Type 1 and Type 2 Diabetes among Youths in Jordan: Incidence and Trends for the period (2011-2016)

This study aimed at analyzing the incidence of Type 1 and Type 2 diabetes among youths in Jordan for the period (2011-2016), the researchers adopted the survey methodology for the period of five years from the records of the medical centers (public and private) in Jordan. Also investigated the differences between Type 1 and Type 2 diabetes in diagnosis and treatments. Results showed significant upward trend in the incidence of type 1 diabetes was observed overall with considerable variation across demographic subgroups of age, sex. And also showed among youths who were 10 to 19 years of age, unadjusted models revealed significant increases in the incidence of type 2 diabetes with increases observed across all age and sex

Awareness and Regulatory Measures in Caffeine Addiction: Medical Statistical Review

This study aimed at analyzing the degree of awareness and regulatory measures in the caffeine addiction within a medical statistical survey in Jordan, by attempting to answer the study two questions: What are the level of awareness and regulatory measures in caffeine addiction for positive psychological effects (alertness, attention and concentration)?, and: What are the level of awareness and regulatory measures in caffeine addiction for negative psychological effects (anxiety, depression and irritable)? The results of the study showed that there will be a statistically significant differences at the level of significance (α=0.05) of the awareness of caffeine addiction for both positive psychological effects (alertness, attention and concentration) and negative psychological effects (anxiety, depression and irritable) in Jordan. The researchers recommended to educate university students about the importance of controlling their caffeine intakes, and encourage university students to exploit the medical information provided by the medical studies about the risks of high doses of caffeine intakes

Importance And Roles Of Clinical Pharmacist, Nurses And Social Workers, Dietitian With The Psychologist In Performing Excellent Patient Care

Professionals in the healthcare industry have a favorable attitude toward psychological cases, as well as the role of clinical pharmacists in the right therapeutic management and education of patients, as well as a vital part in optimizing the dosage of psychotic drugs. On the other hand, there is a potential area for improvement that is connected to the empowerment of the clinical service with privilege and personnel, as well as the elevation of consciousness regarding the growth of the service in ambulatory settings. In addition, the significant roles that social workers and dietitians play in the management of patients, in conjunction with the function that psychologists play

Adherence to antidiabetic medication during the month of Ramadan among diabetes mellitus patients in the kingdom of Saudi Arabia

Background: Ramadan may lead to reduced adherence to antidiabetic medications among Saudi diabetes patients due to fasting, changes in daily routine, social and cultural influences, health risks, and inadequate awareness. This study aimed to assess the Saudi population adherence to the diabetes management medication in Ramadan. Methodology: A convenience sampling method was used to recruit participants for the study. Participants were sourced from social media platforms, diabetes mellitus patient groups, and healthcare providers groups. The Medication Adherence Rating Scale (MARS), a tool, was used to assess medication compliance. Results: A total of 384 individuals were included in this study, 20.3% were from Riyadh, 52.3% were males, 35% aged 31-50 years, and 64.1% had type 2 diabetes mellitus of participants. Age between 31-50 years was negatively associated with compliance (β = -1.06, p = 0.002), while age between 51-65 years is positively associated ((β= 1.00, p = 0.003). Being male was negatively associated with compliance (β= -0.72, p = 0.001). Different fasting behaviors like non-fasting one day or more (β = -2.92, p < 0.001) and fasting all month (β = -2.90, p < 0.001), significantly affect compliance scores with negative associations indicating lower compliance during fasting periods. Various HbA1c levels were significant predictors of compliance. Higher HbA1c levels were associated with increased compliance. Conclusions: The study reveals that age, gender, fasting behaviors and HbA1c levels significantly impact medication compliance among patients with diabetes mellitus during Ramadan

Assessment and Management of Atopic Dermatitis in Primary Care Settings

An increasingly common chronic inflammatory skin condition is atopic dermatitis (AD). It exhibits severe itching as well as recurring eczematous lesions. New difficulties for treatment selection and approach occur with the expansion of available therapy alternatives for healthcare professionals and patients.  The article highlights recent developments in scientific research on atopic dermatitis diagnosis and assessment that have led to the identification of novel therapeutic targets and the development of targeted therapies, both of which have the potential to completely change the way AD is treated, particularly in a primary care setting

