Background: Laryngotracheal invasion occurs in a subset of patients with well-differentiated thyroid cancer (WDTC) and is associated with a poor prognosis. We aimed to analyze patterns and predictors/outcomes related to this high-risk manifestation. Methods: This population-based analysis utilized the Surveillance, Epidemiology, and End Results (SEER) registry (2000 to 2015) to identify WDTC patients. Temporal trends and geographic variation in invasion rates were assessed. Logistic regression and propensity score matching were employed to identify predictors of secondary malignancy, mortality, and treatment impact on overall and thyroid cancer (TC)-specific survival. Results: Of 131,721 WDTC patients, 1,662 (1.3%) had tracheal invasion and 976 (0.7%) had laryngeal invasion at diagnosis. Tracheal and laryngeal invasion rates declined from 3.7%–0.7% and 1.5%–0.6%, respectively, from 2000 to 2015. Compared to 98,835 noninvasive cases, patients with laryngotracheal invasion were older and more often male, Asian, and Hispanic (all P<0.001). This group had larger tumors with higher rates of nodal (N1: 61.8% vs. 15.1%) and distant metastases (M1: 9.3% vs. 0.4%). Age ≥55 years (hazard ratio [HR], 1.19; P=0.004) and metastases (HR, 1.75; P<0.001) increased TC-specific mortality, whereas the converse pattern was found for Asian race (HR, 0.63; P=0.002) and surgery (HR, 0.35; P<0.001). In rigorously matched groups to control confounding, adding radioactive iodine to surgery reduced mortality by 30% (P<0.001). However, external beam radiation and systemic therapy did not improve survival over surgery alone. Conclusion Laryngotracheal invasion is present in 0.7% to 1.3% of cases, conferring over double the mortality risk. Radioactive iodine with surgery improves outcomes in this aggressive WDTC subset.

Background: Laryngotracheal invasion occurs in a subset of patients with well-differentiated thyroid cancer (WDTC) and is associated with a poor prognosis. We aimed to analyze patterns and predictors/outcomes related to this high-risk manifestation. Methods: This population-based analysis utilized the Surveillance, Epidemiology, and End Results (SEER) registry (2000 to 2015) to identify WDTC patients. Temporal trends and geographic variation in invasion rates were assessed. Logistic regression and propensity score matching were employed to identify predictors of secondary malignancy, mortality, and treatment impact on overall and thyroid cancer (TC)-specific survival. Results: Of 131,721 WDTC patients, 1,662 (1.3%) had tracheal invasion and 976 (0.7%) had laryngeal invasion at diagnosis. Tracheal and laryngeal invasion rates declined from 3.7%–0.7% and 1.5%–0.6%, respectively, from 2000 to 2015. Compared to 98,835 noninvasive cases, patients with laryngotracheal invasion were older and more often male, Asian, and Hispanic (all P<0.001). This group had larger tumors with higher rates of nodal (N1: 61.8% vs. 15.1%) and distant metastases (M1: 9.3% vs. 0.4%). Age ≥55 years (hazard ratio [HR], 1.19; P=0.004) and metastases (HR, 1.75; P<0.001) increased TC-specific mortality, whereas the converse pattern was found for Asian race (HR, 0.63; P=0.002) and surgery (HR, 0.35; P<0.001). In rigorously matched groups to control confounding, adding radioactive iodine to surgery reduced mortality by 30% (P<0.001). However, external beam radiation and systemic therapy did not improve survival over surgery alone. Conclusion Laryngotracheal invasion is present in 0.7% to 1.3% of cases, conferring over double the mortality risk. Radioactive iodine with surgery improves outcomes in this aggressive WDTC subset.

Background: Laryngotracheal invasion occurs in a subset of patients with well-differentiated thyroid cancer (WDTC) and is associated with a poor prognosis. We aimed to analyze patterns and predictors/outcomes related to this high-risk manifestation. Methods: This population-based analysis utilized the Surveillance, Epidemiology, and End Results (SEER) registry (2000 to 2015) to identify WDTC patients. Temporal trends and geographic variation in invasion rates were assessed. Logistic regression and propensity score matching were employed to identify predictors of secondary malignancy, mortality, and treatment impact on overall and thyroid cancer (TC)-specific survival. Results: Of 131,721 WDTC patients, 1,662 (1.3%) had tracheal invasion and 976 (0.7%) had laryngeal invasion at diagnosis. Tracheal and laryngeal invasion rates declined from 3.7%–0.7% and 1.5%–0.6%, respectively, from 2000 to 2015. Compared to 98,835 noninvasive cases, patients with laryngotracheal invasion were older and more often male, Asian, and Hispanic (all P<0.001). This group had larger tumors with higher rates of nodal (N1: 61.8% vs. 15.1%) and distant metastases (M1: 9.3% vs. 0.4%). Age ≥55 years (hazard ratio [HR], 1.19; P=0.004) and metastases (HR, 1.75; P<0.001) increased TC-specific mortality, whereas the converse pattern was found for Asian race (HR, 0.63; P=0.002) and surgery (HR, 0.35; P<0.001). In rigorously matched groups to control confounding, adding radioactive iodine to surgery reduced mortality by 30% (P<0.001). However, external beam radiation and systemic therapy did not improve survival over surgery alone. Conclusion Laryngotracheal invasion is present in 0.7% to 1.3% of cases, conferring over double the mortality risk. Radioactive iodine with surgery improves outcomes in this aggressive WDTC subset.

