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.

Gender Differences in Prevalence of Sleepy Driving Among Young Drivers in Saudi Arabia.

Introduction: Sleepy driving is associated with Motor Vehicles Accidents (MVAs). In Saudi Arabia, previous studies have addressed this association among men only. Therefore, the aim of this study was to compare the prevalence of sleepy driving and associated factors between genders. Methods: In a cross-sectional study design, we offered a self-administered online questionnaire to 3272 participants from different regions of Saudi Arabia. The questionnaire included 46 questions covering sociodemographics, driving habits, sleeping habits, Epworth Sleepiness Scale, and Berlin questionnaire to assess the risk of sleep apnea. Univariable and multivariable logistic regression analyses were used to determine the significant factors associated with self-reported sleepy driving, defined as operating a motor vehicle while feeling sleepy in the preceding six months. Results: Of the 3272 invitees, 2958 (90%) completed the questionnaire, of which 1414 (48%) were women. The prevalence of sleepy driving in the preceding six months was 42% (men: 50% and women 32%, p<0.001). Specifically, participants reported the following: 12% had had to stop their vehicle due to sleepiness (men: 16.2% and women 7%, p<0.001), 12.4% reported near-miss accidents (men: 16.2% and women: 8.2%, p<0.001) and 4.2% reported an accident due to sleepiness (men: 4.3% and women: 4%, p=0.645). In multivariable analysis, being male, younger age, use of any type of medications, shift working, working more than 12 hours per day, driving duration of 3-5 hours per day, driving experience of more than 2 years, excessive daytime sleepiness and risk of having obstructive sleep apnea were all associated with increased likelihood of falling asleep while driving in the preceding 6 months. Conclusion: Sleepy driving and MVA are prevalent in both gender but was higher in men. Future public health initiatives should particularly focus on men, since men reported a greater likelihood of both sleep-related MVA and "near miss" events.

COVID-19 booster enhances IgG mediated viral neutralization by human milk in vitro.

Background: Facilitated by the inability to vaccinate, and an immature immune system, COVID-19 remains a leading cause of death among children. Vaccinated lactating mothers produce specific SARS-CoV-2 antibodies in their milk, capable of neutralizing the virus in vitro. Our objective for this study is to assess the effect of COVID-19 booster dose on SARS-CoV-2 antibody concentration and viral neutralization in milk, plasma, and infant stool. Methods: Thirty-nine mothers and 25 infants were enrolled from December 2020 to May 2022. Milk, maternal plasma, and infants' stool were collected at various time-points up to 12 months following mRNA COVID-19 vaccination. A subgroup of 14 mothers received a booster dose. SARS-CoV-2 antibody levels and their neutralization capacities were assessed. Results: Booster vaccination led to significantly higher IgG levels within human milk and breastfed infants' stool. In vitro neutralization of VSV-gfp-SARS-CoV-2-S-gp, a laboratory safe SARS-CoV-2 like pseudovirus, improved following the booster, with a 90% increase in plasma neutralization and a 60% increase in milk neutralization. We found that post-booster neutralization by human milk was highly correlated to SARS-CoV-2 IgG level. In support of our correlation result, Protein G column depletion of IgG in milk yielded a significant reduction in viral neutralization (p = 0.04). Discussion: The substantial increase in neutralizing IgG levels in milk and breastfed infants' stool post-booster, coupled with the decrease in milk neutralization capabilities upon IgG depletion, underscores the efficacy of booster doses in augmenting the immune response against SARS-CoV-2 in human milk.

Enhanced Mucoadhesion of Thiolated ß-Cyclodextrin by S-Protection with 2-Mercaptoethanesulfonic Acid.

