Prevalence and risk factors associated with multidrug-resistant bacteria in COVID-19 patients.

Bacterial coinfection among patients with confirmed coronavirus disease 2019 (COVID-19) is a critical medical concern that increases the disease severity and mortality rate. The current study is aimed at evaluating the effects of bacterial coinfections among COVID-19 patients, especially in relation to degree of severity and mortality. A retrospective study was conducted for patients with positive COVID-19 test, admitted to a regional COVID-19 hospital in Jeddah, Saudi Arabia, between May and August 2020. A specimen (e.g., blood, urine, or sputum) was collected from patients with confirmed COVID-19, and was cultured to determine bacterial coinfection caused by multidrug resistant (MDR) bacteria. COVID-19 patients were categorized into 2 groups based on the result of bacterial coinfection culture, as COVID-19 patients with coinfection and COVID-19 patients without coinfection. Independent sample t test or Mann-Whitney U test was used to compare age and hospitalization period between these groups. In addition, binominal logistic regression was applied to identify risk factors associated with mortality and bacterial coinfection. The study included 342 patients with laboratory confirmed COVID-19. Eighty (23.3%) patients were diagnosed with bacterial coinfection, while the remaining 262 (76.6%) patients did not test positive for bacterial coinfection. Length of hospital stay was prolonged among COVID-19 patients diagnosed with bacterial coinfection (16.01 ±â€…11.36 days) when compared with patients without bacterial coinfection (6.5 ±â€…6.12 days). Likewise, the mortality rate was significantly higher among COVID-19 patients with bacterial coinfection (90%) compared to those without bacterial coinfection (49.2%). Gram-negative bacteria were predominant compared to gram-positive, as Klebsiella pneumoniae (35 [43.8%]) and Acinetobacter baumanni (32 [40%]). On the other hand, Staphylococcus aureus (4 [5%]), Enterococcus faecalis (1 [1.3%]), and Enterococcus faecium (1 [1.3%]) were identified as gram-positive bacterial species from recruited patients. The findings of the current study showed that prolong hospitalization is the main risk factor associated with bacterial coinfection and death. Thus, health care providers should minimize hospitalization as well as following a continuous monitoring for bacterial coinfection among COVID-19 patients, to control the spread of infection and reducing the severity and mortality rate among COVID-19 patients.

Short-Term and Long-Term Impact of COVID-19 on Quality of Life and Psychological Outcomes in Saudi Arabia: A Comparative Cross-Sectional Study.

Background: Prior research has revealed notable declines in health-related quality of life (HRQoL) and substantial psychological impacts among individuals infected with COVID-19. However, there is a noticeable gap in studies addressing the enduring long-term effects of COVID-19 on HRQoL and psychological well-being. Objective: The current study investigated and compared short and long-term effects of COVID-19 on HRQoL and psychological outcomes among the Saudi population. Methods: The Arabic version of the SF-36 questionnaire was used to assess HRQoL while Anxiety and depression were evaluated by the Hamilton Anxiety (HAM-A) and Depression Scales (HDRS). Participants (n=292) were categorized into three groups: the "never-been-infected" group (n=134), the "one-year infected group" (n=43), and the "more than one year infected" group (n=115). Descriptive statistics were presented using numerical values and frequencies. To compare the groups, a one-way analysis of variance (ANOVA) test was used. Results: Most SF-36 domains exhibited lower values while HAM-A and HDRS values were higher in individuals infected during last year compared to those who never infected. Social functioning subscale of the SF-36 showed a significant difference between the groups (F (2.289) = 6.094, p = 0.01) and the effect size was d = 0.95. Pairwise comparison showed a significant reduction in the social functioning component of SF-36 in "one-year group" compared to both groups "never-been-infected" group (mean difference -13.58 (4.40-22.76) p < 0.01) and "more than one year infected" group (mean difference -10.80 (1.44-20.16) p = 0.02). HAM-A and HDRS scores showed mild levels of anxiety (<17 score) and depression (8 to 16 score) in all groups. Conclusion: The influence of COVID-19 on psychological well-being and HRQoL is significant regardless of whether individuals infected with the virus. Overall, the consistent presence of mild anxiety and depression across all groups highlights the need for a holistic approach to mental health.

