Pre-hypertension and Hypertension Among University Students in Bahrain: A Study of Prevalence and Associated Risk Factors.

BACKGROUND/OBJECTIVES: In the last 20 years, hypertension has become more common among younger age groups. Based on a global meta-analysis, the combined prevalence of hypertension and prehypertension were 4.0% and 9.7%, respectively. This study aimed to evaluate the prevalence of prehypertension and hypertension among university students and their associated risk factors. METHODS: Four hundred and eleven students aged between 18 and 25 (196 males and 215 females) were randomly selected to participate from the College of Medicine and Medical Sciences (CMMS) and the College of Business Administration, Bahrain. The data was collected through a structured questionnaire, which gathered information about lifestyle habits. Trained students measured the participant's blood pressure and body mass index (BMI) according to standardized settings. All risk factors were studied according to the study field and their gender. RESULTS:  The mean age of the participants was 16.4±0.9 years. Of the total participants, 61.3% (n= 252) were normotensive, 30.7% (n= 126) were pre-hypertensive, and 8% (n= 33) were hypertensive. The prevalence of hypertension and pre-hypertension was higher in male students, 13.8% (n=27) and 44.9% (n= 88), compared to female students, 2.8% (n=6) and 17.7% (n=38), respectively. The results of the univariate analysis showed an association of hypertension with the field of study, gender, age, BMI, exercise frequency, frequency of eating junk food, and family history of hypertension (p < 0.05). Multivariate logistic regression analysis found a significant association between hypertension and pre-hypertension with gender, the field of study, and BMI. CONCLUSIONS: The findings of the study revealed that hypertension and pre-hypertension are common among university students in Bahrain. The risk factors for these conditions include studying medicine, being male, and being obese.

Understanding current ergonomics setup for urologists conducting anatomical endoscopic enucleation of the prostate surgeries: Survey analysis from the endourological society.

BACKGROUND: Ensuring ergonomic posture and safety for surgeons is key to preventing work-related injuries and promoting sustained practice. We evaluated ergonomic aspects of Anatomic Endoscopic Enucleation of the Prostate (AEEP) and its relation to musculoskeletal injuries. METHOD: A two-month online survey involving 119 Endourological Society members provided an in-depth analysis of AEEP practices and their musculoskeletal impacts. RESULTS: The sample experienced general (65.5%), back (32.8%), neck (35.3%) and shoulder (37%) pain. Female AEEP surgeons reported greater back pain. Experience and age were inversely related to MSK injuries, and operative times over 2 â€‹h increased back pain. AEEP procedures predominantly involved sitting (86%) on backless stools (58%), with most surgeons wearing protective eyewear (75.6%) and using large resectoscopes (76.5%). Monitors were usually above eye-level (57%) and beyond 1 â€‹m (68.9%). CONCLUSION: Musculoskeletal complaints are prevalent among AEEP endourologists. More awareness and further studies on risk factors are necessary to limit work-related injuries in urology.

Global environmental and toxicological impacts of polybrominated diphenyl ethers versus organophosphate esters: A comparative analysis and regrettable substitution dilemma.

