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The current study is about the lived experiences of professionals working from home and how it's affecting their work productivity and well-being. Interpretative phenomenological analysis design was utilized in this study and purposive sampling was used for the respondents. Seven professionals from various fields of work in Metro Manila were the respondents of the research, all of them working full-time work from home, which also serves as the homogeneity that is needed for this chosen research design. Interviews through Zoom were conducted in order to acquire the information relevant to the study. The researchers utilized a researcher-made 15-item open-ended questionnaire that was validated by experts in the field of research and psychology as a theme, workplace productivity while working from home, the impact of working from home on well-being, and the importance of having a dedicated workplace at home. The results also concluded that the work-from-home setup had both positive and negative effects on employees. It gives employees a convenient working environment that allows them to work flexibly. In such settings, however, employees also tend to feel isolated and technologically inadequate. Employees tend to be more productive in WFH settings. [ABSTRACT FROM AUTHOR]

A mechanical filter developed to improve the performances of an artificial heart whose electrical motor has a reciprocating motion is presented. The filter phases the mechanical load strongly reducing its inertial component (which is of the same order of magnitude as the useful load). The analysis reported for a prototype developed by us shows that when its rate is equal to the first resonant frequency of the filter, a reduction of about 50 percent for the maximum value of the torque due to inertial and friction forces is obtained.

The performance of an n-input linear threshold element in presence of noise is characterized, in this work, by the probability of correct operation P. A method is shown for the determination of Pas a function of the characteristics of the noise, the parameters of the threshold element and the probabilities of occurrence of the various input patterns. [ABSTRACT FROM AUTHOR]

This work deals with a method of determining the acceptable ranges of the weights in a threshold element, and evaluating the optimum set of a class of symmetric linearly separable functions. This set maximizes the correct operation probability of an n-input threshold element in presence of noise. [ABSTRACT FROM AUTHOR]

Mosquitoes still pose a clear risk to human and animal health. Recently, nanomaterials have been considered one of the cost-effective solutions to this problem. Therefore, alumina nanoparticles (Al) were synthesized using an auto-combustion method, followed by calcination at 600 and 800 °C. Glucose (G) and sucrose (Su) were used as fuels and the combustion was performed at pH 2, 7, and 10. The as-synthesized Al 2 O 3 nanoparticles were characterized by XRD, FTIR, SEM, and TEM. Alumina nanoparticles prepared using G and Su fuels at pH 7 and 800 °C (Al-G7-800 and Al-Su7-800) have crystallite sizes of 3.9 and 4.05 nm, respectively. While the samples (Al-G7-600 and Al-Su7-600) synthesized at pH 7 and 600 °C were amorphous. The prepared alumina nanoparticles were applied to the larval and pupal stages of Culex pipiens. The results showed that alumina nanoparticles cause higher mortality in the 1st larval instar than in all other larval instars and pupal stages of Culex pipiens after treatment at a high concentration of 200 ppm. Additionally, the larval duration after treatment with LC 50 concentrations of alumina (Al-G7-800 and Al-Su7-800) was 31.7 and 23.6 days, respectively, compared to the control (13.3 days). The recorded data found that the content of glutathione-S-transferase, alkaline/acid phosphatase, β/α-esterase, and total protein were altered upon treatment with the LC 50 concentration of alumina (Al-G7-800) nanoparticles. Based on these findings, alumina nanoparticles are a promising candidate as a potential weapon to control pests and mosquitoes., (© 2023. The Author(s).)

It is well known that metal corrosion causes serious economy losses worldwide. One of the most effective ways to prevent corrosion is the continuous development of high-efficient and environment-friendly corrosion inhibitors. Among the widely used organic and inorganic corrosion inhibitors, plant extracts are top candidates due to their nontoxic nature. The present study reports a novel application of the methanolic extract of Terminalia bellerica fruits as an environment friendly corrosion inhibitor for steel in sulphuric acid medium. The phytochemicals of the extract, namely Ellagic, Gallic, and Malic acids, play a key role of the anti-corrosive behavior of the extract. The corrosion prevention activity was studied on the steel in 1 M H 2 SO 4 using a variety of approaches including weight loss analysis (WL), scanning electron microscope (SEM), electrochemical impedance spectroscopy (EIS), density functional theory (DFT), natural bond orbital analysis (NBO), Fukui function and Monte Carlo simulations (MC). In 1 M H 2 SO 4  solution, the maximum electrochemical inhibition efficiency of 91.79% was observed at 4000 mg/L concentration of the extract. The NBO analysis showed that the charge density of the double bonds and the oxygen atoms of carbonyl and hydroxyl groups of the phytochemicals lies on the top of the natural bond orbitals which promotes the anticorrosive properties of the investigated inhibitors. The surface coverage of steel was validated by SEM measurements. According to DFT studies, numerous nucleophilic regions were present in the active phytochemical constituents of the inhibitor, demonstrating their favorable nucleophilicity. The computed electronic structure of the phytochemicals revealed band gaps of 4.813, 5.444, and 7.562 eV for Ellagic, Gallic, and Malic acids respectively suggesting effective metal-inhibitor interactions. A good correlation between experimental and theoretical findings was addressed., (© 2023. The Author(s).)

