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Summary:. This report describes a rare case of necrotizing fasciitis (NF) in a previously healthy 9-year-old girl, emphasizing the complexities and urgent needs associated with its diagnosis and treatment in children. NF, a severe soft-tissue infection characterized by rapid progression and often fatal outcomes, presents diagnostic challenges owing to nonspecific initial symptoms such as pain, erythema, and edema. This patient presented to the emergency department with fever, arm redness, and blisters after the initial discharge with antibiotics from another facility. Despite the lack of clear historical indicators for the cause, the clinical and laboratory findings, including a high Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score of 9, led to immediate surgical intervention. Treatment included multiple sessions of surgical debridement and broad-spectrum antibiotics, culminating in successful skin grafting. This case underscores the importance of high clinical suspicion and prompt surgical consultation to manage potential NF, mainly when the initial symptoms may be misleading. This report highlights the critical need for early recognition and aggressive treatment to improve the prognosis of pediatric cases of NF.

Objective: To assess the antimicrobial, antibiofilm, anti-inflammatory, angiogenic, and wound healing activities of zinc nanoparticles (ZNPs) green synthesized using Ferula macrecolea extract. Methods: The green synthesis was conducted using the precipitation method. Then, the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum biofilm inhibition concentration 50% (MBIC50) of ZNPs against Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) were evaluated. The effects of ZNPs on the gene expressions of Staphylococcus spp. [intracellular adhesion A (icaA) and D (icaD)] and P. aeruginosa (rhlI and rhlR) were investigated using quantitative real-time PCR. In addition, the effects of ZNPs on wound healing, angiogenesis, and anti-inflammatory markers were assessed. Results: The green-synthesized ZNPs demonstrated significant antimicrobial efficacy against S. aureus and P. aeruginosa. The biofilm formation in S. aureus and P. aeruginosa was also inhibited by ZNPs with MBIC50 values of 3.30 μg/mL and 2.08 µg/mL, respectively. Additionally, ZNPs downregulated the expression of biofilm-related genes icaA, icaD, rhlI, and rhlR in the tested bacteria. They also demonstrated promising in vitro wound healing effects by promoting fibroblast cell proliferation and wound closure in a dose-dependent manner. A significant increase in the expression of HLA-G5 and VEGF-A genes as well as a marked decrease in the expression of NF-κB, IL-1β, and TNF-α genes were observed in cells treated with ZNPs compared to the control group (P

Background: Escherichia coli is one of the serious pathogens causing various infections in the animal field, such as neonatal calf diarrhea (NCD), which is responsible for mortality associated with diarrhea during the first days of life. Aim: Current work is aimed to designing an effective and safe multi-epitope vaccine candidate against E. coli infection in calves based on the fimbrial protein K99 of Enterotoxigenic E. coli (ETEC) and Immuno-informatics. Methods: A conserved sequence of K99 protein was generated, and then highly antigenic, non-allergic, and overlapped epitopes were used to construct a multi-epitope vaccine. Five THL, six MHC II, and four beta cell epitopes were targeted to create the candidate. The candidate vaccine was produced utilizing 15 epitopes and three types of linkers, two types of untranslated region (UTR) human hemoglobin subunit beta (HBB), UTR beta-globin (Rabb), and RpfE protein as an immunomodulation adjuvant. Results: Immuno-informatics analysis of the constructed protein showed that the protein was antigenic (antigenic score of 0.8841), stable, non-allergen, and soluble. Furthermore, the Immuno-informatics and Physiochemical analysis of the constructed protein showed a stable, non-allergic, soluble, hydrophilic, and acidic PI (isoelectric point). of 9.34. Docking of the candidate vaccine with the toll-like receptor TLR3 was performed, and results showed a strong interaction between the immune receptor and the vaccine. Finally, the expression efficiency of the construct in Escherichia coli was estimated via computational cloning of the vaccine sequence into Pet28a. Conclusion: Results of Immunoinformatics and in silico approaches reveals that designed vaccine is antigenic, stable, and able to bind to the immune cell receptors. Our results interpret the proposed multi-epitope mRNA vaccine as a good preventive option against E coli infection in calves. [Open Vet J 2024; 14(6.000): 1417-1425]

Background: Computed Tomography (CT) is crucial in medical diagnosis, particularly for head examinations. Diagnostic Reference Levels (DRLs) are pivotal in balancing diagnostic efficacy with radiation safety. International organizations such as the International Atomic Energy Agency (IAEA) and the International Commission on Radiological Protection (ICRP) provide guidelines for establishing DRLs, emphasizing their importance in optimizing radiation doses. Aim: This study aimed to establish and standardize DRLs for head CT imaging in institutional and regional settings, emphasizing the need for tailored reference levels specific to each region’s practices and standards. Method: Data collection included patient demographics, imaging parameters, and radiation dose indices, namely volume-weighted CT dose index (CTDIvol) and dose-length product (DLP). Statistical analyses were conducted to determine the median and 3rd quartile values for establishing DRLs. The results were compared with national and international benchmarks to assess variations in radiation doses across regions. Results: Demographic profiles detailed gender distributions and ages across hospitals. Imaging parameters exhibited variability in tube voltage, milliampere-seconds (mAs), pitch, scan length, and field of view (FOV). For CTDIvol, the 3rd quartile value was 65.8 mGy (range: 24.8–85.9 mGy), and for DLP, it was 1230.95 mGy·cm (range: 382.3–1189.0 mGy·cm). These values were slightly higher than the national DRLs for Saudi Arabia in 2021 and other international benchmarks, underscoring the need for further optimization and alignment of protocols. Conclusion: Optimizing and standardizing DRLs for head CT imaging is crucial for effectively managing radiation doses while ensuring diagnostic accuracy. Comparison with national and international benchmarks highlighted the importance of tailoring reference levels to regional practices and standards, ensuring patient safety without compromising diagnostic efficacy.

