War Injuries and Nurses' Well-Being: Fatigue and Sleep Quality Among Critical Care Nurses in Najran Region, Saudi Arabia.

Introduction Critical care nurses must maintain optimal work performance. Fatigue and sleep disturbance can limit safe practice and cause negative patient outcomes. This study aimed to explore fatigue and sleep quality among critical care nurses in the war zone in Najran City, Saudi Arabia. Methods A cross-sectional research design was used and a convenience sample was applied to include 352 nurses working in critical units at various hospitals in Najran City, Saudi Arabia. A self-administered questionnaire containing three parts was used: demographic characteristics, the Pittsburgh Sleep Quality Index (PSQI), and the Fatigue Severity Scale (FSS). Results The study revealed that 232 nurses (65.9%) reported poor sleep quality. Regarding fatigue levels, 89 nurses (25.2%) reported severe fatigue and 113 (32.1%) reported moderate fatigue. Notably, caring for war-related injuries exhibited a significant positive correlation (r = 0.62, p = 0.0001). Experience correlated negatively (r = -0.47, p = 0.003) with sleep quality and fatigue scores. Most significantly, involvement in caring for war-related injuries showed a strong positive correlation (r = 0.71, p = 0.00001) with FSS scores. Conclusions Poor sleep quality was significantly widespread among the studied nurses. The results indicated that about one-quarter of the studied nurses reported severe fatigue, which was alarmingly prevalent among nurses. Nurses involved in caring for war-related injuries exhibited a strong positive correlation with both PSQI and FSS scores. Recommendations The authors recommend developing and implementing counseling and stress management programs to address the unique challenges faced by nurses caring for war-related injuries.

Integrated resonance Rayleigh scattering approach utilizing Box-Behnken experimental design for the facile quantification of prucalopride in pharmaceutical tablets and human urine with sustainability assessment.

Prucalopride (PCP) is one of the recent drugs used for the regulation of gastrointestinal tract motility and the treatment of constipation. A new, highly sensitive and fast resonance Rayleigh scattering (RRS) approach was suggested for PCP determination. The approach was based on its reaction of PCP with eosin Y in buffered medium (pH 3.5) to form an ion pair association complex which had a significant enhancement in RRS compared to that of eosin Y or PCP alone. The enhancement of RRS intensity had straight correlation to PCP concentration ranging from 150 to 2000 ng mL-1 with 38 ng mL-1 as LOD and 125 ng mL-1 as LOQ. The measurements were done at a wavelength of 365 nm that provided the maximum sensitivity. All the experimental parameters were studied carefully and optimized via Box-Behnken experimental design. The International Council for Harmonization (ICH) guidelines were employed to validate the suggested method and the obtained results proved the appropriate method performance. The method was efficiently utilized to determine PCP in pure form, pharmaceutical tablets and spiked urine samples with no interferences from the surrounding matrices. Furthermore, the greenness of the suggested procedure was confirmed using different green metric approaches.

Sensitive spectrofluorimetric determination of the prokinetic drug prucalopride succinate based on supramolecular aggregation approach with evaluation of method greenness: application to content uniformity test.

The prokinetic drug, prucalopride (PCP) succinate, was determined using a new spectrofluorimetric approach with a highly sensitive, rapid, and simple procedure. The method exploited the enhancement of the inherent native fluorescence of PCP by micellar aggregation with sodium lauryl sulfate (SLS) as an anionic surfactant. Different factors that could affect the fluorescence intensity were carefully studied in order to achieve the maximal fluorescence signal. Measurement of the enhanced fluorescence was done at 354 nm after the excitation at 276 nm. The fluorescence intensity-concentration plot was rectilinear in the concentration range of 50-600 ng/ml with detection and quantitation limits of 13.9 and 42.1 ng/ml, respectively. The method underwent validation according to the International Council for Harmonisation criteria in order to assess its analytical performance, and promising results were achieved that proved the validity and reliability of the method. Furthermore, the method was employed effectively for the analysis of the cited drug in commercial pharmaceutical tablets.

Level of knowledge, acceptability, and willingness to use oral fluid HIV self-testing among medical students in Kilimanjaro region, Tanzania: a descriptive cross-sectional study.

