Comparative Study between Pregnant and Non-Pregnant Women Regarding Variation of Liver Function Tests: Assessment of Health Literacy

Context: Pregnancy is associated with normal physiological adaptive changes. Biochemical parameters reflect these changes and are distinct from the non-pregnant state. Low levels of health literacy have been shown to result in less healthy choices, riskier behavior, poorer health, less self-management, and more hospitalization among that category of adult patients.Aim: The study aimed to examine the effect of pregnancy on liver function tests among pregnant women during various trimesters of pregnancy and compare with non-pregnant and determine the patients' level of health literacy regarding the variation of liver function tests among those patients. Methods: A descriptive cross-sectional design was used to achieve the study aim. A random sample of 65 women was selected from an outpatient clinic in the maternity hospital; 54 out of them were pregnant women. Three tools were used to collect data, socio-demographic and clinical data assessment sheet; assessment of liver function tests by Cobas c 311; and health literacy management scale.Results: The sample's age range was between 20-40 years. This study revealed that; serum albumin levels decreased from the first trimester (3.7-4.7), and this decrease became progressively more accentuated as the pregnancy advanced (3.35-4.36 decreased significantly to 3.19-3.81). There was no significant decrease in serum AST between pregnant and non-pregnant women, but there was a significant decrease in ALT in pregnant women compared with non-pregnant women (11.90 Vs. 8.60 at p 0.017). In the current study, Serum alkaline phosphatase (ALP) was significantly higher (P˂0.0001) during the third trimester (63-171) compared with the second trimester (33-137), and the first trimester (36-129), and with the control group (48-122). Finally, it was found that a significant decrease in total serum bilirubin concentrations during the second (0.11-0.38) and third trimesters (0.12-0.42) compared to control (0.11-1.57) and the first trimester (0.12-0.85). Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores. Conclusion: During normal pregnancy, most values of liver function tests remain below the normal upper limits compared to non- pregnant women. Any increase in serum ALT and AST activity levels and serum bilirubin should be considered pathologic and prompt for further evaluation. Moreover, most of the studied sample has a low level of health literacy for all subscales and the total scores. The study recommended that the liver function tests should be routinely investigated during pregnancy to outline any pathologic changes. Focusing on the nurse's role, she should emphasize increasing the patient's level of health literacy regarding the variation of liver function tests. So, it is a must for nurses to develop many skills to enable them to function for this category of patients with low health literacy levels. Also, those patients should be equipped with information-seeking behavior, decision-making abilities, and problem-solving approaches along their health and illness continuum

Investigation of the presence of pharmaceuticals and personal care products (PPCPs) in groundwater of Jazan area, Saudi Arabia

Purpose: To investigate the possible occurrence of some selected  pharmaceutical compounds in the groundwater of Jazan area, Saudi Arabia.Methods: Water samples from 46 wells were collected from different sites covering Jazan area of Saudi Arabia between February and March 2017. These samples were first analyzed to investigate the presence of eleven drugs mostly used in the study area. Thereafter, samples were subjected to liquid chromatography-mass spectrometry (LC-MS/MS) by direct injection and external standard calibration.Results: Despite the low detection limit (0.001 - 0.02 μg/L) applied to the investigated compounds with a variety chemical groups (acetylsalicylic acid, paracetamol, ibuprofen, metronidazole, caffeine, olmesartan, omeprazole, nifedipine, diclofenac sodium, glibenclamide and loratidine), none of these compounds was detected in any of the analyzed samples.Conclusion: The main source of environmental contamination with  pharmaceuticals and personal care products (PPCPs) is wastewater. The results obtained reveal the absence of groundwater contamination by these compounds in Jazan area. However, further extended investigations and monitoring are recommended.Keywords: Pharmaceuticals, Groundwater, Wastewater, Pollution, Personal care products, Liquid chromatography-mass spectrometer (LC-MS/MS

Gestational diabetes prevalence and risk factors among pregnant women — Jazan Region, Saudi Arabia

