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Objectives: To assess, the serum levels of immunoglobulins (IgG, IgA, IgM) and complement subfactors (C٣, C٤) in newly diagnosed epileptic patients in the pretherapy stage and ٣ months after valproate therapy, in comparison with controls. Methods: This study was conducted at Iben-Seena Hospital and the College of Medicine- University of Mosul from January to December ٢٠٠٩. Forty-two newly diagnosed epileptic patients were selected and included in this study. Fifty apparently healthy subjects , age and sex matched to the patients group also included and taken as a control. Initially from both the patients and controls, blood samples were taken and assessment of sera levels of immunoglobulins and complement subfactors were done by single radial immuno diffusion method, using commercial kits. Then patients were put on valporate therapy for ٣ months and a blood sample were taken from the patients and assay of the same parameters mentioned above were done using the same technique and the same kits. Results: There were insignificant differences between patients in pre-therapy stage and controls with regard serum immunoglobulin levels (and complement subfactors). Also there were insignificant differences between epileptic patients before and ٣ months after therapy with valproate . Conclusion: valproate as an anticonvulsant have no influence on serum immunoglobulin (IgG, IgA, IgM) and complement subfactors (C٣, C٤) after ٣ months of therapy.

Abstract Background Down syndrome (DS), or Trisomy 21, is defined by the existence of an additional chromosome 21. Various physiological considerations in DS patients might lead to challenges in adequate pain management and sedation after surgery. The aim of this systematic review and meta-analysis is to evaluate the variations of the requirement needed for pain management and sedation in patients with DS who have undergone surgery compared to patients without DS. Methods A systematic review and meta-analysis of studies were conducted, focusing on critically ill patients with DS who were admitted to Intensive care units (ICUs) post-surgery and received opioids and/or benzodiazepines. Searches were conducted in four databases from their inception to November 18, 2023 (Pubmed, Scopus, Cochrane Library, and Web of Science). The primary outcome measured was the dosage of Oral Morphine Equivalent (OME) administered in the days following surgery. Fixed-effect models were used, an approach advisable when only a limited number of studies are available. Results Out of the 992 studies initially screened, the systematic review included ten studies, encompassing 730 patients, while the meta-analysis consisted of seven studies, encompassing 533 patients. Of the seven studies included in the analysis, 298 patients were identified to have DS, and 235 patients served as controls. Patients with DS showed a slight increase in OME needs on the first day, but this increase was not statistically significant (mean difference [MD] = 0.09; 95% Confidence Interval [CI]: [-0.02, 0.20]; P = 0.11). There was also no significant difference in the requirement for Midazolam on the first day among DS patients (MD = 0.01; CI [-0.16, 0.19]; P = 0.88). In addition, the duration of mechanical ventilation was not statistically significant in patients with DS compared with the control group (MD = -1.46 hours; 95% CI [-9.74, 6.82]; P = 0.73). Conclusion Patients with Down syndrome did not require more sedation or analgesia in the first three days after surgery than patients without Down syndrome. Additionally, the two groups showed no significant difference in the duration of mechanical ventilation.

Somalia has experienced extreme flash floods in recent years across the arid regions causing tremendous loss of lives and properties. However, the flood magnitude, depth, and frequency of occurrence are not yet quantified. This is mainly due to scarce datasets in the area. . In this study, integration of observed and Climate Hazards Infrared Precipitation (CHIRP) satellite rainfall products and remote sensing raster data were used to improve hydrological model simulation outputs. The Hydrologic Engineering Center namely HEC-HMS and HEC-RAS models were used to simulate the rainfall-runoff processes and flood inundation, respectively. The land use, soil, slope and Digital Elevation map (DEM) were used to set-up the models and generate outputs. The HEC-HMS model calibration results depict that the model is able to reproduce the observed streamflow The simulated flows generated by the model predicted good agreement with the observed flow with values of 0.79, 0.74, 0.78, and 0.78 evaluated through the Nash and Sutcliffe Efficiency (NSE), Runoff Volume Error (RVE), coefficient of determination (R2), and percentage error of peak flow (PEPF), respectively. The HEC-RAS model result indicates that the maximum flood depth and velocity were obtained at the floodplain area. The peak flood at 50, 100, and 200-year return period using General Extreme Value (GEV) distribution revealed 384m3s-1, 409m3s-1, and 434m3s-1, respectively. The 100-year peak flood discharge in a specific part of the river revealed a flood depth of 7.53m. The provision of Levees as mitigation measures revealed reduction of the flood extent by 35% and suggested as possible flood protection measures for the study area.

Background/Purpose: To develop a prediction model for emergency medical technicians (EMTs) to identify trauma patients at high risk of deterioration to emergency medical service (EMS)-witnessed traumatic cardiac arrest (TCA) on the scene or en route. Methods: We developed a prediction model using the classical cross-validation method from the Pan-Asia Trauma Outcomes Study (PATOS) database from 1 January 2015 to 31 December 2020. Eligible patients aged ≥18 years were transported to the hospital by the EMS. The primary outcome (EMS-witnessed TCA) was defined based on changes in vital signs measured on the scene or en route. We included variables that were immediately measurable as potential predictors when EMTs arrived. An integer point value system was built using multivariable logistic regression. The area under the receiver operating characteristic (AUROC) curve and Hosmer-Lemeshow (HL) test were used to examine discrimination and calibration in the derivation and validation cohorts. Results: In total, 74,844 patients were eligible for database review. The model comprised five prehospital predictors: age 20/minute, pulse oximetry

