Long term visual outcomes in laser treated threshold retinopathy of prematurity in Central Saudi Arabia

AbstractPurposeTo assess the long term visual outcomes and refractive status of patients who underwent diode laser for threshold retinopathy of prematurity (ROP) and to investigate the risk factors leading to poor visual outcomes.MethodsFifty-seven patients (114 eyes) with threshold ROP who underwent laser therapy were contacted for reassessment. A chart review was performed for all patients to collect data on visual acuity, retinal status and strabismus. A favorable visual outcome was defined as ⩾20/160 (Snellen acuity) for young adults (cooperative patients), and ⩾CSM for children (uncooperative patients) while unfavorable visual outcome was defined as <20/160 or <CSM. Vision in uncooperative children was graded as central, steady, maintain. Descriptive and inferential analyses were conducted. Chi2 and odds ratios were calculated whenever appropriate. A P value <0.05 was considered as statistically significant.ResultsThe mean age at reassessment was 5.2±2.5years (range, 1–10years) where 36 (63.2%) patients were males and 21 (36.8%) were females. Out Of the 114 laser treated eyes, 73 (64%) were myopic, with mean spherical equivalent (SE) of −6.69 (5.9), range (−0.25 to −21) diaopters, 8 (7%) were emmetrope, while other 33 (29%) were hyperopic with mean SE of +2.43 (3.04), range (+0.25 to +17) diaopters. Strabismus was present in 31 patients (54.4%) of whom 81% (25/31) were esotropic. Retina was found to be normal in 77.1% of the examined eyes, while the remaining eyes had either macular dragging or retinal detachment. Almost 70% of the eyes with a normal retinal examination had favorable visual outcome. Thirteen (11.4%) eyes had zone 1 retinopathy, 83 (72.8%) eyes had zone 2 retinopathy and 2 (1.8%) eyes had zone 3 retinopathy. Vitreous hemorrhage was present in 7 (6.1%) eyes prior to laser treatment. The relationship between final retinal status and visual outcome was statistically significant (P<0.0001). There was no statistically significant correlation between visual outcome and the zone of the retinopathy (P=0.448).ConclusionThe majority of patients who underwent diode laser therapy for threshold ROP had favorable anatomical and visual outcomes. However, high refractive error and strabismus may be clinically the pertinent causes of visual impairment

Knowledge and attitude towards mental illness among health and non-health university students in Riyadh

Background: Mental illness can affect anyone regardless of age, gender, and residence. Studying the attitude and knowledge about mental illnesses among university students is important, because they are the future decision makers dealing with such problems. The aim of this study was to assess level of knowledge and attitude towards mental illnesses among health and non-health university students in Riyadh.Methods: This study was a cross-sectional study on students of the governmental universities in Riyadh with both health and non-health speciality. The total sample size was 587 students. The questionnaire was designed electronically, and the link was distributed through social media. It included socio-demographic questions, 17 questions to assess knowledge and 22 questions to assess the attitudes. The statistical tests used were chi square, independent sample t-test, spearman’s correlation and multiple linear regression tests.Results: More than half of the participants had a positive attitude toward mental illness (52%). Only 13.46% of university students had good knowledge about mental illness. Significant higher level of good knowledge and positive attitude were reported among health college students compared to non-health (24.7% versus 7.9% for good knowledge and 60.8% versus 48.3 for positive attitude respectively). Attitude towards mental illness can be successfully predicted by using the knowledge score about mental illness and the type of college.Conclusion: Low percentage of university students had good knowledge about mental illness and their attitude towards mental illness was generally positive. Health college students had better attitude and knowledge about mental illness than non-health

Multi-Expression Programming (MEP): Water Quality Assessment Using Water Quality Indices

Water contamination is indeed a worldwide problem that threatens public health, environmental protection, and agricultural productivity. The distinctive attributes of machine learning (ML)-based modelling can provide in-depth understanding into increasing water quality challenges. This study presents the development of a multi-expression programming (MEP) based predictive model for water quality parameters, i.e., electrical conductivity (EC) and total dissolved solids (TDS) in the upper Indus River at two different outlet locations using 360 readings collected on a monthly basis. The optimized MEP models were assessed using different statistical measurements i.e., coefficient-of-determination (R2), root-mean-square error (RMSE), mean-absolute error (MAE), root-mean-square-logarithmic error (RMSLE) and mean-absolute-percent error (MAPE). The results show that the R2 in the testing phase (subjected to unseen data) for EC-MEP and TDS-MEP models is above 0.90, i.e., 0.9674 and 0.9725, respectively, reflecting the higher accuracy and generalized performance. Also, the error measures are quite lower. In accordance with MAPE statistics, both the MEP models shows an “excellent” performance in all three stages. In comparison with traditional non-linear regression models (NLRMs), the developed machine learning models have good generalization capabilities. The sensitivity analysis of the developed MEP models with regard to the significance of each input on the forecasted water quality parameters suggests that Cl and HCO3 have substantial impacts on the predictions of MEP models (EC and TDS), with a sensitiveness index above 0.90, although the influence of the Na is the less prominent. The results of this research suggest that the development of intelligence models for EC and TDS are cost effective and viable for the evaluation and monitoring of the quality of river water

