Publications by authors named "Mohammed Alshehri"

124 Publications

Awareness, knowledge, and attitude toward venous thromboembolism among Aseer Population, Saudi Arabia.

J Family Med Prim Care 2021 Jun 2;10(6):2411-2415. Epub 2021 Jul 2.

Medical Student, Department of Medicine, College of Medicine, King Khalid University, Abha, Kingdom of Saudi Arabia.

Objectives: Calls to carry efforts to increase awareness about venous thromboembolism (VTE) as a preventable major healthcare problem with serious consequences has been upraised. This study was planned to get an overview of the awareness, knowledge, and attitude toward VTE among Aseer population, Saudi Arabia and the need for an education plan.

Materials And Methods: Questionnaire composed of 35 questions based cross-sectional study was conducted online via Google documents to public in Aseer that included both genders aged more than 18 years who agreed to be involved in the study, to assess knowledge and attitude toward VTE. The collected data were presented as numbers, percentages, and were analyzed using Statistical Package for Social Sciences version 24.

Results: The results of the data showed that awareness knowledge and attitude toward VTE were lacking and unsatisfactory.

Conclusion: Diligence to spread knowledge and awareness of VTE among public in Aseer is required. Further surveys involving other populations are warranted.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_2430_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8284245PMC
June 2021

Comparison of immobilization periods following open reduction and internal fixation of distal radius fracture: A systematic review and meta-analysis.

J Hand Ther 2021 Jul 22. Epub 2021 Jul 22.

College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Orthopedic Surgery, King Abdulaziz Medical City, Jeddah, Saudi Arabia.

Study Design: Systematic review and meta-analysis.

Introduction: The use of volar locking plate (VLP) in the fixation of fracture fragments promised a new era in the management of distal radius fracture (DRF).

Purpose Of The Study: To compare the patient-reported outcomes, functional outcomes, pain, and adverse events between the different periods of immobilization following open reduction and internal fixation of DRFs with VLP.

Methods: We searched Medline/Pubmed, Web of Science, Ovid, and CINAHL. The inclusion criteria was randomized controlled trials that compared different immobilization periods after open reduction and internal fixation of DRFs with VLP. The last search was performed on 2 June 2020. The different immobilization periods were divided into the following 3 groups: ≤1-week group, 2-3-week group, and 5-6-week group.

Results: Seven eligible randomized controlled trials provided data on 509 patients. We found that compared to 5-6-week group, ≤1-week and 2-3-week groups showed a reduction in overall Patient-Reported Wrist Evaluation score (SMD = -0.48, 95% CI -0.73 to -0.22, P < .001; SMD = -0.69, 95% CI -0.97 to -0.41, P < .001, respectively). We also found that there were improvements in the other patient-reported outcomes including overall Disabilities of the Arm, Shoulder, and Hand score and pain; and functional outcomes including overall grip strength and range of motion measures in favor of ≤1-week and 2-3-week groups.

Conclusion: This systematic review and meta-analysis showed that compared to immobilization for 5 to 6 weeks after DRF repair, immobilization for ≤1 week or 2-3 weeks showed improvements in the patients-reported outcomes and functional outcomes. The differences between the 3 immobilization groups may not be clinically important considering the small changes as follow up progresses.
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http://dx.doi.org/10.1016/j.jht.2021.06.004DOI Listing
July 2021

Venlafaxine demonstrated anti-arthritic activity possibly through down regulation of TNF-α, IL-6, IL-1β, and COX-2.

Inflammopharmacology 2021 Jul 24. Epub 2021 Jul 24.

Department of Clinical Laboratory Sciences, Faculty of Applied Medical Sciences, Najran University, 1988, Najran, 61441, Saudi Arabia.

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor used to treat depression. Previous studies demonstrated its anti-nociceptive and anti-inflammatory activities through the suppression of pro-inflammatory cytokines. Present research aimed to explore its anti-arthritic potential. Different in-vitro assays including egg albumin, bovine serum albumin denaturation and human red blood cell (RBC) membrane stabilization assays along with in-vivo models of formaldehyde and complete Freund's adjuvant-induced arthritis were used to study its anti-arthritic effect. Venlafaxine inhibited egg albumin and bovine serum albumin denaturation and preserve the integrity of red blood cells membrane in concentration-dependent manner. In formaldehyde-induced arthritis venlafaxine significantly (p < 0.001) reduced the paw edema on treatment for 10 days. Chronic administration of venlafaxine for 28 days in Freund's adjuvant-induced arthritis model decreased the paw volume (p < 0.001), arthritic index (p < 0.01), flexion pain score (p < 0.05), mobility score (p < 0.05), and improved the stance score (p < 0.05). Venlafaxine also significantly declined the rheumatoid factor (p < 0.01) and C-reactive protein (p < 0.05) levels and increased the RBC count (p < 0.01) and Hb value (p < 0.001). Upon PCR analysis venlafaxine remarkably turndown the mRNA expression of TNF-α, IL-6, IL-1β, and COX-2. Taken together it is inferred from current findings that venlafaxine possesses the significant anti-arthritic activity and could be a potential therapeutic option for the treatment of rheumatoid arthritis.
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http://dx.doi.org/10.1007/s10787-021-00849-0DOI Listing
July 2021

Histological, Histochemical, and Ultrastructural Approach to the Ductus Deferens in Male Nile Monitor Lizard ().

Microsc Microanal 2021 Jun 22:1-6. Epub 2021 Jun 22.

Department of Theriogenology, Faculty of Veterinary Medicine, South Valley University, Qena83523, Egypt.

The ductus deferens is a fundamental part of the male genital tract and the continuation of the epididymal duct. As a male secondary sex organ, the ductus deferens plays a crucial role in the nourishment, storage, and maturation of spermatozoa. Some studies have provided information about the ductus deferens structure in reptiles; however, the full description of the ductus deferens remains to be clarified. The current study aimed to describe the Nile monitor lizard (Varanus niloticus) ductus deferens from histological, histochemical, and ultrastructural perspectives. The results revealed that the ductus deferens is formed histologically from two main cell types: principal and basal. The principal cells were tall and filled with periodic acid Schiff (+)/alcian blue (−) cytoplasmic granules. The basal cells were found just above the basement membrane. By transmission electron microscopy, the principal cells exhibited typical protein-secreting cell features. Additionally, some intraepithelial cells, such as halo cells, undifferentiated mesenchymal cells, and agranular leukocytes, were identified. This study presents the first detailed description of the Varanus niloticus ductus deferens. Further immunohistochemical studies are required to explore the function(s) of the cellular components.
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http://dx.doi.org/10.1017/S1431927621012046DOI Listing
June 2021

Nonlinear dynamics for the spread of pathogenesis of COVID-19 pandemic.