Engrailed-1 Promotes Pancreatic Cancer Metastasis.

Engrailed-1 (EN1) is a critical homeodomain transcription factor (TF) required for neuronal survival, and EN1 expression has been shown to promote aggressive forms of triple negative breast cancer. Here, it is reported that EN1 is aberrantly expressed in a subset of pancreatic ductal adenocarcinoma (PDA) patients with poor outcomes. EN1 predominantly repressed its target genes through direct binding to gene enhancers and promoters, implicating roles in the activation of MAPK pathways and the acquisition of mesenchymal cell properties. Gain- and loss-of-function experiments demonstrated that EN1 promoted PDA transformation and metastasis in vitro and in vivo. The findings nominate the targeting of EN1 and downstream pathways in aggressive PDA.

Relationship Between Sonographic Findings, Fine Needle Aspiration, and Histopathological Findings of Post-thyroid Surgery.

BACKGROUND: Thyroid diseases can affect various bodily functions and often go unnoticed. Tools such as sonography and fine needle aspiration (FNA) puncture are necessary to diagnose diseases that require surgical intervention. These tools help identify signs of malignancy or benignity and obtain further data to guide therapeutic decisions. This study aims to validate the relationship between sonographic results, FNA, and final thyroid pathology. This research describes the level of correlation between sonographic findings and FNA, the sonographic and final pathology reports, and the FNA and final pathology reports. Additionally, this research aims to identify the most common diagnoses in the final pathology. METHODS: A retrospective descriptive observational study was carried out with a sample of 95 patients who underwent thyroid surgery at the National Institute of Diabetes, Endocrinology, and Nutrition (INDEN), Dominican Republic, in 2019 to determine whether a relationship exists between the sonography findings, FNA, and the final pathology in surgical thyroid pathologies. RESULTS: A total of 95 patients were studied. The success rate of the sonography results compared with the benign final biopsy result was 100% and 45.9% with the malignant final biopsy result. The success rate of the fine needle biopsy results was 95.9% for the benign final biopsy and 28% for the malignant final biopsy. Of the malignant final biopsy reports, 84.6% were papillary carcinomas, 7.7% were follicular carcinomas, and 7.7% were medullary carcinomas. CONCLUSIONS: The relationship between the sonographic results, FNA, and histopathological findings of surgical thyroid diseases is validated. The sonographic findings are specific for diagnosing benignity and malignancy. A fine needle biopsy is useful for diagnosing benignity, and the final biopsy is the standard for confirming both benign and malignant pathologies.

Knowledge, attitude, and practice of the Saudi population toward COVID-19 vaccination: A cross-sectional study.

Coronavirus Disease 2019 (COVID-19) vaccination is the most effective protective measure to control the spread of infections and provide protection against hospitalization and mortality during the pandemic. There was a necessity to measure public knowledge and acceptance for COVID-19 vaccines in different countries. Thus, the current study is aimed at evaluating the knowledge, attitude, and practice of the population in all regions of Saudi towards COVID-19 vaccination. This was a cross-sectional, online self-reported survey of Saudi residents that was conducted between March 2021 and April 2021. To be eligible for the study, participants had to be above 18 years old. All participants were adult, Arabic speakers and residents of Saudi Arabia. In total, 1658 adults participated in this study and showed high knowledge (81.8%), attitude (71.2%), and practice (59.3%). The level of knowledge, attitude, and practice differed based on different demographic characteristics. Regression analysis showed that having a low income, low education level, and middle-aged status, living in a village, and being married were associated with lower scores in knowledge, attitude, or practice. Targeted education and campaigns should be provided for these populations to increase their knowledge, attitude, and practice towards COVID-19 vaccination.

