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A perforated peptic ulcer is an emergency requiring immediate treatment by laparotomy. Special attention needs to be established on systemic nutritional status. The postoperative early feeding is important to patients with preoperative non optimum nutritional status. This study aimed to examine the correlation between nutritional status, early feeding, and post-laparotomy surgical site infection in perforated peptic ulcer patients. This was a prospective observational study on 32 patients with perforated peptic ulcers underwent emergency laparotomy at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from October 2021–2022. The nutritional status was assessed using Albumin, SGA. Eleven subjects had severe hypoalbuminemia and six subjects had severe malnutrition (SGA C). Early feeding was not performed on 7 subjects. The highest surgical wound infection rate was found on the 7th day with an incidence rate of 18.8%. Among patients experiencing infection, six (6) had SGA C (p0.05). There is no association among albumin level, SGA, and early feeding in post-laparotomy wound infection in perforated peptic ulcer patients.

Introduction A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs).Methods A prospective, observational study in 17 countries in Africa, Asia, Europe and South America, including adults with confirmed COVID-19 assessed at 2 to

Many countries have developed their coasts according to the requirements of their activities and the nature of their users on the basis of sustainability criteria through the provision of energy, the use of renewable resources, respect for the environment and other sustainability strategies. Although Egypt is distinguished from the rest of the global coastal countries with much potential for actual competition, it lacks the optimal utilization of these potentials on the one hand, and the need for integrated and conscious management on the other. One of the problems faced by cities in Egypt, especially coastal cities, is to direct investment to development in the capital by much larger proportions than to the development of these cities. The aim of the research is to identify sustainable strategies that may support and promote the achievement of sustainable development goals in Al-Arish city and then any other coastal city in Egypt.

In Egypt, it has been obvious that most cities suffer from deterioration in all life systems of their built environments. Moreover, what makes the increases the problem is that the gap between theoretical systems and corresponding practical systems in which policies have always emphasized the physical aspects of development which is measured by how many cubic meters of reinforced concrete were poured, without addressing to what extent this development achieves livability with the intention of reaching the quality of life at which the community can live in symbiotic harmony with its urban environment. This paper aims to identify livable urban community principles and demonstrate how the concept of livability can enhance the quality of life in Al-Rehab city as a case study from the Egyptian context. Moreover, this study offers an assessment tool by which urban communities in Egypt could be assessed to figure out the livability situation and give recommendations about further improvements to achieve more livable communities.

Introduction Very little is known about possible clinical sequelae that may persist after resolution of acute COVID-19. A recent longitudinal cohort from Italy including 143 patients followed up after hospitalisation with COVID-19 reported that 87% had at least one ongoing symptom at 60-day follow-up. Early indications suggest that patients with COVID-19 may need even more psychological support than typical intensive care unit patients. The assessment of risk factors for longer term consequences requires a longitudinal study linked to data on pre-existing conditions and care received during the acute phase of illness. The primary aim of this study is to characterise physical and psychosocial sequelae in patients post-COVID-19 hospital discharge.Methods and analysis This is an international open-access prospective, observational multisite study. This protocol is linked with the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) and the WHO’s Clinical Characterisation Protocol, which includes patients with suspected or confirmed COVID-19 during hospitalisation. This protocol will follow-up a subset of patients with confirmed COVID-19 using standardised surveys to measure longer term physical and psychosocial sequelae. The data will be linked with the acute phase data. Statistical analyses will be undertaken to characterise groups most likely to be affected by sequelae of COVID-19. The open-access follow-up survey can be used as a data collection tool by other follow-up studies, to facilitate data harmonisation and to identify subsets of patients for further in-depth follow-up. The outcomes of this study will inform strategies to prevent long-term consequences; inform clinical management, interventional studies, rehabilitation and public health management to reduce overall morbidity; and improve long-term outcomes of COVID-19.Ethics and dissemination The protocol and survey are open access to enable low-resourced sites to join the study to facilitate global standardised, longitudinal data collection. Ethical approval has been given by sites in Colombia, Ghana, Italy, Norway, Russia, the UK and South Africa. New sites are welcome to join this collaborative study at any time. Sites interested in adopting the protocol as it is or in an adapted version are responsible for ensuring that local sponsorship and ethical approvals in place as appropriate. The tools are available on the ISARIC website (www.isaric.org).Protocol registration number osf.io/c5rw3/Protocol version 3 August 2020EuroQol ID 37035.

During the global financial crisis, central banks around the globe implemented a series of unconventional monetary policy measures such as quantitative easing among others to avert the impact of financial crisis on financial system. There exist numerous studies on this area of interest, with each guided by a specific view of the problem and selectively chosen empirical observations with regard to the different developments. This paper reviewed literature to ascertain the effectiveness of conventional monetary policy measures and unconventional monetary measures used in mitigating the impact of the 2007/2008 global financial crisis, specifically by the major central banks including the Federal Reserve, European Central Bank and Bank of England. The study used systematic quantitative assessment technique (SQAT) to determine a high quality of papers that have been reviewed in the study. The result proved that conventional monetary policy measures are still potent to deliver their desired objectives but inadequate in times of acute crisis. Empirical evidences proved that central banks have not practically abandoned the core elements of their pre-crisis monetary policy. Through a complex form of strengthening and reassessment, they have instead complimented, extended and somewhat improved their measures to mitigate the impact of the financial crisis. An important lesson of the crisis is that there is opportunity to reinforce central banks with macro prudential supervision and regulation. This should be seen as complementary to the existing monetary policy measure in order to deliver the twin objectives of price and financial stability.

Gathering useful insights from social media data has gained great interest over the recent years. User representation can be a key task in mining publicly available user-generated rich content offered by the social media platforms. The way to automatically create meaningful observations about users of a social network is to obtain real-valued vectors for the users with user embedding representation learning models. In this study, we presented one of the most comprehensive studies in the literature in terms of learning high-quality social media user representations by leveraging state-of-the-art text representation approaches. We proposed a novel doc2vec-based representation method, which can encode both textual and non-textual information of a social media user into a low dimensional vector. In addition, various experiments were performed for investigating the performance of text representation techniques and concepts including word2vec, doc2vec, Glove, NumberBatch, FastText, BERT, ELMO, and TF-IDF. We also shared a new social media dataset comprising data from 500 manually selected Twitter users of five predefined groups. The dataset contains different activity data such as comment, retweet, like, location, as well as the actual tweets composed by the users.

The recent study aims to identify the Impact of Domestique culture variations on the degree of political participation for rural women at two different sub-cultures in rural Egypt. In addition identify factors affecting the degree of rural women participation in political issues. In order to accomplish the study objectives, Qalubiya Governorate was selected to represent the culture of Lower-Egypt Governorates, and Minia Governorate was selected to represent the culture of Upper-Egypt Governorates. Each Governorate,s administrative districts were divided into three categories (High, Medium, Low) based upon their human development indices, related to status of woman at those communities. Two districts were selected randomly from the medium category of the common human development index, Banha district from Qalubiya Governorate, and Maghagha district from Minia Governorate. From each of those districts two local village units were randomly selected. Within each of those previously mentioned villages, a random sample of 160 rural women was selected, and the total sample was 640 rural women. A questionnaire was designed and collected using the personal interview (after it was pre-tested) during August, September, and October 2003, then the data were tabulated and analyzed by using X2 coefficient. The study findings showed that about 43% of the total sample have low level of political participation, medium category represents about 28%, and high category of the political participation

Granulation Technique for Gamma Alumina Catalyst Support was employed in inclined disk granulator (IDG), rotary drum granulator (RD) and extrusion – spheronization equipments .Product with wide size range can be produced with only few parameters like rpm of equipment, ratio of binder and angle of inclination. The investigation was conducted for determination the optimum operating conditions in the three above different granulation equipments. Results reveal that the optimum operating conditions to get maximum granulation occurred at ( speed: 31rpm , Inclination:420 , binder ratio:225,300% ) for the IDG,( speed: 68rpm , Inclination: 12.50 , binder ratio: 300% ) for the RD and ( speed:1200rpm , time of rotation: 1-2min )for the Caleva spheronizer used in the extrusion spheronization method. These results are compatible with similar works on granulation of different materials [1, 2, and 3].

