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This study was conducted to compare the quality of bottled water with potabilized desalinated tap water. Fourteen brands of local and imported bottled water samples were collected from the local market and analyzed for physicochemical parameters in the Royal Commission Environmental Laboratory. Results were compared with 5-year continuous monitoring data of tap water from different locations in Madinat Yanbu Al-Sinaiyah (MYAS) including storage tanks of desalination plant. Results show that there was no significant difference in the quality of tap water and bottled water. Bacteriological test was never found positive in the 5-year data in tap water. Similarly, physicochemical analysis shows the persistent quality of tap water. Based on hardness analysis, bottled and tap water are categorized as soft water. Trihalomethanes (THMs) study also indicates that traces of disinfection by products (DBPs) are present in both tap and bottled water and are much less than the World Health Organization and Environmental Protection Agency maximum permissible limits. It is also important to note that the tap water distribution network in MAYS is a high-pressure recirculation network and there is no chance to grow bacteria in stagnant water in pipe lines or houses. Recently, the Royal Commission has replaced the whole drinking water network, which was made of asbestos-cemented pipes with glass-reinforced plastic (GRP) pipes, to avoid any asbestos contaminations. Based on these results, it is concluded that drinking water distributed in the city is of very good and persistent quality, comparable with bottled water. Continuous monitoring also guarantees the safe drinking water to the community. Hence, it is the responsibility of the Royal Commission to encourage the peoples in the city to drink tap water as it is as good as bottled water even better than some of the brands and is monitored regularly. It is also much cheaper compared to bottled water and is available round the clock. Preference for tap water over bottled water will also reduce the production of bottled water that has flooded the market, the enormous strain on the environment, and the pollution due to used empty plastic bottles in the landfill area and will help to keep the city clean.

BackgroundEpilepsy is a major cause of morbidity and mortality in meningioma patients. The aims of this study were to determine which factors predispose meningioma patients to developing perioperative seizures and to understand the impact of antiepileptic drugs.MethodsPatients treated for a histologically-confirmed intracranial meningioma at the authors’ institution between 2010 and 2015 were retrospectively examined. Clinical and imaging data were assessed. Multivariate analysis was performed using binary logistic regression. The effect of antiepileptic treatment was assessed using survival analysis.ResultsTwo hundred and eighty-three patients met the selection criteria; seizures were present in 68 preoperatively (24%) and in 48 patients (17%) following surgery. Of the 68 with preoperative seizures, 19 continued to have them, whereas de-novo seizures arose postoperatively in 29 seizure-naïve patients. Risk factors of postoperative seizures were convexity location (OR 2.05 [95% CI 1.07–3.98], p = 0.030), fronto-parietal location (OR 4.42 [95% CI 1.49–13.16], p = 0.007) and preoperative seizures (OR 2.65 [95% CI 1.37–5.24], p = 0.005). The two locations, in addition to the presence of midline shift on preoperative imaging (OR 4.15 [95% CI 1.54–11.24], p = 0.005), were significantly correlated with postoperative seizures in seizure-naïve patients. Antiepileptic treatment in patients with those risk factors reduced the possibility of seizures at any time point within the 1st year postoperatively by approximately 40%, although this did not meet statistical significance.ConclusionProphylactic antiepileptic treatment might be warranted in seizure-naïve meningioma patients with ≥ 1 risk factor. High-quality randomised controlled trials are required to verify those factors and to define the role of antiepileptics in meningioma practice.

Royal Commission Environmental Control Department (RC-ECD) at Yanbu industrial city in Kingdom of Saudi Arabia has established a well-defined monitoring program to control the pollution from industrial effluents. The quality of effluent from each facility is monitored round the clock. Different strategic measures have been taken by the RC-ECD to implement the zero discharge policy of RC. Industries are required to pre-treat the effluent to conform pretreatment standards before discharging to central biological treatment plant. Industries are not allowed to discharge any treated or untreated effluent in open channels. After treatment, reclaimed water must have to comply with direct discharge standards before discharge to the sea. Data of industrial wastewater collected from five major industries and central industrial wastewater treatment plant (IWTP) is summarized in this report. During 5-year period, 3,705 samples were collected and analyzed for 43,436 parameters. There were 1,377 violations from pretreatment standards from all the industries. Overall violation percentage was 3.17%. Maximum violations were recorded from one of the petrochemical plants. The results show no significant pollution due to heavy metals. Almost all heavy metals were within RC pretreatment standards. High COD and TOC indicates that major pollution was due to hydrocarbons. Typical compounds identified by GC-MS were branched alkanes, branched alkenes, aliphatic ketones, substituted thiophenes, substituted phenols, aromatics and aromatic alcohols. Quality of treated water was also in compliance with RC direct discharge standards. In order to achieve the zero discharge goal, further studies and measures are in progress.

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Anomalous origin of the left circumflex (Cx) artery is a common and mostly benign coronary artery anomaly. We report the case of a man aged 52 years who presented to his local hospital with progressive breathlessness on exertion and syncopal episodes. His admission transthoracic echocardiography (TTE) showed bicuspid aortic valve, severe aortic stenosis with a valve area of 0.5 cm and his left ventricular ejection fraction (LVEF) was 27%. His coronary angiogram showed normal coronary arteries but anomalous origin of the Cx artery from the right coronary. He underwent elective bioprosthetic aortic valve replacement. His postoperative recovery was uneventful and he was discharged on day 5 postoperatively. His TTE postoperatively showed well-seated aortic valve, improved LVEF to 51%. We here report a case of incidental finding of anomalous Cx artery arising from the right coronary while the patient is being worked up for aortic valve replacement for congenital bicuspid aortic valve.

The Society of Thoracic Surgeons risk prediction algorithm is a better risk assessment tool compared to additive and logistic EuroSCORE and EuroSCORE II in Pakistani patients.

MRI virtopsy may offer a viable alternative to traditional autopsy. By using MRI virtopsy, a potential cost reduction of at least 33% is feasible, and therefore ought to be considered in eligible patients.