Background: Despite an increasing incidence of Staphylococcus aureus infection and dissemination in Pakistan, the epidemiology of different Staphylococcus aureus research clones has been the subject of only a small number of investigations. By analyzing the collected data sequence, this study was designed to study the epidemiology of Staphylococcus aureus in the area using multilocus sequence typing (MLST). Methods: A total of 1015 staphylococcus strains collected from the city's tertiary care facilities were biochemically screened, followed by antimicrobial susceptibility testing against a panel of 13 antibiotics. Analyzed methicillin-resistant Staphylococcus aureus (MRSA) was subjected to molecular characterization using multilocus sequence typing (MLST), clonal complex analysis, recombination testing, and phylogenetic analysis. Results: Approximately 421 bacteria were verified as Staphylococcus aureus by biochemical analysis. 57% of the isolates exhibited multidrug resistance, of which 89% were found to be methicillin-resistant Staphylococcus aureus (MRSA). MLST results in a total of 39 sequence types (ST) and 5 clonal complexes (CC), out of which twenty-two STs were newly documented worldwide. The most common CC identified was CC8. The direct sequencing data also revealed significant shifts at MLST loci, with point mutations resulting in the aroE-343 and tpi-278 alleles. Conclusions: This study concludes that there is high diversity in the locally circulating clones of Staphylococcus aureus present in nature and that they are defined by their geographic epidemiology. These findings have practical implications for public health, including the need for tailored infection control strategies, antibiotic stewardship, global surveillance, and a deeper understanding of bacterial evolution.

This research paper aims to explore the complex relationship between entrepreneurship (REE), economic growth (GDP), and the moderating role of political stability (PS) in the context of the Gulf Cooperation Council (GCC) countries. Utilizing a balanced panel dataset from 2006 to 2020, we employed Panel Least Squares and Panel EGLS (Cross-section random effects) to evaluate the interactions among these variables. The findings reveal that more than entrepreneurship alone is needed to significantly contribute to economic growth in the GCC countries. However, when political stability serves as a moderating variable, the impact of entrepreneurship on economic growth becomes markedly positive. The study provides critical insights for policymakers, indicating the necessity of a multi-faceted approach incorporating entrepreneurship and political stability in economic planning. The research fills a significant gap in the existing literature by shedding light on the intertwined nature of entrepreneurship and political stability as crucial drivers of economic growth in the GCC. This paper further offers concrete policy recommendations rooted in empirical evidence, aiming to guide future economic strategies in the region.

AbstractThis research aims to investigate the impact of economic freedom on entrepreneurship within the GCC countries, spanning the period 2006–2020. Using the Panel ARDL methodology, the research analyzes the impact of economic freedom and its diverse components, including Property Rights, Government Integrity, Tax Burden, Government Spending, Business Freedom, Investment Freedom and Monetary Freedom on entrepreneurship rates, measured by new business density (REE). Additionally, critical control variables like GDP growth, inflation, unemployment and political stability were woven into the analysis. The findings highlight that while economic freedom is a consistent long-term catalyst for entrepreneurship, the short-term dynamics are influenced by many factors, with notable implications for GDP growth and political stability. Further dissection revealed that specific components of economic freedom, such as Tax Burden and Government Spending, held pronounced significance in shaping entrepreneurial inclinations. This research offers policymakers a nuanced understanding of how economic freedom, with its diverse components, shapes the entrepreneurial landscape in the GCC region, underscoring the importance of policies that factor in regional specificities. This research, also offers a detailed examination of individual economic freedom elements and their influence on entrepreneurial activity. This approach allows for providing a fresh perspective and contributing significantly to the existing literature.

The release of carbon dioxide (CO2) into the earth's atmosphere is a substantial global environmental concern that arises from the processes of industrialization and urbanization. The increase in atmospheric CO2 concentrations has resulted in the phenomenon of global warming and subsequent alterations in climate patterns. Accelerated CO2 sequestration in cementitious materials is currently the subject of extensive research as a highly efficacious approach to mitigating the carbon footprint of the concrete industry. The sequestration procedure entails the transformation of gaseous CO2 into carbonate minerals. The review presented in this paper outlines the most recent carbonation (i.e., CO2 sequestration) techniques, such as mineral carbonation, accelerated CO2 curing (ACC), pre-carbonation, and carbonation mixing, that have been recently explored. The potential of mineral carbonation of industrial wastes and the advantages of their incorporation in the concrete matrix is investigated. Carbonation technologies and their effect on the performance of cementitious composites are reported. Information on life cycle assessment are also included to evaluate the environmental impact associated with the production of carbonated materials. Various commercialized CO2 utilization technologies in construction sector, such as CarbonCure, Solidia, Carbstone, Calera, and Carbon8 are reviewed. Moreover, this review offers a thorough insight into the carbonation technologies, evaluating their advantages, limitations, and the existing gaps in research.

Dear Editor, Cancer is one of the major public health concerns globally. Despite the advances in anticancer therapies, we still lack the approach to enhance its efficacy. Although the gold standard of treatment for most cancers includes a combination of chemotherapy, radiation and surgery, many patients still suffer from poor prognosis and alternative effective therapy is required.

The aim of this work is to study the effect of the addition of nickel oxide nanoparticles in different concentrations to the polymer matrix of polyvinylpyrrolidone on the electrical and optical properties of the membrane. Nickel oxide nanoparticles were prepared by the hydrothermal method, and the nanoscale size of the particles was measured by scanning field emissions (SEM). To find out the crystal size, X-ray diffractivity (XRD) was carried out. the chemical bonds of composite membranes were determined by infrared spectroscopy (IR) examination .where the Ni-O bond appeared at wavenumber 408cm-1. The energy gap was calculated for the pure polymer and the composite polymer, and there was a decrease. The Hall Effect test was performed to measure the electrical properties of the composite and pure membrane and the results showed that the best conductivity For a composite membrane, at the nickel concentration (0.1) in the polymer matrix. As a result, a composite thin film of PVP-NiO NPs can be utilized as a semi-conductor in photo sensor and solar cell applications.