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

The Saudi Critical Care Society practice guidelines on the management of COVID-19 in the ICU: Therapy section

BACKGROUND: The rapid increase in coronavirus disease 2019 (COVID-19) cases during the subsequent waves in Saudi Arabia and other countries prompted the Saudi Critical Care Society (SCCS) to put together a panel of experts to issue evidence-based recommendations for the management of COVID-19 in the intensive care unit (ICU). METHODS: The SCCS COVID-19 panel included 51 experts with expertise in critical care, respirology, infectious disease, epidemiology, emergency medicine, clinical pharmacy, nursing, respiratory therapy, methodology, and health policy. All members completed an electronic conflict of interest disclosure form. The panel addressed 9 questions that are related to the therapy of COVID-19 in the ICU. We identified relevant systematic reviews and clinical trials, then used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach as well as the evidence-to-decision framework (EtD) to assess the quality of evidence and generate recommendations. RESULTS: The SCCS COVID-19 panel issued 12 recommendations on pharmacotherapeutic interventions (immunomodulators, antiviral agents, and anticoagulants) for severe and critical COVID-19, of which 3 were strong recommendations and 9 were weak recommendations. CONCLUSION: The SCCS COVID-19 panel used the GRADE approach to formulate recommendations on therapy for COVID-19 in the ICU. The EtD framework allows adaptation of these recommendations in different contexts. The SCCS guideline committee will update recommendations as new evidence becomes available

Global burden and strength of evidence for 88 risk factors in 204 countries and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