Background. The gestational diabetes (GDM) is considered as a global public health problem that affects pregnant women. GDM can become chronic type II and usually it is associated with many risk factors that may lead to many serious complications for the mother and the fetus. The main objective of this study was to estimate the prevalence of GDM among pregnant women in Jazan region and to determine the possible associated factors of the GDM. Material and methods. The study involved pregnant women attending department of Obstetrics and Gynecology at government hospitals of Jazan region. A sample of 440 pregnant women were randomly selected. Interviews were conducted using a questionnaire prepared to measure the GDM prevalence, risk factors, awareness and adherence to the advice of the doctor and medications. Results. The prevalence of gestational diabetes among pregnant women in Jazan is estimated at 8.2%. The GDM prevalence was significantly higher among obese women (20.2%; 95% CI 13.2–29.2) compared with women with normal weight (7.1%; 95% CI 1.7–7.6). The analysis showed that GDM was significantly associated with child weight more than 3.5 kg (OR 4.315; p = 0.004), mother’s BMI more than 30 kg/m2 (OR 4.703; p = 0.001), and family history of GDM (OR 2.606; p = 0.046). Conclusion. In conclusion, the GDM prevalence obtained in this study is more than global prevalence and less than other studies in KSA. The BMI of mothers and having neonates that weight more than 3.5 kg are the main risk factors for GDM. Suitable interventions programs are highly required for control and risk factor modifications

Częstość występowania cukrzycy ciążowej i jej czynników ryzyka u ciężarnych kobiet w prowincji Dżazan w Arabii Saudyjskiej

Wstęp. Cukrzycę ciążową (GDM) uważa się za globalny problem zdrowotny dotyczący ciężarnych kobiet. Może ona przejść w cukrzycę typu 2 i zwykle wiąże się z wieloma czynnikami ryzyka, które mogą prowadzić do poważnych powikłań u matki i płodu. Głównym celem badania było oszacowanie częstości GDM u kobiet w ciąży mieszkających w prowincji Dżazan oraz określenie czynników, które mogą wiązać się z GDM. Materiał i metody. Badanie obejmowało kobiety w ciąży będące pod opieką oddziałów położniczo-ginekologicznych szpitali państwowych w prowincji Dżazan. Wybrano losowo próbę liczącą 440 ciężarnych kobiet. Przeprowadzając wywiady z uczestniczkami badania, korzystano z kwestionariusza opracowanego w celu oceny częstości występowania GDM, czynników ryzyka, wiedzy kobiet na temat GDM i przestrzegania zaleceń lekarskich oraz przyjmowania leków. Wyniki. Częstość GDM wśród ciężarnych kobiet w prowincji Dżazan wynosiła 8,2%. Była ona istotnie wyższa u kobiet otyłych [20,2%; 95-procentowy przedział ufności (CI) 13,2–29,2) niż u osób z prawidłową masą ciała (7,1%; 95% CI 1,7–7,6). Analiza wykazała, że GDM wiązała się istotnie z urodzeniem dziecka o masie ciała wynoszącej ponad 3,5 kg [iloraz szans (OR) 4,315; p = 0,004), wskaźnikiem masy ciała (BMI) matki wynoszącym ponad 30 kg/m2 (OR 4,703; p = 0,001) oraz dodatnim wywiadem rodzinnym dotyczącym GDM (OR 2,606; p = 0,046). Wnioski. Podsumowując, częstość GDM stwierdzona w badaniu była większa niż globalna częstość występowania GDM, lecz mniejsza niż obserwowana w innych badaniach w populacji saudyjskiej. Wskaźnik BMI matki i urodzenie dziecka o masie ciała powyżej 3,5 kg to główne czynniki ryzyka GDM. Potrzebne są odpowiednie programy interwencyjne w celu kontroli i modyfikacji czynników ryzyka

Elective cancer surgery in COVID-19-free surgical pathways during the SARS-CoV-2 pandemic: An international, multicenter, comparative cohort study

PURPOSE As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19–free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19–free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19–free surgical pathways. Patients who underwent surgery within COVID-19–free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19–free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score–matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19–free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION Within available resources, dedicated COVID-19–free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Elective Cancer Surgery in COVID-19-Free Surgical Pathways During the SARS-CoV-2 Pandemic: An International, Multicenter, Comparative Cohort Study.

