Municipal sewage sludge dewatering performance enhancement by ultrasonic cavitation and advanced oxidation: A case study.

The number of published literature on the effect of ultrasonic cavitation and advanced oxidation pretreatment on the dewatering performance of anaerobically digested sludge is very limited. This study aims at determining the optimum operating conditions of large-scale filtering centrifuges in wastewater treatment plants. The optimum dose of hydrogen peroxide, ultrasonic power, ultrasonic duration, ultrasonic pulse and particle size distribution for improved dewatering performance were determined in this study. In addition, shear stress-shear rate and viscosity-shear rate rheograms were developed to show the rheological flow properties for varying ultrasonic power and treatment duration. Optimum sonication power, time, pulse and amplitude were determined to be 14 W, 1 min, 55/5 and 20%, respectively. At a pH of 6.8, the optimum concentration of hydrogen peroxide was found to be 43.5 g/L. The optimum hydrogen peroxide dose in the combined conditioning experiments was determined to be 500 mg/L at a pH of 3. Under these optimum conditions, capillary suction time was reduced significantly by 71.1%. This study helps to reduce polymer consumption and provides the optimum pretreatment and dewatering operating conditions, and better monitoring and control in the dewatering unit has significant impact in the overall economy of wastewater treatment plants.

Effectiveness of the Eutectic Mixture of Local Anaesthetics Cream in the Management of Arteriovenous Fistula Needle Insertion Pain in Patients Undergoing Haemodialysis.

This review aimed to assess the effectiveness of the eutectic mixture of local anaesthetics (EMLA) cream in the management of arteriovenous fistula (AVF) needle insertion pain in adult patients undergoing haemodialysis (HD) compared with other alternative interventions. The main search was conducted in November 2020 and updated in December 2021. In the search strategy, keywords and synonyms were used and multiple databases were searched with no date limitation to ensure a comprehensive search that would yield all studies relevant to the review and minimise location bias. A total of 209 studies were found in this search and filtered. After filtering through these studies, only five studies were finally included in the review. EMLA-cream was found to be effective in reducing AVF needle insertion pain among adult patients undergoing HD. Despite EMLA cream's effectiveness in reducing HD needle insertion pain and its fewer side effects, the findings of the included studies should be interpreted with caution, as there are some limitations, and further research is required.

Protective effect of coenzyme Q10 against doxorubicin-induced cardiotoxicity: Scoping review article.

Introduction: Doxorubicin (dox) is classified as an antineoplastic antibiotic which is known as adriamycin from the anthracycline group. Due to the release of free radicals and lipid peroxidation which can cause acute cardiotoxicity. Coenzyme Q10 is found in many cells of the body, it is an antioxidant that reduces oxidative stress and lipid peroxidation. Aim: This scoping review aims to evaluate the cardioprotective effect of coenzyme Q10 in doxorubicin-induced cardiotoxicity in animals. Methods: This review was done based on Arksey and O'Malley's methodology, reviewing published articles from October 1978 and September 2023. Results: 14 out of 11,303 articles were included from the initial search, (10 out of 14 articles found that coenzyme Q10 protect has a protection effect against doxorubicin-induced cardiotoxicity). Conclusion: The results of this review found coenzyme Q10 protects against doxorubicin cardiotoxicity. It is a promising supplement that could be used to prevent cardiotoxicity induced by doxorubicin in cancer patients.

Brain meningioma incidentally detected on a bone scan: A Case report.

Incidental meningioma is defined as a mass diagnosed radiologically on MRI and CT scans without histopathological confirmation. In occasional cases, meningiomas can be diagnosed incidentally by bone scintigraphy. This article presents an interesting case where a 44-year-old lady with known breast cancer was found to have a brain meningioma, incidentally, detected on a bone scan, which was initially suspected to be metastatic brain changes. The follow-up MRI and histopathological studies confirmed the diagnosis of meningioma.

Supplementation with spinach-derived thylakoid augments the benefits of high intensity training on adipokines, insulin resistance and lipid profiles in males with obesity.

