Prevalence, Awareness, Treatment, and Control of Hypertension among Saudi Adult Population: A National Survey

This cross-sectional study aimed at estimating prevalence, awareness, treatment, control, and predictors of hypertension among Saudi adult population. Multistage stratified sampling was used to select 4758 adult participants. Three blood pressure measurements using an automatic sphygmomanometer, sociodemographics, and antihypertensive modalities were obtained. The overall prevalence of hypertension was 25.5%. Only 44.7% of hypertensives were aware, 71.8% of them received pharmacotherapy, and only 37.0% were controlled. Awareness was significantly associated with gender, age, geographical location, occupation, and comorbidity. Applying drug treatment was significantly more among older patients, but control was significantly higher among younger patients and patients with higher level of physical activity. Significant predictors of hypertension included male gender, urbanization, low education, low physical activity, obesity, diabetes, and hypercholesterolemia. In conclusion prevalence is high, but awareness, treatment, and control levels are low indicating a need to develop a national program for prevention, early detection, and control of hypertension

Sinteza novih derivata testosterona sa supstituiranim pirazolinskim prstenom kao inhibitori 5alpha-reduktaze

Condensation of 3β-hydroxy-16-[(4-chlorophenyl)methylene]androst-5-en-17-one 1 with hydrazine hydrate in acetic acid afforded N-acetyl pyrazoline derivative 2, while, condensation of 1 with semicarbazide afforded compound 3. Also, compound 1 was treated with hydrazine hydrate in absolute methanol or ethanol to afford the corresponding -methoxy (4) and -ethoxy (5) derivatives, which were cyclized with etherated boron trifluoride to the pyrazoline derivative 6. The later could be prepared directly by refluxing of 1 with hydrazine hydrate in dioxane. Oxidation of compound 6 with Oppenour or Moffat oxidizing agents yielded 3-oxo-derivatives 7 and 8, respectively. On the other hand, condensation of compound 1 with substituted hydrazines, gave the corresponding 3beta-hydroxyandrostenopyrazolines 9a,b, which were oxidized using Moffat method give 3-oxo-androstenopyrazolines 10a,b, which were condensed with ethylene triphenyl-phosphorane in DMSO to yield 3-ethylene androstenopyrazolines 11a,b. Dehydrogenation of 9a,b with Wettestein oxidation afforded 4,6-diene-3-one analogues 12a,b, which were treated with chloranil to yield delta4,6,8(14)-triene-3-one analogues 13a,b. Oppenour oxidation of 9a,b afforded Δ4-ene-3-one analogues 14a,b, which were treated with dichlorodicyanoquinone (DDQ) in dioxane to give Δ1,4,6-triene-3-one analogues 15a,b. Pharmacological screening showed that many of these compounds exhibit 5alpha-reductase activity.Kondenzacijom 3β-hidroksi-16-[(4-klorofenil)metilen]androst-5-en-17-ona 1 s hidrazin hidratom u octenoj kiselini dobiven je derivat N-acetil pirazolina 2, a kondenzacijom 1 sa semikarbazidom priređen je spoj 3. Reakcijom spoja 1 s hidrazin hidratom u apsolutnom metanolu ili etanolu nastali su odgovarajući -metoksi (4) i -etoksi (5) derivati, koji su ciklizirani s borovim trifluoridom u derivat pirazolina 6. Isti spoj se može pripaviti izravno refluksiranjem spoja 1 s hidrazin hidratom u dioksanu. Oksidacijom spoja 6 s Oppenourovim ili Moffatovim oksidansom dobiveni su 3-okso derivati 7, odnosno 8. S druge strane, kondenzacija spoja 1 sa supstituiranim hidrazinima dala je odgovarajuće 3beta-hidroksiandrostenopirazoline 9a,b, koji su oksidirani Moffatovom metodom u 3-okso-androstenopirazoline 10a,b. Ovi produkti su dalje kondenzirani s etilen rifenil-fosforanom u DMSO u 3-etilen androstenopirazoline 11a,b. Wettesteinovom dehidrogenacijom 9a,b dobiveni su delta4,6-dien-3-on analozi 12a,b, koji su s kloranilom dali 4,6,8(14)-trien-3-on analoge 13a,b. Oppenourovom oksidacijom 9a,b dobiveni su Δ4-en-3-on analozi 14a,b, koji su s diklorodicianokinonom (DDQ) u dioksanu dali Δ1,4,6-trien-3-on analoge 15a,b. Farmakološka ispitivanja ukazuju da mnogi od sintetizirnih spojeva inhibiraju 5alfa-reduktazu

