Spectral and conductivity measurements insights on loading mechanisms of DMSO/water-kaolin complexes.

Kaolin, a naturally occurring clay mineral renowned for its distinctive properties, holds significant importance across various industries. The integration of dimethyl sulfoxide (DMSO) into kaolin matrices, both in the presence and absence of water, has been extensively explored for its potential to enhance material characteristics. Addressing debates surrounding the proposed adsorption mechanism for the type I structure of DMSO, this study undertook a comprehensive physicochemical characterization of DMSO-kaolin complexes (DMSO-KCs) derived from untreated (UnK) and HCl-treated (HK) Egyptian ore, with a focus on elucidating the loading mechanism facilitated by water. Key insights gleaned from electrical conductivity, dielectric constant, and Fine Testing Technology - Fourier-transform infrared (FTT-FTIR) measurements, shedding light on the bonding nature of DMSO-KCs. FTT-FTIR analysis revealed two stages of water departure at 180 °C, with the final stage coinciding with the release of pyrolysis gases, confirming the catalytic degradation of DMSO. Through X-ray diffraction (XRD), Fourier-transform infrared spectroscopy (FTIR), and thermogravimetric analysis (TGA), two distinct bonding types of DMSO molecules with kaolinite were identified: amorphous adsorbed (type I) and lattice-oriented intercalated (type II). Electrical characteristic evaluations within the temperature range of room temperature (RT) to 260 °C and frequency range of 42 Hz-1 MHz revealed that DMSO intercalation enhances the electrical properties of kaolin. Hydrated DMSO-KCs exhibited higher values of σac and ɛ' compared to non-hydrated samples. The activation energy (Ea) values for HCl-treated samples were smaller than those of untreated ones. Alternating current (AC) conductivity analysis indicated predominantly ionic behavior with frequency and temperature dependency in both HCl-treated and untreated kaolin. Our findings substantiate the adsorption mechanism of Type I DMSO, highlighting its amorphous nature, instability, and catalytic degradation over time, in contrast to the intercalated type II. This elucidation is pivotal for understanding the behavior of DMSO-KCs across diverse applications, including electronics, ceramics, and materialsscience.

Impact of high-pressure treatments on physicochemical and structural changes of reconstituted micellar casein concentrates from bovine and caprine milk: A comparative study.

This study investigated the impact of high-pressure processing (HPP) on the physicochemical and structural changes in reconstituted micellar casein concentrates (MCC) sourced from bovine (B) and caprine (C) milk. Applying pressures ranging from 100 to 500 MPa for 30 min at 25 ± 2°C, it was observed that BMCC exhibited a notable increase in soluble minerals and solubility percentages with a simultaneous reduction in particle size and zeta potential compared with CMCC. In BMCC, calcium (Ca) and phosphorus (P) solubility rose from 27.71% and 33.02% to 90.33% and 92.01%, respectively. In CMCC, the solubility of Ca and P increased from 36.12% and 38.29% at 100 MPa to 52.57% and 56.77% at 500 MPa. Additionally, the reduction in particle size was more pronounced in BMCC, with a 53% decrease at 500 MPa, compared with a 19.90% reduction in CMCC. Furthermore, fluorescence intensity, indicative of surface hydrophobicity, decreased in BMCC samples (from 3478 to 2571 a.u.), whereas it increased in CMCC samples (from 2388 to 4058 a.u.) across the same pressure range. Comparative analysis revealed that HP-treated CMCC samples exhibited a decline in α-helix content until the treatment at 300 MPa, followed by an increase post-treatment at 500 MPa. Additionally, a rise in ß-sheet structure content was observed, except for the sample treated at 500 MPa, where ß-sheet content significantly decreased. These findings suggest that HPP holds promise as a viable technological approach in the dairy sector for enhancing the functional characteristics of CMCC.

Impact of Initial Surgical Interventions on Empyema Outcomes: Insights From a Cohort Study in Yemen.

