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Background: Transurethral resection of the prostate gland (TURP) is considered a gold standard in Benign Prostatic Hypertrophy. This study aimed to determine the effectiveness of early catheter removals at 48 hours after TURP in patients with mild to moderate enlargement of the prostate. Methodology: A single interventional study was conducted on 79 male subjects with mild to moderate prostate enlargement, and moderate to severe lower urinary tract symptoms. The outcome was measured six hours after trial without a catheter. Results: The mean age of participants was 64.9 ± 7.8 years, and the mean size of the prostate was 54.8 ± 5.9 gm. The frequency of procedural success was 91% (72) and patients with age < 60 years, 24(96%) had procedural success compared to 48(88.9%) age ≥ 60 years. Conclusion: Early catheter removal trial was found successful in most of the study participants at 48 hours after TURP.

Digital holography (DH) has experienced significant advancements in recent years, with improvements in both experimental and algorithmic techniques. This has resulted in an expansion of DH’s applications in biomedicine, as well as other scientific and engineering fields. The introduction of machine learning (ML) and deep learning (DL) has provided a breakthrough in the recognition and prediction of patterns, especially with regards to visual imagery data. This characteristic of ML and DL makes them highly suitable for processing digital holographic data, and they have thus become widely used in digital holography. This review aims to assimilate the research where ML and DL have been employed alongside digital holography in the biomedical field for tasks such as the identification and classification of organelles, diseases, and microbes. The combination of DH and ML/DL has shown significant potential in addressing various challenges in biomedical microscopy, including the identification and classification of cellular and subcellular

Supplemental Material for The Impact of Cancer Relapse and Poor Patient Outcomes on Health Care Providers Practicing in the Oncology Field by Abdulrahman Alwhaibi, Miteb Alenazi, Bana Almadi, Nora aljabali, Sahar Alkhalifah, Wajid Syed, Reem Alsaif, Salmeen D Bablghaith, and Mohammed N Al-Arifi in Cancer Control

Introduction: Hypertension (HTN) is one of the most serious public health issues in the world, affecting around 1.4 billion people worldwide. HTN is becoming highly prevalent in Pakistan, about more than 33% of people over the age of 40 years suffering from the HTN. The illness burden is continuously growing due to the incorrect medicine prescriptions, a lack of education, and a lack of patient compliance. The existence of comorbidities such as Diabetes Mellitus (DM) should be properly considered while choosing an Antihypertensive medication. Similarly, the prescriptions of Oral Hypoglycemic agent’s appropriate consideration are essential. Oral hypoglycemic medications are divided into several categories. Physicians face a challenge in rationally selecting a regimen from a variety of classes, and the situation becomes more complicated when the patients have additional non-communicable illnesses, such as HTN. The combination therapy of ailments not only effects the patient`s economic status but also effects the quality of life. Objective: To study the prescribing pattern of Antihypertensive drugs in Hypertensive patients with Type 2 Diabetes Mellitus at Tertiary care hospitals in Karachi, Pakistan. Methods: A cross sectional study was undertaken for six months in medicine outpatient department at tertiary care hospitals of Karachi. The study population was observed for the prescribed pattern of Antihypertensive medicines by assessing the 300 prescriptions of Hypertensive patients with Type 2 Diabetes Mellitus. Statistical analysis was performed using SPSS version 20. Data was presented as frequencies and percentages. Results: The result revealed that the most commonly prescribed single antihypertensive drug was Enalapril 66 (22%) followed by Amlodipine 63(21%), Ramipril 57(19%), Diltiazem 33(11%), Lisinopril 21(7%) losartan k 6(2%), Nebivolol 6(2%), Bisoprolol 3(1%). Dual therapy included Ramipril and Nebivolol 1(0.33%) and Amlodipine+Valsartan 35 (11.67%), Amlodipine+Valsartan+HCTZ 9 (3%) were the antihypertensive drugs prescribed as fixed dose combinations. Conclusion: The present study shows Enalapril belonging to Angiotensin Converting Enzyme Inhibitor (ACEI) class was frequently used as single Antihypertensive agent and Amlodipine+Valsartan belonging Calcium Channel Blockers (CCBs) and Angiotensin Receptor Blockers (ARBs) was the most frequently prescribed fixed dose combination while managing Hypertension of Hypertensive patients with Type 2 Diabetes Mellitus.

Antibiotic contamination of water is an emerging global issue with severe implications for both public health and the environment. Ciprofloxacin (CIP) is a synthetic fluoroquinolone antibiotic, which is broadly used in human and veterinary medicines around the world to treat various bacterial infections. The presence of CIP in the aquatic environment poses serious health problems to human beings and other living entities. Floating treatment wetland (FTW) is a low-cost and eco-friendly wastewater remediation technology. In the current study, the Canna indica. (Indian shot) was vegetated in a floatable mat to develop FTWs. A consortium of three bacterial strains, Acinetobacter lwoffii ACRH76, Bacillus pumulis C2A1, and Acinetobacter sp. HN3, was immobilized on iron oxide nanoparticles (Fe3O4-NPs) and augmented in the FTWs for the remediation of CIP-contaminated (100 mg/L) water. The augmentation of bacteria (immobilized or free) in the FTWs significantly enhanced the removal of CIP from water. The maximum reduction in CIP (98%), chemical oxygen demand (COD; 90%), biochemical oxygen demand (BOD; 93%) and total organic carbon (TOC; 95%) was observed in FTWs that had Fe3O4-NP supported bacteria. This study reveals that FTWs have a great potential to remove the CIP from contaminated water, albeit its CIP removal efficiency was substantially enhanced by augmentation with Fe3O4-NPs supported bacteria.