Cu 2+ , Pb 2+ , and Cd 2+ were individually and simultaneously determined using a novel and effective electroanalytical approach that has been devised and improved. Cyclic voltammetry was used to examine the electrochemical properties of the selected metals, and their individual and combined concentrations were determined by square wave voltammetry (SWV) using a modified pencil lead (PL) working electrode functionalized with a freshly synthesized Schiff base, 4-((2-hydroxy-5-((4-nitrophenyl)diazenyl)benzylidene)amino)benzoic acid (HDBA). In a buffer solution of 0.1 M tris-HCl, heavy metal concentrations were determined. To improve the experimental circumstances for determination, scan rate, pH, and their interactions with current were studied. At some concentration levels, the calibration graphs for the chosen metals were linear. The concentration of each metal was altered while the others remained unchanged for both the individual and simultaneous determination of these metals, and the devised approach was proven to be accurate, selective, and rapid., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (This journal is © The Royal Society of Chemistry.)

Solar radiation, which is emitted by the sun, is required to properly operate photovoltaic cells and solar water pumps (SWP). A parabolic trough surface collector (PTSC) installation model was created to investigate the efficacy of SWP. The thermal transfer performance in SWP is evaluated thru the presence of warmth radiation and heat cause besides viscid dissipation. This evaluation is performed by measuring the thermal transmission proportion of the selected warmth transmission liquid in the PTSC, known as a hybrid nano-fluid. Entropy analysis of Oldroyd-B hybrid nano-fluid via modified Buongiorno's model was also tested. The functions of regulating parameters are quantitatively observed by using the Keller-box approach in MATLAB coding. Short terms define various parameters for tables in velocity, shear pressure and temperature, gravity, and Nusselt numbers. In the condition of thermal radiation and thermal conductivity at room temperature, the competence of SWP is proven to be enhanced. Unlike basic nano-fluids, hybrid nano-fluids are an excellent source of heat transfer. Additionally, with at least 22.56% and 35.01% magnitude, the thermal efficiency of AA7075-Ti-6Al-4 V/EO is higher than AA7075-EO., (© 2022. The Author(s).)

Solar photovoltaic (PV) energy has met great attention in the electrical power generation field for its many advantages in both on and off-grid applications. The requirement for higher proficiency from the PV system to reap the energy requires maximum power point tracking techniques (MPPT). This paper presents an adaptive MPPT of a stand-alone PV system using an updated PI controller optimized by harmony search (HS). A lookup table is formed for the temperature and irradiance with the corresponding voltage at MPP (V MPP ). This voltage is considered as the updated reference voltage required for MPP at each temperature and irradiance. The difference between this updated reference voltage at MPP and the variable PV voltage due to changing the environmental conditions is used to stimulate PI controller optimized by HS to update the duty cycle (D) of the DC-DC converter. The temperature, irradiance, and corresponding duty cycle at MPP are utilized to convert this MPP technique into an adaptive one without the PI controllers' need. An experimental implementation of the proposed adaptive MPPT is introduced to test the simulation results' validity at different irradiance and temperature levels., (© 2021. The Author(s).)

Background: Approximately 50% of patients with colorectal cancer (CRC) develop metastases most commonly in the liver. Liver transplantation (LT) can be used in certain cases of primary liver malignancy or in metastatic diseases, such as Neuroendocrine tumors. However, there are controversies regarding LT as a treatment option for liver metastasis from CRC due to poor outcomes in previously reported cases., Case Presentation: We report a 37-year-old male who underwent resection of the left-sided colon due to cancer and was found to have synchronous liver metastasis for which he received chemotherapy. Later, he underwent a right hepatectomy, which was complicated by insufficient liver remnant function despite the preserved liver perfusion. Therefore, salvage liver transplantation was performed successfully with a good long-term outcome., Conclusions: Many studies examined the survival and quality of life in patients undergoing liver transplantation for unresectable colorectal liver metastasis; these studies include the SECA Study (secondary cancer) and others with favorable outcomes. We reviewed the literature and compared the outcomes of some of these studies in this article. Our case emphasizes that liver transplantation could be an option for some colon cancer liver metastasis (CLM) patients, specifically, as a salvage procedure. Thus, more research is needed to develop selection criteria for patients who may benefit from liver transplantation.

Background: Membrane proteins are key gates that control various vital cellular functions. Membrane proteins are often detected using transmembrane topology prediction tools. While transmembrane topology prediction tools can detect integral membrane proteins, they do not address surface-bound proteins. In this study, we focused on finding the best techniques for distinguishing all types of membrane proteins., Results: This research first demonstrates the shortcomings of merely using transmembrane topology prediction tools to detect all types of membrane proteins. Then, the performance of various feature extraction techniques in combination with different machine learning algorithms was explored. The experimental results obtained by cross-validation and independent testing suggest that applying an integrative approach that combines the results of transmembrane topology prediction and position-specific scoring matrix (Pse-PSSM) optimized evidence-theoretic k nearest neighbor (OET-KNN) predictors yields the best performance., Conclusion: The integrative approach outperforms the state-of-the-art methods in terms of accuracy and MCC, where the accuracy reached a 92.51% in independent testing, compared to the 89.53% and 79.42% accuracies achieved by the state-of-the-art methods.