Plant small molecules, such as nitric oxide (NO) and melatonin (MN) as natural and human health-friendly compounds, play important roles in the mitigation of abiotic stresses in plants. Heavy metals such as chromium (Cr) are hazardous for the survival of ornamentals, especially edible flowers. This study evaluated the effects of NO (50 µM; sourced as sodium nitroprusside) and MN (50 µM) applied two times through foliar spraying at 1-week intervals on alleviating Cr (120 µM; K2Cr2O7)-induced oxidative stress in edible flowers of Calendula officinalis cv. Orange King. Cr stress decreased plant dry mass, leaf SPAD values, net photosynthetic rates, and the maximum photochemical quantum yield (Fv/Fm), and increased the oxidative stress markers. The individual application of NO or MN significantly mitigated the adverse effects, and the combined application of NO and MN synergistically enhanced plant tolerance to Cr stress, including increased activities of antioxidant enzymes in plants and concentrations of carbohydrate, ascorbic acid, sugar, total protein, as well as ash contents of edible flowers. The co-application also significantly elevated the concentrations of total phenolics, flavonoids, free reducing power, antioxidant capacity DPPH, and total carotenoids in Cr-treated plants compared with those in Cr-stressed plants. Additionally, the essential oil contents in flowers increased in response to the signaling molecule treatment under Cr stress. Compared with individual applications, the co-application of NO and MN had more significant effects. Our results indicate that the combination of signaling molecules, such as MN and NO, can not only increase the biomass of edible calendula plants but also improve flower quality for use as a novel food.

Quercetin (QT) is a flavonoid that exhibits anti-oxidant and chemo-preventive activity. This research work aimed to develop surface-modified bilosomes (BS) of QT. The BS was prepared by the solvent evaporation method and optimized by the Box-Behnken design. The optimized QT-BS (QT-BS3opt) displayed vesicle size (143.51 nm), PDI (0.256), zeta potential (−15.4 mV), and entrapment efficiency (89.52%). Further, the optimized QT-BS formulation was coated with chitosan (CS). The XRD diffractogram of CS-QT-BS3opt1 did not exhibit extensive peaks of QT, revealing that QT is properly encapsulated in the polymer matrix. The QT-BS3opt and CS-QT-BS3opt1 exhibited sustained-release (86.62 ± 3.23% and 69.32 ± 2.57%, respectively) up to 24 h with the Korsmeyer-Peppas kinetic model (R2 =0.9089). CS-QT-BS3opt1 exhibited significantly (P

Background: Computed Tomography (CT) is crucial in medical diagnosis, particularly for head examinations. Diagnostic Reference Levels (DRLs) are pivotal in balancing diagnostic efficacy with radiation safety. International organizations such as the International Atomic Energy Agency (IAEA) and the International Commission on Radiological Protection (ICRP) provide guidelines for establishing DRLs, emphasizing their importance in optimizing radiation doses. Aim: This study aimed to establish and standardize DRLs for head CT imaging in institutional and regional settings, emphasizing the need for tailored reference levels specific to each region's practices and standards. Method: Data collection included patient demographics, imaging parameters, and radiation dose indices, namely volume-weighted CT dose index (CTDIvol) and dose-length product (DLP). Statistical analyses were conducted to determine the median and 3rd quartile values for establishing DRLs. The results were compared with national and international benchmarks to assess variations in radiation doses across regions. Results: Demographic profiles detailed gender distributions and ages across hospitals. Imaging parameters exhibited variability in tube voltage, milliampere-seconds (mAs), pitch, scan length, and field of view (FOV). For CTDIvol, the 3rd quartile value was 65.8 mGy (range: 24.8–85.9 mGy), and for DLP, it was 1230.95 mGy·cm (range: 382.3–1189.0 mGy·cm). These values were slightly higher than the national DRLs for Saudi Arabia in 2021 and other international benchmarks, underscoring the need for further optimization and alignment of protocols. Conclusion: Optimizing and standardizing DRLs for head CT imaging is crucial for effectively managing radiation doses while ensuring diagnostic accuracy. Comparison with national and international benchmarks highlighted the importance of tailoring reference levels to regional practices and standards, ensuring patient safety without compromising diagnostic efficacy. [ABSTRACT FROM AUTHOR]

