Comparative Evaluation of Clinical Outcome Including Neurosensory Deficit and Pain Score Variables Using Rigid Internal Fixation with Three-Dimensional Miniplate Internal Fixation in Simultaneous Angle and Contralateral Body/Parasymphysis Fractures of the Mandible: A Prospective, Randomized Controlled Study.

Purpose There have been numerous advancements in the strategies used for treating mandibular fractures in the present times, while open reduction and internal fixation is still accepted as the most preferred treatment option for such fractures despite numerous drawbacks. The aim of the present prospective, randomized controlled study was to evaluate the clinical outcome including neurosensory deficit and pain score variables in mandibular fractures that were treated using rigid internal fixation with three-dimensional (3D) miniplate internal fixation. Materials and Methods For the present study, a total of 20 patients of either sex in an age range of 18 to 55 years with simultaneous angle and contralateral body/parasymphysis fractures of the mandible were included, while the clinical outcome was compared in relation to the two groups wherein different treatment options were used including using rigid internal fixation in one as against 3D miniplate internal fixation in the other. Results Pairwise comparison of pain scores in Group I and Group II patients by the Mann-Whitney U-test at different time zones revealed the results to be statistically significant for all pairs except when the findings were compared between 1 month and 3 months after the procedure in Group II patients. Also, significant recovery was observed in both Group I and II patients during healing when assessed preoperatively to 1 month and then 3 months after the procedure with the results being statistically highly significant in case of the variations observed in relation to the neurosensory deficit observed at different time zones for both Group I and II patients ( p = 0.0001). Conclusion Based on the results obtained, it can be concluded that 3D miniplate-led osteosynthesis was found comparable to the osteosynthesis accomplished using reconstruction plates during fixation of unfavorable body/parasymphysis fractures of mandible in study, providing optimal stability, while satisfactorily meeting the biomechanical requirements for occlusal loading, and an early return to normal function.

Impulsiveness, suicide, and aggression in a sample of patients with disorders of methyl amphetamine use.

BACKGROUND: Research has showed a link between patients with methamphetamine dependence and the risk of impulsiveness, aggression, and the risk of suicide. But, this link has not been studied in patients abusing methamphetamine, and it is unknown how impulsiveness, aggression, and the risk of suicide affect them. MATERIALS AND METHODS: This cross-sectional study included 130 adult patients diagnosed with the disorder of the use of amphetamine, methamphetamine, cannabinoids, alcohol, other substances, and polysubstance admitted in the Addiction Department for Mental Health. Participants were interviewed for detailed psychiatric history using a structured questionnaire comprising of structured clinical interview for diagnosis I, Arabic version of the Barratt Impulsiveness Scale-11 (BIS), Beck Scale for Suicidal Ideation for the evaluation of suicidal ideation and behavior, and the Aggression and Hostility scale for adolescents and youth. SPSS was used for data analysis; Initial analysis included descriptive statistics: frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Chi-square test/Fisher's exact test assessed for association between categorical variables, whereas one-way analysis of variance (ANOVA)/ Kruskal-Wallis test was used to compare continuous variables. RESULTS: Patients who used methamphetamine either alone (23%) or with polysubstance (42.6%) were associated with higher suicidal risk than patients who did use other substances than methamphetamine (36.1%). A comparison of the three groups on impulsivity, showed significant difference regarding total scores, motor preservation, and non-planning self-control. No significant differences found between three groups on the aggression scores. CONCLUSIONS: There was a higher rate of impulsivity and suicidal risk in patients with methamphetamine dependence in comparison to dependence on other substances, while there was no difference with regard to aggression between patients with methamphetamine dependence and those dependent on other substances. This finding raises the issue of methamphetamine use disorder as a new substance of dependence.

Postmastectomy Pain Syndrome: A Narrative Review.

