Study of menstrual cycle synchrony in female medical students sharing common accommodation.

Context: Menstrual cycle synchronization is a phenomenon in which menstrual onset shifts progressively closer with time. It is an adoptive conditional phenomenon seen in the females who associate closely and share a common environment. Aims: To ascertain whether menstrual cycle synchrony exists in the roommates living in a closed space in a medical hostel. Settings and Design: This is a prospective observational study comprising 62 female medical students of a mean age of 22 years living in twin sharing accommodation with a history of regular menses (26-32 days). Methods and Material: These participants were followed on a monthly basis for 13 months. Menstrual cycle history was obtained using standardized Google forms. Menstrual cycle initial and final onset differences, expected cycle cut-off values, and absolute differences were calculated. The menstrual cycle synchrony score was obtained by subtracting the expected difference from the onset difference. Wilson's absolute difference method was used for determining menstrual synchrony between pairs. Statistical Analysis Used: The descriptive analysis was done using mean and standard deviation. One sample t-test was used to assess the synchrony between roommates. P value ≤0.05 was considered as statistically significant. Results: The initial onset difference of the menstrual cycle was 7.58 ± 4.25 days, whereas the final onset difference was 6.06 ± 3.92 days. The calculated synchrony score was -9.28 ± 5.05, which was statistically significant. Menstrual cycle synchrony was observed in 17 pairs (54.8%) and asynchrony in eight pairs (25.8%). Conclusions: Long-term association between roommates has potential to cause menstrual cycle synchrony. It has significant implications in reproductive medicine for reproductive scheduling and family planning.

Prevalence of Dyslipidemia in Ischemic Stroke Patients: A Single-Center Prospective Study From Pakistan.

Background Stroke is a debilitating condition that adds morbidity to the patient and is an economic burden to society. Several modifiable risk factors can be identified and controlled, and dyslipidemia is one such under-diagnosed and least reported risk factor in Pakistan. We aimed to conduct this study to determine the frequency of dyslipidemia in ischemic stroke patients. Methodology We conducted a prospective cross-sectional study for seven months at Shalamar Hospital, Lahore, from November 2020 to May 2021. One hundred four patients were enrolled as per inclusion and exclusion criteria. After informed consent, a blood sample was taken from the patients and sent to a laboratory to determine dyslipidemia. Demographic details, history, and co-morbidities were also noted on a performa. All the collected data were analyzed in SPSS 20.0. Results The mean age was 53.09 ± 12.51 years. Of 104 patients, 60 (57.69%) were male, and 44 (42.31%) were females, with a male-to-female ratio of 1.4:1. The mean duration of disease in our study was 5.77 ± 3.33 hours. The mean BMI was 27.54 ± 3.03 kg/m2. In our study, the frequency of dyslipidemia in ischemic stroke patients was 39.42% (41 patients).  Conclusion This study concluded that dyslipidemia in ischemic stroke patients is very high in the Pakistani population. This highlighted the need to control this modifiable risk factor in the population. Strategic measures, including pharmacological therapy and diet modification, should be adopted, and awareness about the disease burden, control, and importance should be spread.

Frequency of Urinary Tract Infections in Type 2 Diabetic Patients Taking Dapagliflozin.

Background Urinary tract infections (UTIs) are common in patients with diabetes. The use of sodium-glucose cotransporter-2 inhibitors (SGLT2i) to achieve good glycemic control increases glucose levels in urine. This glycosuria further enhances the risk of UTIs. This study aimed to evaluate the frequency of UTIs in patients with type 2 diabetes receiving the SGLT2i dapagliflozin as an add-on therapy. Methods We conducted this cross-sectional study at the Endocrinology Department of Hayatabad Medical Complex in Peshawar from April 2020 to September 2020. A total of 400 patients with diabetes receiving either 5 mg or 10 mg of dapagliflozin as an add-on therapy for the treatment of type 2 diabetes were included in this study. We collected blood and urine samples from participants and measured glycosylated hemoglobin levels. Urine samples were cultured on cysteine lactose electrolyte deficient agar. We used IBM SPSS Statistics for Windows, version 25.0 (IBM Corp., Armonk, NY) to analyze our data. Results The prevalence of UTIs in diabetic patients receiving 5 mg or 10 mg of dapagliflozin was 5.3%. Women were more affected (76.2%) than men (p < 0.05). UTIs were more prevalent in patients older than 50 years (85.7%) than in any other age group. The dose strength of dapagliflozin was not associated with UTIs (p > 0.05). Conclusion This study examined UTIs in patients taking dapagliflozin for the treatment of type 2 diabetes. These infections were mild to moderate and were treated easily. None of these infections caused the patient to discontinue the treatment. Dapagliflozin is well-tolerated in patients with diabetes but should be used with appropriate caution and monitoring.