Plant small molecules, such as nitric oxide (NO) and melatonin (MN) as natural and human health-friendly compounds, play important roles in the mitigation of abiotic stresses in plants. Heavy metals such as chromium (Cr) are hazardous for the survival of ornamentals, especially edible flowers. This study evaluated the effects of NO (50 µM; sourced as sodium nitroprusside) and MN (50 µM) applied two times through foliar spraying at 1-week intervals on alleviating Cr (120 µM; K2Cr2O7)-induced oxidative stress in edible flowers of Calendula officinalis cv. Orange King. Cr stress decreased plant dry mass, leaf SPAD values, net photosynthetic rates, and the maximum photochemical quantum yield (Fv/Fm), and increased the oxidative stress markers. The individual application of NO or MN significantly mitigated the adverse effects, and the combined application of NO and MN synergistically enhanced plant tolerance to Cr stress, including increased activities of antioxidant enzymes in plants and concentrations of carbohydrate, ascorbic acid, sugar, total protein, as well as ash contents of edible flowers. The co-application also significantly elevated the concentrations of total phenolics, flavonoids, free reducing power, antioxidant capacity DPPH, and total carotenoids in Cr-treated plants compared with those in Cr-stressed plants. Additionally, the essential oil contents in flowers increased in response to the signaling molecule treatment under Cr stress. Compared with individual applications, the co-application of NO and MN had more significant effects. Our results indicate that the combination of signaling molecules, such as MN and NO, can not only increase the biomass of edible calendula plants but also improve flower quality for use as a novel food. [ABSTRACT FROM AUTHOR]

Objective: To assess the anti-tumor effects of Pistacia atlantica methanolic extract (PAME) compared with cyclophosphamide against Ehrlich solid tumors in mice. Methods: Swiss albino mice (n=40) were divided into five groups: normal control mice, mice with Ehrlich solid tumors treated with normal saline, mice with Ehrlich solid tumors treated with cyclophosphamide intraperitoneally once a day for 14 d, or 50 mg/kg or 100 mg/kg PAME orally once a day for 14 d. Tumor growth inhibition, body weight, tumor markers, liver and kidney enzymes, oxidative stress markers, antioxidant enzymes, tumor necrosis factor-alpha level (TNF-α), and apoptosis-regulatory gene expression were evaluated. Results: Treatment of mice bearing Ehrlich solid tumors with PAME at 50 and 100 mg/kg orally significantly decreased tumor volume, body weight, tumor markers, liver and kidney enzymes, oxidative stress markers and TNF-α level in comparison with mice with Ehrlich solid tumors receiving normal saline. whereas PAME at 50 and 100 mg/kg/day significantly elevated the level of antioxidant enzymes (P

Objective: To assess the antidiarrheal effects of Terfezia claveryi methanolic extract against Escherichia coli, Salmonella typhimurium, Shigella flexneri, and Giardia lamblia. Methods: Antibacterial effects of the Terfezia claveryi methanolic extract were carried out by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration through micro broth dilution technique. Furthermore, reactive oxygen species production and protein leakage were evaluated. To evaluate the in vitro anti-giardial effects of Terfezia claveryi methanolic extract, Giardia lamblia WB (ATCC® 30957) trophozoites were treated with various concentrations of Terfezia claveryi methanolic extract for 10-360 min. In addition, the plasma membrane permeability of trophozoites treated with Terfezia claveryi methanolic extract was determined. The cytotoxicity effects of Terfezia claveryi methanolic extract against normal (HEK293T) and cancer (MCF-7) cells were also assessed using the MTT assay. Results: The MIC and minimum bactericidal concentration of Terfezia claveryi methanolic extract against bacterial strains were in the range of 0.52-1.04 and 1.04-2.08 mg/mL, respectively. The results revealed that reactive oxygen species production and protein leakage were significantly increased after the bacteria were treated with the Terfezia claveryi methanolic extract, especially at 1/3 and 1/2 MICs (P

In dairy industry, bovine mastitis is the most prevalent disease, which reduces milk production and causes economic losses. This study was conducted to estimate the prevalence of Mycoplasma bovis and some bacteria causing mastitis in dairy farms and partial sequencing of 16SrRNA target genes and Quinolones Resistance Determining Regions (QRDRs) (gyrA and parC) in M. bovis isolates. 370 milk samples were obtained from farms located in villages in Fayoum governorate, Egypt. The examined milk samples (8,91%) were positive for the California mastitis test (CMT). Multiplex RT-PCR was used for the recognition of microorganisms causing mastitis (Staphylococcus (S.) aureus, Streptococcus species (spp.), Escherichia (E.) coli, and Mycoplasma (M.) bovis) from mastitic milk. The results revealed that E. coli was the most predominant (84.8%) followed by S. aureus (81.8%) while M. bovis was the lowest one (51.5%). Mixed infection with two or more mastitic bacterial agents was also identified. All 33 examined mastitic milk samples were diagnosed with mixed infection with E. coli, S. aureus, Streptococcus spp. and M. bovis (36.36%), E. coli and S. aureus (21.21%), and rephrase E. coli, M. bovis, and Streptococcus spp. (6.06%). The sequence analysis of M. bovis 16SrRNA genes illustrated a high similarity of examined isolates to strains previously deposited in the GenBank recovered from the same locality. The gyrA amino acids showed no substitution but showed 100% similarity with M. bovis isolates worldwide. However, the amino acid sequence of parC, showed substitution at positions 2 (Gln to Arg) (CAG >>CGT), 75 (Ile to Ser) (ATT>>AGC), and 79 (Asn to Asp) (AAC>>GAT). Sequence results can lead to the creation of appropriate treatment and control measures for M. bovis, while multiplex RT-PCR, can be exploited as a standard diagnostic method for major mastitis pathogens.

