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Abstract Medicinal plants (MPs) have long been used for their therapeutic properties in traditional forms of medicine. However, the presence of potentially toxic elements (PTEs) in MPs raises concerns about their safety, efficacy, and potential adverse effects on human health. The current study aimed to determine the level of potentially toxic and essential elements (PTEEs) in commonly consumed MPs in Zabol, Iran, along with their health risk assessments. To conduct the present study, 10 types of MPs widely used in Zabol, Iran, were selected, and 15 samples of each type (150 samples in total) were taken. Each sample was analyzed for the presence of various PTEEs using Inductively Coupled Plasma Optical Emission Spectroscopy (ICP-OES) for Lead (Pb), cadmium (Cd), chrome (Cr), nickel (Ni), copper (Cu), zinc (Zn), iron (Fe), aluminum (Al) and manganese (Mn); and Atomic Absorption Spectrometry (AAS) for arsenic (As) and mercury (Hg). Finally, to better comprehend the scope of exposure and its possible effects, the Monte Carlo simulation method is successfully applied to assess human health risks related to PTEs in MPs. Statistical analysis revealed statistically significant (P

Abstract Background A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity’s environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation. Methods The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15–76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use. Results Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p

Introduction Acute subdural hematomas are major causes of morbidity which warrant immediate treatment. If surgical intervention is warranted, craniotomy (CO) and decompressive craniectomy (DC) are employed, largely based on a loosely defined criteria and the neurosurgeon’s best judgment. The primacy of one approach over another is a matter of dispute. Objective We attempt to further clarify any advantages in the two techniques, and include a propensity score matched (PSM) subgroup analysis to eliminate bias. Design This meta-analysis was conducted following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Data Sources and Methods A literature review was conducted on PubMed/Medline, Cochrane Central, and Google Scholar from inception to September 2023. 15 studies were extracted, and three outcomes were meta-analyzed: Mortality, Glasgow Outcome Scale (GOS) scores and patients undergoing re-operations/revisions. Odds Ratios (OR) and Mean Difference (MD) were used in dichotomous and continuous variables respectively. PSM data was used wherever possible. A subgroup analysis was conducted with 5 PSM studies and a trial. Heterogeneity was addressed if above 40% and the P -value is significant (≤ .05). Results A total of 15 studies were meta-analyzed with a total of 2327 and 2171 patients undergoing CO and DC respectively. Patients undergoing DC had a significantly worse GOS 5 outcome (OR: .63 [95% CI: .45-.87]; P = .005; I2 = 0%) and higher mortality (OR: 1.58 [95% CI: 1.20-2.08]; P = .001; I2 = 67%). In subgroup analysis of adjusted studies, DC still had significantly higher mortality. (OR: 1.50 [95% CI: 1.03-2.18]; P = .001; I2 = 83%). Conclusions This meta-analysis determines that CO is more viable than DC as a surgical option due to its less invasive nature. DC can be employed, albeit under strict preprocedural patient selection and for highly specific indications.

This study aimed to assess the transfer factor (TF) of heavy metals (HMs) from soil to commonly consumed vegetables irrigated with different water sources. The field study covered 36 m2 of agricultural land in Kermanshah province, Iran, divided into nine equal-sized plots. Coriander, basil, and radish were the three types of vegetables cultivated and subjected to irrigation over two months, utilizing three different water sources: treated wastewater effluent (TWE), river water (RW), and well water + nitrogen fertilizer (WWF). After the irrigation and harvesting stages, soil samples from the cultivation area and harvested vegetables were collected. These samples underwent analysis using the ICP-OES method to assess HM levels and subsequent calculation of the TF of HMs from soil to plants. The results revealed that the TF levels indicated plants' relatively weak response (TF

