Thermodynamics and Kinetics of Inhibition of Aluminum in Hydrochloric Acid by Date Palm Leaf Extract

The corrosion behavior of commercial aluminum in HCl was investigated by gravimetric method in absence and presence of date palm leaf extract (DPLE) as inhibitor. Corrosion rates in absence of extract ranged from 2.4-8.0 mg/cm2/h in the temperature range 20- 50ºC but decreased down to 0.30-2.6 mg/cm2/h in presence of the inhibitor. Hot-water extract of date palm leaves has shown inhibition efficiency (IE) of 40- 88%at the tested conditions. IE was found to increase with increasing inhibitor concentration from 0.2 to 0.6 g/L and decrease as temperature increased. Data showed that Langmuir adsorption isotherm represents surface coverage versus extract concentration data indicating that inhibition is due to monolayer adsorption of extract components on aluminum surface. Low activation energy and enthalpy values support physical adsorption mechanism. SEM-EDS microanalysis of aluminum surface supported the inhibitive effect of the extract at the metal surface.© JASE

Awareness of hypertension guidelines among family physicians in primary health care

Background: Only 14% of patients on treatment achieve the recommended blood pressure target. Guidelines aim to assist clinicians in the management of patients with hypertension.Objectives: The primary purpose of the study was to survey family physicians(FPs) in Kuwait about their awareness, and to understand better their reasons for not implementing specific guidance within the WHO/ISH guidelines.Methods: This study is a cross-sectional survey that was carried out in the five health regions of Kuwait. All PHC physicians who were currently working as FPs were asked to participate in the study. Data were collected using a structured questionnaire of clinically oriented questions formulated on the basis of the 1999 World Health Organization/International Society of Hypertension (WHO/ISH), as standard reference.Results: The study revealed that 49.1% and 42.1% of FPs were very familiar or somewhat familiar with the guidelines respectively, 92.1% were in agreement, and 79.8% indicated that they always or usually follow these guidelines when treating patients. Regarding the correct choice of the guideline statements, only 8.8% of the FPs choose correctly less than ten of the 20 statements, 64% choose 10 to less than 15, and only 27.2% choose > 15 statements. When asked about perceived patient barriers to blood pressure control, 84.0% of the respondents ranked overcrowded clinics as important or most important barrier to blood pressure control while, 87.4% considered lack of patient knowledge as important or most important barrier. Non availability of the drugs in the clinic was considered by 88.4% of the physicians, and poor adherence to antihypertensive drugs by 90.1%.Conclusion: There is a need to establish nationwide educational and quality monitoring programs to facilitate the correct implementation of hypertension guidelines in PHC clinical practices in Kuwait.Keywords:  Family physicians; Awareness; Hypertension; Guideline

A novel pathogenic mutation of the CYP27B1 gene in a patient with vitamin D-dependent rickets type 1: a case report

BACKGROUND: Rickets can occur due to Vitamin D deficiency or defects in its metabolism. Three rare genetic types of rickets with different alterations of genes have been reported, including: Vitamin D dependent rickets type 1, Vitamin D dependent rickets type 2 or also known as Vitamin D resistant rickets and 25 hydroxylase deficiency rickets. Vitamin D dependent rickets type 1 is inherited in an autosomal recessive pattern, and is caused by mutations in the CYP27B1 gene encoding the 1α-hydroxylase enzyme. We report here a new mutation in CYP27B1, which lead to Vitamin D dependent rickets type 1. CASE PRESENTATION: We report on a 13-month-old Arabic Saudi girl with Vitamin D dependent rickets type 1 presented with multiple fractures and classic features of rickets. A whole exome sequencing identified a novel pathogenic missense mutation (CYP27B1:Homozygous c.1510C > T(p.Q504X)) which results in a protein truncating alteration. Both parents are heterozygous carriers of the mutation. Based on data search in Human Gene Mutation Database, 63 CYP27B1 alterations were reported: only 28.6% are protein truncating (5 nonsense, 13 frameshift insertions/deletions, 0 gross deletions), while 61.9% are non-truncating (38 missense, 1 small in-frame insertions/deletion), and 9.5% are possible protein-truncating (5 splice, 1 regulatory). CONCLUSION: The deleterious effect of this alteration, which was the only mutation detected in the CYP27B1 common gene of Vitamin D dependent rickets type 1 in the proband, and its autosomal recessive inheritance fashion, both support a pathogenic nature of this mutation as the cause of Vitamin D dependent rickets type 1

Bedside testing of CYP2C19 vs. conventional clopidogrel treatment to guide antiplatelet therapy in ST-segment elevation myocardial infarction patients

