Can shear wave elastography predict the success of shock­wave lithotripsy used in renal stones treatment? A prospective study.

OBJECTIVE: To evaluate the usage of shear wave elastography (SWE) in the prediction of the success rate of shock­wave lithotripsy (SWL) treatment of renal stones. PATIENTS AND METHODS: In the present study, SWL was performed for 100 patients presented with renal stones in the duration from May 2022 to August 2023. The patients were divided into 2 groups SWL responders and non-responders. The study compared between the 2 groups in terms of baseline parameters of the patients as age, sex, body mass index (BMI), stone size, stone location, stone density (HU), skin-to-stone distance (SSD), the degree of hydronephrosis and the stone elastography values. RESULTS: There was no statistically significant relation between stone-free rate and degree of obstruction (p = 0.628), stone size (p = 0.390) upper calyceal location (p = 0.17), middle calyceal location (p = 0.66), and renal pelvis location (p = 1.0). Nevertheless, a statistically significant relation was found as regards lower calyceal location, stone density (HU), and stone Elastography values using multivariate analysis. CONCLUSIONS: Measurement of stone density by shear wave elastography (SWE) can be used as an alternative to HU in decision-making before SWL. SWL success depends mainly on stone site, HU, and SWE values.

Novel insights on the probable mechanism associated with histamine oral model-inducing neuropathological and behavioral toxicity in rats.

Histamine (HIS) is an important chemical mediator that causes vasodilation and contributes to anaphylactic reactions. Recently, HIS is an understudied neurotransmitter in the central nervous system, and its potential role in neuroinflammation and neurodegeneration is a critical area of research. So, the study's goal is to investigate the consequences of repeated oral intake of HIS on the rat's brain and explore the mechanistic way of its neurotoxicity. Thirty male rats were divided into three groups (n = 10). The following treatments were administered orally to all rats every day for 14 days. Group (1) was given distilled water, whereas groups (2 & 3) were given HIS at dosage levels 250 and 500 mg/kg body weight (BWT), respectively. Brain tissue samples were collected at 7- and 14-days from the beginning of the experiment. Our results revealed that continuous oral administration of HIS at both doses for 14 days significantly reduced the BWT and induced severe neurobehavioral changes, including depression, dullness, lethargy, tremors, abnormal walking, and loss of spatial learning and memory in rats. In all HIS receiving groups, HPLC data showed a considerable raise in the HIS contents of the brain. Additionally, the daily consumption of HIS causes oxidative stress that is dose- and time-dependent which is characterized by elevation of malondialdehyde levels along with reduction of catalase activity and reduced glutathione levels. The neuropathological lesions were commonly observed in the cerebrum, striatum, and cerebellum and confirmed by the immunohistochemistry staining that demonstrating moderate to strong caspase-3 and inducible nitric oxide synthase expressions in all HIS receiving groups, mainly those receiving 500 mg/kg HIS. NF-κB, TNF-α, and IL-1ß gene levels were also upregulated at 7- and 14-days in all HIS groups, particularly in those getting 500 mg/kg. We concluded that ROS-induced apoptosis and inflammation was the essential mechanism involved in HIS-mediated neurobehavioral toxicity and histopathology.

Does the duration of catheterization have an impact on the outcome of trial without catheter in patients with acute urine retention (AUR) due to benign prostatic hyperplasia (BPH)? A prospective randomized study.

BACKGROUND: To study the impact of early in comparison to late catheter removal following acute urine retention (AUR) secondary to benign prostatic hyperplasia (BPH) using silodosin therapy on the outcome of trial without catheter (TWOC). METHODS: Two hundred sixty patients with AUR 2ry to BPH were catheterized then were randomly divided to receive silodosin 8 mg either for three or 7 days followed by catheter removal and successful voiding unaided was assessed. RESULTS: Out of the 260 men (mean age 64.8 ± 6.5 years) treated, 74 men who were receiving 3 days of silodosin and 88 patients who were receiving 7 days of silodosin didn't require re-catheterization on the day of TWOC (57% and 68% respectively, p = 0.096). Complications like urinary leakage, acute urinary tract infection, hematuria, or catheter blockage recorded in 21 men (16.2%) who received 3 days of silodosin, and in 63 men (48.5%) who received 7 days of silodosin (p ⩽ 0.001). CONCLUSION: Patients catheterized after AUR 2ry to BPH can spontaneously void following catheter removal if treated by silodosin, independent of the catheterization duration, while side effects have increased with prolonged catheterization.

