Urolithiasis-related ureteric intussusception: A rare case report.

Ureteral intussusception is a rare condition that historically occurs as a complication of ureteral neoplasms or iatrogenic endoscopic procedures. Although the exact mechanism of ureteral intussusception is unclear, most reported cases are due to leading points as malignant or benign masses. Urolithiasis related is rarely reported and can be challenging in stone management as it might decrease the spontaneous stone passage rate. In addition, it will increase the complexity of the endoscopic stone management. We present the second reported case of urolithiasis-related ureteric intussusception presented with urosepsis due to obstructive uropathy, successfully managed by an endourological approach.

The application of artificial intelligence in diabetic retinopathy screening: a Saudi Arabian perspective.

Introduction: Diabetic retinopathy (DR) is the leading cause of preventable blindness in Saudi Arabia. With a prevalence of up to 40% of patients with diabetes, DR constitutes a significant public health burden on the country. Saudi Arabia has not yet established a national screening program for DR. Mounting evidence shows that Artificial intelligence (AI)-based DR screening programs are slowly becoming superior to traditional screening, with the COVID-19 pandemic accelerating research into this topic as well as changing the outlook of the public toward it. The main objective of this study is to evaluate the perception and acceptance of AI in DR screening among eye care professionals in Saudi Arabia. Methods: A cross-sectional study using a self-administered online-based questionnaire was distributed by email through the registry of the Saudi Commission For Health Specialties (SCFHS). 309 ophthalmologists and physicians involved in diabetic eye care in Saudi Arabia participated in the study. Data analysis was done by SPSS, and a value of p < 0.05 was considered significant for statistical purposes. Results: 54% of participants rated their level of AI knowledge as above average and 63% believed that AI and telemedicine are interchangeable. 66% believed that AI would decrease the workforce of physicians. 79% expected clinical efficiency to increase with AI. Around 50% of participants expected AI to be implemented in the next 5 years. Discussion: Most participants reported good knowledge about AI. Physicians with more clinical experience and those who used e-health apps in clinical practice regarded their AI knowledge as higher than their peers. Perceived knowledge was strongly related to acceptance of the benefits of AI-based DR screening. In general, there was a positive attitude toward AI-based DR screening. However, concerns related to the labor market and data confidentiality were evident. There should be further education and awareness about the topic.

LDMRes-Net: A Lightweight Neural Network for Efficient Medical Image Segmentation on IoT and Edge Devices.

In this study, we propose LDMRes-Net, a lightweight dual-multiscale residual block-based convolutional neural network tailored for medical image segmentation on IoT and edge platforms. Conventional U-Net-based models face challenges in meeting the speed and efficiency demands of real-time clinical applications, such as disease monitoring, radiation therapy, and image-guided surgery. In this study, we present the Lightweight Dual Multiscale Residual Block-based Convolutional Neural Network (LDMRes-Net), which is specifically designed to overcome these difficulties. LDMRes-Net overcomes these limitations with its remarkably low number of learnable parameters (0.072M), making it highly suitable for resource-constrained devices. The model's key innovation lies in its dual multiscale residual block architecture, which enables the extraction of refined features on multiple scales, enhancing overall segmentation performance. To further optimize efficiency, the number of filters is carefully selected to prevent overlap, reduce training time, and improve computational efficiency. The study includes comprehensive evaluations, focusing on the segmentation of the retinal image of vessels and hard exudates crucial for the diagnosis and treatment of ophthalmology. The results demonstrate the robustness, generalizability, and high segmentation accuracy of LDMRes-Net, positioning it as an efficient tool for accurate and rapid medical image segmentation in diverse clinical applications, particularly on IoT and edge platforms. Such advances hold significant promise for improving healthcare outcomes and enabling real-time medical image analysis in resource-limited settings.

Epidemiological characteristics, clinical course, and laboratory investigation of pediatric COVID-19 patients in a tertiary care center in Saudi Arabia.