This study examines the relationship between entrepreneurship and sustainable development in Saudi Arabia from 2006 to 2022, focusing on the economic, social, and environmental dimensions. Using the autoregressive distributed lag (ARDL) model, the research investigates both short-run and long-run dynamics to understand how entrepreneurial activities influence sustainable development within the framework of Saudi Arabia’s Vision 2030 initiative. The findings indicate that entrepreneurship significantly contributes to economic growth through job creation and innovation, thereby aiding in the diversification of the economy away from oil dependency. Socially, entrepreneurial initiatives have a positive impact on gender equality and social inclusion by empowering women and integrating youth into the labor market. Environmentally, entrepreneurship helps reduce carbon emissions and promotes sustainable business practices. Despite these positive outcomes, challenges such as regulatory barriers, limited access to finance, and the need for a supportive entrepreneurial ecosystem remain. Recommendations include enhancing entrepreneurial education, providing financial incentives, and streamlining regulatory processes to better support start-ups and SMEs. This study highlights the necessity of addressing these challenges to fully realize the potential of entrepreneurship for sustainable development in Saudi Arabia. By providing empirical evidence on the significant role of entrepreneurship in driving sustainable development, this research offers actionable insights for policymakers aiming to foster a more resilient and diversified economy in line with Vision 2030.

Background: The COVID-19 pandemic has resulted in a global humanitarian crisis. Despite ongoing research, transmission risks and many disease characteristics remained unclear. Most patients have displayed elevated levels of certain inflammatory markers, which we sought to investigate further in relation to disease severity. The aim of this study was to examine the correlation between inflammatory markers and the severity of COVID-19 among patients. Methods: We conducted a cross-sectional study from April to September 2020, involving 143 COVID-19 PCR-positive patients from Ziauddin Hospital. Electronic patient records provided data on demographics, clinical status, and laboratory results. Results: The majority of PCR-positive patients were elderly males with comorbidities such as diabetes and hypertension. Almost all patients exhibited increased levels of various inflammatory markers, with procalcitonin (97.2%) being the most common. Statistically significant differences were observed in the levels of TLC (p = 0.005), CRP (p = 0.001), LDH (p = 0.001), Ferritin (p = 0.001), D-dimer (p = 0.001), and procalcitonin (p = 0.028), in relation to COVID-19 severity. Conclusions: The data suggest a significant association between levels of inflammatory markers and COVID-19 severity. All markers, except procalcitonin, demonstrated a significant correlation with disease severity. These results could enhance our understanding of COVID-19 pathogenesis and help predict and manage severe cases.

Patlayıcı ve yanıcı özellikteki maddelerin ortama sızması sonucunda oluşabilecek tehlikeli bölgelerin bilimsel yöntemle ve nicel değerlerle belirlenmesi, çalışma ortamının güvenliği için son derece önemlidir. Bu çalışmada bir işletmede bulunan amonyak tankının alt çıkışında ve bağlantılarında oluşabilecek sızıntı ihtimalleri değerlendirilerek, muhtemel patlayıcı bölgelerin sınırları ALOAH programında, patlayıcı bölgelerin sınıflandırılması standardına (TS 60079-10-1) göre yapılmıştır. Amonyak tankının pompa ve alt bağlantı flanşlarından meydana gelebilecek tali boşalmanın karakteristiği sırasıyla 24,64 ve 10,36 m3/s, bölge yarıçapları 14 ve 7 m olarak hesaplanmıştır. Yapılan hesaplama ve değerlendirmeler sonucunda oluşacak patlayıcı ortamın Bölge 1 tanımına uyduğu bulunmuştur. L-tipi matris sistemi kullanılarak, haftada bir patlama ihtimalinin oluşabileceği (3P) ve ciddi yaralanmalara (4P) sebep olabileceği düşünülerek risk derecesi 12 olarak hesaplanmıştır. ATEX hesaplamalarının ortam risklerinin nicel olarak tanımlanmasında ve gereken önlemlerin zamanında alınmasında faydalı olduğu anlaşılmaktadır. Ancak bu hesaplamaların farklı iş yerinde her bir patlayıcı kimyasala özgü yapılması halinde riskleri belirlemede etkili olacağı sonucuna varılmıştır.

Abstract Science is digging for the varied presentation of COVID-19 patients exposed to the same risk factors, and medical conditions may be influenced by the presence of polymorphic genetic variants. This study investigated the link between ACE2 gene polymorphisms and the severity of SARS-CoV-2. This cross-sectional study recruited COVID-19 PCR-positive patients by consecutive sampling from Ziauddin Hospital from April to September 2020. DNA was extracted from whole blood, followed by gene amplification and Sanger’s sequencing. Most of the patients, 77: 53.8%, were serious. Males were higher (80; 55.9%) with age more than 50 years (106: 74.1%). We found 22 ACE2 SNPs. rs2285666 SNP was most prevalent with 49.2% CC, 45.2% TT, 4.8% CT heterozygosity, and 0.8% AA genotypes. Variants with multiple genotypes were also insignificantly associated with the severity of COVID-19 in the analysis of the dominant model. Only rs2285666 had a significant statistical link with gender (p-value 0.034, OR; 1.438, CI; 1.028–2.011) while rs768883316 with age groups (p-value 0.026, OR; 1.953, CI; 1.085–3.514). Haplotypes ATC of three polymorphisms (rs560997634, rs201159862, and rs751170930) commonly found in 120 (69.77%) and TTTGTAGTTAGTA haplotype consisting of 13 polymorphisms (rs756737634, rs146991645, rs1601703288, rs1927830489, rs1927831624, rs764947941, rs752242172, rs73195521, rs781378335, rs756597390, rs780478736, rs148006212, rs768583671) in 112 (90.32%) had statistically significant association with the severity having p = value 0.029 and 0.001 respectively. Males of old age and diabetics are found to have more severe COVID-19 infection in the current study. We also found that common ACE2 polymorphism rs2285666 influences the susceptibility of acquiring the severe SARS-CoV-2 infection.

