Exploring the detailed role of interleukins in cancer: A comprehensive review of literature.

The cancer cells that are not normal can grow into tumors, invade surrounding tissues, and travel to other parts of the body via the lymphatic or circulatory systems. Interleukins, a vital class of signaling proteins, facilitate cell-to-cell contact within the immune system. A type of non-coding RNA known as lncRNAs mediates its actions by regulating miRNA-mRNA roles (Interleukins). Because of their dual function in controlling the growth of tumors and altering the immune system's response to cancer cells, interleukins have been extensively studied concerning cancer. Understanding the complex relationships between interleukins, the immune system, the tumor microenvironment, and the components of interleukin signaling pathways that impact the miRNA-mRNA axis, including lncRNAs, has advanced significantly in cancer research. Due to the significant and all-encompassing influence of interleukins on the immune system and the development and advancement of cancers, lncRNAs play a crucial role in cancer research by modulating interleukins. Their diverse effects on immune system regulation, tumor growth encouragement, and tumor inhibition make them appealing candidates for potential cancer treatments and diagnostics. A deeper understanding of the relationship between the biology of interleukin and lncRNAs will likely result in more effective immunotherapy strategies and individualized cancer treatments.

Sensitivity Profile of Fosfomycin, Nitrofurantoin, and Co-trimoxazole Against Uropathogens Isolated From UTI Cases in a Secondary Care Center, KSA.

Background Fosfomycin, nitrofurantoin, and co-trimoxazole are cheap and effective first-line oral antimicrobials in cases of uncomplicated cystitis in males and non-pregnant females. Fosfomycin and nitrofurantoin are called urinary antiseptics because these two drugs are primarily excreted in the kidney and concentrated in the urine without systemic effect. The present study was designed to evaluate the in vitro activities of fosfomycin, nitrofurantoin, and co-trimoxazole against uropathogens isolated at King Khalid Hospital Al-Majmaah, KSA. Methods The study was conducted at the King Khalid Hospital Al Majmaah, KSA, from September 1, 2021, until February 28, 2022. The patients' urine samples were inoculated on the Cystein Lactose Electrolytes Deficient (CLED) medium, and uropathogens were isolated. The organisms' identification and sensitivity testing against cotrimoxazole, fosfomycin, and nitrofurantoin was conducted using a Microscan automated analyzer, the MicroScan WalkAway Beckman Coulter, Sacramento, CA, USA. Results The study comprised non-repeat 137 patients who were either admitted to the hospital or treated as outpatients, yielding a total of 147 isolates. Nitrofurantoin showed a lower resistance rate, around 20% (n = 29), followed by fosfomycin at 23% (n = 34). The resistance rate of cotrimoxazole was 43% (n = 63). Overall, nitrofurantoin and fosfomycin showed relatively lower resistance against all isolates. Conclusions Being cheap and effective, we propose that fosfomycin and nitrofurantoin be used as first-line treatments in patients presenting with uncomplicated UTIs.

Assessing Medical Ethics Knowledge and Practice Among Healthcare Professionals in Al Majma'ah, Saudi Arabia.

