Prevalence of Comorbidities Associated With Type 2 Diabetes Mellitus In Ksa: A Cross-Sectional Study

Objective: To determine the prevalence of comorbidities associated with type 2 diabetes mellitus among the Saudi adult population. Methods: A cross-sectional study design will be employed to investigate the prevalence of comorbidities associated with Type 2 Diabetes Mellitus (T2DM) within the Kingdom of Saudi Arabia (KSA) population. This design allows for the collection of data at a single point in time, providing insights into the existing relationship between T2DM and comorbidities.Results: The study included 601 participants. The most frequent body mass index BMI value among study participants was overweight 25-29.9 kg/m2 (n= 196, 33%), followed by Normal 18.5-24.9 kg/m2 (n= 177, 29%). The frequent gender among study participants was male years (n= 356, 59%) and female (n= 245, 41%). The most frequent age among study participants was 40-50 years (n= 145, 24%), followed by 18-28 years (n= 140, 23%). The most frequent marital status among study participants was married (n= 360, 60%), followed by single (n= 160, 27%). The perceived physical activity per week among study participants, most of whom did not do any activity (n=231,38%) followed one-time activity (n=98,16%). Conclusion: The results showed that most of the study participants were overweight according to their BMI. The majority of patients had normal blood pressure. Most of the participants suffer from diabetes. In addition, most of the participants do not do any activity, and the majority of participants are non-smokers

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

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

Simulation of train passage

The project simulates the passage of a moving train on the railway when it is passing a level crossing. The project uses hardware and software to simulate the signals that the relays, which are connected to the track, get when a train is passing the level crossing. This simulation is to evaluate a new level crossing system that is called Alex and will be used in Sweden in the future. One set of relays and two Alex systems will be installed at the Swedish school of transportation (Trafikverksskolan) in Ängelholm at a simulated level crossing for testing and training purposes. The project also evaluates the reactions of the relays of any level crossing without running any real train on them

Simulation of train passage

The project simulates the passage of a moving train on the railway when it is passing a level crossing. The project uses hardware and software to simulate the signals that the relays, which are connected to the track, get when a train is passing the level crossing. This simulation is to evaluate a new level crossing system that is called Alex and will be used in Sweden in the future. One set of relays and two Alex systems will be installed at the Swedish school of transportation (Trafikverksskolan) in Ängelholm at a simulated level crossing for testing and training purposes. The project also evaluates the reactions of the relays of any level crossing without running any real train on them

Thoraco-lumbar stiffness during rotation before and after two myofascials techniques :Non manipulative osteopathic techniques associated to Instrument Assisted Soft Tissue Mobilisation

info:eu-repo/semantics/publishe

Epidemiology and pathology of oral squamous cell carcinoma in a multi-ethnic population : Retrospective study of 154 cases over 7 years in Qatar

Background: Oral cancer (OC) is a neoplastic process of the oral cavity that has high mortality and significant effects on patients’ aesthetics. The majority of OC is oral squamous cell carcinoma (OSCC) and resection remains the most frequent treatment. Recurrence is the main cause of tumor-related mortality. Material and methods: A retrospective review of patients’ charts at Hamad Medical Corporation examined 154 adults who were diagnosed as OSCC and referred to the national head and neck cancer multi-disciplinary team meetings between 2012 and 2018. The data extracted was demographic, pathologic and clinical. All patients with oral cavity tumors other than squamous cell carcinoma were excluded. Results: Males comprised the majority of the sample, mean age was 46.93 years. Tongue was the most common location. The majority of the patients were diagnosed at early stages, and a small subset of patients had histologically-proven local recurrence. Conclusion: The young male predominance of OSCC patients in Qatar is unprecedented worldwide. Most patients were non-Qataris, mainly from South Asia. Loss of follow-up was a challenge in assessing the long-term outcomes of OSCC. Our findings suggest the need for a more vigilant surveillance approach to oral lesions particularly in male South-Asian patients, as well as improving the follow-up strategies. CC BY-NC-ND 4.0. Cross-sectional Study</p

Artificial Intelligence in Endodontics

ABSTRACTBackground In recent years, with advancements in science and technology, artificial intelligence (AI) has been gaining more relevance in the field of dentistry in general, as well as endodontics. AI-guided algorithms have a great potential to better diagnose, treatment plan, and execute endodontic treatments, as well as outcome prediction of the various endodontic treatments. A review of literature was conducted to assess the application of AI in the field of endodontics.Results AI has been used in a variety of clinical applications including the assessment of root canal anatomy, working length, presence of root fractures, and outcome prediction.Conclusion Within the field of endodontics, AI has already been proven to be useful. The evolution of this technology and its continuous application can positively impact the field of endodontics and assist in preserving the natural dentition. Clinical implications: AI is currently being used for specific endodontic applications and possible potential applications in the future horizon

Choroidal metastasis as initial presentation of aggressive medullary thyroid carcinoma with widespread mediastinal, brain, pituitary, bone, lung, and liver metastasis: Case report and literature review

Introduction Medullary thyroid carcinoma (MTC) is a neuroendocrine tumor that originates from the parafollicular C cells of the thyroid gland. MTC can be due to sporadic or hereditary causes due to gain of function germ line mutations in the RET proto-oncogene. MTC presenting as ocular symptoms due to choroidal mass is rare with bad prognosis. Presentation of case A 38-year-old Sudanese male presented to Hamad General Hospital, complaining of sudden painless decrease of vision of the right eye of 3 weeks duration. After investigations using imaging methods, the patient was discovered to have metastatic MTC that presented as choroidal mass and metastasized to his lung, bone, brain, pituitary, liver and mediastinum. Discussion In terms of investigations, serum levels of calcitonin have superior diagnostic accuracy. Our patient undertook diagnostic imaging including ultrasonography, fine needle aspiration and computerized tomography (CT) scan and/or MRI imaging. He undertook total thyroidectomy and left neck dissection followed by stereotactic radiosurgery for the right orbit and pituitary. He then received systemic anti-RET therapy (Selpercatinib). At 5 months follow up there was dramatic drop in CEA from 888 μg/L to 164 μg/L, and calcitonin from >585.2 pmol/L to 354 pmol/L. Conclusion Choroidal metastasis as initial presentation of MTC is extremely rare and challenging to diagnose. Surgeons need a high index of suspicion when ocular symptoms accompany a neck mass or thyroid-related symptoms. MTC has a progressive course with involvement of blood vessels and neck lymph nodes. Choroidal metastasis of MTC is challenging to manage