J Infect Public Health 2021 Jul 20;14(7):817-831. Epub 2021 Apr 20.

University School of Basic & Applied Sciences (USBAS), Head, Non-Linear Dynamics-Research-Lab, GGS Indraprastha University, New Delhi, India. Electronic address:

Coronaviruses did not invite attention at a global level and responsiveness until the series of 2003-SARS contagion followed by year-2012 MERS plus, most recently, 2019-nCoV eruptions. SARS-CoV &MERS-CoV are painstaking, extremely pathogenic. Also, very evidently, both have been communicated from bats to palm-civets & dromedary camels and further transferred ultimately to humans. No country has been deprived of this viral genomic contamination wherever populaces reside and are interconnected. This study aimed to develop a mathematical model for calculating the transmissibility of this viral genome. The analysis aids the study of the outbreak of this Virus towards the other parts of the continent and the world. The parameters such as population mobility, natural history, epidemiological characteristics, and the transmission mechanism towards viral spread when considered into crowd dynamism result in improved estimation. This article studies the impact of time on the amount of susceptible, exposed, the infected person taking into account asymptomatic and symptomatic ones; recovered i.e., removed from this model and the virus particles existing in the open surfaces. The transition from stable phase to attractor phase happens after 13 days i.e.; it takes nearly a fortnight for the spread to randomize among people. Further, the pandemic transmission remains in the attractor phase for a very long time if no control measures are taken up. The attractor-source phase continues up to 385 days i.e., more than a year, and perhaps stabilizes on 386th day as per the Lyapunov exponent's analysis. The time series helps to know the period of the Virus's survival in the open sources i.e. markets, open spaces and various other carriers of the Virus if not quarantined or sanitized. The Virus cease to exist in around 60 days if it does not find any carrier or infect more places, people etc. The changes in LCEs of all variables as time progresses for around 400 days have been forecasted. It can be observed that phase trajectories indicate how the two variables interact with each other and affect the overall system's dynamics. It has been observed that for exposed and asymptomatically infected (y-z), as exposed ones (y) change from 0 to 100 the value of asymptomatically infected (z) increased upto around 58, at exposed ones (y)=100, asymptomatically infected (z) has two values as 58 and 10 i.e. follows bifurcation and as exposed ones (y) changes values upto 180, the value of asymptomatically infected (z) decreases to 25 so for exposed ones (y) from 100 to 180, asymptomatically infected (z) varies from 58 to 25 to 10 follows bifurcation. Also, phase structures of exposed-symptomatically infected (y-u), exposed-removed (y-v), exposed-virus in the reservoir (y-w), asymptomatically infected-removed (z-v), symptomatically infected-removed (u-v) specifically depict bifurcations in various forms at different points. In case of asymptomatically infected-virus in the reservoir (z-w), at asymptomatically infected (z)=10, the value of viruses in the reservoir (w)=50, then as asymptomatically infected (z) increases to upto around 60. At this point, removed ones (v) increase from 50 to 70 and asymptomatically infected (z) decrease to 20 i.e., crosses the same value twice, which shows its limiting is known as limit cycle behavior and both the values tend to decrease towards zero. It shows a closed-loop limit cycle. Today, there has been no scientific revolution in the development of vaccination, nor has any antiviral treatment been successful, resulting in lack of its medication. Based on the phases, time series, and complexity analysis of the model's various parameters, it is studied to understand the variation in this pandemic's scenario.
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http://dx.doi.org/10.1016/j.jiph.2021.04.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8056826PMC
July 2021

Awareness to consequences of teeth missing and prosthodontics treatment options among people of Aseer region, Saudi Arabia.

J Family Med Prim Care 2021 Jan 30;10(1):307-311. Epub 2021 Jan 30.

General Practitioner, Ministry of Health, Abha, KSA.

Background: Good teeth play a significant role in keeping a healthy personality and a decent quality of life. Loss of tooth is listed among the top hundred health condition affecting the world population, resulting not only in aesthetic and functional damage but also has negative social impact thus affecting the overall quality of life. It has been estimated to cause 7.6 million disability adjusted life years (DALY). Tooth loss has negative consequences on oral health as it may cause drifting of adjacent teeth or over eruption of opposing teeth, further loss of adjacent tooth and temporomandibular diseases (TMDs).

Methods: This cross sectional study was performed in the clinics of Aseer Dental Centre and King Khalid University during the period from February 2020 to April 2020. In the current study, we kept a 95% level of confidence, precision error of 5%, and we anticipated the awareness among targeted population to be 85%. The sample size for our study was 200. Patients attending the Prosthodontic department for any dental consultation with a prosthetically unrestored partial edentulous areas in oral cavity were the target population.

Results: Out of total 200 patients 50% of them were male while 50% of them were female. Mean Age ± S.D = 57.8 ± 22.5. We have observed that demographical variables have significant relationship regarding teeth awareness and treatment.

Conclusion: Although tooth loss has a high prevalence, the common causes found were dental caries and loosing of teeth. As both these conditions can be prevented, repeated awareness campaign should be carried out in order to increase the awareness regarding oral hygiene..
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http://dx.doi.org/10.4103/jfmpc.jfmpc_1621_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132801PMC
January 2021

The Effect of Amiloride on Proteinuria in Patients with Proteinuric Kidney Disease.

Am J Nephrol 2021 6;52(5):368-377. Epub 2021 May 6.

Division of Nephrology and Hypertension, Department of Medicine, MedStar Georgetown University Hospital, Washington, District of Columbia, USA.

Introduction: Proteinuric kidney diseases share an aggressive clinical course of developing end-stage renal disease. However, the treatment is limited. Amiloride, an epithelial sodium channel (ENaC) inhibitor, was reported to reduce proteinuria in animal studies and case reports independent of ENaC inhibition. We hypothesized that amiloride not triamterene (an analog of amiloride) would reduce proteinuria in the patients with proteinuric kidney disease.

Methods: Patients with proteinuria >1.0 g/day and estimated glomerular filtration rate (eGFR) >30 mL/min/1.73 m2 on a maximum tolerable dose of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers were randomized to receive amiloride 5 mg twice daily or triamterene 50 mg twice daily for 8 weeks, followed by 4 weeks of washout, and then crossed over to the other drug for 8 weeks. The primary outcome was 24-h urine protein reduction. Secondary outcomes were changes in body weight, blood pressure (BP), serum potassium, and eGFR. Data were analyzed by analysis of variance.

Results: A total of 12 patients completed the study. Amiloride reduced 24-h urine protein by 38.7% (p = 0.002) and decreased systolic BP by 12.3 mm Hg (p = 0.04). Interestingly, triamterene reduced 24 h urine protein as well, by 32.8% (p = 0.02). Triamterene lowered eGFR by 9.0 mL/min/1.73 m2 (p = 0.007), but it was reversible. The average weight change was insignificant in both groups (p = 0.40 and 0.34 respectively). Three patients withdrew the study due to hyperkalemia.

