Percutaneous embolization of contained iatrogenic vesicourethral fistula using Amplatzer vascular plug and N-butyl-2-cyanoacrylate : a case report

Purpose: Reports on percutaneous embolization of vesicourethral anastomotic fistula are limited. Case presentation: A 59-year-old male presented with persistent contained vesicourethral fistula following low anterior resection and radical retropubic prostectomy for rectal cancer. A contained fistula with urinary leakage of 350 ml/day through a Jackson-Pratt (JP) tube was found at the posterior aspect of the vesicourethral anastomotic site on cystography. After 1 month of failed conventional urinary drainage manoeuvre, percutaneous embolization of the contained fistula was successfully performed through the JP tube. An Amplatzer vascular plug (AVP) was used to block the fistula and N-butyl-2-cyanoacrylate (NBCA) was used to obliterate the urinoma cavity. Computed tomography scans at 1-month and 1-year follow-ups showed stable AVP position and complete obliteration of the cavity by NBCA. Conclusions: The contained vesicourethral anastomotic fistula was successfully managed with AVP and NBCA via a JP drainage tube. It is expected that AVP will block the fistula and NBCA will obliterate the urinoma cavity effectively

Liposuction Anaesthesia: Considerations and Techniques

This study aimed at recognizing the ultimate decision to select the type of anesthesia depends on the type and extent of the liposuction surgery planned, the patient’s underlying health condition and the psychological disposition of the patient. The study also describes the four types of liposuction techniques based on the volume of infiltration or wetting solution injected, dry, wet, superwet, and tumescent technique. Besides analyzing the main differences between these techniques and the amount of infiltration done into the tissues and the resultant blood loss as a percentage of aspirated fluid, highlighting that the tumescent technique is the most common of all liposuction techniques. The study found that liposuction is a popular procedure for reducing excessive fat from the body. It is associated with major hemodynamic changes, especially in large-volume liposuction surgery. Anaesthesia for these procedures requires a thorough understanding of the physiological changes and likely complications associated with them. Keywords: Anaesthesia, liposuction, techniques

Seroprevalence of SARS-CoV-2 (COVID-19) among Healthcare Workers in Saudi Arabia: Comparing Case and Control Hospitals

Healthcare workers (HCWs) stand at the frontline for fighting coronavirus disease 2019 (COVID-19) pandemic. This puts them at higher risk of acquiring the infection than other individuals in the community. Defining immunity status among health care workers is therefore of interest since it helps to mitigate the exposure risk. This study was conducted between May 20th and 30th, 2020. Eighty-five hospitals across Kingdom of Saudi Arabia were divided into 2 groups: COVID-19 referral hospitals are those to which RT-PCR-confirmed COVID-19 patients were admitted or referred for management (Case-hospitals). COVID-19 nonaffected hospitals where no COVID-19 patients had been admitted or managed and no HCW outbreak (Control hospitals). Next, seroprevalence of severe acute respiratory syndrome coronavirus 2 among HCWs was evaluated; there were 12,621 HCWs from the 85 hospitals. There were 61 case-hospitals with 9379 (74.3%) observations, and 24 control-hospitals with 3242 (25.7%) observations. The overall positivity rate by the immunoassay was 299 (2.36%) with a significant difference between the case-hospital (2.9%) and the control-group (0.8%) (P value <0.001). There was a wide variation in the positivity rate between regions and/or cities in Saudi Arabia, ranging from 0% to 6.31%. Of the serology positive samples, 100 samples were further tested using the SAS2pp neutralization assay; 92 (92%) samples showed neutralization activity. The seropositivity rate in Kingdom of Saudi Arabia is low and varies across different regions with higher positivity in case-hospitals than control-hospitals. The lack of neutralizing antibodies (NAb) in 8% of the tested samples could mean that assay is a more sensitive assay or that neutralization assay has a lower detection limits; or possibly that some samples had cross-reaction to spike protein of other coronaviruses in the assay, but these were not specific to neutralize severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)

On <i>r</i>-Compactness in Topological and Bitopological Spaces

This paper defines the so-called pairwise r-compactness in topological and bitopological spaces. In particular, several inferred properties of the r-compact spaces and their connections with other topological and bitopological spaces are studied theoretically. As a result, several novel theorems of the r-compact space are generalized on the pairwise r-compact space. The results established in this research paper are new in the field of topology

Soft closure spaces via soft ideals

This paper was devoted to defining new soft closure operators via soft relations and soft ideals, and consequently new soft topologies. The resulting space is a soft ideal approximation. Many of the well known topological concepts were given in the soft set-topology. Particularly, it introduced the notations of soft accumulation points, soft continuous functions, soft separation axioms, and soft connectedness. Counterexamples were introduced to interpret the right implications. Also, a practical application of the new soft approximations was explained by an example of a real-life problem

Factors associated with diabetic foot among type 2 diabetes in Northern area of Saudi Arabia: a descriptive study

