Diagnosis and management of infantile epileptic spasms syndrome (IESS) in Gulf Cooperation Council (GCC) countries: Expert consensus statement.

Despite the availability of international recommendations for the management of Infantile Epileptic Spasms Syndrome (IESS), there is a lack of recommendations adapted to the local context of clinical practice of pediatric neurology in the Gulf Cooperation Council (GCC) countries. By an initiative from the Saudi Pediatric Neurology Society (SPNS), a literature review was performed and an expert panel comprised of 13 pediatric neurologists from all GCC countries (Saudi Arabia, Kuwait, Bahrain, Oman, Qatar, and the United Arab Emirates) was subsequently convened to discuss all issues related to the management and diagnosis practices of IESS in the GCC. The overall aim of this consensus document was to develop practical recommendations to support the care of patients with IESS in the GCC and to reflect on how clinical management approaches compare with those adopted internationally.

Urolithiasis in patients with inflammatory bowel disease: A systematic review and meta-analysis of 13,339,065 individuals.

BACKGROUND: This study aimed to summarize the current literature regarding the prevalence of renal stones in patients with inflammatory bowel disease (IBD). Moreover, we aimed to evaluate the risk factors of urolithiasis in patients with IBD and the difference between patients with IBD and healthy controls in terms of urinary profile. METHODS: On February 23, 2022, a computerized search was conducted on PubMed, OVID via MEDLINE, Web of Science, and Scopus using relevant keywords. Three independent reviewers performed 2-stage screening and data extraction. The National Institutes of Health tools were employed for quality assessment. Review Manager 5.4 software was used to calculate the mean difference (MD) between IBD patients and non-IBD in terms of urine profile using the Inverse-variance model and to estimate the odds ratio of reported risk factors for renal stones with the Generic Inverse-Variance model. RESULTS: Thirty-two articles (n = 13,339,065 patients) were included. The overall prevalence of renal stones in patients with IBD was 6.3%, 95% Confidence interval (4.8%-8.3%). The prevalence of urolithiasis was more common in Chron's disease vs Ulcerative colitis (7.9% vs 5.6%) and in old studies (1964-2009) than in more recent studies (2010-2022) (7.3% vs 5.2%), respectively. Compared to non-IBD patients, patients with IBD were associated with significantly lower urine volume (MD = -518.84 mL/day, P < .00001), calcium 24-hour urine (MD = -28.46 mg/day, P < .0001), citrate 24-hour urine (MD = -144.35 mg/day, P < .00001), sodium 24-hour urine (MD = -23.72 mg/day, P = .04), and magnesium 24-hour urine (MD = -33.25 mg/day, P < .00001). CONCLUSION: The overall prevalence of renal stones in patients with IBD was comparable to the general population. Patients with Chron's disease were associated with a higher prevalence of urolithiasis compared to Ulcerative colitis. Drugs that induce renal calculi should be stopped in high-risk patients.

Assessment of Saudi Females' Knowledge Regarding Human Papillomavirus Infection, Screening, and Available Methods for Prevention: A Cross-Sectional Study in Qassim Region.

Introduction Human papillomaviruses (HPV) are known to be the main culprit of cervical cancer. It is the fourth most common cancer among women worldwide. In recent years, it has begun to spread more widely in Saudi Arabia. Saudi Arabia's Ministry of Health recently added HPV vaccination for women to the list of recommended vaccinations. Aim This study aimed to assess Saudi females' knowledge regarding HPV infection, screening, and the available tools for prevention in Qassim, Saudi Arabia. Subject and methods This is a descriptive cross-sectional study conducted among women living in the Qassim region of Saudi Arabia. A self-administered pre-structured questionnaire was distributed among the targeted women using an online platform. The questionnaire includes socio-demographic characteristics (i.e. age, education, occupation, etc.) knowledge questionnaire and a questionnaire about the attitude toward HPV protection. The minimum required sample size was 385. This means 385 or more measurements/surveys are needed to have a confidence level of 95% that the real value is within ±5% of the measured/surveyed value. All females aged 18 years and above who are living in the Qassim region of Saudi Arabia were included in our study. Males are excluded from this study. All data analyses were performed using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Version 26.0, Armonk, NY). Results Of the 387 women involved, 52.2% were aged between 18 and 25 years old. The prevalence of women who have heard of HPV was 49.1%. Fifty-four percent were willing to accept HPV vaccination if offered. The overall mean knowledge score was 3.56 (SD 2.51) out of 11 points. Poor knowledge levels constituted most of the women (71.1%), 24.5% had moderate knowledge and only 4.4% were considered good. Increased awareness was more prevalent in younger women, more educated, those who underwent Pap smear, and those who were willing to accept HPV vaccination. Conclusion The awareness of women toward HPV infection was deficient. Younger women who had a better education and who are willing to receive HPV vaccination were more likely to demonstrate better awareness levels toward HPV infection as compared to the rest of the women. More research is needed to establish the level of awareness among women in our region.

