Could antiseptic gargling prevent COVID-19?

@#Coronavirus Disease 2019 (COVID-19) has infected more than 8 million people globally since its discovery in December 2019. For COVID-19 prevention, the World Health Organization recommended regular handwashing with soap, cough etiquette, mask wearing and social distancing. However, COVID-19 is rather difficult to contain because of its high transmissibility property. Gargling is effective for reducing infection in the respiratory tract. Most antiseptic gargles have antimicrobial properties against common respiratory pathogens. No published study on the effectiveness of antiseptic gargling among COVID-19 patients has been available to date. This article reviewed available literature on methods and solutions available for gargling and their effect on respiratory tract infections.

The effects of diet and temperature on enzymes, hormones, and fecundity of the African Catfish Clarias gariepinus (Burchell 1822)

The aim of this study was to check the effect of multiple temperatures and various protein diet formulas on liverenzymes, gonadotropins, and growth hormone (GH) using African catfish Clarias gariepinus. C. gariepinus wasexposed to multiple temperatures (T24°C, T28°C, and T32°C) and various protein diet formulas: D1 (fishmeal-baseddiet), D2 (soymeal-based diet), and D3 (pea-meal based diet). Tilapia commercial feed (D4) was used as reference diet.A total of 720 individuals with an average weight (101–104 g) were stocked at a density of 20 individual fish per tankin 12 tanks of three replicates. Liver enzymes, gonadotropins, GH, and fish fecundity were measured after 16 weeks.The results revealed that liver enzyme like glutamate-oxaloacetate transaminase was significantly (P < 0.05)lowered at T28°C: D2 diet, while glutamic pyruvic acid transaminase was lowered by T28°C: D4 diet. However,no effect was observed on creatinine (P > 0.05) at any experimental condition. Follicle-stimulating hormone andluteinizing hormone were significantly (P < 0.05) increased at T28°C: D1 diet and T32°C: D1 diet, respectively. GH wassignificantly (P < 0.05) increased by T28°C: D1. The relative weight of the ovary of C. gariepinus was significantly (P< 0.05) increase at T32°C: D1, while the testis relative weight was increased with T24°C: D3. The result from this studyrevealed that there is a direct relationship of temperature on fish fecundity, enzymes, and reproductive hormonesin C. gariepinus. The temperature of 28°C along with fishmeal or soy-meal positively improved the fecundity andhealth of fish.

nutritional, glutathione and oxidant status of elderly subjects admitted to a university hospital

Malnutrition in elderly patients is common in hospitals, and many of the age associated chronic diseases have a common factor, which is oxidative stress. The aim of the study was to evaluate the nutritional status, glutathione, and oxidant status of elderly patients. The mini-nutritional assessment [MNA] was used to determine the nutritional status of elderly patients. Glutathione concentration in the whole blood, plasma albumin, and thiobarbituric acid-reactive substances [TEARS] levels was measured spectrophotometrically by the enzymatic recycling method. In addition, length of hospital stay was estimated. All measurements were taken within 48 h after admission. The results showed that more than two-thirds of the elderly were classified as at risk of malnutrition and malnourished. About 45% and 53% elevation in the TEARS was found in at risk of being malnourished and in the malnourished groups, respectively, compared to the well-nourished group, but the elevation did not reach the significant level. No significant differences in the glutathione concentration and in the length of hospital stay were found among the three mini-nutritional assessment categories. The study indicated the necessity of performing the MNA test for elderly upon admission to hospitals, and more attention needs to be paid to this vulnerable group of people

Minimally invasive parathyroidectomy: initial experience with short incision approach at a university hospital

In the great majority of patients diagnosed with primary hyperparathyroidism, the primary pathology is a benign solitary adenoma. Until recently, bilateral neck exploration has been the routine surgical procedure done worldwide to deal with such patients. However, due to the great advancement in localization techniques, this routine approach has been challenged by less invasive procedures. A retrospective study which was done by reviewing the medical records of all patients who were diagnosed to have primary hyperparathyroidism and selected to undergo minimally invasive parathyroidectomy [MIP] at King Khalid University Hospital, King Saud University between June 2003 and December2008. There were 40 such patients that had MIP done for them. The surgically removed glands were sent for frozen section in all cases. The sample included 6 males and 34 females with a mean age of 49.32 +/- 13.52. Preoperative laboratory evaluation confirmed hypercalcaemia [2.86 +/- 0.06 mmol/L] and elevated serum parathyroid hormone [66.23+8.00 pg/mL]. The mean operative time was 52.30 +/- 11.45 minutes [range 40-75 minutes]. Postoperatively, both serum calcium and parathyroid hormone levels returned to normal range [calcium 2.20+0.02 mmol/L and parathyroid hormone 3.32 +/- 0.21 pg/mL]. These normal postoperative values for calcium and parathyroid hormone remained so during the follow-up period which is 18 postoperative months for every patient. Minimally invasive parathyroidectomy [MIP] is a suitable alternative for appropriately selected patients diagnosed to have primary hyperparathyroidism due to a single adenoma

