The prevalence of depression among adult asthmatic patients in Jizan Region, Saudi Arabia

Background: Depression is an important issue in asthma. Uncover depression in asthmatic patients has important implications for identifying patients and suitable treatment of these patients this will improve quality of life, decrease medication intake and decrease hospitalization.Objective: The aim of this study was to determine the prevalence of depression among adult asthmatic patients in Jizan region, Saudi Arabia.Patients and methods: Cross-sectional study that was conducted in Jizan region at the chest diseases hospital. 270 (18-90 yrs.) asthmatic patients were recruited. The questionnaire including socio-demographic data, clinical risk factors of asthma, assessment of asthma by using asthma control test (ACT) and assessment of depression by using Patient Health Questionnaire-9 (PHQ-9).Results: Out of 270 adult asthmatic patients, 255 responded (94.4%). The mean age of patients was 41.03 ± 15.893 years. The prevalence of depression among adult asthmatic patients was 32.9%. By multivariate analysis the lower education level [elementary school or below (Odds ratio 3.219 (95% CI; 1.443-7.177)] and longer asthma duration (22 years and above) Odds ratio 2.065 (95% CI; 1.089-3.916) were independently associated with the development of depression in adult patients with asthma.Conclusion: The study showed that there was a high prevalence of depression among adult asthmatic patients in Jizan region, Saudi Arabia. The higher prevalence of depression was associated with lower education level, longer asthma duration, poor control of asthma and among married subjects. Screening for depression in adult asthmatic patients should be emphasized in primary health care centers, chest clinics and in hospitals. Adult asthmatic patients should be motivated to comply with asthma treatment

Superimposed structure in the southern periphery of Abu Gharadig Basin, Egypt: Implication to petroleum system

South West Abu-Sennan (SWS) area near the southern periphery of the Abu-Gharadig petroliferous basin in the Egyptian Northern Western Desert is an important hydrocarbon field characterized by being a multi-reservoir with a complex structural architecture. Therefore, in this study, we illustrated the regional structural role that facilitated having Jurassic mature source rocks (Masajid and Khatatba formations) through surgical seismic interpretation and observed the controlling petroleum system of the study area using a set of 20 seismic lines and 4 wells data. The study resulted in having the SWS oil field controlled by a strike-slip movement that occurred during the Upper Cretaceous time accompanying the African Plate movement against the Eurasian Plate superimposing an ENE–WSW strike-slip fault zone in the region and a strong pattern of NW–SE-oriented faults due to numerous phases of extension. The associated structures include horsts, normal fault propagation folds, and strike-slip-related anticlines. The strike-slip tectonics played a major role in forming entrapment for the Jurassic expelled hydrocarbons. The seismic horizons flattening exercise performed on AR/G member and Khoman Formation demonstrated that the main reason for not having hydrocarbon accumulations in the Jurassic levels in the study area is that the trap configuration was ready to accumulate hydrocarbon but after the hydrocarbon generation and migration time. The study concluded that the hydrocarbons migrated along the faults which cut deeply to the source rocks and entrapped in the possible cretaceous reservoirs during the late cretaceous time. The conducted workflow in this study can be utilized to better explore and develop cretaceous reservoirs in the study and neighbouring areas

A hidden cause of infertility in hypothyroid patients

Methylene tetrahydrofolate reductase (MTHFR) gene mutations could be the cause of infertility in hypothyroid patients. Hence, it is worthy to screen for MTHFR gene mutations in infertile hypothyroid females and their partners if infertility persists after optimizing thyroid function

Role of diffusion-weighted magnetic resonance imaging in the differentiation of benign and malignant pulmonary lesions

Purpose: To evaluate the role of magnetic resonance (MRI) diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) measurement of solid and cystic pulmonary masses in differentiating benign from malignant lesions. Material and methods: The study included 41 patients with pulmonary masses, who underwent conventional MRI and DWI (b value 0, 500, and 1000 s/mm²) examinations with 1.5-T MRI. The diffusion signal and the mean ADC values of the solid and cystic lesions were obtained. Statistical analyses were performed with the Mann-Whitney U test (z), Pearson's chi-square test, and receiver operating characteristic (ROC) analysis. Results: Thirty-three lesions were malignant, and eight lesions were benign. The malignant masses showed significantly higher signal intensity on DWI than benign masses (p = 0.006), and the mean ADC value of malignant solid lesions was significantly lower than that of benign lesions (p = 0.02). By ROC analysis, an ADC cut-off value of 1.4 × 10-3 mm2/s was considered the threshold value, and the sensitivity and specificity were 93.8% and 75%, respectively. There was no significant difference between the ADC value of the cystic parts inside the benign and the malignant lesions. Conclusions: Diffusion-weighted MRI and measurement of ADC value can significantly differentiate between solid benign and malignant pulmonary masses

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Grain-Scale Plasticity Based Fatigue Modelling Of Metal Bridges Materials

This study investigates fatigue behavior at the grain-scale in structural steel, a crucial issue for ensuring the safety and dependability of steel bridges in modern railway transportation systems. The field of bridge engineering has undergone significant transformation in recent years, transitioning from wrought iron to contemporary structural steels, resulting in a revolutionary impact on methodologies. The study uses a two-fold methodology, integrating computational models and experimental validation, to understand fatigue at the grain level. Using numerical crystal plasticity finite element (CPFE) modeling, it provides a comprehensive understanding of microstructural characteristics' impact on fatigue performance. This evaluation is crucial for assessing fatigue susceptibility in existing bridges, especially those built using older technologies and exposed to modern traffic demands. This study analyzes the relationship between microscale and mesoscale fatigue behavior using CPFE RVE analysis and FeSafe simulations. It examines the impact of microstructural characteristics on fatigue start and propagation, while providing forecasts of macroscopic fatigue behaviors under realistic loading situations. Comparing stress-life curves at grain-scale and mesoscale levels provides insight into the material's overall fatigue behavior. In essence, this study provides a comprehensive understanding of the fatigue characteristics at the grain level in structural steel, so acting as a fundamental contribution to the progress of materials science and engineering methodologies. The study provides a comprehensive analysis of fatigue mechanisms by integrating microscale insights with macroscopic fatigue responses. This not only enhances our understanding of fatigue mechanisms but also provides practical guidance for the design and maintenance of durable bridges that can withstand the challenging conditions of contemporary railway transportation systems

Jaffe-Campanacci syndrome; a case series and review of the literature

Abstract Background Jaffe-Campanacci syndrome is a rare syndrome, characterized by multiple non-ossifying fibromas (NOF) and cafe-au-lait patches. The name was coined in 1982 by Mirra after Jaffe who first described the case in 1958. Although it’s suggested there is a relation with Neurofibromatosis type 1, there is still no consensus on whether Jaffe-Campanacci syndrome is a subtype or variant of neurofibromatosis-1(NF-1). Case presentation In this article, we present a case series of 2 patients. The first case is a 13-year-old male with Jaffe-Campanacci syndrome who presented with a distal femur fracture. His father had positive features of both Jaffe-Campanacci syndrome and NF-1, while his sister only had features of NF-1, so we presented both. Conclusion Jaffe-Campanacci has a clear relationship with type 1 neurofibromatosis, which still has to be genetically established. Due to the presence of several large non-ossifying fibromas of the long bones, it is linked to a significant risk of pathological fractures. We concur with previous authors, that an osseous screening program should be performed for all patients with newly diagnosed type 1 neurofibromatosis, to identify non-ossifying fibromas and assess the potential for pathological fracture. Moreover, siblings of patients with NF-1 should be screened for multiple NOFs that may carry a high risk of pathological fractures