The crustal structure beneath the Sulaymaniyah area in northeast Iraq which is located in a seismically active zone, was investigated and the results were presented in this study. Teleseismic and regional earthquakes recorded by the Sulaymaniyah broadband seismic station (SLY1) were used to conduct the P-wave receiver functions and Rayleigh wave group velocities using Computer Programs in Seismology (CPS). Joint inversion of receiver functions and surface waves dispersion curves were used to infer the crustal structure below the station. The waveforms were analyzed for 72 earthquakes with epicentral distances ranging from 30º to 90º that occurred during the period from October 2015 to Oct. 2021 with magnitudes ≥ 7Mw. The generated crustal model shows that the sedimentary cover in the area is around 6km with a P-wave velocity of 5.4817km/sec and Moho discontinuity around 48km with a P-wave velocity of 8.0560km/sec. These outcomes indicate that the crystalline crustal thickness at Sulaymaniyah station is 42 km with a P-wave velocity ranging from 5.4817km/sec to 8.0560km/sec. There are two sharp discontinuities around 20km and 38km with P-wave velocities of 5.9182km/sec and 7.1485km/sec respectively. It is believed that these are the discontinuities between the upper, middle, and lower crust.

Legionnaire's disease can cause rare and severe complications such as rhabdomyolysis and acute kidney injury. This case report details a 45-year-old male patient who presented with features of Legionnaire's disease. Laboratory results showed a significantly elevated serum creatinine kinase level and an increased creatinine level. Imaging showed right lower lobe consolidation, and a positive urine antigen test confirmed Legionnaire's disease. The patient was administered azithromycin and underwent fluid repletion to manage the rhabdomyolysis and acute kidney injury, resulting in improved creatinine kinase levels and kidney function. He was discharged and continued on azithromycin for 10 days. His outpatient follow-up showed that creatinine kinase levels had further decreased. This case report emphasises the importance of early recognition and management of Legionnaire's disease and its rare but severe complications.

Abstract Jejunal diverticula are often asymptomatic and rare, so they can go unnoticed until serious complications like obstruction, bleeding, perforation, volvulus, or diverticulitis occur. Elderly people over 60 are more likely to have this condition.

Rubberized concrete (RuC) is a green and environmentally friendly concrete that can be a sustainable production material by replaced mineral aggregate by rubber particles. Rubber particles used for replacing mineral aggregate classified by two types: shredded or chipped rubber as coarse aggregate and crumb rubber as fine aggregate. Mechanical properties and stress-strain curve of rubberized concrete change as mineral aggregate replaced by rubber particles. However, present constitutive stress-strain models for conventional concrete are not valid for rubberized concrete. Also, proposed modified models for rubberized concrete have been done based on limited experimental tests or low volume replacement ratio for coarse aggregate replacement. Therefore, this paper presents an investigation on the mechanical properties of rubberized concrete with volume replacement of coarse aggregate by rubber particles with size larger than 4 mm up to 100%, which represent about 60–65% from total aggregate, after analyzing published experimental tests in the literature for 98 concrete mixes. New equations were proposed to predict the compressive strength, modulus of elasticity, peak strain and compressive stress-strain relationship with taken the volume replacement of coarse aggregate from total aggregate into account. The proposed equations showed reliable prediction of the mechanical properties and compressive stress-strain relationship of the published experimental tests and improved accuracy over existing models.

Abstract not needed for LTE as described by the author instructions of JPMA

With over 500 million confirmed cases and 6.2 million deaths worldwide, the novel coronavirus has highlighted the underlying disparities in healthcare, unpreparedness to deal with a new disease and the need for monitoring and surveillance for a post-infectious syndrome as well as complicated diseases. Initially, children were thought to be spared but reports of a new phenomenon manifesting as Kawasaki-like disease, toxic shock syndrome, and multi-system inflammatory syndrome, which developed after a few weeks of severe COVID-19 infection, emerged in the pediatric population. As the pandemic progressed, increased prevalence of multi-system inflammatory syndrome in children (MIS-C) related to COVID-19 was seen in non-Hispanic blacks, Asians, and Latinos as compared to the white population drawing attention to a possible role of ethnicity and socio-economic disparities. The CDC currently reports that 31% of MIS-C cases were seen in Black Non-Hispanics and 26% in Latinos, who were historically more affected in previous pandemics. Furthermore, MIS-C cases in developing countries showed higher mortality as compared to high-income countries, which points toward the role of social determinants of health and limitations in a low-resource set up in increasing the disease burden of MIS-C, which should be treated as a public health emergency. Our review highlights the role of ethnicity, socio-economic factors, comorbidities, and differences in populations affected by MIS-C in high-income vs. low- and middle-income countries.