Conclusions: Both amiloride and triamterene significantly reduced proteinuria in patients with proteinuric kidney disease. The anti-proteinuric effect was additive to renin-angiotensin-aldosterone system (RAAS) blockade, given all patients were on RAAS blockade. Hyperkalemia was a safety concern. Larger trials might be needed to examine the antiproteinuric effects of ENaC inhibitors.
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http://dx.doi.org/10.1159/000515809DOI Listing
May 2021

Classification model for accuracy and intrusion detection using machine learning approach.

PeerJ Comput Sci 2021 7;7:e437. Epub 2021 Apr 7.

Department of Computer Science, Community College, King Saud University, Riyadh, Saudi Arabia.

In today's cyber world, the demand for the internet is increasing day by day, increasing the concern of network security. The aim of an Intrusion Detection System (IDS) is to provide approaches against many fast-growing network attacks (e.g., DDoS attack, Ransomware attack, Botnet attack, etc.), as it blocks the harmful activities occurring in the network system. In this work, three different classification machine learning algorithms-Naïve Bayes (NB), Support Vector Machine (SVM), and K-nearest neighbor (KNN)-were used to detect the accuracy and reducing the processing time of an algorithm on the UNSW-NB15 dataset and to find the best-suited algorithm which can efficiently learn the pattern of the suspicious network activities. The data gathered from the feature set comparison was then applied as input to IDS as data feeds to train the system for future intrusion behavior prediction and analysis using the best-fit algorithm chosen from the above three algorithms based on the performance metrics found. Also, the classification reports (Precision, Recall, and F1-score) and confusion matrix were generated and compared to finalize the support-validation status found throughout the testing phase of the model used in this approach.
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http://dx.doi.org/10.7717/peerj-cs.437DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8049129PMC
April 2021

The role of Twitter in dental education: A systematic review.

J Dent Educ 2021 May 4. Epub 2021 May 4.

UWA Dental School, The University of Western Australia, Nedlands, WA, 6009, Australia.

Background: The rapid growth of social media in recent years has highlighted uses beyond their original purposes, particularly in education. Twitter is a free, open access social network with high potential to enhance interactive learning. The use of Twitter in dental education has been far less investigated; therefore, the objective of this systematic review is to explore the current uses and to examine the impact of Twitter on dental education, and to analyze and predict potential models of Twitter for future application in dental training, education, and teaching.

Methods: Five databases (PubMed, Embase, Medline, Scopus, and Web of Science) and the gray literature using keywords related to Twitter and dental education were searched. Articles were screened for inclusion, and two researchers independently extracted the data using a standardized data collection template and analyzed the quality of the included articles using the Medical Education Research Study Quality Instrument.

Results: Of the 121 articles identified from the initial search, 68 remained after duplications were removed. Article screening removed 61 articles leaving 7 eligible for inclusion and data extraction. Five studies were cross-sectional and two were cohort studies, and all involved survey-based designs with 998 respondents in total. Quality assessment gave a score range between 8 and 12.5 out of a total of 18 points.

Conclusions: Our study supports the potential for Twitter as a useful learning tool in dental education. Features, including the open access nature of Twitter as well as the low level of ads and free registration, make it appealing to students as well as a useful tool for interactive learning. However, there are significant barriers to its use, including privacy and concerns about professionalism. Higher quality and greater impact research is required.
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http://dx.doi.org/10.1002/jdd.12621DOI Listing
May 2021

Gait Speed as a Predictor for Diabetes Incidence in People with or at Risk of Knee Osteoarthritis: A Longitudinal Analysis from the Osteoarthritis Initiative.

Int J Environ Res Public Health 2021 04 21;18(9). Epub 2021 Apr 21.

Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia.

Background: This study examined the association between baseline gait speed with incident diabetes mellitus (DM) among people with or at elevated risk for knee OA.

Materials And Methods: Participants from the Osteoarthritis Initiative, aged 45 to 79 years, where included. Participants with or at risk of knee OA from baseline to the 96-month visit were included. Participants with self-reported DM at baseline were excluded. DM incidence was followed over the 4-time points. Gait speed was measured at baseline using a 20-m walk test. Generalized estimating equations with logistic regression were utilized for analyses. Receiver operator characteristic curves and area under the curve were used to determine the cutoff score for baseline speed.

Results: Of the 4313 participants included in the analyses (58.7% females), 301 participants had a cumulative incidence of DM of 7.0% during follow-up. Decreased gait speed was a significant predictor of incident DM (RR 0.44, = 0.018). The threshold for baseline gait speed that predicted incident DM was 1.32 m/s with an area under the curve of 0.59 ( < 0.001).

Conclusions: Baseline gait speed could be an important screening tool for identifying people at risk of incident diabetes, and the determined cutoff value for gait speed should be examined in future research.
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http://dx.doi.org/10.3390/ijerph18094414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8122394PMC
April 2021

The awareness of water intake and its correlation with BMI among students attending national and international secondary schools in Riyadh, Saudi Arabia.

Libyan J Med 2021 Dec;16(1):1918903

College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.

Dehydration is linked to worse cognitive functions and preference for beverages that are linked to obesity and other health conditions. Saudi Arabia's hot climate can exacerbate these effects and it is important to ensure that children in the region understand the benefits of adequate water intake. To evaluate secondary school student perceptions and practices regarding water intake, investigate how water intake is related to BMI and school performance, and compare international schools to national schools. This cross-sectional study surveyed understanding and practices relating to water intake of national and international secondary school students using a questionnaire based on a random selection of schools and students. One-hundred and sixty-two students from international schools (I) and 157 from national schools (N) responded. Most were aged 16 and 17 years old (I:61.1%, N:76.5%, p = .005). The average BMI of all students was 24.9 ± 6.013 (I:23.6 ± 4.658, N:26.1 ± 6.931, p < 0.001). Students understood beverages do not replace water intake (I:80.2%, N:75.8%, p = .337) and preferred water when thirsty (I:77.8%, N:75.2%, p = .549). However, water consumption was low with more than 50% of students drinking less than 1500 ml a day (I:54.3%, N:70.7%, p = .002). A positive correlation between BMI and water intake was observed only among international school students. Students have inadequate water intake despite understanding the importance of hydration. There are some differences between international school students and national school students that can be attributed to the availability and sources of water, though other factors cannot be excluded.
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http://dx.doi.org/10.1080/19932820.2021.1918903DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079079PMC
December 2021

Sacral chordoma with incidental rectal adenocarcinoma: a case report.

