Postoperative Patient Pain Severity and Its Association With Anxiety, Depression, and Sleep Quality.

Introduction The experience of pain is a complex phenomenon. A patient in the acute postsurgical pain setting may feel a constant bombardment of nociceptive input from the surgical site; this in turn influences psychological factors that determine the overall emotional experience of pain, which is significant. The aim of our study was to investigate the severity of pain in postsurgical patients three days after surgery using the 100 mm visual analog scale (VAS). Methods This was a cross-sectional assessment of postoperative pain. Participants were patients between 18 and 64 years of age who had undergone a surgical procedure (laparoscopic or open surgery), three days prior to the data collection and who were admitted or discharged postoperatively at the Al Salmaniya Complex, Manama, Bahrain. Participants were asked demographic questions about whether they had laparoscopic or open surgeries and completed self-reporting scales. Patient Health Questionnaire-9 (PHQ-9) was utilized to screen for both the presence and severity of depression; Generalized Anxiety Disorder 7-item (GAD-7) was administered to screen for anxiety; the Insomnia Severity Index (ISI) was used to evaluate insomnia; and the VAS was used to evaluate pain.  Results Sixty-seven patients were recruited, with a mean age of 61.53 years (SD = 7.37). Twenty-nine (43%) were females, 38 (57%) were males, 36 (54%) underwent elective surgery, 31 (46%) underwent emergency surgery, 31 (46%) underwent laparoscopic surgery, and 36 (54%) underwent open surgery. The average score on the Brief Pain Inventory Short Form (BPISF) was 8.12 (SD = 1.16), indicating a moderate level of pain. Twenty-six (43%) patients had moderate-severe insomnia, 21 participants (31%) had no insomnia, 17 participants (25%) had subthreshold insomnia, 28 (42%) had moderate depression, five (7%) had moderate-severe depression, and 34 (51%) had severe depression. Eighteen participants (27%) had mild anxiety, 46 (69%) had moderate anxiety, and 3 (4%) had severe anxiety. Six of the participants (9%) reported moderate pain, while 61 participants (91%) reported severe pain.

Retraction: Isolated Polycystic Liver Disease: A Rare Genetic Disorder.

[This retracts the article DOI: 10.7759/cureus.18560.].

Orbital and Intracranial Complications of Acute Rhinosinusitis in a Tertiary Center, Saudi Arabia.

Background Rhinosinusitis is an inflammatory condition affecting the nasal cavity's mucosa and paranasal sinuses. In rare cases, acute rhinosinusitis (ARS) might lead to significant orbital and intracranial complications. This study aims to review the patients who presented with orbital or intracranial complications of ARS and to identify the main outcomes of these complications and their prognosis. Methods In this study, a retrospective chart review of patients with orbital or intracranial complications of ARS who presented to the otolaryngology department at King Abdulaziz Medical City, Riyadh, Saudi Arabia from 2016 to 2022 was conducted. Results A total of 43 patients with orbital, intracranial, or both (orbital and intracranial) complications of ARS were included. The most involved sinuses were maxillary sinuses. The most reported orbital complications were subperiosteal abscesses, and the most reported intracranial complications were epidural abscesses. Conclusion Orbital and intracranial complications of ARS are serious and life-threatening if not recognized early and treated effectively. The majority of ARS complications in this study were orbital complications. Fortunately, most of the cases carry a favorable outcome.

Knowledge, Attitude, and Practice of Diabetic Foot Ulcer Care in Asser Region: A Cross-Sectional Study.

Background Foot problems continue to be the leading cause of hospital admissions among people with diabetes. The objective of this study was to explore and assess the knowledge and attitudes of individuals about diabetic foot ulcers in the Asser region, Saudi Arabia. Methodology An anonymous, online, cross-sectional survey was conducted. The questionnaire was distributed through commonly used social media platforms such as Instagram, Facebook, and Twitter. Results A total of 445 participants were included in this survey. Overall, 37.1% (165) were aged 18-25 years, 64.3% (286) were women, and 75.7% (337) had university-level education. A significant number of participants had relatives with diabetes (57.1%, 254), while a smaller percentage reported having diabetes themselves (7.3%, 33), and a substantial proportion were neither diabetic nor had a relative with diabetes (35.6%, (158). Nearly two-fifths of the participants (37.8%, 168) received information about diabetes and diabetic foot care from physicians, and 34.1% (152) of the participants accessed information online. There were significant differences between those who did not have diabetes mellitus (DM) and those who had DM or whose relatives were diabetic in responses to the following questions: "Do you think that diabetes may cause gangrene in the foot?" (50.9% (205) vs. 45.7% (32), p = 0.019), "Do you think that preventing diabetic foot ulcers is more important than treating diabetic foot ulcers?" (60.8% (228) vs. 46.9% (60), p = 0.002), and "Do you think it is important to constantly monitor diabetic foot wounds?" (63.1% (200) vs. 30.4% (17), p < 0.001). There was a statistically significant difference between groups in the practice of daily foot checks, washing feet, moisturizing feet, keeping feet away from hot and cold, and nail care (p < 0.001). Conclusions The participants in the study showed a lack of knowledge regarding diabetic foot care, indicating the potential for better outcomes through the implementation of enhanced health education programs.