Abstract Objective Foot complications are considered to be a devastating consequence of type 2 diabetes mellitus (T2DM), posing a major medical and economic burden. A prospective study was conducted at researchers’ area “Northern area of Saudi Arabia” to determine the factors associated with diabetic foot (DF) among T2DM patients. Identifying the extent of this problem and the associated factors will enable the health providers to imply early preventive measurements. Results Two hundred T2DM patients with/without DF (n = 100 for each group) were recruited. In total, the mean (SD) age of participants was 56 (± 12.2) years and nearly 70% of the patients were females. They showed a trend for higher frequency of impaired vibration perception, light touch pressure, proprioception and pain sensation than males in T2DM with DF. In univariate analysis, older age, long duration of diabetes and poor glycemic control reflected in high levels of HbA1c were significant factors associated with DF (OR = 4.1, 95% CI 2.3–7.4, P < 0.0001; OR = 6.5, 95% CI (4.9–9.3), P < 0.0001, and OR = 1.1, 95% CI (1.05–1.3), P = 0.002, respectively). Taken together, the current results could highlight the importance of epidemiological studies to raise the awareness of this important health care problem around the country

Multiple environmental antigens may trigger autoimmunity in psoriasis through T-cell receptor polyspecificity

IntroductionPsoriasis is a T-cell mediated autoimmune skin disease. HLA-C*06:02 is the main psoriasis-specific risk gene. Using a Vα3S1/Vβ13S1 T-cell receptor (TCR) from a lesional psoriatic CD8+ T-cell clone we had discovered that, as an underlying pathomechanism, HLA-C*06:02 mediates an autoimmune response against melanocytes in psoriasis, and we had identified an epitope from ADAMTS-like protein 5 (ADAMTSL5) as a melanocyte autoantigen. The conditions activating the psoriatic autoimmune response in genetically predisposed individuals throughout life remain incompletely understood. Here, we aimed to identify environmental antigens that might trigger autoimmunity in psoriasis because of TCR polyspecificity.MethodsWe screened databases with the peptide recognition motif of the Vα3S1/Vβ13S1 TCR for environmental proteins containing peptides activating this TCR. We investigated the immunogenicity of these peptides for psoriasis patients and healthy controls by lymphocyte stimulation experiments and peptide-loaded HLA-C*06:02 tetramers.ResultsWe identified peptides from wheat, Saccharomyces cerevisiae, microbiota, tobacco, and pathogens that activated both the Vα3S1/Vβ13S1 TCR and CD8+ T cells from psoriasis patients. Using fluorescent HLA-C*06:02 tetramers loaded with ADAMTSL5 or wheat peptides, we find that the same CD8+ T cells may recognize both autoantigen and environmental antigens. A wheat-free diet could alleviate psoriasis in several patients.DiscussionOur results show that due to TCR polyspecificity, several environmental antigens corresponding to previously suspected psoriasis risk conditions converge in the reactivity of a pathogenic psoriatic TCR and might thus be able to stimulate the psoriatic autoimmune response against melanocytes. Avoiding the corresponding environmental risk factors could contribute to the management of psoriasis

The impact of health volunteering of radiology students on improving their self-skills and practical capabilities in the Kingdom of Saudi Arabia

BackgroundVolunteering is a beneficial activity with a wide range of positive outcomes, from the individual to the communal level. In many ways, volunteering has a positive impact on the development of a volunteer’s personality and experience. This study aimed to evaluate the impact of health volunteering on improving the self-skills and practical capacities of students in the western region of the Kingdom of Saudi Arabia.Materials and methodsThe study was a descriptive cross-sectional electronic web-based survey that was submitted on a web-based questionnaire; 183 students answered the survey, and then, the data were analyzed using SPSS.ResultsThis study shows that 95.6% of participants agree and strongly agree that the health volunteering experience was useful, 2.7% of the participants neither agree nor disagree, and 1.6% disagree and strongly disagree. Regarding the distribution of the participants on skills learned from volunteering experience, the largest proportion of student (36.1%) volunteers in the health sector acquired communication skills and the smallest proportion of student (14.8%) volunteers in the acquired time management skills. Regarding the disadvantages, 81.4% of the participants do not think there were any disadvantages to their previous health volunteering experience, while only 18.6% of them think there were any disadvantages to their previous health volunteering experience. Additionally, the study found that the type of the sector affects the skills acquired from health volunteering.ConclusionResearch revealed that the majority considered volunteering a great experience. Volunteering increased the self-skills and practical capacities of radiology students, which proved the hypothesis

Table_1_The impact of health volunteering of radiology students on improving their self-skills and practical capabilities in the Kingdom of Saudi Arabia.DOCX

BackgroundVolunteering is a beneficial activity with a wide range of positive outcomes, from the individual to the communal level. In many ways, volunteering has a positive impact on the development of a volunteer’s personality and experience. This study aimed to evaluate the impact of health volunteering on improving the self-skills and practical capacities of students in the western region of the Kingdom of Saudi Arabia.Materials and methodsThe study was a descriptive cross-sectional electronic web-based survey that was submitted on a web-based questionnaire; 183 students answered the survey, and then, the data were analyzed using SPSS.ResultsThis study shows that 95.6% of participants agree and strongly agree that the health volunteering experience was useful, 2.7% of the participants neither agree nor disagree, and 1.6% disagree and strongly disagree. Regarding the distribution of the participants on skills learned from volunteering experience, the largest proportion of student (36.1%) volunteers in the health sector acquired communication skills and the smallest proportion of student (14.8%) volunteers in the acquired time management skills. Regarding the disadvantages, 81.4% of the participants do not think there were any disadvantages to their previous health volunteering experience, while only 18.6% of them think there were any disadvantages to their previous health volunteering experience. Additionally, the study found that the type of the sector affects the skills acquired from health volunteering.ConclusionResearch revealed that the majority considered volunteering a great experience. Volunteering increased the self-skills and practical capacities of radiology students, which proved the hypothesis.</p