Knowledge, attitudes, and practices related to dietary salt among older adults in Abha, Saudi Arabia.

The need to foster successful aging has intensified with the aging of the global population. This study aimed to assess the knowledge, attitudes, and practices (KAP) concerning dietary salt consumption and to investigate the correlations between sociodemographic variables and salt-related KAP. A structured interview was administered to a cohort of 200 older adults in Abha City, Saudi Arabia, recruited through a convenience sampling approach. The evaluation of salt-related KAP revealed widespread low knowledge (91.5%) as participants scored less than 3, negative attitudes (85.5%) scored less than 12, and predominantly unsatisfactory practices (69.5%) with scores less than 26. Noteworthy differences emerged between participants with poor overall KAP (81.5%) and those with good KAP (18.5%). Significantly weak negative correlations were found between age (r=-0.212), marital status (-0.236), and body mass index (-0.243) with overall KAP. Further examination revealed a significantly weak positive correlation between attitude and practice (r = 0.141). KAP scores show a highly significant positive correlation with overall KAP scores (r = 0.169, 0.352, 0.969). The uncovered correlations contribute to a valuable understanding of the complex dynamics surrounding salt-related KAP. This understanding guides the design of targeted interventions, such as health education programs, promoting successful aging and public health outcomes.

Gestational diabetes mellitus, hypertension, and dyslipidemia as the risk factors of preeclampsia.

Gestational diabetes mellitus (GDM) is a known risk factor for gestational hypertension which further progress toward conditions like proteinuria, dyslipidemia, thrombocytopenia, pulmonary edema leading to Preeclampsia (PE). Pregnancy can be a challenging time for many women, especially those diagnosed with GDM and PE. Thus, the current prospective study investigates the association of OGTT glucose levels with systolic and diastolic blood pressure and lipid profile parameters in pregnant women diagnosed with GDM and PE. A total of 140 pregnant women were stratified into GDM (n = 50), PE (n = 40) and controls (n = 50). Two hour 75 g oral glucose tolerance test (OGTT) was performed for screening GDM. Biochemical parameters analysis of OGTT, total cholesterol (TC), triglyceride (Tg), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), urinary albumin and creatinine were tested to find urinary albumin creatinine ratio (uACR). Statistical analysis was performed using ANOVA followed by post hoc test and regression analysis. Among the studied groups, GDM and PE groups showed no significant difference in age and increased BMI. Increased 2 h OGTT & TC in GDM group; elevated uACR, systolic/diastolic blood pressure, Tg, HDL-C, LDL-C in PE group was observed and differ significantly (p < 0.0001) with other groups. A significant positive effect of 2 h OGTT was observed on blood pressure (R2: GDM = 0.85, PE = 0.71) and lipid profile determinants (R2: GDM = 0.85, PE = 0.33) at p < 0.0001. The current study concludes that glucose intolerance during the later weeks of pregnancy is associated with gestational hypertension and hyperlipidemia as a risk factor for PE. Further research is needed for a detailed assessment of maternal glucose metabolism at various pregnancy stages, including the use of more sensitive markers such as C-peptide and their relation to pregnancy-related hypertensive disorders.

Association of Academic Stress, Acne Symptoms and Other Physical Symptoms in Medical Students of King Khalid University.

Academic stress has varied effects on medical student life due to multiple factors, like study load, competition, frequent assessment, social pressure, etc. The authors of this paper conducted research to find the academic stress level and its sequel over acne and other physical symptoms on the medical students of King Khalid University (KKU), Saudi Arabia. A total of 168 participant responses were analyzed. Data collection was performed using a self-administered online questionnaire through the university website portal. The study tool was comprised of four sections: demographic characteristics, academic stress, acne symptoms, and other physical symptoms. Statistical analysis was performed using SPSS software. A high proportion of females (88.7%) participated in the study. Upon categorization of overall academic stress, it was found that a majority of the medical students were moderately stressed (58.34%). The response on the academic stress scale revealed that exams are the major cause of stress among students. The Mean ± SD of academic stress, acne symptoms, and physical symptoms differ significantly at <0.01 level of significance. Overall academic stress showed a significant positive association with acne (<0.01) and physical symptoms (<0.01). The strength of this study is the fact that its categorization of stress caused by academics has not been done elsewhere. In addition, the impact of acne and physical symptoms has not been found in recent literature. Keeping the outcome of the present study in mind, it is suggested to arrange timely counselling sessions in medical colleges which can alert medical students to remain conscious about the consequences of stress.

