Exploring the burden of irritable bowel syndrome among university students in Saudi Arabia: A study on prevalence, psychological associations, and well-being.

Patients with irritable bowel syndrome (IBS) experience not only a detrimental impact on their physical health but also a significant influence on their psychological well-being. This study aimed to assess the prevalence of IBS among university students, investigating the sociodemographic and lifestyle factors influencing its onset. Furthermore, it explored the potential impact of psychological factors such as depression, anxiety, and overall well-being on the prevalence of IBS. A cross-sectional analytical study was conducted at Saudi Arabian universities in November and December 2023. To collect data, an anonymous, validated, predesigned questionnaire was used. The diagnosis of IBS was carried out using the validated Arabic version of the Rome IV questionnaire. We used the Arabic version of the World Health Organization Well-being Index to assess the participants' well-being. We used the Arabic version of the Hospital Anxiety and Depression Scale (HADS) to identify people who show clinically significant symptoms of anxiety and depression. Our study included a total of 379 university students, 46.7% were female 86.0% of participants resided in urban areas, and 7.2% had been previously diagnosed with IBS. The prevalence of IBS among participants was found to be 31.9%. We observed a significant association between marital status and IBS (χ2 = 3.95, P = .047). Furthermore, the highest prevalence of IBS was observed among students majoring in literary and scientific disciplines (χ2 = 0.952, P = .049). Individuals with IBS demonstrate a significantly higher prevalence of anxiety (71.90% vs 41.09%, P < .001) and depression (64.46% vs 42.64%, P < .001) compared to those without IBS. Furthermore, people with IBS had a slightly higher prevalence of poor well-being (38.84%) compared to those without IBS (33.72%), but this association was not statistically significant. In multivariate analysis, having a family history of IBS [OR = 1.75 (95% CI, 1.06-2.87), P = .029] having borderline anxiety [OR = 7.58, 95% CI (2.12-27.06), P = .012] and anxiety [OR = 16.07, 95% CI (4.57-56.52), P < .001], and depression [OR = 2.97, 95% CI (1.13-7.83), P = .010] were the main significant predictors of IBS among university students. The high prevalence of IBS among university students was associated with a family history of IBS as well as depression and anxiety. Increasing awareness, multidisciplinary support, and access to mental health services is required to ensure university students' well-being.

Young-onset dementia following chronic abuse of amphetamine-type stimulants.

Young-onset dementia (YOD) is influenced by various risk factors, including substance abuse. In this report, we present the case of a 54-year-old man who developed YOD following prolonged abuse of amphetamine-type stimulants. The patient exhibited insidious cognitive decline over a three-year period before seeking medical attention. Neuroimaging revealed atrophy of the temporal lobe, suggesting a connection between amphetamine-induced neurotoxicity and the cognitive abnormalities observed in the patient condition. Our case highlights the importance of considering amphetamine-type stimulants as potential risk factors for YOD and emphasizes the need to recognize cognitive impairment resulting from substance abuse. Additionally, we look into relevant literature to provide further context and insights.

Advancing brain tumor detection: harnessing the Swin Transformer's power for accurate classification and performance analysis.

The accurate detection of brain tumors through medical imaging is paramount for precise diagnoses and effective treatment strategies. In this study, we introduce an innovative and robust methodology that capitalizes on the transformative potential of the Swin Transformer architecture for meticulous brain tumor image classification. Our approach handles the classification of brain tumors across four distinct categories: glioma, meningioma, non-tumor, and pituitary, leveraging a dataset comprising 2,870 images. Employing the Swin Transformer architecture, our method intricately integrates a multifaceted pipeline encompassing sophisticated preprocessing, intricate feature extraction mechanisms, and a highly nuanced classification framework. Utilizing 21 matrices for performance evaluation across all four classes, these matrices provide a detailed insight into the model's behavior throughout the learning process, furthermore showcasing a graphical representation of confusion matrix, training and validation loss and accuracy. The standout performance parameter, accuracy, stands at an impressive 97%. This achievement outperforms established models like CNN, DCNN, ViT, and their variants in brain tumor classification. Our methodology's robustness and exceptional accuracy showcase its potential as a pioneering model in this domain, promising substantial advancements in accurate tumor identification and classification, thereby contributing significantly to the landscape of medical image analysis.

Artificial intelligence approaches for early detection of neurocognitive disorders among older adults.

