Factors Affecting the Awareness of Diabetic Retinopathy: An Observational Cross-Sectional Study.

BACKGROUND: Diabetes mellitus (DM) is a chronic metabolic disease characterized by elevated blood glucose levels. Over time, it can lead to serious complications in the eyes, heart, blood vessels, kidneys, and nerves, being the leading cause of blindness among working-age patients. AIM AND METHODS: This descriptive observational cross-sectional study aims to evaluate the factors affecting the awareness of the general adult diabetic population about their chronic disease and its complications. A survey was distributed anonymously among diabetic patients in different parts of Jordan over four months (January 2023-April 2023), targeting diabetic patients (DMT2 or adults DMT1). The link was sent via WhatsApp to willing candidates. Data collected included age, sex, region, education, home blood sugar (BS) testing, knowledge about cumulative blood sugar test (HbA1c), eye affection by DM, optician role, and doctor and nutritionist follow-up visits. A chi-squared test or Fisher's exact test explored the association between categorical data; a z-test was applied for column proportion differences. An alpha level of 0.05 was deemed statistically significant. IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York) was used for data analysis. RESULTS: The sample comprised 447 diabetic adults aged 18-80 years. The majority were school-educated or school leavers (278; 62.2%); 20 (4.5%) held a master's or PhD degree. The largest group had DM for one to five years. Insulin was the sole treatment for 188 patients (42.1%), while oral hypoglycemic agents (OHA) were used by 170 patients (38%) as the only anti-DM medication. A total of 174 patients (38.9%) had never been seen by an ophthalmologist, and 153 (34.2%) believed an optometrist checkup suffices. Although 381 (85.2%) reported knowing DM affects the eyes, 272 (60.9%) believed they needed to see an ophthalmologist only when experiencing eye symptoms. Less than half (186; 41.6%) had an HbA1c reading of 7% or less. There was a significant correlation between education level and awareness of DM and diabetic retinopathy (DR): HbA1c, regular home BS checkups, early DR symptoms, and optometrist visits. Significant variations in awareness were noted across Jordan's major areas. Diabetics with abnormal HbA1c who visited a nutritionist were almost triple those who did not. The main information source about DM and DR was the treating physician for 298 (66.7%) respondents. CONCLUSION: Awareness of DM and DR in Jordan is not satisfactory for assisting patients in their long journey with minimal complications. A national awareness campaign utilizing social media and a sustainable screening program prioritizing the north, south, and middle regions of Jordan are needed.

Integrating virtual screening, pharmacoinformatics profiling, and molecular dynamics: identification of promising inhibitors targeting 3CLpro of SARS-CoV-2.

Introduction: The pursuit of effective therapeutic solutions for SARS-CoV-2 infections and COVID-19 necessitates the repurposing of existing compounds. This study focuses on the detailed examination of the central protease, 3-chymotrypsin-like protease (3CLpro), a pivotal player in virus replication. The combined approach of molecular dynamics simulations and virtual screening is employed to identify potential inhibitors targeting 3CLpro. Methods: A comprehensive virtual screening of 7120 compounds sourced from diverse databases was conducted. Four promising inhibitors, namely EN1036, F6548-4084, F6548-1613, and PUBT44123754, were identified. These compounds exhibited notable attributes, including high binding affinity (ranging from -5.003 to -5.772 Kcal/mol) and superior Induced Fit Docking scores (ranging from -671.66 to -675.26 Kcal/mol) compared to co-crystallized ligands. Results: In-depth analysis revealed that F6548-1613 stood out, demonstrating stable hydrogen bonds with amino acids His41 and Thr62. Notably, F6548-1613 recorded a binding energy of -65.72 kcal/mol in Molecular Mechanics Generalized Born Surface Area (MMGBSA) simulations. These findings were supported by Molecular Dynamics simulations, highlighting the compound's efficacy in inhibiting 3CLpro. Discussion: The identified compounds, in compliance with Lipinski's rule of five and exhibiting functional molecular interactions with 3CLpro, present promising therapeutic prospects. The integration of in silico methodologies significantly expedites drug discovery, laying the foundation for subsequent experimental validation and optimization. This approach holds the potential to develop effective therapeutics for SARS-CoV-2.

"She's dead!" - Nursing simulation practices: A discourse analysis approach.

Background: The literature on nursing education has revealed a growing wave of interest in the use of simulation sessions to promote undergraduate nurses' learning experiences. This high prevalence of simulation practices in nursing programs has led to opportunities to research this topic from various angles, including its impact on students' skill performance, self-efficacy, self-confidence, self-satisfaction, and clinical knowledge acquisition. Design and Methods: Participants in this qualitative study included 54 senior female undergraduates enrolled in a critical care nursing course in Saudi Arabia. Recordings were made of six authentic, acute care simulation sessions. One of these sessions was examined in depth using discourse analysis approaches to gain insights into communication in simulation sessions, examining the way students linguistically managed this critical communication, exhibiting their logical, reflective, decision-making, problem-solving, and collaborative work skills and use of communicative strategies. Results: The analyses revealed various training and communication issues including the lack of harmony among the team members (e.g., regarding understanding and performing their assigned roles as well as delegating and conducting delegated tasks) and the students' inability to effectively communicate with the patient as a valuable source of information and to make appropriate and timely clinical decisions regarding patient assessment. Conclusions: Simulation sessions have been shown to be a promising instructional tool to support nursing education, allowing students to practice in a safe and controlled environment. However, for more effective sessions and to avoid poor simulation sessions, students need to be thoroughly briefed regarding the sessions prior to implementation.

HUMAN BABESIOSIS: A GENERAL REVIEW WITH SPECIAL REFERENCE TO EGYPT.

Babesiosis is a tick-borne malaria-like illness caused by species of the intra-erythrocytic protozoan Babesia. Humans are opportunistic hosts for Babesia when bitten by nymph or adult ticks. Currently, Babesia infection is transmitted by various tick vectors in Europe, Asia, Africa and the northwestern and northeastern United States. Human babesiosis was first described in 1957 but is now known to have worldwide distribution. The increase in reported cases is likely due to increases in actual incidence as well as increased awareness of the disease. Despite the diagnostic and preventive advances resulting from extensive research and a greater understanding of the disease, babesiosis continues to have significant medical impact as a confounding variable in the diagnosis and treatment of Lyme disease and as a potential threat to the blood supply, especially in the United States. Diagnostic advances, like the development of PCR assays, have resulted in increased sensitivity for detection as well as the discovery and characterization of new babesial species. Further studies using the molecular tools now available and those to be developed will lead to a better understanding of the natural history of these organisms, including the transmission cycle and the, potential role of Babesia parasites themselves as immunomodulAtor. Human babesiosis is usually an asymptomatic infection in healthy individuals. Several patients become symptomatic, and, within these subpopulations, significant morbidity and mortality occur, especially in elderly, immunocompromised, or asplenic patients. It is difficult to diagnose. Although the index of suspicion should be high in rural Babesia endemic areas, patients with babesiosis have few, if any, localizing signs to suggest the disease. Diagnosis confirmation depends on the parasitemia degree, the expertise and well trained laboratory personnel. Most patients infected by B microti who are otherwise healthy appear to have a mild illness and typically recover without specific chemotherapy; however, treatment is recommended for all diagnosed cases to prevent sequelae and potential transmission through blood donation. In addition, patients should be advised to take precautions against tick exposure and to refrain from donating blood until completely cured of babesiosis.