Results of Modified Stenströms Technique Otoplasty and Patients' Satisfaction at King Fahad Armed Forces Hospital (KFAFH).

Background Globally, the prevalence of protruding ears is relatively frequent. Ear deformities manifest due to underdevelopment of the antihelical fold, conchal hypertrophy, and/or an obtuse conchoscaphal angle. The availability of multiple approaches proves that there isn't a single optimal accepted procedure. The Modified Stenström otoplasty technique supports the surgeon in the management of underdeveloped antihelix fold, conchal hypertrophy, and obtuse conchoscaphal angle among other deformities. We are the first to evaluate the clinical effects and measure the satisfaction rate post-otoplasty using the modified Stenström technique with a case series study. Methods Six patients were included in the study with a total of 12 ears operated on between February 2021 and July 2022. Utilizing the modified Stenström technique for bilateral protruding ears. All patients had six postoperative follow-up visits with fixed intervals; one week, three weeks, six weeks, three months, six months, and one year. During their one-year postoperative follow-up appointment, all patients completed the satisfaction survey questions. Results Six individuals were studied, three males and three females with a mean age of 23.1 (range, 7-53 years old). There were no complications or recurrences observed. Based on the responses we collected, all patients reported a high satisfaction rate at one-year postoperative follow-up. Conclusion The modified Stenström technique yields good naturally appearing ears. It is an easy and safe technique to apply. It has a short recovery period, and no hospital stay is required. All contribute to a high satisfaction rate among studied patients.

Vastus lateralis flap for trochanteric sarcoma reconstruction following prior main pedicle dissection: A case report.

The reconstruction of trochanteric defects presents a challenge to the reconstructive surgeon. There have been a number of locoregional reconstructive options described in the literature. These include flaps based on the lateral circumflex femoral artery and its branches, such as the tensor fascia lata, vastus lateralis (VL), anterolateral thigh (ALT) flaps. The present case further complicated this challenge as the patient had multiple recurrences of a sarcoma overlying the trochanteric region, with previous surgical resections, reconstruction and radiotherapy. The present case study describes an approach to harvesting the VL flap in a patient with previously harvested ALT.

Coxiella burnetii Pathogenesis: Emphasizing the Role of the Autophagic Pathway.

Coxiella burnetii (C. burnetii), the etiological agent of the Q fever disease, ranks among the most sporadic and persistent global public health concerns. Ruminants are the principal source of human infections and diseases present in both acute and chronic forms. This bacterium is an intracellular pathogen that can survive and reproduce under acidic (pH 4 to 5) and harsh circumstances that contain Coxiella-containing vacuoles. By undermining the autophagy defense system of the host cell, C. burnetii is able to take advantage of the autophagy pathway, which allows it to improve the movement of nutrients and the membrane, thereby extending the vacuole of the reproducing bacteria. For this method to work, it requires the participation of many bacterial effector proteins. In addition, the precise and prompt identification of the causative agent of an acute disease has the potential to delay the onset of its chronic form. Moreover, to make accurate and rapid diagnoses, it is necessary to create diagnostic devices. This review summarizes the most recent research on the epidemiology, pathogenesis, and diagnosis approaches of C. burnetii. This study also explored the complicated relationships between C. burnetii and the autophagic pathway, which are essential for intracellular reproduction and survival in host cells for the infection to be effective.

The Prevalence of Atypical Antipsychotics, Antidepressants, and Benzodiazepines Use in Dementia Patients in King Abdulaziz Medical City.

Background Dementia is a major neuropsychiatric disease defined by a progressive decline in cognitive functions. Atypical antipsychotics, antidepressants, and benzodiazepines are mainly prescribed for dementia. Many dementia pharmacological management options are associated with serious health risks. Therefore, this study aimed to determine the prevalence of antipsychotic, antidepressant, and benzodiazepine use in dementia patients in King Abdulaziz Medical City. Methodology A cross-sectional study was conducted at a tertiary hospital (King Abdulaziz Medical City, Jeddah) between December 2016 and January 2019. The participants were patients over the age of 65 years diagnosed with dementia. Data were collected from the medical records of the hospital after acquiring ethical approval. Patients with psychiatric diseases preceding the diagnosis of dementia, or patients with dementia-like symptoms as a side effect of any medications were excluded. The variables included were demographics, dementia subtypes, medications, and the presence or absence of chronic diseases. Results This study included 139 patients of whom 51.1% were males. The mean age was 82.8 ± 8.8 years. Moreover, 34.53% of the patients were prescribed medications for dementia management. Importantly, medications prescribed for dementia were classified as the following: atypical antipsychotics (20.86%), antidepressants (17.3%), and benzodiazepines (5%). The most commonly prescribed atypical antipsychotics were quetiapine (93.1%), risperidone (13.8%), and olanzapine (3.44%). For antidepressants, the most commonly prescribed medications for dementia were mirtazapine (62.5%), citalopram (45.8%), amitriptyline (8.3%), and paroxetine (4.2%). Moreover, most prescriptions for benzodiazepine were divided between lorazepam (71.4%), clonazepam (14.3%), and diazepam (14.3%). Conclusions This study's results were consistent with previous epidemiological studies that have been conducted worldwide regarding the increase in the use of antipsychotics and antidepressants, with the exception of benzodiazepines. To our knowledge, there is a lack of research regarding the medications prescribed in the geriatrics age group with dementia. Therefore, the outcomes of this study recommend initiating awareness campaigns among physicians, regarding the harm of using antipsychotics, especially for this age group. Lastly, future studies should focus on increased surveillance and evaluation of drug safety warnings in dementia patients to improve the outcomes of the intervention.

In vitro evaluation of a polytope DNA construct as a novel DNA vaccine strategy against human cytomegalovirus-associated diseases.