Introduction: Dementia is one of the major global health issues among the aging population, characterized clinically by a progressive decline in higher cognitive functions. This paper aims to apply various artificial intelligence (AI) approaches to detect patients with mild cognitive impairment (MCI) or dementia accurately. Methods: Quantitative research was conducted to address the objective of this study using randomly selected 343 Saudi patients. The Chi-square test was conducted to determine the association of the patient's cognitive function with various features, including demographical and medical history. Two widely used AI algorithms, logistic regression and support vector machine (SVM), were used for detecting cognitive decline. This study also assessed patients' cognitive function based on gender and developed the predicting models for males and females separately. Results: Fifty four percent of patients have normal cognitive function, 34% have MCI, and 12% have dementia. The prediction accuracies for all the developed models are greater than 71%, indicating good prediction capability. However, the developed SVM models performed the best, with an accuracy of 93.3% for all patients, 94.4% for males only, and 95.5% for females only. The top 10 significant predictors based on the developed SVM model are education, bedtime, taking pills for chronic pain, diabetes, stroke, gender, chronic pains, coronary artery diseases, and wake-up time. Conclusion: The results of this study emphasize the higher accuracy and reliability of the proposed methods in cognitive decline prediction that health practitioners can use for the early detection of dementia. This research can also stipulate substantial direction and supportive intuitions for scholars to enhance their understanding of crucial research, emerging trends, and new developments in future cognitive decline studies.

Comprehensive mapping of mutations in TDP-43 and α-Synuclein that affect stability and binding.

Abnormal aggregation and amyloid inclusions of TAR DNA-binding protein 43 (TDP-43) and α-Synuclein (α-Syn) are frequently co-observed in amyotrophic lateral sclerosis, Parkinson's disease, and Alzheimer's disease. Several reports showed TDP-43 C-terminal domain (CTD) and α-Syn interact with each other and the aggregates of these two proteins colocalized together in different cellular and animal models. Molecular dynamics simulation was conducted to elucidate the stability of the TDP-43 and Syn complex structure. The interfacial mutations in protein complexes changes the stability and binding affinity of the protein that may cause diseases. Here, we have utilized the computational saturation mutagenesis approach including structure-based stability and binding energy calculations to compute the systemic effects of missense mutations of TDP-43 CTD and α-Syn on protein stability and binding affinity. Most of the interfacial mutations of CTD and α-Syn were found to destabilize the protein and reduced the protein binding affinity. The results thus shed light on the functional consequences of missense mutations observed in TDP-43 associated proteinopathies and may provide the mechanisms of co-morbidities involving these two proteins.Communicated by Ramaswamy H. Sarma.

Advancing Brain Tumor Classification through Fine-Tuned Vision Transformers: A Comparative Study of Pre-Trained Models.

This paper presents a comprehensive study on the classification of brain tumor images using five pre-trained vision transformer (ViT) models, namely R50-ViT-l16, ViT-l16, ViT-l32, ViT-b16, and ViT-b32, employing a fine-tuning approach. The objective of this study is to advance the state-of-the-art in brain tumor classification by harnessing the power of these advanced models. The dataset utilized for experimentation consists of a total of 4855 images in the training set and 857 images in the testing set, encompassing four distinct tumor classes. The performance evaluation of each model is conducted through an extensive analysis encompassing precision, recall, F1-score, accuracy, and confusion matrix metrics. Among the models assessed, ViT-b32 demonstrates exceptional performance, achieving a high accuracy of 98.24% in accurately classifying brain tumor images. Notably, the obtained results outperform existing methodologies, showcasing the efficacy of the proposed approach. The contributions of this research extend beyond conventional methods, as it not only employs cutting-edge ViT models but also surpasses the performance of existing approaches for brain tumor image classification. This study not only demonstrates the potential of ViT models in medical image analysis but also provides a benchmark for future research in the field of brain tumor classification.

Toxic trespassers: Uncovering phthalates and organophosphate flame retardants in children's rooms and their health implications.