Background The healthcare system is increasingly confronted with ethical challenges, necessitating a thorough exploration of healthcare providers' ethical knowledge and attitudes. This study aims to evaluate the ethical awareness and attitudes of healthcare providers in the Al Majma'ah region of the Kingdom of Saudi Arabia (KSA). Aim This research focuses on assessing the level of knowledge and practice regarding medical ethics among healthcare providers in a community hospital in Majmaah, KSA. Methods A comprehensive cross-sectional study was undertaken in the Majmaah governorate of Saudi Arabia. Data collection involved distributing a meticulously designed questionnaire to healthcare providers and faculty members affiliated with the College of Medicine. Subsequently, the acquired dataset underwent analysis utilizing SPSS software. Results A total of 183 participants were included in the study. The findings revealed that only 77 respondents (42.1%) considered ethical issues in their profession as extremely important. Moreover, 104 participants (56.8%) were aware of the existence of an ethics committee in their institution. A total of 113 respondents (61.7%) disagreed with the notion that ethical conduct is primarily important to avoid legal consequences, and 120 participants (65.6%) believed in the significance of in-service training on medical ethics for doctors. The study also highlighted that 100 participants (54.6%) believed that healthcare providers' opinions supersede patient preferences. However, a majority, 163 participants (89.1%), agreed that patients should be informed of any wrongdoing, contrasting with only 20 (10.9%) who disagreed. When asked about adhering to patients' wishes despite doctors' opinions, 112 (61.2%) responded affirmatively, while 71 (38.3%) disagreed. There was also a disparity in opinions regarding the necessity of obtaining consent, with 81 (44.3%) agreeing that consent is required not only for surgical procedures but also for medications or investigations. Furthermore, 137 participants (74.9%) recognized the importance of discussing ethical, social, and legal issues during clinical rounds alongside clinical aspects of patient care, while 46 (25.1%) disagreed. Conclusion Although medical ethics were introduced into the Saudi healthcare system more than a decade ago, this study underscores the ethical necessity of obtaining comprehensive informed consent prior to invasive and other medical procedures. It also highlights the significance of engaging patients in the decision-making process regarding their treatment. Well-informed patients typically exhibit higher satisfaction levels and are less inclined to pursue legal action.

Knowledge, acceptance, motivators and barriers of booster dose of COVID-19 vaccination among dental patients: A cross-sectional study.

Given the lingering threat of COVID infection, questions are being raised if coronavirus disease 2019 (COVID-19) vaccine needs annual or regular boosters to maintain high levels of immunity against both the original virus and variants. This study was designed to evaluate the knowledge, acceptance, motivators and barriers of the booster dose of COVID-19 vaccine among the dental patients of District Lucknow, India. A total of 297 respondents were selected by a convenience sampling method in this cross-sectional study from various dental clinics. An anonymous, self-administered, closed-ended questionnaire was used. Overall 37.7% respondents reported to have taken all 3 doses and 57.9% had taken single/double doses. Correct information about booster doses shows a significant association with the number of doses taken. The majority had information about the availability of the Pfizer booster vaccine (69.0%). About 58% of participants had information about the technology used in booster doses. The hesitancy for booster doses and the development of natural immunity by infection show significant associations with the number of doses taken. Only 18.2% patients had hesitation about the booster dose and most of them 78.8% recommended others to take the booster vaccine as soon as possible. The majority assumed that previous COVID-19 vaccines can help them get immune (21.5%) followed by not much research has been done on the booster vaccines (15.5%) and their chronic diseases warn them against the booster dose administration (12.5%). Nearly 18.2% of respondents had hesitation about booster dose and less than one third of the respondents trusted a government source for information about booster dose of COVID vaccine. Nearly 36 % did not know that the booster dose of COVID vaccine is available at health centers. Dental health professionals and policymakers should implement and support strategies to ensure people are vaccinated for COVID-19 booster doses.

Environmental sustainability through green HRM: Measuring the perception of university managers.

Environmental sustainability has gained great momentum worldwide especially in the United Nations (UN), governments, and corporations, and by those who promote global awareness of environmental challenges and are engaged in environmental management. Even as these stakeholders struggle hard, academia has actively engaged in an ongoing debate to make "green human resource management" an independent field of research and teaching. From the large body of academic literature, it has been observed that the field is yet in its embryonic stage in many developing countries such as Pakistan and there is insufficient knowledge on how universities face and manage environmental challenges. Hence, this study addressed this gap in the literature and measured the perception of public and private sector university managers regarding environmental sustainability by using a multi-respondent multi-wave design and collected data from academic heads/supervisors and university faculty in three-time intervals. The data found support for all the hypothetical relationships. The study revealed that the green human resource management (GHRM) practices of public and private universities have a positive impact on environmental sustainability through the mediation of innovative work behavior of employees.

Epidemiological Analysis And Successful Management Of A Candida Auris Outbreak In A Secondary Care Hospital Setting In Saudi Arabia; An Outbreak Report.

Candida auris has emerged as a major diagnostic and therapeutic challenge in the hospital environment. C. auris is resistant to many antifungals, making it a newer example of one of the world's most problematic and feared health threats. We recently confronted a cluster of C. auris cases at our hospital during the spring of 2020.This outbreak investigation took place at the ICU of King Khalid hospital Al Majmaah Saudi Arabia. Considering its potential to cause an outbreak with serious consequences, strict control measures were implemented thus effectively controlling the outbreak.

