The Impact of Bariatric Surgery on Weight Reduction and the Resolution of Comorbidities in Older Geriatric Populations of Saudi Arabia: A Retrospective Study.

Background Obesity is a significant health concern among older adults, leading to various comorbidities and reduced quality of life. Bariatric surgery (BS) has emerged as a potential intervention, but its efficacy in geriatric populations, particularly in Saudi Arabia, is not well-established. Aims This retrospective study aims to evaluate the impact of BS on weight reduction and comorbidity resolution in Saudi Arabian geriatric populations. Methods A retrospective cohort study was conducted at King Khalid Hospital, Saudi Arabia, involving geriatric patients aged 60 and above who underwent BS between January 2018 and December 2022. Data were collected from medical records and analyzed using descriptive statistics, chi-square tests, t-tests, and multivariate regression analysis. Results The study included a total of 26 patients with a mean age of 64 years. Of these, 18 (69.3%) were females, while eight (30.7%) were males, and 23 (87%) underwent sleeve gastrectomy (SG), while three (13%) had Roux-en-Y gastric bypass (RYGB). Preoperative comorbidities majorly included diabetes (17, 35.42%), hypertension (11, 22.92%), and anemia (four, 8.33%). The average body mass index (BMI) of the patients decreased significantly from 45.12 to 37.29 at three months and further to 31.36 at six months post surgery. Total weight loss (TWL) was 19.92% at three months and 35.15% at six months, while the percentage of excess weight loss (%EWL) was 33.42% at three months and 57.85% at six months. Results also showed a significant reduction in the number of comorbidities postoperatively. A significant association with gender, preoperative weight, and preoperative height at three and six months and a significant association with preoperative BMI and comorbidity status at six months were recorded. Conclusion The study suggests that bariatric surgery is effective in achieving significant weight loss and improving comorbidities in geriatric patients. Few demographic and clinical features affect the outcome of the weight loss.

Menstrual Changes in Women Who Undergo Sleeve Gastrectomy in Saudi Arabia.

Introduction Obesity affects over 650 million globally, with rising rates posing significant public health challenges, especially among Saudi Arabian women. Obesity correlates with menstrual irregularities and reproductive health issues such as polycystic ovary syndrome (PCOS). Bariatric surgery (BS), particularly laparoscopic sleeve gastrectomy (LSG), is increasingly used due to its safety and effectiveness in treating obesity-related conditions. This study explores LSG's impact on menstrual cycles and fertility in Saudi women, aiming to optimize patient care and understand surgical effects on hormonal dynamics and reproductive health. Methodology It is a cross-sectional design among Saudi women post-sleeve gastrectomy from December 2023 to May 2024. Variables included age, marital status, and region, with primary outcomes focusing on menstrual cycle changes post surgery. Results Our study includes 387 participants, and demographic characteristics showed a significant proportion aged 26-35 years (n=147, 38.0%) and 36-45 years (n=119, 30.7%), with the majority being married (n=230, 59.4%). Regional distribution highlighted the south as the most represented (n=139, 35.9%), followed by the central (n=74, 19.1%). About 30.2% (n=117) reported chronic conditions. Post surgery, 70.5% (n=273) experienced menstrual changes, with regular cycles being the most common (n=102, 26.3%). Logistic regression indicated younger age as a protective factor against menstrual changes (p=0.028), while pre-surgery menstrual irregularities significantly predicted post-surgery changes (p=0.002). Regional analysis showed no significant association between geographic location and post-surgery menstrual changes (p=0.140). Overall, quality of life post-surgery was rated highly by participants, with 70.8% (n=274) giving ratings of 4 or 5. Conclusion Our study highlights a high prevalence of post-sleeve gastrectomy menstrual changes, predominantly regular cycles. Younger age appears protective, while pre-existing menstrual irregularities strongly predict postoperative changes. Regional differences did not significantly influence outcomes. Overall, participants reported high satisfaction with their quality of life post surgery.

Green synthesis of zinc oxide nanoparticles from Wodyetia bifurcata fruit peel extract: multifaceted potential in wound healing, antimicrobial, antioxidant, and anticancer applications.