Objectives: The objective of this study was to explore the attitudes towards plagiarism among pharmacy students in Saudi Arabia. Methods: A cross-sectional study was conducted on pharmacy students at King Saud University in Riyadh to assess their attitudes towards plagiarism. The questionnaire consists of 27 items on a 5-point Likert scale (strongly disagree, disagree, neutral, agree, and strongly agree) that assess three attitudes about plagiarism (positive and negative attitudes, as well as subjective norms). Results: A total of 415 pharmacy students took part in this research. Among the whole sample, 55.7% were male, and 44.3% were female. The findings demonstrated a moderately positive attitude towards plagiarism (30 ± 6) and subjective standards (29 ± 7) as well as a moderate negative attitude (22 ± 5). About 26.5% of students did not believe that they worked in a plagiarism-free workplace, and 45.3% of students believed that self-plagiarism should not be punished in the same way as plagiarism. Conclusions: The overall attitudes of pharmacy students were positive. Training in medical writing and research ethics in the undergraduate and graduate pharmacy curricula is mandatory.

The unwanted occurrence of antibiotics in the environment is an emerging concern of non-target toxicity and antimicrobial resistance. Floating treatment wetland (FTW) is a low-cost and ecofriendly wastewater remediation strategy; however, the effect of immobilized bacteria on its efficacy during the remediation of ciprofloxacin (CIP)-contaminated water has not been documented. In this study, Phragmites australis was planted to develop FTW, and it was augmented with a bacterial consortium (Acinetobacter lwoffii ACRH76, Bacillus pumulis C2A1, and Acinetobacter sp. HN3), with and without immobilization for the remediation of CIP-contaminated (100 mg L−1) water. The augmentation of bacteria (immobilized or in suspension) in the FTWs significantly increased the elimination of CIP from the water. Maximum removal of CIP (97%), COD (92%), BOD (93%), and TOC (90%) from the water was observed in the FTWs having immobilized bacteria. This research revealed that the FTWs have tremendous potential to remove the CIP from the water and its removal efficiency can be enhanced via immobilized bacterial augmentation strategies.

Objectives: This study was aimed to investigate the knowledge and practice about COVID-19 among adults living in capital of Telangana, India. Methods: A cross sectional web based online study was conducted over a period of 3 months from April to June using structured self- administered online questionnaires. We targeted adults living in Hyderabad using convenience sampling technique. A total of 384 respondents completed the study questionnaires. The data were analyzed using the Statistical Package for Social Sciences (SPSS) version 24.0. Descriptive statistics were used to describe the status of knowledge, attitude, and practices. Results: Most of the respondents were male (65.1%) aged between 21-30 years (220 out of 384). The most common source of information for the COVID-19 was social media (50.7%). Almost 78% of the respondents were known that COVID-19 associated with dry cough, body pains and fever. Also majority of them were knew that disease can transfer from the infected patients (87%), while most of them (85%) were agreed that wearing facemask can help in controlling the infection. Almost all (92%) of the respondents agreed that isolation and treatment of COVID-19 patients may help in controlling the spread of virus. There was a significant difference among the attitudes of the participants about covid-19 (p Key words: COVID-19, Knowledge, Attitudes, Clinical symptoms, Flue, Fever, Respiratory failure.

Background: This study aimed to evaluate the Impact of diabetes continuing education on knowledge and practice of diabetes care among health care professionals in Yemen. Methods: A quasi-experimental study was carried out among health care professionals. The original questionnaire consisted of 22 multiple choice questions. A total of 73 HCPs received continuing education (CE) intervention. Knowledge attitude and practice (KAP) was assessed using a validated questionnaire. Results: The result showed that majority of the HCPs has a good general knowledge on diabetes and its managements prior to the CE program. Evaluation of the general knowledge score of the HCPs found some improvement in the knowledge score, however the improvement was not significant (p=0.31). The result of this study found that HCPs has good knowledge on monitoring the sign, symptoms and laboratory parameters. Conclusion: Evaluation of the knowledge score on Goal of Diabetes Management of HCPs found significant (p=0.024) improvement in the knowledge score. The results indicated that the lab values were rated as the most important in the goal for the treatment of diabetes patients. The study also found no significant difference in practice score after CE program among HCPs.

Pharmacovigilance is an essential process when dealing with the medicines. It is one of the basic roles of community pharmacist. This role is not found in practice. Due to lacking this role, monitoring of adverse drug reactions and awareness to report them is missed in the society. However, no significant data has been published to exhibit the role of community pharmacists in Pharmacovigilance. This study was aimed to help in stowing the pharmacist role, in community Pharmacovigilance of Pakistan, to give awareness not only to community pharmacists but to regulatory authorities to establish policies regarding ADRs. A cross-sectional study was conducted through a pre-validated questionnaire. This study was conducted in 16 Districts of Sindh Province of Pakistan. 368 pharmacies/ medical stores responded to the self administered questionnaire. The results showed dependence of Awareness to the Pharmacovigilance upon Professional Status, Education of Participants and Experience of study population in pharmacies/ medical stores.

Objectives: Currently, the use of generic medicines has increased globally. The purpose of this study was to evaluate the impact of education program (CEP) on future health care professionals’ knowledge of generic medicines. Methods: A prospective, one-group, and pre- and post-test design was used to assess the effects of the educational program on future health care professionals’ knowledge of generic medicines. The participants were final year pharmacy students a total of 24 Pharm.D students received the Continue education intervention. Findings: About 91% of them heard of generic medicines, with the most common source of information being the hospital (16.7%), followed by teachers and lecturers (33.3%). About 50% of them received generic medicine information from their course work. Most 91% of the respondents indicated that they had heard about generic and branded medicines. Pharm.D students’ knowledge score significantly increased from 7.2 before the CEP program to 9.4 after. Conclusion: The results of this study concluded that before the educational intervention, students had inadequate knowledge and misconceptions about generic medicine. CEP on generic medicines was effective in the improvement of the knowledge of future health care professionals. Key words: Continuing Education, Future Health Care Professionals, Knowledge, Generic Medicine, Saudi Arabia.

