Effect of four irrigation solutions on the intraocular pressure and total bacterial count of the normal eye in dogs

There are numerous agents that have been used for irrigation of the ocular tissue from attached foreign bodies, inflammatory exudate and microorganisms. For evaluation of four agents of these irrigation solutions, sixteen clinically healthy dogs of both sexes were used in this study. The dogs were allocated into four equal groups. The right eye of dogs for each group was irrigated 3 times daily for three successive days. The groups were irrigated as following: The first group: ringer’s lactate, the second group: normal saline 0.9%, the third group: boric acid 2% and sodium bicarbonate 1% was used for the fourth group. The left eye was considered control one. The results revealed that the four solutions did not cause any obvious alteration of the eyes and change the intraocular pressure (IOP). According to their effects on the total bacterial count, the four irrigation solutions had not any significant effect. It could be concluded that all of these agents may be used for irrigation of the intact eye and removal of the attached exudate and foreign bodies

Emirates consensus recommendations on cardiovascular risk management in type 2 diabetes

BackgroundThe combination of cardiovascular disease and diabetes is a highly prevalent condition in the United Arab Emirates. Development and dissemination of evidence-based regional recommendations for optimal screening, treatment and referrals of people with diabetes and high cardiovascular risk is an important priority.Consensus panelAn expert panel of diabetologists, endocrinologists and cardiologists from the Emirates Cardiac Society and Emirates Diabetes and Endocrine Society as well as different entities in the UAE, discussed and reviewed evidence and also a consensus report from the American Diabetes Association to formulate contextualized recommendations that could be applied for optimal management of cardiovascular risk in people with diabetes in the UAE.Consensus findingsThe combination of heart failure and other cardiovascular risks is a highly prevalent finding among people with diabetes in the United Arab Emirates. The causal inter-relationships between diabetes and heart failure are multifactorial and regular assessments of symptoms and steps for mitigation of risk factors are an important priority. The universal definition and classification of heart failure provides a useful framework for recommending optimal screening, treatment, and referral strategies to diabetic individuals at various stages of the cardiovascular continuum. Routine measurement (at least yearly) of natriuretic peptides and high-sensitivity troponins can help identify patients requiring cardiac imaging referrals. However, recommending routine measurements of natriuretic peptides and/or high-sensitivity troponins to all diabetic individuals must balance clinical judgment and cost implications. While SGLT2i must be an important part of the standard of care, insulin, GLP1 receptor agonists and/or metformin can be useful for additional glycemic control.ConclusionThe consensus panel hopes that the recommendations presented herein can offer guidance for optimal screening, treatment and referral of people with a concomitance of diabetes and high cardiovascular risk in the United Arab Emirates

Left Main Coronary Artery Revascularization in Patients with Impaired Renal Function: Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting

Introduction: The evidence about the optimal revascularization strategy in patients with left main coronary artery (LMCA) disease and impaired renal function is limited. Thus, we aimed to compare the outcomes of LMCA disease revascularization (percutaneous coronary intervention [PCI] vs. coronary artery bypass grafting [CABG]) in patients with and without impaired renal function. Methods: This retrospective cohort study included 2,138 patients recruited from 14 centers between 2015 and 2,019. We compared patients with impaired renal function who had PCI (n= 316) to those who had CABG (n = 121) and compared patients with normal renal function who had PCI (n = 906) to those who had CABG (n = 795). The study outcomes were in-hospital and follow-up major adverse cardiovascular and cerebrovascular events (MACCE). Results: Multivariable logistic regression analysis showed that the risk of in-hospital MACCE was significantly higher in CABG compared to PCI in patients with impaired renal function (odds ratio [OR]: 8.13 [95% CI: 4.19–15.76], p < 0.001) and normal renal function (OR: 2.59 [95% CI: 1.79–3.73]; p < 0.001). There were no differences in follow-up MACCE between CABG and PCI in patients with impaired renal function (HR: 1.14 [95% CI: 0.71–1.81], p = 0.585) and normal renal function (HR: 1.12 [0.90–1.39], p = 0.312). Conclusions: PCI could have an advantage over CABG in revascularization of LMCA disease in patients with impaired renal function regarding in-hospital MACCE. The follow-up MACCE was comparable between PCI and CABG in patients with impaired and normal renal function

Laryngofissure in comorbid patient under ultrasound-guided regional anesthesia of the neck

Abstract Background Major neck surgery is done typically under general anesthesia (GA). The neural blocks of the neck include blocking of the cervical plexus, superior laryngeal nerve, trans-laryngeal, block of the glossopharyngeal nerve, and local anesthetic infiltration. In patients with a high risk of GA, including those with pulmonary dysfunction, and prior myocardial ischemia or infarction, regional anesthesia is mainly indicated. Case presentation We record a case of a comorbid geriatric patient with dysphonia and left glottic mass that was diagnosed as squamous cell papilloma by transoral biopsy using curved biopsy forceps under local spray anesthesia, and after 6 months, this patient developed stridor for which tracheostomy, laryngofissure, and left cordectomy were then performed solely under neck blocks. Surgery was performed while the patient remained pain-free and stable without any morbidity throughout the operation. Conclusions In high-risk patients and low-resource health systems, regional anesthesia in neck surgery can be a reasonable and cheap alternate to general anesthetics. </jats:sec

Achieving resilience in COVID-19's New Normal: Changes in office buildings and workspaces design according to social distancing and teleworking parameters