Factors associated with poor outcomes among hospitalized patients with COVID-19: Experience from a MERS-CoV referral hospital

BACKGROUND: Coronavirus disease 2019 (COVID-19) has resulted in millions of deaths, including more than 6000 deaths in the Kingdom of Saudi Arabia (KSA). Identifying key predictors of intensive care unit (ICU) admission and mortality among infected cases would help in identifying individuals at risk to optimize their care. We aimed to determine factors of poor outcomes in hospitalized patients with COVID-19 in a large academic hospital in Riyadh, KSA that serves as a Middle East Respiratory Syndrome coronavirus (MERS-CoV) referral center. METHODS: This is a single-center retrospective cohort study of hospitalized patients between March 15 and August 31, 2020. The study was conducted at King Saud University Medical City (KSUMC). COVID-19 infection was confirmed using real-time reverse transcriptase polymerase chain reaction (RT-PCR) for SARS-COV-2. Demographic data, clinical characteristics, laboratory, radiological features, and length of hospital stay were obtained. Poor outcomes were, admission to ICU, need for invasive mechanical ventilation (IMV), and in-hospital all-cause mortality. RESULTS: Out of 16,947 individuals tested in KSUMC, 3480 (20.5%) tested positive for SARS-CoV-2 and of those 743 patients (21%) were hospitalized. There were 62% males, 77% were younger than 65 years. Of all cases, 204 patients (28%) required ICU admission, 104 (14%) required IMV, and 117 (16%) died in hospital. In bivariate analysis, multiple factors were associated with mortality among COVID-19 patients. Further multivariate analysis revealed the following factors were associated with mortality: respiratory rate more than 24/min and systolic blood pressure 37 units/L in the first 48 h of presentation, while a RT-PCR cycle threshold (Ct) value ≤24 was a predictor for IMV. CONCLUSION: Variable factors were identified as predictors of different outcomes among COVID-19 patients. The only predictor of IMV was a low initial Ct values of SARS-CoV-2 PCR. The presence of tachypnea, hypotension, lymphopenia, and elevated AST in the first 48h of presentation were independently associated with mortality. This study provides possible independent predictors of mortality and invasive mechanical ventilation. The data may be helpful in the early identification of high-risk COVID-19 patients in areas endemic with MERS-CoV

Life satisfaction and risk of burnout among men and women working as physiotherapists

Objectives: Recently in Poland as a result of the high rate of aging population and high rates of morbidity, a growing demand for the physiotherapist profession is observed. The results of this study can be used to formulate principles for better organization of physiotherapist's workplace in order to prevent occurrence of burnout. The aim of this study is to investigate the effect of gender on satisfaction with life and burnout among active physiotherapists. Material and Methods: The survey was anonymous and voluntary, and involved a group of 200 active physiotherapists working in health care units and educational centers in Poland. The study group was selected randomly and incidentally. Each respondent received a demographic data sheet and a set of self-rating questionnaires (Life Satisfaction Questionnaire, Burnout Scale Inventory). Results: Burnout among men decreased along with increasing satisfaction with one's work and occupation, friends, relatives and acquaintances, sexuality, and increased due to greater satisfaction with one's housing status. Burnout among women decreased along with increasing satisfaction with one's health, free time and friends, relatives and acquaintances, and increased due to work at a setting other than a health care unit or educational center. Statistical analysis failed to reveal any significant differences with regard to the BSI domains and with regard to the overall burnout index as well as with regard to the assessment of satisfaction with life between female and male physiotherapists. Conclusions: Satisfaction with children, marriage and partnership, with one's work and occupation, interactions with friends, relatives and acquaintances and sexuality may contribute to reduction of burnout among men. Women who are satisfied with their children, family, health, free time and contacts with friends, relatives and acquaintances are less prone to burnout. Weak financial situation among women and deficiency of free time among men can induce burnout. Improving staff happiness may contribute to decreasing burnout

