Intrathyroidal parathyroid carcinoma: a case report with clinical and histological findings

The chance of an intrathyroidal occurrence of a parathyroid gland is about 1–3%. Among the causes of hyperparathyroidism, parathyroid cases occur in less than 1% of patients. Here we present the case of a 63 year old Saudi female suffering from an intrathryroidal parathyroid carcinoma. The suspicion coming from the clinical investigations that the removed tumor tissue may be a parathyroid carcinoma could be confirmed by histology. Additionally non-radioactive in situ hybridization to localize mRNA transcripts for Cyclin D1 and immunohistochemical localization of Cyclin D1 was performed. Although parathyroid adenoma and carcinoma have disparate natural history, it can be difficult to differentiate between the two entities. Clinical presentation, operative findings may raise suspicion, but may not be conclusive especially if there is no evidence of invasion or metastasis, especially if the gland was intrathyroidal

ENVIRONMENTAL ASSESSMENT OF AL-HILLAH RIVER POLLUTION AT BABIL GOVERNORATE (IRAQ)

In this study, the environmental characteristics of Al-Hillah River were studied using geoinformatics applications, which is one of the geospatial techniques (GST). Applying this methodology, a geographic information system was developed, and it was supplied with laboratory data for the physical and chemical properties of 16 parameters for 2021. These data were linked to their spatial locations, using radar imagery of the Digital Elevation Model (Shuttle Radar Topography Mission), and Landsat ETM+7 satellite image. The results indicated that Al-Hillah River was affected by the liquid discharges of factories, cities, and farms spread on its sides, especially in the cities of Sadat Al-Hindiya, Al-Hillah, and Al-Hashimiyah. The seasonal changes in the climate affected some characteristics, including water temperature, pH, turbidity, total dissolved solids, and total hardness. The study showed that the concentration of sulfate (SO4) has risen above the permissible limits for the waters of Iraqi rivers. There are relatively high hardness and alkalinity values, but they were within the permissible limits. The study also showed that most of the results of environmental parameters that were used in the laboratory, were within the permissible limits of Iraqi water, except for sulfates. The justification for conducting this study is to help government agencies and decision-makers to adopt a correct vision for development projects that serve Babil Governorate. Also, it is the first time that the environmental characteristics of Al-Hillah River are studied using geoinformatics applications

Diabesity in the Arabian Gulf: Challenges and Opportunities

Diabesity (diabetes associated with obesity) is a major global and local public health concern, which has almost reached an epidemic order of magnitude in the countries of the Arabian Gulf and worldwide. We sought to review the lifestyle trends in this region and to highlight the challenges and opportunities that health care professionals face and attempt to address and correct them. In this regard, we aimed to review the regional data and widely held expert opinions in the Arabian Gulf and provide a thematic review of the size of the problem of diabesity and its risk factors, challenges, and opportunities. We also wished to delineate the barriers to health promotion, disease prevention, and identify social customs contributing to these challenges. Lastly, we wished to address specific problems with particular relevance to the region such as minimal exercise and unhealthy nutrition, concerns during pregnancy, the subject of childhood obesity, the impact of Ramadan fasting, and the expanding role of bariatric surgery. Finally, general recommendations for prevention, evidence-based, and culturally competent management strategies are presented to be considered at the levels of the individual, community, and policymakers

Clinical experience with insulin detemir, biphasic insulin aspart and insulin aspart in people with type 2 diabetes: Results from the Bahraini cohort of the A 1 chieve study

Background: The A 1 chieve, is a multicentric (28 countries), 24-weeks, non-interventional study to evaluate the safety and effectiveness of insulin detemir, biphasic insulin aspart and insulin aspart in people with T2DM (n = 66,726) in routine clinical care across four continents. Materials and Methods: Data was collected at baseline, at 12 weeks and at 24 weeks. This short communication presents the results for patients enrolled from Manama, kingdom of Bahrain. Results: A total of 115 patients were enrolled in the study. Four different insulin analogue regimens were used in the study. Study patients had started on or were switched to biphasic insulin aspart (n = 67), insulin detemir (n = 16), insulin aspart (n = 4), basal insulin plus insulin aspart (n = 21) and other insulin combinations (n = 7). At baseline, glycaemic control was poor for both insulin naïve (mean HbA1c: 10.2%) and insulin users (mean HbA1c: 9.8%) groups. After 24 weeks of treatment, both the groups showed improvement in HbA1c (insulin naïve: −1.1%, insulin users: −1.3%). SADRs including major hypoglycaemic events did not occur in the study patients. Conclusion: Starting or switching to insulin analogues was associated with improvement in glycaemic control with a low rate of hypoglycaemia