Background: We reported our experience in managing patients with single ventricle (SV) physiology and increased pulmonary blood flow (PBF), aiming to assess if it is feasible to proceed with primary Bidirectional Glenn (BDG) without a prior operation to limit PBF., Materials and Methods: This is a retrospective study with 51 consecutive patients who underwent BDG operation as a primary operation or a second stage prior to the definitive Fontan operation at King Abdulaziz University Hospital (KAUH) in Jeddah, Saudi Arabia between 2010 and 2018. Patients were categorized into two groups based on their PBF prior to the operation: Patients who had SV physiology and increased PBF (seven patients) vs. patients with SV physiology and restricted PBF (44 patients)., Results: The median age for the increased PBF group was 9.9 months [interquartile range (IQR): 2-16.9 months], and the median age for the restricted PBF group was 15.3 months (IQR: 6.7-42.6 months). Although the length of hospital stay was longer in patients with increased PBF (P = 0.039), we couldn't find a statistically significant difference in early mortality, duration of mechanical ventilation, length of pleural drainage, and length of intensive care unit (ICU) stay between the groups., Conclusion: In our experience, we found that primary BDG could be done safely for patients having SV physiology and increased PBF with acceptable short-term outcomes. It might further reduce the morbidity and mortality for those patients by avoiding the risk of initial pulmonary artery banding or aortopulmonary shunts.

The aim of this work is to discuss the effect of mth-order reactions on the magnetic flow of hyperbolic tangent nanofluid through extending surface in a porous material with thermal radiation, several slips, Joule heating, and viscous dissipation. In order to convert non-linear partial differential governing equations into ordinary ones, a technique of similarity transformations has been implemented and then solved using the OHAM (optimal homotopy analytical method). The outcomes of novel effective parameters on the non-dimensional interesting physical quantities are established utilizing the tabular and pictorial outlines. After a comparison with previous literature studies, the results were finely compliant. The study explores that the reduced Nusselt number is diminished for the escalating values of radiation, porosity, and source (sink) parameters. It is found that the order of the chemical reaction m = 2 is dominant in concentration as well as mass transfer in both destructive and generative reactions. When m reinforces for a destructive reaction, mass transfer is reduced with 34.7% and is stabled after η = 3. In the being of the destructive reaction and Joule heating, the nanofluid's temperature is enhanced.

Metabolomic profiling of different Premna odorata Blanco (Lamiaceae) organs, bark, wood, young stems, flowers, and fruits dereplicated 20, 20, 10, 20, and 20 compounds, respectively, using LC-HRESIMS. The identified metabolites ( 1 - 34 ) belonged to different chemical classes, including iridoids, flavones, phenyl ethanoids, and lignans. A phytochemical investigation of P. odorata bark afforded one new tetrahydrofurofuran lignan, 4 β -hydroxyasarinin 35 , along with fourteen known compounds. The structure of the new compound was confirmed using extensive 1D and 2D NMR, and HRESIMS analyses. A cytotoxic investigation of compounds 35 - 38 against the HL-60, HT-29, and MCF-7 cancer cell lines, using the MTT assay showed that compound 35 had cytotoxic effects against HL-60 and MCF-7 with IC 50 values of 2.7 and 4.2 µg/mL, respectively. A pharmacophore map of compounds 35 showed two hydrogen bond acceptor (HBA) aligning the phenoxy oxygen atoms of benzodioxole moieties, two aromatic ring features vectored on the two phenyl rings, one hydrogen bond donor (HBD) feature aligning the central hydroxyl group and thirteen exclusion spheres which limit the boundaries of sterically inaccessible regions of the target's active site.

Background: The internet revolution of the 21st century has made sexual content available and accessible on a scale that has never existed before. Many studies have indicated that the use of pornography was associated with more permissive sexual attitudes and tended to be linked with stronger gender-stereotypical sexual beliefs. It also seemed to be associated with other risky behaviors and sexual promiscuity. Pornography exposure in conservative societies leads to conflicts with religious and cultural taboos., Objective: The aim of this study was to characterize the barriers and difficulties that prevent sexual discourse in the Arab society and enable pornography viewing according to the perceptions of adolescents and mothers., Methods: This study involved qualitative research methods and in-depth interviews with 40 participants. This study included 20 Arab adolescents, sampled by 2 age groups (14-16 years and 16-18 years), and 20 mothers of adolescents from both sexes., Results: The findings indicate that mothers "turn a blind eye" to porn viewing and sexual activity by boys; however, they show a sweeping prohibition and denial of such behavior by girls. Boys reported viewing porn routinely, whereas girls denied doing so, but admitted that their female friends watched porn. The study also found that boys experienced guilt during and after viewing porn as a result of the clash between modernity and traditional values. The mothers and adolescents emphasized the need for an open sexual discourse to reduce violent behaviors such as Web-based sexual harassment, including sending videos and pictures of naked girls, often accompanied by threats and blackmail., Conclusions: It is necessary to find a way to encourage a significant sexual discourse to prevent the violent consequences of its absence in the Arab society. A controlled, transparent, and critical sexual discourse could help youth make more informed decisions concerning the search for sexual content, porn viewing, and sexual behavior., (©Anat Gesser-Edelsburg, Munawar Abed Elhadi Arabia. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 09.10.2018.)