Introduction: This study investigated the effects of 12 weeks of high-intensity functional training (HIFT) combined with spinach-derived thylakoid supplementation on some selected Adipokines and insulin resistance in males with obesity. Method: Sixty-eight participants (mean age: 27.6 ± 8.4 yrs.; mean height: 168.4 ± 2.6 cm; mean weight: 95.7 ± 3.8 kg, mean BMI: 32.6 ± 2.6 kg/m2) were randomly divided into four groups of 17 per group: Control group (CG), Supplement group (SG), Training group (TG), and Training + supplement group (TSG). Following baseline measurements, the two training groups (TG and TSG) started the 12 weeks of exercise training program (3 sessions per week). A total of 36 sessions lasting up to 60 min were included in the HIFT program using the CrossFit program. The eligible participants received 5 g/day of thylakoid-rich spinach extract or matching placebo as 5 g/day of raw corn starch (one sachet, 30 min before lunch) for 12 weeks. Baseline assessments were obtained 48 hours before the start of the training protocols and 48 hours after the last training session in all groups. Results: There were significant interactions (p<0.001 for all) between exercise and time for adiponectin (ES:0.48), leptin (ES:0.46), resistin (ES:0.3), omentin (ES:0.65), vaspin (ES:0.46), visfatin (ES:0.62), apelin (ES:0.42), RBP4 (ES:0.63), chemrin (0.36) and semaphorin3c (ES: 0.5). Plasma levels of semaphorin3c were significantly correlated (p<0.05) with body weight (r= 0.57), BMI (r= 0.43), FFM (r= -0.612), FAT (r= 0.768), VO2peak (r=-0.53), insulin (r= 0.756), glucose (r= 0.623), and HOMA-IR (r= 0.727). There were also significant group differences in insulin (ES: 0.77), glucose (ES: 0.21), and HOM-IR (ES: 0.44) (p<0.05). Discussion: Our findings indicate that 12 weeks of HIFT supplemented with spinach-derived thylakoid reduced levels of leptin, resistin, vaspin, visfatin, apelin, RBP4, chemrin, semaphorin3c and insulin resistance while increasing adiponectin and omentin levels in men with obesity.

Abnormal Biologic Distribution Related to Normal Saline Among 99mTc-Dimercaptosuccinic Acid Scans.

The primary aim was to describe the incidence and causes of abnormal distribution of 99mTc-dimercaptosuccinic acid (99mTc-DMSA) among patients who underwent renal scans in Royal Hospital (Oman) in 2020. The secondary aim was to assess the effect of a specific batch of normal saline A (batch 132129) compared with another normal saline, B (batches 132589 and 133325), used in the preparation of 99mTc-DMSA on the abnormal biodistribution of 99mTc-DMSA. Methods: This was an ambidirectional cohort study that included all patients who underwent 99mTc-DMSA renal scanning between January and December 2020. Both prospective and retrospective data collection was used. The collected data included possible causes of abnormal biodistribution, quality of 99mTc-DMSA and normal saline, and time of 99mTc-DMSA injection. Results: The total incidence of abnormal biodistribution was 26.5%, with the most common cause being a high creatinine level (29%). Normal saline batch A was significantly associated with abnormal biodistribution (49.7%), compared with batch B (6.6%) (P < 0.001). This association was more prominent among patients injected with the 99mTc-DMSA preparation after 2 h (83.0%) compared with before 2 h (13.3%). Conclusion: A high incidence of abnormal biodistribution of 99mTc-DMSA was detected and-for what is the first time, to our knowledge, in the literature-a specific preservative-free, normal saline that is up to standard has been identified as a significant cause of abnormal biodistribution. Nuclear medicine professionals and pharmaceutical companies should take note of this possible cause of abnormal 99mTc-DMSA biodistribution.

Use of Complementary and Alternative Medicines (CAMs) Among Diabetic Patients in Al Ahsa, Saudi Arabia: A Cross-Sectional Study.

