The Effect and Implication of Social Media Platforms on Cosmetic Facial Plastic Surgery Among Females in Saudi Arabia.

Introduction Facial plastic surgery addresses various facial imperfections, offering a range of procedures like rhinoplasty and facelifts. Social media promotes unrealistic beauty standards, leading to increased demand for such surgeries. Studies highlight its influence, emphasizing the need for research in this area. Our study aimed to evaluate the effect of social media advertisements and selfies on facial cosmetic surgery decisions and plans among females in Saudi Arabia. Methodology This is a cross-sectional study conducted in the Kingdom of Saudi Arabia that targeted females aged 18-80 years old. An electronic questionnaire in Arabic was used for data collection. Data was analyzed in IBM SPSS Statistics for Windows, Version 29 (Released 2023; IBM Corp., Armonk, New York, United States). Results Our study assessed 568 Saudi females regarding social media's impact on facial cosmetic surgery. Most of them were aged 21-30 years (39.4%) and Saudi nationals (94.2%). The majority, 87.9% (n=499), had not undergone cosmetic surgeries, and 12.1% (n=69) had; 68.1% (n=387) did not plan future surgeries. Notably, 42.6% (n=242) cited surgeon self-advertising and 38.0% (n=216) better selfies as an influencing factor in their cosmetic surgery decision. Logistic regression revealed several significant predictors of cosmetic surgery decisions including surgeon's advertisement (Exp(B) = 2.812, p < 0.001), cosmetic show viewing (Exp(B) = 2.327, p = 0.004), and social media photos (Exp(B) = 2.762, p = 0.001). Education (Exp(B) = 1.533, p = 0.035) and previous surgery (Exp(B) = 4.523, p < 0.001) correlated positively with considering surgery. Conclusion Our study highlights social media's influence on facial cosmetic surgery decisions among Saudi females. Surgeon advertisements, social media exposure, education, and previous surgery history emerged as significant predictors, warranting further research and targeted interventions.

Preoperative ECG Abnormalities Among Patients Who Underwent Elective Surgical Operations at the Kuwaiti Specialised Hospital, Khartoum, Sudan: A Cross-Sectional Study.

BACKGROUND: The presence of preoperative ECG abnormalities has shown wide variation, and its value has been argued; thus, this study aimed to determine preoperative ECG abnormalities among Sudanese patients and their correlates. MATERIALS AND METHODS: An observational descriptive cross-sectional study was conducted at the Kuwaiti Specialised Hospital, Khartoum, Sudan, from October 2020 to March 2021, including all patients over 40 years of age who planned to undergo elective surgery. Demographic, clinical, and ECG findings were obtained during the pre-anaesthesia check-up. The data were analysed using IBM SPSS software version 28 (IBM Corp., Armonk, NY). RESULTS: The study included a total of 304 patients with a mean age of 60±14 years, a male predominance of 210 (69.1%) patients, the presence of hypertension (HTN) in 65 (21.4%), and diabetes mellitus (DM) in 58 (19.1%) patients. The study showed that 235 (77%) patients had at least one ECG abnormality. However, 62 (20.4%) were diagnosed as having normal ECG variations; the most commonly diagnosed abnormality was ischemic heart disease (IHD) (32.5%), followed by sinus tachycardia (39, 12.8%). The QRS complex abnormalities were the most common (100, 32.9%), with M-shaped QRS (RSR pattern) being the most common single ECG abnormal sign (65, 21.4%). The ECG abnormalities showed no significant association with age (p-value = 0.24), gender (p-value = 0.16), DM (p-value = 0.77), HTN (p-value = 0.35), asthma (p-value = 0.35), or the grade of surgery (p-value = 0.52). However, the diagnosis of IHD was associated with the presence of HTN (p-value = 0.001). CONCLUSION: Incidental preoperative ECG abnormalities are common among Sudanese patients undergoing elective surgery, affecting more than three-quarters of them and being of diagnostic value as they led to the diagnosis of ischemic heart disease in nearly one-third of patients. Hypertensive patients may benefit from routine preoperative ECG testing, as ECG signs of ischemic heart disease are more common among hypertensive patients.

Knowledge, Awareness, and Attitude Regarding Obstructive Sleep Apnea Among Primary Healthcare Physicians in the Al-Baha Region of Saudi Arabia.