Recurrent Urinary Tract Infection in a Renal Transplant Patient by Pan-resistant Myroides Spp.

The myroides bacteria species are multidrug-resistant gram-negative aerobic bacilli. The genus myroides comprises two species, i.e., M. odoratimimus and M. odoratus, and is usually associated with infections in immunocompromised patients; though infections in immunocompetent individuals have also been reported. They are a rare cause of infection worldwide. So far, only 53 cases have been reported in the literature. Here, we report a case of recurrent urinary tract infection by myroides species. This is the first documented case in Saudi Arabia to the best of our knowledge. Key Words: Myroides, Recurrent UTI, Renal transplant recipient, Immunosuppression.

Safe Zone for Dissection in Frontotemporal Region to Avoid Injury to the Temporal Branch of Facial Nerve.

ABSTRACT: The objective of this study is to provide a reliable roadmap for temporal branch of the facial nerve, in order to minimize, the risk of injury to the nerve during surgical dissections. A literature search was conducted on temporal branch of facial nerve. The date search range was 1950 to 2017. Databases searched included Medline, Web of science, Biosis, SciELO, Data Citation, and Zoologic Records. Data were collected on, author specialty, date of publication, and the relationship of the temporal branch of facial nerve to various landmarks in the frontotemporal region reported in human anatomic studies. Among the 48 studies reviewed, a total of 3477 anatomic dissections were performed in the craniofacial region. Temporal branch of facial nerve was located between 2.5 and 3 cm from lateral orbital rim. In relation to the zygomatic arch, it was found anywhere from the midpoint of the arch to 1 finger breath posterior to the arch. For the plane, it was most commonly described as being under the superficial temporal fascia (STF) or within the loose areolar tissue. Most anatomic dissections found 2 to 4 twigs of the temporal branch of facial nerve. In relation to the lateral canthus, it was found to be 2.85 +/- 0.69 cm superior and 2.54 +/- 0.43 cm lateral to the lateral canthus. Our study suggests consolidated data on surgical landmarks in order to ensure safe dissection in temporal region and prevent injury to the temporal branch of facial nerve.

Antibiotic Prescribing Patterns for Hospitalized children with Community-Acquired Pneumonia in a Secondary Care Center.

BACKGROUND: Narrow-spectrum antibiotics are recommended as the first-line therapy for management of children hospitalized with community-acquired pneumonia (CAP). There are limited data evaluating the antibiotic prescription patterns for CAP in Saudi Arabia. The goal of this study to report on the antibiotic patterns in children hospitalized with CAP. METHODS: A prospective cross-sectional study was conducted in children aged 1 month to 13 years who were hospitalized with a diagnosis of CAP at King Khalid Hospital in Majmaah, Saudi Arabia, between January 2019 and January 2020. RESULTS: Data from 233 patients were collected. The majority of patients received amoxicillin clavulanate (57.9%), followed by ceftriaxone (30%), azithromycin (20.6%), cefuroxime (6%), ampicillin (2.1%), and piperacillin-tazobactam (2.1%). None of our patients were started on narrow-spectrum therapy. The younger age group (1-3 months) and patients with severe pneumonia were more likely to receive broad-spectrum cephalosporin and have a longer hospital stay (P = .000 and P = .002, respectively). However, the 4 months to 5 years age group was more likely to receive amoxicillin clavulanate (P = .001). Male gender was a significate risk factor for patients with severe pneumonia (P=.013) CONCLUSIONS: We demonstrated the inappropriate use of broad-spectrum therapy in children hospitalized with CAP. Further large multicenter studies are necessary to evaluate the patterns of antibiotic use and implement antimicrobial stewardship programs or quality-improvement projects to improve adherence to guidelines.

Efficacy of newer modalities in the management of indirect hyperbilirubinaemia at a secondary care hospital: A prospective study from 2015-2018.

