The Comprehension of Synonyms by Saudi EFL Learners: Acquisition and Pedagogical Implications

This study investigates 40 Saudi EFL learners’ receptive knowledge of synonyms in English. It also tests whether the participants’ English proficiency level plays a role in their comprehension of English synonyms. To achieve this, the researcher designed a multiple-choice test to measure Saudi EFL learners’ ability to recognise the correct English synonym in contextualised sentences. In order to test whether the English proficiency level of the participants plays a role in their comprehension of English synonyms, the participants were divided on the basis of their scores on the Oxford Placement Test into two groups: 20 Advanced Learners (ALs) and 20 Intermediate Learners (ILs). Twenty native speakers of English (NSs) acted as the control group. The native speakers’ answers on the multiple-choice test were considered as the accurate answers. The answers provided by the ALs and ILs were compared to those provided by the NSs to determine whether the answers of the former approximate those of the latter. A Chi-square test was employed to determine whether the differences between the three groups, ALs, ILs and NSs on the multiple-choice test were statistically significant. The results reveal that the answers supplied by the ILs differed statistically from those of NSs on all items on the multiple-choice test, whereas those provided by the ALs differed significantly from those of the NSs on eight items. The results also show that participants’ English proficiency level may not have played a role in their ability to recognise the correct synonym on all items on the test. The researcher argued that the main sources of error were interference habits from the participants’ first language (L1), lack of awareness of the semantic differences between the synonyms in English and lack of familiarity with English collocations. The study concluded with some pedagogical implications for ESL/EFL teachers in the context of teaching English synonyms to L2 students

Medication prescribing errors in a pediatric inpatient tertiary care setting in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Medication errors (MEs) are among the most common types of medical errors and one of the most common and preventable causes of iatrogenic injuries. The aims of the present study were; (i) to determine the incidence and types of medication prescribing errors (MPEs), and (ii) to identify some potential risk factors in a pediatric inpatient tertiary care setting in Saudi Arabia.</p> <p>Findings</p> <p>A five-week retrospective cohort study identified medication errors in the general pediatric ward and pediatric intensive care unit (PICU) at King Abdulaziz Medical City (KAMC) through the physical inspection of physician medication orders and reviews of patients' files. Out of the 2,380 orders examined, the overall error rate was 56 per 100 medication orders (95% CI: 54.2%, 57.8%). Dose errors were the most prevalent (22.1%). These were followed by route errors (12.0%), errors in clarity (11.4%) and frequency errors (5.4%). Other types of errors were incompatibility (1.9%), incorrect drug selection (1.7%) and duplicate therapy (1%). The majority of orders (81.8%) had one or more abbreviations. Error rates were highest in prescriptions for electrolytes (17.17%), antibiotics (13.72%) and bronchodilators (12.97%). Medication prescription errors occurred more frequently in males (64.5%), infants (44.5%) and for medications with an intravenous route of administration (50.2%). Approximately one third of the errors occurred in the PICU (33.9%).</p> <p>Conclusions</p> <p>The incidence of MPEs was significantly high. Large-scale prospective studies are recommended to determine the extent and outcome of medication errors in pediatric hospitals in Saudi Arabia.</p

Effect of General Anesthesia on Postoperative Cognitive Function in Elderly Patients

