A novel layered double hydroxide-based ternary nanocomposite for the effective photocatalytic degradation of rhodamine B.

Photocatalytic degradation of organic pollutants is a green and effective route of wastewater treatment. Zinc oxide was initially used for this purpose; however, calcined zinc/chromium layered double hydroxide (ZnCr-LDO) and cadmium sulfide quantum dots (CdSQDs)-based nanocomposites proved as superior alternatives. Herein, we report a green sonochemical method for the sol-gel fabrication of novel CdSQDs@ZnCr-LDO/ZnO ternary nanocomposite that exhibited exceptional photocatalytic activity for the degradation of rhodamine B dye (RhB), in wastewaters, under UV-A-irradiation. The features of the ternary nanocomposite were investigated using various physicochemical techniques, including XRD, SEM, TEM, EDX, XPS, BET, zeta potential, DRS, and PL measurements. The RhB dye % removal was 38.02, 40.2, and 98% using pristine ZnO, ZnCr-LDO and the ternary CdSQDs@ZnCr-LDO/ZnO-based nanomaterials, respectively, reflecting the superior ternary nanocomposite's photocatalytic activity that made it an excellent competitor to commonly reported photocatalysts. Additionally, an investigation was carried out to determine the key reactive species in the photocatalytic degradation of RhB, considering both scavenger's type and concentration. The prevailing mechanism was found to be the reductive photodegradation pathway. Furthermore, several models were utilized to describe the kinetics of photocatalytic performance of the ternary nanocomposite and a typical Z-scheme type-II photocatalytic heterojunction mechanism was inferred.

Serum Level of 25-Hydroxyvitamin D and Symptoms of Pica Among Adolescent School Children in Northern Sudan: A Cross-Sectional Study.

Objectives. To assess levels of 25(OH)D among adolescents with symptoms of pica in northern Sudan. Methods. A cross-sectional study was conducted in North Sudan. Questionaries were used to collect adolescents' sociodemographics. The enzyme-linked immunosorbent assay was used to measure 25(OH)D level. Results. Of the 344 adolescents enrolled, 161 (46.8%) and 183 (53.2%) were male and female, respectively and 103 (29.9%) had symptoms of pica. The median (IQR) of 25(OH)D level was significantly lower in adolescents with symptoms of pica. Multiple linear regression analysis showed that while age (coefficient = 1.1, P = .023) was positively associated with 25(OH)D level, female sex (coefficient = -7.5, P < .001), and pica symptoms (coefficient = -3.5, P = .032) were negatively associated with 25(OH)D level. Conclusion. Adolescents with symptoms of pica had lower 25(OH)D levels. Adolescents with symptoms of pica have to be assessed for vitamin D status.

Comparative studies of four cumin landraces grown in Egypt.

One of the significant aromatic plants applied in food and pharma is cumin. Despite its massive trading in Egypt, there are no comprehensive reports on cumin landraces profile screening. This study aimed to investigate the variation in seeds' physical and biochemical profiles and genetic diversity as well as assess the efficiency of seeds' germination under salinity stress. Consequently, during the 2020/2021 growing season, four common cumin seed landraces were gathered from various agro-climatic regions: El Gharbia, El Menia, Assiut, and Qena. Results showed a significant variation in physical profile among the four seeds of landraces. In addition, Assiut had the highest percentage of essential oil at 8.04%, whilst Qena had the largest amount of cumin aldehyde, the primary essential oil component, at 25.19%. Lauric acid was found to be the predominant fatty acid (54.78 to 62.73%). According to ISSR amplification, El Menia presented a negative unique band, whereas other landraces offered a positive band. Additionally, the cumin genotypes were separated into two clusters by the dendrogram, with El Gharbia being located in an entirely separate cluster. There were two sub-clusters within the other cluster: El Menia in one and Assiut and Qena in the other. Moreover, the germination sensitivity to the diverse salinity concentrations (control, 4, 8, 12, and 16 dS/m) findings showed that landraces exhibited varying responses to increased salinity when El Gharbia and El Menia showed a moderate response at four dS/m. Whilst, Qena landraces showed supreme values among other landraces under 12 and 16 dS/m. The majority of the examined features had strong positive associations over a range of salinity levels, according to phenotypic correlation coefficient analysis. To accomplish the aims of sustainable agriculture in Egypt, it would be imperative that the potential breeding program for cumin landraces consider this screening study.