Objective: This study was to assess the common withdrawal effects of drugs among addicted population in rehabilitation. Study Design: Cross Sectional Survey. Setting: Different Rehabilitation Centers Located Across the City, Karachi. Period: December 2018 to June 2019. Material & Methods: 400 filled questionnaires were obtained from randomly selected subjects (addicted persons). Results: The results of the study showed, most drugs abused age group is 20-40 year i.e. 71.6%, 13-19 year 18.7%, and 9.7% for population above 40 years of age. Most abused drugs found 34.8%, 26.8%, 9.6% 6.7% for cannabis, tobacco, heroin, and morphine accordingly. n=188 (47%) of patients had adaptive response towards treatment in rehabilitation while n=60 (15%) shows negative and aggressive behaviors. n=60 (15%) patients found guilty of drugs abused while n= 180 45% found it pleasurable. Conclusions: A persistent, safe and evidence-based practices is required in management of drugs abuse among the addicted patients to avoid the risk factors.

In this paper the dropout trend in Government Girls Primary Schools in District Mardan was analyzed through a descriptive research study. This study has investigated the class wise trend of dropout in Government Girls Primary Schools in District Mardan, analyzed the reasons of the dropout trend and determined a strategy for minimizing the dropout trend. The research was conducted by using systems analysis as theoretical framework of this study. Population for the study consisted of all the10324dropouts. A stratified random sample of 300dropouts was drawn out of total population. Survey and questionnaires were used as tools for collecting data. Data regarding enrolment, dropouts and dropout rate was collected through survey. The researcher administered a self assessment Questionnaire on sampled dropouts to gather their perceptions regarding the dropout phenomenon in Government Girls Primary Schools in District Mardan. The study found the highest dropout rate(15.98%) in Kachhi which gradually falls down in class 2.But in class 3 it jumps to(8.64%) and then it keeps on increasing up to class 5. The perceptual analysis of the responses of the Questionnaires revealed that the factors were divided into three main categories i.e. the institutional problems and procedures: including; frequent failure in classes, unpleasant teaching learning processes, high level of difficulty of courses, harsh behavior of teachers and insecurity in schools; Home based factors: including; high poverty level of the parents, frequent migration of their families, and community factors such as Lack of immediate returns of schooling. The study recommended: Teachers’ training focused on enhancing teachers’ competency to retain students in schools; introducing academic monitoring system; adopting strategies for reducing absenteeism of students; Mass mobilization of parents towards schooling of their kids; provision of stipends; special schooling arrangements for migrating families and introduction of individualized teaching strategies for slow learners.

BackgroundCoronavirus disease-2019 (COVID-19) is caused by severe acute respiratory syndrome-coronavirus (SARS-CoV) and represents a major public health threat that aggressively promotes increased morbidity and mortality. Changes in public behavior were more common during the pandemic to protect against the infection. Suboptimal behavioral practices for a specific disease would increase the susceptibility of the public to infection. This study aimed to determine changes in behaviors of the general public during the COVID-19 pandemic.MethodsA cross-sectional study was conducted using an online questionnaire survey to determine the extent of public behavioral changes in Saudi Arabia during the COVID-19 pandemic. Data were collected with a self-reported survey, and analysis was conducted using Statistical Package for the Social Sciences version 26 (SPSS). A chi-square test was performed to determine the association among variables. A P ≤ 0.05 was considered statistically significant.ResultsOf 348 respondents, 244 (70.1%) were male, and 270 (77.6%) had a university degree. Approximately 48% used social media to seek COVID-19 information, and 36% (n = 124) avoided large gatherings. Approximately one-fourth of the respondents always avoided public transportation, while 65.8% reported avoiding traveling to infected areas. Of the participants, 33% always washed their hands, while 36% always used an alcohol-based sanitizer. There was a significant association between age group and employment status with respect to hand washing frequency (p < 0.05). There was also a significant association between age group (p < 0.0001) and employment status and wearing of face masks (p < 0.048).ConclusionThis study highlights changes in the public's behaviors in Saudi Arabia during the COVID-19 pandemic for protection against the infection and reports acceptable preventative practices against COVID-19 in the Saudi community. Furthermore, continuous awareness of recommended protective measures for COVID-19 is still warranted.

White clover (Trifolium repens) is an allotetraploid pasture legume widely used in moist temperate climates, but its vulnerability to drought, grazing pressure and pests has restricted its wider use. A related species, Caucasian clover (Trifolium ambiguum), is a potential source of resistances to drought, cold, grazing pressure and pests that could potentially be transferred to white clover by interspecific hybridization. Although direct hybridization has been achieved with difficulty, the hybrids have not been easy to backcross for introgression breeding and no interspecific chromosome recombination has been demonstrated. The present work shows that interspecific recombination can be achieved by using Trifolium occidentale, one of the ancestral parents of T. repens, as a bridging species and that large white clover breeding populations carrying recombinant chromosomes can be generated. A 4x hybrid between T. ambiguum and T. occidentale was crossed with T. repens and then backcrossed for two generations. Five backcross hybrid plants with phenotypes appearing to combine traits from the parent species were selected for FISH-GISH analyses. Recombinant chromosome segments from T. ambiguum were found in all five plants, suggesting that recombination frequencies were significant and sufficient for introgression breeding. Despite early chromosome imbalances, the backcross populations were fertile and produced large numbers of seeds. These hybrids represent a major new resource for the breeding of novel resilient forms of white clover.

