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BACKGROUND: To investigate the current prescribing patterns for correcting hyperopia among optometrists in clinical practice in Saudi Arabia and compare those to current international guidelines. And explore the factors that influence practitioners' prescribing decision. METHOD: This cross-sectional study employed 30 items online survey that encompass demographic data, current practice and cycloplegia use, numerical response to indicate the minimum level of hyperopia at which optometrists would consider prescribing spectacles to non-strabismic children and determine the diopter value required for prescribing correction for hyperopia if present with other factors. RESULT: A total of 104 optometrists responded to the survey (52 females and 52 males). They recruited from 35 cities across Saudi Arabia. Out of total, 44% of them considered cycloplegic refraction essential under 12 years and 56% of them extended the range to 18 years. Large variation were found between the optometrists' responses and current guideline recommendations. Several factors influenced the decision-making of the practicing optometrist including signs and symptoms, bilateral hyperopia, average dioptric value, reading difficulty, and accommodative function. CONCLUSION: There are some matches between the international guidelines and the practice patterns that followed by optometrists in Saudi Arabia, however, the optometrists did not report that they are following them purposefully. These findings highlight the need to improve optometrists' practice about spectacle prescription in pediatric population.
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Óculos , Hiperopia , Optometristas , Padrões de Prática Médica , Prescrições , Humanos , Hiperopia/terapia , Masculino , Feminino , Estudos Transversais , Arábia Saudita , Padrões de Prática Médica/estatística & dados numéricos , Adulto , Criança , Prescrições/estatística & dados numéricos , Adolescente , Pessoa de Meia-Idade , Adulto Jovem , Pré-Escolar , Inquéritos e Questionários , Refração Ocular/fisiologia , OptometriaRESUMO
PURPOSE: To explore whether differences in choroidal thickness arise from nicotine consumption in healthy young individuals, specifically comparing the effects of nicotine gum to electronic cigarette (vaping), while maintaining a consistent 4 mg nicotine dosage. METHODS: In a randomized double-blinded prospective cross-sectional study, 20 healthy participants (mean age ± standard deviation: 23 ± 2.36 years) were randomly assigned to either the nicotine gum or vaping group. Choroidal thickness (ChT) measurements were conducted using optical coherence tomography (OCT) (Topcon 3D OCT-1 Maestro System) at baseline, 30, and 60 min after ingesting 4 mg of nicotine, with ChT measurements taken from five different horizontal areas. RESULTS: Neither the nicotine delivery method (gum or vaping) demonstrated a statistically significant impact on ChT mean scores among subjects in the five measured areas at baseline, 30, and 60 min (p > 0.05). However, significant differences were observed in ChT mean scores within subjects across the five areas (F (1.83, 72) = 36.43, p < 0.001), regardless of other study factors such as group, time, and visit (p > 0.05). A statistically significant interaction was identified between the factors of area and time concerning participants' ChT mean scores when stratified by the type of smoking (tobacco, vaping, and dual) (p = 0.003). CONCLUSION: The results of this study revealed that nicotine, up to particular concentration of 4 mg, does not have a statistically significant vasoconstrictive effect on choroidal thickness, regardless of the delivery method, within the examined group. These findings offer valuable insights into the relationship between nicotine intake and choroidal dynamics in young adults.