In Vitro Antiproliferative Apoptosis Induction and Cell Cycle Arrest Potential of Saudi Sidr Honey against Colorectal Cancer.

A range of natural products have been extensively studied for their chemopreventive potential for cancer, including those that inhibit growth and induce apoptosis. Sidr honey derived from the Ziziphus or Lote tree (Ziziphus spina-christi, Ziziphus lotus, or Ziziphus jujuba) is used in a wide range of traditional medicine practices. In the current study, the Saudi Sidr honey was analyzed by means of a GC-MS chromatogram and investigated for its antiproliferative effects on colorectal cancer cells (HCT-116), breast cancer cells (MCF-7), and lung cancer cells (A-549), as well as its apoptosis induction and cell cycle arrest potentials against human colorectal cancer cells (HCT-116). The effects of Saudi Sidr honey on cells were determined using the MTT assay and the clonogenic assay. The induction of apoptosis was studied using Annexin V-FITC flow cytometry analysis. The propidium iodide staining method was used to detect cell cycle arrest via flow cytometry. By means of performing GS-MS and HR-LCMS analysis, 23 different chemical components were identified from Saudi Sidr honey. A dose-response analysis showed that Saudi Sidr honey was more effective against HCT-116 (IC50 = 61.89 ± 1.89 µg/mL) than against MCF-7 (IC50 = 78.79 ± 1.37 µg/mL) and A-549 (IC50 = 94.99 ± 1.44 µg/mL). The antiproliferation activity of Saudi Sidr honey has been found to be linked to the aggregation of cells during the G1 phase, an increase in early and late apoptosis, and necrotic cell death in HCT-116 cells. Considering these promising findings that highlight the potential use of Saudi Sidr honey as an antitumor agent, further research should be carried out with the aim of isolating, characterizing, and evaluating the bioactive compounds involved in Sidr honey's antiproliferative activity to better understand the mechanism of their action.

Influence of Residual Water Traces on the Electrochemical Performance of Hydrophobic Ionic Liquids for Magnesium-Containing Electrolytes.

A trace amount of water is typically unavoidable as an impurity in ionic liquids, which is a huge challenge for their application in Mg-ion batteries. Here, we employed molecular sieves of different pore diameters (3, 4, and 5 Å), to effectively remove the trace amounts of water from 1-methyl-1-propylpiperidinium bis(trifluoromethylsulfonyl)imide (MPPip-TFSI) and 1-butyl-1-methylpyrrolidinium bis(trifluoromethylsulfonyl)imide (BMP-TFSI). Notably, after sieving (water content <1 mg ⋅ L-1 ), new anodic peaks arise that are attributed to the formation of different anion-cation structures induced by minimizing the influence of hydrogen bonds. Furthermore, electrochemical impedance spectroscopy (EIS) reveals that the electrolyte resistance decreases by ∼10 % for MPPip-TFSI and by ∼28 % for BMP-TFSI after sieving. The electrochemical Mg deposition/dissolution is investigated in MPPip-TFSI/tetraglyme (1 : 1)+100 mM Mg(TFSI)2 +10 mM Mg(BH4 )2 using Ag/AgCl and Mg reference electrodes. The presence of a trace amount of water leads to a considerable shift of 0.9 V vs. Mg2+/ Mg in the overpotential of Mg deposition. In contrast, drying of MPPip-TFSI enhances the reversibility of Mg deposition/dissolution and suppresses the passivation of the Mg electrode.

Thrombolysis Outcomes in Acute Ischaemic Stroke Patients with Pre-Existing Cognitive Impairment.

