External fixation versus intramedullary nailing for the management of open tibial fracture: meta-analysis of randomized controlled trials.

AIM: Tibial shaft fractures are the most common type of long-bone fractures. External fixation (EF) and intramedullary nailing (IMN) are widely used surgical techniques for the definitive fixation of open tibial shaft fractures. The aim of this systematic review and meta-analysis was to compare EF to IMN for the definitive fixation of open tibial fractures. METHODS: Medline, Embase, and CENTRAL databases were searched for eligible studies. We included randomized controlled trials (RCTs) that compared EF to IMN for skeletally mature adults with open tibial fracture (Gustilo I, II, and III). We evaluated the following outcomes: superficial infection, pin-track infection, deep infection, malunion, nonunion, delayed union, and implant/hardware failure. The risk ratio (RR) was used to represent the desired outcomes. The statistical analysis was performed using the random-effects model. RESULTS: A total of 12 RCTs that enrolled 1090 participants were deemed eligible for the analysis. EF showed a significantly higher rate of superficial infection, pin track infection, and malunion compared to IMN (RR = 2.30, 95% confidence interval (CI): 1.34 to 3.95; RR = 13.52, 95% CI: 6.16 to 29.66; RR = 2.29, 95% CI 1.41 to 3.73, respectively). No substantial difference was found between EF and IMN in terms of deep infection, nonunion, delayed union, or implant/hardware failure (RR = 1.15, 95% CI 0.67 to 1.98; RR = 0.92, 95% CI 0.77 to 1.10; RR = 1.50, 95% CI 0.98 to 3.33; RR = 0.96, 95% CI 0.36 to 2.60, respectively). DISCUSSION: The findings of our meta-analysis are consistent with the previous systematic reviews excepts for the implant/hardware failure which was found to be significant in favour of IMN by one of the previous reviews. CONCLUSION: This meta-analysis confirms that IMN is better than EF with respect to clinical outcomes and complication rate for the definitive fixation of open tibial fracture.

The clinical features and impact of SARS-CoV-2/COVID-19 infection in children with Cystic Fibrosis (CF): A Qatari experience.

BACKGROUND: SARS-CoV-2 in children with cystic fibrosis (CF) has been reported to cause mild illness without pre-existing severe lung disease. This review described the clinical presentation and course of COVID-19 infection in children with CF in Qatar. METHODS: The pediatric CF registry of 51 patients in Qatar was reviewed for COVID-19 cases from February 2020 to February 2022. Demographics, vaccination status, symptoms, and course were reviewed. Data were expressed as median, range, frequencies, and percentages. RESULTS: The study included eight patients with CF below 18 years of age infected with COVID-19. The incidence of COVID-19 in children with CF was 15.7%. The median age was 11 (2-18) years. Half of the cohort were males. Seven patients were pancreatic sufficient (I1234V mutation), and one was pancreatic insufficient (3129del4 mutation). The median baseline FEV1 was 91 (78-107%) predicted. None had received CFTR modulators or undergone a lung transplant. Three patients were vaccinated before their infections. Two of them were asymptomatic. Six patients (75%) had a cough and flu-like symptoms. Three patients had a fever. Two patients were hospitalized due to pulmonary exacerbation; both had mild CF-lung disease. None required respiratory support. CONCLUSION: We report a favorable outcome of COVID-19 infection in children with CF, similar to published international studies. Our findings are attributable to the community-dominant milder CFTR mutation, precautionary measures, and causative COVID-19 strain. More longitudinal data are needed to study these factors as potential protective mechanisms.

Adamantane-derived scaffolds targeting the sigma-2 receptor; an in vitro and in silico study.

Novel adamantane-based compounds were synthesized and assessed as potential sigma-2 receptor ligands. Molecular docking and 50 ns molecular dynamic simulation were carried out to determine the binding modes, mechanism of interaction, and stability of these compounds within the active site of the sigma-2 receptor. In addition, the ADME-T properties have been explored. The cytotoxicity in cancer cell lines that express sigma-2 receptors was also examined. In addition, the in silico and cytotoxicity data for the new compounds were compared to a reference sigma-2 receptor ligand with high receptor-binding affinity and selectivity. The data suggests that the new compounds interact with the sigma-2 receptor in a comparable manner to the reference compound, and that adamantane can be used as a scaffold to synthesize sigma-2 receptor ligands with useful functional groups that can be used to conjugate moieties for tumor-imaging or cytotoxic cargo delivery.