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Corioide , Sistemas Eletrônicos de Liberação de Nicotina , Nicotina , Tomografia de Coerência Óptica , Humanos , Corioide/patologia , Corioide/diagnóstico por imagem , Corioide/efeitos dos fármacos , Masculino , Método Duplo-Cego , Feminino , Tomografia de Coerência Óptica/métodos , Estudos Prospectivos , Estudos Transversais , Adulto Jovem , Adulto , Nicotina/administração & dosagem , Nicotina/efeitos adversos , Abandono do Hábito de Fumar/métodos , Dispositivos para o Abandono do Uso de Tabaco , Goma de Mascar de NicotinaRESUMO
Background: The practice of dispensing drugs in primary healthcare centers has shifted to community pharmacies in Saudi Arabia. These changes increase demand and mandate improving their services; one such is establishing pharmacy drive-thru services. To explore the effects of drive-thru services on the pharmacy profession, this study aimed to measure community pharmacists' acceptance, perception, and satisfaction regarding drive-thru services. Methods: This cross-sectional study design was conducted in Saudi Arabia between January 2023 and May 2023-comparing the perception, acceptance, and satisfaction of pharmacists who work in a community pharmacy that provides a drive-thru service versus no drive-thru service. Community pharmacists were invited to complete an online questionnaire consisting of four sections developed from previous studies with some modifications. Descriptive statistical analysis and an independent t-test were utilized to test the difference between the two groups (providing drive-thru service vs. non) in their responses. Results: This study included 380 community pharmacists, of whom 33 % provided drive-thru services and 67 % did not. Pharmacists' perceptions of drive-thru services differed significantly. Those with drive-thru services perceived lower convenience for delivering drug information and patient counseling, and they were concerned about the potential impact on their health effects (M = 3.15, SD = 1.34) compared to those without (M = 3.58, SD = 1.10), t (3 7 8) = -3.32, p < 0.01). However, they recognized the convenience of serving sick patients, the elderly, disabled individuals, and mothers with children in cars (M = 3.71, SD = 1.17), which was higher than those without (M = 4.04, SD = 1.21), t (3 7 8) = -2.70, p < 0.01). Regarding the current pharmacy layout suitability, pharmacists with drive-thru services found it more suitable (M = 3.13, SD = 1.14) than those without (M = 2.49, SD = 1.14), t (3 7 8) = 5.1, p < 0.01). However, the two groups had no significant difference in overall satisfaction. Conclusion: Pharmacists working in pharmacies offering drive-thru services recognized certain benefits but also expressed concerns about health effects and decreased convenience for counseling. These findings provide valuable insights for policymakers and pharmacy management, highlighting the nuanced views of pharmacists in adopting drive-thru services.
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A concoction of unhealthy eating, inactivity, and the adverse effects of specific drugs brings on obesity. The primary cause of Obesity is the storage of too much energy and triglycerides in adipocytes, particularly white adipose tissue (WAT). In addition to modifying one's lifestyle, anti-obesity medicines are increasingly used as adjuvant therapy. Flavonoids are the major class of compounds having significant biological impacts and health-improving properties. To find novel flavonoid compounds that fight obesity using computational drug design techniques. This work targets 1DI protein to predict new flavonoid compounds that fight obesity. The study uses computational approaches to anticipate potential anti-obesity/inflammatory flavonoid compounds against obesity to prevent WAT differentiation by targeting ID-1, a DNA-binding protein inhibitor. Our study led to the identification of the protein target inhibitor lead CID: 5280443, which was found to be a potent inhibitor of the receptor. According to the findings of this study, this bio-active molecule may be used as a lead for the development of drugs that preferentially fight obesity without interfering with the functions of the human proteasome. The scientific community will benefit from these discoveries, which could aid in the creation of new medications that treat obesity more successfully.
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Fármacos Antiobesidade , Proteínas de Ligação a DNA , Humanos , Proteínas de Ligação a DNA/metabolismo , Obesidade/tratamento farmacológico , Obesidade/metabolismo , Tecido Adiposo Branco/metabolismo , Fármacos Antiobesidade/farmacologia , Fármacos Antiobesidade/uso terapêutico , Adipócitos , Tecido Adiposo Marrom/metabolismoRESUMO
Membrane-based purification of therapeutic agents has recently attracted global attention as a promising replacement for conventional techniques like distillation and pervaporation. Despite the conduction of different investigations, development of more research about the operational feasibility of using polymeric membranes to separate the detrimental impurities of molecular entities is of great importance. The focus of this paper is to develop a numerical strategy based on multiple machine learning methods to predict the concentration distribution of solute through a membrane-based separation process. Two inputs are being analyzed in this study, specifically r and z. Furthermore, the single target output is C, and the number of data points exceeds 8000. To analyze and model the data for this study, we used the Adaboost (Adaptive Boosting) model over three different base learners (K-Nearest Neighbors (KNN), Linear Regression (LR), and Gaussian Process Regression (GPR)). In the process of hyper-parameter optimization for models, the BA optimization algorithm applied on the adaptive boosted models. Finally, Boosted KNN, Boosted LR, and Boosted GPR have scores of 0.9853, 0.8751, and 0.9793 in terms of R2 metric. Based on the recent fact and other analyses, boosted KNN model is introduced as the most appropriate model of this research. The error rates for this model are 2.073 × 101 and 1.06 × 10-2 in terms of MAE and MAPE metrics.
