Outcomes of Hypospadias Repair Based on Surgical Techniques: A 4-Year Retrospective Study.

Purpose: This study aimed to report the outcomes of hypospadias repair performed at a tertiary-level hospital during 2018 to 2021. Methods: A retrospective chart review of 119 patients was performed. Results: The most frequent coronal hypospadias cases were distal. However, the most common scrotal hypospadias cases were proximal. The average age at the time of the first surgery was 2.4 years (standard deviation, ±2.3 years). The tubularised incised plate technique was performed for 57 of these 119 patients. Urethral fistula was the most common complication associated with distal and proximal cases (23.96% and 30.43%, respectively). No significant correlation was observed between any complication and the surgical technique. Based on the logistic regression model, the duration of urethral stenting was statistically significant (p=0.025), indicating that a urinary catheter duration of more than 5 days resulted in a 2.9-times increased risk of postoperative urethral fistula. Conclusion: Prolonged urethral stenting for more than 5 days may result in subsequent urethral fistula development. Neither the severity of hypospadias nor the surgical technique seems to affect postoperative complications.

Prevalence and Pattern of Birth Defects in Saudi Arabia: A Systematic Review of Observational Studies.

INTRODUCTION: Birth defects are a significant concern since they can lead to permanent disability and death. This study comprehensively reviews the prevalence and patterns of birth defects in Saudi Arabia. METHODS: A systematic analysis of the literature retrieved from three databases (Pub Med, Science Direct, and the Saudi digital library) published between 1989 and 2022 was performed. Observational studies that addressed the prevalence and patterns of birth defects in Saudi Arabia were chosen based on the eligibility criteria, while systematic reviews, review articles, non-relevant articles, and studies that did not fulfill the eligibility criteria were excluded. Quality and risk of bias were evaluated based on the JBI and GRADE tools, respectively. RESULTS: We identified 26 eligible publications of 1277 records that included 297,668 patients from different regions of Saudi Arabia. The highest overall prevalence of birth defects was 46.5 per 1000 live births compared to a lowest rate of 8.6 per 1000 in one study. Several studies have reported positive associations of consanguinity, maternal folic acid supplementation, family history of birth defects or genetic abnormalities, and maternal co-morbidities. The most frequent birth defects include cardiac, genitourinary, craniofacial, and nervous system defects. CONCLUSION: Robust findings have improved our understanding of the prevalence and pattern of birth defects in Saudi Arabia. Importantly, future studies will likely require multicenter collaboration to arrive at appropriate sample sizes in the context of the effects of risk factors on elevated prevalence. Furthermore, quantitative data require careful evaluation in more complex statistical models.

Conceptualization social influence from the need to belong perspective on psychological needs' satisfaction to share knowledge.

Purpose: Aiming to comprehend the function of social influence as an extrinsic motive influencing individuals' psychological needs satisfaction to share knowledge in higher educational institutions, the study will profile prior literature on how social influence affects knowledge sharing and conceptualize a suggested framework. Design/methodology/approach: The research thoroughly examined the literature for the previous ten years using a comprehensive evaluation, mapping and analyzes research networks of the literature on relational social influence factors through bibliometric analysis. It offers a conceptual framework that explains extrinsic social factors and their effects on the psychological needs satisfaction to share knowledge among people from the viewpoint of a need to belong. Findings: The study concluded a unique a conceptual framework that provides a solid understanding for the relational social influence phenomenon in the perspective of the need to belong, which satisfy the psychological needs to share knowledge. This will contribute to further investigations in the research area. Research limitations: The study is a qualitative study and is limited in its generalizability as it needs further investigations to overcome the bias on the part of the researcher. Practical implications: Adopting the proposed conceptual framework serves as a diagnostic tool for researchers to address the social influence that is likely to boost individuals' satisfaction to share knowledge. Originality/value: This research presents a novel understanding of social influence as an extrinsic motivator arising from a sense of belonging that affects individuals' needs satisfaction to share knowledge. Social implications: Increasing the awareness of how social influence is likely to motivate individuals to connect with one another, interact socially, and work together collaboratively to fulfil their satisfaction of psychological needs to share knowledge.

The relationship between physical activity and burnout among respiratory therapists in Jeddah City, Saudi Arabia.

