Search Results (11)

Background/Objectives: Hospital readmissions within 30 days are a major challenge in general internal medicine (GIM), impacting patient outcomes and healthcare costs. This study aimed to develop and evaluate machine learning (ML) models for predicting 30-day readmissions in patients admitted under a GIM unit and to identify key predictors to guide targeted interventions. Methods: A prospective study was conducted on 443 patients admitted to the Unit of General Internal Medicine at Sultan Qaboos University Hospital between May and September 2023. Sixty-two variables were collected, including demographics, comorbidities, laboratory markers, vital signs, and medication data. Data preprocessing included handling missing values, standardizing continuous variables, and applying one-hot encoding to categorical variables. Four ML models—logistic regression, random forest, gradient boosting, and support vector machine (SVM)—were trained and evaluated. An ensemble model combining soft voting and weighted voting was developed to enhance performance, particularly recall. Results: The overall 30-day readmission rate was 14.2%. Among all models, logistic regression had the highest clinical relevance due to its balanced recall (70.6%) and area under the curve (AUC = 0.735). While random forest and SVM models showed higher precision, they had lower recall compared to logistic regression. The ensemble model improved recall to 70.6% through adjusted thresholds and model weighting, though precision declined. The most significant predictors of readmission included length of hospital stay, weight, age, number of medications, and abnormalities in liver enzymes. Conclusions: ML models, particularly ensemble approaches, can effectively predict 30-day readmissions in GIM patients. Tailored interventions using key predictors may help reduce readmission rates, although model calibration is essential to optimize performance trade-offs. Full article

Vitamin D plays an important role in maintaining human health. Its deficiency has been associated with an increased risk of several chronic diseases. Sun exposure, particularly UV-B radiation, accounts for greater than 90% of vitamin D production in humans. The aim of this study was to examine the relationship between dust and UV index and its effect on vitamin D concentrations. Data on the UV index and the number of dusty days measured at ≤1000 m, ≤3000 m, and ≤5000 m altitudes in the period January 2017 to June 2022 were collected. Dust particles (PM_2.5 and PM₁₀) and vitamin D values were also gathered. No correlation was observed between UV index and PM_2.5 (r = −0.013, p = 0.947) and between UV index and PM₁₀ (r = 0.251, p = 0.165) due to numerous factors, such as unavailable data on UV-B and particle concentrations at a maximum of 1000 m rather than 20 to 30 km. A positive correlation was observed between the number of dusty days at all altitudes and PM₁₀ (p < 0.001), whereas no correlation was found between the number of dusty days at all altitudes and PM_2.5. A positive correlation was found between vitamin D-deficient patients and PM_2.5 (r = 0.529, p = 0.005) and between vitamin D-deficient patients and PM₁₀ (r = 0.399, p = 0.024). The PM _2.5 and PM₁₀ concentrations exceeded both the WHO guidelines and the Environmental Protection Agency’s recommended levels during most months of the study period. The average range of the PM_2.5/PM₁₀ ratio was low (0.24–0.35), indicating dust pollution. The results indicate a strong relationship between PM₁₀ dust particles and the number of vitamin D-deficient patients, indicating high levels of dust air pollution, which might have an influence on the high levels of vitamin D deficiency in Bahrain. This study hypothesized that dust events may reduce UV-B levels, leading to vitamin D deficiency (VDD). However, the results of the study supported this hypothesis only partially due to several limitations, including the unavailability of data on UV-B, dusty days, and dust particles (PM_2.5 and PM₁₀) at higher altitudes (20–30 Km). Full article

This literature review critically examines the historical, current, and prospective dimensions of sternal wound reconstruction in the specific context of deep sternal wound infection (DSWI), aiming to enhance patient outcomes and optimise surgical techniques. Preventive measures, including prophylactic antibiotic administration and surgical site preparation, are crucial in reducing the incidence of DSWI. Effective management necessitates a multidisciplinary approach encompassing surgical debridement, drainage, and sternum repair utilising diverse procedures in conjunction with antibiotic therapy. Traditional approaches to managing DSWI involved closed irrigation and drainage techniques. While these methods exhibited certain advantages, they also exhibited limitations and varying degrees of success. The current care paradigms emphasise prophylactic antibiotic administration and surgical interventions like closed suction and irrigation, vacuum-assisted closure, and flap reconstruction. Future advancements in surgical techniques and technology hold promise for further enhancing sternal wound reconstruction. This review separates and emphasises the distinct roles of prophylaxis, antibiotic treatment, and reconstructive techniques, each relevant specifically to DSWI management. Collaborative efforts between cardiac and plastic surgeons, supported by ongoing research and innovation, are indispensable to advance sternal wound restoration and achieve superior outcomes in terms of patient welfare, morbidity and mortality reduction, and surgical efficacy. Full article

