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Ibrahim Albawardi,1 Abdullah H Alqahtani,1 Dana A Aljamea,2 Sara A Aljaafari,2 Fajar A Aldulijan,2 Seereen R Almuhaidib,2 Mohamed Elamin,3 Nourah H Al Qahtani4 1Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Biochemistry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Obstetrics and Gynecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Ibrahim Albawardi, King Fahad University Hospital, Office 155, Building 200, Alburaq Street, Alkhobar, Saudi Arabia, Tel/Fax +966138966877. Ex.: 1554, Email imbawardi@iau.edu.saPurpose: To estimate the prevalence of depression amongst hormonal and non-hormonal contraception users, and the risk factors associated with depression in the sample.Patients and Methods: This is a community-based cross-sectional study conducted in the Kingdom of Saudi Arabia from October to November 2021, covering all regions of Saudi Arabia. All participants were women, living in Saudi Arabia, ≥ 21 years old and ≤ 45 years old, using a contraceptive method, and with no established history of depression.Results: A total of 4853 out of 18,596 met our criteria and were included in this study. Among all sample groups, 29% had moderate to severe depression. Rates of depression and association studies’ results in women using hormonal were higher than those who use non-hormonal birth control methods. Psychiatric disorders, medical illnesses, substance use and depressogenic medication use were all associated with depression in both hormonal and non-hormonal contraception users.Conclusion: The current study shows high prevalence of depression amongst hormonal contraceptive users compared to non-hormonal contraceptive users.Keywords: hormonal contraception, non-hormonal contraception, depression, psychiatric disorders

Reem A Al Dossary,1 Sarah Althuwaiqeb,2 Khaled R Alkharsah,1 Nahid HO Wanni,1 Basavaraja C Hunasemaranda,1 Obeid E Obeid,1 Zaheenul Islam Siddiqui,1 Ayman A El-Badry,1 Nourah Hasan Al Qahtani3 1Department of Microbiology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 2Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia; 3Department of Obstetrics and Gynecology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Reem A Al Dossary, Email raaldossary@iau.edu.saIntroduction: Rubella is considered one of the most serious and most common congenital infections. Despite global efforts for elimination, rubella cases are still being reported in many parts of the world. The purpose of this study is to determine the level of immunity to rubella in the community and most importantly among women at childbearing age in the eastern province of Saudi Arabia and compare it with the target set by the World Health Organization (WHO) along with the incidence of acute rubella infection and the associated congenital rubella infection and congenital rubella syndrome.Methods: This is a retrospective cross-sectional study over the six years period (Jan 2014–Jun 2020) on all individuals tested for rubella IgM and IgG in a university teaching hospital.Results: Nighty one percent (15,894/17,469) of the population tested showed evidence of rubella immunity with 8.8% (1546/17,469) being susceptible. Among women at childbearing age, susceptibility to rubella was higher with 9.2% (1220/13,278) of women showing no evidence of immunity. In addition, acute rubella infection was reported for 0.17% (29/17,469) of the population tested and 0.15% (20/13,278) in women at childbearing age. No cases of congenital rubella infection were reported in the study period.Discussion: The level of Rubella immunity in the population is 91% and is less than the WHO target for rubella control therefore, risk of resurge of cases is present, indicating the need for continued national surveillance and more efforts to improve vaccination coverage in the kingdom.Keywords: rubella, immunity, susceptibility, congenital

