Pulmonary matrix-derived hydrogels from patients with idiopathic pulmonary fibrosis induce a proinflammatory state in lung fibroblasts in vitro.

Idiopathic pulmonary fibrosis (IPF), one of the most common forms of interstitial lung disease, is a poorly understood, chronic, and often fatal fibroproliferative condition with only two FDA-approved medications. Understanding the pathobiology of the fibroblast in IPF is critical to evaluating and discovering novel therapeutics. Using a decellularized lung matrix derived from patients with IPF, we generate three-dimensional hydrogels as in vitro models of lung physiology and characterize the phenotype of fibroblasts seeded into the hydrogels. When cultured in IPF extracellular matrix hydrogels, IPF fibroblasts display differential contractility compared with their normal counterparts, lose the classical myofibroblast marker α-smooth muscle actin, and increase expression of proinflammatory cytokines compared with fibroblasts seeded two-dimensionally on tissue culture dishes. We validate this proinflammatory state in fibroblast-conditioned media studies with monocytes and monocyte-derived macrophages. These findings add to a growing understanding of the lung microenvironment effect on fibroblast phenotypes, shed light on the potential role of fibroblasts as immune signaling hubs during lung fibrosis, and suggest intervention in fibroblast-immune cell cross-talk as a possible novel therapeutic avenue.

COVID-19 infections among health care workers at a university hospital in Jeddah, Saudi Arabia.

BACKGROUND: The objective of this study was to describe the prevalence, characteristics, and risk factors of coronavirus disease-2019 (COVID-19) infection among health care workers (HCWs) at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. METHODS: A prospective cross-sectional study of HCWs confirmed to have COVID-19 infection from March 1, 2020 to December 31, 2022. RESULTS: A total of 746 HCWs were diagnosed with COVID-19. Patients' age ranged from 22 to 60 years with a mean ± standard deviation of 37.4 ± 8.7 years. The infection was community-acquired in 584 (78.3%) HCWs. The vast majority (82.6%) of the infected HCWs had no comorbidities. Nurses (400/746 or 53.6%) represented the largest professional group, followed by physicians (128/746 or 17.2%), administrative staff (125/746 or 16.8%), respiratory therapists (54/746 or 7.2%), and physiotherapists (39/746 or 5.2%). Symptoms included fever (64.1%), cough (55.6%), sore throat (44.6%), headache (22.9%), runny nose (19.6%), shortness of breath (19.0%), fatigue (12.7%), body aches (11.4%), diarrhea (10.9%), vomiting (4.4%), and abdominal pain (2.8%). Most (647 or 86.7%) patients were managed as outpatients. Four (0.5%) HCWs died. CONCLUSIONS: HCWs face a dual risk of SARS-CoV-2 infection, both from community exposure and within the hospital setting. Comprehensive infection control strategies are needed to protect HCWs both inside and outside the hospital environment.

The impact of nicotine smoking on spondyloarthritis and rheumatoid arthritis.

OBJECTIVE: Nicotine has major side effects on human health through numerous mechanisms, one of which is the alteration of the immune system and its genetic components. Such alteration can be a predisposing factor for autoimmune diseases such as spondyloarthritis (SpA) and rheumatoid arthritis (RA). This review aims to shed light on the effects of nicotine smoking on the pathophysiology, clinical presentation, and management of SpA and RA. METHODS: This review looked into the studies, excluding case reports and series, which were cited by PubMed/MEDLINE. RESULTS: Patients with established autoimmune conditions may have a different underlying pathophysiology and disease course when exposed to nicotine through cigarette smoking. Through the involvement of several cytokines, endothelial dysfunction, and epigenetic mechanisms, the severity of SpA is more prominent in smokers. The global health status, pain, and fatigue are worse in SpA patients. The evidence on the effect of nicotine smoking on the treatment of SpA is still limited. Nicotine can contribute to RA via the disruption of cellular regulatory activity, inflammatory responses, morphological, physiological, biochemical, and enzymatic responses. As such, smokers with RA have higher disease activity and are more likely to be seropositive through the citrullination of peptides. In addition, these patients are at risk of achieving a suboptimal response to tumor necrosis factor inhibitors. CONCLUSIONS: Cigarette smoking can substantially affect the pathophysiology and clinical presentation of patients with SpA and RA. The impact of nicotine on the management of these diseases still needs to be further studied.

