HbA1c and risk factors' prevalence in patients with stroke: a retrospective study in a tertiary care hospital in Saudi Arabia.

OBJECTIVES: To determine the relationship between hemoglobin A1c (HbA1c) and different types of stroke, and how different comorbidities and risk factors are related to the occurrence of stroke in a Saudi Arabian tertiary care hospital. METHODS: This retrospective study was conducted at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. The study included patients who experienced either hemorrhagic stroke (HS), ischemic stroke (IS), or transient ischemic attack (TIA) between 2015 and 2020. RESULTS: In total, 976 patients were included, of whom 670 were males (68.6%). The incidence of HS was significantly higher in males compared to females (14.2% vs. 6.9%), whereas the incidence of IS was higher in females (76.8% vs. 74.6%) (p=0.001). Ischemic stroke was significantly higher in the 65 years or older age group, whereas HS was comparatively higher among those aged <65 years. The means HbA1c levels in all three types of stroke were abnormally high. However, HbA1c levels were significantly higher in IS than in the other 2 stroke types (p=0.017). The HbA1c levels showed statistically significant differences between the different types of stroke, where the estimated marginal means were higher in patients with IS with a small effect size. Heart disease was also more prevalent in the IS group. Stroke-related mortality was reported in 16 patients and was significantly higher in the IS group than in the HS group. CONCLUSION: The HbA1c levels were elevated in all types of stroke, significantly in IS. Controlling patients' HbA1c and other modifiable risk factors could significantly reduce the risk of stroke.

Unveiling the Veil: Exploring Diabetic Retinopathy Awareness and Behaviors of the General Population of Hafr Al Batin, Saudi Arabia.

BACKGROUND: Diabetic retinopathy (DR) is a potentially blinding complication of diabetes mellitus (DM). The current study set out to explore the awareness level and attitude of the general population of Hafr Al Batin, Saudi Arabia, where DM prevalence is high. METHODOLOGY: Data was collected through community-based, self-administered questionnaires in the general population of Hafr Al Batin, Saudi Arabia. The study included 406 participants, and the analysis revealed varying levels of knowledge, attitude, and practices related to DR. The study also explored the associations between sociodemographic factors and knowledge, attitude, and practices related to DR. The analysis showed that the participants had medium (67.4%) knowledge levels, while 32.5% had low knowledge. RESULTS: The participants comprised 55.7% males and 44.3% females, with varying education levels and economic statuses. The majority were diagnosed with diabetes (94.3%). Attitude scores revealed that 30.8% had a favorable attitude, and 69.2% had medium attitude levels. Regarding practices, 71.2% of the respondents had low practice levels. The association between sociodemographic factors and knowledge, attitude, and practice were also explored. CONCLUSION: The current study concluded a medium level of knowledge (67.4%), and attitude toward DR is also low (69.2%). More than half of the respondents followed a poor level of practice (71.2%). The results of the current investigation demonstrated that the general population does not have sufficient knowledge, attitude, and practices regarding DR in Saudi Arabia. By promoting greater knowledge and understanding of DR, the burden of visual impairment brought on by this complication can be lessened by early detection and efficient care.

Municipal solid waste generation and its compositional assessment for efficient and sustainable infrastructure planning in an intermediate city of Pakistan.

It is imperative to design and operate sustainable solid waste management (SWM) systems in cities based on the results of waste amount and characterization study (WACS). In this work, WACS was conducted and results were used to design an SWM system for an intermediate city of Pakistan. The study revealed that about 110 tons of solid waste per day is generated with a per capita rate of 0.337 kg/day. Around 51.2% of mixed municipal solid waste (MSW) is organic in nature and its non-scientific disposal is resulting in higher greenhouse gas (GHG) emissions. It was also found that more than 80% of valuables are taken away by the informal sector during the transfer of MSW from the generation source to the dumping site. Ultimate analyses showed that the moisture content (MC) and carbon to nitrogen (C:N) ratio were 64.23% and 51.14%, respectively. Proximate analysis revealed that moisture and calorific values were 57 % and 3505 BTU/lb., respectively. Based on these results, a material sorting facility (MSF) was proposed, with an estimated investment cost of US $3.64 million. However, the efficiency of the existing collection system is limited to 32 % only. In order to improve the collection efficiency (>90 %), an additional investment of US $1.638 million was estimated with an operations and maintenance (O&M) cost of US $19.25 per ton. Existing non-scientific MSW disposal practices contribute 32,079.61 CO2e tons/year of GHG emissions. The proposed MSF followed by composting is estimated to reduce GHG emissions by 38% to 19,722.38 CO2e tons/year.