INTRODUCTION: Obstructive sleep apnea (OSA) is a clinically significant disorder that requires attention from healthcare professionals. This study aimed to assess the knowledge, awareness, and attitude of primary healthcare physicians regarding OSA in Saudi Arabia. METHODOLOGY: A cross-sectional observational study design was employed from January 18, 2023, to August 18, 2023, focusing on primary healthcare physicians practicing in the Al-Baha region of Saudi Arabia. The survey included questions related to knowledge, awareness, and attitudes toward OSA, using the Obstructive Sleep Apnea Knowledge and Attitude (OSAKA) questionnaire for OSA, and demographic information. Descriptive statistics and chi-square tests were used to analyze the data. RESULTS: A total sample size of 174 primary health care physicians was collected, where the majority of participants were male (101, 58.0%), and the mean age of the participants was 32.73 years (SD = 9.14). The item with the most correct answers was "The majority of patients with obstructive sleep apnea snore" (150, 86.2%). On the other hand, the item with the lowest number of correct answers was "Laser-assisted uvulopalatoplasty is an appropriate treatment for severe obstructive sleep apnea" (17, 9.8%). The majority of participants agreed that it is essential for physicians to know about OSA as a clinical disorder (161, 92.5%). However, when it came to screening all patients for possible OSA, there was a higher proportion of participants who disagreed or strongly disagreed (111, 63.8%). In general, the majority of participants had a low level of knowledge (109, 62.6%). Gender was significantly associated with both knowledge (p = 0.021) and awareness (p = 0.039), as well as nationality (knowledge (p = 0.012) and awareness (p = 0.039)), and specialty training, which was significantly associated with both knowledge (p = 0.000) and awareness (p = 0.002). CONCLUSION: Although all participants acknowledged that OSA is a clinical disease, their perspectives on screening and levels of confidence in utilizing screening techniques varied. While the participants exhibited commendable understanding in the majority of domains, there were some facets of OSA in which they lacked expertise.

Antisperm Antibody Levels After Vasectomy Reversal Are Not Associated With Pregnancy Rates or Method of Conception.

OBJECTIVE: To examine the relationship between antisperm antibody (ASA), pregnancy rates, and method of conception following vasectomy reversal, given that before and after vasectomy reversal, patients wonder if ASAs will prevent them from achieving pregnancy and American Urological Association vasectomy guidelines call for additional research to answer this question. METHODS: We performed retrospective chart review and phone interview of patients who underwent vasectomy reversal at our institution from 1/1/2000 to 12/31/2018. We excluded patients who underwent vasectomy reversal for pain, or without postoperative semen analysis with ASA. We categorized patients as having low (<50%) or high (≥50%) ASA levels using the first postoperative semen analysis. Our primary outcome was pregnancy rate, including method of conception. Differences in pregnancy rates were tested using Fisher exact test. RESULTS: Two hundred and four patients were chart reviewed. Median age at time of surgery was 40years and median obstruction interval was 7.3years. Median partner age was 32years. One hundred sixty-four (80%) patients underwent bilateral vasovasostomy. Eighty-five patients (42%) had low (<50%) ASA levels and 119 (58%) had high (≥50%) ASA levels. Sixty-seven patients completed phone interviews. Of 27 men with low ASA levels, 19 (70%) achieved a pregnancy with 16 (59%) spontaneous pregnancy. Of 40 men with high ASA levels, 30 (75%) achieved a pregnancy with 16 (40%) spontaneous pregnancy. The Fisher exact test P-value was .2. CONCLUSION: ASA levels are not associated with pregnancy rate or method of conception after vasectomy reversal. These findings can improve patient counseling before and after vasectomy reversal.

Association of Treatment Duration and Clinical Outcomes in Dry Eye Treatment with Sutureless Cryopreserved Amniotic Membrane.

