Infiltration of local anesthetic in the Interspace between the popliteal artery and capsule of the posterior knee "IPACK block" versus adductor canal block "ACB" for pain relief after open wedge high tibial osteotomy: a randomized clinical trial.

BACKGROUND: A high tibial osteotomy is usually associated with severe postoperative pain. Both adductor canal block (ACB) and interspace between the popliteal artery and capsule of the posterior knee (IPACK) have been described as effective block techniques for providing analgesia after knee surgeries, with few comparisons in wedge osteotomy cases. We aim to compare the postoperative analgesic profile of the previously mentioned two block techniques in patients undergoing tibial osteotomies. METHODS: Sixty patients were enrolled in this randomized prospective trial (30 received IPACK and 30 received ACB). Both blocks were installed before the spinal anesthesia after infiltration of 2 mL lidocaine 2%. Twenty mL of bupivacaine 0.25% mixed with dexamethasone as anesthetic adjuvant were used for both blocks. The postoperative analgesic profiles were compared between the two groups. RESULTS: Postoperative pain scores were lower in the IPACK group, and that decrease was evident throughout the first 10 hours postoperatively. Additionally, the duration of analgesia was much prolonged with the same block (487.50±82.39 vs. 301.93±92.06 minutes with ACB). There was a significant decline in postoperative analgesic consumption (1.27±0.45 vs. 1.8±0.61 gm, P=0.000), and a significant increase in the ambulation distance (19.10±0.60 vs. 17.73±0.45 m, P=0.000) with a significant decline in the duration of hospitalization (43.27±7.61 vs. 54±8.35 hours) in the IPACK group compared to the ACB group. CONCLUSIONS: IPACK is a superior block technique compared to ACB in patients undergoing high tibial osteotomy regarding postoperative analgesia, ambulation distance, and patient satisfaction with little rate of adverse events in both groups.

Radiographic graft changes following maxillary sinus floor augmentation with autogenous bone compared with composite grafts: a one-year single-blind randomized controlled trial.

This study evaluated radiographic graft changes following maxillary sinus floor augmentation with (A) autogenous bone, (B) 1:1 autogenous bone and deproteinized porcine bone mineral, or (C) 1:1 autogenous bone and biphasic bone graft material. Sixty patients were randomly allocated to groups A, B, and C (20 in each). CBCT scans were obtained at enrolment, after surgery (T1), after prosthetic rehabilitation (T2), and 1 year after implant loading (T3). Significant decreases in graft volume (3D) and graft height (2D) from T1 to T3 were observed in all groups (P < 0.05). However, at T2 and T3, graft volume was significantly higher in group B than in groups A and C (P < 0.05), and graft height was significantly higher in group B than in group A (P < 0.05). Bone density increased significantly from T1 to T2 in all groups (P < 0.001). However, bone density was significantly higher in group B than in groups A and C, at T2 and T3 (P < 0.05). No significant correlation between graft volume or height and implant protrusion length or residual bone height was found. In conclusion, 1:1 autogenous bone and porcine bone resulted in significantly higher graft volume, height, and bone density when compared with autogenous bone or a 1:1 ratio of autogenous bone and biphasic bone. However the higher graft volume, height, and bone density did not appear to lead to improved outcomes at 1 year of functional loading when compared to the other groups.

Cardiac Rehabilitation in Saudi Arabia: Current Status and Future Directions.

