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IntroductionPilonidal sinus (PNS) is a small hole or “tunnel” in the skin that frequently occurs in the sacrococcygeal region. Nevertheless, PNS has been reported to occur between the fingers (interdigital) in barbers, hairdressers, and animal groomers. The aim of this study was to estimate the prevalence of interdigital PNS among animal handlers in Bahrain and to treat any patients encountered.MethodsThis is a cross-sectional study with convenience sampling from November 2020 to October 2021. The study participants were animal handlers from stables, veterinary, and pet shops in Bahrain. There were 43 males and 7 females with direct animal contact. 86% of the study population were handling horses, and 15% were handling different types of animals.ResultsNo positive cases of interdigital PNS among participants were found, this might reflect the positive impact of good personal hygiene among our study population. Our study shows that groomers in Bahrain frequently wash their hands after handling animals, and 98% have a daily habit of bathing after work. It was also estimated that 60% of the participants use gloves to handle animals themselves or their waste.DiscussionThis could be the first study looking at the prevalence of interdigital PNS in animal groomers worldwide. The absence of any case report of interdigital PNS among animal groomers in the recent literature strengthens our assumption that the association between interdigital PNS and hair grooming could be a narrative coincidence rather than a true occupational hazard. The present work may help in better understanding of occupation-disease association, and highlights the importance of mass screening of animal handlers for occupation-dependent health problems.

Granular volcanic ash (GVA) is a volcanic activity material with low density, high porosity, and other undesirable properties that must be improved prior to use in any construction. This material can be considered an alternative for use in road building, given its availability in many locations and in large quantities in Yemen. This article aims to investigate the potential use of GVA for the construction of roads in Yemen when treated with cement stabilizer. Two types of GVA materials with different colors were selected and referred to as red and black GVA materials. Tests performed included the unconfined compressive strength (UCS), compaction, indirect tensile strength (ITS), wetting–drying durability test, and ultrasonic pulse velocity (UPV) test for samples curried for 7 and 28 days. For each GVA–cement mixture, the cement content varied as 2%, 5%, and 8% by dry weight of GVA. Test results revealed that the compaction energy applied during sample preparation led to a significant reduction in the finesse modulus for red and black coarse GVA materials, with reductions of 10% and 23%, respectively. In addition, the cement content and curing period had a significant effect on UCS, ITS, and UPV for cement-treated GVA. The applicable quantity of cement required stabilizing GVA and achieving the base course specification for strength and durability criteria in flexible pavement with low traffic is 8% cement.

Background: Opioids are potent analgesics used for the treatment of moderate to severe acute and chronic cancer and non-cancer pain. However, opioid usage may be limited by negative side effects, such as potentially life-threatening respiratory depression. Objectives: The aim of our study is to investigate the prevalence of opioid-induced respiratory depression (OIRD) and its predictors at King Abdulaziz Medical City in Jeddah (KAMC-JD). Method: This is a retrospective cross-sectional (chart review) study conducted from January 1, 2016, to December 31, 2020. Results: A total of 15,753 patients received opioids during admission to KAMC-JD, and only 144 (0.915%) of them received naloxone from January 1, 2016 to December 31, 2020. Only 91 patients (0.57%) developed opioid-induced respiratory depression (OIRD), which was more frequently reported among young and middle-aged adults. OIRD was significantly associated with receiving a daily morphine milligram equivalent (MME) dose of ≥150 MME and with having a low urea concentration at the baseline and at admission under surgery. Also, fentanyl use remained a significant risk factor for OIRD. Conclusion: In conclusion, monitoring patient receiving opioids with a daily MME dose of ≥150 MME, prescribed Fentanyl, low urea concentration at the baseline, and patients’ admissions to the surgery department may mitigate the risk of developing OIRD.

Dysfunctional right ventricular outflow tracts after a repair for tetralogy of Fallot using a transannular patch offer limited nonsurgical opportunities due to their large dimensions. A discrete subannular narrowing between a dilated right ventricle and the enlarged pulmonary trunk was a potential anatomical target for the creation of a landing zone using a prestent in a young male with severe pulmonary regurgitation and moderate stenosis. Asymmetric expansion of the prestent in the angulated outflow tract led to distal stent embolization that was stabilized by another telescoping stent before successful valve implantation. This manuscript details the unique challenges posed by a dilated regurgitant outflow tract for implanting a pulmonary valve.

