Search

IntroductionPilonidal sinus (PNS) is a small hole or “tunnel” in the skin that frequently occurs in the sacrococcygeal region. Nevertheless, PNS has been reported to occur between the fingers (interdigital) in barbers, hairdressers, and animal groomers. The aim of this study was to estimate the prevalence of interdigital PNS among animal handlers in Bahrain and to treat any patients encountered.MethodsThis is a cross-sectional study with convenience sampling from November 2020 to October 2021. The study participants were animal handlers from stables, veterinary, and pet shops in Bahrain. There were 43 males and 7 females with direct animal contact. 86% of the study population were handling horses, and 15% were handling different types of animals.ResultsNo positive cases of interdigital PNS among participants were found, this might reflect the positive impact of good personal hygiene among our study population. Our study shows that groomers in Bahrain frequently wash their hands after handling animals, and 98% have a daily habit of bathing after work. It was also estimated that 60% of the participants use gloves to handle animals themselves or their waste.DiscussionThis could be the first study looking at the prevalence of interdigital PNS in animal groomers worldwide. The absence of any case report of interdigital PNS among animal groomers in the recent literature strengthens our assumption that the association between interdigital PNS and hair grooming could be a narrative coincidence rather than a true occupational hazard. The present work may help in better understanding of occupation-disease association, and highlights the importance of mass screening of animal handlers for occupation-dependent health problems.

Granular volcanic ash (GVA) is a volcanic activity material with low density, high porosity, and other undesirable properties that must be improved prior to use in any construction. This material can be considered an alternative for use in road building, given its availability in many locations and in large quantities in Yemen. This article aims to investigate the potential use of GVA for the construction of roads in Yemen when treated with cement stabilizer. Two types of GVA materials with different colors were selected and referred to as red and black GVA materials. Tests performed included the unconfined compressive strength (UCS), compaction, indirect tensile strength (ITS), wetting–drying durability test, and ultrasonic pulse velocity (UPV) test for samples curried for 7 and 28 days. For each GVA–cement mixture, the cement content varied as 2%, 5%, and 8% by dry weight of GVA. Test results revealed that the compaction energy applied during sample preparation led to a significant reduction in the finesse modulus for red and black coarse GVA materials, with reductions of 10% and 23%, respectively. In addition, the cement content and curing period had a significant effect on UCS, ITS, and UPV for cement-treated GVA. The applicable quantity of cement required stabilizing GVA and achieving the base course specification for strength and durability criteria in flexible pavement with low traffic is 8% cement.

ImportanceRecent epidemiologic and therapeutic advances have transformed understanding of the role of and therapeutic approach to patent foramen ovale (PFO) in ischemic stroke. Patent foramen ovale is likely responsible for approximately 5% of all ischemic strokes and 10% of those occurring in young and middle-aged adults.ObservationsRandomized clinical trials have demonstrated that, to prevent recurrent ischemic stroke in patients with PFO and an otherwise-cryptogenic index ischemic stroke, PFO closure is superior to antiplatelet medical therapy alone; these trials have provided some evidence that, among medical therapy options, anticoagulants may be more effective than antiplatelet agents.Conclusions and relevanceThese new data indicate a need to update classification schemes of causative mechanisms in stroke, developed in an era in which an association between PFO and stroke was viewed as uncertain. We propose a revised general nomenclature and classification framework for PFO-associated stroke and detailed revisions for the 3 major stroke subtyping algorithms in wide use.

Until recently, evidence to support Patent Foramen Ovale (PFO) closure for secondary prevention of recurrent stroke has been controversial. Publication of high-quality evidence from randomized clinical trials and the subsequent FDA approval of two devices for percutaneous PFO closure is expected to increase the volume of PFO closure procedures not only in the United States but worldwide. As this technology is disseminated broadly to the public, ensuring the safe and efficacious performance of PFO closure is essential to mitigate risk and avoid unnecessary procedures. This document, prepared by a multi-disciplinary writing group convened by the Society for Cardiovascular Angiography and Interventions and including representatives from the American Academy of Neurology, makes recommendations for institutional infrastructure and individual skills necessary to initiate and maintain an active PFO/stroke program, with emphasis on shared decision making and patient-centered care.