Background: The interaction between type 2 diabetes and periodontal disease underscores the importance of exploring dietary interventions that could mitigate inflammation and improve periodontal health in diabetic patients. Materials and Methods: This randomized controlled trial included 100 patients with type 2 diabetes who were equally divided into two groups: Group A (low-carbohydrate diet) and Group B (control group). Patients in Group A followed a low-carbohydrate diet for 12 weeks, while Group B maintained their regular dietary habits. Periodontal health was assessed using clinical parameters such as probing depth (PD) and clinical attachment level (CAL), and inflammation was measured by analyzing levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Statistical analyses were performed using appropriate tests. Results: After 12 weeks, Group A exhibited significant improvements in periodontal health compared to Group B. The mean PD reduction was 0.5 mm in Group A and 0.1 mm in Group B, with a corresponding mean CAL gain of 0.3 mm in Group A and no significant change in Group B. Inflammatory markers also showed favorable outcomes in Group A, with a decrease of 1.2 mg/L in CRP levels and 20% reduction in IL-6 levels. In contrast, Group B demonstrated minimal changes in inflammatory markers. The differences in PD, CAL, CRP, and IL-6 levels between the two groups were statistically significant (P < 0.05). Conclusion: The adoption of a low-carbohydrate diet for 12 weeks demonstrated significant improvements in periodontal health and reduction of inflammation in patients with type 2 diabetes.

Background: This study aims to compare the long-term success rates of immediate implant placement and delayed implant placement in patients with periodontally compromised teeth. Materials and Methods: A total of 30 patients presenting with periodontally compromised teeth requiring extraction and subsequent implant placement were enrolled in this retrospective study. Patients were divided into two groups based on the timing of implant placement: Group A (immediate implant placement) and Group B (delayed implant placement). Implants were placed according to standard protocols. Patient records were reviewed for implant survival, peri-implant bone loss, and prosthetic complications. Data were statistically analyzed using appropriate tests. Results: The mean follow-up period was 5 years. In Group A, the implant survival rate was 90%, while in Group B, it was 83%. The mean peri-implant bone loss was 1.5 mm in Group A and 2.2 mm in Group B. Prosthetic complications were observed in three cases in Group A and five cases in Group B. The differences in implant survival and bone loss between the two groups were not statistically significant (P > 0.05). Conclusion: Both immediate implant placement and delayed implant placement demonstrated comparable long-term success rates in patients with periodontally compromised teeth

This study is the first to focus on the preconcentration and determination of histamine (HIS) in food samples using zeolite imidazole frameworks (ZIFs) on a solid-phase microextraction (SPME) platform. ZIF was developed on a polypropylene hollow fiber (PPHF) substrate (ZIF@PPHF) and characterized. The extraction performance was optimized by adjusting several parameters, including pH, contact time for adsorption, and desorption conditions. Under the optimized conditions, a wide linear dynamic range (0.05–250 mg/L) with high R2 values (0.9989), low limit of detection (0.019 mg/L), and low limit of quantification (0.050 mg/L) were determined as analytical figures of merit. Additionally, a reusability study confirmed that ZIF@PPHF preconcentrated 83% of the HIS up to the fourth cycle. The developed method was used to preconcentrate HIS in fish and cheese samples. The spiked real samples confirmed the validity and accuracy of this method. The percentage mean recoveries ± relative standard deviation (% RSD, n = 3) at the concentration levels of 5, 10, and 50 mg/L of HIS and the sample amount of 5 g for intra- and inter days ranged from 97 ± 1.10 to 102.80 ± 0.90 and from 96.40 ± 1.82 to 103.40 ± 0.79, respectively. The results suggest that the analytical method validation parameters were acceptable, indicating the repeatability and sensitivity of the method.

Cheese is popular in Iran because of its high nutritional value; therefore, it is necessary to control this product regarding health risk factors, particularly aflatoxin M1 (AFM1). This research reviewed AFM1 in various varieties of cheese in Iran to assess the potential health risks associated with consuming these products for different age groups. In this regard, all accessible papers from different databases were screened between June 27, 2000 and October 10, 2022 b y systematic research and then considering the selection criteria of the studies; finally, 22 articles were selected for the current review. The amount and prevalence of AFM1 were calculated and separated based on the cheese variety, and the sampling location; health risk assessment (HRA), statistical, uncertainty, and sensitivity analysis for AFM1 of cheese for different age groups were performed. The study results for 2143 samples showed that the overall average AFM1 for cheese is 160 ± 175 ng/kg, below the European Commission (EC) regulation (250 ng/kg). AFM1 contaminated 72.42% of all cheese samples, and 13% of these contaminated samples had a higher AFM1 than the EC regulation. Cheese varieties were ranked based on average levels of AFM1 as white pasteurized > traditional > creamy > probiotic > Lighvan, and this ranking was obtained based on sampling locations as market > dairy factories > livestock farms. Based on the HRAs, from the perspective of the liver cancer risk (LCR), the margin of exposure (MOE), and the hazard index (HI) approach, it can be concluded that cheese produced in Iran, in terms of AFM1, particularly for children, poses serious health risks. Accordingly, it is imperative to carefully consider implementing suitable management methods to inhibit the growth of aflatoxin B1 (AFB1) in livestock fodder, and training in sanitary production and processing of dairy products according to world standards is suggested for industrial and traditional cheese producers across Iran.

