Estimated Glomerular Filtration Rate (eGFR): A Serum Creatinine-Based Test for the Detection of Chronic Kidney Disease and its Impact on Clinical Practice

Abstract Chronic kidney disease (CKD) is an important epidemic and public health problem that is associated with a significant risk for vascular disease and early cardiovascular mortality as well as progression of kidney disease. Currently it is classified into five stages based on the glomerular filtration rate (GFR) as recommended by many professional guidelines. Radiolabelled methods for measuring GFR are accurate but not practical and can be used only on a very limited scale while the traditional methods require timed urine collection with its drawback of inaccuracy, cumbersomeness and inconvenience for the patients. However, the development of formula-based calculation of estimated GFR (eGFR) has offered a very practical and easy approach for converting serum creatinine value into GFR result taking into consideration patient's age, sex, ethnicity and weight (depending on equation type). The commonly used equations include Cockraft and Gault (1976), Modification of Diet in Renal Disease (MDRD) (1999) and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) (2009). It is the implementation of these equations particularly the MDRD that has raised the medical awareness in the diagnosis and management of CKD and its adoption by many guidelines in North America and Europe. The impact and pitfalls of each of these equations in the screening, diagnosis and management of patients with CKD are presented and discussed in this review

Some Amino Acids Affect the Response of Grape (Vitis vinifera L.) Single Nodules In Vitro Multiplication

Organic nitrogen, which comes from amino acids, is absorbed and transported more rapidly than inorganic nitrogen by plant cells and tissues. Therefore, this study was conducted to evaluate the effect of some amino acids on the response of single nodes of grape Vitis vinifera L. Superior and Red globe cultivars were classified for in vitro multiplication to develop an efficient protocol for propagation of these two valuable species. The study included two experiments: first, the effect of adding three concentrations (0, 0.5, and 1) mg L-1 of Benzyl Adenine (BA) to the MS medium in the initiation stage. The second investigation utilized three amino acid types (glutamine, asparagine, and methionine) at five concentrations (0, 10, 20, 40, and 80) mg L-1 added to MS medium containing 2 mg L-1 of BA. Results indicated that the most significant newly initiated shoots (2.40 and 2.88) and the largest leaves number (7.90 and 5.88) for both cultivars, Superior and Red globe, respectively were obtained in a medium with 1 mg L-1 of BA. The multiplication results in eight weeks after cultivation showed that adding amino acid glutamine at 10 mg L-1 significantly increased the number of shoots/explant (6.60 and 6.00) and (29.50 and 38.30) leaves/explant for Red globe and Superior, respectively. The high amino acid concentrations (40 and 80) mg L-1 significantly reduced the studied growth parameters, especially the number of newly formed shoots. The results obtained from the present study exhibited the possibility of applying this modified protocol to the propagation of selected grape cultivars to encourage the expansion of the grape-growing industry in Iraq

Reference Ranges of Serum Anti-Müllerian Hormone in Healthy Reproductive-aged Omani Women

Objectives: Anti-Müllerian hormone (AMH), a glycoprotein that belongs to the transforming growth factor-beta superfamily, is important for women’s health. We aimed to determine the age-specific reference range of serum AMH in healthy Omani women from reproductive ages to menopause. Methods: This cross-sectional cohort study was conducted among a group of healthy 20–50 years old Omani women. The participants were required to have body mass index < 32 kg/m2 regular periods, no history of chronic illness, polycystic ovary syndrome, or gynecological operation. They were also required to not be using any hormonal contraceptive. Serum concentrations of AMH, follicle-stimulating hormone, luteinizing hormone, progesterone, and hemoglobin A1c were measured. AMH-age nomogram and AMH levels were compared between the six selected age groups. Results: The subjects were 319 Omani women aged 20–50 years. Serum AMH concentrations were found to decrease progressively with increasing age. An exponential model defined as √AMH = 479.02 × 0.91age was selected to explain the reduction in AMH with age (R2 = 0.298). The median AMH levels were 26.61 pmol/L for those aged 20–25 years, 20.89 pmol/L for 26–30 years, 19.92 pmol/L for 31–35 years, 13.71 pmol/L for 36–40 years, 9.24 pmol/L for 41–45 years, and 0.68 pmol/L for 46–50 years. The recommended 2.5thto 97.5thpercentiles of AMH level, as reference ranges for various age groups, were found to be: 10.63–55.64 pmol/L (20–25 years), 3.74–61.88 pmol/L (26–30 years), 5.49–47.56 pmol/L (31–35 years), 2.15–48.91 pmol/L (36–40 years), 0.92–41.26 pmol/L (41–45 years), and 0.14–5.10 pmol/L (46–50 years).Conclusions: This study (the first in Oman) determined the age-specific reference ranges of serum AMH in healthy Omani women in the age range of 20–50 years

