Self-efficacy, self-management, and glycemic control in adults with type 2 diabetes mellitus

ObjectiveThe objective was to evaluate the relationships between diabetes management self-efficacy and diabetes self-management behaviors and glycemic control.MethodsA cross-sectional design was used. A convenience sample of 223 subjects with type 2 diabetes, ≥25 years old, who sought care at the National Diabetes Center in Amman, Jordan, was enrolled. A structured interview and medical records provided the data. The instruments included a sociodemographic and clinical questionnaire, a diabetes management self-efficacy scale, and a diabetes self-management behaviors scale. Glycosylated hemoglobin was used as an index for glycemic control. The analyses are presented as proportions, means (±S.D.), odds ratios, and 95% confidence intervals obtained from logistic regressions.ResultsDiet self-efficacy and diet self-management behaviors predicted better glycemic control, whereas insulin use was a statistically significant predictor for poor glycemic control. In addition, subjects with higher self-efficacy reported better self-management behaviors in diet, exercise, blood sugar testing, and taking medication. The findings showed that more than half of the subjects did not have their diabetes under control and that only 42% had attended diabetes education programs.ConclusionsThe majority of subjects did not have their diabetes controlled; their self-efficacy was low, and they had suboptimal self-management behaviors. Therefore, strategies to enhance and promote self-efficacy and self-management behaviors for patients are essential components of diabetes education programs. Furthermore, behavioral counseling and skill-building interventions are critical for the patients to become confident and be able to manage their diabetes.     

Cancer Management in Saudi Arabia: Recommendations by the Saudi Oncology HeAlth Economics ExpeRt GrouP (SHARP)

Cancer is widely recognized as a major global health problem and is estimated to rank as one of the leading causes of death worldwide. Saudi Arabia has undergone remarkable socioeconomic development in the past 40 years which has contributed to the increase in cancer incidence. The high costs of new oncology medications in combination with uncertainty of long-term effectiveness and safety outcomes highlight the importance of considering value, in terms of clinical outcomes, relative to cost. We convened a group of experts to discuss key factors impacting the current state of cancer management in Saudi Arabia and to agree on a list of recommendations, with a focus on value-based care, considering evidence, patients, and costs.     

Anti-SARS-CoV-2 activities of tanshinone IIA,carnosic acid,rosmarinic acid,salvianolic acid,baicalein, and glycyrrhetinic acid between computational and in vitro insights

Six compounds namely, tanshinone IIA (1), carnosic acid (2), rosmarinic acid (3), salvianolic acid B (4), baicalein (5), and glycyrrhetinic acid (6) were screened for their anti-SARS-CoV-2 activities against both the spike (S) and main protease (Mpro) receptors using molecular docking studies. Molecular docking recommended the superior affinities of both salvianolic acid B (4) and glycyrrhetinic acid (6) as the common results from the previously published computational articles. On the other hand, their actual anti-SARS-CoV-2 activities were tested in vitro using plaque reduction assay to calculate their IC₅₀ values after measuring their CC₅₀ values using MTT assay on Vero E6 cells. Surprisingly, tanshinone IIA (1) was the most promising member with IC₅₀ equals 4.08 ng μl⁻¹. Also, both carnosic acid (2) and rosmarinic acid (3) showed promising IC₅₀ values of 15.37 and 25.47 ng μl⁻¹, respectively. However, salvianolic acid (4) showed a weak anti-SARS-CoV-2 activity with an IC₅₀ value equals 58.29 ng μl⁻¹. Furthermore, molecular dynamics simulations for 100 ns were performed for the most active compound from the computational point of view (salvianolic acid 4), besides, the most active one biologically (tanshinone IIA 1) on both the S and Mpro complexes of them (four different molecular dynamics processes) to confirm the docking results and give more insights regarding the stability of both compounds inside the SARS-CoV-2 mentioned receptors, respectively. Also, to understand the mechanism of action for the tested compounds towards SARS-CoV-2 inhibition it was necessary to examine the mode of action for the most two promising compounds, tanshinone IIA (1) and carnosic acid (2). Both compounds (1 and 2) showed very promising virucidal activity with a most prominent inhibitory effect on viral adsorption rather than its replication. This recommended the predicted activity of the two compounds against the S protein of SARS-CoV-2 rather than its Mpro protein. Our results could be very promising to rearrange the previously mentioned compounds based on their actual inhibitory activities towards SARS-CoV-2 and to search for the reasons behind the great differences between their in silico and in vitro results against SARS-CoV-2. Finally, we recommend further advanced preclinical and clinical studies especially for tanshinone IIA (1) to be rapidly applied in COVID-19 management either alone or in combination with carnosic acid (2), rosmarinic acid (3), and/or salvianolic acid (4).

Tanshinone IIA shows the most promising anti-SARS-CoV-2 biological activity: molecular docking, molecular dynamics, in vitro, and SAR studies.     

