Age-period-cohort analysis of colorectal cancer mortality in Saudi Arabia from 1990 to 2019

OBJECTIVES

The current study aimed to describe and estimate the independent effects of age, period, and cohort on colorectal cancer (CRC) mortality in Saudi Arabia from 1990 to 2019.

STUDY DESIGN

This was an epidemiological study.

METHODS

Data were obtained from the Global Burden of Disease study 2019. Age-period-cohort modelling was used to compute the net drift, local drift, cross-sectional age curve, longitudinal age curve, and rate ratios (RRs) of period and cohort of CRC mortality in Saudi Arabia.

RESULTS

In 2019, there were 1629 (95% uncertainty interval [UI]: 1263 to 2045) CRC cancer deaths in Saudi Arabia, and the age-standardised mortality rate of CRC was 9.7 (95% UI: 7.8 to 11.6) per 100,000 population. For men, between 1990 and 2019, the total number of CRC deaths increased dramatically from 199 (95% UI: 130 to 286) in 2019 to 942 (95% UI: 725 to 1228). For the period effects, the relative risk (RR) of mortality rate for both sexes followed similar monotonic increase patterns throughout the study period.

CONCLUSIONS

Results from this study highlight a concerning increase in CRC mortality rates in Saudi Arabia from 1990 to 2019, particularly among individuals aged 30-50 years. While mortality rates for men were higher at the start of the study period, more favourable trends for men were seen in the later years of the study period, indicating evolving gender disparities. Establishing evidence-based national screening guidelines and adopting multi-level diagnostics, risk assessment, and population-wide screening, especially for younger populations, is crucial.

Using algae in Li-ion batteries: A sustainable pathway toward greener energy storage

This paper reviews and analyzes the innovations and advances in using algae and their derivatives in different parts of Li-ion batteries. Applications in Li-ion battery anodes, electrolytes, binders, and separators were discussed. Algae provides a sustainable feedstock for different materials that can be used in Li-ion batteries, such as carbonaceous material, biosilica, biopolymers, and other materials that have unique micro- and nano-structures that act as biotemplates for composites structure design. Natural materials and biotemplates provided by algae have various advantages, such as electrochemical and thermal stability, porosity that allows higher storage capacity, nontoxicity, and other properties discussed in the paper. Results reveal that despite algae and its derivatives being a promising renewable feedstock for different applications in Li-ion batteries, more research is yet to be performed to evaluate its feasibility of being used in the industry.

A critical insight on nanofluids for heat transfer enhancement

There are numerous reports and publications in reputable scientific and engineering journals that attribute substantial enhancement in heat transfer capabilities for heat exchangers once they employ nanofluids as working fluids. By definition, a nanofluid is a working fluid that has a small volume fraction (5% or less) of a solid particle with dimensions in the nanoscale. The addition of this solid material has a reported significant impact on convective heat transfer in heat exchangers. This work investigates the significance of the reported enhancements in many recent related publications. Observations on these publications' geographical origins, fundamental heat transfer calculations, experimental setups and lack of potential applications are critically made. Heat transfer calculations based on methodologies outlined in random selection of available papers were conducted along with a statistical analysis show paradoxically inconsistent conclusion as well as an apparent lack of complete comprehension of convective heat transfer mechanism. In some of the surveyed literature for example, heat transfer coefficient enhancements were reported to be up to 27% and 48%, whereas the recalculations presented in this work restrain proclaimed enactments to ~ 3.5% and - 4% (no enhancement), respectively. This work aims at allowing a healthy scientific debate on whether nanofluids are the sole answer to enhancing convective heat transfer in heat exchangers. The quantity of literature that confirms the latter statement have an undeniable critical mass, but this volition could be stemming from and heading to the wrong direction. Finally, the challenges imposed by the physical nature of nanoparticles, as well as economic limitations caused by the high price of conventional nanoparticles such as gold (80$/g), diamond (35$/g), and silver (6$/g) that hinder their commercialization, are presented.