PURPOSE OF REVIEW: Cardiovascular diseases (CVDs) are the leading cause of mortality in Saudi Arabia. Cardiac rehabilitation (CR) is one of the well-known interventions to control and minimize the burden of CVDs. Despite recommendations, CR utilization remains suboptimal in Saudi Arabia due to many reasons, including limited awareness, logistical barriers, shortage of specialized facilities and trained professionals, and perceptions about CVDs illness. This review is to evaluate the current status, effectiveness, accessibility, and challenges of CR utilization in Saudi Arabia, and to explore potential future directions for improving these services. The review addresses key questions regarding the incidence of CVDs, the characteristics of existing CR programs, barriers to CR access, and stakeholder perspectives. RECENT FINDINGS: Recent studies demonstrate that the effectiveness of CR, particularly exercise training, in improving outcomes for post-coronary artery bypass grafting (CABG) patients is well-documented, though data on its impact on other cardiac conditions is limited. There are significant barriers to CR utilization in Saudi Arabia, including limited awareness, logistical challenges, a shortage of specialized facilities and trained professionals, and cultural perceptions about CVD. Stakeholder perspectives highlight the necessity for culturally sensitive and inclusive approaches, particularly in addressing gender-specific needs and enhancing patient-provider communication. The Saudi Vision 2030 presents opportunities to expand and enhance CR services in alignment with international standards. This review found that while CR is a crucial intervention for managing CVDs, its utilization in Saudi Arabia is suboptimal due to various barriers. To improve CR access and effectiveness, future strategies should focus on increasing public and professional awareness, developing infrastructure, training healthcare professionals, and fostering public-private partnerships. These measures are essential to making CR more accessible and tailored to the diverse needs of the Saudi population, ultimately enhancing the quality of cardiovascular care and patient outcomes in the region.

Is Arabic online patient-centered information about dental extraction trustworthy? An infodemiological study.

Background: Assessment of the Arabic online patient-centered information is understudied. The study aims to assess the quality and readability of the Arabic web-based knowledge about dental extraction. Methods: The first 100 Arabic websites focusing on dental extraction were gathered using popular terms from Google, Bing, and Yahoo searches. These sites were organized and their quality was assessed using three key standards: the Journal of the American Medical Association (JAMA) benchmark criteria, the DISCERN instrument, and the inclusion of the Health on the Net Foundation Code of Conduct (HON code) seal. Additionally, the ease of reading of these websites was evaluated through various online readability indexes. Results: Out of 300 initially reviewed websites on dental extraction in Arabic, 80 met the eligibility criteria. Nonprofit organizations were most common (41.3%), followed by university/medical centers (36.3%), and commercial entities (21.3%). Government organizations were minimally represented (1.3%). All websites were medically oriented, with 60% offering Q&A sections. Quality assessment showed moderate scores on the DISCERN instrument, with no site reaching the highest score. JAMA benchmarks were poorly met, and none had the HON code seal. Readability was generally high, with most sites scoring favorably on readability scales. Conclusions: The rapidly evolving online information about dental extraction lacks readability and quality and can spread misinformation. Creators should focus on clear, unbiased content using simple language for better public understanding.

Review of Role of Surgery with Electroporation in Melanoma: Chemotherapy, Immunotherapy, and Gene Delivery.

Electroporation with chemotherapy (ECT) is currently offered as a treatment in Europe for locoregional or metastatic melanoma with cutaneous lesions. However, the role of surgery and other forms of electroporation in melanoma requires further evaluation. Two reviewers used two databases to conduct a literature search and review, and 51 publications related to electroporation with chemotherapy, immunotherapy, or gene delivery were found. ECT appears to be effective in reducing tumor burden for surgical resection, replacing surgical intervention with evidence of complete regression in some lesions, and inducing both local and systemic immune effects. These immune effects are pronounced when ECT is combined with immunotherapy, with a statistically significant improvement in overall survival (OS). Other forms of electroporation, such as those using calcium chloride, an IL-12 plasmid, and vaccination, require further study. However, IL-12 plasmid electroporation may be inferior to ECT based on the evidence available. Furthermore, irradiation of the tumor prior to ECT treatment is negatively correlated with local response. Access to ECT is restricted in the US and requires further evaluation. More randomized controlled trials of ECT and electroporation treatment in locoregional melanoma are recommended.

Serological markers of transfusion transmissible infections and ABO blood groups in Najran, Saudi Arabia.