The clinical assessment of changes in bone density in rheumatoid arthritis patients': Role of DEXA scan and bone turnover biomarkers.

In addition to generalised of bone loss and a higher fracture risk, rheumatoid arthritis (RA) causes periarticular bone erosions. Improvements in bone density/erosion and turnover may not go hand in hand with a positive clinical response to biological anti-inflammatory drugs assesed by disease activity score 28 (DAS28) in RA patients. This study aimed to understand how biologic anti-inflammatory drugs affect bone density, erosion, and turnover in RA patients. We examined bone mineral density (BMD) and bone turnover biomarkers. The study population consisted of 62 RA patients, 49 (79%) of whom were female and 13 (21%) of whom were male. The patients ranged in age from 40 to 79 years old. The patients' BMD was measured using a DEXA scan, and their plasma levels of bone turnover biomarkers CTX and osteocalcin were quantified utilizing an ELISA. BMD of the hip and lumbar spine in responder patients rose after therapy by 0.001g/cm2 (0.11 percent, p0.001 vs. before treatment) and 0.0396g/cm2 (3.96 percent, p0.001 vs. before treatment), respectively. Clinically non-responder patients' DAS28 revealed minor reductions in hip BMD values of -0.008g/cm2 (-0.78 percent, p0.001 vs. before therapy), as well as an improvement in lumbar spine BMD of 0.03g/cm2 (3.03 percent, p0.001 vs. before treatment). After 12 weeks of therapy, the CTX levels in responder patients dropped from 164 125 pg/ml to 131 129 pg/ml. Osteocalcin levels in non-responder patients increased substantially from 11.6 ng/ml to 14.9 ng/ml after 12 weeks of therapy compared to baseline (p = 0.01). Treatment with biologic anti-inflammatory medicines decreases widespread bone loss in RA patients' hip and lumbar spine. The beneficial effects of therapy on BMD were not associated with changes in disease activity of RA patients. Changes in plasma levels of bone turnover biomarkers such as sCTX and osteocalcin confirmed the treatment's beneficial effects.

A state-of-the-art review of the recent advances in exosome isolation and detection methods in viral infection.

Proteins, RNA, DNA, lipids, and carbohydrates are only some of the molecular components found in exosomes released by tumor cells. They play an essential role in healthy and diseased cells as messengers of short- and long-distance intercellular communication. However, since exosomes are released by every kind of cell and may be found in blood and other bodily fluids, they may one day serve as biomarkers for a wide range of disorders. In many pathological conditions, including cancer, inflammation, and infection, they play a role. It has been shown that the biogenesis of exosomes is analogous to that of viruses and that the exosomal cargo plays an essential role in the propagation, dissemination, and infection of several viruses. Bidirectional modulation of the immune response is achieved by the ability of exosomes associated with viruses to facilitate immunological escape and stimulate the body's antiviral immune response. Recently, exosomes have received a lot of interest due to their potential therapeutic use as biomarkers for viral infections such as human immunodeficiency virus (HIV), Hepatitis B virus (HBV), Hepatitis C virus (HCV), Epstein-Barr virus (EBV), and SARS-CoV-2. This article discusses the purification procedures and detection techniques for exosomes and examines the research on exosomes as a biomarker of viral infection.

Entangled-Based Quantum Wavelength-Division-Multiplexing and Multiple-Access Networks.

This paper investigates the mathematical model of the quantum wavelength-division-multiplexing (WDM) network based on the entanglement distribution with the least required wavelengths and passive devices. By adequately utilizing wavelength multiplexers, demultiplexers, and star couplers, N wavelengths are enough to distribute the entanglement among each pair of N users. Moreover, the number of devices employed is reduced by substituting a waveguide grating router for multiplexers and demultiplexers. Furthermore, this study examines implementing the BBM92 quantum key distribution in an entangled-based quantum WDM network. The proposed scheme in this paper may be applied to potential applications such as teleportation in entangled-based quantum WDM networks.

