The Association between Chronic Arsenic Exposure and Hypertension: A Meta-Analysis

Background. There is inconclusive evidence from cross-sectional and cohort studies that arsenic exposure is a risk factor involved in the development of hypertension. Methods. A database search, using several keywords, was conducted to identify relevant studies. Separate odds ratio estimates for arsenic exposure with concentration only and arsenic exposure with duration, including biomarker, were extracted from studies that met all inclusion criteria. The extracted odds ratios (OR) comparing the highest exposure categories with the lowest in each study were pooled using the random effects methods of meta-analysis. Heterogeneity of odds ratios in the included studies were analyzed using I2 statistics. Results. Eight studies were analyzed. Using the exposure as arsenic concentration in the drinking water, the OR estimate was 1.9 (95% CI: 1.2–3.0), with the I2 = 92%, while using the exposure as concentration and duration, the OR estimate was 1.4 (95% CI: 0.95–2.0) with the I2 = 80%. Meta-regression was done and the quality of exposure measurement was found to be significantly associated with the effect measure. For a one unit increase in the score from exposure assessment, the odds ratio decreased by 6%. No publication bias was evident. The only major weaknesses of this study were heterogeneity across studies and small sample size. Conclusions. The study findings provide limited evidence for a relationship between arsenic and hypertension. In summary, the relationship between arsenic exposure and hypertension is still inconclusive and needs further validation through prospective cohort studies

(E)-3-(2-Chloro-6-methyl-3-quinol­yl)-1-(2,3-dihydro-1,4-benzodioxin-6-yl)prop-2-en-1-one

In the title mol­ecule, C21H16ClNO3, the quinoline and benzene rings are inclined at 56.96 (6)° with respect to each other and the dioxine ring is in a twist-chair conformation. The structure is devoid of any classical hydrogen bonds. Rather weak inter­molecular hydrogen-bonding inter­actions of the types C—H⋯N and C—H⋯O are present, consolidating the crystal structure

Air Pollution and Its Effect on Human Health: A Case Study in Dera Ghazi Khan Urban Areas, Pakistan

Presently, air pollution is a principal global health threats which is responsible for enhancing the chances for spreading of many chronic diseases. This problem occurred over past few decades due to fast growth in urbanization, industrialization and massive of vehicles volume in developed and under developed countries.  The contaminated air leads the detrimental effects on the human health. Principal air pollutants are particulate matter, sulpher dioxide, nitrogen oxides, ammonia, carbon monoxide and ozone. When the level of these pollutants is increased at certain degree, the outcome may cause serious respiratory problems which lead to happening of deaths. In recent years, rapidly increasing population, economic and educational developments in the city brought a huge pressure of traffic. So, the current study was planned to determine the roots and examine the awful consequences of air pollution on the humanity health. Public opinions on exposure are severe in examining human reaction and adoption of concerned strategies. Hence, viewing people’ perception is vital in establishing the plan of suitable managing actions.  We arranged this study in Dera Ghazi Khan City to obtain the local people know-how of the existing air pollution situation and their postures towards measures to control of air pollution. Multistage sampling technique was applied for the selection of 120 respondents and data was collected by developing questioners.  Most of the interviewees illustrated that air pollution is very hazardous for the people health and is responsible for the cause of many diseases. Keywords: Air Pollution, Human health, Pollutants, Environment, Dera Ghazi Kha

) in an Emerging Economy

Abstract: This study explores the level of awareness of corporate social responsibility (CSR) among MBA students at a major Saudi university; MBA students were chosen for this research because these students represent future business leaders. All of the attending MBA students were surveyed, and 204 valid responses were used for the analysis. Four CSR dimensions were investigated: economic, legal, ethical, and philanthropic dimensions. Significant differences were found in the respondents' awareness of the CSR dimensions. Significant awareness differences were also found among the respondents based on gender, work experience, and managerial position. Implications, recommendations, limitations, and directions for future research are discussed

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

Comparative Study of Service Performance in Saudi Hospitals – The Government versus the Private Healthcare System

Healthcare system in recent past has undergone a transition from being provider driven into the one that is consumer driven. Also it has moved away from basic healthcare to service sophistication. Scholars have argued that increased service satisfaction builds enduring relationship with the patient often in resulting in repeat visits. Poised to become a key driver in the rapidly changing economic landscape of KSA, it is a $140 Billion market in Saudi Arabia and over$ 7 Trillion globally. This work is an attempt to figure out the existing service performance gap in the Govt. and the private healthcare system of KSA. This paper draws upon a young sample to reflect on the service dichotomies, so that they can envisage the future contours of the healthcare system in the Kingdom of Saudi Arabia

