Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia.

AIM: To evaluate the risk factors associated with caries development after full-mouth rehabilitation for early childhood caries (ECC) under general anesthesia. MATERIALS AND METHODS: A total of 100 children diagnosed with ECC requiring full-mouth rehabilitation under general anesthesia were recruited for the study. At baseline, caries status, plaque index, Streptococcus mutans count, and Lactobacillus count were evaluated. The risk assessment for caries was evaluated using a cariogram. Children were recalled after 12 months for evaluation. All children returned for the recall and data was recorded at the recall visit. Children were grouped into caries-free or caries recurrent based on the absence or presence of caries. Chi-square tests and student's t-test were used for statistical analysis using the statistical package for the social sciences (SPSS), version 23. RESULTS: All 100 children returned for follow-up. 76% of the children developed new carious lesions in a period of 1 year. A statistically significant association between caries recurrence and S. mutans count and caries risk assessment (CRA) score was found (p < 0.001). No significant associations were seen between parental education levels and the oral health practices of the child. CONCLUSION: Children treated under full-mouth rehabilitation for ECC under general anesthesia are at risk for developing new carious lesions after treatment. New carious lesions are strongly correlated with the presence of S. mutans, and high cariographic risk scores serve as an indication of future caries. Early childhood caries may be avoided if children are more diligent in practicing good dental hygiene. CLINICAL SIGNIFICANCE: Relapse of caries after full-mouth rehabilitation under general anesthesia can affect the quality of life of children. Preventive measures should be initiated and reinforced to prevent the occurrence of new carious lesions after full-mouth rehabilitation. How to cite this article: Mathew MG, Jeevanandan G, Maganur PC, et al. Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia. J Contemp Dent Pract 2024;25(1):85-91.

Bioactive agents from Parkia biglobosa (Jacq.) R.Br. ex G. Don bark extracts for health promotion and nutraceutical uses.

BACKGROUND: Parkia biglobosa stem bark extracts were prepared using methanol, methanol 80%, water and ethyl acetate to investigate their phytochemical contents, as well as antioxidant and enzyme inhibitory properties. RESULTS: Liquid chromatography (LC) quadrupole time-of-flight mass spectrometry (MS) and LC-MSn revealed the presence of flavonoids, hydroxycinnamic acid derivatives and gallotannins. Particularly, the water extract contained rutin (480 µg per 100 mg) and 3-caffeoylquinic acid (1109 µg per 100 mg) in higher amounts, whereas the 80% methanol extract contains methoxyluteolin-7-O-rutinoside and catechin derivatives as major compounds. Total phenolic and flavonoid contents of the extracts were yielded in the range of 32.26-119.88 mg gallic acid equivalents g-1 and 0.60-2.39 mg rutin equivalents g-1 , respectively. Total antioxidant capacity was also displayed in the range of 0.53-6.34 mmol Trolox equivalents (TE) g-1 . Both the methanolic extracts showed higher total antioxidant capacity that could be related to the total phenolic contents. Radical scavenging capacity in DPPH (2,2-diphenyl-2-picryl-hydrazyl) (37.21-508.30 mg TE g-1 ) and ABTS [2,2-azinobis(3-ethylbenzothiazoline- 6-sulfonic acid)] (60.95-1068.06 mg TE g-1 ) assays, reducing power in cupric ion reducing antioxidant capacity (54.23-1002.78 mg TE g-1 ) and ferric ion reducing antioxidant power (33.18-558.68 mg TE g-1 ) assays, as well as metal chelating activity (2.45-11.28 mg EDTA equivalents g-1 ), were exhibited by all extracts. All extracts were found to inhibit acetylcholinesterase [0.23-2.47 mg galanthamine equivalents (GALAE) g-1 ], tyrosinase [27.20-83.33 mg kojic acid equivalents g-1 ], amylase [mmol acarbose equivalents (ACAE) g-1 ]. On the other hand, all extracts, except the water extract, inhibited butyrylcholinesterase (5.38-6.56 mg GALAE g-1 ), whereas only the water and ethyl acetate extract showed glucosidase inhibitory potential (1.96 and 1.82 mmol ACAE g-1 ). In general, the water extract was found to be a weaker enzyme inhibitor suggesting that water is not the preferrable extraction solvent to obtain active products. CONCLUSION: The present study demonstrated that the stem bark extracts of P. biglobosa contains good amount of phytochemical and extracts present significant antioxidant, as well as reasonable enzyme inhibitory effects. Hence, these findings suggest that further studies can be performed on more specific biological targets and models of bioactivity to determine their safe usage as a nutraceutical or for the preparation functional foods. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Prognosis of Postoperative Pulmonary Embolism in High Altitude.

