Prevalence of Acute Tonsillitis and Its Association With Oral Hygiene Among the Population of Taif City, Saudi Arabia

Introduction  Dental surfaces have dense bacterial deposits, and poor oral hygiene can exacerbate bacterial infections, causing acute tonsillitis. The study aims to quantify acute tonsillitis prevalence and assess its association with oral hygiene practices. Methods  A descriptive cross-sectional study aimed to assess the prevalence of acute tonsillitis and its association with oral hygiene was conducted among adults aged 20 and above in Taif City, Saudi Arabia. Illiterates and those unwilling to participate were excluded. We employed an Arabic online self-administered questionnaire that was disseminated conveniently via Google Forms to social media assessing oral hygiene such as last dental visit, age at starting dental care, number of toothbrushes per day, frequency of toothbrush change, and duration of brushing teeth, and acute tonsillitis characteristics of the participants. Results About 393 participated in the study. Of them, 54% were aged 20-30, 53% were males, and 70% had a university education. The prevalence of acute tonsillitis was 64%. Approximately 28% reported dental clinic visits within three months, and 21% initiated oral hygiene practices at age 20. Among participants, 43% brushed twice daily, with 33% spending one minute and 43% two minutes. About 31% replaced toothbrushes every three months, while 23% acknowledged having bad breath. Experiencing bad breath, changing toothbrushes every three months, and having dental visits within less than three months were associated with having acute tonsillitis (p<0.05). However, regression analysis revealed that experiencing bad breath (OR: 2.11, 95% CI: 1.23, 3.70) was associated with a higher risk of acute tonsillitis, while less frequent toothbrush changes correlated with a lower risk (OR: 0.54, 95% CI: 0.30, 0.94). Conclusion  This study revealed a substantial prevalence of acute tonsillitis among adults in Taif City. Oral care practices need improvement. There are significant associations between oral hygiene practices, bad breath, and the occurrence of acute tonsillitis. Addressing oral hygiene practices could be a key focus for preventative measures.

Herpes simplex encephalitis with normal brain magnetic resonance imaging and normocellular initial cerebrospinal fluid

Introduction: Herpes simplex virus (HSV) is associated with one of the lethal diseases, Herpes simplex encephalitis (HSE). Diagnosis is confirmed using MRI and CT scan imaging techniques and more sensitive DNA PCR from cerebrospinal fluid analysis and brain biopsy.Case presentation: However, after four days, the patient's HSE diagnosis was confirmed by the detection of herpes simplex virus type 1 (HSV1) via polymerase chain reaction (PCR) testing. This case highlights the importance of utilizing multiple diagnostic aids and not solely relying on initial test results, as infections may not appear in CSF analysis or MRI scans initially. Furthermore, this case also emphasizes the necessity of initiating empirical treatment based on clinical signs and symptoms, even in cases where diagnostic tests initially appear negative. Prompt and efficient diagnosis and treatment are crucial in managing HSE and preventing long-term neurological damage.Conclusion: This case of HSE underscores the significance of a multifaceted diagnostic approach and timely intervention in managing this potentially severe and life-threatening condition. As mentioned, sometimes the infection does not appear in CSF analysis initially, nor does its effects appear in MRI. HSV PCR remains the golden test to confirm the diagnosis of HSE.

Association Between Musculoskeletal Pain and Studying Hours Among Medical Students in Jeddah, Saudi Arabia

Introduction Musculoskeletal (MSK) disorders are one of the common health issues affecting people of various ages. The main risk factors for musculoskeletal pain are age, obesity, gender, level of education, psychosocial factors, occupational factors, decreased mobility and flexibility, and common factors such as consuming TV and video games. College students, especially medical students, are at a higher risk of these complaints as they have longer hours of studying than most faculties due to the competitiveness of their specialty. The objective of this study was to identify the relationship between musculoskeletal pain and studying hours in medical students in Jeddah, Saudi Arabia, and to increase awareness of this problem. Methods This cross-sectional study was conducted in 2022. Data was collected using an online questionnaire. A total of 314 participants were included in this study. The demographic variables, studying hours, studying locations, and postures were collected and analyzed. Results A total of 314 medical students were included in this study. The majority were males (71.0%) and, the mean age was 22.05±2.13 years. Most of them were sixth-year students, and most of them reported studying between three and four hours (40.1%), with the most common studying location reported being the students' home or residence (79.3%). The number of daily studying hours had no significant effect on the occurrence of musculoskeletal problems. Conclusion There was no significant relationship between the number of studying hours and the MSK pain. Clinical trials could be used to evaluate the most effective approaches to alleviate MSK pain in medical students.