PURPOSE: As cancer surgery restarts after the first COVID-19 wave, health care providers urgently require data to determine where elective surgery is best performed. This study aimed to determine whether COVID-19-free surgical pathways were associated with lower postoperative pulmonary complication rates compared with hospitals with no defined pathway. PATIENTS AND METHODS: This international, multicenter cohort study included patients who underwent elective surgery for 10 solid cancer types without preoperative suspicion of SARS-CoV-2. Participating hospitals included patients from local emergence of SARS-CoV-2 until April 19, 2020. At the time of surgery, hospitals were defined as having a COVID-19-free surgical pathway (complete segregation of the operating theater, critical care, and inpatient ward areas) or no defined pathway (incomplete or no segregation, areas shared with patients with COVID-19). The primary outcome was 30-day postoperative pulmonary complications (pneumonia, acute respiratory distress syndrome, unexpected ventilation). RESULTS: Of 9,171 patients from 447 hospitals in 55 countries, 2,481 were operated on in COVID-19-free surgical pathways. Patients who underwent surgery within COVID-19-free surgical pathways were younger with fewer comorbidities than those in hospitals with no defined pathway but with similar proportions of major surgery. After adjustment, pulmonary complication rates were lower with COVID-19-free surgical pathways (2.2% v 4.9%; adjusted odds ratio [aOR], 0.62; 95% CI, 0.44 to 0.86). This was consistent in sensitivity analyses for low-risk patients (American Society of Anesthesiologists grade 1/2), propensity score-matched models, and patients with negative SARS-CoV-2 preoperative tests. The postoperative SARS-CoV-2 infection rate was also lower in COVID-19-free surgical pathways (2.1% v 3.6%; aOR, 0.53; 95% CI, 0.36 to 0.76). CONCLUSION: Within available resources, dedicated COVID-19-free surgical pathways should be established to provide safe elective cancer surgery during current and before future SARS-CoV-2 outbreaks

Synthesis and use of magnetic nanoparticles for the adsorption of mercury from water

This study used magnetite (Fe3O4) nanoparticles (NPs), mesoporous silica coated magnetite NPs (SCMNPs) and thiol functionalised silica-coated magnetite nanoparticles (SH-SCMNPs) for Hg(II) removal and recovery from water. The Fe3O4 NPs were prepared via conventional co-precipitation methods. Mesoporous silica coating was created on dense liquid-silica coated magnetite NPs (DLSC-Fe3O4 NPs) using cetyltri-methyl-ammonium chloride (CTAC) as molecular templates and followed by a sol-gel reaction. SCMNPs were functionalised with 3-MPTMS using the co-condensation method. Functionalisation of SCMNPs with this specific organic group was performed to enhance the selectivity of the magnetic NPs towards Hg(II). The characteristics of these particles were assessed at different stages in the production process. The hydrodynamic particle size distribution increased from an average diameter of ~75 nm for Fe3O4 NPs to ~105 nm after silica coating, and was found to be ~111 nm after functionalisation with thiol. The particles were found to be almost spherical with a uniform mesoporous structure with a pore size of ~2.1 nm. The particles were strongly responsive to an external magnetic field making separation from solution possible in less than 1 minute using a permanent magnet.Batch tests were used to evaluate the feasibility of the prepared NPs for the adsorption and desorption of Hg (II) from synthetic wastewater. SH-SCMNPs displayed a high removal efficiency for Hg(II) uptake, with 90% of Hg(II) removed during the first 5 minutes and equilibrium in less than 15 minutes. The adsorption efficiency was highly pH dependant. Adsorption was not affected by the majority of coexisting cations and anions under the conditions tested. 3 M HCl and thiourea in a 3 M HCl solution was an effective eluent for the desorption of adsorbed-Hg on SCMNPs and SH-SCMNPs respectively. This did not result in the destruction of the nanoparticles and they could subsequently be reused, without loss of their activity, in further adsorption tests. The adsorption characteristics of the particles were quantified in a series of isotherm experiments using Hg(II) solution concentrations of between 40 and 1000 ?g L?1 at adsorbent concentrations of 4 and 8 mg L-1. The adsorption capacity was higher than for other commonly used adsorbents. Both the Langmuir and Freundlich isotherm models were applied to the isotherm data and the maximum adsorption capacity was achieved when the ratio of adsorbent to adsorbate was low.A semi-continuous method for using the process at a lab scale was developed and was found to be successful in the removal and recovery of Hg(II) and confirmed the results of the batch experiments

Influence of aqueous environment on agglomeration and dissolution of thiol-functionalised mesoporous silica-coated magnetite nanoparticles