BACKGROUND: Pulmonary embolism (PE) is a common cause of death and serious disability, with risks that extend beyond the acute phase. Despite advances in diagnosis and treatment, high mortality rates remain a persistent problem. AIM: The current study aimed to investigate PE prognosis and its determinants among native highlanders in Taif City, Saudi Arabia. METHODS: This is a retrospective study where data was collected from the medical records of native high-altitude PE patients in Taif, Saudi Arabia, from 2017 to 2022. RESULTS:  The study included 154 native high-altitude PE patients with a mean age of 54±19 years. Most were females and nonsmokers (51.3% (n=79) and 89% (n=137), respectively). Of them, 28.6% (n=44) had undergone a previous surgery, and 61.4% (n=27) of these surgeries were within 1-3 weeks before hospital admission. The majority of patients had sub-massive PE (59.1% (n=91)), followed by non-massive PE (24% (n=37)) and massive PE (16.9% (n=26)). After management, 98 (63.6%) patients were improved, and 56 (36.4%) patients were not improved at the time of data collection. In terms of improvement after PE, patients who had undergone a previous surgery were less than those who had not, with no significant difference (56.8% (n=25) and 66.4% (n=73), respectively, p=0.266). All patients with heart rates (HRs) less than 70 bpm improved after PE compared to those with higher HRs (p=0.003). The thrombus location had no statistically significant association with patient outcomes (p=0.058). CONCLUSION: This study provides valuable insights into patient outcomes at high altitudes after PE and the prognostic factors influencing these outcomes. It was identified that a low HR was associated with positive outcomes.

Neck Health Metrics and Quality of Life: A Comparative Study in Bike Drivers with and without Neck Pain.

Purpose: Neck pain is a prevalent musculoskeletal issue among bike drivers, often resulting from extended static postures, repetitive head movements, and exposure to vibrations. This study aims to assess the connection between cervical ROM, neck proprioception, CVA, and QOL in bike drivers with neck pain compared to those without neck pain so that the targeted interventions can be developed to enhance their well-being. Methods: A cross-sectional study involving 100 bike drivers aged 20-50 years was conducted, split into two groups: those with neck pain (n=50) and those without neck pain (n=50). Cervical ROM was measured using a smartphone, neck proprioception was assessed through a head repositioning test, and CVA was determined using lateral-view photographs with a plumb line. The Short Form-36 (SF-36) questionnaire was employed to evaluate QOL. Data analysis was conducted using independent t-tests and Pearson's correlation coefficient. Results: Bike drivers with neck pain exhibited significantly reduced cervical ROM (p-value=<0.001), impaired neck proprioception (p-value=<0.001), and decreased CVA (p-value=<0.001) compared to their counterparts without neck pain. A strong negative correlation was found between neck pain and QOL, with lower scores in all eight domains of the SF-36. Cervical ROM, neck proprioception, and CVA showed moderate correlations with various QOL domains (p-value=<0.05). Conclusion: Neck pain in bike drivers is linked to decrease cervical ROM, compromised neck proprioception, and reduced CVA. These factors correlate with a lower quality of life, both physical and mental domains. Interventions addressing these aspects may enhance the quality of life for bike drivers experiencing neck pain.

Personalised Online Upper-Limb Physiotherapy for Stroke Survivors during the Inpatient Phase: A Feasibility Study.

