Antenatal Magnesium Sulfate for Preterm Neuroprotection: A Single-Center Experience from Kuwait Tertiary NICU

Objectives: The study aimed to evaluate the impact of antenatal exposure of magnesium sulfate (MgSO4) on short- and long-term outcomes in preterm neonates born less than 32 weeks gestation. Methods: Single-center retrospective cohort study of 229 neonates born between 24 and 32 weeks gestation was conducted from January 2018 through December 2018 in a level III neonatal care unit in Kuwait. Antenatal MgSO4 exposure was collected from the medical records, and the indication was for neuroprotection effect. Brain MRI was done on 212 neonates (median gestational age 36 weeks), and brain injury was assessed using the Miller’s score. Neurodevelopmental outcome was assessed by Bayley-III scales of infant development at 36 months corrected age (N = 146). The association of exposure to MgSO4 with brain injury and neurodevelopmental outcomes was examined using multivariable regression analysis adjusting for gestational age at MRI and variables with p value <0.05 on univariate analysis. Results: Among the 229 neonates, 47 received antenatal MgSO4. There were no differences between the groups in gestational age and birth weight. MgSO4 exposure was not associated with an increased risk of necrotizing enterocolitis, chronic lung disease, retinopathy of prematurity, and mortality. The incidence of cerebellar hemorrhage was significantly less in the MgSO4 group (0% vs. 16%, p value = 0.002). Neonates who received MgSO4 had lower risks of grade 3–4 intraventricular hemorrhage (IVH) adjusted OR 0.248 (95% CI: 0.092, 0.66), p = 0.006; moderate-severe white matter injury (WMI) adjusted odd ratio 0.208 (95% CI: 0.044, 0.96), p = 0.046; and grade 3–4 IVH and/or moderate-severe WMI adjusted OR 0.23 (95% CI: 0.06, 0.84), p = 0.027. Neurodevelopmental assessment at 36 months corrected age showed better motor (adjusted beta coefficient 1.08 [95% CI: 0.099, 2.06]; p = 0.031) and cognitive composite scores (adjusted beta coefficient 1.29 [95% CI: 0.36, 2.22]; p = 0.007) in the MgSO4 group. Conclusion: Antenatal exposure to MgSO4 in preterm neonates less than 32 weeks was independently associated with lower risks of brain injury and better motor and cognitive outcomes

Intravenous tirofiban in acute ischemic stroke patients not receiving reperfusion treatments: a systematic review and meta-analysis of randomized controlled trials

BackgroundReperfusion treatments with intravenous thrombolysis and endovascular thrombectomy after acute ischemic stroke (AIS) can improve patients’ outcomes significantly. Yet, a substantial portion of patients miss the opportunity to receive reperfusion treatments. In this study, we aimed to assess the role of intravenous tirofiban in this specific population.MethodsA search was performed in Embase, Cochrane Central Register of Controlled Trials, Medline, and Web of Science databases from inception until August 2024. The random-effects model was used to calculate odds ratios (ORs) with their corresponding 95% confidence intervals (CIs). Efficacy endpoints included excellent (modified Rankin scale of 0–1) and good (modified Rankin scale of 0–2) functional outcomes at 90 days. Safety outcomes included symptomatic intracerebral hemorrhage (sICH), any ICH, and 90-day mortality.ResultsFour randomized clinical trials, including a total of 1,199 patients, were included. Of these, 599 patients (50%) received tirofiban. The meta-analysis demonstrated that tirofiban was associated with significantly higher rates of both excellent (OR 1.63 [95% CI, 1.24–2.13]; I2 = 0) and good (OR 1.65 [95% CI, 1.19–2.29]; I2 = 0) functional outcomes at 90 days. No significant differences were observed in sICH, any ICH, or 90-days mortality.ConclusionTreatment with intravenous tirofiban can be beneficial without increased risk in patients with AIS who are not eligible for reperfusion treatment. Further studies are still needed to validate the generalizability of these findings.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024590097, CRD42024590097

