As medical science and technology progress towards the era of "big data", a multi-dimensional dataset pertaining to medical diagnosis and treatment is becoming accessible for mathematical modelling. ...However, these datasets are frequently inconsistent, noisy, and often characterized by a significant degree of redundancy. Thus, extensive data processing is widely advised to clean the dataset before feeding it into the mathematical model. In this context, Artificial intelligence (AI) techniques, including machine learning (ML) and deep learning (DL) algorithms based on artificial neural networks (ANNs) and their types, are being used to produce a precise and cross-sectional illustration of clinical data. For prostate cancer patients, datasets derived from the prostate-specific antigen (PSA), MRI-guided biopsies, genetic biomarkers, and the Gleason grading are primarily used for diagnosis, risk stratification, and patient monitoring. However, recording diagnoses and further stratifying risks based on such diagnostic data frequently involves much subjectivity. Thus, implementing an AI algorithm on a PC's diagnostic data can reduce the subjectivity of the process and assist in decision making. In addition, AI is used to cut down the processing time and help with early detection, which provides a superior outcome in critical cases of prostate cancer. Furthermore, this also facilitates offering the service at a lower cost by reducing the amount of human labor. Herein, the prime objective of this review is to provide a deep analysis encompassing the existing AI algorithms that are being deployed in the field of prostate cancer (PC) for diagnosis and treatment. Based on the available literature, AI-powered technology has the potential for extensive growth and penetration in PC diagnosis and treatment to ease and expedite the existing medical process.
Trained immunity is a renewed concept of innate immune memory that facilitates the innate immune system to have the capacity to remember and train cells via metabolic and transcriptional events to ...enable them to provide nonspecific defense against the subsequent encounters with a range of pathogens and acquire a quicker and more robust immune response, but different from the adaptive immune memory. Reversing the epigenetic changes or targeting the immunological pathways may be considered potential therapeutic approaches to counteract the hyper-responsive or hypo-responsive state of trained immunity. The efficient regulation of immune homeostasis and promotion or inhibition of immune responses is required for a balanced response. Trained immunity-based vaccines can serve as potent immune stimuli and help in the clearance of pathogens in the body through multiple or heterologous effects and confer protection against nonspecific and specific pathogens. This review highlights various features of trained immunity and its applications in developing novel therapeutics and vaccines, along with certain detrimental effects, challenges as well as future perspectives.
Objective: The ongoing pandemic of the coronavirus disease 2019 (COVID-19), which originated from Wuhan, China, has been identified to be caused by the novel beta coronavirus, severe acute ...respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has been spreading rapidly worldwide within just a few months. Our aims were to analyze clinical and laboratory abnormalities in ICU patients with COVID-19, in order to define which predictors can distinguish between those who are at higher risk of developing fatal versus non-fatal forms of the disease. Methods: A descriptive cross-sectional survey was used; demographics, comorbidities, symptoms, laboratory parameters at ICU admission, and clinical outcomes for the adult patients admitted to ICU were collected from five hospitals in Saudi Arabia. Results: A total of 86 patients with COVID-19 admitted in ICU, 50 patients died, 23 recovered, and 13 were still admitted, with a mortality rate of 58.1%. Septic shock (OR (95% CI): 58.1 (5.97-7812.8), p < 0.001) and acute kidney injury (AKI) (OR (95% CI): 7.279 (1.191-65.43), p = 0.032) had a significant impact on mortality. Cox proportionalhazards regression analysis revealed that septic shock (HR (95% CI): 9.502 (2.958-30.524), p < 0.001) and neutrophil count (HR (95% CI): 1.053 (1.023-1.085), p < 0.001) were significant predictors for mortality. Conclusion: Septic shock, AKI, and high neutrophil count were found to be predictive of death in these patients. Further studies are needed to aid efficient recognition and management of severe COVID-19 patients in our population. Keywords: COVID-19, severe acute respiratory syndrome coronavirus 2, intensive care units, Saudi Arabia, mortality
Background: Burnout is defined as a long-term work stress. The prevalence of burnout syndrome among nurses is 42% of nurses in England. Many countries have conducted studies to measure the level of ...burnout among health care providers. There is a lack of research on burnout among healthcare providers in the Arabic countries. Aims: This study aimed to assess the burnout level among healthcare providers in Saudi Arabia and United Arab Emirates and to predict the burnout factors of healthcare providers working in tertiary private hospitals. Methods: A descriptive cross-sectional survey was used to evaluate the burnout among healthcare providers. A total of 900 healthcare providers working in the clinical areas of six private hospitals in the Arabia Gulf Region were recruited for the study. A total of 892 healthcare providers were included in the study. A total of eight surveys were excluded due to major missing data. Results: A total of 892 healthcare providers were included in the study. The average age was 32 years ± 7 years for male and female healthcare providers. A high burnout level was found in the results. The participating female healthcare providers had a higher level of emotional exhaustion as compared with their male counterparts. Nurses had more emotional exhaustion as compared with physicians, respiratory therapists, and other colleagues. Conclusions: High burnout levels among healthcare providers can reflect negatively on the healthcare providers well-being, job satisfaction, and mental health. Burnout has been linked with medical errors and physician–patient relationships. We believe that it is important to deal with this issue of public health in Saudi Arabia and UAE. This study aimed to explore burnout levels among healthcare providers in Saudi Arabia and UAE. Results showed a high level of burnout among the healthcare.
