Community Pharmacy Professionals' Knowledge and Counseling Skills for the Treatment of Acute Diarrhea in Children in Qassim Region, Saudi Arabia: Questionnaire Based and Simulated Client Study.

Objective: The study aimed to evaluate the knowledge and counseling skills of community pharmacy professionals regarding managing acute diarrhea in children in the Qassim region of Saudi Arabia. Methods: A cross-sectional study consisting of a questionnaire and simulated client scenario was conducted to collect data from pharmacy professionals working in community pharmacies over a period of 3 months in the Qassim region of Saudi Arabia. Pharmacy professionals were assessed for evaluating cases using 5 indicators (the age of the child, the frequency of diarrhea, fever and the presence of mucus or blood) and also for their recommendations and counseling. Results: The data were collected from 60 pharmacy professionals after site visits. In the questionnaire, 60% of the pharmacy professionals used all 5 indicators, while in the simulation, 13.3% used at least 3 indicators and 80% used 2 or fewer indicators (p = 0.35). An oral rehydration solution was recommended alone by 35% of the pharmacy professionals and with other drugs by 13.3% in the questionnaire, while in the simulation, an oral rehydration solution alone was recommended by 15% and other drugs by 48.3%. Approximately 86.7% of the pharmacy professionals did not give any dietary advice, and 50% did not counsel the simulated client on the recommended drug. Conclusion: The community pharmacy professionals in the study did not ask enough questions to evaluate a child suffering from acute diarrhea appropriately in the simulation. More questions were asked in the questionnaire; however, the difference is not significant. Additionally, they did not provide proper dietary advice, and their recommendation of an oral rehydration solution was insufficient.

A comprehensive study of the novel 4D hyperchaotic system with self-exited multistability and application in the voice encryption.

This paper describes a novel 4-D hyperchaotic system with a high level of complexity. It can produce chaotic, hyperchaotic, periodic, and quasi-periodic behaviors by adjusting its parameters. The study showed that the new system experienced the famous dynamical property of multistability. It can exhibit different coexisting attractors for the same parameter values. Furthermore, by using Lyapunov exponents, bifurcation diagram, equilibrium points' stability, dissipativity, and phase plots, the study was able to investigate the dynamical features of the proposed system. The mathematical model's feasibility is proved by applying the corresponding electronic circuit using Multisim software. The study also reveals an interesting and special feature of the system's offset boosting control. Therefore, the new 4D system is very desirable to use in Chaos-based applications due to its hyperchaotic behavior, multistability, offset boosting property, and easily implementable electronic circuit. Then, the study presents a voice encryption scheme that employs the characteristics of the proposed hyperchaotic system to encrypt a voice signal. The new encryption system is implemented on MATLAB (R2023) to simulate the research findings. Numerous tests are used to measure the efficiency of the developed encryption system against attacks, such as histogram analysis, percent residual deviation (PRD), signal-to-noise ratio (SNR), correlation coefficient (cc), key sensitivity, and NIST randomness test. The simulation findings show how effective our proposed encryption system is and how resilient it is to different cryptographic assaults.

The Effect and Implication of Social Media Platforms on Cosmetic Facial Plastic Surgery Among Females in Saudi Arabia.

Introduction Facial plastic surgery addresses various facial imperfections, offering a range of procedures like rhinoplasty and facelifts. Social media promotes unrealistic beauty standards, leading to increased demand for such surgeries. Studies highlight its influence, emphasizing the need for research in this area. Our study aimed to evaluate the effect of social media advertisements and selfies on facial cosmetic surgery decisions and plans among females in Saudi Arabia. Methodology This is a cross-sectional study conducted in the Kingdom of Saudi Arabia that targeted females aged 18-80 years old. An electronic questionnaire in Arabic was used for data collection. Data was analyzed in IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York, United States). Results Our study assessed 568 Saudi females regarding social media's impact on facial cosmetic surgery. Most of them were aged 21-30 years (39.4%) and Saudi nationals (94.2%). The majority, 87.9% (n=499), had not undergone cosmetic surgeries, and 12.1% (n=69) had; 68.1% (n=387) did not plan future surgeries. Notably, 42.6% (n=242) cited surgeon self-advertising and 38.0% (n=216) better selfies as an influencing factor in their cosmetic surgery decision. Logistic regression revealed several significant predictors of cosmetic surgery decisions including surgeon's advertisement (Exp(B) = 2.812, p < 0.001), cosmetic show viewing (Exp(B) = 2.327, p = 0.004), and social media photos (Exp(B) = 2.762, p = 0.001). Education (Exp(B) = 1.533, p = 0.035) and previous surgery (Exp(B) = 4.523, p < 0.001) correlated positively with considering surgery. Conclusion Our study highlights social media's influence on facial cosmetic surgery decisions among Saudi females. Surgeon advertisements, social media exposure, education, and previous surgery history emerged as significant predictors, warranting further research and targeted interventions.

