Extraintestinal Manifestations Of Ulcerative Colitis In Saudi Arabia: Systematic Review

Background: Inflammatory bowel disease (IBD), particularly ulcerative colitis (UC), exhibits varied clinical presentations and extraintestinal manifestations (EIMs) that impact the overall well-being of affected individuals. This systematic review aims to consolidate recent studies conducted in Saudi Arabia to comprehensively analyze the sociodemographic characteristics and clinical features of UC patients, with a specific focus on bone-related complications. Objective: To systematically review Extraintestinal Manifestations of Ulcerative Colitis in Saudi Arabia Methodology: Using the PRISMA guidelines, a comprehensive A systematic search was conducted to identify relevant studies published between 2014 and 2023 on PubMed in English that investigated UC in Saudi Arabia. resulting in the inclusion of seven studies with a collective participant count of 1580. Sociodemographic characteristics & Clinical characteristics, particularly the prevalence of bone-related complications, were examined across these studies. Results: The sociodemographic analysis of 1580 participants from seven studies highlighted variations in extraintestinal manifestations in IBD. Due to the inflammatory nature of the UC disease, and increased glucocorticoids concentrations, bone-related complications, including osteoporosis and osteopenia, were prevalent in UC patients, with distinct patterns observed in different studies. Arthropathy emerged as one of the most common extraintestinal manifestation. Moreover, renal stones are another issue for these patients. Finally, all of these manifestations contribute to the prevalence of anxiety and depression symptoms that was identified among UC patients, that indicated that fifth of these cohort suffer from, psychological disease. Conclusion: This systematic review provides a comprehensive overview of recent studies on UC in Saudi Arabia, emphasizing the prevalence of bone-related complications as predominant extra intestinal manifestations. The findings underscore the importance of addressing these complications in the management of UC patients, necessitating regular testing of the bone density in these patients and provide supplements and other necessary treatments for these patients. Moreover, it is important to consider the psychological impact of such disease on the quality of life of patients. Comprehensive multi-disciplinary medical teams need to work together to address various clinical aspects regarding Ulcerative colitis. This does not only include gastroenterologist, nephrologists and general internists, but also include psychologists/therapists to ensure all patients needs are addressed. Finally, further research is needed to have comprehensive view of UC in Saudi Populations and improve the overall quality of care

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

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

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

Determinants of Corporate Social Responsibility Disclosure in the Financial Services Sector: Evidence from Gulf Cooperation Council Countries

This study investigates the determinants of Corporate Social Responsibility (CSR) disclosure in Gulf Cooperation Council (GCC) listed financial firms. It builds on a growing literature investigating the role and determinants of corporate responsibility and sustainability disclosure in accounting reporting, but is unique in its focus on the GCC, and particularly its financial services sector. It further investigates the differences in the extent and determinants of CSR disclosure between Islamic and conventional listed financial firms in the GCC

Effect of self-etching ceramic primer on bond strength of zirconia-reinforced lithium silicate ceramics

This study evaluated the effect of self-etching ceramic primer (SECP) on shear bond strength (SBS) of zirconia-reinforced lithium silicate (ZLS) ceramics. Two hundred and seventy block-specimens of two types of ZLS ceramics and one type of lithium disilicate (LS) ceramics were prepared. Ninety blocks of each material were divided into three groups (n = 30), namely group 1: no surface treatment (control), group 2: hydrofluoric acid (HF), silane-based primer (S), and group 3: SECP. Resin cement was applied, and light-cured for build-up. Shear bond strength (SBS) test was used. Half of the bonded specimens (n = 15) were tested after storage in distilled water for 24 h, whereas the other half were tested after 5000 thermo-cycles. The failure modes were evaluated using scanning electron microscope (SEM). The SBS values for samples treated with SECP and HF + S within the respective materials were statistically comparable (p > 0.05). Thermocycling significantly reduced the SBS (p < 0.05) for all ceramic materials in groups 2 and 3. Mixed failure followed by adhesive failure were the most common failure modes in groups 2 and 3, whereas pretest failure was only detected in group 1. Considering the limitations of the study, with respect to in vitro bond strength, the SECP is an alternative for the conditioning of internal surface of glass ceramics