Prevalence of refractive errors in school-going children of Taif region of Saudi Arabia.

PURPOSE: To determine the prevalence of refractive errors in the pediatric population in Taif, Saudi Arabia. METHODS: This cross-sectional study included 7356 eyes of 3678 primary and secondary school children (males = 1837; females = 1841) with a mean age of 11.8 ± 2.2 years (range: 7-18) (males = 11.4 ± 2.0 [range: 8-16]; females = 12.2 ± 2.3 [range: 7-18]). All participants were selected from the school registers. The participants underwent noncycloplegic refraction to determine refractive errors. Students who refused visual acuity assessment or eye examination and were inconsistent in visual acuity assessment were excluded. RESULTS: The manifest refraction spherical equivalent of the study population was 0.37 ± 1.52 D (range from - 18.4 to 8.8 D) (males = -0.32 ± 1.4 D [range - 15.88-8.8 D]; females = -0.42 ± 1.6 D [range - 18.38-8.0 D]). The overall prevalence of uncorrected refractive errors among school children in this study was 50.91%. The overall distribution of astigmatism (cylinder error of ≥0.50 D) in the current study population was found to be 50.14% (3688/7356 eyes). CONCLUSION: Nearly half of the study population in this area was affected with at least one type of refractive error. The findings reveal the necessity for implementing timely and sensitive screening programs/methods to identify and correct refractive errors in this age group.

Validation of the isothermal Schistosoma haematobium Recombinase Polymerase Amplification (RPA) assay, coupled with simplified sample preparation, for diagnosing female genital schistosomiasis using cervicovaginal lavage and vaginal self-swab samples.

BACKGROUND: Female genital schistosomiasis (FGS) is a neglected and disabling gynecological disease that can result from infection with the parasitic trematode Schistosoma haematobium. Accurate diagnosis of FGS is crucial for effective case management, surveillance and control. However, current methods for diagnosis and morbidity assessment can be inaccessible to those at need, labour intensive, costly and unreliable. Molecular techniques such as PCR can be used to reliably diagnose FGS via the detection of Schistosoma DNA using cervicovaginal lavage (CVL) samples as well as lesser-invasive vaginal self-swab (VSS) and cervical self-swab samples. PCR is, however, currently unsuited for use in most endemic settings. As such, in this study, we assessed the use of a rapid and portable S. haematobium recombinase polymerase amplification (Sh-RPA) isothermal molecular diagnostic assay, coupled with simplified sample preparation methodologies, to detect S. haematobium DNA using CVL and VSS samples provided by patients in Zambia. METHODOLOGY/PRINCIPAL FINDINGS: VSS and CVL samples were screened for FGS using a previously developed Sh-RPA assay. DNA was isolated from VSS and CVL samples using the QIAamp Mini kit (n = 603 and 527, respectively). DNA was also isolated from CVL samples using two rapid and portable DNA extraction methods: 1) the SpeedXtract Nucleic Acid Kit (n = 223) and 2) the Extracta DNA Tissue Prep Kit (n = 136). Diagnostic performance of the Sh-RPA using VSS DNA extacts (QIAamp Mini kit) as well as CVL DNA extracts (QIAamp Mini kit, SpeedXtract Nucleic Acid Kit and Extracta DNA Tissue Prep Kit) was then compared to a real-time PCR reference test. Results suggest that optimal performance may be achieved when the Sh-RPA is used with PuVSS samples (sensitivity 93.3%; specificity 96.6%), however no comparisons between different DNA extraction methods using VSS samples could be carried out within this study. When using CVL samples, sensitivity of the Sh-RPA ranged between 71.4 and 85.7 across all three DNA extraction methods when compared to real-time PCR using CVL samples prepared using the QIAamp Mini kit. Interestingly, of these three DNA extraction methods, the rapid and portable SpeedXtract method had the greatest sensitivity and specificity (85.7% and 98.1%, respectively). Specificity of the Sh-RPA was >91% across all comparisons. CONCLUSIONS/SIGNIFICANCE: These results supplement previous findings, highlighting that the use of genital self-swab sampling for diagnosing FGS should be explored further whilst also demonstrating that rapid and portable DNA isolation methods can be used to detect S. haematobium DNA within clinical samples using RPA. Although further development and assessment is needed, it was concluded that the Sh-RPA, coupled with simplified sample preparation, shows excellent promise as a rapid and sensitive diagnostic tool capable of diagnosing FGS at the point-of-care in resource-poor schistosomiasis-endemic settings.