J Med Case Rep 2021 Apr 12;15(1):195. Epub 2021 Apr 12.

King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.

Background: We report a unique case of synchronous sacrococcygeal chordoma in association with rectal invasive adenocarcinoma. Retrorectal tumors are a rare disease caused by a variety of pathologies. To our knowledge, no prior cases of such a coincidental finding of both cancers have been reported in the literature.

Case Presentation: This is the case of a 74-year-old white middle eastern man, with known hypertension under treatment, who presented with complaints of progressive lower back pain associated with urinary incontinence over the past 12 months. Magnetic resonance imaging (MRI) of the pelvis showed a large midline, well-defined, oval-shaped lesion replacing the sacrococcygeal portion of the spine, with extension to the presacral region. Computed tomography (CT)-guided Tru-Cut biopsy revealed features suggestive of chordoma. At surgery, we performed excision of the entire mass en bloc, sacrectomy with rectus abdominis myocutaneous flap reconstruction and end sigmoid colostomy. Surgical histopathology proved it to be sacral dedifferentiated chordoma and rectal invasive adenocarcinoma. Overall, the patient recovered well postoperatively, was discharged home with functional stoma and on permanent Foley catheter use.

Conclusion: To the best of our knowledge, this is the only reported case of such a presentation, and sheds light on the approach and management. We hope that reporting such a case will add value to the medical literature.
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http://dx.doi.org/10.1186/s13256-021-02728-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8040199PMC
April 2021

Prevalence of frailty and associated factors among Saudi community-dwelling older adults: a cross-sectional study.

BMC Geriatr 2021 03 17;21(1):185. Epub 2021 Mar 17.

College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia.

Background: Prevalence of frailty has been previously established in different Western countries; however, the prevalence and the burden of in the aging populations of Saudi Arabia has not been examined. Therefore, the aim of this study was to examine the prevalence of frailty, and associated factors among Saudi older population.

Methods: The study included a total of 486 community-dwelling elderly adults aged 60 years and over living in the Riyadh area. This study took place from August 2019 to June 2020. The prevalence of frailty was determined using the Fried's frailty phenotype. Association between sociodemographic features and clinical factors and frailty was estimated by Odds Ratio and confidence intervals (OR, IC 95%) using a multinomial logistic regression model.

Results: The overall prevalence of pre-frailty and frailty were 47.3 and 21.4%, respectively. The following factors were associated with being frail: age (OR: 6.92; 95%CI 3.11-15.41); living alone (OR: 2.50; 95%CI: 1.12-5.59); had more chronic conditions (OR: 1.96; 95%CI: 1.16-3.30); and cognitive impairment (OR: 7.07; 95%CI: 3.92-12.74).

Conclusions: The Compared with other populations, the prevalence of frailty and pre-frailty in the Riyadh region of Saudi Arabia was high. The implications of frailty in this population should be discussed in future study.
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http://dx.doi.org/10.1186/s12877-021-02142-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7972196PMC
March 2021

Prevalence and incidence of osteoarthritis among people living in the Gulf Cooperation Council countries: a systematic review and meta-analysis.

Clin Rheumatol 2021 Mar 14. Epub 2021 Mar 14.

Department of Rehabilitation Sciences, King Saud University, Riyadh, Saudi Arabia.

Osteoarthritis (OA) is a common degenerative disease affecting joints with an increasing prevalence around the world and in the Middle East region. Research about the prevalence/incidence of OA in the Gulf Cooperation Council (GCC) countries was limited with inconsistent findings. Therefore, the aim of this study was to conduct a systematic review and meta-analysis for studies reporting the prevalence/incidence of OA among people living in the GCC countries. A comprehensive search was performed using MEDLINE, PubMed, CINAHL, Web of Science, and Google Scholar from inception to December 2020 to identify eligible studies examining the prevalence/incidence of OA in the GCC countries. Meta-analysis was conducted, and the Newcastle Ottawa Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was utilized to evaluate methodological quality. Thirteen studies were included (12 studies reported prevalence and one study reported incidence), with a total of 24,625 participants with an estimated overall prevalence of 16.13% and incidence of 3.5% of OA in the GCC countries. The quality of the included studies was unsatisfactory (six studies), satisfactory (six studies), and good quality (one study). Common risk factors were being older adult, female, obese, and having lower scores for quality of life. This study shows a high prevalence of OA among individuals living in the GCC countries at approximately 16.13%. Only one study reported incidence of 3.5% of OA in this population. This prevalence rate needs to be confirmed in future research with a similar population and at the site of joint OA levels. Common risk factors should be interpreted with caution since only a few studies reported risk factors. Key Points • The pooled prevalence of Osteoarthritis in the Gulf Cooperation Council countries was 16.13% based on 12 included studies.
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http://dx.doi.org/10.1007/s10067-021-05662-2DOI Listing
March 2021

Prevalence and mortality of lung comorbidities among patients with COVID-19: A systematic review and meta-analysis.

Lung India 2021 Mar;38(Supplement):S31-S40

University of Glasgow, Glasgow, UK; Prince Sultan Military Medical City, Respiratory Care Department, Riyadh, Saudi Arabia.

COVID-19 infections are seen across all age groups, but they have shown to have a predisposition for the elderly and those with underlying comorbidities. Patients with severe COVID-19 infections and comorbidities are more prone to respiratory distress syndrome, mechanical ventilator use, and ultimately succumb to these complications. Little evidence exists of the prevalence of underlying lung comorbidities among COVID-19 patients and associated mortality. We performed a systematic review of the literature including PubMed (Medline), Embase (Ovid), Google Scholar, and Cochrane Library. The last date for our search was April 29, 2020. We included all original research articles on COVID-19 and calculated prevalence of chronic lung disease patients among COVID-19 patients using random effects model. Further, we assessed for mortality rates among COVID-19 patients associated with these lung comorbidities. The authors identified 29 articles that reported prevalence of chronic lung conditions among COVID-19 patients. Among those, 26 were from China and 3 from the United States. The pooled prevalence of lung comorbidities including asthma, chronic obstructive pulmonary disease (COPD), and lung cancer was 3% (95% confidence interval [CI] = 0%-14%), 2.2% (95% CI = 0.02%-0.03%), and 2.1% (95% CI = 0.00%-0.21%), respectively. Mortality rates associated with these comorbidities was 30% (41/137) for COPD and 19% (7/37) for lung cancer respectively. No mortality rates were reported for patients with asthma. This study offers latest evidence of prevalence of chronic lung conditions among patients with COVID-19. Asthma, followed by COPD and lung cancer, was the most common lung comorbidity associated with COVID-19, while the higher mortality rate was found in COPD. Future studies are needed to assess other lung comorbidities and associated mortality among patients diagnosed with COVID-19.
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http://dx.doi.org/10.4103/lungindia.lungindia_497_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104330PMC
March 2021

Prevalence of laser refractive surgery among ophthalmologists in Saudi Arabia.