Background: Laryngotracheal invasion occurs in a subset of patients with well-differentiated thyroid cancer (WDTC) and is associated with a poor prognosis. We aimed to analyze patterns and predictors/outcomes related to this high-risk manifestation. Methods: This population-based analysis utilized the Surveillance, Epidemiology, and End Results (SEER) registry (2000 to 2015) to identify WDTC patients. Temporal trends and geographic variation in invasion rates were assessed. Logistic regression and propensity score matching were employed to identify predictors of secondary malignancy, mortality, and treatment impact on overall and thyroid cancer (TC)-specific survival. Results: Of 131,721 WDTC patients, 1,662 (1.3%) had tracheal invasion and 976 (0.7%) had laryngeal invasion at diagnosis. Tracheal and laryngeal invasion rates declined from 3.7%–0.7% and 1.5%–0.6%, respectively, from 2000 to 2015. Compared to 98,835 noninvasive cases, patients with laryngotracheal invasion were older and more often male, Asian, and Hispanic (all P<0.001). This group had larger tumors with higher rates of nodal (N1: 61.8% vs. 15.1%) and distant metastases (M1: 9.3% vs. 0.4%). Age ≥55 years (hazard ratio [HR], 1.19; P=0.004) and metastases (HR, 1.75; P<0.001) increased TC-specific mortality, whereas the converse pattern was found for Asian race (HR, 0.63; P=0.002) and surgery (HR, 0.35; P<0.001). In rigorously matched groups to control confounding, adding radioactive iodine to surgery reduced mortality by 30% (P<0.001). However, external beam radiation and systemic therapy did not improve survival over surgery alone. Conclusion Laryngotracheal invasion is present in 0.7% to 1.3% of cases, conferring over double the mortality risk. Radioactive iodine with surgery improves outcomes in this aggressive WDTC subset.

Acetabular fracture surgery can cause severe postoperative pain. A combined lumbar erector spinae plane block and paraspinous sagittal shift quadratus lumborum block may augment analgesia. Methods: Fifty two patients undergoing posterior column acetabular surgery were divided into: Group Single puncture combined lumbar Erector spinae and Quadratus lumborum block (SEQ), patients who received SEQ block before anesthesia; and Group morphine (MOR), those who received general anesthesia (GA) and morphine. Results: Demographic characteristics were comparable. The heart rate and mean arterial blood pressure were significantly lower in the SEQ group than in the MOR group between 60 and 180 min intraoperatively (P < 0.001). Postoperative resting and dynamic visual analogue scale scores in the SEQ group were significantly lower than those in the MOR group at all studied periods (P = 0.022-0.001), except at 20 and 24 h postoperatively. Fentanyl was required in all MOR group patients at a mean dose of 110.0 ± 28.42 µg while 18 patients required fentanyl in SEQ group at a mean dose of 60.55 ± 25.54 µg. Postoperative morphine consumption was significantly less in SEQ group (6.33 ± 2.37 mg) than MOR group (17.0 ± 2.55 mg). Postoperative nausea and vomiting were recorded in eight and four patients in MOR and SEQ group, respectively. No complications associated with the block technique were observed. Conclusions: The SEQ block reduces the postoperative opioid consumption and provides stable intra and postoperative hemodynamics without observed complications in posterior column acetabular surgery.

Purpose: The present study aimed to compare the immune-enhancing potential of gold nanoparticles (AuNPs) to Alum against rabies vaccine and the related immunological, physiological, and histopathological effects. Materials and Methods: Alum and AuNPs sole and in combination with rabies vaccine were used at 0.35 mg/mL and 40 nM/mL, respectively. Rats used were categorized into six groups (20/each): control rats, rabies vaccine, aluminum phosphate gel, rabies vaccine adsorbed to Alum, AuNPs, and rabies vaccine adjuvant AuNPs. Results: Liver and kidney functions were in the normal range after AuNPs and Alum adjuvanted vaccine compared to control. Interleukin-6 and interferon-γ levels were significantly increased in groups immunized with Alum and AuNPs adjuvanted vaccine, the peak level was in the case of AuNP adjuvanted vaccine on the 14th day. Ninety days post-vaccination, total immunoglobulin G (IgG) against adjuvanted rabies vaccine showed a significantly elevated anti-rabies IgG with AuNPs and Alum adsorbed vaccine compared with unadjuvanted one. The total antioxidant capacity, malondialdehyde (MDA) levels, superoxide dismutase, and glutathione peroxidase activities were significantly increased post-adjuvanted AuNPs adjuvanted vaccine vaccination than in Alum adsorbed vaccine, while MDA was significantly decreased. The histopathological examination revealed detectable alterations post-AuNPs and Alum adjuvanted vaccine immunization compared with liver and kidney profiles post-administration of unadjuvanted and non-immunized groups, meanwhile, splenic tissue revealed hyperplasia of lymphoid follicles indicating increased immune reactivity. Conclusion The AuNPs are promising enhancers of the immune response as Alum, and the undesirable effects of AuNPs could be managed by using suitable sizes, shapes, and concentrations.

