Contamination Assessment of Mangrove Ecosystems in the Red Sea Coast by Polycyclic Aromatic Hydrocarbons.

Mangroves are known as a naturally based solution for climate mitigation and adaptation. Mangroves are at a potential risk of degradation by contaminants such as polycyclic aromatic hydrocarbons (PAHs). In this study, sixteen priority PAHs were analyzed and characterized in forty samples of mangrove seawater and mangrove sediments collected from two coastal areas (i.e., Sharm and Khor Rabigh) along the Red Sea Coast of Rabigh city in August 2013. We found that the average concentration of total PAH in mangrove sediments in the Sharam area (22.09 ng/kg) was higher than that in the Alkhor area (6.51 ng/kg). However, the average concentration of the total PAH in the mangrove seawater in the Alkhor area (9.19 ng/L) was double that in the Sharam area (4.33 ng/L). Phenanthrene and pyrene were the major components in both the mangrove seawater and sediment in all the investigated areas. We observed that the abundance of PAHs with 2-3 aromatic rings was dominant in sediment samples collected from both study areas. This abundance was also observed in seawater from the Sharam area. However, seawater samples from the Alkhor area had abundant PAHs with four aromatic rings. The majority of PAHs in sediment samples of both study areas originated from petrogenic sources, whereas the majority of PAHs in seawater samples originated from pyrogenic sources.

Air Quality of Work, Residential, and Traffic Areas during the COVID-19 Lockdown with Insights to Improve Air Quality.

This study investigated the concentrations of air pollutants (NO, NO2, NOx, SO2, CO, O3, PM10, and PM2.5) at three sites with different traffic loads (work, residential, and traffic sites) before, during, and after the COVID-19 lockdown. The main objective of this study was to evaluate the effects and associated potential pollution control implications of the lockdown on the quality of ambient air at three selected sites in the urban area of Riyadh City. The average concentrations of NO, NO2, NOx, and CO decreased during the lockdown period by 73%, 44%, 53%, and 32% at the work site; 222%, 85%, 100%, and 60% at the residential site; and 133%, 60%, 101%, and 103% at the traffic site relative to the pre-lockdown period, respectively. The average concentration of O3 increased by 6% at the work site, whereas the concentration of SO2 increased by 27% at the residential site and decreased by 6.5% at the work site. The changes in PM10 and PM2.5 varied and did not exhibit a clear pattern. The air quality index (AQI) results indicated that the contribution to "undesired" air quality by O3 was 35.29% of the lockdown period at the work site while contributions to undesired air quality by PM10 and PM2.5 were 75.6% and 100% at the work site, 94.5% and 100% at the residential site, and 96.7% and 100% at the traffic site, respectively. The findings of this study are useful for devising effective urban pollution abatement policies. Applying control measures comparable to the lockdown measures over one week will result in a decrease of approximately 19% and 15% in CO mean concentration and 25% and 18% in NO2 mean concentration at residential and traffic sites, respectively.

Orchiepididymitis in the context of multisystem inflammatory syndrome in a child with Covid-19 from Syria: a very rare presentation for SARS-Cov-19 in children.

The coronavirus disease 2019 (COVID-19) is still striking the global population affecting all age groups. So far, many clinical features associated with COVID-19 illness remain under-identified, especially atypical manifestations. It is essential to characterize associated rare symptoms to better recognize complications. As severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causes Multisystem Inflammatory Syndrome in children (MIS-C) in severe infection manifesting as a generalized inflammatory reaction and immune response in many body systems, potential involvement of the male urogenital tract by SARS-CoV-2 should be considered. Herein, we report a case of a pediatric patient with orchiepididymitis associated with COVID-19 infection, emphasizing the importance of considering other manifestations such as genital involvement of MIS-C in children with COVID-19 and highlighting the need to monitor the genitourinary function after infection. Therefore, andrological consultation is necessary to evaluate fertility as a long-term follow-up, especially as the effects of SARS-CoV-2 on male reproductive function are still to be thoroughly researched.

Case Report: Neonatal Multi-System Inflammatory Syndrome Associated With SARS-CoV-2 Exposure in Two Cases From Saudi Arabia.