BACKGROUND: After a stroke, inpatients often receive less than the recommended dose of therapy. Telerehabilitation may assist by providing personalised rehabilitation programmes without face-to-face therapy time. This study aimed to evaluate the acceptability and feasibility of an individualised programme of upper-limb rehabilitation that is delivered via an online rehabilitation platform for inpatient stroke survivors. METHODS: Stroke survivors were recruited from three stroke units in one NHS Board in Scotland and randomised to the intervention (personalised upper-limb exercise programme delivered via an online physiotherapy platform for four weeks, up to 30 min five times per week, in addition to usual care) or the control group (usual care). The main outcomes are related to recruitment, attrition, adherence and safety. The clinical measures were the Action Research Arm Test, Trunk Impairment Scale and Modified Ashworth Scale. The intervention participants, their carers and physiotherapists completed questionnaires on the acceptability of the intervention. RESULTS: Twenty-six participants, 42% males, were recruited around three weeks post-stroke, on average. There were 13 participants in each group, with a mean age of 69 years (SD of 12) and 67 years (SD of 11) for the control and intervention groups, respectively. Overall, 47% of those screened for eligibility were randomised, and attrition was 23% in the intervention group mainly due to discharge before the end of the intervention. Participants who adhered to their programme (completed more than two-thirds), generally those with an engaged carer, demonstrated a trend toward improved clinical outcomes. Overall, the patients, carers and physiotherapists were positive regarding the intervention. There was a total of five reported adverse events, none of which were related to the study. CONCLUSION: An upper-limb unsupervised exercise intervention using an online physiotherapy platform for inpatient stroke survivors is feasible, safe and acceptable to patients, carers and physiotherapists. A fully powered RCT is warranted to investigate the clinical- and cost-effectiveness of such interventions for this patient group.

Generating signals at converging liquid fronts to create line-format readouts of soluble assay products in three-dimensional paper-based devices.

The correct interpretation of the result from a point-of-care device is crucial for an accurate and rapid diagnosis to guide subsequent treatment. Lateral flow tests (LFTs) use a well-established format that was designed to simplify the user experience. However, the LFT device architecture is inherently limited to detecting analytes that can be captured by molecular recognition. Microfluidic paper-based analytical devices (µPADs), like LFTs, have the potential to be used in diagnostic applications at the point of care. However, µPADs have not gained significant traction outside of academic laboratories, in part, because they have often demonstrated a lack of homogeneous shape or color in signal outputs, which consequently can lead to inaccurate interpretation of results by users. Here, we demonstrate a new class of µPADs that form colorimetric signals at the interfaces of converging liquid fronts (i.e., lines) to control where colorimetric signals are formed without relying on capture techniques. We demonstrate our approach by developing assays for three classes of analytes-an ion, an enzyme, and a small molecule-to measure using iron(III), acetylcholinesterase, and lactate, respectively. Additionally, we show these devices have the potential to support multiplexed assays by generating multiple lines in a common readout zone. These results highlight the ability of this new paper-based device architecture to aid the interpretation of assays that create soluble products by using flow to constrain those colorimetric products in a familiar, line-format output.

Determinants of Inadequate Empiric Antimicrobial Therapy in ICU Sepsis Patients in Al-Madinah Al-Munawwarah, Saudi Arabia: A Comparison of Artificial Neural Network and Regression Analysis.

In the management of sepsis, providing adequate empiric antimicrobial therapy is one of the most important pillars of sepsis management. Therefore, it is important to evaluate the adequacy of empiric antimicrobial therapy (EAMT) in sepsis patients admitted to intensive care units (ICU) and to identify the determinants of inadequate EAMT. The aim of this study was to evaluate the adequacy of empiric antimicrobial therapy in patients admitted to the ICU with sepsis or septic shock, and the determinants of inadequate EAMT. The data of patients admitted to the ICU units due to sepsis or septic shock in two tertiary healthcare facilities in Al-Madinah Al-Munawwarah were retrospectively reviewed. The current study used logistic regression analysis and artificial neural network (ANN) analysis to identify determinants of inadequate empiric antimicrobial therapy, and evaluated the performance of these two approaches in predicting the inadequacy of EAMT. The findings of this study showed that fifty-three per cent of patients received inadequate EAMT. Determinants for inadequate EAMT were APACHE II score, multidrug-resistance organism (MDRO) infections, surgical history (lower limb amputation), and comorbidity (coronary artery disease). ANN performed as well as or better than logistic regression in predicating inadequate EAMT, as the receiver operating characteristic area under the curve (ROC-AUC) of the ANN model was higher when compared with the logistic regression model (LRM): 0.895 vs. 0.854. In addition, the ANN model performed better than LRM in predicting inadequate EAMT in terms of classification accuracy. In addition, ANN analysis revealed that the most important determinants of EAMT adequacy were the APACHE II score and MDRO. In conclusion, more than half of the patients received inadequate EAMT. Determinants of inadequate EAMT were APACHE II score, MDRO infections, comorbidity, and surgical history. This provides valuable inputs to improve the prescription of empiric antimicrobials in Saudi Arabia going forward. In addition, our study demonstrated the potential utility of applying artificial neural network analysis in the prediction of outcomes in healthcare research.

