Case report: breast cancer associated with contralateral tuberculosis of axillary lymph nodes

BACKGROUND: Breast cancer coexisting with tuberculous axillary lymph nodes is rare. CASE REPORT: We report a 69 years old Yemeni patient with a left breast invasive ductal carcinoma associated with contralateral tuberculous axillary lymph nodes containing microcalcifications mimicking malignancy. The patient had to be investigated for the possibility of bilateral breast cancer since she had no history of previous exposure to tuberculosis. CONCLUSION: Tuberculosis involving lymph nodes can create a diagnostic dilemma in the presence of a malignant process. The presence of calcifications in lymph nodes should raise the possibility of tuberculosis even in the absence of contact history with tuberculosis

Insomnia in chronic renal patients on dialysis in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Studies have shown that insomnia is a common sleep disorder among patients with end-stage renal disease (ESRD). This study aimed to assess the prevalence of insomnia in Saudi patients with ESRD who are on maintenance dialysis.</p> <p>Methods</p> <p>This was an observational cross-sectional study carried out over a period of five months in two hemodialysis centers in Saudi Arabia. To assess the prevalence of insomnia, we used the ICSD-2 definition. We also examined the association between insomnia and other sleep disorders, the underlying causes of renal failure, dialysis duration, dialysis shift, and other demographic data.</p> <p>Results</p> <p>Out of 227 enrolled patients, insomnia was reported by 60.8%. The mean patient age was 55.7 ± 17.2 years; 53.7% were male and 46.3% were female. Insomnia was significantly associated with female gender, afternoon hemodialysis, Restless Legs Syndrome, high risk for obstructive Sleep Apnea Syndrome and excessive daytime sleepiness (<it><b>P-values: </b></it>0.05, 0.01, < 0.0001, < 0.0001, and < 0.0001, respectively). No significant association was found between insomnia and other variables, including BMI, smoking habits, underlying etiology of renal failure, dialysis duration, association with hemoglobin, ferritin, and phosphorus or dialysis adequacy as measured by the Kt/V index.</p> <p>Conclusion</p> <p>Insomnia is common in dialysis patients and was significantly associated with other sleep disorders. Greater attention needs to be given to the care of dialysis patients with regard to the diagnosis and management of insomnia and associated sleep disorders.</p

Tandem Aldol-Michael reactions in aqueous diethylamine medium: a greener and efficient approach to dimedone-barbituric acid derivatives

BACKGROUND: Green chemistry is a rapidly developing new field that provides us with a proactive avenue for the sustainable development of future science and technologies. Green chemistry uses highly efficient and environmentally benign synthetic protocols to deliver lifesaving medicines, accelerating lead optimization processes in drug discovery, with reduced unnecessary environmental impact. From this view point, it is desirable to use water instead of organic solvents as a reaction medium, since water is safe, abundant and an environmentally benign solvent. RESULTS: A convenient one-pot method for the efficient synthesis of the novel Zwitterion derivatives 4a-pvia a three-component condensation reaction of barbituric acid derivatives 1a,b, dimedone 2, and various aldehydes 3 in the presence of aqueous diethylamine media is described. This new approach is environmentally benign, with clean synthetic procedure, short reaction times and easy work-up procedure which proceeded smoothly to provide excellent yield (88-98%). The synthesized products were characterized by elemental analysis, IR, MS, NMR and CHN analysis. The structure of 4a was further confirmed by single crystal X-ray diffraction. The compound crystallizes in the orthorhombic space group Pbca with α = 14.6669 (5) Å, b = 18.3084 (6) Å, c = 19.0294 (6) Å, α = 90°, β = 90°, = 90°, V = 5109.9 (3) Å(3), and Z = 8. The molecules are packed in crystal structure by weak intermolecular C–H⋅ ⋅ ⋅O hydrogen bonding interactions. CONCLUSIONS: An environmentally benign Aldol-Michael protocol for the synthesis of dimedone-barbituric derivatives using aqueous diethylamine medium is achieved

CARBON FOOTPRINT REDUCTION IN ACID GAS RECOVERY SYSTEM THROUGH DESIGN, DEVELOPMENT AND DEPLOYMENT OF A 2000HP HYDRAULIC TURBOCHARGER

