Self-Reported Knowledge of Diabetes among High School Students in Al-Amerat and Quriyat, Muscat Governate, Oman

Objectives: Type 2 diabetes mellitus (T2DM) is emerging as one of the world’s greatest health problems, and its incidence and prevalence are increasing at an alarming rate and globally reaching epidemic proportions. With this increasing incidence, emphasis is now being placed on implementing primary prevention, early detection, and educational prevention programmes. This study was undertaken to estimate the level of knowledge of T2DM among high school students and to explore the factors influencing the knowledge of T2DM. Methods: A cross-sectional study was conducted in four secondary schools in two wilayats (districts) of Muscat governate, Oman, namely Al-Amerat and Quriyat. The study was conducted using a validated English questionnaire covering all aspects of T2DM in one-to-one interviews. A scoring system was used to assess the students’ knowledge. Results: Of the 541 students enrolled in the study (45% male and 55% female), only 24% achieved a score of over 10 out of 20. The key areas of poor knowledge were wrong perceptions about diabetic meals (73%), and the possibility of a cure for diabetes (63%). Conclusion: Overall poor knowledge levels about T2DM were found among school students. National efforts and school health-based interventions are highly recommended to increase awareness about diabetes among this age group

glue sniffing neuropathy and review of literature

Glue sniffing neuropathy commonly known as n-hexane neuropathy. It is well documented that industrial exposure to n-hexane causes neuropathy, however it is less well recognized that inhalation of n-hexane present in the vapors can also cause neuropathy However such patients are not seen that frequently. The acute worsening also generates differential diagnosis of GBS. Most of literature is reported from west .We report such case for the first time from Saudi Arabia. A 35 year old male presented to us with progressive numbness followed by weakness in both legs since last three weeks. Over next two week he became chair bound and in the beginning of third week he also stated to feel numbness in both the hands and some weakness was also noted in hands. His past history was significant for carpet cleaning glue sniffing for many years. His exam was significant for distal weakness feet greater than hands, deep tendon reflexes were absent all over. All sensory modalities showed glove and stocking pattern. Nerve conduction velocities showed slowing. His CSF exam was normal. We conclude that n-hexane is neurotoxic when inhaled to excess and, that the neuropathy has characteristic electrophysiological and pathological features

Evolving trends in the management of acute appendicitis during COVID-19 waves. The ACIE appy II study

Background: In 2020, ACIE Appy study showed that COVID-19 pandemic heavily affected the management of patients with acute appendicitis (AA) worldwide, with an increased rate of non-operative management (NOM) strategies and a trend toward open surgery due to concern of virus transmission by laparoscopy and controversial recommendations on this issue. The aim of this study was to survey again the same group of surgeons to assess if any difference in management attitudes of AA had occurred in the later stages of the outbreak. Methods: From August 15 to September 30, 2021, an online questionnaire was sent to all 709 participants of the ACIE Appy study. The questionnaire included questions on personal protective equipment (PPE), local policies and screening for SARS-CoV-2 infection, NOM, surgical approach and disease presentations in 2021. The results were compared with the results from the previous study. Results: A total of 476 answers were collected (response rate 67.1%). Screening policies were significatively improved with most patients screened regardless of symptoms (89.5% vs. 37.4%) with PCR and antigenic test as the preferred test (74.1% vs. 26.3%). More patients tested positive before surgery and commercial systems were the preferred ones to filter smoke plumes during laparoscopy. Laparoscopic appendicectomy was the first option in the treatment of AA, with a declined use of NOM. Conclusion: Management of AA has improved in the last waves of pandemic. Increased evidence regarding SARS-COV-2 infection along with a timely healthcare systems response has been translated into tailored attitudes and a better care for patients with AA worldwide

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Gordonia sputi related multiple brain abscesses, an AIDS-presenting illness: Thinking outside the box

HIV/AIDS has been recognized as a global health issue with significant burden on healthcare services worldwide. Diagnostic and therapeutic challenges include wide range of difficult to identify and treat infections. Gordonia sputi is known to cause multi-system infections in setting of HIV/AIDS. It is often difficult to isolate this organism requiring high suspicion index and special testing techniques. While there is no guidelines-recommended antibacterials regimen for Gordonia sputi infection, extended combined broad spectrum antibacterials have been successfully used. Our patient in this report is a 50-year-old male with no past history who presented with progressive weakness on the right side of the body and urinary incontinence over the duration of one month. MRI scan of the brain showed bilateral ring-enhancing lesions. Gordonia sputi was identified from a tissue biopsy using 16S ribosomal RNA sequencing technique. HIV test for antibodies came to be reactive and a CD4 cell count of 7/μL. The patient was treated with combination of antibacterials and had remarkable radiological interval changes and relatively slower yet apparent clinical improvement. Unfortunately, and despite initial recovery, patient has later developed multi-drug resistant hospital acquired pneumonia leading to his death in ICU during course of hospitalization. Treatment of Gordonia sputi in setting of HIV infection with a combination of antibacterials over extended period appears to be safe and effective. To our knowledge, this is the first report of Gordonia sputi related multiple brain abscesses as AIDS-presenting illness

What do Omani Women know about Breast Cancer Symptoms?