Herein this study, pure and manganese- (Mn-) doped ZnO (2 wt. %) nanoparticles have been synthesized using the chemical precipitation method and characterized for the photodegradation of methyl green (MG) pollutant dye under natural sunlight. The structural analysis via XRD patterns has revealed that both intrinsic and Mn-doped ZnO (2 wt. %) samples have hexagonal wurtzite structures with appropriate phase purity, clearly indicating the absence of any external impurity. The incorporation of Mn in the host ZnO lattice has decreased the crystallite size (21.10 → 18.76 nm), and nanoparticle-type surface features with sizes in the 50–100 nm range have been observed through FESEM-based surface morphological studies. Both aforementioned observations have merit in providing more active area and a high surface area to volume ratio for photocatalytic reaction. The investigation of photophysical properties indicates that in Mn-doped ZnO nanoparticles, the absorption peak is blue-shifted by 5 nm (365 → 360 nm), due to the widening of the bandgap. The degradation kinetics of MG dye follow the pseudo-second-order kinetics, and the degradation efficiency has been observed to be 62.78% mediated by pure ZnO and 66.44% by Mn-doped ZnO (2 wt. %) photocatalyst under 60 minutes of sunlight irradiation. Specifically, the rate of photocatalytic reaction (K) ~0.01792 min-1 and R2~0.97992 has been achieved for pure ZnO, whereas slightly higher (K) ~0.02072 min-1 and R2~0.97299 have been observed for Mn-doped ZnO, respectively. Conclusively, the synergistic interactions with multiple charge transfer pathways, improvement of e−/h+ pair charge separation, improved surface area, and efficient generation of hydroxyl radicals are supposed to be responsible for the highly efficient photocatalytic activity of the Mn–doped ZnO photocatalyst for MG dye.

Abstract Background Hydatid disease is an endemic disease in many countries of the world including the Middle East. It mainly affects the liver and lungs. Intramuscular hydatid disease is rarely reported in children. Such uncommon localization of hydatid cyst may pose difficulties in the clinical and radiological diagnosis; hence affecting patient’s management and outcome even in endemic areas. Case presentation We herein describe intramuscular hydatid cysts in 2 different children. The first case is a 5-year-old boy who presented with a painless palpable lump over the right lumbar paraspinal region. His history was remarkable for sheep contact. His laboratory results revealed a mild increase in white blood cell (WBC) count and C-reactive protein. The lesion showed typical features of a hydatid cyst on ultrasound. Further imaging including ultrasound of the abdomen and CT of the chest, abdomen, and pelvis showed infestation of the liver and lung as well. The lesions were resected surgically without complications. The patient received Albendazole preoperatively and after surgery for 3 months. No evidence of recurrence was seen during follow-up. The second case is a 6-year-old girl who presented with an incidental palpable lump in her left thigh during her hospital admission for recurrent meningitis. Ultrasound and MRI imaging were performed demonstrating a unilocular cystic lesion in the left proximal rectus femoris muscle. A provisional diagnosis of hematoma vs. myxoma was given. Biopsy was performed and yielded blood products only. The lesion was resected surgically with a postoperative diagnosis of hydatid cyst. Blood tests performed afterward showed a positive titer for Echinococcus. The patient received Albendazole for 3 months. No evidence of recurrence was seen during follow-up. Conclusions Despite its rarity; skeletal muscle hydatid cyst should always be considered in the differential diagnosis of cystic muscle lesions in children in endemic areas even if imaging studies did not show any of the typical signs. This will improve patient outcome by preventing unnecessary cystic puncture which might lead to serious complications, such as anaphylaxis and local dissemination.

