Hand‐foot‐skin reaction related to use of the multikinase inhibitor sorafenib and hard orthotics

Hand‐foot‐skin reaction is a distinct clinical condition arising in association with the use of multikinase inhibitors, including sorafenib. Because multikinase inhibitors are increasingly being used in children with cancer, recognition of this previously unfamiliar condition is of importance to pediatric dermatologists. We describe the diagnosis and successful treatment of a case of hand‐foot‐skin reaction in a child taking sorafenib for an unresectable desmoid tumor.     

Membrane technology for sustainable water resources management: Challenges and future projections

Although water is essential for human survival and has always been critical to the social and economic growth of the world, it is unfortunately distributed irregularly worldwide and is threatened by countless source of pollution. Addressing the issue of water resources sustainability is extremely crucial for societies in order to maintain safety as well as social, ecological and economic progress. The issue of water scarcity has pushed the world to develop adequate technologies and approaches for sustainable water resources management. In addition, to seawater and brackish water, industrial and municipal wastewater are also considered to be important available resources that need to be taken into consideration to increase sustainability and at the same time to meet SDGs. Indeed, as the population grows, agricultural, domestic and industrial activities produce large amounts of wastewaters that can be treated and reused in variety of purposes considering circular economy philosophy. Nowadays, wastewaters are treated in order to be reused for industrial, agricultural and other domestic purposes. In this context, membrane technology is a preferred choice for treatment of water from different wastewater streams for reuse in a more sustainable way, taking into account the philosophy of circular economy and the targets set from UN. This review discusses the links between the concept of sustainability and the treatment of water resources, including wastewaters with membrane technology. It provides a tangible framework for presenting the relevant challenges and future prospects but also the benefits that will come. The practical results of the research serve as reference point for stakeholders, policy makers dealing with sustainable water development strategies considering SDGs and circular economy.     

Knowledge and Attitudes of Saudi Dental Undergraduates on Oral Cancer

Oral cancer awareness among future dental practitioners may have an impact on the early detection and prevention of oral cancer. A cross-sectional survey was undertaken to assess the current knowledge of future Saudi dentists on oral cancer and their opinions on oral cancer prevention. A pretested questionnaire was sent to 550 undergraduate dental students in the fourth, fifth, and sixth year of the Al-Farabi College for Dentistry and Nursing, Riyadh, Saudi Arabia. Questions relating to knowledge of oral cancer, risk factors, and opinions on oral cancer prevention and practices were posed. Four hundred seventy-nine students returned the questionnaire (87.1 %). Eighty-one percent of respondents correctly answered questions relating to oral cancer awareness. Eighty-seven percent of respondents felt confident in performing a systematic oral examination to detect changes consistent with oral malignancy. Interestingly, 57 % of respondents had seen the use of oral cancer diagnostics aids. Thirty-seven percent of respondents felt inadequately trained to provide tobacco and alcohol cessation advice. There is a need to reinforce the undergraduate dental curriculum with regards to oral cancer education; particularly in its prevention and early detection. Incorporating the use of oral cancer diagnostic aids should be made mandatory.     

Evolution of drug-resistance genes in Plasmodium falciparum in an area of seasonal malaria transmission in Eastern Sudan

We investigated the evolution of drug-resistant Plasmodium falciparum in a village in eastern Sudan. The frequencies of alleles of 4 genes thought to be determinants of drug resistance were monitored from 1990 through 2001. Changes in frequencies of drug-resistance genes between wet and dry seasons were monitored from 1998 through 2000. Parasites were also typed for 3 putatively neutral microsatellite loci. No significant variation in frequencies was observed for the microsatellite loci over the whole study period or between seasons. However, genes involved in resistance to chloroquine showed consistent, significant increases in frequencies over time (rate of annual increase, 0.027/year for pfcrt and 0.018/year for pfmdr1). Genes involved in resistance to the second-line drug used in the area (Fansidar) remained at low frequencies between 1990 and 1993 but increased dramatically between 1998 and 2000, which is consistent with the advent of Fansidar usage during this period. For mutant alleles of the primary drug-resistance targets for chloroquine and pyrimethamine, higher frequencies were seen during the dry season than during the wet season. This cyclical fluctuation in drug-resistance genes most likely reflects seasonal variation in drug pressure and differences in the fitness of resistant and sensitive parasites.     

Specific balance training included in an endurance-resistance exercise program improves postural balance in elderly patients undergoing haemodialysis

Purpose: The purpose of this study was to evaluate the effects of 6 months of specific balance training included in endurance-resistance program on postural balance in haemodialysis (HD) patients.

Methods: Forty-nine male patients undergoing HD were randomly assigned to an intervention group (balance training included in an endurance-resistance training, n?=?26) or a control group (resistance-endurance training only, n?=?23). Postural control was assessed using six clinical tests; Timed Up and Go test, Tinetti Mobility Test, Berg Balance Scale, Unipodal Stance test, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scale.

Results: All balance measures increased significantly after the period of rehabilitation training in the intervention group. Only the Timed Up and Go, Berg Balance Scale, Mini-Balance Evaluation Systems Test and Activities Balance Confidence scores were improved in the control group. The ranges of change in these tests were greater in the balance training group.

Conclusions: In HD patients, specific balance training included in a usual endurance-resistance training program improves static and dynamic balance better than endurance-resistance training only.

• Implications for rehabilitation

• Rehabilitation using exercise in haemodialysis patients improved global mobility and functional abilities.

• Specific balance training included in usual endurance resistance training program could lead to improved static and dynamic balance.