Postmastectomy pain syndrome is a very common disorder in breast cancer survivors. The impact on the quality of patients' lives is significantly adverse. The precise pathophysiology has not been determined as yet though various risk factors have been identified that make the patient vulnerable. Required preoperative work includes the identification and possible elimination of risk factors. Treatment is multidisciplinary involving surgical and non-surgical modalities. There is a great scope of research in this field.

Knowledge and attitudes of gout patients and their perspectives about diagnosis and management: A cross-sectional study in Saudi Arabia.

BACKGROUND: Gout is a chronic noncommunicable disease that might lead to multiple systemic complications if it is left untreated. The knowledge, attitudes, and perceptives among patients toward the diagnosis and management of gout are important indicators in determining the prognosis and predicting sequelae of the disease. This cross-sectional survey aimed to assess the knowledge, attitudes, and perspectives of patients diagnosed with gout toward the disease diagnosis and treatment. METHODOLOGY: An observational cross-sectional study was conducted at university clinics and local health facilities in central Riyadh, Saudi Arabia, for the duration between April and August 2022. Pearson χ2 test was used to determine the difference in the proportion of patients who adapt different attitudes and perspectives in terms of their demographic variables. Statistical significance was defined as a p value less than .05. RESULTS: Two-hundred thirteen patients were involved in this study. The majority of the patients (84.0%) were diagnosed for more than 1 year. The majority of the patients (76.5%) were aged 25-60 years when they were diagnosed with gout. The most common complaint at the time of the diagnosis was joint pain (73.7%). The most commonly reported gout medication treatment being used was allopurinol accounting for 23.0%. The majority of the patients (83.6%) were satisfied regarding the effects of gout management on their job performance, work life, and careers. The vast majority (97.5%) reported that they are satisfied with the health service provided. CONCLUSION: The patients diagnosed with gout in Saudi Arabia exhibited a satisfactory level of information, attitude, and perspectives regarding their condition. The participants expressed a significant degree of satisfaction with the impact of gout management on their occupational performance, work-life balance, and professional plans. Additional research is necessary to ascertain the risk factors associated with gout and provide suitable preventative interventions.

An IoT Enable Anomaly Detection System for Smart City Surveillance.

Since the advent of visual sensors, smart cities have generated massive surveillance video data, which can be intelligently inspected to detect anomalies. Computer vision-based automated anomaly detection techniques replace human intervention to secure video surveillance applications in place from traditional video surveillance systems that rely on human involvement for anomaly detection, which is tedious and inaccurate. Due to the diverse nature of anomalous events and their complexity, it is however, very challenging to detect them automatically in a real-world scenario. By using Artificial Intelligence of Things (AIoT), this research work presents an efficient and robust framework for detecting anomalies in surveillance large video data. A hybrid model integrating 2D-CNN and ESN are proposed in this research study for smart surveillance, which is an important application of AIoT. The CNN is used as feature extractor from input videos which are then inputted to autoencoder for feature refinement followed by ESN for sequence learning and anomalous events detection. The proposed model is lightweight and implemented over edge devices to ensure their capability and applicability over AIoT environments in a smart city. The proposed model significantly enhanced performance using challenging surveillance datasets compared to other methods.

To Assist Oncologists: An Efficient Machine Learning-Based Approach for Anti-Cancer Peptides Classification.

In the modern technological era, Anti-cancer peptides (ACPs) have been considered a promising cancer treatment. It's critical to find new ACPs to ensure a better knowledge of their functioning processes and vaccine development. Thus, timely and efficient ACPs using a computational technique are highly needed because of the enormous peptide sequences generated in the post-genomic era. Recently, numerous adaptive statistical algorithms have been developed for separating ACPs and NACPs. Despite great advancements, existing approaches still have insufficient feature descriptors and learning methods, limiting predictive performance. To address this, a trustworthy framework is developed for the precise identification of ACPs. Particularly, the presented approach incorporates four hypothetical feature encoding mechanisms namely: amino acid, dipeptide, tripeptide, and an improved version of pseudo amino acid composition are applied to indicate the motif of the target class. Moreover, principal component analysis (PCA) is employed for feature pruning, while selecting optimal, deep, and highly variated features. Due to the diverse nature of learning, experiments are performed over numerous algorithms to select the optimum operating method. After investigating the empirical outcomes, the support vector machine with hybrid feature space shows better performance. The proposed framework achieved an accuracy of 97.09% and 98.25% over the benchmark and independent datasets, respectively. The comparative analysis demonstrates that our proposed model outperforms as compared to the existing methods and is beneficial in drug development, and oncology.