Abstract Dampened immunity and impaired wound healing in diabetic patients may lead to diabetic foot ulcer disease, which is the leading cause of limb amputations and hospitalization. On the other hand, cancer is the most significant cause of mortality globally, accounting for over 10 million fatalities in 2020, or nearly one in every six deaths. Plants and herbs have been used to treat chronic diseases due to their essential pharmaceutical attributes, such as mitigating drug resistance, ameliorating systemic toxicities, reducing the need for synthetic chemotherapeutic agents,and strengthening the immune system. The present study has been designed to evaluate the effects of Tribulus terrestris on wound healing, cytotoxic and anti-inflammatory responses against HepG-2 liver cancer cell line. Two solvents (methanol and ethanol) were used for root extraction of T. terrestris. The wound healing potential of the extracts was studied on diabetic cell culture line by scratch assay. The anti-oxidant and cytotoxic potentials were evaluated by in vitro assays against HepG2 cell line. The methanolic root extract resulted in the coverage of robust radical scavenging or maximum inhibition of 66.72%,potent cytotoxic activity or reduced cell viability of 40.98%, and anti-diabetic activity having mighty α-glucosidase inhibition of 50.16% at a concentration of 80 μg/ml. Significant reduction in the levels of LDH leakage (56.38%), substantial ROS (48.45%) and SOD (72.13%) activities were recorededMoreover, gene expression analysis demonstrated the down-regulation of inflammatory markers (TNF-α, MMP-9, Bcl-2, and AFP) in HepG-2 cells when treated with T. terresteris methanolic extract as compared to stress. Furthermore, the down-regulation of inflammatory markers was validated through ELISA-mediated protein estimation of IL-1β and TNF-α. It is expected that this study will lay a foundation and lead to the development of efficient but low-cost, natural herbs extract-based dressing/ointment for diabetic patients and identify potential drug metabolites to treat out-of-whack inflammatory responses involved in cancer onset, progression, and metastasis.

Abstract The quality of irrigation water sources can significantly affect the concentrations of heavy metals (HMs) in cultivated vegetables. This study aimed to investigate the effect of various water resources, including treated wastewater effluent (TWE), river water (RW), and well water with chemical fertilizer (WW+F), on the accumulation of heavy metals (HMs) in the three most widely consumed edible vegetables (Coriander, Radish, and Basil) in Iran. A total of 90 samples of edible vegetables, 13 samples of irrigation water, and 10 soil samples were collected to determine HMs concentrations. Iron (Fe), Zinc (Zn), Copper (Cu), Manganese (Mn), Lead (Pb), Cadmium (Cd), Chromium (Cr), Nickel (Ni,) and Arsenic (As) were analyzed by inductively coupled plasma optical emission spectrometry (ICP-OES). Eventually, the Total Target Hazard Quotient (TTHQ) for the toxic metals of As, Pb, and Cd was determined. The results revealed that the TTHQ of toxic metals in vegetables was less than the allowable limits (TTHQ = 1). Also, TWE was the best irrigation water type since the HMs content of vegetables was low. By comparing the results with national and international standards, it can be concluded that the Gharasou RW for irrigation of edible vegetables was inappropriate.