Objectives: Breast cancer is one of the most common cancers and a leading cause of cancer-related mortality in women worldwide. Studies to detect the awareness of breast cancer among Arab women are few and point to a lack of breast cancer knowledge among females. Early detection of breast cancer plays a leading role in reducing mortality rates and improving prognosis. This study aims to assess the knowledge and awareness of breast cancer symptoms among Omani women.  Method: A descriptive, cross-sectional survey design was carried out in Muscat, Oman. The study was conducted at three health centers and three shopping malls using convenience sampling. A total of 369 women consented to be part of the study and completed a questionnaire. Responses to the questionnaire were summed to give an overall knowledge score. Descriptive statistics were used to summarize the data, which was also analyzed statistically.  Results: Among the total number of women 68 (19%) were calculated to have poor knowledge, 219 (59%) had average knowledge, 77 (21%) had good knowledge, and five (1%) had excellent knowledge on breast cancer. Among the variables, education status (p=0.002, p<0.050), and family history of breast cancer (p =0.000, p<0.010) was significantly related to a higher knowledge level.  Conclusion: The study revealed that there was lack of awareness and knowledge on breast cancer symptoms among Omani women. Breast cancer awareness and early detection through regular breast screening is important to reduce the mortality and morbidity of the disease

Printed Electrodes Based on Vanadium Dioxide and Gold Nanoparticles for Asymmetric Supercapacitors

Printed energy storage components attracted attention for being incorporated into bendable electronics. In this research, a homogeneous and stable ink based on vanadium dioxide (VO2) is hydrothermally synthesized with a non-toxic solvent. The structural and morphological properties of the synthesized material are determined to be well-crystalline monoclinic-phase nanoparticles. The charge storage mechanisms and evaluations are specified for VO2 electrodes, gold (Au) electrodes, and VO2/Au electrodes using cyclic voltammetry, galvanostatic charge–discharge, and electrochemical impedance spectroscopy. The VO2 electrode shows an electrical double layer and a redox reaction in the positive and negative voltage ranges with a slightly higher areal capacitance of 9 mF cm−2. The VO2/Au electrode exhibits an areal capacitance of 16 mF cm−2, which is double that of the VO2 electrode. Due to the excellent electrical conductivity of gold, the areal capacitance 18 mF cm−2 of the Au electrode is the highest among them. Based on that, Au positive electrodes and VO2 negative electrodes are used to build an asymmetric supercapacitor. The device delivers an areal energy density of 0.45 μWh cm−2 at an areal power density of 70 μW cm−2 at 1.4 V in the aqueous electrolyte of potassium hydroxide. We provide a promising electrode candidate for cost-effective, lightweight, environmentally friendly printed supercapacitors

Mesoporous Magnetic Cysteine Functionalized Chitosan Nanocomposite for Selective Uranyl Ions Sorption: Experimental, Structural Characterization, and Mechanistic Studies

Nuclear power facilities are being expanded to satisfy expanding worldwide energy demand. Thus, uranium recovery from secondary resources has become a hot topic in terms of environmental protection and nuclear fuel conservation. Herein, a mesoporous biosorbent of a hybrid magnetic&ndash;chitosan nanocomposite functionalized with cysteine (Cys) was synthesized via subsequent heterogeneous nucleation for selectively enhanced uranyl ion (UO22+) sorption. Various analytical tools were used to confirm the mesoporous nanocomposite structural characteristics and confirm the synthetic route. The characteristics of the synthesized nanocomposite were as follows: superparamagnetic with saturation magnetization (MS: 25.81 emu/g), a specific surface area (SBET: 42.56 m2/g) with a unipore mesoporous structure, an amine content of ~2.43 mmol N/g, and a density of ~17.19/nm2. The experimental results showed that the sorption was highly efficient: for the isotherm fitted by the Langmuir equation, the maximum capacity was about 0.575 mmol U/g at pH range 3.5&ndash;5.0, and Temperature (25 &plusmn; 1 &deg;C); further, there was excellent selectivity for UO22+, likely due to the chemical valent difference. The sorption process was fast (~50 min), simulated with the pseudo-second-order equation, and the sorption half-time (t1/2) was 3.86 min. The sophisticated spectroscopic studies (FTIR and XPS) revealed that the sorption mechanism was linked to complexation and ion exchange by interaction with S/N/O multiple functional groups. The sorption was exothermic, spontaneous, and governed by entropy change. Desorption and regeneration were carried out using an acidified urea solution (0.25 M) that was recycled for a minimum of six cycles, resulting in a sorption and desorption efficiency of over 91%. The as-synthesized nanocomposite&rsquo;s high stability, durability, and chemical resistivity were confirmed over multiple cycles using FTIR and leachability. Finally, the sorbent was efficiently tested for selective uranium sorption from multicomponent acidic simulated nuclear solution. Owing to such excellent performance, the Cys nanocomposite is greatly promising in the uranium recovery field

Self Reported Knowledge of Diabetes among High School Students in Al-Amerat and Quriyat , Muscat Governate , Oman

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