On a New Class of p-Valent Meromorphic Functions Defined in Conic Domains.

We define a new class of multivalent meromorphic functions using the generalised hypergeometric function. We derived this class related to conic domain. It is also shown that this new class of functions, under certain conditions, becomes a class of starlike functions. Some results on inclusion and closure properties are also derived.

New QTL alleles for quality-related traits in spring wheat revealed by RIL population derived from supernumerary × non-supernumerary spikelet genotypes.

KEY MESSAGE: A population developed from an exotic line with supernumerary spikelets was genetically dissected for eight quality traits, discovering new genes/alleles with potential use in wheat breeding programs. Identifying new QTLs and alleles in exotic germplasm is paramount for further improvement of quality traits in wheat. In the present study, an RIL population developed from a cross of an elite wheat line (WCB414) and an exotic genotype with supernumerary spikelets (SS) was used to identify QTLs and new alleles for eight quality traits. Composite interval mapping for 1,000 kernels weight (TKW), kernel volume weight (KVW), grain protein content (GPC), percent of flour extraction (FE) and four mixograph-related traits identified a total of 69 QTLs including 19 stable QTLs. These QTLs were located on 18 different chromosomes (except 4D, 5D, and 6D). Thirteen of these QTLs explained more than 15% of phenotypic variation (PV) and were considered as major QTLs. In this study, we identified 11 QTLs for TKW (R (2) = 7.2-17.1 %), 10 for KVW (R (2) = 6.7-22.5%), 11 for GPC (R (2) = 4.7-16.9%), 6 for FE (R (2) = 4.8-19%) and 31 for mixograph-related traits (R (2) = 3.2-41.2%). In this population, several previously identified QTLs for SS, nine spike-related and ten agronomic traits were co-located with the quality QTLs, suggesting pleiotropic effects or close linkage among loci. The traits GPC and mixogram-related traits were positively correlated with SS. Indeed, several loci for quality traits were co-located with QTL for SS. The exotic parent contributed positive alleles that increased PV of the traits at 56% of loci demonstrating the suitability of germplasm with SS to improve quality traits in wheat.

Effect of pre-harvest sprouting on physicochemical changes of proteins in wheat.

BACKGROUND: High moisture before harvest can cause sprouting of the wheat kernel, which is termed pre-harvest sprouting (PHS). The aim of this study was to examine the variation in physicochemical properties of proteins in PHS-damaged (sprouted) hard red and white spring wheat genotypes. Specifically, protein content, enzyme activity and degradation of proteins were evaluated in sound and PHS-damaged wheat. RESULTS: Protein contents of sprouted wheat samples were lower than that of non-sprouted samples; however, their differences were not significantly (P > 0.05) correlated with sprouting score. Sodium dodecyl sulfate (SDS) buffer extractable proteins (EXP) and unextractable proteins (UNP) were analyzed by high-performance size exclusion chromatography. PHS damage elevated endoprotease activity and consequently increased the degradation of polymeric UNP and free asparagine concentration in wheat samples. Free asparagine is known to be a precursor for formation of carcinogenic acrylamide during high heat treatment, such as baking bread. Free asparagine content had significant correlations (P < 0.01) with sprouting score, endoprotease activity and protein degradation. CONCLUSIONS: Genotypes with higher endoprotease activity tend to exhibit a larger degree of degradation of UNP and higher free asparagine concentration in sprouted wheat samples.

Okra-gum fortified bread: formulation and quality.