This study evaluates the anti-diabetic potential and underlying mechanisms of curcumin in streptozotocin (STZ)-induced type 2 diabetes mellitus (T2DM) rats. The rats were randomly divided into four groups: normal control, negative control (diabetic group), diabetic group receiving glibenclamide (positive control group), and curcumin plus STZ (treatment group). The anti-diabetic activities of curcumin were examined at a dose of 50 mg/kg body weight through physiological, biochemical, and histopathological analysis. Compared to the normal control group rats, elevated levels of glucose, creatinine, urea, triglycerides (TG), and total cholesterol (TC) and low levels of insulin were found in the negative control rats. Curcumin treatment showed a significant decrease in these parameters and an increase in insulin level as compared to negative control rats. In negative control rats, a reduced level of antioxidant enzymes and an increased level of lipid peroxidation and inflammatory marker levels were noticed. Oral administration of curcumin significantly ameliorated such changes. From histopathological findings, it was noted that diabetic rats showed changes in the kidney tissue architecture, including the infiltration of inflammatory cells, congestion, and fibrosis, while oral administration of curcumin significantly reduced these changes. Expression of IL-6 and TNF-α protein was high in diabetic rats as compared to the curcumin treatment groups. Hence, based on biochemical and histopathological findings, this study delivers a scientific suggestion that curcumin could be a suitable remedy in the management of diabetes mellitus.

Objectives: This research was done to assess how much bone is lost around dental implants in smokers. Material and Method: There were 80 participants total in the study, 40 of whom were smokers (Group I) and 40 of who were non-smokers (Group II). By evaluating the patients' clinical and radiographic data, the marginal bone-level measurements were determined. The acquired information underwent statistical analysis. Results: Smokers were found to have worse overall clinical parameters than non-smokers (P 0.05). Smokers experience more marginal bone loss around implants than non-smokers do. Conclusion: Smoking has a negative impact on the outcome rate of dental implants.

Contaminated irrigation water can increase trace heavy metals concentration in agricultural soil. The present research aimed to investigate the effect of three types of irrigation water sources, including treated wastewater effluent, Gharasoo river water, and well water with chemical fertilizer, on the accumulation and ecological risk of heavy metals in agricultural soils. Soil samples were collected before and after crop irrigation to evaluate heavy metal concentrations. The samples were analyzed to determine the presence of arsenic, nickel, cadmium, iron, chromium, zinc, lead, copper, and manganese. Based on the results, the concentration of essential metals in the soil before the irrigation process was more than toxic metals. The different irrigation sources increased the concentration of all heavy metals in the soil, and the accumulation of Cr, Ni, and Cd significantly elevated more than others. Irrigation resources' effectiveness in transferring heavy metals to the soil was obtained as treated wastewater effluent

AimThis study explored the Coronavirus Disease 2019 (COVID-19) pandemic effects on overseas Pakistani's residing in various parts of the world, particularly in China, Saudi Arabia (SA), and the United Kingdom (UK).MethodsThis cross-sectional study was completed between November 2020 and April 2021. An online questionnaire was designed and circulated via various social media mediums to overseas Pakistani communities. The obtained data were statistically analyzed through SPSS version 19 for windows. P < 0.05 was considered statistically significant.ResultsA total of 542 overseas Pakistani participated in the current study. In total, 157 (29%) were females and 385 (71%) males. There were 174 (32.1%), 142 (26.45%), 117 (21.6%), and 109 (19.85%) participants from the UK, SA, China, and other countries respectively. Some participants, or their family members, 93 (17.2%), got infected with the COVID-19. About one-third, 165 (30.4%), of the respondents were afraid that their company would violate their contracts or lose their jobs or be paid less. The majority, 469 (86.5%), believed that the lockdown is increasing their psychological stress. More than half of the participants, 314 (57.9%), stated that the Pakistani embassy did not facilitate them in their country of stay. About one-third, 194 (35.8%), of the respondents faced visa-related issues. More than one-third of respondents, 221 (40.8%), faced health issues due to lack of physical activities during the lockdown. Males were afraid that their company would violate their contract, lose jobs, or be paid less than females (p < 0.001). Both genders had psychological stress and health issues because of the pandemic. The participants from SA faced more visa-related issues, and they were less satisfied with the efforts of the Pakistani embassy to facilitate them compared to the UK and China participants (p = 0.013).ConclusionOur data indicate that the COVID-19 pandemic impacted Pakistanis living in the UK, SA, China, and other parts of the world. They had health-related issues, visa problems and dissatisfaction with Pakistani embassy facilitations. Pakistanis living abroad require government assistance to resolve their issues.