Background/objective: Burnout is a condition in which a person feels physically fatigued and mentally drained. It occurs after a long period of work-related stress and may lead to mental disorders, such as depression and anxiety. Therefore, healthcare providers especially require early intervention. Regular physical activity has been reported to benefit individuals with mental illness, suggesting that a relationship between physical activity and burnout might exist. Hence, this study's objective was to analyze the relationship between physical activity and burnout among respiratory therapists and student interns in Jeddah City, Saudi Arabia. Methods: A cross-sectional descriptive study with respiratory therapists and interns working in public and private hospitals was conducted from November 2, 2020, to November 27, 2020. Participants responded to an electronic survey consisting of the Maslach Burnout Inventory - Human Services Survey for Medical Personnel, which measures the burnout dimensions of emotional exhaustion, depersonalization, and personal accomplishment. They also completed the International Physical Activity Questionnaire - Long Form and a demographic questionnaire. Results: Among the 250 eligible respiratory therapists and interns, data from the 152 respondents who completed the electronic survey were analyzed. Although no association between physical activity and burnout was found, a significant effect of the novel coronavirus disease 2019 (COVID-19) on physical activity and significant associations of high burnout (emotional exhaustion) with nationality and smoking were found. Conclusion: No association was found between burnout level and physical activity. Confounding factors, such as the COVID-19 pandemic during the study's data collection and analyses, likely contributed to the study's findings.

COVID-19 Vaccine Hesitancy Prevalence and Predictors among the Students of Jazan University, Saudi Arabia Using the Health Belief Model: A Cross-Sectional Study.

Vaccination has a major role in the control of the COVID-19 pandemic. The behavior toward accepting the COVID-19 vaccine is complex and multifactorial, while the level of acceptance and hesitancy depends on many factors. This study aims to measure the level of vaccine acceptance among Jazan University students and identify its predictors. In this cross-sectional study, an online questionnaire based on the health belief model (HBM) was sent through social media "WhatsApp" to two strata of students selected by convenient sampling. The overall desire to get vaccinated was noted in 83.6% of participants, and 16.4% reported no desire to be vaccinated. The constructs of the HBM were shown to significantly predict vaccine acceptance with the exception of "perceived susceptibility". In conclusion, the level of acceptance of the COVID-19 vaccine among Jazan University students was relatively high. The HBM constructs are important predictors of the vaccination behavior with the exception of the construct "perceived susceptibility".

Investigation of the effect of the calcium channel blocker, verapamil, on the parasite burden, inflammatory response and angiogenesis in experimental Trichinella spiralis infection in mice.

Trichinella spiralis larvae have very special characters that make them able to completely transform the function of the affected muscle cells towards a self-serving environment, offering them nourishment and protection via what is known as "nurse cells". This setting may be affected by drugs that are used for the treatment of co-morbidities and co-infections as calcium channel blockers, which are widely used in clinical practice. In the present study, the effects of verapamil, ivermectin (IVM), and their combined administration on the parasitic burden, immuno-pathology and angiogenesis were investigated during experimental trichinellosis. Estimation of intestinal adult parasitic stages and muscle larvae was done. VEGF gene expression and CD31 immunohistochemical local expression were measured to investigate angiogenesis, in addition to histopathological examination to explore the extent of inflammation. Although verapamil did not have an effect on the adult worm count during the intestinal phase, it induced an anti-inflammatory effect on intestinal pathology. During the muscle phase, it was very effective in reducing the larval count by 93.78%. IVM effectively reduced the worm count by 85.34%, and the muscle larval count by 97.84%, while combined verapamil and IVM administration resulted in a significant reduction in both adult parasites by 69.5% and larval stages by 99%. Both verapamil and IVM and their combination induced a potent decrease in local CD31 protein expression and VEGF gene expression. The important role of calcium and calcium channels during the pathology of trichinellosis, in addition to the pivotal role of calcium on biological processes such as immunity and angiogenesis, make calcium-channel blockers promising candidates for drug repurposing in the management of helminthic infection.

Deferiprone vs deferoxamine for transfusional iron overload in SCD and other anemias: a randomized, open-label noninferiority study.