The prevalence of organophosphate esters (OPEs) in the global environment is increasing, which aligns with the decline in the usage of polybrominated diphenyl ethers (PBDEs). PBDEs, a category of flame retardants, were banned and classified as persistent organic pollutants (POPs) through the Stockholm Convention due to their toxic and persistent properties. Despite a lack of comprehensive understanding of their ecological and health consequences, OPEs were adopted as replacements for PBDEs. This research aims to offer a comparative assessment of PBDEs and OPEs in various domains, specifically focusing on their persistence, bioaccumulation, and toxicity (PBT) properties. This study explored physicochemical properties (such as molecular weight, octanol-water partition coefficient, octanol-air partition coefficient, Henry's law constant, and vapor pressures), environmental behaviors, global concentrations in environmental matrices (air, water, and soil), toxicities, bioaccumulation, and trophic transfer mechanisms of both groups of compounds. Based on the comparison and analysis of environmental and toxicological data, we evaluate whether OPEs represent another instance of regrettable substitution and global contamination as much as PBDEs. Our findings indicate that the physical and chemical characteristics, environmental behaviors, and global concentrations of PBDEs and OPEs, are similar and overlap in many instances. Notably, OPE concentrations have even surged by orders of several magnitude compared to PBDEs in certain pristine regions like the Arctic and Antarctic, implying long-range transport. In many instances, air and water concentrations of OPEs have been increased than PBDEs. While the bioaccumulation factors (BAFs) of PBDEs (ranging from 4.8 to 7.5) are slightly elevated compared to OPEs (-0.5 to 5.36) in aquatic environments, both groups of compounds exhibit BAF values beyond the threshold of 5000 L/kg (log10 BAF > 3.7). Similarly, the trophic magnification factors (TMFs) for PBDEs (ranging from 0.39 to 4.44) slightly surpass those for OPEs (ranging from 1.06 to 3.5) in all cases. Metabolic biotransformation rates (LogKM) and hydrophobicity are potentially major factors deciding their trophic magnification potential. However, many compounds of PBDEs and OPEs show TMF values higher than 1, indicating biomagnification potential. Collectively, all data suggest that PBDEs and OPEs have the potential to bioaccumulate and transfer through the food chain. OPEs and PBDEs present a myriad of toxicity endpoints, with notable overlaps encompassing reproductive issues, oxidative stress, developmental defects, liver dysfunction, DNA damage, neurological toxicity, reproductive anomalies, carcinogenic effects, and behavior changes. Based on our investigation and comparative analysis, we conclude that substituting PBDEs with OPEs is regrettable based on PBT properties, underscoring the urgency for policy reforms and effective management strategies. Addressing this predicament before an exacerbation of global contamination is imperative.

Psychometric testing of the nurse professional competence scale Arabic version: An exploratory and confirmatory factor analyses.

AIM: To translate the Nurse Professional Competence Scale-Short Form English version into Arabic and psychometrically validate its properties among Saudi citizen nurses. BACKGROUND: Evaluating nurses' professional competence is vital in delivering safe, cost-effective care and developing healthcare systems. However, psychometrically reliable and validated nurse competence scales in Arabic-speaking countries remain scant. DESIGN: A descriptive cross-sectional design adhering to the Strengthening the Reporting of Observational Studies in Epidemiology guidelines. METHODS: Participant nurses (n = 598) were conveniently recruited from four government-owned hospitals and completed the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form. We used Spearman's rank-order correlation, exploratory factor analysis, Kaiser-Meyer-Olkin test, and confirmatory factor analysis to analyze the data. RESULTS: After exploratory factor analysis and reliability analyses, several items of the Arabic-translated 35-item Nurse Professional Competence Scale-Short Form were omitted due to high inter-item correlations and low factor loading difference. The Arabic version of the Nurse Professional Competence Scale-Short Form was reduced to 21 items, consisting of a three-factor structure: Professional Care Pedagogics, Holistic Value-Based Care, and Direct Nursing Care. Results also demonstrated that the revised three-factor structure had good overall scale reliability, good subscale internal consistencies, and acceptable construct validity using the confirmatory factor analysis. CONCLUSION: The 21-item Nurse Professional Competence Scale-Short Form Arabic version is a useful scale, having demonstrated construct validity and reliability. Therefore, nurse managers in Arabic-speaking nations could assess their nurses' professional competence using the 21-item Nurse Professional Competence Scale-Short Form Arabic version to develop proactive programs that enhance professional competence.

Evaluation of urodynamic pattern in short and long-standing diabetic patients.