This study focuses on the synthesis, characterization, and use of zinc oxide nanoparticles (ZnONPs) derived from W. bifurcata fruit peel extract. ZnONPs are frequently synthesized utilizing a green technique that is both cost-effective and ecologically friendly. ZnONPs were characterized utilizing analytical techniques. Ultra Violet visible (UV-Vis) spectra showed peaks at 364 nm, confirming the production of ZnONPs. Scanning Electron Microscope analysis indicated that the nanoparticles generated were spherical/agglomerated, with diameters ranging from 11 to 25 nm. FTIR spectroscopy was used to identify the particular functional groups responsible for the nanoparticles' reduction, stabilization, and capping. Phytochemical analysis of the extract revealed that flavonoids, saponins, steroids, triterpenoids, and resins were present. The antibacterial activity of W. bifurcata synthesised nanoparticles was evaluated against pathogenic bacteria. The ZnONPs antioxidant activity was assessed using DPPH assay. The in vitro cytotoxicity was assessed against prostate cancer PC3 cells. The wound healing potential was assessed by employing in vitro scratch assay and in vivo excision model in Wistar rats. Because of its environmentally benign production, low toxicity, and biocompatibility, ZnONPs exhibited potential antibacterial, antioxidant, anticancer, and wound healing activities, indicating that they could be used in cancer treatment and wound management. Further study is required to examine the fundamental mechanisms and evaluate the safety and effectiveness of the test sample in clinical situations.

Nonwoven/Nanomembrane Composite Functional Sweat Pads.

Sweat is a natural body excretion produced by skin glands, and the body cools itself by releasing salty sweat. Wetness in the underarms and feet for long durations causes itchiness and an unpleasant smell. Skin-friendly reusable sweat pads could be used to absorb sweat. Transportation of moisture and functionality is the current challenge that many researchers are working on. This study aims to develop a functional and breathable sweat pad with antimicrobial and quick drying performance. Three layered functional sweat pads (FSP) are prepared in which the inner layer is made of an optimized needle-punched coolmax/polypropylene nonwoven blend. This layer is then dipped in antimicrobial ZnO solution (2, 4, and 6 wt.%), and super absorbent polymer (SAP) is embedded, and this is called a functional nonwoven (FNW1) sheet. Electrospun nanofiber-based nanomembranes of polyamide-6 are optimized for bead-free fibers. They are used as a middle layer to enhance the pad's functionality, and the third layer is again made of needle-punched optimized coolmax/polypropylene nonwoven sheets. A simple nonwoven-based sweat pad (SSP) is also prepared for comparison purposes. Nonwoven sheets are optimized based on better comfort properties, including air/water vapor permeability and moisture management (MMT). Nonwoven webs having a higher proportion of coolmax show better air permeability and moisture transfer from the inner to the outer layer. Antimicrobial activity of the functional nonwoven layer showed 8 mm of bacterial growth, but SSP and FSP showed only 6 mm of growth against Staphylococcus aureus. FSP showed superior comfort and antibacterial properties. This study could be a footstone toward highly functional sweat pads with remarkable comfort properties.

Synthesis and Characterization of Silver Nanoparticles from Rhizophora apiculata and Studies on Their Wound Healing, Antioxidant, Anti-Inflammatory, and Cytotoxic Activity.

Silver nanoparticles (AgNPs) have recently gained interest in the medical field because of their biological features. The present study aimed at screening Rhizophora apiculata secondary metabolites, quantifying their flavonoids and total phenolics content, green synthesis and characterization of R. apiculata silver nanoparticles. In addition, an assessment of in vitro cytotoxic, antioxidant, anti-inflammatory and wound healing activity of R. apiculata and its synthesized AgNPs was carried out. The powdered plant material (leaves) was subjected to Soxhlet extraction to obtain R. apiculata aqueous extract. The R. apiculata extract was used as a reducing agent in synthesizing AgNPs from silver nitrate. The synthesized AgNPs were characterized by UV-Vis, SEM-EDX, XRD, FTIR, particle size analyzer and zeta potential. Further aqueous leaf extract of R. apiculata and AgNPs was subjected for in vitro antioxidant, anti-inflammatory, wound healing and cytotoxic activity against A375 (Skin cancer), A549 (Lung cancer), and KB-3-1 (Oral cancer) cell lines. All experiments were repeated three times (n = 3), and the results were given as the mean ± SEM. The flavonoids and total phenolics content in R. apiculata extract were 44.18 ± 0.086 mg/g of quercetin and 53.24 ± 0.028 mg/g of gallic acid, respectively. SEM analysis revealed R. apiculata AgNPs with diameters ranging from 35 to 100 nm. XRD confirmed that the synthesized silver nanoparticles were crystalline in nature. The cytotoxicity cell viability assay revealed that the AgNPs were less toxic (IC50 105.5 µg/mL) compared to the R. apiculata extract (IC50 47.47 µg/mL) against the non-cancerous fibroblast L929 cell line. Antioxidant, anti-inflammatory, and cytotoxicity tests revealed that AgNPs had significantly more activity than the plant extract. The AgNPs inhibited protein denaturation by a mean percentage of 71.65%, which was equivalent to the standard anti-inflammatory medication diclofenac (94.24%). The AgNPs showed considerable cytotoxic effect, and the percentage of cell viability against skin cancer, lung cancer, and oral cancer cell lines was 31.84%, 56.09% and 22.59%, respectively. R. apiculata AgNPs demonstrated stronger cell migration and percentage of wound closure (82.79%) compared to the plant extract (75.23%). The overall results revealed that R. apiculata AgNPs exhibited potential antioxidant, anti-inflammatory, wound healing, and cytotoxic properties. In future, R. apiculata should be further explored to unmask its therapeutic potential and the mechanistic pathways of AgNPs should be studied in detail in in vivo animal models.