Dear Editor, The current Coronavirus disease (COVID-19) was first identified around the end of 2019 in Wuhan, China and was declared a global pandemic by WHO a few months after, in March 2020. Since then, the Coronavirus caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is of great concern to human life, affecting around 24.8 million people worldwide and causing 5.3 million lives to succumb to it as of 15th December’2021. (1) Even though vaccines against the virus have readily been made available to the population, with new strains of the virus coming to light every few months, the end still seems bleak. As part of the body’s innate mechanism, antibodies develop against a pathogen after one’s been exposed to it. Antibodies also make up a considerable composition of breast milk that provide immune protection to the neonates against diseases such as gastrointestinal tract infections, respiratory infections and middle ear infections. (2) COVID-19 targets individuals of all age groups, however in neonates the positivity ratio is considerably lower. While vertical transmission of COVID-19 has been a topic of much debate, there has been no definitive evidence to prove the phenomenon. (3) Currently studies state that there is no concrete proof confirming the association of COVID-19 and its spread via breast milk. (3) In a recent study by Rebecca Powell, strong associations were made between antibodies present in breast milk and COVID-19. After taking and assessing donated milk samples of eight COVID-19 recovered and seven COVID-19 suspected lactating females, it was found that milk from all COVID-19 recovered individuals showed notable SARS-CoV-2 specific IgA reactivity, suggesting that breast milk may contain immunoglobulins protective against the novel Coronavirus. (4) In another study, it was found that a woman who tested positive for COVID-19 had discoverable IgG and IgA in breast milk. Her newborn infant tested negative for the Virus at birth but showed an elevated IgG in serum (5), re-establishing our prior argument about the presence of COVID-19 antibodies in breast milk. Though, yet not fully researched, this discovery could possibly be a revolutionary step towards formulating a preventive measure to the Virus, thus helping eradicate the pandemic. The severity of neonatal complications arising with the malady may be drastically reduced. A more scientific research and thorough analysis to this finding is required to prove a causal relationship between the disease and antibodies present in breast milk.

A survey was conducted in Al-Kharj governorate, Riyadh region to identify viruses causing variety of virus-like symptoms on tomato plants. A total of 135 samples were collected from symptomatic tomato plants. Symptoms included mottling, deformation, necrosis of leaves and fruits. Eighteen viruses were tested by DAS-ELISA. Tomato black ring virus (TBRV) was the virus of concern as it was not detected in Saudi Arabia before and was detected in 52.6% of the collected samples in this study. RT-PCR was used to confirm detection of TBRV and to sequence the amplified products to determine molecular characteristics of this virus. In the host range test study that was performed using a purified isolate of TBRV, sixteen out of the twenty two tested plants showed symptoms. Brassica oleracea was not infected by this virus. Gel electrophoreses (2% agarose) yielded fragments of 978 bp of coat protein gene of TBRV. Nucleotide sequences of purified RT-PCR products for three TBRV Saudi isolates were deposited in the GenBank with the following accession numbers MT274656, MT274657, and MT274658. These isolates of TBRV indicated a close Phylogenetic relationship of (99–100%) among themselves and with five isolates from Poland (95–98%) but a distant relationship of 85% with isolates from England and Lithuania deposited in the GenBank. This is the first report for detection and molecular characterization of TBRV infecting tomato plants in Saudi Arabia.

Dear madam, the last year emerged COVID-19 disease is a highly transmissible viral infection caused by novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pandemic infected over 220 million people, and caused over 4.6 million deaths, within Pakistan there are about 1.2 million confirmed cases and approximately 26,000 deaths, dated 12th September 2021. (1) It’s primary mode of transmission is human to human via respiratory droplets and direct contact. The clinical presentation can range from asymptomatic to severe pneumonia and death. (2) Following the rise in Covid-19 cases, there has also been a surge in number of cases of Mucormycosis fungal superinfection described as, Covid-19-Associated mucormycosis (CAM) (3). (CAM) is already declared an epidemic in India, the neighboring country of Pakistan, due to its rapidly increasing number of cases, currently present at 14,872 cases (4). Recently Pakistan has alarmingly reported 5 cases of mucormycosis in Covid-19 patients out of which 4 patients died (5). Mucormycosis is an opportunistic invasive fungal infection frequently presenting in immunosuppressed patients with high glucose levels (Diabetes & Steroid-induced hyperglycaemia) (6). Covid-19 patients are already immunocompromised due to impaired cell mediated immune response and decreased (CD4+) and (CD8+?T-cells) (7). Combined with misuse of antibiotics in covid-19 patients that further suppress the normal bacterial flora and steroid use in diabetic covid-19 patients provides an ideal condition for mucormycosis to grow. The 2 clinical manifestations are Rhino-Orbital-Cerebral (ROCM) and Pulmonary Mucormycosis. The (ROCM) form commonly manifests in (CAM) disseminating systemically, resulting in facial deformity, cranial nerve palsy, blindness, brain invasion and abscesses with necrosis of the nasal cavity. Mortality is high, especially if diagnosis and prompt initiation of medical and surgical therapy are delayed (6). Since Pakistan has over 27.4 million cases of diabetes (?20 years) (8) and an overall hot and humid environment that promotes growth of mucomycosis, (CAM) is an emerging problem necessitating increased vigilance in recovered and infected Covid-19 patients. Hence, blood glucose levels must be closely monitored and controlled, particularly in diabetic Covid-19 patients or those receiving corticosteroids. Corticosteroid therapy should only be used when required and only at recommended doses and duration. Stronger restrictions on over-the-counter sales of systemic corticosteroids and antibiotics should be considered by the government. Efforts must be taken to educate health care providers and aware the public about signs and symptoms of mucormycosis. Lastly, the health care delivery system should be well equipped to pre-empt Continue....