Thyroid Cancer Knowledge and Awareness in Saudi Arabia: A Cross-Sectional Study.

Background Thyroid cancer incidence has been increasing worldwide over the last few decades. It is the most common endocrine cancer and is most common among females. The study contributes to filling the knowledge gap among Saudi people regarding thyroid cancer. Objectives This research aims to investigate the level of thyroid cancer knowledge and awareness in Saudi Arabia, identify potential knowledge gaps, and develop targeted strategies for enhancing public awareness and education. Methods A cross-sectional, voluntary online survey was conducted from 1st August 2023 to 1st October 2023 among residents living in Saudi Arabia over 18 years of age. The participants included were 2030 respondents. Data analysis was performed using RStudio (R version 4.3.0; R Foundation for Statistical Computing, Vienna, Austria). Results Among the participants, the majority were female (60.4%). A total of 49.7% of the individuals reported having a moderate to high level of knowledge about thyroid cancer. While 63.9% knew the association of a lump in the neck to thyroid cancer, 82.6% affirmed to consult a doctor upon discovering a lump, 72.1% knew that regular monitoring of neck lumps is crucial for early diagnosis and treatment of precancerous conditions, 38.7% were aware of females being prone to thyroid cancer, and 59.2% were aware of the link between lifestyle and increased risk. Higher awareness scores were positively associated with female gender, previously having thyroid function tests done, and previously undergoing a US scan of the thyroid. Conclusion In this study, Saudi individuals are reported to lack some aspects of knowledge and perception of thyroid cancer. This study emphasizes filling the existing knowledge gap in thyroid cancer awareness in the Saudi population.

A rare case of chondrosarcoma at the posterior costovertebral junction: a case report.

Chodrosarcoma is the third most common primary malignancy of the bone, it is considered the most frequent malignancy of the chest wall. Chondrosarcoma at the costovertebral junction is rare and few cases are described in the literature. Case Presentation: The authors present a case of a 47-year-old female with a complaint of chronic pain in the right posterior upper chest, dyspnea, and episodes of dizziness.The diagnosis of low-grade chondrosarcoma at the posterior costovertebral junction was made by video-assisted thoracic surgery and computed tomography.The surgical management included resection of the tumor and parts of adjacent ribs. Discussion: Chondrosarcoma is chemotherapy and radiotherapy-resistant. The total surgical excision of the tumor with sufficient margins is usually curative. Conclusion: A follow-up is necessary because of the potential for recurrence.

A Brief Review of Demographic and Clinical Correlates of Cholesteatoma Surgery in the Qassim Region.

Background Cholesteatoma is described as the accumulation of squamous epithelium and keratinocytes within and around the middle ear cleft. There is a paucity of information regarding demographic and treatment outcomes for cholesteatoma in Saudi Arabia. An evaluation of the prevalence of comorbidities, complications and associations, of surgical treatment and demographics in the Qassim region was conducted. Methods This was a six-year retrospective review of patients treated for cholesteatoma at a private health facility, from August 2016 to July 2022. Data for age, gender, nationality, presence of comorbidities, type of surgery, type of anesthesia, and associated complications were collected from the electronic medical records and analyzed with Statistical Package for Social Sciences software. Results A total of 60 participants records were retrieved. The average age of the study population was ([43.2 ±SD] 21.8) years. There was a slightly higher male preponderance (males 51.7% and females 48.3%). Hypertension was the most commonly reported comorbidity (31.7%), followed by diabetes mellitus (25%). Age and gender were not statistically significantly associated with type of surgery or complications. Conclusion Demographic variables were not significantly associated with clinical correlates, however, further studies with larger sample sizes, robust clinical information, and long-term follow-up are required.

The global convergence of spectral RMIL conjugate gradient method for unconstrained optimization with applications to robotic model and image recovery.