Association of BMI, Physical Activity with Academic Performance among Female Students of Health Colleges of King Khalid University, Saudi Arabia.

Body mass index (BMI) is an indicator to detect weight category and known to influence the academic achievements of students. The present study assesses the association of BMI, physical activity with academic performance among undergraduate female students of health colleges, King Khalid University (KKU). Responses from 379 participants were analyzed in the study. Data collection was done by administering an online questionnaire using the university website portal. The questionnaire consists of two sections: the first section includes demographic information along with cumulative Grade point average (GPA) and another section rated student's physical activity. A high frequency of respondents (53.6%) ranged within the normal BMI category. For academic performance, the majority (79.9%) of students reported high GPA scores with a mean of 4.28 ± 0.41. Upon correlation, academic performance was found negatively correlated with BMI at 0.0001 level of significance, and insignificantly correlated with physical activity. The present study observed that more than half of the respondents had normal BMI. An inverse relationship was observed between BMI and academic performance, showing participants within the normal BMI category achieved significantly higher GPA. In contrast, physical activity directly influenced the academic performance of the subjects. Therefore, the study suggests to enact counselling centers, health clubs in universities urging the students to adopt regular exercise and healthy lifestyle which could prepare them in achieving future endeavors.

Increased IL-23R+ Th Cells Population Exhibits Higher SLEDAI-2K Scores in Systemic Lupus Erythematosus Patients.

The IL-23/IL-17 axis plays causative roles in the development and progression of systemic lupus erythematosus (SLE). However, it remains unclear if the IL-17RA+ and IL-23R+ T helper (Th) cells populations are associated with the serum IL-17 and IL-23 levels, or with the immunological parameters and disease activities in SLE patients. Herein, we examined the proportion of IL-17RA+ and IL-23R+ Th cells and serum levels of IL-17 and IL-23 in established SLE patients (n = 50) compared with healthy controls (n = 50). The associations of these interleukins and their receptors with immunological parameters [anti-nuclear antibody (ANA), anti-dsDNA antibody, and C-reactive protein (CRP)] and SLE disease activity (SLEDAI-2K scores) in SLE patients were assessed. CD3+CD4+ Th cells of SLE patients demonstrated significantly elevated IL-17RA+ (p = 1.12 x 10-4) or IL-23R+ (p = 1.98 x 10-29) populations compared with the healthy controls. Serum IL-17 levels were significantly lower in SLE patients compared with the healthy controls (p = 8.32 x 10-5), while no significant difference was observed for the IL-23 serum levels between both groups. IL-23R+ Th cells population was significantly associated with higher SLEDAI-2K scores (p = 0.017). In multivariate analysis, the proportion of IL-23R+ Th cells remained significantly associated with higher SLEDAI-2K scores independent of prednisolone intake (p = 0.027). No associations were observed between the interleukin parameters (i.e., IL-17, IL-23, IL-17RA+ Th cells, and IL-23R+ Th cells) with ANA, anti-dsDNA, and CRP status, suggesting that the IL-17/IL-23 axis acts independently of these immunological parameters. In conclusion, our results support that therapeutic inhibition of the IL-23/IL-17 axis receptors on Th cells, particularly IL-23R, is potentially relevant in SLE patients.

Effects of Hybridized Synthetic Fibers on the Shear Properties of Cement Composites.

The use of fibers in cementitious composites yields numerous benefits due to their fiber-bridging capabilities in resisting cracks. Therefore, this study aimed to improve the shear-resisting capabilities of conventional concrete through the hybridization of multiple synthetic fibers, specifically on reinforced concrete structures in seismic-prone regions. For this study, 16 hybrid fiber-reinforced concretes (HyFRC) were developed from the different combinations of Ferro macro-synthetic fibers with the Ultra-Net, Super-Net, Econo-Net, and Nylo-Mono microfibers. These hybrids were tested under direct shear, resulting in improved shear strength of controlled specimens by Ferro-Ultra (32%), Ferro-Super (24%), Ferro-Econo (44%), and Ferro-Nylo (24%). Shear energy was further assessed to comprehend the effectiveness of the fiber interactions according to the mechanical properties, dosage, bonding power, manufactured material, and form of fibers. Conclusively, all fiber combinations used in this study produced positive synergistic effects under direct shear at large crack deformations.

Knowledge, attitudes and practices among people in Saudi Arabia regarding COVID-19: A cross-sectional study.