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Herein, we reported an HPLC method for the simultaneous determination of tibezonium iodide (TBN) and lignocaine hydrochloride (LGN). The method was developed according to the International Conference for Harmonization guidelines (ICH) Q2R1 using Agilent® 1260 with a mobile phase consisting of acetonitrile and phosphate buffer (pH 4.5) in a volumetric ratio of 70:30 and flowing through a C8 Agilent® column at 1 mL/min. The results revealed that TBN and LGN peaks were isolated at 4.20 and 2.33 min, respectively, with a resolution of 2.59. The accuracy of TBN and LGN was calculated to be 100.01 ± 1.72% and 99.05 ± 0.65% at 100% concentration, respectively. Similarly, the respective precision was 100.03 ± 1.61% and 99.05 ± 0.48%. The repeatability for TBN and LGN was found to be 99.05 ± 0.48% and 99.19 ± 1.72%, respectively, indicating that the method was precise. The respective regression co-efficient (r2) for TBN and LGN was found to be 0.9995 and 0.9992. Moreover, the LOD and LOQ values for TBN were 0.012 and 0.037 µg/mL, respectively, while for LGN, they were 0.115 and 0.384 µg/mL, respectively. The calculated greenness of the method for ecological safety was found to be 0.83, depicting a green contour on the AGREE scale. No interfering peaks were found when the analyte was estimated in dosage form and in volunteers' saliva, depicting the specificity of the method. Conclusively, a robust, fast, accurate, precise and specific method was successfully validated to estimate TBN and LGN.
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Benzodiazepinas , Iodetos , Humanos , Cromatografia Líquida de Alta Pressão/métodos , LidocaínaRESUMO
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic had a devastating effect on college students worldwide. Here, the authors aimed to determine the prevalence of anxiety and its related coping strategies, provide a theoretical basis for understanding self-prescription, and identify the factors contributing to stress and anxiety in medical students during the pandemic. METHODS: The authors conducted a cross-sectional study among medical students in Saudi Arabia from September to November 2020. They assessed anxiety using the GAD-7 scale based on seven core symptoms. The authors also examined perceived psychological stress using a single-item measure of stress, the factors contributing to stress during the transition to online learning and examinations, and related coping strategies. The Statistical Package for Social Sciences (SPSS) version 26.0 was used to examine the data for both descriptive and inferential analyses. Chi-square test, one-way ANOVA, and univariate linear regression were used to test the research hypotheses. RESULTS: The authors collected and analyzed data from 7116 medical students distributed across 38 medical colleges. Among them, 40% reported moderate to severe anxiety symptoms. Pre-clinical and female students experienced more stress than clinical and male students. 12.19% (n = 868) of respondents reported using medication during their college years. Among those, 58.9% (n = 512) had moderate to severe anxiety, and the most commonly used drug was propranolol (45.4%, n = 394). Among the studied sample, 40.4% (n = 351) decreased their medication use after switching to online teaching. Most students used these medications during the final exam (35.8%, n = 311) and before the oral exam (35.5%, n = 308). In terms of coping strategies, males were much more likely to use substances than females, who mainly resorted to other strategies. CONCLUSIONS: This study provides a national overview of the impact of COVID-19 on the mental health of medical students. The results indicated that the pandemic is associated with highly significant levels of anxiety. These findings can provide theoretical evidence for the need for supportive psychological assistance from academic leaders in this regard.