Pneumomediastinum, pneumothorax, and subcutaneous emphysema due to duodenal ulcer

The presence of pneumothorax, pneumomediastinum, or cervical subcutaneous emphysema due to perforated duodenal ulcer is a rare presentation. We report a 23-year man who showed bilateral cervical subcutaneous emphysema, pneumomediastinum, and pneumothorax with no respiratory abnormality. He was found to have active duodenal ulcers, but no detectable pneumoperitoneum or duodenal leal. A sealed perforation from the duodenal ulcers was suspected, and he fully improved after conservative management

Gender differences in the surgical management and early clinical outcome of coronary artery disease: Single centre experience

To investigate the gender disparity in the distribution of patient-related risk factors and their effect on the surgical management and clinical outcome of coronary artery disease in Saudi population. We carried out a retrospective analysis of prospectively collected data of 971 patients undergoing isolated coronary artery bypass grafting [CABG] at our institution between January 2005 and December 2008. Seven hundred and eighty seven patients [81%] were males and 184 patients [19%] were females. We analyzed gender-based difference in clinical presentation and patient-related pre-operative risk factors and studied their impact on surgical management and clinical outcome. The mean age was 59.5 years in males and 63.4 years in females [p = < 0.0001]. Associated co-morbidities were higher in females. Prevalence of diabetes mellitus was 61.2% in males and 78.8% in females [p-value < 0.0001]; hypertension 61.9% in males and 79.9% in females [p-value < 0.0001]; hyperlipidemia 66.7% in males and 77.7% in females [p-value 0.0035]; morbid obesity 24.7% in males and 45.1% in females [p-value < 0.0001]; and Hypothyroidism 2.5% in males and 13.6% in females [p-value < 0.0001]. Smoking was the only risk factor with higher prevalence in males compared to females [44.2% v/s 2.2%; p-value < 0.0001]. The mean logistic euro-SCORE was 3.94 in males and 5.51 in females [p < 0.0003]. On-pump and off-pump CABG was carried out in equal numbers in two groups. Females required urgent surgery and less than 3 grafts more frequently while males underwent elective surgery and more than 3 grafts in greater numbers. No significant difference was present between the two gender groups in aortic occlusion times and bypass times. Univariant analysis revealed females gender as an independent risk factor for higher in-hospital mortality [1.1% versus 4.9% p = 0.0026] and higher incidence of post-operative complications like surgical wound infection, need for prolonged ventilation, low cardiac output state and multi-organ failure [p-values 0.01 or less]. Female gender is an independent predictor of adverse outcome after isolated CABG due to significantly higher co-morbidities and acute presentation and independent of their peri-operative management. Therefore, major socioeconomic education and preventive measures are needed to reduce the burden of major co-morbidities in females and to seek early cardiac advice and care

Rockall score of the acute upper gastrointestinal bleeding patients the experience in Sudan

Innovation of scoring systems helps to rectify personal experience based on subjective evaluation of outcome of patient treatment. To predict the morbidity and mortality in patients presenting with acute upper gastrointestinal bleeding at Ibn-Sina Hospital using the Rockall score. Prospective hospital-based study conducted from June 2007 through December 2007 at the Ibn-Sina Hospital Bleeding Centre. Demographic, data of history and physical examination and results of laboratory investigations of 238 patients were collected and allotted a Rockall score, Child-Pugh class and fed to Statistical Package of Social Sciences [SPSS] to calculate means and find the levels of statistical differences and define the predicted and observed mortality rates. The mean [ +/- SD] age 44.6 [ +/- 15.31] range [8-85] years. There were 190 [79%] males. Patients with oesophageal varices, peptic ulcer, and upper GI tumours were 215 [90.3%], 18 [7.6%], and 5 [2.1%], respectively. The mean/predicted mortality was 3.8% while the actual observed mortality 3.8%. The mortality in cases of oesophageal varices was 8[3.4%], while that of bleeding peptic ulcers was one [0.4%]. Rockall score is feasible, accurate, effective system for predicting outcome in patients with upper GI bleeding. The risk factor for mortality are Rockall score>3, age>70 and rebleeding