Background: Complementary and Alternative Medicine (CAM) is a popular practice among Saudis. CAM refers to drugs and medical procedures that doctors do not typically employ. Objective: The study's goal was to determine the prevalence of CAM and the most prevalent form used among patients with diabetes in Al Ahsa, Saudi Arabia. Methods: This cross-sectional study enrolled individuals with diabetes mellitus (DM) in Al Ahsa, Saudi Arabia. Online questionnaires were employed between March to July 2023 to collect data on sociodemographic characteristics, information about diabetes, knowledge and use of CAM, and the different types of herbal supplements used. Results: Of the 386 patients, 54.1% were males, 45.9% were aged between 46 and 60 years old, and 45.9% had heard of CAM. The most popular CAM treatment for diabetes was biologically based, and the most common reason for using CAM was its accessibility (27.1%). The majority (82.1%) of diabetic patients reported using CAM as a treatment. Independent predictors of CAM use were diabetes complications, having heard of CAM, and social media. Conclusion: CAM use has a high prevalence in the treatment of diabetes. Independent predictors of CAM use were a shorter disease duration, diabetes complications, having heard of CAM, and social media. To avoid negative and unnecessary side effects, patients must be informed about CAM use.

Polymeric ethosomal gel loaded with nimodipine: Optimisation, pharmacokinetic and histopathological analysis.

This study was performed with the main objective of formulating and evaluating the potential of ethosomesl gel (Etho gel) to deliver nimodipine (NiM) for cardiovascular disease, a potent water insoluble anti-hypertensive drug via skin to reach the deeper layers of skin. The Box-Behnken design (BBD) was used to optimize the NiM-Eth to determine the impact of the independent and depended variables. The effectiveness of drug entrapment, vesicle size, and cumulative drug release were assessed for the NiM loaded ethosomes and NiM-Eth gel using carbopol 934 as a gelling agent. Fourier transform infrared spectroscopy (FTIR), Differential scanning calorimetry (DSC), Power X-ray diffraction (PXRD), and scanning electron microscopy (SEM) analysis were performed and analysed their physicochemical characters. Rat abdomen skin was used to investigate drug permeability and deposition. As compared to marketed products, NiM-Eth gel produced an improved drug permeability in ex vivo experiments. The mean AUC0 to AUC0-∞ of NiM-Eth gel when compared to oral formulation (Nymalize oral preparation) was found to be increased from 4.1 to 5.9 folds which was found to be resulted from first pass effect. Histophatlogical findings revealed that the maximum amount of NiM penetrated the stratum corneum of the skin and create drug depots in the deep layer. In summary, it can be said that NiM might be successfully prepared in NiM-Eth gel for transdermal drug delivery.

Intra-abdominal desmoplastic small blue round cell tumor: A case report.

Desmoplastic small round blue cell tumors are a rare and aggressive type of malignant small round blue cell tumor with a limited number of cases published in the literature. They commonly affect males in their second decade of life who usually present with a metastasis picture, resulting in a poor prognosis. We present a case of an intra-abdominal desmoplastic small blue round cell tumor in a 23-year-old male who presented with abdominal pain and bloating. Computed tomography revealed a large intra-abdominal mass which was followed by laparotomy and surgical resection of the abdominal mass with histology confirming the diagnosis. Careful clinical, radiological, and histopathological correlations are crucial to reach an accurate diagnosis which would be followed by surgical cytoreduction with primary, partial or complete tumor removal.

Bacteriological Study of Urinary Tract Infections among Pregnant Women in Al Samawa City of Iraq.