Freeze-dried okra extract was added to Hard Red Spring (HRS) wheat flour intended for high soluble-fiber bread. Seedless okra pods were blended in 0.05 M NaOH solution and the extract (OE) was freeze-dried at pH 7. SE-HPLC of OE showed the presence of covalently bound peptides. Okra extract powder (OE) 4, 7, 10, and 13 % was used to replace wheat flour in preparing four bread formulations. Although Farinograph water absorption was increased up to 4.4 % due to OE addition, the dough mixing Tolerance (MIT) was also increased. In the presence of OE, bread loaf volume was lower and freezable water was higher. Overall, bread firmness was lower at lower storage temperature, but higher OE increased firmness, due to water migration from crumb to crust. Color was darker for both crust and crumb. The bread melting temperature shifted to lower values at higher OE content as shown by Dynamic Mechanical Analysis (DMA). The test indicated that the properties of the blends were similar around the glass transition region. Dynamic rheology of the blends revealed weaker visco-elastic behavior compared to the control. The magnitude of the complex moduli for the 4 % OE was independent of frequency, while the remaining blends were frequency dependent.

Utilizing Edge-Oxidized Graphene Oxide to Enhance Cement Mortar's Properties Containing Crumb Rubber: Toward Achieving Sustainable Materials.

Scrap tires have become one of the most serious environmental issues worldwide in recent years. Exploiting this scrap has caught the attention of researchers in their efforts to conserve the environment. From a structural engineering materials perspective, a partial fine aggregate in cement mortar can be replaced by crumb rubber produced from scrap tires. This research mainly emphasizes the role of adding 0.1% edge-oxidized graphene oxide EOGO (by the weight of cement) in enhancing the properties of cement mortars containing 5%, 10%, and 15% of crumb rubber (by sand replacement). Cube and prism specimens were employed to investigate compressive and flexural strengths at 7- and 28-day curing ages. A porosity test was also conducted after 28 days of curing. In addition, a scanning electron microscopy (SEM) test was performed to investigate the effect of incorporating EOGO on the interfacial transition zone (ITZ). Results showed an enhancement of the mechanical properties of cement mortar, including compressive and flexural strengths, with the inclusion of EOGO in the mixes. The findings demonstrated that adding EOGO can improve the mechanical properties of mixes containing crumb rubber particles. Specifically, the mortar mix with 0.1% EOGO and 5% crumb rubber exhibited better performance compared with the virgin mix without rubber particles. Therefore, crumb rubber is viable for use as a sand replacement when EOGO is included.

Comparing the softening effect of three gutta-percha solvents on different types of gutta-percha with different application durations.

Introduction: During non-surgical endodontic retreatment, gutta-percha (GP) solvents are indispensable in difficult cases when used with mechanical removal, however studies comparing their efficacy against different types of GP are limited. The purpose of this study was to investigate the softening effect of three solvents on the conventional (CGP), cross-linked carrier-based (CLGP), and thermoplasticized (TGP) and compare the effect of time on the softening effect of the solvents. Methods: Tested GP were embedded in cuboidal blocks of stone with their upper surfaces exposed (1 mm diameter). Three commercial GP solvents based on D-Limonene (DL), Eucalyptol oil (EO), and orange oil (OO) were added to the exposed GP before an indenter (weight = 1Kg) was applied. Using a digital camera, the indentation depth was measured (mm) directly after applying the solvent and indenter (T = 0), and after 1, 2, and 3 min of application (T = 1,2,3). The means of indentation depth were calculated and compared using a two-way analysis of variance and Tukey's post-hoc test to assess the effect of the types of solvent, GP for each application duration, and Friedman's test to evaluate the effect of application duration on the softening effect of solvents. Results: The type of GP (F = 261.43, p < 0.001), type of solvent (F = 3.57, p = 0.015), and application duration (F = 53.088, p < 0.001) were all found to significantly affect GP softening. DL exhibited the highest and only significant effect on CGP after 1 min (p < 0.05), while OO had the only significant effect against CLGP when applied for at least 2 min (p < 0.05). Both OO and EO had significant softening effects on TGP instantly or after 1 min of application, respectively. Conclusions: The results of this study revealed that the softening effect of GP solvents varies depending on their type, their application duration, and the type of GP.

Prevalence of nasal obstruction and its impact on quality of life in Saudi Arabia.