Punicalagin prevents cisplatin-induced nephrotoxicity by attenuating oxidative stress, inflammatory response, and apoptosis in rats.

Nephrotoxicity is a major complication that limits the therapeutic application of cisplatin (CIS). Oxidative stress and inflammation are implicated in CIS-induced acute kidney injury (AKI) and apoptotic cell death. Punicalagin (PUN), a polyphenol in pomegranate, possesses promising anti-inflammatory and antioxidant activities, and its beneficial effect against CIS-induced AKI has not been fully elucidated. This investigation evaluated the protective effect of PUN against CIS-induced renal oxidative stress, inflammation and cell death. Rats received PUN (25 and 50 mg/kg) for 10 days and a single injection of CIS at day 7. The results showed increased serum urea and creatinine and several histopathological alterations in the kidney of CIS-intoxicated rats. Renal malondialdehyde (MDA) and nitric oxide (NO) were increased, and reduced glutathione, superoxide dismutase and catalase were declined in rats treated with CIS. PUN effectively ameliorated kidney function and attenuated tissue injury induced by CIS, decreased MDA and NO, and enhanced antioxidant defenses. Additionally, PUN downregulated NF-κB p65, iNOS, TNF-α, IL-6 and IL-1ß in the kidney of rats that received CIS. Bax and caspase-3 were increased, and Bcl-2 was decreased in the kidney of CIS-intoxicated rats, an effect that was reversed by PUN. PUN upregulated Nrf2 expression in the kidney of CIS-intoxicated rats. In conclusion, PUN prevents CIS-induced AKI in rats by attenuating oxidative stress, inflammatory response and apoptosis, and upregulating Nrf2 and antioxidants.

Visnagin prevents isoproterenol-induced myocardial injury by attenuating oxidative stress and inflammation and upregulating Nrf2 signaling in rats.

Oxidative tissue injury and inflammatory responses play major roles in cardiovascular diseases and heart failure. Visnagin (VIS) is a natural bioactive component of Ammi visnaga, with promising radical scavenging and anti-inflammatory activities. This study explored the protective effect of VIS against isoproterenol (ISO)-induced acute myocardial injury and oxidative stress in rats. VIS was supplemented for 14 days, and the rats received ISO (100 mg/kg) twice at an interval of 24 h. ISO-induced myocardial injury was characterized by elevated serum CK-MB, LDH, and troponin-I associated with increased heart weight and several histopathological changes. ISO increased reactive oxygen species (ROS), malondialdehyde (MDA), NF-κB p65, TNF-α, IL-6, and decreased glutathione and antioxidant enzymes in rats' hearts. VIS prevented myocardial injury and ameliorated the cardiac function markers, ROS, MDA, NF-κB p65, and pro-inflammatory cytokines in ISO-intoxicated rats. In addition, VIS decreased Bax mRNA and caspases, and upregulated Nrf2, HO-1, Bcl-2, and PPARγ. Molecular docking simulations revealed the binding method of VIS to NF-κB, Keap1, and PPARγ. In conclusion, VIS protects against ISO-induced acute myocardial injury by attenuating oxidative tissue injury and reducing key inflammatory and apoptosis markers. In vivo and in silico results showed that activation of Nrf2/HO-1 signaling and PPARγ mediates the cardioprotective effect of VIS.

Galangin attenuates diabetic cardiomyopathy through modulating oxidative stress, inflammation and apoptosis in rats.