Pregnancy causes some changes in pregnant women due to mechanical and hormonal changes that lead to ureteral dilatation and urinary stasis which in turn contribute to an increased risk of developing urinary tract infection (UTI). This study aimed to determine the frequency of urinary tract infections among pregnant women in Samawa city, Iraq, and examine the isolated organisms. In total, 210 and 55 urine samples were collected from pregnant and non-pregnant women with clinical signs and symptoms of UTI who were hospitalized in the Obstetric and Pediatric Hospital in Samawa, Iraq, respectively. The data collected from each woman included their age, gestational period, parity, level of education, and residence. The frequency of urinary tract infections among the studied woman was 86%. Escherichia coli (38.6%), staphylococcus aureus (20.4%), and Proteus mirabilis (12.7%) were the most frequently isolated bacteria in the current study. According to the recorded data in this study, 86% of the infections in pregnant women occurred in the age group of 25-34 years (52.4%) and the 3rd trimester of pregnancy (49.1%). On the other hand, the results revealed that the infection rate in women with one to three pregnancies was 50.2% more than non-pregnant women. The findings of the current study showed that the highest rate of infection was observed in women who were in the age range of 25-34 years (52.4%). This can be explained by the fact that women often experience the highest reproductive activity during this period. In fact, in this period of life, women are most prone to sexual activity which predisposes them to the introduction of microorganisms to the urinary tract which causes infection. The recorded data showed that UTI became more prevalent with the progress of pregnancy, accounting for 49.1% of infections occurring in the third trimester of pregnancy. Parity and frequent pregnancies are other factors that account for 50.2% of UTI. The prevalence of UTI in women with 1 to 3 children was 58.5%. Moreover, the rate of UTI was 61.3% among pregnant women who attended the antenatal care unit, which was the highest risk of UTI among the pregnant participants. In the non-pregnant women, the prevalence of UTI was 50.2 at the age range of 6-12 years. Based on the obtained results, pregnant women were more vulnerable to renal infection. On the other hand, the concurrence of UTI was positively influenced by sexual activity and pregnancy.

Short and long-term immune changes in different severity groups of COVID-19 disease.

BACKGROUND: There are limited data on short- versus long-term changes in adaptive immune response across different COVID-19 disease severity groups. METHODS: A multicenter prospective study of 140 adult patients with COVID-19 (a total of 325 samples) were analyzed for inflammatory markers and lymphocyte subsets at presentation, week 2, and week 24. RESULTS: Inflammatory markers at presentation were higher in the critical/severe than in moderate and mild groups. A predominance of memory B cell response in the mild and moderate group was noted by week 2. In contrast, the immune system in the severe/critical group was dysfunctional, with expansion of exhausted CD8+ T cells and atypical memory B cells. By 24 weeks, there was a possible trend of normalization. CONCLUSION: There was substantial difference in the degree of inflammation and distribution of different B and T cell subsets in the different disease severity groups. Despite the initial dysfunctional immune response in the severe/critical group, a comparable memory B and CD8+ T cell responses to the mild group was achieved at 24 weeks.

Predicting Patients at Risk for Prolonged Hospital Stays Following Pediatrics Traumatic Head Injuries in High-Income Developing Country: A Retrospective Cohort Study.

BACKGROUND: Traumatic brain injuries (TBIs) in pediatrics are the most common cause of long-term morbidity and mortality, generating a considerable burden on the health care system. In the current retrospective study, we aimed to identify the predictors that contribute to prolonged hospital stays in pediatric TBI. METHODS: A retrospective cohort study including all pediatric cases (age younger than 14) who presented to Khoula Hospital with TBI and were seen from January 2015 to December 2019. The multivariate binary logistic regression analysis has been used to determine the independent predictors of prolonged hospital stay. Prolonged hospitalization was defined as mean ± 2 standard deviation days. RESULTS: A total of 866 cases of pediatric TBI were documented. The mean age was 4.33 years. The length of hospital stay ranged from <1 day to 90 days (mean = 3.65, standard deviation = 6.84). Prolonged hospitalization was calculated to be >17 days. Thirty-one patients had prolonged hospital stay out of the studied cohort, with an incidence proportion of prolonged stay = 3.6% (95% CI = 2.4%-5.0%). Prolonged hospitalizations were associated with motor vehicle collision injuries (odds ratio [OR]: 27.028, 95% confidence interval [CI] = 2.744-266.194, P = 0.005); pedestrian injuries (OR = 11.667, 95% CI = 1.017-133.805, P = 0.048), and Glasgow Coma Scale score on arrival of <9 (OR = 8.149, 95% CI = 1.167-56.921, P = 0.034). CONCLUSIONS: The current study identified motor vehicle collision and pedestrian injuries, as well as initial Glasgow Coma Scale score of <9 as independent predictors of prolonged hospitalization in pediatrics TBI.