Predictors of mortality and morbidity in critically ill COVID-19 patients: An experience from a low mortality country.

Background and Aims: Clinical characteristics and factors associated with mortality in patients admitted to the intensive care unit (ICU) in countries with low case fatality rates (CFR) are unknown. We sought to determine these in a large cohort of critically ill COVID-19 patients in Qatar and explore the early mortality predictors. Methods: We retrospectively studied the clinical characteristics and outcomes in patients admitted to the ICU at the national referral hospital for COVID-19 patients in Qatar. Logistic regression analysis was used to determine factors associated with mortality. Results: Between March 7 and July 16, 2020, a total of 1079 patients with COVID-19 were admitted to the ICU. The median (IQR) age of patients was 50 (41-59) years. Diabetes (47.3%) and hypertension (42.6%) were the most common comorbidities. In-hospital mortality was 12.6% overall and 25.9% among those requiring mechanical ventilation. Factors independently associated with mortality included older age ([OR]; 2.3 [95% CI; 1.92-2.75] for each 10-year increase in age, p < 0.001), chronic kidney disease (OR; 1.9 [95% CI; 1.02-3.54], p = 0.04), active malignancy (OR; 6.15 [95% CI; 1.79-21.12], p = 0.004), lower platelet count at ICU admission (OR; 1.41 [95% CI; 1.13-1.75] for each 100 × 103/µl decrease, p = 0.002), higher neutrophil-to-lymphocyte ratio at admission (OR; 1.01 [95% CI; 1-1.02] for each 1- point increase, p = 0.016), higher serum ferritin level at admission (OR; 1.05 [(95% CI; 1.02-1.08] for each 500 µg/L increase, p = 0.002), and higher serum bilirubin level at admission (OR; 1.19 [95% CI; 1.04-1.36] for each 10 µmol/L increase, p = 0.01). Conclusions: The mortality rate among critically ill COVID-19 patients is low in Qatar compared to other countries. Older age, chronic kidney disease, active malignancy, higher neutrophil-to-lymphocyte ratios, lower platelet counts, higher serum ferritin levels, and higher serum bilirubin levels are independent predictors of in-hospital mortality.

Factors associated with self-efficacy in patients with hypertension: a cross-sectional study from Palestine.

BACKGROUND: Self-efficacy is a widely applied psychosocial concept that is commonly used in association with management of chronic diseases, including hypertension. The aim of this study was to assess self-efficacy of hypertension management and patient-physician communication, as well as the factors associated with self-efficacy and patient-physician communication among patients with hypertension in Palestine. METHODS: We conducted face-to-face, questionnaire-based interviews using validated instruments to assess self-efficacy in managing hypertension (Self-Efficacy for Managing Chronic Disease 6-Item Scale (SES6C)) and patient-physician communication (Perceived Efficacy in Patient-Physician Interaction Questionnaire (PEPPI)) in patients with hypertension at the three main primary healthcare centers in Nablus district in northern West Bank, Palestine. We also performed a multiple linear regression analysis to determine the variables independently associated with PEPPI and SES6C scores. RESULTS: We enrolled 377 participants with hypertension in this study. The average age (measured in years) was 56.8 with a standard deviation of 11.6. The mean PEPPI and SES6C scores were 20.0 (SD 4.4) and 41.1 (SD 10.6), respectively. In a multiple linear regression model, subjects who were city dwellers (B=3.597, p=0.004), and subjects with high education levels (B=4.010, p=0.001) achieved higher PEPPI scores, whereas subjects in the normal weight category (B=5.566, p<0.001) and those with higher PEPPI scores (B=0.706, p<0.001) achieved higher SES6C scores. CONCLUSIONS: We found that impairment in self-efficacy was linked to overweight and obesity, as well as lower patient-physician communication. Moreover, our results showed that lower patient-physician communication was independently associated with low education level as well as non-city residency types. We recommend making the appropriate changes by both the policy-makers and the health care providers to improve the health facilities and its services, especially outside the cities. We also suggest holding specific counseling and training session on the management and control of hypertension.