Background: While sutureless, cryopreserved amniotic membrane (cAM) has been shown to significantly improve signs and symptoms of dry eye disease (DED), no studies have assessed the association of cAM treatment duration to the differential response in clinical outcomes. Methods: A multi-center, retrospective study was conducted on patients with moderate-to-severe DED who were treated with self-retained cAM (Prokera® Slim) for 2 to 7 days. The primary outcome measure was DEWS severity score assessed at 1 week, 1 month, and 3 months. Secondary outcome measures included ocular discomfort, visual symptoms, corneal staining, and visual acuity. Results: A total of 89 eyes (77 patients) with moderate-to-severe DED (DEWS severity 3.24 ± 0.56) received treatment with self-retained cAM for 2 days (n = 10), 3 days (n = 15), 4 days (n = 12), 5 days (n = 19), 6 days (n = 6), or 7 days (n = 27). DEWS scores significantly improved at 1 week, 1 month, and 3 months for all treatment duration groups, with no significant difference observed between groups at any timepoint. In addition to an improvement in DEWS severity scores, those receiving cAM treatment for 2 days demonstrated a significant improvement in corneal staining, visual symptoms, and ocular discomfort at 1 week, 1 month, and 3 months. Conclusion: This retrospective study suggests that a single placement of self-retained cAM for 2 days can significantly improve signs and symptoms of DED with a lasting benefit observed for up to 3 months.

Prevalence and Risk Factors of Dry Eye Disease among Adults in Saudi Arabia.

Background: Environmental and epidemiological factors increase the risk of dry eye in Saudi Arabia, but most studies have limited generalizability. Objective: To determine the prevalence of dry eye disease (DED) among adults across Saudi Arabia and the associated risk factors. The secondary objective was to estimate the economic burden of DED by calculating lubricant usage and its annual costs. Methods: This cross-sectional study invited adults from across Saudi Arabia to complete a questionnaire that collected data regarding demographics, symptoms related to DED, previous diagnosis of DED, use of contact lenses, and use of eye lubricants. Results: A total of 2042 responses were received, of which 784 (38.4%) respondents had previously been diagnosed with DED and 752 (36.8%) were symptomatic but undiagnosed. Between the DED diagnosed and symptomatic-undiagnosed groups, a significant difference was found in terms of age (P < 0.001), gender (P = 0.002), presence of diabetes mellitus (P = 0.004), smoking status (P = 0.007), duration of electronic screen use (P = 0.05), number of ocular complaints (P < 0.001), and frequency of lubricants use (P < 0.001). Between the DED-diagnosed and non-DED groups, significant differences were found in terms of age (P < 0.001), gender (P < 0.001), presence of diabetes mellitus (P = 0.001), allergy (P = 0.001), autoimmune disease (P = 0.005), smoking status (P < 0.001), and history of refractive surgery (P < 0.001). The mean estimated annual cost of using lubricating agents was SAR 328.2 ± 210.3 (USD 87.5 ± 56.1), and this was significantly higher in the diagnosed group (P = 0.01) than the symptomatic-undiagnosed group. Conclusions: The prevalence of DED is high among adults in Saudi Arabia. High-risk population include elderly, female, and using electronic screens for >2 hours/day.

Effect of using spirulina algae methyl ester on the performance of a diesel engine with changing compression ratio: an experimental investigation.

Diesel engine characteristics were investigated experimentally while adding different concentrations of third generation biodiesel spirulina algae methyl ester (SAME). Three volumetric blends of SAME are added to standard Iraqi diesel, namely 10% SAME, 20% SAME, and 30% SAME. The properties of the fuels were found according to the American Society for Testing and Materials standards (ASTM). Experimental work was conducted on a single-cylinder diesel engine under variable load and compression ratio. Three compression ratios are used, starting from 14.5, 15.5, and 16.5. Based on the results obtained, the presence of SAME along with diesel caused an increase in Brake specific fuel consumption (BSFC), carbon dioxide (CO2), and nitrogen oxides (NOx) while decreasing both brake thermal efficiency (BTE) and exhaust gas temperature (EGT). Hydrocarbon (HC) emissions decreased by 7.14%, 8.57%, and 10.71%, for 10% SAME, 20% SAME, and 30% SAME, respectively, compared to the original neat diesel fuel. The dramatic carbon monoxide (CO) emission reduction was at full load point. The addition of SAME from (10 to 30)% reported a decrease in CO by (6.67-20)%. NOx, as well as CO2 emission, are increased as a result of SAME addition. The compression ratio change from (14.5/1 to 16.5/1) led to increased BTE, NOx, and decreased BSFC and all carbon emissions. The experimental results are validated with other studies' findings, and minor divergence is reported.