A passive isolation of sensor faults from un-stealthy attacks in uncertain nonlinear systems

In this paper, a novel nonlinear observer-based approach is established to cast light on the problem of isolating sensor faults from un-stealthy attacks for Lipschitz affine nonlinear systems subjected to unknown uncertainties and disturbances. A structure consisting of a multi-line transmission mechanism, a random number generator (RNG), and Dedicated Observer Scheme is developed to make the abnormal behaviors distinguishable. A group of two interlinked nonlinear Luenberger-Like observers is designed in nonlinear coordinates to detect abnormal behaviors. Two banks of detection observers and an incidence matrix are introduced to make the final decisions. Adaptive threshold techniques are exploited to guarantee the robustness against the model uncertainties and disturbances. Compared with the existing results, the proposed approach isolates the abnormal behaviors without the need for any redundant hardware components. Finally, the performance of the proposed approach is evaluated on a continuous stirred tank reactor (CSTR).

Autistic traits and obsessive-compulsive personality traits in OCD patients

Background

Studies have reported a high prevalence of autism spectrum disorder in young people with obsessive-compulsive disorder with a negative effect on psychosocial functioning. However, the extent to which autism spectrum disorder and obsessive-compulsive personality disorder traits overlap and by inference, the extent to which these separately classified Diagnostic and Statistical Manual of Mental Disorders disorders five (obsessive-compulsive personality disorder, personality disorder, autism spectrum disorder, neurodevelopmental disorder) may share a nosological relationship has not so far been systematically investigated in clinical samples.

This study is done to detect the frequency of obsessive-compulsive personality traits and autistic traits in a sample of patients with obsessive-compulsive disorder.

Results

Results revealed that younger patients had significantly more severe and extreme obsessive-compulsive disorder scores. Moreover, Structured Clinical Interview for DSM-IV (SCID-II) and Autism Spectrum Quotient analysis revealed that younger patients had a significantly higher prevalence of personality traits and autistic traits respectively. Statistical significance as many patients with severe and extreme Yale-Brown Obsessive-Compulsive Scale showed criteria of obsessive-compulsive personality disorder. No association of statistical significance was found between obsessive-compulsive disorder severity and autistic trait presence. On the contrary, statistical significance was found between autistic traits and obsessive-compulsive personality disorder.

Conclusions

There is the presence of comorbidity of obsessive-compulsive personality traits and autism spectrum traits in obsessive-compulsive disorder patients. Obsessive-compulsive personality traits prevalence in obsessive-compulsive disorder patients was higher than in autistic traits. Several factors of genetic predisposition, environmental factors like education and marital status, employment, and intrinsic factors as age of patients all exhibited a pivotal role in obsessive-compulsive disorder prevalence and severity.

Clinical and epidemiological characteristics of the first 150 patients with COVID-19 in Lebanon: a prospective descriptive study

Background

Clinical features of confirmed COVID-19 cases cover a wide spectrum.

Aims

To study the clinical, radiological and virological features of the first 150 patients with COVID-19 in Lebanon.

Methods

Our university hospital was designated as the primary COVID-19 care centre in Lebanon. Between 21 February 2020, the date of the first confirmed case of COVID-19 in Lebanon, and 3 April 2020, our team treated 150 patients diagnosed with COVID-19. In this prospective descriptive study, we present our experience in treating these patients, specifically the diagnostic criteria, outcome, and demographic, clinical, radiological and biological characteristics.

Results

Ninety-five (63.33%) of the patients were male and 55 (36.67%) were female. Most patients (58%) were aged > 50 years, and 8 (5.33%) were healthcare workers. Diagnosis was based on reverse transcription polymerase chain reaction, and patients were classified as mild, moderate or critical. Fifteen (10%) patients had a critical presentation and fever was the most prominent symptom at presentation. One hundred and thirty-eight (92%) patients underwent radiological evaluation. The most common laboratory findings were lymphocytopenia (34.38%), followed by neutropenia (28.13%), but leukocytosis was not prevalent (1.56%). Old age and comorbidity were significant indicators in patient risk stratification. Chest computed tomography was an invaluable method of diagnosis and management. Our radiological findings were consistent with the published literature.

Conclusion

Our study underlines the variable presentation of COVID-19, the difference in severity, and the diverse methods of diagnosis. This suggests the need for a tailored approach, taking into consideration the wide spectrum of presentation.

