Articles

Introduction: Busulfan (Bu)-based regimens are crucial for myeloablative conditioning in pediatric allogeneic stem cell transplantation. Despite its efficacy, Intravenous Bu has a narrow therapeutic index and variable pharmacodynamics especially in children, heightening the risk of adverse events. This study explores Bu dosing and related organ toxicities in pediatric patients at a tertiary center in Saudi Arabia.Methodology: This retrospective study at King Fahad Specialist Hospital in Dammam (KFSH-D), Saudi Arabia, included pediatric patients (≤16 years) treated with intravenous Bu before bone marrow transplantation from 2010 to 2022. Pharmacokinetic dose adjustments were based on AUC targets of 900-1350 µMol-min. Descriptive measures included mean, Standard Deviation (SD), median, minimum-maximum values, counts, and percentages. Statistical analyses used Kruskal-Wallis, Chi-square, and Fisher’s exact tests. Ethical approval was obtained from KFSH-D.Results: We identified 44 pediatric patients who underwent Bu prior to HSCT. Mean age was 4.95 ± 2.49 years, with a female majority (56.8%). Primary diseases included Beta Thalassemia (34.09%), Neuroblastoma (29.55%) among others. There was no significant difference in the cohort’s demographic and clinical features of the cohort. Nonetheless, higher infections were found in the Low-AUC group (66.7%) compared to the Target-AUC (40.0%) and Higher-AUC groups (0.0%) (p = 0.015).Conclusion: This study emphasizes the need for therapeutic drug monitoring and individualized Bu dosing in pediatric HSCT to minimize toxicity and improve outcomes. Larger multicenter studies are recommended to refine dosing strategies and enhance the safety and efficacy of Bu-based regimens.

In the world, millions of hectares of cultivated land are affected by salt, making salinity a major constraint for plant production. The effects of different levels of banana peel on growth, yield, and chemical changes of jute (Corchorus olitorius L.) under salt stress were examined herein. Response of jute to applications of different levels of banana peel (5, 10, and 15 t ha-1), as well as water irrigation salinity at 50, 100, and 200 mM NaCl were evaluated under greenhouse conditions. The outcome uncovered that salinity caused significant reduction of plant growth and yield parameters, chlorophyll (at 21.6%), LRWC (at 18.9%), P (at 57.1%) and K (at 45.4%) content, while MDA content (at 351.8%), Na (at 266%), soluble proteins (70.2%), total phenolic (at 23.4%) accumulation showed an increase from 0 to 200 mM NaCl without BP application. The banana peel treatments (at 15 t ha-1 under 200 mM NaCl) diminished significantly damaging effects caused by salinity via a reduction in the Na (at 28.4%), total soluble sugars (at 17.8%), total flavonoids (at 20.1%), which enhanced number of leaves per plant (37.1%), plant height (at 19.8%), leave yield (at 41.4%), LRWC (at 12.8%), Mg (at 24.2%) and reduced the MDA content (at 20%), presenting a favorable effect in reducing the oxidative stress that emerged from salt stress. It could be concluded, that the application of 15 t ha-1 of BP was superior in promoting plant growth, yield, and nutritional quality than others under control and in the saline soils in this study. BP at 15 t ha-1 had a more reduced damage of salt stress effect on growth, yield, nutritional value, and use efficiency.

We know that until today no experiment observation has shown the existence of Supersymmetric particles [1] or additional dimensions.

Cyclical cosmic conditions illuminate profound philosophical and physical implications regarding the fundamental nature of the universe. From this perspective, a singularity could actually symbolize a transformation of the underlying structures and laws of our universe, providing insights into the relationships among energy, curvature, and existence of the universe itself. In cyclical cosmology, the universe can be understood as existing in two distinct states: a static potential state and an active kinetic state. Quantum mechanics also reinforces the belief that even in seemingly empty spaces, vacuum fluctuations and differences in potential can give rise to emergent phenomena.

The present study aimed to analyze Cholinesterase (CE) levels in cord blood from preeclamptic women and to evaluate cholinesterase status in patients with osteosarcoma. Serum cholinesterase levels were assessed in 30 cases of osteosarcoma and 30 controls suffering from musculoskeletal pain. Additionally, maternal and cord blood samples were collected from 25 women with preeclampsia and compared with those from 25 normotensive pregnant women and 25 normal, healthy controls. The results indicated that serum cholinesterase levels were significantly lower in osteosarcoma patients (Group I) compared to those with musculoskeletal pain (Group II, p < 0.05). Similarly, cholinesterase levels were reduced in the maternal blood of women with preeclampsia when compared to normotensive controls. Cord blood cholinesterase levels were lower in the infants of normotensive mothers, with levels reaching 88.65% of the maternal levels. Furthermore, cord blood cholinesterase levels were significantly lower in preeclamptic women compared to normotensive pregnant women. When comparing cholinesterase levels to those of normal controls, it was observed that CE levels were significantly elevated in both normotensive and preeclamptic women. The findings of low serum cholinesterase levels in this study suggest that cholinesterase secreted by osteoblasts is utilized in bone formation and tumorigenesis. Additionally, the decrease in cholinesterase levels associated with preeclampsia may be linked to the loss of muscarinic cholinergic receptors that occur in this condition.

