Recent Advancements in Fluorometric and Colorimetric Detection of Cd2+ Using Organic Chemosensors: A Review (2019-2024).

In recent decades, heavy metal ions have emerged as a significant global environmental concern, posing threats to the delicate balance of ecosystems worldwide. Their introduction into ecosystems occurs through various activities and poses a serious risk to human health. Among heavy metal ions, Cd2+ is recognized as a highly toxic pollutant. Its widespread use contributes to its accumulation in the environment. Chronic exposure to Cd2+ ions present serious risks to both the environment and human health. Therefore, the detection of these metal ions are very important. Organic fluorometric and colorimetric detection have emerged as promising tools for this purpose, offering advantages such as high sensitivity, selectivity, and sometimes reversibility. This review offers a comprehensive overview of the recent advancements in the fluorometric and colorimetric detection of Cd2+ using organic chemosensors from 2019 to 2024. We delve into key aspects of these studies, including the design strategies employed to design novel chemosensors and the underlying sensing mechanisms. Furthermore, we explore the diverse applications of these organic chemosensors, ranging from environmental monitoring to biomedical diagnostics. By analyzing the latest research findings, this review aims to offer insights into the current state-of-the-art in the field of Cd2+ detection using organic chemosensors. Additionally, it highlights the potential opportunities and challenges that lie ahead, paving the way for future advancements in this important area of research.

Awareness and Knowledge of Venous Thromboembolism Among Saudi Adults in the Dawadmi Province: A Cross-Sectional Study.

Background Venous thromboembolism (VTE) significantly contributes to the global disease burden. The annual incidence of VTE is one to two per 1,000 adults worldwide. We aimed to evaluate the awareness and knowledge of VTE risk factors, manifestations, prevention, and treatment options among the general adult population of Dawadmi, Riyadh, Saudi Arabia. Methodology We conducted a cross-sectional study using the self-designed and validated VTE knowledge questionnaire. A survey was conducted online via Google Documents, composed of 12 questions. Participants included in the study were over 18 years old, regardless of their medical history. However, medical students and healthcare providers were excluded. Results A total of 384 participants (46.4% men and 53.6% women) completed the survey; most respondents were between 18 and 28 years of age. Majority of the participants recognized that immobility, obesity, complicated surgery, road traffic accidents, smoking, and old age are the most common risk factors for VTE. However, more than half of the elderly and lower-educated participants did not identify complicated surgery and consumption of oral contraceptive pills as risk factors for VTE. Awareness of VTE was significantly higher among those with a family history of VTE and a graduate degree (p<0.001). Results showed a deficit of awareness and information about VTE, especially among males, those with low education, and elderly participants. Conclusion This study demonstrates the need for more awareness of VTE among the Saudi adult population. The urge to spread awareness and knowledge about VTE among the public in Dawadmi province is required.

An Unusual Case of Peripheral Nerve Vasculitis.

Peripheral neuropathy is a common manifestation of systemic vasculitis. The etiology of vasculitic peripheral neuropathy is generally classified into two groups: systemic and nonsystemic. In systemic vasculitic neuropathy (SVN), neuropathy is a consequence of a systemic disease, most commonly involving medium and small vessels throughout the body. There are three main clinical presentations: multifocal neuropathy, distal symmetric polyneuropathy, and overlapping multifocal neuropathy. Specifically, distal symmetric polyneuropathy affects multiple somatic nerves diffusely in a symmetric and length-dependent pattern (also known as the classic stocking-glove pattern). This case represents an atypical presentation of SVN, presenting with widespread symmetric polyneuropathy.A 73-year-old woman presented with distal acute on chronic bilateral upper and lower extremity weakness, sensory changes, and widespread pain. Symptoms started about three months prior and gradually worsened with progressive difficulty with ambulation and required assistive devices. Elevated ESR is at 70 mm/hour, CRP at 25.66 mg/dL, elevated c-ANCA titers at 1 : 320 and PR3 at 5.0 AI, and elevated creatine kinase (CK) at 500-600 U/L. A muscle biopsy of the left vastus showed neurogenic atrophy without myositis. Initial improvement was with oral prednisone, but was stopped on discharge. Many purpuric and petechial lesions were developed on distal legs/feet and right fourth digit distal gangrene. EMG showed distal, symmetric, and axonal polyneuropathy affecting the upper and lower extremities and acute denervation in more distal muscles. The patient received pulse dose steroids and two doses of rituximab induction therapy and was discharged with an oral steroid taper. The patient's symptoms started as distal symmetric neuropathy at the onset and progressively worsened over the course of 3 months. Neuropathy, both on the exam and on EMG, seemed to have developed more rapidly than expected, regardless of its distribution. The EMG showed severe peripheral nerve damage and denervation, which is unusual for ANCA-associated systemic vasculitis.