Synergistic immunomodulatory effect of synbiotics pre- and postoperative resection of pancreatic ductal adenocarcinoma: a randomized controlled study.

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a highly immunosuppressive microenvironment. This single-blind, randomized study aimed to evaluate the synergistic immunomodulatory effects of synbiotics (probiotics and inulin prebiotics), as well as their impact on postoperative complications and outcomes, compared to the use of probiotics alone. Ninety patients diagnosed with PDAC were enrolled and randomly assigned into three groups: the placebo group, the probiotics group (receiving a mixture of ten strains of Lactobacillus, Bifidobacterium, and Streptococcus bacteria at a dose of 25 billion CFUs), and the synbiotics group (the same probiotics along with inulin prebiotics). The interventions were administered for 14 days before the surgery and continued for one month postoperatively. Tumor tissue infiltration of CD8 + T cells and the expression of IFN γ were assessed by immunohistochemistry (IHC). Inflammatory cytokines concentrations, including Il 1 B, IL 6, and IL 10, were evaluated as well by ELISA at various time points pre- and postoperative. Furthermore, patients were followed up after the surgery to assess postoperative short-term outcomes. Our results showed a significant elevation of CD8 + T cell proportion and IFN γ expression in the synbiotics group compared to the probiotics group (p = 0.049, p = 0.013, respectively). Inflammatory cytokines showed a significant gradual decrease in the synbiotics group compared to placebo and probiotics-treated groups (p = 0.000 for both). Administration of synbiotics and probiotics significantly decreased the rate of postoperative complications including anastomotic leakage, diarrhea, and abdominal distension (p = 0.032, p = 0.044, p = 0.042, respectively), with a remarkable reduction in bacteremia in the synbiotics group. These results revealed that this synbiotics formulation potentially enhances the immune response and reduces complications associated with surgery.Clinical trial identification: NCT06199752 (27-12-2023).

Epidemiological characteristics, etiological spectrum, and outcomes of adult patients with pericardial effusion at a Teaching Hospital in Somalia.

Background: Pericardial effusion (PE) is an abnormal fluid volume in the pericardial space and is a common clinical entity. The incidence of PE is estimated diversely and depends on risk factors, etiologies, and geographic locations. Objectives: This study aimed to assess the clinical characteristics, etiologic spectrum, echocardiographic features, and outcomes among patients with different types of PE. Method: This retrospective observational study included 93 patients with confirmed PE. Their medical records were reviewed in the hospital information system of Mogadishu Somali Turkish Training and Research Hospital between April 2022 and September 2022. Patient demographics, clinical characteristics, chest X-rays, echocardiography, laboratory findings, management approaches, and outcome reports were reviewed and recorded. Results: Out of the 3000 participants, 3.1% (n = 93/3000) met the definition of definitive PE. In this study, we included 51 females and 42 males. Among the patients, 86% (n = 80) had at least one comorbidity, with diabetes (38.7%) and hypertension (37.6%) being the most common. The most frequently reported clinical presentation findings were shortness of breath (67.7%), chest pain (49.4%), cough (47.3%), and palpitations (47.3%). Cardiac tamponade developed in 9.7% (n = 9) of the patients. Pericardial taps were performed in 64.5% of the cases. Our analysis showed that the most common cause of PE was cardiac disease (n = 33, 35.4%), followed by tuberculosis (TB) (n = 25, 26.8%), uremic pericarditis (n = 24, 25.8%), and hypothyroidism (n = 10, 10.7%). Regarding the severity of PE based on echocardiographic findings, nearly half of the patients (n = 46, 49.4%) had mild PE, whereas 26.8% (n = 25) had moderate PE, and 23.6% (n = 22) had severe PE. Two-thirds of the cases (66.6%) were managed with furosemide, 48 (51.6%) patients were treated with an anti-inflammatory, hemodialysis was performed in 24 (25.8%) patients and antituberculous medications were administered to 7 (7.5%) patients. Out of the 93 patients, 24 (25.8%) died during the hospital stay. It was determined that the mortality risk of patients with renal failure was 7.518 times higher than those without (p = 0.004), and the risk for those with TB was 5.554 times higher than those without (p = 0.011). Other variables were not influential on mortality (p > 0.050). Conclusion: Our study results demonstrate the epidemiological profile of PE in Somalia. The leading causes of PE were cardiac diseases, uremic pericarditis, TB, and hypothyroidism. PE is a significant cause of morbidity and mortality in Somalia, especially in individuals with renal failure and TB infection.

