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Naja species bite is the commonest cause for consultation to Remote Envenomation Consultancy Services in Malaysia. Envenomation by Naja species may result in neuroparalysis and cardiotoxic effects including arrhythmias, hypertension, tachycardia, atrioventricular blocks, ventricular tachycardia, and ventricular fibrillation. We report a case of cardiotoxicity as an early manifestation following an equatorial spitting cobra, Naja sumatrana bite, preceding early paralytic envenomation manifestation. A 14-year-old boy presented to an emergency department with mild local envenomation. ECG showed multiple ventricular premature complexes. Subsequently patient developed ptosis. Complete resolution of ptosis and resumption of normal sinus rhythm occurred following administration of the appropriate antivenom. The patient was discharged well after two days of hospitalization. The patient's ECG findings and neurotoxic manifestation suggested acute systemic envenomation. High index of suspicion for cardiotoxicity with close serial monitoring is recommended to ensure timely administration of antivenom.

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A unique method for determining chlorophyll content in microalgae is devised employing a gold interdigitated electrode (G-IDE) with a 10-µm gap, augmented by a nano-molecularly imprinted polymer (nano-MIP) and a titanium dioxide/multiwalled carbon nanotube (TiO2/MWCNT) nanocomposite. The nano-MIP, produced using chlorophyll template voids, successfully trapped chlorophyll, while the TiO2/MWCNT nanocomposite, synthesized by the sol-gel technique, exhibited a consistent distribution and anatase crystalline structure. The rebinding of procured chlorophyll powder, which was used as a template for nano-MIP synthesis, was identified with a high determination coefficient (R2 = 0.9857). By combining the TiO2/MWCNT nanocomposite with nano-MIP, the G-IDE sensing method achieved a slightly better R2 value of 0.9892 for detecting chlorophyll in microalgae. The presented G-IDE sensor showed a significant threefold enhancement in chlorophyll detection compared with commercially available chlorophyll powder. It had a detection limit of 0.917 mL (v/v) and a linear range that spanned from 10-6 to 1 mL. The effectiveness of the sensor in detecting chlorophyll in microalgae was confirmed through validation of its repeatability and reusability.

Asunto(s)

Clorofila , Técnicas Electroquímicas , Electrodos , Oro , Microalgas , Polímeros Impresos Molecularmente , Nanotubos de Carbono , Titanio , Titanio/química , Nanotubos de Carbono/química , Oro/química , Clorofila/química , Clorofila/análisis , Microalgas/química , Polímeros Impresos Molecularmente/química , Técnicas Electroquímicas/métodos , Técnicas Electroquímicas/instrumentación , Límite de Detección , Impresión Molecular

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BACKGROUND: Occupational diseases are one of the most important health problems related to employment However, in Malaysia, there are few epidemiological studies discussing these issues, especially among workers in the industry. For that, this study aimed to screen workers from high-risk industrial sectors, identify hazards in the workplace and recommend improvement measures in the workplace to prevent occupational diseases. METHODS AND ANALYSIS: This is a 3-year project in which a survey of 100 000 workers from all 13 states in Malaysia will be conducted using a web-based screening tool that is comprised of two parts: occupational disease screening tool and hazard identification, risk assessment and risk control method. Data will be collected using a multistage stratified sampling method from 500 companies, including seven critical industrial sectors. The independent variables will be sociodemographic characteristics, comorbidities, previous medical history, high-risk behaviour and workplace profile. The dependent variable will be the types of occupational diseases (noise-induced hearing loss, respiratory, musculoskeletal, neurotoxic, skin and mental disorders). Subsequently, suggestions of referral for medium and high-risk workers to occupational health clinics will be attained. The approved occupational health service clinics/providers will make a confirmatory diagnosis of each case as deemed necessary. Subsequently, a walk-through survey to identify workplace hazards and recommend workplace improvement measures to prevent these occupational diseases will be achieved. Both descriptive and inferential statistics will be used in this study. Simple and adjusted binary regression will be used to find the determinants of occupational diseases. ETHICS AND DISSEMINATION: This study has been approved by the MARA University of Technology Research Ethics Board. Informed, written consent will be obtained from all study participants. Findings will be disseminated to the Department of Occupational Health and Safety, involved industries, and through peer-reviewed publications.