Bioequivalence of a hybrid pegylated liposomal doxorubicin hydrochloride injection and Caelyx®: A single-dose, randomized, multicenter, open-label, two-period crossover study in patients with advanced ovarian cancer.

OBJECTIVE: To evaluate the bioequivalence of a hybrid pegylated liposomal doxorubicin (PLD) hydrochloride injection with reference product Caelyx®. METHODS: This multicenter, open-label, balanced, randomized, two-treatment, two-period, two-sequence, single-dose, crossover, bioequivalence study was conducted in female patients aged ≥18 years and ≤75 years with ovarian cancer, whose disease progressed or recurred after platinum-based chemotherapy, and who were scheduled to start PLD therapy. Patients were intravenously infused drugs over 1 h at 50 mg/m2 dose two hours after breakfast on the first day of the chemotherapy cycle in period-I and crossed over to the other arm in period-II (day 29). Pharmacokinetic (PK) analyses were performed using two separate, validated liquid chromatography-mass spectrometry methods for encapsulated and unencapsulated doxorubicin. RESULTS: Both the test and reference formulations were well-tolerated and safe. The pharmacokinetic analysis for both encapsulated and unencapsulated doxorubicin was conducted in 50 patients and PK parameters were found to be comparable between test and reference products. The geometric mean ratios (90% confidence interval) of hybrid PLD/Caelyx® were; maximum measured plasma concentration (Cmax): 91.94-97.28%, area under the plasma concentration versus time from time 0 to t (AUC0-t): 95.19-103.67%, AUC from time 0 to ∞ (AUC0-∞): 95.13-103.66% for encapsulated doxorubicin and for unencapsulated doxorubicin Cmax: 92.08-116.46%, AUC0-t: 91.91-108.28%, AUC0-∞: 93.45-110.05%. CONCLUSION: The PLD formulation was found to be bioequivalent to Caelyx®.

Fixed dose combination of capecitabine and cyclophosphamide in metastatic breast cancer: Results from THE ENCLOSE phase 2/3 randomized multicenter study.

AIM: To evaluate pharmacokinetics, efficacy and safety of fixed-dose combination (FDC) of oral capecitabine + cyclophosphamide in metastatic breast cancer (MBC) patients progressing after anthracycline and/or taxane chemotherapy. METHODS: In this prospective, adaptive, phase-2/3, open-label study (CTRI/2014/12/005234), patients were randomized (1:1:1) to three FDC doses (doses/day: D1, capecitabine + cyclophosphamide 1400 mg + 60 mg; D2, 1800 mg + 80 mg; D3, 2200 mg + 100 mg) for 14 days, in 21-day cycles. In Part-I, multiple-dose pharmacokinetics and optimal dose(s) were evaluated with futility analysis. Group(s) with <3 responders based on best overall response rate (BOR, complete response [CR]+partial response [PR]), were discontinued. Efficacy (BOR, disease control rates [DCR; CR + PR + stable disease]) and safety of optimal dose(s) were evaluated in Part-II. RESULTS: Of 66 patients (n = 22/group) in Part-I, pharmacokinetics (D1 = 7/22, D2 = 9/22, D3 = 8/22) showed dose-proportionality for cyclophosphamide and greater than dose-proportionality for capecitabine. Modified intent-to-treat (mITT) analysis showed BOR of 7.14% (1/14) in D1 (discontinued), and 22.22% (4/18) each in D2 and D3, respectively. In Part-II, 50 additional patients were randomized in D2 and D3 (n = 144; total 72 [22 + 50] patients/group). mITT analysis in D2 (n = 54) and D3 (n = 58) showed BOR of 29.63% (16/54, 95%CI: 17.45-41.81%) and 22.41% (13/58, 95%CI: 11.68-33.15%), respectively. DCR in D2 and D3 were 87.04% (47/54, 95%CI: 78.08-96.00%) and 82.76% (48/58; 95%CI: 73.04-92.48%) after 3 and 57.41% (31/54; 95%CI: 52.41-79.50%) and 50.00% (29/58; 95%CI: 40.40-67.00%), after 6-cycles, respectively. Hand-foot syndrome (16.67%), vomiting (9.72%) in D2, and hand-foot syndrome (18.06%), asthenia (15.28%) in D3 were most-common adverse events. CONCLUSION: FDC of capecitabine + cyclophosphamide (1800 + 80 mg/day) showed high disease control rates and good safety profile in MBC patients.