Background: Burnout is known as result of long term exposing to stress. There are some factors that may cause stress in physicians: nature of work, their training, their public image, their families and themselves. The person who has burnout syndrome (BOS) seems like to have tiredness, low energy, nervousness, and mentally unstable. The aim of the study is to assess the pattern and magnitude of burnout among orthopedic surgeons in southern region, Saudi Arabia. Methodology: A descriptive cross-sectional survey was applied targeting all orthopedic surgeons in 12 hospitals all southern region, Saudi Arabia during the period from December 2018 to April 2019. Data were collected using self-administered questionnaire that was developed by the researchers. The questionnaire included personal data. Burnout was assessed using Maslach Burnout Inventory Scale. Results: A total sample of 107 orthopedic surgeons were included with their ages ranged from 25 to 65 years old with mean age of 38.1 ± 8.9 years. About 94% of the surgeons were males and 43.9% were Saudi. Generally, the surgeons recorded mean score for emotional exhaustion of 18.9 points out of 54 with mean score% of 35.1%. Regarding depersonalization, the surgeons had mean score % of 30.7% and had a score of 39.6% for personal accomplishment. Conclusions: The study revealed that all included physicians had moderate levels of burnout. Personal accomplishment was the highest level of burnout recorded. Health education sessions and periodic training is required to improve surgeons coping strategies to overcome burnout.

Introduction: Urolithiasis is a public health concern, yet there are limited studies in our community. This study aimed to provide a current estimate of the prevalence of urolithiasis and to evaluate the public's awareness about dietary and lifestyle habits that impact on urolithiasis among the Jeddah population in 2017. Methods: This is an observational cross-sectional study design where a self-administered questionnaire was distributed in two major malls in Jeddah. The total number of participants was 2173, who were Saudis and non-Saudis aged 18 years and above. The questionnaire includes five sections: demographics, general information related to urolithiasis, dietary information related to urolithiasis, lifestyle habits, and medical conditions. Results: The overall prevalence of urolithiasis was 11.2%, 48.8% of which had a family history with a first-degree relative. The odds of urolithiasis among males was 1.8 times higher than in females (odds ratio [OR] =1.8, 95% confidence interval [CI], 1.4–2.4). The median age of stone disease was 33 years (25%–75%: 26–42 years). Diabetic individuals were 3.2 times more likely to have urolithiasis when compared to nondiabetic individuals (OR = 3.2, 95% CI, 2.1–4.9). Low level of awareness was observed in this cohort group with a mean score of 37.7%; 64.1% of the population were in the low awareness level, 35.3% were in the medium level, and only 0.6% participants were in the high level of awareness. Conclusion: This study highlights the lack of public awareness about urolithiasis and knowledge about its causation despite the high prevalence. There is a clear need to inform and educate the public on matters relating to the known risk factors associated with urolithiasis.

Obstructive sleep apnea (OSA) is highly prevalent in the general population. In addition, patients with comorbid OSA are frequently hospitalized for unrelated conditions. This review focuses on managing patients with comorbid OSA in inpatient and acute care settings for inpatient providers. OSA can impact the length of stay, the risk of intubation, the transfer to the intensive care unit, and mortality. Screening questionnaires such as STOP-BANG can help with screening hospitalized patients at admission. High-risk patients can also undergo additional screening with overnight pulse oximetry, which can be used to guide management. Options for empiric treatment include supplemental oxygen, continuous positive airway pressure therapy (CPAP), auto adjusting-PAP, bilevel positive airway pressure therapy (BPAP), or high-flow nasal cannula. In addition, discharge referral to a board-certified sleep physician may help improve these patients’ long-term outcomes and decrease readmission risks.