The building sector consumes as much as 80% of generated electricity in the UAE; during the COVID-19 pandemic, the energy consumption of two sub-sectors, i.e., commercial (50%) and residential (30%), was significantly impacted. The residential sector was impacted the most due to an increase in the average occupancy during the lockdown period. This increment continued even after the lockdown due to the fear of infection. The COVID-19 pandemic and its lockdown measures can be considered experimental setups, allowing for a better understanding of how users shift their consumption under new conditions. The emergency health measures and new social dynamics shaped the residential sector’s energy behavior and its increase in electricity consumption. This article presents and analyzes the identified issues concerning residential electricity consumers and how their behaviors change based on the electricity consumption data during the COVID-19 period. The Dubai Electricity and Water Authority conducted a voluntary survey to define the profiles of its residential customers. A sample of 439 consumers participated in this survey and four years of smart meter records. The analysis focused on understanding behavioral changes in consumers during the COVID-19 period. At this time, the dwellings were occupied for longer than usual, increasing their domestic energy consumption and altering the daily peak hours for the comparable period before, during, and after the lockdown. This work addressed COVID-19 and the lockdown as an atypical case. The authors used a machine learning model and the consumption data for 2018 to predict the consumption for each year afterward, observing the COVID-19 years (2020 and 2021), and compared them with the so-called typical 2019 predictions. Four years of fifteen-minute resolution data and the detailed profiles of the customers led to a better understanding of the impacts of COVID-19 on residential energy use, irrespective of changes caused by seasonal variations. The findings include the reasons for the changes in consumption and the effects of the pandemic. There was a 12% increase in the annual consumption for the sample residents considered in 2020 (the COVID-19-affected year) as compared to 2019, and the total consumption remained similar with only a 0.2% decrease in 2021. The article also reports that machine learning models created in only one year, 2018, performed better by 10% in prediction compared with the deep learning models due to the limited training data available. The article implies the need for exploring approaches/features that could model the previously unseen COVID-19-like scenarios to improve the performance in case of such an event in the future.

Gets in the world at this time continued growth and rapid development in the whole aspects of life. The urgent needing accomplished that is in civil engineering demands like the construction of houses, schools, hospitals, roads, and other structures. Because of that and for economic and security reasons; classifying soil and knowing its bearing capacity appeared to be very necessary conditions that offer a large domain of benefits that could not be counted. This study focused on classifying and determining the bearing capacity of some samples of soil that classified as soft soils of Baquba city the center of Diyala governorate in Iraq. Then trying to increase their bearing capacity. The California Bearing Ratio (CBR) was used in the paper to define soil strength because it is considered a force measuring parameter. Five elected physical and chemical treatments were used in predetermined percents taken from the literature and suited the kind of soil. They were quicklime, class F fly ash activated by cement, rock powder, crushed waste concrete, and crumb rubber of tires. The treatment that was the best among the five used methods was by the rock powder that improved CBR value by 570% in soil samples A used. Conclusions From the foregoing, the following conclusions can be drawn: • There are soils with problems in some locations in the Diyala governorate that need geotechnical treatment before building projects on them. • All the five stabilizers used in the paper gave positive results, and the taken soils responded to them. • The ideal fixator in this study can be considered the rock powder, which was proven by the results of its treatment as if it was a cement stabilizer or an alternative substitute for it in stabilizing the soil. • The California Bearing Ratio (CBR) test can be considered a very successful experiment and is ideal for measuring the tolerance and resistivity of soils. • Soil was the most responsive to treatment with the five additives is soil A, and this may be attributed to the weakness of this soil represented by its high activity. Besides, although it is classified according to the USCS system as the remaining two soils B and C being three clay soils of low plasticity (CL), but we note of AASHTO's Sample A classification A-7-6(35), it is the weakest of the three soils. • Soils first in response to treatment are followed by soils B and then C as a possibility for AASHTO classification of them; A-6(18) for soil B and A-6(12) for soil C. • The success of using industrial stabilizers (lime and cement) and residues (fly ash, rock powder, waste concrete, and crumb rubber of tires) in stabilizing the soil is the success of having structural, economic, and environmentally friendly benefits.

A hybrid approach for obtaining normally off high electron mobility transistors (HEMTs) combining fluorine treatment, recess etch techniques, and AlGaN buffer was studied. The effects of process variations (recess etch depth and fluorine treatment duration) and epitaxial differences (AlGaN and carbon doped GaN buffers) on the DC characteristics of the normally off HEMTs were investigated. Two different epitaxial structures and three different process variations were compared. Epitaxial structures prepared with an AlGaN buffer showed a higher threshold voltage (Vth = +3.59 V) than those prepared with a GaN buffer (Vth = +1.85 V).

This study investigates asymmetry in the effect of the exchange rate on the Sudanese stock market prices. We applied the Nonlinear ARDL model by Shin et al. (2014) to monthly data for the period from September 2003 to September 2019, using inflation, money supply, and Murabaha profit margin as control variables. No study found that test the nonlinearity effect of the exchange rate on stock prices in Sudan. This study proposed to fill this gap by examining the impact of the exchange rate of Sudanese Pound nonlinearity on the stock prices in the Khartoum Stock Exchange. The results show that the exchange rate has asymmetric effects on stock prices in both the short run and long run. The policy implication of this paper is that modeling the exchange rate and stock prices symmetrically may affect negatively the effectiveness of economic planning. Thus, NARDL emerges as a more suitable model than the ARDL model for investigating such a relationship. Keywords: Exchange Rate, Stock Prices, Nonlinear Autoregressive Distributed Lag, Autoregressive Distributed Lag, Asymmetry, Symmetry JEL Classifications: E31, E44, G2 DOI: https://doi.org/10.32479/ijefi.9268