An investigation was conducted for the determination of the effects of the forming conditions in the production of Gamma Alumina catalyst support on the crushing strength property. Eight variables were studied , they are ;binder content which is the sodium silicate , Solvent content which is the water, speed of mixing , time of mixing, drying temperature , drying time , calcinations temperature and the calcinations time Design of the experiments was made by using the response Surface method in Minitab 15 software which supply us 90 experiments . The results of this investigation show that the crushing strength for the dried Gamma alumina extrudate was affected by the drying temperature and the drying time only and there is no interaction effect between the variables studied. Furthermore, the results show that, the crushing strength for the calcined extrudate was affected by the speed of mixing only and the optimum speed is 900rpm. The maximum crushing strength of 38.38 after calcinations and 11.865 Kg/mm after drying were obtained

Background: Eating habits are important determinants of health. Young adults who have recently transitioned to university life experience stress and lack of time, which are major risk factors for poor eating habits. This study's objectives were to identify and compare eating habits between students at health and non-health colleges at Northern Border University (NBU), Saudi Arabia and to determine the relationship between students' eating habits and their sociodemographic, lifestyle, and psychological factors., Methods: This comparative cross-section study was conducted on 480 students equally from health and non-health colleges at NBU from March to April 2023. A pre-designed electronic questionnaire was used to collect data on students' sociodemographic characteristics, eating habits, and diet-related psychological factors. Statistical analyses were carried out using STATA/SE version 11.2 for Windows., Results: Unhealthy eating habits were reported by 44.6% and 41.3% of students at health and non-health colleges, respectively. Most students had irregular meals, skipped breakfast, ate fast food frequently, and consumed insufficient amounts of vegetables, fruits, and water. Parental separation, living away from family predisposed to unhealthy eating habits. Being 21-23 years old, playing sports, and high body mass index were linked to healthy eating habits. Psychological factors such as overeating until the stomach hurts and eating to feel happy were associated with unhealthy eating habits., Conclusion: Unhealthy eating habits were prevalent among students at NBU irrespective of the type of study. Thus, implementing initiatives to promote nutrition and healthy eating habits within the university environment is crucial for health promotion and well-being among students., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bayomy et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background and Objectives: Migraine is a chronic neurological disorder affecting approximately 14% of the global population. Beyond physical pain, migraines significantly impact individuals' quality of life, influencing education, employment, and income levels. Topiramate, a second-generation antiepileptic medication, has demonstrated notable efficacy in reducing the occurrence of chronic migraine. Over the past three decades, extensive research has implicated the neuropeptide calcitonin gene-related peptide (CGRP) in migraine pathogenesis. Erenumab, the first FDA-approved CGRP inhibitor, received approval in 2018. This study aims to compare the clinical efficacy of Erenumab and Topiramate for migraine prevention. Materials and Methods: We conducted a retrospective cohort study of adults with episodic or chronic migraine over a 12-month period, comparing Erenumab ( n = 52) and Topiramate ( n = 56). Outcomes assessed included changes in the Migraine Disability Assessment (MIDAS) scores from baseline over the last three months of treatment and the proportion of patients achieving a ≥50% reduction in MIDAS scores by the end of the study. Results: The Erenumab group showed significant improvement, with nearly 79% of patients achieving a 50% reduction in their MIDAS score, with a mean reduction of 3.76. Notably, only two patients (3.8.5) discontinued treatment due to adverse events. In contrast, the Topiramate group had over 15% of patients achieve a 50% reduction in MIDAS scores, with a mean reduction of 5.89, and a had discontinuation rate of 14.2% due to adverse events. Conclusions: Both Topiramate and Erenumab are effective for migraine prevention. However, Topiramate has lower tolerability and more side effects, while Erenumab offers better tolerability and safety at a higher cost. Treatment decisions should be individualized based on patient needs, efficacy, safety, and cost considerations.

Background: Breast cancer is heterogeneous and the existing prognostic classifiers are limited in accuracy, leading to the unnecessary treatment of numerous women. B-cell lymphoma 2 (BCL-2), an anti-apoptotic protein, has been proposed as a marker of poor prognosis, associated with resistance to therapy in most tumor types expressing BCL-2. In breast cancer, however, BCL-2 expression has been reported to be a favorable prognostic factor. This study aimed to describe the association between BCL-2 and other well-known pathological prognostic markers among different molecular sub-types of invasive breast carcinoma of no special type (IBC; NST)., Methods: BCL-2 expression, as well as that of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2), were immunohistochemically (IHC) evaluated and compared with other pathological factors, including tumor size, grade, tumor-infiltrating lymphocytes (TILs), lymph-vascular invasion (LVI), and lymph node (LNd) metastasis, in 128 breast cancer cases diagnosed with IBC; NST. Moreover, we analyzed the correlation between BCL-2 expression and relapse-free survival (RFS) in all patients over a two-year period., Results: We found that BCL-2 expression had different pathological prognostic factor associations with different molecular subtypes of breast carcinoma. In the luminal A (i.e., hormonal receptor-positive and HER2-negative) and triple-negative subtypes, the expression of BCL-2 in tumor cells was significantly associated with tumor size, tumor grade, and TILs. BCL2-positive expression in luminal IBC; NST patients resulted in a significantly favorable two-year survival., Conclusion: BCL-2 expression in IBC; NST has different prognostic effects depending on the molecular subtype of the cancer. In cancers with a HER2-enriched phenotype, BCL-2 expression was a marker of poor prognosis, while in cancers with a hormone receptor-positive phenotype, BCL-2 expression had a better prognostic impact., (©The Author(s) 2024. Open Access. This article is licensed under a Creative Commons CC-BY International License.)

Background: The quality of reporting in randomized controlled trials (RCTs) is crucial for accurate interpretation and synthesis of evidence. The Consolidated Standards of Reporting Trials (CONSORT) guidelines provide a standardized framework for reporting RCT abstracts. This study aimed to evaluate the adherence of RCT abstracts published in three major plastic surgery journals to the CONSORT tool guideline for reporting abstracts, utilizing Generative Pre-trained Transformer 4 artificial intelligence (GPT-4 AI) technology., Methods: Abstracts of RCTs published between 2010 and 2023 were collected. The GPT-4 AI model was utilized to assess the abstracts based on the CONSORT criteria. Descriptive statistics were used to report the compliance scores and identify areas where abstracts lacked compliance., Results: Of the initially identified 500 abstracts, a total of 371 RCT abstracts met the inclusion criteria and were analyzed. The mean CONSORT score was 10.05 (±2.22), with a median score of 10.72. Specific areas where abstracts lacked compliance included trial design (39.6%), participant details (28.8%), intervention descriptions (15.6%), randomization process (25.3%), and the number of participants analyzed (33.4%). Trial registration (18.3%) and funding information (15.1%) were also frequently missing., Conclusions: Our study's innovative use of the GPT-4 AI model for analysis demonstrated the potential of AI technology in streamlining and enhancing the evaluation of research compliance. We advocate for heightened awareness and more rigorous application of CONSORT guidelines among authors, reviewers, and journal editors. Emphasizing the role of AI technology in the evaluative process can further improve the reporting quality of future RCTs in plastic surgery, contributing to more reliable and transparent research in the field., Competing Interests: The authors have no financial interest to declare in relation to the content of this article., (Copyright © 2024 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Background: This study aimed to investigate whether the presence of two palatal roots on permanent maxillary second molars (MSMs) can affect the crown size and crown's buccolingual and mesiodistal diameters., Materials and Methods: A retrospective study was conducted using 592 CBCT scans to investigate 1120 MSMs of Mongoloid Malaysians. 3D models were created to assess the four-rooted MSMs and other related teeth carefully. Crown size and crown's buccolingual and mesiodistal diameters were measured for the four-rooted MSM, the adjacent maxillary first molar (MFM), and their antimeres to investigate the effect of the presence of an extra root on the size and morphological features of the crown of these associated teeth., Results: Only six out of the 1120 MSMs displayed four roots (0.53%). The incidence was 0.67% (2/298) for the Malay males and 0.4% (1/247) for the Malay females, with the Malay male having a bilateral occurrence of four-rooted MSM. The incidence was 0.34% (1/294) for the Chinese males, while 0.71% (2/281) was detected in Chinese females. Interestingly, the four-rooted MSMs showed a wider mesiodistal distance than their three-rooted antimeres in three out of four cases. The presence of two palatal roots may also increase the crown's buccolingual diameter., Conclusions: The presence of anatomical variations and the dramatic change in crown measurements can be good indicators of the presence of extra roots, including in some of their related neighbours. This might help dentists to take precautionary measures when performing tooth extractions and endodontic therapy.