Home infusion services in Saudi Arabia: Where are we standing?

Diseases management has reached the highest level of complexity and cost in history, worldwide, and in Saudi Arabia in particular, which led to prolonged, unnecessary hospital stays. There have been many recent innovative measures to reduce these issues. One is to provide home infusion services. Hence, this narrative review emphasizes the expected benefits and challenges of such services and the applicability of their implementation in Saudi Arabia. A literature search was conducted via PubMed database, involving all published studies from inception until March 24th, 2023. Many studies showed positive impacts of home infusion on reducing the length of hospital stays, increasing cost-saving, and leading to high patient satisfaction.

BRCA1-specific machine learning model predicts variant pathogenicity with high accuracy.

Identification of novel BRCA1 variants outpaces their clinical annotation which highlights the importance of developing accurate computational methods for risk assessment. Therefore our aim was to develop a BRCA1-specific machine learning model to predict the pathogenicity of all types of BRCA1 variants and to apply this model and our previous BRCA2-specific model to assess BRCA variants of uncertain significance (VUS) among Qatari patients with breast cancer. We developed an XGBoost model that utilizes variant information such as position frequency and consequence as well as prediction scores from numerous in silico tools. We trained and tested the model with BRCA1 variants that were reviewed and classified by the Evidence-Based Network for the Interpretation of Germline Mutant Alleles (ENIGMA) consortium. In addition we tested the model's performance on an independent set of missense variants of uncertain significance with experimentally determined functional scores. The model performed excellently in predicting the pathogenicity of ENIGMA-classified variants (accuracy: 99.9%) and in predicting the functional consequence of the independent set of missense variants (accuracy: 93.4%). Moreover it predicted 2 115 potentially pathogenic variants among the 31 058 unreviewed BRCA1 variants in the BRCA exchange database. Using two BRCA-specific models we did not identify any pathogenic BRCA1 variants among those found in patients in Qatar but predicted four potentially pathogenic BRCA2 variants, which could be prioritized for functional validation.

Antibiofilm Activity of 3D-Printed Nanocomposite Resin: Impact of ZrO2 Nanoparticles.

Poly(methyl methacrylate) (PMMA) is a commonly used material, as it is biocompatible and relatively cheap. However, its mechanical properties and weak antibiofilm activity are major concerns. With the development of new technology, 3D-printed resins are emerging as replacements for PMMA. Few studies have investigated the antibiofilm activity of 3D-printed resins. Therefore, this study aimed to investigate the antibiofilm activity and surface roughness of a 3D-printed denture base resin modified with different concentrations of zirconium dioxide nanoparticles (ZrO2 NPs). A total of 60 resin disc specimens (15 × 2 mm) were fabricated and divided into six groups (n = 10). The groups comprised a heat-polymerized resin (PMMA) group, an unmodified 3D-printed resin (NextDent) group, and four 3D-printed resin groups that were modified with ZrO2 NPs at various concentrations (0.5 wt%, 1 wt%, 3 wt%, and 5 wt%). All specimens were polished using a conventional method and then placed in a thermocycler machine for 5000 cycles. Surface roughness (Ra, µm) was measured using a non-contact profilometer. The adhesion of Candida albicans (C. albicans) was measured using a fungal adhesion assay that consisted of a colony forming unit assay and a cell proliferation assay. The data were analyzed using Shapiro-Wilk and Kruskal-Wallis tests. A Mann-Whitney U test was used for pairwise comparison, and p-values of less than 0.05 were considered statistically significant. The lowest Ra value (0.88 ± 0.087 µm) was recorded for the PMMA group. In comparison to the PMMA group, the 3% ZrO2 NPs 3D-printed group showed a significant increase in Ra (p < 0.025). For the 3D-printed resins, significant differences were found between the groups with 0% vs. 3% ZrO2 NPs and 3% vs. 5% ZrO2 NPs (p < 0.025). The highest Ra value (0.96 ± 0.06 µm) was recorded for the 3% ZrO2 NPs group, and the lowest Ra values (0.91 ± 0.03 µm) were recorded for the 0.5% and 5% ZrO2 NPs groups. In terms of antifungal activity, the cell proliferation assay showed a significant decrease in the C. albicans count for the 0.5% ZrO2 NPs group when compared with PMMA and all other groups of 3D-printed resins. The group with the lowest concentration of ZrO2 NPs (0.5%) showed the lowest level of C. albicans adhesion of all the tested groups and showed the lowest Candida count (0.29 ± 0.03). The addition of ZrO2 NPs in low concentrations did not affect the surface roughness of the 3D-printed resins. These 3D-printed resins with low concentrations of nanocomposites could be used as possible materials for the prevention and treatment of denture stomatitis, due to their antibiofilm activities.