Introduction: A good early diagnostic and prognostic marker for bacterial meningitis will decreasethe morbidity and mortality due to this infection. Serum procalcitonin has been evaluated forusefulness in diagnosis and as a prognostic marker in bacterial meningitis. Methods: Children from5 months to 15 years of age who were cases of bacterial meningitis as per WHO Criteria and wereadmitted to the Pediatric Department in SKIMS Srinagar, Jammu, and Kashmir were taken for thestudy. A total of 45 bacterial meningitis cases participated in this prospective study. Serum PCT wasmeasured by a fluorescence immunoassay using QDX Insta check with a detection limit of 0.25-100ng/ml. Data were analyzed using standard statistical tests using SPSS 20. Results: The meanserum PCT on admission in ng/ml in the present study for bacterial meningitis was14.9293±4.49122 and after 72 hours mean serum PCT was 12.4386±4.40964). A significant drop(mean difference = 2.49086; p=0.000) in serum procalcitonin was seen after 72 hours followingantibacterial treatment. Conclusion: It was concluded that serum PCT can be used as a goodprognostic marker to see the response to treatment in bacterial meningitis.

Purpose Dietary supplements (DSs) are popular in many countries, and their use among individuals is increasing worldwide. Therefore, this study aimed to assess the prevalence and use of DSs among pharmacy students in King Saud University College of Pharmacy, Riyadh, Saudi Arabia. Methods This study used a cross-sectional design targeting male senior pharmacy students in their fourth and fifth years of Bachelor and Doctor of Pharmacy courses. The data were collected between August and October 2019 using paper-based questionnaires. Results A total of 46.8% of the students used DSs. Of all students surveyed, 19% used branded supplements whereas 9.7% used generic or local supplements and 12.3% used both generic and branded supplements. Furthermore, 8.2% students suffered from side effects, including 5.6% who suffered from nausea, vomiting, and diarrhea and 2.6% who suffered from headache, confusion, and disorientation. Approximately 24.6% of students used fiber DSs whereas 19% and 16.4% used DSs for protein and glucosamine/omega 3 fatty acids, respectively. Conclusion The study findings indicated that the prevalence of DS use is increasing. However, approximately half of the respondents encourage the use of DSs only with a doctor's recommendation. Educating about the safe use of DSs is warranted.

الملخص: أهداف البحث: أجريت هذه الدراسة لتحديد مدى انتشار وعوامل اختطار التضخم الشحمي في المرضى الذين يعانون من داء السكري من النوع ٢ على علاج الأنسولين في المملكة العربية السعودية. طرق البحث: أجريت هذه الدراسة متعددة المراكز في عيادات الرعاية الأولية في المدينة الطبية بجامعة الملك سعود ومستشفى الأمير محمد بن عبد العزيز في الرياض بالمملكة العربية السعودية في الفترة من ٢٠١٧ مايو إلى أكتوبر ٢٠١٧. جميع المرضى البالغين الذين تزيد أعمارهم عن ١٨ عاما الذين يعانون من داء السكري من النوع ٢ مع الأنسولين من خلال المحاقن أو الأقلام لمدة سنتين على الأقل تم فحصهم جسديا للتضخم الشحمي. النتائج: كان انتشار التضخم الشحمي في مجموعة الدراسة ٣٩.٧ ٪. وتم العثور على ما يصل إلى ٥٧.٥٪ من المرضى في الدرجة الأولى من التضخم الشحمي، و٣٣.٧٥٪ من الدرجة ٢، و٨.٧٥٪ من الدرجة ٣. كما تم الكشف عن التضخم الشحمي في ٦٨.٨٪ من المرضى الذين استخدموا مواقع مختلفة لكل حقنة وفي ٦٣.٧٪ من المرضى الذين اعتادوا على حقن أكثر من ٦٠ وحدة في اليوم. أظهر تحليل الانحدار اللوجستي أن المرضى الذين استخدموا مسحات الكحول كانوا أكثر عرضة للإصابة بـالتضخم الشحمي بـ ٢.٦ مرة. ومن المثير للاهتمام، أن المرضى الذين استخدموا أكثر من ٦٠ وحدة من الأنسولين في اليوم كانوا أكثر عرضة بنسبة ٠.٣٦٢ مرة لحصول التضخم الشحمي. الاستنتاجات: التضخم الشحمي من المضاعفات الشائعة بين مرضى داء السكري من النوع ٢ في المملكة العربية السعودية. يجب على مقدمي الرعاية الصحية رفع مستوى الوعي حول التضخم الشحمي وتوفير تعليم مكثف حول إعطاء الأنسولين المناسب بين المرضى الذين يعانون من داء السكري من النوع ٢. Abstract: Objectives: We conducted this study to establish the prevalence and associated risk factors of lipohypertrophy (LH) in patients with type 2 diabetes mellitus (T2DM) who are on insulin therapy in the Kingdom of Saudi Arabia (KSA). Methods: This multicenter, cross-sectional study was executed at primary care clinics in King Saud University Medical City and Prince Mohammed Bin Abdulaziz Hospital in Riyadh KSA from May 2017 to October 2017. All adult patients over 18 years old with T2DM who had been treated with insulin via either a syringe or pen for at least two years were physically examined for LH. Results: A 39.7% prevalence of LH was found in our study cohort of which as many as 57.5% patients were found to be in LH grade 1, 33.75% grade 2, and 8.75% grade 3. LH was detected in 68.8% patients who used different sites for every injection and in 63.7% (p = 0.182) of patients who had injected more than 60 units per day (p