Background: Since the initial emergence of the novel SARS-CoV-2 coronavirus responsible for the 2019 coronavirus disease (COVID-19) pandemic, many studies have been exploring the nature and characteristics of this virus and its associated clinical manifestations. The present study aimed to describe the clinical presentation and outcomes of COVID-19 infections in pediatric patients. Methods: A retrospective review of findings associated with 143 pediatric patients (age <14 years) with a confirmed COVID-19 diagnosis who had undergone inpatient or outpatient treatment at King Faisal Specialist Hospital and Research Center in Riyadh, Saudi Arabia, between March 2020 and October 2020, was conducted. The analyzed data included patient demographic information, pre-existing medical conditions, symptoms, interventions, and outcomes. Results: The median age of this patient population was 7 years. Of these 143 patients, 67 (46.8%) had known pre-existing medical conditions including bronchial asthma (12.8%), chronic lung disease (CLD) (3%), congenital heart disease (CHD) (17%), primary immunodeficiencies (1.5%), malignancies (9.8%), and 7.5% were post-transplant patients. Thirty-seven patients (26%) were overweight or obese. Sixty-three of these patients (51%) were symptomatic, with the most common symptom being fever (55%). Ultimately, 45 patients (31%) required admission to the hospital, with a median duration of hospitalization of 9.6 days for admitted patients. There were no documented cases of infection-related mortality among this pediatric cohort, although 11 patients experienced post-infectious complications that primarily manifested as a loss of taste and smell. Conclusion: These findings suggest that pediatric COVID-19 patients tend to experience mild forms of the disease, without any significant differences in disease severity as a function of patient gender or immune status.

Implementation of pressure ulcer prevention and management in elderly patients: a retrospective study in tertiary care hospital in Qatar.

OBJECTIVE: Preventing pressure ulcers is an essential part of patient care and it is important to be aware of the best way to prevent it. Hence, the present study aims to look for the demographics, clinical characteristics, and risk factors in patients with and without pressure ulcer among elderly patients. METHODS: A retrospective longitudinal study was conducted in elderly (above 65 years) patients from a period of October 2014 to October 2015 in the medical ward under acute Geriatric care at Hamad General Hospital in Qatar. RESULTS: Overall, a total of 90 patients were included with an average age of 79 ± SD 11.3 years of which 45 patients developed pressure ulcer. There was male (64.4%) preponderance in the study population. Most common comorbidity was hypertension (77.8%). Anemia correction (91%), high protein diet supplementation (1.5 g/kg body wt.) (100%), and 2 h repositioning (100%) were implemented for majority of the pressure ulcer patients as preventive intervention. CONCLUSIONS: From the study finding, it is observed that, anemia correction, high protein diet supplementation and 2 h repositioning are the best practices for the management of pressure ulcer. Hence, these best practices are recommended for the early prevention of pressure ulcer among elderly.

Comprehensive Account on Prevalence and Characteristics of Hydatid Cysts in Livestock from Pakistan

Pakistan is at intersection of hyperendemic regions for hydatidosis. Current study aimed to determine the prevalence of hydatid cysts and cyst characteristics in different intermediate hosts (sheep, goats, cattle and buffaloes) across the 4 provinces of Pakistan. A total of 991 sheep, 1,478 goats, 1,602 cattle and 1,343 buffaloes were examined for presence of hydatid cysts during 2 years (January 2016-December 2018). Differences in frequency of hydatidosis were observed with highest overall prevalence in buffaloes (11.9%) and sheep (11.5%). Highest prevalence and burden of infection were observed in older age animals (23.8%, 9.78±0.49) and females (26.5%, 12.53±0.67). Data for seasonal prevalence alluded to year-round presence of disease with non-significant statistical difference. Organ predilection indicated liver as the most preferred site of cyst localization followed mainly by lungs. An over-dispersion pattern was observed in all infected animals as majority of cysts belonged <10 cysts per infected host category. Highest percentage of fertile cysts was observed in liver of sheep. Interestingly, solitary form of cysts had higher fertility rate than multiple form. Amid lack of data and wide gap of knowledge, this study would try to fill up the lacunae regarding this neglected tropical disease. Extensive rearing of livestock, unregulated official slaughter and home slaughtering have played role in adaptability of E. granulosus in Pakistan.

The current use of anti-cariogenic agents and fluoride agents to cure write spot lesion: A systematic analysis.

To find the best option to treat White Spot Lesion in existing caries treatments, and to identify the selected articles discussing etiology of caries along with White spot lesion. Null hypothesis was that "Only anticariogenic agent can cure White Spot Lesion". PRISMA guidelines were used to conduct the systematic analysis. An electronic customized search was performed using mesh terminologies on PubMed database based on inclusion criteria that included studies with; any treatment option that can treat or prevent WSL; and minimally invasive treatment options that may be altered to treat WSL. While exclusion criteria comprised studies with treatment of rampant caries, severe early childhood caries and root caries. Inclusion criteria for etiological factors incorporated studies with factors that lead to white spot lesion or carious lesion. Finally, therapeutic agents of dental caries were analyzed. Only the use of anti-cariogenic agent cannot cure White Spot Lesion. Hence study fails to prove the null hypothesis. Although combination of anti-cariogenic agents with a re-mineralizing agent can provide additional options for the treatment or prevention of WSL.