Background: Peroxisome proliferator-activated receptor α (PPARα) is a nuclear transcription factor responsible for gene expression, particularly those associated with lipid metabolism. The lipoprotein lipase enzyme (LPL) is considered a key enzyme in lipid metabolism and transport. The link between dyslipidemia and obesity is well understood. Dyslipidemia is also an established risk feature for cardiovascular disease. Thus, it becomes progressively essential to identify the role of genetic factors as risk markers for the development of dyslipidemia among obese males., Methods: A case-control study was performed including 469 males. Anthropometric characteristics and serum lipid profiles such as triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were evaluated. Genomic DNA extraction and purification were performed using whole blood samples. Restriction enzyme fragment length polymorphism was used to genotype PPARα and LPL single nucleotide polymorphisms. The associations between these polymorphisms and dyslipidemia were examined., Results: The CC and CG genotypes of PPARα gene polymorphisms were significantly associated with higher TC and LDL-C levels ( P <0.05). The TT genotype of the LPL gene polymorphism was significantly associated with higher TG levels and lower HDL-C levels ( P <0.05). In contrast, the GG genotype may have a protective action against dyslipidemia., Conclusion: The study reaches the interesting conclusion that there was a significant association between PPARα as well as LPL gene polymorphisms and dyslipidemia among obese and non-obese males.

Background/Objectives: Obesity is a growing global health concern, which increases the risk of various diseases and has seen a rising prevalence over time. The global prevalence of obesity among adults has doubled over time. Obesity significantly impacts health by increasing the risk of a range of severe medical conditions. Cardiovascular diseases, such as heart attacks and strokes, are more prevalent in individuals with obesity due to factors like high blood pressure and abnormal cholesterol levels. This systematic review and meta-analysis sought to establish the effectiveness of bariatric surgery in treating infertility in women. Methods: This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. A broad electronic search was conducted through PubMed, Web Science, and Medline databases for studies published between April 2017 and October 2023. The search strategy used the following terms: bariatric surgery, metabolic surgery, bariatric surgical procedures, stomach stapling, infertility, and fertility issues. The data were analyzed using the Revman version 5.1.2 software. Results: The results of the study show that despite the heterogeneity found in the studies, irregular menstrual cycles were found to reduce significantly in patients who underwent bariatric surgery ( p = 0.01), with an RR of 0.22, at a 95% CI (0.06, 0.74). With regards to infertility, the results indicate that bariatric surgery reduced the level of infertility among the patients significantly ( p = 0.00001), with an RR of 0.55, at a 95% CI (0.45, 0.68). Further, the results show bariatric surgery reduced rate of miscarriages among patients ( p = 0.01), with an RR of 0.51, at a 95% CI (0.30, 0.86). Moreover, bariatric surgery reduced the level of congenital malfunction, but the effect was not statistically significant ( p = 0.16), with an RR of 0.39, at a 95% CI (0.10, 1.45). However, the overall effect of bariatric surgery on treating infertility was found to be significantly effective ( p = 0.0001), with an RR of 0.54, at a 95% CI (0.43, 0.68). This implies that bariatric surgery helps in weight loss, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. Conclusions: This study found that bariatric surgery helps infertile women of a reproductive age to lose weight, which improves ovulatory dysfunction and irregular menstruation while boosting spontaneous conception. On the other hand, the study noted that after bariatric surgery, spontaneous conception can occur because of a decreased rate of miscarriage, increased fertility, reduced levels of congenital malfunction, and the restoration of regular menstrual cycles. Therefore, this study highlights the need to offer adequate preconception care and counselling to women who are about to be pregnant, both before and after bariatric surgery. Further, based on the fact that this study focused on general bariatric surgery, future research should focus on specific types of bariatric surgery to establish the most effective type of bariatric surgery in treating infertility in women.

Background: Anorectal malformations (ARMs) comprise a spectrum of congenital anomalies that continue to present a challenge to patients, caregivers and paediatric surgeons. The main objective of this study was to determine the anal position index (API) from anal dimple and neoanus at the sphincter muscle complex in children with high ARM., Methods: Using a cross-sectional study design, the API was assessed from anal dimple and neoanus at the sphincter muscle complex in children with high ARM. All eligible children with high ARM who presented to AKTH during the study period were recruited into the study., Results: Forty eligible patients with an age range of 8 months to 108 months were recruited. Twenty-five were males (62.5%) with a male: female ratio of 1.7:1. The mean pre-operative API using anal dimple was 0.47 ± 0.05, while that of the post-operative API using neoanus was 0.53 ± 0.04. There was a statistically significant difference between the two indices (t = -11.8, P < 0.01). There was also a statistically significant difference amongst male and female indices P < 0.05, but there were no significant differences between different age groups., Conclusion: This study has shown that there was a statistically significant difference between the pre-operative API and post-operative API; thus, the position of the anal dimple does not significantly predict the central position of the sphincter muscle complex., (Copyright © 2024 Copyright: © 2024 African Journal of Paediatric Surgery.)

Background: There is limited data on sleep, physical activity, and health-related behaviors among the general public during Ramadan, particularly during the COVID-19 pandemic. This study aimed to assess the factors associated with sleep and physical activity changes among Nigerian Muslims during Ramadan fasting., Materials and Methods: A nationwide web-based cross-sectional study was conducted among Nigerians aged ≥18 years who performed diurnal fasting during Ramadan. The target sample size was obtained using Fisher's formula, and snowball sampling was employed. Adapted versions of the International Physical Activity Questionnaire Short Form and Copenhagen Psychosocial Questionnaire II were used to evaluate sleep and physical activity. Correlates of change in physical activity and sleep quality were assessed using logistic regression analysis., Results: Seven hundred and seventy individuals participated in the study. During Ramadan, 39.1% (95% confidence interval (CI): 35.6%-42.6%) reported decreased physical activity, and 56.6% (95% CI; 53.0%-60.2%) stated having self-reported good sleep. The independent correlates of physical activity were female sex (adjusted odds ratio (aOR):0.5, 95% CI: 0.4-0.8), having very good sleep (aOR: 0.4, 95% CI: 0.2-0.7), and obesity (aOR: 2.0, 95% CI: 1.1-3.7). In addition, factors associated with improved self-reported sleep quality were perceived good health state (aOR: 8.8, 95% CI: 1.1-72.4), sleeping 7-9 h per day (aOR: 5.5, 95% CI: 2.6-10.3), and sleeping for over 9 h per day (aOR: 4.6, 95% CI: 2.1-14.1)., Conclusions: Although physical activity decreased by about a third, over half of the respondents lost weight and slept well during Ramadan. Strategies to include intermittent fasting in positive lifestyle changes could improve the health and well-being of the population., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Education and Health Promotion.)