The burden of the spread of the COVID-19 pandemic has impacted widely on the healthcare providers physically and mentally. Many healthcare providers are exposed to psychological stressors due to ...their high risk of contracting the virus.
This study aimed to measure the level of anxiety among healthcare providers during the COVID-19 pandemic in Saudi Arabia. In addition, this study aimed to measure the level of anxiety based on demographic characteristics.
A cross-sectional survey was employed to recruit a convenience sample of healthcare providers. A pencil and paper self-administered questionnaires were used to collect data from demographic and generalized anxiety disorder GAD-7 data. However, this study received written informed consent from participants of the study. In addition, the study was approved by the Institutional Review Board at Dr. Sulaiman Al Habib Medical Group (IRB Log No. RC20.06.88-03).
A total of 650 participants were recruited, results of GAD-7 showed that 43.5%, 28.9% and 27.5% of healthcare providers in Saudi Arabia experienced mild, moderate and severe anxiety, respectively, during the COVID-19 pandemic. Results indicated that age, health specialty, nationality, and sleeping disorders before COVID-19 were associated with anxiety levels.
The generalized anxiety among healthcare providers in Saudi Arabia was mild. Older healthcare providers were found to have a higher level of anxiety compared to other participating healthcare providers. Several factors may contribute to a higher level of anxiety including age, socioeconomic status, marital status, having chronic conditions, and sleeping disorder before the COVID-19 pandemic. To further understand the level of anxiety among healthcare providers during the COVID-19 pandemic in Saudi Arabia, longitudinal and mixed-method research is needed.
Burnout is known to negatively impact healthcare providers both physically and mentally and is assessed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Many versions of this tool ...have been developed for different parts of the world, but there is currently no valid version specifically designed for use in the Gulf Cooperation Council Region. This study aims to use data collected across six different regions in the Gulf Cooperation Council Region to assess the validity and reliability of the MBI-HSS model and develop a version of the MBI-HSS best suited for evaluating burnout levels among the healthcare providers in this region. The MBI-HSS questionnaire adapted by Maslach was distributed to 888 healthcare providers aged 32 years ± 7 years, 231 (26.1%) of whom were males and 651 (73.9%) of whom were females, between 2017 and 2018. The data collected were randomly divided into two subsamples, resulting in a sample with the data of 300 healthcare professionals for exploratory factor analysis (EFA) and 588 healthcare professionals for confirmatory factor analysis (CFA). The CFA of the original version of the MBI-HSS yielded a chi-square value of 1897 (p < 0.001), indicating the need for revision. EFA was then used to construct a new model of the MBI-HSS, and a CFA was performed on the second subsample to evaluate the model fit to the data. The EFA produced a 3-factor version that accounted for 56.3% of the total variance, with item 11 of the MBI moved to the Emotional Exhaustion (EE) subscale and item 16 loaded onto Depersonalisation (DP) instead of EE. Additionally, items 18 and 20 were omitted. The reconstructed version had a Root Mean Square Error of Approximation (RMSEA) value of 0.065 (<0.08), a goodness of fit index (GFI) value of 0.915 (>0.90) and an adjusted goodness of fit index (AGFI) value of 0.893 (>0.8). These results when compared to the CFA of the original model, which produced a GFI value of 0.79, an AGFI value of 0.74 and an RMSEA value of 0.09 (>0.08), indicate that this new version has a more satisfactory fit to the data and should be used when assessing burnout in the Gulf Cooperation Council Region.
In addition to the pathogenesis of SARS-CoV-2, bacterial co-infection plays an essential role in the incidence and progression of SARS-CoV-2 infections by increasing the severity of infection, as ...well as increasing disease symptoms, death rate and antimicrobial resistance (AMR). The current study was conducted in a tertiary-care hospital in Lahore, Pakistan, among hospitalized COVID-19 patients to see the prevalence of bacterial co-infections and the AMR rates among different isolated bacteria. Clinical samples for the laboratory diagnosis were collected from 1165 hospitalized COVID-19 patients, of which 423 were found to be positive for various bacterial infections. Most of the isolated bacteria were Gram-negative rods (
= 366), followed by Gram-positive cocci (
= 57). A significant association (
< 0.05) was noted between the hospitalized COVID-19 patients and bacterial co-infections.