The Effects of Social Media Addiction, Psychological Distress, and Loneliness on Suicide Ideations and Attempts Among Healthcare Professionals in Saudi Arabia.

INTRODUCTION: Recently, there has been an alarming increase in psychological distress in many populations. One of the reasons can be attributed to the rapid development of technology and social media, which could adversely affect the mental health of individuals, including those working in healthcare. This study aimed to assess the influence of social media addiction, psychological distress, and loneliness on suicidal ideations and suicide attempts among healthcare students and professionals in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study collected data from healthcare students and professionals using a five-part questionnaire: (i) demographics, (ii) the Bergen Social Media Addiction Scale (BSMAS), (iii) the Kessler Psychological Distress Scale (K10), (iv) the De Jong Gierveld Loneliness Scale (DGLS), and (v) suicide ideation and attempts scale. RESULTS: There were 800 participants from 33 cities who completed the questionnaire. A total of 31.37% reported lifelong thoughts of suicide, regardless of whether they would actually go through with it (S1), 18.38% had suicidal thoughts within the last 12 months (S2), and 11% had attempted suicide (S3). Of those who attempted suicide, 79 (89.77%) reported seeking help. Multiple logistic regression showed that lifetime suicidal thoughts were predicted by psychological distress, emotional loneliness (EL), social loneliness (SL), and age. Having had suicidal thoughts within the prior 12 months was predicted by psychological distress, SL, and age. Suicidal attempts were predicted by psychological distress, EL, age, and social media addiction. CONCLUSIONS: Our findings demonstrated that psychological distress and loneliness are strongly associated with suicidal ideas and suicide attempts. Such results could serve as a warning call that assists healthcare professionals and mental health teams in arranging and planning effective interventions and actions to raise awareness, as well as reduce the levels of psychological distress and loneliness that could lead to grave consequences.

The potential mechanism of histamine-inducing cardiopulmonary inflammation and apoptosis in a novel oral model of rat intoxication.

Histamine (HIS) is a potent vasodilator that contributes to anaphylactic reactions. Our investigation aims to study the possible toxic impact of repeated oral administration of histamine on the target organs of HIS poisoning (lung & heart) in rats as a model of scombroid poisoning. We used 15 rats that were separated into three groups with 5 rats in each. All rats received the treatments orally for 14 days as follows; (1): distilled water, (2) HIS at a dosage level of 250 mg/kg BWT daily and (3) HIS at a dosage level of 1750 mg/kg BWT weekly. Our results revealed that the consumption of HIS either daily or weekly could cause marked cardiopulmonary toxicity in rats. HIS can trigger inflammatory reactions in the cardiopulmonary tissues and induce oxidative stress damage along with apoptosis of such organs. HIS was markedly increase the MDA levels and decrease the CAT and GSH activity in both lung and heart tissues. The main pathological lesion observed is inflammation which was confirmed by immunohistochemistry and demonstrated strong iNOS and TNF-α protein expressions. Cardiac muscles showed extensive degeneration and necrosis and displayed strong casp-3 protein expression. Additionally, all HIS receiving groups noticed marked elevation of the pulmonary transcription levels of Cox2, TNF-α, and IL1ß along with substantial elevation of casp-3 and bax genes and downregulation of Bcl2 gene in the cardiac tissue. We concluded that the oral administration of HIS either daily or weekly can induce cardiopulmonary toxicity via the upregulation of proinflammatory cytokines resulting in ROS overgeneration and inducing both oxidative stress and apoptosis.

Immune Cell Reaction Associated with Coenurus cerebralis Infection in Sheep with Particular Reference to ELISA as a Diagnostic Tool.