PURPOSE: To address the pattern of urodynamic findings in diabetic patients with lower urinary tract symptoms (LUTS), comparing short-standing and long-standing type 2 diabetes mellitus (T2DM). METHODS: A prospective study was conducted on 50 patients presenting with LUTS and a concurrent diagnosis of T2DM, between February 2016 and May 2018. Patients were classified and evaluated according to the duration of diabetes into two groups: short-standing DM (< 15 years, n = 31), and long-standing DM (≥ 15 years, n = 19) groups. The impact of LUTS and quality of life were assessed in female patients using ICIQ-FLUTS and male patients using ICIQ-MLUTS. RESULTS: A total of 50 patients were included in the study. The mean duration of T2DM was 10 ± 0.7 years. The mean age was 56.3 ± 1.2 years, and the mean HbA1c was 7.5 ± 1.2%. Urodynamic evaluation detected significantly higher detrusor overactivity (DO) and increased bladder sensation with the short-standing DM group (35.5 vs. 15.8%, p = 0.01 and 32.3 vs. 5.3%, p = 0.01, respectively). Comparatively, weak, or absent detrusor contractility were more frequent in patients with long-standing DM (52% and 26% respectively p = 0.01). As expected, overflow incontinence and straining during voiding were significantly higher in the long-standing DM group (p = 0.04 and p = 0.03, respectively). Surprisingly, there was no significant correlation between patients presenting with urgency in their voiding diary (subjective) and urodynamic detection of DO (p = 0.07). CONCLUSIONS: There are different patterns in urodynamic characterizations of T2DM. Patients with short-standing DM present more commonly with storage symptoms and detrusor overactivity on urodynamics. Contrastingly, patients with long-standing DM present more frequently with voiding symptoms and detrusor underactivity on urodynamics. Thus, screening for an underactive bladder is advisable in patients with long-standing T2DM.

Surgical vs Transcatheter Aortic Valve Replacement in Patients With a Low Ejection Fraction.

Currently, there is no preference for surgical (SAVR) vs transcatheter (TAVR) aortic valve replacement in patients with low ejection fraction (EF). The present study retrospectively compared the outcomes of SAVR vs TAVR in patients with EF ≤40% (70 SAVR and 117 TAVR patients). Study outcomes were survival and the composite endpoint of stroke, aortic valve reintervention, and heart failure readmission. The patients who had TAVR were older (median: 75 (25-75th percentiles: 69-81) vs 51 (39-66) years old; P < .001) with higher EuroSCORE II (4.95 (2.99-9.85) vs 2 (1.5-3.25); P < .001). Postoperative renal impairment was more common with SAVR (8 (12.5%) vs 4 (3.42%); P = .03), and they had longer hospital stay [9 (7-15) vs 4 (2-8) days; P < .001). There was no difference between groups in stroke, reintervention, and readmission (Sub-distributional Hazard ratio: .95 (.37-2.45); P = .92). Survival at 1 and 5 years was 95% and 91% with SAVR and 89% and 63% with TAVR. Adjusted survival was comparable between groups. EF improved significantly (ß: .28 (.23-.33); P < 0.001) with no difference between groups (P = .85). In conclusion, TAVR could be as safe as SAVR in patients with low EF.

Choroidal neo-vascular membrane in a paediatric optic disc pit: A case report.

Purpose: To report a paediatric patient with unilateral optic nerve pit found to have choroidal neo-vascular membrane in the same eye. Observation: An 8-year old girl known to have a unilateral optic nerve pit presented with exotropia of the right eye. On examination, her vision was 20/40; sub-retinal haemorrhage was noted on clinical fundus exam and a sub retinal vascular net was confirmed on optical coherence tomography angiography. Conclusion and importance: The unusual finding of a choroidal neo-vascular membrane in a known optic nerve pit case represents a new finding of a possible complication. Patients with optic nerve pit may be considered as candidates for OCT-angiography for further diagnosis and proper treatment leading to improved vision, care and prognosis.

The moderating effect of burnout on professionalism, values and competence of nurses in Saudi Arabia amidst the COVID-19 pandemic: A structural equation modelling approach.