The Effects of Health Education on the Awareness of Antimicrobial Resistance Among High School Students in Riyadh, Saudi Arabia During 2023: A Quasi-experimental Study.

Introduction Antimicrobial resistance (AMR) is a major health threat, recently declared a crisis by the WHO, and recognized as one of the top 10 threats to global health. One of the strategies to curb AMR is interventional education to raise awareness. Therefore, this study evaluated the impact of interventional education on awareness of antimicrobial resistance among high school students in Riyadh, Saudi Arabia. Methods This was a quasi-experimental study that included 120 high school students as a control group and 120 students as the experimental group. It used a questionnaire pre- and post-educational intervention, which was a lecture by trained healthcare workers. Pearson's Chi-square test and ANOVA were used to assess the effects of the intervention, and the p-value was set at <0.05 for significance. Results Over half (53.4%) of the controls reported no prior exposure to an antibiotic awareness campaign, compared to 46.6% in the intervention (experimental) group. Half of the participants in both groups were without a family relative who works in the healthcare sector. Almost half (51.2%) in the intervention group used antibiotics compared to 48.2% of controls; 53.3% in the control group reported self-medication compared to 46.7% in the intervention group. We found a statistically significant increase in the overall mean scores regarding knowledge of antibiotics resistance before and after the education intervention in the control group (p<0.001) and intervention group (p<0.001). Post-intervention, there was a significant reduction in the mean scores of misbeliefs about antibiotic use (p<0.001). We found an improvement in the perception scores toward AMR and antibiotic resistance post-educational intervention (P=0.008), and the perception difference remained significant between the two study groups (p=0.002). Conclusion These findings showed that interventional education effectively raises awareness, knowledge, and perceptions toward AMR. Therefore, public health, medical, and scientific professionals in Saudi Arabia are urged to emphasize education to fight AMR, in addition to other strategies.

Effect of Nighttime Exercise on Sleep Quality Among the General Population in Riyadh, Saudi Arabia: A Cross-Sectional Study.

Introduction Engaging in physical activity has been proven to have health benefits, with a positive impact on sleep quality. While the timing of exercise plays a significant role in determining its effect on sleep, nighttime exercise still needs to be explored, especially in Saudi Arabia. This study assessed the effect of nighttime exercise on sleep quality among the general population in Riyadh, Saudi Arabia. Methods A cross-sectional study was conducted on people performing physical exercises in the gym, training, and walking places using a self-administered questionnaire evaluating exercising behaviors and sleep quality. Comparisons were performed using the Chi-square test and ANOVA, and p<0.05 was considered for significance. Results We enrolled 385 participants, among whom 53.8% were male, and 47.2% were female. The mean age was 28.2±7.85 years, and mostly aged 25-29 years (24.7%), followed by 20-24 years old (21.3%). Most had university degrees (61.3%) and were also employed (60%). Of all participants, the majority were overweight and obese (61.3%). Most (n=225) participants practiced vigorous physical exercise, and the mean Pittsburgh Sleep Quality Index (PSQI) global score was 7.37±3.49 points. Evening vigorous (r= 0.25, p=0.038) and moderate (r=0.30, p=0.025) physical exercise sessions lasting > 90 min had a significant positive correlation with poor sleep quality (high PSQL score). There was no statistically significant correlation between sleep quality and other variables (p>0.05). Conclusion This study found that participants had poor sleep quality, and lengthy, intense evening exercises had a negative effect on sleep. Incorporating regular exercise tailored to individual preferences and encouraging people to widen the time interval between exercise and bedtime could improve sleep quality.