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Enfermedades Profesionales , Lugar de Trabajo , Humanos , Estudios Transversales , Malasia/epidemiología , Medición de Riesgo/métodos , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/prevención & control , Tamizaje Masivo/métodos , Masculino , Salud Laboral , Femenino , Encuestas y Cuestionarios , Proyectos de Investigación , Exposición Profesional/efectos adversos , Exposición Profesional/prevención & control , Adulto

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Snakebite envenomation remains an important, yet a neglected public health issue in most tropical and subtropical countries. Underdeveloped medical infrastructure, suboptimal medical services, poor documentation and failure to make snake-related injury a mandatory notifiable disease are important contributing factors. The King Cobra (Ophiophagus hannah) is a medically significant species encountered in Malaysia however, there have been few publications from the clinical perspective. The objectives of this study were to determine the frequency of King Cobra related injuries, geographical distribution, clinical presentation, type and frequency of antivenom utilization and the management outcome. This is a cross-sectional study of confirmed King Cobra related injuries consulted to Remote Envenomation Consultation Services (RECS) from 2015 to 2020. Data were extracted from the RECS database and descriptively analyzed. A total of 32 cases of King Cobra bite were identified. Most cases were from Peninsular Malaysia with the most frequent from the state of Pahang (n = 9, 28.1%). Most patients got bitten while attempting to catch or play with the snake (68.8%). Signs and symptoms of envenomation were documented in 24 (75.0%) cases and the most frequent systemic manifestation was ptosis (n = 13, 40.6%). Tracheal intubation and ventilatory support were required in 13 (40.6%) patients. Antivenom was administered to 22 (68.8%) patients with most (25.0%) receiving 10 vials (1 dose). The commonest antivenom used was monospecific King Cobra antivenom (50.0%) from Thai Red Cross. There was one death documented due to complications from necrotizing fasciitis and septicemia. Public awareness of the dangers and proper handling of King Cobras needs to be emphasised. Timely administration of the appropriate antivenom is the definitive treatment and leads to favorable outcomes.

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Antivenenos , Ophiophagus hannah , Mordeduras de Serpientes , Humanos , Mordeduras de Serpientes/tratamiento farmacológico , Mordeduras de Serpientes/terapia , Mordeduras de Serpientes/epidemiología , Antivenenos/uso terapéutico , Antivenenos/administración & dosificación , Animales , Malasia/epidemiología , Masculino , Femenino , Estudios Transversales , Adulto , Persona de Mediana Edad , Adulto Joven , Adolescente , Niño , Anciano , Resultado del Tratamiento , Venenos Elapídicos , Preescolar

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The investigations of real industrial wastewater, such as palm oil mill effluent (POME), as a recalcitrant pollutant remain a subject of global water pollution concern. Thus, this work introduced the preparation and modification of g-C3N4 and WO3 at optimum calcination temperature, where they were used as potent visible light-driven photocatalysts in the degradation of POME under visible light irradiation. Herein, g-C3N4-derived melamine and WO3 photocatalyst were obtained at different calcination temperatures in order to tune their light absorption ability and optoelectronics properties. Both photocatalysts were proven to have their distinct phases, crystallinity levels, and elements with increasing temperature, as demonstrated by the ultraviolet-visible spectroscopy (UV-Vis), X-ray diffraction analysis (XRD), thermogravimetric analysis (TGA), Fourier-transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET), transmission electron microscopy (TEM), and X-ray photoelectron spectroscopy (XPS) results. Significantly, g-C3N4 (580 °C) and WO3 (450 °C) unitary photocatalysts exhibited the highest removal efficiency of POME without dilution due to good crystallinity, extended light absorption, high separation, and less recombination efficiency of electron-hole pairs. Furthermore, surprisingly, the superior energy storage photocatalytic performance with outstanding stability by WO3 achieved an approximately 10% increment during darkness, compared with g-C3N4 under visible light irradiation. Moreover, it has been proven that the WO3 and g-C3N4 photocatalysts are desirable photocatalysts for various pollutant degradations, with excellent visible-light utilization and favorable energy storage application.

