Loss of Consciousness at Onset of Aneurysmal Subarachnoid Hemorrhage is Associated with Functional Outcomes in Good-Grade Patients

BACKGROUND Transient loss of consciousness (LOC) is one of the most common presentations of aneurysmal subarachnoid hemorrhage (SAH) and may be an indicator of early brain injury. The aim of the current study was to examine the association of LOC to functional outcomes in patients with good-grade SAH. METHODS We searched the Subarachnoid Hemorrhage International Trialists Repository for patients that presented with LOC at ictus of SAH. A propensity score analysis was performed on good-grade patients (defined as World Federation of Neurosurgical Societies grades 1-3) to balance selected covariates between those with and without LOC. Primary outcome was Glasgow Outcome Score (GOS) at 3 months (with poor outcome defined as GOS of 1-3). Secondary outcomes were delayed cerebral ischemia (DCI), rebleed, length of hospital stay, and time to death. RESULTS A propensity score-matching algorithm identified 337 patients (168 with LOC at ictus, and 168 without). The proportion of patients with poor functional outcome at 3-months was significantly higher in those who had LOC at ictus compared to the matched cohort without LOC (30% vs. 19%; P = 0.02). There was a non-significant trend toward higher mortality in patients with LOC (19% vs. 13%; P = 0.14). There were no differences in the secondary outcomes. CONCLUSIONS LOC of at ictus of SAH is associated with higher rate of unfavorable functional outcomes but not mortality, DCI or rebleed in good-grade SAH patients. Future studies should further investigate the putative mechanisms by which LOC mediates early brain injury in SAH

In vivo and in vitro studies evaluating the chemopreventive effect of metformin on the aryl hydrocarbon receptor-mediated breast carcinogenesis

Metformin (MET) is a clinically used anti-hyperglycemic agent that shows activities against chemically-induced animal models of cancer. A study from our laboratory showed that MET protectes against 7, 12-dimethylbenz[a]anthracene (DMBA)-induced carcinogenesis in vitro human non-cancerous epithelial breast cells (MCF10A) via activation of the aryl hydrocarbon receptor (AhR). However, it is unclear whether MET can prevent the initiation of breast carcinogenesis in an in vivo rat model of AhR-induced breast carcinogenesis. Therefore, the main aims of this study are to examine the effect of MET on protecting against rat breast carcinogenesis induced by DMBA and to explore whether this effect is medicated through the AhR pathway. In this study, treatment of female rats with DMBA initiated breast carcinogenesis though inhibiting apoptosis and tumor suppressor genes while inducing oxidative DNA damage and cell cycle proliferative markers. This effect was associated with activation of AhR and its downstream target genes; cytochrome P4501A1 (CYP1A1) and CYP1B1. Importantly, MET treatment protected against DMBA-induced breast carcinogenesis by restoring DMBA effects on apoptosis, tumor suppressor genes, DNA damage, and cell proliferation. Mechanistically using in vitro human breast cancer MCF-7 cells, MET inhibited breast cancer stem cells spheroids formation and development by DMBA, which was accompanied by a proportional inhibition in CYP1A1 gene expression. In conclusion, the study reports evidence that MET is an effective chemopreventive therapy for breast cancer by inhibiting the activation of CYP1A1/CYP1B1 pathway in vivo rat model

Assessment and Management of Atopic Dermatitis in Primary Care Settings

An increasingly common chronic inflammatory skin condition is atopic dermatitis (AD). It exhibits severe itching as well as recurring eczematous lesions. New difficulties for treatment selection and approach occur with the expansion of available therapy alternatives for healthcare professionals and patients.  The article highlights recent developments in scientific research on atopic dermatitis diagnosis and assessment that have led to the identification of novel therapeutic targets and the development of targeted therapies, both of which have the potential to completely change the way AD is treated, particularly in a primary care setting

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

Effects of Decompressive Craniectomy on Functional Outcomes and Mortality in Poor-Grade Aneurysmal Subarachnoid Hemorrhage