BACKGROUND: ST-segment elevation myocardial infarction (STEMI) patients are treated with dual antiplatelet therapy comprising aspirin and a P2Y12 inhibitor. Clopidogrel is widely used in these patients in several areas worldwide, such as Middle East, but is associated to sub-optimal platelet inhibition in up to 1/3 of treated patients. We investigated a CYP2C19 genotype-guided strategy to select the optimal P2Y12 inhibitor. METHODS: This prospective randomized clinical trial included STEMI patients. The standard-treatment group received clopidogrel, while the genotype-guided group were genotyped for CYP2C19 loss-of-function alleles and carriers were prescribed ticagrelor and noncarriers were prescribed clopidogrel. Primary outcome was a combined ischemic and bleeding outcome, comprising myocardial infarction, non-fatal stroke, cardiovascular death, or Platelet Inhibition and Patient Outcomes major bleeding one year after STEMI. RESULTS: STEMI patients (755) were randomized into a genotype-guided- (383) and standard-treatment group (372). In the genotype-guided group, 31 patients carrying a loss-of-function allele were treated with ticagrelor, while all other patients in both groups were treated with clopidogrel. Patients in the genotype-guided group had a significantly lower risk of primary outcome (odds ratio (OR) 0.34, 95% confidence interval (CI) 0.20–0.59,), recurrent myocardial infarction (OR 0.25, 95%CI 0.11–0.53), cardiovascular death (OR 0.16, 95%CI0.06–0.42) and major bleeding (OR 0.49, 95%CI 0.32–0.74). There was no significant difference in the rate of stent thrombosis (OR 0.85, 95%CI 0.43–1.71). CONCLUSION: A genotype-guided escalation of P2Y12 inhibitor strategy is feasible in STEMI patients treated with clopidogrel and undergoing PCI and is associated with a reduction of primary outcomes compared to conventional antiplatelet therapy

Blended learning in undergraduate dental education: a global pilot study.

AIMS: To explore the global trends in blended learning in undergraduate dental education during the COVID pandemic and during the recovery phase by engaging with the students and faculty and evaluate the implications for dental education in the post-COVID era. METHODS: It was a pilot cross-sectional study which employed a convenience sampling technique to recruit representatives of dental faculty and undergraduate students in 80 dental institutions globally. A previously validated questionnaire consisting of a combination of closed and open-ended items was used for data collection. Responses to these online questionnaires were processed and analysed using the R statistical computing environment. RESULTS: A total of 320 dental students and 169 faculty members from 47 different dental institutions participated in the study. Video and Live Online Tutorials were considered to be the most effective method of online learning followed by online question banks by both groups. Significant differences were noted between faculty and students regarding time spent and effectiveness of online teaching and learning, respectively, both before and after the start of COVID. The results highlight the faculty need to engage more closely with the students to address their learning needs. Finally, the participants provided several recommendations regarding the future development of teaching and learning strategies as well as assessments in the post-pandemic era. CONCLUSIONS: This is the first study which explores blended learning in dental education with participants from multiple institutions in different regions of the globe. Compared to the faculty, students considered online learning to be less interactive and preferred learning activities and all assessments to be delivered face-to-face. The results underscore the need to adapt teaching practices to suit the learning needs of the students

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA

Adaptive multi-polling scheduler for QoS support of video transmission in IEEE 802.11e WLANs

The 802.11E Task Group has been established to enhance quality of service (QoS) provision for time-bounded services in the current IEEE 802.11 medium access control protocol. The QoS is introduced throughout hybrid coordination function controlled channel access (HCCA) for the rigorous QoS provision. In HCCA, the station is allocated a fixed transmission opportunity (TXOP) based on its TSPEC parameters so that it is efficient for constant bit rate streams. However, as the profile of variable bit rate traffics is inconstant, they are liable to experience a higher delay especially in bursty traffic case. In this paper, we present a dynamic TXOP assignment algorithm called adaptive multi-polling TXOP scheduling algorithm (AMTXOP) for supporting the video traffics transmission over IEEE 802.11e wireless networks. This scheme invests a piggybacked information about the size of the subsequent video frames of the uplink streams to assist the hybrid coordinator accurately assign the TXOP according to actual change in the traffic profile. The proposed scheduler is powered by integrating multi-polling scheme to further reduce the delay and polling overhead. Extensive simulation experiments have been carried out to show the efficiency of the AMTXOP over the existing schemes in terms of the packet delay and the channel utilization

Zofenopril Protects Against Myocardial Ischemia-Reperfusion Injury by Increasing Nitric Oxide and Hydrogen Sulfide Bioavailability.