BACKGROUND: Thrombolysis treatment for ischaemic stroke in patients with pre-existing disabilities, including cognitive impairment, remains controversial. Previous studies have suggested functional outcomes post-thrombolysis are worse in patients with cognitive impairment. This study aimed to compare and explore factors contributing to thrombolysis outcomes, including haemorrhagic complications, in cognitively and non-cognitively impaired patients with ischaemic stroke. MATERIALS AND METHODS: A retrospective analysis of 428 ischaemic stroke patients who were thrombolysed between January 2016 and February 2021 was performed. Cognitive impairment was defined as a diagnosis of dementia, mild cognitive impairment, or clinical evidence of the condition. The outcome measures included morbidity (using NIHSS and mRS), haemorrhagic complications, and mortality, and were analysed using multivariable logistic regression models. RESULTS: The analysis of the cohort revealed that 62 patients were cognitively impaired. When compared to those without cognitive impairment, this group showed worse functional status at discharge (mRS 4 vs. 3, p < 0.001) and a higher probability of dying within 90 days (OR 3.34, 95% CI 1.85-6.01, p < 0.001). A higher risk of a fatal ICH post-thrombolysis was observed in the cognitively impaired patients, and, after controlling for covariates, cognitive impairment remained a significant predictor of a fatal haemorrhage (OR 4.79, 95% CI 1.24-18.45, p = 0.023). CONCLUSIONS: Cognitively impaired ischaemic stroke patients experience increased morbidity, mortality, and haemorrhagic complications following thrombolytic therapy. However cognitive status is not independently predictive of most outcome measures. Further work is required to elucidate contributing factors to the poor outcomes observed in these patients and help guide thrombolysis decision-making in clinical practice.

Prevalence of Symptomatic Knee Osteoarthritis in Saudi Arabia and Associated Modifiable and Non-Modifiable Risk Factors: A Population-Based Cross-Sectional Study.

OBJECTIVE: This study aimed to determine the prevalence of knee osteoarthritis (OA) in Saudi Arabia and the association between knee OA and modifiable and non-modifiable risk factors. METHODS: A self-reported, population-based, cross-sectional survey between January 2021 and October 2021 was conducted. A large, population-representative sample (n = 2254) of adult subjects aged 18 years and over from all regions of Saudi Arabia was collected electronically using convenience sampling. The American College of Rheumatology (ACR) clinical criteria were used to diagnose OA of the knee. The knee injury and osteoarthritis outcome score (KOOS) was used to investigate the severity of knee OA. This study focused on modifiable risk factors (body mass index, education, employment status, marital status, smoking status, type of work, previous history of knee injury, and physical activity level) and non-modifiable risk factors (age, gender, family history of OA, and presence of flatfoot). RESULTS: The overall prevalence of knee OA was 18.9% (n = 425), and women suffered more compared to their male counterparts (20.3% vs. 13.1%, p = 0.001). The logistic regression analysis model showed age (OR: 1.06 [95% CI: 1.05-1.07]; p < 0.01), sex (OR: 2.14 [95% CI: 1.48-3.11]; p < 0.01), previous injury (OR: 3.95 [95% CI: 2.81-5.56]; p < 0.01), and obesity (OR: 1.07 [95% CI: 1.04-1.09]; p < 0.01) to be associated with knee OA. CONCLUSIONS: A high prevalence of knee OA underlines the need for health promotion and prevention programmes that focus on modifiable risk factors to decrease the burden of the problem and the cost of treatment in Saudi Arabia.

Current Status and Future Perspectives on the Internet of Things in Oncology.

The Internet of Things (IoT) has penetrated many aspects of everyday human life. The use of IoT in healthcare has been expanding over the past few years. In this review, we highlighted the current applications of IoT in the medical literature, along with the challenges and opportunities. IoT use mainly involves sensors and wearables, with potential applications in improving the quality of life, personal health monitoring, and diagnosis of diseases. Our literature review highlights that the current main application studied in the literature is physical activity tracking. In addition, we discuss the current technologies that would help IoT-enabled devices achieve safe, quick, and meaningful data transfer. These technologies include machine learning/artificial intelligence, 5G, and blockchain. Data on current IoT-enabled devices are still limited, and future research should address these devices' effect on patients' outcomes and the methods by which their integration in healthcare will avoid increasing costs.

The effect of foot position during static calibration trials on knee kinematic and kinetics during walking.