Background: Nowadays, interest in the use of nanotechnology for medical purposes is increasing. The current experimental investigation is planned for the green synthesis, characterization, and efficacy of copper nanoparticles (CLN) against chronic Toxoplasma gondii infection. Methods: Green synthesis of CNP was performed using the Lupinus arcticus extract via the precipitation method. The effects of CNP on tachyzoites, infectivity rate, parasites inside THP-1 cells, nitric oxide (NO) triggering, iNOS, and IFN-γ expression genes were evaluated. Following toxoplasmosis in BALB/c mice via the T. gondii ME49 strain, mice received CNP at 5 and 10 mg/kg/day alone and combined with pyrimethamine (PYM) at 5 mg/kg for two weeks. CNP’s in vivo effects were evaluated by analyzing the load and size of cysts, oxidant/antioxidant enzymes, and bradyzoite surface antigen 1 (BAG1) expression gene levels. Results: CNP displayed a circular shape ranging from 10 to 85 nm. The IC50 value of CNP and PYM against tachyzoites was 37.2 and 25.7 µg/mL, respectively, whereas the CC50 value of CNP and pyrimethamine against THP-1 cells was 491.4 μg/mL and 269.5 μg/mL, respectively. The rate of infectivity and parasite load among THP-1 cells exposed to CNP was obviously reduced (p < 0.05). CNP at the doses of 5 and 10 mg/kg predominantly along with PYM evidently (p < 0.05) reduced the number and size of the T. gondii cysts in the infected mice. The levels of NO, iNOS, and IFN-γ genes were remarkably (p < 0.001) boosted compared with the cells without treatment. CNP at the doses of 10 and 20 mg/kg drastically (p < 0.05) reduced the oxidative stress markers in the infected mice, whereas CNP significantly elevated the level of antioxidant factors. CNP also revealed no toxicity in the liver and kidney at the tested doses in healthy mice. Conclusions: Our experimental study reported the beneficial effects of CNP principally along with existing chemical drugs against latent toxoplasmosis in mice, whereas the possible action mechanisms of CNP are controlling oxidative stress, refining antioxidant enzymes, and increasing the production of immunomodulatory cytokines with no toxicity to the function of vital organs. But, additional trials are required to confirm these results, as well as to clarify the accurate mechanisms and their toxicity.

Nuclear receptors (NRs) form a family of druggable transcription factors that are regulated by ligand binding to orchestrate multifaceted physiological functions, including reproduction, immunity, metabolism, and growth. NRs represent attractive and valid targets for the management and treatment of a vast array of ailments. Pentacyclic triterpenes (PTs) are ubiquitously distributed natural products in medicinal and aromatic plants, of which ursolic acid (UA) is an extensively studied member, due to its diverse bio-pertinent activities against different cancers, inflammation, aging, obesity, diabetes, dyslipidemia, and liver injury. In fact, PTs share a common lipophilic structure that resembles NRs’ endogenous ligands. Herein, we present a review of the literature on UA’s effect on NRs, showcasing the resulting health benefits and potential therapeutic outcomes. De facto, UA exhibited numerous pharmacodynamic effects on PPAR, LXR, FXR, and PXR, resulting in remarkable anti-inflammatory, anti-hyperlipidemic, and hepatoprotective properties, by lowering lipid accumulation in hepatocytes and mitigating non-alcoholic steatohepatitis (NASH) and its subsequent liver fibrosis. Furthermore, UA reversed valproate and rifampicin-induced hepatic lipid accumulation. Additionally, UA showed great promise for the treatment of autoimmune inflammatory diseases such as multiple sclerosis and autoimmune arthritis by antagonizing RORγ. UA exhibited antiproliferative effects against skin, prostate, and breast cancers, partially via PPARα and RORγ pathways. Herein, for the first time, we explore and provide insights into UA bioactivity with respect to NR modulation.

Nuclear receptors (NRs) constitute a superfamily of ligand-activated transcription factors with a paramount role in ubiquitous physiological functions such as metabolism, growth, and reproduction. Owing to their physiological role and druggability, NRs are deemed attractive and valid targets for medicinal chemists. Pentacyclic triterpenes (PTs) represent one of the most important phytochemical classes present in higher plants, where oleanolic acid (OA) is the most studied PTs representative owing to its multitude of biological activities against cancer, inflammation, diabetes, and liver injury. PTs possess a lipophilic skeleton that imitates the NRs endogenous ligands. Herein, we report a literature overview on the modulation of metabolic NRs by OA and its semi-synthetic derivatives, highlighting their health benefits and potential therapeutic applications. Indeed, OA exhibited varying pharmacological effects on FXR, PPAR, LXR, RXR, PXR, and ROR in a tissue-specific manner. Owing to these NRs modulation, OA showed prominent hepatoprotective properties comparable to ursodeoxycholic acid (UDCA) in a bile duct ligation mice model and antiatherosclerosis effect as simvastatin in a model of New Zealand white (NZW) rabbits. It also demonstrated a great promise in alleviating non-alcoholic steatohepatitis (NASH) and liver fibrosis, attenuated alpha-naphthol isothiocyanate (ANIT)-induced cholestatic liver injury, and controlled blood glucose levels, making it a key player in the therapy of metabolic diseases. We also compiled OA semi-synthetic derivatives and explored their synthetic pathways and pharmacological effects on NRs, showcasing their structure-activity relationship (SAR). To the best of our knowledge, this is the first review article to highlight OA activity in terms of NRs modulation.