Purpose/Background: Nasal obstruction is a significant issue influencing the patient's quality of life. Chronic nasal obstruction is frequently associated with other symptoms such as headache, sleep disturbance, and daytime sleepiness. This study aims to investigate the prevalence of nasal obstruction in Saudi Arabia and examine its effect on patients' quality of life. Methods: This is a cross-sectional study conducted in Saudi Arabia. Data were collected using a self-administered combination of two previously validated questionnaires (the NOSE scale and the WHOQOL-BREF) translated into Arabic. The Mann-Whitney test was used to investigate the association between nasal obstruction prevalence and the participants' QOL. Results: The study included 1039 participants from different regions of Saudi Arabia. The prevalence of nasal obstruction was 60.3% among the participants. Several factors significantly affected the prevalence of nasal obstruction, including sex, suffering from a chronic disease, having a family member with nasal obstruction, and using medications (P < 0.001 for all factors). A better score was shown in the four domains of the WHOQOL-BREF questionnaire by the participants who had no nasal obstruction: the physical health domain, psychological health, social relationships, and environment (P < 0.001 for all factors). Conclusions: Quality of life is affected by nasal obstruction. The subjective assessment is essential in evaluating the severity of nasal obstruction disease. It is recommended that healthcare providers use subjective tools combined with objective tools to assess the degree of nasal obstruction severity.

Enhancing the engineering characteristics of sustainable recycled aggregate concrete using fly ash, metakaolin and silica fume.

The present global environment is facing growing issues linked to production of concrete, mostly due to high consumption of concrete as the dominating construction material globally. In today's climate of environmental sustainability, recycled concrete production using RA (recycled aggregates) requires a more holistic approach. This study examined how recycled aggregate (RA), metakaolin, silica fume and fly ash affect mechanical characteristics (compressive strength, split tensile strength), and durability characteristics (acid resistance, absorption, sorptivity) of concrete. The objective of this investigation is to figure out how the potential of RA based concrete can be improved so that they can be used to their maximum extent. To achieve the desired outcome, the study involved testing three distinct groups of concrete samples, each containing different percentages (25%, 50%, and 75%) of recycled aggregate (RA) with a constant amount of silica fume, (25 kg/m3). The first group was used as the control mix, while the second group incorporated 10% fly ash, and the third group included 15% metakaolin. The findings of this research show that the RA concrete mechanical properties as well as durability can be significantly improved by incorporating 15% metakaolin and 10% fly ash. The investigation involves the examination of all ternary blends within two distinct acidic environments, specifically a 5% hydrochloric acid (HCl) solution and sulfuric acid (H2SO4). Both the ternary mixes (metakaolin and fly ash) with the combination of silica improve all characteristics. The quality assurance, cost analysis and the reduction of CO2 emissions are carried out, utilizing RA (recycled aggregates) as a substitute for NA (natural aggregate). In case of producing superior structural concrete, it is recommended based on results to limit the replacement percentage of recycled aggregate (RA) to a maximum of 50% in presence of 10% fly ash and 15% metakaolin, otherwise the RA replacement percentage should not be more than 25%.

The Prevalence of Shoulder Pain and Awareness of Frozen Shoulder Among the General Population in Taif City, Saudi Arabia.

Background The global prevalence of shoulder pain varies widely across countries. Additionally, shoulder pain and frozen shoulder can significantly affect patients' quality of life due to high levels of pain and disability. Objective This study aimed to investigate the prevalence of shoulder pain and its risk factors. It also aims to assess the level of knowledge regarding frozen shoulders and its related factors in Taif City, Saudi Arabia. Methods A cross-sectional observational study was conducted in Taif City in December 2023 using a validated questionnaire comprised of socio-demographic characteristics, the prevalence of shoulder pain, and the awareness of frozen shoulders. Results A total of 378 participants enrolled in the study, with 54.8% being male and 62.7% being graduates and having jobs equally distributed among office (24.9%) and in the field (24.9%). Most participants were smokers (75.9%) and did not engage in body-building activities (79.6%). Around 26.5% of them had diabetes. The prevalence of shoulder pain was 32.8%. Aging from 35 to 44 years (p<0.001), having a higher salary from 6000 to 10000 SAR (p<0.001), retirement (p<0.001), engaging in body-building activities (p=0.035), having diabetes (p<0.001), and having other comorbidities (p<0.001) are significantly impacted having shoulder pain. Increased knowledge about the frozen shoulder is correlated with aging from 25-34 (p=0.026), smoking (p=0.002), engaging in bodybuilding (p<0.001), having diabetes (p=0.010), and having other medical conditions (p=0.010). Conclusion The study has shown that shoulder pain is prevalent among Taif City's population. Nevertheless, a low level of knowledge was observed. Therefore, enhancing the national educational programs is needed to increase public awareness of frozen shoulders.