Sturdy is a disease caused by Coenurus cerebralis (C. cerebralis) that typically affects the brain and spinal cord of sheep. So, this study aimed to detect the pathological, hematological and immunological changes caused by C. cerebralis in sheep. On examination, a total of 17 sheep out of 30 sheep (56.7%) from various regions in Egypt were found infected with C. cerebralis from May to August 2019. Each cyst was extracted from the sheep brain; in addition, tissue specimens were taken from the brain tissues for histopathological examination. The hematological profile was analyzed. Enzyme-Linked Immunosorbent Assay's (ELISA) specificity and sensitivity were evaluated using cystic fluid and protoscolices antigens (Ag). The cell-mediated immunity against the C. cerebralis cyst was also assessed via quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) to show alterations in mRNA expression of the Tumor Necrosis Factor-alpha (TNF-α) and gamma Interferon (IFN-γ) cytokines qRT-PCR. In histopathological sections, cerebral tissue showed an areolar cyst wall with many protoscolices attached to the tissue. The affected part showed prominent necrosis together with inflammatory cells' aggregation. Hyperplastic proliferation of the ependymal cells was a common finding. The infected sheep exhibited significantly lower total erythrocyte numbers (ER), hemoglobin levels (Hb), packed cell volume (PCV), platelet numbers (PN) and segmented cell numbers compared to apparently healthy sheep. Despite the sensitivity for the indirect ELISA being 100% for both of the Ags (fluid and scolex), the evaluation of ELISA specificity using the two antigen (Ag) preparations showed specificities of 46.2% and 38.5% for fluid and scolex Ag, respectively. Meanwhile accuracy ranged from 76.7% and 73.3% for the fluid and scolex Ags, respectively, that showed the priority was directed to the fluid to be used as an ideal sample type for ELISA. Levels of TNF-α and IFN-γ were significantly elevated in infected sheep compared to non-infected control ones. In conclusion, C. cerebralis is a serious disease infecting sheep in Egypt revealing economic losses. Although this investigation supports preliminary information about the prevalence, pathological and serological characterization of C. cerebralis, further sequencing and phylogenetic analysis is needed to understand better the T. multiceps epidemiology in ruminants and canines in Egypt.

Population health data in KSA: Status, challenges, and opportunities.

Population dynamics and health risk factors keep changing in the KSA, requiring continuous research and quality data. We aimed to review the current status of population health data, outline the available opportunities for data utilization, and provide recommendations for population data-related improvement initiatives. We provide practical solutions to support the collection, linkage, quality assurance, and governance of population health data.

Immunological status of some edible fishes exposed to parasitic infections in relation to heavy metals pollution.

In this study, six heavy metals (Pb, Fe, Cu, Ni, Cd, and Mn) have been measured in water, and muscles from mullet (Mugil cephalus), tilapia (Oreochromis niloticus), and African catfish (Clarias gariepinus) collected from Lake Manzal, Egypt. In addition, the existence of different encysted metacercariae in fish muscle with an evaluation of cell-mediated immune response in infected muscles was also investigated. Water samples generally contained less than the permissible level of heavy metals. The metal accumulation levels in muscle were: Pb > Ni > Cd > Cu > Fe > Mn. The levels of Pb and Ni in the muscles exceed the permissible limits, while the concentration of Mn varied significantly (p < 0.05) depending on fish species. Based on the estimated weekly intake in this study, the EWI values of these heavy metals are below the established Provisional Permissible Tolerable Weekly Intake. On the other hand, Prohemistomum vivax encysted metacercaria were found in the muscle of O. niloticus and C. gariepinus with the intensity of 1-10 cyst per 1 cm of muscle. While M. cephalus was found to be infected with Heterophyes heterophyes EMC. TNF- α1 was 10 folds upregulated in O. niloticus than in control fish. IL-1ß expression in O. niloticus was upregulated by 15 folds compared with the control one. By examining C. gariepinus, the MHC II gene expression was increased by 15-fold in comparison to the control group.

Knowledge and attitude towards emergency department utilization in Riyadh.