Determinants of Flu Vaccine Uptake Among the General Population in Saudi Arabia: A Study Based on the Health Belief Model.

Background and objective Recently, influenza has emerged as a significant public health concern worldwide, including in Saudi Arabia. Vaccination against the flu is widely recognized as a crucial preventive measure to reduce morbidity and mortality associated with the virus. However, the uptake of flu vaccines among the general population in Saudi Arabia still remains low. In light of this, this study aimed to examine the determinants of influenza vaccine uptake in Saudi Arabia by using the Health Belief Model (HBM). Methods This cross-sectional study was conducted among adults living in all regions of Saudi Arabia by using an online self-administered questionnaire based on the HBM. The questionnaire inquired about demographics, knowledge about influenza, knowledge about vaccines, and beliefs/barriers. It was distributed via social media platforms, including WhatsApp, Twitter, and Instagram. IBM SPSS Statistics software version 29 (IBM Corp., Armonk, NY) was used for statistical analyses, and both the Chi-square test and logic regression analyses were applied to determine associations between explanatory and response variables, with the level of significance set at p<0.05. Results This study enrolled a total of 1040 participants, and the majority were Saudi nationals (96.9%). Of note, 66.2% of the participants were males, and the rest were females. Most of the participants were employed by governmental institutions (42.0%), had bachelor's degrees (58.4%), had never worked in the health sector (70.2%), and earned above 10,000 Saudi riyals per month (62.1%). Over half (55.7%) of participants had taken the flu vaccine at the time of this study. Working in the healthcare sector was associated with increased flu vaccine uptake [adjusted odds ratio (aOR): 3.84, p<0.001]. The likelihood of getting the flu vaccines was greater among men (aOR: 1.38, p=0.027), and obesity was associated with lower flu vaccine uptake (aOR: 0.29, p=0.034). Having contact with people with flu, having had flu in the past, and experiencing severe flu complications (aOR: 4.71, p=0.029; aOR: 0.13, p=0.006; and aOR: 0.29, p=0.033, respectively) were significantly associated with the flu vaccine uptake among our study participants. Perceived potential risks of the flu vaccine were also associated with taking the flu vaccine (aOR: 0.213, p=0.042). There was a significant association between seeing an advertisement for the flu vaccine and the likelihood of taking the vaccine (aOR: 5.488, p=0.042). Conclusion This study found that certain sociodemographic factors are associated with flu vaccine uptake. These factors included contact with flu-infected individuals, past experiences with flu, perceived risks, and exposure to flu vaccine advertisements. Improving healthcare accessibility, conducting awareness campaigns, and implementing workplace initiatives are recommended to address the issues related to flu vaccine uptake.

Compliance of Healthcare Providers With the Notifiable Diseases Surveillance System in Riyadh, Saudi Arabia.