Efficacy and safety of nanosomal docetaxel lipid suspension based chemotherapy in metastatic ovarian carcinoma: A retrospective study.

The aim of the current study was to assess the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS) based chemotherapy in patients with metastatic epithelial ovarian carcinoma. In the present multicenter study, the medical records of patients who received NDLS (60-75 mg/m2; 3-weekly cycles) based chemotherapy for metastatic epithelial ovarian cancer in routine clinical care were retrospectively evaluated. Patients were followed-up from September 2014 until September 2018. The efficacy endpoints were the overall response rate (ORR) and disease control rate measured in accordance with the Response Evaluation Criteria in Solid Tumours 1.1. Overall survival (OS) and safety were also evaluated. Of the 13 patients evaluated, 46.2% (6/13) received NDLS-based first-line chemotherapy and 53.8% (7/13) patients received second-line chemotherapy [platinum-sensitive, 57.1% (4/7); platinum-resistant, 42.9% (3/7)]. The ORRs were 60.0% (3/5) and 57.1% (4/7) for patients receiving first- and second-line chemotherapy, respectively. The estimated median OS for patients receiving NDLS-based first-line chemotherapy was 17.4 months (follow-up duration, 4.3-49.4 months). The estimated median OS was 26.1 months (follow-up duration, 5.1-37.5 months) in patients with platinum-sensitive disease, whereas the OS was 14.8 months (follow-up duration, 3.5-14.8 months) in patients with platinum-resistant disease. No grade III/IV adverse events (AEs) were observed; ≥1 AE in grade I-II was reported in 84.6% (11/13) of patients. Overall, NDLS-based chemotherapy was efficacious and well-tolerated in the management of metastatic epithelial ovarian carcinoma.

Kawasaki Disease Shock Syndrome in the Eastern Region of Saudi Arabia: Case Series.

Kawasaki disease (KD) is a treatable medium-sized vasculitis in the pediatric population consisting of a myriad of specific signs and symptoms. A new entity of the disease, Kawasaki disease shock syndrome (KDSS), is defined as a KD patient presenting with signs of hypoperfusion. Our aim is to describe the signs and symptoms of KDSS and how it is treated and its consequences. Out of 37 patients diagnosed with KD in the period between January 2018 and December 2019 in hospitalized patients younger than 14 years of age at Maternity and Children's Hospital in Al-Hassa, Eastern Province, Saudi Arabia, 3 (8.10%) patients fulfilled the diagnostic criteria for KDSS: 2 (66%) were male and 1 (33%) was female. The cardinal feature in all of them was peripheral cardiovascular collapse. Two patients (66%) were found to have aseptic meningitis. All patients were treated with immunomodulatory agents (intravenous immunoglobulin) and all responded well to anti-inflammatory doses of aspirin. KDSS is the shock state of KD presenting with hypoperfusion symptoms, mainly irritability and changes in the level of consciousness and peripheral cardiovascular collapse. Awareness of such presentation and management by immunomodulatory medications helps in recovery and prevention of tragic consequences of such disease.

Biweekly DoceAqualip in mCRPC patients beyond 20 cycles: A case series.

INTRODUCTION: Docetaxel 75 mg/m2 every 3 weeks for up to 10 cycles is an accepted standard regimen in metastatic castration-resistant prostate cancer (mCRPC). We report our experience with >20 cycles of biweekly nanosomal docetaxel lipid suspension (NDLS) treatment in patients with mCRPC. CASE REPORTS: Cases with long-term treatment of NDLS treatment in mCRPC patients were identified from the medical records of Jawaharlal Nehru Cancer Hospital & Research Centre Bhopal, India. A total of three cases with >20 cycles of NDLS are presented here. MANAGEMENT AND OUTCOMES: Overall, the 3 patients received biweekly NDLS at a dose of 45 mg/m2 for 22, 36, and 40 cycles, respectively, except for one patient where NDLS was initiated at 50 mg/m2 and later reduced to 45 mg/m2. All the 3 patients reported prostate-specific antigen (PSA) response (>50% decline in PSA levels from baseline). The time to treatment failure (TTF) was 14.8, 18.2, and 20.6 months in these 3 patients, respectively. PSA nadir occurred after 14, 6 and 13 cycles, respectively. The OS was 21.6, 22.2 and 25.8 months, respectively. Anemia, lymphopenia, and neutropenia were the most common adverse events. NDLS treatment was overall well-tolerated without any new safety concerns. CONCLUSIONS: Biweekly NDLS for >20 cycles was effective and well-tolerated in patients with mCRPC. NDLS can potentially be used for long-term management, which may be a requirement for most patients with mCRPC.

