Knowledge and attitudes toward the use of anabolic-androgenic steroids among physical education university students: a cross-sectional study from Palestine.

The use of androgenic-anabolic steroids (AASs) has increased in recent years, especially among athletes, due to their effect on body shape and performance. These agents could have serious side effects on this highly susceptible population, which tends to use these substances frequently to promote muscle growth and physical performance. Therefore, this study aimed to evaluate the knowledge and attitudes toward the use of anabolic androgenic steroids among physical education university students in Palestine. A cross-sectional study of physical education students from November 2020 to January 2021 was conducted using an electronic questionnaire. The main outcome was to measure the level of knowledge and use of the AAS. A total of 380 students were included. The mean age of the students was 21 years (SD = 4.2), and the study participants were distributed almost equally according to sex. Approximately a quarter of the students were smokers. Eighty percent (80%) of the study participants were from the West Bank, while the remaining 20% were from Jerusalem and 48 territories. Furthermore, most of the students lived with their families; half lived in cities, approximately 152 (40%) lived in villages, and only 29 (8%) lived in camps. The average level of knowledge of the AAS was 2.95 out of 8 (37/100), with a median of three. Furthermore, only 36 (10%) of the participants had satisfactory knowledge, scoring 80% or more. Regarding the use of AAS, 11 (2.9%) participants, all males, confirmed that they were currently using AAS. Additionally, approximately 28 (7%) had previously used them, while 30 (8%) planned to try them in the future. Overall, 221 (58%) patients were confirmed to use vitamins and minerals. Our study showed that most of the participants had a substantial lack of information on the potential side effects of AAS, while the level of use was comparable with that of other populations.

Clinical Presentation, Management, and Outcome in Patients With Myasthenia Gravis: A Retrospective Study From Two Tertiary Care Centers in Saudi Arabia.

INTRODUCTION: A limited number of research studies were published to delineate the clinical pattern of myasthenia gravis in Saudi Arabia. This paper is an attempt to describe some of the clinical aspects related to this disease in two large centers from two main cities in Saudi Arabia. METHODS: A retrospective multi-center observational study of patients diagnosed with myasthenia gravis was conducted. The study setting was King Abdulaziz Medical City in Jeddah and Riyadh, Saudi Arabia. The study period was 12 years, starting from January 2007 to May 2019. RESULTS:  A total of 144 patients were included in this study (60 males and 84 females). The most common symptoms at diagnosis were ocular symptoms in 118 patients (81.9%), diplopia in 84 patients (58.3%), and/or blurred vision in 30 patients (20.8%). The majority had positive anti-acetylcholine receptor antibodies (72.2%). Pyridostigmine was the most prescribed medication for 136 patients (94.4%). Immunosuppressive medications were prescribed for 114 patients (79.2%). Around 40% of patients had exacerbations, and approximately 20% were admitted to the ICU. Thymectomy was performed for 97 patients (67.4%). CONCLUSION: The present study indicates that the clinical presentation and management of myasthenia gravis remained the same in the last few years despite the introduction of new modalities of diagnosis such as the anti-muscle-specific kinase (anti-MuSK) and other autoantibodies tests. Furthermore, we observed that the number of exacerbations and ICU admission were high, which may indicate inadequate therapy. We are stressing the need for establishing specialized neuromuscular clinics with neurologists trained in neurophysiology to improve the diagnostic accuracy and outcomes for patients with myasthenia gravis.

Application of triazine "superactive esters" in the repetitive synthesis of oligopeptides. Part 1. Synthesis of [54-59] fragment of human beta-casein.

A new synthetic protocol which considerably improves the classic REMA procedure is proposed herein. The offered modification is based on the application of triazine "superactive esters" as the superior substitutes for mixed anhydrides, which have been used as acylating reagent in the classic procedure. The improved repetitive procedure in solution was applied to the preparation of [54-59] fragment of human beta-casein. The structure and high purity of the intermediates, as well as of the final products, was confirmed by FAB-MS, 1H-NMR and HPLC.

Application of triazine "superactive esters" in the repetitive synthesis of oligopeptides. Part 2. Synthesis of N-terminal hexapeptide of emerimicin III.

N-terminal fragment of emerimicin III has been synthesized by the repetitive method in solution, involving triazine ,,superactive esters". The synthetic protocol, equivalent to the classic REMA procedure, has been applied in the step by step approach, and in the fragment coupling affording all the peptide bonds. By monitoring the progress of the synthesis by FAB-MS, 1H-NMR and HPLC, the structure and high purity of the final products have been confirmed.