Rapid Response of Palmoplantar Psoriasis to Risankizumab: A Case Report

Palmoplantar psoriasis, a clinical variant of plaque psoriasis, has a significant impact by causing deterioration in the social and functional aspects of patients' lives. Numerous therapeutic interventions are available for palmoplantar psoriasis. Although emerging biological agents have had an enormous positive impact on chronic plaque psoriasis, studies assessing their effectiveness in the palmoplantar phenotype are limited in the literature. We therefore present a case report of a patient with a 10-year history of palmoplantar psoriasis, which has significantly impacted her occupational life. She was treated with Risankizumab, showing a significant and rapid improvement in her symptoms. We believe that Risankizumab could be one of the most effective therapeutic interventions in the clinical context where rapid clearance of palmoplantar psoriasis is required.

Cardiac Surgery-Associated Acute Kidney Injury (CSA-AKI) in Adults and Pediatrics; Prevention is the Optimal Management

Background: Cardiac surgery-associated acute kidney injury (CSA-AKI) is a significant and severe complication that affects morbidity and mortality. We studied both pediatric and adult patients using the Acute Kidney Injury Network (AKIN) definition. Methods: This was an observational retrospective cohort study done at King Abdulaziz University Hospital in Jeddah, Saudi Arabia, and approved by the ethical committee. The exclusion criteria were baseline serum creatinine (SCr) ≥ 4 mg/dL or preexisting renal failure requiring dialysis, reoperation, death within 24 hours postoperatively, and operative mortality or missing data. We included 941 patients in the analysis using statistical software SPSS, version 15.0. Results: Of the total number of patients, 28.68% in the adult group and 20.07% in the pediatric group developed CSA-AKI. Adult risk factors included the age group 60-69 years, cardiopulmonary bypass (CPB), number of grafts, and hypertension. In the pediatric group, CPB, aortic cross-clamping (ACX), and the lower preoperative SCr were the main risk factors Conclusion: Conventional conservative management and preoperative identification of predictor risk factors are essential for preventing CSA-AKI, constituting the primary strategy for optimal management.

Scholarly Activity of Radiation Oncologists in High-Income Developing Countries: Saudi Arabia as an Example

PURPOSE

To examine the trends and quality metrics of publications by radiation oncologists in Saudi Arabia.

METHODS

PubMed was searched using names of all Saudi radiation oncologists to retrieve published articles between January 2010 and December 2019. International collaboration, journal impact factor and country of origin, and number of citations were collected. Each article was assessed for epidemiologic type and independently assigned a level of evidence (LOE) by two authors. The trend in publications was examined and compared in the first and second 5-year periods (2010-2014 and 2015-2019) using relevant parameters.

RESULTS

A total of 186 publications were found and included. The most common type of research was cohort studies followed by case reports and case series in 24%, 14%, and 13% of all publications, respectively. Dosimetry, clinical, and preclinical studies formed 7%, 8.6%, and 7.5% of the total publications, respectively. The LOE was I, II, III, IV, and not applicable in 8.6%, 22%, 25.8%, 29%, and 14.5% of the included publications, respectively. Comparing the first and second 5-year periods, there was an increase in international collaboration (P < .001) in the second period. The number of citations (P < .001) and journal impact factor (P = .028) were lower in the second period. LOE and publications in international journals were not statistically different between the two periods.

CONCLUSION

Although radiation oncology research activity in Saudi Arabia has gained momentum in terms of volume and international collaboration over time, the LOE has not improved. This calls for a national effort to make the contribution to the literature a priority, allocate adequate resources, and apply appropriate measures to enhance research productivity and quality.

Interface Assembly to Magnetic Mesoporous Organosilica Microspheres with Tunable Surface Roughness as Advanced Catalyst Carriers and Adsorbents

Surface roughness endows microspheres with unique and useful features and properties like improved hydrophobicity, enhanced adhesion, improved stability at the oil-water interface, and superior cell uptake properties, thus expanding their applications. Core-shell magnetic mesoporous microspheres combine the advantages of magnetic particles and mesoporous materials and have exhibited wide applications in adsorption, catalysis, separation, and drug delivery. In this study, virus-like rough core-shell-shell-structured magnetic mesoporous organosilica (denoted as RMMOS) microspheres with controllable surface roughness were successfully obtained through electrostatic interaction-directed interface co-assembly. The obtained RMMOS microspheres possess uniform spherical morphology with tunable surface roughness, radially aligned pore channels with a diameter of 3.0 nm in the outer organosilica shell, high specific surface area (396 m²/g), large pore volume (0.66 cm³/g), high magnetization (35.1 emu/g), and superparamagnetic property. The RMMOS microspheres serve as desirable candidates to support Au nanoparticles (2.5 nm) and show superior catalytic activity and excellent stability in hydrogenation of 4-nitrophenol. In addition, the RMMOS microspheres modified with carboxylic groups further displayed promising performance in convenient adsorption removal of dyes in polluted water.