Purpose: Granular data on breast cancer (BC) are pertinent for surveillance, planning, and monitoring of cancer care delivery. We determined the trends in clinical presentation, management, and survival of women with BC in a multiethnic middle-income Asian setting over 15 years., Methods: Data of 7,478 Malaysian women newly diagnosed with invasive BC between 2005 and 2019 from three hospital-based cancer registries were included. Trends in demographic, tumor, and treatment characteristics were compared across period 1 (P1): 2005-2009, period 2 (P2): 2010-2014, and period 3 (P3): 2015-2019. Overall survival and net survival were determined., Results: More women in P3 than P1 were older than 60 years at diagnosis. Only a marginal increase in proportion of women with stage I disease was observed (23.7% v 27.2% in P1 and P3, respectively, P = .004). Nonetheless, patients were increasingly presenting with smaller tumors, fewer axillary node involvement, well-differentiated tumors, and hormone receptor expression in recent times. Proportion of women with human epidermal growth factor receptor 2 (HER2)-overexpressed tumors significantly decreased. Among indicated patients, receipt of anticancer therapies was somewhat similar over the calendar periods, except for neoadjuvant chemotherapy and anti-HER2 therapy, where increases in administration were noted. Significant improvements in survival were observed over the 15 years, particularly for HER2-overexpressed BCs., Conclusion: Although the improvements in BC survival that we have observed validate ongoing cancer control efforts and treatment advances, study findings suggest that more could be done for earlier detection and improved access to effective therapies in our settings.

This research endeavors to prognosticate gender by harnessing the potential of skull computed tomography (CT) images, given the seminal role of gender identification in the realm of identification. The study encompasses a corpus of CT images of cranial structures derived from 218 male and 203 female subjects, constituting a total cohort of 421 individuals within the age bracket of 25 to 65 years. Employing deep learning, a prominent subset of machine learning algorithms, the study deploys convolutional neural network (CNN) models to excavate profound attributes inherent in the skull CT images. In pursuit of the research objective, the focal methodology involves the exclusive application of deep learning algorithms to image datasets, culminating in an accuracy rate of 96.4%. The gender estimation process exhibits a precision of 96.1% for male individuals and 96.8% for female individuals. The precision performance varies across different selections of feature numbers, namely 100, 300, and 500, alongside 1000 features without feature selection. The respective precision rates for these selections are recorded as 95.0%, 95.5%, 96.2%, and 96.4%. It is notable that gender estimation via visual radiography mitigates the discrepancy in measurements between experts, concurrently yielding an expedited estimation rate. Predicated on the empirical findings of this investigation, it is inferred that the efficacy of the CNN model, the configurational intricacies of the classifier, and the judicious selection of features collectively constitute pivotal determinants in shaping the performance attributes of the proposed methodology., (© 2024. The Author(s).)

Introduction: hypertension is a major public health problem globally. The occurrence has been associated with unhealthy lifestyles (such as high salt consumption, physical inactivity, excessive intake of alcohol and unhealthy diet), which are very critical for hypertension control. The study was conducted to assess the lifestyle practices and their determinants among adults with hypertension in Nigeria., Methods: data on 762 adults living with hypertension were extracted from a cross-sectional survey conducted across three States (Abia, Kano and Oyo States) in Nigeria. A semi-structured pre-tested, interviewer-administered questionnaire was used for data collection. Knowledge of lifestyle practices was categorized into good and poor at 25 th percentile cut-off point. Overall lifestyle practice was grouped into healthy and unhealthy practices. Healthy lifestyle practice was defined as score of four and above while unhealthy lifestyle practice was defined as score of three and below; in all the 7 specific domains of lifestyle practices assessed (maximum obtainable was 7). The cut off was chosen based on 90% sensitivity from the Receiver Operating Curve (ROC) distribution of the scores. Data was summarized using descriptive statistics, Chi-square test and binary logistic regression were used to explore associations and determine predictors of lifestyle practices. Level of significance was set at 5%., Results: the mean age of the respondents was 55.4±16.3 years. About one-quarter of the respondents (24.3%) had good knowledge of lifestyle practices. Overall, 11.8% of respondents were engaged in good lifestyle practices. Independent predictors of good lifestyle practices were earning monthly income of N30,000 and above [AOR=1.58; 95% CI (1.03-2.42)], being a farmer [AOR=1.09; 95% CI (0.55-2.18)] and artisan [AOR=1.50; 95% CI (0.70-3.14)]., Conclusion: the poor knowledge of lifestyle practices and engagement among adults with hypertension found in this study underscore the need to emphasize integrating lifestyle education for effective management of hypertension., Competing Interests: The authors declare no competing interests., (Copyright: Mobolaji Modinat Salawu et al.)

Background: Quetiapine (QET) abuse has increased due to its anxiolytic and hedonic effects, necessitating protective adjunct treatments. Acacia saligna ( A. saligna ) flowers, used in traditional medicine, have potential health benefits., Aim: To investigate the protective role of A. saligna flower extract against QET-induced sexual toxicity, and to elucidate the possible underlying mechanisms through metabolomic and physiological studies., Methods: A. saligna extract was subjected to metabolite profiling via High-Resolution Ultra-Performance Liquid Chromatography-Mass Spectrometry (UPLC-ESI-qTOF-MS). Forty-eight adult male albino rats were assigned into six groups for 30 days. The intracavernosal pressure (ICP), semen, biochemical, hormonal, histological, genetic and Western blot (WB) analyses were determined., Results: A. saligna extract is rich in phenolic compounds, flavonoids, tannins, and unsaturated fatty acids. QET significantly decreased ICP and negatively affected semen parameters. A. saligna mitigated decreased sperm motility and ameliorated overexpressed proinflammatory genes in QET-55 group. A. saligna ameliorated the reduction of the antioxidant biomarkers, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH), concurrent with downregulation of the nuclear factor kappa B ( NF-κB ) protein. A. saligna counteracted the disrupted testicular and prostatic structures revealed by histological examination., Conclusion: The extract from A. saligna , which contains a high concentration of antioxidants and anti-inflammatory chemicals, effectively mitigates sexual toxicity caused by QET. This study provided the first known explanation of the hypothesized processes behind the protective properties of A. saligna through biological, biochemical, and histological parameters. The results emphasize the potential of A. saligna as a safeguarding agent against drug-induced sexual toxicity., Competing Interests: No conflict of interest., (© 2024 The Authors.)

Objective: The objective of this study was to identify the factors associated with the outcome of the 2023 diphtheria outbreak in Jigawa State, Nigeria., Methods: A descriptive cross-sectional study was conducted amongst all line-listed diphtheria cases reported from Jigawa State, Nigeria, using the 2023 Integrated Disease and Surveillance Response line list of cases that met the World Health Organization case definition of diphtheria. A total of 245 line-listed cases from January 2023 to December 2023 met the criteria for inclusion in the study. Data were analysed using IBM SPSS version 22.0 with a P value set at ≤5%. Binary logistic regression was used to identify the independent predictors of the outcome of the 2023 outbreak., Results: The maximum age of the line-listed cases was 39 years, and the minimum was 1 year with a median of 8 (interquartile range = 5-8) years. More than two-thirds (68.2%) of the cases were ≥5 years of age. More than one-third of the cases (39.6%) were from the northeast senatorial zone of the state. Out of the total 245 cases, 14 died of the disease representing a case fatality rate of 6%, and an attack rate of 3.4 per 100,000 populations. The majority of the cases (95.5%) had fever, cough (81.2%), pharyngitis (86.9%), tonsillitis (96.7%) and laryngitis (82.0%). More diphtheria-related mortalities were recorded amongst cases <5 years of age (7.7%), female cases (5.9%), rural residence (7.7%) and cases from the northeast senatorial zone (8.2%) of the state. Significantly higher mortalities (8.8%, P = 0.003) were recorded amongst cases with nasopharyngitis. The odds of diphtheria-related mortality were higher amongst cases who presented clinically with nasopharyngitis and were 4 times more likely to die (adjusted odds ratio = 3.9; 95% confidence interval = 1.1-14.3) compared with those with no nasopharyngitis., Conclusions: Significantly higher mortalities were recorded amongst diphtheria cases whose samples were not taken, and those with nasopharyngitis. These findings underscored the importance of improved immunisation uptake, early and prompt case detection, investigation and proper management., (Copyright © 2024 Copyright: © 2024 Nigerian Postgraduate Medical Journal.)