Resident Physicians' Knowledge and Preparedness Regarding Human Monkeypox: A Cross-Sectional Study from Saudi Arabia.

This study aimed to evaluate knowledge about monkeypox and confidence in dealing with monkeypox diagnosis and management among resident physicians in the Asir region of Saudi Arabia. The data of this cross-sectional study were collected online through a structured questionnaire (N = 315). Knowledge about monkeypox was assessed by 24 questions and a three-item scale assessed confidence in managing monkeypox cases. Multiple logistic regression analysis was performed to assess the associations. Overall, two-thirds of the respondents (67.3%) showed good knowledge about monkeypox and the rest of them (32.7%) had poor knowledge. Respondents who received a copy of the Saudi MOH protocol for monkeypox and attended any conference or lecture about monkeypox were more likely to have good knowledge about monkeypox. Moreover, almost two-thirds of the participants were not confident that they could diagnose or manage the monkeypox. Respondents who received information about monkeypox during residency or medical school had higher confidence in managing monkeypox cases. It can be concluded that the Saudi healthcare system has scope to take necessary steps to contain the monkeypox endemic. The Saudi MOH should arrange conferences and educational programs on monkeypox so that healthcare professionals can improve their knowledge and be confident in the management and diagnosis of monkeypox cases.

Lifestyle habits and obesity indices among male adolescents in Riyadh, Saudi Arabia.

Obesity among adolescents is a global health apprehension which requires early prevention. The aim of this study was to determine the association between lifestyle habits including physical activity, sedentary behaviors and eating habits with obesity indices of body mass index (BMI) and waist-to-height ratio (WHtR) among male adolescents in Riyadh, Saudi Arabia. We randomly selected 471 secondary school male adolescents aged 14-18 years. A pre-validated self-reported questionnaire was used to record the data on physical activity level, sedentary behaviors, sleep duration and eating habits. The International Obesity Task Force (IOTF) cutoff values for adolescents under 18 years of age were used to define overweight and obesity. Total energy expenditure was calculated using metabolic equivalent-minutes per week. Anthropometry including weight, height, BMI, waist circumference, waist/height ratio (WHtR), were assessed. 53.7% and 48.4% of the adolescents were overweight/obese and had abdominal obesity; respectively. Those with overweight and obesity or above 50% of WHtR were much less active in terms of METs-min/week from vigorous-intensity sports, sum of all METs-min/week from all vigorous-intensity physical activity, total METs-min/week from all physical activity compared with non-obese adolescents and below 50% of WHtR. The present study identified the lifestyle habits that were associated with obesity and may represent valid targets for the prevention and management of obesity among Saudi adolescents. Knowledge of the factors that contribute to obesity could be used in preventive programs for the control of obesity among adolescents.

Novel Photodynamic/Photothermal Treatment of Fungal Keratitis Using Rose Bengal-Loaded Polypyrrole-Gold Nanoparticles in Wistar Albino Rats.

Purpose: Fungal keratitis is a potential corneal contagious disease mainly caused by yeast such as Candida albicans and filamentous fungi such as Aspergillus niger. The response of fungal keratitis to standard antifungals is limited by the poor bioavailability, the limited ocular penetration of antifungal drugs, and the development of microbial resistance. Photodynamic therapy using rose bengal (RB) as a photosensitizer was found to be effective in fungal keratitis management; however, the hydrophilicity of RB limits its corneal penetration. Polypyrrole-coated gold nanoparticles (AuPpy NP) were introduced as a nano-delivery system of RB with high loading capacity. It was proved that (RB-AuPpy NP) exhibited a combined photodynamic/photothermal effect. This study aims to use the combined photodynamic/photothermal effect of RB-AuPpy NP as a novel protocol for treating Fungal Keratitis in albino Wistar rats. Methods: The rats were infected by C. albicans and A. niger. Each infected group of rats was subdivided into groups treated by RB followed by radiation (photodynamic only), AuPpy NP followed by radiation (photothermal only), and RB-AuPpy NP followed by radiation (combined photodynamic/photothermal). Histopathological examination and slit lamp imaging were done to investigate the results. Results: The results revealed that 3 weeks post-treatment, the corneas treated by RB-AuPpy NP (combined photodynamic/photothermal effect) exhibited the best improvement compared to other groups. Conclusion: This protocol can be considered a promising one for Fungal Keratitis management that overcomes microbial resistance problems.

