Paediatric poisoning in Kuwait-Al Adan joint hospital: The need for functional poisoning control centre in Kuwait.

Poisoning is a major global health concern. Every year, unintentional poisoning contributes to 106,683 deaths globally. In Kuwait, paediatric poisoning cases comprise approximately 50% of total poisoning cases. Despite the extensive importance and the long history of poison control centres (PCCs) and the emphasis of the World Health Organization (WHO) to establish a PCC in Kuwait, no functional PCC exists in Kuwait. Here we reported 82 poisoning cases between July and December 2020, revealing a 100% increase in comparison to the official figures published in 2004 and 2005. No fatalities were reported, and all cases were discharged home within 12 h of their visit to the casualty. Children aged 2 to < 4 years comprised the most reported poisoning cases with approximately 45% of the total. The number of male child poisoning cases was approximately two-fold of female children. The most common poisoning agent was silica gel granules (9%) followed by medicines - reported as paracetamol (7%), diclofenac (7%), multivitamin gummies (7%) and vitamin C (5%). Among other causes of poisoning were ingestion of salbutamol nebulizer solution (4%), oral contraceptives and insecticides (4%). These findings reveal the importance of establishing a functional PCC in Kuwait to minimise the unnecessary visits following ingestion of expired orange juice and henna, that may encounter further contraction of infections, especially with the current state of the COVID-19 pandemic. Moreover, a functional PCC would provide comprehensive data and hence further intervention such as shifting the dosage form of salbutamol from nebulizer solution to metered dose inhaler with a spacer, in addition to increasing public awareness towards minimizing such a dramatic increase in casualty visits because of -suspected poisoning

Potential of utilization of renewable energy technologies in gulf countries

This critical review report highlights the enormous potentiality and availability of renewable energy sources in the Gulf region. The earth suffers from extreme air pollution, climate changes, and extreme problems due to the enormous usage of underground carbon resources applications materialized in industrial, transport, and domestic sectors. The countries under Gulf Cooperation Council, i.e., Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates, mainly explore those underground carbon resources for crude oil extraction and natural gas production. As a nonrenewable resource, these are bound to be exhausted in the near future. Hence, this review discusses the importance and feasibility of renewable sources in the Gulf region to persuade the sci-entific community to launch and explore renewable sources to obtain the maximum benefit in electric power generation. In most parts of the Gulf region, solar and wind energy sources are abundantly available. However, attempts to harness those resources are very limited. Furthermore, in this review report, innovative areas of advanced research (such as bioenergy, biomass) were proposed for the Gulf region to extract those resources at a higher magnitude to generate surplus power generation. Overall, this report clearly depicts the current scenario, current power demand, currently installed capacities, and the future strategies of power production from renewable power sources (viz., solar, wind, tidal, biomass, and bioenergy) in each and every part of the Gulf region

The performance of stochastic designs in wellbore drilling operations

© 2018, The Author(s). Wellbore drilling operations frequently entail the combination of a wide range of variables. This is underpinned by the numerous factors that must be considered in order to ensure safety and productivity. The heterogeneity and sometimes unpredictable behaviour of underground systems increases the sensitivity of drilling activities. Quite often the operating parameters are set to certify effective and efficient working processes. However, failings in the management of drilling and operating conditions sometimes result in catastrophes such as well collapse or fluid loss. This study investigates the hypothesis that optimising drilling parameters, for instance mud pressure, is crucial if the margin of safe operating conditions is to be properly defined. This was conducted via two main stages: first a deterministic analysis—where the operating conditions are predicted by conventional modelling procedures—and then a probabilistic analysis via stochastic simulations—where a window of optimised operation conditions can be obtained. The outcome of additional stochastic analyses can be used to improve results derived from deterministic models. The incorporation of stochastic techniques in the evaluation of wellbore instability indicates that margins of the safe mud weight window are adjustable and can be extended considerably beyond the limits of deterministic predictions. The safe mud window is influenced and hence can also be amended based on the degree of uncertainty and the permissible level of confidence. The refinement of results from deterministic analyses by additional stochastic simulations is vital if a more accurate and reliable representation of safe in situ and operating conditions is to be obtained during wellbore operations.Published versio

Biallelic mutations in SORD cause a common and potentially treatable hereditary neuropathy with implications for diabetes

Here we report biallelic mutations in the sorbitol dehydrogenase gene (SORD) as the most frequent recessive form of hereditary neuropathy. We identified 45 individuals from 38 families across multiple ancestries carrying the nonsense c.757delG (p.Ala253GlnfsTer27) variant in SORD, in either a homozygous or compound heterozygous state. SORD is an enzyme that converts sorbitol into fructose in the two-step polyol pathway previously implicated in diabetic neuropathy. In patient-derived fibroblasts, we found a complete loss of SORD protein and increased intracellular sorbitol. Furthermore, the serum fasting sorbitol levels in patients were dramatically increased. In Drosophila, loss of SORD orthologs caused synaptic degeneration and progressive motor impairment. Reducing the polyol influx by treatment with aldose reductase inhibitors normalized intracellular sorbitol levels in patient-derived fibroblasts and in Drosophila, and also dramatically ameliorated motor and eye phenotypes. Together, these findings establish a novel and potentially treatable cause of neuropathy and may contribute to a better understanding of the pathophysiology of diabetes

Large Intragenic Deletion in DSTYK Underlies Autosomal-Recessive Complicated Spastic Paraparesis, SPG23

