Role of Nemolizumab and Omalizumab in management of atopic dermatitis: A review

BackgroundNemolizumab (CIM331) is a monoclonal antibody that binds the IL-31 receptor α component. This inhibits IL-31 from acting on neurons that constrains the initialization of the sense of pruritus in cases of atopic dermatitis.AimsTo summarize the results of reported studies evaluating the role of nemolizumab and omalizumab in management of atopic dermatitis.Methods This is a systematic review was carried out, including PubMed, Google Scholar, and EBSCO that examining randomized controlled trials, observational, and experimental studies which study role of nemolizumab in management of atopic dermatitis.Results The review included 8 randomized studies reported efficacy of both nemolizumab and omalizumab for management of atopic dermatitis.ConclusionOther studies with large numbers of patients with AD are necessary to define the adverse effects of both drugs in the treatment of AD

Global overview of the management of acute cholecystitis during the COVID-19 pandemic (CHOLECOVID study)

Background: This study provides a global overview of the management of patients with acute cholecystitis during the initial phase of the COVID-19 pandemic. Methods: CHOLECOVID is an international, multicentre, observational comparative study of patients admitted to hospital with acute cholecystitis during the COVID-19 pandemic. Data on management were collected for a 2-month study interval coincident with the WHO declaration of the SARS-CoV-2 pandemic and compared with an equivalent pre-pandemic time interval. Mediation analysis examined the influence of SARS-COV-2 infection on 30-day mortality. Results: This study collected data on 9783 patients with acute cholecystitis admitted to 247 hospitals across the world. The pandemic was associated with reduced availability of surgical workforce and operating facilities globally, a significant shift to worse severity of disease, and increased use of conservative management. There was a reduction (both absolute and proportionate) in the number of patients undergoing cholecystectomy from 3095 patients (56.2 per cent) pre-pandemic to 1998 patients (46.2 per cent) during the pandemic but there was no difference in 30-day all-cause mortality after cholecystectomy comparing the pre-pandemic interval with the pandemic (13 patients (0.4 per cent) pre-pandemic to 13 patients (0.6 per cent) pandemic; P = 0.355). In mediation analysis, an admission with acute cholecystitis during the pandemic was associated with a non-significant increased risk of death (OR 1.29, 95 per cent c.i. 0.93 to 1.79, P = 0.121). Conclusion: CHOLECOVID provides a unique overview of the treatment of patients with cholecystitis across the globe during the first months of the SARS-CoV-2 pandemic. The study highlights the need for system resilience in retention of elective surgical activity. Cholecystectomy was associated with a low risk of mortality and deferral of treatment results in an increase in avoidable morbidity that represents the non-COVID cost of this pandemic

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Sharia-driven policy constraints to enforcement of arbitration awards in the kingdom of Saudi Arabia

This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University LondonInternational arbitration is posited on the intention that its awards will be recognised, binding, and enforceable between different stakeholders. However, recognition and enforcement may vary in different jurisdictions. Courts may have to decide upon competing parties’ rights when enforcing an award. This thesis investigates the key challenges and barriers in recognition and enforcement of arbitral awards in the Kingdom of Saudi Arabia (KSA), where applicable law is grounded in Sharia (traditional Islamic jurisprudence and local customs) and compatible international laws and conventions. Although current Saudi legislation is considered to meet international regulatory systems and standards, there are still many reservations about it from international legislators and legal communities. Arbitration awards should be registered in the KSA and validated by the Kingdom’s courts, because current enforcement and recognition of foreign arbitral awards is subject to Islamic law, which can be problematic for the recognition and enforcement of foreign arbitration awards. This is related to Sharia implications of international arbitration conditions, and a lack of familiarity and knowledge of foreign arbitration among the Kingdom’s judiciary, along with the general incoherence between domestic and foreign arbitration mechanisms. The findings of the analysis undertaken in this thesis support five key recommendations to overcome these challenges: (1) establishment of a quasi-judicial committee; (2) defining arbitration for domestic and foreign arbitral awards; (3) providing and clarifying conditions for enforcement; (4) limiting the judges’ capacity to refusal of arbitral awards; and (5) clarifying the grounds for public policy and limiting automatic incorporation of sharia law. The implications of this research, its limitations, and directions for future studies are also outlined

The Pleasure of Playing Less: A Study of Incremental Games Through the Lens of Kittens

<p>In this book, we explore the pleasure of playing less through a collective experience of playing the Kittens Game – a self-described “Dark Souls of incremental gaming”. We draw on techniques of close reading and hermeneutics to ground our analysis and supplement our individual reflections on how these games incentivize players to play less and plan more.</p