Background: Decompressive craniectomy (DC) is often considered as a life-saving measure for trauma and ischemic stroke. Selected patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) have been subjected to DC, but its benefits remain unknown. The aim of this meta-analytic review is to surmise the overall effects of DC on poor-grade aSAH outcomes. Methods: Data were acquired from previous publications on DC and the Subarachnoid Hemorrhage International Trialists (SAHIT) Repository. We performed both study-level and individual participant analysis. Results: Fifteen published studies and one dataset from SAHIT met our inclusion criteria. DC was associated with high event rate of unfavorable outcomes and mortality, however, the overall quality of evidence was poor due to high risks of bias and significant heterogeneity in most outcome measures. Conclusion: The currently available evidence suggests that the impact of DC on poor-grade aSAH outcomes is trending toward a harmful effect. High-quality prospective studies are urgently needed.M.Sc

A Cross-Sectional Study of Gender Differences in Calorie Labeling Policy among Students: Dietary Habits, Nutritional Knowledge and Awareness

Calorie labels may be the most important predictor of dietary choices among college students. The Saudi Food and Drug Authority (SFDA) has imposed calorie labels on the menus of restaurants and cafes. The current study looked at how the calorie labeling policy affects Saudi male and female students’ dietary habits, nutritional knowledge, and awareness. The study included 802 students (360 males and 442 females) from Saudi Arabia’s King Saud University, ranging between 18 and 35 years. Between December 2020 and October 2021, a cross-sectional, electronic, approved and validated survey was conducted to collect data on gender socio-demographic variables, food habits, and nutritional knowledge and awareness, in accordance with the food policy stated. The collected data were analyzed using descriptive statistical analysis. The Likert scale was used to determine the level of awareness and the food habit scores, and the Mann-Whitney U-test was used to determine the differences between the males and females. Spearman’s correlation coefficient and simple regression analysis were performed to determine the association between the demographic factors and nutritional knowledge and the awareness of males and females. The results demonstrated that, with the exception of living situations, males and females differed significantly (p ≤ 0.01) in their socio-demographic characteristics. When asked about their food habits after the implementation of calorie labeling, the majority of respondents (>50%) gave negative responses, with a significant difference observed between maintaining body weight (p ≤ 0.05) and gaining weight (p ≤ 0.01). According to the Likert scale, there was a significant difference between males and females in terms of knowledge (p ≤ 0.01) and awareness (p ≤ 0.05). An average of 80.53% of males had very high knowledge (4.07) and 65.65% had medium level (3.24) awareness of calorie labeling, while 83.73% of females had very high knowledge (4.17) and 66.50% had medium level (3.32) awareness of calorie labeling. The socio-demographic and lifestyle variables were significantly and positively or negatively associated with calorie label utilization and varied between respondents, according to the Spearman correlation coefficients (r) and simple linear regression analysis. The number of factors that negatively impacted the males’ knowledge and awareness was greater than that of the females. In conclusion, among college students, there were numerous gender differences in the demographic and social characteristics. The respondents’ knowledge was insufficient, with females outperforming males

Primary segmental intestinal volvulus associated with acute appendicitis

Introduction: Segmental intestinal volvulus without underlying causes is called Primary Segmental Volvulus. Herein, we report a rare case of segmental ileal volvulus associated with acute appendicitis. Case Presentation: A 3-year-old boy presented with complaints of diarrhoea associated with vomiting, central abdominal pain, and decreased activity for 2 days. He was referred to paediatric surgery as a case of acute appendicitis. Ultrasound of the abdomen showed acute appendicitis with ileoileal target sign. Laparotomy was done, which showed segmental ileal volvulus without malrotation associated with inflamed appendix and fecolith at the tip. Appendectomy plus intestinal resection and anastomosis were also done. Discussion: Primary Segmental Intestinal Volvulus is a very rare condition, and only a few cases have been reported in the literature. It has a prevalence of 22.9%–26.3% in children.In our case, ultrasound findings are suggestive of acute appendicitis and suspicion of intussusception. Intraoperatively, segmental intestinal volvulus was observed along with inflamed appendix and a fecolith at its tip. Conclusion: Primary Segmental Intestinal Volvulus should be considered as a differential diagnosis of any child patient who came with small bowel obstruction symptom. Keywords: Segmental intestinal volvulus, Malrotation, Fecolith, Acute appendicitis, Case repor