Expression patterns of p1 alleles in maize zea mays L. tissues

Repeated tandemly endogenous genes are common in plants, but their regulatory transcription is not well described. The p1-wr allele of pericarp colon in maize is composed of multiple copies arranged in an opposite fashion. P1-wr is responsible for white kernel pericarp and red cob glume pigment phenotype which shows stability over generations. This paper aims to describe a spontaneous epiallele of p1-wr designated probably as p1-wr, that specifies a white pericarp and white cob glume phenotype. To understand the mechanisms which regulate tissue-specific expression of P1-wr, p1-wr may be characterized as a spontaneous loss of function epimutation that shows a white kernel pericarp and white cob glume phenotype. P1-wr shows a range of cob glume pigmentation, whereas penicarps remain colorless, with the prescence of the epigenetic modifier Ufo1 [Unstabe factor for orange]]. P1-wr Ufol plants did not show any change in a distal enhancer region that has previously been implicated in Ufol-induced gain of pericarp pigmentation of the P1-wr allele. These results reveal that distinct regulatory sequences in the p1-wr promoter can show independent epigenetic modification to generate tissue-specific expression patterns

Bone mass measurement using quantitative ultrasound in healthy Saudi women. A cross-sectional screening

To study the prevalence of osteopenia and osteoporosis in healthy Saudi women, a community-based screening was carried out. Three thousand and two hundred sixty-nine women in the young women in peak bone mass [PBM] age group and 3131 in the postmenopausal age [PMA] group were screened using Achilles Insight [GE, USA]. Subjects included in the study were healthy and residents of eastern province. The screening was conducted between January 2006 and December 2007. The study took place in King Fahd University Hospital, Al-Khobar, Kingdom of Saudi Arabia. In the PBM age group, 2090 [63.9%] were normal, 791 [24.2%] were osteopenic and 388 [11.9%] were osteoporotic. Osteopenia was more common in single urban women compared to those who were married and living in rural areas [p<0.01 and p<0.001]. Women with college education had significantly normal bone mass than women with less than high school education [p<0.01]. In the PMA, 948 [30.3%] were osteopenic and 720 [23%] were osteoporotic. Osteopenic was more common in women in urban areas as compared to industrial and the rural areas [p<0.01]. Those women whose education was less than primary had significantly more osteoporosis when compared to women with college education [p<0.001]. In the PBM, 11.9% were osteoporotic and in PMA group 23% were osteoporotic. Factors that influenced the risk for osteopenia and osteoporosis included level of education, number of children, and place of living

Assessment of the accuracy of death certification at two referral hospitals

Death certification is a vital source of information used in mortality statistics worldwide to assess the health of the general population. This study focuses on the consistency of information between the death reports and the clinical records [files] of deceased patients in two hospitals: the King Khalid University Hospital [KKUH] and King Fahad National Guard hospital [KFNGH] in Saudi Arabia. A random sample of the records of 157 deceased patients' registered in 2002 in the two hospitals was retrospectively reviewed independently to determine the underlying cause of death and compare them with death reports. It was also to check the accuracy of the translation from English in to Arabic. It was found that the underlying cause of death was misdiagnosed in 80.3% of the death reports. When the two hospitals were compared, no significant difference was observed [p>0.05]. In addition, 81.8% of the accurate [correct] death reports in both hospitals were of patients who had died of a malignant disease. However, the translation of the underlying cause of death in KFNGH was correct in 86.1% of the death reports, while in KKUH it was only 25%, which is highly statistically significant [p<0.0001]. With the limitation of studying only a small number of cases, these results indicate a discrepancy between the file and death reports in relation to the cause of death. Also, the translation of the cause of death was inconsistent in the two hospitals. Hence, there is a real need to adopt suitable measures to improve the quality of death certification

Evaluation of three instructional methods of teaching for undergraduate medical students, at King Saud university, Saudi Arabia

There is an international move from traditional curriculum towards the learner - centered, and patient-oriented curriculum. In spite of its advantages, problem-based learning requires a larger number of teaching staff and space. This study was done to compare the problem-based learning [PBL], lectures and modified PBL methods. Thirty-three fifth year medical students who were taking the Family Medicine rotation participated in the study at the College of Medicine, King Saud University. Three instructors participated in the teaching of three topics to the three groups of students. Students acted as control for themselves across the three instructional methods, namely; lectures, PBL and modified PBL. The main outcomes were students' recall of knowledge, problem solving skills and topic comprehension. In the initial assessment, there was a significant difference in favor of PBL and the modified PBL regarding comprehension of the topic as tested by the short answer questions [p = 0.0001], problem solving skills as tested by the modified essay question [p = 0.002]. Non-significant results were observed at the second stage of assessment. The modified PBL method was the preferred one for 39% of the students, followed by the PBL [36%] and lastly the lectures [25%].This empirical study suggests some advantages for the PBL method and the modified PBL over the lecture method. Larger studies are needed to confirm our results of this important issue as the modified PBL is an affordable option for schools that can not meet the staff and space requirements of the PBL curriculum

