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Abstract Background We aimed to study the impact of biological therapies in Saudi Arabia on patients with severe asthma (SA) combined with chronic rhinosinusitis (CRS) in terms of clinical outcomes. Methods This is a retrospective observational cohort research that was undertaken at the severe asthma clinics of the Armed Forces Hospital of the Southern Region (AFHSR) and King Khalid University Hospital, Abha, from March to September 2022 to delineate the effects of 3 biological therapies (dupilumab, benralizumab, and omalizumab) in adults with SA and concomitant CRS. Clinical outcomes assessed included asthma exacerbation frequency, hospitalization rates, use of oral corticosteroids (OCs), and the asthma control test (ACT) scores before and 1 year after biological therapies. Results Eighty patients were enrolled, with a mean age of 46.68. There were 45 (56%) females and 35 (44%) males. There was a notifiable decrease in the frequency of exacerbations and hospitalization and in the number of patients who received OCs after 6 and 12 months of biological therapies compared to pre-biological therapies, respectively (p

Abstract Background This study’s purposes were to evaluate the impact of biological therapies on outcomes in patients with severe asthma (SA) and chronic rhinosinusitis (CRS) and to compare these effects among those with NP (CRSwNP) versus those without NP (CRSsNP) in the “real-world” setting in Saudi Arabian patients. Methods From March to September 2022, a retrospective observational cohort study was undertaken at the severe asthma clinics of the Armed Forces Hospital—Southern Region (AFHSR) and King Khalid University Hospital, Abha, Saudi Arabia, to delineate the effects of dupilumab therapy. Outcomes were assessed, including clinical outcomes, FEV1, and laboratory findings before and one year after dupilumab. Post-therapy effects were compared between CRSwNP and CRSsNP. Results Fifty subjects were enrolled, with a mean age of 46.56. There were 27 (54%) females and 23(46%) males. Significant improvements in clinical parameters (frequency of asthma exacerbations and hospitalizations, the use of OCs, anosmia, SNOTT-22, and the ACT), FEV1, and laboratory ones (serum IgE and eosinophilic count) were observed 6 and 12 months after using dupilumab (p

A lithium metal anode has a high energy density, but its applications face numerous challenges, particularly the irregular deposition of lithium dendrites, which form due to the aggregation of lithium clusters, posing serious safety risks. Research has revealed that small lithium clusters have the potential to enhance the electrode potential in Lithium-ion batteries (LIBs), and cluster energy affects the stability of lithium clusters. Modern computational tools and DFT calculations of lithium clusters can provide invaluable insights into their chemical, physical, and structural properties. However, calculating structural properties through large-scale experiments can be time-consuming and expensive. To overcome the challenges inherent in studying lithium clusters, this study employs a novel approach. We construct molecular graphs for the most stable structures and leverage CoM Polynomial computations to generate codescriptors, enabling efficient and accurate predictions of cluster energy for diverse lithium cluster configurations. The curvilinear regression analysis filters out highly significant regression equations and highly predictive codescriptors. Additionally, we investigated two molecular structures of porous graphene, namely linear and triangular, and obtained topological codescriptors’ analytical expressions by utilizing the CoM Polynomial in each case. A deeper understanding of both lithium clusters and porous graphene properties is essential for optimizing LIBs’ performance and stability.

Ethylene Glycol (EG) and diethylene Glycol (DEG) are two contaminants known to cause various human health problems. These glycols might be present in drug syrups that are based on glycerol, sorbitol, or polyethylene glycol. In late 2022, several batches of cough, antipyretics, and antihistamine syrups were reported to contain toxic levels of EG and DEG in multiple countries; this incident concerned the World Health Organization (WHO). From an analytical perspective, several methods of glycols analysis in pharmaceuticals have been reported in the literature, with the majority being dedicated to raw material analysis. This study aims to develop a selective method capable of evaluating a wide range of paediatric syrups in order to assess the safety of commercially available paediatric syrups currently distributed in the local market. This research introduces a method for determining glycols utilizing gas chromatography-tandem mass spectrometry (GC–MS/MS), which offers significantly higher selectivity than conventional single quadrupole gas chromatography-mass spectrometry (GC–MS). The developed method meets the current International Council for Harmonisation (ICH) guidelines for validation. The absence of any interfering peaks in both the unspiked sample of promethazine syrup and the reference standard solutions proved the method's selectivity. Furthermore, 2,2,2-trichloroethanol was used as an internal standard, and a new GC–MS/MS method was developed to analyze it. The calibration curves for EG and DEG were linear within the selected concentration range of 1–10 μg/mL. The detection limit for both EG and DEG was 400 ng/mL, while the quantification limit was 1 μg/mL. Recovery values for both EG and DEG met the accuracy acceptance criterion. Thus, the developed method proved to be efficient and accurate for determining EG and DEG levels in suspected contaminated syrups.