OBJECTIVES: To ascertain the prevalence of transfusion transmissible infections (TTIs) across diverse donor groups in the Najran province. Additionally, to establish a potential association between the development of TTI and the donors' blood group, as determined by the ABO/Rh blood grouping system. METHODS: Blood donation data of 4120 donors, spanning from January to December 2020, were retrospectively reviewed. The blood were screened for TTI markers, including hepatitis B surface antigen (HBsAg), anti-hepatitis B core (anti-HBc), anti-hepatitis C virus (anti-HCV), anti-human immunodeficiency viruses 1 and 2 (anti-HIV1&2), anti-human T-lymphotropic virus types 1 and 2 (anti-HTLV-1&2), and syphilis antigen. RESULTS: Positive TTI markers were detected in 10.9% of the donors. The most detected TTI marker was anti-HBc (8.9%), followed by HBsAg (0.7%). Other markers were individually detected in <1% of the donors. Anti-HBc-positive was significantly elevated among non-Saudi blood donors. There was an association between age groups and anti-HCV (p=0.002), anti-HTLV (p=0.004) and syphilis antigen (p=0.02) markers positivity. The AB positive blood group exhibited the most positivity for TTI markers, followed by O positive blood group. Similarly, association was found between ABO group and HBsAg (p=0.01), anti-HBc (p=0.001), and anti-HCV (p<0.001) markers positivity. CONCLUSION: Emphasis on implementing robust screening measures for donated blood is underscored by this study. There is the need for future study to extensively evaluate TTI status to enhance our understanding of the trend in TTI.

SARS-CoV-2 clearance in term of Cycle Threshold (Ct) during first two waves of COVID-19 in Pakistan: a phenomenon of delayed viral clearance post-corticosteroid treatment.

SARS-CoV-2 is recently emerged virus, which caused millions of deaths, all over the world. To tackle COVID-19 pandemic, there is an utmost need for in-depth analysis of viral replication. We aimed to examine viral load in SARS-CoV-2 patients during first two waves of COVID-19 in Pakistan. 225,615 suspected subjects from 75 different regions of Pakistan were selected in the study. SARS-CoV-2 RNAs were detected via real time PCR. During first wave (period of June-July, 2020) of COVID-19 the prevalence of SARS-CoV-2 was 20.38%. However, during second wave (period of November-December, 2020) of COVID-19, the rate of prevalence was 9.41%. During first wave of COVID-19 96.31% of participants remained PCR positive for 14 to 21 days, 3.39% of subjects showed positive results for 22 to 35 days, while delayed Ct values were observed among 0.26% of participants for 36 to 49 days. However, during second wave of COVID-19 89.31% of the subjects exhibited symptoms and showed real-time PCR positive results for 14 to 21 days, 9.42% showed positive results for 22 to 35 days, while significantly delayed Ct value results were observed among 1.026% of participants for 36 to 63 days (3.95 times higher than first wave). In contrast to first wave of COVID-19, the factors that were different in second wave were neither viral (different strains) nor host (same population). But treatment factors changed significantly. As during second wave besides azithromycin, corticosteroid dexamethasone consumption was increased consequently causing delayed Ct value negativity. This suggests that corticosteroid treatment might be linked with delayed Ct value or viral clearance. This study is crucial for re-considering effective therapeutic options against COVID-19.

MicroRNA:Siglec crosstalk in cancer progression.

Aberrant Siglec expression in the tumour microenvironment has been implicated in tumour malignancies and can impact tumour behaviour and patient survival. Further to this, engagement with sialoglycans induces masked antigen recognition and promotes immune evasion, highlighting deregulated immune function. This necessitates the elucidation of their expression profiles in tumour progression. MicroRNAs (miRNAs) mediated targeting represents a novel approach to further elucidate Siglec potential and clinical relevance. Although miRNA activity in Siglec expression remains limited, we highlight current literature detailing miRNA:Siglec interactions within the tumour landscape and provide insights for possible diagnostic and therapeutic strategies in targeting the Siglec/sialic acid axis.

Digital assessment of tertiary lymphoid structures and therapeutic responses in gastric cancer: A multi-centric retrospective study.

