Eight-year epidemiological study for drug poisoning in Qassim, Saudi Arabia, 2008-2015.

Literature reported drug poisoning as a major cause for visiting emergency departments, with various rates of occurrences across countries, regions, socioeconomic status, and cultures. Therefore, this study was conducted in Qassim to describe the sociodemographic patterns of acute drug poisoning as well as the most common drugs involved. A retrospective method of data collection was used employing medical record review for drug poisoning cases that occurred in the Qassim region during the 8 years from January 2008 to December 2015. Data was collected using a standardized, validated data collection sheet. The study failed to reveal any pattern (either decreasing or increasing) in the number of poisoning cases over time. Most cases (56.2%) of drug poisoning were accidental, caused by analgesics (35%), affected children younger than 5 years of age (41.4%), and occurred via ingestion (99.2%). It can be concluded that as most poisoning cases affected children, this highlights the importance of increasing awareness and educating families about the safe handling and storage of drugs out of reach of children.

Analysis of dermoscopy images of multi-class for early detection of skin lesions by hybrid systems based on integrating features of CNN models.

Skin cancer is one of the most fatal skin lesions, capable of leading to fatality if not detected in its early stages. The characteristics of skin lesions are similar in many of the early stages of skin lesions. The AI in categorizing diverse types of skin lesions significantly contributes to and helps dermatologists to preserve patients' lives. This study introduces a novel approach that capitalizes on the strengths of hybrid systems of Convolutional Neural Network (CNN) models to extract intricate features from dermoscopy images with Random Forest (Rf) and Feed Forward Neural Networks (FFNN) networks, leading to the development of hybrid systems that have superior capabilities early detection of all types of skin lesions. By integrating multiple CNN features, the proposed methods aim to improve the robustness and discriminatory capabilities of the AI system. The dermoscopy images were optimized for the ISIC2019 dataset. Then, the area of the lesions was segmented and isolated from the rest of the image by a Gradient Vector Flow (GVF) algorithm. The first strategy for dermoscopy image analysis for early diagnosis of skin lesions is by the CNN-RF and CNN-FFNN hybrid models. CNN models (DenseNet121, MobileNet, and VGG19) receive a region of interest (skin lesions) and produce highly representative feature maps for each lesion. The second strategy to analyze the area of skin lesions and diagnose their type by means of CNN-RF and CNN-FFNN hybrid models based on the features of the combined CNN models. Hybrid models based on combined CNN features have achieved promising results for diagnosing dermoscopy images of the ISIC 2019 dataset and distinguishing skin cancers from other skin lesions. The Dense-Net121-MobileNet-RF hybrid model achieved an AUC of 95.7%, an accuracy of 97.7%, a precision of 93.65%, a sensitivity of 91.93%, and a specificity of 99.49%.

Non-genomic actions of steroid hormones on the contractility of non-vascular smooth muscles.

Steroid hormones play an important role in physiological processes. The classical pathway of steroid actions is mediated by nuclear receptors, which regulate genes to modify biological processes. Non-genomic pathways of steroid actions are also known, mediated by cell membrane-located seven transmembrane domain receptors. Sex steroids and glucocorticoids have several membrane receptors already identified to mediate their rapid actions. However, mineralocorticoids have no identified membrane receptors, although their rapid actions are also measurable. In non-vascular smooth muscles (bronchial, uterine, gastrointestinal, and urinary), the rapid actions of steroids are mediated through the modification of the intracellular Ca2+ level by various Ca-channels and the cAMP and IP3 system. The non-genomic action can be converted into a genomic one, suggesting that these distinct pathways may interconnect, resulting in convergence between them. Sex steroids mostly relax all the non-vascular smooth muscles, except androgens and progesterone, which contract colonic and urinary bladder smooth muscles, respectively. Corticosteroids also induce relaxation in bronchial and uterine tissues, but their actions on gastrointestinal and urinary bladder smooth muscles have not been investigated yet. Bile acids also contribute to the smooth muscle contractility. Although the therapeutic application of the rapid effects of steroid hormones and their analogues for smooth muscle contractility disorders seems remote, the actions and mechanism discovered so far are promising. Further research is needed to expand our knowledge in this field by using existing experience. One of the greatest challenges is to separate genomic and non-genomic effects, but model molecules are available to start this line of research.