Early recognition and treatment of TC II deficiency: Case report

Transcobalamin (TC) is a carrier protein and it delivers vitamin B12 to the cellular TC receptor. TC II deficiency is a very rare disease and is life-threatening if left untreated. It is an Autosomal recessive disease and needs lifelong treatment. The clinical presentations are variable, started at early infancy, and sometimes mimic severe combined immunodeficiency or acute leukemia. It includes failure to thrive, diarrhea, anemia and or pancytopenia, hypotonia, developmental delay, and recurrent infection. Diagnosis of TC II deficiency is suspected based on clinical presentations with megaloblastic anemia, the elevation of plasma homocysteine, and urine methylmalonic acid level with a normal level of vitamin B12 and folate. Molecular analysis of the TCN 2 gene is needed for confirmation of the diagnosis. We present a case of 2 years old Saudi boy who was admitted to the hospital with a history of fever, recurrent chest infection, failure to thrive with diarrhea, and hypotonia, and his complete blood counts showed Pancytopenia. Though, normal vitamin B12 level and folate level, homocysteine, and urine methylmalonic acid lever were elevated. Peripheral smear and bone marrow aspiration and biopsy revealed Hypersegmented neutrophils and megaloblastic change.&nbsp

Utilization of smart phones related medical applications among medical students at King Abdulaziz University, Jeddah: A cross-sectional study

Summary: Introduction: The present study explored the utility, attitude, and trends regarding Smartphone related Medical Applications (Apps) among medical students of King Abdulaziz University (KAU) Jeddah, Saudi Arabia (SA) and their perceptions of the impact of Medical Apps in their training activities. Subjects and methods: This survey was conducted at the Faculty of Medicine, Jeddah, and Rabigh campuses, KAU, Jeddah, SA. All participants were medical students of 2nd to 6th year. The data was collected by using an anonymous questionnaire regarding the perception of medical students about Medical Apps on the smart devices and the purpose of installation of the Apps. Additionally examined was the use of different Medical Apps by the students to investigate the impact of Medical Apps on the clinical training/practice. Data was analyzed on SPSS 21. Results: The opinion of 330/460 medical students from all academic years was included in the study with a response rate of 72%. There were 170 (51.5%) males and 160 (48.5%) females with a mean age of 21.26 ± 1.86 years. Almost all participating students 320 (97%) were well aware of Medical Apps for smart devices and 89.1% had installed different applications on their smart devices. The main usage was for either revision of courses (62.4%) or for looking up of medical information (67.3%), followed by preparing for a presentation (34.5%) and getting the medical news (32.1%). Regarding the impact of Medical Apps, most of the students considered these helpful in clinical decision-making, assisting in differential diagnosis, allowing faster access to Evidence-Based Medical practice, saving time and others. The practical use of these Apps was found to be minimal in medical students. Around 73% were occasional users of Medical Apps, and only 27% were using Medical Apps at least once a day. Conclusion: The regular use of Medical Apps on mobile devices is not common among medical students of KAU. Keywords: Medical Apps, Saudi Arabia, Medical students, Smartphone

Development of Security Rules and Mechanisms to Protect Data from Assaults

Cloud cryptography is the art of converting plain text into an unreadable format, which protects data and prevents the data from being misused by the attacker. Different researchers designed various Caesar cipher algorithms for data security. With the help of these algorithms, the data can be converted into a nonreadable format, but the data cannot be completely secured. In this paper, data security is provided in different phases. Firstly, data are secured through a bit-reversing mechanism in which those replace the actual values with no relation to the original data. Then the four-bit values are added at the beginning and end of bits using a salting mechanism to interlink the salting and existing bit-values and hide the original data. A Caesar cipher value is obtained by applying the Caesar cipher algorithm to the resulting bits. The Caesar cipher algorithm is used to implement number-of-shifting on the obtained values. An efficient cipher matrix algorithm is then developed in which different rules are designed to encrypt the data. Afterward, a secure cipher value is obtained by implementing Cipher XORation rules on the result obtained and the user-defined key. In the end, the proposed algorithm is compared with various papers. It identifies how much better the proposed algorithm performs than all the previous algorithms and how much the attack rate can be reduced if this algorithm is used for data security