Comparative abrasive wear resistance and surface analysis of dental resin-based materials.

OBJECTIVE: The objective of this study was to assess the surface properties (microhardness and wear resistance) of various composites and compomer materials. In addition, the methodologies used for assessing wear resistance were compared. MATERIALS AND METHODS: This study was conducted using restorative material (Filtek Z250, Filtek Z350, QuiXfil, SureFil SDR, and Dyract XP) to assess wear resistance. A custom-made toothbrush simulator was employed for wear testing. Before and after wear resistance, structural, surface, and physical properties were assessed using various techniques. RESULTS: Structural changes and mass loss were observed after treatment, whereas no significant difference in terms of microhardness was observed. The correlation between atomic force microscopy (AFM) and profilometer and between wear resistance and filler volume was highly significant. The correlation between wear resistance and microhardness were insignificant. CONCLUSIONS: The AFM presented higher precision compared to optical profilometers at a nanoscale level, but both methods can be used in tandem for a more detailed and precise roughness analysis.

Molecular epidemiology of Echinococcus species in Pakistan

Objective:Cystic echinococcosis (CE) is a zoonotic parasitic disease and a neglected infectious disease affecting more than one million people globally. It is caused by the tapeworm parasite of Echinococcus granulosus sensu lato. It is endemic in the neighbours of Pakistan. However, there are limited studies on molecular epidemiology of CE in Pakistan.Methods:Discrimination of Echinococcus species has been done mostly by morphologically and less work has been done by molecular methods in Pakistan. There are limited studies have been conducted to explore the molecular epidemiology of Echinococcus species in human and livestock. In human just retrospective studies have been conducted and there is a serious lack of studies on molecular basis.Results:So far in Pakistan just four studies have been published on genotyping of Echinococcus spp. common sheep strain (G1) and buffalo strain (G3) in livestock (small and large ruminants) and Echinococcus granulosus sensu stricto (G1-G3) in buffaloes, while Echinococcus granulosus sensu stricto (G1-G3), Echinococcus multilocularis, Echinococcus canadensis (G6/7) in human have been reported. Based on these four studies clearly shows that CE is yet neglected in Pakistan. These findings indicate that due to the higher population of sheep and buffaloes, G1 and G3 strains are highly prevalent in human and animals. Association of stray dogs with sheep herds and other livestock at the grazing sites is responsible for the higher prevalence of CE that acts an active role in the transmission of CE while the wild animals and camel are responsible for the less infection.Conclusion:There is dire need of more studies on molecular identification of CE to understand its species diversity and molecular epidemiology in Pakistan. It is an important step toward management of echinococcosis based on One Health Concept.

Prevalence of hydatidosis in livestocks in Chakwal District of Pakistan

Background:Hydatidosis is a zoonotic parasitic disease and a serious human and animal health problem in many endemic areas of the world. It is caused by the tapeworm parasite of Echinococcus granulosus sensu lato. This parasite is endemic in the neighboring countries like China, Iran and India. There are limited studies on CE in Pakistan.Methods:This study primarily aimed to determine the prevalence of hydatidosis in slaughtered livestocks in Chakwal district (Chakwal, Bhaun, Kallar kahar, Choa saidan shah and Balkasar) from June to December 2015. The livestocks were inspected after slaughtering and the ages, breeds and organ wise prevalence were recorded.Results:A total of 6 095 animals (sheep, goat, buffaloes and cattle) of different genders, ages and breeds were inspected after slaughtering. Overall prevalence was 8.55% (88/1 045) in sheep followed by 8.42% (88/1 045), 6.90% (4/58), 2.99% (138/4 608) in cattle, buffaloes and goats, respectively. Liver wise prevalence was 7.75%, 6.90%, 0.06%, 1.30% in cattle, buffaloes, goats and sheep, respectively while lung wise prevalence was 7.55%, 0.67%, 0.00%, 0.00%, in sheep, cattle, buffaloes and goats, respectively. Male (9.50%) were more infected than female (1.96%) in all hosts. Breed wise prevalence was higher in desi breed of cattle followed by crossbreed and other breeds. In goats, teddhi breed was more infected then beetal while in sheep Afghani breed was more infected than the others. Cattle of 6-9 years groups were more infected than 0-3 and 3-6 years age groups. Buffaloes of the only age group of 6-9 years were infected while in goat and sheep 3-6 years were more infected than 0-3 years. According to the statistical analysis there was a significant difference (P<0.05) in prevalence of hydatidosis when ages, genders and organs were compared.Conclusion:The hydatidosis is a serious parasitic problem in the study area for livestocks. The disease should be monitored on regular basis in other areas of Pakistan and future studies should be carried out to explore the real prevalence in Pakistan.