Purpose The study aimed to evaluate the effectiveness of different initial interventions, including thoracostomy drain tubes, open thoracotomy with decortication, and video-assisted thoracoscopic surgery (VATS) thoracoscopy in the management of empyema. Methods This prospective cohort study was conducted at two teaching hospitals in Sana'a, Yemen, over a two-year period from 2022 to 2024. The study included 40 patients diagnosed with empyema, categorized according to the type of initial intervention received. Demographic data, clinical presentation, imaging findings, intervention details, and outcomes were systematically collected and analyzed. Statistical analyses were performed to identify associations between demographic characteristics, empyema stage, intervention type, and treatment success. Results The study included 40 patients with a higher proportion of males (67.5%) than females (32.5%). The mean age was 47.1 years (standard deviation (SD): 12.85). The overall success rate of the initial interventions was 55%, with significant variation based on empyema stage, comorbidities, and intervention type. Stage I empyema had the highest success rate (80%), followed by Stage II (50%) and Stage III (27.3%), with a statistically significant difference (p = 0.034). Smoking history was identified as a significant negative predictor of success (p = 0.001). Higher pleural fluid pH was associated with better outcomes (p = 0.015). The most common complications were chest infections (20%) and bronchopleural fistulas (10%), with a mortality rate of 7.5%. Conclusion The empyema stage significantly affects the success rate, with early stages showing better outcomes. Early and appropriate intervention, particularly in later stages, is crucial for better outcomes. Effective management of postoperative complications is vital. This study highlights the need for early diagnosis and tailored interventions based on the empyema stage to improve patient outcomes. Future research should focus on larger multicenter studies to validate these findings and develop standardized treatment protocols.

Synthesis, Characterization, and Biological Activity of New 4`-Functionalized Bis-Terpyridine Ruthenium(II) Complexes: Anti-inflammatory Activity Advances.

Ruthenium complexes incorporating 2,2':6',2''-terpyridine ligands have emerged as promising candidates due to their versatile biological activities including DNA-binding, anti-inflammatory, antimicrobial, and anticancer properties. In this study, three novel 4'-functionalized bis(terpyridine) ruthenium (II) complexes were synthesized. These complexes feature one ligand as 4-(2,2':6',2''-terpyridine-4'-yl) benzoic acid and the second ligand as either 4'-(2-thienyl)-2,2':6',2''-terpyridine, 4'-(3,4-dimethoxyphenyl)-2,2':6',2''-terpyridine, or 4'-(4-dimethylaminophenyl)-2,2':6',2''-terpyridine. Besides the chemical characterization by 1H and 13C NMR, mass spectrometry, and absorption and emission spectroscopy, the complexes were tested for their biological activity as anti-inflammatory, anticancer, and antimicrobial agents. Moreover, the toxicity of the Ru(II) complexes was assessed and benchmarked against diclofenac potassium and ibuprofen using a haemolysis assay. Biological evaluations demonstrate that these ruthenium complexes exhibit promising therapeutic potential with reduced haemolytic activity compared to standard drugs. They demonstrate substantial anti-inflammatory effects through inhibition of albumin denaturation along with moderate cytotoxicity against cancer cell lines and broad-spectrum antimicrobial activity. These findings highlight the multifaceted biomedical applications of 4'-functionalized bis(terpyridine) ruthenium (II) complexes, suggesting their potential for further development as effective and safe therapeutic agents.

Biosynthesis of Iron Oxide Nanoparticles by Marine Streptomyces sp. SMGL39 with Antibiofilm Activity: In Vitro and In Silico Study.