The Effectiveness of Artificial Intelligence in Detection of Oral Cancer

AimThe early detection of oral cancer (OC) at the earliest stage significantly increases survival rates. Recently, there has been an increasing interest in the use of artificial intelligence (AI) technologies in diagnostic medicine. This study aimed to critically analyse the available evidence concerning the utility of AI in the diagnosis of OC. Special consideration was given to the diagnostic accuracy of AI and its ability to identify the early stages of OC.Materials and methodsFrom the date of inception to December 2021, 4 databases (PubMed, Scopus, EBSCO, and OVID) were searched. Three independent authors selected studies on the basis of strict inclusion criteria. The risk of bias and applicability were assessed using the prediction model risk of bias assessment tool. Of the 606 initial records, 17 studies with a total of 7245 patients and 69,425 images were included. Ten statistical methods were used to assess AI performance in the included studies. Six studies used supervised machine learning, whilst 11 used deep learning. The results of deep learning ranged with an accuracy of 81% to 99.7%, sensitivity 79% to 98.75%, specificity 82% to 100%, and area under the curve (AUC) 79% to 99.5%.ResultsResults obtained from supervised machine learning demonstrated an accuracy ranging from 43.5% to 100%, sensitivity of 94% to 100%, specificity 16% to 100%, and AUC of 93%.ConclusionsThere is no clear consensus regarding the best AI method for OC detection. AI is a valuable diagnostic tool that represents a large evolutionary leap in the detection of OC in its early stages. Based on the evidence, deep learning, such as a deep convolutional neural network, is more accurate in the early detection of OC compared to supervised machine learning.Key words: Oral cancer, Artificial intelligence, Neural network, Machine learning, Diagnosis     

Revisiting activity of some glucocorticoids as a potential inhibitor of SARS-CoV-2 main protease: theoretical study

The global breakout of COVID-19 and raised death toll has prompted scientists to develop novel drugs capable of inhibiting SARS-CoV-2. Conducting studies on repurposing some FDA-approved glucocorticoids can be a promising prospective for finding a treatment for COVID-19. In addition, the use of anti-inflammatory drugs, such as glucocorticoids, is a pivotal step in the treatment of critical cases of COVID-19, as they can provoke an inflammatory cytokine storm, damaging lungs. In this study, 22 FDA-approved glucocorticoids were identified through in silico (molecular docking) studies as the potential inhibitors of COVID-19''s main protease. From tested compounds, ciclesonide 11, dexamethasone 2, betamethasone 1, hydrocortisone 4, fludrocortisone 3, and triamcinolone 8 are suggested as the most potent glucocorticoids active against COVID-19''s main protease. Moreover, molecular dynamics simulations followed by the calculations of the binding free energy using MM-GBSA were carried out for the aforementioned promising candidate-screened glucocorticoids. In addition, quantum chemical calculations revealed two electron-rich sites on ciclesonide where binding interactions with the main protease and cleavage of the prodrug to the active metabolite take place. Our results have ramifications for conducting preclinical and clinical studies on promising glucocorticoids to hasten the development of effective therapeutics against COVID-19. Another advantage is that some glucocorticoids can be prioritized over others for the treatment of inflammation accompanying COVID-19.

The global breakout of COVID-19 and raised death toll has prompted scientists to develop novel drugs capable of inhibiting SARS-CoV-2.     

Diaminobenzene schiff base, a novel class of DNA minor groove binder

Molecules that target the deoxyribonucleic acid (DNA) minor groove are relatively sequence specific and they can be excellent carrier structures for cytotoxic chemotherapeutic compounds which can help to minimize side effects. Two novel isomeric derivatives of diaminobenzene Schiff base [N,N'-bis (2-hydroxy-3-methoxybenzylidene)-1,2-diaminobenzene (2MJ) and N,N'-bis(2-hydroxy-3-methoxybenzylidene)-1,3-diaminobenzene (2MH)] were analyzed for their DNA minor groove binding (MGB) ability using viscometry, UV and fluorescence spectroscopy, computational modeling and clonogenic assay. The result shows that 2MJ and 2MH are strong DNA MGBs with the latter being more potent. 2MH can form interstrand hydrogen bond linkages at its oxygens with N3 of adenines. Changing the 2-hydroxy-3-methoxybenzylidene binding position to the 1,3 location on the diaminobenzene structure (2MJ) completely removed any viable hydrogen bond formation with the DNA and caused significant decrease in binding strength and minor groove binding potency. Neither compound showed any significant cytotoxicity towards human breast, colon or liver cancer cell lines.     

Saudi views on consenting for research on medical records and leftover tissue samples

Background  

Consenting for retrospective medical records-based research (MR) and leftover tissue-based research (TR) continues to be controversial. Our objective was to survey Saudis attending outpatient clinics at a tertiary care hospital on their personal preference and perceptions of norm and current practice in relation to consenting for MR and TR.