Background: Because the emergency department (ED) is such an important element of health care, efficient usage must be taken into account while planning and creating the scope of service for emergency care. Our study's goal is to assess the participants' knowledge and attitude towards ED. Concerns among the general public over the use of emergency rooms (ER). Materials and Methods: A cross-sectional study was carried out among the sample of Saudi Arabia's population of Riyadh City in the year 2020. There were 440 people who responded. The information was gathered with a self-administered questionnaire. Statistical Package for Social Sciences (SPSS) version 23.0 was used to analyze the data. Results: As a result of the findings, 22 symptoms were reported as the cause of ER visits, ranging from acute, urgent, and cold symptoms. Of these, 45.7% of those polled said they visited an ER if they get sick, then seek primary care, online consultation, and community pharmacy, which was 28.2%, 17.5%, and 8.6%, respectively. Around 14.32% of the visitors had a chronic condition, with asthma accounting for 41.3%, diabetes for 23.8%, and hypertension for 11.1%. In terms of the frequency of visits, 66.4% said they visit the emergency care once in every 3-6 months, and 47.7% said they visit once in a month. With a mean score of 16.16 ± 3.02/high in knowledge, the results revealed that the participants possessed a high degree of knowledge, with a significant difference among married group (F = 4.83, P < 0.05 = 0.003), and those from 24 to 29 years of age (F = 3.26, P < 0.05 = 0.012). Conclusions: Because there were characteristics connected to population knowledge, limited hours, and ED overutilization without necessity, the findings of our study could be valuable in understanding the reasons for ED overutilization without necessity. In Riyadh's primary health care centers (PHCCs), there are limited medical resources. Thus, we recommend that the primary health care (PHC) admission process should be improved putting in place a triage mechanism that determines the best location for patient care that is suited.

Oxidative stress markers, immune-regulating cytokines, and the pathological evaluation of sheep co-infected with Oestrus ovis and Coenuruscerebralis.

This study aimed to evaluate the immune response using the immune-regulating cytokines as (IL-1ß; MHC-I and MHC-II) associated with co-infected sheep Oestrusovis and Coenurus cerebralis as well as oxidative stress markers (malondialdehyde "MDA" and nitric oxide "NO"). So; sheep samples from different regions in Egypt showed different neurological signs, were examined for detection of the cause of the nervous manifestations. Moreover, the O. ovis and C. cerebralis cysts were collected and identified using scanning electron microscopy. The brain tissues were evaluated for different immunological genes such as MHC-I, MHC-II, and Interleukin-1ß activity using quantitative real-time PCR (qRT-PCR) techniques, where the infected sheep showed higher MHC-I gene expression (10-fold), higher MHC-II gene expression (peaked at 25-fold), and higher IL-1ß gene expression (14-fold) than the control group. The MDA level was significantly increased. Also, stress marker (nitric oxide) levels were significantly higher in infectedsheep than in negative control one. During gross pathology, migrating larvae of O. ovis and C. cerebralis were noticed In such areas, hemorrhages and patches of clotted blood were noticed. cysts with prominent protoscolices were also observed and were attached to the caudal region near the cerebellum.

Electron Doping of Semiconducting MoS2 Nanosheets by Silver or Gold Nanoclusters.

Semiconducting two-dimensional (2D) materials have potential applications as ultrathin optoelectronic materials. Therefore, being able to precisely modulate the band gap is useful to improving their applicability. Electron doping of the semiconducting materials is one of the successful techniques used to modulate their band gap. Silver nanoclusters (AgNCs) or gold nanoclusters (AuNCs) a few nanometers in size can generate a high density of highly energetic hot electrons with relatively long lifetimes when photoexcited. The optical band gap of 2D MoS2 nanosheets shows different responses when integrated with different amounts of AgNCs or AuNCs due to the electron doping effect. Introducing a small amount of the nanoclusters to the surface of a MoS2 nanosheet lowered its optical band gap. Further reduction of the optical band gap of MoS2 is obtained upon tripling the amount of integrated nanoclusters. Conversely, the optical band gap of MoS2 was increased when integrated with 5 times the concentration of AuNCs and AgNCs. The optical band gap of the MoS2 nanosheets was significantly increased when integrated with an even higher concentration of AuNCs or AgNCs. The magnitude of the shift of the optical band gap of MoS2 induced by AgNCs is higher than that induced by AuNCs because the energy of LUMO of the AgNCs is higher than that of the AuNCs.

Can we successfully predict the outcome for extracorporeal shock wave lithotripsy (ESWL) for medium size renal stones? A single-center experience.

BACKGROUND: Extracorporeal shock wave lithotripsy (ESWL) is one of the most used modalities in treatment of renal stones, but its effectiveness can be influenced by many factors related to the patient or the stone itself which may affect the success of stone disintegration. The aim of our study was to investigate the predictive value of some patient and stone-related factors for ESWL success for renal stones. METHODS: A total of 100 patients with single radiopaque renal stone 10-20 mm in diameter, undergoing ESWL were enrolled in this study. All patients had non contrast computed tomography (NCCT) done before ESWL. We evaluated body mass index (BMI), skin-to-stone distance (SSD), stone size and Hounsfield density comparing these values between stone free (SF) and residual stone (RS) groups. RESULTS: Of the 100 patients, 70% had successful disintegration. There was no significant difference between stone free (SF) and residual stone (RS) groups as regard age or BMI. Meanwhile, there was a significant difference between SF and RS groups as regard stones' density and SSD, with higher values in RS group but there was statistically insignificant difference as regard stone size (p = 0.522). Using logistic regression analysis, we found that Hounsfield unit (HU) was better in predicting successful disintegration than SSD but without statistical significance. CONCLUSION: HU and SSD are the independent predictive factors for ESWL outcome, and they should be considered when planning ESWL in treatment of medium size renal stones.