Microscopic Hematuria Associated with Rheumatoid Arthritis: Review of Literature.

Microscopic hematuria is common manifestation in patients with mild rheumatoid arthritis (RA). It has not been extensively addressed, to our knowledge, by scholars. In this review, we discussed in detail the epidemiological aspect of this problem from the clinical point of view. We reviewed many articles from different electronic databases on the web such as PubMed, LILACS, CINAHL, and PSYCH INFO to get up with a narrative review. Twenty-eight studies entailed the issue regarding etiology, pathology, clinical picture, prognosis complications, and treatment. This clinical sign must be addressed by clinical staff treating patients with RA. Also, further studies should be done to discover the hidden areas in this topic.

A kinetic study and mechanisms of reduction of N, N'-phenylenebis(salicyalideneiminato)cobalt(III) by L-ascorbic acid in DMSO-water medium.

The kinetics of reduction of N, N 1 -phenylenebis-(salicylideneiminato)cobalt (III), referred to as [Co(Salophen)]+ by L-ascorbic acid (H2A) was studied in mixed aqueous medium (DMSO:H2O; 1:4 v/v) under pseudo-first-order conditions at 33 ± 1 °C, µ = 0.1 mol dm-3 (NaCl) and λ max = 470 nm. L-ascorbic acid was oxidized to dehydroascorbic acid with kinetics that was first order in both the [H2A] and [Co(Salophen)+] and second-order overall. The reaction involves two parallel reaction pathways; an acid-dependent and the inverse acid-dependent pathways. The inverse acid pathway shows that there is a pre-equilibrium step before the rate determining-step in which a proton is lost. The kinetics followed negative Brønsted-Debye salt effect. Evidence was obtained for the presence of free radicals but none to support the formation of an intermediate complex of significant stability during the reaction. Overall, the data obtained suggest an outer-sphere mechanism for the reaction. A plausible mechanism is proposed.

Fatal Coronavirus Disease 2019-associated Pulmonary Aspergillosis; A Report of Two Cases and Review of the Literature.

Coronavirus Disease 2019 (COVID-19)-associated pulmonary aspergillosis is an emerging entity. We report two fatal cases of putative COVID-19-associated pulmonary aspergillosis. Both cases were diagnosed on the basis of respiratory tract cultures yielding Aspergillus species and otherwise unexplained clinical and radiological deterioration. Existing published literature on COVID-19-associated pulmonary aspergillosis indicate poor outcomes and high mortality. CAPA should be considered in patients with critical COVID-19 who have unexplained progressive respiratory failure despite optimized supportive care. Diagnostic work-up should be initiated as early as possible and should ideally include fungal cultures, galactomannan detection and Aspergillus PCR on tracheal aspirates or broncho-alveolar lavage fluid. Empiric systemic antifungal therapy may be justified in selected cases, pending diagnostic work up results. Large, multi-center studies are required to further understand the pathogenesis of invasive aspergillosis in COVID-19, and the optimal diagnostic and treatment strategies.

Complementary and alternative medicine use in coronary heart disease patients: a cross-sectional study from Palestine.