Application of ZnO NPs, SiO2 NPs and Date Pollen Extract as Partial Substitutes to Nitrogen, Phosphorus, and Potassium Fertilizers for Sweet Basil Production.

The reduction in mineral fertilizer usage is crucial to the production of medicinal and aromatic products for safety and health purposes. Presently, nanotechnology and the utilization of natural extracts have been extensively studied due to their significant contribution. Ocimum basilicum is commonly employed for various medicinal and aromatic applications. Therefore, randomized complete block design field experiments containing 10 treatments were conducted during the 2021 and 2022 seasons to investigate the effect of nanoparticles (NPs) of ZnO (1.5 and 2.0 g/L) and SiO2 (100 and 150 mg/L) and date palm pollen extract (DPPE) at 10 and 20 g/L either alone or in combination with the ¾ or ½ NPK recommended dose (RD). The NPK RD was served as a control treatment on basil plant production in each season. The effectiveness of ZnO NPs, SiO2 NPs, and DPPE for the decrease in NPK utilization was evaluated. Meanwhile, the most effective treatment for vegetative traits (except for plant height), essential oil %, and yield was ½ NPK RD + 20 g/L DPPE + 2.0 g/L ZnO NPs. Such a treatment increased the branch number/plant, main stem diameter, relevant chlorophyll content, fresh weight/plant, dry weight/plant, essential oil %, and essential oil yield/plant by 21.00 and 9.94%, 58.70 and 40.00%, 20.69 and 15.83%, 68.83 and 58.28%, 48.70 and 56.16%, 45.71 and 35.53%, and 113.22 and 110.32% over the control in the two seasons, respectively. For total phenol and antioxidant activity, the most effective treatments were the ¾ NPK +1.5 g/L ZnO NPs and ½ NPK +2.0 g/L ZnO NPs, respectively. Simultaneously, essential oil composition (with their compound numbers identified (11-29 for control and ¾ NPK RD + 1.5 g/L ZnO NPs)) and the percentage of total compounds, monoterpene hydrocarbons, sesquiterpene hydrocarbons, and oxygenated hydrocarbons were varied among the used applications. The major observed compounds (>8%) estragole, methyl eugenol, linalool, cineole, and caryophyllene were found in different treatments. Thus, the findings of this study indicate the favorable utilization of ZnO NPs, SiO2 NPs, and DPPE in reducing the application of NPK, which may present a novel strategy and beneficial approach.

Compost and humic acid amendments are a practicable solution to rehabilitate weak arid soil for higher winter field pea production.

Arid soils are often weak, low in fertility, and lack essential plant nutrients. Organic amendments might be a feasible solution to counter the detrimental impact and rehabilitate weak arid soil for the growth of legumes. The study aimed to investigate how organic amendments of compost and humic acid may affect winter field pea productivity in arid soil. Over 2 years of field experiments, a range of treatments were applied, including different amounts of compost and humic acid. The results showed higher microbial carbon (C), and nitrogen (N) biomass, root length, shoot length, grains pod-1, and grain yield of pea, gained from the collective application of 8 Mg ha-1 compost and 15 kg ha-1 humic acid compared to all other treatments. Organic amendments increased soil microbial C density by 67.0 to 83.0% and N biomass by 46.0 to 88.0% compared with the control. The combined application of compost and humic acid increased soil microbial N biomass by 57.0 to 60.0% compared to the sole applications of compost-only and humic acid-only. It was concluded that organic amendments of 8 Mg ha-1 compost and 15 kg ha-1 humic acid in arid soil modulated microbial density, resulting in improved winter field pea productivity. This study suggests organic amendments of compost and humic acid might be a practicable solution to rehabilitate weak arid soil to grow legumes.