BACKGROUND: HIV Self-Testing (HIVST) is universally accepted as an innovative strategy complimenting existing HIV testing services to archive the UNAIDS, 95-95-95 goals by 2030. However, the adoption of HIVST is lagging in most sub-Saharan countries, including Tanzania. This study aimed to determine the level of knowledge, acceptability, and willingness to use HIVST among Medical students in Kilimanjaro region, Tanzania. METHODS: A descriptive cross-sectional study using a self-administered, semi-structured questionnaire was conducted from May to June 2019 among 271 medical students aged 18-44 years enrolled in a degree of Medicine course at Kilimanjaro Christian Medical University College. RESULTS: A total of 271 participants were enrolled (response rate of 100%). The mean age was 23.9 (SD 2.9), the majority (91%) were Christians, being single (92%), and a half (50.2%) were males. More than half (55.7%) was sexually active, 67.5% reported the age of first sexual debut at 19 years and above. The majority (81.5%) reported that they had one sexual partner, 37% used condoms during the last sexual act. The majority (98.7%) had never had a sexually transmitted disease during the past 3 months, 22.5% reported using alcohol when having sex. More than three-quarters (79%) ever tested for HIV, and 41.6% tested for HIV in the past year. More than two-thirds (67.9%) had a high level of knowledge on oral fluid HIV self-test. Being a female was related with high level of knowledge (P = 0.225). The acceptability of HIVST was 62.7%, and about two-thirds showed a willingness to buy a self-test kit if available for public use. CONCLUSIONS: The high level of knowledge on oral fluid HIV self-testing, acceptability and willingness to buy self-test kit if available for public use among sexually active medical students underscores the importance of introducing HIVST as a complementary approach for existing HIV testing services in this setting. To make HIVST effective, interventionist should address concerns associated with self-testing, such as lack of pre and post-test counseling, suicidal risks after receiving HIV positive results, perceived risks of inaccurate HIVST test results, lack of linkage to care of individuals receiving HIV positive results, perceived risks of intimate partner violence, coercive testing of a female partner, and perceived high cost of buying self-test kits.

Switch on fluorescence probe for the selective determination of lisinopril in pharmaceutical formulations: application to content uniformity testing.

Lisinopril, an ACE inhibitor, was selectively determined in pharmaceutical products using spectrofluorimetry. The method was based on the switch on fluorescamine fluorescence as a result of its interaction with the primary amino group of the drug in the presence of aqueous borate buffer (pH 9.5). The fluorescence emission was measured at 475 nm after excitation at 390 nm. The fluorescent product was suggested to be a diaryl pyrrolone cation which has a coplanar structure. Different experimental conditions affecting the reaction were optimized to give the maximum sensitivity. The fluorescence intensity was linear with the drug concentration in the range of 0.55-4.5 µg mL-1. The method was validated according to ICH guidelines and the result was acceptable. The calculated limits of detection and quantitation were 0.182 and 0.55 µg mL-1, respectively. The commercially available dosage forms containing lisinopril alone or in combination with hydrochlorothiazide were effectively analyzed by the proposed method. The obtained results were in agreement with those of the reported method in respect to accuracy and precession. Moreover, the suggested method was employed to determine the content uniformity testing of the investigated dosage forms.

An innovative validated spectrofluorimetric method for determination of Lisinopril in presence of hydrochlorothiazide; application to content uniformity testing.

A new sensitive and discriminating spectrofluorimetric method has been developed and validated for determination of Lisinopril, one of the angiotensin converting enzyme inhibitors, in its pure bulk form and pharmaceutical tablets. The reaction of Lisinopril with ethylacetoacetate and formaldehyde in acidic buffered medium (pH3.8) has yielded a pale yellow product that exhibited a high fluorescence measured at 438nm after excitation at 350nm. All the experimental parameters affecting the formation and stability of the produced fluorophore were carefully investigated and optimized to give the maximum sensitivity. The fluorescence intensity was directly proportional to the drug concentration in the range of 0.5-4.5µg/mL with a limit of detection equal to 0.16µg/mL. The method was successfully applied in the analysis of the commercially available pharmaceutical tablets containing the single drug or its binary mixtures with Hydrochlorothiazide. Furthermore, the developed procedure was adapted for studying the content uniformity test of some dosage forms containing the cited drug.

Selective spectrofluorimetric method for determination of Lisinopril in pharmaceutical preparations and in presence of hydrochlorothiazide: Application to content uniformity testing.

A novel sensitive and cost-effective spectrofluorimetric method has been developed and validated for determination of lisinopril (an angiotensin converting enzyme inhibitor) in its pure form and pharmaceutical preparations. The method is based on the reaction of the drug with ninhydrin and phenylacetaldehyde in buffered medium (pH 7.0) to form a highly fluorescent product measured at 460 nm after excitation at 390 nm. Different experimental parameters were optimized and calibration curve was constructed. The fluorescence-concentration relationship was linear in the range of 0.15-4.0 µg mL-1 . The calculated Limit of detection (LOD) and Limit of quantitation (LOQ) were 0.04 and 0.12 µg mL-1 , respectively. The method was successfully applied for the analysis of pharmaceutical preparations containing the studied drug either alone or co-formulated with hydrochlorothiazide. The obtained results were in agreement with those of the reported method in respect to accuracy and precession. Moreover, the method was applied content uniformity testing according to United States Pharmacopeia (USP) guidelines.