The impacts of different heating systems on the environment: A review

This paper presents a review of the environmental impacts of most heating systems drawing together published literature on the subject, not previously available. Here, a comparison between the different systems such as coal, wood, oil, natural gas, heat pump, geothermal and solar energy is provided in terms of their environmental impact. The most important parameters considered are the emission rate and toxicity. This places the coal-fired system as the worst among all heating systems regarding the impacts on the environment. On the other hand, renewable energy sources are the most preferred sources decreasing total emissions and air pollution. In order to make a comparison between the different systems, the emissions that must be taken into consideration are CO, CO₂, NO_x, SO₂, PMs, N₂O, CH₄, volatile organic compounds, polycyclic aromatic hydrocarbons and aldehydes.

A review on maintenance strategies for PV systems

PV (PhotoVoltaic) systems gained popularity in being eco-friendly power supplies, reducing toxic gas emissions for energy production. Unfortunately it's been seen that efficiency reduction and output deficit are two common scenarios for PV systems when confronted with faulty events: this fact creates the crucially important need of knowing types of different possible faults and be able to detect them according to their ways of striking, timing and density of their leftovers. What comes after is fixing the damages, by preventing them from happening repeatedly and stop them from reaching the surface. Since knowing the fault without correcting it is counterproductive, maintenance strategies can reduce competencies of the system, accelerate operation time, and compensate the system in a way that prevents lowering in efficiency and consequently financial losses. This paper aims to present different schemes used in fault intervention categorized by preventive, corrective, predictive and urgent case faults maintenance methods with corresponding effects on environment. A critical comparison between different strategies is presented as well as an economical assessment of the maintenance costs and energy production increase. Each type is individually clarified to reveal what area of PV faults types it can withstand. With a recommendation on maintenance choice, an informative reference for researchers in the field is established to optimally maintain a sustainable PV system.

New Concept of Power Generation Using TEGs: Thermal Modeling, Parametric Analysis, and Case Study

In this manuscript, an innovative concept of producing power from a thermoelectric generator (TEG) is evaluated. This concept takes advantage of using the exhaust airflow of all-air heating, ventilating, and air-conditioning (HVAC) systems, and sun irradiation. For the first step, a parametric analysis of power generation from TEGs for different practical configurations is performed. Based on the results of the parametric analysis, recommendations associated with practical applications are presented. Therefore, a one-dimensional steady-state solution for the heat diffusion equation is considered with various boundary conditions (representing applied configurations). It is revealed that the most promising configuration corresponds to the TEG module exposed to a hot fluid at one face and a cold fluid at the other face. Then, based on the parametric analysis, the innovative concept is recognized and analyzed using appropriate thermal modeling. It is shown that for solar radiation of 2000 W/m² and a space cooling load of 20 kW, a 40 × 40 cm² flat plate is capable of generating 3.8 W of electrical power. Finally, an economic study shows that this system saves about $6 monthly with a 3-year payback period at 2000 W/m² solar radiation. Environmentally, the system is also capable of reducing about 1 ton of CO₂ emissions yearly.

The effect of preoperative oral administration of prednisolone on postoperative pain in patients with symptomatic irreversible pulpitis: a single-centre randomized controlled trial

AIM

This single-centre randomized, double-blind, placebo-controlled clinical trial assessed the effect of a preoperative, single, oral dose of prednisolone on postoperative pain and postoperative analgesic intake in patients with symptomatic, irreversible pulpitis in mandibular molars.

METHODOLOGY

Four hundred participants, randomly assigned to two equal groups, received either 40 mg prednisolone or placebo tablets 30 min before single-visit root canal treatment. Patients recorded their pain level 6, 12 and 24 h after treatment on a 100-mm visual analogue scale. All patients received a sham capsule to take if needed as a postoperative analgesic, and, if the pain persisted, an analgesic was prescribed. The relative risk reduction and 95% confidence intervals (CI) were estimated for binary data. Mann-Whitney U-test was used to compare postoperative pain intensity between groups.