Background: Vertical transmission of SARS-CoV-2 is under investigation. A few reports suggest the possibility of SARS-CoV-2 transmission from mothers to their neonates. Most neonates have mild symptoms, but some develop multisystem involvement and shock. Case Presentation: We report two cases of possible SARS-CoV-2 vertical transmission from mothers to their neonates. The first case shows maternal infection with SARS-CoV-2 in the second trimester followed by recurrent infection in the third trimester right before the delivery. The infant demonstrated respiratory distress soon after delivery along with myocardial dysfunction and multi-organ system involvement. The second case shows maternal infection with SARS-COV-2 at the time of delivery with preterm labor secondary to placental abruption, with that delivery resulting in the preterm neonate requiring non-invasive ventilation with multisystem involvement in the context of persistently positive SARS-COV-2 PCR in the neonate. Both neonates were treated with IVIG along with steroids. Both neonates recovered fully and were discharged and allowed to go home. Conclusion: In neonates, COVID-19 usually presents as an asymptomatic or mild illness; some may develop a more severe course. Our two cases, however, demonstrate that multisystem involvement, although rare, is possible. This report also supports the current evidence of possible vertical transmission from mothers to their neonates. This multisystem involvement might be underreported and should be considered in neonates with respiratory distress when born to mothers suffering of COVID-19. Clinical Trial Registration: [KSUMC], identifier [No#98763298].

Firefighter exposures to organic and inorganic gas emissions in emergency residential and industrial fires.

The gas emissions generated from fires could cause mortalities and diseases in firefighters. Gas emissions from fire contain a mixture of a wide range of organic and inorganic gases, depending on several elements that are not currently known. In this study, firefighters were equipped with portable gas detectors to measure selected organic and inorganic gases in 26 emergency fire incidents. The fire incidents were categorized as industrial or residential based on their source. The exposure of firefighters to volatile organic compounds (VOCs) in residential fires was double that in industrial fires. This is probably due to the contents of the houses, as more VOCs are released from textiles and furniture. The concentration of toluene, which is widely used in cosmetics and paints in housing, was fifteen-fold higher in residential fires than industrial fires. The exposure of firefighters to inorganic gases was much higher in industrial fires than residential fires. The concentration of hydrogen chloride, which is generated from the combustion of chlorinated plastics, such as industrial pipes and cables, in industrial fires was 18-fold higher than that in residential fires. Additionally, in this study, we found that the concentration of VOCs that poses cancer and non-cancer health risk to firefighters increases in residential fire incidents to almost three times that in industrial fire incidents. Hydrogen sulfide and sulfur dioxide concentrations were higher in industrial fire incidents than in residential fire incidents. The level of hydrogen sulfide and sulfur dioxide were 19-fold and 8-fold higher, respectively, in industrial fire incidents than in residential fire incidents. This study reveals that gas emissions vary widely between industrial and residential fires.

The prevalence of MERS-CoV among military personnel and their families: A single-center study.

Middle East respiratory syndrome coronavirus (MERS-CoV) is a Betacoronavirus that results in a severe fatal respiratory disease; however, it is also associated with mild inapparent infections. The western part of the Kingdom of Saudi Arabia (KSA) contains the holy places where millions of Muslims gathered from all over the world, all year round, with a high probability of mass disease transmission. The aim of this study was to estimate the prevalence of MERS-CoV among military personnel and their families during the period 2014-2019, in the western part of the KSA. A total of 35,203 sputum samples collected from patients with respiratory distress were screened for the presence of MERS-CoV using real-time reverse-transcription polymerase chain reaction in the examined patients. MERS-CoV infections were detected at a very low percentage in the examined patients. Only 42 of the examined subjects (0.12%) were found positive for MERS-CoV. Most infected cases (32/42) cases were detected in 2014, and the rest of the cases were reported in 2015-2019. The cases with fatal consequences (n = 20) were only detected in 2014. It was concluded that there is a very low prevalence of MERS-CoV infections among the military personnel and their families.

Assessing the response of five tree species to air pollution in Riyadh City, Saudi Arabia, for potential green belt application.