The prevalence of postoperative cognitive dysfunction continues to be significant following surgical procedures. It has been posited that external factors, among which the type of anesthesia plays a vital role, are significant contributors to POCD. In older adults, cognitive decline post-surgery can lead to devastating physical, psychological, and societal impacts. Advancing our comprehension of cognitive deterioration postoperatively is critical for eradicating this potentially avoidable contributor to cognitive decline. Therefore, a thorough grasp of the cognitive repercussions of various anesthetic agents used intraoperatively has become crucial. This surge of interest has propelled research focusing on the repercussions of general anesthesia on post-surgical cognitive abilities. The objective of this literature review is to enrich readers\u27 insights into POCD among the geriatric demographic and to scrutinize the evidence of how various anesthetic components—mainstay anesthetics, supplemental agents, and sedatives—influence postoperative cognition. Prior to the 1950s assumptions, it was surmised that anesthesia merely rendered cerebral functions dormant during surgery, with normalcy resuming upon awakening. Contemporary understanding now acknowledges the nuanced impact of anesthetics, which instigate distinctive alterations in specific cerebral activities and memory capacities. Concerns about post-surgical cognitive deficit burgeoned with the advent of inhalational anesthetic pharmacology, paralleled by heightened life expectancy and health service utilization in the aging population. While minor surgical interventions like dental extractions, often under local anesthesia, were thought to yield better cognitive outcomes, this notion was upended by Bedford\u27s revelation in 1960 that major surgical procedures such as coronary bypass, involving cardiopulmonary bypass and extended hypothermia, markedly disrupted cognitive faculties. This link between significant surgical interventions and cognitive impairment fueled further inquiry into the influence of surgery and anesthetic agents on postoperative brain function. The late 1970s witnessed heightened awareness of postoperative "forgetfulness" in the aged, evolving into substantial focus in the late 1990s. At that point, profound documentation surfaced indicating cognitive decline post-surgery was pervasive across all ages but was especially pronounced in elderly individuals—representing a critical public health concern. The era following this revelation has witnessed an avalanche of studies probing into POCD

Knowledge and Awareness of Diabetes Mellitus Disease among High School Students in King Abdulaziz Military City, Tabuk, Saudi Arabia

BACKGROUND: Saudi Arabia is considered to be one of the highest countries in the Middle East for the incidence of diabetes mellitus (DM). Data are lacking regarding knowledge and awareness about DM among school students in Saudi Arabia. AIM: The study aimed to assess the level of knowledge and awareness of DM among high school students within the military city, Tabuk, Saudi Arabia. METHODS: A descriptive type of cross-sectional study was conducted among 278 high school students applying a convenience sampling technique. The sample size was calculated using OpenEpi, Version 3. Self-administered questionnaires were distributed to the high school students (male and female) after official communication with the school’s dean. The level of knowledge and awareness was categorized into “adequate” and “inadequate” as per each topic/question, and also as per each response/answer. Data entry and analysis were carried out using the Statistical Package for the Social Sciences. Pearson’s Chi-square tests were performed to explore if there is any significant association between the knowledge and awareness level of the high school students and their (i) gender, (ii) age, and (iii) level of education. RESULTS: More than half of the high school students had adequate level of knowledge and awareness about DM in terms of symptoms (67.3%), complications (56.5%), monitoring method (62.6%), lifestyle modifications (63.7%), frequency of routine eye check-up (63.3%), important factors for blood sugar control (79.1%), treatment (56.5%), and management of hypoglycemia symptoms (57.6%). On the contrary, a large number of the students showed inadequate level of knowledge and awareness about the disease in terms of definition (80.6%), major causes (57.9%), effect of high blood pressure (51.8%), frequency of routine blood pressure check-up (55%), rationale of a regular urine test (58.3%), medication for DM (66.9%), and duration of medication (69.8%). However, no significant associations were found between the knowledge and awareness level of the high school students about the definition or major causes of DM and the (i) gender, (ii) age group, and (iii) level of education of the students. CONCLUSION: The level of knowledge and awareness of a considerable number of high school students regarding DM was inadequate, and some of them possessed various misconceptions about this particular chronic disease. Health authorities and school authorities in the region should offer special efforts to improve the level of knowledge and awareness of the students through regular health education campaigns

Theoretical study of the antioxidant mechanism and structure-activity relationships of 1,3,4-oxadiazol-2-ylthieno[2,3-d]pyrimidin-4-amine derivatives: a computational approach