Organophosphate flame retardants (OPEs) and phthalates have garnered significant attention due to their widespread presence in indoor environments. Many recent investigations have reported extensive contamination of indoor dust, air, children's toys, and other environmental compartments with these chemicals. This research aimed to analyze OPEs and phthalates in air (PM10) and dust samples collected from the bedrooms of children (N = 30) residing in various households in Jeddah, Saudi Arabia. High mean levels (ng/g) of phthalates namely DEHP (1438600) and DnBP (159200) were found in indoor dust while TPhP (5620) was the major OPEs in indoor dust. Similarly, DEHP and DnBP were the predominant phthalates in PM10 samples, exhibiting mean levels of 560 and 680 ng/m3, respectively. However, TCPP was the main OPEs with average levels of 72 ng/m3 in PM10 samples. The majority of individual phthalates and OPEs were detected in 90-100 % of the dust samples, whereas in PM10 samples, their presence ranged from 25 % to 100 %. The concentrations of OPEs were notably greater than those of PBDEs and other BFRs previously reported in these samples, suggesting their broader use than alternative BFRs. The estimated long-term non-carcinogenic risk, hazardous index (HI) and daily exposure via dust for children was above threshold levels for DEHP. On the other hand, the cumulative risk of cancer was below the concerning levels. Further research is required to explore diverse groups of chemicals in indoor microenvironments particularly significant for children, such as kindergartens, primary schools, and their rooms at home.

A native mitral valve mass beyond imagination.

The authors report a case of a patient with a history of IgA nephropathy that, during the admission for pneumonia, was found to have an incidental finding of a huge mitral valve (MV) mass on transthoracic echocardiography. The differential diagnosis was challenging because the clinical scenario raised the suspicion of possible infective endocarditis and the imaging features were suggestive of a myxoma or vegetation. The patient underwent urgent excision of the mass with MV replacement due to the high risk of embolism. Intraoperative findings were consistent with clot or vegetation. Pathology result of thrombus was beyond our imagination and at the best of our knowledge one case only has been reported. Awareness about native MV thrombosis and its etiologic factors, workup, and management is key for better medical and surgical management planning because this condition is extremely rare and challenging in the clinical and imaging arena.

Alzheimer's Behavioral and Psychiatric Burden in Saudi Arabia: Validation of the Saudi Version of the Neuropsychiatric Inventory.

BACKGROUND: The burden of behavioral and psychiatric symptoms in dementia (BPSD) has not been characterized in Saudi patients with Alzheimer disease (AD). Moreover, the Saudi version of the Neuropsychiatric Inventory (SNPI) has not been validated. OBJECTIVES: The purpose of this study was to validate the SNPI and describe frequency and determinants of BPSD in Saudi AD patients. METHODS: The SNPI and BEHAVE-AD instruments were administered to community-dwelling Saudi AD patients and their caregivers. RESULTS: The sample size was 192. The first 59 constituted the validation cohort. Cronbach alpha of the SNPI and BEHAVE-AD were 0.91 and 0.79, respectively. There were significant correlations between: (1) the total SNPI and BEHAVE-AD scores ( r =0.84, P <0.001); (2) analogous SNPI and BEHAVE-AD symptom subscores ( P <0.05); (3) SNPI and BEHAVE-AD caregiver distress ( F =22.6, P <0.001). Inter-rater reliability of the SNPI was excellent (kappa=0.74). Ninety percent of patients experienced 4 SNPI symptoms or more. Patients with stroke and prior psychiatric history were most likely to experience BPSDs. The most common symptom was apathy (82%). Caregiver distress was determined by the total NPI score and impulsiveness subscale score. CONCLUSIONS: The SNPI is valid and reliable for assessing BPSD in Saudi AD patients. Longitudinal studies of BPSDs in Saudi specialized dementia clinics are needed.

A Ping Pong Ball in the Left Ventricle.

Diagnosing cardiac masses, especially those related to cardiac tumors, is often challenging in clinical practice. Though myxomas are the most common and well-known benign cardiac tumors, other rare and often-neglected tumors can be difficult to diagnose. In this case report, the authors describe a left ventricular cardiac mass with unique and striking imaging features.

Systematic review and pooled analysis of randomized controlled trials in countries of the Gulf Cooperation Council (GCC): Methods and quality assessment.