A Retrospective Analysis on the Cystic Echinococcosis Cases Occured in Northeastern Punjab Province, Pakistan

A retrospective study was performed to report the case occurrence of cystic echinococcosis (CE) in three hospitals of north-eastern region in Punjab Province, Pakistan. We reviewed retrospectively the clinical records of patients in 4 hospitals which were diagnosed with CE during 2012–2017. A total of 198 cases, 82 (41.4%) male and 116 (58.6%) females were detected as CE. The most Highest incidence was revealed in.... 21–30 years-old group (24.2%) followed by 41–50 (22.7%), 31–40 (16.2%), 11–20 (13.6%), 51–60 (8.1%), below 10 (5.5%), over 71 (5.1%) and 61–70 year-old group (4.5%). CE was detected in various organs of infected individuals. However, most of CE cases were detected in the liver (47.4%) and lung (18.6%). The present study indicated that CE is more or less prevalent in surveyed areas and one of the most important public health problems in Punjab Province, Pakistan.

First Molecular Characterization of Hypoderma actaeon in Cattle and Red Deer (Cervus elaphus) in Portugal

Hypoderma spp. larvae cause subcutaneous myiasis in several animal species. The objective of the present investigation was to identify and characterize morphologically and molecularly the larvae of Hypoderma spp. collected from cattle (Bos taurus taurus) and red deer (Cervus elaphus) in the district of Castelo Branco, Portugal. For this purpose, a total of 8 larvae were collected from cattle (n=2) and red deer (n=6). After morphological identification of Hypoderma spp. larvae, molecular characterization was based on PCR-RFLP and mitochondrial CO1 gene sequence analysis. All larvae were morphologically characterized as the third instar larvae (L3) of H. actaeon. Two restriction enzymes were used for molecular identification of the larvae. TaqI restriction enzyme was not able to cut H. actaeon. However, MboII restriction enzyme differentiated Hypoderma species showing 210 and 450 bp bands in H. actaeon. Furthermore, according to the alignment of the mt-CO1 gene sequences of Hypoderma species and to PCR-RFLP findings, all the identified Hypoderma larvae were confirmed as H. actaeon. This is the first report of identification of Hypoderma spp. (Diptera; Oestridae) from cattle and red deer in Portugal, based on morphological and molecular analyses.

Seroprevalence and Spatial Distribution of Toxoplasmosis in Sheep and Goats in North-Eastern Region of Pakistan

Toxoplasmosis is a protozoan disease that is caused by Toxoplasma gondii in livestock and humans. Due to its medical and veterinary importance, it is essential to study the seroprevalence of T. gondii infection among humans and animals in various parts of the world. The major objective of this study was to determine the seroprevalence and spatial distribution of toxoplasmosis in small ruminants (sheep and goats) of north-eastern region, Pakistan. A total of 1,000 animals comprising of sheep (n=470) and goats (n=530) were examined for T. gondii infection by using ELISA. An epidemiological data was collected in the form of questionnaire. A surface has been generated by using method of interpolation in Arc GIS with the help of IDW (inverse distance weight). The results showed higher seroprevalence of T. gondii in goats (42.8%) as compared to sheep (26.2%). The seroprevalence was higher in females as compared to males in all examined ruminants. Similarly, there is a wide variation in the seroprevalence of T. gondii in different breeds of sheep and goats showing higher seroprevalence in Teddy (52.8%) and Damani breed (34.5%) of goat and sheep's, respectively. The geographical and spatial distribution of T. gondii shows that it is widely distributed in different parts of the north-eastern region of Pakistan. Our results suggest widespread environmental contamination with T. gondii oocysts. It suggests us that small ruminants could be a potentially important source of T. gondii infection if their infected meat is consumed undercooked.