Objective: The objective of this study was to identify rabies virus in camels and other animals in Sudan. Materials and methods: Four camel samples were collected from Garraht Elzawia, Kab-kabia and North Darfur areas in Sudan. The samples were collected based on clinical signs. In addition, two camel samples were obtained from Khartoum and Tambool, one goat sample was collected from El-Fashir, and one cattle sample was obtained from Atbara. The samples were transported to the Veterinary Research Institute (VRI) at Khartoum, Sudan for further studies. The samples were subjected for nested and hemi nested RT-PCR (hnRT-PCR) along with the gold standard Fluorescent antibody test (FAT) to diagnose rabies. Results: Out of eight samples, seven were found to be positive by both FAT and RT-PCR methods. The remaining one sample was positive by FAT but negative by hnRT-PCR indicating the suitablity of hnRT-PCR along with FAT for accurate diagnosis of rabies in animals. Conclusion: The study concluded that FAT and RT-PCR are useful tools for research and diagnosis of rabies. [J Adv Vet Anim Res 2016; 3(3.000): 274-277]

BACKGROUND: Tocilizumab (TCZ) is a humanized anti-human IL-6R antibody, a novel therapy for rheumatoid arthritis (RA) patients who fail treatment with disease modifying anti-rheumatic drugs (DMARDs) or anti-tumor necrosis factor (anti-TNFs). OBJECTIVE: To assess the safety and efficacy of TCZ monotherapy or in combination with non-biologic DMARDs or anti-TNFs in moderate to severe active RA. DESIGN: Prospective, phase III, multi-center, open-label, single arm, 24-week trial. SETTING: Three centers in Saudi Arabia. PATIENTS AND METHODS: The study included consecutive RA patients infused with TCZ (8 mg/kg) over 60 minutes every 4 weeks (up to 6 times), either alone or with non-biologic DMARDs. Patients were followed for 24 weeks. Patients with good/moderate European League Against Rheumatism responses, continued on TCZ as long as commerically available or for 1 year. MAIN OUTCOME MEASURE(S): Disease activity measured by DAS28 score. RESULTS: Of 28 patients enrolled from 2 November 2011 to 12 May 2013 (18 months), 21 completed (77.8%) and 7 (25%) discontinued TCZ therapy. One patient was excluded from the intent-to-treat analysis. Efficacy analysis showed a significant difference (P

Cichorium intybus L., (chicory) is employed in various traditional medicines to treat a wide range of diseases and disorders. In the current investigation, two new naphthalane derivatives viz., cichorins D (1) and E (2), along with one new anthraquinone cichorin F (3), were isolated from Cichorium intybus. In addition, three previously reported compounds viz., β-sitosterol (4), β-sitosterol β-glucopyranoside (5), and stigmasterol (6) were also isolated from Cichorium intybus. Their structures were established via extensive spectroscopic data, including 1D (1H and 13C) and 2D NMR (COSY, HSQC and HMBC), and ESIMS. Cichorin E (2) has a weak cytotoxic effect on breast cancer cells (MDA-MB-468: IC50: 85.9 µM) and Ewing’s sarcoma cells (SK-N-MC: IC50: 71.1 µM); cichorin F (3) also illustrated weak cytotoxic effects on breast cancer cells (MDA-MB-468: IC50: 41.0 µM and MDA-MB-231: IC50: 45.6 µM), and SK-N-MC cells (IC50: 71.9 µM). Moreover compounds 1–3 did not show any promising anthelmintic effects.

Abstract Background In Low and Middle Income Countries, mental health services are often poorly developed due to the lack of resources and trained personnel. In order to overcome these challenges, new ways of care have been suggested such as a focus on community-based services. In Somalia, the consumption of the natural stimulant khat is highly prevalent, aggravating mental illness. At the same time, mental health care is largely unavailable to the vast majority of the population. In a pilot project, we tested possibilities for effective measures in community-based out-patient mental health care. Methods Thirty-five male patients with chronic psychotic disorders and their carers were involved in a 10-months follow-up study. All of them abused khat. Seventeen outpatients experiencing acute psychotic episodes were recruited from the community and received an intensive six week home-based treatment package. Additionally eighteen patients with chronic psychotic disorders in remission were recruited either following hospital discharge or from the community. In a second phase of the study, both groups received community-based relapse prevention that differed in the degree of the family’s responsibility for the treatment. The treatment package was comprised of psycho-education, low-dose neuroleptic treatment, monthly home visits and counseling. The Brief Psychiatric Rating Scale (BPRS) was applied three times. Additionally, we assessed functioning, khat use and other outcomes. Results Of the 35 patients enrolled in the study, 33 participated in the 10-month follow-up. Outpatients improved significantly in the first six weeks of treatment and did not differ from remitted patients at the start of the second treatment phase. In the preventive treatment phase, we find heterogeneous outcomes that diverge between symptom and functioning domains. With the exception of depressive symptoms, symptoms in all patients tended to worsen. The outpatient group had higher BPRS positive and negative symptom scores compared to the remitted group. Levels of functioning in 20 out of 33 patients significantly improved, with small differences between groups. Most patients experienced improvements in basic functioning, such as communication, self-care etc. Khat use could only be reduced in the group of outpatients. Conclusions Community-based out-patient mental health treatment for chronic psychotic disorders has demonstrated positive effects in Somalia and is both feasible and practical, despite facing formidable challenges, e.g. controlling khat intake.