Norah F Alhur,1 Nourah H Al Qahtani,2 Entissar S AlSuhaibani,1 Eman Alsulmi,2 Noor B Almandil,3 Sayed AbdulAzeez,4 J Francis Borgio4 1College of Science, Zoology Department, King Saud University, Riyadh, Saudi Arabia; 2Obstetrics and Gynecology Department, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Clinical Pharmacy Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, 31441, Saudi Arabia; 4Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: J Francis BorgioDepartment of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaTel +966 13 3330864Email fbalexander@iau.edu.sa; borgiomicro@gmail.comBackground: Deoxyribonucleic acid from invasive, non-invasive and 9th week embryo can be a resource for the determination of fetal sex using highly sensitive and specific multiplex PCR.Methods: A total of 402 DNA samples were used to test the newly developed novel multiplex PCR including male specific (3 genes: SRY, DAZ2 and TSPY1) Y-biomarkers and internal control, ACTB. The study isolated cffDNA (Cell-free fetal DNA; n = 73) from mother’s plasma, serum and urine, fetal DNA from 9th week embryo and cord blood, and fetal DNA from CD71+ve nucleated red blood cells (fNRBC; n = 73). Paternal and maternal DNA from buccal cells (n = 20) and blood (n = 232) used for male and female confirmation.Results: The study observed that SRY alone cannot be a suitable Y-biomarker. Confirmation from any two Y-biomarkers is mandatory for male fetus identification. Direct sequencing of the gel eluted multiplex and single amplicons confirmed the specific sequences. Presence of two out of 3 Y-biomarkers OR single Y-biomarker with > 1,000,000 intensity is considered positive for male. The multiplex PCR is suitable for determining sex from all source of fetal DNA including highly degraded cffDNA and can detect the sex using 0.5ng DNA. Individual marker-based real-time qPCR followed by combined melt curve analysis showed distinguished melt curve peaks for the markers.Conclusion: The multiplex PCR achieved 100% accuracy on fetal DNA from fNRBC for early determinations (< 13 weeks) of gender. The developed novel and simple multiplex PCR and individual qPCR can be adopted in all types of laboratories for determining human fetal gender using fetal DNA from fNRBC. Early identification of gender can support to prepare for possible X-linked analysis, reduce anxiety in mother, strengthen a bond between mother and fetus, and effective decision making. Non-invasive source of fetal DNA from fNRBC preferred for identifying gender to reduce the risk of invasive procedures in early (8– 13 weeks) pregnancy.Keywords: cffDNA, male PCR, invasive, non-invasive, Y biomarkers, fetal gender, fNRBC

Abdullah H Alqahtani,1 Kholoud Al Khedair,2 Reem Al-Jeheiman,2 Haifa A Al-Turki,2 Nourah H Al Qahtani2 1Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, 2Department of Obstetrics and Gynaecology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia Background: Anxiety and depression during the antenatal period is a growing problem with major effects on the mother, the developing fetus, and the neonate.Objectives: To assess the prevalence of anxiety and depression during pregnancy in women attending the hospital for antenatal care and assess the associated factors.Methods: This is a prospective cohort study conducted in the University Hospital of Imam Abdulrahman Bin Faisal University. Anxiety was evaluated using State Trait Anxiety Inventory. Depression was assessed using Edinburgh Postnatal Depression Scale (EPDS).Results: Complete data were available for 575 women. The mean EPDS score was 10.5 (SD 5.5). The prevalence of depression was 26.8%. The mean state-anxiety score was 38.4 (SD 11.4) and mean trait-anxiety score was 38.2 (SD 9.5). The prevalence of anxiety using state-anxiety scale was 23.6%, while using the trait scale it was 23.9%. The risk is higher among unemployed women with history of miscarriage and unplanned pregnancy.Conclusion: Anxiety and depression are common during pregnancy. Keywords: anxiety, depression, pregnancy

Nourah H Al Qahtani1 Fatma Al Hajeri21MRCOG, College of Medicine, Department of Obstetrics and Gynecology in King Fahad University Hospital, University of Dammam, Saudi Arabia; 2Department of Obstetrics and Gynecology in King Fahad University Hospital, Saudi ArabiaBackground and objectives: Hyoscine butylbromide (HBB) is widely used in labor rooms. There have been many studies on the use of HBB during labor with conflicting results, involving both primiparous and multiparous women. The aim of this trial was to study the efficacy of HBB for shortening the first stage of labor in primiparous women.Methods: The study was a randomized, double blind, controlled trial. Ninety-seven primigravid term pregnant women in spontaneous labor received either hyoscine butylbromide or a placebo intramuscularly once the women entered the active phase of labor. The primary outcome measured was the duration of the first stage of labor. Secondary outcomes were the duration of the second and third stages of labor, blood loss at delivery, rate of cesarean section, and Apgar scores for the neonates.Results: A total of 97 women yielded data for analysis. Of these, 45 women received the placebo and 52 received HBB. The mean duration of the first stage in the control group was 215 minutes, compared with 165 minutes in the study group, representing a decrease of 23.3% (P = 0.001). There were no significant changes in the duration of the second (P = 0.063) or third (P = 0.0418) stages of labor, and no significant differences in blood loss or Apgar scores. There was a slightly higher (but statistically insignificant) rate of instrumental delivery in the control group, but no difference in the Cesarean section rate. There was a 60% reduction in opioid analgesic use in the HBB group.Conclusion: HBB is effective in significantly reducing the duration of the first stage of labor, and is not associated with any apparent adverse maternal or neonatal outcomes.Keywords: hyoscine butylbromide, first stage, labor, duration, augmentation