Neurodevelopmental and epilepsy outcomes of patients with infantile spasms treated in a tertiary care center.

OBJECTIVES: To assess the neurodevelopmental and epilepsy outcomes in children with infantile spasms (IS). METHODS: A retrospective chart review of all patients with infantile spasms admitted to King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia between January 2000 and December 2017. Infants who were diagnosed to have IS as per the International League Against Epilepsy (ILAE) definition were included in this study. Patients who lost follow-up and those who did not receive treatment at KKUH were excluded. RESULTS: Total of 53 patients were included and categorized into unknown, cryptogenic and symptomatic type of IS. The majority had symptomatic etiology (71.7%). Type of etiology and delay in initiation of treatment were significant predictors of motor and cognitive outcomes, but not seizure control. Patients with unknown IS, who were diagnosed earlier (0.72-month), had better neurodevelopmental outcomes. Vigabatrin in combination with either Adrenocorticotropic hormone (ACTH) or Prednisolone showed better seizure control in comparison to monotherapy and other combination modalities. CONCLUSION: Neurodevelopmental outcomes of IS are strongly associated with the underlying etiology. Early initiation of treatments had a favorable cognitive and motor outcome. Early response to combination therapy with resolution of spasms and hypsarrhythmia had better seizure outcomes. However, motor and cognitive outcomes were not affected by the response to the combination therapy.

Coronavirus Disease -2019 (COVID-19) in 2020: A Perspective Study of a Global Pandemic.

Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is responsible for the coronavirus disease- 2019 (COVID-19) pandemic, which was first reported from Wuhan, China, in late 2019. This infection spread to thousands of people globally within a short span of time with a progressive trend to mortality of citizens. Posing a potential public health threat, SARS-CoV-2 progressed from animal-to-human to human-tohuman transmission with symptoms ranging from little or no illness to persons being severely ill and many deaths, confirming two criteria for declaring COVID-19 a pandemic. The disease shows a progressive trend in symptomology, ranging from mild to severe pneumoniae to respiratory and multi-visceral failure that often leads to the death of patients with comorbidity within a short span of time. Intensive research efforts on different aspects of this human pathogen are underway across the globe for elucidating viral transmission routes and the mechanisms employed to overcome host defense responses. Due to the massive infective potential, studies are being carried out to develop effective diagnostics and therapeutic interventions, including re-purposing antivirals and other potential inhibitors. Herein, we describe the taxonomic classification of 'SARS-CoV-2', the structural organization of its genome, its infectivity, transmission, and receptor interaction; and we summarize risk assessment and approaches used for prevention of the infection. Finally, we discuss important aspects of the development of diagnostic tools and therapeutic countermeasures that have the potential to help in controlling the COVID-19 pandemic.

A Multicentric, Retrospective Efficacy and Safety Study of Nanosomal Docetaxel Lipid Suspension in Metastatic Castration-Resistant Prostate Cancer.