BACKGROUND: Gait analysis has been used extensively for computing knee kinematics and kinetics, in particular, in healthy and impaired individuals. One variable assessed is the external knee adduction moment (EKAM). Variations in EKAM values between investigations may be caused by changes in static standing position, especially foot placement angles which may increase or reduce any differences seen. PURPOSE OF THE STUDY: The current study aimed to explore the influence of static trial foot position on knee kinematic and kinetic variables during walking. METHODS: Twelve healthy male participants completed three different static standing trials; 1) 20-degrees toe-in, 2) 0° and 3) 20-degrees toe-out before walking at their own pace during a lower limb kinematics and kinetics assessment. First and second peak EKAM was compared between static foot position trials, as well other knee kinematic and kinetic outcomes. Repeated measures ANOVA was used with post hoc pairwise comparison to determine the differences between static foot position trials. RESULTS: The first peak of EKAM was significantly smaller in the 20o toe-out angle, than the 20o toe-in angle (p = 0.04-8.16% reduction). Furthermore, significant changes were found in peak knee kinematics and kinetics variables (adduction angle, external rotation angle, knee flexion moment external rotation moment, abduction angle and internal rotation angle) in the different positions. CONCLUSION: Modification in static foot position between study visits may result in changes especially in the 1st peak EKAM and other kinematics and kinetics variables during walking. Therefore, standardisation of static foot position should be utilised in longitudinal studies to ensure changes in EKAM are not masked or accentuated between assessments.

The reliability of lower limb 3D gait analysis variables during a change of direction to 90- and 135-degree manoeuvres in recreational soccer players.

BACKGROUND: Several biomechanical outcomes are being used to monitor the risk of injuries; therefore, their reliability and measurement errors need to be known. OBJECTIVE: To measure the reliability and measurement error in lower limb 3D gait analysis outcomes during a 90∘ and 135∘ change of direction (COD) manoeuvre. METHODS: A test re-test reliability study for ten healthy recreational players was conducted at seven-day intervals. Kinematics (Hip flexion, adduction, internal rotation angles and knee flexion abduction angles) and kinetics (Knee abduction moment and vertical ground reaction force) data during cutting 90∘ and 135∘ were collected using 3D gait analysis and force platform. Five trials for each task and leg were collected. Standard error of measurement (SEM) and the intraclass correlation coefficient (ICC) were calculated from the randomised leg. RESULT: The ICC values of the kinematics, kinetics, and vertical ground reaction force (VGRF) outcomes (90∘ and 135∘) ranged from 0.85 to 0.95, showing good to excellent reliability. The SEM for joint angles was less than 1.69∘. The VGRV showed a higher ICC value than the other outcomes. CONCLUSION: The current study results support the use of kinematics, kinetics, and VGRF outcomes for the assessment of knee ACL risk in clinic or research. However, the hip internal rotation angle should be treated with caution since the standard measurement error exceeded 10% compared to the mean value. The measurement errors provided in the current study are valuable for future studies.

Public acceptance of COVID-19 vaccination among residents of Saudi Arabia: a cross-sectional online study.