One of the major global health threats in the present era is antibiotic resistance. Biosynthesized iron oxide nanoparticles (FeNPs) can combat microbial infections and can be synthesized without harmful chemicals. In the present investigation, 16S rRNA gene sequencing was used to discover Streptomyces sp. SMGL39, an actinomycete isolate utilized to reduce ferrous sulfate heptahydrate (FeSO4.7H2O) to biosynthesize FeNPs, which were then characterized using UV-Vis, XRD, FTIR, and TEM analyses. Furthermore, in our current study, the biosynthesized FeNPs were tested for antimicrobial and antibiofilm characteristics against different Gram-negative, Gram-positive, and fungal strains. Additionally, our work examines the biosynthesized FeNPs' molecular docking and binding affinity to key enzymes, which contributed to bacterial infection cooperation via quorum sensing (QS) processes. A bright yellow to dark brown color shift indicated the production of FeNPs, which have polydispersed forms with particle sizes ranging from 80 to 180 nm and UV absorbance ranging from 220 to 280 nm. Biosynthesized FeNPs from actinobacteria significantly reduced the microbial growth of Fusarium oxysporum and L. monocytogenes, while they showed weak antimicrobial activity against P. aeruginosa and no activity against E. coli, MRSA, or Aspergillus niger. On the other hand, biosynthesized FeNPs showed strong antibiofilm activity against P. aeruginosa while showing mild and weak activity against B. subtilis and E. coli, respectively. The collaboration of biosynthesized FeNPs and key enzymes for bacterial infection exhibits hydrophobic and/or hydrogen bonding, according to this research. These results show that actinobacteria-biosynthesized FeNPs prevent biofilm development in bacteria.

Current Updates of CRISPR/Cas System and Anti-CRISPR Proteins: Innovative Applications to Improve the Genome Editing Strategies.

The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/CRISPR-associated sequence (CRISPR/Cas) system is a cutting-edge genome-editing tool employed to explore the functions of normal and disease-related genes. The CRISPR/Cas system has a remarkable diversity in the composition and architecture of genomic loci and Cas protein sequences. Owing to its excellent efficiency and specificity, this system adds an outstanding dimension to biomedical research on genetic manipulation of eukaryotic cells. However, safe, efficient, and specific delivery of this system to target cells and tissues and their off-target effects are considered critical bottlenecks for the therapeutic applications. Recently discovered anti-CRISPR proteins (Acr) play a significant role in limiting the effects of this system. Acrs are relatively small proteins that are highly specific to CRISPR variants and exhibit remarkable structural diversity. The in silico approaches, crystallography, and cryo-electron microscopy play significant roles in elucidating the mechanisms of action of Acrs. Acrs block the CRISPR/Cas system mainly by employing four mechanisms: CRISPR/Cas complex assembly interruption, target-binding interference, target cleavage prevention, and degradation of cyclic oligonucleotide signaling molecules. Engineered CRISPR/Cas systems are frequently used in gene therapy, diagnostics, and functional genomics. Understanding the molecular mechanisms underlying Acr action may help in the safe and effective use of CRISPR/Cas tools for genetic modification, particularly in the context of medicine. Thus, attempts to regulate prokaryotic CRISPR/Cas surveillance complexes will advance the development of antimicrobial drugs and treatment of human diseases. In this review, recent updates on CRISPR/Cas systems, especially CRISPR/Cas9 and Acrs, and their novel mechanistic insights are elaborated. In addition, the role of Acrs in the novel applications of CRISPP/Cas biotechnology for precise genome editing and other applications is discussed.

Application of PLA/GO/ZnO and PLA/GO/Cu2O as sensor.

Polylactic acid modified with graphene oxide (PLA/GO) is proposed to interact with ZnO through 6 different schemes. Density functional theory at B3LYP/LANL2DZ level was utilized to calculate total dipole moment (TDM), HOMO/LUMO energy gap (ΔE) and to map the molecular electrostatic potential (MESP). Results indicated that PLA/GO interacted with ZnO through O-atom forming PLA/GO/OZn composite. This composite interacts with methane, hydrogen sulfide, humidity (H2O), carbon dioxide and ethanol. The same gases were supposed to interact further with PLA/GO/Cu2O. Adsorption energy for the interaction between each composite and the proposed gases were calculated. Both PLA/GO/OZn and PLA/GO/Cu2O composites interacted favorably with H2O. Adsorption energy for interaction of other gases with studied structures are generally low compared to H2O. PLA/GO/OZn have adsorption energy slightly higher than that of PLA/GO/Cu2O. PLA/GO/OZn has higher TDM values than those of PLA/GO/Cu2O, indicating a more polar material. Conversely, PLA/GO/Cu2O exhibited larger ΔE values than those of PLA/GO/OZn. TDM and energy gap results for both studied structures indicated good sensing capabilities. Further insights come from analyzing the calculated density of states (DOS) and partial density of states (PDOS). PLA/GO/Cu2O exhibited high peak for copper in its DOS and PDOS spectra compared to zinc and oxygen in case of PLA/GO/OZn. This means a higher density of available electronic states associated with Cu.

