The Association Between Parents' Knowledge About Human Papillomavirus and Their Intention to Vaccinate Their Daughters: A Cross-Sectional Study.

Introduction The human papillomavirus (HPV) causes the most sexually transmitted infections (STIs) worldwide. According to the World Health Organization (WHO), cervical cancer is the fourth most common type of cancer among women worldwide and the eighth leading cause of female cancer death in Saudi Arabia, especially in women between the ages of 15 and 44. The HPV vaccine is known to prevent HPV disease and death. Because parents are often the decision-makers regarding receiving HPV vaccination during adolescence, assessing parents' knowledge about HPV and its relationship with their intention to vaccinate their daughters is highly necessary. Materials and methods An exploratory descriptive cross-sectional study design was used. A total of 773 parents, both mothers and fathers, of female students attending sixth grade from all areas of Jeddah city in Saudi Arabia were recruited. A self-administered validated questionnaire was used to collect the necessary data. Results The current study findings showed that 356 (46.1%) parents had poor knowledge about HPV, 119 (15.4%) had a fair level of knowledge, and 298 (38.5%) had a good level of knowledge. While 344 (44.5%) had intention to vaccinate, 337 (43.6%) were not sure and 92 (11.9%) were not intending to vaccinate. A significant association was identified between knowledge level and respondents' variables such as being the father or mother, nationality, age, educational level, sector of employment, and monthly income. Employment status was significantly associated with the intention to vaccinate against HPV. Conclusion Concerns about the effectiveness and safety of the HPV vaccine as well as lack of knowledge about HPV and the vaccine influenced parents' negative intention to obtain the vaccine. Health promotion initiatives for the HPV vaccine should be culturally responsive and emphasize the risks and benefits of the vaccine for women. Knowledge and attitudes about HPV can be improved through concise, visually designed, and comprehensive educational intervention programs targeting parents and their children at schools. Despite the proven safety and efficacy of HPV vaccines, more comprehensive strategies may be needed in the future to increase coverage rates of HPV vaccination nationwide.

Mucocele of the Paranasal Sinuses: Retrospective Analysis of a Series of Eight Cases.

BACKGROUND:  Paranasal sinus mucoceles are epithelium-lined cystic masses usually resulting from obstruction of sinus ostia. They most frequently occur in the frontal and ethmoid sinuses. The etiology is not clarified, but the most common identifiable cause of mucoceles following functional endoscopic sinus surgery (FESS), trauma, neoplasms, and allergy. The clinical symptoms of mucocele vary and are not specific, the most common being ophthalmic symptoms and headache, impinging on adjacent orbital structures, and causing ophthalmic sequelae such as double vision, commonly followed by orbital swelling, epiphora, proptosis, and ptosis. All patients in this study had frontal and frontoethmoidal mucocele and initially complained of frontal headache and ophthalmic symptoms. Definitive treatment options for paranasal sinus mucoceles include external approaches and endoscopic marsupialization.  Objective: The study aimed to identify the etiology, clinical presentation, most common para nasal sinus affected by mucocele, management, and the rate of recurrence in eight cases with mucocele of the paranasal sinuses. METHODS:  Eight patients diagnosed with mucocele of the paranasal sinuses were admitted to our institution between 2014 and 2021. There were two females and six males aged between 14 and 67. Initial symptoms, duration, clinical presentation upon admission, location of the mucocele, type of surgical intervention, and outcome have all been studied.  Results: The most common symptoms at diagnosis were orbital involvement, retrobulbar, and frontal headache. Most patients were diagnosed with frontal mucocele (40%), and three were frontoethmoidal mucocele at the time of presentation. The rest of the cases were diagnosed with ethmoidal mucocele (25%). The etiology was identified in four patients and was unclear in the rest. All patients underwent endoscopic sinus surgery. The most identifiable postoperative complication was a headache. CONCLUSIONS:  The endonasal endoscopic approach is a safe and effective treatment for paranasal sinus mucocele and provides adequate drainage with a low recurrent rate.

Androgenic steroids dysregulation and the risk of coronary artery disease.