Malaria is an intraerythrocytic parasitic disease caused by the genus Plasmodium of which Plasmodium vivax and Plasmodium falciparum are the major species. The high cost and associated side effects of antimalarial drugs triggered research about medicinal plants to develop alternative and low-cost drugs with lesser side effects. Therefore, this study was designed to investigate the antiplasmodial activity of the Eucalyptus obliqua L’Hér. leaf extract against P. vivax and its phytochemicals in in vitro. The methanolic extract of E. obliqua was prepared and different concentrations of the crude extract and phytochemicals were used against P. vivax. The methanolic extract of E. obliqua showed profound antiplasmodial activity (LD50 0.084 mg/mL; 80.04%) at 0.1 mg/mL concentration after 24 h. Alkaloids, flavonoids, saponins, and tannins were found in the E. obliqua methanolic extract. Only alkaloids at the concentration (0.1 mg/mL) exhibited 60.93% inhibition of P. vivax. The methanolic extract of E. obliqua exhibits antiplasmodial activity in vitro. However, in vivo efficacy is an important aspect in the testing of medicinal plants against parasitic infections and should be evaluated in future.

The present study aimed to evaluate the in vitro, in vivo, and safety of Stachys lavandulifolia Vahl. methanolic extract (SLME) against acute toxoplasmosis caused by Toxoplasma gondii RH strain in mice. Methods: MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay was used to evaluate the in vitro effect of the SLME on T. gondii tachyzoites. Totally, 72 male BALB/c mice (40 mice for in vivo evaluation of SLME and 32 mice for its toxicity effects on liver and kidney serum enzymes) were used for the present investigation. At first, 40 mice were orally pre-treated with the SLME at doses of 25, 50, and 75 mg/kg/day for two weeks. Mice were checked daily, and the rate of survival and the mean number of tachyzoites were recorded. Liver lipid peroxidation (LPO) and nitric oxide (NO) levels, the effects on kidney and liver function, as well as the expression level of the proinflammatory cytokines such as interleukin-1β (IL-1β) and interferon-γ (IFN-γ), were studied by the quantitative real-time PCR. Flow cytometry analysis was performed on the effects of SLME on the detection of apoptotic and necrotic cells in T. gondii tachyzoites. Results: The SLME at the concentrations 75 and 150 µg/mL completely killed the tachyzoites after 2 hr of incubation. SLME at 25, 50, and 75 mg/kg/day increased the survival rate of infected mice by the sixth, seventh, and eighth days, respectively. SLME also significantly (p < 0.05) decreased the LPO and NO levels and upregulated the IL-1β and IFN-γ mRNA gene expression levels, whereas no considerable change was observed in the serum level of kidney and liver enzymes. Flow cytometry analysis revealed the prompted early and late apoptosis after exposure to T. gondii tachyzoites with various concentrations of SLME. Conclusion: We found the relevant in vitro anti-Toxoplasma effects of SLME against T. gondii. Moreover, the results confirmed the promising in vivo prophylactic effects of SLME. SLME provokes the innate immune system, induces apoptosis, modulates the proinflammatory cytokines, and inhibits hepatic injury in infected mice. With all these descriptions, further surveys are required to support these findings and elucidate this plant’s possible mechanisms of action.

Background: Sickle cell anemia (SCD) is a relatively uncommon health condition in many countries, but it is prevalent in Saudi Arabia mainly due to the high incidence of consanguineous marriages. Regrettably, there are elevated rates of vaso-occlusive crises (VOCs) and blood transfusions, leading to poor quality of life and significant financial strain. Objective(s): This study aimed to assess the frequency of blood transfusions, out-of-pocket expenditures (OOPEs), and health-related quality of life (HRQoL) in SCD patients. Methods: This was a questionnaire-based cross-sectional study that involved SCD patients at a university-affiliated tertiary care center in Riyadh, Saudi Arabia. The patients' medical and sociodemographic characteristics were obtained from the electronic medical records. Data on HRQoL and OOPEs were collected through a questionnaire-based interview. To present the baseline characteristics, descriptive statistics such as mean, standard deviation, frequency, and percentage were used. In addition, various statistical tests, including the Chi-Square test, Student t-test, one-way ANOVA, and multiple linear regression, were performed. Results: One hundred and eighteen patients consented to participate and were included in the analysis. Almost 53% of the patients were females. The mean age of the sample was 31 years, while the age-adjusted quality-adjusted life years (QALYs) was 24.33 years (p-value < 0.0001). Most patients (83.05%) reside in Riyadh with a monthly family income of less than USD 2666.67 (75.42%). Monthly OOPEs were, on average, USD 650.69 ± 1853.96, and one-third of the adult patients reported income loss due to illness, further exacerbating their financial strain. High frequency of blood transfusion (β = −0.0564, p-value = 0.0066) and higher number of comorbidities (β = −0.10367, p-value = 0.0244) were negatively associated with the HRQoL among adult patients. On the other hand, adult patients with higher levels of education had better HRQoL (β = 0.05378, p-value = 0.0377). Conclusions: The findings of this study highlight the negative impact of SCD on patients' HRQoL and financial well-being. This underscores the urgent need for comprehensive systemic approaches to address the challenges posed by SCD in Saudi Arabia. [ABSTRACT FROM AUTHOR]