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COVID-19 , Educação a Distância , Estudantes de Medicina , Masculino , Feminino , Humanos , Pandemias , Estudantes de Medicina/psicologia , Prevalência , SARS-CoV-2 , Estudos Transversais , Adaptação Psicológica , Ansiedade/epidemiologia , Ansiedade/psicologiaRESUMO
AIM: To investigate the impact of multifocal gas permeable contact lens (MFGPCL) in various add power and distance/near area allocation on short-term changes of choroidal thickness (ChT), axial length (AL), and retinal defocus profile in young adults. METHODS: Seventeen young adults (2 males and 15 females; age 23.17±4.48y) were randomly assigned to wear two designs binocularly with a one-week washout period in between. Total of four MFGPCL designs were assessed. All designs were distance-center that varied in two add power (+1.50 and 3.00 D) and/or two distance zone (DZ) diameters (1.50 and 3.00 mm; design A: DZ 1.5/add 3.0, B: DZ 1.5/add 1.5, C: DZ 3.0/add 3.0, D: DZ 3.0/add 1.5). ChT, AL, and peripheral refraction data were collected on each subject at baseline, on days 1 and 7 of MFGPCL daily wear. ChT was assessed in four quadrants using a spectral-domain optical coherence tomography. RESULTS: AL was shortened by -26±44 µm with lens C, -18±27 µm with lens D, -13±29 µm with lens A, and -8±30 µm with lens B (all P<0.05). A significant overall increase in ChT was observed with all 4 designs (lens A: +6±6 µm, B: +3±7 µm, C: +8±7 µm, and D: +8±7 µm). Temporal and superior choroid exhibited more choroidal thickening associated with MFGPCL. All designs induced significant relative peripheral myopia (RPM) beyond the central 20° across the horizontal meridian in both nasal and temporal fields (P<0.05). CONCLUSION: MFGPCLs show a significant influence on ChT and AL, which are associated with significant increase in RPM after short-term wear. The reliability and feasibility of quantifying short-term changes in ChT support its use as a promising marker for the long-term efficacy of myopia-controlling treatments.
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PURPOSE: To investigate the variations in choroidal thinning between emmetropic and myopic subjects after caffeine intake. METHODS: Forty-five healthy participants (age mean ± standard deviation [SD]: 20.75 ± 1.6 years) recruited in a prospective cross-sectional study. They were divided into three groups, based on refractive error status, emmetropes (spherical equivalent [SE] -0.25 to +0.25D), myopes (SE ≥-0.50D to Ë-6.00D), and high myopes (SE ≥-6.00D). The participants underwent choroidal thickness [ChT] measurements using optical coherence tomography [OCT] (Topcon 3D OCT-1 Maestro System) at baseline, 20, 40, and 60 minutes after consuming 200 mg of caffeine. The measurements of ChT were taken from five different areas horizontally. RESULTS: Compared to baseline measurement, the ChT significantly decreased after 200 mg caffeine intake in all conditions ( P < 0.001). There was a statistically significant difference in ChT at baseline between the refractive groups ( χ2 (2)=6.548, P = 0.038) as the high myope group showed lesser horizontal ChT within Nasal at (1 mm) area compared to the myope group ( P = 0.032), however, no other significant differences in mean scores of horizontal ChT at baseline were found. The thinning in ChT in the high myope group was lesser compared to both emmetrope and myope groups; however, it was not statistically significant ( P > 0.05). CONCLUSION: The results of this study suggest that the reduction in ChT due to caffeine consumption is not significantly affected by the refractive status of the eye. Thus, it is safe to hypothesize that the vascular part of the choroid behaves identically to vasoconstrictive in both emmetropic and myopic eyes. The choroidal thinning found in myopic and high myopic eyes and/or the reduced choroidal vascularity index were not apparent in this study. Therefore, further longitudinal studies recruiting greater numbers of participants, including myopes and high myopes, and measuring both vascular and stromal layers to investigate such variations are warranted.