This study was conducted to assess social media (SM) use, psychological distress, and knowledge, attitude, and practices (KAP) regarding the coronavirus disease 2019 (COVID-19) among a sample of the population of Pakistan. A cross-sectional study was conducted in Multan, Pakistan between April and May 2020. Demographics details, SM use, psychological distress, and KAP on the COVID-19 were investigated. A total of 800 respondents were analyzed out of which 33.5% (n = 268) were women. No gender-wise difference was found in the terms of SM use and duration of SM use. Women were prone to have psychological disorders such as anxiety, depression, and stress than men in the current COVID-19 pandemic. The mean knowledge score of men was significantly higher compared to women (18.69 ± 4.20 vs. 16.89 ± 3.04, p < 0.001), while the mean score of the attitude and practices on the COVID-19 prevention measures was significantly better in women (p = 0.012 and p < 0.001, respectively). The psychological problems such as anxiety (p < 0.001) and depression scores (p = 0.033) were higher among women than men. The stress score was also higher in women but not significantly higher (p = 0.079). The knowledge was significantly correlated with attitude, anxiety, depression, and stress. The regression analysis showed that the COVID-19-related KAPs are the predictors of psychological suffering of an individual. The female gender was positively associated with anxiety and depression. The SM use was the predictor of the stress. Male respondents had significantly more knowledge of the COVID-19 than female respondents, but women had significantly better attitudes and practiced the COVID-19 prevention measures. Gender is a significant determinant of psychological distress and KAP about the COVID-19. The government has already taken significant steps to limit the spread of the disease; however, much more effort is required to tackle this COVID-19 pandemic.

Introduction: The risk of urinary tract infection (UTI) in patients with a ureteric stent is influenced by several factors such as duration of stenting. Antibiotic prophylaxis has been previously used for the prevention of UTI in patients with common urological pathologies. The aims of this study were to evaluate the incidence, to identify the risk factors of symptomatic UTI in pediatric patients with ureteric stents, and to review the effectiveness of antibiotic prophylaxis in reducing the rate of symptomatic UTI compared to a no intervention (control) group. Materials and Methods: This was a retrospective cohort study that was held at a tertiary hospital in Jeddah, Saudi Arabia. The study included 110 pediatric patients who were younger than 18 years and who required ureteric stent insertion. Disregarding gender difference, the patients were divided into two main groups: an antibiotic group and a control group. The patients in the antibiotic group (Group 1) received continuous antibiotic prophylaxis from the date of ureteral stent insertion until removal, while the patients in the control group (Group 2) received antibiotics during the perioperative period only. Results: A total of 110 patients were included in the final analysis. Group 1 patients who were given antibiotic prophylaxis during the presence of ureteric stent were 54 patients (49%). Group 2 patients who were only given antibiotic during the perioperative period were 56 (51%). Males compromised 73% (n = 80) of the sample population, while females were 27% (n = 30). The prevalence of symptomatic UTI was significantly reduced from 25% in the control group to 7% in the antibiotic group (P < 0.004). Conclusion: Antibiotic prophylaxis has significantly reduced the risk of symptomatic UTI by 68% in comparison to the control group.

Background: Herniated lumbar disc is a depositions of discs material (nucleus pulposus and annulus fibrosus) behind the intervertebral disk. Intervertebral disc connected the vertebral bodies together by pad of fibrocartilage. The major functions of intervertebral disc are mechanical, transferring load coming from the body weight and muscle contractions by spinal columns and letting the curving, flexion, and contortion. Aim: To assess the awareness of general population in Aseer region, southern of Saudi Arabia, regarding disc herniation and to identify the predictors for their awareness. Methodology: A descriptive cross-sectional approach was conducted through a questionnaire designed to examine the public herniated disc awareness and knowledge. The questionnaire given to individuals from general population visiting general public places in Aseer region. Content validity for the questionnaire was done as it was reviewed by three experts for any modification of corrections. Results: The study included 1,044 participants aged between 15 and 70 years with mean age of 36.3 ± 11.2 years old. The majority of respondents were males (62.4%) and Saudi (98.9%). About 71% of the participants were university graduated. Generally, only 9% of the study participants recorded good awareness level regarding all aspects of disc herniation. Conclusion: This study showed that awareness regarding disc herniation among the general population was very poor for all domains.

The research is aimed at comparing residential building windows’ thermal performance with and without thermal shutters, and at examining thermal shutters’ performance upon being insulated with various types of insulation, glares, outside temperatures, and solar radiation. As an example, one case study based out of the UAE is chosen, covering the status of the housing typology and traits of building energy consumption. The study uses the primary tool of computer simulation software “DesignBuilder” to examine the impact of window shutters design on energy consumption and environmental impact. It was found that the usage of conventional insulating materials within the shutters is sufficient for the house to attain a reduction in heat gain of up to 50%. Furthermore, the application of the rolling shutters with analyzed control strategies recorded a potential reduction in equivalent CO2 emissions level, up to 15%, which would decrease the environmental burden on a national level. The simulations have shown high insulating materials did not differ much in the reduction in energy when running a simulation for a whole unit of housing rather than experimenting a window unit separably as reviewed in the literature. The findings can be applicable to other regions with similar climatic conditions and cultural constraints, such as those of the Middle East and the GCC countries.