Objective This study examined the incidence of drug-related problems (DRPs) in different inpatient departments along with the medical team response to pharmacist's action in addressing DRPs at Jazan Hospital, Saudi Arabia. Patients and methods This retrospective study was conducted among inpatients at Ministry of Health hospital in Jazan, a region in southwestern Saudi Arabia. We collected data for a 2-year period (from 2016 to 2017). For any detected DRP of the ordered medications for dispensing, the inpatient pharmacist is sending report for that particular DRP with recommendation to the medical team which in turn might accept or reject such recommendation. Serious drug-drug interactions, as part of DRP, were assessed by utilizing three different online DDI checkers, including Lexi-Comp, Medscape, and Drugs.com. Results The most common type of DRP was serious drug-drug interactions (49%). Over the study period, most incidences of DRPs were decreased. Of the DRPs in 2016 and 2017, antibiotics were the most commonly involved (51% and 69.5%) of cases, respectively, followed by proton pump inhibitors (25.3% and 14.1%) and statins (12.9% and 9.4%). Interestingly, of the 241 interventions for DRPs in 2016, 199 (82.5%) were accepted, resulting in a change in drug therapy (p=0.006). In 2017, 90 (70.3%) interventions out of 128 were accepted by the physician and the drug therapy changed (p=0.029). Conclusion Pharmacist interventions appear to decrease the incidence of DRPs, which emphasize the importance of an optimal pharmaceutical care plan for clinical care settings.

In this article, we present a novel user identification mechanism for smart spaces called Echo-ID (referred to as E-ID). Our solution relies on inaudible sound signals for capturing the user’s behavioral tapping/typing characteristics while s/he types the PIN on a PIN-PAD, and uses them to identify the corresponding user from a set of ${N}$ enrolled inhabitants. E-ID proposes an all-inclusive pipeline that generates and transmits appropriate sound signals, and extracts a user-specific imprint from the recorded signals (E-Sign). For accurate identification of the corresponding user given an E-Sign sample, E-ID makes use of deep-learning (i.e., CNN for feature extraction) and SVM classifier (for making the identification decision). We implemented a proof of the concept of E-ID by leveraging the commodity speaker and microphone. Our evaluations revealed that E-ID can identify the users with an average accuracy of 93% to 78% from an enrolled group of 2-5 subjects, respectively.

White clover (

Supplementary evidence on the following topics:Quality Requirements for Identity EvidenceStrength of Methods Employed for Evidence ValidationPopular approaches for generating Replacement DeepfakesPopular approaches for generating Reenactment Deepfakes

Ciprofloxacin (CFX) is a broad-spectrum fluoroquinolone antibiotic that is widely used to treat bacterial infections in humans and other animals. However, its unwanted occurrence in any (eco)system can affect nontarget bacterial communities, which may also impair the performance of the natural or artificially established bioremediation system. The problem could be minimized by optimization of operational parameters via modeling of multifactorial tests. To this end, we used a Box–Behnken design in response surface methodology (RSM) to generate the experimental layout for testing the effect of the CFX biodegradation for four important parameters, that is, temperature (°C), pH, inoculum size (v/v %), and CFX concentration (mg L–1). For inoculation, a consortium of three bacterial strains, namely, Acenitobacter lwofii ACRH76, Bacillus pumilus C2A1, and Mesorihizobium sp. HN3 was used to degrade 26 mg L–1 of CFX. We found maximum degradation of CFX (98.97%; initial concentration of 25 mg L–1) at 2% inoculum size, 7 pH, and 35 °C of temperature in 16 days. However, minimum degradation of CFX (48%; initial concentration of 50 mg L–1) was found at pH 6, temperature 30 °C, and inoculum size 1%. Among different tested parameters, pH appears to be the main limiting factor for CFX degradation. Independent factors attributed 89.37% of variation toward CFX degradation as revealed by the value of the determination coefficient, that is, R2 = 0.8937. These results were used to formulate a mathematical model in which the computational data strongly correlated with the experimental results. This study showcases the importance of parameter optimization via RSM for any bioremediation studies particularly for antibiotics in an economical, harmless, and eco-friendly manner. The authors are thankful to Higher Education Commission (HEC) for the grant No TTSF-77. Scopus

Supplementary evidence on the following topics: Quality Requirements for Identity Evidence Strength of Methods Employed for Evidence Validation Strength of Methods Employed for Identity Verification Types of Neural-Networks used for generating Deepfakes Popular approaches for generating Replacement Deepfakes Popular approaches for generating Reenactment Deepfakes Popular approaches for detecting Deepfakes

Background and Objectives: Blood is an essential body fluid primarily required for regulating the body's systems and maintaining homeostasis. In developed and developing countries, concern about the demand and supply for blood is increasing. The current study aims to assess the beliefs, behaviors, and opinions of the public toward blood donation.Methods: This was a cross-sectional study in which a self-created questionnaire with 17-items was used for data collection. The self-administered questionnaire was disseminated between November 2019 and January 2020 through social media (WhatsApp© and Facebook©). Data was analyzed using SPSS program version 26.Results: A total of 356 questionnaires were completed with a response rate of 89%. The majority of participants were male 253 (71.1%), 336 (94.4%) considered blood donation important, 350 (98.3%) believed that blood donation saves lives, and 254 (71.3%) agreed to receive blood from voluntary donors. One-hundred sixty-seven (49.4%) were willing to donate blood voluntarily. The barriers to blood donation were fear of needles 86 (24.2%), fear of contracting a chronic disease 84 (23.6%), and lack of time 40 (11.2%). One day off (91.9%) and receiving a token 73.6% were common motivational factors for blood donation. Overall, 57% of the participants had favorable attitudes toward blood donation and 41.9% were knowledgeable. Favorable attitudes were significantly associated with being married (P = 0.018) and having university level of education (P = 0.005). Younger participants (18–29 years) had a statistically significant better knowledge than older participants (≥30 years).Conclusion: The respondents displayed positive beliefs, opinions, and motivation toward blood donation. Additionally, most of them considered blood donation an important act and a national duty of every individual and are willing to donate in the future.