BACKGROUND: Tertiary lymphoid structures (TLSs) are associated with favorable prognosis and enhanced response to anti-cancer therapy. A digital assessment of TLSs could provide an objective alternative that mitigates variability inherent in manual evaluation. This study aimed to develop and validate a digital gene panel based on biological prior knowledge for assessment of TLSs, and further investigate its associations with survival and multiple anti-cancer therapies. MATERIALS AND METHODS: The present study involved 1,704 patients with gastric cancer from seven cancer centers. TLSs were identified morphologically through hematoxylin-and-eosin staining. We further developed a digital score based on targeted gene expression profiling to assess TLSs status, recorded as gene signature of tertiary lymphoid structures (gsTLS). For enhanced interpretability, we employed the SHapley Additive exPlanation (SHAP) analysis to elucidate its contribution to the prediction. We next evaluated the signature's associations with prognosis, and investigated its predictive accuracy for multiple anti-cancer therapies, including adjuvant chemotherapy and immunotherapy. RESULTS: The gsTLS panel with nine gene features achieved high accuracies in predicting TLSs status in the training, internal and external validation cohorts (area under the curve, range: 0.729-0.791). In multivariable analysis, gsTLS remained an independent predictor of disease-free and overall survival (hazard ratio, range: 0.346-0.743, all P < 0.05) after adjusting for other clinicopathological variables. SHAP analysis highlighted gsTLS as the strongest predictor of TLSs status compared with clinical features. Importantly, patients with high gsTLS (but not those with low gsTLS) exhibited substantial benefits from adjuvant chemotherapy (P < 0.05). Furthermore, we found that the objective response rate to anti-programmed cell death protein 1 (anti-PD-1) immunotherapy was significantly higher in the high-gsTLS group (40.7%) versus the low-gsTLS group (5.6%, P = 0.036), and the diagnosis was independent from Epstein-Barr virus (EBV), tumor mutation burden (TMB), and programmed cell death-ligand 1 (PD-L1) expression. CONCLUSION: The gsTLS digital panel enables accurate assessment of TLSs status, and provides information regarding prognosis and responses to multiple therapies for gastric cancer.

The Expression of a Subset of Aging and Antiaging Markers Following the Chondrogenic and Osteogenic Differentiation of Mesenchymal Stem Cells of Placental Origin.

Mesenchymal stem cells (MSCs) of placental origin hold great promise in tissue engineering and regenerative medicine for diseases affecting cartilage and bone. However, their utility has been limited by their tendency to undergo premature senescence and phenotypic drift into adipocytes. This study aimed to explore the potential involvement of a specific subset of aging and antiaging genes by measuring their expression prior to and following in vitro-induced differentiation of placental MSCs into chondrocytes and osteoblasts as opposed to adipocytes. The targeted genes of interest included the various LMNA/C transcript variants (lamin A, lamin C, and lamin A∆10), sirtuin 7 (SIRT7), and SM22α, along with the classic aging markers plasminogen activator inhibitor 1 (PAI-1), p53, and p16INK4a. MSCs were isolated from the decidua basalis of human term placentas, expanded, and then analyzed for phenotypic properties by flow cytometry and evaluated for colony-forming efficiency. The cells were then induced to differentiate in vitro into chondrocytes, osteocytes, and adipocytes following established protocols. The mRNA expression of the targeted genes was measured by RT-qPCR in the undifferentiated cells and those fully differentiated into the three cellular lineages. Compared to undifferentiated cells, the differentiated chondrocytes demonstrated decreased expression of SIRT7, along with decreased PAI-1, lamin A, and SM22α expression, but the expression of p16INK4a and p53 increased, suggesting their tendency to undergo premature senescence. Interestingly, the cells maintained the expression of lamin C, which indicates that it is the primary lamin variant influencing the mechanoelastic properties of the differentiated cells. Notably, the expression of all targeted genes did not differ from the undifferentiated cells following osteogenic differentiation. On the other hand, the differentiation of the cells into adipocytes was associated with decreased expression of lamin A and PAI-1. The distinct patterns of expression of aging and antiaging genes following in vitro-induced differentiation of MSCs into chondrocytes, osteocytes, and adipocytes potentially reflect specific roles for these genes during and following differentiation in the fully functional cells. Understanding these roles and the network of signaling molecules involved can open opportunities to improve the handling and utility of MSCs as cellular precursors for the treatment of cartilage and bone diseases.

Evidence-based nursing practice and improving pediatric patient care outcomes in the prevention of infection transmission: Emergency department findings.