Evaluation of serum copper status in patients with chronic heart failure

Chronic heart failure is one of the main cardiovascular diseases that has increased prevalence in the recent years and it has been projected that chronic heart failure will be a major cause of morbidity and mortality in the future. Recent researches demonstrate the importance of certain trace elements in the pathogenesis of cardiovascular disorders. Among these elements is copper metal. It is considered as a strong antioxidant. This study was undertaken in order to investigate the serum copper level in patients with chronic heart failure compared to healthy individuals, and to find whether there is any relationship between serum copper level and patients with chronic heart failure. A case series study was conducted on 53 patients [37 males, 16 females] with chronic heart failure, with a mean age of 52.23 +/- 13.1 years who randomly selected from patients admitted to medical wards and Cardiac Care Unit of Ibin-Seena Teaching Hospital in Mosul city during the period from July 2006 to December 2006. The study also included 32 healthy volunteers [18 males, 14 females] with a mean age of 41.31 +/- 14.72 years, as a control group. Serum copper concentration was measured in patients with chronic heart failure and healthy controls. The results indicate that patients exhibited significant decrease in the serum copper level [p<0.001] as compared to the healthy controls. Also the results showed that there is no statistically significant difference in the concentration of serum copper between males and females in patients with chronic heart failure [p>0.05]. Chronic heart failure is a multifactorial syndrome. Several factors had been found to contribute to the development of this syndrome. Low serum copper level may be one of these contributing factors, probably by elevating blood pressure, impairing different tissue formation and inducing high serum cholesterol level. Measurement of serum copper level might provide additional and useful laboratory test for the assessment of the patients with chronic heart failure and oral copper may have a role in therapy

Level of health awareness of Saudi patients on renal replacement therapy

To assess health awareness in patients on renal replacement therapy [RRT] in Saudi Arabia. This is a cross-sectional survey using a 22-item questionnaire in 143 randomly selected adult RRT patients [40 on hemodialysis [HD], 61 on peritoneal dialysis [PD] and 42 with renal transplant [TX]]. The study was carried out at King Abdul-Aziz Medical City, Riyadh in April 2006. The questionnaire was designed to evaluate patients' knowledge in 5 areas: 1. causes of renal failure, 2. biology of the kidneys, 3. symptoms of kidney disease, 4. therapeutic options available, 5. national kidney patients support facilities. The association between the level of awareness [the percentage of correct answers] to different demographic factors was assessed. Three fifths of the patients had less than secondary education. The average mark for correct responses of all patients was 45.9% with a highest [58%] for the category on biology of the kidney and lowest [36.8%] for national kidney patients support facilities. The PD group had the highest score [54.4%] followed by HD [44.3%] and finally TX [35.1%]. The level of our patients' health awareness is lower than satisfactory. Level of education seems to be a contributory factor

Saphenoperitoneal shunt for intractable ascites

Ascites usually complicates chronic liver disease, and some patients with ascites are refractory to medical treatment. Recently, saphenoperitoneal shunt [SPS] was described to treat this condition. This procedure avoids the insertion of a foreign expensive shunt into the circulation. We present our experience with this procedure with some modification in the technique. We performed a prospective study on 11 patients with intractable ascites admitted to the Vascular Unit, Suez Canal University Hospital, Egypt from June 2001 to October 2003. We divided the long saphenous vein approximately at 15 cm distally. We turned the proximal cut end upwards and tunneled under the skin towards the midline in the suprapubic region where we anastomosed it to the peritoneum. One patient died from liver failure 8 days after the operation. Two patients died during follow-up, one at 3 months from liver failure, and the other at 4 months from variceal hemorrhage. We lost one patient to follow up. Seven patients remained alive with patent shunt up to 6 months follow up. The SPS is a safe and effective procedure in the management of intractable ascites

Mucormycosis of the jaw after dental extractions: Two case reports

Mucormycosis is a rare opportunistic fungal infection, which is mainly reported to occur in patients with immunocompromised conditions such as uncontrolled diabetes mellitus and leukaemias. In this paper, two cases of mucormycosis are reported after dental extractions. The first case of mucormycosis occurred in the maxilla and mandible of a 14 year old male patient undergoing chemotherapy for acute myeloid leukaemia. The second case occurred in the mandible of a 49 year old male patient with a recently diagnosed type-2 diabetes mellitus, presenting with ketoacidosis and underlying undiagnosed acute lymphoblastic leukaemia. The outcome of these reported cases of mucormycosis was favourable after comprehensive surgical and medical management