This study was aimed to investigate the response of some wheat (Triticum aestivum L.) landraces to three irrigation sources, freshwater (FW), well water (WW), and treated municipal wastewater (TMW), regarding the impact on growth, yield, and grains elements contents. The results showed that the various wheat landraces irrigated with treated wastewater were significantly taller (117.3 cm) with multi tillers (22 tiller plant-1), had maximum spikes per plant (2.6), and longer weighty spikes (14.5 cm & 12.1 g). Landraces L1(Burr), L2 (Baldy Burr), C7 (Yecora Rojo), had maximum tillers, L4 (Alssamaa Burr), L5 (Bahaal Burr), L7 (Yecora Rojo) had more spikes per plant and the longer weighty spikes were recorded in L5 Baldy Burr, L1(Burr), heavy spikes were reported in L5 (Bahaal Burr) and L1(Burr). Moreover, these landraces had the highest yield per plant and 1000 grains weight (49.8 g, 12.5 g) respectively. The N, P, K, and Mg contents were increased under TMW, and their levels in landraces and cultivars in order are 3>L2>L4>L5>L1>C6>C7. Even Cu, Fe, Mn, Zn levels were higher in various landraces irrigated with TMW, however, L3, L2, and L4 had maximum contents of all microelements. TMW irrigation enhanced growth, yield, and grain quality in terms of essential elements. The irrigation of landraces L1, L4, L5 with TMW may be a feasible alternative for sustainable wheat production and safe water in arid regions such as Saudi Arabia.

ObjectiveParents' hesitancy (PH) toward childhood vaccination, including the vaccine of coronavirus disease (COVID-19), is one of the top public health threats. We aim to assess the PH toward children COVID-19 vaccination as compared to PH toward children routine vaccination among the residents of Saudi Arabia.MethodBefore the official approval of children's COVID-19 vaccination in the country, a cross-sectional study using an electronically distributed survey was performed. Responses from parents of children younger than 18 years of age were accepted. The Oxford COVID-19 vaccine hesitancy scale (OC19-VHS) and the routine vaccination hesitancy scale (R-VHS) were used. Parents were classified as hesitant, non-hesitant, and unsure.ResultsBetween June 18th−30th, 2021, we included 1,052 parents. More than half of the parents were positive toward the childhood COVID-19 vaccination (63%) while 10% were unsure. Higher parental hesitancy toward children COVID-19 vaccination among mothers, parents younger than 40 years, did not receive COVID-19 nor influenza vaccines, had higher educational levels, and parents who recovered from COVID-19 infection. Hesitancy was mainly driven by the novelty of the vaccines and the fear of serious adverse effects. Compared to the routine vaccination, parents were more hesitant toward COVID-19 vaccination (6 vs. 27%).ConclusionGenerally, parents in Saudi Arabia were positive toward children's COVID-19 vaccination. Focused education to reassure hesitant parents on the safety of the vaccine is essential to achieve larger vaccination coverage.

Sustainable agriculture aims to eliminate the excessive usage of chemical fertilizers and can be crucial for soil fertility. A factorial pot experiment in a randomized complete block design was carried out in King Khaled International Airport Nursery, Riyadh, Saudi Arabia, during 2019/2020, to evaluate the role of a biofertilizer (i.e., Bio-Fert, nitrogen-fixing microorganisms; Biot-Phos, phosphorus-released microorganism; and Bio-Potas, potassium-released microorganisms, either alone or in combinations) and slow-release compound chemical fertilizer (Osmocote), with or without compost, on Pelargonium peltatum plant growth, flowering, chlorophyll level, and ion percentage. Soil amendment with compost in general significantly increased plant growth and flowering attributes as well as chlorophyll level, nitrogen (N), phosphorous (P), and potassium (K) percentage over garden soil (without compost). All growth and flowering traits as well as ion percentage and chlorophyll level were significantly increased by biofertilizer treatments either alone or in combinations. The supreme treatment was the triple interaction over single or double interactions or untreated plants. Osmocote application increases chlorophyll levels, ions, flowering, and vegetative growth relative to untreated plants. Additionally, the data also revealed that all interactions between either osmocote or biofertilizers with compost significantly increased all studied attributes over each treatment alone or untreated control plants. Accordingly, it is recommended to add compost to the soil along with a triple mixture of biofertilizers for obtaining high plant growth and flowering attributes along with soil fertility.

The world faces a challenge with the pervasion of multidrug-resistant bacteria that encourages scientists to develop and discover alternative, ecofriendly, and easy-to-produce new antibacterial agents. Our work is part of the greater effort of scientists around the world to achieve this goal by the biological synthesis of silver nanoparticles using cyanobacterial extracellular and intracellular components as nonchemical reducing agents. Two Egyptian cyanobacteria were isolated and identified according to 16S rRNA gene sequencing as Phormidium ambiguum and a novel species Desertifilum tharense. The sequences were deposited with accession numbers MW762709 and MW762710 for Desertifilum tharense and Phormidium ambiguum, respectively, in the GenBank. The results of UV-Vis analysis showed promising extracellular Ag-NPs synthesis by Desertifilum tharense and Phormidium ambiguum under light conditions. Therefore, these Ag-NPs were characterized and evaluated for antibacterial and antioxidant activity. TEM and SEM analyses revealed the spherical crystals with face-centered cubic structures and size range of 6.24–11.4 nm and 6.46–12.2 nm for Ag-NPs of Desertifilum tharense and Phormidium ambiguum, respectively. XRD and EDX results confirmed the successful synthesis of Ag-NPs in their oxide form or chloride form. The FTIR spectrum data confirmed the presence of hydroxyl and amide groups. Desertifilum tharense Ag-NPs displayed the largest inhibition zone that ranged from 9 mm against Micrococcus luteus ATCC 10240 to 25 mm against methicillin-resistant Staphylococcus aureus (MRSA) ATCC 43300. For Phormidium ambiguum Ag-NPs, the inhibition zone diameter was in the range of 9 mm to 18 mm. The biosynthesized Ag-NPs significantly inhibited the growth of medically important resistance-pathogenic Gram-positive and Gram-negative bacteria. The Ag-NPs of Phormidium ambiguum exhibited the highest scavenging activity of 48.7% when compared with that of Desertifilum tharense, which displayed 43.753%.