Background: The general population's compliance with preventive measures and legislation is mainly influenced by their knowledge level, attitude, and practices. This study assessed the knowledge, attitude, and practices of public residents towards corona virus disease-2019 preventive measures in Saudi Arabia. Design and Methods: This is a cross-sectional study; it used a validated cross-sectional online survey that received responses from 13 Saudi administrative regions. Results: There were 1513 participants who completed the study (55% females; 77.7%, university education). Knowledge level, attitude, and practices towards corona virus disease-2019 were 81.3%, 86.6%, and 81.9%, respectively. The knowledge subscales showed that 1496 (98.9%) participants knew the system targeted by the virus, 96.2% and 97.3% knew the causative agent and symptoms, 783 (52.2%) participants knew the transmission modes, and 696 (46.0%) participants knew about the complications. The attitude subscales included 1465 (96.5%) participants who had dealt with an infected person, 1451 (95.9%) participants who isolated in a health facility, 1195 (97.0%) participants who knew about hand washing, and 1387 (91.7%) participants who thought the virus spread through home delivery. The practice subscales included 1505 (99.5%) participants who properly disposed of gloves and tissues and 1347 (89.0%) participants who reported safe practices when coughing or sneezing. Conclusions: This study showed satisfactory knowledge, attitude, and practice towards corona virus disease-2019 in Saudi Arabia. The educational level is a dominant influencing factor for knowledge, attitude, and practice.

Dietary assessment and its awareness in female students from different Health Departments: unhealthy diet with normal BMI.

Background: Dietary habits are of substantial concern related to the health of college students. Medical students are expected to have better dietary habits and healthy lifestyle, but due to various factors they are least bothered to follow recommended healthy diet. The present study assessed and compared the eating habits, nutritional awareness and BMI in females from health departments of King Khalid University (KKU), Saudi Arabia. Designs and Methods: The cross-sectional survey was conducted in undergraduate females from eight health departments: Public Health, Nursing, Medical Laboratory Science, Physiotherapy, Medicine and Surgery, Dental and Oral surgery, Diagnostic Radiology and Pharmacy. Participants completed online questionnaire that include demographic, anthropometric information, questions related to food preference and nutritional awareness. BMI, food preferences, and nutritional awareness responses were assessed and compared among different departments at 0.05 and 0.001 level of significance. Results: Total of 377 females were analysed and the mean BMI differ significantly at p<0.05 in all departments reporting the highest BMI mean in medicine and surgery department. Upon further stratification of BMI 53% of total analysed students comes under normal BMI. The utmost frequency of overweight students (55.3%) were observed in physiotherapy with no obese category followed by nursing with least obese students (2.2%). Conclusions: Inadequate food preference with unhealthy dietary habits but satisfactory nutritional awareness was observed in students of all departments with no significant difference. Designing of nutrition promotional programs and motivation is required for the acquisition of healthy dietary habits.

Serum Selenium and Lead Levels: a Possible Link with Diabetes and Associated Proteinuria.

The study assessed trace element selenium (Se) and a heavy metal lead (Pb) in patients with type II diabetes mellitus (T2DM) and its associated proteinuria. Total 275 subjects aged between 30 and 90 years were studied: 93 T2DM, 98 T2DM with proteinuria, and 84 as controls. Serum Se and Pb were analyzed by inductively coupled plasma optical emission spectrometer (ICP-OES) and other biochemical indices by ROCHE module COBAS 6000 analyzer. Statistical analysis was done by one-way analysis of variance (ANOVA) at P < 0.0001 followed by Tukey's honest test. Pearson's correlation coefficient was applied to observe the effects of Se and Pb on FPG and ACR. Decreased Se levels were observed in T2DM and T2DM with proteinuria with no significant difference and serum Pb was found within reference range in both groups. Se showed no significant association with FBG and ACR while mid-upper tertile of Pb was significantly associated with ACR of T2DM with the proteinuria group (P < 0.01). Se is known to have a U-shaped relationship with T2DM. Low Se levels in both groups may be due to the effect of disease and its related inflammation. Detected levels of Pb suggest that studied population had lower exposure to it. Association of Pb with ACR showed consistency with the classical studies that even low levels of Pb may cause the renal deterioration.

Immune-mediated ECM depletion improves tumour perfusion and payload delivery.