Pill-burden and its association with treatment burden among patients with advanced stages of chronic kidney disease.

Introduction: Chronic kidney disease (CKD) is associated with multimorbidity and high treatment burden. Pill-burden is one component of the overall treatment burden. However, little is known about its magnitude and contribution to the overall treatment burden among patients with advanced stages of CKD. This study aimed to quantify the magnitude of pill-burden in dialysis-dependent vs. non-dialysis-dependent advanced-stage CKD patients and its association with treatment burden. Methods: This was a cross-sectional study for the assessment of pill-burden and treatment burden among non-dialysis and hemodialysis (HD)-dependent CKD patients. Pill-burden was quantified as "number of pills/patient/week" through electronic medical record, while treatment burden was assessed using the "Treatment Burden Questionnaire (TBQ)". Furthermore, oral and parenteral medication burden was also quantified. Data were analyzed using both descriptive and inferential analysis, including Mann - Whitney U test and two-way between groups analysis of variance (ANOVA). Results: Among the 280 patients included in the analysis, the median (IQR) number of prescribed chronic medications was 12 (5.7) oral and 3 (2) parenteral medications. The median (IQR) pill-burden was 112 (55) pills/week. HD patients experienced higher pill-burden than non-dialysis patients [122 (61) vs. 109 (33) pills/week]; however, this difference did not reach statistical significance (p = 0.81). The most commonly prescribed oral medications were vitamin D (90.4%), sevelamer carbonate (65%), cinacalcet (67.5%), and statins (67.1%). Overall, patients who had high pill-burden (≥112 pills/week) had significantly higher perceived treatment burden compared to low pill-burden patients (<112 pills/week) [47(36.2) vs. 38.5(36.7); p = 0.0085]. However, two-way ANOVA showed that dialysis status is the significant contributor to the treatment-burden in the high overall pill-burden group (p < 0.01), the high oral-medication-burden group (p < 0.01), and the high parenteral-medication-burden group (p = 0.004). Conclusions: Patients with advanced CKD experienced a high pill-burden, which increases the treatment burden; however, the dialysis status of the patient is the main factor affecting the overall treatment burden. Future intervention studies should target this population with an aim to reduce polypharmacy, pill-burden, and treatment burden, which may ultimately improve CKD patients' quality of life.

Influence of prior internist encounter on glycaemic control among patients with type 2 diabetes mellitus at a family practice setting in Nigeria.

Background: The huge global diabetes burden and the paucity of diabetes specialists make primary care physicians important stakeholders in controlling diabetes. Hence, we examined the predictors of glycaemic control among primary care patients with type 2 diabetes mellitus (T2DM), highlighting the influence of prior internist encounters during the preceding year on glycaemic control. Methods: This questionnaire-based cross-sectional study involved 276 T2DM patients systematically recruited from attendees of a general outpatient clinic (GOPC) in Kano, Nigeria. Data regarding their sociodemographic, clinical and internist encounter and GOPC visit characteristics were collected. Data were subjected to descriptive and inferential statistical analysis. Results: Most participants (56.5%) were females; their mean age was 57.7 ± 9.6 years, mean glycated haemoglobin level was 7.3 ± 1.9%. Age, educational level, ethnicity, insurance status, current blood pressure (BP), treatment type, medication adherence, awareness of the importance of diet in DM control, specialist diabetic clinic visited, number of GOPC visits and prior encounter with an internist in the preceding year were associated with glycaemic control after bivariate analysis (P < 0.05). On multivariate regression, low education, retirees, being self-employed, uninsured, overweight, having optimal BP, using metformin alone, sulphonylurea-metformin and insulin-based treatments and prior encounter with the internist in the preceding year were predictors of optimal glycaemic control. Conclusion: There are multiple predictors of glycaemic control in this setting. These predictors should be considered in glycaemic control risk stratification towards quality individualised care, which includes establishing referral protocols to available specialists. Regular training of primary care physicians on diabetes care is also required.

Assessing awareness and knowledge level of clubfoot among a rural city population in Saudi Arabixsa: A cross-sectional study.