On Odd Perks-G Class of Distributions: Properties, Regression Model, Discretization, Bayesian and Non-Bayesian Estimation, and Applications

In this paper, we present a new univariate flexible generator of distributions, namely, the odd Perks-G class. Some special models in this class are introduced. The quantile function (QFUN), ordinary and incomplete moments (MOMs), generating function (GFUN), moments of residual and reversed residual lifetimes (RLT), and four different types of entropy are all structural aspects of the proposed family that hold for any baseline model. Maximum likelihood (ML) and maximum product spacing (MPS) estimates of the model parameters are given. Bayesian estimates of the model parameters are obtained. We also present a novel log-location-scale regression model based on the odd Perks–Weibull distribution. Due to the significance of the odd Perks-G family and the survival discretization method, both are used to introduce the discrete odd Perks-G family, a novel discrete distribution class. Real-world data sets are used to emphasize the importance and applicability of the proposed models

On Odd Perks-G Class of Distributions: Properties, Regression Model, Discretization, Bayesian and Non-Bayesian Estimation, and Applications

In this paper, we present a new univariate flexible generator of distributions, namely, the odd Perks-G class. Some special models in this class are introduced. The quantile function (QFUN), ordinary and incomplete moments (MOMs), generating function (GFUN), moments of residual and reversed residual lifetimes (RLT), and four different types of entropy are all structural aspects of the proposed family that hold for any baseline model. Maximum likelihood (ML) and maximum product spacing (MPS) estimates of the model parameters are given. Bayesian estimates of the model parameters are obtained. We also present a novel log-location-scale regression model based on the odd Perks–Weibull distribution. Due to the significance of the odd Perks-G family and the survival discretization method, both are used to introduce the discrete odd Perks-G family, a novel discrete distribution class. Real-world data sets are used to emphasize the importance and applicability of the proposed models

Modeling to Factor Productivity of the United Kingdom Food Chain: Using a New Lifetime-Generated Family of Distributions

This article proposes a new lifetime-generated family of distributions called the sine-exponentiated Weibull-H (SEW-H) family, which is derived from two well-established families of distributions of entirely different nature: the sine-G (S-G) and the exponentiated Weibull-H (EW-H) families. Three new special models of this family include the sine-exponentiated Weibull exponential (SEWEx), the sine-exponentiated Weibull Rayleigh (SEWR) and sine-exponentiated Weibull Burr X (SEWBX) distributions. The useful expansions of the probability density function (pdf) and cumulative distribution function (cdf) are derived. Statistical properties are obtained, including quantiles (QU), moments (MO), incomplete MO (IMO), and order statistics (OS) are computed. Six numerous methods of estimation are produced to estimate the parameters: maximum likelihood (ML), least-square (LS), a maximum product of spacing (MPRSP), weighted LS (WLS), Cramér–von Mises (CRVM), and Anderson–Darling (AD). The performance of the estimation approaches is investigated using Monte Carlo simulations. The total factor productivity (TFP) of the United Kingdom food chain is an indication of the efficiency and competitiveness of the food sector in the United Kingdom. TFP growth suggests that the industry is becoming more efficient. If TFP of the food chain in the United Kingdom grows more rapidly than in other nations, it suggests that the sector is becoming more competitive. TFP, also known as multi-factor productivity in economic theory, estimates the fraction of output that cannot be explained by traditionally measured inputs of labor and capital employed in production. In this paper, we use five real datasets to show the relevance and flexibility of the suggested family. The first dataset represents the United Kingdom food chain from 2000 to 2019, whereas the second dataset represents the food and drink wholesaling in the United Kingdom from 2000 to 2019 as one factor of FTP; the third dataset contains the tensile strength of single carbon fibers (in GPa); the fourth dataset is often called the breaking stress of carbon fiber dataset; the fifth dataset represents the TFP growth of agricultural production for thirty-seven African countries from 2001–2010. The new suggested distribution is very flexible and it outperforms many known distributions