Saudi Arabia-China-Pakistan Economic Corridor: intergovernmental green initiatives.

The objective of the study is to conduct the socio-economic and environmental survey about the feasibility of Saudi Arabia-China-Pakistan Economic Corridor (SCPEC) in five different dimensions, i.e., (i) key strengths of SCPEC project, (ii) prospective weaknesses of SCPEC project, (iii) opportunities attain Pakistan from SCPEC project, (iv) opportunities gain SCPEC from Pakistan, and (v) possible threats from SCPEC to other countries, including India. The larger number of intellects participated in this survey, including armed personnel working in strategic industries, academicians of higher education institutes, colleges, and public/private schools, doctors, civil servants, employees of non-governmental organizations, and others. The survey identified five major key strengths, including tourism promotion, infrastructure development, technology diffusion, energy demand, and mutual trade gains, while the prospective weaknesses are financial constraints, political instability, international dumping, corruption, and lack of good governance. The survey results show that Pakistan economy could attain maximum opportunities from SCPEC project in the form of economic empowerment, mutual trade gains, transportation development, entrepreneurship, and development of Gwadar port, while the SCPEC project gains from Pakistan in the form of economic stabilization, trade gains, and low transportation cost. The possible threats to SCPEC project to the other countries including India are political threats, security issues, Kashmir issue, and economic issues. The survey results conclude that the large number of intellects confirmed the positivity of SCPEC project for both the Pakistan and for the Chinese economy, while few intellects in numbers are incompatible with the SCPEC project due to economic, environmental, and security threats.

Socio-economic and environmental factors influenced the United Nations healthcare sustainable agenda: evidence from a panel of selected Asian and African countries.

The objective of the study is to evaluate socio-economic and environmental factors that influenced the United Nations healthcare sustainable agenda in a panel of 21 Asian and African countries. The results show that changes in price level (0.0062, p < 0.000), life risks of maternal death (4.579, p < 0.000), and under-5 mortality rate (0.374, p < 0.000) substantially increases out-of-pocket health expenditures, while CO2 emissions (5.681, p < 0.003), prevalence of undernourishment (15.184, p < 0.000), PM2.5 particulate emission (1557, p < 0.000), unemployment, and private health expenditures (30.729, p < 0000) are associated with high mortality rate across countries. Healthcare reforms affected by low healthcare spending, unsustainable environment, and ease of environmental regulations that ultimately increases mortality rate across countries. The Granger causality estimates confirmed the different causal mechanisms between socio-economic and environmental factors, which is directly linked with the country's healthcare agenda, i.e., the causality running from (i) CO2 emissions to life risks of maternal death and under-5 mortality rate, (ii) from depth of food deficit to incidence of tuberculosis and unemployment, (iii) from PM2.5 emissions to infant mortality rate, (iv) from foreign direct investment (FDI) inflows to PM2.5 emissions, (v) from trade openness to greenhouse gas (GHG) emissions, and (vi) from mortality indicators to per capita income, while there is a feedback relationship between health expenditures and per capita income across countries. The variance decomposition analysis shows that (i) under-5 mortality rate will increase out-of-pocket health expenditures, (ii) unemployment rate will increase mortality indicators, and (iii) health expenditures will increase economic well-being in a panel of selected countries, for the next 10 years.

Management of green transportation: an evidence-based approach.