LecturesFour sets of hydraulic turbocharger based energy recovery systems (2000 hp each) were successfully designed, manufactured, tested and commissioned for Acid Gas Recovery plants (AGR) in Saudi Arabia. These five units can result in reduction in CO2 footprint by 40,400 tons per year in addition to providing stability of operations, increasing reliability, reducing energy consumption by a total of 57.5 GW-hr each year and a major reduction in noise level otherwise generated by the let-down valve. A somewhat smaller unit (1000 hp) has also been designed tested and commissioned on a fifth AGR unit on a different gas field. The hydraulic turbocharger consists of a liquid phase turbine runner and a pump impeller mounted in a back�to�back configuration on a common rigid shaft, in a single seal�less casing. The shaft is supported by process lubricated hydrodynamic radial and axial (dual�acting) bearings of non�metallic construction. The turbine side extracts wasted pressure energy from the rich amine and along with a series of throttle, auxiliary and bypass valves, controls the level in the absorber. The pump side boosts the lean amine solvent to the absorber. Such a design provides major advantages compared to a conventional configuration of a reverse running pump�as�turbine coupled to a pump. These advantages include a compact single stage hydraulic design (as opposed to a multi�stage design for a reverse running pump), smaller footprint, higher efficiency, absence of mechanical seals & associated support system, absence of lubrication oil system as well as simpler control. Several complex design and testing challenges were overcome through development of novel design features and incorporation of provisions in a highly specialized test loop. Some of the unique experiences are shared in the paper. The seal�less design of the turbocharger with no exposed rotating or bearing parts presented testing challenges such as determination of shaft power, individual pump side and turbine side performance and efficiencies; measurement and validation of axial thrust & axial position; as well as monitoring & control of bearing performance parameters. The test loop was engineered to operate the hydraulic turbocharger through its testable operating range with provisions to measure, control and monitor all the needed parameters. Testing was performed using water with viscosity 2.5 times lower than the operating fluid. This implied suitable modification to the design, monitoring and controlling of process�lubricated bearings along with the internal system during testing to account for the change in viscosity. Data was evaluated to conduct root cause analysis of apparent bearing failures such as rub marks and to eliminate root causes by improving the manufacturing method to reduce misalignment & also using non�metallic bearings. Four identical units were built and completed successful Factory Acceptance Tests (FAT) in early 2018. The turbochargers achieved & surpassed the pump side rated requirements of 2148ft of head at 2820 gpm, at a rated speed of 8000 rpm, as part of the FAT. The fifth smaller unit is also installed and commissioned. All the units were installed & commissioned in early 2020 by the End User. Each unit is part of 4x50 configuration – which includes the turbocharger and three circulation pumps running in parallel. The paper will provide details about the commissioning effort of the turbocharger units in the field, and their operating experience over a period of one year

Phylogeny and functional diversity of halophilic microbial communities from a thalasso environment

The El-Rawda solar saltern, located in North Sinai, Egypt, is formed through the process of water evaporation from the Bradawil lagoon. This evaporation leads to the precipitation of gypsum, halite minerals, and salt flats, which subsequently cover the southern and eastern areas of the lagoon. This study employed the shotgun metagenomic approach, the illumine platform, and bioinformatic tools to investigate the taxonomic composition and functional diversity of halophilic microbial communities in solar saltern. The metagenomic reads obtained from the brine sample exhibited a greater count compared to those from the sediment sample. Notably, the brine sample was primarily characterized by an abundance of archaea, while the sediment sample displayed a dominant abundance of bacteria. Both samples exhibited a relatively low abundance of eukaryotes, while viruses were only found in the brine sample. Furthermore, the comparative analysis of functional pathways showed many important processes related to central metabolism and protein processing in brine and sediment samples. In brief, this research makes a valuable contribution to the understanding of very halophilic ecosystems in Egypt, providing insights into their microbial biodiversity and functional processes

Design and fabrication of dioxyphenylcoumarin substituted cyclotriphosphazene compounds photodiodes