Introduction: Self-care practices among patients with hypertension have been shown to improve blood pressure control. Video-based interventions (VBIs) are helpful in enhancing patients' selfcare practices. However, validated VBIs in the Malay language for patients in primary care settings are scarce. This study aimed to develop and validate a VBI series in the Malay language to educate patients with hypertension on self-care practices in primary care settings., Methods: This study was conducted in three phases: (1) pre-production, (2) production and (3) post-production. The pre-production phase involved designing the storyboard and scripts, which underwent content validation by content experts and subsequently by patients with hypertension. Once the storyboards and scripts achieved acceptable consensus, the videos were recorded (production phase). The post-production phase included video editing and face validation among patients with hypertension. Statistical analysis included the calculation of the item-level content validation index (I-CVI) and item-level face validation index (I-FVI) during content and face validation, respectively., Results: The storyboards and scripts for five videos were developed. The I-CVI of all videos was 1.0 after two rounds of content validation among six content experts. The I-CVI of all videos was 1.0 among five patients with hypertension. Five videos were recorded and edited, achieving an I-FVI of 1.0 during face validation among 10 patients., Conclusion: A VBI series consisting of five videos was developed and validated for use among patients with hypertension in primary care settings to improve their knowledge of self-care practices., Competing Interests: None., (© Academy of Family Physicians of Malaysia.)

Background: Postpartum depression (PPD) is a significant mental health concern affecting mothers globally. However, research on PPD prevalence and risk factors in Najran City, Saudi Arabia, is limited., Study Aim: this cross-sectional study aimed to determine the prevalence and risk factors associated with PPD among mothers in Najran City., Methodology: A questionnaire-based study was conducted from September 2023 to January 2024, involving 420 mothers aged 16-50 years with newborns (2-10 weeks after delivery). The questionnaire included demographic information and the Arabic version of the Edinburgh Postnatal Depression Scale (EPDS). Statistical analysis utilized SPSS software v. 26, including descriptive statistics, Mann-Whitney U test, Kruskal-Wallis H test, and logistic regression., Results: The majority of participants were aged 20-35 years (61.4%), Saudi nationals (87.6%), and had university education (51.4%). EPDS scores indicated that 66.7% of mothers screened positive for possible depression. Significant associations were found between higher EPDS scores and factors such as unemployment ( p = 0.004), younger age ( p = 0.003), caesarean delivery ( p = 0.043), mental illness ( p = 0.0001), lack of adequate family support ( p = 0.0001), and higher stress levels ( p = 0.0001)., Conclusion: The study revealed a high prevalence of PPD among mothers in Najran City, with sociodemographic, obstetric, and psychosocial factors significantly influencing PPD risk. These findings emphasize the need for targeted interventions and support systems to address maternal mental health needs effectively., Competing Interests: The authors report no financial affiliations or other conflicts of interest related to the subject of this study.

Combating Pseudomonas aeruginosa infection is challenging. It secretes pyocyanin (PCN) pigment that contributes to its virulence. Neutralizing PCN via reaction with thiol-containing compounds may represent a potential therapeutic option. This study investigates the neutralization reaction between PCN and N-acetyl cysteine (NAC) for bacterial inhibition and explores its mechanism of action. The neutralization adduct (PCN-NAC) was synthesized by reacting the purified PCN and NAC. The adduct was analyzed and its structure was elucidated. LC-MS/MS method was developed for the determination of PCN-NAC in P. aeruginosa cultures post-treatment with NAC (0-5 mg/mL). The corresponding anti-bacterial potential was estimated and compared to nanoparticles (NPs) alone and under stress conditions. In silico studies were performed to support explaining the mechanism of action. Results revealed that PCN-NAC was exclusively detected in NAC-treated cultures in a concentration-dependent manner. PCN-NAC concentration (230-915 µg/mL) was directly proportional to the reduction in the bacterial viable count (28.3% ± 7.1-87.5% ± 5.9) and outperformed all tested NPs, where chitosan NPs induced 56.9% ± 7.9 inhibition, followed by zinc NPs (49.4% ± 0.9) and gold NPs (17.8% ± 7.5) even post-exposure to different stress conditions. A concomitant reduction in PCN concentration was detected. In silico studies revealed possible interactions between key bacterial proteins and PCN-NAC rather than the NAC itself. These results pose NAC as a potential choice for the management of P. aeruginosa infection, where it neutralizes PCN via the formation of PCN-NAC adduct., (© 2024. The Author(s), under exclusive licence to The Japan Society for Analytical Chemistry.)

Background: Public knowledge about the role of lifestyle in managing type two diabetes (T2D) is an essential preventive strategy. Despite efforts in public awareness, the prevalence continues to rise, with the majority relying on the availability of effective therapeutics, underestimating the role of healthy lifestyle changes. This study aims to assess public awareness of the impact of lifestyle modification in managing T2D in a major metropolitan city in Saudi Arabia, which will help inform the health management authority in the country on the level of public awareness and advise on the development of educational programs., Methods: An observational cross-sectional survey study comprising 16 knowledge and 6 attitude questions was conducted among the population over 18 years old using online survey. After validation, the online self-developed questionnaire was distributed through social media., Results: The knowledge and attitude scores were similar between males and females. Participants with a family member or friend with T2D demonstrated higher knowledge scores. However, the attitude scores did not differ significantly based on family or friend relationships., Conclusion: The knowledge and attitude on the role of lifestyle modifications in preventing and managing T2D is moderate, implying an opportunity for innovative strategies to raise public knowledge and attitude.

Cochlear implantation has emerged as a transformative intervention in addressing profound hearing loss, offering a paradigm shift in auditory rehabilitation for individuals with restricted auditory function. Throughout its history, the understanding of contraindications for cochlear implant (CI) surgery has evolved significantly. This review comprehensively analyzes the chronological advancements in the understanding of CI contraindications, examining studies conducted from historical timelines to the present. Recent research has revealed significant developments in the field, prompting a reevaluation of established criteria and resulting in expanded indications for CI. The chronological evolution of contraindications underscores the transformative nature of the field, offering potential improvements in outcomes and enhancing the quality of life for individuals with profound hearing loss. In conclusion, this narrative review emphasizes the dynamic nature of the field, where the reevaluation of contraindications has created new opportunities and broader indications for CI. The emerging prospects, including improved outcomes and enhanced quality of life, hold promise for individuals with profound hearing loss.