Unplanned Return to the Operating Room (UpROR) After Pediatric Diaphyseal Femoral Fractures.

BACKGROUND: Femoral fractures are the most common cause of fracture-related admissions. Unplanned return to the operating room (UpROR) is a major event and imposes a substantial burden on the family and health care system. The purpose of this study was to determine the incidence of complications and early UpROR during the first 6 months following treatment of femoral fractures and their risk factors. METHODS: In an institutional review board-approved study, a retrospective review of all patients who were treated for a femoral fracture during a 10-year period at a pediatric tertiary care center was performed. Patients less than 18 years old with a diaphyseal fracture and complete records were included, and nondiaphyseal or pathologic fractures, as well as underlying metabolic or genetic disorders, were excluded. All clinic visits in the first 6 months after treatment were reviewed, and all complications and UpRORs were extracted. Patients were grouped based on their age (below 5, 5 to 11, above 11 y old) at initial treatment, and statistical tests were used to infer differences between groups. RESULTS: Overall, 841 fractures in 832 patients were included, with a mean age of 5.5±4.8 years fracture, of which 72% were male. A total of 106 complications (12.6%) and 45 UpRORs (5.3%) were encountered during the study period. Patients with and without UpROR had similar demographics and injury and treatment characteristics. Loss of reduction was the most common reason for UpROR (58%), followed by implant-related complications. Flexible nails had the highest risk of UpROR among patients who were initially treated surgically (P=0.03). CONCLUSIONS: Our findings indicate that children under the age of 5 years have a 5% risk of UpROR in the first 6 months after the fracture, mainly for repeat spica casting due to loss of reduction. Patients aged 5 years or older have an ∼6% risk of UpROR, mainly related to complications of flexible nails. The findings of this study are important when consulting families on different treatments of diaphyseal femoral fractures. LEVEL OF EVIDENCE: Therapeutic level III-retrospective cohort study.

Morphological and pathological appraisal of Huffmanela sp. (Nematoda: Trichosomoididae) infecting orange-spotted grouper (Epinephelus coioides, Hamilton, 1822) at Jubail Province, Saudi Arabia: a case report.

This paper is conducted for identifying the parasite which collected during regular routine inspection for the hygienic condition and health status of fish in 2019 at the central fish market shops at Jubail city, Saudi Arabia. Samples from an orange spotted grouper (Epinephelus coioides) fish showed heavy black streaks between the muscle fibers that was considered unmarketable and rejected by the consumer after had been cut and prepared for sealing. The black discolorations were in the form of heavy diffused focal black spots or forming threads of variable sizes embedded in the entire whole-body musculature of the fish. These samples were subjected to parasitological and pathological evaluation. The parasitological examination of the affected muscular tissues revealed infection by Huffmanela spp. eggs. The parasitic infection was identified on the bases of the morphological and ultra-structural characters of the eggs. The examination of the affected fish showed multifocal black parasitic remnants between the muscle fibers. The parasitic fragments were distributed all over the fish flesh either superficially in subcutaneous area or deep inside the muscular tissue and they have been concentrated in the flesh around the vertebral column. In conclusion; this case report confirmed the occurrence of Huffmanela spp. infection in the muscles of Epinephelus coioides by using light and scanning electron microscopy. Further molecular assessment is recommended.

Tuning the Optical Band Gap of Two-Dimensional WS2 Integrated with Gold Nanocubes by Introducing Palladium Nanostructures.