Forty-four endophytic fungal isolates obtained from marine sponge, Hyrtios erectus, were evaluated and screened for their hydrolase activities. Most of the isolates were found to be prolific producers of hydrolytic enzymes. Only 11 isolates exhibited maximum cellular contents of lipids, rhamnolipids, and protein in the fungal isolates under the isolation numbers MERVA5, MERVA22, MERVA25, MERVA29, MERVA32, MERVA34, MERV36, MERVA39, MERVA42, MERVA43, and MERVA44. These isolate extracts exhibit the highest reducing activities against carbohydrate-metabolizing enzymes including α-amylase, α-glucosidase, β-glucosidase, β-glucuronidase, and tyrosinase. Consequently, based on morphological and cultural criteria, as well as sequence information and phylogenetic analysis, these isolates could be identified and designated as Penicillium brevicombactum MERVA5, Arthrinium arundinis MERVA22, Diaporthe rudis MERVA25, Aspergillus versicolor MERVA29, Auxarthron alboluteum MERVA32, Dothiorella sarmentorum MERVA34, Lophiostoma sp. MERVA36, Fusarium oxysporum MERVA39, Penicillium chrysogenum MERVA42, Penicillium polonicum MERVA43, and Trichoderma harzianum MERVA44. The endophytic fungal species, D. rudis MERVA25, P. polonicum MERVA43, Lophiostoma sp. MERVA36, A. alboluteum MERVA32, T. harzianum MERVA44, F. oxysporum MERVA39, A. versicolor MERVA29, and P. chrysogenum MERVA42 extracts, showed significant hepatitis C virus (HCV) inhibition. Moreover, D. sarmentorum MERVA34, P. polonicum MERVA43, and T. harzianum MERVA44 extracts have the highest antitumor activity against human hepatocellular carcinoma cells (HepG2).

Background: Improving the reproductive health of females has be.come the focus of the developmental efforts of many nations., Objectives: To identify the reproductive health style of married females, and to determine the prevalence and predictors of circumcision among girls aged less than or equal 18 years in Hali semi-urban region., Design: A cross-sectional household survey SETTING: Houses in Hali, Al-Qunfudhah governorate, western Saudi Arabia during 2017., Subjects and Methods: A multistage systematic cluster random sampling method was used to select participants. A validated questionnaire was used in interviewing the head of the selected houses., Main Outcome Measures: Reproductive health profile of women, and circumcision of girls., Sample Size: 365 households., Results: Reproductive life starts early in the Hali region as 41.4% of women are married at or before 18 years of age. Consanguinity was recorded in 57.0% of houses. The prevalence of grand multiparity (GMP) was 54.7%; it was significantly associated with current maternal age, age at marriage, low educational levels of both parents and husbands with non-professional jobs. Current use of birth control methods was reported by 28.9% of families, and oral contraceptives (OCs) were the commonest method. Contraceptive use was significantly associated with higher educational levels of both parents and with women having professional work. The prevalence of circumcision was 80.3%. Circumcision was most frequent (59.4%) at age 7 years or less, and almost always done by doctors (91.4%). Hemorrhage (2.9%) and fever (2.3%) were the minimal recorded complications. Girls with higher parental education, enough income, no parental consanguinity, and whose mothers married at an older age had slightly lower rates of circumcision, but the difference was without statistical significance., Conclusion: The pattern of early female marriage, high consanguinity, GMP, low contraceptive use, and a high frequency of circumcision in girls was apparent in Hali. Public health education and legislative policies are needed., Limitations: Recall bias may affect the reported frequency of circumcision, and related complications., Conflicts of Interest: None.