Machine Learning and Internet of Things Enabled Monitoring of Post-Surgery Patients: A Pilot Study.

Artificial Intelligence (AI) and Internet of Things (IoT) offer immense potential to transform conventional healthcare systems. The IoT and AI enabled smart systems can play a key role in driving the future of smart healthcare. Remote monitoring of critical and non-critical patients is one such field which can leverage the benefits of IoT and machine learning techniques. While some work has been done in developing paradigms to establish effective and reliable communications, there is still great potential to utilize optimized IoT network and machine learning technique to improve the overall performance of the communication systems, thus enabling fool-proof systems. This study develops a novel IoT framework to offer ultra-reliable low latency communications to monitor post-surgery patients. The work considers both critical and non-critical patients and is balanced between these to offer optimal performance for the desired outcomes. In addition, machine learning based regression analysis of patients' sensory data is performed to obtain highly accurate predictions of the patients' sensory data (patients' vitals), which enables highly accurate virtual observers to predict the data in case of communication failures. The performance analysis of the proposed IoT based vital signs monitoring system for the post-surgery patients offers reduced delay and packet loss in comparison to IEEE low latency deterministic networks. The gradient boosting regression analysis also gives a highly accurate prediction for slow as well as rapidly varying sensors for vital sign monitoring.

Peptide Assembled in a Nano-confined Space as a Molecular Rectifier for the Availability of Ionic Current Modulation.

Bioinspired nanochannels have emerged as a powerful tool for bioengineering and biomedical research due to their robust mechanical and controllable chemical properties. Inspired by inward-rectifier potassium (K+) channels, herein, the charged peptide assembly has been introduced into a nano-confined space for the modulation of ion current rectification (ICR). Peptide-responsive reaction-triggered sequence changes can contribute to polarity conversion of the surface charge; therefore, ICR reversal (ICRR) is generated. Compared with other responsive elements, natural charged peptides show the merit of controllable charge polarity. By electrochemically monitoring the ICRR as an output signal, one can utilize the peptide assembly-mediated ICRR to construct an ionic sensory platform. In addition, a logic gate has been established to demonstrate the availability of an ionic sensory platform for inhibitor screening. As peptide nanoassemblies may also have various structures and functions due to their diverse properties, the ionic modulation system can provide alternatives for the assay of peptide-associated biotargets with biomedical applications.

Laparoscopic Sleeve Gastrectomy in a Patient With Situs Inversus Totalis and Kartagener Syndrome.

Laparoscopic sleeve gastrectomy (LSG) is a widely accepted and adopted procedure to achieves weight loss in morbid obesity. Situs inversus (SI) is when the body's visceral organs are not in the normal position with reversal of anatomical orientation. Patients with obesity and SI can be challenging to diagnose and manage. We present a case of a 23-year-old male who has SI totalis with Kartagener syndrome who underwent LSG to treat morbid obesity. Furthermore, we conducted a comprehensive review of the current medical literature. We conclude that LSG can be safely performed in SI. However, it is recommended to leave such cases to more experienced surgeons. In addition, it is advisable to consider few unconventional technical operative methods before surgery. Nevertheless, more data are needed to better study LSG in SI patients, which can be difficult given the rare nature of SI.

Co-assembly of Peptides and Carbon Nanodots: Sensitive Analysis of Transglutaminase 2.

The structures assembled by peptides have attracted great attention due to their unique physicochemical properties. Moreover, the co-assembly of peptides with additional components can endow the structures with extended functions. In this work, we have explored the co-assembly of peptides and carbon nanodots (CNDs) by taking advantage of their non-covalent binding; thus, the obtained structure may show both the recognition capability of peptides and the catalytic activity of CNDs. Therefore, we have further used the assembled structure for the sensitive analysis of transglutaminase 2 with a low detection limit of 0.25 pg/mL. By simply replacing the peptide sequences or the nanomaterials, the strategy proposed in this work can be developed as a universal model to build the co-assemblies of peptides and nanomaterials, thus leading to their broader applications in biological and biomedical research.