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BACKGROUND: Supportive positioning may mimic the intrauterine environment and enhance neonates' physiological and developmental outcomes. Limited research in Saudi Arabia examined the effect of supportive positioning aids (nesting) on infant outcomes in neonatal intensive care units (NICUs). OBJECTIVE: This study compared nesting care to non-nesting care in the short-term outcomes of premature neonates (heart rate, oxygen saturation, and pain) in Saudi NICUs. METHODS: A quasi-experimental design compared two groups of premature neonates from two NICUs regarding their heart rate, oxygen saturation, and pain level. Nesting was used in the first group, and not in the second group. Seventy premature neonates (35 per group) were recruited. An independent t-test was used to compare the two groups. RESULTS: Heart rate was significantly lower in the nesting group than the non-nesting group at baseline and after procedures (136bpm and 139bpm vs 144bpm and 148bpm, P ≤ 0.05). The pain level was significantly lower in the nesting group than the non-nesting group at baseline and after procedures (3.7 and 3.8 vs 4.7 and 4.6, P ≤ 0.05). There was no significant difference between the two groups in oxygen saturation. CONCLUSION: Nesting care supported premature neonates in the NICU. It helped stabilize the heart rate and pain. NICUs in Saudi Arabia would benefit from educating NICU nurses and informing NICU managers and policymakers of nesting care.

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Introduction: This prospective cross-sectional study, conducted from 1 April 2022 to 31 October 2022, aimed to assess the knowledge, acceptance and concerns regarding COVID-19 vaccination among pregnant women visiting the Obstetrics and Gynaecology Department of Hospital Universiti Sains Malaysia. Methods: The study included all pregnant women aged >18 years. Sociodemographic data, information related to COVID-19 and vaccination and information on the knowledge, acceptance and concerns regarding COVID-19 vaccination were collected using a validated questionnaire. Results: Out of 420 eligible pregnant women, 412 participated in the study, yielding a response rate of 98.1%. Of the respondents, 97.1% had received a COVID-19 vaccine, while 2.9% had not. Approximately 85.2% demonstrated a good understanding of COVID-19 vaccination. Among those vaccinated, 76.8% based their decision on recommendations from healthcare providers or the Ministry of Health. Among those unvaccinated, 91.7% believed that COVID-19 vaccines could harm their pregnancy and baby. Although 51% of the respondents expressed concerns about vaccine safety, 202 still chose to be vaccinated, indicating a willingness to prioritise their health despite apprehensions. Conclusion: The study found no significant link between acceptance and good knowledge of COVID-19 vaccination. However, income and prior COVID-19 booster vaccination were strongly associated with acceptance. Despite safety concerns, 97.1% of the respondents had received a COVID-19 vaccine. This emphasises the importance of providing comprehensive information and addressing concerns to support informed decision-making among pregnant women. Healthcare providers play a vital role in guiding them through this crucial decision-making process.

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INTRODUCTION AND IMPORTANCE: Blepharochalasis is a rare eyelid condition that usually affects the upper eyelids and is characterized by persistent, painless edema. This article emphasizes how difficult it can be to diagnose blepharochalasis and how crucial it is to take it into account when making a differential diagnosis for recurrent eyelid swelling. Additionally, it highlights the necessity of surgical intervention and the limited effectiveness of medicinal therapy. CASE PRESENTATION: This case report features a 12-year-old kid who has experienced recurring swelling of the upper eyelid for the previous six years. This was eventually diagnosed as a rare condition called blepharochalasis, and treated with blepharoplasty. CLINICAL DISCUSSION: When nephrotic syndrome was first suspected, systemic involvement was ruled out by careful investigation. Upon physical examination, there was laxity of the eyelids and bilateral ptosis. Renal and liver function tests, among other laboratory testing, came back within normal ranges. The patient was sent to plastic surgery and had blepharoplasty. CONCLUSION: Blepharochalasis presents with recurrent eyelids swelling and is often misdiagnosed as other pathologies such as nephrotic syndrome. This case highlights the importance of clinical manifestation and management of blepharochalasis.

