The influence of community on Transient evoked otoacoustic emissions (TEOAEs) in Iraqi subjects with normal hearing.

Background: The purpose of this study was to compare the parametric measurements of transient otoacoustic (TEOAEs) in normal hearing subjects between two clinical centers in Iraq and to examine the community effect on TEOAEs characteristics. Patients and Methods: Transient otoacoustic emission (TEOAEs) were obtained from eighty subjects (160 ears)-males and females aged (10-20 years), with Forty (40) subjects in Baghdad audiology center and forty subjects in Sulaimania audiology center (North of Iraq)[ Kurdistan-Iraq], in standard, non-linear “Fast Screen” mode. Hearing thresholds, tympanometric, and TEOAE-parameters were recorded between two clinical center groups. Results: The cross correlation (wave reproducibility) was constant between two groups. The mean Signal to noise ratio (SNRs) for all (160 ears) were well above 3 dB at frequencies 1K, 2K, 3K, 4K and 5 KHz. The Sulaimania –subjects group showed the lowest SNR in low frequency (1 KHz) and middle frequency (3 KHz) than the Baghdad-subjects group. No statistical difference was observed in other frequency bands, and in overall mean SNRs between two groups. Conclusions: The observed differences of SNRs at low and middle frequency bands are most likely related to differences in ear canal volume and/or to differences in cochlear mechanisms. The values obtained in the present study can be used as normative data for screening and diagnostic purposes in Iraqi subjects aged (10-20 years)

Assessing Physiological and Psychological Factors Contributing to Stress among Medical Students: Implications for Health

Background: Physiological responses to stress disturb internal homeostasis, leading to serious health consequences. Medical students experience high stress levels that should be managed promptly to prevent stress-related impacts on students’ health and education. Aim: This study aims to identify the relationship between stress factors, general health, and academic performance. Methods: This study recruited 421 medical students of all academic years. Participants completed an online survey assessing stress levels using a validated 10-item Perceived Stress Scale. Stress was also compared with students’ health and academic performance. Results: We found that 93.6% of our sample experienced moderate to severe stress, and 31% reported increased stress due to the coronavirus disease (COVID-19) pandemic. Except for internship students, stress significantly decreases as students progress each academic year (p < 0.05). Students with higher GPAs and with comorbidities are more stressed. Comorbidities were primarily reported in students in their final years of education with a 4% lower GPA than healthy students. Although we had three stress-related themes (general, academic, and pandemic), students’ perceptions of stress factors were primarily academically related. Conclusions: Students experience high stress levels in their final educational years, which might increase the risk of health issues and low academic performance. It is essential to innovate stress-coping strategies specially designed for medical students and mandatorily provided by all medical colleges and to educate students on the effects of stress on their health

Drug resistant tuberculosis in Saudi Arabia: an analysis of surveillance data 2014–2015

Abstract Background There is limited data that investigates the national rates of drug-resistant tuberculosis (TB) in Saudi Arabia. This study aimed to estimate the rates of multi-drug-resistant tuberculosis (MDR-TB), rifampicin-resistant tuberculosis (RR-TB), and monoresistance (MR) in Saudi Arabia. Methods A retrospective cohort study was conducted on all TB cases reported to the National TB Control and Prevention Program (NTCPP) registry at the Saudi Ministry of Health between January 1, 2014 and December 31, 2015. A total of 2098 TB patients with positive TB cultures were included in the study. Subgroup analyses and multivariate binary logistic regression models were performed with IBM SPSS 23.0. Results Of the total TB cases, 4.4% (95% CI: 3.59%–5.40%) were found to have MDR-TB. The rates of MR were 3.8% (95% CI: 2.99%–4.67%) for ethambutol, 5.4% (95% CI: 4.50%–6.49%) for pyrazinamide, 10.2% (95% CI: 5.89%–11.52%) for isoniazid, 11% (95% CI: 9.70%–12.43%) for streptomycin, and 5.9% (95% CI: 4.90%–6.96%) for rifampicin. The high rates of MDR and RR-TB were found among the younger age group, female gender, and those who had a previous history of TB. We also discovered that renal failure tends to increase the risk of rifampicin resistance. Conclusions National TB data in Saudi Arabia shows that the rate of MDR-TB was similar to the global rate reported by the World Health Organization (WHO). It is a relatively high rate as compared to Western countries. The proportion of MDR/RR-TB patients tends to be higher in the younger age group, female gender, and in patients with a previous history of TB treatment. Effective strategies for prevention of all multi-drug-resistant TB cases are warranted