PURPOSE: To evaluate the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS, DoceAqualip) in patients with metastatic castration-resistant prostate cancer (mCRPC). MATERIALS AND METHODS: In this multicenter, retrospective study, we analyzed the medical charts of mCRPC patients, who were treated with NDLS administered as 2-weekly (50 mg/m2) or 3-weekly regimens (75 mg/m2). The study endpoints were prostate-specific antigen (PSA) response (>50% PSA decline from baseline), PSA progression (PSA increase from baseline beyond 12 weeks: ≥25% and ≥2 ng/mL), median PSA decline, and time-to-treatment failure (TTF). Overall survival (OS) and safety were also evaluated. RESULTS: Data of 24 patients with mCRPC were analyzed in this study. NDLS was administered as a 2-weekly regimen in 37.5% (9/24; all first-line) patients and as a 3-weekly regimen in 62.5% patients (15/24; first-line: 20% (3/15), second-line: 80% (12/15)). Overall, PSA response was reported in 66.7% (16/24) patients. The PSA response was 77.8% (7/9 patients) in the 2-weekly group and 60% (9/15 patients) in the 3-weekly group. The median decline in PSA was 96.31% in the 2-weekly group and 83.29% in the 3-weekly group; the median TTF was 6.7 and 6.5 months in the 2 weekly group and 3-weekly group, respectively. The median OS was 14.6 months (follow-up: 5.5-25.8 months) in the 2-weekly group whereas it was not reached in the 3-weekly group (follow-up: 7.9-15.6 months). The most common hematological AEs were anemia, lymphopenia, thrombocytopenia, and neutropenia whereas nausea, weakness, constipation, vomiting, and diarrhea were the most common (≥10%) nonhematological AEs. Overall, NDLS treatment was well tolerated without any new safety concerns. CONCLUSIONS: Nanosomal docetaxel lipid suspension (2-weekly or 3-weekly) was effective and well tolerated in patients with metastatic castration-resistant prostate cancer.

Efficacy and safety of nanosomal docetaxel lipid suspension-based chemotherapy in squamous cell carcinoma of the head and neck: A multicenter retrospective study.

Squamous cell carcinoma of the head and neck (SCCHN) is the most common cancer in Indian men. Docetaxel alone or in combination with other chemotherapeutic agents is recommended for the management of SCCHN. The present multicenter, retrospective study was conducted to evaluate the efficacy and safety of a novel docetaxel formulation 'nanosomal docetaxel lipid suspension (NDLS)'-based chemotherapy in SCCHN. The medical records of patients with SCCHN, who were treated with NDLS-based chemotherapy and followed up between August 2014 and September 2018, were reviewed. The efficacy endpoints were overall response rate [ORR; complete response (CR) + partial response (PR)] and disease control rate (DCR; CR + PR + stable disease) for patients receiving NDLS-based induction or palliative chemotherapy. Overall survival (OS) and safety were also evaluated. Efficacy evaluation was available in 30/34 patients (induction, 20/23; palliative, 10/11). NDLS-based induction chemotherapy showed an ORR and DCR of 95% and a median OS of 43.5 months (follow-up duration, 0.6-80.3 months). For NDLS-based palliative chemotherapy, the ORR and DCR were 50% and the median OS time was 4.6 months (follow-up duration, 1.8 to 14.3 months). At least one adverse event was reported in 82.6% patients. No new safety concerns were reported. Overall, NDLS-based chemotherapy was effective and well tolerated in the treatment of SCCHN.

An association between exposure to Middle East Respiratory Syndrome (MERS) and mortality rate of Coronavirus Disease 2019 (COVID-19).

OBJECTIVE: Our objective was to find an association between exposure of a population to Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and mortality rate due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) across different countries worldwide. MATERIALS AND METHODS: To find the relationship between exposure to MERS-CoV and mortality rate due to SARS-CoV-2, we collected and analyzed data of three possible factors that may have resulted in an exposure of a population to MERS-CoV: (1) the number of Middle East Respiratory Syndrome (MERS) cases reported among 16 countries since 2012; (2) data of MERS-CoV seroprevalence in camels across 23 countries, as working with camels increase risk of exposure to MERS-CoV; (3) data of travel history of people from 51 countries to Saudi Arabia was collected on the assumption that travel to a country where MERS is endemic, such as, Saudi Arabia, could also lead to exposure to MERS-CoV. RESULTS: We found a significantly lower number of Coronavirus disease 2019 (COVID-19) deaths per million (deaths/M) of a population in countries that are likely to be exposed to MERS-CoV than otherwise (t-stat=3.686, p<0.01). In addition, the number of COVID-19 deaths/M of a population was significantly lower in countries that reported a higher seroprevalence of MERS-CoV in camels than otherwise (t-stat=4.5077, p<0.01). Regression analysis showed that increased travelling history to Saudi Arabia is likely to be associated with a lower mortality rate due to COVID-19. CONCLUSIONS: This study provides empirical evidence that a population that was at an increased risk of exposure to MERS-CoV had a significantly lower mortality rate due to SARS-CoV-2, which might be due to cross-protective immunity against SARS-CoV-2 in that population because of an earlier exposure to MERS-CoV.