Biogenic amines, has been implicated as the causative agent in several outbreaks of food poisoning. Fermented food such as Turkish style fermented sausages can also contain biogenic amines, microorganisms possessing the enzymes decarboxylase, which converts amino acids to biogenic amines, are responsible for the formation of biogenic amines in fermented sausages. The purpose of this study was to determine the amount of biogenic amines in Turkish fermented sausage consumed in Van in Turkey, and to evaluate their concentrations in term of public health risks. High performance liquid chromatography method was used to the determination of 8 biogenic amines in 120 sausage samples collected from 10 different brands sold in the local markets of Van. The detection levels of biogenic amines in the samples was ranged from 0 to 129.375 mg/kg for tryptamine, from 0 to 65.625 mg/kg for 2-phenylethylamine, from 0 to 255.625 mg/kg for putrescine, from 0 to 1148.75 mg/kg for cadaverine, from 0 to 469.375 mg/kg for histamine, from 0 to 438.125 mg/kg for tyramine, from 0 to 554.375 mg/kg for spermidine, and from 0 to 614.375 mg/kg for spermine. Keywords: Biogenic amines, Fermented sausages, HPLC, Decarboxylase enzymes

The application of HPLC method to detect the BA concentration in fermented sausage was successful and proved that HPLC system and method served its purposes. Biogenic amines are generated in foods as a result of free amino acid decarboxylation by bacterial enzymes. Biogenic amines accumulations are unwanted in all foods and beverages because if consumed at high concentrations, they may induce foodborne intoxications. Histamine, putrescine, cadaverine, tyramine, tryptamine, beta-phenylethylamine, spermine and spermidine are considered to be the most important biogenic amines occurring in foods. The determination of biogenic amines in foods is of great interest due to their potential toxicity and can be used as indicators for food quality markers.

To review the pathogenesis of pulmonary vascular complications of liver disease, we discuss their clinical implications, and therapeutic considerations, with emphasis on potential reversibility of the hepatopulmonary syndrome after liver transplantation. In this review, we also discuss the role of imaging in pulmonary vascular complications associated with liver disease.

Summoning retrieves quantum information, prepared somewhere in spacetime, at another specified point in spacetime, but this task is limited by the quantum no-cloning principle and the speed-of-light bound. We develop a thorough mathematical framework for summoning quantum information in a relativistic system and formulate a quantum summoning protocol for any valid configuration of causal diamonds in spacetime. For single-qubit summoning, we present a protocol based on a Calderbank–Shor–Steane code that decreases the space complexity for encoding by a factor of two compared to the previous best result and reduces the gate complexity from scaling as the cube to the square of the number of causal diamonds. Our protocol includes decoding whose gate complexity scales linearly with the number of causal diamonds. Our thorough framework for quantum summoning enables full specification of the protocol, including spatial and temporal implementation and costs, which enables quantum summoning to be a well posed protocol for relativistic quantum communication purposes.

Background: Postoperative nausea and vomiting (PONV) is a common complication following general anesthesia. Different regimens have been described for the treatment of PONV with few that mention the prevention of it. Therefore, we conducted this study to compare the effect of preloading with either crystalloids or colloids on the incidence of PONV following laparoscopic cholecystectomy (LC), under general anesthesia. Materials and Methods: This study was carried out on 80 patients who underwent LC. The patients were divided into four groups (each 20 patients), to receive preloading of intravenous fluid, as follows: Group 1 received, 10 ml/kg of low-MW tetrastarch in saline (Voluven TM ), group 2 received, 10 ml/kg medium-MW pentastarch in saline (Pentaspan TM ), group 3, received 10 ml/kg of high-MW heta-starch in saline (Hespan TM ), and group 4, received 10 ml/kg Lactated Ringer′s, and this was considered as the control group. All patients received the standard anesthetic technique. The incidence of PONV was recorded, two and 24 hours following surgery. The need for antiemetics and/or analgesics was recorded postoperatively. Results: The highest incidence of PONV was in group 3 (75% of the patients) compared to the other three groups. Also the same trend was found with regard to the number of patients who needed antiemetic therapy. It was the highest incidence in group 3 (70%), followed by group 2 (60%), and then group 1(35%), and the least one was in the control group (25%). Conclusion: Intravascular volume deficits may be a factor in PONV and preloading with crystalloids showed a lower incidence of PONV.