Tree species (including Eucalyptus camaldulensis, Ziziphus spina-christi, Albizia lebbeck, Prosopis juliflora, Pithecellobium dulce, and Ficus altissima) were investigated to elucidate their appropriates for green belt application. Leaf samples were collected from four different locations in Riyadh: (1) residential; (2) dense traffic; (3) industrial; and (4) reference sites located approximately 20 km away from the city of Riyadh. Leaves collected from the industrial site showed the highest leaf area reduction. The smallest reduction of leaf areas was observed for F. altissima (11.6%), while the highest reduction was observed for P. juliflora (34.8%). Variations in the air pollution tolerance index (APTI) coupled with the anticipated performance index (API) for each species were examined. The APTI value of Z. spina-christi was highest (58.5) at the industrial site while the lowest APTI value was for P. juliflora (14) at the reference site. Correlation coefficient and linear regression analyses determined that the correlation between the ascorbic acid content and APTI is positive and significantly strong. Our findings indicate that urban green planning in Riyadh should include growing F. altissima on roadsides as well as in heavy industrial locations followed by Z. spina-christi and A. lebbeck according to their API and APTI performances.

Contamination and risk levels of metals associated with urban street dust in Riyadh, Saudi Arabia.

Urban street dust was collected from 22 locations in Riyadh, Saudi Arabia, and nine metals (Pb, Cr, Zn, Co, Cu, Al, Fe, Mn, and Ni) were investigated. The concentrations of these metals were employed in several common contamination evaluation indices to examine the contamination and the health risk caused by metals. Evaluation of these indices showed that they had variable degrees of contamination sensitivity. For individual contaminating elements (Pb, Cr, Zn, Co, Cu, and Ni), the sensitivities of the contamination of contamination factor (CF), the potential ecological risk (Ei), and geo-accumulation index (Igeo) were very similar. Therefore, these indices should yield very similar results. However, enrichment factor (EF) exhibited a different sensitivity pattern for determining the contamination caused by metals compared with the contamination level indicated by the other indices used in this study. Therefore, to avoid potential false indication of contamination, it is not recommended to use EF alone for determining contamination level. As indicated by four contamination evaluation indices (CF, Ei, Igeo, and EF), Riyadh was mainly contaminated by Pb. However, the health risk assessment results revealed that the Pb contamination level did not exceed the significant risk level for non-cancer effects. The cancer risk values indicated a negligible cancer risk to inhabitants of Riyadh exposed to metals associated with street dust. Considering the comprehensive contamination evaluation indices, the ecological risk index (RI) showed that about 77% of the sampling locations featured high ecological risk of which approximately 41% also featured high contamination indicated by pollution load index (PLI).

Influence of Different Urban Structures on Metal Contamination in Two Metropolitan Cities.

The influence of urban structures and land use patterns of metropolitan cities on the distribution of contaminants is not well understood. In this study, two metropolitan cities [Jeddah (a typical corridor city) and Madinah (a typical compact city)], featuring different spreading patterns and urban structures, were selected to investigate the contamination level and potential risk caused by metals (i.e., Pb, Zn, Co, Fe, Al, Cr, Cu, Ni, and Mn) associated with urban dust. The findings of this study show that a metropolitan city with a limited variety of activities and a polar center (e.g., Madinah) displays a typical distribution pattern of metals, i.e., concentrations of metals increase gradually toward the center of the city. In contrast, a metropolitan city with multiple major activities (e.g., Jeddah) displays a different distribution pattern, controlled by multiple key actors (e.g., seaports, oil refineries, and desalination/power plants) able to shift the location of highest contamination away from the city center. The above findings are supported by the results of several contamination and health indices. In Jeddah, the highest Pb contamination was found near an oil refinery based on geoaccumulation index (Igeo), contamination factor (CF), enrichment factor (EF), and ecological risk (Ei) values; whereas, the highest Zn contamination was found near a seaport, based on EF, CF, and Ei values. However, in Madinah, the contamination indices indicate that the most contaminated locations are near the city center. The highest non-carcinogenic health risk in Jeddah was found near an oil refinery and in the city center; whereas in Madinah, it was found mainly in the city center. Although there is no significant risk of cancer due to metals associated with dust in the two cities, Cr, representing a health risk contribution of >24%, was the major contributor of non-carcinogenic health risk in the two metropolitan cities.

Metal contamination decrease with new legislation: A decade of metal risk assessment in urban dust.