Abstract In this study, a method for degrading PET-waste plastic bottles using ZnCl2:Urea as a catalyst was developed, resulting in high conversion (87%). The terephthalic acid obtained from the degradation of Waste PET Bottles (WPTs) was combined with copper and zinc salts to synthesize bimetallic metal–organic frameworks (MOF). The effectiveness of a bimetallic Cu-Zn(BDC)-MOF in catalyzing the reduction reaction of organic pollutant dyes (OPDs) was investigated, and the degradation efficiency of individual dyes was optimized, achieving over 95% degradation within 6–12 min under optimal conditions. Various techniques, including FT-IR, XRD, FE-SEM, EDS, and TEM were used to characterize the synthesized MOF. Results showed that the catalytic activity of Cu-Zn-MOF in reduction reaction of OPDs was enhanced by increasing the copper content. The reaction kinetics were investigated following pseudo-first-order kinetics with rate constants of 0.581, 0.43, 0.37, and 0.30 min−1 for Methylene Blue (MB), Methyl Orange (MO), 4-Nitrophenol (4-NP), and 4-Nitroaniline (4-NA), respectively. The investigations revealed that the produced catalyst exhibited excellent stability and recoverability, while its activity remained well-preserved even after undergoing three reuse cycles.

Peripheral nerve sheath tumors (PNSTs), while uncommon, can have a significant impact on appearance and quality of life, especially when they form in prominent areas such as the nose dorsum. We discuss a case of a 29-year-old woman who developed a benign PNST on the right side of her nasal ala. This tumor gradually grew, impairing her face appearance. Diagnostic tests, such as computed tomography (CT) and magnetic resonance imaging (MRI), revealed the tumor as a slowly growing, well-defined mass. The tumor was removed via open rhinoplasty under general anesthesia, and pathological investigation verified its benign nature. After surgery, the patient’s quality of life improved significantly, and there were no evidence of tumor recurrence after eight months. This case emphasizes the need of including PNST in the differential diagnosis of nasal tumors.

Noah Becher,1 Arun Swaminath,2 Keith Sultan3 1Department of Medicine, Hofstra/Northwell Health at Staten Island University Hospital, Staten Island, NY, USA; 2Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA; 3Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USACorrespondence: Keith Sultan, Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 600 Northern Blvd Suite 111, Great Neck, New York, NY, 11021, USA, Tel +1 516-387-3990, Fax +1 516-387-3930, Email ksultan@northwell.eduAbstract: Inflammatory bowel disease (IBD), namely Ulcerative Colitis (UC) and Crohn’s Disease (CD), is believed to be due to a dysregulation of the innate immune response. The complexity of the immune cascade offers both a challenge and an opportunity to researchers seeking out new treatments for IBD, as various points along the inflammatory pathways can be targeted for interruption. Sphinogosine-1-phosphate (S1P) is a phospholipid molecule with wide ranging biological effects caused by binding five known S1P receptor subtypes. Ozanimod is a small molecule drug that selectively targets S1P receptors 1 and 5 which play a crucial role in lymphocyte trafficking. In clinical trials for both UC and CD, it has been shown to induce a reversible lymphopenia which correlates with response to therapy. Reported adverse events include infection, anemia, and elevated liver enzymes. Rare instances of bradycardia, heart block, and macular edema were also reported. As a newly available therapy approved for UC patients, we aim to summarize ozanimod’s novel mechanism of action, pre-clinical and clinical trial results, and to give context to this newly available drug that gastroenterologists may utilize in their treatment algorithm.Keywords: S1P modulator, ozanimod, inflammatory bowel disease, ulcerative colitis, IBD

Abstract Systemic lupus erythematosus (SLE) is an autoimmune disease that may be associated with other autoimmune disorders. To date, limited data are available on thyroid dysfunction and SLE in Saudi Arabia. In this retrospective study, we reviewed the cases of 151 patients with SLE. The prevalence of thyroid dysfunction was 17.2%: 4% in the hyperthyroid group and 11.9% in the hypothyroid group. Euthyroid sick syndrome was found in 1.3% of patients. Moreover, 57% of patients with hypothyroidism were positive for antibodies to thyroglobulin and thyroid peroxidase. No correlation was found between the presence of thyroid dysfunction and higher SLE disease activity, according to the Safety of Estrogens in Lupus National Assessment–Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) score.