Purpose: Clubfoot is among the most common musculoskeletal congenital anomalies. Poor understanding of clubfoot can cause lack of awareness that leads to complications in treating this condition because of late medical intervention. This is considered as a significant public health problem, especially in communities where the burden of clubfoot deformity remains unrecognized. We assessed the level of awareness and knowledge on clubfoot among residents of rural areas and determined the knowledge and attitudes of the public toward the risk factors and general consequences of clubfoot. Methods: This cross-sectional study, conducted from January to July 2021, included the general population of small city and rural area residents. The participants completed a self-administered survey on the web. The questionnaire was pre-tested in a pilot study to ensure comprehension and ease of administration. Results: Altogether, 41.6% of the participants recognized the scientific name of clubfoot in their native language, whereas 38.9% identified the disorder after they were shown a photograph of it. The most recognized risk factors of clubfoot according to the participants were family history (52.2%), complicated pregnancy (46.5%), and medications (43.4%). Only 8.8% of the participants considered casting the initial treatment of clubfoot. Conclusion: An individual's residential area plays a role in their level of awareness concerning clubfoot. Our results suggest that many educational interventions for clubfoot must be provided in rural areas, particularly regarding therapeutic options and plans of care.

Essential Oils Composition and Biological Activity of Chamaecyparis obtusa, Chrysopogon nigritanus and Lavandula coronopifolia Grown Wild in Sudan.

Generally, there are scant data about the constituents and eventually the biological activity of essential oils (EOs) from aromatic plants that grow naturally in Sudan. The present study aimed to determine the chemical composition, and antioxidant and enzyme inhibitory activities of EO extracted from the fruit of Chamaecyparis obtusa (Siebold and Zucc.) Endl. (family Cupressaceae), root of Chrysopogon nigritanus (Benth.) Veldkampis (family Poaceae) and aerial part of Lavandula coronopifolia Poir (family Lamiaceae). The fruit of C. obtusa contained only monoterpenes, mainly hydrogenated ones, with α-pinene (69.07%) as the major component. Oxygenated sesquiterpenes comprised the highest content of the C. nigritanus root EO with cedr-8-en-15-ol (28.69%) as the major constituent while aerial parts of L. coronopifolia contained both monoterpenes and sesquiterpenes and the oxygenated monoterpene lavandulol (26.56%) as dominant compounds. The EO of the root of C. nigritanus significantly displayed (p < 0.05) the highest anti-DPPH radical, Fe3+- and Cu2+-reducing and metal-chelating activities, while that of C. obtusa fruit significantly exerted (p < 0.05) the best anti-ABTS radical and total antioxidant activity. The two EOs significantly exhibited (p < 0.05) the highest anti-acetylcholinesterase and -butyrylcholinesterase activities, respectively, while EO of L. coronopifolia was the only oil to show a considerable inhibitory effect against the tyrosinase and α-glucosidase enzymes. In conclusion, EOs from these three plants could be natural agents with promising functional properties for food, cosmetics, and pharmaceutical applications.

Correction: Abulmeaty et al. Effect of Long-Term Continuous Light Exposure and Western Diet on Adropin Expression, Lipid Metabolism, and Energy Homeostasis in Rats. Biology 2021, 10, 413.

In the original publication [...].

Physicians' Knowledge of Abdominal Compartment Syndrome and Intra-Abdominal Hypertension in Saudi Arabia: An Online Cross-Sectional Survey Study.

Objective: To determine physicians' knowledge of abdominal compartment syndrome and intra-abdominal hypertension in Saudi Arabia. Methods: A cross-sectional online survey study was conducted on physicians in Saudi Arabia between March and August 2022. A previously developed questionnaire was adapted and used in this study. The survey instrument investigated the knowledge and management of intra-abdominal hypertension and abdominal compartment syndrome among physicians. Logistic regression was used to identify predictors of being knowledgeable about abdominal compartment syndrome and intra-abdominal hypertension. Results: A total of 266 physicians participated in this study. Around one-fifth (21.8%) the study participants were ICU physicians and 25.0% reported that they practice internal medicine. Intra-abdominal hypertension (IAH) and the impact of increased intra-abdominal pressure (IAP) on organ function were terms that the majority of research participants (70.3%) reported they were familiar with. A similar percentage (73.7%) reported that they are familiar with abdominal compartment syndrome (ACS). Around 43.0% of the study participants reported that they do not know how to measure IAP. The most frequently reported (13.5%) intervention in the treatment of IAH and ACS was the use of inotropes or vasopressors. The study participants showed a weak level of knowledge of ACS and IAH with a median score of 3.00 (IQR: 5.00-2.00), which represents 27.3% of the maximum attainable score. Physicians working at hospitals with 20-50 ICU beds were 41.0% (odds ratio: 0.59 (CI: 0.37-0.96)) less likely to be knowledgeable about intra-abdominal hypertension and abdominal compartment syndrome (p≤0.05). Conclusion: Physicians demonstrated a low level of IAP and ACS knowledge. To increase the safety of medical practices and enhance clinical outcomes for patients, awareness should be raised about the proper diagnosis and management of IAP and ACS. Future research should focus on developing effective educational strategies to improve physicians' understanding of IAP and ACS.