The association between chronic arsenic exposure and hypertension: A meta-analysis

Background. There is inconclusive evidence from cross-sectional and cohort studies that arsenic exposure is a risk factor involved in the development of hypertension. Methods. A database search, using several keywords, was conducted to identify relevant studies. Separate odds ratio estimates for arsenic exposure with concentration only and arsenic exposure with duration, including biomarker, were extracted from studies that met all inclusion criteria. The extracted odds ratios (OR) comparing the highest exposure categories with the lowest in each study were pooled using the random effects methods of meta-analysis. Heterogeneity of odds ratios in the included studies were analyzed using I 2 statistics. Results. Eight studies were analyzed. Using the exposure as arsenic concentration in the drinking water, the OR estimate was 1.9 (95% CI: 1.2-3.0), with the I 2 = 92%, while using the exposure as concentration and duration, the OR estimate was 1.4 (95% CI: 0.95-2.0) with the I 2 = 80%. Meta-regression was done and the quality of exposure measurement was found to be significantly associated with the effect measure. For a one unit increase in the score from exposure assessment, the odds ratio decreased by 6%. No publication bias was evident. The only major weaknesses of this study were heterogeneity across studies and small sample size. Conclusions. The study findings provide limited evidence for a relationship between arsenic and hypertension. In summary, the relationship between arsenic exposure and hypertension is still inconclusive and needs further validation through prospective cohort studies

Changes in children’s surgical services during the COVID-19 pandemic at a tertiary-level government hospital in a lower middle-income country

Objective The aim of this study was to quantify the changes that occurred in the surgical services of children during the COVID-19 pandemic from the perspective of a low/middle-income country.Design A case–control study was conducted at a large referral centre in Bangladesh among patients aged ≤12 years. Comparisons were made between cases admitted during a period of ‘April to September 2020’ (Pandemic period) and controls during a similar period in 2019 (Reference period). The number of admissions and outpatient department (OPD) attendances, age and sex distribution, diagnosis, number and types of surgeries performed (elective vs emergency), variations in treatment of acute appendicitis, types of anaesthesia and mortality were compared.Results Admissions were only 41% of previous year (635 vs 1549), and OPD attendances were only 28% of previous year (603 vs 2152). Admission of children reduced by 65.8%, but neonatal admission reduced only by 7.6%. The median age of the admitted patients was significantly lower during the pandemic period (3 vs 4 years, p<0.01). Acute appendicitis (151, 9.8%) and trauma (61, 9.6%), respectively, were the the most common causes of admission during the reference and the pandemic period. Elective surgeries were only 17% and emergency surgeries were 64% of previous year (p<0.01). Appendectomy (88, 9.1%) and laparotomy (77, 17.6%), respectively, were the most common surgeries performed during the reference and the pandemic period. Conservative treatment of acute appendicitis was more during the pandemic period (47.5% vs 28.5%, p=0.01), but patients who underwent appendectomies had more complicated appendicitis (63.3% vs 42.1%, p=0.01). In all, 90.4% of surgeries were performed by resident doctors. There were no COVID-19- related deaths.Conclusion Trauma became the most common cause of admission during the pandemic, and neonatal surgical conditions remained almost unchanged with high mortality rates. Elective procedures and laparoscopy remained low and resident doctors played a major role in providing surgical services

NPT-Loss: Demystifying face recognition losses with Nearest Proxies Triplet

Face recognition (FR) using deep convolutional neural networks (DCNNs) has seen remarkable success in recent years. One key ingredient of DCNN-based FR is the design of a loss function that ensures discrimination between various identities. The state-of-the-art (SOTA) solutions utilise normalised Softmax loss with additive and/or multiplicative margins. Despite being popular and effective, these losses are justified only intuitively with little theoretical explanations. In this work, we show that under the LogSumExp (LSE) approximation, the SOTA Softmax losses become equivalent to a proxy-triplet loss that focuses on nearest-neighbour negative proxies only. This motivates us to propose a variant of the proxy-triplet loss, entitled Nearest Proxies Triplet (NPT) loss, which unlike SOTA solutions, converges for a wider range of hyper-parameters and offers flexibility in proxy selection and thus outperforms SOTA techniques. We generalise many SOTA losses into a single framework and give theoretical justifications for the assertion that minimising the proposed loss ensures a minimum separability between all identities. We also show that the proposed loss has an implicit mechanism of hard-sample mining. We conduct extensive experiments using various DCNN architectures on a number of FR benchmarks to demonstrate the efficacy of the proposed scheme over SOTA methods