A rare case report of enteric fever causing gallbladder perforation.

INTRODUCTION AND IMPORTANCE: Enteric fever is one of the major public health problems mainly in developing countries. Gallbladder perforation is very unusual. Enteric fever rarely causes gallbladder perforation. We report a case of gallbladder perforation due to enteric fever in an adult patient. CASE PRESENTATION: A 50-year-old female without any medical illness presented with a history of intermittent fever for two weeks and three days duration of severe abdominal pain. Upper abdominal tenderness and guarding were found in the abdominal examination. Ultrasonography showed thickening of the gallbladder wall and pericholecystic fluid collection. Magnetic resonance cholangiopancreatography revealed a distended gallbladder with sludge, diffuse wall thickening, and contained perforation with a mild amount of free fluid seen in the abdomen. With the diagnosis of type II gallbladder perforation, percutaneous ultrasonography-guided drainage was done. The culture of bile revealed positivity for Salmonella Typhi. Intra-venous antibiotic (ceftriaxone and gentamicin) was administered for 14 days. Four weeks later, cholecystectomy with peritoneal lavage was done. She was discharged on the 8th postoperative day. CLINICAL DISCUSSION: Preoperative diagnosing of gallbladder perforation is challenging. The accurate treatment and precise timing of the surgery remain important. In most cases, cholecystectomy and abdominal lavage are adequate to treat gallbladder perforation. CONCLUSIONS: Gallbladder perforation is a life-threatening surgical problem. The clinician should have a high index of awareness about this unusual surgical entity due to enteric fever and early diagnosis with prompt surgical intervention is necessary to improve patient outcomes.

Prediction of difficult laparoscopic cholecystectomy: An observational study.

BACKGROUND: Laparoscopic cholecystectomy (LC) is a gold standard treatment of symptomatic gallstone disease. Meanwhile, it is also a challenging procedure demanding excellent expertise for the best outcomes. Many times, difficult laparoscopic cholecystectomy is a nerve-wracking situation for surgeons. It endangers patients by causing potential injury to vital structures. Thus, we aimed to identify predictors for difficult LC. METHODS: A retrospective cross-sectional review of surgical records was done. Patients who underwent laparoscopic cholecystectomy on an elective basis from July 2017 to June 2021 were included in the study. We divided our patients into two groups based on operative findings of difficult LC; difficult LC group and non-difficult LC group. We compared patient's demographics, predictors, and perioperative details and analyzed the data. RESULTS: A total of 338 patients (82 males) with a median age of 47 years were studied. Total difficult LC was found in 52 patients (15.4%). The overall conversion rate was 8.9%. Logistic multivariable regression analysis revealed that; male gender (odds ratio (OR); 0.171, confidence interval (CI),(0.043-0.675), P; 0.012), past history of acute cholecystitis (OR; 0.038, CI; (0.005-0.309), P; 0.002), gall bladder wall thickness (≥4-5 mm) (OR; 0.074, CI; (0.008-0.666), P; 0.020), fibrotic gallbladder (OR; 166.6, CI; (7.946-3492), P; 0.001), and adhesion at Calot's triangle (OR; 0.021, CI (0.001-0.311), P; 0.005) were independent predictors of difficult LC. CONCLUSIONS: Gender (male), past history of acute cholecystitis, gallbladder wall thickness (≥4-5 mm), fibrotic gallbladder, and adhesion at Calot's triangle are significant predictors for difficult LC. Moreover, an awareness about reliable predictors for difficult LC would be helpful for an appropriate treatment plan and application of the resources to anticipate difficult LC.

Permanganate release from silica-based hollow mesoporous coagulant combined with UV for spatiotemporal enrichment and degradation of diclofenac sodium.