This study aimed at designing an S-protected thiolated ß-cyclodextrin (ß-CD) exhibiting enhanced mucoadhesive properties. The native ß-CD was thiolated with phosphorus pentasulfide resulting in a thiolated ß-CD (ß-CD-SH) and subsequently S-protected with 2-mercaptoethanesulfonate (MESNA) to form ß-CD-SS-MESNA. The structure of the novel excipient was confirmed by 1H NMR and Fourier-transform infrared spectroscopy. The sulfhydryl content of ß-CD-SH, determined by Ellman's test, was 2281.00 ± 147 µmol/g, and it was decreased to 45.93 ± 19.40 µmol/g by S-protection. Due to thiolation and S-protection, the viscosity of the mixture of mucus with ß-CD-SH and ß-CD-SS-MESNA increased 1.8 and 4.1-fold, compared to native ß-CD, respectively. The unprotected ß-CD-SH diffused to a lesser extent into the mucus than native ß-CD, while S-protected ß-CD-SS-MESNA showed the highest mucodiffusion among the applied CDs. A 1.5- and 3.0-fold higher cellular uptake of ß-CD-SH and ß-CD-SS-MESNA, compared to the native one, was established on Caco-2 cell line by flow cytometry, respectively, causing slightly decreased cell viability. On account of the enhanced mucoadhesion, this higher cellular uptake does not affect the application potential of ß-CD-SS-MESNA as an oral drug delivery system since the carrier remains in the mucus and does not reach the underlying epithelial layer. According to these results, the S-protection of ß-CD-SH with MESNA promotes improved mucodiffusion, strong mucoadhesion, and prolonged mucosal residence time.

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.

A new (T-X[Formula: see text]) family of distributions: properties, discretization and estimation with applications.

In this paper, a new class of distributions called the T-X[Formula: see text] family of distributions for bounded-(0,1)-and unbounded-[Formula: see text]-supported random variables is suggested. Some special sub-models of the proposed family are utilized. A new sub-model is selected to be studied in details. The statistical properties of the suggested family including quantile function, moments, moment generating function, order statistics and Rényi entropy are discussed. The maximum likelihood method is provided to estimate the parameters of the distribution and a Monte Carlo simulation study is used. The discretized T-X[Formula: see text] family provided many sub-families and sub-models. In addition, eight real data sets are utilized to demonstrate the flexibility of the proposed continuous and discrete family's multiple sub models.

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.

Prevalence of depression among Science students during the COVID-19 pandemic period in Riyadh, Saudi Arabia.

Introduction: The present study aimed to examine the prevalence of depression among science students during the COVID-19 pandemic. Methods: A survey-based study was conducted on 521 science students at Al Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia, using Beck's Depression Inventory (BDI), during the course of the semester. Results: Showed that the Most students were female (62.19%). Sadness symptoms were observed among 59.69% of the students. We found a 77.74% overall prevalence of depression among students. Most individuals reported moderate BDI (25.34%), but extremely severe BDI was also reported in 7.29% of individuals. The BDI scores were highly significantly correlated with gender, education, and field of specialty (< 0.001) based on different statistical tests. BDI scores were significantly associated with number of the demographic and academic variables (p < 0.05). Discussion: The study found significant symptoms of depression among students who displayed characteristics of depression during the COVID-19 pandemic. Therefore, students should undergo psychological counseling during difficult pandemic periods to prevent depression and mental stress.

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.

Not all questions are created equal: the weight of the Oxford Knee Scores questions in a multicentric validation study.

BACKGROUND: The Oxford Knee Score (OKS) has been designed for patients with knee osteoarthritis and has a widespread use. It has 12 questions, with each question having the same weight for the overall score. Some authors have observed a significant ceiling effect, especially when distinguishing slight postoperative differences. We hypothesized that each questions' weight will depend significantly on the patient's sociodemographic data and lifestyle. METHODS: In this international multicentric prospective study, we included patients attending a specialist outpatient knee clinic. Each patient filled out 3 questionnaires: (a) demographic data and data pertaining to the OKS, (b) the standard OKS, and (c) the patient gave a mark on the weight of the importance of each question, using a 5-point Likert scale (G OKS). Linear regression models were used for the analysis. RESULTS: In total 203 patients (106 female and 97 male) with a mean age of 64.5 (±12.7) years and a mean body mass index (BMI) of 29.34 (±5.45) kg/m2 were included. The most important questions for the patients were the questions for pain, washing, night pain, stability, and walking stairs with a median of 5. In the regression models, age, gender, and driving ability were the most important factors for the weight of each of the question. CONCLUSION: The questions in the OKS differ significantly in weight for each patient, based on sociodemographic data, such as age, self-use of a car, and employment. With these differences, the Oxford Knee Score might be limited as an outcome measure. Adjustment of the OKS that incorporates the demographic differences into the final score might be useful if the ceiling effect is to be mitigated. LEVEL OF EVIDENCE: Level II prospective prognostic study.