Does the Repair of an Accidentally Discovered Hiatal Hernia and Gastropexy Affect the Incidence of De Novo Postoperative GERD Symptoms After Laparoscopic Sleeve Gastrectomy?

Background: The relationship between laparoscopic sleeve gastrectomy (LSG) and gastroesophageal reflux disease (GERD) is intricate. Hiatal hernia repair or gastropexy can have an impact on postoperative GERD. Aim: To assess the effect of the repair of an accidentally discovered HH and/or gastropexy on the development of de novo postoperative GERD symptoms after LSG. Methods: This retrospective study included all obese patients who underwent LSG at our hospital from January 2018 to June 2022. The data retrieved from patients' files comprised demographic and clinical data, including BMI, GERD symptoms, and comorbidities. Hiatal hernias, surgical technique, gastropexy, duration, and intraoperative complications were recorded. Postoperative data included early and late postoperative complications, weight loss, de novo GERD, and medication use. Results: The study included 253 patients, 89 males (35.2%) and 164 females (64.8%), with a mean age of 33.3±10.04 years. De novo GERD was detected in 94 individuals (37.15%). HH was accidentally found and repaired in 29 patients (11.5%). Only 10.3% of LSG and HH repair patients had de novo GERD symptoms, compared to 40.6% of non-HH patients. 149 patients (58.9%) had gastropexy with LSG. Postoperative de novo GERD symptoms were comparable for LSG with gastropexy (40.5%) and LSG alone (40.9%). Conclusion: After one year, concurrent hiatal hernia repair and LSG seem to be safe and beneficial in lowering postoperative de novo GERD symptoms. The inclusion of gastropexy with LSG had no significant impact on postoperative de novo GERD. Both HH repair and gastropexy lengthened the operation but did not increase its complications.

An Innovative Thermal Imaging Prototype for Precise Breast Cancer Detection: Integrating Compression Techniques and Classification Methods.

Breast cancer detection at an early stage is crucial for improving patient survival rates. This work introduces an innovative thermal imaging prototype that incorporates compression techniques inspired by mammography equipment. The prototype offers a radiation-free and precise cancer diagnosis. By integrating compression and illumination methods, thermal picture quality has increased, and the accuracy of classification has improved. Essential components of the suggested thermography device include an equipment body, plates, motors, pressure sensors, light sources, and a thermal camera. We created a 3D model of the gadget using the SolidWorks software 2020 package. Furthermore, the classification research employed both cancer and normal images from the experimental results to validate the efficacy of the suggested system. We employed preprocessing and segmentation methods on the obtained dataset. We successfully categorized the thermal pictures using various classifiers and examined their performance. The logistic regression model showed excellent performance, achieving an accuracy of 0.976, F1 score of 0.977, precision of 1.000, and recall of 0.995. This indicates a high level of accuracy in correctly classifying thermal abnormalities associated with breast cancer. The proposed prototype serves as a highly effective tool for conducting initial investigations into breast cancer detection, offering potential advancements in early-stage diagnosis, and improving patient survival rates.

Integrative Drug Screening and Multiomic Characterization of Patient-derived Bladder Cancer Organoids Reveal Novel Molecular Correlates of Gemcitabine Response.