Morphological and physio-biochemical responses under heat stress in cotton: Overview.

Cotton is an important cash crop in addition to being a fiber commodity, and it plays an essential part in the economies of numerous nations. High temperature is the most critical element affecting its yield from fertilization to harvest. The optimal temperature for root formation is 30 C -35 °C; however, root development ends around 40 °C. Increased temperature, in particular, influences different biochemical and physiological processes associated with cotton plant, resulting in low seed cotton production. Many studies in various agroecological zones used various agronomic strategies and contemporary breeding techniques to reduce heat stress and improve cotton productivity. To attain desired traits, cotton breeders should investigate all potential possibilities, such as generating superior cultivars by traditional breeding, employing molecular techniques and transgenic methods, such as using genome editing techniques. The main objective of this review is to provide the recent information on the environmental factors, such as temperature, heat and drought, influence the growth and development, morphology and physio-chemical alteration associated with cotton. Furthermore, recent advancement in cotton breeding to combat the serious threat of drought and heat stress.

Enabling Remote Elderly Care: Design and Implementation of a Smart Energy Data System with Activity Recognition.

Seniors face many challenges as they age, such as dementia, cognitive and memory disorders, vision and hearing impairment, among others. Although most of them would like to stay in their own homes, as they feel comfortable and safe, in some cases, older people are taken to special institutions, such as nursing homes. In order to provide serious and quality care to elderly people at home, continuous remote monitoring is perceived as a solution to keep them connected to healthcare service providers. The new trend in medical health services, in general, is to move from 'hospital-centric' services to 'home-centric' services with the aim of reducing the costs of medical treatments and improving the recovery experience of patients, among other benefits for both patients and medical centers. Smart energy data captured from electrical home appliance sensors open a new opportunity for remote healthcare monitoring, linking the patient's health-state/health-condition with routine behaviors and activities over time. It is known that deviation from the normal routine can indicate abnormal conditions such as sleep disturbance, confusion, or memory problems. This work proposes the development and deployment of a smart energy data with activity recognition (SEDAR) system that uses machine learning (ML) techniques to identify appliance usage and behavior patterns oriented to older people living alone. The proposed system opens the door to a range of applications that go beyond healthcare, such as energy management strategies, load balancing techniques, and appliance-specific optimizations. This solution impacts on the massive adoption of telehealth in third-world economies where access to smart meters is still limited.

Morphological, pathogenic and genetic diversity in Diplodia seriata associated with black rot canker of apple in India.

Apple cankers are extremely destructive diseases threatening the global apple industry through direct and indirect losses. The population structure of the pathogens is of paramount significance for the development of efficient management strategies. Therefore, phenotypic, pathogenic, and genetic diversity of Diplodia seriata causing black rot canker of apple was investigated in this study. All the isolates were included for investigating the in vitro mycelial growth, conidial dimensions, and pathogenic variability on two-year-old potted apple seedlings. The ISSR approach was used to investigate the molecular diversity of D. seriata. Mycelial growth rates were found to vary significantly amongst the isolates; however, there were no major variations seen between the different geographical groupings of isolates. Pathogenicity tests revealed variations in the size of cankers among the isolates indicating the presence of virulence variability. The isolates were segregated into three virulence groups based on canker length. The Bayesian analyses of ISSR data divided the isolates into two genetic clusters. The genetic clustering of the isolates revealed no relationship with geographical origin of the isolates. Furthermore, no direct relationship of genetic clustering was observed with morphological or pathogenic variability. The ISSR primers revealed very high level of variability in D. seriata; however, no distinct populations of the pathogen existed which is an indication of high level of gene flow between the diverse geographical populations. According to our knowledge, this is the first thorough investigation on the diversity of D. seriata associated with apple black rot canker in India.

Insights on the Nutritional Profiling of Cantaloupe (Cucumis melo L.) via 1-Naphthalene Acetic Acid.