Rheumatic Tricuspid Valve Disease: An Evidence-Based Systematic Overview

Background and aim of the study: Right-sided valve abnormalities are less common than their left-sided counterparts. Furthermore, whilst organic rheumatic involvement of the tricuspid valve is not uncommon, it receives less attention than left-sided heart valves. An evidence-based systematic overview was carried out to assess the epidemiology, diagnosis and management of organic rheumatic tricuspid valve disease (RTVD) over the past half century. Methods: A computed search spanning more than four decades was conducted to identify articles on various aspects of RTVD. The bibliographies of all relevant articles were also searched. Results: A total of 2,497 rheumatic heart disease Patients (mean age 25.5 years, female:male ratio 1.3:1) was included. RTVD was detected in 193 Patients (7.7%). Echocardiography was used to detect tricuspid valve involvement in all Patients. Associated mitral valve disease was present in 99.3% of the Patients with RTVD. A total of 1,092 Patients (mean age 45.4 years) was included from six studies on surgical correction of the tricuspid valve. Of these Patients, 278 (25.4%) underwent tricuspid valve replacement, while 814 (74.5%) had tricuspid valve repair. The in-hospital mortality was 9.9%, and late mortality 33.2%. Conclusion: RTVD is not uncommon among Patients with rheumatic heart disease, but attracts less attention and might, therefore, be overlooked. Echocardiography is the most common diagnostic tool. Although indications for surgical intervention are not well defined, valve repair may have a better outcome than replacement

Thyroid Cancer Risk Factors and Early Detection Awareness among Umm Al-Qura University Medical Students

Background: Thyroid carcinoma (TC) is the most prevalent head and neck cancer. Pre-clinical students lacked essential knowledge of thyroid cancer. Furthermore, clinical years medical students needed more awareness of thyroid screening and self-examination. Consequently, this study aims to identify the knowledge and understanding of thyroid cancer, among Umm Al-Qura University medical students in Saudi Arabia. Methods: A cross-sectional study was conducted on undergraduate medical students in the third to sixth year of a medical college using an online questionnaire from April to June 2022. Results: A survey of 297 medical students from the 3rd to 6th year found that 46.1% knew all early signs of thyroid cancer, while only 12.5% did not know any diagnostic tools. Most participants (74.4%) knew all desirable candidates for a thyroid cancer screen. 260 (87.5%) students answered positively that any unexplained lump or swelling could be an early sign of cancer. The gender of the participants had a significant correlation with many factors related to student knowledge of thyroid cancer, with gender having a substantial correlation with only two early signs. The student's grade point average (GPA) and academic year also had a significant correlation with many factors related to thyroid cancer knowledge. Conclusion: Thyroid cancer prevalence can be reduced by increasing public awareness and knowledge of risk factors. Students’ knowledge and participation in public education can lead to better results. In addition, increased public awareness about early signs of thyroid cancer can improve overall disease prognosis, morbidity, and mortality

Green Assessment of Chromatographic Methods Used for the Analysis of Four Methamphetamine Combinations with Commonly Abused Drugs

Numerous agents with anxiolytic or stimulant effects have the potential to be overused, and their misuse is associated with serious side effects. In Saudi Arabia, the estimated percentage of Saudis who abuse drugs is around 7–8% and the age range is 12–22 years. Methamphetamine, captagon, tramadol, heroin, and cannabis/cannabinoids have been proven to be the most commonly abused drugs in Saudi Arabia, with methamphetamine being at the top of the list. The present study focuses on the chromatographic analytical methods used for the analysis of methamphetamine in combination with commonly abused drugs, aiming to point out the greenest among them. These mixtures have been chosen as they are analyzed periodically and frequently in criminal evidence and forensic medicine. Therefore, the chances of hazards for analysts and the environment are high if the mixtures are not handled appropriately. This study aims to compare 23 chromatographic methods used for the analysis of methamphetamine mixtures in four major combinations, and to assess their greenness by using three greenness assessment tools, namely, NEMI, ESA and AGREE, to recommend the greenest analytical method. The NEMI results were proven to have low discriminating abilities and, accordingly, the comparisons are based on ESA and AGREE scores. The analysis results show that the safest methods with the most eco-friendly results (based on ESA and AGREE) are the GC-MS method proposed by Mohammed et al. to analyze methamphetamine and captagon mixtures (ESA = 79 and AGREE = 0.57), the UHPLC–MS-MS method proposed by Busardò et al. to analyze methamphetamine and cannabis/cannabinoid mixtures (ESA = 78 and AGREE = 0.57), the LC-MS method proposed by Herrin et al. to analyze methamphetamine and tramadol mixtures (ESA = 81 and AGREE = 0.56), and the LC-MS method proposed by Postigo-et al to analyze methamphetamine and heroin mixtures (ESA = 76 and AGREE = 0.58)