In this work, the novel hollow mesoporous coagulant was prepared by chitosan-polydopamine coating and permanganate loading into silica nanoparticles for investigating the simultaneous enrichment and degradation of diclofenac sodium (DCFS) combined with ultraviolet irradiation. The enrichment kinetic of DCFS was explained well with pseudo-second-order model, indicating the exist of hydrogen bonding. Based on the correlation coefficients, the enriched isotherms were fitted by models which accorded with the BET > Freundlich > Langmuir sequence. The result showed that, in addition to the coagulant and DCFS, there were aromatic stackings among DCFS molecules. Due to both effects of which, the DCFS enrichment could be realized significantly in the range of pH 4.0-9.0. It was degraded at the copresence of ultraviolet and permanganate released from coagulant in acidic aqueous medium. The release mechanism was simulated through Korsmayer-Peppas model, implying case-II transport and Fickian diffusion. Additionally, Mn (V) and •OH radicals were vital in the DCFS degradation process. The coagulant could be reloaded at least ten times and that from each cycle was used directly for DCFS removal for six times without rinse process, which provided a potential application in environmental remediation.

α-Aminoazoles/azines: key reaction partners for multicomponent reactions.

Aromatic α-aminoazaheterocycles are the focus of significant investigations and exploration by researchers owing to their key role in diverse biological and physiological processes. The existence of their derivatives in numerous drugs and alkaloids is due to their heterocyclic nitrogenous nature. Therefore, the synthesis of a structurally diverse range of their derivatives through simple and convenient methods represents a vital field of synthetic organic chemistry. Multicomponent reactions (MCRs) provide a platform to introduce desirable structure diversity and complexity into a molecule in a single operation with a significant reduction in the use of harmful organic waste, and hence have attracted particular attention as an excellent tool to access these derivatives. This review covers the advances made from 2010 to the beginning of 2020 in terms of the utilization of α-aminoazaheterocycles as synthetic precursors in MCRs.

In-situ catalytic pyrolysis upgradation of microalgae into hydrocarbon rich bio-oil: Effects of nitrogen and carbon dioxide environment.

Pyrolysis of Spirulina Platensis (SP) microalgae was carried out under different reaction environment such as nitrogen (N2) and carbon dioxide (CO2) at different reaction temperatures of 300, 350, 400, 450 and 500 °C. Catalytic upgradations were examined over solid acid (ZSM-5) and solid base (MgO) catalyst, and with ZSM-5-MgO catalysts mixtures. Results showed, pyrolysis of non-catalytic biomass yielded maximum bio-oil of 43.6% under N2. However catalytic upgradation in CO2 environment produced lower bio-oil due to the coke formation. Maximum bio-oil (46.2 wt%) was obtained with basic metal MgO catalyst in N2 environment compared to other catalyst and environments. Mixture of MgO-ZSM-5 catalyst improved the bio-oil yield (37.8-48.6 wt%) compared to individual catalytic reaction under N2 and CO2. Higher high heating value (HHV) was observed in catalytic bio-oil 36.8 MJ/Kg. Bio-oil (catalytic) analysis revealed that 64-70% of compounds are in hydrocarbon range. Bio-oil was rich in hydrocarbons of C7-C18 range with less oxygenated compounds.

Microwave assisted preparation and characterization of a chitosan based flocculant for the application and evaluation of sludge flocculation and dewatering.

In this study, a new type of graft modified flocculant (CS-g-PAD) was copolymerized of AM, DAC and chitosan (CS) by microwave assisted initiation and used for sludge conditioning and dewatering. The effect of reaction conditions on microwave assisted copolymerization was investigated and their optimal values were obtained by orthogonal experiments. The structure and chemical properties of CS-g-PAD were characterized and the results indicated that microwave assisted polymerization can cause the generated side polymer chain of PAD to react with the -NH2 active group in CS. Thus, the graft copolymerization occurred at amino group connected with C2 site. Compared with CCPAM, PAD and CS, the synthesized CS-g-PAD exhibits superior sludge dewatering performance (FCMC: 72.1%, SRF: 4.5 × 1012 m/kg, d50: 679.556 µm, Df: 1.72, floc sedimentation rate: 5.72 cm/min) in a wide pH range (pH = 3.5-9.5). Because CS-g-PAD contains a large amount of cationic DAC and positively charged CS as well as many functional groups on CS, it increases the charge neutralization, electrical patching and adsorption capability. Additionally, the grafting PAD on CS has a good extension in solution to increase its adsorption bridging effect. The new grafted CS-g-PAD is promising and has great practical application value in sludge dewatering and condition.