The Osteogenic Role of Biomaterials Combined with Human-Derived Dental Stem Cells in Bone Tissue Regeneration.

The use of stem cells in regenerative medicine had great potential for clinical applications. However, cell delivery strategies have critical importance in stimulating the differentiation of stem cells and enhancing their potential to regenerate damaged tissues. Different strategies have been used to investigate the osteogenic potential of dental stem cells in conjunction with biomaterials through in vitro and in vivo studies. Osteogenesis has a broad implication in regenerative medicine, particularly for maxillofacial defects. This review summarizes some of the most recent developments in the field of tissue engineering using dental stem cells.

Comparison of bone mineral density changes between male and female osteoporosis patients using dual energy X-ray absorptiometry scan.

The goal of the current research was to define the impact of individual characteristics on the response of osteoporosis patients to bisphosphonate medication, as well as the influence of gender on changes in the bone mineral density (BMD).The DXA scan was used to assess a group of 647 osteoporosis patients (533 females and 114 males) who visited the St Bartholomew's Hospitals and Royal London osteoporosis clinics. All male subjects received statistically substantial increases in BMD relative to baseline values after two years of therapy. When compared to prior therapy, men's BMD of the lumbar spine (LS) and hip joint (HJ) rose by 0.057 g/cm2 (6.9%, p0.001) and 0.021 g/cm2 (2.48 percent, p0.001), respectively.. Female patients had BMD changes of 0.028 g/cm2 (3.58 percent, p0.001 vs. prior therapy) and -0.006 g/cm2 (-0.78 percent, p0.001 vs. before treatment) in the lumbar spine and hip, respectively. Male patients exhibited a greater increase in BMD than female patients due to ovarian failure and significant oestrogen loss, which speeds up bone resorption by 90% following menopause, according the research findings.

Tactics of the tobacco industry in an Arab nation: a review of tobacco documents in Oman.

BACKGROUND: Few studies have investigated tobacco industry interference in the tobacco control policies of Arab nations. This paper explores the tactics used by the industry to subvert tobacco control policies in Oman and offers lessons on how to prevent such interference in the future. METHODS: We searched the Truth Tobacco Industry Documents Archive using the word 'Oman', names of government institutions, policymakers and local tobacco distributors. Extracted data were noted chronologically by key elements of tobacco control measures. Gulf Cooperation Council (GCC) Health Ministers' Council resolutions on tobacco control were also reviewed. RESULTS: Out of 1020 tobacco documents located, 327 were closely related to policy interference. Documents revealed that the industry met key government officials, offered in-kind services, used local diplomatic missions to influence Omani policymakers, opposed smoking bans, delayed regulations to lower tar and nicotine content of cigarettes, and to require effective health warnings, circumvented a tobacco advertising, promotion and sponsorship ban and provided voluntary codes as an alternative to effective regulations. Additionally, industry representatives lobbied individual countries in the GCC to veto tax increments and defeat consensus on agreed resolutions of the Health Ministers' Council. CONCLUSION: The tobacco industry interfered in all key public health policies aimed to reduce tobacco use in Oman. There is an urgent need for the Omani government to enforce the Civil Code of Conduct and develop guidelines for all policymakers through implementing Article 5.3 of the WHO Framework Convention on Tobacco Control to curb the tobacco epidemic.

