Compliance to patching in the treatment of amblyopia

AbstractPurposeTo evaluate compliance of amblyopic patients to patching, and to identify reasons of poor compliance and suggest methods to overcome the problem.MethodsWe conducted a cross-sectional, retrospective study that included 37 families with a child diagnosed with unilateral amblyopia (age range 3–16years) and attending the Pediatrics Ophthalmology clinic at the King Abdulaziz University Hospital (a tertiary eye hospital). Data were collected through interviews and from hospital charts. In the interviews we asked questions that sought information with regard to four aspects (domains); knowledge, attitude, insight and community’s effect. A score representing each domain was given to every family then we correlated these scores with family’s compliance percentage.ResultsWhen correlated with compliance, the insight and attitude domains showed a statistically significant correlation; p-value 0.002 and 0.004, respectively. However, the knowledge and community’s effect domains were not; p-value 0.084 and 0.114, respectively. Other qualitative factors affecting compliance were identified with open questions. Quotes from families of what they think can improve compliance are shown.ConclusionTo improve compliance, merely educating patients is not sufficient and more efforts should be undertaken toward ensuring true sense of the problem and its impact. Factors affecting compliance due to the physical properties in the patch itself should be addressed too (heat, irritation, poor adhesive material and design)

Energy modulated electron therapy : design, implementation, and evaluation of a novel method of treatment planning and delivery

Energy modulated electron therapy (EMET) is a promising treatment modality that has the fundamental capabilities to enhance the treatment planning and delivery of superficially located targets. Although it offers advantages over x-ray intensity modulated radiation therapy (IMRT), EMET has not been widely implemented to the same level of accuracy, automation, and clinical routine as its x-ray counterpart. This lack of implementation is attributed to the absence of a remotely automated beam shaping system as well as the deficiency in dosimetric accuracy of clinical electron pencil beam algorithms in the presence of beam modifiers and tissue heterogeneities. In this study, we present a novel technique for treatment planning and delivery of EMET. The delivery is achieved using a prototype of an automated "few leaf electron collimator" (FLEC). It consists of four copper leaves driven by stepper motors which are synchronized with the x-ray jaws in order to form a series of collimated rectangular openings or "fieldlets". Based on Monte Carlo studies, the FLEC has been designed to serve as an accessory tool to the current accelerator equipment. The FLEC was constructed and its operation was fully automated and integrated with the accelerator through an in-house assembled control unit. The control unit is a portable computer system accompanied with customized software that delivers EMET plans after acquiring them from the optimization station. EMET plans are produced based on dose volume constraints that employ Monte Carlo pre-generated and patient-specific kernels which are utilized by an in-house developed optimization algorithm. The structure of the optimization software is demonstrated. Using Monte Carlo techniques to calculate dose allows for accurate modeling of the collimation system as well as the patient heterogeneous geometry and take into account their impact on optimization. The Monte Carlo calculations were validated by comparing them against output measurements with an ionization chamber. Comparisons with measurements using nearly energy-independent radiochromic films were performed to confirm the Monte Carlo calculation accuracy for 1-D and 2-D dose distributions. We investigated the clinical significance of EMET on cancer sites that are inherently difficult to plan with IMRT. Several parameters were used to analyze treatment plans where they show that EMET provides significant overall improvements over IMRT

Effects of saline irrigation water on morphological characteristics of banana (Musa spp.)

Banana is one of the most important food crops after rice, wheat and corn around the world. It is susceptible to a wide spectrum of non-infectious problems such as abiotic stresses resulting in restricting growth and production. Studies were conducted to determine the effects of four salinity levels (0.17 (control), 3.0, 6.0, and 9.0 dS m-1) on morphological characteristics of four banana cultivars at vegetative growth stage. Banana cultivars from the Cavendish group (Williams, Malindi) and plantains group (FHIA18 and Diwan) were grown in 61 x 76 cm polyethylene bags filled with soil mixture comprising of top soil, sand and peat moss (3:1:2 v/v), with pH ranging from 6 - 6.5 and EC 0.02 mScm-1. The experiment was carried out under a rain-shelter in split-plot design with three replicates. Plants were irrigated manually. Data were collected at 3, 6 and 9 months after transplanting. The results revealed that, the number of leaves, stem height, stem girth and total leaf area were significantly affected by salinity, variety and plant age. Significant interaction was also found between salinity and variety, salinity and plant age, as well as variety and plant age. The morphological characteristics of banana were negatively affected by higher salinity levels (6.0 and 9.0 dS m-1). Under similar salinity level, cultivar Malindi had higher number of leaves, stem height, stem girth and total leaf area as compared to cultivar Williams. Among plantains banana, cultivar FHIA18 was more tolerance to high salinity levels than Diwan cultivar, while Malindi from Cavendish group shows high salt tolerant than Williams. Therefore cultivars Malindi and FHIA18 could be grown in arid and semiarid environment depend on their tolerance to high salinity level above 1.0 dS m-1