OBJECTIVES: The acceptance of the COVID-19 vaccine is essential for protecting the world population and stopping the COVID-19 pandemic. This paper aimed to measure public acceptance of the COVID-19 vaccination and the factors that may play an important role in increasing the acceptance of vaccinations in future pandemics. DESIGN: A cross-sectional, observational study was conducted through a survey designed using the Google Forms platform. In this study, a logistic regression analysis was used to study and detect the variables linked to the acceptance of COVID-19 vaccination. To meet inclusion criteria, participants had to be 18 years or older at the time of collecting the data, reside in Saudi Arabia at the time of the survey, agree to the consent form and be able to complete the survey in Arabic. SETTING: Randomly selected residents of Saudi Arabia. NUMBER OF PARTICIPANTS: 1658. RESULTS: In general, the population of Saudi Arabia is supportive of the COVID-19 vaccine (72.0%) and has one of the highest acceptance rates, according to global studies. We found that men (OR 0.73; 95% CI: 0.55 to 0.97) were less likely to hesitate with regard to taking the vaccine, whereas previously infected individuals were more likely to hesitate (OR 1.77; 95% CI: 1.25 to 2.50). Those with a lower monthly income (<3000 Saudi riyal) were more likely to refuse the vaccine (OR 3.54; 95% CI: 1.81 to 6.91), while those living in cities (OR 0.62; 95% CI: 0.39 to 0.99) and the unemployed (OR 0.52; 95% CI: 0.33 to 0.83) were less likely to refuse it. Participants' history of viral infection and trust in the healthcare system were found to be important factors in the public's acceptance of the vaccine. CONCLUSION: In general, acceptance of the COVID-19 vaccination is high in Saudi Arabia. Several factors have shown a method for predicting those who might reject the vaccine or hesitate to take it; thus, the healthcare system should target those residents throughout the campaign. Based on the conclusions of the current research, the acceptance of vaccinations could be increased.

Propolis mouthwash for preventing radiotherapy-induced mucositis in patients with nasopharyngeal carcinoma.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is the most common head and neck cancer in Malaysia. The gold standard treatment of NPC is radiotherapy (RT), as NPC is a radiosensitive tumour. Although RT is successful in treating NPC, patients cannot avoid the resulting RT complications. Oral mucositis is the most frequently encountered debilitating complication of RT and has no specific preventive treatment. The aim of this study was to evaluate the efficacy and safety of a 2.5% propolis mouthwash for preventing RT-induced mucositis in patients with NPC. MATERIALS AND METHODS: The study was a prospective, double-arm, randomised control trial with intervention. The patients were randomly divided into an experimental group receiving propolis mouthwash and a placebo group receiving normal saline mouthwash. All patients were instructed to rinse their mouths with 7mL mouthwash three times daily for six weeks. The severity of oral mucositis was then evaluated by the World Health Organization Oral Toxicity Scale at the second, fourth, and sixth weeks of the study. RESULTS: In total, 17 patients completed the study: 10 patients used the propolis mouthwash and seven used the placebo mouthwash. The mean mucositis scores for the propolis mouthwash compared to the placebo at the second, fourth, and sixth weeks were 0.10 vs. 1.14, 0.50 vs. 2.00, and 1.20 vs. 2.86, respectively, and the differences between the two groups were statistically significant (p<0.001). CONCLUSION: A 2.5% propolis mouthwash was both safe and effective for reducing the severity of oral mucositis following RT for NPC.

Predicting Intensive Care Unit Admission for COVID-19 Patients from Laboratory Results.

Trends in routine laboratory tests, such as high white blood cell and low platelet counts, correlate with COVID-19-related intensive care unit (ICU) admissions. Other related biomarkers include elevated troponin, alanine aminotransferase, and aspartate transaminase levels (liver function tests). To this end, the aim of this study was to investigate the effect of changes in laboratory test parameters on ward-based and ICU COVID-19 patients. A total of 280 COVID-19 patients were included in the study and were divided based on admission status into ICU (37) or ward (243) patients. ICU admission correlated significantly with higher levels of several tested parameters, including lactate dehydrogenase, creatinine, D-dimer, creatine kinase, white blood cell count, and neutrophil count. In conclusion, routine laboratory tests offer an indication of which COVID-19 patients are most likely to be admitted to the ICU. These associations can assist healthcare providers in addressing the needs of patients who are at risk of COVID-19 complications.

Long-Term Prevalence and Risk Factors of Musculoskeletal Disorders among the Schoolteachers in Hail, Saudi Arabia: A Cross-Sectional Study.