AIM: To examine the moderating effect of burnout on the relationship between nurses' competence, professional competence and professional values. BACKGROUND: There is a preponderance of burnout studies of nurses before and during the COVID-19 pandemic. However, little is known about burnout's moderating influence on nurses' professionalism, competence and values during the ongoing pandemic. METHODS: This study used a correlational, cross-sectional design and convenience sampling to recruit 809 Saudi nurses employed in four government hospitals. Four self-report instruments were used to collect data from August 2021 to March 2022. Spearman Rho, structural equation modelling and multi-group moderation analysis were used to analyse the data. RESULTS: Most of the participants had high burnout. There was a moderate to high correlation between the dimensions of professional competence, nurse professional values, burnout and nurse competence. Both professional competence and nurse professional values significantly affected nurse competence. Nurse professional values also had a direct effect on professional competence. Professional competence and nurse professional values on nurse competence may vary among those with low, moderate and high levels of burnout, suggesting the moderating effect of burnout. CONCLUSIONS: The positive impacts of nurse professional values and professional competence on nursing competence were validated in this study, as was the evidence of burnout's moderating effect on the studied connections. To avoid burnout, it is necessary to increase organizational knowledge and support for nurses, their working conditions and the environment through strategies that promote well-being and empowerment. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers can implement policies to help nurses minimize burnout and improve their professional values and competence. Management policies may be considered include increased staffing, opportunities to improve technical abilities through education and vocational training programs, and increased diversity of job assignments.

Molecular dynamics simulation analysis of the beta amyloid peptide with docked inhibitors.

Beta amyloid peptide is widely studied due to its association with Alzheimer disease (AD). Various study reported that the accumulation of beta amyloid in brain cells leads to Alzheimer disease. Hence, Beta amyloid peptide could be a potential target of anti-AD therapy. Hence, it is of interest to develop potent inhibitors for Beta amyloid peptide in the context of Alzheimer disease (AD). We report the binding features of Ascorbic acid, Cysteine, Dithioerythriol, Dithiothreitol, Malic acid and α-Tocopherol with beta amyloid having binding energy values of -6.7, -6.5, -6.0, -6.5, -6.7 and - 7.0 kcal/mol respectively. The molecular docking of top-scoring compounds with beta amyloid suggests that amino acids such as ASP23, GLU22, Phe19, are crucial in binding. Molecular dynamics simulation study showed steady-state interaction of compounds with beta amyloid for further consideration.

Pediatric urology surgical practice in the time of COVID-19: Results from tertiary Saudi Arabia hospitals.

PURPOSE: Our study aimed to evaluate the effect of COVID-19 on pediatric urology practice in the Kingdom of Saudi Arabia (KSA). METHODS: Data of 10 tertiary hospitals in KSA were retrospectively analyzed. Data of outpatient department (OPD) visits and pediatric urology surgical procedures from January 1, 2019, to April 30, 2019, and from January 1, 2020, to April 30, 2020, were extracted. The primary outcome was to compare OPD visits and pediatric urology workload in the first third of 2020 versus 2019, where there was no curfew. The secondary outcome was to compare the same variables during the full curfew time, i.e., April 2020 versus April 2019. RESULTS: The number of OPD visits was lower in the first third of 2020 (7390 vs. 10,379 in 2019 P < 0.001). OPD visits in April 2020 were 78.6% lower than in April 2019, and teleclinics represented 850 (94.3%). Elective procedures in the first third of 2020 were 688, with a reduction rate of 34.3% compared to the same period of 2019 (P < 0.001). In April 2020, there were 18 elective surgeries, with a 91.4% decrease than in April 2019. Ureteric reimplantation, hypospadias, cryptorchidism, and circumcision stopped, while pyeloplasty (n = 14) and urolithiasis (n = 4) procedures had declined by 50% and 76.5%, respectively. Most of the procedures (71.8%) were day surgery. Emergency procedures were similar in the first third of 2020 (65 vs. 64 in 2019, P = 0.994) and declined in April 2020 by 6.7% versus April 2019. During the full curfew, the most common emergency intervention were cases with obstructive uropathy (42.8%), followed by torsion testis (28.6%), posterior urethral valve (14.3%), and urological trauma (14.3%). CONCLUSIONS: In KSA, the number of elective pediatric surgical procedures were reduced by >90%, while the number of emergency pediatric surgical procdures were similar during COVID-19 pandemic compared with non-COVID-19 time. Ureteric reimplantation, hypospadias repair, cryptorchidism, and circumcision procedures were postponed. Pyeloplasty and urolithiasis-related procedures were performed to prevent irreversible disease progression or organ damage. There was an increase in rate of teleclinic and day surgery to reduce the risk of COVID-19 infection.