RESULTS

The relative risk reduction in pain incidence was 20.31% (95% CI: 12.03%, 27.82%) at 6 h, 23.39% (95% CI: 14.75%, 31.16%) at 12 h and 28.85% (95% CI: 18.08%, 38.20%) at 24 h. Prednisolone had significantly less post-obturation pain intensity compared to placebo at 6, 12 and 24 h (P < 0.001). The relative risk reduction in sham-capsule intake was 54% (95% CI: 38%, 66%) and of analgesic intake was 55% (95% CI: 3%, 79%). No adverse effects were recorded.

CONCLUSION

Preoperative oral administration of a single dose of 40 mg prednisolone was beneficial to control short-term post-obturation pain after single-visit root canal treatment in patients with symptomatic irreversible pulpitis reducing pain incidence after 24 h by approximately 30% and postoperative analgesic intake by approximately 55%.

A multicentric prospective study evaluating the safety and efficacy of Kii® Fios® First Entry Trocar in laparoscopic bariatric surgery

INTRODUCTION

Laparoscopic surgery has evolved as an important field of surgery due to its clear benefits when compared to open laparotomy surgery. However, specific complications of laparoscopic surgery have been reported, of which the majority are complications associated with first entry to the abdominal cavity. The emergence of bariatric surgery, combined with the special considerations of the abdominal wall and cavity of obese patients, leads to seeking new modalities of access to the abdominal cavity in this specific population.Kii Fios First Entry Bladeless Trocar (Applied) is a new device that may allow surgeons to facilitate the creation of pneumoperitoneum. This prospective multicenter nonrandomized trial aims to evaluate the safety and efficacy of Kii Fios First Entry Bladeless Trocar in laparoscopic bariatric surgery.

METHODS

In the period between December 2013 and June 2014, 588 patients were included by 18 surgeons from several French hospitals to undergo laparoscopic surgery using Kii Fios First Entry Trocar as a first-entry trocar. The surgeons filled out a questionnaire assessing the safety and efficacy of the trocar for every patient.

RESULTS

There were no mortality and no major complications. However, 11 cases (1.87%) of minor complications (liver and greater omentum injuries) were reported. The surgeons reported successful entry in less than 1 min for 70.58% of the cases.

CONCLUSIONS

Kii Fios First Entry Trocar (Applied) is a safe and efficient method to establish first entry in laparoscopic bariatric surgery when all the recommendations are followed and respected.

Preliminary characterization of human skin microbiome in healthy Egyptian individuals

Human skin is a large, complex ecosystem that harbors diverse microbial communities. The rapid advances in molecular techniques facilitate the exploration of skin associated bacterial populations. The objective of this study was to perform a preliminary characterization of skin associated bacterial populations in Egyptian individuals. Samples were collected from five healthy subjects from two skin sites; Antecubital Fossa (AF) and Popliteal Fossa (PF). Genomic DNA was extracted and used to amplify bacterial 16S rRNA genes which were sequenced on Illumina MiSeq platform. The two sites showed distinct diversity where PF was more diverse than AF. Taxonomic analysis of sequences revealed four main phyla Proteobacteria, Firmicutes, Actinobacteria and Deinococcus-Thermus, with Proteobacteria presenting the highest diversity. Klebsiella, Bacillus, Pseudomonas and Escherichia were the most predominant genera. Our data suggest that environmental factors can shape the composition of the skin microbiome in certain geographical regions. This study presents a new insight for subsequent analyses of human microbiome in Egypt.

Duodenal duplication cyst in a 52-year-old man: A challenging diagnosis and management

INTRODUCTION

Duodenal duplication is a rare congenital malformation. Although more frequent in childhood, it may rarely be observed in adulthood. Pre-operative diagnosis can be difficult.

PRESENTATION OF CASE

We report the case of a 52-year-old man with a duodenal duplication cyst, who was misdiagnosed even after a primary surgery. Definitive treatment needed an extensive diagnostic workup and a second delicate operation.

DISCUSSION

This article discusses the incidence of duodenal duplications, their types, their clinical presentations, the radiologic and diagnostic features along with different therapeutic options.

CONCLUSION

Duodenal duplication should always be one of the differential diagnoses proposed when approaching upper abdominal cystic formations.

