Comorbidities and Risk Factors for Severe Outcomes in COVID-19 Patients in Saudi Arabia: A Retrospective Cohort Study

Purpose: The first novel coronavirus disease-19 (COVID-19) case in the Kingdom of Saudi Arabia (KSA) was reported in Qatif in March 2020 with continual increase in infection and mortality rates since then. In this study, we aim to determine risk factors which effect severity and mortality rates in a cohort of hospitalized COVID-19 patients in KSA. Method: We reviewed medical records of hospitalized patients with confirmed COVID-19 positive results via reverse-transcriptase-polymerase-chain-reaction (RT-PCR) tests at Prince Mohammed Bin Abdulaziz Hospital, Riyadh between May and August 2020. Data were obtained for patient’s demography, body mass index (BMI), and comorbidities. Additional data on patients that required intensive care unit (ICU) admission and clinical outcomes were recorded and analyzed with Python Pandas. Results: A total of 565 COVID-19 positive patients were inducted in the study out of which, 63 (11.1%) patients died while 101 (17.9%) patients required ICU admission. Disease incidences were significantly higher in males and non-Saudi nationals. Patients with cardiovascular, respiratory, and renal diseases displayed significantly higher association with ICU admissions (p< 0.001) while mortality rates were significantly higher in COVID-19 patients with cardiovascular, respiratory, renal and neurological diseases. Univariate cox proportional hazards regression model showed that COVID-19 positive patients requiring ICU admission [Hazard’s ratio, HR=4.2 95% confidence interval, CI 2.5– 7.2); p< 0.001] with preexisting cardiovascular [HR=4.1 (CI 2.5– 6.7); p< 0.001] or respiratory [HR=4.0 (CI 2.0– 8.1); p=0.010] diseases were at significantly higher risk for mortality among the positive patients. There were no significant differences in mortality rates or ICU admissions among males and females, and across different age groups, BMIs and nationalities. Hospitalized patients with cardiovascular comorbidity had the highest risk of death (HR=2.9, CI 1.7– 5.0; p=0.020). Conclusion: Independent risk factors for critical outcomes among COVID-19 in KSA include cardiovascular, respiratory and renal comorbidities

Omics-based molecular techniques in oral pathology centred cancer: Prospect and challenges in Africa

: The completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and “big data” processing have contributed immensely to individualized/personalized medicine in the developed world.At the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratifcation of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the profciency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among diferent human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences

Secure and Efficient WBAN Authentication Protocols for Intra-BAN Tier

Telecare medical information system (TMIS) is a technology used in a wireless body area network (WBAN), which has a crucial role in healthcare services. TMIS uses wearable devices with sensors to collect patients’ data and transmit the data to the controller node via a public channel. Then, the medical server obtains the data from the controller node and stores it in the database to be analyzed. Unfortunately, an attacker can try to perform attacks via a public channel. Thus, establishing a secure mutual authentication protocol is essential for secure data transfer. Several authentication schemes have been presented to achieve mutual authentication, but there are performance limitations and security problems. Therefore, this study aimed to propose two secure and efficient WBAN authentication protocols between sensors and a mobile device/controller: authentication protocol-I for emergency medical reports and authentication protocol-II for periodic medical reports. To analyze the proposed authentication protocols, we conducted an informal security analysis, implemented BAN logic analysis, validated our proposed authentication protocol using the AVISPA simulation tool, and conducted a performance analysis. Consequently, we showed that our proposed protocols satisfy all security requirements in this study, attain mutual authentication, resist active and passive attacks, and have suitable computation and communication costs for a WBAN