Fiber laser with intracavity parallel Mach-Zehnder interferometers towards Vernier refractive index sensing.

In this paper, dual-wavelength laser emission of an erbium-doped fiber laser (EDFL) with a tunable distinct wavelength selection of the simultaneously produced laser lines was achieved by applying a parallel comb filter configuration based on the optical Vernier effect. The intracavity inserted proposed comb filter consists of two parallel branches to generate the Vernier effect. Each branch is an in-line Mach-Zehnder interferometer (MZI) filter, which is composed of a polarization-maintaining fiber fusion spliced between single-mode fibers with sphere shapes at both ends. The tunability of the selected laser wavelength was realized by submerging the proposed filter in different sodium chloride/water mixtures. The proposed comb filter-based Vernier effect was used to independently achieve the selection of the dual-wavelength EDFL lines and for refractive index (RI) sensing applications. The in-line M Z I 1 and M Z I 2 structures show a wavelength shift sensitivity to RI variations of -88 and 79 nm/RIU, respectively. Our proposed MZI structure presents a reliable, straightforward, and low-cost spectral comb filter for separate tunable dual-wavelength laser generation in the c-band region. Furthermore, the proposed filter structure-based Vernier effect presents a new perspective and method in the RI sensing application.

Gender Differences in Knowledge, Attitudes, and Practices toward COVID-19 in Saudi Arabia: A Cross-Sectional Study.

Days after the World Health Organization (WHO) declared that COVID-19 was a pandemic, Saudi Arabia took preventative and precautionary measures to avoid its spread and to safeguard its citizens. In this study, we investigated the knowledge, attitudes, and practices (KAP) of both men and women toward COVID-19 as well as associated factors. A cross-sectional study was conducted using an online, self-report questionnaire distributed via Google Forms. The overall percentage of correct answers for the knowledge statements was 80.2%, with a higher rate among the female respondents (82.4% vs. 78.5%, p = 0.005). Slightly more than half (i.e., 165: 51.6%) of the participants showed that they did not go to crowded places during the pandemic; however, more female respondents recorded that they avoided crowded places than male respondents (57.7% vs. 46.2%, p = 0.04). Most participants (i.e., 272: 85.0%) reported that they had worn a mask in recent days, and more than two-thirds (84.4%) said that they still follow the strategies recommended by government authorities to prevent the spread of the virus. Again, more female respondents reported this than males (89.9% vs. 79.5%; p = 0.01). Significant correlations (p < 001) were noted between knowledge and practices (r = 0.31), knowledge and attitudes (r = 0.37), and attitudes and practices (r = 0.29). In the multivariate logistic regression analysis, occupation and education were independently associated with knowledge among both the male and female respondents (adjusted odds ratio [aOR]: 2.9; 95% confidence interval [CI]: 1.2-7.2; aOR: 5.9; 95% CI: 2.2-15.9). Residence was independently associated with attitudes, but only among the male respondents (aOR: 2.3; 95% CI: 1.1-4.9), and COVID-19 was independently associated with practices among both the male and female respondents (aOR: 4.5; 95% CI: 1.4-14.2; aOR: 9.8; 95% CI: 1.2-81.2). There were significant gender differences in both knowledge and practices toward COVID-19, with the female respondents achieving better scores than the male respondents. Thus, we recommend that health education campaigns are tailored to specifically target males.

Evaluation of patients' knowledge about their medications: A cross-sectional study in Qassim region, Saudi Arabia.