The nutritional components of cantaloupe, including vitamins, minerals, antioxidants, and dietary fiber, contribute to overall health, improved immunity, hydration, and protection against chronic diseases. This study was conducted to investigate the influence of different concentrations (0 (control), 100, 150, and 200 ppm) of 1-naphthalene acetic acid (1-NAA) on the nutritional components of the cantaloupe (Cucumis melo L. Var. Super White Honey). All the studied treatments were applied twice at the 2nd and 4th leaf stages. The applied concentrations of 1-NAA significantly improved the sex expression and fruit yield attributes. Different nutritional components like proximate contents, minerals, vitamins, selected fatty acids, and amino acids were analyzed. The results showed that the maximum moisture content, proteins, carbohydrates, ash, and energy were recorded with 100 ppm. The higher lipids were recorded during the supplementation of 150 ppm. Significantly greater fibers were recorded using 200 ppm. Regarding minerals, 100 ppm was found to be the best as it increased calcium (Ca), magnesium (Mg), potassium (K), sodium (Na), phosphorous (P), manganese (Mn), copper (Cu), iron (Fe), and zinc (Zn). Vitamins were also found to be the maximum with 100 ppm, including vitamin A, vitamin B, vitamin C, vitamin D, vitamin E, and vitamin K. Total selected fatty acids and amino acids were also found significantly greater in the fruits administered 100 ppm.

Comparative Analysis of Growth and Physiological Responses of Sugarcane Elite Genotypes to Water Stress and Sandy Loam Soils.

Stumpy irrigation water availability is extremely important for sugarcane production in Pakistan today. This issue is rising inversely to river flow due to inadequate water distribution and an uneven rainfall pattern. Sugarcane growth faces a shortage of available water for plant uptake due to the low water-holding capacity of sandy loam soil, particularly under conventional flood irrigation methods. To address this problem, sugarcane clones were evaluated for their agronomic and physiological traits under conditions of low water availability in sandy loam soil. Ten cane genotypes, HSF-240, SPF-213, CPF-249, CP 77-400, S2008-FD-19, S2006-US-469, S2007-AUS-384, S2003-US-633, S2003-US-127, and S2006-US-658, were exposed to four levels of water deficit created through skip irrigations. These deficit levels occurred during the 9th, 11th, 13th, and 16th irrigations at alternate deficit levels between 2020 and 2022. Physiological data were collected during the tillering and grand growth stages (elongation) in response to the water deficit. The sugarcane clones S2006-US-658, S2007-AUS-384, and HSF-240 exhibited resistance to low water availability at both the tillering and grand growth stages. Following them, genotypes S2006-US-658, S2007-AUS-384, and HSF-240 performed better and were also found to be statistically significant. Clones susceptible to water deficit in terms of growth and development were identified as CP 77-400, S2008-FD-19, S2006-US-469, and S2003-US-633. These genotypes showed reduced photosynthetic rate, transpiration rate, stomatal conductance, relative water content, cane yield, and proline content under stressed conditions. Therefore, genotypes S2006-US-658, S2007-AUS-384, and HSF-240 were better performers concerning physiological traits under water deficit and sandy loam soil in both years. Moreover, a significant positive correlation was assessed between agronomic traits and photosynthetic rats. This study highlights that sugarcane can sustain its growth and development even with less irrigation frequency or moisture availability, albeit with certain specific variations.

Peripheral Arterial Disease: A Narrative Review.