Haemonchus contortus is an infectious gastrointestinal nematode parasite of small ruminants. This study addresses the in vitro/in vivo anti-haemonchiasis potential, toxicological effects, and mechanism of action of nanoparticles. Online databases were used to search and retrieve the published literature (2000 to 2021). A total of 18 articles were selected and reviewed, out of which, 13 (72.2%) studies reported in vitro, 9 (50.0%) in vivo, and 4 (22.2%) both in vitro/in vivo efficacy of different nanoparticles. Mostly, organic nanoparticles (77.7%) were used including polymeric (85.7%) and lipid nanoparticles (14.3%). The highest efficacy, in vitro, of 100% resulted from using encapsulated bromelain against eggs, larvae, and adult worm mortality at 4, 2, and 1 mg/ml, respectively. While in vivo, encapsulated Eucalyptus staigeriana oil reduced worm burden by 83.75% and encapsulated Cymbopogon citratus nano-emulsion by 83.1%. Encapsulated bromelain, encapsulated Eucalyptus staigeriana oil, and encapsulated Cymbopogon citratus nano-emulsion were safe and non-toxic in vivo. Encapsulated bromelain damaged the cuticle, caused paralysis, and death. Nanoparticles could be a potential source for developing novel anthelmintic drugs to overcome the emerging issue of anthelmintic resistance in H. contortus. Studies on molecular effects, toxicological consequences, and different pharmacological targets of nanoparticles are required in future research.

Background: Hepatocellular carcinoma (HCC) is the most common form of liver cancer that occurs in hepatocytes. Although many chemical drugs, e.g., cisplatin, methotrexate, taxis, and doxorubicin are used to treat HCC, there have been numerous reports related to the side effects of these drugs (e.g., emerging drug resistance, bone marrow failure, and gastrointestinal disorders). These issues led scientists to search for the novel anti-cancer drugs, mainly in natural products with greater efficiency and less toxicity. The current survey was intended to assess the anti-cancer effects of queen bee acid (10-Hydroxy-2-Decenoic Acid, 10-HDA) and its cellular mechanisms against the human hepatoma cell line HepG2. Materials and Methods: The MTT (3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide) assay was used to evaluate the effect of 10-HDA on the viability of HepG2 cells. The initial and late apoptosis in the HepG2 cells treated with 10-HDA were assessed by the Annexin-V (AV) assay. The level of the gene and protein expression of some apoptosis genes (e.g., caspase-3, Bcl-2-associated X protein (BAX), and B-cell lymphoma protein 2 (Bcl-2)), Poly (ADP-ribose) polymerases (PARP), and miRNA-34a (miR-34a), were measured by real-time PCR and Western blot. Results: The obtained findings revealed that HepG2 cell viability was markedly reduced (p < 0.01) following exposure to 10-HDA in a dose-dependent matter. The calculated half maximal cytotoxic concentration (CC50) value of 10-HDA was 59.6 µg/mL for HepG2 cells, while this value for normal THLE-3 cells was 106.4 µg/mL. We found that 10-HDA markedly elevated (p < 0.01) the percentage of necrotic and apoptotic cells from 0.94 to 9.7 and 27.6%, respectively. The real-time PCR results showed that the expression levels of the caspase-3, Bax, and miR-34a genes were significantly (p < 0.001) elevated. Contrary to these results, a significant (p < 0.01) reduction in the expression level of the Bcl2 gene was observed. The levels of protein expression of Caspase-3, PARP, and Bax were markedly elevated following exposure of HepG2 cells to 10-HDA at ¼ CC50, ½ CC50, and CC50. The level of protein expression of Bcl-2 was markedly reduced following exposure of HepG2 cells to 10-HDA at ¼ CC50, ½ CC50, and CC50 (p < 0.01). Conclusion: The current results confirmed the potent in vitro cytotoxic effects of 10-HDA on HepG2 cells with no significant cytotoxic effects on normal cells. Although its mechanisms of action have not been fully studied, the induction of apoptosis via different pathways was determined as one of the principle mechanisms of action of 10-HDA against HepG2 cells. Nevertheless, additional surveys must be performed to clearly understand the mechanisms of action and safety of this fatty acid.

Reliability is called not only one of the main characteristics of the magnetic modulation DC converters, but also the ability to correctly perform the required function of the measuring device in the specified operating modes and operating conditions for a certain period of time. One of the main tasks in the development of magnetic modulation DC converters is to reduce the number of inference errors. Magnetic modulation DC converters errors include the main errors which are technological and corrective errors, internal sources of additional errors, external sources of additional errors which can be static errors, dynamic errors.