Background: Opioids are potent analgesics used for the treatment of moderate to severe acute and chronic cancer and non-cancer pain. However, opioid usage may be limited by negative side effects, such as potentially life-threatening respiratory depression. Objectives: The aim of our study is to investigate the prevalence of opioid-induced respiratory depression (OIRD) and its predictors at King Abdulaziz Medical City in Jeddah (KAMC-JD). Method: This is a retrospective cross-sectional (chart review) study conducted from January 1, 2016, to December 31, 2020. Results: A total of 15,753 patients received opioids during admission to KAMC-JD, and only 144 (0.915%) of them received naloxone from January 1, 2016 to December 31, 2020. Only 91 patients (0.57%) developed opioid-induced respiratory depression (OIRD), which was more frequently reported among young and middle-aged adults. OIRD was significantly associated with receiving a daily morphine milligram equivalent (MME) dose of ≥150 MME and with having a low urea concentration at the baseline and at admission under surgery. Also, fentanyl use remained a significant risk factor for OIRD. Conclusion: In conclusion, monitoring patient receiving opioids with a daily MME dose of ≥150 MME, prescribed Fentanyl, low urea concentration at the baseline, and patients’ admissions to the surgery department may mitigate the risk of developing OIRD.

Dysfunctional right ventricular outflow tracts after a repair for tetralogy of Fallot using a transannular patch offer limited nonsurgical opportunities due to their large dimensions. A discrete subannular narrowing between a dilated right ventricle and the enlarged pulmonary trunk was a potential anatomical target for the creation of a landing zone using a prestent in a young male with severe pulmonary regurgitation and moderate stenosis. Asymmetric expansion of the prestent in the angulated outflow tract led to distal stent embolization that was stabilized by another telescoping stent before successful valve implantation. This manuscript details the unique challenges posed by a dilated regurgitant outflow tract for implanting a pulmonary valve.

Herein this study, pure and manganese- (Mn-) doped ZnO (2 wt. %) nanoparticles have been synthesized using the chemical precipitation method and characterized for the photodegradation of methyl green (MG) pollutant dye under natural sunlight. The structural analysis via XRD patterns has revealed that both intrinsic and Mn-doped ZnO (2 wt. %) samples have hexagonal wurtzite structures with appropriate phase purity, clearly indicating the absence of any external impurity. The incorporation of Mn in the host ZnO lattice has decreased the crystallite size (21.10 → 18.76 nm), and nanoparticle-type surface features with sizes in the 50–100 nm range have been observed through FESEM-based surface morphological studies. Both aforementioned observations have merit in providing more active area and a high surface area to volume ratio for photocatalytic reaction. The investigation of photophysical properties indicates that in Mn-doped ZnO nanoparticles, the absorption peak is blue-shifted by 5 nm (365 → 360 nm), due to the widening of the bandgap. The degradation kinetics of MG dye follow the pseudo-second-order kinetics, and the degradation efficiency has been observed to be 62.78% mediated by pure ZnO and 66.44% by Mn-doped ZnO (2 wt. %) photocatalyst under 60 minutes of sunlight irradiation. Specifically, the rate of photocatalytic reaction (K) ~0.01792 min-1 and R2~0.97992 has been achieved for pure ZnO, whereas slightly higher (K) ~0.02072 min-1 and R2~0.97299 have been observed for Mn-doped ZnO, respectively. Conclusively, the synergistic interactions with multiple charge transfer pathways, improvement of e−/h+ pair charge separation, improved surface area, and efficient generation of hydroxyl radicals are supposed to be responsible for the highly efficient photocatalytic activity of the Mn–doped ZnO photocatalyst for MG dye.