Polyetheretherketone (PEEK) has emerged as a revolutionary material in modern dentistry because of its unique combination of mechanical strength, biocompatibility, and versatility. This literature review examines the current applications and future potential of PEEK in various dental disciplines. PEEK's favorable properties, including its low specific weight, high strength-to-weight ratio, and ability to be easily machined, have led to its adoption in prosthetics, implantology, and dental esthetic restorations. This material has shown promise for fabricating crowns, bridges, removable partial denture frameworks, and implant components. PEEK's radiolucency and bone-like elastic modulus make it particularly suitable for dental implants and abutments. Additionally, its resistance to degradation and compatibility with various surface treatments enhances its long-term performance in the oral environment. While challenges such as bonding to other dental materials and aesthetic limitations exist, ongoing research is addressing these issues through surface modifications and composite formulations. As the dental field continues to evolve, PEEK's adaptability and biocompatibility position it a key player in the development of next-generation dental materials and techniques, potentially transforming patient care and treatment outcomes in dentistry.

Background: Hydrocephalus is a highly heterogeneous multifactorial disease that arises from genetic and environmental factors. Familial genetic studies of hydrocephalus have elucidated four robustly associated hydrocephalus associated loci. This study aims to identify potential genetic causation in cases of hydrocephalus, with or without spina bifida and Dandy Walker Syndrome (DWS), using family-based rare variant association analysis of whole exome sequencing., Methods: We performed whole exome sequencing in 143 individuals across 48 families where at least one offspring was affected with hydrocephalus (N.=27), with hydrocephalus with spina bifida (N.=21) and with DWS (N.=3), using Illumina HiSeq 2500 instrument., Results: No pathogenic or putative pathogenic single-nucleotide variants were evident in the four known hydrocephalus loci in our subjects. However, after examining 73 known hydrocephalus genes previously identified from literature, we identified three potentially impactful variants from the cohort. Using a gene panel comprising variants in known neural tube defects loci, we identified a total of 1024 potentially deleterious variants, of which 797 were missense variants and 191 were frameshift variants, 36 were stop gain/loss variants. A small portion of our family pedigree analyses yielded putative genetic signals which may be responsible for hydrocephaly elated phenotypes, however the low diagnostic yield may be due to lack of capture of genetic variants in the exonic regions i.e. structural variants may only be evident from whole genome sequencing., Conclusions: We identified three potentially impactful variants from our cohort in 73 known hydrocephalus genes previously identified in literature.