OBJECTIVES: To describe variations in characteristics of randomized controlled trials conducted in the Gulf Cooperation Council (GCC) countries, and critically appraising the quality of design, conduct and analysis of the trials. METHODS: We carried out a systematically comprehensive electronic search of articles published between 1990 and 2018 and indexed in several databases: i) MEDLINE/PubMed, ii) EMBASE, iii) Cochrane Central Register of Controlled Trials (CENTRAL), iv) ClinicalTrials.gov, and v) World Health Organization International Clinical Trials Registry Platform. We summarized the overall risk of bias present in all analyzed studies using the Cochrane Collaboration risk of bias tool (CCRBT). RESULTS: A remarkable shift in numbers of publications from 2006 onwards was found. The largest number of publications were from Saudi Arabia and consisted of hospitals/clinics based studies. Lack of randomization was found in the majority of reports, and nearly three-fourth of the studies involved the use of intention-to-treat (ITT) principle. However, the proportion of adequately generated random sequence methods has increased yearly, and this increase accounted for a relatively large proportion over the latter half of the studied period (p<0.001), in contrast to the proportion of allocation concealment and blinding. Journal impact factor was significantly correlated with the quality of random sequence generation (r=0.145; p=0.014). CONCLUSION: The randomization methods have gained more attention over the last 3 decades. Secondly, Journal impact factor can serve as an indicator of randomization quality. To mitigate the large rate of overall high risk of bias in GCC studies, high-quality trials must be considered by ensuring adequate allocation concealment and blinding methods. PROSPERO No. ID: CRD42022310331.

Modulation of Insulin Resistance by Silybum marianum Leaves, and its Synergistic Efficacy with Gymnema sylvestre, Momordica charantia, Trigonella-foenum graecum Against Protein Tyrosine Phosphatase 1B.

Prolonged insulin resistance is considered one of the reasons for Type 2 Diabetes Mellitus. Upregulation of Protein tyrosine phosphatase 1B (PTP1B), a negative regulator of insulin signalling, has been well studied as a key regulator in prognosis to insulin resistance. It has been widely studied as a desirable molecular therapeutic target. The study aimed to evaluate the efficacy of leaf extract of the medicinal plants Silybum marianum on the inhibition of PTP1B activity. It also explored the synergistic effect with extracts of Gymnema sylvestre (leaves), Momordica charantia (seeds), and Trigonella foenum graecum (seeds). The S. marianum leaves showed dose-dependent inhibition of PTP1B ranging from 9.48-47.95% (25-1000 µg mL-1). Assay with individual plant extracts showed comparatively lesser inhibition of PTP1B as compared to metformin as a control (38% inhibition). However, a synergistic effect showed nearly 45% PTP1B inhibition (higher than metformin) after the assay was done with selected four plant extracts in combination. The effect of leaf extracts of S. marianum was studied for glucose uptake efficiency in yeast cell lines which was found to be increased by 23% as compared to the control (without extract). Metformin improves glucose upake by yeast cells by ~15-31%. GC-MS analysis revealed 23 phytochemicals, some of which possessed anti-diabetic properties. A dose-dependent increase in antioxidant activity of S. marianum leaves extracts was observed (40-53%). The findings of the study highlighted the presence of various phytochemicals in leaves extracts that are effective against PTP1B inhibition and may help in reinvigorating drug development.

Falls and correlations among community-dwelling older adults: A Cross-sectional study in Jeddah, Saudi Arabia.

Objectives: Falls are one of the major health issues faced by older adults, and they can result in physical harm, eventual loss of independence, and even death. Herein, we investigated the prevalence, alongside the main risk factors and resulting injuries, of falls among older adults. Methods: We employed a descriptive cross-sectional approach. Data were collected between February and July 2021 from 403 older adults aged 60 years or above via an online self-reported questionnaire. Basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs) were also recorded. Results: The prevalence of falls among community-dwelling older adults was 47.4%. Among those who had experienced a fall, 36.2% incurred injuries, 25.3% had fractures, and 23.1% required walking aids. Age between 95-104 years, female sex, participants on anti-hypertensive medications, history of hip or knee replacement surgery, and presence of a caregiver, were significantly more likely to have had a previous history of falls (p < 0.05). Furthermore, having a previous history of stroke, osteoporosis, lower limb weakness, dizziness, using wheelchairs as walking aids, and living with the fear of stumbling or slipping were significantly associated with history of previous falls (p < 0.05). Conclusions: The prevalence of falls is high among community-dwelling older adults in Jeddah. Physicians should identify older adults with higher falling risk and provide them with appropriate interventions. Public health strategies could significantly reduce falls and fall-related injuries in older adults.

Profiling of phthalates, brominated, and organophosphate flame retardants in COVID-19 lockdown house dust; implication on the human health.