BACKGROUND: Reducing the risk of infection transmission by getting emergency care for pediatric patients is a challenging task. AIM: The study aim was to assess emergency nurses' readiness to provide care for pediatric patients with infectious diseases. METHOD: Two hundred Jordanian emergency department nurses were surveyed using a descriptive design. RESULTS: The study revealed that insufficient safety and infection control procedures were put into place, starting with family support to allow nurses to work 145 (78%), family care plans intended to assist caregivers 139 (74.7%), the availability of respiratory protection and a backup plan for standard precautions, training requirements, and equipment 131 (70.4%), create a unit pandemic safety strategy 124 (66.7%), have a plan for emergencies for at-risk staff 116 (62.4%), have a hospital pandemic safety plan 113 (60.8%), manage inventory 102 (54.8%), use reuse guidelines if there will be severe shortages 99 (53.2%), create a strategy for nurses' access to healthcare for themselves and their families 96 (51.6%), and end with any required system updates for new policies 88 (47.3%). Staff nurses made up a large proportion of participants (145; 78%; 115; 62.8%) who said they lacked experience with care for pediatric patients with infectious illnesses who were critically sick. A 62.8% of nurses reported they did not have training in infectious disease emergency prevention and control for pediatric patients. What nurses prioritize it was determined that the concept of crisis standards of care (34.9%) was the most important educational topic for training emergency room nurses to care for pediatric patients who are critically ill with infectious infections, while the clarity of communication pathways was ranked lowest. CONCLUSION: More training and support are needed for emergency room nurses to properly care for children's patients with infectious illnesses.

Comparative Study of Treatment Outcome with Tenofovir Alafenamide and Entecavir in Patients with HBV Related Acute on Chronic Liver Failure.

Major causes of acute insult in Hepatitis B virus related acute on chronic liver failure in the Asian region are reactivation of Hepatitis B virus and super infection with hepatitis A and E virus (ACLF). Anti viral therapy should be started as soon as possible in the ACLF patients at presentation while waiting for confirmation by HBV DNA level. This randomized controlled trial was carried out at the Department of Hepatology, BSMMU, Bangladesh from September 2019 to august 2020 with Hepatitis B virus related ACLF patient. This trial was conducted among twenty seven HBV acute on chronic liver failure patient to compare Child Turcotte pugh (CTP) score, Model for end stage liver disease (MELD) score, Asia Pacific Association for study of Liver (APASL) ACLF Research consortium (AARC) score, survival of the patients and HBV DNA level at 3 months with antiviral therapy between tenofovir alafenamide (25mg) and entecavir (0.5mg) group. CTP score, MELD score and AARC score were significantly (p<0.05) decline from baseline to all subsequent follow-up at 1st (at 7 days), 2nd (at 14 days), 3rd (at 30 days) and 4th (at 90 days) in each group but non significant (p>0.05) difference occurred between two group. All twenty seven patients had detectable HBV DNA level at pre-treatment and all survived patients became undectable at 4th, 90 days follow-up. Total 10 patients (37.07%) were survived at 90 days follow-up, out of them seven patients (70.0%) were in tenofovir alafenamide group and three patients (30.0%) were in entecavir group which was statistically significant (p<0.05) in between two group. Hepatic encephalopathy and hepatorenal syndrome were most common causes of death in both groups. Both drugs tenofovir alafenamide and entecavir significantly improves liver functions but the former one is superior regarding survival.

The relationship between socioeconomic status and perinatal outcomes in in vitro fertilization conceptions.

BACKGROUND: In vitro fertilization is the most used assisted reproductive technology in the United States that is increasing in efficiency and in demand. Certain states have mandated coverage that enable individuals with low income to undergo in vitro fertilization treatment. OBJECTIVE: This study aimed to evaluate if socioeconomic status has an impact on the perinatal outcomes in in vitro fertilization pregnancies. We hypothesized that with greater coverage there may be an alleviation of the financial burden of in vitro fertilization that can facilitate the application of evidence-based practices. STUDY DESIGN: This was a retrospective, population-based, observational study that was conducted in accordance with the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database over the 6-year period from 2008 to 2014 during which period 10,000 in vitro fertilization deliveries were examined. Maternal outcomes of interest included preterm prelabor rupture of membranes, preterm birth (ie, before 37 weeks of gestation), placental abruption, cesarean delivery, operative vaginal delivery, spontaneous vaginal delivery, maternal infection, chorioamnionitis, hysterectomy, and postpartum hemorrhage. Neonatal outcomes included small for gestational age neonates, defined as birthweight <10th percentile, intrauterine fetal death, and congenital anomalies. RESULTS: Our study found that the socioeconomic status did not have a statistically relevant effect on the perinatal outcomes among women who underwent in vitro fertilization to conceive after adjusting for the potential confounding effects of maternal demographic, preexisting clinical characteristics, and comorbidities. CONCLUSION: The literature suggests that in states with mandated in vitro fertilization coverage, there are better perinatal outcomes because, in part, of the increased use of best in vitro fertilization practices, such as single-embryo transfers. Moreover, the quality of medical care in states with coverage is in the highest quartile in the country. Therefore, our findings of equivalent perinatal outcomes in in vitro fertilization care irrespective of socioeconomic status possibly suggests that a lack of access to quality medical care may be a factor in the health disparities usually seen among individuals with lower socioeconomic status.