Cardiovascular complications are the leading cause of morbidity in diabetes. Oxidative stress and inflammation are implicated in the development and progression of diabetic cardiomyopathy (DCM). This study explored the cardioprotective effect of galangin (Gal), a natural flavonoid with radical-scavenging and anti-inflammatory activities, in diabetic rats. An experimental diabetic rat model was achieved by a single injection of 50 mg/kg streptozotocin. Gal (15 mg/kg) was administered daily for six weeks and the samples were then collected. Diabetic rats exhibited hyperglycemia, increased glycosylated hemoglobin, triglycerides and cholesterol levels and reduced serum insulin. Serum troponin I, CK-MB and LDH were increased in diabetic rats. Furthermore, hearts of diabetic rats were characterized by elevated malondialdehyde, protein carbonyl, NF-κB p65, TNF-α, IL-1ß, iNOS, IL-6, Bax, caspase-3 and 8-Oxo-dG, and decreased superoxide dismutase, catalase, reduced GSH, and Bcl-2. Gal ameliorated hyperglycemia, dyslipidemia, and heart function markers, and prevented histopathological alterations in diabetic rats. In addition, Gal attenuated cardiac oxidative injury, inflammation and apoptosis, and boosted antioxidant defenses. In conclusion, Gal has a protective effect on cardiomyopathy by attenuating hyperglycemia, dyslipidemia, oxidative stress and inflammation in diabetic rats.

Vitamin D is a potential inhibitor of COVID-19: In silico molecular docking to the binding site of SARS-CoV-2 endoribonuclease Nsp15.

Novel coronavirus disease (COVID-19) has become a pandemic threat to public health. Vaccines and targeted therapeutics to prevent infections and stop virus proliferation are currently lacking. Endoribonuclease Nsp15 plays a vital role in the life cycle, including replication and transcription as well as virulence of the virus. Here, we investigated Vitamin D for its in silico potential inhibition of the binding sites of SARS-CoV-2 endoribonuclease Nsp15. In this study, we selected Remdesivir, Chloroquine, Hydroxychloroquine and Vitamin D to study the potential binding affinity with the putative binding sites of endoribonuclease Nsp15 of COVID-19. The docking study was applied to rationalize the possible interactions of the target compounds with the active site of endoribonuclease Nsp 15. Among the results, Vitamin D was found to have the highest potency with strongest interaction in terms of LBE, lowest RMSD, and lowest inhibition intensity Ki than the other standard compounds. The investigation results of endoribonuclease Nsp15 on the PrankWeb server showed that there are three prospective binding sites with the ligands. The singularity of Vitamin D interaction with the three pockets, particularly in the second pocket, may write down Vitamin D as a potential inhibitor of COVID-19 Nsp15 endoribonuclease binding sites and favour addition of Vitamin D in the treatment plan for COVID-19 alone or in combination with the other used drugs in this purpose, which deserves exploration in further in vitro and in vivo studies.

Prevalence of malocclusion, its association with occlusal interferences and temporomandibular disorders among the Saudi sub-population.

AIMS: This Study was conducted to determine the incidence of malocclusion, occlusal interferences, temporomandibular Disorder (TMD) among the Saudi population and to evaluate the possible existence of an association between malocclusion, occlusal interferences and TMD. METHODS: 250 patients attending dental clinics in Abha city, Saudi Arabia for treatment was clinically examined for the degree of malocclusion. Patients were further evaluated for the presence of occlusal interferences and TMD. Data was evaluated by person's correlation and logistic regression to evaluate the association between malocclusion, occlusal interference and TMD. RESULTS: The results of the study indicate 42.8% of the evaluated subjects had a definitive degree of malocclusion. Among the occlusal interference observed, balancing side interferences were high (47.6%), followed by protrusive interferences (41.2%). The prevalence of TMD among the evaluated subjects was 41.6%, with mandibular deviation and joint sounds were most prevalent. Statistical Analysis (Pearson's correlation) showed the statistically significant correlation between malocclusion and centric slide (p-0.030), posterior missing teeth (p-000). The statistically significant correlation was observed between TMD and balanced side interferences (p-0.000), slide RCP-ICP (p-0.001), reduced occlusal contacts (0.033). Logistic regression analysis showed the strong association of TMD with anterior open bite, increased maxillary overjet, balanced side interferences, and centric slide. CONCLUSION: The prevailing malocclusion and TMD among studied population is significantly higher. The preventive dental treatment and community dental education need to be more emphasized.