BACKGROUND AND OBJECTIVE: Predicting response to therapy for each patient's tumor is critical to improving long-term outcomes for muscle-invasive bladder cancer. This study aims to establish ex vivo bladder cancer patient-derived organoid (PDO) models that are representative of patients' tumors and determine the potential efficacy of standard of care and curated experimental therapies. METHODS: Tumor material was collected prospectively from consented bladder cancer patients to generate short-term PDO models, which were screened against a panel of clinically relevant drugs in ex vivo three-dimensional culture. Multiomic profiling was utilized to validate the PDO models, establish the molecular characteristics of each tumor, and identify potential biomarkers of drug response. Gene expression (GEX) patterns between paired primary tissue and PDO samples were assessed using Spearman's rank correlation coefficients. Molecular correlates of therapy response were identified using Pearson correlation coefficients and Kruskal-Wallis tests with Dunn's post hoc pairwise comparison testing. KEY FINDINGS AND LIMITATIONS: A total of 106 tumors were collected from 97 patients, with 65 samples yielding sufficient material for complete multiomic molecular characterization and PDO screening with six to 32 drugs/combinations. Short-term PDOs faithfully represent the tumor molecular characteristics, maintain diverse cell types, and avoid shifts in GEX-based subtyping that accompany long-term PDO cultures. Utilizing an integrative approach, novel correlations between ex vivo drug responses and genomic alterations, GEX, and protein expression were identified, including a multiomic signature of gemcitabine response. The positive predictive value of ex vivo drug responses and the novel multiomic gemcitabine response signature need to be validated in future studies. CONCLUSIONS AND CLINICAL IMPLICATIONS: Short-term PDO cultures retain the molecular characteristics of tumor tissue and avoid shifts in expression-based subtyping that have plagued long-term cultures. Integration of multiomic profiling and ex vivo drug screening data identifies potential predictive biomarkers, including a novel signature of gemcitabine response. PATIENT SUMMARY: Better models are needed to predict patient response to therapy in bladder cancer. We developed a platform that uses short-term culture to best mimic each patient's tumor and assess potential sensitivity to therapeutics.

MolDy: molecular dynamics simulation made easy.

MOTIVATION: Molecular dynamics (MD) is a computational experiment that is crucial for understanding the structure of biological macro and micro molecules, their folding, and the inter-molecular interactions. Accurate knowledge of these structural features is the cornerstone in drug development and elucidating macromolecules functions. The open-source GROMACS biomolecular MD simulation program is recognized as a reliable and frequently used simulation program for its precision. However, the user requires expertise, and scripting skills to carrying out MD simulations. RESULTS: We have developed an end-to-end interactive MD simulation application, MolDy for Gromacs. This front-end application provides a customizable user interface integrated with the Python and Perl-based logical backend connecting the Linux shell and Gromacs software. The tool performs analysis and provides the user with simulation trajectories and graphical representations of relevant biophysical parameters. The advantages of MolDy are (i) user-friendly, does not requiring the researcher to have prior knowledge of Linux; (ii) easy installation by a single command; (iii) freely available for academic research; (iv) can run with minimum configuration of operating systems; (v) has valid default prefilled parameters for beginners, and at the same time provides scope for modifications for expert users. AVAILABILITY AND IMPLEMENTATION: MolDy is available freely as compressed source code files with user manual for installation and operation on GitHub: https://github.com/AIBResearchMolDy/Moldyv01.git and on https://aibresearch.com/innovations.

Distinct inflammatory markers in primary and secondary dengue infection: can cytokines CXCL5, CXCL9, and CCL17 act as surrogate markers?

Dengue fever poses a significant global health threat, with symptoms including dengue hemorrhagic fever and dengue shock syndrome. Each year, India experiences fatal dengue outbreaks with severe manifestations. The primary cause of severe inflammatory responses in dengue is a cytokine storm. Individuals with a secondary dengue infection of a different serotype face an increased risk of complications due to antibody-dependent enhancement. Therefore, it is crucial to identify potential risk factors and biomarkers for effective disease management. In the current study, we assessed the prevalence of dengue infection in and around Aligarh, India, and explored the role of cytokines, including CXCL5, CXCL9, and CCL17, in primary and secondary dengue infections, correlating them with various clinical indices. Among 1,500 suspected cases, 367 tested positive for dengue using Real-Time PCR and ELISA. In secondary dengue infections, the serum levels of CXCL5, CXCL9, and CCL17 were significantly higher than in primary infections (P < 0.05). Dengue virus (DENV)-2 showed the highest concentrations of CXCL5 and CCL17, whereas DENV-1 showed the highest concentrations of CXCL9. Early detection of these cytokines could serve as potential biomarkers for diagnosing severe dengue, and downregulation of these cytokines may prove beneficial for the treatment of severe dengue infections.