The two characteristic absorption peaks of semiconducting two-dimensional tungsten disulfide (WS2) are red-shifted after integrating with gold nanocube (AuNC) arrays. The amount of the red shift is reduced when the AuNCs are coated with a high concentration of Pd. A negligible shift was observed in the absorption peaks of WS2 when smaller amounts of Pd are introduced to the surface of AuNCs. Conversely, the photoluminescence (PL) of WS2 is blue-shifted when measured on top of AuNCs and AuNCs coated with different amounts of Pd. AuNC-Pd Janus nanoparticles are prepared by depositing Pd atoms asymmetrically on AuNCs assembled into 2-D arrays on the surface of a glass substrate by the chemical reduction of Pd ions. Due to the large AuNC or AuNC-Pd/WS2 Schottky barrier, the plasmon-induced hot electron transfer (PHET) from AuNCs and AuNCs coated with a high concentration of Pd is responsible for the red shift of the absorption spectrum of WS2. Introducing a lower concentration of Pd to AuNCs increases the Schottky barrier further due to the formation of the Au-Pd equilibrium Fermi level of lower energy, reducing the efficiency of PHET. The effect of Pd on the Fermi level of AuNCs vanishes at high Pd deposition. Pauli blocking and phase-space filling are responsible for the blue shift of PL of WS2 on top of AuNCs and AuNCs coated with Pd. The Pauli blocking effect is directly proportional to the PHET efficiency. This explains the significant blue shift of PL of WS2 after integrating with AuNCs and AuNCs coated with a high concentration of Pd. Additionally, depositing Pd onto AuNCs elongates the lifetime of the hot electrons and enhances the PHET efficiency.

Coinfections of Aeromonas spp., Enterococcus faecalis, and Vibrio alginolyticus isolated from farmed Nile tilapia and African catfish in Egypt, with an emphasis on poor water quality.

The high mortality rate among Nile tilapia (Oreochromis niloticus) and African catfish (Clarias gariepinus) polycultured in earthen ponds in Manzala, Egypt, was investigated. Mortality has been linked to poor water quality parameters accompanied with bacterial infections. Moribund farmed fishes exhibited general septicemic signs. Fish from both species (45 each) were sampled and analyzed bacteriologically. Vibrio alginolyticus (32.3%), Enterococcus faecalis (29.4%), Aeromonas caviae (23.5%), and A. veronii (14.7%) were isolated from moribund fishes using selective media and further identified by biochemical tests. 16S rRNA gene sequencing and phylogenetic analysis confirmed the identity of these isolates. Experimental infection of O. niloticus with different bacterial isolates resulted in clinical signs of hemorrhagic septicemia and mortality rates of 80%, 60%, 40%, and 30%, respectively, for E. faecalis, A. veronii, V. alginolyticus, and A. caviae. Water parameter analysis revealed marked divergence from typical values. In addition, different bacterial isolates (including Staphylococcus sciuri, S. aureus, E. faecalis, A. veronii, A. caviae, and V. alginolyticus) were identified and isolated from water samples. BLAST analysis of water bacterial isolates displayed a 100% similarity score with relevant fish isolates, indicating that the water was the likely source of infections. Histopathological examination revealed signs of bacterial infection in both fish species. In addition, common circulatory and degenerative changes with melanophore aggregation, and lymphocytic depletion in hematopoietic organs were recorded.

Streptococcus, Centrocestus formosanus and Myxobolus tilapiae concurrent infections in farmed Nile tilapia (Oreochromis niloticus).

Stress triggered concurrent microbial/parasitic infections are prevalent in earthen pond based farmed Nile tilapia Oreochromis niloticus. In the current study, a total of thirty five O. niloticus were collected from a commercial fish farm with a history of severe mortalities at Port Said, Egypt. Nile tilapia samples were subjected to bacteriological, parasitological and pathological examinations. Twenty one Enterococcus fecalis and 15 Streptococcus agalactiae isolates were presumptively identified utilizing the semi-automated API 20 Strept test kit. The identities of the retrieved bacteria were confirmed by the sequencing of 16 S rRNA gene. Moribund O. niloticus were found to be heavily infected by one or both of Centrocestus formosanus encysted metacercariae (EMC) and/or Myxobolus tilapiae spores presenting a unique form of synergistic and/or symbiotic relationship. The identities of both parasites were confirmed through morphological and molecular characterization. Variable circulatory, degenerative, necrotic and proliferative changes were also noticed in hematopoietic organs. Interestingly, multiple myxobolus spores and EMC were noticed in some histological sections. It was obvious that the current concurrent bacterial and parasitic infections are triggered by the deleterious effects of some stressing environmental conditions. The unfavorable climatic conditions (high temperature and high relative humidity) recorded at the surge of mortalities are probable predisposing stress factors.