In 2012, Rivaie et al. introduced RMIL conjugate gradient (CG) method which is globally convergent under the exact line search. Later, Dai (2016) pointed out abnormality in the convergence result and thus, imposed certain restricted RMIL CG parameter as a remedy. In this paper, we suggest an efficient RMIL spectral CG method. The remarkable feature of this method is that, the convergence result is free from additional condition usually imposed on RMIL. Subsequently, the search direction is sufficiently descent independent of any line search technique. Thus, numerical experiments on some set of benchmark problems indicate that the method is promising and efficient. Furthermore, the efficiency of the proposed method is demonstrated on applications arising from arm robotic model and image restoration problems.

Numerical simulation on energy transfer enhancement of a Williamson ferrofluid subjected to thermal radiation and a magnetic field using hybrid ultrafine particles.

In this numerical investigation, completely developed laminar convective heat transfer characteristics of a Williamson hybrid ferronanofluid over a cylindrical surface are reported. This new model in 2D is engaged to examine the effects of the magnetic field, thermal radiation factor, volume fraction of ultrafine particles, and Weissenberg number with the help of the Keller box method. The numerical calculations are implemented at a magnetic parameter range of 0.4 to 0.8, volume fraction range of 0.0 to 0.1, and a Weissenberg number range of 0.1 to 0.8. The numerical outcomes concluded that the velocity increases when the thermal radiation parameter and the volume fraction of a nanoparticle are increased, but inverse impacts are obtained for the magnetic parameter and the Weissenberg number. The rate of energy transport increases with increasing thermal radiation and volume fraction, while it declines with increasing the magnetic parameter and Weissenberg number. The drag force shows a positive relationship with the thermal radiation parameter and has an opposite relationship with the Weissenberg number and the magnetic parameter. Furthermore, even when the magnetic field, thermal radiation, volume fraction, and Weissenberg number are all present, the heat transfer rate of Williamson hybrid ferronanofluid is greater than that of mono Williamson ferronanofluid.

Impact of differential occupational LPG exposure on cardiopulmonary indices, liver function, and oxidative stress in Northwestern city of Nigeria.

Exposure to hydrocarbon products has been associated with numerous health risks and toxicities. Outdoor or indoor occupational exposure to highly volatile and lipid-soluble hydrocarbons has been linked to impairment of respiratory, cardiovascular, and liver functions. This study is aimed at determining the potential impact of occupational exposure to liquefied petroleum gas (LPG) in varying work environments. Respiratory symptoms, oxidative stress, cardio-pulmonary, and liver function parameters were assessed among LPG workers in the Kano metropolis, Nigeria. Study subjects were recruited from LPG filling stations and street LPG retail shops. Results of the study showed that the forced vital capacity (FVC) of LPG station workers was significantly lower (2.81 L/min; H = 22.473, p < 0.001) relative to the values recorded among LPG retail shop workers and the controls (3.54 L/min and 4.24 L/min respectively). A similar reduction was seen in the forced expiratory volume in the first second (FEV1) and the forced expiratory flow in 25-75 % of forced vital capacity (FEF25-75) obtained from the filling station workers (H = 32.722, p < 0.001 & H = 15.655, p <0.001 respectively). Furthermore, exposure to non-combusted LPG increased systolic blood pressure, mean arterial pressure, and serum liver enzymes. Findings from this study revealed that despite the high amount of coarse particulate matter in LPG retail shops, the filling station workers are more susceptible to the impairment of lung function possibly due to the high quantity of total volatile organic compounds (TVOCs) in the filling station environment.

The patterns of facial fractures in traumatic brain injury (TBI) patients using ordinal regression: a retrospective study of five years.

According to the World Health Organization (WHO), traumatic brain injury (TBI) will mainly contribute to disability and death by 2020. Facial fractures associated with TBI are a significant public health concern worldwide. The main etiological factors are road traffic accidents, violence, and falls. Neurological injury associated with facial fractures has been reported to be as high as 76%. Therefore, we retrospectively evaluated facial fracture patterns in patients with a traumatic brain injury in Hospital Universiti Sains Malaysia and evaluated their associations in our study. Ordinal regression was used to examine the facial fracture patterns in patients with traumatic brain injuries. The confounding variables were controlled using ordinal regression analysis, and probabilities of p < 0.1 were considered significant associations. The results found that zygomatic arch fracture -1.141 (95% CI, -2.487 to 0.204, p-value = 0.096), Le Fort II fracture -1.080 (95% CI, -2.138 to -0.022, p-value = 0.045), maxillary bone fracture 2.924 (95% CI, 1.784 to 4.063, p-value .001), nasal bone fracture 4.047 (95% CI, 1.243 to 6.851, p-value = 0.005), and mandibular bone fracture 1.501 (95% CI, 0.711 to 2.291, p-value .001) were the most common facial fracture types associated with traumatic brain injury (TBI). This study provides valuable data for creating prevention plans and gives a chance to discover the epidemiology, prevalence, and connection between TBI and facial fracture.