Ondansetron or beta-sitosterol antagonizes inflammatory responses in liver, kidney, lung and heart tissues of irradiated arthritic rats model.

BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disorder mainly affecting joints, yet the systemic inflammation can influence other organs and tissues. The objective of this study was to unravel the ameliorative capability of Ondansetron (O) or ß-sitosterol (BS) against inflammatory reactions and oxidative stress that complicates Extra-articular manifestations (EAM) in liver, kidney, lung, and heart of arthritic and arthritic irradiated rats. METHODS: This was accomplished by exposing adjuvant-induced arthritis (AIA) rats to successive weekly fractions of total body γ-irradiation (2 Gray (Gy)/fraction once per week for four weeks, up to a total dose of 8 Gy). Arthritic and/or arthritic irradiated rats were either treated with BS (40 mg/kg b.wt. /day, orally) or O (2 mg/kg) was given ip) or were kept untreated as model groups. RESULTS: Body weight changes, paw circumference, oxidative stress indices, inflammatory response biomarkers, expression of Janus kinase-2 (JAK-2), Signal transducer and activator of transcription 3 (STAT3), high mobility group box1 (HMGB1), and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), as well as pro- and anti-inflammatory mediators in the target organs, besides histopathological examination of ankle joints and extra-articular tissues. Treatment of arthritic and/or arthritic irradiated rats with BS or O powerfully alleviated changes in body weight gain, paw swelling, oxidative stress, inflammatory reactions, and histopathological degenerative alterations in articular and non-articular tissues. CONCLUSION: The obtained data imply that BS or O improved the articular and EAM by regulating oxidative and inflammatory indices in arthritic and arthritic irradiated rats.

Apigenin: A Bioflavonoid with a Promising Role in Disease Prevention and Treatment.

Apigenin is a powerful flavone compound found in numerous fruits and vegetables, and it offers numerous health-promoting benefits. Many studies have evidenced that this compound has a potential role as an anti-inflammatory and antioxidant compound, making it a promising candidate for reducing the risk of pathogenesis. It has also been found to positively affect various systems in the body, such as the respiratory, digestive, immune, and reproductive systems. Apigenin is effective in treating liver, lung, heart, kidney, neurological diseases, diabetes, and maintaining good oral and skin health. Multiple studies have reported that this compound is capable of suppressing various types of cancer through the induction of apoptosis and cell-cycle arrest, suppressing cell migration and invasion, reduction of inflammation, and inhibiting angiogenesis. When used in combination with other drugs, apigenin increases their efficacy, reduces the risk of side effects, and improves the response to chemotherapy. This review broadly analyzes apigenin's potential in disease management by modulating various biological activities. In addition, this review also described apigenin's interaction with other compounds or drugs and the potential role of nanoformulation in different pathogeneses. Further extensive research is needed to explore the mechanism of action, safety, and efficacy of this compound in disease prevention and treatment.

Recent Updates of the CRISPR/Cas9 Genome Editing System: Novel Approaches to Regulate Its Spatiotemporal Control by Genetic and Physicochemical Strategies.