Management of hypertension is challenging in multi-cultural and multi-ethnic sub-Saharan African countries like Nigeria. This diversity calls for multi-dimensional interventional approaches for hypertension control. This study assessed the treatment seeking behaviour and associated factors among adults with high blood pressure from three ethnic groups in Nigeria. A cross-sectional study was conducted among 762 adults with high blood pressure from three purposively selected States representing the three main tribes in Nigeria. Using a multistage stratified sampling technique, five communities were selected from two Local Government Areas (LGAs) stratified into urban and rural LGAs in each State. All consenting respondents in each community were consecutively screened for hypertension and recruited. A pretested interviewer-administered questionnaire was used to obtain information on socio-demographic characteristics, treatment seeking behaviour and factors affecting their choice. Data were summarized using descriptive statistics. Relationship between individual, health-related factors and treatment seeking behaviour, as well as the predictors were assessed using a binary logistic regression. at p<0.05 Participants' mean age was 55.4 ± 16.6 years, 63.0% were females and most were Igbo speaking (39.9%). About half (368, 48.3%) were unaware of their status. Of those aware, most (58.9%) went to hospital upon diagnosis of hypertension while some sought advice from health care professionals (28.5%) mostly Hausas, others either went to chemists (6.2%) or did nothing (5.1%), predominantly Yorubas. Significant predictors of orthodox treatment seeking practices for hypertension were female gender [(AOR = 2.60; 95%CI (1.18-5.71)], availability of medicine and personnel [(AOR = 8.7; 95%CI (4.15-18.3)] and perceived good quality of care [(AOR = 4.88; 95%CI (1.81-13.1)]. Orthodox treatment was the common choice among adults with high blood pressure. To further encourage patronage of orthodox treatment, the health facilities should be adequately equipped with medications and trained personnel to improve the quality of care. Targeted education on continuous practice of orthodox treatment is recommended., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Bamgboye et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Alendronate sodium (ALS) is a nitrogen-containing bisphosphonate used for the treatment of different bone disorders. However, its adverse effect on oral soft tissue has been detected. Rutin (RUT) is natural flavonoid with antioxidant and anti-inflammatory properties. This work aimed to investigate the possible effect of ALS on the tongue of adult male albino rats and to evaluate the possible protective role of RUT. Forty adult male albino rats were equally divided into four groups: group I (control), group II (RUT): Received RUT 50 mg/kg, group III (ALS): Received ALS 1 mg/kg, group IV (ALS+RUT): Received ALS and RUT with the same doses as pervious groups. The drugs were given once daily for 5 weeks. Tongue specimens were taken and processed for light and scanning electron microscopic inspection. ALS treated group revealed structural changes in the tongue in the form of decrease in the height of the filiform papillae with blunt ends, marked atrophy in some papillae with areas of focal loss, loss of some epithelial cells, pyknotic nuclei and cytoplasmic vacuoles in some epithelial cells. The lamina propria showed inflammatory cellular infiltration with congested blood vessels. Statistically, there were highly significant decrease in the number of proliferating cell nuclear antigen immunopositive cells, area percentage of Bcl-2 immunoexpression and highly significant increase in the collagen content compared to control group. Administration of RUT with ALS minimizes these changes. RUT protected the rat tongue against the histological and immunohistochemical changes induced by ALS through its antioxidant and anti-inflammatory properties.

Background: Obesity is a preventable public health problem associated with a significantly increased risk of non-communicable diseases. This study aimed to find the socio-demographic and nutritional factors associated with obesity amongst adults from high-burden kidney disease areas of Jigawa State, Nigeria., Methodology: A cross-sectional survey was conducted to assess the socio-demographic and nutritional factors associated with obesity among 361 adults from four local government areas (LGAs) of Jigawa state identified to have a high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed, and data were analyzed using IBM SPSS version 22.0., Results: The minimum age of the respondents was 18, and the maximum was 102 with a median of 45 (interquartile range = 30-80) years. The prevalence of obesity and overweight in the high-burden LGAs of Jigawa state was 33.0% and 27.1% respectively. Hadejia LGA had the highest (68.1%) prevalence of obesity. The prevalence of overweight was higher in Jahun LGA (38.9%). About one-third (38.2%) had a waist circumference (WC) greater than 88cm. Up to half of the female respondents had a waist-hip ratio (WHR) greater than 0.85. For male respondents, many (74.3%) had a WHR of greater than 0.9, and obesity was significantly higher (39.8%, P s< 0.001) among those ≥40 years of age. Obesity was significantly higher (39.8%,P < 0.001) among those ≥40 years of age, known diabetic, (57.1%, P=0.02), and rare consumption of vegetables, (45.8%, P<0.001).The odds of developing obesity were significantly higher among those who were known diabetics and were 3 times more likely to be obese than those who were not known to be diabetics (adjusted odds ratio [aOR] = 3.1, 95% CI = [1.1-8.9]., Conclusions: The prevalence of obesity was high in the areas with high burdens of kidney disease. The government and relevant stakeholders should develop a cost-effective prevention, early diagnosis, and treatment model., Competing Interests: There are no conflicts of interest., (Copyright © 2023 Nigerian Medical Association.)

The burden of postpartum depression (PPD), an important but largely neglected cause of maternal morbidity, is often increased by the presence of common co-morbidities, such as postpartum haemorrhage (PPH). Additionally, stress and the absence of social support can amplify PPD risk. Understanding the relationship between these conditions will help identify at-risk women and allow prompt intervention. Using a prospective cohort design, we recruited 72 women who had experienced PPH and another 72 women who had not within 24 h of delivery to assess the risk of PPD among them. The cumulative incidence of PPD among all participants was 15.3% (19/124). There was insufficient evidence to suggest that women with PPH have a higher risk of PPH than women without PPH (OR: 1.32; 95% CI: 0.55-3.13). Poor social support and high perceived stress increased the risk of PPD. We recommend screening for PPD among women with high perceived stress and low social support., Competing Interests: Competing interestsThe authors declare no competing interests., (© The Author(s) 2024.)

Sickle cell disease (SCD), a chronic debilitating disorder that may negatively affect health-related quality-of-life (HRQoL). In this observational, case-control study, we aim to assess the prevalence of impaired psychosocial profile and poor HRQoL among SCD patients and their caregivers as well as to determine the association of such impairment with parameters of disease severity. Sixty-five children and adolescents with SCD and 65 age- and sex-matched healthy controls and their caregivers were recruited. Demographic and clinical characteristics were collected, and a thorough clinical and psychiatric assessments and HR QoL were conducted. Recruited children and adolescents with SCD were 34 (52.3%) boys and 31 (47.7%) girls, and their mean age was 11.40 ± 3.55. Most of them ( n  = 44, 67.7%) had sickle HbSβ+, and vaso-occlusive crises were the most common causes for hospital admission ( n  = 24, 36.9%). Children with SCD and their caregivers had depression and anxiety symptoms scores higher than reported in the control group. Children with SCD had significantly less self-esteem and less QoL scores with the least scores were in the communication domain. This adverse psychological profile was significantly negatively correlated with the age of the child, duration of illness, number and duration of hospitalizations, disease severity score, and occurrence of complications. We conclude that HRQoL of children suffering from SCD, and their caregivers are adversely affected necessitating implementation of interventions which focus on reducing depressive symptoms, enhancing self-esteem and QoL.

Composites made from fiber-reinforced polymers (FRPs) are a crucial and highly adaptable category of materials widely utilized in numerous fields. Their flexibility and the range of criteria for classification enable the creation of tailored solutions to address distinct requirements in sectors such as civil engineering, aerospace, automotive, and marine, among others. The distinguishing characteristics of FRP composites include the type of reinforcing fiber used, the composition of the matrix material, the employed manufacturing process, the orientation of the fibers, and the specific end-use application. These classification variables offer engineers a versatile structure to determine and select the most appropriate materials and production techniques for their specific needs. Furthermore, the present study aims to reunite the criteria of classification for FRPs and specific manufacturing technologies of FRPs, such as conventional ones (matched die molding, contact molding), automated ones (filament winding, tape lay-up, and fiber placement), and advanced ones (electrospinning and additive manufacturing),with the chronological development of FRPs, insights on material characteristics, and comprehensive design guidelines based on their behavior in different environments of use.