ObjectiveThe impact of pharmaceutical services on public health especially in regards to smoking cessation counseling can influence the rate of smoking cessation. The present study aims to evaluate prevalence, beliefs, and attitude of pharmacy students toward smoking habit and SC methods.MethodsAn online cross-sectional survey was conducted among pharmacy students at King Saud University, Riyadh, Saudi Arabia over 4-month period from May to August 2021. The survey consisted of 22-items focused on evaluating the prevalence, belief, and attitude toward smoking habits and smoking cessation methods. Data was descriptively analyzed using a statistical package for social science version 26 (SPSS).ResultsA total of 675 students completed the survey, among which 78.7 % were non-smokers and only 31.7% received education on the dangers of smoking. The most common methods of smoking cessation they heard of were consultation (58.6%), followed by use of electronic cigarettes (41.92 %) and Nicotine patch (40.7%). One-third of the surveyed students (36.8 %) agreed that specialized smoking cessation clinics enhance the efficacy of smoking cessation methods. The majority of students (80.6%) agreed to ban smoking in public places and 92.2% believed that tobacco sales to adolescents should be forbidden. Health professionals should actively participate and advise their patients to quit smoking as 89.8 % students agreed on that. Age and gender of students had significantly influenced the prevalence of smoking, history of smoking, frequency of smoking, efforts to quit smoking among smokers (p = 0.0001).ConclusionThe prevalence of non-smokers among pharmacy students is encouraging, yet level of awareness about and usefulness of smoking cessation methods is unsatisfactory. Therefore, the study clearly highlights a great need for integrating smoking cessation programs in their academic curricula to prepare them for real-world practice.

Interprofessional education within healthcare has been shown to have many benefits, however, it is a relatively new educational concept within the Arabic setting. Although the Readiness for Interprofessional Learning Scale is a commonly utilised tool to examine student attitudes, there is a lack of evidence for use of an Arabic translated version. The aim of this study was to develop and psychometrically evaluate an Arabic language version of the Readiness for Interprofessional Learning Scale with Saudi nurses. Two independent translators, proficient in both English and Arabic languages, completed a forward-backward translation of the original English version of the Readiness for Interprofessional Learning Scale. Subsequently, this Readiness for Interprofessional Learning Scale–Arabic version was used to collect data from undergraduate nursing students enrolled at a number of Saudi Arabian universities. Exploratory and Confirmatory Factor Analyses were then performed on the scale. Six hundred and fifty-two participants were recruited. Exploratory Factor Analysis of the Readiness for Interprofessional Learning Scale-Arabic version resulted in a 15-item, three-factor model. Subsequent analysis with Confirmatory Factor Analysis and the resultant final 13-item model demonstrated a poor fit between the hypothesized model and the data. Although our three-factor model is supported by previous studies, the proposed model did not perform well on Confirmatory Factor Analysis assessment. This suggests that there may be issues of applicability of the Readiness for Interprofessional Learning Scale-Arabic version within the current cohort. The present study of the Readiness for Interprofessional Learning Scale-Arabic version has demonstrated some psychometric inadequacies and thus it is possible that this scale may not be appropriate for use with Saudi nurses. However further research with different professional groups is suggested to fully explore its utility within the Saudi setting.

The primary function of the Drug Information Center (DIC) is to provide drug-related information to healthcare professionals. The purpose of this research was to assess the use of drug information centers by health care the professionals to improve medication safety in Saudi Arabia.A retrospective study was carried out at King Khalid University Hospital's drug and poison information center (DPIC). During the study period, requests received by drug information specialists were saved in the DPIC questions' bank. Patients' demographic, type of drug information request, caller information, number of references used, medications, class of medication, medication error type and subclass were assessed and analyzed using descriptive analysis. Medication error types were captured based on nature of questions.A total of 243 drug information inquiries were assessed. Most of the inquiries were about adult population (n = 168; 69.1%). Most drug information inquiries were received from pharmacists (n = 117; 48.1%), followed by physicians (n = 94; 38.7%), then nurses (n = 23; 9.5%). Prescribing error were the most type of medication error prevented by drug information specialists (n = 214; 88.1%) followed by dispensing errors (n = 11; 4.5%). Approximately half of the medication errors in this study were near-misses (n = 110; 45.3%), followed by potential near misses (n = 84; 34.6%). Only, (n = 49; 20.2%) were identified as errors.This study highlights the role of drug information specialists in providing evidence-based information and helps in preventing possible medication errors which will enhance the safety of the services provided to the patients.

Background and aim During the Coronavirus 2019 (COVID-19) crisis, there has been a huge demand for medications and unprecedented utilization of intensive care unit (ICU) services that subsequently and profoundly impacted the quality of medical care provided to COVID-19 patients. This study aimed to shed light on the role of pharmacists on the health care provided to critically ill COVID-19 patients. Methods A retrospective study, was conducted in Diriyah hospital in Riyadh, Saudi Arabia on all COVID-19 patients admitted to the ICU between June 27th and August 15th, 2020 until patients were transferred to the medical ward, discharged, or deceased. All medication related interventions performed by pharmacists have been documented electronically, collected and subsequently categorized and analyzed. Results The mean age of patients was 58.8 years (±12.98 SD), with age of >64 years in approximately 37%. Four hundred and seventy interventions (470) were made by pharmacists of which 32%, 11.7%, 4%, 2.6%, 2.1% were due to error in dosing regimens, drug duplication, missing drug information, drugs requiring prior authorization, and missing critical information, respectively; while 40.6% were due to medication shortage of which 40.3% were substituted with alternative medications. Based on the analysis of drugs involved in interventions, medication groups that were mainly associated with interventions included antibiotics (16.8%), electrolytes/minerals (11.7%) and vitamins (9.4%). Conclusion During health crises such as COVID-19 pandemic, the role of pharmacists in the ICU services becomes extremely crucial for providing better patients’ outcomes. Further studies should be conducted to follow up these findings in the context of COVID-19 pandemic.