The purpose of the present research work is to investigate the stability and dissolution of magnetite (Fe3O4) nanoparticles (NPs) and thiol-functionalised mesoporous silica coated magnetite NPs (TF-SCMNPs). The state of NPs in an aqueous environment was investigated under different pH conditions. Changes in the NPs’ mean diameter due to aggregation were measured over a specific time. The effects of contact time and pH on the dissolution of NPs were also investigated. In order to avoid possible aggregation, Fe3O4 NPs were coated with silica and functionalised further with thiol organic groups. These methods imparted excellent stability to magnetite NPs in an aqueous medium over a wide range of pH values with reasonable hydrodynamic size. The organic group bound magnetite NPs allowed these particles to circulate over a long time in the aqueous system, and particle aggregation and sedimentation did not occur. The trend of decreasing zeta potential was observed after grafting thiol onto the surface of the SCMNPs. The results also revealed that silica exhibited a noteworthy efficient in eliminating the pH dependence and enhancing the NP stability of SCMNPs and SH-SCMNPs in aqueous medium. On the other hand, the dissolution of Fe3O4 NPs was found to be detrimental at pH 2.0 and 4.0 or had a long contact time

Synthesis, anticancer activity and molecular docking of new quinolines, quinazolines and 1,2,4-triazoles with pyrido[2,3-d] pyrimidines

Recently, heterocyclic compounds such as pyrido [2,3-d] pyrimidinones, 1,2,4-triazolopyrimidines, pyrimidoquinazolines, and quinoline derivatives have gained attention from researchers due to their pharmacological and biological activities. To synthesize new compounds, quinoline-2-thioxopyrido [2,3-d] pyrimidinone (1) and methylthioquinoline-pyrido [2,3-d] pyrimidinones (2) were used as starting materials. The new compounds synthesized were quinoline-pyrido [2,3-d] (DeGoey et al., 2013; Gouda et al., 2020; Dangolani et al., 2018) [1, 2,4]triazolopyrimidinones (5a-d), 2-methylsulfonyl-quinoline-pyrido [2,3-d]pyrimidinone (6), pyrido [2,3-d]pyrimidine derivatives, pyridopyrimido (Gouda et al., 2020; DeGoey et al., 2013) 2,12,1-b] quinazoline (9), pyrido [(Khajouei et al., 2021; Gouda et al., 2020) 3,23,2-e]bis (1,2,4-triazole)pyrimidine (12a,b) and pyridopyrimido-diquinazoline-dione (16) derivatives. These compounds were synthesized with high efficiency, producing yields ranging from 69% to 90%, under moderate conditions, through treating (2) or (10) with various reagents such as anthranilic acid, phosphorus oxychloride, hydrazine hydrate, formic acid, glacial acetic acid, arylamine (aniline, 4-chloroaniline, or 4-methoxyaniline), and sec-amine (piperazine or morpholine). The new structures of the synthesized compounds were verified using various spectroscopic procedures, such as IR, NMR, and mass spectra. Molecular docking studies were carried out to investigate and discuss how the prepared compounds bind to amino acids such as Estrogen Receptor alpha, EGFR, and NADPH oxidase protein. Also, the synthesized products were tested for their anticancer and antioxidant activities against the (MCF-7) breast carcinoma cell line and human normal Retina pigmented epithelium cells (RPE-1). The study on the structure-activity relationship (SAR) established a correlation between the chemical structure of the newly synthesized compounds and their anticancer activity. The findings suggest that compounds 5a-d, 9,12a-b, and 16 exhibited promising anticancer activity and antioxidant effects as measured by DPPH inhibition

Evaluation of self-medication practices in acute diseases among university students in Oman

Objective: To evaluate the practices of university students towards self-medication to treat minor ailments in Muscat and Sohar region of Sultanate of Oman. Methods: A cross sectional study was conducted in October 2013-January 2014. A total of 450 university students were randomly selected and their verbal consent was obtained. The data were collected through the self-administered, close ended, pretested questionnaire and was analyzed statistically by SPSS version 19.0. Results: Overall 204 males (45.3%) and 246 females (56.7%) participated in the study. The mean age of respondents was 22.3 years. Ninety-four percent of respondents reported practicing self-medication and 165 (36.7%) participants admitted of having purchased drugs without prescription more than four times over the last six months. Headache, fever, cough and cold were the most common ailments which prompted respondents to seek self-medication. Analgesics, cough preparations and antibiotics were the most common classes of drugs used in self-medication. The majority of respondents practiced self-medication either because their illness was not serious or they had prior experience with the drug. The majority of respondents had good medication knowledge which they reported to acquire from reading drug leaflet or from pharmacists' advice. Conclusion: The prevalence of self-medication among university students was very high. There is a need for intensive education and comprehensive awareness campaign to advocate for reduction in the prevalence of self-medication practices among students