(
) showed high resistance against tetracycline (61.7%),
against penicillin (100%),
against Amp-clavulanic acid (88.72%),
against ampicillin (100%), and
against ciprofloxacin (75.40%).
was 100% resistant to the majority of tested antibiotics. The prevalence of methicillin-resistant
(MRSA) was 14.7%. The topmost symptoms of >50% of COVID-19 patients were fever, fatigue, dyspnea and chest pain with a significant association (
< 0.05) in bacterial co-infected patients. The current study results showed a comparatively high prevalence of AMR, which may become a severe health-related issue in the future. Therefore, strict compliance of antibiotic usage and employment of antibiotic stewardship programs at every public or private institutional level are recommended.
Improper use of antimicrobials has resulted in the emergence of antimicrobial resistance (AMR), including multi-drug resistance (MDR) among bacteria. Recently, a sudden increase in ...Carbapenem-resistant Enterobacterales (CRE) has been observed. This presents a substantial challenge in the treatment of CRE-infected individuals. Bacterial plasmids include the genes for carbapenem resistance, which can also spread to other bacteria to make them resistant. The incidence of CRE is rising significantly despite the efforts of health authorities, clinicians, and scientists. Many genotypic and phenotypic techniques are available to identify CRE. However, effective identification requires the integration of two or more methods. Whole genome sequencing (WGS), an advanced molecular approach, helps identify new strains of CRE and screening of the patient population; however, WGS is challenging to apply in clinical settings due to the complexity and high expense involved with this technique. The current review highlights the molecular mechanism of development of Carbapenem resistance, the epidemiology of CRE infections, spread of CRE, treatment options, and the phenotypic/genotypic characterisation of CRE. The potential of microorganisms to acquire resistance against Carbapenems remains high, which can lead to even more susceptible drugs such as colistin and polymyxins. Hence, the current study recommends running the antibiotic stewardship programs at an institutional level to control the use of antibiotics and to reduce the spread of CRE worldwide.
To assess the efficacy of Favipiravir compared to the standard therapy in treating patients with severe COVID-19 infection.
This is a retrospective cohort of patients with COVID-19 pneumonia who were ...treated with favipiravir, versus comparison group that received the standard of care.
A total of 226 patients were included; 110 patients received favipiravir and 116 patients received standard of care. Patients who received favipiravir had longer time to recovery (14.2 ± 8.8 versus 12.8 ± 5.2, p = 0.17). Favipiravir was associated with an improved early day 14 mortality (4 3.6% versus 11 9.5%), p = 0.008), but was associated with a higher day 28 mortality (26 23.6% versus 11 9.5%, p = 0.02). The overall mortality was higher in the favipiravir versus the standard of care group but difference was not statistically significant (33 30.0% versus 24 20.7%, p = 0.10).
The addition of favipiravir to standard of care was not associated with any improvement in clinical outcomes or mortality. Larger randomized controlled clinical trials are needed to further assess the efficacy of favipiravir.
•Rising rates of antimicrobial resistance (AMR) are a threat to healthcare systems.•Gram-negative pathogens were four times more likely to cause nosocomial infections compared with Gram-positive ...bacteria.•Most common resistant pathogens were extended-spectrum cephalosporin (ESC)-resistant E. coli and ESC-resistant Klebsiella.•Acinetobacter spp. were the only pathogens to decrease significantly (7% reduction; P = 0.033).•National collaboration is required to tackle facility and regional differences in AMR rates.
Awareness of antimicrobial resistance (AMR) patterns in a given healthcare setting is important to inform the selection of appropriate antimicrobial therapy to reduce the further rise and spread of AMR as well as the rate of healthcare-associated infections (HAIs) and multidrug-resistant (MDR) organisms. We aimed to describe resistance patterns to several antimicrobial agents in pathogens causing HAIs isolated from patients using data gathered at three private tertiary-care hospitals in Saudi Arabia.
Data on trends in AMR among bacteria causing HAIs and MDR events in children and adults at three private hospitals were collected retrospectively (2015–2019) using surveillance data.
Over the 5-year period, 29 393 pathogens caused 17 539 HAIs in 15 259 patients. Approximately 57.3% of patients were female and the mean age was 38.4 ± 16.8 years (81.4% adults, 18.6% children). Gram-negative pathogens were four times more likely to cause HAIs compared with Gram-positive bacteria (79.3% vs. 20.7%). Ranking of causative pathogens in decreasing order was Escherichia coli (42.2%), Klebsiella spp. (16.8%) and Staphylococcus aureus (13.9%). Acinetobacter spp. were the only pathogens to decrease significantly (7% reduction; P = 0.033). The most common resistant pathogens were extended-spectrum cephalosporin-resistant E. coli (37.1%), extended-spectrum cephalosporin-resistant Klebsiella (27.8%), carbapenem-non-susceptible Acinetobacter spp. (19.5%), carbapenem-non-susceptible Pseudomonas aeruginosa (19.2%) and methicillin-resistant S. aureus (18.6%).
National collaboration is required by prompt feedback to local authorities to tackle regional differences in AMR. This can help plan timely containment interventions to stop and contain microbial threats and swiftly assess their impact.
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