Workplace Violence Among Healthcare Workers in a Tertiary Medical City in Riyadh: A Cross-Sectional Study.

Introduction Workplace violence is a common problem that is encountered by healthcare workers worldwide; however, it is still under-studied in Saudi Arabia. This study aims to determine the prevalence of workplace violence and to explore reasons for not reporting it among healthcare workers in a tertiary medical city in Riyadh. Methods This cross-sectional study was conducted among 404 healthcare workers who had direct contact with patients or their relatives in a tertiary care medical city in Riyadh, Saudi Arabia. Data were analyzed using Statistical Analysis Software Package (SPSS; IBM, Armonk, NY, USA). Results Most participants (81.4%) had experienced verbal, physical, academic, or sexual violence. Approximately 39.6% of those who experienced workplace violence did not report the incident, and the most common reason for not reporting was identified as "reporting would not accomplish anything" (49.4%). About 27.5% of violence victims did not know how to report the incidents. Patients or their relatives were the main sources of violence across all violence categories except academic violence, in which consultant physicians were the main source. Conclusions The prevalence of workplace violence in the population studied was higher than anticipated compared to similar studies both in Saudi Arabia and globally. Almost half of those who were subjected to violence did not report the incident, believing that reporting would not change anything. There is arguably an urgent need to develop strategies that reduce workplace violence and facilitate reporting it in hospitals. Moreover, awareness programs regarding the negative impacts of violence against healthcare workers on the quality of care are necessary.

Morphomolecular and pathological study of Scaphanocephalus sp. in new host Siganus argenteus in the Arabian Gulf.

In this study, Scaphanocephalus parasite (Platyhelminthes: Heterophyidae) metacercariae were found in Siganus argenteus (forktail rabbitfish or streamlined spinefoot) in the Arabian Gulf of Jubail province, Saudi Arabia. The findings may constitute new host and locality records for this parasite. Based on the number of black spots containing parasite cysts per fish, our study indicated that Siganus argenteus had high infection intensities of encysted metacercariae belonging to the genus Scaphanocephalus. Of the 3500 S. argenteus specimens examined, 800 (22.9%) showed multiple black cysts over the entire body surface, including the membranous parts of fins, while none were seen on the internal organs. The prevalence of infection was highest in summer (June-August) (8.8%). The excysted metacercariae differed morphologically from previously identified Scaphanocephalus spp. Molecular analysis of rDNA showed 100% identity with an unnamed Scaphanocephalus sp. reported in Caribbean fish. Therefore, our findings may indicate a new species of this previously rarely recorded fish parasite. The histopathological examination revealed that the encysted parasites were restricted to the dermal layer of the skin and surrounded by melanophores and a fibrous connective tissue capsule, with focal myositis and Zenker's necrosis in the underlying muscle tissue. The characteristically 'winged' parasite was clearly observed within the cysts. The high prevalence of Scaphanocephalus infection in siganid fish we detected requires further epidemiological study.

Knowledge and awareness of parents in the Kingdom of Saudi Arabia regarding unintentional home injuries in children 2019 a descriptive cross-sectional study.

AIM: To evaluate the adherence of parent's preventive measures of unintentional home injury in their children by measuring the parents' knowledge and awareness regarding the risk factors of unintentional home injury. SETTINGS AND DESIGN: An online questionnaire was used. The study followed a descriptive cross-sectional design. METHOD AND MATERIALS: The study was conducted between December 2019 and January 2020 included 324 participants who fulfilled the criteria during the period. An appropriate statistical test was used to register the statistical significance between the participants' answers and demographic characteristics. STATISTICAL ANALYSIS: SPSS 20.0 software package was used for entering the collected data and for statistical analysis. RESULTS: Descriptive statistics showed that (66%) of participants were female. At least 50% of the participants were aged 26-35 years and had a bachelor's degree. Most reported at a good level of practice against the risk factors of unintentional home injury. The correlation between the participants' level of practice against the unintentional home injury, their age, and their level of education was statistically significant. CONCLUSIONS: The results showed the level of practice against unintentional home injury was significantly higher in parents their age more than forty, and those with a high educational level. This result suggested that nationwide health programs and initiatives must be toward families and parents in assessing their home hazards.