Severe soft tissue infection: A complication of mpox in an individual with HIV coinfection requiring vaccinia intravenous immunoglobulin and intravenous tecovirimat.

We highlight a case of a 38-year-old immunocompromised man with untreated human immunodeficiency virus and Hepatitis C who presented with progressive soft tissue infection of the right foot despite appropriate antibiotic therapy. While he was admitted, the patient disclosed a recent diagnosis of mpox treated with oral tecovirimat. He subsequently developed worsening lesions over his entire body. In addition, a polymerase chain reaction of the wound on the right foot was positive for mpox virus, and the patient improved on treatment with intravenous tecovirimat and vaccinia immunoglobulin.

Does bacterial colonization influence ureteral stent-associated morbidity? A prospective study.

Objective: to evaluate the effect of bacterial colonization on ureteral stent-associated morbidity. Methods: This was a prospective study that took place between February 2019 and March 2022. We examined one hundred fifteen patients for ureteric stents application. On the same day of stent removal, the Arabic version of Ureteral Stent Symptoms Questionnaire (USSQ) was used to assess stent-associated morbidity. The stent-associated morbidity and the specificity and sensitivity of culture in the stent and midstream urine were recorded. Results: In 15.6% of the patients stent colonization was positive; E. coli was the most common isolated organism. There was no statistically significant difference between sex, age, irrigation fluid volume and duration of operation for stent colonization. However, stent indwelling time was significantly higher in patients with stents with positive cultures. In the colonized stents, there was a statistically significant difference with regards to the total score of USSQ, pain, urinary symptoms, work performance and additional problems of USSQ. Meanwhile, there was no statistically significant difference in the general health and sexual matter. Conclusions: stent colonization may be a contributing factor in stent-related morbidity. Stent bacterial colonization increases with the time of stent retention. Stent cultures are not needed as the same microorganisms are detected in urine cultures.

Knowledge and attitude towards monkeypox among the Lebanese population and their attitude towards vaccination.

Introduction: Monkeypox is a currently re-emerging disease in the world and several cases have been detected in Lebanon. For this reason, an assessment of the knowledge and attitude of the Lebanese population towards monkeypox and smallpox or monkeypox vaccines had to be done. Methods: A cross-sectional study was conducted using a questionnaire developed from previous literature among a sample of Lebanese residents. It recorded the sociodemographic characteristics and comorbidities of the participants and analyzed the patterns of knowledge and attitudes in Lebanon. Results: Among 493 participants, it was found that there is a generally low knowledge of and an average attitude toward monkeypox. However, knowledge is better with higher educational levels, COVID-19 vaccination, and residency in the south of Lebanon and poorer with marriage and residency in Beirut. Attitude is better in females but poorer with higher educational levels. Several other effectors have been devised too. As for vaccination, taking the smallpox vaccine as a proactive measure is predicted with previous COVID-19 vaccination and better attitude but not in the residents of the north of Lebanon and married Lebanese residents. Higher educational levels and a better attitude were positive predictions of taking the monkeypox vaccine whenever it is developed. Conclusion: This study revealed low level of knowledge and attitude towards monkeypox and its vaccines, which can be a rich resource when proactive measures are developed.

Comparative genome analyses of three serotypes of Lactococcus bacteria isolated from diseased cultured striped jack (Pseudocaranx dentex).