Association of ABO blood types and novel obesity markers in healthy adolescents.

INTRODUCTION: Association of ABO blood type with body mass index (BMI) was explored in the past studies, but literature on association of novel obesity markerssuch as total body fat and lean body mass (LBM) is scarce. The present study aimed to evaluate the relationship of ABO blood types with novel obesity markers in normal adolescents. MATERIALS AND METHODS: A cross-sectional study was done on 387 medical students. Bio-impedance analysis (BIA)-derived novel obesity markers such as body fat percent (BFP) and lean body mass (LBM) were recorded. Blood typing was done using slide-agglutination method. Mean and SD were calculated; analysis of variance and Chi-square (χ2) correlation were used to determine the relationship between ABO blood types and obesity markers. RESULTS: Highest propensity for BFP and LBM was seen in blood groups AB and B (25.09 ± 8.92 and 44.45 ± 6.91) respectively. Highly significant (P < 0.001) differences were observed in the values of BFP and LBM in normal and obese participants across ABO blood types. Prevalence of obesity did not show significant relationship (χ2 = 2.069; P = 0.913) with ABO blood types. CONCLUSIONS: Unlike BMI, novel obesity markers (BFP and LBM) significantly differ across ABO blood groups in normal and obese population. The findings suggest that ABO blood type might have role in determining body composition. This will be helpful in recognition of the participants at the risk of obesity on the basis of their blood groups.

Better understanding the polymerization kinetics of ultrasonic-template method and new insight on sludge floc characteristics research.

As one of the core technologies employed in the field of sludge conditioning, flocculation has the ability to improve the sludge dewatering performance and reduce its volume and amount, which can accordingly result in lower costs in sludge transportation as well as subsequent disposal. Therefore, the development of new and high-efficiency flocculants is a hot topic in this field. The template copolymer (TPAD) of acryloyloxyethyl trimethyl ammonium chloride (DAC) and acrylamide (AM) was successfully synthesized through ultrasonic-template copolymerization using sodium-polyacrylate (NaPAA) as a template. The analysis of FTIR, 1H (13C) NMR, TG/DSC and SEM revealed that TPAD had a conspicuously significant cationic segmental structure. In addition, the results obtained from the analysis on the association constant (KM) and the kinetics of the template reaction indicated that the ultrasonic-template was a free radical initiated polymerization and the polymerization mechanism was I Zip-up (ZIP), and which once again confirmed the formation of the cationic fragment structure. This novel cationic fragment structure in TPAD greatly enhanced the ability of charge neutralization, electric patching, adsorption and bridging, thus improving the active sludge conditioning and dewatering performance (FCMC: 72.9%, SRF: 4.0 × 1012 m·kg-1, d50: 228.604 µm, Df: 2.02 at 400 r/min). The floc breakage and regeneration experiments showed that the cationic fragment structure in TPAD could make great contribution to the formation of large and dense floc structures, and these flocs were able to regenerate rapidly after breakage. Finally, it was also known that these large and compact floc structures were beneficial to the creation of more channels and voids, thereby decreasing sludge resistance (SRF) and improving sludge dewatering performance.

Effect of Water Chemistry on Antimony Removal by Chemical Coagulation: Implications of ζ-Potential and Size of Precipitates.

The process of coagulation and precipitation affect the fate and mobility of antimony (Sb) species in drinking water. Moreover, the solubility and physico-chemical properties of the precipitates may be affected by the media chemistry. Accordingly, the present study aimed to investigate the removal of Sb(III, V) species by ferric chloride coagulation under various water chemistry influences with a particular focus on the role of the properties of the precipitates. The results indicated that the amount of Sb(III) removed increased with increasing solution pH, showing the insignificant effects of the hydrodynamic diameter (HDD) and ζ-potential of the precipitates. However, no Sb(V) removal occurred at alkaline pH values, while a highly negative ζ-potential and the complete dissolution of precipitates were observed in the aqueous solution. The solution pH was also useful in determining the dominant coagulation mechanisms, such as co-precipitation and adsorption. The Fe solubility substantially affects the Sb removal at a certain pH range, while the HDD of the precipitates plays an insignificant role in Sb removal. The presence of divalent cations brings the ζ-potential of the precipitates close to point of zero charge (pzc), thus enhancing the Sb(V) removal at alkaline pH conditions. Pronounced adverse effects of humic acid were observed on Sb removal, ζ-potential and HDD of the precipitates. In general, this study may provide critical information to a wide group of researchers dealing with environmental protection from heavy metal pollution.