CT Liver Segmentation Using Artificial Bee Colony Optimisation

The automated segmentation of the liver area is an essential phase in liver diagnosis from medical images. In this paper, we propose an artificial bee colony (ABC) optimisation algorithm that is used as a clustering technique to segment the liver in CT images. In our algorithm, ABC calculates the centroids of clusters in the image together with the region corresponding to each cluster. Using mathematical morphological operations, we then remove small and thin regions, which may represents flesh regions around the liver area, sharp edges of organs or small lesions inside the liver. The extracted regions are integrated to give an initial estimate of the liver area. In a final step, this is further enhanced using a region growing approach. In our experiments, we employed a set of 38 images, taken in pre-contrast phase, and the similarity index calculated to judge the performance of our proposed approach. This experimental evaluation confirmed our approach to afford a very good segmentation accuracy of 93.73% on the test dataset

Comparison of the Effects of Albumin 5% versus Ringer's Lactate on Blood Loss and Coagulation after Vascular Surgery Using Thromboelastography

AIM: Comparing the effects of Albumin 5% versus Ringer's lactate on blood loss and coagulation after vascular surgery using METHODS: In this randomised study, 60 patients, aged (18-60 years) ASA physical status (I-III) undergoing vascular surgery were included in the study and randomly allocated into two groups using a random number generator, to receive either Human albumin or Ringer lactate after obtaining written informed consent. Group A received 1-2 ml per minute of human albumin 5% combined with normal saline (0.9%). Group B received Ringer's lactate only as of the main solution. Variables were measured after administration of fluids as postoperative measures. The amount of blood needed for testing was 4 ml drawn before the operation and at the end of surgery with a citrate tube (blue tube) from the venous line or using a regular needle. The standard time of 15 minutes was considered to begin processing. RESULTS: There was no statistically significant difference observed between both groups regarding demographic data, surgical wound drainage, haemoglobin level, hematocrit level and coagulation profile. Regarding ROTEM thermoelectrometry variables showed that there was no statistically significant difference was found between the two groups In-TEM variables (Ex-TEM Clotting time, TEM Clot Formation Time) but In-TEM Alpha Angel measured in degrees showed a Statistically significant difference between the two groups. P < 0.001 and Ex-TEM Maximum Clotting Firmness MCF values measured in mm, there was a statistically significant difference between the two groups P = 0.045. CONCLUSION: This study concluded that the use of human albumin (5%) in vascular surgeries before reaching the trigger point for blood transfusion didn’t improve blood loss or coagulation profile compared to the use of ringer lactate only. Therefore, ringer lactate can be used as a good replacement for human albumin. Ringer lactate is readily available and inexpensive while human albumin may be costly

Minerals and insulin dependent diabetes in children: A review article

Background: The human body contains trace levels of minerals and other micronutrients. Particularly advantageous for physiologic processes, a wide range of biochemical processes, stabilizing proteins and enzymes, and serving as cofactors for different enzymes. These essential micronutrients have a major physiological effect and are significantly associated with diabetes. Cobalt, boron, chromium, copper, Sulphur, iodine, fluoride, selenium, manganese, zinc, and molybdenum are examples of trace elements. Sodium, potassium, calcium, phosphorus, magnesium, and iron related to macro elements. The main focus of this review is the effect of particular minerals and trace elements on childhood insulin-dependent diabetes. Objective: Our understanding of how minerals and trace elements affect insulin-dependent diabetes in children will be improved as a result of this review, which is its main goal. Conclusion: The interaction, development, and outcomes of insulin-dependent diabetes in children are significantly influenced by minerals and trace elements

A New High Yielding and Long Staple Egyptian Cotton (Gossypium barbadense L.) Variety "Super Giza 94"

The Egyptian long staple cotton variety "Super Giza 94" was developed by Cotton Research Institute CRI, Giza, Egypt, which belongs to Gossypium barbadense L. Super Giza 94 is a novel plant structure improved seed cotton yield, lint percentage and fiber quality traits. Super Giza 94 was developed through one-way hybridization of elite parental cotton genotypes accompanied by pedigree selection method to incorporate the excellent combinations of higher yield potential, early maturity and fiber quality traits with resistance to Fusarium wilt. The superior plant combinations were selected in F2-F6 generations entirely based on phenotypic plant traits and progeny yield potential in the field conditions. The selected strains were evaluated in multilocations yield trials over three years and six locations in a randomized complete block design with six replications. The results of these trials exhibited that the new variety surpassed the three commercial varieties of these locations in most yield traits. Super Giza 94 is characterized by early maturity with high yield potential, fluffy opening and easy to pick, strong resistance to Fusarium wilt disease, high lint percentage (40.2%) with improved fiber traits including fiber length (34.1mm), fiber strength (43.4 g/tex), micronaire reading (4.2), uniformity ratio (86.9%), yellowness +b (8.3), brightness Rd (79.8%) and white lint color. Super Giza 94 can solve maximum challenges of better cotton production in the area and fulfill industrial requisitions. For that, recommended for general cultivation in the Delta region in the 2016 growing season

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020