A theoretical thermodynamic study was conducted to investigate the antioxidant activity and mechanism of 1,3,4-oxadiazol-2-ylthieno[2,3-d]pyrimidin-4-amine derivatives (OTP) using a Density Functional Theory (DFT) approach. The study assessed how solvent environments influence the antioxidant properties of these derivatives. With the increasing prevalence of diseases linked to oxidative stress, such as cancer and cardiovascular diseases, antioxidants are crucial in mitigating the damage caused by free radicals. Previous research has demonstrated the remarkable scavenging abilities of 1,3,4-oxadiazole derivatives, prompting this investigation into their potential using computational methods. DFT calculations were employed to analyze key parameters, including bond dissociation enthalpy (BDE), ionization potential (IP), proton dissociation enthalpy (PDE), and electron transfer enthalpy (ETE), to delineate the antioxidant mechanisms of these compounds. Our findings indicate that specific electron-donating groups such as amine on the phenyl rings significantly enhance the antioxidant activities of these derivatives. The study also integrates global and local reactivity descriptors, such as Fukui functions and HOMO-LUMO energies, to predict the stability and reactivity of these molecules, providing insights into their potential as effective synthetic antioxidants in pharmaceutical applications

Evaluation of time to sputum smear conversion and its association with treatment outcomes among drug-resistant tuberculosis patients: a retrospective record-reviewing study

Background: This study examined the time to sputum smear and culture conversion and determinants of conversion, as well as variables associated with treatment outcomes among drug-resistant pulmonary tuberculosis (DR-PTB) cases.Methods: The electronic database and written medical records of patients were utilized to assess the sociodemographic, clinical, microbiological, and treatment characteristics and outcomes of study participants.Results: Among 736 patients with pulmonary tuberculosis (PTB), the mean age was 36.5 ± 16.5 years, with males comprising 53.4% and a mean weight of 47.76 ± 11.97 kg. The median time period for sputum smear conversion and sputum culture conversion was a month. The first-month culture conversion (p &lt; 0.001, aOR = 5.817, and 95% CI = 3.703–9.138) was the determinant of sputum smear conversion and receiver operating curve analysis with AUC = 0.881, 95% CI = 0.855–0.907, and p &lt; 0.001, which showed a high level of predictive ability for the regression model for the initial sputum smear conversion. However, the first-month sputum conversion (p &lt; 0.001, aOR = 7.446, and 95% CI = 4.869–11.388) was attributed to sputum culture conversion, and the model has shown excellent predictive ability for regression with ROC curve analysis demonstrating AUC = 0.862, 95% CI = 0.835–0.889, and p &lt; 0.001. A total of 63.2% of patients showed favorable treatment outcomes, with 63.1% of cases achieving treatment-cured status. The previous use of SLD, history of smoking, duration of illness ≤ 1 year, extensively drug-resistant tuberculosis, and first-month sputum conversion were the variables attributed to favorable treatment outcomes observed in drug-resistant pulmonary tuberculosis cases. ROC curve analysis with AUC = 0.902, 95% CI = 0.877–0.927, and p &lt; 0.001) has shown outstanding ability for regression model prediction for the variables influencing treatment outcomes.Conclusions: Within 2 months of treatment, most patients had converted their sputum cultures and sputum smears. The determinants of early sputum smear and sputum culture conversion, as well as favorable treatment outcomes, were identified. These factors should be considered during the design and implementation of effective strategies for drug-resistant tuberculosis control programs

The Important Role of Optometrist and Qualified Nursing in Primary Healthcare for Eye Care

The use of evidence-based practice is essential for delivering high-quality care, ensuring patient satisfaction, and making efficient use of limited healthcare resources. Nevertheless, there have been reports of inconsistency in the administration of evidence-based eye care. To enhance our comprehension of the obstacles and enablers to delivering optometric care, it is necessary to recognize the significant role that optometrists play in providing primary eye care. This narrative study sought to identify the provision of eye care services by optometrists and measures that could enhance the delivery of eye care in primary care settings, alongside certified nursing. In the field of optometry, similar to other healthcare professions like nursing, there has been a broadening of the optometrist\u27s responsibilities in primary eye care. This includes taking on tasks such as prescription medication, which was previously done by general practitioners. Within the field of optometry, this expanded responsibility entails overseeing eye diseases that do not necessitate treatment or monitoring in secondary healthcare settings, which were historically referred to. Nevertheless, any expanded responsibility necessitates educational assistance