Renal hydatid cyst: A case report.

Hydatid disease is a parasitic infection commonly involving the liver, less frequently the lungs, and rarely the kidneys. Reports on renal hydatid disease are limited in literature. In this case study, we share a case of a 37-year-old female who presented with a 3-month history of left flank pain and following further evaluation with laboratory testing and radiological imaging was revealed to be a case of renal hydatid disease. The patient was successfully managed surgically with left total nephrectomy. The study will focus on the findings of renal hydatid disease in radiological imaging modalities.

Management of Early-Stage Resected Non-Small Cell Lung Cancer: Consensus Statement of the Lung cancer Consortium.

BACKGROUND: Management of early-stage non-small cell lung cancer (ES-NSCLC) has evolved over the last few years especially in terms of work-up and the use of systemic therapy. This consensus statement was developed to present updated guidelines for the management of this disease. METHODS: Multidisciplinary team (MDT) of lung cancer experts convened to discuss a set of pertinent questions with importance relevance to the management of ES-NSCLC. ES-NSCLC includes stages I, II and resected stage III. The experts included consultants in chest imaging, thoracic surgery, radiation oncology, and medical oncology. Questions were discussed in virtual meetings and then a written manuscript with supporting evidence was drafted, reviewed, and approved by the team members. RESULTS: The Consensus Statement included 9 questions addressing work-up and management of ES-NSCLC. Background information and literature review were presented for each question followed by specific recommendations to address the questions by oncology providers. The Statement was endorsed by various oncology societies in the Gulf region. CONCLUSION: The Consensus Statement serves as a guide for thoracic MDT members in the management of ES-NSCLC. Adaptation of these to the local setting is dictated usually by available resources and expertise, however, all efforts should be excreted to provide the optimal care to all patients whenever possible.

Fast resolution and good outcomes of isolated traumatic intraventricular haemorrhage: a case report.

The location and the size of intracranial haemorrhage play an important role in determining the time for the hematoma resolution. Without surgical intervention, it takes at least a few weeks for the whole hematoma to resolve spontaneously. Despite that the rapid and spontaneous resolution of intracranial haemorrhage is well described in the literature, it is considered rare. Moreover, we could identify only one case of rapid spontaneous resolution of isolated traumatic intraventricular haemorrhage (ITIVH) in the literature. Herein, we report a rare case of ITIVH that disappeared rapidly without surgical intervention. Our case supported the hypothesis that the cerebrospinal fluid (CSF) and its circulation are major players in the rapid resolution of ITIVH.

Predictors of psychological distress among the public in Oman amid coronavirus disease 2019 pandemic: a cross-sectional analytical study.

Coronavirus disease 2019 (COVID-19) is a global, virulent pandemic disease that emerged in December 2019, with both short- and long-term psychological repercussions being inevitable. This study aimed to investigate the prevalence and predictors of psychological distress, defined by the presence of either depression or anxiety, among the public in Oman during the COVID-19 pandemic. This was a web-based, cross-sectional study conducted using governmental and private institutional e-mail systems and social media platforms. Anxiety and depression were assessed using both the Generalized Anxiety Disorder-7 Scale and the Patient Health Questionnaire-9. Logistic regression analysis was used to assess the independent predictors. There were a total of 1538 participants in this study (75% female). The prevalence of psychological distress was 30%. Being female, having financial instability, being treated for mental illness and self-medication for coping with stress were independent predictors of psychological distress among the study sample (Odds ratio [OR] = 1.69, confidence interval [CI] = 1.24-2.29; OR = 2.05, CI = 1.54-2.74; OR = 5.35, CI = 3.50-8.18; OR = 7.23, CI = 3.06-17.09, respectively). The results from this study will help public health officials in Oman to plan for and mitigate psychological repercussions of the current and future pandemics.