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Objectives: Rib fractures are common, morbid, and potentially lethal. Intuitively, if interventions to mitigate downstream effects of rib fractures can be implemented early, likelihood of developing these complications should be reduced. Surgical stabilization of rib fractures (SSRF) is one therapeutic intervention shown to be useful for mitigating complications of these common fractures. Our aim was to investigate for association between time to SSRF and complications among patients with isolated rib fractures undergoing SSRF. Methods: The 2016-2019 American College of Surgeons Trauma Quality Improvement Program (TQIP) database was queried to identify patient >18 years with isolated thoracic injury undergoing SSRF. Patients were divided into three groups: SSRF ≤2 days, SSRF >2 days but <3 days, and SSRF >3 days. Poisson regression, and adjusting for demographic and clinical covariates, was used to evaluate the association between time to SSRF and the primary endpoint, in-hospital complications. Quantile regression was used to evaluate the effects of time to SSRF on the secondary endpoints, hospital and intensive care unit (ICU) length of stay (LOS). Results: Out of 2185 patients, 918 (42%) underwent SSRF <2 days, 432 (20%) underwent SSRF >2 days but <3 days, and 835 (38%) underwent SSRF >3 days. Hemothorax was more common among patients undergoing SSRF >3 days, otherwise all demographic and clinical variables were similar between groups. After adjusting for potential confounding, SSRF >3 days was associated with a threefold risk of composite in-hospital complications (adjusted incidence rate ratio: 3.15, 95% CI 1.76 to 5.62; p<0.001), a 4-day increase in total hospital LOS (change in median LOS: 4.09; 95% CI 3.69 to 4.49, p<0.001), and a nearly 2-day increase in median ICU LOS (change in median LOS: 1.70; 95% CI 1.32 to 2.08, p<0.001), compared with SSRF ≤2 days. Conclusion: Among patients undergoing SSRF in TQIP, earlier SSRF is associated with less in-hospital complications and shorter hospital stays. Standardization of time to SSRF as a trauma quality metric should be considered. Level of evidence: Level II, retrospective.

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Background: With an aging global population, the prevalence of frailty in patients with traumatic spinal injury (TSI) is steadily increasing. The aim of the current study is to evaluate the utility of the Orthopedic Frailty Score (OFS) in assessing the risk of adverse outcomes in patients with isolated TSI requiring surgery, with the hypothesis that frailer patients suffer from a disproportionately increased risk of these outcomes. Methods: The Trauma Quality Improvement Program database was queried for all adult patients (18 years or older) who suffered an isolated TSI due to blunt force trauma, between 2013 and 2019, and underwent spine surgery. Patients were categorized as non-frail (OFS 0), pre-frail (OFS 1), or frail (OFS ≥2). The association between the OFS and in-hospital mortality, complications, and failure to rescue (FTR) was determined using Poisson regression models, adjusted for potential confounding. Results: A total of 43 768 patients were included in the current investigation. After adjusting for confounding, frailty was associated with a more than doubling in the risk of in-hospital mortality (adjusted incidence rate ratio (IRR) (95% CI): 2.53 (2.04 to 3.12), p<0.001), a 25% higher overall risk of complications (adjusted IRR (95% CI): 1.25 (1.02 to 1.54), p=0.032), a doubling in the risk of FTR (adjusted IRR (95% CI): 2.00 (1.39 to 2.90), p<0.001), and a 10% increase in the risk of intensive care unit admission (adjusted IRR (95% CI): 1.10 (1.04 to 1.15), p=0.004), compared with non-frail patients. Conclusion: The findings indicate that the OFS could be an effective method for identifying frail patients with TSIs who are at a disproportionate risk of adverse events. Level of evidence: Level III.

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This report presents a dataset of offline handwriting samples among Malaysian schoolchildren with potential dysgraphia. The images contained Malay sentences written by primary school students and children under intervention by the Malaysia Dyslexia Association (PDM). Students were expected to copy and write the sentences provided on the paper form that was used to gather data. Students were required to write three sets of sentences. The paper was digitalized by scanning it and converting it into digital form. Furthermore, the images were pre-processed using image processing techniques by converting the images into binary format and interchanging the foreground and background colors. The images were then classified into two categories, namely potential dysgraphia and low potential dysgraphia. The dataset comprised a total of 249 handwriting images, obtained from a sample of 83 participants who were selected in the data collection process, with 114 for potential dysgraphia and 135 for low potential dysgraphia. Both categories of handwriting images were prepared in black and white images.