Chronic suppurative otitis media with intracranial complication

A complication of otitis media is defined as a spread of infection beyond the pneumatized area of the temporal bone and the associated mucosa. Complications can be classified as intra temporal or intra cranial, which includes extradural abscess, brain abscess, subdural abscess, sigmoid sinus thrombophlebitis, otic hydrocephalus, and meningitis. Since the introduction of antibiotics, intra cranial complications in otitis media are less common, however, the occurrence should not be underestimated due to their associated morbidity and mortality. Herein, we report a case of chronic suppurative otitis media [CSOM] with intra cranial complication [brain abscess] in a 25-year-old male patient with ear discharge, severe headache, and vomiting. Computerized tomography scan confirmed the diagnosis. The patient was managed by a combined neurosurgical and otologic approach. Surgery of the abscess includes aspiration through a bur hole or craniotomy and by radical mastoidectomy for CSOM

Novel presenilin 1 mutation associated with early-onset Alzheimer's disease in a Saudi patient

We report a 60-year-old Saudi patient with the clinical diagnosis of Alzheimer's disease [AD] and a novel mutation in the presenilin gene. We investigated mutations in the presenilin-1 gene in Saudi patients with AD using polymerase chain reaction and direct DNA sequencing methods. We extracted genomic DNA from the whole blood of both patients and normal control individuals. We sequenced and compared amplicons with the sequences of the respective exons of normal individuals as well as data available in GenBank. We detected a homozygous mutation [g c] in exon 12, resulting in the missense mutation [Arg377Thr], in the DNA of a 60-year-old patient. We located this mutation in the cytoplasmic loop near the transmembrane domain 7

Scorpion sting syndrome in a general hospital in Saudi Arabia.

To evaluate the incidence of scorpion stings and to draw the attention of clinicians, concerning the dilemma of scorpion sting syndrome and its management in the Kingdom of Saudi Arabia [KSA]. In a retrospective survey, 251 cases were presenteds with scorpion stings to the Emergency Department of the Armed Forces Hospital, Riyadh, KSA during a period of 15 years [April 1986 to April 2000]. Their ages ranged from 2 months to 101 years [male to female ratio was 2.6:1] and 70.6% of the cases were under 20 years of age. The mean annual incidence of the scorpion sting in the month of May was 16.7%, with the highest mean percentage of approximately 36% each year. The seasonal sting cycle showed the highest record was in the summer period [51%] as compared to the lowest winter period [10%]. Local pain was the primary presenting complaint [95%], with a total systemic toxicity of 78.3% and 35.2% of these were children. Hypertension, sweating, salivation and tachycardia were the most common signs of systemic symptoms. The majority of patients received analgesia, local anesthetics, and application of ice and a period of observation dictated by clinical findings. Eighty-two patients [32.6%] had signs of serious envenoming, requiring admission. There were no deaths. All of these cases were mainly treated symptomatically. The beneficial effect of antivenom in protecting victims against scorpion stings is still questionable. The higher risk groups of systemic toxicity were either those with ages less than 10 years or greater than 50 years, being more susceptible due to their decreased physiologic reserves and increased debilitation

Breast self-examination among Saudi female nursing students in Saudi Arabia

The purpose of this study was to investigate the knowledge and practice of breast self-examination [BSE] among Saudi female nursing college students in Riyadh, Kingdom of Saudi Arabia [KSA]. A cross-sectional study was conducted between October and December 2003. Saudi female nursing students [149] from the College of Applied Medical Sciences, King Saud University, and from the College of Nursing, King Abdulaziz Medical City, National Guard, Riyadh, KSA, constituted the study population. The questionnaire contained items on the demographic characteristics of the respondents, knowledge of breast cancer, attitudes toward BSE and questions regarding the practice of BSE. The analysis included descriptive statistics and chi-squared tests to examine the association between BSE and demographic, medical history, knowledge of BSE and attitudes toward BSE. The results of the study indicated that 66% of the sample performs BSE. Approximately 62% of those who perform BSE said they learned information regarding BSE in their college curricula. The significant relation was found between higher levels in nursing college and BSE practice. Except for age, no significant relation was found between the socio-demographic factors and BSE practice. The sample showed strong belief in nipple discharge as a causing factor of breast cancer and had significant correlation and BSE practice. Positive correlations were found between nursing students BSE practice and their academic experience in nursing college. Studies like these can enhance the knowledge regarding BSE among nurses and other medical professionals