Electrical energy is very necessary for human life in the modern era. The rising energy prices, depletion of fossil fuels, and instability of the grid are alarming situations. So, it needs a smart solution to ensure the balance between pricing and saving natural resources. Some other issues like environmental change, limitations on installation of new transmission lines, reliability concerns, and considering the expansion in distributed energy generation technologies promise the implementation of distributed generation extensively. The integration of two or more energy supplies in a power system is known as distributed energy resource system. In this study, a university campus is taken as a case study to reduce the energy cost while considering the aforementioned issues. The intelligent source–load–storage coordination scheme is proposed to utilize the available renewable energy resources with storage systems. The proposed linear model is solved in MATLAB using the exact method technique considering the economic parameters. The campus microgrid analysis is not addressed considering the Internet-of-Thing (IoT)-based building, especially in the scenario of Pakistan. The results show the efficacy of the proposed model and can be implemented on the existing campus for source–load–storage coordination as an economical solution.

Background/Objectives: Potentially inappropriate prescribing (PIP) is a common health problem in older adults and is associated with negative health outcomes such as the occurrence of adverse drug events. Several studies have been conducted in different countries and settings to assess the prevalence of PIP, including in Home Care Services. However, data on the prevalence of PIP in home-care services in Saudi Arabia are limited. This study aimed to evaluate PIP use among older patients receiving home healthcare services in Saudi Arabia and to identify the predictors and commonly implicated medications.; Methods: A cross-sectional study was conducted over an 8-month period between January and August 2023. Data were collected from the medical records of patients older than 65 years who were currently receiving home health care services at King Faisal Hospital in Taif City, Saudi Arabia. PIPs were identified using the 2019 updated Beers Criteria.; Results: A total of 375 patients were included. Out of these, 285 PIPs were identified, of which 219 patients (58.4%) received at least one PIP. The most common therapeutic class associated with the PIPs was gastrointestinal medications (66.3%). Patient age and number of medications were significant predictors of PIP.; Conclusions: Our study found a high prevalence of PIP among elderly patients receiving home health care in Taif, Saudi Arabia. This study highlights the need for improved patient data automation and implementation of the Beers criteria to prevent PIPs in the future. [ABSTRACT FROM AUTHOR]

Introduction: Delivery systems are crucially important for the implantation of medical devices in patients with congenital heart disease. However, very little data is available comparing the advantages and disadvantages of the various delivery systems. Areas covered: This article describes the delivery systems and methods used for delivery of atrial septal occluder devices, ventricular septal occluder devices, devices to occlude patent arterial ducts, and transcatheter pulmonary valves. Delivery systems are compared relating to prepping and loading, positioning of the delivery sheath/catheter, deployment, ability to recapture and reposition, as well as device release. Expert opinion: For most ASD/VSD/PDA occluder devices, the basic delivery mechanism has changed very little over the preceding 20 years. Future modifications may focus on meaningful modifications to the cable systems that reduce stiffness and improve angulation at the connection to the device. Over the next 5–10 years, it is expected to see significant changes to delivery systems used for transcatheter pulmonary valve implantation, that result in improvements in the ability to recapture and reposition self-expandable transcatheter valves during the deployment process, combined with kink resistant sheaths that facilitate easy tracking across often complex right ventricular outflow tracts. [ABSTRACT FROM AUTHOR]

The Food and Drug Administration released a safety communication in 2014 advising physicians not to do laparoscopic power morcellation for myomectomy, hysterectomies, or the removal of uterine fibroids. The purpose of this study was to ascertain how morcellation affected the survival rates (SRs) of patients with uterine sarcoma who had myomectomy or hysterectomy. The Web of Science, PubMed, Embase, and Scopus databases were searched for publications that had been published between the years 2003 and 2024. It aimed to find all original English-language studies comparing the outcomes between patients with uterine morcellation following laparoscopic myomectomy or hysterectomy and those without. A total of seven stud- ies were included in this review. In most of the included studies, the group that underwent morcellation included patients undergoing laparoscopic, open abdominal, vaginal, and hysteroscopic surgery. In contrast, the group without morcellation consisted of all patients undergoing open abdominal surgery. Patients who had uterine morcellation were more likely to experience tumor metastases than those in the group without morcellation. The rate of reoperations was higher in patients who had morcellation than those who did not. Overall, five studies found that morcellation deteriorated outcomes, whereas the other two found no signifi- cant difference between morcellation and non-morcellation. The available evidence indicated that in patients with uterine sarcomas, morcellation increases the risk of intra-abdominal and total recurrences but not the risk of extra-abdominal recurrences. Nevertheless, a link was found between morcellation and reduced SRs. [ABSTRACT FROM AUTHOR]