Peripheral arterial disease (PAD) describes the partial or complete occlusion of blood flow in the distal arteries of the body. A decreased arterial patency may occur due to a reduction in the elasticity or diameter of the vessel. The goal of interventions is to decrease incidence and reduce complications by identifying and minimizing the primary causes. This paper discusses PAD affecting the aortoiliac, common femoral, and femoropopliteal arteries. In a significant portion of the population, PAD may lack usual symptoms such as limb pain, claudication, and diminished pulses. Imaging techniques become crucial to ensuring timely diagnosis, monitoring treatment effectiveness, and preventing recurrence. Duplex ultrasound (DUS) is a cheap and non-invasive preliminary technique to detect atherosclerotic plaques and grade arterial stenosis. Magnetic resonance angiography (MRA) provides the added advantage of minimizing artifacts. Digital subtraction angiography (DSA) remains the gold standard for grading the degree of stenosis but is only employed second-line to DUS or MRA due to the high dose of nephrotoxic contrast. Computed tomography angiography (CTA) is able to overcome the anatomical limitations of DUS and MRA and proves to be a suitable alternative to DSA in patients with renal disease. Preventative measures involve monitoring blood pressure, cholesterol levels, and tobacco usage. First-line treatment options include endovascular procedures as well as surgical interventions in cases of significant arterial involvement. Endovascular treatments involve the use of balloon angioplasty, drug-coated balloons, and drug-coated stents, to name a few, that serve as minimally invasive techniques to manage PAD. Surgical procedures, although more complex, are considered gold-standard treatment options for long and intricate lesions. Endovascular methods are generally preferred over surgical options as the complication risk is severely reduced and the rates of reintervention are comparable to surgical options.

Wound Dressing Scaffold with High Anti-biofilm Performance Based on Ciprofloxacin-Loaded Chitosan-Hydrolyzed Starch Nanocomposite: In Vitro and In Vivo Study.

Today, the search for solutions to reduce wound infection and restore wound receptivity also reduces its side effects which are a difficult problem in medical science research. The greatest options for this purpose are hydrogel dressings since they are compatible with tissue and have an antibacterial effect on wound healing. Chronic wounds represent a significant burden on people and healthcare systems worldwide. Bacteria often enter such skin wounds, causing irritation and complicating the healing process. In addition, bacteria cause infection, which inhibits rejuvenation and the production of collagen. This study is aimed at developing novel chitosan (CS)-hydrolyzed starch nanocomposite (HS/Ch-NC) loaded with ciprofloxacin to enhance its skin retention and wound healing efficacy and anti-biofilm efficacy. Drug-loading on the (HS/Ch-NC) and encapsulation efficiency was 55.2% and 97.2%, respectively. The activity of HS-NC loaded with ciprofloxacin as anti-biofilm activity by 72% and 63% against Enterobacter aerogenes and Pseudomonas aeruginosa, respectively. The obtained (HS/Ch-NC) loaded with ciprofloxacin is a promising candidate for the development of improved bandage materials, as cell viability and proliferation was assessed using an SRB assay with half-maximal inhibitory concentrations (IC50) at 119.1 µg/ml. In vitro scratch wound healing assay revealed significant (p ≤ 0.05) acceleration in wound closure at 24 h enhanced by 56.04% 24-h and 100% 72-h post-exposure to (HS/Ch-NC) loaded ciprofloxacin, compared to the negative control. In vivo skin retention study revealed that (HS/Ch-NC)-loaded ciprofloxacin showed 3.65-fold higher retention, respectively, than ciprofloxacin. Thus, our study assumes that ciprofloxacin-loaded HS-NC is a potential delivery system for enhancing ciprofloxacin skin retention and wound healing activity.

Rosemary and neem methanolic extract: antioxidant, cytotoxic, and larvicidal activities supported by chemical composition and molecular docking simulations.

This study aimed to employ GC-MS to assess the chemical composition of MeOH leaf extracts of R. officinalis and A. indica and evaluate their insecticidal, antioxidant, and antibacterial activities. Twelve components, representing 98.61% and 100% of the total volatile compounds, were deduced from the extracted R. officinalis and A. indica, respectively, using this method. In R. officinalis extract, limonene is typically positioned as the main component (23.03%), while the main chemicals identified in A. indica extract were methyl (E)-octadec-13-enoate (23.20%) and (2R)-1,3,8-trimethyl-4-propyl-5-ethyl-2-(1-hydroxyethyl)-7-methoxycardonylethyl-6-methylenecarbonyl-porphyrin (23.03%). Both extracts of R. officinalis and A. indica exhibited different toxicity against the stored grain pest T. castaneum, with LC50 values of 1.470 and 2.588 mg/ml, respectively. Additionally, after 4 and 5 h of treatment at a concentration of 0.2 mg/ml, the A. indica extract showed the highest levels of repellent action (81.4% and 93.4%), and the R. officinalis extract showed a good repellent rate (64.9% and 80.7%) against T. castenum larvae. With an IC50 value of 35.83 and 28.68 mg/L and a radical scavenging activity percentage of 67.76% and 72.35%, the leaf extract was found to be the most potent plant extract when tested for DPPH antioxidant activity. Overall results showed that MeOH extracts of R. officinalis and A. indica were more effective against S. aureus than E. coli. To determine how the investigated chemicals attach to the active sites of E. coli DNA gyrase A and S. aureus undecaprenyl diphosphate synthase, docking studies were carried out. The consensus score analysis showed that limonene exhibits the best binding energy with both enzymes in docking analysis and more stability in molecular dynamics simulations. The RMSD was obtained at 20.6 and 4.199 (Kcal/mole). The two compounds were successfully used in molecular dynamics simulation research to generate stable complexes with DNA gyrase A.