New scientific discoveries for new applications of materials (e.g., metals) lead to extensive industrial use of these materials, which in turn, has significant negative health and environmental impacts. Governments use legislation as a management tool to control the usage of certain materials to lower contamination. This study investigates the level of metal contamination over a period of 12 years to observe the dynamic changes in response to new legislation or industrial improvements. Metals (i.e., Pb, Zn, Co, Cu) associated with urban roadside dust in 21 sites in Riyadh, Saudi Arabia were analyzed during the period of 2001-2013. Three main conclusions were drawn from this study: 1) Phasing out leaded gasoline was an effective tool to control Pb contamination. The average Pb concentration in the city was 37 times higher in 2001 compared to that in 2013. Twenty-nine percent of the investigated sites were at a significant health risk in 2001 compared to none in 2013. 2) The new substitutes of Zn oxides and new limitations of the Zn content in the rubber industry were effective at controlling the Zn contamination in the urban environment. The average Zn concentration of the city was 8 times higher in 2001 compared to that in 2013. Eighty-one percent of the investigated sites in 2001 were considered to be very highly contaminated (CF > 6) compared to none in 2013. 3) The lack of legislation regarding the Co-content in fossil fuels was probably the main reason for the enhancement of the Co contamination in the whole city, with an increase in the average Co concentration >3 times in 2013 compared to that in 2001. Likewise, the health risk index was increased by ∼3 times from 2001 to 2013. For Cu, the average Cu concentration in 2001 was almost twice that in 2003 and 2013. Legislation has been observe to be an effective management tool for controlling metal contamination.

Torsion of a wandering spleen as a cause of portal hypertension and mesenteric varices: a rare aetiology.

A wandering spleen is a condition characterized by excessive splenic mobility due to the mal-development or the laxity of its ligaments that leads to migration from its normal anatomical location. This condition renders its long mobile vascular pedicle liable to torsion and occasional infarction. Herein, we report a case of a 27-year-old nulliparous woman who presented with acute abdominal pain and a tender right-sided pelvi-abdominal mass. CT scan of the abdomen and pelvis revealed a torted, infarcted wandering spleen with portal hypertension and mesenteric varices that mandated an emergency splenectomy. Although there are a few reported cases describing the association of wandering spleen with portal hypertension and fundal varices, cases of mesenteric varices are extremely rare. To the best of our knowledge, this case is considered the third reported case of a wandering spleen which was subsequently complicated by portal hypertension and mesenteric varices that was managed effectively with splenectomy.

Long-term cognitive outcome of very low birth-weight Saudi preterm infants at the corrected age of 24-36 months.

OBJECTIVES: To assess infants' cognitive function at the corrected age of 24-36 months, and to identify factors associated with adverse outcome and examine the correlation between Bayley Infants Neurodevelopmental Screener (BINS) score and Gesell Schedule of Child Development (GSCD). Methods: This retrospective study was performed on Saudi very low birth-weight (VLBW)  infants born   in King Khalid University Hospital, Riyadh, Saudi Arabia between 1997 and 2014 by the use of BINS as screening test and GSCD as definitive test. Results: Of 561 enrolled infants, 367 (65.4%) continued to follow-up. Three-hundred and fifteen infants (85.6%) had a normal cognitive function. In addition to lower birth weight (beta = -0.003) (p less than 0.001), male gender (OR =3.9) (p=0.001)and cerebral palsy (OR =33.9) (p less than 0.001) were the strongest factors associated with poor cognitive outcome. Approximately 75.4% of infants with normal BINS score had normal cognitive function and 7.6% of total infants had sever cognitive impairment. Conclusion: The majority of VLBW infants in our center have  normal cognitive function at the corrected age of 24-36 months. Male gender, lower birth weight, and cerebral palsy are major predictors of poor outcome. The BINS scores were correlated with GSCD as a valid predictor for future developmental outcome.

Neonatal brucellosis: A case report.

Although brucellosis is not uncommon in Saudi Arabia, neonatal brucellosis has been infrequently reported. In this case of neonatal brucellosis, Brucella abortus was isolated by blood culture from both the mother and the neonate. Serology was positive only in the mother.