As addiction counselors suffer from Burnout (BO) and Compassion Fatigue (CF), turnover rates increase and subsequently, there are fewer addiction counselors available to provide care for those experiencing addiction. A qualitative transcendental phenomenological study was conducted to interview addiction counselors believed to be resilient to BO and CF. All nine participants held the Master Addiction Counselor (MAC) certification awarded by the National Certification Commission for Addiction Professionals (NCC AP) and worked in addiction counseling for five years minimum. Previous studies show only 58% of addiction counselors remain in the field for five or more years and 29% maintain their current job for 5 or more years (therefore resiliency in this sample was inferred). Identified themes relating to resiliency factors were gleaned and implications were explored.

The increasing reliance on digital health services, particularly in light of recent global health crises, has highlighted the importance of eHealth literacy. This study explores the role of eHealth literacy in managing health outcomes, with a specific focus on gender disparities. Using data from the “Truck Tour-Banca del Cuore 2023” survey, which included 354 participants, we examined how integrated technology influences health monitoring and management strategies. Our findings underscore the critical role of eHealth literacy in improving health outcomes and reducing gender disparities, particularly in the context of digital health interventions.

Background: Atrial fibrillation (A-Fib) poses a significant clinical challenge, particularly in the elderly and those with hypertension. If A-Fib represents one stage in the spectrum of electrical degeneration caused by aging-induced remodeling of the left atrial wall, catheter ablation is not an essential treatment. The efficacy of Vaughan Williams Class IC drug in preventing the progression of multiple premature atrial contractions (mPAC) toward paroxysmal atrial fibrillation (PAF) and A-Fib in the earlier stage of histological change was investigated.Method and results: Group A (4 patients with mPAC) and Group B (9 patients with PAF) were treated with Class IC drugs. Treatment outcomes were compared between these two Groups and Group C (8 patients with chronic A-Fib). Follow-up assessments were performed to evaluate the maintenance of sinus rhythm. All mPAC patients maintained sinus rhythm during the follow-up period. In the PAF group, 8 out of 9 patients maintained their sinus rhythm. Conclusion: Early treatment with Class IC drugs shows promise in preventing the progression of A-Fib and maintaining sinus rhythm in patients with mPAC and PAF. These findings highlight the potential role of pharmacological therapy in delaying the onset of A-Fib, thereby improving clinical outcomes and reducing the need for invasive procedures such as ablation.

Background and importance: Sacral fractures often lead to injuries of the lumbosacral nerve, which will cause tremendous damage to the patient’s motor and sensory functions. At present, the most commonly used surgical method is the posterior median approach, the extent and degree of neurolysis are often insufficient, so the effect of neurolysis is not well, and the functional recovery of patients after operation is often incomplete.Clinical presentation: The patient was a 17-year-old male who accidentally fell from a height and landed on his hip. The main clinical feature of the patient was persistent radiating pain in the right lower extremity with right lower limb sensorimotor disorder. The results of the X-ray examination indicated a sacral fracture and a right pubic fracture. After the injury, the patient underwent pelvic internal fixation surgery within 72 hours. Then 6 months after the surgery, there was no significant improvement in right lower limb function, and the patient came to our hospital seeking treatment. Considering the severe lumbosacral plexus injury and the history of surgery, we performed an “Anterior surgery approach combined with posterior approach for lumbosacral neurolysis” for the patient, postoperative radiation pain disappeared completely, and there were significant improvements in the muscle strength of some muscles and sensory function.Conclusion: The relaxation of the lumbosacral plexus is usually performed through a single surgical approach, which has great limitations in the effect of relaxation. Here, we demonstrate a case in which posterior lumbar incision and anterior laparoscopic lumbosacral plexus neurolysis can benefit the patient, the lumbosacral nerve was released to a great extent. We aim to bring this case to the attention of our worldwide neurosurgical colleagues and share our surgical approach to assist those who may encounter this case in the future.

Objective: This research was conducted to determine medication compliance and factors affecting compliance with type 2 diabetes patients in public hospitals.Method: This research is a descriptive type of research, which is one of the Quantitative research types. There was no sample selection in the study, and the study was conducted with 100 patients who met the Inclusion criteria. Research data was collected between December 2022 and June 2023. Results: The patients ' compliance with the medication appears to be at a moderate level. The difference in the Medication Compliance Reporting scale mean scores difference According to the patients' genders, whom they live with, marital status, diabetes duration, treatment method, and daily insulin application the status is not statistically significant. Conclusion: In this study, it was determined that the medication compliance of elderly type 2 diabetic patients was at a moderate level. It is recommended That nurses organize awareness training on the factors affecting medication compliance of elderly type 2 diabetic patients and That the research be conducted​ with a larger sample group.