Aim Warfarin is commonly used in patients with thrombotic diseases. This study aimed to evaluate the impact of Ramadan fasting on warfarin efficacy by investigating international normalized ratio (INR) stability in medically stable patients. Methods A retrospective observational study was conducted at King Khalid University Hospital during Ramadan 2016 on fasting adult patients aged above 18 years and receiving warfarin. The INR values during pre-Ramadan, Ramadan, and post-Ramadan periods were collected after satisfying the inclusion criteria. Time within the therapeutic range (TTR) during the whole period was estimated using the conventional method. Results 101 patients were included in the study. The mean age (SD) was 55.8 ± 15.5 years, and 52.4% were females. The target INR range for 62.4% was 2-3, while 37.6% had a target INR range of 2.5-3.5. An upward trend in the proportion of patients with therapeutic INR was noticed during Ramadan (59.4%) as compared to pre- (56.4%) and post-Ramadan periods (53.5%), respectively. Additionally, the proportions of patients with supratherapeutic and sub-therapeutic INR were the highest and lowest, 23% and 24%, respectively, post-Ramadan as compared to other periods. Based on target INR categorization, achieving therapeutic INR during Ramadan was more feasible with the low INR (2-3) compared to the high INR (2.5-3.5) target patients, 63.5% vs. 52.6%, respectively. TTR estimation revealed 62.4% and 37.6% of the patients had good and poor, respectively, anticoagulation status throughout the study period. Conclusion Despite the changes in mean INR and proportion of patients with therapeutic INR during Ramadan compared to other non-fasting months, our results confirmed that short-term fasting during Ramadan has no significant influence on INR stability and, consequently, therapeutic efficacy in warfarin-treated medically stable patients.

Massage therapy (MT) is the physical manipulation of the soft tissues. It primarily consists of manual or hands-on techniques such as applying fixed or movable pressure, holding, and moving muscles and body tissues. MT is beneficial for pain relief, sport-related injury rehabilitation, stress reduction, and to address psychological disorders. MT is the most prevalent form of complementary and alternative (CAM) therapy worldwide. The aim of this study was to evaluate the knowledge, attitudes, and perceptions regarding MT among the Saudi community. A cross-sectional online survey using WhatsApp©, Google Forms©, Facebook©, and Twitter© was conducted among the general community of the Kingdom of Saudi Arabia (KSA) to assess the knowledge, attitudes, and perceptions regarding MT. Data was collected using a 20-item, self-administered questionnaire consisting of a series of both closed-ended and Likert-type questions. A total of 436 respondents completed the survey. Most of the respondents were female 84.2% (n = 367). Approximately 65% resided in the central region of KSA. The majority of the respondents, 81.4%, believed that MT is effective, 27.7% thought that MT leads to complications, and more than half of the residents, 55.7%, believed that patients should consult with their physicians prior to MT. The most common reasons for MT were to treat muscle pain, for relaxation purposes, to treat bone and joint pain, and backache relief, which were reported by 49%, 20%, 19%, and 16% of the participants, respectively. The knowledge, attitudes, and perceptions of the Saudi population towards MT are insufficient in some aspects. The establishment of community-based health education programs to improve knowledge of MT is recommended. Keywords: Massage therapy, Swedish massage, Knowledge, Saudi Arabia

Diabetes mellitus (DM) is a worldwide rising concern that leads to an increased rate of morbidity, mortality, and health-care costs. DM is a chronic, endocrine disorder associated with hyperglycemia. The current estimated DM prevalence is over 422 million and has been progressively increasing over the past decades. Consequently, it is considered a significant problem in health-care settings. Health-care professionals who deal with such patients need to have an adequate information and drug therapy management including drugs and its regimen that are presently available in the market. This review provides an overview of potential diabetic drugs and their mechanisms. Hence, it will be proved beneficial for health-care professionals.