Background: To authors' knowledge, in Saudi Arabia, information regarding patients' knowledge about their medications is lacking. Objectives: This study aimed to fill this literature gap by assessing patients' knowledge and perceptions about their medications. Design: To achieve the objective of the study, a cross-sectional survey was conducted outside community pharmacies in Qassim region through an exit interview with patients after getting their prescriptions filled or refilled. Methods: A convenient sample of patients was chosen based on acceptance to participate. A form was prepared based on the core and complementary medicines use indicators for evaluation of medicines use in healthcare settings developed by the World Health Organization (WHO). Results: Four hundred forty-three forms were completed. A total of 70% of the indicators of patients' knowledge about their medications were found to be satisfactory, and a total of 89% of the patients were found to have positive perceptions about safety and effectiveness of their medications. Conclusion: Overall, patients' knowledge about their medications was found to be reasonable with exception of the area "information about precautions and possible side effects" which had shown poor patients' knowledge.

Microwave NDT of Smart Composite Structures with Embedded Antennas.

The integration of antennas in composite structures is gaining popularity with advances in wireless communications and the ever-increasing demands for efficient smart structures. Efforts are ongoing to ensure that antenna-embedded composite structures are robust and resilient to inevitable impacts, loading and other external factors that threaten the structural integrity of these structures. Undoubtedly, the in situ inspection of such structures to identify anomalies and predict failures is required. In this paper, the microwave non-destructive testing (NDT) of antenna-embedded composite structures is introduced for the first time. The objective is accomplished using a planar resonator probe operating in the UHF frequency range (~525 MHz). High-resolution images of a C-band patch antenna fabricated on an aramid paper-based honeycomb substrate and covered with a glass fiber reinforced polymer (GFRP) sheet are presented. The imaging prowess of microwave NDT and its distinct advantages in inspecting such structures are highlighted. The qualitative as well as the quantitative evaluation of the images produced by the planar resonator probe and a conventional K-band rectangular aperture probe are included. Overall, the potential utility of microwave NDT for the inspection of smart structures is demonstrated.

Recurrence Rate of Pulmonary Tuberculosis in Patients Treated with the Standard 6-Month Regimen: Findings and Implications from a Prospective Observational Multicenter Study.

Tuberculosis (TB) recurrence following successful treatment is a significant challenge in TB control programs. However, the rate of TB recurrence varies among studies. It depends on several factors, including the country/region where the investigation occurs, the study design, sample characteristics, and the anti-TB regimen used. In Yemen, a few previous studies examined the rate of TB recurrence and reported high recurrence rates, with a 5-year recurrence rate of approximately 9.5%. However, they were conducted before 2010 using the previous anti-TB regimen which was phased out and replaced with the World Health Organization's (WHO) standard 6-month TB regimen. Consequently, this study aimed to examine the rate of TB recurrence after the implementation of the WHO standard 6-month regimen in Yemen. A prospective observational study was conducted with patients diagnosed with drug-susceptible pulmonary TB. The patients were recruited from five health centers with TB units in five governorates from January to December 2011. All the patients were followed up for five years after treatment completion. A total of 439 patients who completed the anti-TB regimen met the inclusion criteria and were included in the study. During the 5-year follow-up period, 8 patients (1.8%) died, and 13 patients (2.96%) were lost to follow-up, resulting in a final cohort of 418 patients. Of the cohort, 50.5% (n = 211) were male, while 49.5% (n = 207) were female patients. Of the patients, 129 patients (30.9%) were illiterate, 56 (13.4%) had cavitary pulmonary disease, and 6.2% (n = 26) had diabetes. The overall 5-year rate of TB recurrence in this study for the patients receiving the standard 6-month regimen was 2.9% (12/418). Moreover, almost half of the recurrent cases (41.7%; n = 5) were seen during the first year of the follow-up period. Some patient groups with risk factors recorded a higher recurrence rate, including patients with diabetes (15.4%), non-compliant patients (14.3%), pre-treatment lung cavitation patients (8.9%), illiterate patients (7.8%), and underweight patients (5.1%). In conclusion, the overall TB recurrence rate with the standard 6-month regimen was lower than that with the previous TB regimens. However, more efforts are needed to decrease TB recurrence rates further and achieve a durable cure for TB. In addition, healthcare professionals and TB control programs should consider potential risk factors of recurrence and address them to provide optimal care.