Major cardiovascular events and associated factors among routine hemodialysis patients with end-stage renal disease at tertiary care hospital in Somalia.

Introduction: Cardiovascular complications are the most significant cause of death in patients undergoing routine hemodialysi (HD) with end-stage renal disease (ESRD). The main objective of this study is to determine the significant cardiac events and risk factors in patients undergoing routine hemodialysis in Somalia. Methods: We carried out a cross-sectional retrospective study in a single dialysis center in Somalia. Two hundred out of 224 were included. All of them had ESRD and were on hemodialysis during the study period between May and October 2021. The records of all patients were reviewed, and the following parameters were analyzed socio-demographic factors, risk factors for cardiovascular disease, and the presence of cardiovascular diseases. Results: The mean age was 54 ± 17.5 years (range 18-88 years), and 106 (53%) patients were males. The prevalence of a cardiovascular disease among hemodialysis patients was 29.5%. Moreover, the distribution of cardiovascular diseases was different; heart failure was the most common, about 27.1%, followed by coronary artery disease (17%), pericarditis and pericardial-effusion (13.6%), dysrhythmia (10.2%), cerebrovascular-accident (8.5%), and peripheral vascular disease (3.4%). About 176 (88%) participants had at least one modifiable cardiovascular risk factor. The most common modifiable cardiovascular risk factor was hypertension (n = 45, 25.1%), followed by anemia (n = 28, 15.6%) and diabetes (n = 26, 14.5%). Younger (18-30) participants were six times less likely to have cardiovascular events among hemodialysis than older age 0.4 (0.11-1.12). Conclusion: Low prevalence rate of cardiovascular complications was confirmed in ESRD patients receiving hemodialysis in the main HD center in Somalia. Diabetes, anemia, and hypertension were the highest significant risk factors for CVD in HD patients with ESRD in Somalia.

Percutaneous decannulation of venoarterial extracorporeal membrane oxygenation using the Manta vascular closure device: A systematic review and meta-analysis.

OBJECTIVES: To perform a systematic review and meta-analysis of the techniques and outcomes associated with percutaneous decannulation of venoarterial extracorporeal membrane oxygenation (VA-ECMO) using the Manta vascular closure device. BACKGROUND: Peripheral VA-ECMO can be used to treat critically ill patients with conditions such as refractory cardiogenic shock. After percutaneous implantation of VA-ECMO, VA-ECMO can also be decannulated completely percutaneously by using a vascular closure device. The Manta vascular closure device is a dedicated device used in the closure of large-bore arteriotomies by sandwiching the arteriotomy with an intra-arterial toggle and an extraluminal collagen plug. METHODS: We performed a thorough literature search using various electronic databases. We included studies that reported outcomes after peripheral femorofemoral VA-ECMO decannulation with the Manta vascular closure device. We performed a meta-analysis of proportions on outcome measures, including technical success, bleeding complications, vascular complications, wound complications, major amputation, and procedural-related deaths. RESULTS: We included seven studies with a total of 116 patients. The overall technical success of percutaneous decannulation of VA-ECMO with the Manta vascular closure device was 93.7%. The overall incidence of bleeding, vascular and wound complications was 1.7%, 13.8%, and 3.4%, respectively. No patient required lower limb amputation or died due to VA-ECMO decannulation. CONCLUSION: Percutaneous decannulation with the Manta vascular closure device is an effective and safe procedure that should be considered in suitable patients on VA-ECMO.

