CR group compared to NCR group, a significant correlation for T allele with LDL, cholesterol and serum VEGFR2 in dominant and co-dominant models. RFLP-PCR results were documented by gene sequencing and results were compatible with HWE. CONCLUSION: rs2305948 SNP is associated with occurrences of CR and have an influence in the development of other metabolic changes.

Confocal laser endomicroscopy features of sessile serrated adenomas/polyps.

BACKGROUND AND AIMS: Sessile serrated adenomas/polyps (SSA/Ps) are difficult to differentiate from non-neoplastic tissue on white-light endoscopy. Confocal laser endomicroscopy (CLE) provides subcellular imaging and real-time "optical biopsy". The aim of this study was to prospectively describe CLE features of SSA/Ps. PATIENTS AND METHODS: Consecutive patients with SSA/Ps were prospectively evaluated with probe-based CLE imaging. CLE images and polyp histology were independently reviewed by three endoscopists and an expert gastrointestinal (GI) pathologist. Distinguishing CLE features of SSA/Ps were identified in conjunction with pathologic correlation. RESULTS: In total, 260 CLE images were generated from nine SSA/Ps evaluated in seven patients. Four consensus CLE features of SSA/P were identified: (1) a mucus cap with a bright, cloud-like appearance; (2) thin, branching crypts; (3) increased number of goblet cells and microvesicular mucin-containing cells; and (4) architectural disarray, with dystrophic goblet cells and lack of regular circular crypts. CONCLUSION: This is a novel description of characteristic CLE features of SSA/Ps. The four features we identified are easy to detect and may allow for CLE to serve as a diagnostic modality.

Splenectomized versus non-splenectomized patients with thalassemia major. Echocardiographic comparison.

OBJECTIVE: To study the effect of splenectomy in patients with thalassemia major on the cardiovascular system through echocardiographic study. METHODS: A prospective, cross sectional study was carried out from December 2006 to December 2007. Patients from the Thalassemia Center in the Maternity and Children's Hospital, Madina, Kingdom of Saudi Arabia, were screened by means of history, physical examination, laboratory studies, and echocardiography. RESULTS: Fifty-seven patients were studied: 36 were non-splenectomized, while 21 were surgically splenectomized. The 2 study groups were well matched for age, gender, height, and weight. The total amount of blood given during the previous year (6577.1+/-206.9 ml versus 5390.5+/-220.2 ml, p=0.0005), and the annual transfusion index (200.9+/-11.3 versus 134.1+/-7.3, p=0.0001) were significantly lower in the splenectomized group. There was no significant difference between the 2 groups regarding laboratory studies. Left ventricular systolic function shows no difference regarding fraction shortening between the 2 groups. The mitral valve E/A ratio was significantly higher in the splenectomized group (1.6+/-0.2 versus 1.4+/-0.2, p=0.02). The pulmonary artery pressure was higher in the splenectomized group (34.2+/-9.1 versus 20.8+/-9.2 mm Hg, p=0.0001). There was a significantly higher number of patients with pulmonary hypertension in the splenectomized group (14 [66.7%] versus 6 [16.7%], p=0.0004). CONCLUSION: Splenectomized patients with thalassemia major are at high risk of having impaired diastolic left ventricular function and pulmonary hypertension.