Saudi J Ophthalmol 2020 Apr-Jun;34(2):116-119. Epub 2020 Dec 28.

College of Medicine, King Khalid University, Saudi Arabia.

Purpose: The primary aims of this study are to assess the prevalence of excimer laser refractive surgery among ophthalmologists in Saudi Arabia, evaluates the satisfaction rates among ophthalmologists who have undergone laser refractive surgery and whether they would recommend the procedure to their immediate family members.

Methods: A cross-sectional study surveyed ophthalmologist irrespective of specialty or subspecialty in Saudi Arabia. A self-reported survey tool has been used for data collection. Candidates were contacted by email and WhatsApp messages that introduced the nature of the study and an online link to a survey was included. For those who did not respond to the digital contact, direct survey interviews were conducted at an Ophthalmology conference in Riyadh, Saudi Arabia, 2018.

Results: The final study sample was comprised of 183 ophthalmologists. Most of them 107 (58%) reported that they currently are performing laser refractive surgery.There were 73 (39.89%) ophthalmologist who self-reported that they are emmetropic, 110 (60.11%) self-reported themselves as ametropic, not including presbyopia.Of the 110 ophthalmologists with refractive errors, 52 (47.27%) were candidate for laser refractive surgery for myopia, hyperopia or astigmatism. Most of non- candidates attributed the non-candidacy to non- specific reasons and dry eye. Of the 52 participants who reported themselves as candidates for laser refractive surgery, 20 (38.46%) reported that they had undergone laser refractive surgery, and 32 (61.54%) had not. Most of them (50%) reported that they "like to wear glasses or contact lenses. In general, 14 (70%) reported complete satisfaction with the postoperative outcome.Of all ophthalmologists participated in the study, 94% would advise laser refractive surgery to their first-degree relatives.

Conclusion: Excimer laser vision correction among ophthalmologists in Saudi is much higher than the market penetration in the general population reported in other countries. Most of the ophthalmologists who underwent the procedure were satisfied with the outcome.
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http://dx.doi.org/10.4103/1319-4534.305043DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7866714PMC
December 2020

Heparan sulfate proteoglycans and their modification as promising anticancer targets in hepatocellular carcinoma.

Oncol Lett 2021 Feb 4;21(2):173. Epub 2021 Jan 4.

PharmD Program, Faculty of Pharmacy, University of Tabuk, Tabuk 71491, Saudi Arabia.

Hepatocellular carcinoma (HCC) is one of the most common types of primary liver cancer. Despite advancements in the treatment strategies of HCC, there is an urgent requirement to identify and develop novel therapeutic drugs that do not lead to resistance. These novel agents should have the potential to influence the primary mechanisms participating in the pathogenesis of HCC. Heparan sulfate proteoglycans (HSPGs) are major elements of the extracellular matrix that perform structural and signaling functions. HSPGs protect against invasion of tumor cells by preventing cell infiltration and intercellular adhesion. Several enzymes, such as heparanase, matrix metalloproteinase-9 and sulfatase-2, have been reported to affect HSPGs, leading to their degradation and thus enhancing tumor invasion. In addition, some compounds that are produced from the degradation of HSPGs, including glypican-3 and syndecan-1, enhance tumor progression. Thus, the identification of enzymes that affect HSPGs or their degradation products in HCC may lead to the development of novel therapeutic targets. The present review discusses the main enzymes and compounds associated with HSPGs, and their involvement with the pathogenicity of HCC.
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http://dx.doi.org/10.3892/ol.2021.12434DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7798035PMC
February 2021

Cloud and IoT based smart architecture for desalination water treatment.

Environ Res 2021 04 2;195:110812. Epub 2021 Feb 2.

Department of Information Technology, College of Computer and Information Sciences, Majmaah University, Majmaah, 11952, Saudi Arabia.

Increasing water demand and the deteriorating environment has continuously stressed the requirement for new technology and methods to attain optimized use of resources and desalination management, converting seawater into pure drinking water. In this age, the Internet of Things use allows us to optimize a series of previously complicated processes to perform and required enormous resources. One of these is optimizing the management of water treatment. This research presents an implementable water treatment model and suggests smart environment that can control water treatment plants. The proposed system gathers data and analysing to provide the most efficient approach for water desalination operations. The desalination framework integrates smart enabling technologies such as Cloud Portal, Network communication, Internet of Things, Sensors powered by solar energy with ancient water purification as part of seawater's desalination project. The proposed framework incorporates the new-age technologies, which are essential for efficient and effective operations of desalination systems. The implemented desalination dual membrane framework uses solar energy for purifying saline water using ancient methods to produce clean water for drinking and irrigation. The desalination produced 0.47 m3/l of freshwater from a saline concentration of 10 g/l, consuming 8.31 KWh/m3 energy for production from the prototype implementation, which makes desalination process cost effective.
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http://dx.doi.org/10.1016/j.envres.2021.110812DOI Listing
April 2021

Renal Impairment After Cardiac Surgery: Risk Factors, Outcome and Cost Effectiveness.

Cureus 2020 Nov 25;12(11):e11694. Epub 2020 Nov 25.

Department of General Surgery, Imam Abdulrahman Bin Faisal University, Dammam, SAU.

Introduction Acute kidney injury (AKI) is considered one of the serious complications in the medical field. It has a large impact on patients' life medically, socially and economically. It also has a financial burden on governments and hospitals regardless of which part of the world is considered. On the other hand, AKI is a common complication of cardiac surgery, which alone has a tremendous burden and implications on patients and governments. In this study, we will discuss the various risk factors, outcomes and financial burden of renal impairment associated with cardiac surgery. Methods This is a retrospective case-control study, which included 144 adult patients who underwent open cardiac surgical procedures at King Fahad University Hospital in the Eastern Province of Saudi Arabia over a period of five years from January 2015 till the end of December 2019. We included all types of cardiac surgeries performed such as coronary artery bypass grafting (CABG), valve surgery and aortic dissection repair and excluded patients with end-stage renal disease (ESRD) requiring dialysis preoperatively and pediatric patients. Two control groups were defined, those who developed renal impairment (group A) and those who did not develop it (group B). Results The mean age of the patients was 58.59 ± 12.6 years (range: 42 to 77 years). Mean serum creatinine level in the postoperative period was 1.95 ± 1.5 mg/dL in group A compared to group B of 1.0 ± 0.32 mg/dL (P-value<0.01). Mean serum blood urea nitrogen (BUN) in group A was 26.45 ± 19.9 mg/dL compared to group B of 16.79 ± 16.2 mg/dL in group B (P-value < 0.01). Diabetic were more likely to develop renal impairment than non-diabetic (P-value = 0.049, OR 2.73; 95% CI: 0.97-7.66). Obese patients were two times more likely to develop renal impairment than non-obese (P-value = 0.056, OR 2.6; 95% CI: 0.94-7.1). The average cost for each patient with renal impairment who required dialysis was 110,000 Saudi Riyal (~ 29,000 $) compared to other patients. Conclusion Serum creatinine, BUN, diabetes and obesity are strong indicators in developing AKI in cardiac surgery. In addition, the financial burden was almost doubled in patients developing AKI.
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http://dx.doi.org/10.7759/cureus.11694DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7689806PMC
November 2020

Anatomical Shaping for Zirconia Custom Implant Abutment to Enhance Anterior Esthetic: A Clinical Technique.