Lactococcosis, caused by members of the genus Lactococcus, represents a devastating disease inducing mass mortalities and economic losses in many fish species worldwide. The present work aimed to compare the whole genome sequences of three different serotypes of Lactococcus garvieae isolated from diseased cultured striped jack (Pseudocaranx dentex) in Ehime prefecture, Japan. The three serotypes showed different virulence in the challenge test using Japanese amberjack (Seriola quinqueradiata). The genome sequencing revealed that two of the strains (serotype I and serotype III) were identified as L. garvieae, while the third strain (serotype II) was identified as L. formosensis. The chromosome sizes of the three serotypes ranged from 1.9 to 2.0 Mb; the GC content ranges were 38.2 to 38.9%; and the numbers of predicted protein-coding sequences (CDSs) were from 1922 to 1959. Only the serotype II harbours two plasmids, sizes of around 14 kb and 9 kb. The detected virulence factors varied among the different serotypes with some shared factors like adherence, anti-phagocytosis, secretion system, toxin (haemolysin), serum resistance, antimicrobial resistance and others. The genomes also contained factors responsible for resistance to toxic compounds. The genome of the serotype III tended to encode more prophage regions than the other serotypes.

Associations between IL-17A G/A-rs2275913 and IL 23R A/G-rs11209026 gene polymorphisms and severe coronavirus disease 2019 (COVID-19).

Severe COVID-19 disease was linked to a severe proinflammatory response and cytokine storm interleukin 17 (IL-17) is one of these cytokines, was associated with severe acute lung injury and multiorgan dysfunction. Single nucleotide polymorphisms (SNPs) in genes coding IL-17 can affect level of IL-17 hence its role in diseases. Also, SNPs in IL-23 R which control IL-23 is the main activator of IL-17 production. This study aimed to determine whether the IL-17A (G/A-rs2275913), IL-23R (A/G rs11209026) SNPs and serum levels of IL-17 were related to the risk of severe COVID-19. This case-control study included 120 confirmed COVID-19 patients, divided into two categories according to the severity of the disease and 74 normal subjects as controls. COVID-19 patients were SARS-CoV-2 positive by a reverse transcription-polymerase chain reaction and subjected to full clinical examinations, routine laboratory tests, and radiographic evaluations. The IL-17 levels were assessed using ELISA method, and genotyping of IL-17A (197 A/G; rs2275913) and IL-23R rs11209026 (A/G) was performed by the TaqMan Genotyping Assay. There were no differences in the distribution of IL-17A or IL-23R genotypes between COVID-19 groups and the control group (p=0.93 and p=0.84, respectively). Severe COVID-19 patients had significantly higher IL-17 serum levels than non-severe COVID-19 (p=0.0001). The GG genotypes of IL-17A were significantly higher in severe COVID-19 patients (p=0.004). Multivariate logistic regression analysis revealed that AG, GG genotypes of IL-17 and IL-17A were independent predictors of COVID-19 disease severity (p < 0.0001, p=0.06 and p=0.04, respectively). ROC curve analysis for IL-17, as predictor of severe COVID-19 disease revealed a sensitivity of 87.9% and specificity of 66.1% at a cutoff point of 114 pg/ml with AUC = 0.799. In conclusion, these findings indicated that IL-17 may be considered a marker of severe COVID-19. IL-17A SNPs may have a role in COVID-19 severity. IL-23R SNPs had no role in COVID-19.

The association between smartphone use and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia.

BACKGROUND: The use of smartphones among the general public and health care practitioners, in particular, is ubiquitous. The aim of this study was to investigate the relationship between smartphone addiction and sleep quality, psychological distress, and loneliness among health care students and workers in Saudi Arabia. METHODS: This cross-sectional study used an online questionnaire to collect data on smartphone addiction, sleep quality, psychological distress, and loneliness as well as demographic information. RESULTS: A total of 773 health care students and workers participated in the study, with an average age of 25.95 ± 8.35, and 59.6% female participants. The study found a positive significant association between smartphone addiction and psychological distress (F(1,771) = 140.8, P < 0.001) and emotional loneliness (F(1,771) = 26.70, P < 0.001). Additionally, a significant negative association between smartphone addiction and sleep quality was found (F(1,771) = 4.208, P = 0.041). However, there was no significant relationship between smartphone addiction and social loneliness (F (1,771) = 0.544, P < 0.461). CONCLUSION: These findings suggest that smartphone addiction has a negative impact on psychological distress, sleep quality, and emotional loneliness among health care students and workers. It is important to promote strategies to reduce smartphone dependency in order to avoid the harmful consequences of smartphone addiction.

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.