Real time adaptive probabilistic recurrent Takagi-Sugeno-Kang fuzzy neural network proportional-integral-derivative controller for nonlinear systems.

This paper presents an adaptive probabilistic recurrent Takagi-Sugeno-Kang fuzzy neural PID controller for handling the problems of uncertainties in nonlinear systems. The proposed controller combines probabilistic processing with a Takagi-Sugeno-Kang fuzzy neural system to proficiently address stochastic uncertainties in controlled systems. The stability of the controlled system is ensured through the utilization of Lyapunov function to adjust the controller parameters. By tuning the probability parameters of the controller design, an additional level of control is achieved, leading to enhance the controller performance. Furthermore, it can operate without relying on the system's mathematical model. The proposed control approach is employed in nonlinear dynamical plants and compared to other existing controllers to validate its applicability in engineering domains. Simulation and experimental investigations demonstrate that the proposed controller surpasses alternative controllers in effectively managing external disturbances, random noise, and a broad spectrum of system uncertainties.

Advanced Optoelectronic Modeling and Optimization of HTL-Free FASnI3/C60 Perovskite Solar Cell Architecture for Superior Performance.

In this study, a novel perovskite solar cell (PSC) architecture is presented that utilizes an HTL-free configuration with formamide tin iodide (FASnI3) as the active layer and fullerene (C60) as the electron transport layer (ETL), which represents a pioneering approach within the field. The elimination of hole transport layers (HTLs) reduces complexity and cost in PSC heterojunction structures, resulting in a simplified and more cost-effective PSC structure. In this context, an HTL-free tin HC(NH2)2SnI3-based PSC was simulated using the solar cell capacitance simulator (SCAPS) within a one-dimensional framework. Through this approach, the device performance of this novel HTL-free FASnI3-based PSC structure was engineered and evaluated. Key performance parameters, including the open-circuit voltage (Voc), short-circuit current density (Jsc), fill factor (FF), power conversion efficiency (PCE), I-V characteristics, and quantum efficiency (QE), were systematically assessed through the modulation of physical parameters across various layers of the device. A preliminary analysis indicated that the HTL-free configuration exhibited improved I-V characteristics, with a PCE increase of 1.93% over the HTL configuration due to improved electron and hole extraction characteristics, reduced current leakage at the back contact, and reduced trap-induced interfacial recombination. An additional boost to the device's key performance parameters has been achieved through the further optimization of several physical parameters, such as active layer thickness, bulk and interface defects, ETL thickness, carrier concentration, and back-contact materials. For instance, increasing the thickness of the active layer PSC up to 1500 nm revealed enhanced PV performance parameters; however, further increases in thickness have resulted in performance saturation due to an increased rate of hole-electron recombination. Moreover, a comprehensive correlation study has been conducted to determine the optimum thickness and donor doping level for the C60-ETL layer in the range of 10-200 nm and 1012-1019 cm-3, respectively. Optimum device performance was observed at an ETL-C60 ultra-thin thickness of 10 nm and a carrier concentration of 1019 cm-3. To maintain improved PCEs, bulk and interface defects must be less than 1016 cm-3 and 1015 cm-3, respectively. Additional device performance improvement was achieved with a back-contact work function of 5 eV. The optimized HTL-free FASnI3 structure demonstrated exceptional photovoltaic performance with a PCE of 19.63%, Voc of 0.87 V, Jsc of 27.86 mA/cm2, and FF of 81%. These findings highlight the potential for highly efficient photovoltaic (PV) technology solutions based on lead-free perovskite solar cell (PSC) structures that contribute to environmental remediation and cost-effectiveness.