Introduction Though reporting notifiable diseases is obligatory in Saudi Arabia, and the Saudi Ministry of Health establishes guidelines, there are concerns about healthcare providers' compliance, and studies evaluating the notifiable diseases surveillance system (NDSS) are lacking, underlying the urgent need to assess the compliance of healthcare providers with the NDSS in Saudi Arabia. Methods This cross-sectional study involved doctors, nurses, and epidemiologists working in healthcare facilities in Riyadh, Saudi Arabia. The data collection was done using a self-administered questionnaire. SPSS version 27 software (IBM Corp., Armonk, NY) was used for statistical analyses. Results We included 420 participants enrolled in our study, and 63.1% were female. Of 51.4% of participants who worked in private healthcare facilities, 75.7% of them were nurses, while the majority of those working in governmental facilities were doctors (69.1%). The age range was 20-62 years, and the dominant age group was 31-40 years (63.8%). Most participants had no training in epidemiology (79.7%) and of those trained, 64% had a certificate training level. Most notifiable diseases worked were detected in governmental health facilities (35.6% vs. 18.8%). Of those who identified notifiable diseases, 84.3% notified them. COVID-19, measles, and hepatitis A, B, and C were the most notified diseases. The lack of knowledge of the notification system was the most common barrier to the notification among 81 nurses, 39 doctors, and one epidemiologist. There was a significant relationship between being a doctor in the governmental institution and notification timeline (p = 0.024). Conclusion This study showed that identifying notifiable diseases was poor despite good compliance among those who identified them. This study showed the lack of proper training of participants, explaining poor knowledge. The findings highlight the differences in notification practices between private and governmental facilities and the need for educational interventions to tackle the knowledge barrier reported.

Use of Euphorbia balsamifera Extract in Precursor Fabrication of Silver Nanoparticles for Efficient Removal of Bromocresol Green and Bromophenol Blue Toxic Dyes.

Silver nanoparticles (Ag-NPs) are attracting great attention for their use in various applications, along with methods for their green and facile production. In this study, we present a new eco-friendly approach based on the use of Euphorbia balsamifera extract (EBE) in the green synthesis of silver nanoparticles (Ag-NPs), which are then applied as a reducing and stabilizing agent for the efficient removal of water-based reactive dyes such as bromocresol green (BCG) and bromophenol blue (BPB). The as-prepared Ag-NPs are quasi-spherical in shape, with an average diameter of 20-34 nm. Diverse characterization methods, including X-ray diffractometry (XRD), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), and Brunauer-Emmett-Teller (BET) analysis, were used to analyze these Ag-NPs. The results reveal that water-soluble biomolecules in the Euphorbia balsamifera extract play an important role in the formation of the Ag-NPs. The removal of toxic dyes was studied under varied operational parameters such as Ag-NP dosage, initial dye concentration, pH, stirring time, and temperature. Under the optimum investigated conditions, nearly 99.12% and 97.25% of the bromocresol green and bromophenol blue dyes, respectively, were removed. Both BCG and BPB adsorption were found to adhere to pseudo-second-order kinetics (r22 = 1 and 0.995) and fit the Langmuir isotherm models well (R12 = 0.998 and 0.994), with maximal monolayer adsorption capacities of 20.40 and 41.03 mg/g, respectively. Their adsorption processes were observed to be intrinsically endothermic. The results confirm the potential of the Euphorbia balsamifera extract as a low-cost, nontoxic, and eco-friendly natural resource for the synthesis of Ag-NPs that may be useful in the remediation of hazardous dye-contaminated water sources.

Insight into the corrosion mitigation performance of three novel benzimidazole derivatives of amino acids for carbon steel (X56) in 1 M HCl solution.

Three new organic molecules having a benzimidazole base were synthesized and used for the protection of carbon steel (X56) against corrosion in 1.00 M HCl solution. The protection against corrosion was assessed by electrochemical frequency modulation (EFM), electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization (PDP). In addition, the electronic and molecular structure of the synthesized molecules were computationally investigated and correlated to corrosion inhibition. Global reactivity descriptors, molecular orbitals (FMO and NBO) and local reactivity descriptors (molecular electrostatic potential map and Fukui functions) were discussed. The results showed a maximum protective efficiency range between 95% and 98% indicating high corrosion inhibition. Moreover, all molecules were able to combat the cathodic as well as anodic reaction simultaneously, revealing a mixed-type resistance. SEM and EDX verified effective adhering film formation to the metal surface. In accordance, the theoretical calculations showed effective electron reallocation from the organic film to the X56 c-steel surface. Furthermore, the adsorption annealing calculations revealed that structural layers of these molecules hold parallel and close to the metal surface with adsorption energy from 249.383 to 380.794 kcal mol-1, showing strong inhibitor-metal contact.