Summary:. Acupuncture, one of the most ancient forms of Chinese medicine, is widely used to treat many chronic ailments, but the extant literature reveals uncertainty regarding its efficacy and adverse complications. A specific adverse complication reported multiple times is the finding of broken needles incidentally or after symptomatic presentation. We report a case of an incidental finding of an acupuncture needle after a carpal tunnel release.

Background Supracondylar fractures of the humerus (SCFHs) are the most common type of elbow fracture in children. Because of the influence on functional outcome, neuropraxia is one of the most common concerns at presentation. The impact of preoperative neuropraxia on surgery duration is not extensively probed. The clinical implications of several other risk factors associated with preoperative neuropraxia at presentation may contribute to longer surgical duration of SCFH. Hypothesis Preoperative neuropraxia is likely to increase surgery duration in patients who sustained SCFH. Patients and Methods This is a retrospective cohort analysis. Sixty-six patients who sustained surgical pediatric supracondylar humerus fracture were included in the study. Baseline characteristics including age, gender, the type of fracture according to Gartland classification, mechanism of injury, patient weight, side of injury, and associated nerve injury were included in the study. Logistic regression analysis was performed using mean surgery duration as the main dependent variable and age, gender, fracture type according to the mechanism of injury, Gartland classification, injured arm, vascular status, time from presentation to surgery, weight, type of surgery, medial K-wire use, and afterhours surgery as the independent variables. A follow-up of 1 year was implemented. Result The overall preoperative neuropraxia rate was 9.1%. The mean surgery duration was 57.6 ± 5.6 minutes. The mean duration of closed reduction and percutaneous pinning surgeries was 48.5 ± 5.3 minutes, whereas the mean duration of open reduction and internal fixation (ORIF) surgeries was 129.3 ± 15.1 minutes. Preoperative neuropraxia was associated with an overall increase in the surgery duration (p

Hypoglycemia is a common complication in patients with chronic kidney disease (CKD), more so if they have diabetes as well. The occurrence of hypoglycemia in CKD is associated with considerable morbidity and mortality, both of which are treatable and preventable. This review summarizes the incidence and risk factors associated with hypoglycemia among patients with CKD. The meta-analysis was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. A search was done on PubMed, EMBASE, SCOPUS, Cochrane Library, Google Scholar, and Cumulative Index to Nursing and Allied Health Literature for cohort studies in English published between January 2000 and August 2019 using search terms related to hypoglycemia (low blood sugar), chronic kidney disease (chronic renal failure OR renal failure), and incidence (risk OR epidemiology OR risk factors). Summary measures were calculated using random-effects model. A total of 5 studies involving 311,817 persons were included in the meta-analysis. The pooled incidence of hypoglycemia in patients with CKD was 0.188 (confidence interval [CI] = 0.097–0.287). The incidence of hypoglycemia was significantly higher in patients with CKD than in patients without CKD (Relative risk [RR] = 1.89, 95% CI = 1.86–1.92,P < 0.0001). No heterogeneity was reported between the studies (I2 = 0%, P > 0.05), and publication bias was also found. Females, patients who had diabetes mellitus of long duration, and those on antidiabetic drugs such as insulin and sulfonylureas were at risk of developing hypoglycemia in CKD as per narrative review. The incidence of hypoglycemia in patients with CKD is high. Therefore, there is need to closely monitor affected individuals so that appropriate management protocols could be set up. Further probing of various risk factors for hypoglycemia in CKD patients is necessary for early detection and initiation of timely preventive and curative measures.

Summary:. Lips play an important role in the function of the oral stoma. Lips also have a vital aesthetic role in the face. Lips are typically reconstructed by local, regional, or free flaps. Tongue flaps have been used for reconstruction of oral and palate defects resulting from congenital disorders, trauma, infection, and surgery. Because of its versatility, rich blood supply, and position, the tongue flap is reliable for defect reconstruction. In this study, we report a case of an upper lip full thickness defect managed with a tongue flap. The results were functionally and aesthetically excellent. To the best of our knowledge, this is the first attempt to reconstruct a full upper lip defect using the tongue.