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The aim of the current investigation was to compare the ability of several frailty scores to predict adverse outcomes in hip fracture patients. All adult patients (18 years or older) who suffered a hip fracture due to a fall and underwent surgical fixation were extracted from the 2019 National Inpatient Sample (NIS) Database. A combination of logistic regression and bootstrapping was used to compare the predictive ability of the Orthopedic Frailty Score (OFS), the Nottingham Hip Fracture Score (NHFS), the 11-factor modified Frailty Index (11-mFI) and 5-factor (5-mFI) modified Frailty Index, as well as the Johns Hopkins Frailty Indicator. A total of 227,850 patients were extracted from the NIS. In the prediction of in-hospital mortality and failure-to-rescue (FTR), the OFS surpassed all other frailty measures, approaching an acceptable predictive ability for mortality [AUC (95% CI): 0.69 (0.67-0.72)] and achieving an acceptable predictive ability for FTR [AUC (95% CI): 0.70 (0.67-0.72)]. The NHFS demonstrated the highest predictive ability for predicting any complication [AUC (95% CI): 0.62 (0.62-0.63)]. The 11-mFI exhibited the highest predictive ability for cardiovascular complications [AUC (95% CI): 0.66 (0.64-0.67)] and the NHFS achieved the highest predictive ability for delirium [AUC (95% CI): 0.69 (0.68-0.70)]. No score succeeded in effectively predicting venous thromboembolism or infections. In summary, the investigated frailty scores were most effective in predicting in-hospital mortality and failure-to-rescue; however, they struggled to predict complications.

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INTRODUCTION: Asthma management is strongly dependent on physician and patient beliefs and perceptions about the disease and its long-term treatment. The APPaRENT 3 study was conducted to explore factors influencing treatment choice and to understand patients' and physicians' attitudes and perspectives on the use of controller inhalers in regular versus flexible dosing for asthma management. METHODS: This cross-sectional survey of patients with asthma and treating physicians was conducted in seven countries: Indonesia, Malaysia, Philippines, Thailand, Vietnam (patient survey only), Saudi Arabia, and the United Arab Emirates. Assessment was carried out through an online/face-to-face questionnaire, where patients' viewpoints were focused on their attitudes and beliefs about asthma and treatment adherence, whereas physicians' viewpoints were gathered on their attitudes and beliefs about asthma management, knowledge of and adherence to asthma treatment guidelines, and asthma treatment regimens. RESULTS: Overall, 1400 patients (mean age, 34 years) and 599 physicians (mean age, 43 years) were included in the survey. Physicians similarly prioritised symptom control (39%) and exacerbation reduction (40%) in moderate asthma, whereas patients prioritised symptom control (41%) over exacerbation reduction (22%). Although both groups (physicians, 86%; patients, 84%) perceived asthma as well-controlled, poor management was evident based on Asthma Control Test (ACT) scores (mean, 15.7; standard deviation, 4.14; 82% had an ACT score < 20) and high symptom burden (39% reported nighttime awakenings or early mornings ≥ 2 nights/week). Most patients (76%) with moderate asthma were prescribed regular dosing, with the most common treatment being inhaled corticosteroid (ICS)/long-acting ß2-agonist (LABA) with as-needed inhaled short-acting ß2-agonist (SABA; 20%). Among patients on maintenance and reliever therapy, 93% of patients received a separate inhaled reliever. CONCLUSIONS: Despite high symptom burden, patients overestimated their level of asthma control. Physicians prioritised controlling symptoms and reducing exacerbations as treatment goals for moderate asthma, often prescribing regular dosing with ICS/LABA with as-needed inhaled SABA.