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AIM: To investigate the short-term effects of commercially available eyelid-cleaning wipes on film parameters. METHODS: This study enrolled 48 healthy participants aged 20-35y (both males and females). Clinical assessment included the Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear break-up time (NITBUT), tear meniscus height (TMH), and lipid layer pattern (LLP). Based on these initial results, participants were categorized as either non-dry eye or dry eye. Participants in each group were randomly allocated to either Blephaclean® or Systane® treatments. Changes in NITBUT, TMH, and LLP levels before and after lid wipe treatment were assessed. RESULTS: The dry eye group exhibited significantly higher OSDI scores and lower NITBUT and TMH levels than in the non-dry eye group (P<0.001). Following the application of eyelid wipes (Systane® wipes), dry eye subjects experienced a significant improvement in NITBUT levels (P=0.0014) compared to the non-dry eye individuals. Although the remaining participants showed a marginal increase in TMH and NITBUT levels, these changes did not achieve statistical significance (P>0.05). Similarly, the LLP levels were significantly improved with Systane® (P<0.001) post-treatment compared to individuals in the non-dry eye group. However, the dry eye subjects showed higher post-treatment LLP levels than the untreated group (P<0.02). CONCLUSION: The short-term effects of Systane® eyelid wipes on tear film parameters suggest their effectiveness in dry eye disease. Nonetheless, further exploration of their long-term impact is essential to justify their cost effectiveness and efficacy in treating both aqueous deficiency and evaporative dryness.
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Purpose: To investigate topographical and within-day changes in the choroidal vascularity index and its association with choroidal thickness parameters (total, luminal, and stromal thickness) among young adults. Methods: : Choroidal thickness and vascularity index were measured in 28 healthy young adults (age mean ± standard deviation [SD]: 25 ± 3.0) using spectral-domain optical coherence tomography. Participants were divided into three refractive groups: emmetropes, myopes, and high myopes. Choroidal parameters were evaluated in the macular and peripheral regions in the superior and inferior regions at two time points during the day; in the morning (at 7 am) and in the afternoon (at 1 pm). Results: : All investigated choroidal thickness parameters showed a significant topographical variation across the vertical meridian, between the foveal (270 ± 89 µm, 170 ± 45 µm, and 111 ± 47 µm, respectively) and peripheral (246 ± 68 µm, 160 ± 39 µm, 86 ± 36 µm, respectively). The superior choroid was thicker in all thickness parameters compared to the inferior choroid. A significant increase in the vascularity percentage was seen from the fovea (61.8 ± 7%) toward the periphery (66.4 ± 7%). Thinner choroidal parameters were associated with high myopia, whereas an increase in the vascularity index was observed in high myopes. Significant within-day changes were observed in all choroidal thickness parameters, which were slightly reduced in the afternoon. The choroidal vascularity index (CVI) increased from 61.3 ± 5.3% in the morning and 63.2 ± 5.8% in the afternoon. High myopes exhibited reduced within-day amplitude in stromal thickness. Conclusion: : All parameters showed significant regional variations. Myopia is associated with greater thinning in stromal thickness rather than vascular thickness. Only high myopes experienced reduced within-day change amplitudes in stromal choroidal thickness that was more predominant in the foveal and parafoveal regions.
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Miopia , Adulto Jovem , Humanos , Miopia/diagnóstico , Fóvea Central , Refração Ocular , Emetropia , Corioide/irrigação sanguínea , Tomografia de Coerência Óptica/métodosRESUMO
AIM: To investigate the practice patterns of optometrists in Saudi Arabia regarding myopia management. METHODS: An internet-based survey was distributed to all practicing optometrists in Saudi Arabia (n=1886). The survey contained questions related to 1) demographics, 2) knowledge about myopia and its associated complications, 3) current clinical care, 4) type and frequency of myopia treatment prescribed, and 5) potential barriers limiting treatment adoption. RESULTS: The completed surveys were collected from 171 optometrists (9.06% response rate, 60% male). Knowledge regarding myopia-associated complications was prevalent but somewhat inaccurate among the respondents. Cycloplegic refraction at initial visit was used by 59% of the respondents. The cover test was the most reported binocular vision test (83%), and 38% of optometrists did not perform any ocular biometrics. Two-thirds prescribed single-vision spectacles for children with myopia. Increased time spent outdoors was selected by 80% of the practitioners who prescribed myopia control treatment as the primary approach. Insufficient support and lack of clinical experience in providing myopia treatment were reported as the most important factors limiting the adoption of myopia management strategies. CONCLUSION: The current optometric practices in Saudi Arabia require further investigation. Optometrists appear to be somewhat aware of myopia and the associated risks. However, most evidence-based myopia treatments are not being locally adopted, primarily because of lack of support, lack of experience, and limited availability.