Choroidal melanoma is a rare malignant tumour, yet it is the most common primary intra-ocular neoplasm and second on the list of top ten most malignant melanoma sites in the body. Clinical presentation can be non-specific and includes photopsia, floaters, progressive visual field loss, and blurry vision. The tumour is quite often diagnosed clinically during fundus examination; however, the most valued diagnostic tests are A- and B-scan ultrasonography (US). Several factors affect prognosis, including the patient’s age, tumour size, histological features, and presence of metastases. Still, with primary treatment and tight surveillance, around 50% of choroidal melanoma patients metastasise. Full article

Diabetes mellitus, a well-established risk factor for stroke, is related to higher mortality and poorer outcomes following the stroke event. Advanced glycation end products(AGEs), their receptors RAGEs, other ligands, and several other processes contribute to the cerebrovascular pathomechanism interaction in the diabetes–ischemic stroke combination. Critical reappraisal of molecular targets and therapeutic agents to mitigate them is required to identify key elements for therapeutic interventions that may improve patient outcomes. This scoping review maps evidence on the key roles of AGEs, RAGEs, other ligands such as Leukotriene B4 (LTB4), High-mobility group box 1 (HMGB1) nuclear protein, brain–kidney–muscle crosstalk, alternate pathomechanisms in neurodegeneration, and cognitive decline related to diabetic ischemic stroke. RAGE, HMGB1, nitric oxide, and polyamine mechanisms are important therapeutic targets, inflicting common consequences of neuroinflammation and oxidative stress. Experimental findings on a number of existing–emerging therapeutic agents and natural compounds against key targets are promising. The lack of large clinical trials with adequate follow-up periods is a gap that requires addressing to validate the emerging therapeutic agents. Five therapeutic components, which include agents to mitigate the AGE–RAGE axis, improved biomarkers for risk stratification, better renal dysfunction management, adjunctive anti-inflammatory–antioxidant therapies, and innovative neuromuscular stimulation for rehabilitation, are identified. A comprehensive therapeutic strategy that features all the identified components is needed for outcome improvement in diabetic stroke patients. Full article

Helicobacter pylori (H. Pylori) infection is the main bacterial cause of several gastrointestinal disorders. This study aims to estimate the prevalence of H. pylori infection in a population of Bahraini adults seeking care in gastroenterology clinics in a tertiary care hospital in the Kingdom of Bahrain and examine the association between dietary habits and other factors with H. pylori infection. The study is a hospital-based retrospective, cross-sectional analytical study that included 200 participants. H. pylori infection prevalence among the studied group was 55.5%, and it was significantly higher among participants with a high school education or less (44.1%). Among dietary habits, the mean of frequency of green tea, coffee and honey intake was significantly lower among the H. pylori infected participants compared to their non-infected counterparts. H. pylori infection was significantly higher among participants with vitamin D deficiency (63.6%) compared to participants with normal vitamin D (30%) (p = 0.001) and each unit decrease in serum vitamin D was associated with an increased risk of infection by 1.1 times (OR = 1.1; 95% CI: 1.05, 1.18; p < 0.001). The study revealed that high educational levels, consumption of honey, green tea, and coffee, as well as normal serum vitamin D level, were independent protectors against H. pylori infection. Additional studies are needed to estimate the prevalence and predisposing factors of H. pylori infection in the general population. Full article

Background: Metabolic syndrome (MetS) is a multifactorial condition characterized by a complex interrelation between genetic and environmental factors that heighten the risk of cardiovascular diseases and all-cause mortality. It is hypothesized that diet may play an important role in the regulation of metabolic syndrome factors and influence the process. Therefore, the main objective of this study was to investigate the specific dietary patterns associated with metabolic syndrome markers and quantify the possible effects of dietary patterns among Bahrain older adults. Methods: This is a cross-sectional study that included 151 Bahraini patients diagnosed with MetS, 89 (58.7%) were females and 62 (41.3%) males. Results: The prevalence of Non-Alcoholic Fatty Liver was 89%. Statistically significant correlations were found between dairy products with low fat and SBP (r = 0.182, p < 0.001) body mass index (BMI) (r = −0.195; p < −0.01). Higher chicken consumption was associated with reduction of BMI (r = −0.273; p < −0.01). A higher consumption of ricotta and cheddar cheese (high in fat) was associated with higher levels of triglycerides (p < 0.01). Higher frequent consumption of rice (basmati) was associated with lower glucose levels (r = −0.200; p < −0.01). Fatty liver has been associated with high consumption of cream cheese (p < 0.01). Conclusion: In older Bahraini adults with metabolic syndrome, higher frequency of food consumption of full-fat cheese was linked with a derangement of lipid profile and Non-Alcoholic Fatty Liver. Positive effects on BMI have been recorded with higher-frequency consumption of basmati rice and chicken. Full article