INTRODUCTION: Endogenous testosterone deficiency or excess anabolic-androgenic steroids (AAS) have been linked to alter the physiology of different organs in the body, more specifically, the vasculature of coronary arteries. Despite the health-related concerns of using synthetic testosterone derivatives, such as AAS, there has been a tremendous increase in the use of AAS among athletes and bodybuilders. AREAS COVERED: We have highlighted the three main mechanisms that AAS increase the risk of coronary artery disease (CAD): altering the homeostasis of lipid metabolism which results in dyslipidemia and subsequently atherosclerosis, disturbing the function of platelet which results in platelet aggregation and subsequent thrombosis, and increasing the risk of coronary vasospasm by affecting the physiological function of vascular bed. EXPERT OPINION: Despite the restriction of AAS in specific clinical conditions such as testosterone deficiency and cancer therapy, many amateurs' athletes misuse the AAS. Although there has been a strong association between the AAS misuse and risk of developing CAD, the more valued approach would be a randomized clinical double-blind trial. The suggested primary endpoint would be an occurrence of adverse cardiovascular events, such as myocardial infarction, cerebrovascular accidents, and death. Increasing awareness of the risk of missing AAS among high-risk groups is imperative.

New bioanalytical microemulsion Electrokinetic chromatography method for the simultaneous determination of Trifluridine with its metabolites and Tipiracil in rat plasma: Application to pharmacokinetic studies.

A Microemulsion Electrokinetic Chromatography method coupled with diode array detector (MEEKC-DAD) was developed for the first time and found to be efficient, sensitive, and selective for the simultaneous analysis of Trifluridine (FTD), and its metabolites 5-(trifluoromethyl) uracil (FTY) and 5-carboxy-2'-deoxyuridine (5CDU), and Tipiracil (TIP) in rat plasma. Sample pre-treatment involved a simple protein precipitation from plasma using acetonitrile. The separation was achieved using a fused silica capillary (65 cm total length, 55 cm effective length and 50 µm i.d.) and a microemulsion solution consisted of 1.66% sodium dodecyl sulfate (SDS), 0.91% heptane, 6.61% 1-butanol, and 90.72% borate buffer (20 mM, pH 9.5). Electrophoretic separation was carried out at 20 °C and 20 kV. The samples were injected for 40 s at 20 mbar and detected simultaneously at 205 nm. The electrophoretic parameters indicated that the developed MEEKC-DAD method permitted complete resolution of the analytes within 13 min. The developed method was fully validated according to the FDA guidelines for bioanalytical method validation. The method was linear in the range 200-4000 ng/ml for FTD, FTY, 5CDU, and 100-1000 ng/ml for TIP. The intra/inter-day accuracy and precisions were ≤4% for all drugs. Extraction recovery and stability were also assessed and were within acceptable range. After being validated, the method was applied for the determination of the studied drugs in plasma samples collected from rats injected intraperitoneally with a combination of FTD and TIP. The results obtained were used to study the pharmacokinetics of FTD with its metabolite and TIP in rat plasma.

Nonimmunologic Factors Affecting Long-Term Outcomes of Deceased-Donor Kidney Transplant.

OBJECTIVES: We investigated the impact of nonimmuno-logic factors on patient and graft survival after deceased-donor kidney transplant. MATERIALS AND METHODS: All deceased-donor kidney transplants performed between January 2004 and December 2015 were included in our analyses. We used the independent t test to calculate significant differences between means above and below medians of various parameters. RESULTS: All study patients (N = 205; 58.7% males) received antithymocyte globulin as induction therapy and standard maintenance therapy. Patients were free from infection, malignancy, and cardiac, liver, and pulmonary system abnormalities. Most patients (89.2%) were recipients of a first graft. Median patient age, weight, and cold ischemia time were 38 years, 65 kg, and 15 hours, respectively. Delayed graft function, diabetes mellitus, and hypertension occurred in 19.1%, 43.4%, and 77.9% of patients, respectively. The 1- and 5-year graft survival rates were 95% and 73.8%. Graft survival was not affected by donor or recipient sex or recipient diabetes or hypertension. However, graft survival was longer in patients who received no graft biopsy (8.2 vs 6.9 y; P = .027) and in those who had diagnosis of calcineurin inhibitor nephrotoxicity versus antibody-mediated rejection after biopsy (8.19 vs 3.66 y; P = .0047). Longer survival was shown with donors who had traumatic death versus cerebro-vascular accident (5.9 vs 5.3 y; P = .029) and donors below the 50th percentile in age (8.23 and 7.14 y; P = .0026) but less with donors who had terminal acute kidney injury (6.97 vs 8.16 y; P = .0062). We found a negative correlation between graft survival and donor age (P = .01) and 1-year serum creatinine (P = .01). CONCLUSIONS: Donor age, cause of brain death, and acute kidney injury affected graft survival in our study cohort but not donor or recipient sex or posttransplant or donor blood pressure.