Background: Asthma and chronic obstructive pulmonary disease (COPD) are chronic conditions with an increasing prevalence in developing countries. The evaluation of endobronchial biopsies has emerged as a tool to differentiate between both conditions via the measurement of the reticular basement membrane (RBM) thickness with various conclusions drawn from different studies., Objectives: Compare the thickness of the RBM between asthma and COPD and evaluate other histomorphological features in both groups., Design: Prospective, descriptive and analytical., Setting: University teaching hospital., Patients and Methods: The study included patients with COPD and irreversible and reversible asthma with diagnosis based on clinical assessment, pulmonary function tests and high-resolution computed tomography scans. Endobronchial biopsies were obtained from all patients and, using a light microscope and a computerized image analyzer, the thickness of the reticular basement membrane was calculated in all patients. We also made a qualitative assessment of other histo-morphological features., Main Outcome Measures: Mean RBM thickness., Sample Size: Thirty male patients., Results: The mean RBM thickness in asthmatic patients was 8.9 (2.4) micro m. The mean RBM thickness in COPD patients was 5.3 (1.1) micro m. However, there was no thickening of the RBM in patients with reversible asthma. The RBM was significantly thicker in patients with irreversible asthma than in patients with COPD or reversible asthma. There were no significant differences in epithelial desquamation or metaplasia, mucosal or submucosal inflammation, the presence of eosinophils, submucosal glandular hyperplasia or submucosal smooth muscle hyperplasia between groups., Conclusions: The thickness of the RBM is the only reproducible histopathological feature to differentiate COPD from irreversible asthma., Limitations: The study included a limited number of patients. A qualitative approach was used to compare epithelial cell injury, inflammation, submucosal glandular and muscular hyperplasia., Conflict of Interest: None.

Background: Failed corneal graft management is a challenge. Descemet stripping automated endothe.lial keratoplasty (DSAEK) and repeat penetrating keratoplasty (PKP) are two options. Only two studies have compared outcomes of DSAEK and PKP in the management of a failed graft., Objective: To compare the visual outcomes, changes in intraocular pressure (IOP) and complications in eyes with failed corneal grafts that were subsequently managed with DSAEK and PKP., Design: Retrospective cohort study., Settings: Tertiary eye hospital of central Saudi Arabia., Patients and Methods: A retrospective chart review was performed for cases managed between 2007 and 2012. Data were collected on the best-corrected visual acuity (BCVA) before and at day 1, 1 week, 4 weeks, 12 weeks, and 24 weeks after intervention. BCVA was compared in patients managed with DSAEK or PKP. Intra- and postoperative complications were compared in both groups., Main Outcome Measures: Clear graft, vision at last follow up, complications., Results: There were 15 eyes in the DSAEK group and 30 in the PKP group. The causes of previously failed PKP differed between groups. BCVA at 6 months after repeat surgeries was 20/20 to 20/40 in 4 (27%) eyes in the DSAEK group and in 8 (27%) eyes in the PKP group. The IOP at 6 months was statistically significantly higher in the DSAEK group than the PKP group (P=.006). In DSAEK group, one graft rejection occurred in one eye and graft dislocation in another eye. Seven eyes in PKP group had signs of graft rejection that regressed in 5 eyes following medical management., Conclusions: DSAEK and PKP for previously failed corneal graft resulted in similar BCVA 6 months after repeat surgery. However, the visual outcomes were less promising with both types of surgeries. The lower complication rate and surgical ease may favor DSAEK over PKP in managing failed grafts., Limitations: Small sample, retrospective study.

Background: Dental caries and obesity are multifactorial diseases with diet being a common contributory factor., Objective: The main purpose of the present study was to investigate the association between dental caries and obesity among special care female school children in Makkah City, Saudi Arabia., Design: Analytical cross-sectional study., Setting: Special schools in Makkah City., Study Population and Methods: Schools were chosen by lottery and female children were ran.domly selected. Dental caries detection was performed according to the World Health Organization criteria. The medical evaluation assessed the body mass index (BMI)., Main Outcome Measures: With appropriate sample weighting, relationships between dmft/DMFT (decayed, missing, filled teeth for deciduous and permanent dentition) and obesity were assessed using multilevel logistic regression., Results: In 275 special care children, the prevalence of dental caries was 56.7 percent. The mean dmft and DMFT scores for the entire study population were 3.9 (4.8) and 3.2 (4.1), respectively. Forty percent of children were mentally retarded, 22.2% presented with deafness, blindness or both, 18.9% presented with Down syndrome and 14.9% were autistic. From the total sample, the mean BMI was 20.2 (2.8). When adjusted for covariates, the logistic regression model showed strong association between caries and obesity (adjusted odds ratio=2.9; 95% CI=1.2-4.9)., Conclusion: This study demonstrated a significant association between caries frequency and overweight/obesity in special care school children., Limitations: Since the data was cross-sectional, causal relationships cannot be established and the observed association could be due to other unexplored factors. Because of cultural and ethical consideration, including segregation of gender in Saudi Arabia, only female children were included in the present study, which limited the findings.

Individuals with a factitious ocular disorder feign or exaggerate having an eye injury or intentionally produce an eye injury so as to assume the role of a sick person. We report two cases of self-inflicted ocular injury using needle-like foreign bodies and razor that represent possible diagnoses of Munchausen syndrome. Both patients presented with different clinical pictures that misguided the clinical diagnosis and delayed proper management. Although self-inflicted ocular injuries are rare, ophthalmologists should be aware of the possibility of their existence, particularly when caring for patients with psychiatric conditions., Similar Cases Published: 13.