Knowledge, Attitudes and Practices of the General Population in Yemen Regarding COVID-19: A Cross-Sectional Study.

BACKGROUND: Following the World Health Organization declaration of COVID-19 as a pandemic, Yemen has taken preventive and precautionary measures against COVID-19 to control its spread. This study evaluated the knowledge, attitudes, and practices (KAP) of the Yemeni public regarding COVID-19. METHODS: A cross-sectional study using an online survey was conducted during the period from September 2021 to October 2021. RESULTS: The mean total knowledge score was 9.50 ± 2.12. The majority of the participants (93.4%) were aware that to prevent infection by the COVID-19 virus, going to crowded places and gatherings should be avoided. Approximately two thirds of the participants (69.4%) believed COVID-19 is a health threat to their community. However, in terms of actual behavior, only 23.1% of the participants reported that they did not go to any crowded places during the pandemic, and only 23.8% had worn a mask in recent days. Moreover, only about half (49.9%) reported that they were following the strategies recommended by the authorities to prevent the spread of the virus. CONCLUSION: The findings suggest that the general public has good knowledge and positive attitudes regarding COVID-19, but that their practices are poor.

Artificial Intelligence and Its Application in Endodontics: A Review.

AIM AND BACKGROUND: Artificial intelligence (AI) since it was introduced into dentistry, has become an important and valuable tool in many fields. It was applied in different specialties with different uses, for example, in diagnosis of oral cancer, periodontal disease and dental caries, and in the treatment planning and predicting the outcome of orthognathic surgeries. The aim of this comprehensive review is to report on the application and performance of AI models designed for application in the field of endodontics. MATERIALS AND METHODS: PubMed, Web of Science, and Google Scholar were searched to collect the most relevant articles using terms, such as AI, endodontics, and dentistry. This review included 56 papers related to AI and its application in endodontics. RESULT: The applications of AI were in detecting and diagnosing periapical lesions, assessing root fractures, working length determination, prediction for postoperative pain, studying root canal anatomy and decision-making in endodontics for retreatment. The accuracy of AI in performing these tasks can reach up to 90%. CONCLUSION: Artificial intelligence has valuable applications in the field of modern endodontics with promising results. Larger and multicenter data sets can give external validity to the AI models. CLINICAL SIGNIFICANCE: In the field of dentistry, AI models are specifically crafted to contribute to the diagnosis of oral diseases, ranging from common issues such as dental caries to more complex conditions like periodontal diseases and oral cancer. AI models can help in diagnosis, treatment planning, and in patient management in endodontics. Along with the modern tools like cone-beam computed tomography (CBCT), AI can be a valuable aid to the clinician. How to cite this article: Ahmed ZH, Almuharib AM, Abdulkarim AA, et al. Artificial Intelligence and Its Application in Endodontics: A Review. J Contemp Dent Pract 2023;24(11):912-917.

Saudi pharmacy students' perceived knowledge and attitude on their role in public health services.

OBJECTIVES: This study aimed to explore the preparedness of pharmacy students to actively participate in public health services by examining their attitude towards and knowledge about the national public health programmes (NPHPs). METHODS: A cross-sectional study was conducted using an online questionnaire survey of the students in Unaizah College of Pharmacy (UCP) and College of Pharmacy Main Campus (CPMC), Qassim University, between October 2019 and February 2020. KEY FINDINGS: A total of 100 out of 125 students responded to the questionnaire at a response rate of 80%. While the majority (77%) of the participants agreed on the necessity for pharmacists to know about the NPHPs, 71% reported they did not learn about National Health Policy in their pharmacy curriculum. Also, a small number of pharmacy students, at 16%, believed that their current knowledge about the NPHPs was sufficient or very sufficient. Lastly, 81% of the participants felt that they had an important or very important role to play in the NPHPs. CONCLUSIONS: The majority of the participants expressed interest in more education on public health during their pharmacy education. Their interest supports the advancement of public health education to facilitate greater involvement of pharmacists in public health services.