Urolithiasis, characterized by the formation of solid crystalline structures within the urinary tract, presents a significant global health burden with high recurrence rates and limited treatment efficacy. Recent research has identified various protein receptors and enzymes implicated in the pathogenesis of urolithiasis, offering potential targets for therapeutic intervention. Protein receptors such as the calcium-sensing receptor and vasopressin V2 receptor play crucial roles in regulating urinary calcium excretion and water reabsorption, respectively, influencing stone formation. Additionally, modulation of receptors like the angiotensin II receptor and aldosterone receptor can impact renal function and electrolyte balance, contributing to stone prevention. Furthermore, enzymes such as urease inhibitors and xanthine oxidase inhibitors offer targeted approaches to prevent the formation of specific stone types. This review discusses the potential of targeting these receptors and enzymes for the treatment of urolithiasis, exploring associated drugs and their mechanisms of action. Despite promising avenues for personalized and precision medicine approaches, challenges such as the need for robust clinical evidence and ensuring cost-effectiveness must be addressed for the translation of these interventions into clinical practice. By overcoming these challenges, receptor-targeted therapies and enzyme inhibitors hold promise for revolutionizing the management of urolithiasis and reducing its global burden., Competing Interests: Declaration of competing interest No any conflict., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Ocular drug delivery presents significant challenges due to intricate anatomy and the various barriers (corneal, tear, conjunctival, blood-aqueous, blood-retinal, and degradative enzymes) within the eye. Lipid-based nanoparticles (LNPs) have emerged as promising carriers for ocular drug delivery due to their ability to enhance drug solubility, improve bioavailability, and provide sustained release. LNPs, particularly solid lipid nanoparticles (SLNs), nanostructured lipid carriers (NLCs), and cationic nanostructured lipid carriers (CNLCs), have emerged as promising solutions for enhancing ocular drug delivery. This review provides a comprehensive summary of lipid nanoparticle-based drug delivery systems, emphasizing their biocompatibility and efficiency in ocular applications. We evaluated research and review articles sourced from databases such as Google Scholar, TandFonline, SpringerLink, and ScienceDirect, focusing on studies published between 2013 and 2023. The review discusses the materials and methodologies employed in the preparation of SLNs, NLCs, and CNLCs, focusing on their application as proficient carriers for ocular drug delivery. CNLCs, in particular, demonstrate superior effectiveness attributed due to their electrostatic bioadhesion to ocular tissues, enhancing drug delivery. However, continued research efforts are essential to further optimize CNLC formulations and validate their clinical utility, ensuring advancements in ocular drug delivery technology for improved patient outcomes., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Baig, Karade, Ahmad, Khan, Haque, Webster, Faiyazuddin and Al-Qahtani.)

Silver oxide (Ag 2 O) particles are wonderful candidates due to their unique properties, and their use in a wide range of research, industrial and biomedical applications is rapidly increasing. This makes it fundamental to develop simple, environmentally friendly methods with possible scaling. Herein, sodium borohydride and Datura innoxia leaf extract were applied as chemical and biological stabilizing and reducing agents to develop Ag 2 O particles. The primary aim was to evaluate the anticancer and antiviral activity of Ag 2 O particles prepared via two methods. XRD, UV-visible and SEM analyses were used to examine the crystallite structure, optical properties and morphology, respectively. The resulting green-synthesized Ag 2 O particles exhibited small size, spherically agglomerated shape, and high anticancer and antiviral activities compared to chemically synthesized Ag 2 O particles. The MTT (3-(4,5-dimethylthiazol-2-yl)-2,5 diphenyltetrazolium-bromide) assay of green-synthesized Ag 2 O particles showed high anticancer activity against MCF-7 cells with IC 50 = 17.908 µg/mL compared to chemically synthesized Ag 2 O particles with IC 50 = 23.856 µg/mL. The antiviral activity of green-synthesized Ag 2 O particles and chemically synthesized Ag 2 O particles was also evaluated by a plaque-forming assay, and green-synthesized Ag 2 O particles showed higher antiviral ability with IC 50 = 0.618 µg/mL as compared to chemically synthesized Ag 2 O particles with IC 50 = 6.129 µg/mL. We propose the use of green-synthesized Ag 2 O particles in cancer treatment and drug delivery.

Bilayer electrospun fibers aimed to be used for skin tissue engineering applications were fabricated for enhanced cell attachment and proliferation. Different ratios of PHBV-PLLA (70:30, 80:20, and 90:10 w / w ) blends were electrospun on previously formed electrospun PHBV membranes to produce their bilayers. The fabricated electrospun membranes were characterized with FTIR, which conformed to the characteristic peaks assigned for both PHBV and PLLA. The surface morphology was evaluated using SEM analysis that showed random fibers with porous morphology. The fiber diameter and pore size were measured in the range of 0.7 ± 0.1 µm and 1.9 ± 0.2 µm, respectively. The tensile properties of the bilayers were determined using an electrodynamic testing system. Bilayers had higher elongation at break (44.45%) compared to the monolayers (28.41%) and improved ultimate tensile strength (7.940 MPa) compared to the PHBV monolayer (2.450 MPa). In vitro cytotoxicity of each of the scaffolds was determined via culturing MC3T3 (pre-osteoblastic cell line) on the membranes. Proliferation was evaluated using the Alamar Blue assay on days 3, 7, and 14, respectively. SEM images of cells cultured on membranes were taken in addition to bright field imaging to visually show cell attachment. Fluorescent nuclear staining performed with DAPI was imaged with an inverted fluorescent microscope. The fabricated bilayer shows high mechanical strength as well as biocompatibility with good cell proliferation and cell attachment, showing potential for skin substitute applications.