Screening, awareness and challenges for colorectal cancer treatment in Saudi Arabia: an update.

Colorectal cancer (CRC) is the second most common cancer in the world. In Saudi Arabia, CRC is the most common cancer in males and the third most common in females, and its incidence rate is rising as the country continues to develop. However, the country does not have a national CRC screening program for CRC. This review aims to review recent studies that have attempted to address and rectify this issue and discern the most notable and prevalent barriers. Despite these efforts, guidelines are still lacking. Two prospective studies have been conducted in recent years, one of which was a national pilot screening program conducted by the Ministry of Health (MOH). While both had a similar number of participants, the colonoscopy rate for patients with a positive fecal immunochemical test (FIT) in the MOH program was only 20% compared to 75.8% in the Al-Kharj program. Awareness of the Saudi population regarding CRC and its screening appears to be insufficient. The most common barriers to patients' willingness to undergo screening were embarrassment, fear, and pain. Barriers to physicians are mostly related to factors outside their hands, such as lack of equipment and time. We conclude that efforts should be made to establish a national screening program and improve awareness of the population and physicians.

The Knowledge, Attitudes, and Practices Regarding Diabetic Ketoacidosis Among Diabetic Patients in the Northern and Western Regions of Saudi Arabia.

Background and objective Diabetes mellitus (DM) is a chronic debilitating metabolic disease caused by insulin deficiency. Diabetic ketoacidosis (DKA) is a potentially fatal complication characterized by acute hyperglycemia and metabolic acidosis. In light of the high prevalence of DM in Saudi Arabia, we sought to investigate the knowledge, attitudes, and practices of the Saudi general population about DKA. Methods An online self-administered questionnaire was distributed through popular social media platforms among diabetics in the Saudi population. The survey questions involved demographic data; diabetes status including the time of diagnosis, current medications, and the latest HbA1c level; and an assessment of the knowledge about DKA through queries related to diagnostic criteria, definition, risk factors, symptoms, and preventive measures. Results Our study involved 400 participants, and 42.5% of them were able to correctly identify DKA as an emergency requiring immediate medical attention. Regarding the awareness of DKA's symptoms among the participants, 33.8% correctly identified excessive thirst as a key indicator, followed closely by frequent urination (31.8%), and the characteristic fruity breath odor (31.3%). As for the awareness of the participants of the causes of DKA, 33.8% correctly linked forgetting insulin injections to DKA development. Encouragingly, 39.8% of participants identified regular blood sugar monitoring as the most effective way to prevent DKA. Conclusions Most patients in our study demonstrated limited knowledge of DKA. However, a significant portion of them was able to identify it as an emergency. To prevent such events, raising awareness about DM and its complications may serve as the first step toward better outcomes in diabetic patients. We believe our findings can be used to devise quality-improving interventions in this field.

Foot kinematics in runners with plantar heel pain during running gait.

BACKGROUND: Plantar heel pain associated with plantar fascia pathology (PHP) is one of the most common running overuse injuries. Degeneration and changes in the mechanical properties of the plantar fascia associated with PHP can result in changes in foot kinematics during gait. RESEARCH QUESTION: How do running gait foot kinematics differ between female and male runners with and without PHP? METHODS: Retrospective study of 13 runners with PHP (7 female, 6 male) and a matched group of 13 uninjured runners (6 female, 7 male). A seven-segment foot model was used to quantify six functional articulations (rearfoot complex, lateral and medial midfoot, lateral and medial forefoot, and first metatarsophalangeal). Functional articulation ROM during early, mid, and propulsion running stance subphases was assessed. Two-way ANOVAs and Friedman's two-way ANOVA for ranks tests were conducted for normally distributed variables and non-normally distributed variables, respectively. RESULTS: During early stance, PHP runners demonstrated significantly increased lateral midfoot eversion ROM compared to uninjured runners. During the propulsion phase, male runners with PHP demonstrated increased medial midfoot eversion and dorsiflexion ROM and increased medial forefoot plantar flexion compared to uninjured male runners. Also during propulsion, females with PHP went through significantly less medial forefoot plantar flexion ROM compared to uninjured female runners. SIGNIFICANCE: Given the function of the plantar fascia to assist foot supination, the differences in runners with PHP, which were consistent with increased pronation or inadequate supination, may be the result of insufficient tension during the stance phase of running gait caused by degeneration of the plantar fascia. Further, the significant medial midfoot and medial forefoot group by sex interactions during propulsion suggest that PHP may affect male and female runners differently. Understanding the effect of PHP on foot function during running may aid in the development of future rehabilitation programs and/or treatment outcome assessments.