Maxillofacial prosthesis in a palliative care for terminally ill patient with squamous cell carcinoma.

It is the god given right of every human being to appear human. - Ernest L. DaBreo. A 55-year-old man with combined surgical and radiation therapy for buccal mucosa required the prosthetic rehabilitation for full thickness facial cheek defect. Apart from the aesthetics concerns, he had several oral debilities like difficulty in speaking, eating and swallowing. Though the carcinoma is known for high rates of morbidity and mortality, it is an obligation of a prosthodontist to help the patient to have a dignified and normal social life for their remaining lifespan. Palliative dental care's main focus is to re-establish the quality of the remaining life, in addition to the alleviation of physical and psychological suffering of the far-advanced disease patients. This case report summarises the importance of maxillofacial prosthesis in a postoperative malignancy and palliative care.

Prosthetic rehabilitation of a patient with adenoid cystic carcinoma with continuous orbital-maxillary defect.

Extensive head and neck surgical procedures severely affect vital functions, physical appearance and lead to huge psychological trauma in the patients. Well-constructed maxillofacial prosthesis will help them lead a normal social life for the remaining precious time. This case report explains the prosthetic rehabilitation of continuous orbital-maxillary surgical defect in a patient with adenoid cystic carcinoma with restricted mouth opening. Maxillofacial prosthesis needs individual modification to a treatment plan according to the defect and existing clinical conditions. In this case, magnetically retained three-piece prosthesis was designed because of high recurrence rate of the adenoid cystic carcinoma, lack of adequate bone for implants and limited mouth opening in the patient. The prosthesis restored the phonetics, aesthetics and deglutition of the patient by re-establishing the separation of oral-nasal-orbital cavities.

Reconstruction of a midfacial defect using an intraoral-extraoral combination prosthesis employing magnets: a clinical report.

Radical maxillectomy frequently leads to extended defects in hard and soft tissues that result in a connection between the oral cavities and orbit. If the defect cannot be surgically reconstructed, a combination prosthesis may be necessary to remedy dysfunction in patient function, comfort, esthetics. For minor defects, enlargement of the base of the intra oral prosthesis is generally sufficient. Resections that affect more than one third of the maxilla usually require an intra oral and an extra oral prosthesis that could be assembled and retained in the patient. This clinical report describes a technique of prosthetic rehabilitation of midfacial defect with a silicone orbital prosthesis and intra oral obturator that are retained by magnets. Key words:Combination Prosthesis, Silicone Prosthesis, Magnets, obturators.

Synthesis, characterization and comparison of antimicrobial activity of PEG/TritonX-100 capped silver nanoparticles on collagen scaffold.

Silver nanoparticles have received attention as novel antimicrobial agents. In order to study the effects of silver nanoparticles on both Gram positive and negative bacteria, the nanoparticles were synthesized via chemical reduction method using different concentrations (0.3, 0.6 and 0.9 mM) of poly(ethylene) glycol (PEG) and TritonX-100 (TX). Also, mixed PEG/TX systems with equimolar concentrations capped silver nanoparticles were synthesized and confirmed by UV-vis, fluorescence spectroscopy and particle size analysis. These coated silver nanoparticles were incorporated into collagen, lyophilized to form scaffolds and characterized by SEM, XRD, ATR-FTIR, DSC, TGA and zeta potential. Results on mechanical property of all the scaffolds displayed no significant difference in the percentage elongation at break. However, the maximum percentage of 46.67% was observed with the combinations (0.9 mM PEG+0.9 mM TX). This implies that the combinations of surfactants increase the elasticity, which is useful for biomedical applications, e.g., heart-valve preparations. Furthermore, the antimicrobial activities of these capped silver nanoparticles homogenized with collagen were tested against both Gram positive and negative bacteria. Minimum inhibitory concentration values obtained for the combination (0.9 mM PEG+0.9 mM TX) were found to be better than others and thus provide strong antibacterial property to the collagen scaffolds prepared for tissue regeneration applications.