The genome editing approach by clustered regularly interspaced short palindromic repeats (CRISPR)/associated protein 9 (CRISPR/Cas9) is a revolutionary advancement in genetic engineering. Owing to its simple design and powerful genome-editing capability, it offers a promising strategy for the treatment of different infectious, metabolic, and genetic diseases. The crystal structure of Streptococcus pyogenes Cas9 (SpCas9) in complex with sgRNA and its target DNA at 2.5 Å resolution reveals a groove accommodating sgRNA:DNA heteroduplex within a bilobate architecture with target recognition (REC) and nuclease (NUC) domains. The presence of a PAM is significantly required for target recognition, R-loop formation, and strand scission. Recently, the spatiotemporal control of CRISPR/Cas9 genome editing has been considerably improved by genetic, chemical, and physical regulatory strategies. The use of genetic modifiers anti-CRISPR proteins, cell-specific promoters, and histone acetyl transferases has uplifted the application of CRISPR/Cas9 as a future-generation genome editing tool. In addition, interventions by chemical control, small-molecule activators, oligonucleotide conjugates and bioresponsive delivery carriers have improved its application in other areas of biological fields. Furthermore, the intermediation of physical control by using heat-, light-, magnetism-, and ultrasound-responsive elements attached to this molecular tool has revolutionized genome editing further. These strategies significantly reduce CRISPR/Cas9's undesirable off-target effects. However, other undesirable effects still offer some challenges for comprehensive clinical translation using this genome-editing approach. In this review, we summarize recent advances in CRISPR/Cas9 structure, mechanistic action, and the role of small-molecule activators, inhibitors, promoters, and physical approaches. Finally, off-target measurement approaches, challenges, future prospects, and clinical applications are discussed.

Pathological Extramural Venous Invasion in High-stage Urothelial Carcinoma of the Bladder has Shorter Locoregional Recurrence-free Survival.

Extramural venous invasion is an independent prognostic factor in colorectal cancers; the pathological identification of extramural venous invasion in bladder cancer remains unclear. By focusing on high-stage urothelial carcinoma of the bladder, we provide insights into the pathological identification of extramural venous invasion in this particular clinical context. Clinical and demographic details and pathological reports were extracted from electronic medical records. Histological sections were reviewed for the pathological identification of extramural venous invasion. Statistical analysis was done using SPSS version 23 software. Survival analysis was done using Kaplan-Meier method. In patients with available follow-up data, 62% (n = 21) exhibited pathologically evidenced extramural venous invasion, whereas 38% (n = 13) did not. The extramural venous invasion positive group showed trends toward more advanced and pathological staging and a higher occurrence of extra-nodal extension. Positive margins were more frequent in the extramural venous invasion positive group (33%) compared to the extramural venous invasion negative group (8%). However, these differences were not statistically significant. Notably, all instances of recurrence were in the extramural venous invasion positive group of patients. The extramural venous invasion positive group of patients showed a significantly shorter locoregional recurrence-free survival (P-value of 0.045). However, extramural venous invasion did not emerge as a significant factor in univariate analyses for recurrence-free survival. These findings highlight the potential role of extramural venous invasion as a prognostic factor in bladder cancer but underscore the need for further research with larger cohorts to confirm its significance.

Prevalence and Risk Factors of Cardiovascular Disease in Chronic Kidney Disease Patients at King Abdulaziz University Hospital (KAUH).

BACKGROUND: Chronic kidney disease (CKD) has emerged as a significant global health concern, with its incidence doubling over the past three decades. Cardiovascular diseases (CVD) pose a major threat to CKD patients, surpassing the risk of progressing to end-stage renal disease. While previous studies worldwide have shed light on this association, limited research has been conducted in Saudi Arabia regarding this burden. This study aims to fill this gap by identifying the prevalence and risk factors of CVD in CKD patients at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, between 2017 and 2022. METHODS: A six-year retrospective review of medical records at KAUH was conducted, including 465 non-end-stage CKD patients aged 30 to 79. Data, including demographics, clinical information, and laboratory results, were collected and statistically analyzed to investigate the association between variables. RESULTS: Out of 465 CKD patients, 262 (56.3%) were diagnosed with CVD, with congestive heart failure and ischemic heart disease being the most common types. The majority were male 259 (55.7%), non-Saudi 278 (59.8%), and aged 60 years and older 291 (62.6%). Hypertension 394 (84.7%) and diabetes mellitus 336 (72.3%) were prevalent comorbidities. Severely reduced left ventricular ejection fraction, proteinuria, diabetes mellitus, and higher BMI were identified as significant risk factors for CVD in CKD patients. CONCLUSION: This research contributes valuable insights into the prevalence and risk factors of CVD in CKD patients in Saudi Arabia, emphasizing the need for early detection and intervention. The identified risk factors provide a basis for developing targeted preventive strategies to mitigate this population's CVD burden.

Cupping Therapy as a Potential Complimentary Treatment for Meniere's Disease: A Case Report.