Renal cell carcinoma in a duplex kidney in pediatric.

Renal cell carcinoma (RCC) in children is relatively uncommon, especially in the absence of syndromes or hereditary diseases. Duplex kidney - as a common congenital anomalies in children - is usually insignificant with no serious impact or known risk of tumor association. Herein, we report a 5-year-old girl who presented with gross hematuria and a right renal mass in duplex system identified on computed tomography. Radical nephrectomy was performed; the patient was diagnosed with Xp11 translocation RCC and no other modalities of treatments were needed over 3-month follow-up.

Small Ureteral Access Sheath in Treating Paediatric Urolithiasis: A Single Centre Experience.

INTRODUCTION: Urolithiasis is not commonly encountered in the pediatric population. The adoption of ureteral access sheaths (UAS) facilitates the passage to the pediatric ureter and limits the harm and ureteral injury. However, the debate continues regarding whether or not to use UAS in children. OBJECTIVE: To assess the safety and outcomes of using UAS in the treatment of pediatric renal and ureteral stones. STUDY DESIGN: This was a prospective cohort study of 14 pediatric patients who underwent flexible ureteroscopy (fURS) with the use of UAS for symptomatic renal and ureteric stones. RESULTS: Of the fourteen enrolled patients, nine (64.3%) were males, and five (35.7%) were females with an average age of 9.5 years. Eleven (78.6%) of the patients were rendered stone-free. The average operative time was 55.7 min. None of the patients developed any complications. The stone-free rate was significantly higher with stone burdens of ≤10 mm (p ≤ 0.05). CONCLUSION: The use of UAS in children facilitates the passage of a flexible ureteroscope without complications. The procedure is considered to be efficient and safe with minimal morbidity.

Language barriers to studying medicine in English: perceptions of final-year medical students at the Arabian Gulf University.

BACKGROUND: English is the language of instructions in many medical schools in the Arab world. Its use may create a language barrier and adversely affect an individual's learning and later professional life. AIMS: This study examined the views of final-year Arab medical students of a language barrier and its effect on their learning and academic performance, and their language preference for medial education. METHODS: All final-year medical students (n = 142, 62% females) at the Arabian Gulf University, Bahrain, were invited to respond to a self-completed questionnaire. Differences in responses according to English proficiency and sex were assessed. RESULTS: Of the 142 students, 99 (70%) responded. Most students did not feel a language barrier irrespective of their proficiency in English (P = 0.088). Most respondents did not think that language issues made studying more difficult, although there was a significant difference in responses between students considered proficient in English and those less proficient (P = 0.005). Most students (82%) were not aware or were not sure of medical terms in Arabic, but 66% were confident that they would be able to communicate with patients in Arabic. About half of the students (51%) supported medicine being taught only in English and 36% supported teaching in Arabic and English. CONCLUSIONS: Most students thought that learning in English did not affect their academic learning and performance. However, a good proportion supported being taught medicine in Arabic and English.

The learning curve for robotic-assisted pyeloplasty in children: Our initial experience from a single center.