The objective of the study is to examine the impact of air-railways transportation on environmental degradation in the form of high mass carbon emission, natural resource depletion and forest depletion in the context of Pakistan by using an annual time series data from 1975 to 2016. The results show that railway passengers carried increases carbon emissions while air-railways transportation and travel services degrade environment in the form of natural resource depletion. The study verified "pollution haven hypothesis" where trade liberalization policies increases carbon emissions; however, "population genius" principle is hold where population growth conserve natural resources and environment through affluence and technology. The study concluded that government should take serious action to re-define transportation infrastructure in order to promote environmental sustainability agenda by introducing green vehicles and green transportation system, which is imperative for country's long-term sustainable development.

Moderating and mediating role of renewable energy consumption, FDI inflows, and economic growth on carbon dioxide emissions: evidence from robust least square estimator.

The relationship between renewable energy consumption (REC), foreign direct investment (FDI) inflows, economic growth, and their resulting impact on CO2 emissions is widely discussed area in energy and environmental literature; however, there is an unseen literature on moderation and mediation effect of per capita income and FDI inflows with the renewable energy consumption on CO2 emissions in developing countries like Pakistan, which is being evaluated in this study by using a consistent time series data for a period of 1975-2016. The results show that economic growth and FDI inflows both increase CO2 emissions, while REC substantially decreases CO2 emissions during the study time period. The results do not support the inverted U-shaped Environmental Kuznets Curve (EKC) hypothesis for per capita income (and FDI inflows) and per capita CO2 emissions in a country. The results supported 'pollution haven hypothesis' where FDI inflows damage the natural flora of the country. By inclusion of moderation and mediation effect of per capita income and FDI inflows with the REC on CO2 emissions averted the positive impact of REC, and converted into negative externality, where environmental sustainability agenda is compromised by lower environmental regulations and unsustainable production techniques that increase country's economic growth. The study concludes that by adding REC in existing energy portfolio may help to reduce CO2 emissions while strict environmental compliance may disregard the negative externality of unsustainable production and it will support to achieve green development programmes in a country.

Food-beverage-tobacco consumption, smoking prevalence, and high-technology exports influenced healthcare sustainability agenda across the globe.

The objective of the study is to analyze the long-run, causal, and inter-temporal relationships between food-beverage-tobacco consumption, smoking prevalence in male and females, and high-technology exports and their resulting impact on global healthcare sustainability agenda in a panel of 19 European, North American, and Asian countries during a period of 1990-2016. The results show that the sample countries are largely affected by high mass consumption of food, beverages, and tobacco, due to which the health spending is very high in their economies that increase healthcare costs and mortality rates accordingly. The relationship between death rate and per capita income is found negative in a panel of selected countries, where high death rates substantially decrease country's per capita income. The Granger causality estimates confirm the unidirectional causality running from (i) high-technology exports to CO2 emissions, (ii) smoking prevalence of male and female to health expenditures, (iii) industrial value added to mortality, (iv) health expenditures to per capita income, (v) per capita income to death rates, and (vi) food, beverages, and tobacco consumption to mortality indicators, whereas, the inter-temporal causation confirmed that lifetime risk of maternal death will largely influence health expenditures in a panel of selected countries for the next 10-year time period.

The Effect of Satellite Laboratory Installation on Chemotherapy Waiting Time in an Oncology Treatment Unit.

Background Timely treatment is a patient's right. Increasing the efficiency of laboratory testing could potentially improve hospital operations, provide quicker access to health services, and have a positive impact on patient experience. Installation of a satellite laboratory may shorten laboratory turnaround time (TAT) and chemotherapy waiting time. Method The laboratory TAT and chemotherapy waiting time were analyzed and compared before and three years after the establishment of the satellite laboratory. Result The mean laboratory TAT decreased from one hour and 30 minutes at baseline in 2012 to 43, 43, and 37 minutes in 2013, 2014, and 2015, respectively; a reduction rate of 59%. Mean chemotherapy waiting time also reduced, from a 2012 baseline of 252 minutes to 170, 157, and 146 minutes in 2013, 2014, and 2015, respectively; a reduction rate of 42%. Conclusion The reduced chemotherapy waiting time after the installation of a satellite laboratory had a positive impact on patient care. It also reduced employee workload and maximized the utilization of hospital resources.