Background: Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications., Objectives: To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA)., Design: Single-blind, nonrandomized., Setting: Diabetes clinic of a university hospital in Saudi Arabia., Patients and Methods: Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups., Main Outcome Measure(s): Lipid and cardiovascular parameters, and BMI., Results: Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group., Conclusion: N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents., Limitations: There were 9 subjects in each group lost to follow up; thus the sample size could not be maintained as per the sample size calculation. The study was nonrandomized and thus there was a possibility of allocation bias. (Clinical trial registration number: CTRI/2013/06/003781, Clinical Trial Registry of India).

Background: The liver performs diverse functions that are essential for life. In the absence of reliable liver protective drugs, a large number of natural medicinal preparations are used for the treatment of liver diseases. Therefore the present study aims to investigate the hepatoprotective effects of Salix subserrata Willd flower ethanolic extract (SFEE) against carbon tetrachloride (CCl4)-induced liver damage., Methods: Rats were divided into 4 groups of 10 animals each. Group I served as the normal healthy control, groups II rats were intoxicated with CCl4 i.p. (0.8 ml/kg body weight CCl4/olive oil, twice weekly for 9 weeks), group III rats received CCl4 i.p. and SFEE orally (150 mg/kg daily) and group IV rats received CCl4 i.p. and Silymarin orally (100 mg/kg, daily). The hepatoprotective potential of SFEE in rats was evaluated by measuring the protein levels of two inflammatory biomarkers; tumor necrosis factor-alpha (TNF-α) and nuclear factor kappa-B (NF-kB) in addition to other liver biomarkers. Histopathological changes in the liver were assessed using hematoxylin and eosin staining (HE)., Results: The administration of SFEE showed hepatic protection at an oral dose of 150 mg/kg. SFEE significantly reduced the elevated serum levels of intracellular liver enzymes as well as liver biomarkers in comparison to CCl4- intoxicated group. Notably, SFEE significantly reduced the expression levels of TNF-α and NFkB proteins compared to their levels in CCl4 intoxicated group. These findings were confirmed with the histopathological observations, where SFEE was capable of reversing the toxic effects of CCl4 on liver cells compared to that observed in CCl4-intoxicated animals., Conclusion: Our results show that SFEE has potential hepatoprotective effects at 150 mg/kg. These effects can be regarded to the antioxidant and anti-inflammatory properties of the extract.

Background: Whole-exome sequencing has transformed gene discovery and diagnosis in rare diseases. Translation into disease-modifying treatments is challenging, particularly for intellectual developmental disorder. However, the exception is inborn errors of metabolism, since many of these disorders are responsive to therapy that targets pathophysiological features at the molecular or cellular level., Methods: To uncover the genetic basis of potentially treatable inborn errors of metabolism, we combined deep clinical phenotyping (the comprehensive characterization of the discrete components of a patient's clinical and biochemical phenotype) with whole-exome sequencing analysis through a semiautomated bioinformatics pipeline in consecutively enrolled patients with intellectual developmental disorder and unexplained metabolic phenotypes., Results: We performed whole-exome sequencing on samples obtained from 47 probands. Of these patients, 6 were excluded, including 1 who withdrew from the study. The remaining 41 probands had been born to predominantly nonconsanguineous parents of European descent. In 37 probands, we identified variants in 2 genes newly implicated in disease, 9 candidate genes, 22 known genes with newly identified phenotypes, and 9 genes with expected phenotypes; in most of the genes, the variants were classified as either pathogenic or probably pathogenic. Complex phenotypes of patients in five families were explained by coexisting monogenic conditions. We obtained a diagnosis in 28 of 41 probands (68%) who were evaluated. A test of a targeted intervention was performed in 18 patients (44%)., Conclusions: Deep phenotyping and whole-exome sequencing in 41 probands with intellectual developmental disorder and unexplained metabolic abnormalities led to a diagnosis in 68%, the identification of 11 candidate genes newly implicated in neurometabolic disease, and a change in treatment beyond genetic counseling in 44%. (Funded by BC Children's Hospital Foundation and others.).

The present work describes the synthesis of a series of four novel biologically active 2-amino-5-arylazothiazole disperse dyes containing the sulfa drug nucleus. The structures of the synthesized thiazole derivatives are confirmed using UV-spectrophotometry, infrared and nuclear magnetic resonance techniques and elemental analysis. The synthesized dyes are applied to polyester fabrics as disperse dyes and their fastness properties to washing, perspiration, rubbing, sublimation, and light are evaluated. The synthesized compounds exhibit promising biological efficiency against selected Gram-positive and Gram-negative pathogenic bacteria as well as fungi.