Background: Musculoskeletal disorders (MSDs) are affecting up to 95% of teachers and are considered a primary occupational health hazard leading to absenteeism, early retirement, and lower quality of life and teaching quality. Aim: The current study is aimed at exploring the prevalence and risk factors of MSDs among the schoolteachers in Hail, Saudi Arabia. Methods: A cross-sectional study was conducted online among the teachers in Hail City using the Nordic Musculoskeletal Questionnaire. Teachers were randomly selected from randomly selected high schools. Teachers with at least 1 year experience were recruited for the study. Descriptive statistics, Cochran's Q test, and binominal regression were used to investigate the prevalence of MSDs among such teachers and to determine if the percentage of MSDs differed by anatomical region and risk factor (one hundred forty-five males and 106 females filled out the questionnaires). Results: The prevalence of MSDs in the last 12 months was 93.63% (235 of 251 teachers). Interestingly, 91% of the affected participants (214 of 235 teachers) complained of MSDs in more than one anatomical region. The most affected site was the lower back (183 of 251 teachers, 72.91%), followed by the shoulders (168 of 251 teachers, 66.93%), and the least affected sites were the elbows (45 of 251 teachers, 17.93%). The females showed a higher prevalence of MSDs than the males. Only gender was a significant risk factor for shoulder and neck MSDs (p < 0.02). Conclusion: Overall, the findings of the current study suggest a high prevalence of MSDs among teachers, especially in the lower back and shoulders. The affected teachers should learn more about biomechanics and ergonomics and should engage in exercise to improve their health. Future studies should focus on identifying the biomechanical and ergonomic risk factors of MSDs and on designing MSD prevention programmes to reduce the burden of MSDs.

A Systematic Review and Meta-analysis Investigating the Pain-Relieving Effect of Interferential Current on Musculoskeletal Pain.

BACKGROUND: Interferential current is one of the most common electrotherapeutic modalities used in the treatment of painful conditions. Patients seeking medical help to reduce their musculoskeletal pain can be treated using interferential current. OBJECTIVE: The current review aimed to analyze the recently available information regarding the efficacy of interferential current in alleviating the pain of musculoskeletal origin. METHODS: This study used Scopus, CINAHL, Cochrane Library, Web of Science, MEDLINE, Embase, and EBSCOas as data sources. The initial selection of the studies, thorough assessment of the full articles, and extraction of the necessary study characteristics were carried out by two independent reviewers. Another two independent reviewers assessed the methodological quality of each included trial against 39 criteria. These criteria were integrated from several popular scales. Pain intensity-measured using the visual analog scale, numeric pain rating scale, or McGill Pain Questionnaire-was the outcome of interest. RESULTS: This review included 35 trials of variable methodological quality from which 19 trials were selected for the meta-analysis. In general, interferential current alone versus placebo demonstrated a significant pain-relieving effect. On the other hand, interferential current showed no significant difference when added to standard treatment compared with placebo plus standard treatment or standard treatment alone. Similarly, interferential current showed no significant difference when compared with other single interventions (laser, transcutaneous electrical nerve stimulation, cryotherapy). CONCLUSIONS: Interferential current alone is better than placebo at discharge. However, the low number of studies raises suspicions about this conclusion. Interferential current alone or added to other interventions is not more effective than comparative treatments in relieving musculoskeletal pain.

Influence of using knee sleeve and lateral wedge insole on knee loading among healthy individuals during stair negotiation.