Influenza is a highly transmissible respiratory virus. Public awareness about the nature of the disease and how to prevent it must be explored to effectively mitigate the adverse effects of the disease. This study aimed to assess the parents’ knowledge and attitudes towards the influenza and the influenza vaccine in Al-Kharj Governate, Saudi Arabia. A cross-sectional study was performed, and an electronic questionnaire was distributed from December 2020 to the end of April 2021 to parents living in Al-Kharj, Saudi Arabia. Data were collected and analyzed using IBM SPSS version 21. The study had 510 participants, of which 75.1% were mothers. Overall knowledge about the influenza disease was found to be low in 68.6% of participants. In addition, 55.7% of respondents displayed an inadequate level of knowledge of the influenza vaccine. Almost 75% of parents had chosen not to vaccinate their children in the past and of those, only 35.9% were willing to vaccinate their child this year. The most common reason for parents choosing not to vaccinate their children was that they believed the child to be in good health. This demographic studied in Al-Kharj, Saudi Arabia did not demonstrate sufficient knowledge about the influenza disease and vaccine. Study participants were hesitant to vaccinate their children. This should prompt healthcare workers and the Ministry of Health to lead a broad awareness campaign on influenza vaccination that extends to both urban and rural areas.

With the emergence of computation-intensive and delay-sensitive applications, such as face recognition, virtual reality, augmented reality, and Internet of Things (IoT) devices; Mobile Edge Computing (MEC) allows the IoT devices to offload their heavy computation tasks to nearby edge cloud network rather than to compute the tasks locally. Therefore, it helps to reduce the energy consumption and execution delay in the ground mobile users. Flying Unmanned Aerial Vehicles (UAVs) integrated with the MEC server play a key role in 5G and future wireless communication networks to provide spatial coverage and further computational services to the small, battery-powered and energy-constrained devices. The UAV-enabled MEC (U-MEC) system has flexible mobility and more computational capability compared to the terrestrial MEC network. They support line-of-sight (LoS) links with the users offloading their tasks to the UAVs. Hence, users can transmit more data without interference by mitigating small-scale fading and shadowing effects. UAVs resources and flight time are very limited due to size, weight, and power (SWaP) constraints. Therefore, energy-aware communication and computation resources are allocated in order to minimize energy consumption.In this paper, a brief survey on U-MEC networks is presented. It includes the brief introduction regarding UAVs and MEC technology. The basic terminologies and architectures used in U-MEC networks are also defined. Moreover, mobile edge computation offloading working, different access schemes used during computation offloading technique are explained. Resources that are needed to be optimized in U-MEC systems are depicted with different optimization problem, and solution types. Furthermore, to guide future work in this area of research, future research directions are outlined. At the end, challenges and open issues in this domain are also summarized.

Congenital heart defects (CHDs) affect a wide range of societies with an incidence rate of 1.0–1.2%. These defects initiate at the early developmental stage and result in critical health disorders. Although genetic factors play a role in the formation of CHDs, the occurrence of cases in families with no history of CHDs suggests that mechanobiological forces may also play a role in the initiation and progression of CHDs. Hypoplastic left heart syndrome (HLHS) is a critical CHD, which is responsible for 25–40% of all prenatal cardiac deaths. The comparison of healthy and HLHS hearts helps in understanding the main hemodynamic differences related to HLHS. Echocardiography is the most common imaging modality utilized for fetal cardiac assessment. In this study, we utilized echocardiographic images to compare healthy and HLHS human fetal hearts for determining the differences in terms of heart chamber dimensions, valvular flow rates, and hemodynamics. The cross-sectional areas of chamber dimensions are determined from 2D b-mode ultrasound images. Valvular flow rates are measured via Doppler echocardiography, and hemodynamic quantifications are performed with the use of computational fluid dynamics (CFD) simulations. The obtained results indicate that cross-sectional areas of the left and right sides of the heart are similar for healthy fetuses during gestational development. The left side of HLHS heart is underdeveloped, and as a result, the hemodynamic parameters such as flow velocity, pressure, and wall shear stress (WSS) are significantly altered compared to those of healthy hearts.