Background: As artificial intelligence makes rapid inroads across various fields, its value in medical education is becoming increasingly evident. This study evaluates the performance of the GPT-4.0 large language model in responding to plastic surgery board examination questions and explores its potential as a learning tool., Methods: We used a selection of 50 questions from 19 different chapters of a widely-used plastic surgery reference. Responses generated by the GPT-4.0 model were assessed based on four parameters: accuracy, clarity, completeness, and conciseness. Correlation analyses were conducted to ascertain the relationship between these parameters and the overall performance of the model., Results: GPT-4.0 showed a strong performance with high mean scores for accuracy (2.88), clarity (3.00), completeness (2.88), and conciseness (2.92) on a three-point scale. Completeness of the model's responses was significantly correlated with accuracy ( P < 0.0001), whereas no significant correlation was found between accuracy and clarity or conciseness. Performance variability across different chapters indicates potential limitations of the model in dealing with certain complex topics in plastic surgery., Conclusions: The GPT-4.0 model exhibits considerable potential as an auxiliary tool for preparation for plastic surgery board examinations. Despite a few identified limitations, the generally high scores on key parameters suggest the model's ability to provide responses that are accurate, clear, complete, and concise. Future research should focus on enhancing the performance of artificial intelligence models in complex medical topics, further improving their applicability in medical education., Competing Interests: The authors have no financial interest to declare in relation to the content of this article. Disclosure statements are at the end of this article, following the correspondence information., (Copyright © 2023 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

Idiopathic scoliosis is characterized by a three-dimensional deformity of the spine with axial rotation and lateral inclination with an angle greater than 10° according to the Cobb method. Its approach can be conservative or surgical, depending on the degree of angulation, musculoskeletal development and age of the affected child or adolescent, or even depending on the functional impairment resulting from the condition. The aim of this study was to analyze the impact of videoassisted thoracoscopic surgery in the management of idiopathic scoliosis. This is a systematic literature review, built according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol and registered with PROSPERO under number CRD42022351466. The search for studies was performed between August 2022 and September of the same year, in bibliographic databases including MEDLINE, The Cochrane Library and Web of Science. The technique is a minimally invasive alternative to thoracotomy that has shown great evolution in recent years. The main advantages include less blood loss during the procedure, shorter hospital stay and improved post-surgical esthetics. One of the disadvantages mentioned by the authors is the greater complexity and technological requirement, longer surgical time and the need for careful selection of patients, according to degrees of vertebral deviation. The use of analgesics and anti-inflammatory drugs had no significant difference between traditional procedures (thoracotomy) or thoracoscopic surgery., Competing Interests: Conflito de Interesses Os autores declaram não haver conflito de interesses., (Sociedade Brasileira de Ortopedia e Traumatologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

As point-of-care testing (POCT) is becoming the new paradigm of medical diagnostics, there is a growing need to develop reliable POCT devices that can be conveniently operated in a minimally invasive manner. However, the clinical potential of POCT diagnostics is yet to be realized, mainly due to the limited and inconsistent amount of collected samples on these devices, undermining their accuracy. This study proposes a new biosensing platform modified with a functional polysuccinimide (PSI)-silica nanoparticle (SNP) composite system that can substantially increase the protein conjugation efficiency by modulating physicochemical interaction with proteins by several hundred percent from an unmodified device. The efficacy of this PSI-SNP system is further validated by applying it on the surface of a microneedle array (MN), which has emerged as a promising POCT device capable of accessing interstitial fluid through minimal penetration of the skin. This PSI-SNP MN is demonstrated to detect a wide array of proteins with high sensitivity on par with conventional whole serum analysis, validated by in vivo animal testing, effectively displaying broad applicability in biomedical engineering., (© 2023 Wiley-VCH GmbH.)

Introduction: Postpartum depression is a significant episode of depression beginning after giving birth. The prevalence of postpartum depression is approximately 20% in Jeddah, Saudi Arabia. Epidural analgesia is the gold standard for labour pain management. Conflicting results exist regarding the association between postpartum depression and epidural analgesia use during labour. Accordingly, this study assessed the association between epidural analgesia use and postpartum depression incidence., Methods: A prospective observational study of 170 mothers was conducted, with surveys administered after labour and at six weeks postpartum. Surveys included the following: mothers' demographics, obstetric history, postpartum depression (Edinburgh Postnatal Depression Scale), and pain severity (Visual Analogue Scale)., Results: In the final analysis, 91 patients were enrolled. Epidural analgesia was administered to 48.4% of mothers during labour. Nearly two-thirds of mothers learned about EA via sources including family members and social media. However, more than half reported worries regarding epidural analgesia. Edinburgh Postnatal Depression Scale scores showed that 38 mothers (41.8%) likely had depressive symptoms within two days following delivery. Further, 35 (38.5%) met criteria for postpartum depression at six weeks postpartum. For both groups regardless use of analgesia, the mean Visual Analogue Scale score at two days postpartum was 4.16 ± 2.13. Data revealed no correlation between epidural analgesia use and Edinburgh Postnatal Depression Scale within two days and at six weeks postpartum. Multiple regression analysis showed Edinburgh Postnatal Depression Scale scores correlated with Visual Analogue Scale scores but not epidural analgesia use at 1-2 days postpartum., Conclusion: This study showed that depressive symptoms resolved in three percent of participants. This suggests that institutions should increase postpartum depression awareness during the antenatal period and implement effective post-delivery screening systems for postpartum depression., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ahmad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

A positive response in reversibility testing is widely used to diagnose patients with airway limitations. However, despite its simple procedure, it doesn't accurately reflect the exact airway irreversibility. This study aimed to investigate the efficacy of a bronchodilation reversibility test using salbutamol and fluticasone/salmeterol combination in obese non-smoker subjects.The study included patients without a history of obstructive lung disease or bronchodilators. A sub-classification of patients based on body mass index (BMI) was carried out into normal (< 24.9 kg/m 2 ), overweight (25-29.9 kg/m 2 ), and obese (BMI ≥ 30). Spirometry measurements were performed before and after salbutamol or fluticasone/salmeterol administration.The study included 415 (49.9% male) patients with a mean age of 40.92 ± 10.86 years. Obese subjects showed a high prevalence of restrictive patterns (23.4%), with non-significantly lower spirometric values compared to normal and overweight subjects (p > 0.05). The magnitude of bronchodilation, as identified by spirometry, following fluticasone/salmeterol was higher in all participants, with a significant increase in obese subjects with a p-value of 0.013, 0.002, and 0.035 for FEV 1 , FEV 1 % predicted, and FEV 1 /FVC, respectively.Fluticasone/salmeterol combination increases FEV 1 , FEV 1 % of predicted, and FEV 1 /FVC ratio than the conventional test using salbutamol inhaler, and it can be a potential candidate for assessment of airway obstruction using reversibility test, especially among the obese population., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Hypertension is the leading risk factor for preventable cardiovascular-related complications and mortalities worldwide., Materials and Methods: A cross-sectional survey was conducted to assess the prevalence and factors associated with hypertension among 361 adults from four local government areas (LGAs) of Jigawa state identified to have high burden of kidney diseases. The Modified WHO STEPS questionnaire and multi-stage sampling technique were employed and data were analysed using IBM SPSS version 22.0., Results: The age of the respondents ranged from 18 to 102 years with a median of 45 (interquartile range = 30-80) years. More than a quarter (34.9%) of the respondents were unemployed. Few reported history of alcohol ingestion (0.8%) and cigarette smoking (1.1%). The prevalence of systolic hypertension was 116 (32.1%), while that of diastolic hypertension was 133 (36.8%). Jahun LGA had higher cases (36.7%) of systolic hypertension, whereas Dutse LGA had higher cases (47.8%) of diastolic hypertension. Systolic hypertension was significantly higher (P < 0.001) among those >35 years of age. The odds of developing systolic hypertension were significantly lower among those between the ages of 18 and 35 years, and those between the ages of 18 and 35 years were less likely to have systolic hypertension than those above the age of 35 years (adjusted odds ratio = 9.0; 95% confidence interval = 4.6-17.6). Similarly, those who reported family history of diabetes and hypertension (P < 0.001) had a significantly higher proportion of systolic hypertension., Conclusions: The prevalence of hypertension was alarming in the high burden kidney disease areas. The government should develop a sustainable model for the mass community screening of risk factors and community-based health insurance for the effective management of all identified cases.