Architects still aim to immortalize their buildings and achieve resilience against changes that threaten their designs to be futility. The struggle to keep buildings from crises and their consequences is a challenge. The buildings' persistence is a design success. Pandemics and crises are an invisible enemy of both humanity and buildings. Viruses can make buildings deserted due to changing uses, failure to up-to-date with the era's technologies, or failure of their designs to resist health crises. The resilient architectural design can withstand during and after crises. Now, the world is suffering from the COVID-19 pandemic. The new health's enemy threatens our work style, and it causes economic collapse. Office buildings face the greatest danger that destabilizes their prosperity. Unfortunately, office buildings have not been designed to be healthy places. Precautionary measures, especially social distancing and teleworking, will cause enormous changes in office buildings and workspaces' design. These changes do not limit to new buildings but existing ones also. This research aims to simulate the future design changes in office buildings and workspaces caused by social distancing and telework to achieve architectural resilience against current and future health crises caused by infectious diseases

Handling Multicollinearity and Outliers in Logistic Regression Using the Robust Kibria&ndash;Lukman Estimator

Logistic regression models encounter challenges with correlated predictors and influential outliers. This study integrates robust estimators, including the Bianco&ndash;Yohai estimator (BY) and conditionally unbiased bounded influence estimator (CE), with the logistic Liu (LL), logistic ridge (LR), and logistic KL (KL) estimators. The resulting estimators (LL-BY, LL-CE, LR-BY, LR-CE, KL-BY, and KL-CE) are evaluated through simulations and real-life examples. KL-BY emerges as the preferred choice, displaying superior performance by reducing mean squared error (MSE) values and exhibiting robustness against multicollinearity and outliers. Adopting KL-BY can lead to stable and accurate predictions in logistic regression analysis

فعالية العلاج المرتكز على الانفعالات في تخفيف حدة الضغوط النفسية لدى عينة من طالبات المرحلة الثانوية

هدفت الدراسة إلى الكشف عن فعالية العلاج المرتكز على الانفعالات في تخفيف حدة الضغوط النفسية لدى عينة من طالبات المرحلة الثانوية، واعتمدت الدراسة على المنهج شبه التجريبي بطريقة القياسات القبلية والبعدية والتتبعية على مجموعتين إحداهما تجريبية والأخرى ضابطة. وتكونت عينة الدراسة الأساسية من (130) طالبة في المرحلة الثانوية في محافظة رياض الخبراء، ممن تراوحت أعمارهنَّ الزمنية ما بين (16-18) عامًا، بمتوسط عمري قدره (16,831) عامًا. وتكونت عينة الدراسة الأساسية من (12) طالبة من المرحلة الثانوية، وتم تقسيمهنَّ إلى مجموعتين إحداهما الضابطة وتكونت من (6) طالبات والأخرى التجريبية وتكونت من (6) طالبات. واعتمدت أدوات الدراسة على مقياس الضغوط النفسية لدى المراهقين المتمدرسين بالثانوية، من إعداد بكيري (2019)، وبرنامج العلاج المرتكز على الانفعالات من إعداد الباحثتين، وأشارت النتائج إلى فعالية البرنامج في خفض الضغوط النفسية لدى أفراد المجموعة التجريبية بعد تطبيق البرنامج، وكذلك استمرارية فعالية البرنامج الإرشادي الذي تم تطبيقه على المجموعة التجريبية في خفض الضغوط النفسية لدى أفراد عينة الدراسة

Evaluating the performance of black sand products on the linear attenuation coefficient in heavyweight concrete

Black sand, spanning approximately 400 km and exceeding one million cubic meters in volume, can be found along Egypt's Mediterranean coast. For every ton of steel produced, approximately 20 % of steel slag waste is generated, posing a significant environmental challenge. The study aimed to use black sand and steel slag products to produce eco-friendly radiation-shielding heavyweight concrete. The experimental program, fourteen mixtures were prepared. Two mixtures, one of natural aggregate and the other of electrical furnace steel slag (EAFSS), and twelve mixtures divided into four groups of magnetite, ilmenite, hematite, and steel, used as powder at a ratio of 10 %, 20 %, and 30 % by weight of cement 550 kg/m³ , respectively. The slump test, concrete density, compression and tensile strength (fts) test, linear attenuation coefficient (LAC), ultrasonic, and microstructure were tested. The attenuation coefficient was affected by magnetite, hematite, ilmenite, and steel powder. Sample M30, which contains 30 % magnetite powder, showed the higher shielding capacity 0.1511 cm⁻¹ compared to all samples. The HVL values were reduced when 30 % magnetite, hematite, ilmenite, and steel powder were utilized. Black sand products effectively enhance the radiation resistance capacity of concrete

Developing the generalized Dawoud-Kibria estimator for the multinomial logistic model: Simulation study and application

The multinomial logistic regression model (MLRM) is commonly used to analyze relationships between a categorical response variable and multiple explanatory variables. The maximum likelihood (ML) method is typically used for parameter estimation but becomes inefficient in the presence of multicollinearity. Several generalized biased estimators, such as the multinomial ridge, Liu, and Huang-Yang estimators, have been proposed to address this issue. However, existing methods still suffer from performance limitations in high-multicollinearity scenarios. In this study, we propose the Generalized Multinomial Dawoud-Kibria (GMDK) estimator as an alternative solution. Theoretical comparisons, simulation studies, and a real data application demonstrate that the GMDK estimator outperforms existing biased estimators in terms of mean squared error (MSE) reduction. The results of the real data application confirm that the ML estimator performs the worst, with the highest MSE (82.80), while the proposed GMDK estimator achieves the lowest MSE (44.01), reducing error by 46.8 % compared to ML. This result aligns with the theoretical and simulation findings, confirming the superiority of GMDK in handling multicollinearity