Oncology research in Saudi Arabia over a 10-year period. A synopsis

Objectives:

To assess the quality and quantity of Saudi publications in oncology over a 10-year period.

Methods:

A systematic PubMed search was conducted between January 2008 and December 2017 to retrieve all Saudi oncology publications. Data about the articles was collected. The level of evidence (LOE) was independently assessed by 2 authors. Two 5-year periods (2008-2012 and 2013-2017) were compared using the relevant parameters. Clinicaltrials.gov was also searched for all oncology trials registered in Saudi Arabia.

Results:

A total of 839 publications met our inclusion criteria. The most common type of research was case series, totaling 32% of all publications. Clinical trials formed less than 2% of the total. The LOE was I, II, III, and IV in 0.3%, 2.1%, 58.4%, and 39.3% of the included publications, respectively. The LOE was the same in the 2 periods. There were more publications in international journals (p=0.004), more international collaborations (p=0.001), and higher journal impact factors (p=0.037) in 2013-2017 than in 2008-2012. Only 76 registered clinical trials were found in the Clinicaltrials.gov registry.

Conclusion:

Despite an increase in the number of Saudi publications in the field of oncology over time, the LOE did not change. There were, however, some improvements in the international collaboration and journal impact factor, as well as an increase in the number of studies published in international journals. These observations call for a national strategy to improve oncology research in Saudi Arabia.

General and Efficient Synthesis of Two-Dimensional Monolayer Mesoporous Materials with Diverse Framework Compositions

Two-dimensional (2D) mesoporous materials have received substantial research interest due to their highly exposed active sites and unusual nanoconfinement effect. However, controllable and efficient synthesis of 2D mesoporous materials and investigation of their intrinsic properties have remained quite rare. Herein, a general and effective surface-limited cooperative assembly (SLCA) method enabled by leveling precursor solutions on KCl crystals via centrifugation is employed to conveniently synthesize two-dimensional (2D) monolayer mesoporous materials with different compositions. This novel strategy is performed in a manner similar to spin coating, not only enabling generation of ultrathin mesostructured composite film on KCl particles and recycling excessive precursor solution but also providing favorable solvent annealing environment for the film to form ordered mesostructures. Taking monolayer mesoporous Ce_0.8Zr_0.2O₂ solid solutions as a sample, they display ultrathin nanosheet morphology with a thickness of ∼20 nm, highly open porous structure, and easily accessible active sites of surface superoxide species. Upon decoration of 2D mesoporous Ce_0.8Zr_0.2O₂ nanosheets with Pt nanoparticles, the obtained catalyst exhibits superior catalytic activity and stability toward CO oxidation with a low onset temperature of 30 °C and a 100% conversion temperature of 95 °C, which are 35-70 °C lower than those for their counterpart materials, namely, three-dimensional (3D) mesoporous Pt/Ce_0.8Zr_0.2O₂. Moreover, their TOF_Pt value is ∼11.3 times higher than that of 3D mesoporous Pt/Ce_0.8Zr_0.2O₂. Characterizations based on various techniques indicate that such an outstanding catalytic performance is due to the ultrashort distance (20 nm) of mass diffusion, highly exposed active sites, rich surface-chemisorbed oxygen, and the synergistic effect between the Ce_0.8Zr_0.2O₂ matrix and Pt species.

Au Nanoparticles Decorated Mesoporous SiO2 -WO3 Hybrid Materials with Improved Pore Connectivity for Ultratrace Ethanol Detection at Low Operating Temperature

Semiconducting metal oxides-based gas sensors with the capability to detect trace gases at low operating temperatures are highly desired in applications such as wearable devices, trace pollutant detection, and exhaled breath analysis, but it still remains a great challenge to realize this goal. Herein, a multi-component co-assembly method in combination with pore engineering strategy is proposed. By using bi-functional (3-mercaptopropyl) trimethoxysilane (MPTMS) that can co-hydrolyze with transition metal salt and meanwhile coordinate with gold precursor during their co-assembly with PEO-b-PS copolymers, ordered mesoporous SiO₂ -WO₃ composites with highly dispersed Au nanoparticles of 5 nm (mesoporous SiO₂ -WO₃ /Au) are straightforward synthesized. This multi-component co-assembly process avoids the aggregation of Au nanoparticles and pore blocking in conventional post-loading method. Furthermore, through controlled etching treatment, a small portion of silica can be removed from the pore wall, resulting in mesoporous SiO₂ -WO₃ /Au with increased specific surface area (129 m²  g^-1 ), significantly improved pore connectivity, and enlarged pore window (>4.3 nm). Thanks to the presence of well-confined Au nanoparticles and ε-WO₃ , the mesoporous SiO₂ -WO₃ /Au based gas sensors exhibit excellent sensing performance toward ethanol with high sensitivity (R_a /R_g = 2-14 to 50-250 ppb) at low operating temperature (150 °C).