OBJECTIVE: To evaluate the efficacy of current practices and new modalities for the management of neonatal indirect hyperbilirubinaemia. METHODS: The prospective study was conducted at King Khalid Hospital, Al Majmaah, Saudi Arabia, from September 2015 to September 2018, and copmprised neonates with hyperbilirubinaemia who were managed using the National Institute for Health and Clinical Excellence 2010 guidelines. The outcomes were measured in terms of decrease in total serum bilirubin and clinical improvement. Data was analysed using SPSS 25. RESULTS: Of the 233 subjects, there were 119(51%) girls and 114(49%) boys. Phototherapy was used in 162(69.5%) cases, intensive phototherapy in 36(15.5%) and intravenous immunoglobulin in 35(15%). Exchange transfusion was done in 2(0.85%) patients. All the 233(100%) patients improved with the management and total serum bilirubin significantly reduced (p<0.05). CONCLUSIONS: Newer techniques were found to have a vital role in the management of neonatal hyperbilirubinaemia.

The Impact of Cardiac Rehabilitation on Mental and Physical Health in Patients With Atrial Fibrillation: A Matched Case-Control Study.

BACKGROUND: Patients with atrial fibrillation (AF) experience symptom burden, exercise intolerance, weight gain, poor mental health, and diminished quality of life (QoL). Cardiac rehabilitation (CR) is recommended for patients with heart disease, and its benefits are well established, yet clinical guidelines for patients with AF do not include the referral to CR. METHODS: In this matched retrospective, case-control study, we examined the impact of CR on changes in QoL, mental health, and cardiometabolic health indicators in patients with or without persistent or permanent AF. Patients attended CR that addressed risk factor management and provided support services and exercise training twice weekly for 3 months. Height, body mass, waist circumference, blood pressure, and heart rate were measured, and the Short Form-36 and Hospital Anxiety and Depression Scale were administered at baseline and 3 months follow-up. RESULTS: A total of 94 patients (AF, n = 47; no AF, n = 47) (aged 70 ± 8 years) participated. Significant improvements in 2 of the 8 subscales and the Physical Component Summary of the Short Form-36 were observed across groups after CR (P < 0.05). Significant interactions revealed that the effect of CR was greater for energy, emotional well-being, social functioning, pain, and the Physical Component Summary in patients without AF (P < 0.05 for each). No significant improvements in anxiety (AF: -1.3 ± 3.4; no AF: -1.3 ± 4.3), depression (AF: -1.1 ± 2.9; no AF: -0.4 ± 2.7), body mass index (AF: -0.5 ± 1.2; no AF: -0.8 ± 1.5, kg/m2), waist circumference (AF: -1.7 ± 4.6; no AF: 0.4 ± 8.1, cm), or blood pressure (AF: -2.3 ± 17.1/-3.9 ± /9.3; no AF: 1.8 ± 16.4/-0.8 ± /9.3 mm Hg) were observed across groups after CR. CONCLUSIONS: CR improved QoL to a greater extent in patients with heart disease without than with persistent or permanent AF.

Concomitant Simple Limbal Epithelial Transplantation After Surgical Excision of Ocular Surface Squamous Neoplasia.

PURPOSE: To compare the surgical outcomes of ocular surface squamous neoplasia (OSSN) following wide excisional biopsy with and without primary simple limbal epithelial transplantation (p-SLET). DESIGN: Nonrandomized clinical study with historical controls. METHODS: setting: Single-institutional study. PATIENTS: Eight patients who underwent wide excisional biopsy of OSSN without p-SLET (historical controls) and 7 patients with p-SLET (cases). INTERVENTION: Wide excisional biopsy, p-SLET. MAIN OUTCOME MEASURES: Limbal stem cell deficiency (LSCD). RESULTS: The tumor features of cases vs historical controls, including mean number of limbal clock hours affected by OSSN (6 vs 4; P = .12), mean tumor basal dimension (13 mm vs 8 mm; P = .11), and mean number of clock hours of corneoscleral limbal dissection owing to wide tumor excision (8 vs 7; P = .12), were comparable. The occurrence of partial LSCD in historical controls vs cases was 75% vs 0% (P = .007) at a mean follow-up period of 12 months in both groups. Of these 6 historical controls that developed LSCD, pannus was noted in 1 (13%) and pseudopterygium extending onto the cornea in 5 (63%) patients. The mean number of clock hours of LSCD was 3 (median, 2; range, 2-6) in these historical controls. The mean time interval between surgical excision of OSSN and onset of LSCD was 8 weeks (median, 6 weeks; range, 6-12 weeks). CONCLUSION: Corneoscleral limbal dissection of ≥6 clock hours during wide excision of OSSN can cause LSCD. Concomitant p-SLET after surgical excision of OSSN prevents LSCD in cases requiring extensive corneoscleral limbal dissection.