Nasopharyngeal Carcinoma Presenting With Occipital Headache as a Sole Symptom in a Young Adult Male: A Case Report.

Nasopharyngeal carcinoma (NPC) is a rare type of cancer that is one of the most challenging cancers to diagnose correctly at the initial phase because of the different irrelative symptoms. Headache per se is rare and maybe a misleading symptom for diagnosing NPC. We report a case of a 37-year-old Saudi civil servant male with NPC who presented to the clinic complaining of a continuous, dull occipital headache that is progressively worsened over the last three months, not responding to over-the-counter analgesics. Computed tomography revealed a large ill-defined infiltrative heterogeneously enhancing soft tissue mass that obliterated the fossae of Rosenmuller and pharyngeal openings of both Eustachian tubes. The histopathological diagnosis was undifferentiated non-keratinizing NPC that is positive for Epstein-Barr virus. As in this case, headache alone can be the sole presenting symptom for NPC. Therefore, physicians should think broader in such a presentation to appropriately diagnose and treat NPC.

Effective corrosion inhibition of mild steel in hydrochloric acid by newly synthesized Schiff base nano Co(ii) and Cr(iii) complexes: spectral, thermal, electrochemical and DFT (FMO, NBO) studies.

Two new cobalt(ii) and chromium(iii) complexes were synthesized and characterized by FT-IR, 1HNMR, UV, elemental analysis, TGA, conductivity, XRD, SEM, and magnetic susceptibility measurements. Structural analysis revealed a bi-dentate chelation and octahedral geometry for the synthesized complexes. The optical band gap of the Co(ii)-L and Cr(iii)-L complexes was found to be 3.00 and 3.25 eV, respectively revealing semiconducting properties. The X-ray diffraction patterns showed nano-crystalline particles for the obtained complexes. In addition, the synthesized metal complexes were examined as corrosion inhibitors for mild steel in HCl solution. The electrochemical investigations showed a maximum inhibition efficiency of 96.60% for Co(ii)-L and 95.45% for Cr(iii)-L where both complexes acted as mixed-type inhibitors. Frontier Molecular orbital (FMO) and Natural bond orbital (NBO) computations showed good tendency of the ligand to donate electrons to the metal through nitrogen atoms while the resultant complexes tended to donate electrons to mild steel more effectively through oxygen atoms and phenyl groups. A comparison between experimental and theoretical findings was considered through the discussion.

The SARS-CoV-2 Spike Protein Activates the Epidermal Growth Factor Receptor-Mediated Signaling

ObjectivesThe coronavirus disease-19 (COVID-19) pandemic is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). At the molecular and cellular levels, the SARS-Cov-2 uses its envelope glycoprotein, the spike S protein, to infect the target cells in the lungs via binding with their transmembrane receptor, the angiotensin-converting enzyme 2 (ACE2). Here, we wanted to invesitgate if other molecular targets and pathways may be used by SARS-Cov-2. MethodsWe investigated the possibility for the spike 1 S protein and its receptor-binding domain (RBD) to target the epidermal growth factor receptor (EGFR) and its downstream signaling pathway in vitro using the lung cancer cell line (A549 cells). Protein expression and phosphorylation was examined upon cell treatment with the recombinant full spike 1 S protein or RBD. ResultsWe demonstrate for the first time the activation of EGFR by the Spike 1 protein associated with the phosphorylation of the canonical ERK1/2 and AKT kinases and an increase of survivin expression controlling the survival pathway. ConclusionsOur study suggests the putative implication of EGFR and its related signaling pathways in SARS-CoV-2 infectivity and Covid-19 pathology. This may open new perspectives in the treatment of Covid-19 patients by targeting EGFR.