Int J Dent 2020 5;2020:8857410. Epub 2020 Nov 5.

Restorative Dental Sciences Department, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.

Abutments are used in dentistry to attach dental crowns to dental implant. Currently, zirconia custom abutment is the one which is mostly used in restorations, since it offers several advantages, especially better esthetics and prevention from infection. Several innovations are done in the implant designs and procedures to achieve better esthetics. Computer-aided design & computer-aided manufacturing (CAD/CAM) system is widely used innovative technology in dentistry. This technology offers custom implants that help to achieve better esthetics and good internal fit. This procedure used a novel technique of anatomical modification of the final abutment incisal edge from straight anatomical edge to irregular one with a mamelon-incisal effect to enhance esthetic, shade matching, and anatomical replication of incisal structure that resembles the natural incisor. Usually, dental technicians will perform facial and incisal cut-back and apply porcelain layers to the crown in order to reproduce the translucency and the other optical effects that most closely match that of natural dentin and enamel, especially at the incisal edge. These optical effects will make the prosthetic crown look more natural and esthetically pleasant. By this presented technique will help the dental technician to achieve highly esthetic crown with completely digital workflow without the need for porcelain layering. The procedure was also followed up to 3, 6, and 12 months after the surgery and found no complications or complaints from the patient and esthetically satisfied.
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http://dx.doi.org/10.1155/2020/8857410DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7661132PMC
November 2020

Effects of the Ketogenic Diet on Glycemic Control in Diabetic Patients: Meta-Analysis of Clinical Trials.

Cureus 2020 Oct 5;12(10):e10796. Epub 2020 Oct 5.

Internal Medicine, King Khalid University, Abha, SAU.

Introduction The ketogenic diet is a diet that relies on reducing carbohydrate intake to a minimum while increasing fat intake. This induces a state of ketosis where it is hypothesized to favor fat metabolism for energy instead of carbohydrates. The diet is used to treat pediatric patients with seizures to control their symptoms. Today, it is used by many to help in weight loss. Extensive research is being conducted on the benefits of the diet, as it gains popularity among patients with diabetes and obesity, to evaluate its effects on glycemic control. Methods This review looks at the published literature and summarizes the interventional trials that use the ketogenic diet for glycemic control. Emphasis was on pooling the results of selected variables such as weight, glycemic control, and lipid profile. The meta-analysis was conducted by a trained statistician using the Cochrane software review manager (Revman version 5.4; Cochrane, London, UK). Results were reviewed by an independent reviewer adhering to the Cochrane Collaboration's guidelines. Results The findings of this review show a significant effect of the ketogenic diet as compared to controls in terms of weight reduction, glycemic control, and improved lipid profile. A noticeable improvement was seen in glycated hemoglobin (HbA1c) and in high-density lipoprotein (HDL), favoring the ketogenic diet as compared to control. Conclusion This review concludes that the ketogenic diet is superior to controls in terms of glycemic control and lipid profile improvements, and the results are significant enough to recommend it as an adjunctive treatment for type two diabetes.
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http://dx.doi.org/10.7759/cureus.10796DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7641470PMC
October 2020

Complicated community-acquired methicillin-resistant Staphylococcus aureus pancarditis with cardiac pseudoaneurysm in a healthy child: A case report.

Int J Surg Case Rep 2020 29;77:71-75. Epub 2020 Oct 29.

Department of Pediatrics Infectious Diseases, King Fahad Medical City, Riyadh, Saudi Arabia. Electronic address:

Introduction: Infective endocarditis is more prevalent among children with congenital heart diseases as compared to healthy children. Community-acquired methicillin-resistant Staphylococcus aureus is a causative pathogen of infective endocarditis, and it rarely causes pancarditis in healthy children. The clinical decision for surgical intervention of left-sided heart vegetation is challenging despite the availability of management guidelines.

Presentation Of Case: We report a case of a previously healthy 12-year-old girl who presented with aggressive endocarditis secondary to community-acquired methicillin-resistant Staphylococcus aureus infection, with left-sided vegetation, mitral valve regurgitation, pancarditis, brain abscess, and stroke. She underwent an emergency vegetectomy and mitral valve repair. Three weeks after the first surgery, she developed left ventricular pseudoaneurysm that required life-saving surgical intervention. The child gradually recovered and was discharged home with acceptable cardiac function and mild neurological deficit.

Discussion: Pancarditis, especially with an aggressive progression resulting in intracardiac pseudoaneurysm, is rarely reported in healthy children. The definition of the optimal timing of surgical intervention in pediatric infective endocarditis management is lacking and the clinical decision-making process remains challenging. The development of left ventricular pseudoaneurysm is serious and also needs an immediate intervention, given the high risk of its rupture and subsequent devastating outcomes.

Conclusion: Community-acquired methicillin-resistant Staphylococcus aureus is an etiology for aggressive infective pancarditis in a healthy child, leading to an intracardiac pseudoaneurysm. Emergency surgical interventions should be considered in children with left-sided vegetation to prevent devastating consequences.
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http://dx.doi.org/10.1016/j.ijscr.2020.10.085DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7644799PMC
October 2020

Freshwater Clam as a Potential Bioindicator for Silver/Saponin Nanocomposites Toxicity.

Bull Environ Contam Toxicol 2020 Dec 6;105(6):827-834. Epub 2020 Nov 6.

Zoology Department, Faculty of Science, Cairo University, Giza, Egypt.