On three-term conjugate gradient method for optimization problems with applications on COVID-19 model and robotic motion control.

The three-term conjugate gradient (CG) algorithms are among the efficient variants of CG algorithms for solving optimization models. This is due to their simplicity and low memory requirements. On the other hand, the regression model is one of the statistical relationship models whose solution is obtained using one of the least square methods including the CG-like method. In this paper, we present a modification of a three-term conjugate gradient method for unconstrained optimization models and further establish the global convergence under inexact line search. The proposed method was extended to formulate a regression model for the novel coronavirus (COVID-19). The study considers the globally infected cases from January to October 2020 in parameterizing the model. Preliminary results have shown that the proposed method is promising and produces efficient regression model for COVID-19 pandemic. Also, the method was extended to solve a motion control problem involving a two-joint planar robot.

Epigenetic modifications associated with genes implicated in cytokine storm: The potential biotherapeutic effects of vitamins and minerals in COVID-19.

Cytokine storm is a phrase used to refer to an abrupt upsurge in the circulating levels of various pro-inflammatory cytokines, causing increased stimulation and activity of immune cells during disease conditions. The binding of pattern recognition receptors to pathogen-associated molecular patterns during COVID-19 infection recruits response machinery involving the activation of transcription factors and proteins required for a robust immune response by host cells. These immune responses could be influenced by epigenetic modifications as evidenced by significant variations in COVID-19 pathophysiology and response to therapy observed among patients across the globe. Considering that circulating levels of interleukin 1, tumor necrosis factor-α, and interleukin 6 are significantly elevated during cytokine storm in COVID-19 patients, genetic and epigenetic variations in the expression and function of these proteins could enhance our understanding of the disease pathogenesis. Treatment options that repress the transcription of specific cytokine genes during COVID-19 infection could serve as possible targets to counteract cytokine storm in COVID-19. Therefore, the present article reviews the roles of cytokines and associated genes in the COVID-19 cytokine storm, identifies epigenetic modifications associated with the disease progression, and possible ameliorative effects of some vitamins and minerals obtained as epigenetic modifiers for the control of cytokine storm and disease severity in COVID-19 patients. PRACTICAL APPLICATIONS: COVID-19 causes mortality and morbidity that adversely affect global economies. Despite a global vaccination campaign, side effects associated with vaccination, misconceptions, and a number of other factors have affected the expected successes. Cytokine storm in COVID-19 patients contributes to the disease pathogenesis and response to therapy. Epigenetic variations in the expression of various cytokines could be implicated in the different outcomes observed in COVID-19 patients. Certain vitamins and minerals have been shown to interfere with the expression and activity of cytokines implicated in cytokine storm, thereby counteracting observed pathologies. This review examines cytokines implicated in cytokine storm in COVID-19, epigenetic modifications that contribute to increased expression of identified cytokines, specific foods rich in the identified vitamins and minerals, and suggests their possible ameliorative benefits. The article will be beneficial to both scientists and the general public who are interested in the role of vitamins and minerals in ameliorating COVID-19.

Some novel mathematical analysis on the fractional-order 2019-nCoV dynamical model.

Since December 2019, the whole world has been facing the big challenge of Covid-19 or 2019-nCoV. Some nations have controlled or are controlling the spread of this virus strongly, but some countries are in big trouble because of their poor control strategies. Nowadays, mathematical models are very effective tools to simulate outbreaks of this virus. In this research, we analyze a fractional-order model of Covid-19 in terms of the Caputo fractional derivative. First, we generalize an integer-order model to a fractional sense, and then, we check the stability of equilibrium points. To check the dynamics of Covid-19, we plot several graphs on the time scale of daily and monthly cases. The main goal of this content is to show the effectiveness of fractional-order models as compared to integer-order dynamics.

Comparative Evaluation of Buccal Infiltration Technique with Buccal Plus Palatal Infiltration Technique Using 4% Articaine in Patients with Irreversible Pulpitis of Maxillary 1st Molars: A Prospective, Randomized, In-Vivo Study.