The emerging role of lncRNA MEG3 and MEG3 rs7158663 in hepatocellular carcinoma.

OBJECTIVE: Hepatocellular carcinoma (HCC) is the most common primary liver malignancy in Egypt. Genetic and environmental factors play a role in its development. This study explored the association between the long non-coding RNA (lncRNA) MEG3 rs7158663 polymorphism, MEG3 expression, and the risk of HCC and other clinicopathologic characteristics in an Egyptian population. PATIENTS AND METHODS: This case-control study included 114 patients with HCC and 110 healthy controls. TaqMan Real-time PCR was used to analyze lncRNA MEG3 rs7158663. Serum MEG3 expression levels were measured using RT-PCR. RESULTS: The AA, GA+AA, and A alleles were associated with increased risk for HCC (adjusted odds ratio (OR) 11.84%, 95% CI 4.07-34.45, p < 0.0001; adjusted OR 3.18, 95% CI 1.79-5.67, p < 0.0001; and adjusted OR 2.87, 95% CI 1.91-4.34, p < 0.0001, respectively). The mutant genotype and allele were linked to an increased risk in male patients and patients ≥ 50 years old. MEG3 serum expression level was downregulated in HCC patients. The rs7158663 G > A polymorphism and downregulated MEG3 were significantly associated with larger tumor size and advanced disease stage. CONCLUSIONS: MEG3 rs7158663 single nucleotide polymorphisms and downregulated lncRNA MEG3 were associated with HCC risk and may represent diagnostic and bad prognostic factors for HCC patients.

Port-a-Cath Insertion in Pediatric Patients With Malignancy in Tabuk.

Objectives A port-a-cath has become the cornerstone of supportive care and therapy for most childhood malignancies. It is routinely used in children for recurrent blood sampling or intravenous therapies. This study aimed to investigate the complications of port-a-cath insertion in children, the reasons for its removal or reinsertion, and to compare open and percutaneous techniques of insertion in pediatric patients with cancer in the northwest region of Saudi Arabia. Materials and methods This is a retrospective observational study, which reviews pediatric cases that underwent port-a-cath insertion between 2008 and 2017. Their medical records were assessed for patient characteristics, indications for insertion, the nature of port use, their reasons for removing them, and port-related complications.  Results We included 64 patients who had a total of 79 port-a-cath insertions in this study. The median age at first insertion was 38 months (51.56% female, 48.44% male). The mean duration between the first insertion and the removal of the port-a-cath was 36 ± 17 months. The right internal jugular vein was used in most cases. The rate of complications at our institution was 9.38%. Conclusions In pediatric cancer patients, a port-a-cath can be safely used, is associated with minimal complications, and can be easily managed without serious complications. The most common complications were attributed to infections, followed by the malfunction and obstruction of ports.

Patterns and Correlations of Hearing Loss Among Adolescents, Adults, and Elderly in Saudi Arabia: A Retrospective Study.

Background According to the World Health Organization (WHO), hearing loss (HL) has a significant disease burden with a global prevalence as high a 5% with an expected exponential rise in the coming years. HL has medical, social, and psychological implications on one's health. A significant proportion of HL cases might be the result of preventable conditions, especially among the young.  Aim To estimate the pattern of HL and its correlates among adolescent, adult, and elderly populations in the southern regions of Saudi Arabia. Methodology A retrospective observational study was carried out between May 2018 and April 2019 across four different ENT clinics located across Saudi Arabia. We included all patients who had a clinical diagnosis of conductive, sensorineural, or mixed HL with varying degrees of severity tested via Pure Tone Audiometer (PTA). Results We included 332 cases with HL, ages ranged from 14 to 62 years old with a mean age of 45.2 ±12.6 years. HL was bilateral in 72% of the cases and was associated with tinnitus in 43.1% of cases. Sensorineural HL was the predominant pattern of HL among the elderly and conductive pattern was more common among the young. Causes such as infections, congenital causes, and age-related damage were among the key causes of HL.  Conclusion Our study showed that HL might be more prevalent among the Saudi population than previously reported. Sensorineural HL is most common among the elderly. However, conductive HL following ear infections is the main cause of HL among young. Therefore, there is a need for significant improvement in public health surrounding ear health to prevent reversible causes of HL, especially among the young.