Background: Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021. Methods: The GBD 2021 risk factor analysis used data from 54 561 total distinct sources to produce epidemiological estimates for 88 risk factors and their associated health outcomes for a total of 631 risk–outcome pairs. Pairs were included on the basis of data-driven determination of a risk–outcome association. Age-sex-location-year-specific estimates were generated at global, regional, and national levels. Our approach followed the comparative risk assessment framework predicated on a causal web of hierarchically organised, potentially combinative, modifiable risks. Relative risks (RRs) of a given outcome occurring as a function of risk factor exposure were estimated separately for each risk–outcome pair, and summary exposure values (SEVs), representing risk-weighted exposure prevalence, and theoretical minimum risk exposure levels (TMRELs) were estimated for each risk factor. These estimates were used to calculate the population attributable fraction (PAF; ie, the proportional change in health risk that would occur if exposure to a risk factor were reduced to the TMREL). The product of PAFs and disease burden associated with a given outcome, measured in disability-adjusted life-years (DALYs), yielded measures of attributable burden (ie, the proportion of total disease burden attributable to a particular risk factor or combination of risk factors). Adjustments for mediation were applied to account for relationships involving risk factors that act indirectly on outcomes via intermediate risks. Attributable burden estimates were stratified by Socio-demographic Index (SDI) quintile and presented as counts, age-standardised rates, and rankings. To complement estimates of RR and attributable burden, newly developed burden of proof risk function (BPRF) methods were applied to yield supplementary, conservative interpretations of risk–outcome associations based on the consistency of underlying evidence, accounting for unexplained heterogeneity between input data from different studies. Estimates reported represent the mean value across 500 draws from the estimate's distribution, with 95% uncertainty intervals (UIs) calculated as the 2·5th and 97·5th percentile values across the draws. Findings: Among the specific risk factors analysed for this study, particulate matter air pollution was the leading contributor to the global disease burden in 2021, contributing 8·0% (95% UI 6·7–9·4) of total DALYs, followed by high systolic blood pressure (SBP; 7·8% [6·4–9·2]), smoking (5·7% [4·7–6·8]), low birthweight and short gestation (5·6% [4·8–6·3]), and high fasting plasma glucose (FPG; 5·4% [4·8–6·0]). For younger demographics (ie, those aged 0–4 years and 5–14 years), risks such as low birthweight and short gestation and unsafe water, sanitation, and handwashing (WaSH) were among the leading risk factors, while for older age groups, metabolic risks such as high SBP, high body-mass index (BMI), high FPG, and high LDL cholesterol had a greater impact. From 2000 to 2021, there was an observable shift in global health challenges, marked by a decline in the number of all-age DALYs broadly attributable to behavioural risks (decrease of 20·7% [13·9–27·7]) and environmental and occupational risks (decrease of 22·0% [15·5–28·8]), coupled with a 49·4% (42·3–56·9) increase in DALYs attributable to metabolic risks, all reflecting ageing populations and changing lifestyles on a global scale. Age-standardised global DALY rates attributable to high BMI and high FPG rose considerably (15·7% [9·9–21·7] for high BMI and 7·9% [3·3–12·9] for high FPG) over this period, with exposure to these risks increasing annually at rates of 1·8% (1·6–1·9) for high BMI and 1·3% (1·1–1·5) for high FPG. By contrast, the global risk-attributable burden and exposure to many other risk factors declined, notably for risks such as child growth failure and unsafe water source, with age-standardised attributable DALYs decreasing by 71·5% (64·4–78·8) for child growth failure and 66·3% (60·2–72·0) for unsafe water source. We separated risk factors into three groups according to trajectory over time: those with a decreasing attributable burden, due largely to declining risk exposure (eg, diet high in trans-fat and household air pollution) but also to proportionally smaller child and youth populations (eg, child and maternal malnutrition); those for which the burden increased moderately in spite of declining risk exposure, due largely to population ageing (eg, smoking); and those for which the burden increased considerably due to both increasing risk exposure and population ageing (eg, ambient particulate matter air pollution, high BMI, high FPG, and high SBP). Interpretation: Substantial progress has been made in reducing the global disease burden attributable to a range of risk factors, particularly those related to maternal and child health, WaSH, and household air pollution. Maintaining efforts to minimise the impact of these risk factors, especially in low SDI locations, is necessary to sustain progress. Successes in moderating the smoking-related burden by reducing risk exposure highlight the need to advance policies that reduce exposure to other leading risk factors such as ambient particulate matter air pollution and high SBP. Troubling increases in high FPG, high BMI, and other risk factors related to obesity and metabolic syndrome indicate an urgent need to identify and implement interventions

Rme-6, a Novel Regulator for EGFR Trafficking and Signaling

The Epidermal Growth Factor Receptor (EGFR) is a key regulator for critical cellular processes including proliferation, migration, and apoptosis. Dysregulation of EGFR trafficking and signaling plays a crucial role in cancer development and contributes significantly to resistance to chemotherapy. This thesis examines the novel regulatory role of Rme-6, a Rab5 guanine nucleotide exchange factor (GEF), in modulating EGFR signaling by influencing its endocytic flux, a key determinant in the spatial and temporal dynamics of EGFR-mediated signaling pathways. Through a series of molecular and cellular experiments, I demonstrate that Rme-6 critically influences EGFR endocytic trafficking. Specifically, loss of Rme-6 results in increased accumulation of EGFR in APPL1-positive endosomes. This accumulation alters the downstream signaling fate of ERK1/2 by modulating its nuclear translocation. I have shown that Rme-6 has a positive effect on ERK1/2 signaling, while its disruption leads to aberrant ERK1/2 activity. This change in ERK1/2 signaling correlates with altered cell proliferation rates, suggesting a potential mechanism for cancer progression. Additionally, I reveal that Rme-6 may act as a scaffold for CK2 to phosphorylate ERK1/2 on its SPS motif, which is essential for its nuclear translocation and activation of transcription factors such as c-Fos. This phosphorylation impacts gene expression and subsequent cell fate decisions. This research not only advances our understanding of the molecular dynamics of EGFR signaling but also proposes Rme-6 as a potential therapeutic target in cancers characterized by dysregulated EGFR signaling pathways