Perceived Risk of falls among Acute Care Patients

Purpose: In an effort to lower the number of falls that occur among hospitalized patients, several facilities have begun introducing various fall prevention programs. However, the efficacy of fall prevention programs is diminished if patients do not consider themselves to be at risk for falls and do not follow recommended procedures. The goal of this study was to characterize how patients in four different acute care specialist services felt about their risk of falling while in the hospital. Methods: One hundred patients admitted to the study hospital with a Morse Fall Scale score of 45 or higher were given the Patient Perception Questionnaire, a tool designed to assess a patient's perception of their own fall risk, fear of falling, and motivation to take part in fall prevention efforts. Scores on the Morse Fall Scale were gathered through a historical assessment of medical records. Descriptive statistics, Pearson's correlation coefficients, and independent sample t tests were used to examine the data. Results: The average age was 65, and around half (52%) were men and half (48%) were women. Based on their ratings on the Morse Fall Scale, all 100 participants were classified as being at high risk for falls. However, only 55.5% of the individuals agreed with this assessment. The likelihood that a patient would seek assistance and the degree to which they feared falling both declined as their faith in their mobility improved. Patients hospitalized after a fall exhibited considerably lower confidence scores and greater fear scores than patients who had not been injured in a fall. Conclusions: Patients who have a high fall risk assessment score may not believe they are at risk for falls and may not take any steps to reduce their risk. The prevalence of falls in hospitals might be mitigated by the creation of a fall risk assessment technique that takes into account both objective and subjective factors

Ketamine-based sedation use in mechanically ventilated critically ill patients with COVID-19: A multicenter cohort study

Backgrounds: Ketamine possesses analgesia, anti-inflammation, anticonvulsant, and neuroprotection properties. However, the evidence that supports its use in mechanically ventilated critically ill patients with COVID-19 is insufficient. The study's goal was to assess ketamine's effectiveness and safety in critically ill, mechanically ventilated (MV) patients with COVID-19. Methods: Adult critically ill patients with COVID-19 were included in a multicenter retrospective-prospective cohort study. Patients admitted between March 1, 2020, and July 31, 2021, to five ICUs in Saudi Arabia were included. Eligible patients who required MV within 24 hours of ICU admission were divided into two sub-cohort groups based on their use of ketamine (Control vs. Ketamine). The primary outcome was the length of stay (LOS) in the hospital. P/F ratio differences, lactic acid normalization, MV duration, and mortality were considered secondary outcomes. Propensity score (PS) matching was used (1:2 ratio) based on the selected criteria. Results: In total, 1,130 patients met the eligibility criteria. Among these, 1036 patients (91.7 %) were in the control group, whereas 94 patients (8.3 %) received ketamine. The total number of patients after PS matching, was 264 patients, including 88 patients (33.3 %) who received ketamine. The ketamine group's LOS was significantly lower (beta coefficient (95 % CI): −0.26 (−0.45, −0.07), P = 0.008). Furthermore, the PaO2/FiO2 ratio significantly improved 24 hours after the start of ketamine treatment compared to the pre-treatment period (6 hours) (124.9 (92.1, 184.5) vs. 106 (73.1, 129.3; P = 0.002). Additionally, the ketamine group had a substantially shorter mean time for lactic acid normalization (beta coefficient (95 % CI): −1.55 (−2.42, −0.69), P 0.01). However, there were no significant differences in the duration of MV or mortality. Conclusions: Ketamine-based sedation was associated with lower hospital LOS and faster lactic acid normalization but no mortality benefits in critically ill patients with COVID-19. Thus, larger prospective studies are recommended to assess the safety and effectiveness of ketamine as a sedative in critically ill adult patients