High extracellular matrix (ECM) content in solid cancers impairs tumour perfusion and thus access of imaging and therapeutic agents. We have devised a new approach to degrade tumour ECM, which improves uptake of circulating compounds. We target the immune-modulating cytokine, tumour necrosis factor alpha (TNFα), to tumours using a newly discovered peptide ligand referred to as CSG. This peptide binds to laminin-nidogen complexes in the ECM of mouse and human carcinomas with little or no peptide detected in normal tissues, and it selectively delivers a recombinant TNFα-CSG fusion protein to tumour ECM in tumour-bearing mice. Intravenously injected TNFα-CSG triggered robust immune cell infiltration in mouse tumours, particularly in the ECM-rich zones. The immune cell influx was accompanied by extensive ECM degradation, reduction in tumour stiffness, dilation of tumour blood vessels, improved perfusion and greater intratumoral uptake of the contrast agents gadoteridol and iron oxide nanoparticles. Suppressed tumour growth and prolonged survival of tumour-bearing mice were observed. These effects were attainable without the usually severe toxic side effects of TNFα.

Radioactive seed localisation to guide removal of impalpable lymph nodes (radioguided occult lesion localisation using iodine-125 seeds, "ROLLIS").

Two patients with cancer requiring removal of specific impalpable lymph nodes for full pathological analysis underwent ultrasound-guided lesion localisation and marking with a low-activity I-125 seed. A gamma probe was used in theatre to localise the signal from the seed and guide excision. Successful removal of the lesions was confirmed with the probe and by specimen radiography. Radioguided Occult Lesion Localisation using I-125 Seeds ("ROLLIS") provides a method of precisely marking impalpable lesions for surgical excision.

Tumour necrosis factor: implications for surgical patients.

Tumour necrosis factor alpha (TNF-alpha) is an inflammatory cytokine primarily produced by macrophages. It is a unique protein with contradictive properties; it has the ability to induce cellular death by apoptosis and oncosis, but can also induce cellular regeneration and growth. Genetic polymorphisms in TNFA have been associated with poor outcome in some surgical patients and this may provide a useful tool to screen for high-risk patients. Manipulating TNF-alpha levels in vivo may influence the progression of several pathological conditions. TNF-alpha has anti-cancer properties and has been used to treat cancer patients. Treatment with anti-TNF-alpha drugs and antibodies has been successful in rheumatoid arthritis and other autoimmune diseases, but disappointing in the management of patients with sepsis. This review article focuses on the biological activities, genetic polymorphism of TNFA and the role of TNF-alpha and anti-TNF-alpha treatments, based on animal experiments and clinical trials.

Reperfusion injury.

The restoration of blood flow to ischemic tissues causes additional damage, which is termed reperfusion injury. All tissues are susceptible to reperfusion injury, but this susceptibility varies between tissues. Reperfusion has wide clinical relevance. It influences the outcome of patients after myocardial infarction, stroke, organ transplantation, and cardiovascular surgery. Advances in the treatment of reperfusion injury have created an opportunity for plastic surgeons to apply these treatments to flaps and reimplanted tissues. The main putative mechanisms identified in animal models involve leukocyte-endothelium interactions, reactive oxygen species, and the complement system. However, it has become evident that these fundamental biological systems are controlled by many interrelated pathways. Attempts to bypass this complexity have led to a search for the early "upstream" initiating events, rather than the "downstream" cascading events. This contrasts with current clinical efforts that are directed toward hypothermia, intraarterial flushing, and preconditioning. This article outlines the molecular and cellular events that occur during reperfusion injury and then reviews the efforts that have been made to exploit this knowledge for clinical advantage.

Evolution of trends in risk management.

In the past, the detection and response to adverse clinical events were viewed as an inherent part of professionalism; and, if perceived problems were not sorted out at that level, the ultimate expression of dissatisfaction was litigation. There are now demands for the adoption of more transparent and effective processes for risk management. Reviews of surgical practice have highlighted the presence of unacceptable levels of avoidable adverse events. This is being resolved in two ways. First, attention is being directed to the extent that training and experience have on outcomes after surgery, and both appear to be important. Second, a greater appreciation of human factors engineering has promoted a greater involvement of surgeons in processes involving teamwork and non-technical skills. The community wants surgeons who are competent and health-care systems that minimize risk. In recent times attention has been focused on the turmoil associated with change; but, when events are viewed over a period of several decades, there has been considerable progress towards these ideals. Further advancement would be aided by removing the adversarial nature of malpractice systems that have failed to maintain standards.