Adherence to Treatment and Level of Satisfaction Among Saudi Hypertensive Patients: A Multi-City Study.

Background and objective Hypertension (HTN) is a common disease among patients who visit primary healthcare clinics. Uncontrolled HTN is associated with increased morbidity and mortality; therefore, awareness of its risk factors and adherence to treatment can lead to better control of HTN. In this study, we aimed to determine the level of adherence to treatment and satisfaction among Saudi hypertensive patients. Methods In this cross-sectional study, we used an interviewer-administered questionnaire among hypertensive patients aged 40 years or older who attended primary healthcare centers in the five main regions within Saudi Arabia. We excluded patients with mental disorders, dementia, or those unable to provide consent to participate. The estimated sample size was 384 patients as calculated by Raosoft® based on the AlNozha study (prevalence of HTN in Saudi Arabia is 26.1%). The questionnaire included questions about demographic data, awareness about HTN risk factors and complications, adherence to treatment, and patient satisfaction along with the information related to management from their physicians. Microsoft Excel was used for data entry, and SPSS Statistics version 23 (IBM, Armonk, NY) was used for statistical analysis. Results Of the 384 hypertensive patients recruited, most were in the age group of 40-49 years (36.5%), and the majority of them were female (75%). Most patients (n=305, 79.4%) reported good adherence to the management plan. Also, most of the patients (73.4%) were satisfied in terms of receiving simplified information and justification of the management plan from their physicians. Conclusions A good level of satisfaction was observed among patients of HTN in Saudi Arabia with respect to information, simplification, and justification of treatment plans provided by health professionals. This high satisfaction level accounts for the high adherence to the treatment plan.

The Diagnosis and Treatment of Impalpable Testes at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia.

Background Impalpable testes may be caused by atrophy, congenital dysgenesis/agenesis, or the presence of testes at unusual sites. Early intervention can improve patient outcomes. The recommended age for surgery ranges from 6 to 18 months. Objective To investigate the diagnosis, treatment, and outcomes of impalpable testes and sensitivity and specificity of ultrasonography to diagnose impalpable testes at King Salman Armed Forces Hospital (KSAFH), Tabuk, Saudi Arabia. Methods We conducted a retrospective study to review cases of impalpable testes admitted to KSAFH, Tabuk, Saudi Arabia from January 1, 2015 to May 20, 2019. Fifty patients diagnosed with impalpable testes were treated surgically in our center during the period. Patients' data were tabulated, and statistical analysis was performed using Statistical Package for Social Sciences software (SPSS, version 22; IBM, Armonk, NY).  Results We included 50 patients in our study, with a total number of 66 impalpable testes. The median age at diagnosis was 7 months, while the median age at surgery was 17.5 months. The median interval between diagnosis and surgery was 8.5 months, with 44% of cases undergoing surgery after the age of 1.5 years. Two-thirds of the cases were unilateral. The most common site was intracanalicular (57.6%) followed by intra-abdominal (34.8%). The testicular size was average in 36.4%, small in 42.4%, and atrophic in 21.2% of the evaluated cases.  Conclusions The overall sensitivity of ultrasonography was 56.1% (it correctly detected the location of 37 out of 66 impalpable testes). The sensitivity of ultrasonography for the detection of intra-abdominal testes was 43.5%, while that of intracanalicular testes was 71.1%.

Age at Surgery and Outcomes of Undescended Testes at King Salman Armed Forces Hospital, Tabuk, Saudi Arabia.