BACKGROUND: There is a lack of data on the use of complementary and alternative medicine (CAM) in patients with coronary heart disease (CHD). This study examined the use of CAM among patients with CHD, the reasons and factors influencing their use, the types of CAM used, and the relationship between patient's demographics and the use of CAM. METHODS: In order to determine the prevalence and usage of CAM among Palestinian patients with CHD, a cross-sectional descriptive study was performed from three different hospitals. Using a convenient sampling method, a questionnaire was completed in a face-to-face interview with the patients. Descriptive statistics were used for socio-demographic, and clinical variables. Siahpush scale was used to examine the attitude of CHD patients toward CAM use. RESULTS: Of the 150 patients that were interviewed, 128 (85.3%) of the patients completed the questionnaire. The majority of CAM users reported CAM use for health problems other than CHD, while a total of 59 (45.9%) patients have used CAM for their heart problems. On the other hand, it was found that the place of residency and pattern of CHD were significantly associated with CAM use (p = 0.039 and 0.044, respectively). In addition, religious practices were found to be the most common form of CAM used by patients, while body and traditional alternative methods were the least being used. A significant association between the attitudes of patients with CHD and their use of CAM was found (patients' attitudes towards alternative medicine and natural remedies were p = 0.011 and 0.044, respectively). CONCLUSIONS: CAM use among our respondents is common. Despite a lack of evidence-based research supporting its potential benefits and side effects. Understanding the factors that affect CAM use by CHD patients offers healthcare workers and policymakers an opportunity to better understand CAM use and ultimately improve patient-physician interactions.

Reaction of N, N 1 -phenylenebis(salicyalideneiminato)cobalt(III) and l-cysteine in mixed aqueous medium: kinetics and mechanism.

The redox kinetics involving the reaction of N, N'-phenylenebis(salicyalideneiminato)cobalt(III) ([CoSalophen]+) and l-cysteine (LSH) was studied using pseudo-first order approach under the following conditions, [H+] = 1.0 × 10-3 mol/dm3, µ = 0.1 C2 mol/dm3 (NaCl), λmax = 470 nm and T = 27 ± 1 °C in DMSO: H2O; 1:4 v: v medium. The redox reaction was 1st order in both [CoSalophen+] and [LSH], with the overall 2nd order. Hydrogen ion concentration effect revealed the activeness of both the protonated and deprotonated form of the reductant, positive Brønsted-Debye salt effect and was also ion catalyzed. There was no evidence suggesting an intermediate complex of significant stability in the reaction. Free radical was detected to take part and as such the reasonable mechanistic pathway for the reaction is suggested to be outer-sphere, hence proposed.

A study of expected lifetime of XLPE insulation cables working at elevated temperatures by applying accelerated thermal ageing.

Deterioration of cable insulation during its normal operation is a major concern. Usually, electric cables receive less periodic maintenance compared to the other electric components, although they are subjected to several environmental conditions during operation such as high temperature and oxidative atmospheres. In this study, a standardized accelerated thermal ageing technique was used, with the application of the Arrhenius model. This technique is commonly used in accelerated life testing to establish a lifetime-stress relationship and estimate cable lifetime. Two types of Cross-Linked Polyethylene (XLPE) material working at elevated temperatures between 95 and 105 °C were selected for testing. In such accelerated ageing processes, it is required for the insulation to reach a degradation level, which is considered the end of life for the material under evaluation. The end of life criteria (also called endpoint) is defined as a percentage reduction of elongation at break, which is considered in this study to be 50% retention of elongation at break. Thermal ageing was carried out according to the BS 7870-2 standard, while elongation at break was evaluated at several ageing stages. The uncertainty in the measurement was estimated. The short-term data points determined by ageing treatment is represented graphically in the Arrhenius plot. The extrapolation of such data was used to predict the long-term performance and estimate the cable lifetime. The lifetime for XLPE is expected to be between 40 and 60 years at 90 °C rated operating temperature. Experimental findings of this study show an estimated cable lifetime between 7 and 30 years for rated operating temperatures between 95 and 105 °C.

Knowledge, attitude, and practice of diabetic retinopathy among physicians in Northwestern Nigeria.