Background: Celomic fluid can be considered as an ultra-filtrate of maternal serum, containing a high protein concentration, urea, and many other molecules. It is an important transfer interface and a reservoir of nutrients for the embryo. Celomic fluid contains fetal cells that can be used for prenatal diagnosis of monogenic diseases in an earlier gestational period than villocentesis and amniocentesis., Objective: The purpose of this study was to evaluate the characteristics of celomic fluid and to establish a workflow laboratory procedure for very early prenatal diagnosis of monogenic diseases., Methods: Three hundred and eighty-five celomatic fluids were collected between the seventh and tenth week of gestation. We sampled 1 mL of celomic fluid in all cases. The embryo-fetal erythroid precursor cells were selected by the anti-CD71 microbead method or by a direct micromanipulator pick-up on the basis of their morphology. We amplified the extracted DNA using a nested polymerase chain reaction. Primers for short tandem repeat amplification were used to perform a quantitative fluorescent polymerase chain reaction evaluation to control maternal contamination., Results: We observed maternal contamination in 95% of celomic fluids with a range between 5 and 100%. No fetal cells were observed in 0.78% of celomic fluids. The number of fetal cells ranged from a few units to several hundred. Isolation of embryo-fetal erythroblasts selected by the micromanipulator made diagnosis feasible in all cases., Conclusions: The selection of fetal cells by a micromanipulator and nested polymerase chain reaction analysis made celomatic fluid suitable for early prenatal diagnosis of monogenic disorders even in the presence of high maternal contamination and few fetal cells. The procedure reported in this study provides the opportunity for the use of celomic fluid sampled by celocentesis as an alternative to chorionic villi sampling and amniocentesis, to allow invasive prenatal diagnosis at a very early stage of pregnancy., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

The use of automated systems within the medication use process has significantly reduce the occurrence of medication errors and the associated clinical and financial burden. However, automated systems lull into a false sense of security and increase the risk of medication errors that are often associated with socio-technical interactions, automation bias, workarounds and overrides. The objective of the systematic review is to determine the prevalence, types and severity of medication errors that are associated the use of automated systems in ambulatory and institutionalized care settings. The search strategy will be guided by PRISMA framework. Selected databases and relevant gray literature were searched and screening was done independently by two researchers between 01 April and 29 June 2021. These covered all relevant articles published from the inception of the use of automation in the medication use process (2000) until 2020. De-duplication and screening of all studies were done independently by two researchers with a clear inclusion / exclusion criteria. Data extraction and synthesis are currently on going (started on 06 July 2021) and being conducted independently but the validity and completeness of the processes will be confirmed by the third researcher. The Cochrane Risk of Bias tool and the Hoy et al's quality assessment checklist will be used for the assessment of methodological bias while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system will be used for the quality of evidence assessment. Detailed qualitative synthesis of key findings will be done with thematic and descriptive analyses. If the number and types of included studies permit, fixed or random effect model meta-analysis will be conducted based on the degree of homogeneity in the sampling frame used in the included studies. Heterogeneity will be assessed with I2 statistics and I2 > 50% will be considered a high statistical heterogeneity. The systematic review may provide new perspective especially from developing settings about the prevalence, types and severity of medication errors associated with the use of automated systems at all the stages of medication use process, and in all categories of patients. This may add to global knowledge in the research area. Systematic review registration: The systematic review was registered and published by PROSPERO (CRD42020212900)., Competing Interests: The authors have declared that no competing interests exist.