Bioinformatics and immunoinformatics assisted multiepitope vaccine construct against Burkholderia anthina

Burkholderia anthina is a pathogenic bacterial species belonging to the Burkholderiaceae family and it is mainly considered the etiological agent of chronic obstructive pulmonary diseases associated with cystic fibrosis, due to being intrinsic antibiotic resistant making it difficult to treat pulmonary infections. Hence increased rate of antibiotic-resistant bacterial species vaccine development is the priority to tackle this problem. In research work, we designed a multi-epitope-based vaccine construct against B. anthina using reverse vaccinology immunoinformatics and biophysical approaches. Based on the subtractive proteomic screening of core proteins we identified 3 probable antigenic proteins and good vaccine targets namely, type VI secretion system tube protein hcp Burkholderia, fimbria/pilus periplasmic chaperone and fimbrial biogenesis outer membrane usher protein. The selected 3 proteins were used for B and B cells B-derived T-cell epitopes prediction. In epitopes prediction, different epitopes were predicted with various lengths and percentile scores and subjected to further immunoinformatics analysis. In immunoinformatics screening a total number of 06, IDDGNANAL, KTVKPDPRY, SEVESGSAP, YGGDLTVEV, SVSHDTNGR, and GSKADGYQR epitopes were considered good vaccine target candidates and shortlisted for vaccine construct designing. The vaccine construct was designed by joining selected epitopes with the help of a GPGPG linker and additionally linked with cholera toxin b subunit adjuvant to increase the efficacy of the vaccine construct the sequence of the said adjuvant were retrieved from protein data bank through its (PDB ID: 5ELD). The designed vaccine construct was evaluated for its physiochemical properties analysis in which we reported that the vaccine construct comprises 216 amino acids with a molecular weight of 22.37499 kilo Dalton, 15.55 instability index (II) is computed, and this classifies that the vaccine construct is properly stable. VaxiJen v2.0 web server predicted that the vaccine construct is probable antigenic in nature with 0.6320 predicted value. Furthermore AllerTOP v. 2.0 tool predicted that the designed vaccine construct is non allergic in nature. Molecular docking analysis was done for analysis of the binding affinity of the vaccine construct with TLR-2 (PDB ID: 6NIG), the docking results predicted 799.2 kcal/mol binding energy score that represents the vaccine construct has a good binding ability with TLR-2. Moreover, molecular dynamic simulation analysis results revealed that the vaccine construct and immune cell receptor has proper binding stability over various environmental condition, i.e. change in pressure range, temperature, and motion. After each analysis, we observed that the vaccine construct is safe stable, and probably antigenic and could generate an immune response against the target pathogen but in the future, experimental analysis is still needed to verify in silico base results

Traumatic Injuries of the Dorso-lumbar Spine, Review of Surgical Approaches

In this review we supply information on medical methods for thoraco-lumbar spine fracture management, their efficiency and complication rates, based on previously published researches and also give background information on epidemiology and classification of thoraco-lumbar fractures. We conducted a narrative review over the literature using electronic databases as; MEDLINE, and EMBASE for studies involving data on Dorso-lumbar Spine traumatic injuries, published in September 2019. Spine fractures account for a large portion of musculoskeletal injuries worldwide. A classification of back cracks is essential in order to establish a typical language for therapy indicators and results. Clinical exam, mechanism of injury, and imaging are heavily trusted to choose regarding medical versus non-surgical management

Relationship between obesity and immunological parameters among students at the PSAU University-Alkharj, KSA

Obesity represents a major worldwide health problem, all aspects of which have not fully defined, nor fully understood.  In the current study, we investigated a population of university students in terms of the relationship between incidence of obesity in individuals (n=171),within this larger cohort (n=500), with the comorbidities that these high BMI individuals also carried. We also report important statistical differences in blood levels each of cardiac-related protein (CRP)(p=0.002), IL-6(p=0.005), &leptin(p=0.02), when we related the blood values with individual student BMIs which were used as a measure of obesity

Relationship Between Obesity and Immunological Parameters Among Students at the PSAU University-Alkharj, KSA

Obesity represents a major worldwide health problem, all aspects of which have not fully defined, nor fully understood.  In the current study, we investigated a population of university students in terms of the relationship between incidence of obesity in individuals (n=171),within this larger cohort (n=500), with the comorbidities that these high BMI individuals also carried. We also report important statistical differences in blood levels each of cardiac-related protein (CRP)(p=0.002), IL-6(p=0.005), &leptin(p=0.02), when we related the blood values with individual student BMIs which were used as a measure of obesity