Etiologic analysis of 100 anatomically failed dacryocystorhinostomies.

BACKGROUND: The aim of this study was to assess the etiological factors contributing to the failure of a dacryocystorhinostomy (DCR). PATIENTS AND METHODS: Retrospective review was performed in 100 consecutive patients who were diagnosed with anatomically failed DCR at presentation to a tertiary care hospital over a 5-year period from 2010 to 2015. Patient records were reviewed for demographic data, type of past surgery, preoperative endoscopic findings, previous use of adjuvants such as intubation and mitomycin C, and intraoperative notes during the re-revision. The potential etiological factors for failure were noted. RESULTS: Of the 100 patients with failed DCRs, the primary surgery was an external DCR in 73 and endoscopic DCR in 27 patients. Six patients in each group had multiple revisions. The mean ages at presentation in the external and endoscopic groups were 39.41 years and 37.19 years, respectively. All patients presented with epiphora. The most common causes of failure were inadequate osteotomy (69.8% in the external group and 85.1% in the endoscopic group, P=0.19) followed by inadequate or inappropriate sac marsupialization (60.2% in the external group and 77.7% in the endoscopic group, P=0.16) and cicatricial closure of the ostium (50.6% in the external group and 55.5% in the endoscopic group, P=0.83). The least common causes such as ostium granulomas and paradoxical middle turbinate (1.37%, n=1) were noted in the external group only. CONCLUSION: Inadequate osteotomy, incomplete sac marsupialization, and cicatricial closure of the ostium were the most common causes of failure and did not significantly differ in the external and endoscopic groups. Meticulous evaluation to identify causative factors for failure and addressing them are crucial for subsequent successful outcomes.

Acute lymphoblastic leukemia as second primary tumor in a patient with retinoblastoma.

Second primary tumor (SPT) is defined as a second tumor that presents either simultaneously or after the diagnosis of an index tumor. Second primary malignancies are the leading cause of death in patients with heritable retinoblastoma (RB). Acute lymphoblastic leukemia (ALL), as SPT in RB patients, is extremely rare. To the best of our knowledge, only five cases of ALL as SPT in patients with RB has been documented in the literature. Herein, we report a case of a 6-year-old girl with bilateral RB, who developed ALL during the course of treatment of RB. This case highlights the importance of reviewing blood investigations regularly to diagnose leukemia as SPT in RB and also the necessity for proper counseling and lifelong follow-up in these patients.

A modern cohort of duodenal obstruction patients: predictors of delayed transition to full enteral nutrition.

Background. A common site for neonatal intestinal obstruction is the duodenum. Delayed establishment of enteral nutritional autonomy continues to challenge surgeons and, since early institution of nutritional support is critical in postoperative newborns, identification of patients likely to require alternative nutritional support may improve their outcomes. Therefore, we aimed to investigate risk factors leading to delayed establishment of full enteral nutrition in these patients. Methods. 87 patients who were surgically treated for intrinsic duodenal obstructions from 1998 to 2012 were reviewed. Variables were tested as potential risk factors. Median time to full enteral nutrition was estimated using the Kaplan-Meier method. Independent risk factors of delayed transition were identified using the multivariate Cox proportional hazards regression model. Results. Median time to transition to full enteral nutrition was 12 days (interquartile range: 9-17 days). Multivariate Cox analysis identified three significant risk factors for delayed enteral nutrition: gestational age (GA) ≤ 35 weeks (P < .001), congenital heart disease (CHD) (P = .02), and malrotation (P = .03). Conclusions. CHD and Prematurity are most commonly associated with delayed transition to full enteral nutrition. Thus, in these patients, supportive nutrition should strongly be considered pending enteral nutritional autonomy.