Outcome and complications of outpatient parenteral therapy in pediatric emergency utilizing only peripheral vascular access: A retrospective descriptive study.

OBJECTIVES: To describe the cure and complication rates of outpatient parenteral therapy (OPT) utilizing only peripheral vascular access. METHODS: Using a retrospective descriptive study design, we reviewed the medical charts for children aged up to 15 years old who had been discharged from the emergency department into the care of the OPT unit from January 2018 to April 2019. The primary outcomes were cure and complication rates. RESULTS: Out of 814,150 visits, 2,788 (0.34%), accounting for 2,126 patients, were managed in the OPT unit. The majority had 2 days of symptoms, and 26.4% had comorbidities. Most patients started the treatment for suspected sepsis and suspected or confirmed urinary tract infections. The total days of therapy for all patients were 3,663. Cephalosporins were used for 75%, mostly ceftriaxone. Most patients completed the IV therapy within 2 days, 2.8% of cases required a change of antibiotics. Readmission avoidance and full recovery were achieved in 99.3%, and 0.7% needed readmission. All patients had peripheral vascular access. Complications occurred in 21%. Most were related to vascular access, but more than 80% were managed by one-time IV cannula re-insertion, and only 0.5% had treatment modification because of these complications. CONCLUSION: For carefully selected patients in the pediatric emergency, outpatient parenteral therapy seems effective, safe with manageable complications, and may result in less family disturbance than hospital admission.

Investigation of Alkali-Activated Slag-Based Composite Incorporating Dehydrated Cement Powder and Red Mud.

Recycled construction cementitious materials (RCCM) and red mud (RM) could be considered a type of discarded material with potential cementitious properties. Generally, landfilling and stacking are utilized to dispose of this type of solid waste, which can be detrimental to the environment and sustainability of the construction sector. Accordingly, a productive process for making eco-efficient alkali-activated slag-based samples with the inclusion of RCCM and red mud is studied in this paper. Dehydrated cement powder (DCP) is attained through the high-temperature treatment of RCCM, and red mud can be obtained from the alumina industry. Subsequently, DCP and RM are utilized as a partial substitute for granulated blast furnace slag (GBFS) in alkali-activated mixtures. Two different batches were designed; the first batch had only DCP at a dosage of 15%, 30%, 45%, and 60% as a partial substitute for GBFS, and the second batch had both DCP and RM at 15%, 30%, 45%, and 60% as a partial substitute for GBFS. Different strength and durability characteristics were assessed. The findings show that when both dehydrated cement powder and red mud are utilized in high quantities, the strength and durability of the specimens were enhanced, with compressive strength improving by 42.2% at 28 days. Such improvement was obtained when 7.5% each of DCP and RM were added. The results revealed that DCP and RM have a negative effect on workability, whilst they had a positive impact on the drying shrinkage as well as the mechanical strength. X-ray diffraction and micro-structural analysis showed that when the amount of DCP and RM is increased, a smaller number of reactive products forms, and the microstructure was denser than in the case of the samples made with DCP alone. It was also confirmed that when DCP and RM are used at optimized dosages, they can be a potential sustainable binder substitute; thus, valorizing wastes and inhibiting their negative environmental footprint.

Outcomes of Cardiopulmonary Resuscitation and Predictors of Its Outcomes in the Emergency Department in King Saud Medical City, Saudi Arabia.