Prevalence and Characteristics of Health and Wellness Programs for Arab Hospitals' Employees: A Cross-Sectional Study.

Background: Compared to the general workforce, hospital staff has a greater incidence of chronic diseases and mental health illnesses. Wellness programs have been shown to improve the health and well-being of hospital employees by reducing risk factors and promoting healthy behaviors. In the Arab World, there are no available studies on the number, nature, or impact of wellness services provided to healthcare workers. Objective: The study aims to assess the prevalence, characteristics, and components of health and wellness programs targeting hospital employees in Arab countries. It also aims to test the association of hospitals' characteristics and the challenges faced by these hospitals with the availability of such programs. Methods: A cross-sectional study was conducted through an online questionnaire in English and Arabic emailed to directors of Arab hospitals registered in the Arab Hospital Federation. Results: Only 39.5% of the hospitals in the Arab region have an established wellness program. No significant association was found between hospital characteristics and the availability of these wellness programs. The most provided services for hospital staff are Flu vaccine (90.7%), pre-employment medical exam (79.1%), healthy food options (65.1%), and health risk assessment (60.5%), while the least common provided services are mental health (20.9%) and stress management (23.3%). The most common challenges facing wellness services (scale: 0-10) are financial restriction (5.95), creating a culture of health (5.88), and motivating employees (5.56). Only 4.7% of hospitals provide incentives to participate in their wellness programs. Conclusion: In general, Arab hospitals lack a wellness culture, and more investment is needed in essential wellness services such as mental health, weight reduction, stress management, and smoking cessation.

Prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan: a cross-sectional study.

BACKGROUND: Pica, the craving for and purposive eating of non-food items, is a common worldwide problem, especially among children and pregnant women. There are few published data on pica among adolescents in sub-Saharan Africa, and no study has been carried- out in Sudan. This study was conducted to determine the prevalence and associated factors of symptoms of pica among adolescent schoolchildren in northern Sudan. METHODS: A school­based cross­sectional study was conducted from July to September 2022 among adolescent students (aged 10-19 years) in four public primary and secondary schools in Almatamah locality in north Sudan. Sociodemographic information (age, sex, mother's education, mother's occupation, and father's education) was collected through a questionnaire. Weight and height were measured using a standard procedure, and the body mass index Z-score was computed using the World Health Organization's reference values. Logistic regression analysis was performed. RESULTS: Of the 384 enrolled adolescents, 180 (46.9%) were male and 204 (53.1%) were female. Their median (interquartile range) age was 15.1 (13.1‒16.3) years. The prevalence of symptoms of pica was found to be 30.7%, accounting for 118 adolescents. The most common type of pica was geophagia (eating clay and sand; 102 adolescents, 86.4%), followed by pagophagia (eating ice; 14 adolescents, 11.8%) and flour (starch; two adolescents, 1.6%). In the logistic regression analysis, females (adjusted odds ratio = 3.52, 95% confidence interval (CI) = 2.15‒5.78) and a lower level of father's education (adjusted odds ratio = 2.05, 95% CI = 1.26‒3.34) were associated with symptoms of pica. CONCLUSION: In Sudan, symptoms of pica are common among adolescents, especially females. Caregivers need to assess pica in adolescents. Further research is needed to develop guidelines, medical training, and practice.

We conducted this study from July to September 2022 to estimate the rate of adolescents who would eat non-food items (pica) in Sudan. We gathered sociodemographic characteristics through a questionnaire. Of the 384 enrolled adolescents, 180 (46.9%) were male and 204 (53.1%) were female. We found that 118 (30.7%) adolescents would eat non-food items (pica) and that the most common type was eating clay and sand (102 adolescents, 86.4%), followed by eating ice (14 adolescents, 11.8%) and flour (starch; 2 adolescents, 1.6%). Females and those with a lower level of father's education were likely to eat non-food items.