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Managing asthma depends a lot on what doctors and patients think about the illness and its long-term treatment. This study looked into what influences treatment decisions and what patients and doctors think about using inhalers regularly or on an as-needed basis to manage asthma across seven countries (Indonesia, Malaysia, Philippines, Thailand, Vietnam [patient survey only], Saudi Arabia, and the United Arab Emirates). In this study, patients with asthma and doctors managing asthma completed an online/face-to-face questionnaire. The study aimed to understand what patients think about asthma and their treatment plan. Meanwhile, the doctors were asked what they think about managing asthma and how much they apply clinical guidelines for treating patients with asthma. Doctors believed it is equally important to control symptoms and prevent worsening of symptoms in patients with moderate asthma, while patients cared more about controlling symptoms than preventing worsening of symptoms. While doctors and patients both regarded asthma as well-controlled, many patients had low Asthma Control Test scores and experienced a lot of symptoms, suggesting that they are poor perceivers of asthma control. Most patients with moderate asthma were given regular treatment, usually with inhaled corticosteroid combined with long-acting ß₂-agonist along with as-needed short-acting ß₂-agonist as a reliever. Most patients who were prescribed the same inhaler for regular use and as a reliever also had a separate inhaler for quick relief of symptoms. This study shows the need for patients and doctors to have better conversations about asthma, its treatments, and what to expect from them.

Asunto(s)

Antiasmáticos , Asma , Humanos , Asma/tratamiento farmacológico , Asma/terapia , Masculino , Adulto , Femenino , Estudios Transversales , Antiasmáticos/uso terapéutico , Antiasmáticos/administración & dosificación , Persona de Mediana Edad , Malasia , Emiratos Árabes Unidos , Vietnam , Arabia Saudita , Indonesia , Actitud del Personal de Salud , Tailandia , Filipinas , Conocimientos, Actitudes y Práctica en Salud , Encuestas y Cuestionarios , Administración por Inhalación , Nebulizadores y Vaporizadores , Cumplimiento de la Medicación/estadística & datos numéricos , Adulto Joven , Costo de Enfermedad , Médicos/psicología

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Probiotics are live microorganisms that inhabit the gastrointestinal tract and confer health benefits to consumers. However, a sufficient number of viable probiotic cells must be delivered to the specific site of interest in the gastrointestinal tract to exert these benefits. Enhanced viability and tolerance to sublethal gastrointestinal stress can be achieved using appropriate coating materials and food matrices for orally consumed probiotics. The release mechanism and interaction of probiotic microcapsules with the gastrointestinal tract have been minimally explored in the literature to date. To the authors' knowledge, no review has been published to discuss the nature of release and the challenges in the targeted delivery of probiotics. This review addresses gastrointestinal-related complications in the formulation of targeted delivery and controlled release of probiotic strains. It investigates the impacts of environmental stresses during the transition stage and delivery to the target region in the gastrointestinal tract. The influence of factors such as pH levels, enzymatic degradation, and redox conditions on the release mechanisms of probiotics is presented. Finally, the available methods to evaluate the efficiency of a probiotic delivery system, including in vitro and in vivo, are reviewed and assessed. The paper concludes with a discussion highlighting the emerging technologies in the field and emphasising key areas in need of future study.

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BACKGROUND: Internet addiction is increasing among adolescents worldwide. There is a lack of research assessing internet addiction and factors contributing to it among adolescents in Jeddah city. The current study aimed to assess the rate of internet addiction among adolescents in Jeddah, Saudi Arabia, and the potential factors associated with it. METHODS: A cross-sectional online survey, hosted by SurveyMonkey, was used to capture data on internet use from 462 adolescents aged 12-18 years between March and May 2022. Young's Internet Addiction Scale was used to assess the degree of internet addiction as perceived by adolescents. Multiple linear regression analysis was used to identify possible predictors of internet addiction among adolescents in Jeddah. RESULTS: The mean age of the participants was 15.5 ± 1.9 years. The majority were females (75%) from public schools (63%), spent an average of six hours on the internet daily, owned smartphones (98%), accessed the internet via a smartphone (94%), and used the internet for socializing (82%). Internet addiction mean score was 39.20 ± 15.20 out of 100. More than two-thirds of the participants had mild to moderate levels of internet addiction (68%). Significant predictors contributing to internet addiction were using the internet for socialization and playing online games. The more hours spent on the internet daily, the more the internet addiction was (p ≤ 0.05). CONCLUSIONS: The internet addiction rate is high among school adolescents in Jeddah. The majority of high school adolescents had mild to moderate levels of internet addiction. Interventional multidisciplinary programs are needed to mitigate the factors that influence internet addiction.