Objective: To investigate the prevalence and risk factors of brucellosis in human and animal’s communities in southern Saudi Arabia. Methods: A cross-sectional sero-epidemiological study was conducted in Aseer and Jazan, Saudi Arabia (October 2017-October 2018). Human serum samples (n=339) were initially screened for Brucella antibodies and positive samples were further titrated for Brucella antibodies by immunocapture assay (titer of ⩾1:320 as positive). Animal samples (n=828) were screened using the Rose Bengal test. Relationship status was dichotomized to measure and predict independent contributions to variations in human using univariate and multivariate stepwise binary logistic regression model. Results: The rate of brucellosis among the 339 human samples in the two regions was 33.9%, and the rate of acute brucellosis was 12.4%. The rate of brucellosis in animals was 4.7%. Human brucellosis among the target groups was higher in northwestern Aseer (53.3%) compared to Southeastern Aseer (25.9%) and Jazan region (20.6%). The disease was more prevalent among non-Saudi nationals (35.2%) compared to Saudis (30.5%). The rate of brucellosis among butchers and shepherds was 37.5% and 37.2%, respectively. The rate of brucellosis was 37.8% in people over 30 years of age. Our univariate analysis showed that residing in Aseer region (OR: 2.60, 95% CI: 1.50-4.40), especially residing in northwestern Aseer region (OR: 4.40, 95% CI: 2.40-7.90), frequent consumption of raw meat (OR: 2.90, 95% CI: 1.50-5.50), shepherds (OR: 2.10, 95% CI: 0.80-5.30), owning sheep (OR: 2.20, 95% CI: 1.10-4.40), daily contact with animals (OR: 2.10, 95% CI: 0.75-5.80), and those > 30-year-old (OR: 1.50, 95% CI: 1.00-2.40) were significantly associated with increased risks of brucellosis. Our multivariate analysis further showed that residing in northwestern Aseer (OR: 9.16, 95% CI: 3.39-24.76) and having sheep (OR: 1.16, 95% CI: 1.00-1.35) were significant and independent risks of brucellosis while residing in agricultural region (OR: 0.28, 95% CI: 0.10-0.78) was a significant and independent protector against brucellosis. Conclusions: The study concluded that residing in northwestern Aseer area and having animals (sheep) are associated with significantly increased risks of brucellosis.

Zinc oxide is a promising multifunctional material. The practical use of nano- and polycrystalline ZnO devices faces a serious problem of instability of electrical and luminescent characteristics, due to the adsorption of oxygen by the surface during aging. In this paper, the aging effect in ZnO films and nanorod arrays was studied. It was found that ZnO samples demonstrate different behavior of the degradation process, which corresponds to at least two different types of adsorbing surface sites for O2, where O2 adsorption is of a different nature. The first type of surface sites is rapidly depassivated after hydrogen passivation and the aging effect takes place due to these centers. The second type of surface sites has a stable structure after hydrogen passivation and corresponds to HO–ZnO sites. The XPS components of these sites include the Zn2p3/2 peak at 1022.2 ± 0.2 eV and Zn2p1/2 peak at 1045.2 ± 0.2 eV, with a part of the XPS O1s peak at 531.5 ± 0.3 eV. The annealing transforms the first type of site into the second one, and the subsequent short-term plasma treatment in hydrogen results in steady passivation, where the degradation of characteristics is practically reduced to zero.

Peripheral nerve sheath tumors (PNSTs), while uncommon, can have a significant impact on appearance and quality of life, especially when they form in prominent areas such as the nose dorsum. We discuss a case of a 29‐year‐old woman who developed a benign PNST on the right side of her nasal ala. This tumor gradually grew, impairing her face appearance. Diagnostic tests, such as computed tomography (CT) and magnetic resonance imaging (MRI), revealed the tumor as a slowly growing, well‐defined mass. The tumor was removed via open rhinoplasty under general anesthesia, and pathological investigation verified its benign nature. After surgery, the patient's quality of life improved significantly, and there were no evidence of tumor recurrence after eight months. This case emphasizes the need of including PNST in the differential diagnosis of nasal tumors. [ABSTRACT FROM AUTHOR]

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