Coronary Artery Disease (CAD) is one of the major causes of morbidity and a leading public health issue, comprising the death causes of millions of men and women worldwide. Most of prior studies in the region of the modifiable risk factors were cross-sectional studies. Objectives: Study was conducted to compare those who revealed to have CAD after cardiac catheterization with those who shown to be free from CAD. The comparison planned based on the following variables: age, gender, Body Mass Index (BMI), smoking, hypertension, dyslipidemia, diabetes mellitus, and the presence or absence of family history of CAD, in order to identify significant risk factors of CAD in our population. Second objective was to identify the most important predictors for CAD, in order to help clinicians identifying main characteristics of a cardiac cath candidate in our population. Methods: A case-control study was conducted by extracting data of patients who underwent cardiac cath between 10th of June 2008 and 8 July 2013. Patients’ information was taken from King Abdulaziz Cardiac Center in Riyadh (KACC) catheterization lab with the following inclusion and exclusion criteria: • Inclusion criteria: Age >18, both genders, suspected to have CAD and had at least one visit prior to catheterization. • Exclusion criteria: other cardiac diseases including valvular disease, vacuities, congenital anomalies, and cath done not primarily to rule out CAD Sample size was calculated based on presence of family history with estimated proportion of 0.048 in controls, odd ratio of 3, 95% confidence level and 90% power to be 484 subjects in total (with a case to control ratio of 1:1, 242 for each group). The sample size then was maximized to include all patient who were found not having CAD after heart cath (total of 456 for control group), cases (those found to have CAD) were minimized to 456 subjects through computerized based simple random sampling technique. Data was recorded in data collection sheet based on subjects’ disease status (diseased, or not diseased), and their exposure to single or multiple factors. Results: Total of 912 subjects included in the analysis, 456 for each group. The mean was 58.52 ± 13, and the mean BMI was 29.8 ± 6. Smoker were 25.5%, those with hypertension were 58%. Hyperlipidemia was experienced in 49%, diabetes in 50.7% of subjects. Family history of CAD presented in 4.8% of total subject who went for cardiac cath. All expected risk factors entered in the logistic regression analysis, and showed significantly different prevalence in patients with CAD compared to those without; gender (P

Background Remimazolam is an ester-based ultra-short-acting benzodiazepine that efficiently achieves sedation within a short period and is now being assessed as a suitable alternative to midazolam. This meta-analysis aims to pool the available data assessing and focusing on the safety aspect of remimazolam compared with midazolam. Methods A multi-center randomized control trial for patients undergoing endoscopic procedures like colonoscopy was conducted, comparing remimazolam to placebo for the midazolam group as the intervention group. The safety of remimazolam was the primary endpoint of this meta-analysis. Results A total of 3 studies were included. The total study population was 697, including the placebo, remimazolam, and midazolam groups. The types of studies included are i. randomized, double-blind, parallel-group, active-controlled clinical trial ii. prospective, randomized, parallel-group study comparing remimazolam to placebo (blindly), RCT, and iii. prospective, double-blind, randomized, parallel-group study RCT.; Treatment-emergent adverse effects included vascular disorders (P=0.42), cardiac disorders (p=0.06), respiratory, thoracic, and mediastinal disorders (p=0.26), infections and infestations (0.88), hematologic abnormalities such as anemia (p=0.63), and derangements in Blood pressure (systolic p=0.47 and diastolic p=0.68 and respiratory parameters (p=0.34). Analysis of the reported data suggests that the remimazolam group had a significantly higher incidence of treatment-emergent adverse effects compared to the midazolam group (RR: 0.84; 95% CI [0.78, 0.91]; P 2 = 5%). Conclusions In conclusion, this meta-analysis of three randomized controlled trials showed outcomes favoring both remimazolam and midazolam as successful sedatives, yet the higher requirement of top-up dosage and rescue sedatives in the midazolam group indicates that remimazolam can be used as its replacement, especially in colonoscopy procedures.