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Effective and safe medication use can be maximized by providing medication counseling, which aims to optimize therapeutic results. This approach improves the effectiveness of antibacterial treatment, reduces treatment expenses, and mitigates the emergence of antimicrobial resistance. No research from Pakistan has been previously documented. The purpose of this research was to evaluate both the quality of antibiotic counseling provided and the level of understanding exhibited by pharmacy employees with regard to interactions involving antibiotic medications. Using a simulated client method, two scenarios were used to assess 562 pharmacies that were systematically selected. Scenario 1 focused the counseling for use of prescribed medicines with non-prescribed antibiotics. Scenario2 indicated counseling provision for prescribed antibiotics that have possible antibiotic-drug interactions. The evaluation of counseling skills was also conducted. The analysis involved the use of descriptive statistics and chi-square tests. Only 34.1% of simulated clients received medication counseling directly; 45% received it on request. About 31.2% of clients were referred to a physician without counseling. The most frequently provided information was therapy dose (81.6%) and duration (57.4%). More than half (54.0%) of clients were asked about disease duration, but drug storage was ignored. Insufficient information was provided about side effects (1.1%) and antibiotic-drug interactions (1.4%). Most (54.3%) clients were instructed about dietary or lifestyle modifications. Only 1.9% of clients received information about drug administration route. No information was provided about other medication during therapy, effect of medicine withdrawal, and compliance to medication. The current level of antibiotic counseling within Pakistani community pharmacies is inadequate and requires the attention of medical authorities. Professional training of staff could improve counseling.
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AIM: To determine the choroidal thickness (CT) in young healthy Saudi adults using spectral-domain optical coherence tomography (SD-OCT) with an automated CT segmentation software. METHODS: Fifty-eight young adults (total of 116 eyes), 39 males and 19 females participated in this study between the ages of 18 and 38y (mean 22.65±3.9y). All participants underwent ophthalmic screening examination, including the SD-OCT for measurements of CT in each quadrant egmented into five eccentric regions starting from the foveal region up to 4.5 mm towards the periphery. RESULTS: The choroid was thickest in the foveal region (central 1 mm, 300±60 µm) and began to progressively thinner beyond the parafovea (1.5-2.5 mm, 284±67 µm) towards the peripheral region (3.5-4.5 mm from the fovea, 254±83 µm). The superior choroid showed the thickest profile (309±57 µm), while the nasal choroid exhibited the thinnest (229±76 µm). The rate of the thinning with increasing eccentricity was more predominant in the nasal choroid, which thinned from the foveal region (294±58 µm) to the peripheral region (158±55 µm). The superior and inferior choroid did not show a statistically significant thinning with eccentricity (all P>0.05). There was no statistically significant difference in the CT between gender, age, and laterality of the eyes (all P>0.05). A significant association of myopia with thinner subfoveal choroid was observed (Pearson's, r=0.37), and regression analysis showed that a 10.3 µm choroidal thinning for each diopter increase of myopia. CONCLUSION: CT profile depends on eccentric and the quadrant. The CT profile across the measured area in the young Saudi adult population is comparable to other previous reports. Refractive error is critical for CT evaluation.
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Objective This study is aimed at assessing the perception and worries of Saudi healthcare providers about the application of artificial intelligence (AI) in Saudi healthcare facilities. Methods The study adopted a cross-sectional study involving 1026 Saudi healthcare providers between January 2023 and April 2023. The target population was healthcare providers across Saudi health facilities. Online questionnaires were administered through social media platforms. Data were analyzed using SPSS Statistics, version 26.0 (IBM Corp., Armonk, NY) to obtain important insights. Results The results of this study indicated that more than half (55.2%) of the respondents had good knowledge of AI, with (48.1%) of them being familiar with the application of AI in their specialty. A good proportion of the participants (57.9%) knew at least one term about the difference between machine learning and deep learning. More than half (69.9%) of the participants indicated that they had at one point in time used speech recognition or transcription application in their work. A large section (73.3%) of healthcare providers believed that AI would replace them at their job. A vast majority (84.9%) of the participants agreed that collaboration between medical schools with engineering and computer science faculties could be a game changer to provide a road for incorporating AI into medical curricula. The mean perception of AI in this study was 37.6 (SD=8.41; range 0-241). Age, level of health, health profession, and working experience all significantly impacted the positive perception score (p=0.021; p=0.031; p=0.041; p=0.026). However, there was no significant association between gender, nationality, and Saudi regions with a mean positive perception score. Conclusion There was a positive perception of AI among Saudi healthcare providers. Even though a substantial majority of Saudi healthcare providers were worried that AI would replace their jobs, the study revealed that AI serves as a crucial practitioner's tool rather than a physician's replacement.