Geographic distribution of hematopoietic cancers in the Nile delta of Egypt

BACKGROUND

Previous evidence indicated that incidence rates of non-Hodgkin's lymphoma (NHL) are high in Egypt although little is known about risk factors.

MATERIALS AND METHODS

Using data from the population-based cancer registry of Gharbiah governorate in Egypt, we assessed the 1999-2005 incidence of hematopoietic cancers (HCs) based on the ICD-O3 by age- and sex-specific urban-rural distribution.

RESULTS

NHL showed the highest incidence among all HCs (11.7 per 100 000). Urban incidence of HCs was higher than rural incidence. Incidence rates of Hodgkin's lymphoma (HL) and NHL were high especially among urban males up to the 64-year age category. Rural incidence of HL and NHL was high below age 20. Among the districts of the governorate, we observed NHL incidence pattern similar to that observed for hepatocellular carcinoma because of the possible link to hepatitis C virus for both cancers. Comparison to the published HCs data from Algeria, Cyprus, and Jordan showed the highest NHL rate in Egypt than the other countries in the region.

CONCLUSIONS

Future studies should define the role of environmental exposures in hematopoietic carcinogenesis in this population. In-depth studies should also investigate the role of access to health care in the urban-rural variation of HC distribution in this population.

Urban-rural differences of gynaecological malignancies in Egypt (1999-2002)

OBJECTIVE

In previous studies, we have shown a three to four times higher urban incidence of breast cancer and estrogen receptor-positive breast cancers in the Gharbiah Province of Egypt. We investigated the urban-rural incidence differences of gynaecologic malignancies (uterine, ovarian and cervical cancers) to explore if they show the same trend that we found for breast cancer.

DESIGN

Cancer registry-based incidence comparison.

SETTING

Gharbiah population-based cancer registry (GPCR), Tanta, Egypt.

SAMPLE

All patients with uterine, ovarian and cervical cancer in GPCR from 1999 to 2002.

METHODS

We calculated uterine, ovarian and cervical cancer incidence from 1999 to 2002. For each of the three cancers, we calculated the overall and age-specific rates for the province as a whole, and by urban-rural status, as well as for the eight districts of the province.

RESULTS

Incidence of all three cancer sites was higher in urban than in rural areas. Uterine cancer showed the highest urban-rural incidence rate ratio (IRR = 6.07, 95% CI = 4.17, 8.85). Uterine cancer also showed the highest urban incidence in the oldest age group (70+ age category, IRR = 14.39, 95% CI = 4.24, 48.87) and in developed districts (Tanta, IRR = 4.14, 95% CI = 0.41, 42.04). Incidence rates by groups of cancer sites showed an increasing gradient of urban incidence for cancers related to hormonal aetiology, mainly of the breast and uterus (IRR = 4.96, 95% CI = 2.86, 8.61).

CONCLUSIONS

The higher urban incidence of uterine cancer, coupled with our previous findings of higher incidence of breast cancer and estrogen receptor positive breast cancer in urban areas in this region, may be suggestive of possible higher exposure to environmental estrogenic compounds, such as xenoestrogens, in urban areas.

A Study of Dementia in Home Care Patients in Qatar with the Psychosocial Burden on Caregivers

Dementia is characterized by progressive deterioration of cognitive functions. It places a burden on caregivers and on society,and has been established as one of the major challenges of the present time. A retrospective study of 350 home care patients in Qatar found 50 with dementia for which it assessed various risk factors, co-morbities and the psychosocial burden on the care givers. It was found that the two major types of dementia, Alzheimer's disease and Vascular dementia had equal occurrence amongst home care patients in Qatar, with hypertension and atherosclerosis being the major contributing factors; a family history of dementia played only a minor role. Depression was the main co-morbidity in the patients. The care givers, mostly female, showed no significant psychosocial burden.

A classification of drug substances according to their mechanism of action

Different classification systems for therapeutic agents exist. The most commonly used one is the ATC Code (ATC: Anatomy, Therapeutic properties, Chemical, pharmacological properties). Here, an alternative classification system (TCAT: Target-Chemistry-Anatomy-Therapy) is proposed which refers to the molecular mechanism of action or rather, target. The main subgroups of targets are: enzymes; substrates, metabolies, proteins; receptors; ion channels; transporter molecules and systems; nucleic acids, ribosomes; physicochemical mechanisms; antigen-antibody reactions; unknown targets. This target-oriented approach may be particularly useful in teaching advanced medicinal chemistry.