Objective: To assess the antimicrobial, antibiofilm, antiinflammatory, angiogenic, and wound healing activities of zinc nanoparticles (ZNPs) green synthesized using Ferula macrecolea extract. Methods: The green synthesis was conducted using the precipitation method. Then, the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), and minimum biofilm inhibition concentration 50% (MBIC50) of ZNPs against Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) were evaluated. The effects of ZNPs on the gene expressions of Staphylococcus spp. [intracellular adhesion A (icaA) and D (icaD)] and P. aeruginosa (rhlI and rhlR) were investigated using quantitative real-time PCR. In addition, the effects of ZNPs on wound healing, angiogenesis, and anti-inflammatory markers were assessed. Results: The green-synthesized ZNPs demonstrated significant antimicrobial efficacy against S. aureus and P. aeruginosa. The biofilm formation in S. aureus and P. aeruginosa was also inhibited by ZNPs with MBIC50 values of 3.30 µg/mL and 2.08 µg/mL, respectively. Additionally, ZNPs downregulated the expression of biofilm-related genes icaA, icaD, rhlI, and rhlR in the tested bacteria. They also demonstrated promising in vitro wound healing effects by promoting fibroblast cell proliferation and wound closure in a dose-dependent manner. A significant increase in the expression of HLA-G5 and VEGF-A genes as well as a marked decrease in the expression of NF-κB, IL-1β, and TNF-α genes were observed in cells treated with ZNPs compared to the control group (P<0.05). Conclusions: ZNPs display promising antibacterial effects against S. aureus and P. aeruginosa and wound-healing effects by inhibiting biofilm formation, inducing angiogenesis, and reducing inflammation. However, further studies must be conducted to specify the accurate mechanisms of action and toxicity of ZNPs. [ABSTRACT FROM AUTHOR]

Background: Gastric cancer (GC) is considered the fifth most prevalent type of cancer and the third leading cause of cancer deaths worldwide. This in-depth investigation was performed to generate fresh concepts for the clinical classification, diagnosis, and prognostic evaluation of GC. Methods: The data were retrieved from the Gene Expression Omnibus (GEO) and The Cancer Genome Atlas (TCGA) databases. Unsupervised cluster analysis was used to divide up the GC patients using pyroptosis-related differentially expressed genes (DEGs), which were discovered to be significantly linked with GC prognosis. The therapeutic importance of pyroptosis in GC patients was discovered using PCA analysis of genes associated with pyroptosis. The models were then carefully scrutinized. Results: Three hub genes, ELANE, IL6, and TIRAP, exhibit significant predictive importance among the 15 pyroptosis-related genes. Unsupervised clustering analysis revealed that the DEGs were enriched in the pathway of cytokine–cytokine receptor interactions, and Clusters 1 and 2 had statistically distinct prognoses. PCA analysis revealed significant differences in the area under the curve, immunological checkpoints, immunogenic cell death, and prognostic value between the high- and low-risk groups. Conclusions: These two GC classification models, based on pyroptosis, have significant clinical value for patients with GC.

ObjectivesMeningitis is a medical emergency with permanent disabilities and high mortality worldwide. We aimed to determine causative microorganisms and potential markers for differentiation between bacterial and viral meningitis.MethodologyAdult patients with acute meningitis were subjected to lumber puncture. Cerebrospinal fluid (CSF) microorganisms were identified using Real-time PCR. PCT and CRP levels, peripheral and CSF-leucocyte count, CSF-protein and CSF-glucose levels were assessed.ResultsOut of 80 patients, infectious meningitis was confirmed in 75 cases; 38 cases were bacterial meningitis, 34 cases were viral meningitis and three cases were mixed infection. Higher PCT, peripheral and CSF-leukocytosis, higher CSF-protein and lower CSF-glucose levels were more significant in bacterial than viral meningitis patients. Neisseria meningitides was the most frequent bacteria and varicella-zoster virus was the most common virus. Using ROC analyses, serum PCT and CSF-parameters can discriminate bacterial from viral meningitis. Combined ROC analyses of PCT and CSF-protein significantly improved the effectiveness in predicting bacterial meningitis (AUC of 0.998, 100%sensitivity and 97.1%specificity) than each parameter alone (AUC of 0.951 for PCT and 0.996 for CSF-protein).ConclusionCSF-protein and serum PCT are considered as potential markers for differentiating bacterial from viral meningitis and their combination improved their predictive accuracy to bacterial meningitis.

Coinfections and comorbidities add additional layers of difficulties into the challenges of COVID-19 patient management strategies. However, studies examining these clinical conditions are limited. We have independently investigated the significance of associations of specific bacterial species and different comorbidities in the outcome and case fatality rates among 129 hospitalized comorbid COVID-19 patients. For the first time, to best of our knowledge, we report on the predominance of Klebsiella pneumoniae and Acinetobacter baumannii in COVID-19 non-survival diabetic patients The two species were significantly associated to COVID-19 case fatality rates (p-value = 0.02186). Coinfection rates of Klebsiella pneumoniae and Acinetobacter baumannii in non-survivors were 93% and 73%, respectively. Based on standard definitions for antimicrobial resistance, Klebsiella pneumoniae and Acinetobacter baumannii were classified as multidrug resistant and extremely drug resistant, respectively. All patients died at ICU with similar clinical characterisitics. Of the 28 major coinfections, 24 (85.7%) were in non-survivor diabetic patients, implying aggravating and worsening the course of COVID-19. The rates of other comorbidities varied: asthma (47%), hypertension (79.4%), ischemic heart disease (71%), chronic kidney disease (35%), and chronic liver disease (32%); however, the rates were higher in K. pneumoniae and were all concomitantly associated to diabetes. Other bacterial species and comorbidities did not have significant correlation to the outcomes. These findings have highly significant clinical implications in the treatment strategies of COVID-19 patients. Future vertical genomic studies would reveal more insights into the molecular and immunological mechanisms of these frequent bacterial species. Future large cohort multicenter studies would reveal more insights into the mechanisms of infection in COVID-19.