Human cytomegalovirus (HCMV) establishes severe disease in fetus, newborn and immunocompromised individuals. Polytope DNA vaccine strategy allows us to choose conserved and immunodominant epitopes from different antigens that can stimulate cellular and humoral immune responses simultaneously. In this study, a synthetic chimeric gene fragment was subcloned in to DNA vaccine vector pcDNA3.1+. The recombinant vector was transferred in to suitable eukaryotic cell line HEK 293T and the expression level of polytope construct from HEK 293T-infected cells was determined by western blot. These results show that there was no mutantion in target segment and recombinant vector showed significant levels of expression. Base on these results, using a proper procedure for design can cause expression and stability of polytope peptide.

Ion-beam modification of 2-D materials - single implant atom analysis via annular dark-field electron microscopy.

Functionalisation of two-dimensional (2-D) materials via low energy ion implantation could open possibilities for fabrication of devices based on such materials. Nanoscale patterning and/or electronically doping can thus be achieved, compatible with large scale integrated semiconductor technologies. Using atomic resolution High Angle Annular Dark Field (HAADF) scanning transmission electron microscopy supported by image simulation, we show that sites and chemical nature of individual implants/ dopants in graphene, as well as impurities in hBN, can uniquely and directly be identified on grounds of their position and their image intensity in accordance with predictions from Z-contrast theories. Dopants in graphene (e.g., N) are predominantly substitutional. In other 2-Ds, e.g. dichalcogenides, the situation is more complicated since implants can be embedded in different layers and substitute for different elements. Possible configurations of Se-implants in MoS2 are discussed and image contrast calculations performed. Implants substituting for S in the top or bottom layer can undoubtedly be identified. We show, for the first time, using HAADF contrast measurement that successful Se-integration into MoS2 can be achieved via ion implantation, and we demonstrate the possibility of HAADF image contrast measurements for identifying impurities and dopants introduced into in 2-Ds.

Ion implantation of graphene-toward IC compatible technologies.

Doping of graphene via low energy ion implantation could open possibilities for fabrication of nanometer-scale patterned graphene-based devices as well as for graphene functionalization compatible with large-scale integrated semiconductor technology. Using advanced electron microscopy/spectroscopy methods, we show for the first time directly that graphene can be doped with B and N via ion implantation and that the retention is in good agreement with predictions from calculation-based literature values. Atomic resolution high-angle dark field imaging (HAADF) combined with single-atom electron energy loss (EEL) spectroscopy reveals that for sufficiently low implantation energies ions are predominantly substitutionally incorporated into the graphene lattice with a very small fraction residing in defect-related sites.

Comparison of in vitro antibacterial activities of two cationic peptides CM15 and CM11 against five pathogenic bacteria: Pseudomonas aeruginosa, Staphylococcus aureus, Vibrio cholerae, Acinetobacter baumannii, and Escherichia coli.

In recent years, the widespread use of antibiotics has caused many bacterial pathogens resistance to conventional antibiotics. Therefore, generation of new antibiotics to control and reduce the effects of these pathogens is urgently needed. Antimicrobial peptides and proteins are important members of the host defense system in eukaryotes. These peptides are potent, broad-spectrum antibiotics that demonstrate potential as novel and alternative therapeutic agents for the treatment of drug-resistant infections. Accordingly, we evaluated two hybrid peptides CM11 (WKLFKKILKVL-NH2) and CM15 (KWKLFKKIGAVLKVL-NH2) on five important pathogenic bacteria. These peptides are short cecropin-melittin hybrid peptides obtained through a sequence combination approach, which are highly effective to inhibit the growth of important pathogenic bacteria. The activity of these two cationic peptides (CM11 and CM15) in different concentrations (2-64 mg/L) was investigated against standard and clinical isolates of important hospital infection bacteria by measuring MIC, MBC, and bactericidal assay. These peptides demonstrated the same ranges of inhibitory values: The organisms in early 24 h were more susceptible to polycationic peptides (MIC: 8 mg/L and MBC 32 mg/L), but after 48 h the MIC and MBC remained constant for the CM11 peptide. Bactericidal assay showed that all bacteria strains did not have any growth in agar plates after 40 min. The result showed that these two peptides are more effective than other peptides.

Alcohol and transactional sex: how risky is the mix?

This study examines alcohol use, transactional sex (TS), and sexually transmitted infection (STI) risk among sugar plantation residents near Moshi, Tanzania, from 2002 to 2004. We compare popular discourse gathered through ethnographic methods with cross-sectional questionnaire and STI prevalence data to illuminate the close correspondence of alcohol use and TS with STI transmission. People attributed to alcohol varied consequences: some socially desirable (relaxing, reducing worries) and others (drunkenness, removing shame) thought to put alcohol abusers at risk for STIs. TS-exchanging money, food, gifts, alcohol or work for sex-was not stigmatized, but people believed that seeking sexual partners for money (or providing money to sexual partners) led to riskier sexual relationships. We explore popular discourse about how alcohol use and TS independently and in combination led to increased STI exposure. Popular discourse blamed structural circumstances-limited economic opportunities, few social activities, separated families-for risky sex and STIs. To understand individual behavior and risk, we surveyed 556 people. We measured associations between their self-reported behaviors and infection with herpes simplex virus type-2 (HSV-2), syphilis, and HIV in 462 participants who were tested. Alcohol abuse was associated with prevalent STI and HIV infection. Exchanging sex for alcohol and work were both associated with prevalent STI. Participants who both abused alcohol and participated in TS had greatest risk for STI. Findings from the two analytic methods-interrogation of popular discourse, and association between self-reported behavior and STIs-were largely in agreement. We posit explanations for discrepancies we found through the concepts of sensationalization, self-exceptionalization, and the influence of an authoritative moral discourse.