In-vitro Cytotoxicity and In-silico Insights of the Multi-target Anticancer Candidates from Haplophyllum tuberculatum

This study aimed to investigate the anticancer activity of Haplophyllum tuberculatum(Forsk.) aerial parts ethanol extract and fractions and reveal the potential anticancer targets, binding modes, pharmacokinetics, and toxicity properties of its phytoconstituents. MTT assay was used to investigate the anticancer activity. TargetNet, ChemProt version 2.0, and CLC-Pred web servers were used for virtual screening, and Cresset Flare software was used for molecular docking with the 26 predicted targets. Moreover, pkCSM, swiss ADME, and eMolTox web servers were used to predict pharmacokinetics and safety. Ethanolic extracts of H. tuberculatum on HepG2 and HeLa cell lines showed promising activities with IC50 values 54.12 and 48.1 µg/mL, respectively. Further, ethyl acetate fraction showed the highest cytotoxicity on HepG2 and HeLa cell lines with IC50 values 41.7 and 52.31 µg/mL. Of 70 compounds screened virtually, polygamain, justicidin A, justicidin B, haplotubine, kusunokinin, and flindersine were predicted as safe anticancer drugs candidates. They showed the highest binding scores with targets involved in cell growth, proliferation, survival, migration, tumor suppression, induction of apoptosis, metastasis, and drug resistance. Our findings revealed the potency of H. tuberculatum as a source of anticancer candidates that further studies should support

The Study of Learning Styles among Medical Students at Majmaah University, Saudi Arabia

The main objectives of this research were to detect types of learning styles (LS), time spending in studying, to know the relation with GPA, and to determine which LS is suitable with teaching style used in the College of Medicine at Majmaah University. The study was cross-sectional self-survey conducted among male and female medical students at College of Medicine at Majmaah city over 6 months. Cluster sampling was used and total participants were 194 students from College of Medicine (males & females). The data was collected using a designed questionnaire and analysis of data was performed by SPSS (V26).This study showed that majority of participants preferred the Visual learning (VL) style (27.79%), the second most used type was Kinesthetic (24.79%), and the least used type was Auditory (24.53%). It also showed that students who prefer VL style score more than students who prefer other learning styles. It was observed that the student who prefers kinesthetic style spent more time in the studying the more use of this type. In Conclusion, The study concluded that the majority of participants were preferred the VL style. It is also showed that student who prefers visual learning style score more than students who prefer other learning styles. It is important to increase awareness of students regarding types of their learning styles and teaching strategies in college during admission

Harm perceptions of waterpipe tobacco smoking among university students in five Eastern Mediterranean Region countries: A cross-sectional study

© 2018 Abu-Rmeileh N. INTRODUCTION Waterpipe tobacco smoking (WTS) continues to be very common in the Eastern Mediterranean Region (EMR), partially because of cultural acceptance but also because of misconceptions of its harm. This paper aimed to describe the beliefs towards waterpipe harm of university students who smoked waterpipe in five EMR countries. METHODS This study was conducted in 2016 across five EMR countries: Egypt, Jordan, Occupied Palestinian Territories, Oman and United Arab Emirates (UAE). Participants were recruited from among university students in each country. Students’ characteristics, smoking behavior, flavor preference and knowledge of WTS harm were collected using an internet-based survey. Participants were included if they were ever waterpipe tobacco smokers and between 18 and 29 years of age. Bivariate analyses assessed variations in student-perceived WTS harm across the countries. Linear regression analysis was used to assess WTS perceived harm differences between students in the different countries. RESULTS A total of 2 544 university students participated from the five countries. Among ever smoking students, 66% reported WTS in the past 30 days, with the highest proportions (40%) from Occupied Palestinian Territories (OPT) and (41%) Jordan. Dual smoking of waterpipe and cigarettes was highest among students from Egypt. Most participants from the five countries had high level of perceived harm related to WTS during pregnancy. Less than 50% of the students believed that WTS could lead to the death of the smoker, can be harmful for non-smokers and have an addictive effect. Female students, those older than 22 years, and those who didn’t smoke waterpipe in the last 30 days significantly had a higher level of WTS perceived harm. Participating students believed that cigarettes are more addictive and contain more nicotine compared to waterpipe. CONCLUSIONS Misperceptions of waterpipe harm are common among university students in the five EMR countries. Immediate public health action is needed, including enforcement of waterpipe tobacco control regulations along with awareness campaigns