Meniere's disease is defined by the presence of three essential symptoms: episodic vertigo, tinnitus, and sensorineural hearing loss. The mainstay of its management constitutes lifestyle modification and medical and surgical therapies. Cupping therapy is an ancient treatment that is still widely used especially in the Middle East, Africa, and the United Kingdom. This study portraits the case of a 54-year-old patient suffering from long-standing Meniere's disease. The patient was treated with the routine treatment that was to no avail. It was decided that the patient undergoes cupping therapy. Over two years of monthly cupping therapy sessions, the patient reported a decrease in intensity and frequency of symptoms until its disappearance. Cupping therapy has shown a positive outcome on the patient. According to our search, there is a previous case report published in 2020 that shares multiple similarities with our case. Further studies on cupping therapy and its efficacy, mechanism of action, and complications on a larger scale are advised.

A Retrospective Review of Seasonal Patterns of Idiopathic Facial Nerve Paralysis in a Tertiary Care Center.

Background The objective of this retrospective study was to investigate the seasonal patterns of idiopathic facial nerve paralysis, specifically Bell's palsy, in Riyadh, Saudi Arabia. The study aimed to determine if there is a correlation between cold weather and the incidence of Bell's palsy, as well as to examine the relationship between age, gender, comorbidities, and the development of the disease. Methodology Data were collected from King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2016 and 2021. Electronic medical records of adult patients diagnosed with idiopathic facial paralysis were reviewed. Patients with facial paralysis caused by known illnesses were excluded. Demographic information, clinical characteristics, and the course of the disease were analyzed using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results The study included 136 Bell's palsy patients, with a mean age of 39.9 years. Males represented 58.1% (79) of the sample, and the right side of the face was more commonly affected in 71 (52.2%) patients. The majority of patients had House-Brackmann grade III (51, 37.5%). The monthly distribution showed a higher number of Bell's palsy cases during the winter months, particularly December, October, and November, but the seasonal distribution did not yield a statistically significant difference in incidence. Conclusions While this study observed a higher incidence of Bell's palsy during the winter months, it did not establish a statistically significant correlation between cold temperatures and the onset of Bell's palsy in Riyadh, Saudi Arabia. Furthermore, the study found that Bell's palsy predominantly affects middle-aged males, and comorbidities did not appear to be significant risk factors for the development of the disease. This research lays the groundwork for future investigations into the relationship between weather and the pathogenesis of Bell's palsy in the region.

Modified versus Classical Tubularised Incised Plate Urethroplasty in Hypospadias: A Comparative Study.

BACKGROUND: Hypospadias is a wide-world congenital malformation that accounts for 1 of 300 live male births. Many procedures were considered for its management. As the tubularised incised plate (TIP) urethroplasty, the most prevalent technique, caused many complications, several modifications were applied to the original operation to improve the outcomes and alleviate complications. The aim of this study was to compare the outcome of the ordinary TIP urethroplasty with the technique modified without dissection of the glans penis. MATERIALS AND METHODS: A total of 82 patients with a mean age of 18.8 (±14.8) months, were randomly assigned to undergo TIP with either complete glans wings mobilisation (Group A, n = 42 patients) or without glans dissection (Group B, n = 40 patients). To evaluate the effect of modified TIP urethroplasty without glanular dissection for treatment of distal hypospadias in contrast to classical TIP repair. RESULTS: Both techniques showed similar outcomes regarding functional repair, with good to excellent results between 88% and 90% after 6 months of follow-up. Most confronted post-operative complications were wound infection, oedema, urethrocutaneous fistulas and meatal stenosis. Less frequently haematoma, post-operative bleeding and glans dehiscence were encountered. The differences in complication rates between the two studied groups were statistically insignificant except for oedema (P = 0.04), and need for urethral dilatation (P = 0.002) that were more prevalent among patients who were treated with classic TIP repair with complete glans wings mobilisation. CONCLUSION: From our point of view, it seems that TIP without glanular dissection technique does not outweigh TIP with complete glans wings mobilisation regarding functional outcomes and post-operative complications.