Objective The aim of this study was to investigate the age at diagnosis and surgery of undescended testes and patients' outcomes. Methods This is a retrospective study that reviewed the files of patients who underwent orchidopexy at the King Salman Armed Forces Hospital (KSAFH), Tabuk, Saudi Arabia (SA), between January 1, 2015, and March 30, 2019. All children from birth until 13 years old who were admitted within the specified time frame and underwent orchidopexy were included in this study. The gathered data were analyzed through the Statistical Package for Social Sciences software (SPSS, version 23; SPSS Inc., Chicago, IL, USA). Results  A total of 175 patients were included in this study. The rate of orchidopexy at our institution was 12.2%. The median ages at diagnosis and surgery were 12 and 24 months, respectively. The median duration between diagnosis and surgery was eight months. The most common site of undescended testis was inguinal (80.6%). Bilateral undescended testes were recorded in 24.6% of cases, and 25.7% of cases were impalpable. The size of the undescended testis was average in half the cases, small in 44.6% and atrophic in 6.4% of cases. Postoperative complications were reported in 4.0% of cases. Cox regression analysis revealed that the age at diagnosis was a significant risk factor affecting the time of surgery. Conclusion The findings of this study revealed that most cases of undescended testes in Tabuk were operated beyond the age recommended by international guidelines. The age at diagnosis seems to significantly affect the time of surgery.

Epidemiologic Pattern and Types of Oral Smokeless Tobacco Usage in Saudi Arabia.

Aim: Smokeless tobacco (ST) use is a significant health risk and cause of disease. Most studies conducted in the Kingdom of Saudi Arabia (KSA) focused on cigarette smoking. Therefore, the objective was to study the epidemiologic pattern and types of oral ST usage in northern and western Saudi Arabia. Materials and methods: A total of 428 volunteers living in three cities (Hail, Mecca, and Tabuk) were investigated. All of the study subjects were currently ST users of one type or more, including toombak, shammah, pan masala (PM), Afdhal, Nashooq, and others. Results: Most of the study population were found to use toombak representing 127/428 (29.7%), followed by shammah, PM, Afdhal, Nashooq, Adani, Qat, Majun, and others, representing 67/428 (15.7%), 66/428 (15.4%), 44/428 (10.3%), 36/428 (8.4%), 32/428 (7.5%), 23/428 (5.4%), 22/428 (5.1%), 21/428 (4.9%), and 13/428 (3%) respectively. Conclusion: This survey showed a high prevalence of existing ST usage among foreign workers and Saudis, which can establish a prospective public health problem. Clinical significance: Smokeless tobacco cessation is a crucial element of tobacco control policy since it is the most important determinant of many diseases, including oral cancer. Keywords: Kingdom of Saudi Arabia, Oral cancer, Pan masala, Shammah, Smokeless tobacco, Toombak.

Reduced integration and improved segregation of functional brain networks in Alzheimer's disease.

OBJECTIVE: Emerging evidence shows that cognitive deficits in Alzheimer's disease (AD) are associated with disruptions in brain functional connectivity. Thus, the identification of alterations in AD functional networks has become a topic of increasing interest. However, to what extent AD induces disruption of the balance of local and global information processing in the human brain remains elusive. The main objective of this study is to explore the dynamic topological changes of AD networks in terms of brain network segregation and integration. APPROACH: We used electroencephalography (EEG) data recorded from 20 participants (10 AD patients and 10 healthy controls) during resting state. Functional brain networks were reconstructed using EEG source connectivity computed in different frequency bands. Graph theoretical analyses were performed assess differences between both groups. MAIN RESULTS: Results revealed that AD networks, compared to networks of age-matched healthy controls, are characterized by lower global information processing (integration) and higher local information processing (segregation). Results showed also significant correlation between the alterations in the AD patients' functional brain networks and their cognitive scores. SIGNIFICANCE: These findings may contribute to the development of EEG network-based test that could strengthen results obtained from currently-used neurophysiological tests in neurodegenerative diseases.