BACKGROUND: For individuals with knee osteoarthritis (OA), stair negotiation is a challenging task and the first task during which they report pain due to the high knee loading required. The use of lateral wedge insole (LWI) has been found to reduce loading in patients with OA but not to reduce pain, whereas the use of knee sleeve has been shown to result in good pain reduction. Understanding the effect of combining LWI and knee sleeve use on healthy individuals before testing on individuals with knee OA is an important step. RESEARCH QUESTION: The current study aimed to evaluate the effect of combining the use of LWI and knee sleeve and compare the results with the application of each treatment separately and with the control condition. METHODS: This randomised cross-over study included 17 healthy participants who underwent 3D gait analysis. Participants performed ascending and descending stair activities with the following four treatment conditions: five-degree LWI, off-the-shelf knee sleeve, both LWI and knee sleeve and control condition. External knee adduction moment (EKAM) and knee frontal plane range of motion (ROM) were evaluated as primary outcomes. Repeated measure ANOVA or the Friedman test was selected based on meeting the assumption followed by multiple pairwise comparisons with Bonferroni correction. RESULTS: In general, the use of LWI reduced the first peak EKAM significantly (p < 0.001) compared to the control condition in stir ascending (12% reduction) but not in stair descending (p > 0.05). Interestingly, knee sleeve use did not result in any reduction in the first peak EKAM compared to the control or any other condition. However, knee sleeve use led to a significant reduction in the knee frontal plane ROM during stair descending. The combined treatment was not superior to the LWI use when compared to control in the EKAM reduction. SIGNIFICANCE: Combined knee sleeve and LWI use was not superior to LWI use alone in reducing the knee loading, but it may be beneficial for individuals with knee OA since it helped in reduction of the knee frontal plane ROM during stair descending. Importantly, the effect of LWI use or any other treatment must be investigated for each different activity, and the results found in one activity must not be generalised across other activities.

Potentiation of anti-Helicobacter pylori activity of clarithromycin by Pelargonium graveolens oil.

BACKGROUND AND STUDY AIM: Peptic ulcer is one of the most serious diseases in Egypt, affecting more than one-third of the population. Helicobacter pylori is the main organism responsible for peptic ulcer formation. These ulcers can lead to chronic active gastritis and lymphoma. As such, in this study, we evaluate the efficacy of Pelargonium graveolens oil for the treatment of H pylori, as well as its synergistic effects with the antibiotic clarithromycin (CLR). PATIENTS AND METHODS: We evaluated the chemical composition of P. graveolens volatile oil as well as its anti-Helicobacter activities. We assessed the volatile oil components using gas chromatography coupled with mass spectrometry. We determined anti-H. pylori potential using a micro-well dilution method. RESULTS: We identified 92 compounds from the oil. Citronellol, geraniol, citronellyl formate, and isolongifolan-7-α-ol were the predominant components (15.64%, 11.31%, 10.19%, and 7.84%, respectively). The oil exhibited a good activity against H. pylori at an minimal inhibitory concentration of 15.63 µg/ml. Once we combined the volatile oil with CLR, a significant synergistic effect appeared at an fractional inhibitory concentration index of 0.38 µg/ml. CONCLUSION: The in-vitro interaction between the P. graveolens oil and CLR improved the antimicrobial activity of the latter, suggesting that further studies are needed to determine formulations for potential antimicrobial applications in food and pharmaceuticals.

Prevalence and Factors Associated with Musculoskeletal Disorders among Secondary Schoolteachers in Hail, Saudi Arabia: A Cross-Sectional Survey.

Musculoskeletal disorders (MSDs) are one of the most common occupational health hazards and serious health concerns among teachers. About 39% to 95% of teachers suffer from musculoskeletal pain that can lead to a decline in their performance, frequent sick leaves and early retirement, and can have a negative impact on their quality of life. The aim of this study was to investigate the prevalence of and risk factors for MSDs among secondary schoolteachers in Hail, Saudi Arabia. A cross-sectional study was conducted through an electronic survey. A self-reported and validated Arabic version of the Nordic Musculoskeletal Questionnaire (NMQ) was used. Participants were recruited randomly through a two-stage sampling technique. A total of 251 respondents (57.8% males and 42.2% females) returned the questionnaire. The overall prevalence of MSDs was 87.3%. Female teachers (95.3%) suffered more than their male counterparts (81.4%). The most common site was the lower back (62.55%), followed by the shoulders (53.39%) and knees (41.04%). Most of the participants (72.7%) reported MSDs in multiple sites. Binomial logistic regression predicted that smoking is a significant risk factor for lower back disorders (p < 0.05). A high prevalence of MSDs can be due to a substantial lack of awareness and practice of ergonomics, which warrant the development of preventive strategies and educational programs.