BACKGROUND: Cardiac arrest is a medical emergency marked by the cessation of cardiac mechanical activity and insufficient blood flow. CPR (cardiopulmonary resuscitation) is a life-saving method that involves restoring the essential functions of two vital organs: the heart and lungs. This study was conducted to identify the outcome of CPR in cardiac arrest patients presented to the emergency department (ED) and to identify predictors of CPR outcomes. METHODOLOGY: This was a retrospective, descriptive study. All in-hospital cardiac arrest patients who underwent CPR in the King Saud Medical City (KSMC) ED between January 2017 and January 2020 were analyzed, with a sample size of 351 patients. RESULTS: Overall return of spontaneous circulation (ROSC) and survival to discharge (STD) were achieved in 106 (30.2%) and 40 (11.39%) patients, respectively. When assessing the predictors of ROSC, the analyses showed that patient age, pre-arrest intubation, the method used to deliver oxygen, and CPR duration were all statistically significant predictors for ROSC. Similarly, when assessing predictors associated with STD, the analyses showed that patient age, pre-arrest intubation, the method used to deliver oxygen, and CPR duration were positively associated with STD. CONCLUSION: Comparing the study's findings to those of similar studies, it shows a CPR outcome rate within the range of similar studies. It also highlights that CPR outcomes are highly associated with CPR duration (a maximum of 30 minutes), younger age, and endotracheal intubation.

Predictors of Mortality in Adults With Sickle Cell Disease Admitted to the Intensive Care Unit in King Saud Medical City, Saudi Arabia.

Background Sickle cell disease (SCD) is the most common genetic blood disorder in Saudi Arabia. A limited number of studies have been conducted on SCD patients regarding their intensive care unit (ICU) admissions. We aimed to identify the cause of ICU admission in SCD patients and to identify predictors of mortality. Methodology We identified 64 patients with SCD, aged 14 years and older, who were admitted to the ICU of King Saud Medical City, Riyadh, Kingdom of Saudi Arabia, from January 1, 2017, to December 31, 2020. Results Acute chest syndrome was the most frequent primary diagnosis for ICU admission in 29 (45.3%) patients followed by vaso-occlusive crisis in 23 (35.9%) patients. Pregnancy in eight (12.5%) patients was the most prevalent co-existing condition. The median age was 29 years, with males comprising 45.3% and females comprising 54.7% of the study population. Arterial blood gas pH less than 7.2 on ICU admission (p= <0.001), hemodialysis support (p= 0.049), the use of vasopressors (p= 0.016), intubation (p= <0.001), and being intubated within the first 24 hours of ICU stay (p= 0.04) had a statistically significant association with mortality at ICU discharge out of all the variables tested. Mortality on ICU discharge was 7 (10.9%). Conclusion This was a retrospective study carried out in King Saud Medical City. Comparing the results of the study to those of similar ones conducted around the world revealed a low SCD ICU mortality rate. This low mortality may be a result of improved overall ICU care. We recommend a multi-center, prospective study in future.

Evaluating COVID-19 vaccination intentions and vaccine hesitancy among parents of children with autism spectrum disorder.

As the global vaccination mass campaign against COVID-19 extended to children aged 5 to 11 years, some parents remained hesitant about their children being administered the vaccine despite data supporting its safety. Parent vaccine hesitancy (PVH) may have predisposed certain groups of children, particularly those with autism spectrum disorder (ASD), to COVID-19 when other neurotypical children would have been vaccinated. We investigated the current PVH in 243 parents of children with ASD and 245 controls using the Parent Attitudes about Childhood Vaccines (PACV) scale. The study was conducted in Qatar from May to October 2022. Overall, 15.0% [95% CI 11.7%; 18.3%] of parents were vaccine-hesitant, with no difference (p = 0.054) between groups (ASD children [18.2%] vs. controls [11.7%]). The only sociodemographic factor associated with higher vaccine hesitancy was being a mother (as compared to being a father). The COVID-19 vaccine receipt rate at the time of the study did not differ between ASD (24.3%) and non-ASD groups (27.8%). Around two-thirds of parents of children with ASD refused or were unsure about vaccinating their children against COVID-19. We found that the intent to vaccinate against COVID-19 was higher in parents who were married and in those with a lower PACV total score. Continued public health efforts are needed to address vaccine hesitancy among parents.