Introduction: The purpose of this study was to evaluate and compare the buccal infiltration (BI) technique with the buccal plus palatal infiltration (BPI) technique using 4% articaine with 1:100,000 epinephrine. Methods: A total of 50 adult patients received BI, and the other 50 adult patients received BPI with 4% articaine with 1:100,000 epinephrine. During RCT procedure, when the patient experienced pain, the treatment was stopped and the extent of the procedure was documented. When a patient reported "no pain" (0 mm) or "weak/mild pain" (0 <= 54 mm), the anesthesia was considered successful. Results: Statistical analysis using unpaired t-test showed that the mean pain scores in both groups were comparable. Conclusion: The pain scores in both groups were comparable, but BI is better than BPI as a painful and traumatic palatal injection was avoided.

Sea Urchin Granuloma of the Hands: A Case Report.

Penetrating wounds from sea urchin spines are marine injuries that may cause morbidity in humans. Seasonal fishing for abalone in Dhofar is associated with an increase in the number of these injuries, as divers may strike their extremities, especially the dorsum of hands and fingers, on the rocks where Echinoderms and juvenile abalone (Haliotis mariae) are anchored. The immediate effect of injuries includes pain, edema, bleeding, erythema, and rarely systemic complications. There can be a delayed effect in the form of chronic granulomatous skin disease, which is a slow developing reaction to retained spine fragments in the wound that may take several months to develop. We report a case of sea urchin granulomas in a 45-year-old male who injured his hands by the spines of sea urchin while harvesting Haliotis mariae. Clinical manifestations, histological patterns, and treatment modalities are discussed here, to enhance the knowledge about these injuries and the available therapies.

Advances and challenges in developing andrographolide and its analogues as cancer therapeutic agents.

Andrographolide (AGP), a naturally occurring bioactive compound, has been investigated as a lead compound in cancer drug development. Its multidimensional therapeutic effects have raised interest among medicinal chemists, which has led to extensive structural modification of the compound, resulting in analogues with improved pharmacological and pharmaceutical properties. Nevertheless, the analogues with the improved properties need to be rigorously studied to identify drug-like lead compounds. We scrutinised articles published from 2012 to 2018, to objectively provide opinions on the mechanisms of action of AGP and its analogues, as well as their potential as viable anticancer drugs. Preclinical and clinical data, along with the extensive medicinal chemistry efforts, indicate the compounds are potential anticancer agents with specific value in treating recalcitrant cancers such as pancreatic and lung cancers.

Andrographolide prevented toluene diisocyanate-induced occupational asthma and aberrant airway E-cadherin distribution via p38 MAPK-dependent Nrf2 induction.

Toluene diisocyanate (TDI) is a major cause of chemical-induced occupational asthma, which contributes about 15% of global asthma burden. Resistance and compounded side effects associated with the use of corticosteroid in asthma necessitate the search for alternative drugs. Andrographolide (AGP), a naturally occurring diterpene lactone is known to exhibit various bioactivities. Its ability to ameliorate cardinal features of allergic asthma was previously suggested in an eosinophilic asthma endotype. However, its potential antiasthma activity and mechanism of action in a neutrophilic occupational asthma model, as well as its effect on epithelial dysfunction remain unknown. BALB/c mice were dermally sensitised with 0.3% TDI or acetone olive oil (AOO) vehicle on day 1 and 8, followed by 0.1% TDI intranasal challenge on days 15, 18 and 21. Endpoints were evaluated via bronchoalveolar lavage fluid (BALF) cell analysis, 2',7'-dichlorofluorescein diacetate (DCFDA) assays, immunoblotting, immunohistochemistry and methacholine challenge test. Decreases in total and differential leukocyte counts of BALF were recorded in AGP-treated animals. The compound dose-dependently reduced intracellular de-esterification of DCFDA, thus suggesting AGP's potential to inhibit intracellular reactive oxygen species (ROS). Mechanistically, the treatment prevented TDI-induced aberrant E-cadherin distribution and restored airway epithelial ß-catenin at cell to cell contact site. Furthermore, AGP ameliorated TDI induced pulmonary collagen deposition. In addition, the treatment significantly upregulated pulmonary HO-1, Nrf2 and phospho-p38 levels. Airway hyperresponsiveness was markedly suppressed among AGP-treated animals. Collectively, these findings suggest AGP's protective function against TDI-induced airway epithelial barrier dysfunction and oxidative lung damage possibly through the upregulation of adherence junction proteins and the activation of p38/Nrf2 signalling. This study elucidates the therapeutic potential of AGP in the control and management of chemical-induced allergic asthma. To the best of our knowledge, the potential anti-asthma activity of AGP in TDI-induced occupational asthma has not been reported previously.