Metabolic rewiring in mutant Kras lung cancer

Lung cancer is the leading cause of cancer-related death worldwide, reflecting an unfortunate combination of very high prevalence and low survival rates, as most cases are diagnosed at advanced stages when treatment efficacy is limited. Lung cancer comprises several disease groups with non small cell lung cancer (NSCLC) accounting for ~ 85% of cases and lung adenocarcinoma being its most frequent histological subtype. Mutations in Kirsten rat sarcoma viral oncogene homologue (KRAS) affect ~ 30% of lung adenocarcinomas but unlike other commonly altered proteins (EGFR and ALK, affected in ~ 14% and 7% of cases respectively), mutant KRAS remains untargetable. Therapeutic strategies that rely instead on the inhibition of mutant KRAS functional output or the targeting of mutant KRAS cellular dependencies (i.e. synthetic lethality) are an appealing alternative approach. Recent studies focused on the metabolic properties of mutant KRAS lung tumours have uncovered unique metabolic features that can potentially be exploited therapeutically. We review these findings here with a particular focus on in vivo, physiologic, mutant KRAS activity

F-18-FECH PET/CT to Assess Clinically Significant Disease in Prostate Cancer: Correlation With Maximum and Total Cancer Core Length Obtained via MRI-Guided Template Mapping Biopsies

OBJECTIVE. The objective of this study was to detect clinically significant and insignificant prostate cancer on 18F-fluoroethylcholine (FECH) PET/CT and to correlate findings with transperineal template-guided prostate mapping (TPM) biopsy. SUBJECTS AND METHODS. Fifty-six lobes of the prostate were analyzed in 28 men who underwent FECH PET/CT and TPM. Whole-body images and pelvic images were acquired at 60 and 90 minutes after tracer administration. FECH PET/CT findings were correlated with TPM. Sensitivity, specificity, positive predictive values, negative predictive values, and AUC of dual phase FECH PET/CT were calculated. RESULTS. Mean age of the patients was 68.8 years (range, 53–79 years), and mean prostate-specific antigen level was 12.1 ng/mL (range, 0.6–45 ng/mL). Mean maximum cancer core length was 4.4 mm (median, 4 mm; range, 1–14 mm) and mean total cancer core length, 14.6 mm (median, 14.6 mm; range, 1–82 mm). Prostate cancer was identified in 38 lobes with a Gleason score of 6 in five lobes (13%), 7 in 27 lobes (71%), 8 in four lobes (11%), and 9 in two lobes (5%). FECH PET/CT showed findings of prostate cancer in 46/56 lobes (82%). The ranges for maximum standardized uptake value for 60- and 90-minute FECH PET/CT were 1.3–11.4 and 1.2–10.9, respectively. Clinically significant cancer was seen in 30 of 38 positive lobes; eight had clinically insignificant disease. For 60-minute imaging, the sensitivity, specificity, and ROC AUC were 75%, 75%, and 0.746 (95% CI, 0.612–0.853). For 90-minute imaging, the sensitivity, specificity, and ROC AUC were 73.7%, 58.3%, and 0.646 (95% CI, 0.498–0.776). Overall sensitivity, specificity, positive predictive value, and negative predictive value were 95%, 50%, 82.6%, and 80%, respectively. CONCLUSION. FECH PET/CT can detect prostate cancer and localizes TPM biopsy-proven clinically significant prostate cancer with sensitivity of greater than 89.7%. Of the two imaging durations, 60-minute imaging is more sensitive and specific than 90-minute imaging

COVID-19 Intelligence-Driven Operational Response Platform: Experience of a Large Tertiary Multihospital System in the Middle East

The COVID-19 pandemic has resulted in global disruptions within healthcare systems, leading to quick dynamic fluctuations in hospital operations and supply chain management. During the early months of the pandemic, tertiary multihospital systems were highly viewed as the go-to hospitals for handling these rapid healthcare challenges caused by the rapidly increasing number of COVID-19 cases. Yet, this pandemic has created an urgent need for coordinated mechanisms to alleviate increasing pressures on these large multihospital systems and ensure services remain high-quality, accessible, and sustainable. Digital health solutions have been identified as promising approaches to address these challenges. This case report describes results for developing multidisciplinary visualizations to support digital health operations in one of the largest tertiary multihospital systems in the Middle East. The report concludes with some lessons and insights learned from the rapid development and delivery of this user-centric COVID-19 multihospital operations intelligent platform