Oxidative stress is one of the mechanisms involved in the acute carbon tetrachloride (CCl4)-induced hepatotoxicity. Since 4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl, known as tempol, has powerful antioxidant properties, we investigated its potential hepatoprotective effects and the underlying mechanisms that may add further benefits for its clinical usefulness using an acute model of CCl4-induced hepatotoxicity. One hour after CCl4 induction of acute hepatotoxicity, mice were treated with a daily dose of 20 mg/kg/day tempol for 3 days. It was found that treatment of animals with tempol significantly negated the pathological changes in liver function parameters as well as histology induced by CCl4. In addition, tempol significantly ameliorated CCl4-induced lipid peroxidation and GSH depletion, and improved catalase activity. Furthermore, tempol alleviated the inflammation induced by CCl4 as indicated by reducing the liver expression level of nuclear factor-kappa B (NF-κB) and tumor necrosis factor-α (TNF-α). Finally, tempol significantly reduced expression level of the B-cell lymphoma-2 protein (Bcl-2) and active caspase-3 which are known markers of apoptosis. In conclusion, the present study provides important evidences for the promising hepatoprotective effects of tempol that can be explained by amelioration of oxidative stress mainly through replenishment of GSH, restoration of antioxidant enzyme activities, and reduction of lipid peroxides alongside its anti-inflammatory properties.

Background and Objectives: Dentists suffer a high prevalence of musculoskeletal disorders (MSDs) but studies are quite limited. The present study was carried out to investigate the prevalence of MSDs among dentists in the Ha'il Region, Saudi Arabia., Design and Settings: A cross-sectional, questionnaire study was conducted among 80 licensed dentists af.filiated with the Ministry of Health (MoH), Ha'il Region, Saudi Arabia from January 2014-January 2015., Patients and Methods: A self-administered questionnaire, based on the Nordic Musculoskeletal Questionnaire (NMQ) was sent to participants after translation to Arabic. The questionnaire was delivered by mail with a prepaid return envelope., Results: Sixty-eight questionnaires (85%) were returned. The prevalence of MSDs among respondents was 77.9% (n=53) with the most commonly affected areas the lower back (73.5%) (39/53) followed by the neck (66%) (35/53) and the shoulders (43.3%) (23/53). Twenty-four (45.2%) of 53 respondents had experienced MSDs in the neck and lower back at the same time throughout the past twelve months. Nearly 85% (45/53) of respondents were found to have MSDs affecting two or more sites., Conclusion: Prevalence of MSDs was high among dentists in the Ha'il region. Lower back, neck and shoul.ders were the most commonly affected body sites.

Tilletiopsis minor, a blastoconidia-forming yeast, was isolated from a 4-year-old boy suffering from severe pneumonia. Chest x-rays revealed the progression of widespread and multiple nodular lesions, nonsymmetrical interstitial and airspace infiltrates, and consolidations. Creamy yellow, irregular, wrinkled yeast-like organisms were isolated from the pleural fluid specimens when cultured on Sabouraud dextrose agar for 5 days and incubated at 30°C. Microscopically, the organisms showed broad, irregular filaments with blastoconidia but no budding cells. Manual bench tests and automated phenotypic analyses failed to recognize the organism. This unique and rare organism (AB7-11; DSM 29469) was identified using the sequence analysis of the internal transcribed spacer region of the nuclear ribosomal DNA. It showed a precise alignment with the type strains of T minor. Subsequent to this diagnosis, and the earlier nonre.sponse to vancomycin and meropenem, the patient was put on liposomal amphotericin. However, the condition continued to deteriorate, and then, intravenous voriconazole was added to control the infection. Finally, the patient's condition improved, and he was discharged in good condition after 1 month of stay in the hospital.

Background and Objectives: The lupus anticoagulant (LA) test is an advanced test that is time consuming and requires a highly trained lab specialist. A high proportion of clinicians do not adhere to international guidelines and request the test inappropriately., Design and Settings: This descriptive study covered the period from January 2012 and January 2013 at the Hematology Laboratory at King Khalid University Hospital, Riyadh., Patients and Methods: The 274 lupus anticoagulant requests were categorized as proper or improper based on the guidelines of the International Society of Thrombosis and Haemostasis (ISTH). Data on numbers of requests and cost are summarized., Results: Of the 274 requests, 222 (81%) were classified as proper while 52 (19%) requests did not satisfy ISTH guidelines. The most frequently encountered incorrect indications were warfarin therapy (46%), heparin therapy (27%), a normal aPTT with no clinical indication (25%) and low serum fibrinogen levels (2%). The total cost of all improper requests was about 41080 SAR (10954 USD)., Conclusion: A majority of improper requests were related to anticoagulant therapy, which highlights the importance of implementing a comprehensive diagnostic algorithm for patients on warfarin and heparin therapy.

Background and Objectives: There are limited data on changes in the prevalence of overweight among the Saudi school children and on associated risk factors. We compared recent prevalence data (2012) with early data (1994-98) and assessed risk factors., Design and Setting: Data from a cross-sectional study of children in primary schools in two cities in Al-Qassim province., Patients and Methods: Parental questionnaires were used to collect sociodemographic data and informa.tion on the child's diet/exercise behavior. Children's weight and height were measured. Current and previous data on overweight prevalence were compared and risk factors were assessed in a multiple logistic regression model., Results: The sample consisted of 874 randomly chosen school children, aged 6-10 years; analysis was based on 601 with complete data. Current overweight prevalence was 16.9% and was higher in girls than in boys (29.7% vs. 11.7%, P value < .0001). Prevalence has risen in the last 15 years (overall: 16.9% vs. 10.1%; boys: 11.7% vs. 8.5%; girls: 29.7% vs. 11.5%; all P values < .05). Those who ate restaurant food >=2 times/week were 2.4 times more likely (95% CI=1.26, 4.64) to be overweight and those who engaged in sports >=2 hours/day were 0.5 times less likely to be overweight (95% CI=0.25, 1.20)., Conclusion: The overweight prevalence in primary school children in Saudi Arabia has risen significantly. The focus should be on developing obesity prevention programs for this population.