Pressure Sore among Stroke Patients during Hospital Stay: A Cross-Sectional Study in A Tertiary Care Hospital.

Pressure sore is an important post-stroke complication that results in increased morbidity, mortality and poor prognosis of the patients. The objective of the present study was to find out the prevalence and the factors associated with pressure sore among stroke patients. This prospective cross-sectional study includes 50 stroke patients admitted in the Department of Neurology of Dhaka Medical College Hospital, Bangladesh from July to December 2018. Data were collected from the by direct interview of the patients or their relatives or caregiver using a structured case report form. Descriptive statistics were used to represent patients' characteristics and the chi-square test was used to determine the difference between patients' groups. The mean ±SD age of the stroke patients was 59.16±11.53 years and half of them were male. Fifty percent of the patients had been suffering from ischemic stroke and the rest from hemorrhagic stroke. Of all, one-fourth of the patients (24.0%) developed post-stroke pressure sore during the hospital stay and type-specific prevalence was 20.0% in ischemic stroke and 30.0% in hemorrhagic stroke. Common sites of the pressure sore were sacrum (50.0%), buttock (25.0%), heels (17.0%), and greater trochanter (8.0%). Only 8.0% of the patients developed grade IV wounds. Pressure sores of 42.0% of patients healed spontaneously, 25.0% needed conservative management and 25.0% needed a skin graft. This study found that a large portion of stroke patients develop a pressure sore during hospital stay which can deteriorate clinical outcomes and compromise the quality of life of the patients. Adequate preventive measures and proper rehabilitation should be encouraged for better stroke management and to reduce long-term complications.

Client's perception toward services of smoking cessation clinics in Riyadh, Saudi Arabia.

Background: In Saudi Arabia, approximately 70,000 deaths yearly occur from diseases caused by smoking. Assessing patients' smoking behavior in primary care has apparent benefits. Assisting patients with smoking cessation is one of the essential roles of primary care. This study evaluated the quality of smoking cessation clinic counseling in Riyadh, Saudi Arabia, based on customer opinions of such services. Methods: This research employed a cross-sectional approach involving individuals attending smoking cessation clinics located within primary health care centers in Riyadh city. The participants were chosen through random selection. They were informed about the study's objectives, and those who consented to take part were contacted and provided with an online questionnaire to complete. Results: A total of 340 subjects participated (95.6%) of them were males, and 41.2% were in the age group of 25 to 35 years old. The common modality of tobacco use was cigarettes (82.6%), and 87.9% reported consuming tobacco daily. The mean (±SD) total score of the Fagerstrom Test of Nicotine Dependence was 5.03 (±2.36), and the highest percentage (44.4%) of the participants had a moderate level of nicotine dependence. The vast majority (93.8%) of the participants had former quitting experiences. Half (50.9%) of the participants showed complete satisfaction with the cessation clinics, while 13.2% and 9.1% of them were not satisfied or slightly satisfied, respectively. Conclusion: The majority of smoking cessation clinic visitors were satisfied with the services provided, exceeding three-quarters of them, with half totally satisfied.

Si, O-Codoped Carbonized Polymer Dots with High Chemiresistive Gas Sensing Performance at Room Temperature.

A new type of carbonized polymer dot was prepared by the one-step hydrothermal method of triethoxylsilane (TEOS) and citric acid (CA). The sensor made from carbonized polymer dots (CPDs) showed superior gas sensing performance toward ammonia at room temperature. The Si, O-codoped CPDs exhibited superior ammonia sensing performance at room temperature, including a low practical limit of detection (pLOD) of 1 ppm (Ra/Rg: 1.10, 1 ppm), short response/recovery time (30/36 s, 1 ppm), high humidity resistance (less than 5% undulation when changing relative humidity to 80 from 30%), high stability (less than 5% initial response undulation after 120 days), reliable repeatability, and high selectivity against other interferential gases. The gas sensing mechanism was investigated through control experiments and in situ FTIR, indicating that Si, O-codoping essentially improves the electron transfer capability of CPDs and synergistically dominates the superior ammonia sensing properties of the CPDs. This work presents a facile strategy for constructing novel high-performance, single-component carbonized polymer dots for gas sensing.