A synthetic peptide AWRK6 ameliorates metabolic associated fatty liver disease: involvement of lipid and glucose homeostasis.

Metabolic associated fatty liver disease (MAFLD) is the leading common chronic liver disease affecting more than one-quarter of the population worldwide, but no pharmacological therapy was approved specifically. A synthetic peptide AWRK6 developed in our group based on the antimicrobial peptide Dybowskin-2CDYa was found to attenuated diabetes as a novel GLP-1 receptor agonist candidate. The effects of AWRK6 on MAFLD and its underlying mechanisms were investigated in this paper. In high energy diet (HED)-induced MAFLD mice, obesity and hepatic steatosis were alleviated by AWRK6 via intraperitoneal injection. The biochemistry measurements data indicated that the abnormal lipid metabolism was relieved and the glucose metabolism was improved significantly. Further, the phosphorylation of liver PI3K/AKT/AMPK/ACC was elevated significantly by AWRK6 treatment. Moreover, the effects of AWRK6 on lipid accumulation and insulin sensitivity in human cells were verified using oleic acid-induced HepG2 fatty liver cell model and insulin-induced HepG2 cells, respectively. These in vitro and in vivo results demonstrated that the peptide AWRK6 ameliorates MAFLD by improving lipid and glucose metabolism homeostasis, and it is mediated by the PI3K/AKT/AMPK/ACC signaling pathway. Thus, AWRK6 has a potential in preventing MAFLD.

Electrochemical Trans-Channel Assay for Efficient Evaluation of Tumor Cell Invasiveness.

Efficiently assessing the invasive capability of tumor cells is critical both for the research and treatment of cancer. Here, we report a novel method called the electrochemical trans-channel assay for efficient evaluation of tumor cell invasiveness. A bioinspired extracellular matrix degradation model (EDM) has been first fabricated on a porous anodic alumina (PAA) membrane to construct the electrochemical apparatus. Upon contacting the invasive tumor cells, invasive capability can be sensitively evaluated by the degree of EDM impairment, which is recorded by the electrochemical trans-channel ionic currents in a label-free manner. Compared to the most commonly used trans-well migration method, this assay can be accomplished in an efficient way that is significantly faster (20 min) and more convenient. Besides, quantitation can also be realized for monitoring the invasion process, which cannot be achieved by other currently used methods. Our proposed electrochemical trans-channel assay method has shown a synergistic effect for the evaluation of tumor cell invasiveness, providing a promising method for clinical assessment or prognostic applications of tumor metastasis.

Ghrelin gastric tissue expression in patients with morbid obesity and type 2 diabetes submitted to laparoscopic sleeve gastrectomy: immunohistochemical and biochemical study.

INTRODUCTION: Obesity and type 2 diabetes mellitus (T2DM) are leading causes of morbidity and mortality worldwide. Ghrelin is implicated in the pathophysiology of both disease states. Laparoscopic sleeve gastrectomy is an emerging safe therapeutic technique for patients with morbid obesity. Since the removal of ghrelin-secreting cells by sleeve gastrectomy may be associated with diminished hunger sensation the aim of the study was to: (i) compare body weight and body mass index (BMI) in both obese non-diabetic and obese diabetic patient groups, (ii) determine the ghrelin expression in the resected gastric tissue in both groups, (iii) evaluate relationships between ghrelin cell expression and pre- and post-operative serum ghrelin concentration and glucose levels, and (iv) assess the influence of sleeve gastrectomy on serum glycaemic parameters in this patient population. MATERIAL AND METHODS: Twenty morbidly obese female patients from Saudi Arabia, of whom ten suffered from T2DM participated in the study. All subjects underwent laparoscopic sleeve gastrectomy. The removed fundus, body and antrum were biopsied and underwent immunohistochemical staining to detect ghrelin cell expression. Serum samples were assayed for ghrelin concentration and indicators of glycaemic status at the baseline and three months after sleeve gastrectomy. RESULTS: BMI (p < 0.05) and body weight (p < 0.001) were significantly lower in non-diabetic obese patients compared with diabetic patients before and 3 months after the surgery. Also, pre-operative serum ghrelin level was higher in non-diabetic patients compared with diabetic patients group, and postoperative plasma ghrelin level was reduced in diabetic patients (p < 0.001) compared with non-diabetic patients. Gastric fundic mucosa of the diabetic patients exhibited lower number of ghrelin-positive cells (p < 0.05) compared with non-diabetic patients. There were significant negative correlations between pre- and post-operative ghrelin serum level and blood glucose (r = -0.736, p = 0.0002 and r = -0.656, p = 0.0007, respectively) in all patient populations. CONCLUSIONS: The results of this study suggest that the diabetic status of obese female patients may affect the incidence of ghrelin cells in three major stomach's regions and this novel observation warrants further studies.