BACKGROUND: Diabetic retinopathy (DR) is the leading cause of preventable blindness in the productive population that poses a considerable global public health burden. OBJECTIVE: The objective of this study is to assess the knowledge, attitude, and practice of DR screening among physicians in Northwestern Nigeria. Materials and Methods: Survey responses were obtained from 105 physicians in 4 tertiary hospitals using a Likert scale questionnaire. The internal consistency of the questionnaire was calculated using Cronbach's alpha coefficient. Principal component analysis was used for data reduction and grouping with the varimax rotation method, and the factors were extracted based on an Eigenvalue> 1. RESULTS: Most of the respondents (78.8%) were aware of the most effective method of delaying the onset of DR and frequency of eye examination (94.1%). Lack of ophthalmoscopes (70.6%) and dilating eye drops (50.6%) form important barriers to performing a good eye examination. CONCLUSION: DR screening among physicians practicing in Northwestern Nigeria was suboptimal, which prompts the need for improved training of physicians managing persons with diabetes on eye examination in a bid to strengthen DR screening and reduce the burden of visual impairment in our environment.

TFM classification and staging of oral submucous fibrosis: A new proposal.

BACKGROUND: We have evaluated the rationale of existing grading and staging schemes of oral submucous fibrosis (OSMF) based on how they are categorized. A novel classification and staging scheme is proposed. METHODS: A total of 300 OSMF patients were evaluated for agreement between functional, clinical, and histopathological staging. Bilateral biopsies were assessed in 25 patients to evaluate for any differences in histopathological staging of OSMF in the same mouth. Extent of clinician agreement for categorized staging data was evaluated using Cohen's weighted kappa analysis. Cross-tabulation was performed on categorical grading data to understand the intercorrelation, and the unweighted kappa analysis was used to assess the bilateral grade agreement. Probabilities of less than 0.05 were considered significant. Data were analyzed using SPSS Statistics (version 25.0, IBM, USA). RESULTS: A low agreement was found between all the stages depicting the independent nature of trismus, clinical features, and histopathological components (K = 0.312, 0.167, 0.152) in OSMF. Following analysis, a three-component classification scheme (TFM classification) was developed that describes the severity of each independently, grouping them using a novel three-tier staging scheme as a guide to the treatment plan. CONCLUSION: The proposed classification and staging could be useful for effective communication, categorization, and for recording data and prognosis, and for guiding treatment plans. Furthermore, the classification considers OSMF malignant transformation in detail.

Current protocols in the management of oral submucous fibrosis: An update.

Oral submucous fibrosis (OSMF) is a debilitating condition of oral cavity which has significant potential for malignant transformation. In spite of over 20 years of research, the pathogenesis of the condition is still obscure and no single management modality is effective. Many OSMF treatment protocols have been proposed to alleviate the signs and symptoms of the disorder and there is overwhelming evidence that as areca nut is primary cause, stopping its use may have a considerable effect on symptoms rather than reversing pre-existing fibrosis. We present a review of the current protocols for managing OSMF.

Oral submucous fibrosis: An update on pathophysiology of malignant transformation.

Oral submucous fibrosis (OSMF) is a potentially malignant condition associated with areca nut chewing. Formerly confined to the Indian subcontinent, it is now often seen in Asian populations of the United Kingdom, USA and other developed countries, and is therefore a serious problem for global health. What makes it more sinister is the malignant transformation rate, which has been reported to be around 7.6% over a 17-year period. In this concise article, we review the current trends in the pathophysiology of malignant transformation of OSMF.

Breath Alkane as an index of severity for oral submucous fibrosis: A new perspective?

Oral submucous fibrosis (OSMF) is a devastating disease commonly seen in the Asian subcontinent that results in significant functional morbidity for patients and has a high potential for malignant transformation. Over the last three decades, different diagnostic methods have been described to quantify and grade OSMF severity. Some methods have been used with perceived favorable outcomes although recurrence and malignant transformation remains a problem in many cases, and OSMF presents a major therapeutic challenge. We present a simple, noninvasive and less time-consuming diagnostic method which measures the severity of OSMF, helping to predict its malignant transformation and monitoring the effect of medical therapy on this disease.