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AIM: This systematic review and meta-analysis aimed to evaluate the success rates of pulpotomy treatment for irreversible pulpitis in primary teeth. METHODS: This study was registered and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. Relevant studies published between January 1980 and April 2023 were identified across eight online databases and two paediatric dentistry textbooks. Study selection, data extraction, and quality assessment were conducted by multiple investigators independently. Data analysis involved single-arm and two-arm meta-analyses, leave-one-out sensitivity analysis, meta-regression, and assessment of publication bias. The risks of bias were evaluated using the Cochrane Collaboration's assessment tools. The levels of evidence were determined using the Oxford Centre for Evidence-Based Medicine (OCEBM) tool. RESULTS: Five primary studies were included. The weighted mean overall success rates at 6-month and 12-month follow-ups were 97.2% and 94.4%, respectively. Two-arm meta-analysis revealed no significant difference (p > 0.05) between the use of mineral trioxide aggregate (MTA) and non-MTA bioceramic-based materials as pulpotomy medicaments. The sample size of each study did not affect the degree of data heterogeneity. Egger's test revealed no significant publication bias. CONCLUSIONS: Pulpotomy may be regarded as an alternative modality for treating primary teeth with irreversible pulpitis. Nevertheless, future well-designed trials and extended follow-up periods are warranted.

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Simple and efficient removal of Pb(II) ion from aqueous solution through adsorption has accelerated the development of many new composites to improve this popular method. In this study, the composites of graphene oxide (GO), zeolitic imidazolate framework-8 (ZIF-8), and magnetic materials were synthesized via coprecipitation method utilizing a different molar ratio between FeCl2 and FeCl3 of 1:0.5, 2:1, 3:1.5, and 4:2. The ZIF-8/GO was prepared via room temperature synthesis method prior to its further modification with magnetic materials for ease of separation. It was observed that the MZIF-8/GO2 of molar ratio 2:1 showed the best performance in adsorbing Pb(II) ion. As confirmed by FESEM image, it appeared to be ZIF-8 particles that have grown all over the GO platform and overlayed with Fe3O4 granular-shaped particles. The MZIF-8/GO2 successfully achieved 99% removal of Pb(II) within 10 min. The optimum values obtained for the initial concentration of Pb (II) were 100 mg/L, pH of 4 to 6, and adsorbent dosage used was 10 mg. The Langmuir isotherm and the pseudo-second-order kinetic model were deemed suitable to evaluate the adsorption of Pb(II) using MZIF-8/GO2. Results showed that MZIF-8GO2 achieved a maximum adsorption capacity of 625 mg/g of Pb(II) adsorption. All parent materials demonstrated a good synergistic effects, while exhibiting a significant contribution in providing active sites for Pb(II) adsorption. Therefore, this ternary composite of MZIF-8/GO2 is expected to be a promising adsorbent for Pb(II) adsorption from aqueous solution with an added value of ease of post phase separation using external magnetic field.

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BACKGROUND: Research reveals that neonatal pain management in Neonatal Intensive Care Units (NICUs) is suboptimal. There is limited research that assessed NICU nurses' pain assessment practices in Saudi Arabia. AIM: To assess the nurses' pain assessment practices in the NICU in Saudi Arabia. DESIGN: This study used a descriptive cross-sectional design. SETTINGS: Research was conducted using an online survey. PARTICIPANTS/SUBJECTS: This study was carried out on 65 NICU nurses. The participants were recruited from one governmental and one private hospital in Saudi Arabia. METHODS: Data on pain assessment practices were collected, including the frequency of pain assessment, pain assessment scales used for preterm and term neonates, and pain assessment documentation. Data were analyzed using frequencies and percentages. RESULTS: The majority of the participants (94%) routinely assessed pain and documented pain assessment (97%). One-third of the participants assessed pain regularly every hour (32%). The most used pain assessment scales for term neonates were the neonatal infant pain scale (40%) and the cry, required oxygen, increased vital signs, expression, and sleeplessness scale (23%). The most used pain assessment scales for preterm neonates were the neonatal infant pain scale (31%), the cry, required oxygen, increased vital signs, expression, sleeplessness scale (19%), and the premature infant pain profile (17%). CONCLUSIONS: NICU nurses in Saudi Arabia consistently assessed for and documented pain; however, the tools chosen were sometimes suboptimal. A substantial number of NICU nurses used invalid tools to assess pain in term and preterm neonates. An interventional program is needed to enhance the use of evidence-based practice recommendations regarding neonatal pain assessment by nurses in the Neonatal Intensive Care Units in Saudi Arabia.