Prevalence of serological markers and nucleic acid for blood-borne viral infections in blood donors in Al-Baha, Saudi Arabia.

INTRODUCTION: Data on blood-borne viral infections in some regions in Saudi Arabia remain scarce. This study investigates the prevalence of serological markers and nucleic acid for blood-borne viruses among blood donors in Al-Baha, Kingdom of Saudi Arabia. METHODOLOGY: In this cross-sectional study, 2,807 donors who donated blood between January 2009 and November 2011 were investigated for blood-borne viral serological markers including HBsAg, anti-HBc, anti-HBs, anti-HCV, anti-HIV, and anti-HTLVI/III in addition to viral nucleic acid. RESULTS: All donors were males between 16 to 66 years of age (mean: 31.5 ± 9.3 years). Viral nucleic acid and/or serological markers were detected in a total of 36 (1.3%) donors; of them, 26 (72.2%) had nucleic acid concomitant with serological markers, 6 (16.7%) had only viral nucleic acid, while 4 (11.1%) had only serological markers. Of all donors, 22 (0.8%) had HBsAg, 227 (8.0%) had anti-HBc, 157 (5.0%) had anti-HBs, 2,577 (91.8%) had no HBV markers, 2 (0.07%) had anti-HIV, 1 (0.04%) had anti-HCV, and 1 (0.04%) had anti-HTLVI/II. The donors who were born during HBV vaccination era showed no HBsAg (0.0%; p = 0.052), lower rates of anti-HBc (1.5%; p < 0.001) and anti-HBs (0.7%; p < 0.001), while the majority had no HBV markers (98.5%; p < 0.001). CONCLUSIONS: Combined viral nucleic acid and serological testing of donated blood enhances blood safety. The absence of HBV markers among donors suggests susceptibility or declined anti-HBs levels. Thus, HBV revaccination or a vaccine boost among adolescents and adults might be indispensable.

Pursuing Quality in the Application of Bladder Cancer Quality of Life Research.

Patient-reported outcomes (PRO), including health-related quality of life (HRQOL) measures, represent important means for evaluating patients' health outcomes and for guiding health care decisions made by patients, practitioners, investigators, and policy makers. In spite of the large number of studies examining HRQOL in patients with bladder cancer, very few review articles investigated this topic. Because these review studies report mixed results, incorporating bladder cancer HRQOL measures into standard urological practice is not a viable option. In this non-systematic review of the literature and commentary we note some general concerns regarding PRO research, but our primary focus is on the HRQOL methodology within the context of two types of bladder cancer: muscle invasive and non-muscle invasive bladder cancer. Considering bladder cancer HRQOL as the interaction of four areas of the assessment process (i.e., what model of HRQOL to choose, what instruments are available to fit the choice, how interpretation of the resulting data fits the model, and how to derive some utility from the chosen model) and the two types of disease (i.e., muscle invasive and non-muscle invasive) may move us toward a better understanding of bladder cancer HRQOL. Establishing a useful model of perceived general health or specific symptoms is the first and most important step in developing the responsive bladder cancer HRQOL measures necessitated by clinical settings.

Development and usability testing of a web-based self-management intervention for oral cancer survivors and their family caregivers.

Oral cancer (OC) survivors experience debilitating side effects that affect their quality of life (QOL) and that of their caregivers. This study aimed to develop and evaluate a dyadic, web-based intervention to improve survivor self-management and survivor/caregiver QOL. A qualitative needs assessment (semi-structured interviews) with 13 OC survivors and 12 caregivers was conducted to discern information and support needs as well as preferences regarding website features and tools. Results using Grounded Theory analysis showed that OC survivors and caregivers: (1) want and need practical advice about managing side effects; (2) want to reach out to other survivors/caregivers for information and support; and (3) have both overlapping and unique needs and preferences regarding website features. Usability testing (N = 6 survivors; 5 caregivers) uncovered problems with the intuitiveness, navigation and design of the website that were subsequently addressed. Users rated the website favourably on the dimensions of attractiveness, controllability, efficiency, intuitiveness and learnability, and gave it a total usability score of 80/100. Overall, this study demonstrates that OC survivors and caregivers are interested in using an online programme to improve QOL, and that providing tailored website content and features based on the person's role as survivor or caregiver is important in this population.