Antenatal Magnesium Sulfate for Preterm Neuroprotection: A Single-Center Experience from Kuwait Tertiary NICU

&lt;b&gt;&lt;i&gt;Objectives:&lt;/i&gt;&lt;/b&gt; The study aimed to evaluate the impact of antenatal exposure of magnesium sulfate (MgSO&lt;sub&gt;4&lt;/sub&gt;) on short- and long-term outcomes in preterm neonates born less than 32 weeks gestation. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Single-center retrospective cohort study of 229 neonates born between 24 and 32 weeks gestation was conducted from January 2018 through December 2018 in a level III neonatal care unit in Kuwait. Antenatal MgSO&lt;sub&gt;4&lt;/sub&gt; exposure was collected from the medical records, and the indication was for neuroprotection effect. Brain MRI was done on 212 neonates (median gestational age 36 weeks), and brain injury was assessed using the Miller’s score. Neurodevelopmental outcome was assessed by Bayley-III scales of infant development at 36 months corrected age (&lt;i&gt;N&lt;/i&gt; = 146). The association of exposure to MgSO4 with brain injury and neurodevelopmental outcomes was examined using multivariable regression analysis adjusting for gestational age at MRI and variables with &lt;i&gt;p&lt;/i&gt; value &amp;#x3c;0.05 on univariate analysis. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; Among the 229 neonates, 47 received antenatal MgSO&lt;sub&gt;4&lt;/sub&gt;. There were no differences between the groups in gestational age and birth weight. MgSO&lt;sub&gt;4&lt;/sub&gt; exposure was not associated with an increased risk of necrotizing enterocolitis, chronic lung disease, retinopathy of prematurity, and mortality. The incidence of cerebellar hemorrhage was significantly less in the MgSO&lt;sub&gt;4&lt;/sub&gt; group (0% vs. 16%, &lt;i&gt;p&lt;/i&gt; value = 0.002). Neonates who received MgSO&lt;sub&gt;4&lt;/sub&gt; had lower risks of grade 3–4 intraventricular hemorrhage (IVH) adjusted OR 0.248 (95% CI: 0.092, 0.66), &lt;i&gt;p&lt;/i&gt; = 0.006; moderate-severe white matter injury (WMI) adjusted odd ratio 0.208 (95% CI: 0.044, 0.96), &lt;i&gt;p&lt;/i&gt; = 0.046; and grade 3–4 IVH and/or moderate-severe WMI adjusted OR 0.23 (95% CI: 0.06, 0.84), &lt;i&gt;p&lt;/i&gt; = 0.027. Neurodevelopmental assessment at 36 months corrected age showed better motor (adjusted beta coefficient 1.08 [95% CI: 0.099, 2.06]; &lt;i&gt;p&lt;/i&gt; = 0.031) and cognitive composite scores (adjusted beta coefficient 1.29 [95% CI: 0.36, 2.22]; &lt;i&gt;p&lt;/i&gt; = 0.007) in the MgSO&lt;sub&gt;4&lt;/sub&gt; group. &lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Antenatal exposure to MgSO&lt;sub&gt;4&lt;/sub&gt; in preterm neonates less than 32 weeks was independently associated with lower risks of brain injury and better motor and cognitive outcomes. </jats:p

The significance of evaporation heat and mass transfer through a spray sheet with two-phase transitional momentum transport and vapour dispersion