Ultrasound to the Rescue: Management of Looped Guidewire during Hemodialysis Catheter Insertion in the Left Internal Jugular Vein.

Hemodialysis catheters are commonly placed in the major central vein for the purpose of dialysis. Coiling or looping of guidewire is a rare but reported complication of a central vascular catheter insertion. We report a case in which we encountered a rare complication of looping of the guidewire used for dialysis catheter placement and how we correctly diagnosed and repositioned it under ultrasound guidance. A 68-yearold man diagnosed with Carcinoma of Pyriform Fossa admitted in our ICU had Acute Renal Failure. An attempt to insertion of hemodialysis catheter in left internal jugular vein was made. Following successful puncture, the guide wire was threaded through needle. After five centimeter length of guide wire was threaded, resistance was felt and a loop of guidewire was visualized which was abutting the posterior wall of vein in out-of-plane view, creating a dual-point echogenicity. Under ultrasound guidance, we slowly pulled out the guidewire till the loop disappeared.The catheter was then inserted without repeat puncture of the vessel, thus preventing chance of thrombosis by repeated attempts. Real time USG guidance not only improves the success rates but also decreases the number of attempts and complications related to hemodialysis catheterization. Moreover, it benefits the patients by reducing the risks and discomforts of the procedure by reducing the duration of cannulation. The intelligent use of real-time ultrasound guidance in each step of the central venous catheterization is absolutely the need of the hour to prevent catastrophic yet preventable complications.

Investigating the Impact of Face-to-Face vs Online Learning on the Eating Habits of Non-Clinical Students Registered at the Faculty of Medical Sciences, St. Augustine

University students lack adequate and balanced meals due to the separation from their families, insufficient funds, or lack of time and information about healthy nutrition. Most university students' diets are not nutritionally adequate or balanced during their school years. The COVID-19 pandemic has led to the closure of schools and the implementation of lockdowns, resulting in isolation at home to curb the spread of the virus. The transition to online school disrupted the normal routine of most students making it difficult to maintain a healthy eating habit. However, not all students reported an unhealthy change. Information gathered can be used to promote healthy eating amongst students and make them aware of eating habits that would promote better health and wellbeing.

Influence of the Aryl Hydrocarbon Receptor Activating Environmental Pollutants on Autism Spectrum Disorder.

Autism spectrum disorder (ASD) is an umbrella term that includes many different disorders that affect the development, communication, and behavior of an individual. Prevalence of ASD has risen exponentially in the past couple of decades. ASD has a complex etiology and traditionally recognized risk factors only account for a small percentage of incidence of the disorder. Recent studies have examined factors beyond the conventional risk factors (e.g., environmental pollution). There has been an increase in air pollution since the beginning of industrialization. Most environmental pollutants cause toxicities through activation of several cellular receptors, such as the aryl hydrocarbon receptor (AhR)/cytochrome P450 (CYPs) pathway. There is little research on the involvement of AhR in contributing to ASD. Although a few reviews have discussed and addressed the link between increased prevalence of ASD and exposure to environmental pollutants, the mechanism governing this effect, specifically the role of AhR in ASD development and the molecular mechanisms involved, have not been discussed or reviewed before. This article reviews the state of knowledge regarding the impact of the AhR/CYP pathway modulation upon exposure to environmental pollutants on ASD risk, incidence, and development. It also explores the molecular mechanisms involved, such as epigenesis and polymorphism. In addition, the review explores possible new AhR-mediated mechanisms of several drugs used for treatment of ASD, such as sulforaphane, resveratrol, haloperidol, and metformin.

Factors Influencing Clinical After Effects of Post Orthognathic Surgery - An Observational Clinical Study.