Surface modification of pH-responsive poly(2-(tert-butylamino)ethyl methacrylate) brushes grafted on mesoporous silica nanoparticles

Poly(2‑(tert-butylamino)ethyl methacrylate) brushes (PTBAEMA) are grown from mesoporous silica nanoparticles via surface-initiated atom transfer radical polymerization (SI-ATRP). Linear PTBAEMA brushes are protonated and highly swollen at low pH; brushes are collapsed at pH higher than 7.7 due to deprotonation, as determined by dynamic light scattering (DLS). Quaternization of these brushes is conducted using 2-iodoethanol in alkali media. DLS measurement of nanoparticles shows that surface-confined quaternization occurs and produces pH-responsive brushes with a hydrophobic upper surface. Variation of the 2-iodoethanol reaction time enables the mean degree of surface quaternization. The pH-responsive behaviour of quaternized PTBEAMA brushes at 1 h reaction time indicates low degrees of surface quaternization, dictated by the spatial location of 2-iodoethanol. Almost uniformly quaternized brushes prepared when the conducted for 3 h and became less swollen at low pH than brushes that conducted for 1 h. The intensity of the C - C - O component (286.5 eV) in the C1s X-ray photoelectron spectrum increased, suggesting that the reaction with iodoethanol was successful occurred.

Echocardiographic findings in asymptomatic systemic lupus erythematosus patients

The aim of this study is to use transthoracic echocardiographic (TTE) imaging methods to identify cardiac dysfunction in asymptomatic systemic lupus erythematosus (SLE) patients and to determine the association between echocardiographic findings and serology. This is a prospective cross-sectional study where 50 patients with confirmed diagnoses of SLE were recruited from rheumatology outpatient clinics. Clinical and serological evaluation to confirm the diagnosis of lupus was done in all patients. Fifty SLE patients, 46 (92%) females and 4 (8%) males, were recruited. Anti-double-stranded DNA (Anti-dsDNA), anticardiolipin, lupus anticoagulant, and anti-β2-glycoproteins were positive in 52.1, 32.6, 13.3, and 15.6%, respectively. Transthoracic echocardiogram revealed mitral regurgitation in 16 patients (32%), pericardial effusion in16 patients (32%), aortic regurgitation in five patients (10%), and tricuspid regurgitation in 10 patients (20%). Eleven patients had left ventricular hypertrophy (22%), and eight patients had ventricular systolic dysfunction (16%). Only four patients had ventricular diastolic dysfunction (8%). A significant association between mitral and tricuspid valve regurgitation and positive anti-dsDNA (p < 0.018, p < 0.006, respectively) was found. Positive anticardiolipin antibodies, lupus anticoagulant, and anti-β 2 glycoprotein antibodies were also associated with mitral valve regurgitation (p values 0.044, 0.006, and 0.023), respectively. Active disease assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) was found to be associated with increased risk of mitral valvular leaflet thickening (p value 0.028). Performing regular transthoracic echocardiogram in asymptomatic SLE patients is important for early detection and appropriate treatment of cardiac lesions. Clinically quiescent but serologically active disease and presence of antiphospholipid antibodies were associated with structural heart abnormalities.

Use of plastic adhesive drapes during surgery for preventing surgical site infection

BACKGROUND

Surgical site infection has been estimated to occur in about 15% of clean surgery and 30% of contaminated surgery. Using plastic adhesive drapes to protect the wound from organisms that may be present on the surrounding skin during surgery is one strategy used to prevent surgical site infection. Results from non-randomised studies have produced conflicting results about the efficacy of this approach but no systematic review has been conducted to date to guide clinical practice.

OBJECTIVES

To assess the effect of adhesive drapes used during surgery on surgical site infection, cost, mortality and morbidity.

SEARCH STRATEGY

We searched the Cochrane Wounds Group Specialised Register (last searched 24/4/07), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2,2007), Ovid MEDLINE (1950 to April Week 2, 2007), Ovid EMBASE (1980 to 2007 Week 16), and Ovid CINAHL (1982 to 1980 to April Week 2 2007).