Swedish Concrete Roads : Performance, Damages and Rehabilitation 10-30 Years after Construction

This thesis presents a comprehensive investigation on the performance and durability of five concrete roads in Sweden focusing on the time after 2010. The studied roads include Arlanda, Falkenberg Part 1 (Heberg-Långås), Falkenberg Part 2 (Heberg-Fastarp), Eskilstuna, and Uppsala. The study focuses on various aspects, such as strength, wear and tear, evenness, friction, and rehabilitation measures, to assess the overall condition and maintenance requirements of each road. Initially, the concrete roads were constructed with compressive strengths of 60 MPa for all roads except Arlanda, which was built with a higher strength of 80 MPa. The study tracks the development of concrete strength over time, considering factors like the type of cement used, water-to-cement ratio, concrete age, and prevailing temperature and humidity conditions. Analysing both wear and tear patterns and road evenness allows for a comprehensive understanding of the performance of right hand lanes K1 across all five concrete roads. By examining these patterns and comparing K1 lanes among all five concrete roads, and also comparing K1 and K2 lanes, the study aims to assess the impact of heavy truck traffic, which is more frequent on K1 lanes, while K2 lanes experience less intense traffic. The primary objective is to identify the factors contributing to the varying levels of deterioration and damage observed in these concrete roads. Furthermore, the thesis explores the frictional factors related to road safety and comfort wear, with a specific focus on identifying the appropriate friction factors for concrete roads. The friction factor plays a vital role in maintaining vehicle stability and reducing braking distance, especially in adverse weather conditions. Damages and rehabilitation measures for concrete roads since 2010 have been identified to address existing issues and ensure road durability. Documenting the damages recorded since 2010, along with outlining the rehabilitation measures aimed at stopping further deterioration. Furthermore, the study examines a brief analysis of the underlying reasons behind these damages. The thesis also includes interviews with concrete road specialists from the Swedish Transport Administration (Trafikverket), covering all five concrete roads. The primary objective of these interviews was to obtain a comprehensive understanding of various aspects related to the development of these roads over the last decade. Additionally, the interviews aimed to fill in any missing data gaps and facilitate the interpretation of the available data. This study shows that Falkenberg part 1: Heberg-Långås and Arlanda are considered as the best performers. In contrast, Eskilstuna and Uppsala are identified as the poorest-performing concrete roads. Notably, Falkenberg part 2: Fastarp-Heberg is reported to come second in terms of performance between the concrete roads, maintaining a good level of performance despite some damages. This assessment is based on the criteria as mentioned earlier which are strength, wear and tear, evenness, friction, and rehabilitation measures.  The results of this study offer valuable insights into the development and maintenance strategies of concrete roads in Sweden. The study includes an analysis of climate conditions and traffic levels for each road, as well as information about their construction. Moreover, it provides essential data regarding the maintenance and rehabilitation measures implemented since 2010. Overall, this investigation offers an in-depth summary of the conditions of the five concrete roads in Sweden, providing valuable information on their development, maintenance, and rehabilitation, thereby giving a complete picture of how they have performed and lasted over the last decade. This study can serve as a resource for road authorities and engineers, offering a comprehensive overview of the state of concrete road infrastructure in Sweden.

Swedish Concrete Roads : Performance, Damages and Rehabilitation 10-30 Years after Construction