The Influence of Ionic and Nonionic Surfactants on the Colloidal Stability and Removal of CuO Nanoparticles from Water by Chemical Coagulation.

The widespread use of copper oxide nanoparticles (CuO NPs) and surfactants in various consumer products makes it likely that they coexist in aqueous environments, making it important to study the effects of surfactants on the fate and transport behavior of CuO NPs. The present study aims to investigate the influence of anionic sodium lauryl sulfate (SLS) and nonionic nonylphenol ethoxylate (NPEO, Tergitol NP-9), on CuO NPs adsorption, aggregation, and removal from water by the coagulation process. The result of the sorption study indicates that both surfactants could be adsorbed on the surface of CuO NPs, and that SLS remarkably decreases the ζ potential as well as the hydrodynamic diameter (HDD) of CuO as compared to NP-9. The kinetic aggregation study showed that both SLS and NP-9 reduced the HDD of CuO NPs and retarded the settling rates at surfactant concentrations above 0.015% (w:v) over a 24 h-period. Moreover, enhanced aggregation of CuO NPs was observed in two environmental waters as compared to pure water, which could be related to their high ionic strength. The addition of surfactants in natural waters has been shown to reduce the aggregation and sedimentation of CuO; however, the reductive effect of SLS was more pronounced than that of NP-9. Finally, the coagulation results showed that the removal efficiencies of CuO, Cu2+, and the surfactant in all tested waters at optimum ferric chloride dosage reached around 98, 95, and 85%, respectively. Furthermore, the coagulation mechanism revealed that the combination of charge neutralization and adsorptive micellar flocculation (AMF) might be involved in the removal of both pollutants. The results of the present study provide new insight into the environmental behavior of coexisting NPs and surfactants in wastewater treatment processes.

Complexation of Antimony with Natural Organic Matter: Performance Evaluation during Coagulation-Flocculation Process.

The presence of natural organic matter (NOM) in drinking water sources can stabilize toxic antimony (Sb) species, thus enhancing their mobility and causing adverse effects on human health. Therefore, the present study aims to quantitatively explore the complexation of hydrophobic/hydrophilic NOM, i.e., humic acid (HA), salicylic acid (SA), and L-cysteine (L-cys), with Sb in water. In addition, the removal of Sb(III, V) species and total organic carbon (TOC) was evaluated with ferric chloride (FC) as a coagulant. The results showed a stronger binding affinity of hydrophobic HA as compared to hydrophilic NOM. The optimum FC dose required for Sb(V) removal was found to be higher than that for Sb(III), due to the higher complexation ability of hydrophobic NOM with antimonate than antimonite. TOC removal was found to be higher in hydrophobic ligands than hydrophilic ligands. The high concentration of hydrophobic molecules significantly suppresses the Sb adsorption onto Fe precipitates. An isotherm study suggested a stronger adsorption capacity for the hydrophobic ligand than the hydrophilic ligand. The binding of Sb to NOM in the presence of active Fe sites was significantly reduced, likely due to the adsorption of contaminants onto precipitated Fe. The results of flocs characteristics revealed that mechanisms such as oxidation, complexation, charge neutralization, and adsorption may be involved in the removal of Sb species from water. This study may provide new insights into the complexation behavior of Sb in NOM-laden water as well as the optimization of the coagulant dose during the water treatment process.

Interaction of Arsenic Species with Organic Ligands: Competitive Removal from Water by Coagulation-Flocculation-Sedimentation (C/F/S).