Many people with sickle cell disease (SCD) or other anemias require chronic blood transfusions, which often causes iron overload that requires chelation therapy. The iron chelator deferiprone is frequently used in individuals with thalassemia syndromes, but data in patients with SCD are limited. This open-label study assessed the efficacy and safety of deferiprone in patients with SCD or other anemias receiving chronic transfusion therapy. A total of 228 patients (mean age: 16.9 [range, 3-59] years; 46.9% female) were randomized to receive either oral deferiprone (n = 152) or subcutaneous deferoxamine (n = 76). The primary endpoint was change from baseline at 12 months in liver iron concentration (LIC), assessed by R2* magnetic resonance imaging (MRI). The least squares mean (standard error) change in LIC was -4.04 (0.48) mg/g dry weight for deferiprone vs -4.45 (0.57) mg/g dry weight for deferoxamine, with noninferiority of deferiprone to deferoxamine demonstrated by analysis of covariance (least squares mean difference 0.40 [0.56]; 96.01% confidence interval, -0.76 to 1.57). Noninferiority of deferiprone was also shown for both cardiac T2* MRI and serum ferritin. Rates of overall adverse events (AEs), treatment-related AEs, serious AEs, and AEs leading to withdrawal did not differ significantly between the groups. AEs related to deferiprone treatment included abdominal pain (17.1% of patients), vomiting (14.5%), pyrexia (9.2%), increased alanine transferase (9.2%) and aspartate transferase levels (9.2%), neutropenia (2.6%), and agranulocytosis (0.7%). The efficacy and safety profiles of deferiprone were acceptable and consistent with those seen in patients with transfusion-dependent thalassemia. This trial study was registered at www://clinicaltrials.gov as #NCT02041299.

Hepatocellular Carcinoma Score and Subclassification Into Aggressive Subtypes Using Immunohistochemical Expression of p53, ß-Catenin, CD133, and Ki-67.

Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy in adults. Several studies have classified HCC into molecular subtypes aiming at detecting aggressive subtypes. The aim of the present study was to investigate the role of p53, ß-catenin, CD133, and Ki-67 in subclassification of HCC into different aggressive subtypes and the correlation between those markers and the clinicopathologic characteristics of HCC patients. This retrospective study was conducted on paraffin-embedded blocks of 114 HCC specimens. Tissue microarray was constructed and immunostaining for p53, ß-catenin, CD133, and Ki-67 was performed and HCC score was formulated. P53 expression was associated with old age (P=0.028), large tumor size (P=0.019), poorly differentiated HCC (P=0.012), hepatitis B virus (HBV) positivity (P=0.032), and hepatitis C virus (HCV) negativity (P =0.046). ß-catenin expression was associated with small sized tumors (P=0.005), HBV negativity (P=0.027), early-staged tumors (P=0.029), and prolonged recurrence-free survival (P=0.045). High percentage of CD133 expression was associated with old patients (P=0.035) and HBV positivity (P= 0.045). Ki-67 expression was associated with large tumor size (P= 0.049), vascular invasion (P= 0.05), old age (P=0.035), and previous treatment of HCV by direct acting antiviral agents (P=0.005). Cases with high HCC score showed significant association with old patients (P=0.002), previous treatment of HCV by direct acting antiviral agents (P<0.001), large tumor size (P<0.001), and poorly differentiated tumors (P= 0.009). The proposed HCC score can divide HCC patients into subtypes necessitating tailoring of treatment strategy according to this proposed score to target and optimally treat the aggressive subtypes. This score needs to be further validated on large number of patients with longer follow-up period.

Endocanalicular, high-pressure balloon catheter, endoscopic dacryocystorhinostomy: a randomized controlled trial.

OBJECTIVES: To conduct a prospective randomized controlled study to investigate the safety and efficacy of endocanalicular, high-pressure, 5-mm balloon catheter, endoscopic dacryocystorhinostomy (DCR) in adult patients with acquired complete nasolacrimal obstruction. STUDY DESIGN: Prospective randomized controlled study. SETTING: General hospital. SUBJECTS AND METHODS: Sixty-six adult patients with a total of 70 procedures were recruited to undergo endoscopic DCR. They were prospectively, equally randomized into 2 groups: endocanalicular, high-pressure, 5-mm balloon catheter, endoscopic DCR (group I) and conventional endoscopic DCR (group II). Regular follow-up sessions were conducted to document the patient's subjective improvement, judge ostium patency on irrigation, and record any complications. RESULTS: Both groups demonstrated a success rate of 91.4%. There was a shorter mean operative time (25.7 minutes) in group I (P < .001). The number of adverse events was significantly higher in group II (P < .05). Group I showed statistically significantly more comfort during surgery under local anesthesia with minimal sedation (P < .05). CONCLUSION: Endocanalicular balloon catheter endoscopic DCR shares the advantages and success rate of conventional endoscopic DCR. In addition, the former is simpler, requires less manipulation, consumes a shorter operative time, has a better safety profile, and can be conducted under local anesthesia with minimal sedation.