This thesis presents a comprehensive investigation on the performance and durability of five concrete roads in Sweden focusing on the time after 2010. The studied roads include Arlanda, Falkenberg Part 1 (Heberg-Långås), Falkenberg Part 2 (Heberg-Fastarp), Eskilstuna, and Uppsala. The study focuses on various aspects, such as strength, wear and tear, evenness, friction, and rehabilitation measures, to assess the overall condition and maintenance requirements of each road. Initially, the concrete roads were constructed with compressive strengths of 60 MPa for all roads except Arlanda, which was built with a higher strength of 80 MPa. The study tracks the development of concrete strength over time, considering factors like the type of cement used, water-to-cement ratio, concrete age, and prevailing temperature and humidity conditions. Analysing both wear and tear patterns and road evenness allows for a comprehensive understanding of the performance of right hand lanes K1 across all five concrete roads. By examining these patterns and comparing K1 lanes among all five concrete roads, and also comparing K1 and K2 lanes, the study aims to assess the impact of heavy truck traffic, which is more frequent on K1 lanes, while K2 lanes experience less intense traffic. The primary objective is to identify the factors contributing to the varying levels of deterioration and damage observed in these concrete roads. Furthermore, the thesis explores the frictional factors related to road safety and comfort wear, with a specific focus on identifying the appropriate friction factors for concrete roads. The friction factor plays a vital role in maintaining vehicle stability and reducing braking distance, especially in adverse weather conditions. Damages and rehabilitation measures for concrete roads since 2010 have been identified to address existing issues and ensure road durability. Documenting the damages recorded since 2010, along with outlining the rehabilitation measures aimed at stopping further deterioration. Furthermore, the study examines a brief analysis of the underlying reasons behind these damages. The thesis also includes interviews with concrete road specialists from the Swedish Transport Administration (Trafikverket), covering all five concrete roads. The primary objective of these interviews was to obtain a comprehensive understanding of various aspects related to the development of these roads over the last decade. Additionally, the interviews aimed to fill in any missing data gaps and facilitate the interpretation of the available data. This study shows that Falkenberg part 1: Heberg-Långås and Arlanda are considered as the best performers. In contrast, Eskilstuna and Uppsala are identified as the poorest-performing concrete roads. Notably, Falkenberg part 2: Fastarp-Heberg is reported to come second in terms of performance between the concrete roads, maintaining a good level of performance despite some damages. This assessment is based on the criteria as mentioned earlier which are strength, wear and tear, evenness, friction, and rehabilitation measures.  The results of this study offer valuable insights into the development and maintenance strategies of concrete roads in Sweden. The study includes an analysis of climate conditions and traffic levels for each road, as well as information about their construction. Moreover, it provides essential data regarding the maintenance and rehabilitation measures implemented since 2010. Overall, this investigation offers an in-depth summary of the conditions of the five concrete roads in Sweden, providing valuable information on their development, maintenance, and rehabilitation, thereby giving a complete picture of how they have performed and lasted over the last decade. This study can serve as a resource for road authorities and engineers, offering a comprehensive overview of the state of concrete road infrastructure in Sweden.

Can interprofessional education change students’ attitudes? A case study from Lebanon

Abstract Background Interprofessional collaboration is key to improving the health of individuals and communities. It is supported by provision of Interprofessional education (IPE) which has recently emerged in the Middle East region. This study investigated changes in healthcare students’ attitudes towards interprofessional collaboration after undertaking the Interprofessional Education and Collaboration (IPEC) course. Methods A paper-based anonymous survey using the Interprofessional Attitude Scale (IPAS) was administered to a sample of 346 health students (nursing, medicine, and public health) pre/post undertaking the IPEC course. Less than half of the students provided a post response, with pre/post survey results of 111 pairs subsequently matched and analyzed. Results Results showed elevated pre-course scores, an improvement in students’ attitudes towards the interprofessional biases domain of the IPAS, and a slight decline in their scores in the remaining 4 domains (team roles and responsibilities, patient centeredness, community centeredness, and diversity and ethics). These changes were not statistically significant, except for the patient centeredness domain (p = 0.003**). Conclusions The study provided important results about attitudes towards interprofessional collaboration. These findings are essential because our institution is one of few in Lebanon that provides this mandatory course to a large group of health professionals. Future studies should investigate these changes in attitude scores in a larger sample size, and how these attitudes would influence collaboration post-graduation

Diagnosis and management of vitamin D deficiency in the Gulf Cooperative Council (GCC) countries: an expert consensus summary statement from the GCC vitamin D advisory board.

OBJECTIVE A summary of recommendations is given within the Gulf Cooperation Council (GCC) setting on the assessment and management of vitamin D deficiency in the region. METHODS An assembly of 11 regional experts gathered to formulate an all-inclusive approach to vitamin D deficiency within GCC. RESULTS AND CONCLUSION Several gaps were identified before regional guidelines could be developed. These include adequacy and standardization of vitamin D testing, frequency of repeated testing and reference ranges, distinguishing prevention from the treatment of vitamin D deficiency, quality assurance of vitamin D products sold within GCC including contents and origins of products, and cut-points for vitamin D levels in local populations. A platform is created that can be further developed for overall regional implementation