SELECTION CRITERIA

Randomised controlled trials comparing any plastic adhesive drape with no adhesive drape, used alone or in combination with woven (material) drapes or disposable (paper) drapes in patients undergoing any type of surgery.

DATA COLLECTION AND ANALYSIS

Two authors independently selected and assessed studies for trial quality and both independently extracted data. Study authors were contacted for additional information.

MAIN RESULTS

This review includes five studies involving 3,082 participants comparing adhesive drapes with no drape and two studies involving 1,113 participants comparing iodine-impregnated adhesive drapes with no drape. A significantly higher proportion of patients in the adhesive drape group developed a surgical site infection when compared with no drape. (Relative Risk (RR) 1.23, 95% Confidence Intervals (CI) 1.02 to 1.48, p=0.03). Iodine-impregnated adhesive drapes had no effect on the surgical site infection rate (RR 1.03, 95% CI 0.064 to 1.66, p=0.89). Length of hospital stay was similar in adhesive drape and non-adhesive drape groups.

AUTHORS' CONCLUSIONS

There was no evidence from the seven trials that plastic adhesive drapes reduces surgical site infection rate and some evidence that they increase infection rates. Further trials may be justified using blinded outcome assessment to examine the effect of adhesive drapes on surgical site infection based on different wound classifications.

Risk factors for red cell transfusion in adults undergoing coronary artery bypass surgery: a systematic review

BACKGROUND AND OBJECTIVE

Identifying factors that can predict adults at high risk of receiving red blood cell transfusion during coronary artery bypass graft (CABG) surgery may aid in more efficient blood banking practices and may tailor blood conservation strategies for these adult patients. The objective was to identify clinical factors associated with increased red cell transfusion in adults undergoing CABG surgery.

METHODS

A systematic review of the MEDLINE and HealthSTAR databases from 1966 to December 2005 was conducted. Citations containing the medical subject heading or textwords 'coronary artery bypass graft', 'CABG' and 'cardiovascular surgery' were combined with the medical subject headings or textwords 'transfusion' and 'blood transfusion'.

RESULTS

A total of 2461 abstracts were retrieved. Twenty-one studies met the inclusion/exclusion criteria. Transfusion rates ranged from 7 to 97%. Several variables were identified that were associated with increased red cell transfusion rates including older age, female sex, low haemoglobin concentration or haematocrit value, renal insufficiency and urgent/emergent surgery. The strongest risk factor was the urgency of surgery (urgent or emergent surgery), which was associated with a 4x to 8x increase in transfusion rates compared to elective surgery. Increasing age and female sex increased the likelihood of transfusion by 1x to 3x and 2x, respectively.

CONCLUSIONS

Increasing patient age, female sex, lower preoperative haemoglobin levels, as well as the urgency of the CABG surgery were associated with higher transfusion rates. Identifying risk factors for transfusion may allow for targeted use of blood conservation strategies, improved efficiency in blood utilization and informing adults at risk of transfusion.

A high-resolution anthropomorphic voxel-based tomographic phantom for proton therapy of the eye

Proton therapy is increasingly used in medical treatments for cancer patients due to the sharp dose conformity offered by the characteristic Bragg peak. Proton beam interactions with the eye will be simulated using the MCNPX Monte Carlo code and available nuclear cross-section data to calculate the dose distribution in the eye gel and surrounding organs. A high-resolution eye model will be employed using a 3D geometrical voxel-based anthropomorphic head phantom obtained from the Visible Human Project (female data). Manual segmentation of the eye, carried out by the Medical Physics group at the University of Surrey resulted in 15 identified structures. This work emphasizes the use of a realistic phantom for accurately predicting dose deposition by protons.

Neutron-fluence-to-dose conversion coefficients in an anthropomorphic phantom

A set of fluence-to-effective-dose conversion coefficients has been calculated for neutrons with energies <20 MeV using a high-resolution anthropomorphic phantom (Zubal model) and the MCNPX code. The calculation used 13 monodirectional monoenergetic neutron beams in the energy range 10(-9) to 20 MeV, under three different source irradiation configurations: anterior-posterior, posterior-anterior and left lateral. Dose calculations were performed for 18 selected organs of the body, for which the International Commission on Radiological Protection and the International Commission on Radiological Units and Measurements have set tissue weighting factors for the determination of the effective dose. Another set of neutron-fluence-to-effective-dose conversion coefficients was also calculated with the proposed modification wR from ICRP Publication 92. From comparison between the dose results calculated and the data reported for the MIRD and VIPMAN models, it can be concluded that, although some discrepancies exist between the Zubal model and the two other models, there is good agreement in the left lateral irradiation geometry.