Seroprevalence of anti-hepatitis A virus antibody in Iraq.

Background: Hepatitis A virus infection is widespread in Iraq, therefore, assessing its seroprevalence is important for infection control at the community level. Aims: To determine hepatitis A virus seroprevalence in a representative sample in Duhok Governorate, northern Iraq; evaluate changes in the epidemiological pattern; and assess factors associated with its seropositivity. Methods: This cross-sectional study was conducted from July 2020 to November 2021. Random cluster sampling was used to select participants aged 5-74 years. Hepatitis A virus immunoglobulin G (IgG) was determined among the participants and demographic data were collected on sex, residency (urban or rural), age, history of jaundice, number of family members (≤ five or > five), and sources of drinking water. Results: A total of 1052 participants (625 males and 427 females) were enrolled. The overall seroprevalence of hepatitis A virus IgG was 68.3%: 24.4% in ages 5-10 years; 38.3% in ages 11-15; 86.9% in ages 16-20; 85.4% in ages 21-30; 95.3% in ages 31-40; and 89.2% in ages > 40 years. Factors significantly associated with hepatitis A virus IgG positivity were rural residence, male sex and family size greater than five (all P < 0.01). Conclusion: Hepatitis A virus seroprevalence in Iraq has been declining since the past decade, indicating intermediate-to-low endemicity of hepatitis A virus. However, people are still many susceptible, indicating the need for hepatitis A virus vaccination in the country.

Laparoscopic extraction of a migrated pacemaker in a 6-year-old child: A case report.

The laparoscopic approach can provide a safe option with good results for extracting an uncomplicated migrated pacemaker in children.

Junctional bradycardia in a patient with COVID-19: A case report.

BACKGROUND: Cardiac arrhythmias, including bradyarrhythmias, have been described as manifestations of coronavirus disease 2019 (COVID-19). Herein, we present a case of junctional bradycardia secondary to possible sinus node dysfunction in a patient with COVID-19. CASE SUMMARY: The patient was a 32-year-old woman with no significant medical history. On the third day of hospitalization, she developed junctional bradycardia while being hemodynamically stable. The episodes of nodal dysrhythmia with a low heart rate persisted for the next few days and were associated with elevated levels of systemic inflammatory markers. The patient received antiviral and anti-inflammatory treatments for the viral infection but no antiarrhythmic medications. She had a normal sinus rhythm on day 12. CONCLUSION: Cardiac rhythm monitoring, focusing on the association between cardiac arrhythmias and the systemic inflammatory response, is important in COVID-19 patients.

A Cross-sectional Study of Antecedents and Consequence of Panic Buying Behavior: The Moderating Effect of COVID-19 Rumors.

The novel corona virus pandemic has influenced people buying behaviors. Due to the significant psychological and behavioral impact of COVID-19 on society, this study aimed to examine the determinants of panic buying behavior and a resultant psychological outcome in the form of a sense of security. The purpose of this study is to investigate the effect of COVID-19 caller ringback tone (CRT) experiences, that is, informational and stimulation experience, on the panic buying behavior and how rumors moderate this relationship. This research is quantitative and uses a purposive sampling method to collect the survey-based data from 264 respondents. The researchers analyzed the data using Partial Least Square Structural Equation Modeling (PLS-SEM). The results of data analysis indicated that the informational and stimulation experience of COVID-19 CRT had a significant influence on panic buying behavior which further resulted in a sense of security in public. This study could not find evidence of the moderating role of rumors in the relationship between COVID-19 CRT experiences and panic buying behavior. The findings highlight the role of the COVID-19 CRT in causing panic buying behavior and resultant psychological outcome and thus provide implications for policymakers on the control of panic buying under COVID-19.