Health-related quality of life in healthy children and adolescents of HIV-infected parents in Alexandria, Egypt.

BACKGROUND: Egypt as part of the Eastern Mediterranean region is facing a growing HIV epidemic. Developments in the National HIV Program are associated with an increase in survival of HIV-positive persons. This study aimed to assess health-related quality of life (HRQOL) of healthy children/adolescents of HIV-positive parents compared with healthy children/adolescents of healthy HIV-negative parents. MATERIALS AND METHODS: A cross-sectional comparative study was conducted. Healthy children aged 3-17 years old of all HIV-positive parents registered in the national HIV treatment center in Alexandria Fever Hospital during the year 2016 were enrolled (n=33) and compared with a comparable group of children of healthy parents (n=33). The HRQOL of studied groups was assessed by interviewing parents using Kinder Lebensqualität Fragebogen questionnaire revised parents' version. RESULTS: Among the HIV-positive persons, 54.5% of their children had poor to fair HRQOL compared with only 9.1% of children of healthy parent group. They had significantly lower HRQOL scores in the physical, mental, family, and friends domains (P<0.05). Adolescents of HIV-positive parents had significantly lower HRQOL score compared with children (P=0.028). Parents' education was the only independent predictor of daughter/son's HRQOL (b=13.073, P=0.014). CONCLUSION: HIV-positive status of parents negatively affects the HRQOL of their children. Development of organized social and mental support services to families with HIV-affected member/s within the Egyptian National HIV program is highly recommended with specific focus on adolescents and children, especially those having lower educated parents.

Prevention of acute kidney injury in a rodent model of cirrhosis following selective gut decontamination is associated with reduced renal TLR4 expression.

BACKGROUND & AIMS: Superimposed infection and/or inflammation precipitate renal failure in cirrhosis. This study aimed at testing the hypothesis that increased gut bacterial translocation in cirrhosis primes the kidney to the effect of superimposed inflammation by upregulating expression of Toll-like receptor 4 (TLR4), NFκB, and cytokines. A well-characterized bile-duct ligated (BDL) model of cirrhosis, which develops renal failure following superimposed inflammatory insult with lipopolysaccharide (LPS), was used and selective gut decontamination was performed using norfloxacin. METHODS: Sprague-Dawley rats were studied: Sham, Sham+LPS; BDL, BDL+LPS; an additional BDL and BDL+LPS groups were selectively decontaminated with norfloxacin. Plasma biochemistry, plasma renin activity (PRA) and cytokines and, protein expression of TLR4, NFκB, and cytokines were measured in the kidney homogenate. The kidneys were stained for TLR4, TLR2, and caspase-3. Endotoxemia was measured using neutrophil burst and Limulus amoebocyte lysate (LAL) assays. RESULTS: The groups treated with norfloxacin showed significant attenuation of the increase in plasma creatinine, plasma and renal TNF-α and renal tubular injury on histology. The increased renal protein expression of TLR4, NFκB, and caspase-3 in the untreated animals was significantly attenuated in the norfloxacin treated animals. PRA was reduced in the treated animals and severity of endotoxemia was also reduced. CONCLUSIONS: The results show for the first time that kidneys in cirrhosis show an increased expression of TLR4, NFκB, and the pro-inflammatory cytokine TNF-α, which makes them susceptible to a further inflammatory insult. This increased susceptibility to LPS can be prevented with selective decontamination, providing novel insights into the pathophysiology of renal failure in cirrhosis.

Dental age estimation in Egyptian children, comparison between two methods.

The need to estimate age of living individuals is becoming increasingly more important in both forensic science and clinical dentistry. The study of the morphological parameters of teeth on dental radiographs of adult humans is more reliable than most other methods for age estimation. Willems and Cameriere methods are newly presented methods. The aim of this work was to evaluate the applicability of using these methods for Egyptian children. Digitalized panoramas taken from 286 Egyptian children (134 boys, 152 girls) with age range from 5 to 16 years were analyzed. The seven left permanent mandibular teeth were evaluated using the two methods. The results of this research showed that dental age estimated by both methods was significantly correlated to real age. However, Willems method was slightly more accurate (98.62%) compared to Cameriere method (98.02%). Therefore, both methods can be recommended for practical application in clinical dentistry and forensic procedures on the Egyptian population.