Asunto(s)

Unidades de Cuidado Intensivo Neonatal , Dimensión del Dolor , Humanos , Arabia Saudita , Unidades de Cuidado Intensivo Neonatal/organización & administración , Unidades de Cuidado Intensivo Neonatal/estadística & datos numéricos , Estudios Transversales , Dimensión del Dolor/métodos , Dimensión del Dolor/normas , Recién Nacido , Femenino , Masculino , Adulto , Encuestas y Cuestionarios , Manejo del Dolor/métodos , Manejo del Dolor/normas , Manejo del Dolor/estadística & datos numéricos , Enfermería Neonatal/normas , Enfermería Neonatal/métodos , Enfermería Neonatal/estadística & datos numéricos

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Pesticides are used in agriculture to protect crops from pathogens, insects, fungi and weeds, but the release of pesticides into surface/groundwater by agriculture runoff and rain has raised serious concerns not only for the environment but also for human health. This study aimed to investigate the impact of surface properties on the performance of seven distinct membrane types utilized in nanofiltration (NF), reverse osmosis (RO) and forward osmosis (FO) processes in eliminating multiple pesticides from spiked water. Out of the membranes tested, two are self-fabricated RO membranes while the rest are commercially available membranes. Our results revealed that the self-fabricated RO membranes performed better than other commercial membranes (e.g., SW30XLE, NF270, Duracid and FO) in rejecting the targeted pesticides by achieving at least 99% rejections regardless of the size of pesticides and their log Kow value. Despite the marginally lower water flux exhibited by the self-fabricated membrane compared to the commercial BW30 membrane, its exceptional ability to reject both mono- and divalent salts renders it more apt for treating water sources containing not only pesticides but also various dissolved ions. The enhanced performance of the self-fabricated RO membrane is mainly attributed to the presence of a hydrophilic interlayer (between the polyamide layer and substrate) and the incorporation of hydrophilic nanosheets in tuning its surface characteristics. The findings of the work provide insight into the importance of membrane surface modification for the application of not only the desalination process but also for the removal of contaminants of emerging concern.

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Filtración , Membranas Artificiales , Ósmosis , Plaguicidas , Contaminantes Químicos del Agua , Purificación del Agua , Plaguicidas/análisis , Plaguicidas/química , Plaguicidas/aislamiento & purificación , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/química , Purificación del Agua/métodos , Filtración/métodos , Interacciones Hidrofóbicas e Hidrofílicas

RESUMEN

BACKGROUND: Skin-to-skin care (SSC) between newborns and their parents provides many positive outcomes for both newborns and their parents. However, there is a lack of research assessing the perception of parents, especially fathers, of SSC in Saudi Arabia. PURPOSE: The aim of the study is to assess parents' perception of SSC in Saudi Arabia. METHODS: This cross-sectional study used an online survey. Data were collected from a convenience sample of 140 parents of hospitalized neonates between January and June 2023. Data were collected from one private hospital (Dr. Soliman Fakeeh Hospital) and one public hospital (King Abdulla Medical Complex) in Jeddah, Saudi Arabia. The parents' perceptions of SSC were assessed using the Parents' Perceptions of SSC tool. An independent t-test was used to compare mothers and fathers in their perceptions of SSC. RESULTS: One hundred and forty parents completed the online survey (70 females and 70 males). The majority of the parents did not use SSC with their babies (n=102, 73%), did not read or hear about the use and benefits of skin-to-skin care (n=100, 71%), and did not receive information or training on SSC from healthcare professionals (n=112, 80%). Mothers' perception of SSC was significantly higher than that of fathers (p ≤ 0.05). CONCLUSION: Fathers' perception of SSC was lower than that of mothers. Awareness and training programs are needed to inform parents, especially fathers, regarding SSC and its benefits in Saudi Arabia.