Fertility awareness and oocyte cryopreservation among obstetrics and gynecology physicians

Background: Fertility awareness, including the natural decline in fertility with age and fertility preservation through oocyte cryopreservation, is vital for reproductive health. OB/GYN physicians play a crucial role in educating women on these topics, yet their knowledge and attitudes in Saudi Arabia are underexplored. This study assessed OB/GYN physicians’ perceptions, knowledge, and attitudes regarding fertility awareness and oocyte cryopreservation, focusing on their understanding of age-related fertility decline and integration into patient discussions. Methods: A cross-sectional survey of 100 OB/GYN physicians in Saudi Arabia was conducted from April to July 2024, using stratified random sampling. The survey evaluated their knowledge of fertility issues, attitudes towards preconception planning, and views on incorporating oocyte cryopreservation discussions in practice. Data were analyzed using descriptive statistics and ANOVA. Results: Most physicians showed substantial knowledge of fertility decline, with 71% recognizing a slight decline at 35-39 years and 57% a marked decline at 45-49 years. Nearly all (96%) supported OB/GYN-initiated discussions on preconception planning, and 95% endorsed discussing age-related fertility decline. Additionally, 78% favoured discussing oocyte cryopreservation, with 63% supporting its inclusion in routine visits. Concerns about discussion frequency and potential emotional distress were noted by a minority. Conclusions: OB/GYN physicians in Saudi Arabia are generally aware of fertility issues, but knowledge gaps persist, particularly among less experienced physicians. While there is broad support for proactive fertility discussions, some reservations remain, highlighting the need for targeted educational initiatives

Structure-Based Virtual Screening of Antiviral Compounds Targeting the Norovirus RdRp Protein

Background: Human noroviruses (NV) are the primary etiological organisms causing acute gastroenteritis around the world, causing severe morbidity and imposing a significant economic burden. The RNA-dependent RNA polymerase (RdRp) is essential for viral replication and could be a promising target for anti-NV therapeutics. Despite the discovery of a few NV RdRp inhibitors, the majority of these pharmaceuticals have demonstrated limited efficacy in inhibiting viral replication in cellular models.Methods: In this study, computational screening of antiviral compounds was conducted targeting the NV RdRp protein. The assessment was based on binding poses and the key residues of RdRp involved in interactions with compounds.Results: The compounds namely, Ribavirin, BMS806, Dihydromyricetin, R7935788, and LY2784544 were found to bind the RdRp protein with high affinity. Notably, these compounds displayed significantly lower binding affinities compared to the positive control, PPNDS. In addition, these compounds exhibited many RdRp protein binding residues that were also present in the PPNDS.Conclusion: The results presented here suggest that these compounds have the potential to be used as inhibitors of NV RdRp in the development of antiviral medications. Nevertheless, due to the computational nature of this study, it is imperative to do experimental validation.Keywords: Noroviruses; RdRp; Virtual screening; Antiviral Compounds 

The impact of childhood atopic dermatitis on quality of life of the paediatric population

BackgroundAtopic Dermatitis (AD) is a chronic skin condition characterized by pruritis which presents with xerosis, lichenification, and the eruption of eczematous lesions.AimsTo measure the quality of life in the paediatric population with atopic dermatitis at King Abdulaziz Medical City in Jeddah, Saudi Arabia.Methods The assessment tool utilized was the Infants' Dermatitis Quality of Life Index (IDQOL) questionnaire which is validated and available in Arabic. The sample size is 80 participants. Demographics, history of atopy, current treatment, and the percentage of body involved were described as frequencies. Chi-square test was performed to determine if there was a significant difference between gender, age group and the presence of other atopic disease in comparison to percentages of body involved. The analysis of the questionnaire’s items was done by One-way ANOVA to determine where significant impact on quality of life was present.Results There was a significant difference in overall IDQOL score between patient who had asthma with AD and those who did not (p=0.016). Significantly, the higher the percentage of body area affected by AD, the higher IDQOL score (p < 0.0001). No significant difference was identified for the chi-square test. Among questionnaire’s items sleep disturbance was affected the most among patients in relation to increase in distribution of disease along the body (p < 0.0001).ConclusionThe study concluded that the IDQoL among paediatric population with Atopic Dermatitis was significantly impaired, and it showed that the disease severity was proportionally related to the impairment of patients’ quality of life. Therefore, we highly recommend further studies in the same field to be able to generalize the results in the Saudi paediatric population