There have been numerous evidences supporting the relationship between olive oil and cancer, with most of the attention being directed toward its fat and phenolic content. The aims of this study were to investigate whether EVOO and OA could enhance the effects of aromatase inhibitors (letrozole and anastrozole) in ER-positive MCF-7 cells, as well as to investigate its influence on cytochrome c release and GSH levels. It was observed that upon combination treatment, anti-proliferation effects and apoptosis induction were augmented. Apoptosis was triggered via the intrinsic pathway in accordance with cytochrome c release into the cytosol based on IF-IC and ELISA observations. Intracellular GSH levels were also reduced upon EVOO/OA treatment in combination with aromatase inhibitors, and were found to be inversely correlated to cytosolic cytochrome c levels. Additionally, the estrogenic suppressive effects of letrozole and anastrozole were amplified when used in combination with EVOO/OA. Therefore, the employment of aromatase inhibitors in combination with EVOO/OA could orchestrate a reduction in intracellular estrone biosynthesis which feeds ER-positive cells, while simultaneously depleting GSH levels and increasing ROS generation, thus releasing cytochrome c and subsequent induction of apoptosis in MCF-7 cells., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

A survey for schistosomiasis in a village in the Gezira area of the Sudan in 1973 showed that there has probably been a great increase in the incidence of S. mansoni infection in the last 25 years. Severe morbidity was uncommon in this sample but overt infection was associated with the symptoms of bloody diarrhoea, tiredness, and possibly abdominal pain, and with a reduced level of haemoglobin. Hepatosplenomegaly was common and schistosomiasis is considered to have contributed to this, although hyperendemic malaria must also have been important in its causation.

In a study of cutaneous leishmaniasis (CL) caused by Leishmania major in Saudi Arabia, 10% of the patients were found to have subcutaneous nodules (SCN). The SCNs were usually inconspicuous, painless, and proximal to the primary skin lesions; when multiple, they showed a "sporotrichoid" configuration or appeared as "beaded cords." Their number ranged from 1-16 (average 3 25 +/- 2.50; mean +/- 1 SD). In some patients, the SCNs seemed to be triggered by antileishmanial treatment. The clinical picture and pathologic findings suggest that SCNs in patients with CL represent lymphatic dissemination, a phenomenon not widely recognized.

The effect of metrifonate (Bilarcil Bayer) on Schistosoma haematobium and S. mansoni infections was studied in 174 patients near Khartoum. A high cure rate was obtained in S. haematobium infections, but anthelmintic efficacy was minimal in patients passing S. mansoni eggs in their stools. There was, however, a marked reduction of egg output in patients passing S. mansoni eggs in urine. This suggests that the site of infection in man, rather than the species of parasite, renders the parasite more susceptible to metrifonate. The significance of this and the possibility that these results further clarify the mode of action of metrifonate are discussed.

In a field study of cutaneous leishmaniasis (CL) due to Leishmania major, zymodeme Lon-4, in an endemic focus in Saudi Arabia, 80 patients in a group of 643 patients (12.44%) were found to have multiple, inflammatory, satellite papules (SP) around one or more CL lesions. The SP often appeared to erupt after commencement of antileishmanial treatment. They showed a range of morphology and pathology, and comparisons with corresponding CL lesions showed important differences. Amastigotes were seen in only one of seven biopsy specimens. Another morphologic feature, subcutaneous induration (SCI), was noted on routine palpation in 20 patients in the same patient group (3.11%). The SCI either was radiating all around the lesion and appeared as an "iceberg nodule" or was present as a "tonguelike" process proximal to the CL lesion. Amastigotes were seen in four of nine biopsy specimens of SCI. SP and SCI represent reactions to local dissemination of the parasite or its antigenic products, and as morphologic features aid in the clinical diagnosis of CL.

In a prospective clinical trial, patients with urinary schistosomiasis from the Sudan and from other African countries were treated with two or three doses of metrifonate (10 mg/kg), respectively, in two weeks' intervals. Patients seen in the Sudan (n = 37) were followed up for 3 months, those seen in Hamburg (n = 17) up to 20 months. Each dose of metrifonate led to a decrease of almost 90% in egg excretion independently of the pretreatment intensity of infection so that after three doses a reduction of almost 99.9% was achieved. The estimated proportion of parasitological cure after two doses of metrifonate was in the order of 24% in the lightly infected patients seen in Hamburg, and in the order of 8% in the heavily infected Sudanese patients. Almost 59% of the patients who received a complete metrifonate treatment of three doses stopped to excrete ova of S. haematobium. Drug failure was found in almost the same proportion in the two patient groups (17.5% and 16.2%, respectively) and could not be overcome by additional doses of metrifonate. The considerable reduction in egg excretion after a single dose of metrifonate might have a remarkable benefit in large scale programmes where the aim is drastic reduction of worm burden rather than complete cure.

The efficacy and acceptability of oral oxamniquine were assessed in Sudanese patients infected with Schistosoma mansoni. Cure rates, determined by the absence of viable eggs in the stools six months after treatment, were 94.9% in patients treated with a total of 60 mg/kg, 78.8% in patients treated with 40 mg/kg, and 68.9% in patients treated with 30 mg/kg. All treatment regimens considerably reduced the egg count in those patients not cured. The drug was well tolerated and the side effects were minimal and transient, the most common being dizziness. Most of the patients noticed a reddish discoloration of their urine, which was probably caused by a metabolite of the drug. In patients who received 60 mg/kg oxamniquine there were transient rises in eosinophil counts and in serum alanine aminotransferase concentrations. Though 60 mg/kg was by far the most effective dose in terms of cure rate, egg counts were significantly reduced on all three doses. The lower doses could therefore be useful in a low-cost control programme in reducing transmission of S mansoni infection.

Plasma zinc and copper concentrations were determined by atomic absorption spectroscopy in 57 patients with sickle cell anemia and in 45 control subjects from the Eastern Province of Saudi Arabia. Plasma zinc and copper levels in patients were found to be close to those of the control subjects. Similarly, there was a difference neither in urinary zinc level nor in the ratio Cu:Zn in patients and control subjects. This is in contrast to the situation which exists in North American Black subjects with sickle cell anemia, who are known to have zinc deficiency as well as a further decrease in zinc level during sickle cell crises. The near-normal levels of zinc and copper found in Saudi sickle cell patients therefore exclude zinc deficiency and confirm that this population exhibits a milder form of sickle cell anemia.