The co-occurrence of arsenic (As) and organic ligands in water bodies has raised environmental concerns due to their toxicity and adverse effects on human health. The present study aims to elucidate the influences of hydrophobic/hydrophilic organic ligands, such as humic acid (HA) and salicylic acid (SA), on the interactive behavior of As species in water. Moreover, the competitive removal behaviors of As(III, V) species and total organic carbon (TOC) were systematically investigated by coagulation-flocculation-sedimentation (C/F/S) under various aqueous matrices. The results showed the stronger binding affinity of As(V) than As(III) species, with a higher complexation ability of hydrophobic ligands than hydrophilic. The media containing hydrophilic ligands require smaller ferric chloride (FC) doses to achieve the higher As(III, V) removal, while the optimum FC dose required for As(III) removal was found to be higher than that for As(V). Moreover, hydrophobic ligands showed higher TOC removal than hydrophilic ligands. The pronounced adverse effect of a higher concentration of hydrophobic ligands on the removal efficiencies of As(V) and TOC was observed. The adsorption of As(V) on Fe precipitates was better fitted with the Langmuir model but the Freundlich isotherm was more suitable for As(III) in the presence of hydrophilic SA. Moreover, TOC removal was substantially decreased in the As(V) system as compared to the As(III) system due to the dissolution of Fe precipitates at higher As(V) concentrations. The results of FC composite flocs demonstrated that the combined effect of oxidation, charge neutralization and adsorption played an important role in the removal of both toxicants during the C/F/S process. In summary, the findings of the present study provide insights into the fate, mobility and competitive removal behavior of As(III, V) species and organic ligands in the water treatment process.

Interaction between Persistent Organic Pollutants and ZnO NPs in Synthetic and Natural Waters.

The use of zinc oxide nanoparticles (ZnO NPs) and polybrominated diphenyl ethers (PBDPEs) in different products and applications leads to the likelihood of their co-occurrence in the aquatic system, making it important to study the effect of PBDPEs on the fate and transport of ZnO NPs. In this study, we determine the influence of PBDPEs (BDPE-47 and BDPE-209) on the colloidal stability and physicochemical properties of ZnO NPs in different aqueous matrices. The results indicated the shift in ζ potential of ZnO NP from positive to negative in the presence of both PBDPEs in all tested waters; however, the effect on the NPs surface potential was specific to each water considered. The lower concentration of the PBDPEs (e.g., 0.5 mg/L) significantly reduced the ζ potential and hydrodynamic diameter (HDD) of ZnO NP, even in the presence of high content of dissolved organic matter (DOM) in both freshwater and industrial wastewater. Moreover, both BDPE-47 and BDPE-209 impede the agglomeration of ZnO NP in simple and natural media, even in the presence of monovalent and polyvalent cations. However, the effect of BDPE-47 on the ζ potential, HDD, and agglomeration of ZnO NP was more pronounced than that of BDPE-209 in all tested waters. The results of Fourier transform infrared (FT-IR) and X-ray Photon Spectroscopy (XPS) further confirm the adsorption of PBDPEs onto ZnO NP surface via aromatic ether groups and Br elements. The findings of this study will facilitate a better understanding of the interaction behavior between the ZnO NPs and PBDPEs, which can reduce the exposure risk of aquatic organisms to both pollutants.

The Removal of CuO Nanoparticles from Water by Conventional Treatment C/F/S: The Effect of pH and Natural Organic Matter.

The increased use of engineered nanoparticles (ENPs), such as copper oxide nanoparticles (CuO NPs), in commercial products and applications raises concern regarding their possible release into freshwater sources. Therefore, their removal from water is important to eliminate adverse environmental and human health effects. In this study, the effects of pH and natural organic matter (NOM), i.e., humic acid (HA) and salicylic acid (SA) on the removal of CuO NPs by coagulation/flocculation/sedimentation (C/F/S) were evaluated. The results indicated that pH significantly affects the coagulation efficiency, where 10⁻60% CuO NPs removal was achieved under extreme acidic/alkaline conditions. However, at neutral pH, removal of up to 90% was observed with a lower ferric chloride (FC) dosage (0.2 mM). The coagulation efficiency and mechanism were strongly affected by the type of Fe species present in the aqueous phase, which is mainly controlled by pH. Higher concentrations of both HA and SA decrease the CuO NPs agglomeration rate, and thereby improve the colloidal stability due to the NOM molecules adsorbed onto the NPs surface. The presence of hydrophobic HA needs a higher FC dosage of 0.5⁻0.8 mM than a dosage of hydrophilic SA of 0.25⁻0.35 mM, to obtain a similar CuO coagulation efficiency. Moreover, higher removals of dissolved organic carbon (DOC) and UV254 were observed more in hydrophobic NOM than in hydrophilic. The results of the Fourier transform infrared (FT-IR) analysis of FC composite flocs confirm that the charge neutralization and enmeshment of coagulant might be a possible removal mechanism. The findings of the current study may provide critical information in the prediction of the fate, mobility, and removal of CuO NPs during C/F/S in water treatment.