Evaluation of tumour markers in molar pregnancy

METHODS

Circulating CA 125, CA 19-9, CA 15-3 and carcinoembryonic antigen (CEA) levels were studied in sixty patients with hydatidiform mole and in twenty normal pregnant women of a corresponding duration of pregnancy.

DISCUSSION

Serum levels of CA 125, CA 15-3 and CEA are not affected by molar pregnancy. The mean level of CA 19-9 in maternal serum is significantly lower in cases of molar pregnancy when compared with cases of normal pregnancy. The amnion cell origin of CA 19-9 could explain the statistically significant difference between cases of therapeutic abortion and cases of HM (complete HM lacks amniotic membrane).

Prevalence of hepatitis B infection markers in Lebanese children: the need for an expanded programme on immunization

This multi-centre, cross-sectional study was designed to reveal the present status of hepatitis B infection markers among Lebanese children, and provide recommendations regarding childhood immunization policies. A total of 841 children, aged between 6 months and 6.5 years, were enrolled from Lebanon's five districts. Their sera were tested for hepatitis B surface antigen and hepatitis B core IgG. The overall prevalence of hepatitis B virus infection markers was 0.8% with increasing age-specific rates from 0% at 6 months to 1.3 % at > 5 years. There was no statistically significant association between the presence of hepatitis B markers and family characteristics or risk factors for infection. The highest prevalence rates were among children from Beirut suburbs (2.9 %) and South Lebanon (1.6%). The risk of horizontal transmission of hepatitis B to uninfected children increased substantially after the age of 2 years. An expanded programme on immunization that integrates hepatitisB vaccine during the first year of life is needed.

Anti-fasciola IgG isotypes among patients with fascioliasis before and after treatment

Stool examination using modified Kato thick smear method was performed to detect Fasciola eggs and other parasites. Abdominal pain was the major presenting symptom (83.3%) followed by pallor (71.6%) and fever (16.7%). Anaemia and hepatomegaly were recorded in 70% of patients compared to 25% with splenomegaly. Abdominal ultrasonography revealed hepatomegaly and common bile duct dilatation in 70% of patients. Moreover, 6 cases showed Olympic game rings which is diagnostic. All of patients had positive IgG4 levels, 58 cases were found positive for specific total IgG and IgG1, whereas, only 36 cases had positive IgG2 levels (60%). All negative control group showed no cross reactions. On the other hand, ELISA detecting IgG4 showed the highest specificity (95%), followed by IgG2 (85%) and the least specific test was obtained with detection of IgG (70%) and IgG1 (65%). One week after treatment, 90% of patients were completely cured. One and 3 months after treatment, the cure rate was 83.3%. In completely cured patients, none of anti-Fasciola isotypes was significantly changed.

Solidification as low cost technology prior to land filling of industrial hazardous waste sludge

The aim of this study is to stabilize and solidify two different treated industrial hazardous waste sludges, which were selected from factories situated close to Alexandria. They were selected to ensure their safe transportation and landfill disposal by reducing their potential leaching of hazardous elements, which represent significant threat to the environment, especially the quality of underground water. The selected waste sludges have been characterized. Ordinary Portland Cement (OPC), Cement Kiln Dust (CKD) from Alexandria Portland Cement Company, and Calcium Sulphate as a by-product from the dye industry were used as potential solidification additives to treat the selected treated waste sludges from tanning and dyes industry. Waste sludges as well as the solidified wastes have been leach-tested, using the General Acid Neutralization Capacity (GANC) procedure. Concentration of concerning metals in the leachates was determined to assess changes in the mobility of major contaminants. The treated tannery waste sludge has an acid neutralization capacity much higher than that of the treated dyes waste sludge. Experiment results demonstrated the industrial waste sludge solidification mix designs, and presented the reduction of contaminant leaching from two types of waste sludges. The main advantages of solidification are that it is simple and low cost processing which includes readily available low cost solidification additives that will convert industrial hazardous waste sludges into inert materials.