The Osteogenic Role of Biomaterials Combined with HumanDerived Dental Stem Cells in Bone Tissue Regeneration

The use of stem cells in regenerative medicine had great potential for clinical applications. However, cell delivery strategies have critical importance in stimulating the differentiation of stem cells and enhancing their potential to regenerate damaged tissues. Different strategies have been used to investigate the osteogenic potential of dental stem cells in conjunction with biomaterials through in vitro and in vivo studies. Osteogenesis has a broad implication in regenerative medicine, particularly for maxillofacial defects. This review summarizes some of the most recent developments in the field of tissue engineering using dental stem cells.

Influence of ZrO2 Nanoparticle Addition on the Optical Properties of Denture Base Materials Fabricated Using Additive Technologies.

This study investigated the translucency of 3D-printed denture base resins modified with zirconium dioxide nanoparticles (ZrO2NPs) under thermal cycling. A total of 110 specimens were fabricated and divided into 3 groups according to the materials, i.e., heat-polymerized resin, and 3D-printed resins (NextDent, and ASIGA). The 3D-printed resins were modified with 0, 0.5, 1, 3, and 5 wt.% of ZrO2NPs. All the specimens were subjected to 5000 thermal cycles. The translucency was measured using a spectrophotometer. The results showed that the heat-polymerized resin had considerably higher translucency than the 3D-printed resins. Compared to the unmodified group, the translucency decreased significantly after adding 5% ZrO2NPs to NextDent and 3% ZrO2NPs to ASIGA resins. The highest translucency was achieved for NextDent by adding 0.5% ZrO2NPs and for ASIGA without any ZrO2NPs. It was found that the average concentration level in ASIGA was significantly higher than that in NextDent. These findings revealed that 3D-printed resins have lower translucency than heat-polymerized acrylic resin, and adding ZrO2NPs at low concentrations did not affect the translucency of the 3D-printed resins. Therefore, in terms of translucency, 3D-printed nanocomposite denture base resins could be considered for clinical applications when ZrO2NPs are added at low concentrations.

Peritoneal Tuberculosis Mimicking Peritoneal Carcinomatosis in an Immunocompetent Patient.

Peritoneal tuberculosis (TB) is a rare disease among the general population that can be seen in patients with associated immunocompromised conditions such as diabetes mellitus, human immunodeficiency virus (HIV)-positive patients, patients with liver cirrhosis, patients on peritoneal dialysis, and patients on treatment with anti-tumor necrosis factor (TNF) agents. Patients who already have active pulmonary TB and who are not treated promptly can develop disseminated disease within the lungs or can affect extrapulmonary organ systems such as the nervous system, gastrointestinal system, or urinary system. It is unusual to see an otherwise healthy person develop peritoneal TB as a first-time diagnosis, without any previous exposure to TB or any immunocompromising condition. The diagnosis of this condition can be tricky as the clinical and radiological manifestations of this disease strongly mimic that of malignancy, such as ovarian cancer or peritoneal carcinomatosis. In the majority of cases, the first impression of malignancy is made while examining the radiological images of the abdomen, and only after obtaining the biopsy results, an unexpected diagnosis of peritoneal TB is established. Hence, it is an interesting and uncommon diagnosis, which should always be kept in mind while managing patients with an apparent gynecological malignancy. Here, we report a case of a 65-year-old female patient who presented with a history of abdominal pain and weight loss. Initial investigation with abdominal ultrasonography revealed ascites with multiple sub-centimeter mesenteric lymphadenopathies. She also had an elevated cancer antigen 125 (CA-125), which further raised suspicion of gynecological malignancy. However, following the investigations, it was found that the actual diagnosis was an unexpected one.

Rheumatology research output in the Arab World: despite the challenges.