The present study introduces cyclotriphosphazene compounds substituted by dioxyphenylcoumarin as a photodiode application. Firstly, 7,8-dihydroxy-3-(3-methylphenyl)coumarin (1b) has been obtained by conventional as well as microwave assisted methods. Novel optoelectronic device characteristics for both mono and disubstituted dioxyphenylcoumarin bearing cyclotriphosphazene compounds (HCP-2 and HCP-4) have been synthesized from the reactions of cyclotriphosphazene containing dioxybiphenyl (HCP-1 and HCP-3) with compound 1b, respectively. The structures of compounds HCP 1–4 were identified by using elemental analysis, 1H, 13C-APT, 31P NMR and 2D HETCOR NMR and FT-IR spectroscopy methods. The Al/HCP-2/p-Si/Al and Al/HCP-4/-p-Si/Al photodiodes properties have been investigated from current-voltage (I−V) and capacitance-voltage (C−V) measurements. The electrical parameters of the prepared diodes such as ideality factor n and series resistance Rs were investigated in dark and at room temperature from (I−V) curve and Nord's method. As can be seen, the Al/HCP-2/p-Si/Al diode of high rectification ratio RR and with ideality factor greater than unity. The influence of light illuminations on the diode shows that the device can be used as photodiode with good efficiency. The barrier height ϕb and series resistance Rs have been calculated from the capacitance-voltage (C−V)and conductance-voltage (G−V) measurements under various applied frequencies from 10 kHz to 1 MHz. the high difference in the results of barrier height obtained from I-V and C-V calculations confirm the influence of series resistance and localized states on transport of charge carriers and the photodiode performance.TUBITAK-110T652 Fırat University, FÜBAP-FF.161

Saudi-KAU Coupled Global Climate Model: Description and Performance

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Efficacy and safety of empagliflozin in type 2 diabetes mellitus Saudi patients as add-on to antidiabetic therapy: a prospective, open-label, observational study

The Saudi Food and Drug Authority (SFDA) approved sodium-glucose cotransporter-2 (SGLT2) inhibitors in 2018. The efficacy and safety of empagliflozin (EMPA) have been confirmed in the U.S., Europe, and Japan for patients with type 2 diabetes mellitus (T2DM); however, analogous evidence is lacking for Saudi T2DM patients. Therefore, the current study aimed to assess the efficacy and safety of EMPA in Saudi patients (n = 256) with T2DM. This is a 12-week prospective, open-label, observational study. Adult Saudi patients with T2DM who had not been treated with EMPA before enrolment were eligible. The exclusion criteria included T2DM patients less than 18 years of age, adults with type one diabetes, pregnant women, paediatric population. The results related to efficacy included a significant decrease in haemoglobin A1c (HbA1c) (adjusted mean difference −0.93% [95% confidence interval (CI) −0.32, −1.54]), significant improvements in fasting plasma glucose (FPG) (−2.28 mmol/L [95% CI −2.81, −1.75]), and a reduction in body weight (−0.874 kg [95% CI −4.36, −6.10]) following the administration of 25 mg of EMPA once daily as an add-on to ongoing antidiabetic therapy after 12 weeks. The primary safety endpoints were the change in the mean blood pressure (BP) values, which indicated significantly reduced systolic and diastolic BP (−3.85 mmHg [95% CI −6.81, −0.88] and −0.06 mmHg [95% CI −0.81, −0.88], respectively) and pulse rate (−1.18 [95% CI −0.79, −3.15]). In addition, kidney function was improved, with a significant reduction in the urine albumin/creatinine ratio (UACR) (−1.76 mg/g [95% CI −1.07, −34.25]) and a significant increase in the estimated glomerular filtration rate (eGFR) (3.54 mL/min/1.73 m2 [95% CI 2.78, 9.87]). Furthermore, EMPA reduced aminotransferases (ALT) in a pattern (reduction in ALT &gt; AST). The adjusted mean difference in the change in ALT was −2.36 U/L [95% CI −1.031, −3.69], while it was −1.26 U/L [95% CI −0.3811, −2.357] for AST and −1.98 U/L [95% CI −0.44, −3.49] for GGT. Moreover, in the EMPA group, serum high-density lipoprotein (HDL) significantly increased (0.29 mmol/L [95% CI 0.74, 0.15]), whereas a nonsignificant increase was seen in low-density lipoprotein (LDL) (0.01 mmol/L [95% CI 0.19, 0.18]) along with a significant reduction in plasma triglyceride (TG) levels (−0.43 mmol/L [95% CI −0.31, −1.17]). Empagliflozin once daily is an efficacious and tolerable strategy for treating Saudi patients with insufficiently controlled T2DM as an add-on to ongoing antidiabetic therapy