Until now, there has been a lack of two-phase velocity and vapor investigations under the evaporation condition. Therefore, this work addresses this title in order to be additive to this subject. The spray droplets are modelled using the moments method, and the gas phase is modelled using the Eulerian approach. The spray drag, breakup, and evaporation sub-models are taken into account. Based on the RANS turbulence model for the carrier gas phase and a calibrated atomisation model for the dispersed droplets, turbulence closure is accomplished. The spray tip penetration is evaluated and compared with experimental data. The fuel vapour mass fraction is calculated by using a transport equation for the droplet-gas interaction. The distribution of the fuel vapour mass fraction is compared with the KIVA code. Fortunately, there are no experimental results for the spray or gas velocity to be compared with. All presented results are investigated by their variation with positions and time to give the total behaviour. The fuel vapour mass fraction distribution exhibits a bell-shaped behaviour. In close proximity to the injector, the evaporation rate is significantly higher. There was no significant increase in the evaporation rate of the pressure swirl nozzle as the distance from the injector increased. During the evaporation of spray droplets, higher fuel vapour concentrations are present at the core spray than at the peripheral edge. The droplet velocities in the outer edge’s axial and radial directions display a reduced magnitude. The droplet’s diameter is greater at the inner edge than at the outer edge. The comparisons showed that there was good agreement with both the experimental and numerical results

Food consumption patterns in different regions of the Kingdom of Saudi Arabia: Household cross- sectional study

This study investigated food consumption patterns in the Kingdom of Saudi Arabia by categorizing them into ten primary food groups. Data from five selected regions (Riyadh, Jazan, Jeddah, Hail, and Al-Ahsa) were analyzed to determine regional dietary variations. A cross-sectional household research design was employed, utilizing a 3-day food records method. Participants responsible for home cooking were asked to record their food data. Data were analyzed using descriptive statistics. The results indicate significant regional variations in food consumption patterns. For instance, in Hail region there was higher consumption of cereals, particularly rice used in the local dish ''Kabsa,'' and legumes such as fava beans and chickpeas. Jazan had a high intake of starchy roots such as potatoes. Meat, fish, and eggs were regularly consumed in Jazan and Jeddah, whereas milk and dairy products were more prevalent in Riyadh and Jeddah. Vegetables and fruits were commonly consumed in both Hail and Riyadh. This study highlights the growing trend in food consumption outside the home, reflecting changing lifestyles in the Kingdom of Saudi Arabia. The analysis of variance (ANOVA) showed significant variability in daily food consumption among different food groups, and there was a strong correlation between the amount of daily food consumed across different regions. These findings provide valuable insights for policymakers and health professionals to formulate balanced and nutritious dietary recommendations, with the ultimate goal of improving public health outcomes in Saudi Arabia through region-specific nutritional policies and interventions. Further research and policy development are necessary to adapt strategies effectively to the unique dietary habits and challenges of each region

Hospital Hygiene Paradox: MRSA and Enterobacteriaceae Colonization Among Cleaning Staff in a Tertiary Hospital in Saudi Arabia

Background and Objectives: Despite extensive research on the sources and transmission pathways of Hospital-Acquired Infections (HAIs), the role of cleaning staff as potential vectors has been under-explored. This study addresses the gap by examining the cleaning staff&rsquo;s role in nosocomial infection transmission, focusing on pathogenic bacteria and fungi colonization. Identifying potential pathogens harbored by cleaning staff that carry the risk of causing HAIs, especially methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae. Materials and Methods: This current cross-sectional study was conducted on 96 cleaning staff at King Fahad Hospital of the University and Family and Community Medicine-Centre, Eastern Province, Saudi Arabia. Sample collection targeted hands and nostrils using cotton swabs, followed by laboratory testing, including MALDI-TOF mass spectrometry for bacterial identification, and the cefoxitin disc diffusion test for the screening of MRSA. Results: In total, the occurrence of MRSA colonization was 9.4% while Enterobacteriaceae colonization was 15.6%. No significant correlation was found for MRSA among departments or between day and night shifts. Alternatively, individuals working in the ICU and the operating room showed higher chances of being colonized by Enterobacteriaceae, and a notable connection was identified between Enterobacteriaceae and day shifts. Ultimately, the frequency of handwashing reduced the chances of being colonized by MRSA and Enterobacteriaceae, underscoring the significance of good hygiene practices. Conclusions: The study highlights the potential role of cleaning staff in transmitting HAIs, indicating a need for further research and consideration of enhanced hygiene protocols in hospital settings