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Objective: Identifying the burden of disease and the condition of the Saudi population is in high demand from both a surveillance and analytical standpoint. The objective of this study was to determine the most prevalent infections among hospitalized patients (both community-acquired and hospital-acquired), the antibiotics prescribing pattern, and their relationship with patient characteristics like age and gender. Methods: A retrospective study was conducted comprising 2646 patients with infectious diseases or complications admitted to a tertiary hospital in the Hail region of Saudi Arabia. A standardized form was used to collect information from patient's medical records. Demographic data such as age, gender, prescribed antibiotics, and culture-sensitivity tests were included in the study. Results: Males represented about two-thirds (66.5%, n = 1760) of the patients. Most patients (45.9%) who suffered from infectious diseases were between the ages of 20 and 39. The most prevalent infectious ailment was respiratory tract infection (17.65%, n = 467). Furthermore, the most common multiple infectious diseases were gallbladder calculi with cholecystitis (40.3%, n = 69). Similarly, COVID-19 had the greatest impact on people over 60. Beta-lactam antibiotics were the most commonly prescribed (37.6%), followed by fluoroquinolones (26.26%) and macrolides (13.45%). But performing culture sensitivity tests were rather uncommon (3.8%, n = 101). For multiple infections, beta-lactam antibiotics (such as amoxicillin and cefuroxime) were the most commonly prescribed antibiotics (2.26%, n = 60), followed by macrolides (such as azithromycin and Clindamycin) and fluoroquinolones (eg, ciprofloxacin and levofloxacin). Conclusion: Respiratory tract infections are the most prevalent infectious disease among hospital patients, who are primarily in their 20s. The frequency of performing culture tests is low. Therefore, it is important to promote culture sensitivity testing in order to support the prudent use of antibiotics. Guidelines for anti-microbial stewardship programs are also highly recommended.
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Enterococci are troublesome nosocomial, opportunistic Gram-positive cocci bacteria showing enhanced resistance to many commonly used antibiotics. This study aims to investigate the prevalence and genetic basis of antibiotic resistance to macrolides, lincosamides, and streptogramins (MLS) in Enterococci, as well as the correlation between MLS resistance and biocide resistance. From 913 clinical isolates collected from King Khalid Hospital, Hail, Saudi Arabia, 131 isolates were identified as Enterococci spp. The susceptibility of the clinical enterococcal isolates to several MLS antibiotics was determined, and the resistance phenotype was detected by the triple disk method. The MLS-involved resistance genes were screened in the resistant isolates. The current results showed high resistance rates to MLS antibiotics, and the constitutive resistance to all MLS (cMLS) was the most prevalent phenotype, observed in 76.8% of resistant isolates. By screening the MLS resistance-encoding genes in the resistant isolates, the erythromycin ribosome methylase (erm) genes that are responsible for methylation of bacterial 23S rRNA were the most detected genes, in particular, ermB. The ereA esterase-encoding gene was the most detected MLS modifying-encoding genes, more than lnuA (adenylation) and mphC (phosphorylation). The minimum inhibitory concentrations (MICs) of commonly used biocides were detected in resistant isolates and correlated with the MICs of MLS antibiotics. The present findings showed a significant correlation between MLS resistance and reduced susceptibility to biocides. In compliance with the high incidence of the efflux-encoding genes, especially mefA and mefE genes in the tolerant isolates with higher MICs to both MLS antibiotics and biocides, the efflux of resistant isolates was quantified, and there was a significant increase in the efflux of resistant isolates with higher MICs as compared to those with lower MICs. This could explain the crucial role of efflux in developing cross-resistance to both MLS antibiotics and biocides.