Awareness of Breast Cancer among Female Students and Faculty from Najran University, Najran, Saudi Arabia.

BACKGROUND: Breast cancer (BC) is the leading malignancy among women in Najran, Saudi Arabia. However, not much is known about the public's awareness of BC. This study explored the general knowledge, early warning signs, risk factors and sources of information about BC. METHODS: An online-based, anonymous, self-rating, cross-sectional and survey-based study was conducted from March-2019 to April-2019. Three-hundred female students and/or faculty from College of Medicine, Najran University (Najran, Saudi Arabia) participated in the study. RESULTS: A total of 232 students (77.3%) and 68 faculty (22.7%) responded to the survey. Our study showed that nulliparity (83.8%) and early menarche before 12 years of age (29.7%) were the most pertinent obstetric risk factors of BC. Conversely, lack of physical activity (66.3%) and family history of BC (18%) were the most substantial non-obstetric risk factors of BC. According to pre-defined criteria, while the surveyed research subjects demonstrated 'good' general knowledge about BC (75.3%), they unfavorably exhibited 'poor' knowledge about the warning signs of BC (94.3%). The predictors of 'good' overall knowledge (general knowledge plus signs knowledge about BC) included age, marital status, educational level and family history (all p<0.05, two-tailed Chi-square test). Apart from the campaigns' educational materials (43%), the top source of knowledge about BC was internet (33%), whereas the lowest ones were healthcare professionals (11.3%) and training workshops (7.3%). CONCLUSIONS: The surveyed research subjects harbored risk factors of BC and demonstrated 'poor' knowledge about the warning early signs of BC. We call for rigorous and well-crafted educational campaigns geared toward improving the awareness level of BC among women in Najran province.

Predictors of morbidity and mortality post emergency abdominal surgery: A national study.

BACKGROUND/AIM: Emergency surgeries have increased in Saudi Arabia. This study examines these surgeries and associated complications. PATIENTS AND METHODS: This was a prospective multicenter cohort study of patients undergoing emergency intraperitoneal surgery from the eight health sectors of Saudi Arabia. Patients' data were collected over 14 days. RESULTS: In total, 283 patients were included (163 men [54.06%]). The majority of cases were open surgery (204 vs. 79). The 24 h and 30-day mortality rates for the cohort were 0.7 and 2.47%, respectively. Twenty-nine patients (10.24%) required re-intervention, while 19 (8.12%) needed critical care admission. The median length of hospital stay was 3 days. Multivariate analysis showed American Society of Anesthesiologist (ASA) classification score (P = 0.0003), diagnosis (P < 0.0001), stoma formation (P = 0.0123), and anastomotic leak (P = 0.0015) to correlate significantly with 30-day mortality. CONCLUSION: American Society of Anesthesiologist score, diagnosis, stoma formation and anastomotic leak are associated with 30-day mortality after emergency surgery in Saudi Arabia.

Patterns of thyroid cancer in Southwestern Saudi Arabia.

OBJECTIVE: To examine the pattern of thyroid cancer, assess the magnitude of the problem, and evolve a management plan for such malignancies. METHODS: This is a retrospective cohort study of all thyroid cases operated at Aseer Central Hospital, Abha, Kingdom of Saudi Arabia, between January 1998 and December 2007. Clinical presentations, management regimens, and recurrence were reviewed. RESULTS: Five hundred and sixteen patients were operated for different thyroid lesions. Ninety-two (17.8%) were malignant (20 males and 72 females). Mean age for males was 41.35 +/- 15.52 years compared to 36.59 +/- 13.28 years for females. Papillary carcinoma constituted 50%, while follicular carcinoma formed only 4.3% of malignant cases. Lymphoma ranked third with only 1.1% of all malignant thyroid lesions. No cases of medullary carcinoma were found. Of 92 patients, 75 reported for follow-up. The recurrence rate for follow-up patients was 29 (31.5%). CONCLUSION: High resolution neck ultrasonography and image-guided fine needle aspiration cytology should be considered as routine investigative tools in patients with suspicious thyroid swelling. Total thyroidectomy and removal of all lymph nodes in the central compartment of the neck seem to be the ideal management plan, until such trials emerge. Residual thyroid tissues, following surgery, should be ablated using radioiodine I131 isotope.