Family trio next-generation sequencing-based variant analysis was done to identify the genomic reason on unexplained recurrent pregnancy loss (RPL). A family (dead fetus and parents) from Saudi Arabia with an earlier history of three unexplained RPLs at the ninth week of pregnancy was included in the study. Whole-genome sequencing (WGS) of a dead fetus and the parents was done to identify the pathogenic variation and confirmed through Sanger sequencing. WGS of dead fetus identifies a novel homozygous exonic variation (NM&#95;017419.3:c.680G>T) in ASIC5 (acid-sensing ion channel subunit family member 5) gene; the parents are heterozygous. Newly designed ARMS PCR followed by direct sequencing confirms the presence of heterozygous in one subject and absence of homozygous novel mutation among randomly selected healthy Saudis. The second family with heterozygous was confirmed with three unexplained RPLs. Pathogenicity analysis of R227I amino acid substitution in ASIC5 protein through molecular docking and interaction analysis revealed that the mutations are highly pathogenic, decrease the stability of the protein, and prevent binding of amiloride, which is an activator to open the acid-sensing ion channel of ASIC5 . The identified rare and novel autosomal recessive mutation, c.680G>T:p.R227I (ASIC5 Saudi ), in two families confirm the ASIC5 gene association with RPL and can be fatal to the fetus., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Al Qahtani, AbdulAzeez, Almandil, Fahad Alhur, Alsuwat, Al Taifi, Al-Ghamdi, Rabindran Jermy, Abouelhoda, Subhani, Al Asoom and Borgio.)

The prevalence of consanguineous marriage and genetic disorders are high in Saudi Arabia. There were records on the practices of Saudis toward prenatal diagnosis (PND) and termination of pregnancy (TOP), however the sample sizes are small. This study has targeted the Saudi Arabian community and family history of genetic disorders to determine the practices toward PND and TOP. The cross-sectional survey was conducted among Saudis (n = 2761) to determine their practices toward reproductive-decision making. Regression analysis was conducted to identify the association of the limiting factors, relative merits and family history on the outcomes. Total of 2507 participants returned completed questionnaire. The practice towards PND (68%) were more favorable than TOP (33%). PND was found to be a good opportunity for early diagnosis and gives parent's choice. Education, history with affected baby, prior knowledge and religious belief were significant deciding factors of PND and TOP. Down syndrome (n = 161) and sickle cell anemia (n = 152) were commonly available genetic disorder among participant's family. Respondents with autistic cases in their family have higher acceptance rate for TOP. Non-consanguineous are more willing to consider TOP than consanguineous. Participants with abnormal fetus, aged of > 36 years, married and educated Saudis were more likely consider TOP. Though, religion is the most influencing factor for not accepting TOP, comparatively willingness to PND and TOP have increased recently. Awareness campaigns about PND and TOP may increase the chances of accepting prenatal genetic diagnosis.

Sickle cell disease (SCD) is a chronic genetic hematological disorder with multiorgan involvement and is associated with complications during the pregnancy. This is a well-known disorder in Saudi Arabia, but no study has reported its outcomes in pregnant Saudi females of the Eastern region. This study was carried out to compare the fetomaternal outcome in patients with SCD with those without SCD. This was a retrospective cohort study done in the Eastern Province of Saudi Arabia in a tertiary care, teaching hospital, by retrieving the data through the code ICD-9 for SCD, the control group was also selected with comparable characteristics. A total of 302 SCD pregnant patients were included for comparison with 600 pregnant women without SCD as control, during the period of Jan 1, 2008 to December 31, 2018. After the data retrieval, percentages of complications were calculated between the study and control groups. Fischer's exact test and t-test were used for statistical analysis by using SPSS version 22. The results showed higher complication rates in pregnancies of patients with SCD. Hypertensive disorders (13.3%), abruptio placenta (1.6%), intrauterine growth restriction (19.2%), thromboembolism (6.6%) and stroke (2.6%) were all higher in SCD as compared to the control group .The complications of SCD itself including anemia (89.4%), acute chest syndrome (13.2%) and sickle cell crisis (39.2%) were also increased during the pregnancy. Both still birth (3.3%) and neonatal intensive care unit admission (1.6%) were also higher in SCD. SCD during the pregnancy is a high-risk situation and can lead to many fetomaternal complications; however, preconceptional counselling, early booking, a careful monitoring during pregnancy and multidisciplinary management approach can prevent potential adverse outcome in this regard.