Nitroketene N,S-acetals: synergistic building blocks for the synthesis of heterocycles.

The development of novel heterocyclic compounds from simple and easily accessible starting components is of significant importance in medicinal chemistry. Due to the presence of active chromophores and potent pharmacological activities, nitroketene N,S-acetals have emerged as a fascinating building block in organic synthesis. The synergistic skeleton of these acetals and the presence of electron-donating as well as electron-withdrawing groups lead to the generation of distinctive structural features and are highly useful for building diverse heterocyclic rings. This review highlights the preparation of different nitroketene N,S-acetals and their applications in the synthesis of diverse heterocyclic compounds.

Testing the validity and reliability of the Arabic version of the painDETECT questionnaire in the assessment of neuropathic pain.

INTRODUCTION: Neuropathic pain (NP) can cause substantial suffering and, therefore, it must be diagnosed and treated promptly. Diagnosis of NP can be difficult and if made by an expert pain physician is considered the gold standard, however where expert help may not be easily available, screening tools for NP can be used. The painDETECT questionnaire (PD-Q) is a simple screening tool and has been widely used in several languages. We developed an Arabic version of PD-Q and tested its validity and reliability. METHODS: The original PD-Q was translated into the Arabic language by a team of experts. The translated version of the PD-Q was administered to the study population, which included patients having moderate to severe pain for at least three months. Reliability of the Arabic version was evaluated by an intra-class-correlation coefficient (ICC) between pre- and post-measures and Cronbach's α values. Validity was measured by receiver operating characteristic (ROC) curve. Expert pain physician diagnosis was considered as the gold standard for comparing the diagnostic accuracy. RESULTS: A total of 375 patients were included in the study, of which 153 (40.8%) patients were diagnosed with NP and 222 [59.2%] patients had nociceptive pain. The ICC between pre- and post-PD-Q scale total scores for the overall sample, NP group, and NocP group was 0.970 (95% CI, 0.964-0.976), 0.963 (95% CI, 0.949-0.973), and 0.962 (95% CI, 0.951-0.971), respectively. The Cronbach's α values for the post-assessment measures in the overall sample, NP group, and nociceptive pain group, were 0.764, 0.684, and 0.746, respectively. The area under the ROC curve was 0.775 (95% CI, 0.725-0.825) for the PD-Q total score. CONCLUSION: The Arabic version of the PD-Q showed good reliability and validity in the detection of NP component in patients with chronic pain.

Validity and reliability of Arabic version of the ID Pain screening questionnaire in the assessment of neuropathic pain.

Diagnosis of neuropathic pain (NP) can be challenging. The ID Pain (ID-P) questionnaire, a screening tool for NP, has been used widely both in the original version and translated forms. The aim of this study was to develop an Arabic version of ID-P and assess its validity and reliability in detecting neuropathic pain. The original ID-P was translated in Arabic language and administered to the study population. Reliability of the Arabic version was evaluated by percentage observed agreement, and Cohen's kappa; and validity by sensitivity, specificity, correctly classified, and receiver operating characteristic (ROC) curve. Physician diagnosis was considered as the gold standard for comparing the diagnostic accuracy. The study included 375 adult patients (153 [40.8%] with NP; 222 [59.2%] with nociceptive pain). Overall observed percentage agreement and Cohen's kappa were >90% and >0.80, respectively. Median (range) score of ID-P scale was 3 (2-4) and 1 (0-2) in the NP group and NocP group, respectively (p<0.001). Area under the ROC curve was 0.808 (95% CI, 0.764-0.851). For the cut-off value of ≥2, sensitivity was 84.3%, specificity was 66.7%, and correct classification was 73.9%. Thus, the Arabic version of ID-P showed moderate reliability and validity as a pain assessment tool. This article presents the psychometric properties of the Arabic version of ID Pain questionnaire. This Arabic version may serve as a simple yet important screening tool, and help in appropriate management of neuropathic pain, specifically in primary care centers in the Kingdom of Saudi Arabia.