الملخص: أهداف البحث: أجريت هذه الدراسة للتحقق في التواصل بين الوالدين والطفل والممارسات الوقائية التي تركز على الاعتداء الجنسي على الأطفال بين مجموعة من السعوديين. طرق البحث: أجريت دراسة وصفية مستعرضة في مركز واحد للرعاية الصحية الأولية في مدينة الدمام، بالمملكة العربية السعودية. تم قياس التواصل بين الوالدين والطفل والممارسة الوقائية من خلال استبانة ذاتية الإبلاغ مع إجابات ثنائية (نعم / لا). تم اختيار ٤٠٠ شخص باستخدام طريقة أخذ العينات العشوائية الطبقية. النتائج: هذه الدراسة تشير إلى أن ٨٢.٥٪ (عدد=٣٢٩) من الآباء تحدثوا مع أطفالهم حول خصوصية أجسامهم. فيما يتعلق بالإشراف، وأعترف أكثر الآباء (٩١.٧٪) بأن أطفالهم كانوا تحت إشرافهم المباشر طوال الوقت. وأظهرت المتغيرات الأخرى أن ارتداء الملابس المناسبة (٩٤.٧٪)، والمراقبة (٩٣.٥٪) وتعليم الطفل حول خصوصية أجسامهم (٩٣.٢٪).لوحظ أن غالبية المستجيبين (٧٦.٧٪) لديهم درجة جيدة من الممارسة الوقائية، بينما لوحظ عند ٩٥ (٢٣.٨٪) ممارسة التواصل الضعيف. ارتبط تحليل الانحدار اللوجستي عن الجنس، والحالة الاجتماعية، وحجم الأسرة لأكثر من زوجة بشكل كبير بالممارسة الوقائية الجيدة. الاستنتاجات: كشفت الدراسة أن ممارسات التواصل بين الوالدين والطفل في المملكة العربية السعودية تبدو جيدة بشكل معقول. المزيد من الرقابة الأبوية على الأطفال فيما يتعلق بالإيذاء الجنسي يحتاج إلى الاهتمام. ويُنصح الآباء بالتواصل مع أطفالهم وتزويدهم بمعلومات ووسائل إيضاحية عن منع الاعتداء الجنسي. Abstract: Objectives: This study was conducted to investigate parent–child communication and preventive practices centred on child sexual abuse among a cohort of Saudi population. Methods: A cross-sectional descriptive study was carried out at a single primary health care centre (PHC) in Dammam city, KSA. Parent–child communication and preventive practice were measured by a Self-Reporting Questionnaire with binary answers (yes/no). A total of 400 subjects were selected using a stratified random sampling method. Results: This study found that 82.5% (n = 329) of parents talked with their children about the latter's bodily privacy. With regard to supervision, most parents (91.7%) said that their children were under their direct supervision all the time. Other variables wear wearing appropriate clothes (94.7%), supervision (93.5%), and teaching a child about their bodily privacy (93.2%). A majority of the respondents (76.2%) were achieved a good preventive practice score, while 95 (23.8%) were observed to have poor communication practice. Logistic regression analyses for gender (p

The widely divergent species 4xTrifolium ambiguum and 2xT.occidentale are inter-fertile long after speciation (including polyploidisation) has occurred. Tri-species hybrids (T. repens × T. ambiguum × T. occidentale) have the potential to achieve introgression of stress resistant traits from both wild species into white clover. Trifolium ambiguum and T. occidentale are geographically, adaptionally and phenotypically contrasting species in the white clover section (Trifoliastrum) of the genus. T. ambiguum occurs as a high-altitude polyploid series (2x, 4x, 6x) in W Asia and NE Europe. T. occidentale is a diploid coastal species, occurring at sea level in W Europe. This study investigated hybridisation between 4xT. ambiguum and 2xT. occidentale and considered the significance of the hybrids for introgression breeding of white clover. Partially fertile F1 hybrids between 4xT. ambiguum and 2x and 4xT. occidentale were generated by embryo rescue. Hybrid plant morphology and fertility varied widely and hybrids generally expressed traits from both species. Advanced generation (F2–F5) 4x hybrids were highly fertile and constitute a new synthetic allotetraploid species. FISH analyses of 4x hybrids showed multivalent chromosome configurations with homoeologous associations between T. ambiguum and T. occidentale chromosomes. Crosses of the hybrids with T. repens produced fertile tri-species progeny. These very divergent species remain inter-fertile long after speciation (including polyploidisation) has occurred. Tri-species hybrids have the potential to achieve introgression of stress resistance traits from both wild species into white clover.

This study was undertaken to examine the clinical utility of lactate clearance as an indicator of mortality in pediatric septic shock, and to compare the performance of lactate clearance at 6, 12, and 24 h for predicting in-hospital and 60-day mortality. Pediatric patients with septic shock were prospectively studied. Vital signs, laboratory values, Pediatric Risk of Mortality Score, and pediatric logistic organ dysfunction score were obtained at presentation (hour 0), hour 6, hour 24 and over the first 72 h of hospitalization. Lactate clearance was obtained at 6, 12, and 24 h of hospital admission. Therapy received, outcome parameters of mortality, and duration of hospitalization were recorded. The primary outcome variable of 60-day mortality rate was 31.25%. Only lactate clearance at 6 and 24 h was significantly associated with mortality, with odds of 0.97 (95% CI, 0.951–981; p Conclusion We concluded that optimal lactate clearance in pediatric septic shock both during the early presentation and after the initial “golden hours” is associated with lower in-hospital and 60-day mortality. Further, 24-h lactate clearance appears superior to 6 h lactate clearance in predicting mortality in such patients.

Introduction: Although all implemented and ongoing initiatives, drug-drug interactions (DDIs) are still a global problem. Most published studies about DDIs in Saudi Arabia are carried out in hospital settings. In addition, assessing the knowledge of drug interactions in Saudi Arabia is limited. The aim of our study is to evaluate the knowledge of potential common drug-drug interactions among community pharmacists particularly in Saudi Arabia. Methodology: A crosses-sectional study utilizing a self- administered questionnaire was conducted among community pharmacy in Riyadh city Saudi Arabia. DDIs' knowledge was assessed by 26 drug pairs. Community pharmacists were asked to select the DDIs as “contraindication”, “may be used together with monitoring”, “no interaction” and “not sure”. Results: A total of 283 of community pharmacists completed the survey with response rate of 80.9%. Among the 26 drug pairs only 5 of them were identified correctly by most of the participants. To add more 3 out of the 5 pairs had a cutoff of less than 10% between the correct and wrong answer, meaning there still a majority that couldn't identify the correct answer. All the 26 pairs had a statistically significant difference between the correct and incorrect answer. Conclusion: The results of this study showed that knowledge of community pharmacists about DDIs was inadequate. Community pharmacist should have specific courses in drug interactions to cover the most possible interactions that can be seen in this setting. Keywords: Drug-drug interaction, Community pharmacist