In Vitro Evaluation of Antioxidant, Anticancer, and Anti-Inflammatory Activities of Ethanolic Leaf Extract of Adenium obesum.

Adenium obesum commonly known as "desert rose" belongs to the family Apopcynaceae and has previously been reported for its anti-influenza, antimicrobial, and cytotoxic efficacies and well-known for their ethno-medicinal applications. In the present study, ethanolic extracts of A. obesum (AOE) were analyzed by gas chromatography-mass spectrometry (GC-MS) to identify the important phytochemical compounds. The GC-MS analysis of AOE detected the presence of 26 phytochemical compounds. This plant is traditionally used for the treatment of various diseases. In this report, the antioxidant, anti-inflammatory, and anticancer activities of ethanolic leaf extract from A. obesum (AOE) were studied. The antioxidant potential of ethanolic extract of AOE was examined by different antioxidant assays, such as antioxidant capacity by the DPPH, ABTS, superoxide, hydroxyl radical scavenging, and lipid peroxidation inhibition assays. The antioxidant activities of various reaction mixtures of AOE were compared with a reference or standard antioxidant (ascorbic acid). In addition, we also evaluated the anticancer activity of AOE, and it was observed that AOE was found to be cytotoxic against A549 lung cancer cells. It was found that AOE inhibited the viability of A549 lung cancer cells by inducing nuclear condensation and fragmentation. Furthermore, ethanolic AOE demonstrated the anti-inflammatory potential of AOE in murine alveolar macrophages (J774A.1) as an in vitro model system. AOE showed its potential in reducing the levels of inflammatory mediators including the proinflammatory cytokines and TNF-α. The results obtained in the present investigation established the antioxidant, anticancer, and anti-inflammatory potency of AOE, which may account for subsequent studies in the formulation of herbal-based medicine.

Identification of PARP12 Inhibitors By Virtual Screening and Molecular Dynamics Simulations.

Poly [adenosine diphosphate (ADP)-ribose] polymerases (PARPs) are members of a family of 17 enzymes that performs several fundamental cellular processes. Aberrant activity (mutation) in PARP12 has been linked to various diseases including inflammation, cardiovascular disease, and cancer. Herein, a large library of compounds (ZINC-FDA database) has been screened virtually to identify potential PARP12 inhibitor(s). The best compounds were selected on the basis of binding affinity scores and poses. Molecular dynamics (MD) simulation and binding free energy calculation (MMGBSA) were carried out to delineate the stability and dynamics of the resulting complexes. To this end, root means deviations, relative fluctuation, atomic gyration, compactness, covariance, residue-residue contact map, and free energy landscapes were studied. These studies have revealed that compounds ZINC03830332, ZINC03830554, and ZINC03831186 are promising agents against mutated PARP12.

Consequences of SARS-CoV-2 Infection in Pregnant Women and Their Infants: A Systematic Review.

Coronavirus disease 2019 (COVID-19) is a worldwide health problem, particularly for pregnant women. This review assesses the effects of COVID-19 on pregnant women and their infants. A systematic search was performed of studies published on PubMed, Web of Science, Google Scholar, and Embase from January 2020 to January 2021, without restriction by language. This review included 27 studies (22 from China, one from the United States, one from Honduras, one from Italy, one from Iran, and one from Spain), which cumulatively evaluated 386 pregnant women with clinically confirmed COVID-19 and their 334 newborns. Of the 386 pregnant women, 356 had already delivered their infants, four had medical abortions at the time of research, 28 were still pregnant, and two died from COVID-19 before they were able to give birth. Cesarean sections were performed on 71% of pregnant women with COVID-19 to give birth. Fever and cough were common symptoms among women. Premature rupture of membranes, distress, and preterm birth were pregnancy complications. Low birth weight and a short gestational age were common outcomes for newborns. The common laboratory findings among pregnant women were lymphopenia, leukocytosis, and elevated levels of C-reactive protein. Chest computed tomography revealed abnormal viral lung changes in 73.3% of women. Eleven infants tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. There was no evidence of vertical transmission. Most infants were observed to have lymphopenia and thrombocytopenia. The clinical features of pregnant women were found to be similar to those of generally infected patients. There is evidence of adverse pregnancy and neonatal outcomes caused by COVID-19.

Isolated Polycystic Liver Disease: A Rare Genetic Disorder.

Polycystic liver disease is a rare clinical condition that causes portal hypertension. It constitutes a group of disorders with liver lesions resulting from abnormal development of the embryological ductal system. Isolated polycystic disease with the absence of polycystic kidney disease is considered a rare condition. We present the case of a 46-year-old man who presented with epigastric pain and episodes of hematemesis. Abdominal examination revealed enlarged liver. He underwent a computed tomography scan that revealed innumerable cystic liver lesions with the presence of ascites. Further investigations confirmed abnormal liver functions and portal hypertension. Physicians need to consider this diagnosis in the appropriate clinical settings. Extensive involvement of the liver may lead to persistent severe symptoms requiring liver transplantation.