Objective Quantification of Image Quality and Optical Scatter Before and After Nd:YAG Capsulotomy Using a Double-Pass Technique.

PURPOSE: The purpose of this study is to evaluate and compare the correlation between changes in vision and HD Analyzer dual-pass metrics versus changes in vision and conventional subjective slit lamp gradings in pseudophakic patients with posterior capsular opacity undergoing neodymium:yttrium-aluminum-garnet (Nd:YAG) capsulotomy. PATIENTS AND METHODS: High contrast (HC) and low contrast (LC) best spectacle-corrected distance visual acuity (BCVA) and HD Analyzer evaluation were prospectively performed on patients with mild-to-moderate posterior capsular opacification (PCO) and monofocal and accommodating intraocular lens implants. Differences between pre- and post-operative measurements were calculated, along with the correlation of HD Analyzer metrics and slit lamp grading to changes in visual acuity. RESULTS: Following Nd:YAG capsulotomy (n=29), there was statistically significant improvement in HC-BCVA and LC-BCVA, decrease in optical scatter, and corresponding improvement in Strehl ratio and HD Analyzer values at all contrast levels tested (p≤0.05). Pearson test showed a high correlation between the improvement in HC-BCVA (r coefficient = 0.78) and LC-BCVA (r coefficient = 0.71) to the improvement in Objective Scatter Index (OSI). There was a higher correlation of change in HC-BCVA to pre-op OSI  (r2=0.61) than to the subjective PCO grading score (r2 = 0.19). There was also a higher correlation of change in LC-BCVA to pre-op OSI (r2 = 0.49) than to subjective grading (r2 = 0.16). CONCLUSION: The HD Analyzer provides objective measurements of forward light scatter (ie, light directed towards the retina) that can assist with both PCO grading and prediction of improvement of visual quality after YAG laser capsulotomy with higher accuracy than conventional slit lamp assessment based upon backscatter (ie, light traveling to the observer) in patients tested with monofocal and accommodating intraocular lens implants.

Nanosomal Docetaxel Lipid Suspension-Based Chemotherapy in Breast Cancer: Results from a Multicenter Retrospective Study.

PURPOSE: The purpose of this study was to evaluate the efficacy and safety of nanosomal docetaxel lipid suspension (NDLS, DoceAqualip)-based chemotherapy in breast cancer. METHODS: Medical charts of patients with breast cancer, who were treated and followed up with NDLS (75-100 mg/m2; 3-week cycle)-based chemotherapy from August 2014 to September 2018, were analyzed in this multicenter, retrospective study. The study endpoints were overall response rate (ORR: complete response [CR]+partial response [PR]) and disease control rate (DCR: CR+PR+stable disease [SD]) in neoadjuvant and metastatic settings. Overall survival (OS) and safety were evaluated for all settings. RESULTS: Of 91 patients (neoadjuvant: 12, adjuvant: 61, metastatic: 18), efficacy evaluation in 29 patients (neoadjuvant: 12/12, metastatic: 17/18) demonstrated an ORR and DCR of 100%, respectively, in the neoadjuvant setting, and an ORR of 64.7% and DCR of 70.6%, respectively, in the metastatic setting. At a median follow-up of 21.6 months (range: 2.1 to 49.9 months), median OS was not reached in neoadjuvant and adjuvant settings, and it was 30.4 months in metastatic settings. At least one adverse event (AE) was reported in 59.3% of patients. Anemia, thrombocytopenia, lymphopenia, and neutropenia were the most common hematological AEs reported while hyperglycemia and alteration in liver function tests were the most common non-hematological AEs. NDLS-based treatment was well tolerated without any new safety concerns. CONCLUSION: Nanosomal docetaxel lipid suspension-based chemotherapy was efficacious and well tolerated in the treatment of breast cancer. Further, NDLS is being evaluated prospectively in patients with triple-negative breast cancer (ClinicalTrials.gov: NCT03671044).