Objectives: Abnormal uterine bleeding (AUB) is a leading cause of hysterectomies, the cause of which is usually diagnosed with preoperative endometrial sampling. We planned this study to assess the accuracy of diagnosing the histologic patterns of endometrium in the preoperative sample in reference to the final histologic diagnosis in hysterectomy., Methods: We retrospectively reviewed medical charts between January 2011 and December 2015 at a tertiary hospital in Saudi Arabia and identified 43 cases of AUB with complete documentation. The histologic diagnoses were classified into normal and benign pathology group (N/B), or carcinoma and hyperplasia category (Ca/H). Measures of validity were used to compare endometrial sampling histological diagnoses to diagnoses following hysterectomy and Cohen's kappa to assess for agreement between the 2 modalities. Results: The median age of all patients was 49 years. Preoperative histologic examination showed 53.8% sensitivity, 90% specificity, 70% positive predictive values and 81.8% negative predictive values, 30.1%  false positive rates and 18.2% false negative rates. The agreement between preoperative and postoperative histologic diagnoses was moderate (79.1%, k=0.469). Conclusion: The accuracy of preoperative histologic examination was moderate. Our findings recommend cautious clinical decision making and limiting hysterectomy to women who do not respond to other therapeutic measures.

Competing Interests: Competing interests: None declared.

A 44-year-old woman presented with 3 months' history of painless progressive abdominal distension and weight loss of more than 15 kg. Clinically a pelviabdominal mass with ascites was detected. CT scan of the pelvis and abdomen showed a subserosal leiomyoma with huge amount of ascites. Cancer Antigen (CA)-125 was 546 kU/L. Exploratory laparotomy with myomectomy was done and this was followed by dramatic improvement postoperatively., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)

Fullerene-containing materials have the ability to store and release electrical energy. Therefore, fullerenes may ultimately find use in high-voltage equipment devices or as super capacitors for high electric energy storage due to this ease of manipulating their excellent dielectric properties and their high volume resistivity. A series of structured fullerene (C 60 ) polymer nanocomposites were assembled using the thiol-ene click reaction, between alkyl thiols and allyl functionalized C 60 derivatives. The resulting high-density C 60 -urethane-thiol-ene (C 60 -Thiol-Ene) networks possessed excellent mechanical properties. These novel networks were characterized using standard techniques, including infrared spectroscopy (FTIR), differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), and thermal gravimetric analysis (TGA). The dielectric spectra for the prepared samples were determined over a broad frequency range at room temperature using a broadband dielectric spectrometer and a semiconductor characterization system. The changes in thermo-mechanical and electrical properties of these novel fullerene-thiol-ene composite films were measured as a function of the C 60 content, and samples characterized by high dielectric permittivity and low dielectric loss were produced. In this process, variations in chemical composition of the networks were correlated to performance characteristics.

This is a case report of spontaneous haemoperitoneum caused by ruptured utero-ovarian vessels during the third trimester of pregnancy. The patient presented with acute abdominal pain and hypotension twice to the emergency room. The initial diagnosis was placental abruptio and the patient had emergency caesarean section. There was utero-ovarian plexus laceration and suture-ligation was performed. The maternal outcome was good. The infant had birth asphyxia and was extubated on the third day. Both mother and infant were discharged in good condition.

Objective: To review the pregnancy outcome in women with previous complete uterine rupture., Methods: Hospital records of uterine rupture were reviewed from January 1981 to June 2010. All files of these patients were reviewed and patients were contacted by telephone calls to inquire about any further pregnancies after the uterine rupture., Results: Out of 69,452 deliveries, there were a total of 27 cases of uterine rupture. There were 20 pregnancies after repair of complete uterine rupture and 10 of them resulted in live babies, all delivered by cesarean section. Eight pregnancies ended as first-trimeter miscarriages. One pregnancy resulted in preterm vaginal delivery at 24 weeks. There was only one repeat uterine rupture. There were no cases of cesarean hysterectomy. Four women agreed to undergo tubal ligation after the last delivery and two used other contraceptive methods. Two women were being followed for secondary infertility., Conclusion: Pregnancy after uterine rupture is associated with relatively good maternal and neonatal outcome when followed in a tertiary center.