Despite the progress in using silver nano products in many fields, including medicine, food, and industry, their effects on the environment need more attention. Therefore, the current study aimed to assess the effect of silver/saponin nanocomposites (Ag/S NCs) for the first time on the aquatic environment by using freshwater clam, Caelatura aegyptiaca, as a fundamental bioindicator in the freshwater system. Following the preparation and characterization of Ag/S NCs by using atomic absorption spectrophotometer, UV-Vis spectrophotometer, X-ray diffraction, transmission electron microscopy, and acute toxicity study, we exposed the clam to three different doses of Ag/S NCs (12.5, 25 and 50 mg L) for consecutive 6 days. All Ag/S NCs concentrations caused a significant increase in malondialdehyde and nitric oxide while induced a notable decrease in glutathione and catalase levels in all studied organs. Moreover, the histological alternations were observed in gills, labial palp, and foot tissues, particularly at dose 50 mg L. From the results of our work, we concluded that toxicity of Ag/S NCs on freshwater clam leads to an oxidative stress response as well as histopathological changes. Besides, we assumed that Coelatura aegyptiaca could be used as a sensitive bioindicator for monitoring water pollution caused by different nanoparticles. Therefore, we do recommend performing further studies by using fresh clam to provide a better assessment for our aquatic environment to prevent water pollution locally and globally.
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http://dx.doi.org/10.1007/s00128-020-03038-xDOI Listing
December 2020

Using Cognitive Behavioral Therapy for Insomnia in People with Type 2 Diabetes, Pilot RCT Part I: Sleep and Concomitant Symptom.

Behav Sleep Med 2020 Oct 27:1-20. Epub 2020 Oct 27.

Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, Kansas City, Kansas.

Objective/background: The primary aim of this study was to examine the effect of Cognitive Behavioral Therapy for Insomnia (CBT-I) on the severity of insomnia in people with Type 2 diabetes (T2D) compared to a health education (HE) control group. The secondary aim was to explore the effect of CBT-I on other sleep outcomes and concomitant symptoms.

Participants: Twenty-eight participants with T2D were randomly assigned to CBT-I ( = 14) or HE ( = 14).

Methods: Validated assessments were used at baseline and post intervention to assess sleep outcomes and concomitant symptoms. In addition, actigraph and sleep diaries were used to measure sleep parameters. Independent sample tests and Mann-Whitney tests were utilized to measure between-group differences in the mean change scores.

Results: Participants in the CBT-I group showed higher improvements in the following mean change scores compared to the HE group: insomnia symptoms ( = 1.78; < .001), sleep quality ( = 1.53; =.001), sleep self-efficacy ( = 1.67; < .001). Both actigraph and sleep diary showed improvements in sleep latency and sleep efficiency in the CBT-I group as compared to the HE group. In addition, participants in the CBT-I group showed greater improvement in the mean change scores of depression symptoms ( = 1.49; = .002) and anxiety symptoms ( = 0.88; = .04) compared to the HE group.

Conclusion: This study identified a clinically meaningful effect of CBT-I on sleep outcomes and concomitant symptoms in people with T2D and insomnia symptoms. Further work is needed to investigate the long-term effects of CBT-I in people with T2D and insomnia symptoms.
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http://dx.doi.org/10.1080/15402002.2020.1831501DOI Listing
October 2020

Returning to Sport After Anterior Cruciate Ligament Reconstruction in Physically Active Individuals.

Cureus 2020 Sep 15;12(9):e10466. Epub 2020 Sep 15.

Orthopaedic Surgery, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Jeddah, SAU.

Background Physically active individuals are susceptible to sports injuries, one of which is anterior cruciate ligament (ACL) injury. ACL injury can be managed conservatively or by surgical reconstruction. Returning to sport (RTS) after ACL injury is one of the main goals of ACL reconstruction (ACLR). However, rates of return vary and can be affected by several factors. The objectives of this study were to estimate the rate of return and to identify the factors that might affect RTS after ACLR.  Methods This was a cross-sectional study, including individuals who had an ACLR. Participants were sent an online survey included questions about their injury, sport participation, International Knee Documentation Committee form (IKDC), and the Tampa Scale for Kinesiophobia (TSK-11). Participants who had their surgery in the period between January 2011 to December 2018 and participated in sports regularly were included. Descriptive statistics were performed. Chi-square and student t-tests were performed to explore the differences between participants who returned and the ones that did not.  Results A total of 93 participants were included. The majority (69.9%) were playing soccer before the injury. Though more than half (61.3%) returned to sports, only 29% participated at the same level before the injury. Fear of reinjury was the most frequent reason for delaying or not returning (30%), followed by pain (29). Significantly better IKDC (p=0.002) and TSK-11 (p<0.001) scores were noted in participants who had returned to sports. On the other hand, participants' age, body mass index (BMI), time from injury to surgery, time since surgery, and times of sports participation per week were not found to be significantly different between those who returned versus those who did not. Conclusion The participants in this study had a low rate of return with fear of reinjury being the most common reason not to return. However, a participant's IKDC and TSK-11 scores were associated factors for RTS, thus optimizing those factors after surgery is crucial.
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http://dx.doi.org/10.7759/cureus.10466DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7566975PMC
September 2020

Morphology and molecular taxonomy of the tongue worm, genus Raillietiella (Pentastomida) from the lungs of berber skinks Eumeces schneideri (Scincidae): First report.

Rev Argent Microbiol 2021 Apr-Jun;53(2):110-123. Epub 2020 Oct 3.

Zoology Department, Faculty of Science, Cairo University, 12613, Cairo, Egypt; Department of Zoology, College of Science, King Saud University, Riyadh, Saudi Arabia. Electronic address:

In the present study, pentastomids belonging to the order Cephalobaenida were isolated from the lungs of Berber skinks Eumeces schneideri (Famiy: Scincidae), which were morphologically described by light and scanning electron microscopy and taxonomically justified by 18s rDNA molecular analyses of the parasites. Seventeen host specimens were collected from well-vegetated wadis at high altitudes, Jizan, Saudi Arabia as new type locality; twelve specimens (70.59%) were infected. All of the recovered parasites were adults, possessed small broadly triangular cephalothorax flattened on the ventral surface and merged smoothly with a uniformly thick and squat abdomen and terminated in a pair of divergent lobes. The results obtained indicated that the parasites belong to the sharp-tipped posterior-hook Raillietiella spp. distinguished from other raillietiedids of the same group some important characteristic features including annulus number, shape and dimensions of the buccal cadre, copulatory spicules, and anterior and posterior hooks. The anterior hook of the female specimens (n=5) had a blade length (AB) of 135±5 (110-146) μm and shank length (BC) 158±5 (150-169) μm while the posterior hook was much larger with AB measuring 221±5 (200-236) μm and BC 286±6 (280-289) μm. For the male specimens (n=5), the anterior hook had an AB of 73±3 (72-75) μm and a BC 102±5 (100-103) μm. The posterior hook was much larger with AB 190.6±5 (190-191) μm and BC 221±5 (280-289) μm. The morphological characterization of the recovered parasites was closely similar to R. aegypti previously isolated from the same host. Sequence alignment by the maximum likelihood analysis for the data obtained from the 18S rDNA analysis of the parasites exhibits identities ranging between 88-95% with pentastomid genera recovered from the GenBank. The phylogenetic tree supported the inclusion of the parasites within the monophyletic Pentastomida clade with maximum identity to the raillietiellid species. The recovered sequences from the present study were deposited in GenBank under Accession number MK970649.1. The present molecular analysis was the first to confirm the taxonomic position of R. aegypti isolated from the host examined.
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http://dx.doi.org/10.1016/j.ram.2020.06.010DOI Listing
October 2020

Test-Retest Reliability of activPAL in Measuring Sedentary Behavior and Physical Activity in People With Type 2 Diabetes.