BACKGROUND: For maintaining the occlusion, screws to anchor bones are needed to be used in transalveolar manner to get the intermaxillary fixation in participants with no preoperative orthodontic treatment or participants with loose or broken appliances. AIMS: The present clinical trial was hence aimed to assess the postoperative complications following orthognathic surgical repair of skeletal malocclusion. MATERIALS AND METHODS: Forty-two participants were divided into two groups (n = 22). In Group I, predrill was done to create the holes in transalveolar position before screw insertion. For Group II, self-cutting screws were used without the drills. The radiographs were then taken to assess the associated root injuries. To evaluate the effect of different steroid doses on the pain, nerve healing, and swelling, the participants were divided into three groups (n = 14). Plate removal and associated factors were also evaluated. Collected data were statistically analyzed. RESULTS: In Group where no predrill was done, no root injuries were seen. Considerably less facial edema was observed in Group II and III compared to control Group I. This difference was statistically significant with a P value of 0.2057. At 1 week, 3 months, and 6-month postoperatively in Group II and Group III, no significant difference was seen. No significant difference in the postoperative pain between the groups was seen (P = 0.85103). Neurosensory Visual Analog Score measurement revealed no significant difference between three groups at 6 months with the P value of 0.81821. CONCLUSION: The present study concludes that risk for the root injury is possessed by the screws that require predrill, whereas the self-drilling screws had no risk for root injury.

Optimization for synthesis of silver nanoparticles through response surface methodology using leaf extract of Boswellia sacra and its application in antimicrobial activity.

In the present work, leaf extract of Boswellia sacra was used as reductant for synthesis of silver nanoparticles (AgNPs). The variables such as volume of Boswellia sacra leaf extract (1%), volume of silver nitrate (1 mM), and temperature were optimized by response surface methodology via Box-Behnken design for the synthesis of AgNPs. Design-Expert software generated the optimum conditions for the highest yield of silver nanoparticles as 8 mL of 1 mM AgNO3, 8 mL of 1% Boswellia sacra leaf extract, and temperature = 55 °C. The formed AgNPs were isolated and purified by centrifugation process using ethanol/ distilled water. AgNPs were characterized using FTIR, SEM, TEM, EDX, and XRD. AgNPs showed surface plasmon resonance absorption band at 422 nm. XRD pattern indicated the crystalline nature of the particles (diameter 11.17 to 37.50 nm) with face-centered cubic structure. SEM and TEM images highlighted the formation of spherical AgNPs. The energy dispersive spectroscopic spectrum confirmed the presence of elemental silver. The microbial activity of AgNPs was evaluated against bacteria and fungi. Synthesized AgNPs were very effective against Gram-positive E. coli bacterial strains and fungal strains (Penicillium chrysogenum).

Rate and risk factors of recurrent tuberculosis in Yemen: a 5-year prospective study.

Background: Tuberculosis is a major public health concern in Yemen. Recurrence of tuberculosis complicates the situation further, and has severe negative economic and health consequences. This study estimated the tuberculosis recurrence rate during a 5-year follow-up period, and identified risk factors associated with recurrence.Methods: This was a prospective study with a 5-year follow-up period conducted at health centres with tuberculosis units in ten governorates. Participants were prospectively enrolled in the study from July 2007 to June 2008, with the last patient completing treatment on March 15, 2009.Results: A cohort of 814 patients with pulmonary tuberculosis completed treatment and was followed-up for five years. During the follow-up, 3.4% (n = 28) died and 4.3% (n = 35) were lost to the study, giving a final cohort of 751 patients. The mean age ± standard deviation was 32 ± 13 years. Males represented 57.6% of the subjects. The overall recurrence rate of tuberculosis was 9.5% (71/751), with significant variation between subgroups of patients (range = 7-25.8%). The highest recurrence rates were found in patients with diabetes (25.8%, p < .001), non-adherent patients (22%, p < .001), smokers (16.1%, p = .010), patients with cavitary lung disease (14.4%, p = .004), patients with weight gain ≤5% during the intensive phase (13.3%, p < .001) and unemployed patients (11.9%, p = .017). In multivariate logistic regression analysis, these risk factors were independently associated with recurrent tuberculosis: diabetes (adjusted odds ratio, aOR 3.78, 95% confidence interval, CI 1.84-7.80), non-adherence (aOR 3.22, 95% CI 1.76-5.87), weight gain ≤5% (aOR 2.51, 95% CI 1.39-4.55), smoking (aOR 2.18, 95% CI 1.07-4.47), presence of lung cavitation (aOR 2.01, 95% CI 1.16-3.46), and unemployment (aOR 2.15, 95% CI 1.16-4.01).Conclusion: The recurrence rate of tuberculosis in Yemen was high. The presence of risk factors in newly diagnosed patients should alert healthcare professionals. As most of risk factors were modifiable, the World Health Organisation model of patient-centered care in tuberculosis treatment should be promoted in all tuberculosis centres in the country.