BACKGROUND: Robotic-assisted pyeloplasty surgery has become the preferred approach of ureteropelvic junction obstruction (UPJO) in pediatrics. However, to our knowledge, there is limited data on the learning curve for robotic-assisted pyeloplasty in children and no similar study from Saudi Arabia. AIMS: The objective of the study was to evaluate the progression of the surgical team performing robotic-assisted laparoscopic pyeloplasty (RALP) and to assess the feasibility of the RALP in children, since it is having been recently started in the Kingdom. SETTINGS AND DESIGN: Retrospective charts and surgical videos review at the tertiary care centre. SUBJECTS AND METHODS: After approval from the internal review board (IRB), we reviewed the surgical video recording of the RALP procedure of 15 patients presented with UPJO from January 2016 to October 2017. Statistical analysis was done for the variables includes dissection time, pyelotomy, anastomosis on both sides, and total surgery time and calculated in minutes. Renal ultrasound reviewed to assess any change in grade. RESULTS: Fifteen patients with UPJO underwent RALP. Of 15 cases, nine were primary and six cases as secondary UPJO. The median age was 8 (3-15) years. Out of 15 cases, 13 and 2 patients diagnosed as Society for Fetal Urology grades of 4 and 3, respectively. Total operative time was prolonged in secondary group as compared to primary pyeloplasty group (mean [standard deviation (SD)]: 166.3 [35.1], range: 125-223, P = 0.0028 versus mean (SD): 149.17 (30.4), range: (114-207), P = 0.0008). The success rate was 100% in primary and 84% in secondary cases. The median length of follow-up was 12.0 (7.0-18.0) and 10.0 (8.0-12.5) months in primary and secondary cases, respectively. The overall complication rate was 13% (2/15) (Clavien grade: 1-2). CONCLUSIONS: The evaluation of the learning curve of RALP for this group of patients concluded that total operative time for RALP, performed by the pediatric urology team, steadily decreased with collective surgical experience.

Survey of medical students to assess their knowledge and attitudes toward organ transplantation and donation.

Kidney transplantation is the most preferred treatment modality for patients with end-stage renal disease (ESRD). This study aims at understanding the awareness, attitudes, and beliefs among the medical and nonmedical students. The study population consisted of 500 medical students and 39 nonmedical controls, who were surveyed using a reliable questionnaire that examined their knowledge and attitudes. A 24-item self-administered questionnaire, which assessed the levels of knowledge, attitude regarding organ donation with dichotomous scale and demographic data were used. Of the 500 medical students who received the questionnaire, 376 (75.2%) with a mean age of 22.1 ± 2.5 years responded; 39% were male, 43.6% were Bahraini, and 32.2% were from Saudi Arabia, 51.3% were in Grades-5 and 6 and 58.8% resided in big cities. The medical students had a highly positive attitude and great willingness toward organ donation. Majority of them (75.3%) knew the treatment of ESRD, and 70.7% recognized correctly that kidney transplantation is the optimal treatment for ESRD. However, only 10.4% knew that it is performed in Bahrain since 1995. A total of 241 participants (64.3%) reported positive attitude toward living kidney donation and 71.8% expressed their agreement to donation after death. More than half (66.8%) believed that their religion permits organ donation, although 56.6% of the participants believed that there is a danger after donating a kidney. When compared to nonmedical students, there was no statistically significant difference in the attitudes toward living kidney donation (P = 0.823) or organ donation after death (P = 0.066).

Comparison of Penetration Depth and Microleakage of Resin Infiltrant and Conventional Sealant in Pits and Fissures of Permanent Teeth In Vitro.