Total parenteral nutrition-associated cholestasis and risk factors in preterm infants.

BACKGROUND/AIM: Development of hepatic dysfunction is a well-recognized complication of total parenteral nutrition in preterm infants. Previous studies reported the incidence of total parenteral nutrition-associated cholestasis and described possible contributing factors to its pathogenesis, but little is done trying to determine its possible predictive risk factors. The aims of this study was to determine the incidence of total parenteral nutrition-associated cholestasis and to develop a possible predictive model for its occurrence. PATIENTS AND METHODS: A review of medical records of all very low birth weight infants admitted to neonatal intensive care unit at King Khalid University Hospital, Riyadh, Saudi Arabia, between January 2001 and December 2003 was carried out. The infants were divided into two groups: Cholestasis and noncholestasis, based on direct serum bilirubin level >34 µmol/L. A multivariate logistic regression analysis was performed to calculate the statistical significance of risk factors. Receiver-operating characteristic curve was used to determine the optimal cutoff points for the significant risk factors and to calculate their sensitivity and specificity. The level of significance was set at P ≤ 0.05. RESULTS: A total of 307 patients were included in the analysis. The incidence of cholestasis in the whole population was 24.1% (74 patients). Infants with cholestasis had a lower birth weight, 735.4 ± 166.4 g vs. 1185.0 ± 205.6 g for noncholestasis group (P < 0.001), whereas the mean gestational age for the two groups was 25.4 ± 2.1 week and 28.9 ± 2.1 week, respectively (P < 0.001). The significant risk factors for the development of cholestasis were birth weight (P = 0.006) with an odds ratio of 0.99 [95% confidence interval (CI), 0.98, 0.99]; sensitivity of 92%, specificity of 87%; and total parenteral nutrition duration (P < 0.001) with an odds ratio of 1.18 (95% CI, 1.10, 1.27); sensitivity of 96%, specificity of 89%. CONCLUSIONS: A lower birth weight and longer duration of total parenteral nutrition were strong predictive risk factors for the development of cholestasis in preterm infants.

Perinatal statistics of a 15-year period in the Central Region of Saudi Arabia.

Perinatal statistics are one of the most essential outcome indicators used by many developed countries in order to evaluate perinatal services provided to newborns. In this retrospective study, we collected 15 years of perinatal data at King Khalid University Hospital in Riyadh, Saudi Arabia in order to determine stillbirth and other mortality rates in our institute and compare them with international figures. A total of 58,073 babies were evaluated. Data were collected from maternal and neonatal registry books and from perinatal mortality and morbidity meeting reports between 1994 and 2008. Data were entered and analyzed using Microsoft Office Excel 2007. The stillbirth rate was 11.7/1000, early neonatal death rate was 3.4/1000, perinatal mortality rate (PMR) was 14.9/1000, and corrected PMR was 11.9/1000. Our rates were not significantly different from those of North American and European ones. We noticed a dramatic reduction in the corrected PMR in the last 3 years of the study because of greater advancement in perinatal and neonatal care. Our mortality rates were comparable to the North American and European rates which may reflect the quality of perinatal care provided in our institute.

Assessment of visual disability using the WHO disability assessment scale (WHO-DAS-II): role of gender.

OBJECTIVE: To study the role of gender in coping with disability in young visually impaired students attending two schools for blindness. METHODS: The WHO Disability Assessment Schedule (WHODAS II), 36-Item Interviewer Administered translated Arabic version was used. It evaluates six domains of everyday living in the last 30 days. These domains are: understanding and communicating, getting around, self care, getting along with people, household activities and participation in society. Face-to-face interviews were conducted with 200 students who represented the target population of the study. RESULTS: Binary logistic regression analysis of the scores of the six domains revealed that in all of the domains except getting along with people and coping with school activities, females significantly faced more difficulties in coping with daily life activities than did their male counterparts. Increasing age significantly increased difficulties in coping with school activities. Genetic causes of blindness were associated with increased difficulties. CONCLUSION: Females face more difficulties in coping with visual disability. Genetic counselling is needed to decrease the prevalence of visual disability. Girls with blindness need additional inputs to help cope with blindness. Early intervention facilitates dealing with school activities of the visually impaired.