In this study, brominated flame retardants (BFRs), phthalates, and organophosphate flame retardants (PFRs) were analyzed in indoor household dust collected during the COVID-19 related strict lockdown (April-July 2020) period. Floor dust samples were collected from 40 households in Jeddah, Saudi Arabia. The levels of most of the analyzed chemicals were visibly high and for certain chemicals multifold high in analyzed samples compared to earlier studies on indoor dust from Jeddah. Bis (2-ethylhexyl) phthalate (DEHP) was the primary chemical in these dust samples, with a median concentration of 769,500 ng/g of dust. Tris (2-butoxy ethyl) phosphate (TBEP) and Decabromodiphenyl ether (BDE 209) contributed the highest among PFRs and BFRs with median levels of 5990 and 940 ng/g of dust, respectively. The estimated daily exposure in the worst case scenario (23,700 ng/kg bw/day) for Saudi children was above the reference dose (20,000 ng/kg bw/day) for DEHP, and the hazardous index (HI) was also >1. The long-term carcinogenic risk was above the 1 × 10-5, indicating a risk to the health of Saudi young children from getting exposed to DEHP from indoor dust. This study draws attention to the increased indoor pollution during the lockdown period when all of the daily activities by adults and children were performed indoors, which negatively impacted human health, as suggested by the calculated risk. However, the current study has limitations and warrants more monitoring studies from different parts of the world to understand the phenomenon. At the same time, this study also highlights another side of COVID-19 related to our lives.

Prevalence of Highly Sensitive Personality and Its Relationship With Depression, and Anxiety in the Saudi General Population.

Background Highly sensitive personality (HSP) occurs in those who experience stronger processing of emotions and responses to both internal and external stimuli; this, in turn, could cause persons with highly sensitive personalities to suffer from affective disorders such as depression and anxiety at higher rates. This study aimed to measure the prevalence of highly sensitive personality and its relationship with depression and anxiety among the Saudi general population. Subject and methods This cross-sectional study was conducted among the general population in Saudi Arabia. A self-administered questionnaire was sent to the target population using an online survey. The questionnaire includes sociodemographic data (i.e., age, gender, marital status, etc.), the Highly Sensitive Person Scale to measure the degree of sensitivity, and the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression. Results Of the 438 participants, 72.6% were females, and 48.9% were aged between 18 to 25 years. The prevalence of HSP in this study was 29%. Abnormal levels of anxiety and depression were found in 29.5% and 19.9%, respectively. Significant relationships were observed between HSP in terms of anxiety (p<0.001) and depression (p=0.001). It is interesting to note that a previous diagnosis of mental disorder was identified as a significant risk factor for HSP, anxiety, and depression. Conclusion There was a high prevalence of HSP in our population, which was significantly associated with anxiety and depression. Further, female participants were more likely to exhibit HSP and anxiety but not depression. These findings highlight the importance of prevention programs intended for highly sensitive persons with associated mental conditions.

Assessment of Quality of Life Among Patients With Primary Hypothyroidism: A Case-Control Study.

Introduction Hypothyroidism is a globally prevalent condition with a huge impact on health. It has been demonstrated that hypothyroidism is associated with negative health outcomes that have a significant impact on quality of life. The aim of this study is to assess the relative significance of various parts of quality of life satisfaction in adult patients with hypothyroidism. This study has never been done in Saudi Arabia. No previous research was conducted in our region to highlight the quality of life of these patients. From this, it is very important to acknowledge the impact of hypothyroidism on quality of life, to help improve their lives and reduce the burden of the disease. Method This is a case-control study conducted on patients with hypothyroidism presented to the family medicine clinic at King Abdulaziz University Hospital. The participants were divided into two groups: patients with primary hypothyroidism (cases) and euthyroid subjects of the same age without chronic illnesses (control group). We used the Short Form-12 questionnaire (SF-12) and a sociodemographic questionnaire as a tool to assess the quality of life. Results Compared to healthy euthyroid controls, patients with hypothyroidism had a significantly reduced quality of life regarding their physical (p<0.001) aspect, with mental health not being affected. Smoking, female gender, and BMI showed significant associations with their mental health status (p=0.021, p=0.001, and p=0.045) respectively. Conclusions Regarding the results of the current study, there is a reduced level of physical health in patients with hypothyroidism than in healthy controls, which adversely affects their QoL. Smoking, gender, and BMI were associated with lower mental health among patients with hypothyroidism, which adversely affected their quality of life. Health practices should include assessment of the quality of life, monitoring by specialized physicians, and educational programs for these patients.

Predictors of Mortality in Home Health Care Service: Data from Saudi Arabia.