J Phys Act Health 2020 Sep 23;17(11):1134-1139. Epub 2020 Sep 23.

Background: To investigate how changes in sedentary behavior relate to health outcomes, it is important to establish the test-retest reliability of activity monitors in measuring habitual sedentary behavior in people with type 2 diabetes (T2D) as a prerequisite for interpreting this information. Thus, the authors' objective was to examine the test-retest reliability of a common activity monitor (activPAL™) in measuring sedentary behavior and physical activity in people with T2D.

Methods: Sedentary-time, standing-time, stepping-time, step-count, and sit-to-stand transitions were obtained from two 7-day assessment periods separated by at least 1 week. Test-retest reliability was determined with the intraclass correlation coefficient (ICC) to compare sedentary and activity measures between the 2 time points.

Results: A total of 30 participants with self-reported T2D completed the study (age 65 [6] y, 63% women, body mass index 33.3 [5] kg/m2). High test-retest reliability was found for sedentary-time (ICC = .79; 95% confidence interval [CI], .61-.89) and standing-time (ICC = .74; 95% CI, .53-.87). Very high test-retest reliability was found for stepping-time (ICC = .90; 95% CI, .81-.95), step-count (ICC = .91; 95% CI, .83-.96), and sit-to-stand transitions (ICC = .90; 95% CI, .79-.95).

Conclusion: The activPAL™ device showed high to very high test-retest reliability in measuring all tested activity categories in people with T2D.
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http://dx.doi.org/10.1123/jpah.2019-0506DOI Listing
September 2020

The effects of cognitive behavioral therapy for insomnia in people with type 2 diabetes mellitus, pilot RCT part II: diabetes health outcomes.

BMC Endocr Disord 2020 Sep 5;20(1):136. Epub 2020 Sep 5.

Physical Therapy and Rehabilitation Science Department, University of Kansas Medical Center, 3901 Rainbow Blvd., Mail Stop 2002, Kansas City, Kansas, 66160, USA.

Background: Previous studies have shown the negative impact of sleep disturbances, specifically insomnia symptoms, on glucose metabolism for people with type 2 diabetes (T2D). People with insomnia symptoms are at risk of poor glycemic control and suboptimal diabetes self-care behavior (DSCB). Investigating the impact of a safe and effective intervention for individuals with T2D and insomnia symptoms on diabetes' health outcomes is needed. Therefore, the aim of this exploratory study is to examine the effects of Cognitive Behavioral Therapy for Insomnia (CBT-I) on glycemic control, DSCB, and fatigue.

Methods: Twenty-eight participants with T2D and insomnia symptoms, after passing an eligibility criteria at a medical research center, were randomly assigned to CBT-I (n = 14) or Health Education (HE; n = 14). The CBT-I and HE groups received 6 weekly one-hour sessions. This Randomized Controlled Trial (RCT) used a non-inferiority framework to test the effectiveness of CBT-I. Validated assessments were administered at baseline and post-intervention to assess glycemic control, DSCB, and fatigue. A Wilcoxon signed-rank test was utilized to compare within-group changes from baseline to post-intervention. A Mann-Whitney test was utilized to measure the between-group differences. Linear regression was used to assess the association between the blood glucose level and the number of days in the CBT-I group.

Results: The recruitment duration was from October 2018 to May 2019. A total of 13 participants completed the interventions in each group and are included in the final analysis. No adverse events, because of being a part of this RCT, were reported. CBT-I participants showed significantly greater improvement in glycemic control, DSCB, and fatigue. There was a significant association between the number of days in the CBT-I intervention with the blood glucose level before bedtime (B = -0.56, p = .009) and after awakening in the morning (B = -0.57, p = .007).

Conclusions: This study demonstrated a clinically meaningful effect of CBT-I on glycemic control in people with T2D and insomnia symptoms. Also, CBT-I positively impacted daytime functioning, including DSCB and fatigue. Future research is needed to investigate the long-term effects of CBT-I on laboratory tests of glycemic control and to understand the underlying mechanisms of any improvements.

Trial Registration: Clinical Trials Registry ( NCT03713996 ). Retrospectively registered on 22 October 2018.
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http://dx.doi.org/10.1186/s12902-020-00612-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487570PMC
September 2020

Combined diabetes and arthritis are associated with declined gait speed.

Clin Rheumatol 2021 Apr 27;40(4):1593-1598. Epub 2020 Aug 27.

Department of Rehabilitation Science, King Saud University, Riyadh, Saudi Arabia.

This study investigated the association of combined arthritis and diabetes, diabetes only, and arthritis only compared with neither with gait speed in the general population. This cross-sectional study included data from the second wave of Midlife in the United States-2 (MIDUS 2) project 4: Biomarker Project, 2004-2009. The MIDUS 2 biomarker project included 1255 individuals aged between 34 and 84 years. Participants were categorized into four groups: combined arthritis and diabetes, diabetes only, arthritis only, or neither. The main outcome measure was gait speed measured by the 50-ft walk test. Covariates included age, gender, body mass index (BMI), depression symptoms, and number of chronic conditions/symptoms. A total of 1255 participants were included with mean age 54.52 ± 11.71, of those 713 (56.8%) participants were females. The results showed that combined arthritis and diabetes was significantly associated with a greater decline in gait speed (B = - 0.11, 95% confidence interval (CI) [- 0.17 to - 0.6], p < 0.001). Arthritis and diabetes were independently significantly associated with decreased gait speed (B = - 0.072, 95% CI [- 0.10 to - 0.043], p < 0.001), (B = - 0.064, 95% CI [- 0.12 to - 0.012], p = 0.015), respectively. Combined arthritis and diabetes was associated with a greater decline in gait speed compared with diabetes only, arthritis only, or neither group. Key Points • Combined arthritis and diabetes were associated with declined gait speed. • Gait speed did not differ between people with arthritis compared with people with diabetes. • We recommended including gait speed assessment in regular clinical visits to capture gait speed declines for further health assessments.
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http://dx.doi.org/10.1007/s10067-020-05370-3DOI Listing
April 2021
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