Rapidly Sequential Vision Loss From Posterior Ischemic Optic Neuropathy Due to Methicillin-Susceptible Staphylococcus Aureus Bacteremia

A 63-year-old man with a history of high-grade bladder cancer was admitted to the intensive care unit (ICU) with renal failure and methicillin-susceptible Staphylococcus aureus bacteremia originating from his nephrostomy tube. While in the ICU, he had painless, severe loss of vision in the right eye followed by his left eye 12 hours later. Visual acuity was no light perception in each eye. He was anemic, and before each eye lost vision, there was a significant decrease in blood pressure. Dilated fundus examination was normal, and MRI showed hyperintense signal in the bilateral intracanalicular optic nerves on diffusion-weighted imaging and a corresponding low signal on apparent diffusion coefficient imaging. He was diagnosed with bilateral posterior ischemic optic neuropathies (PION), and despite transfusion and improvement in his systemic health, his vision did not recover. PION may be seen in the context of sepsis, and patients with unilateral vision loss have a window for optimization of risk factors if a prompt diagnosis is made

Bewusstsein für und Einhaltung von Infektionskontrolle durch Studenten und Praktikanten der Zahnmedizin an der Riyadh Elm University

Aim: Dental students have increasing patient contact during their education and clinical years, putting them at high risk of cross-infection; therefore, the purpose of this study was to determine the level of infection control practices among dental students and interns at Riyadh Elm University, Riyadh, Saudi Arabia. Methods: Total of 400 questionnaires were distributed among interns and clinical students at Riyadh Elm University. The questionnaire comprised 32 items assessing infection control practices, and the data were tabulated and analyzed by SPSS to produce descriptive statistics.Results: Three hundred nine questionnaires were answered (response rate 77%).The implementation of different infection control measures was good to excellent, except for hepatitis B vaccination and wearing eye protection: only 76% of males and 83% of females were vaccinated against HBV, and only 30% of males and 26% of females always wore protective glasses. Conclusion: Compared to previous studies, an increased awareness regarding infection control practices among dental students and interns was noticeable. However, greater emphasis on the importance of infection control, especially compliance with HBV vaccination and wearing protective eyewear, is necessary.Zielsetzung: Zahnmedizinstudenten und Praktikanten sind während ihrer klinischen Ausbildung Infektionsrisiken ausgesetzt. Daher sollte die Einhaltung der Schutzmaßnahmen der Auszubildenden an der Riyadh Elm University, Saudi Arabien, analysiert werden.Methode: Es wurden 400 Fragebögen mit 32 Items zur Einhaltung ausgewählter Präventionsmaßnahmen ausgegeben. Die Daten wurden mittels SPSS deskriptiv ausgewertet.Ergebnisse: 309 Fragebögen waren auswertbar (Response Rate 77%). Die Implementierung der Präventionsmaßnahmen war mit Ausnahme der HBV-Schutzimpfung und des Tragens einer Schutzbrille gut bis sehr gut. Geimpft waren jedoch nur 76% der männlichen and 83% der weiblichen Personen. Augenschutz trugen sogar nur 30% der männlichen and 26% der weiblichen Personen.Schlussfolgerung: Im Vergleich zu vorangegangen Analysen wurde ein gesteigertes Bewusstsein für Infektionskontrollpraktiken bei zahnmedizinischen Studenten und Praktikanten festgestellt. Es ist jedoch notwendig, dass alle Auszubildenden zur HBV-Schutzimpfung und zum Tragen von Schutzbrillen motiviert werden

Conjunctival Involvement of T-Cell Lymphoma in a Patient with Mycosis Fungoides

Background. Ocular involvement in mycosis fungoides (MF) cases occurs in one-third of patients with the eyelid being the most frequent site affected; however, conjunctival involvement is rarely reported. Herein, we report a rare case of conjunctival involvement of MF. Case Presentation. A 66-year-old man who was previously diagnosed with MF in 2010 and was treated presented in 2014 complaining of foreign body sensation and redness in both eyes. Slit lamp examination of both eyes showed erythematous conjunctival growth that extended circumferentially. Physical examination revealed erythematous skin lesions on different body parts. Conjunctival biopsy was performed and revealed a dense, highly polymorphic lymphocytic population. The immunophenotype demonstrated a neoplastic T-cell origin consistent with MF. A diagnosis of conjunctival involvement by MF was made. The conjunctiva was treated with radiotherapy resulting in tumor regression. There were no recurrences at the 6-month follow-up. Conclusion. T-cell lymphoma should be considered in patients with a history of MF presenting with conjunctival and skin lesions