AIM: To assess the penetration and microleakage of a resin infiltrant for the prevention of noncavitated white lesion progression in the fissure system of permanent teeth and compare it to a conventional sealant. MATERIALS AND METHODS: Sixty extracted permanent teeth with artificially produced noncavitated white lesions were randomly distributed according to the restorative material into group I (experimental) which received ICON resin infiltration, and group II (control) which received Helioseal F fissure sealant. For the penetration test, restorative materials were mixed with a fluorescent dye (eosin H) before light curing; roots were then amputated, and three buccopalatal microscopic sections were obtained from each tooth. These were dipped in 0.001 mg of ethanolic sodium fluorescence solution. Material penetration depth was assessed through confocal microscopy. Thirty teeth (15 from each group) underwent a microleakage test. Teeth were thermocycled, and then immersed in 50% silver nitrate (AgNO3) solution for 3 hours. Microleakage was evaluated using X-ray microtomography (micro-CT); AgNO3 presence between the material and the tooth surface indicated microleakage. RESULTS: The mean material penetration value in teeth treated with ICON (104.8571 ± 7.63360 µm) was significantly higher than that in teeth treated with Helioseal F (5.3158 ± 3.83825 µm) (p < 0.001). The mean microleakage value in demineralized enamel treated with Helioseal F (0.2238 ± 0.12561) was significantly greater than that in demineralized enamel treated with ICON (0.0119 ± 0.0097) (p < 0.001). CONCLUSION: ICON displayed more penetration and less microleakage than Helioseal F in pits and fissures of permanent teeth. CLINICAL SIGNIFICANCE: Resin infiltrant showed superior retention and can provide a good alternative for adhesives and fissure sealants. How to cite this article: Al-Tuwirqi AA, Alshammari AM, Felemban OM, et al. Comparison of Penetration Depth and Microleakage of Resin Infiltrant and Conventional Sealant in Pits and Fissures of Permanent Teeth In Vitro. J Contemp Dent Pract 2019;20(11):1339-1344.

Cobalt-based nanoparticles prepared from MOF-carbon templates as efficient hydrogenation catalysts.

The development of efficient and selective nanostructured catalysts for industrially relevant hydrogenation reactions continues to be an actual goal of chemical research. In particular, the hydrogenation of nitriles and nitroarenes is of importance for the production of primary amines, which constitute essential feedstocks and key intermediates for advanced chemicals, life science molecules and materials. Herein, we report the preparation of graphene shell encapsulated Co3O4- and Co-nanoparticles supported on carbon by the template synthesis of cobalt-terephthalic acid MOF on carbon and subsequent pyrolysis. The resulting nanoparticles create stable and reusable catalysts for selective hydrogenation of functionalized and structurally diverse aromatic, heterocyclic and aliphatic nitriles, and as well as nitro compounds to primary amines (>65 examples). The synthetic and practical utility of this novel non-noble metal-based hydrogenation protocol is demonstrated by upscaling several reactions to multigram-scale and recycling of the catalyst.

Timing of orchidopexy at a tertiary center in Saudi Arabia: reasons for late surgery.

BACKGROUND: Orchidopexy should be performed during the first 18 months of life to decrease the risk of infertility and tumor formation. In our center, the timing of surgical correction varies depending on the availability of an operating room. OBJECTIVES: Evaluate whether orchidopexy performed for patients referred to our center is done within the recommended time period and to determine causes for delay. DESIGN: Retrospective descriptive study. SETTING: Pediatric urology department of a tertiary care center. SUBJECTS AND METHODS: We retrospectively reviewed the charts of patients charts who underwent orchidopexy at our center from 2000 to 2010. We assessed referral time and waiting list time, which were subdivided as follows: from referral to first visit and from first visit to surgery. We included patients younger than 14 years and excluded pa.tients with comorbidities that affected the timing of referral and surgi.cal treatment. MAIN OUTCOME MEASURES: Referral time period and waiting list time for surgical correction of patients presented with undescended testis. SAMPLE SIZE: 128 RESULTS: After exclusion of 32 patients because of comorbidities, we describe 128 who underwent surgery for cryptorchidism at our center. The median (interquartile range, minimum-maximum) for age at sur.gery was 46.7 months (24.4-83.4, 3.1-248.6]). The median (IQR) referral occurred at an age of 25.3 months (4.1-65.5). The median (IQR) waiting list time was 15.2 months (8.1-23.3). The median (IQR) waiting time from referral to the first visit was 4.1 months (1.0-8.2). The median wait.ing time from the first visit to surgery was 8.1 months (3.8-17.5). CONCLUSIONS: The age at the time of surgery at our center was far from ideal because of late referrals. A structured program offered by our National Health Service to educate referring physicians is necessary. Community health initiatives must emphasize prompt referral to reduce the impact of delayed surgery. LIMITATIONS: Lack of data on the type of referring physician (i.e., general practitioner, pediatrician, surgeon, urologist). CONFLICT OF INTEREST: None.