SPG23 is an autosomal-recessive neurodegenerative subtype of lower limb spastic paraparesis with additional diffuse skin and hair dyspigmentation at birth followed by further patchy pigment loss during childhood. Previously, genome-wide linkage in an Arab-Israeli pedigree mapped the gene to an approximately 25 cM locus on chromosome 1q24–q32. By using whole-exome sequencing in a further Palestinian-Jordanian SPG23 pedigree, we identified a complex homozygous 4-kb deletion/20-bp insertion in DSTYK (dual serine-threonine and tyrosine protein kinase) in all four affected family members. DSTYK is located within the established linkage region and we also found the same mutation in the previously reported pedigree and another Israeli pedigree (total of ten affected individuals from three different families). The mutation removes the last two exons and part of the 3′ UTR of DSTYK. Skin biopsies revealed reduced DSTYK protein levels along with focal loss of melanocytes. Ultrastructurally, swollen mitochondria and cytoplasmic vacuoles were also noted in remaining melanocytes and some keratinocytes and fibroblasts. Cultured keratinocytes and fibroblasts from an affected individual, as well as knockdown of Dstyk in mouse melanocytes, keratinocytes, and fibroblasts, were associated with increased cell death after ultraviolet irradiation. Keratinocytes from an affected individual showed loss of kinase activity upon stimulation with fibroblast growth factor. Previously, dominant mutations in DSTYK were implicated in congenital urological developmental disorders, but our study identifies different phenotypic consequences for a recurrent autosomal-recessive deletion mutation in revealing the genetic basis of SPG23.The Centre for Dermatology and Genetic Medicine is supported by a Wellcome Trust Strategic Award (reference 098439/Z/12/Z). The work was supported by the MRC (MR/M018512/1) and the UK National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre (BRC) award to Guy’s and St. Thomas’ NHS Foundation Trust, in partnership with the King’s College London and King’s College Hospital NHS Foundation Trust. This study was also supported by UK Medical Research Council Project Grant (MR/M00046X/1) and Action Research grant SP3706 as well as medical student grants from the Jean Shanks Foundation and the British Association of Dermatologists

Sitagliptin attenuates cardiomyopathy by modulating the JAK/STAT signaling pathway in experimental diabetic rats

Nouf M Al-Rasheed,1 Nawal M Al-Rasheed,1,2 Iman H Hasan,1 Maha A Al-Amin,1 Hanaa N Al-Ajmi,1 Ayman M Mahmoud3 1Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, 2Department of Pharmaceutical Sciences, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia; 3Physiology Division, Department of Zoology, Faculty of Science, Beni-Suef University, Beni-Suef, Egypt Abstract: Sitagliptin, a dipeptidyl peptidase-4 inhibitor, has been reported to promote cardioprotection in diabetic hearts by limiting hyperglycemia and hyperlipidemia. However, little is known about the involvement of the Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathway modulation in the cardioprotective effects of sitagliptin. The current study aimed to investigate the protective effects of sitagliptin against diabetic cardiomyopathy (DCM), focusing on the modulation of the JAK/STAT pathway. Diabetes was induced by streptozotocin injection, and rats received sitagliptin orally and daily for 90 days. Diabetic rats exhibited hyperglycemia, hyperlipidemia, and a significant increase in heart-to-body weight (HW/BW) ratio. Serum troponin I and creatine kinase MB, cardiac interleukin-6 (IL-6), lipid peroxidation, and nitric oxide levels showed significant increase in diabetic rats. In contrast, both enzymatic and nonenzymatic antioxidant defenses were significantly declined in the heart of diabetic rats. Histopathological study revealed degenerations, increased collagen deposition in the heart of diabetic rats. Sitagliptin alleviated hyperglycemia, hyperlipidemia, HW/BW ratio, histological architecture, oxidative stress, and inflammation, and rejuvenated the antioxidant defenses. In addition, cardiac levels of pJAK2 and pSTAT3 were increased in diabetic rats, an effect which was remarkably decreased after sitagliptin treatment. In conclusion, these results confer an evidence that sitagliptin has great therapeutic potential on DCM through down-regulation of the JAK/STAT signaling pathway. Keywords: diabetic cardiomyopathy, DPP-4 inhibitors, JAK/STAT, oxidative stress, inflammatio

Group A streptococcus toxic shock syndrome: an outbreak report and review of the literature

Group A Streptococcal (GAS) Toxic Shock Syndrome (TSS) is an acute, rapidly progressive, and often fatal illness. Outbreaks can occur in hospitals. However, early infection control measures may interrupt transmissions and prevent morbidity and mortality.Two cases of invasive GAS TSS were diagnosed within 48. h after two uncomplicated laparoscopic surgeries that were performed in the same operating room of a women's hospital.Investigations conducted by the infection prevention and control department of the hospital identified 46 obstetrical staff members who were involved in the surgeries and/or had contact with either of the patients. All of the staff members were interviewed regarding any recent history of upper respiratory tract infections, the presence of skin lesions and vaginal or rectal symptoms. Throat, rectal, and vaginal cultures were obtained two times from all of the involved staff members. Throat colonization with GAS was detected in the cultures from one obstetrical intern who attended the 1st surgery and from one nurse who had formerly worked in the postnatal ward. These two strains were epidemiologically different from each other and from the outbreak strain. Both carriers were suspended from direct patient care and were treated with a ten-day course of oral clindamycin. The success of their decolonization status was assessed at the end of therapy and at three, six, nine and twelve months thereafter before reassigning them to routine work.Unfortunately, in spite of the extensive investigation of all involved personnel and of the environment, the mode of transmission to the second patient could not be established. However, droplet or airborne transmission could not be ruled out.Early and meticulous implementation of infection control measures was crucial and instrumental in the successful management and control of this outbreak. Furthermore, there were no subsequent GAS cases detected during the 24 months following the outbreak