Three Component Cascade Reaction of Cyclohexanones, Aryl Amines, and Benzoylmethylene Malonates: Cooperative Enamine-Brønsted Acid Approach to Tetrahydroindoles

Article discusses how a three-component cascade reaction comprising cyclic ketones, arylamines, and benzoylmethylene malonates has been developed to access 4,5,6,7-tetrahydro-1H-indoles. Furthermore, the reaction was achieved through cooperative enamine-Brønsted catalysis in high yields with wide substrate scopes

The aftermath of COVID-19: generalized anxiety disorder and burnout among radiology practitioners and interns in Saudi Arabia

BackgroundThe coronavirus disease (COVID-19) pandemic has presented unprecedented stressors and difficulties for healthcare professionals. This study explored the prevalence of generalized anxiety disorders and burnout among radiology practitioners and interns in various hospitals in Saudi Arabia after the end of the COVID-19 global public health emergency.MethodsA cross-sectional survey of 230 radiology practitioners and interns was conducted between October and November 2023. This study utilized the Generalized Anxiety Disorder 7-item (GAD-7) scale and Maslach Burnout Inventory-Human Services Survey for Medical Personnel (MBI-HSS-MP) 22-item questionnaire, employing a non-probability convenience sampling method. The average scores of the individual components constituting the GAD-7 scale and each burnout scale were calculated, and statistical analyses were conducted using the Mann-Whitney U and Kruskal-Wallis H nonparametric tests.ResultsOf 382 radiology practitioners and interns, 230 (60.2%) responded to the survey. Notably, 42.6% of the participants reported experiencing GAD. Regarding burnout, 82.3% were at moderate-to-high risk for emotional exhaustion, 93.5% for depersonalization, and 52.1% for personal achievement. The 31–40 years age group showed significantly higher burnout rates (p = 0.001) compared with the other age groups. Those with more than three years of experience had notably higher emotional exhaustion scores (p = 0.002) and a nearly significant increase in depersonalization scores (p = 0.051) than those with less experience.DiscussionOur study revealed that 42.6% of radiology practitioners and interns experienced GAD, with the majority facing significant burnout. Furthermore, our research indicates a decline in GAD levels among radiology practitioners and interns compared with the peak COVID-19 pandemic period. It also showed a significant increase in both the incidence and severity of burnout, surpassing pre-pandemic levels in a comparable cohort. These findings emphasize the pressing challenges of GAD and burnout among healthcare workers, especially radiology professionals

The Importance of Preventive Medicine in Family Practice: A Review of Current Guidelines and Recommendations

Prevention is seen as a critical topic in family practice. Primordial prevention, primary prevention, secondary prevention, tertiary prevention, and quaternary prevention are all part of this strategy to disease prevention. To avoid the formation and development of risk factors, primary prevention focuses on addressing the fundamental causes and social determinants of disease. Primary prevention is the practice of preventing illnesses before they arise via the use of treatments such as immunizations and health education. Secondary prevention focuses on illness identification and intervention as early as possible to avoid disease development. Tertiary prevention addresses illness outcomes by restoring health and offering rehabilitation. Finally, quaternary prevention seeks to safeguard patients against needless medical treatments and the harm caused by over-medicating. Risks frequently rise in tandem with frailty and comorbidities. In contrast, advantages frequently drop as life expectancy increases. Preventive management strategies should consider the patient's viewpoint and be mutually agreed upon. Healthcare providers must prioritize the deployment of preventive care services, even when clinical treatments are required, in order to overcome preventive care hurdles. Healthcare practitioners may play a critical role in illness prevention and contribute to family well-being by investing in preventive care and executing these measures