Best evidence topic: Should ventral hernia repair be performed at the same time as bariatric surgery?

A best evidence topic has been constructed using a described protocol. The three-part question addressed was: In morbidly obese patients undergoing bariatric surgery, when a ventral hernia is picked up in clinic or intraoperatively is concurrent repair of the hernia better than delayed repair after weight loss with regards to complication rates? Using the reported search, 179 papers were found. 5 studies were deemed to be suitable to answer the question. All 5 studies assessed were non randomised studies either retrospective or prospective and the overall quality of these studies was poor. The outcomes assessed were incidence of complications associated with hernia repair (recurrence, infection) and deferral of repair (small bowel obstruction). The patient's symptoms and anatomy is important in determining the timing of repair. The evidence does not provide a consensus for the optimal timing of ventral hernia repair for patients undergoing bariatric surgery, with some of the selected studies contradicting each other. However, the studies do affirm the risk of small bowel obstruction if hernias are left alone. The reported rate of surgical site infection is low when mesh repair is performed at the same time as weight loss surgery. Until large volume, high quality randomized control trials can be performed, a case by case approach is best, where the patients' symptoms, anatomy, type of bariatric surgery and their personal preferences are considered, and an open discussion on the risks and benefits of each approach is undertaken.

A study assessing public knowledge, belief and behavior of antibiotic use in an omani population.

OBJECTIVE: This study was aimed to assess public knowledge, belief and behavior towards antibiotics use in a general population in the Sultanate of Oman. METHODS: A 12-item self-administered questionnaire was distributed to 850 prospective participants by researchers using quota sampling in two governorates of Oman. The data obtained were evaluated to assess the responses to individual questions related to knowledge, belief and behavior of antibiotic use. Median score of the respondents was correlated with participant demographics and status on use of antibiotics. RESULTS: A total of 718 completed questionnaires were obtained giving a response rate of 85%. The median total score of the participants was 16 (Interquartile range: 6) out of a possible maximum score of 24. A moderate knowledge and behavior score was observed, while the belief score of the participants was low. A significant difference was observed in the median total score based on age group, educational qualification and employment status. CONCLUSION: Antibiotics are frequently used by the public. An inappropriate belief on antibiotic related aspects was observed and inappropriate behavior was noticed, which are reflections of insufficient knowledge and wrong beliefs. Interventions must be put in place to educate the public on appropriate antibiotic use.

Hepatoprotective efficacy of ursodeoxycholic acid in pediatrics acute lymphoblastic leukemia.

Ursodeoxycholic acid (UDCA) possesses a hepatoprotective effect in drug-induced hepatotoxicity. In a prospective randomized parallel study, 39 children with acute lymphoblastic leukemia (ALL) were randomized to receive UDCA with chemotherapy for 6 months, then discontinued UDCA and were followed up for 3 months, (UDCA group) (N = 19) or receive chemotherapy without UDCA and followed up for 9 months (control group) (N = 20). In this pilot study, UDCA treatment was associated with a trend toward decreased levels of hepatic transaminases when concomitantly administered with chemotherapy and, therefore, safer outcome in children with ALL. Future studies with a larger sample size are needed to confirm the efficacy and safety of UDCA in this setting.