Background: Zofenopril, a sulfhydrylated angiotensin-converting enzyme inhibitor (ACEI), reduces mortality and morbidity in infarcted patients to a greater extent than do other ACEIs. Zofenopril is a unique ACEI that has been shown to increase hydrogen sulfide (H2S) bioavailability and nitric oxide (NO) levels via bradykinin-dependent signaling. Both H2S and NO exert cytoprotective and antioxidant effects. We examined zofenopril effects on H2S and NO bioavailability and cardiac damage in murine and swine models of myocardial ischemia/reperfusion (I/R) injury. Methods and results: Zofenopril (10 mg/kg PO) was administered for 1, 8, and 24 hours to establish optimal dosing in mice. Myocardial and plasma H2S and NO levels were measured along with the levels of H2S and NO enzymes (cystathionine β-synthase, cystathionine γ-lyase, 3-mercaptopyruvate sulfur transferase, and endothelial nitric oxide synthase). Mice received 8 hours of zofenopril or vehicle pretreatment followed by 45 minutes of ischemia and 24 hours of reperfusion. Pigs received placebo or zofenopril (30 mg/daily orally) 7 days before 75 minutes of ischemia and 48 hours of reperfusion. Zofenopril significantly augmented both plasma and myocardial H2S and NO levels in mice and plasma H2S (sulfane sulfur) in pigs. Cystathionine β-synthase, cystathionine γ-lyase, 3-mercaptopyruvate sulfur transferase, and total endothelial nitric oxide synthase levels were unaltered, while phospho-endothelial nitric oxide synthase(1177) was significantly increased in mice. Pretreatment with zofenopril significantly reduced myocardial infarct size and cardiac troponin I levels after I/R injury in both mice and swine. Zofenopril also significantly preserved ischemic zone endocardial blood flow at reperfusion in pigs after I/R. Conclusions: Zofenopril-mediated cardioprotection during I/R is associated with an increase in H2S and NO signaling

Cephalometric norms for the Saudi children living in the western region of Saudi Arabia: a research report

BACKGROUND: Previous studies have established specific cephalometric norms for children with different ethnic backgrounds, showing different facial features for each group. Up till now, there is a paucity of information about the cephalometric features of Saudi children living in the western region of Saudi Arabia, who have distinct social and climatic characteristics. The aim of the present study was to establish cephalometric norms for children living in the western region of Saudi Arabia. METHODS: A total of 62 lateral cephalometric radiographs of Saudis (33 females and 29 males; aged 9–12 years) having good facial proportions and Class I dental occlusion, were traced and analyzed. Using the t-test, the mean value, standard deviation and the range of 20 angular and linear variables were calculated and compared to norms of adult Saudis living in the Western region of Saudi Arabia using the t-test. Male and female groups were also compared using the t- test. RESULTS: Saudi children tend to have a significantly shorter and lower face height, a larger angle of convexity, and more proclined and protruded incisors when compared with adult Saudis (P < 0.05). There were no statistically significant differences between male and female groups. CONCLUSION: Saudi children have distinct cephalometric features, which should be used as a reference in the orthodontic treatment of young Saudi patients

Effects of Artificial Light Spectra and Sucrose on the Leaf Pigments, Growth, and Rooting of Blackberry (Rubus fruticosus) Microshoots

Light emitting diodes (LEDs) are potential light sources for in vitro plant cultures. Here, axillary blackberry shoots were grown in MS medium with indole-3-butyric acid (1 mg L−1), naphthalene acetic acid (0.5 mg L−1), and sucrose supplementation (0–60 g L−1) and the cultures were incubated under four light treatments: three LED light treatments (blue + red light (2:1 spectral ratio), blue + red light (1:2), and cool + warm white light (1:1)) and a standard florescent tube white spectrum treatment. Sucrose was indispensable for rooting of blackberry microshoots. Sucrose concentrations up to 45 g L−1 increased total root length and root surface area under all light treatments. However, at this sucrose concentration, leaf area and vegetative growth were negatively affected. Plantlets grown in media containing 15–30 g L−1 of sucrose exhibited the highest leaf pigments, shoot length, and number of leaves. LED treatments increased leaf pigments as compared with florescent treatment. Plantlets grown under blue + red light (2:1) had the highest stoma aperture length and width, whereas cool + warm white light resulted in the lowest values. Among the LED treatments, blue + red light (2:1) resulted in the highest leaf area, chlorophyll and carotenoid contents, and vegetative growth, whereas fluorescent resulted in the lowest values. A combination of blue and red light at a 2:1 spectral ratio with 30 g L−1 of sucrose is recommended for the optimal in vitro rooting and vegetative growth of blackberry microshoots