As a means to combat the coronavirus disease (COVID-19) global pandemic, educational institutes were forced to stop the accustomed face-to-face teaching methods and adopt an online scheme to ensure the continuity of the education process. Furthermore, only a minimal period of clinical training was offered to the students during the pandemic and this highlighted the critical need to expand and improve the dental simulation curriculum. This article aims to highlight the impact of COVID-19 pandemic on the students and educators in dental schools. This perspective paper will also discuss the effectiveness of online teaching and the challenges in learning environment at the Faculty of Dentistry, Universiti Malaya during the pandemic, based on observations and published literature.

Background: Coronavirus illness (COVID-19) reached the level of a significant public health emergency in 2019, with an estimated worldwide death toll of more than 1,00,000 people 2019. Coronavirus illness (COVID-19). This survey was conducted to identify the factors influencing COVID-19 practice among undergraduate nursing students at the University of Nizwa, Sultanate of Oman. Methods: A quantitative cross-sectional online survey of sixty-four undergraduate nursing students chosen from the school of Nursing at the University of Nizwa in Sultanate of Oman took part from July 30 to August 5, 2021. Results: Participants’ average age was 22.27 ± 1.04, and the male-to-female ratio was 31.8% (n=64). Nursing students had adequate knowledge (13.67 ± 3.46), a positive attitude (48.14 ± 12.29), and good practices (32.6 ± 6.12), according to the results of a survey. Female students, compared to males (0.006, p<0.05), were more likely to follow better practices. Significant positive associations were found between age (0.025, p<0.05), gender (0.006, P<0.05), living areas (0.031, p<0.05), grade (0.000, p<0.05), Clinical practice experienced (0.016, p<0.05) and practice on COVID -19. Conclusions The study findings exhibited the essential elements that affected COVID-19 precautionary practices, knowledge, and a positive attitude, which were the most critical variables to consider. Male students and students who reside in rural regions should be targeted for further health education, and efforts should be made to ensure these groups have access to reliable and effective online tools to assist them.

Backgroun: Social media tends to cause poorer physical and mental health. Students are more addicted to using media in their daily lives and are more likely to stress. Objective: This study's primary objective is to explore the current level of knowledge of cyber bullying and provide awareness programs to bolt their reflective minds with possible coping strategies to prevent consecutive reduction behaviours among students of Aysha Al- Riyamia school in Bahla. Methods: One hundred eighty participants were recruited from Aysha Al- Riyamia school in Bahla in grades 10 through 12 using a convenient sampling technique. The questionnaire was constructed with knowledge and coping skills about cyber bullying and adopted to collect data from the participants before and after an educational awareness program. Results: The results showed that awareness programs had significantly enhanced students' knowledge and coping strategies in cyber bullying. Furthermore, the evidence of the study confirmed that cyber bullying awareness programs had a positive influence on knowledge among school students; the mean difference between pre-test and post-test was 2.81 at p<0.05. Conclusion Given the widespread use of social media in everyday life, these findings highlight the need for more incredible research into the education program to minimize the risks involved in cyber bullying.

Aims: This study was designed to evaluate the effectiveness of the synthesised carvacrol loaded chitosan nanoparticles (CLCNPs) on the growing and pre-formed biofilms of Listeria monocytogenes isolated from slaughterhouses. Methodology and results: The swab samples were collected from knives, hocks and cutting tables representing slaughterhouses meat contact surfaces (MCS), while those samples from walls and floors represent slaughterhouses meat non-contact surfaces (MNCS). The bacteriological analysis revealed the existence of L. monocytogenes with a prevalence rate of 3.3, 10 and 6.7% for knives, hocks and cutting tables, respectively and 2.2 and 6.6% for walls and floors, respectively. The isolates L. monocytogenes were assayed for biofilm production by the crystal violet binding assay method. Among the 10 L. monocytogenes isolates, 10%, 50% and 30% of the isolates were found to be strong, moderate and weak biofilm producers, respectively. The activities of carvacrol, chitosan nanoparticles (NPs) and CLCNPs against the only strong biofilm producer strain of L. monocytogenes were tested by microtiter plate assay. The minimum inhibitory concentrations (MIC) values were 3.75 mg/mL for CAR, 5 mg/mL for chitosan NPs and 0.62 mg/mL for CLCNPs. CLCNPs inhibit the produced biofilm by 35.79, 73.37 and 77.76%, when 0.5 MIC, 1 MIC and 2 MIC were used, respectively. Furthermore, the pre-formed L. monocytogenes biofilms were significantly reduced from 1.01 (control) OD570 to 0.40 and 0.29 OD570 by applying 2 MIC and 4 MIC doses, respectively. Conclusion, significance and impact of study The data generated is promising to develop bio-green disinfectants to inhibit biofilm formation by L. monocytogenes in the food processing environment and control its adverse effects for consumers.
Chitosan--chemistry ; Listeria monocytogenes ; Nanoparticles