Vitamin D serum level predicts stroke clinical severity, functional independence, and disability—A retrospective cohort study

BackgroundStroke is a leading cause of mortality and disability and one of the most common neurological conditions globally. Many studies focused on vitamin D as a stroke risk factor, but only a few focused on its serum level as a predictor of stroke initial clinical severity and recovery with inconsistent results. The purpose of this study was to assess the relationship between serum vitamin D levels and stroke clinical severity at admission and functional independence and disability at discharge in Saudi Arabia.MethodologyA retrospective cohort study of adult ischemic stroke patients who had their vitamin D tested and admitted within 7 days of exhibiting stroke symptoms at King Abdulaziz Medical City (KAMC) Jeddah, Saudi Arabia. Based on vitamin D level, the patients were categorized into normal [25(OH)D serum level ≥ 75 nmol/L], insufficient [25(OH)D serum level is 50–75 nmol/L], and deficient [25(OH)D serum level ≤ 50 nmol/L]. The primary outcome was to assess the vitamin D serum level of ischemic stroke patients’ clinical severity at admission and functional independence at discharge. The National Institute of Health Stroke Scale (NIHSS) was used to assess the clinical severity, whereas the modified Rankin scale (mRS) was used to assess functional independence and disability.ResultsThe study included 294 stroke patients, out of 774, who were selected based on the inclusion and exclusion criteria. The mean age of the participants was 68.2 ± 13.4 years, and 49.3% were male. The patients’ distribution among the three groups based on their vitamin D levels is: normal (n = 35, 11.9%), insufficient (n = 66, 22.5%), and deficient (n = 196, 65.6%). After adjusting for potential covariates, regression analysis found a significant inverse relationship of NIHSS based on 25(OH)D serum level (beta coefficient: −0.04, SE: 0.01, p = 0.003). Patients with deficient serum vitamin D level also had significantly higher odds of worse functional independence in mRS score [OR: 2.41, 95%CI: (1.13–5.16), p = 0.023] when compared to participants with normal vitamin D level.ConclusionLow vitamin D levels were associated with higher severity of stroke at admission and poor functional independence and disability at discharge in patients with acute ischemic stroke. Further randomized clinical and interventional studies are required to confirm our findings

ANTIPSYCHOTICS- CLASSIFICATION, USES, AND ADVERSE EFFECTS

Introduction: Antipsychotic agents are categorized usually as either “typical antipsychotics” or “atypical antipsychotics”. Typical antipsychotic pharmacological agents, which are also called first-generation antipsychotics or traditional antipsychotics, include chlorpromazine and haloperidol. On the other hand, atypical antipsychotic pharmacological agents, which are also called second generation antipsychotics, include risperidone, quetiapine, and olanzapine. Both typical and atypical antipsychotics work in similar mechanisms by inhibiting the activation of specific receptors in the dopamine pathway.Aim of work: In this review, we will discuss the antipsychotics- classification, uses, and adverse effects, Methodology: We did a systematic search for antipsychotics- classification, uses, and adverse effects using PubMed search engine (http://www.ncbi.nlm.nih.gov/) and Google Scholar search engine (https://scholar.google.com). All relevant studies were retrieved and discussed. We only included full articles.Conclusions: The prescription of atypical antipsychotic agents, like quetiapine and olanzapine, has been significantly increasing and in many conditions, they are sometimes prescribed “off-label” – which is a worrying trend due to their possible risk of developing harmful adverse events. Therefore, atypical antipsychotic agents must only be used in their specific indications and with caution, especially among older patients and young adults. Atypical antipsychotic agents can be indicated for schizophrenia treatment and other associated conditions and in some cases to treat the behavioral and psychological manifestations related to dementia (risperidone only). Antipsychotics are not first-line treatments for patients with anxiety and are not generally recommended for the use in patients with posttraumatic stress disorder or insomnia. Key words: antipsychotics, classification, uses, and adverse effects