Busulfan is a widely used cancer chemotherapeutic agent. Temporary or permanent sterility in male patients is one of the most common side effects of this drug. The present study was performed to evaluate the changes in the microscopic structure of the testes of prepubertal rats, as well as the changes in PCNA and caspase-3 immune expression, at different durations after busulfan administration. The rats were 5 weeks old and were divided into two main groups. Control group and busulfan treated group. Busulfan treated group received a single dose of busulfan (40 mg/kg), then animals were subdivided to three subgroups; IIa, IIb, IIc which were sacrificed after four, ten and twenty weeks, respectively, from the beginning of the experiment. Light and electron microscopic studies were done. Serum testosterone level and relative testes weight were assessed. Immunohistochemical staining for anti-proliferating cell nuclear antigen (PCNA) and anti-caspase-3 antigen was also done. Morphometric and statistical studies were carried out. Group II revealed histological and ultrastructural degenerative changes including congested blood vessels and degenerated spermatogenic epithelium, Sertoli cells, and Leydig cells. These changes were more evident after 10 weeks of busulfan administration and were accompanied by absence of mature sperms in the lumen of seminiferous tubules. These changes were associated with a significant reduction in relative testes weight, testosterone level, germinal epithelial height and seminiferous tubule diameter. Moreover, PCNA and caspase-3 immune expression was significantly altered in busulfan treated group. Mild improvement in testicular structure was observed 20 weeks after busulfan treatment.

Bioelectrochemical systems (BESs) such as microbial fuel cells (MFCs) present numerous benefits for the removal and recovery of heavy metals from industrial and municipal wastewater. This study evaluated the life cycle environmental impact of simultaneous hexavalent chromium (Cr(vi)) removal and bioelectricity generation in a dual chamber MFC. Results indicate a global warming potential (GWP) of -0.44 kg carbon dioxide (CO 2 )-eq. per kg of chromium recovered, representing a total saving of up to 97% in comparison with existing technologies for the treatment of Cr(vi) laden wastewater. The observed savings in GWP (kg CO 2 -eq.) reduced to 61.8% with the removal of the allocated credits from the MFC system's life cycle. Of all the various sub-systems considered within the chromium waste treatment plant, the MFC unit and the chromium metal recovery unit had the largest impact in terms of GWP (kg CO 2 -eq.), non-renewable energy use (NREU) (MJ primary), and mineral extraction (MJ surplus). A statistical analysis of the results showed that an increase in chemical oxygen demand (COD) was associated with a reduction in GWP (kg CO 2 -eq.), NREU (MJ primary), and terrestrial ecotoxicity (kg triethylene glycol equivalents into soil (TEG soil)-eq.). The life cycle assessment (LCA) output showed a high sensitivity to changes in the materials and construction processes of MFC reactors, indicating the need for further research into sustainable materials for MFC reactor construction. The observed interaction effects of process variables also suggest the need for combined optimization of these variables. Analysis with other types of metals is also important to further demonstrate the practical viability of metal removal through MFCs., Competing Interests: The authors declared that they have no financial and personal relationships with other people or organizations and potential conflicts of interest in this work. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results., (This journal is © The Royal Society of Chemistry.)

Background: The burden of food-borne diseases is becoming a global problem. The aim of this study was to assess and compare personal hygiene knowledge among street food vendors and canteen food handlers in the Kano metropolis., Methodology: An explanatory sequential mixed methods study was carried out using a structured interviewer-administered questionnaire, focus group discussion guide and observation checklist, to assess and compare personal hygiene knowledge among street food vendors and canteen food handlers in Kano metropolis, Nigeria. Quantitative data was analyzed at univariate, bivariate and multivariate levels using SPSS version 20.0 at a 5% α level of significance. Thematic analysis was used to analyze verbatim transcripts from qualitative interviews., Results: The response rates were 305/310 (98.4%) and 288/310 (92.9%) among street food vendors and canteen food handlers, respectively. The proportions of street food vendors and canteen food handlers with poor, fair and good knowledge of personal hygiene were (29.5% versus 19.8%), (51.8% versus 54.2%) and (18.7% versus 26.0%), respectively (p=0.009). There was a statistically significant association between education and knowledge of personal hygiene among street food vendors (p=0.03) and canteen food handlers (p=0.04). Though slightly better among canteen food handlers, narratives by the two groups of food handlers pointed to the general lack of awareness of basic personal hygiene which was supported by the findings from observation., Conclusion: Personal hygiene knowledge was poor among the two groups of food handlers; therefore, the Government should ensure legislation and enforcement involving training of food vendors, periodic medical examination, and issuance of fitness certificate to all food vendors., Competing Interests: Nil, (Copyright © 2023 Nigerian Medical Association.)

Objective: Photon-induced photoacoustic streaming (PIPS) with pineapple peel extract (PPE) and ethylenediaminetetraacetic acid (EDTA) as a final endodontic irrigant on the push-out bond strength (PBS) of root filling material to conventional irrigation NaOCl with EDTA ., Methods: An in vitro study at Dar Al Uloom University was conducted over three months. Root canal preparation was performed. Based on final irrigation, all the specimens were divided randomly into four groups (n=10) Group 1: 2.25% NaOCl+ 17% EDTA (control), Group-2: 2.25% NaOCl+PIPS + 6.25% PPE, Group-3: 2.25% NaOCl+PIPS + 17% EDTA, Group-4: 2.25% NaOCl + 6.25% PPE. Canals were obturated and sealed with AH Plus sealer. Root sectioning was performed at 1mm thickness and PBS testing was performed using the universal testing machine. The debonded samples were analyzed for failure mode. ANOVA compared the means and standard deviations (SD) of all investigated group. Assessment of multiple comparisons was performed using Tukey's post hoc test., Results: The maximum PBS was demonstrated by the coronal section of Group-2 (2.25%NaOCl +PIPS+6.25%PPE) specimens (8.21±0.81MPa). The apical section of Group-1 (2.25% NaOCl+17% EDTA) specimens demonstrated minimum bond strength (2.80±0.18 MPa). The intergroup comparison revealed that Group-3 (2.25% NaOCl +PIPS +17% EDTA) and Group-2 demonstrated comparable outcomes ( p> 0.05). Group-4 (2.25% NaOCl +6.25% PPE) specimens established significantly lower values than Group-3 and Group-4 ( p< 0.05)., Conclusion: Photon-induced photoacoustic streaming with pineapple peel extract and EDTA demonstrated better bond strength of root canal sealer and have the potential to be used as the final irrigant., Competing Interests: Conflict of Interest Statement: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Background: Kidney diseases requiring haemodialysis are becoming an emerging public health problem. This study aimed to determine the burden, socio-demographic and other risk factors associated with haemodialysis in Northwest Nigeria., Methodology: The study was a retrospective multicentre review of secondary data from the dialysis centres of public hospitals in northwestern Nigeria. Risk factors for renal failure were examined in 1329 patients who were enrolled for haemodialysis between 2019 and 2022 in the four public dialysis centres in Kano and Jigawa state. Data were analysed using IBM SPSS Statistics for Windows, version 22.0, with statistical significance set at P ≤ 0.05., Results: The minimum age of the patients was 2 years and the maximum was 100 years with a median of 48 (interquartile range = 31, 60) years. Chronic kidney disease (CKD) was found amongst more than two-thirds 998 (75.1%) of the patients. Up to 51 (3.8%), 62 (4.7%) and 10 (0.8%) were seropositive for HIV, hepatitis B and hepatitis C, respectively. Acute kidney injury (AKI) was significantly higher (67.9%, P < 0.001) amongst patients with post-partum haemorrhage (PPH), and were 24 times more likely to develop AKI when compared with those with no PPH (adjusted odds ratio [aOR] =24, 95% confidence interval [CI] = [13.5-44.5]). CKD was significantly higher amongst patients with hypertension (HTN) (84.9%, P < 0.001), and were 3.2 times more likely to develop CKD compared with non-hypertensives (aOR = 3.2, 95% CI = [2.4-4.1]). Acute on CKD (AOCCKD) was significantly higher amongst patients with chronic glomerulonephritis (CGN) (28.1%, P < 0.001), and were three times more likely to develop AOCCKD than those without CGN (aOR = 3, 95% CI = [2.1-4.2])., Conclusion: PPH was the major reason for AKI related haemodialysis while diabetes and HTN were the major causes of CKD-requiring haemodialysis. CGN was more amongst patients who had dialysis due to acute exacerbation of CKD. The government and relevant stakeholders should ensure a favourable policy for the screening and management of patients.