Objective: This study aimed to 1) report the prevalence of chronic conditions among Saudi people receiving long-term home health care (HHC) services, 2) identify the predictors of mortality among individuals receiving long-term HHC services, and 3) study the association between frailty and poor health outcomes among HHC users. Design: Retrospective cross-sectional descriptive study. Setting and Participants: A total of 555 participants were recruited from HHC services at King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. We collected the data from electronic health records (EHR), patient charts, and caregiver interviews for 555 participants included in HHC program from the year 2019 to 2022. Methods: Only individuals fulfilling the HHC program's eligibility criteria were included to the study. A total of 555 participants were included in the analysis. We assessed the functional performance by the Katz activity of daily living and Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). We calculated the means and frequency to describe the prevalence of chronic conditions and variables of interest. A Chi-square test or independent-samples t-test was run to determine if there were differences between the alive and deceased individuals. A binary logistic regression model was performed to predict mortality of HHC service recipients. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. We found that the strongest predictors for mortality were pressure ulcers with an odds ratio of 3.75 and p-value of <0.0001, and the Clinical Frailty Scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. Conclusions and Implications: In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services.

Modeling and X-ray Analysis of Defect Nanoclusters Formation in B4C under Ion Irradiation.

In the presented work, B4C was irradiated with xenon swift heavy ions at the energy of 167 MeV. The irradiation of the substrate was done at room temperature to a fluence of 3.83 × 1014 ion/cm2. The samples were then analyzed with the X-ray diffraction technique to study the structural modification, as it can probe the region of penetration of xenon atoms due to the low atomic number of the two elements involved in the material under study. The nano-cluster formation under ion irradiation was observed. Positron lifetime (PLT) calculations of the secondary point defects forming nanoclusters and introduced into the B4C substrate by hydrogen and helium implantation were also carried out with the Multigrid instead of the K-spAce (MIKA) simulation package. The X-ray diffraction results confirmed that the sample was B4C and it had a rhombohedral crystal structure. The X-ray diffraction indicated an increase in the lattice parameter due to the Swift heavy ion (SHI) irradiation. In B12-CCC, the difference between τ with the saturation of H or He in the defect is nearly 20 ps. Under the same conditions with B11C-CBC, there is approximately twice the value for the same deviation.

A Multiwall Path-Loss Prediction Model Using 433 MHz LoRa-WAN Frequency to Characterize Foliage's Influence in a Malaysian Palm Oil Plantation Environment.

Palm oil is the main cash crop of tropical Asia, and the implementation of LPWAN (low-power wide-area network) technologies for smart agriculture applications in palm oil plantations will benefit the palm oil industry in terms of making more revenue. This research attempts to characterize the LoRa 433 MHz frequency channels for the available spreading factors (SF7-SF12) and bandwidths (125 kHz, 250 kHz, and 500 kHz) for wireless sensor networks. The LoRa channel modeling in terms of path-loss calculation uses empirical measurements of RSS (received signal strength) in a palm oil plantation located in Selangor, Malaysia. In this research, about 1500 LoS (line-of-sight) and 300 NLoS (non-line-of-sight) propagation measurement data are collected for path-loss prediction modeling. Using the empirical data, a prediction model is constructed. The path-loss exponent for LoS propagation of the proposed prediction model is found to be 2.34 and 2.9 for 125-250 kHz bandwidth and 500 kHz bandwidth, respectively. Again, for the NLoS propagation links, the attenuation per trunk is found to be 7.58 dB, 7.04 dB, 5.35 dB, 5.02 dB, 5.01 dB, and 5 dB for SF7-SF12, and the attenuation per canopy is found to be 9.32 dB, 7.96 dB, 6.2 dB, 5.89 dB, 5.79 dB, and 5.45 dB for SF7-SF12. Moreover, the prediction model is found to be the better choice (mean RMSE 2.74 dB) in comparison to the empirical foliage loss models (Weissberger's and ITU-R) to predict the path loss in palm oil plantations.

A Rare Case of Vancomycin-Induced Immune Thrombocytopenia.

Vancomycin-induced immune thrombocytopenia (ITP) is a rare type of drug-induced immune thrombocytopenia (DITP) that can lead to life-threatening consequences as a result of its use. We herein report a case of a 74-year-old male with a history of diabetes mellitus type II, Alzheimer's disease, and stroke who presented to the ICU with sepsis. The patient was on heparin for 20 days prior to presentation, with platelet levels at the time within normal limits as per his baseline. Following the introduction of vancomycin to his clinical regimen in the treatment of sepsis, the patient developed a significant drop in platelet count from 400 x10³/mm³ to 70 x10³/mm³. Discontinuation of the drug leads to improvement of the platelet counts confirming the diagnosis of vancomycin-induced ITP.