Diabetes mellitus (DM) is a chronic metabolic condition characterized by persistent hyperglycemia due to insufficient insulin levels or insulin resistance. Despite the availability of several oral and injectable hypoglycemic agents, their use is associated with a wide range of side effects. Monoterpenes are compounds extracted from different plants including herbs, vegetables, and fruits and they contribute to their aroma and flavor. Based on their chemical structure, monoterpenes are classified into acyclic, monocyclic, and bicyclic monoterpenes. They have been found to exhibit numerous biological and medicinal effects such as antipruritic, antioxidant, anti-inflammatory, and analgesic activities. Therefore, monoterpenes emerged as promising molecules that can be used therapeutically to treat a vast range of diseases. Additionally, monoterpenes were found to modulate enzymes and proteins that contribute to insulin resistance and other pathological events caused by DM. In this review, we highlight the different mechanisms by which monoterpenes can be used in the pharmacological intervention of DM via the alteration of certain enzymes, proteins, and pathways involved in the pathophysiology of DM. Based on the fact that monoterpenes have multiple mechanisms of action on different targets in in vitro and in vivo studies, they can be considered as lead compounds for developing effective hypoglycemic agents. Incorporating these compounds in clinical trials is needed to investigate their actions in diabetic patients in order to confirm their ability in controlling hyperglycemia. Full article

The island of Muharraq in the Kingdom of Bahrain was previously in a state of socioeconomic disrepair and neglect, until the nine years-long “Pearling Trail” project revived the area. Historically, Muharraq’s importance inheres in it being the main trade center of the Middle East since the Mesopotamian period, especially as the source of the finest pearls in the world. However, the discovery of oil that led to the rapid urbanization of the region and Japan perfecting the production of cultured pearls had meant that Muharraq dwindled out of cultural significance. Due to the residents’ dissatisfaction and nostalgia for the island’s past glory, along with the government’s new policies towards cultural preservation, the “Pearling Trail” Project commenced in 2012. The Ministry of Culture of Bahrain repaired, renovated and preserved an area of 3.5 km, transforming it into an eco-museum with a thriving business and cultural community. The transformation of the island elevated the city into a trendy local attraction, hosting local and global cultural festivals and events, owing to the “Pearling Trail’s” Urban Regeneration Project’s success. By studying the “Pearling Trail” three success factors are identified: Project expansion beyond UNESCO preservation requirements, focus on sustainability and continuous use, and improved access to culture and cultural opportunities. Identifying these factors could allow for future preservation projects in Bahrain or elsewhere to be upgraded for urban regeneration or revitalization. Full article

The construction of real estate has the potential to advance sustainability in terms of meeting economic and social criteria—the Business Case and the Societal Case. This is a crucial aspect in the stated visions and plans in many developing countries. Hence, it is important to understand how real estate can best contribute. Semi-structured interviews with a number of decision-makers involved in the real estate sector in the Kingdom of Bahrain were undertaken to explore perceptions of how the sector could best contribute to sustainable development. The decision-makers came from government bodies, investment banks, real estate developers, investors, constructors, project consultants and auditors. The interviews highlight the importance of having a stated vision and strategy which is highly visible and shared by all stakeholders. In the case of Bahrain this is Vision 2030 and the National Economic Strategy. It is important to ensure that any plans that are put in place to achieve the vision/strategy are adaptable to reflect changes in the external environment. The decision-makers identified three areas of focus in terms of the content of policy in order to meet the economic and social-related sustainability criteria as set out in Vision 2030 and the National Economic Strategy. These are: infrastructure, affordable housing and tourism/leisure. Within these three areas, that of infrastructure is also the key enabler for developments in the other two areas to be realized. In terms of a method of governance, the use of public-private-partnerships (PPPs) was identified as being highly appropriate. Such partnerships are not only useful to leverage private sector investment into specific development projects but also to ensure that such development harnesses innovative and efficient methods. Full article

The aim of this review was to highlight the current situation of nutrition-related diseases in the Arab countries, and factors associated with prevalence of these diseases. PubMed and Google Scholar were searched for data relating to such nutrition-related diseases published between January 1990 and May 2011. The picture of nutritional status in the Arab countries has changed drastically over the past 30 years as a result of changes in the social and economic situation. Two contrasting nutrition-related diseases exist, those associated with inadequate intake of nutrients and unhealthy dietary habits such as growth retardation among young children and micronutrient deficiencies; and those associated with changes in lifestyle such as cardiovascular disease, cancer, osteoporosis, diabetes and obesity (diet-related non-communicable diseases). Factors contributing to nutritional problems vary from country to country, depending on socio-economic status. In general, unsound dietary habits, poor sanitation, poverty, ignorance and lack of access to safe water and health services are mainly responsible for under-nutrition. Changes in lifestyle and dietary habits as well as inactivity are associated with the occurrence of diet-related non-communicable diseases. Programs to prevent and control nutrition-related diseases are insufficient and ineffective, due mainly to a focus on curative care at the expense of preventive health care services, lack of epidemiological studies, lack of nutritional surveillance, inadequate nutrition information and lack of assessment of the cost-effectiveness of nutrition intervention programs. Full article