Rare Neurovascular Diseases in Korea: Classification and Related Genetic Variants

Rare neurovascular diseases (RNVDs) have not been well-recognized in Korea. They involve the central nervous system and greatly affect the patients’ lives. However, these diseases are difficult to diagnose and treat due to their rarity and incurability. We established a list of RNVDs by referring to the previous literature and databases worldwide to better understand the diseases and their current management status. We categorized 68 RNVDs based on their pathophysiology and clinical manifestations and estimated the prevalence of each disease in Korea. Recent advances in genetic, molecular, and developmental research have enabled further understanding of these RNVDs. Herein, we review each disease, while considering its classification based on updated pathologic mechanisms, and discuss the management status of RNVD in Korea.

Rare Neurovascular Diseases in Korea: Classification and Related Genetic Variants

Rare neurovascular diseases (RNVDs) have not been well-recognized in Korea. They involve the central nervous system and greatly affect the patients’ lives. However, these diseases are difficult to diagnose and treat due to their rarity and incurability. We established a list of RNVDs by referring to the previous literature and databases worldwide to better understand the diseases and their current management status. We categorized 68 RNVDs based on their pathophysiology and clinical manifestations and estimated the prevalence of each disease in Korea. Recent advances in genetic, molecular, and developmental research have enabled further understanding of these RNVDs. Herein, we review each disease, while considering its classification based on updated pathologic mechanisms, and discuss the management status of RNVD in Korea.

Ileo-caecal intussusception secondary to lipoma in an adult: A rare cause for intestinal obstruction.

Intussusception in adults is a rare condition. Unlike in children, it is often associated with a pathologic lesion that serves as a lead point. We report an unusual case of ileo-caecal intussusception due to lipoma. A 51-year-old male presented with symptoms and signs of intestinal obstruction. CT scan revealed bowel obstruction, resulting from ileo-caecal intussusception with the lead point being a lipoma of the terminal ileum. Ileocaecal resection with primary anastamosis was performed with histology confirming lipoma. Intussusception is not a common cause for intestinal obstruction in adults and is best diagnosed with CT scan. Surgical resection remains the definitive treatment in adult intussusception.

How early into the outbreak can surveillance of SARS-CoV-2 in wastewater tell us?

There is increasing interest to use wastewater-based surveillance of SARS-CoV-2 as an early warning of the outbreak within a community. Despite successful detection of SARS-CoV-2 in wastewaters sampled from multiple locations, there is still no clear idea on the minimal number of cases needed in a community to result in a positive detection of the virus in wastewaters. To address this knowledge gap, we sampled wastewaters from a septic tank and biological activated sludge tank located on-site of a hospital. The hospital is providing treatment for SARS-CoV-2 infected patients, with the number of hospitalized patients per day known. It was observed that > 253 positive cases out of 10,000 persons are required prior to detecting SARS-CoV-2 in wastewater. There was a weak correlation between N1 and N2 gene abundances in wastewater with the number of hospitalized cases. This correlation was however not observed for N3 gene. The occurrence frequency of SARS-CoV-2 is at least 5 times lower in the partially treated wastewater than in the septic tank. Furthermore, abundance of N1 and N3 genes in the activated sludge tank were 50 and 70% of the levels detected in septic tank, suggesting poor persistence of the SARS-CoV-2 gene fragments in wastewater. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=115 SRC="FIGDIR/small/20177667v1_ufig1.gif" ALT="Figure 1"> View larger version (28K): org.highwire.dtl.DTLVardef@3c868eorg.highwire.dtl.DTLVardef@1a5ec59org.highwire.dtl.DTLVardef@3fcafborg.highwire.dtl.DTLVardef@273440_HPS_FORMAT_FIGEXP M_FIG C_FIG