Rheumatology is a field in which diagnostic, pathophysiological, and therapeutic advancements occur daily. These developments are the result of research in basic sciences, translational sciences, and clinical sciences. Physical and financial support, provided by individuals and institutions, is essential for all types of research. The political and economic instability in the Arab world has impacted the advancement of healthcare and the output of research. This review seeks to evaluate the quantity and quality of rheumatology-related research conducted in the Arab world. This review examined the number of rheumatological clinical publications produced by Arab countries between 2017 and 2021 and cited by PubMed/MEDLINE. Publications with authors from multiple nations were disqualified. Publications were then categorized by type, including randomized controlled trials (RCTs), cohort studies, cross-sectional studies, systematic reviews, narrative reviews, and case reports. Publications were also organized according to the regions of the Arab world: North and East Africa, the Middle East, and the Arabian Peninsula. The review also used data from the world bank to evaluate the gross domestic product (GDP) and total population of Arabian nations in order to calculate a ratio of publications to GDP and publications to population. Egypt had the highest number of publications among north and east African countries and Arab countries in general, with 261 publications, including the highest number of RCTs, which were 23. With 81 publications, Saudi Arabia had the highest number of publications on the Arabian peninsula. However, no individual country on the Arabian peninsula published an RCT. Lebanon had the most publications in the Middle East, but the majority were reviews and case reports. Tunisia had the highest ratio of publications to GDP. Notably, the number of publications increased during the coronavirus disease 2019 era in some countries. The Arab world is still able to produce clinical rheumatology publications despite its political instability and lack of resources. The influence of such publications on the daily practice of rheumatology is still debatable.

Frequency of Interstitial Lung Disease in Rheumatoid Arthritis Patients: A Hospital-Based Study.

INTRODUCTION: Among various extra-articular manifestations of rheumatoid arthritis (RA), interstitial lung disease (ILD) is the most frequent and concerning manifestation. The reported frequency of RA-associated ILD (RA-ILD) varies in the literature. The objective of the present study was to determine the frequency of ILD in RA patients at a teaching hospital in Rawalpindi. METHODS: 175 male and female patients between 18-70 years were enrolled in the study from January 21, 2022, till July 24, 2022. Patients diagnosed with RA were screened for the concomitant presence of ILD (increased pulmonary markings on chest X-rays and total lung capacity ≤ 80%, predicted on pulmonary function tests). In addition, the frequency of RA-ILD was noted and compared across various subgroups of patients based on age, gender, and disease duration. RESULTS: The mean age of the patients was 45.3 ± 11.5 years. The male-to-female ratio was 1:3.1. The mean disease duration was 6.2 ± 3.5 years at the time of presentation. A total of 118 (67.4%) patients were diagnosed with RA-ILD. The frequency of RA-ILD was significantly higher among patients with a prolonged duration of disease, < 5 years vs. ≥ 5 years (59.1% vs. 75.9%; p-value=0.018). Among 118 patients with RA-ILD, usual interstitial pneumonia (UIP) was the most frequent pattern and was noted in 74 (62.7%) patients, followed by nonspecific interstitial pneumonitis (NSIP), which was noted in 44 (37.3%) patients. When compared, there was no statistically significant difference in the frequency of high-resolution CT (HRCT) pattern of RA-ILD across various subgroups of patients based on age (p-value=0.969), gender (p-value=0.934), and duration of disease (p-value=0.881). CONCLUSION: In the present study, a substantial proportion of RA patients suffered RA-ILD, which warrants routine screening of these patients for undiagnosed pulmonary involvement so that timely identification and anticipated management may improve the outcome of such cases in future clinical practice.

The introduction of tobacco excise taxation in the Gulf Cooperation Council Countries: a step in the right direction of advancing public health.