Background and Objectives: Job satisfaction refers to the extent to which people like or dislike their job. Job satisfaction varies across professions. Few studies have explored this issue among physicians in Saudi Arabia. The objective of this study is to determine the level and factors associated with job satisfaction among Saudi and non-Saudi physicians., Methods: In this cross-sectional study conducted in a major tertiary hospital in Riyadh, a 5-point Likert scale structured questionnaire was used to collect data on a wide range of socio-demographic, practice environment characteristics and level and consequences of job satisfaction from practicing physicians (consultants or residents) across different medical specialties. Logistic regression models were fitted to determine factors associated with job satisfaction., Results: Of 344 participants, 300 (87.2%) were Saudis, 252 (73%) males, 255 (74%) married, 188 (54.7%) consultants and age [median (IQR)] was 32 (27-42.7) years. Overall, 104 (30%) respondents were dissatisfied with their jobs. Intensive care physicians were the most dissatisfied physicians (50%). In a multiple logistic regression model, income satisfaction (odds ratio [OR]=0.448 95% CI 0.278-0.723, P < .001) was the only factor independently associated with dissatisfaction., Conclusion: Factors adversely associated with physicians job satisfaction identified in this study should be addressed in governmental strategic planning aimed at improving the healthcare system and patient care.

Background and Objectives: Diffuse alveolar hemorrhage (DAH) is a life threatening condition with very limited, often unsuccessful, therapeutic options. This study aimed at exploring the feasibility and efficacy of nebulized tranexamic acid TXA (n-TXA) and nebulized recombinant factor VIIa (n-rFVIIa) when used in a two-step therapy protocol in children with intractable DAH in a pediatric intensive care unit., Methods: In a prospective trial, n-TXA (250 mg/dose for children < 25 kg and 500 mg/dose for children > 25 kg) was administered to 18 children (median age [interquartile range]; 24.0 months [11.3, 58.5]) with intractable DAH. N-rFVIIa (35 micro g/kg/dose for children < 25 kg, and 50 micro g/kg/dose for children > 25 kg) was added if no or minimal response was seen after 3 to 4 doses (18 to 24 hours) of n-TXA., Results: DAH was stopped in 10 (55.6%) children with n-TXA alone within 24 hours of therapy. Documented concomitant respiratory infection showed a significant negative association with response to n-TXA in a step.wise regression analysis (OR=0.06; 95% CI=0.01-0.74). In the other 8 (44.4%) children, n-rFVIIa was added due to n-TXA failure. Six (75.0%) showed complete cessation of DAH, while two children failed to respond with the addition of n-rFVIIa (25.0%). None of the children who responded to therapy showed recurrence of DAH after therapy termination. No complications related to therapy were recorded., Conclusions: n-TXA and n-rFVIIa were effective and safe when used in a two-step-therapy protocol to control intractable DAH in pediatric patients in intensive care settings. This therapy modality warrants further exploration through larger multicenter clinical trials.

In non-cardioembolic stroke patients, the cardiac manifestations of high blood pressure are of particular interest. Emerging data suggest that echocardiographically determined left ventricular hypertrophy is independently associated with risk of ischemic stroke.The primary objective of this study was to evaluate the frequency of different patterns of left ventricular (LV) remodeling and hypertrophy in a group of consecutive patients admitted with non-cardioembolic stroke or transient ischemic attack (TIA). In particular, we were interested in how often the relative wall thickness (RWT) was abnormal in patients with normal LV mass index (LVMI). As both abnormal RWT and LVMI indicate altered LV remodeling, the secondary objective of this research was to study whether a significant number of patients would be missing the diagnosis of LV remodeling if the RWT is not measured.All patients were referred within 48 hours after a stroke or a TIA for a clinically indicated transthoracic echocardiogram. The echocardiographic findings of consecutive patients with non-cardioembolic stroke or TIA were analyzed.All necessary measurements were performed in 368 patients, who were enrolled in the study. Mean age was 63.7 ± 12.5 years, 64.4% men. Concentric remodeling carried the highest frequency, 49.2%, followed by concentric hypertrophy, 30.7%, normal pattern, 15.5%, and eccentric hypertrophy, 4.1%. The frequency of abnormal left ventricular RWT (80.4%) was significantly higher than that of abnormal LVMI (35.3%), (McNemar P < 0.05).In this group of non-cardioembolic stroke patients, abnormal LV remodeling as assessed by relative wall thickness is very frequent. As RWT was often found without increased LV mass, the abnormal left ventricular geometry may be missed if RWT is not measured or reported.