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OBJECTIVES: To evaluate the performance of four experimental multifocal gas permeable contact lens (MFGPCL) designs and their impact on visual function in young adults. METHODS: Seventeen young adults (age, 23.17 ± 4.48 years) enrolled in the study. Each participant was randomly assigned to wear two of four MFGPCL designs. They wore the first type of the assigned lens binocularly for one week and, after one week of washout period, wore another design on both eyes for another week. The four MFGPCL designs were as follows: design A (distance zone [DZ] 1.5 mm / add 3.0 D), B (DZ 1.5 mm / add 1.5 D), C (DZ 3.0 mm / add 3.0 D), and D (DZ 3.0 mm / add 1.5 D). Baseline visual acuity, contrast sensitivity function, and accommodation data were collected at baseline and repeated after one week of MFGPCL daily wear. RESULTS: Distance and near visual acuities were not significant affected with the four MFGPCL designs. Contrast sensitivity was significantly lower in design A across all measured spatial frequencies (p < 0.05), with no significant impact from other designs on all frequencies. No significant effect was observed on accommodation measured at 33 cm (p > 0.05). CONCLUSIONS: Three of the investigated MFGPCL designs preserve satisfactory visual performance. Lens design A incorporated with higher add and smaller center zone diameter had a stronger impact on the visual performance.
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Lentes de Contato , Acomodação Ocular , Adulto , Sensibilidades de Contraste , Humanos , Projetos Piloto , Acuidade Visual , Adulto JovemRESUMO
PURPOSE: Due to the COVID-19 pandemic, wearing a face mask has become an essential measure to reduce the rate of virus spreading. The aim of the study was to assess the effect of wearing a surgical face mask for a short period on the tear film parameters in subjects with a high body mass index (BMI). METHODS: Twenty-five females with a high BMI (31.4 ± 5.5 kg/m2) aged 18-35 years (22.7 ± 4.6 years) participated in the study. In addition, a control group consisting of 25 females (23.0 ± 6.7 years) with a high BMI (29.9 ± 4.1 kg/m2) participated in the study in which no mask was worn. The standardized patient evaluation of eye dryness (SPEED) questionnaire was completed first, followed by the phenol red thread (PRT) and tear ferning (TF) tests, before wearing the face mask. The subjects wore the face mask for 1 hour, and the measurements were performed again immediately after its removal. For the control group, the measurements were performed twice with one hour gap. RESULTS: Significant (Wilcoxon test, p < 0.05) differences were found between the SPEED scores (p = 0.035) and the PRT measurement (p = 0.042), before and after wearing the surgical face mask. The PRT scores have improved after wearing the surgical face mask, while the dry eye symptoms detected by the SPEED questionnaire have increased. On the other hand, no significant (Wilcoxon test, p = 0.201) differences were found between the TF grades before and after wearing a surgical face mask. For the control group, no significant (Wilcoxon test, p > 0.05) differences were found between the two scores from the SPEED questionnaire and the PRT, and TF tests. CONCLUSIONS: Wearing a surgical face mask for a short duration leads to a change in volume and quality of tears as well as dry eye symptoms in women with a high BMI.
Assuntos
COVID-19 , Síndromes do Olho Seco , Lacerações , Humanos , Feminino , Máscaras , Índice de Massa Corporal , Pandemias , Síndromes do Olho Seco/etiologia , Síndromes do Olho Seco/diagnóstico , FenolsulfonaftaleínaRESUMO
SARS-CoV-2 is a novel infectious contagion leading to COVID-19 disease. The virus has affected the lives of millions of people across the globe with a high mortality rate. It predominantly affects the lung (respiratory system), but it also affects other organs, including the cardiovascular, psychological, and gastrointestinal (GIT) systems. Moreover, elderly and comorbid patients with compromised organ functioning and pre-existing polypharmacy have worsened COVID-19-associated complications. Microbiota (MB) of the lung plays an important role in developing COVID-19. The extent of damage mainly depends on the predominance of opportunistic pathogens and, inversely, with the predominance of advantageous commensals. Changes in the gut MB are associated with a bidirectional shift in the interaction among the gut with a number of vital human organs, which leads to severe disease symptoms. This review focuses on dysbiosis in the gut-lung axis, COVID-19-induced worsening of comorbidities, and the influence of polypharmacy on MB.