BACKGROUND: The Gulf Cooperation Council (GCC) countries relied, until recently, solely on import duties for tobacco products. The agreement for the introduction of an excise and value added tax (VAT) in 2016 and 2017, respectively, in most GCC countries, was a major breakthrough for public health. There is, however, ample room for improvement. METHODS: The study examines the outcomes of tax reforms, for both public health and public finances, based on the World Health Organization (WHO) recommendations and best practices worldwide. Tax simulations were performed using the WHO TaXSiM model. The study is based on data from Saudi Arabia, the only GCC country for which sufficient data existed. RESULTS: We recommend a stepwise tax reform, which involves increasing the current ad valorem excise tax rate, phasing out import duties keeping total tax share constant and introducing a minimum excise, and finally switching to a revenue-neutral specific excise. Specific excises must be adjusted for inflation and income increases. If implemented, cigarette tax reform simulations show that the recommended reforms would lead to a higher than 50% increase in cigarette prices, 16% reduction in cigarette sales and almost 50% increase in total cigarette tax revenue. A significant number of cigarette-related deaths would be averted. CONCLUSIONS: The recommended tax reforms are expected to lead to significant improvements in both public health and tobacco tax revenues. Our results provide useful insights that are of relevance to the whole GGC region. The effectiveness of the reforms, however, requires a strong tax and customs administration, including the establishment of a good database to monitor and advance public health.

Clinical Profile of Stroke Patients Presenting to the Emergency Department of a Major Stroke Centre in Oman.

Objectives: Stroke is a significant public health problem and one of the most important preventable non-communicable diseases. Preventive stroke programmes with a better focus on increasing awareness among those who are currently at risk are yet to be properly established in Oman. This study was conducted to describe the characteristics of stroke patients presenting to a tertiary care hospital in Oman. Methods: This cross-sectional hospital-based study included 193 stroke cases which were prospectively recruited from the Emergency Department of Khoula Hospital, Muscat, Oman. Data were collected from November 2017 to April 2018. Results: The total number of patients was 193 with 82.9% of strokes being ischaemic strokes. Of this, 58% were male. The mean age of stroke patients was 61.05 years. Risk factors included hypertension (72.5%) and diabetes mellitus (54.4%). Dyslipidaemia, atrial fibrillation and ischaemic heart diseases were not particularly prevalent in the studied population and 24.4% of ischaemic strokes had large artery atherosclerosis while 21.9% had small vessel occlusion. Significantly more patients had lower Glasgow Coma Scale scores, required intensive care unit admission and experienced in-hospital deaths due to haemorrhagic stroke compared to ischaemic stroke. Conclusion: This study provides essential data regarding stroke characteristics specific to Oman's population. Most of the information obtained appears to be in-line with what has been described internationally and, hence, preventive strategies similar to those indicated in extant literature can be implemented. This information can be utilised by health administrators in planning resource allocation. Further research is needed to explore rehabilitation aspects and long-term outcomes.

Validation of the Arabic Version of the Movement Disorder Society-Unified Parkinson's Disease Rating Scale.

BACKGROUND: The Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has become the gold standard for evaluating different domains in Parkinson's disease (PD), and it is commonly used in clinical practice, research, and clinical trials. OBJECTIVES: The objectives are to validate the Arabic-translated version of the MDS-UPDRS and to assess its factor structure compared with the English version. METHODS: The study was carried out in three phases: first, the English version of the MDS-UPDRS was translated into Arabic and subsequently back-translated into English by independent translation team; second, cognitive pretesting of selected items was performed; third, the Arabic version was tested in over 400 native Arabic-speaking PD patients. The psychometric properties of the translated version were analyzed using confirmatory factor analysis (CFA) as well as exploratory factor analysis (EFA). RESULTS: The factor structure of the Arabic version was consistent with that of the English version based on the high CFIs for all four parts of the MDS-UPDRS in the CFA (CFI ≥0.90), confirming its suitability for use in Arabic. CONCLUSIONS: The Arabic version of the MDS-UPDRS has good construct validity in Arabic-speaking patients with PD and has been thereby designated as an official MDS-UPDRS version. The data collection methodology among Arabic-speaking countries across two continents of Asia and Africa provides a roadmap for validating additional MDS rating scale initiatives and is strong evidence that underserved regions can be energically mobilized to promote efforts that apply to better clinical care, education, and research for PD. © 2022 International Parkinson and Movement Disorder Society.