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Red Sea marine sponges are an important source of biologically active natural products. Therefore, the present study aimed to investigate, for the first time, the components of n-hexane, dichloromethane, and ethyl acetate fractions of Cliona sp. marine sponge collected from the Red Sea, Egypt using UPLC-ESI-MS/MS (Ultra-performance liquid chromatography electrospray ionization tandem mass spectrometry) analysis. The analysis revealed the tentative identification of 23, 16, and 24 compounds from the n-hexane, dichloromethane, and ethyl acetate fractions of Cliona sp., respectively. In addition, the examination of these fractions resulted in the isolation and identification of three sterols and one amino acid. The identification of the isolated compounds was confirmed by 1D and 2D NMR (Nuclear Magnetic Resonance), and MS (Mass spectrometry), and IR (Infrared) spectroscopy. The in vitro cytotoxic, antioxidant, and antimicrobial activities of the total ethanolic extract and its sub-fractions were also evaluated. Interestingly, the ethyl acetate fraction showed potent cytotoxic activity against colon (HCT-116) and human larynx carcinoma (HEP-2) cell lines with IC50 (Half-maximal Inhibitory Concentration) 6.11 ± 0.2 and 12.6 ± 0.9 µg/mL, respectively. However, the dichloromethane fraction showed strong antioxidant activity, with IC50 75.53 ± 3.41 µg/mL. Notably, the total ethanolic extract showed the strongest antibacterial activity against Staphylococcus aureus and Escherichia coli, with MIC (Minimum Inhibitory Concentration) 62.5 ± 0.82 and 125 ± 0.62 µg/mL, respectively, compared to other fractions. In conclusion, this is the first report on the secondary metabolites content and biological activities of Cliona sp. from the Red Sea, Egypt. It also highlights the need for further research on the most active fractions against various cancer cell lines and resistant bacterial and fungal strains. Cliona sp. extract and its fractions could be a potential source of novel and safe natural drugs with a wide range of medicinal and pharmaceutical applications.

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The aim of this study was to provide insight into the role of camel's saliva in protecting enamel against erosion and to evaluate the levels of salivary sodium, potassium, calcium, and phosphate ions among 2 groups of camels, those with low-grade tooth surface loss and those with high-grade tooth surface loss. Twenty-eight healthy camels, 5 males and 23 females, aged 20 months to 10 years, were divided into 2 groups. Group I comprise camels with "low-grade tooth surface loss" and Group 2 with "high-grade tooth surface loss." Unstimulated saliva was collected by a draining method. The samples were then analyzed for sodium, potassium, calcium, and phosphate concentrations using automated chemistry analysis. Data were then statistically analyzed using the unpaired Student's t- test and Pearson correlation coefficient test. The study found the salivary calcium and phosphate concentrations were significantly lower in the "high-grade" erosion group, in comparison with the other group (P <.0001 and P =.0257, respectively). The results also revealed that the more extensive the tooth surface loss, the more carious lesions the subject had (P =.023), and that caries are more common in the anterior teeth, particularly the incisors. The authors conclude that alterations in inorganic elements of saliva, particularly the calcium and phosphate ions, play a major role in the development of resistance to tooth surface loss. This work may represent a direction for future research to develop custom-made preventive supplements, which can protect camelid teeth against tooth surface loss. [ABSTRACT FROM AUTHOR]

Economic growth has a potential impact on waste generation worldwide. Growing recognition for resources recovery from waste including production of a clean energy has led to the development of standards for, and the generation of, Solid Recovered Fuel (SRF). SRF, according to BS EN ISO 21640 is a fuel prepared from nonhazardous/treated waste to be utilized for energy recovery in incineration or co-incineration plants which meets the classification and specification. The amount of combustible fractions (i.e., plastic, textile and paper) that are present in Healthcare Waste (HCW) and Municipal Solid Waste (MSW) provides an opportunity for SRF production. HCW is defined as clinical waste generated from healthcare facilities. Limited efforts in utilizing treated HCW in production of SRF were noted, despite the fact that high content of combustible fractions, hence the novelty of this research. This research addresses the opportunities of utilizing autoclaved HCW as an alternate fuel; through a detailed chemical and physical analysis of autoclaved HCW collected from the Sultanate of Oman hospital and healthcare facilities. Furthermore, this study examines the possible uses of such materials instead of landfilling. The utilization of treated HCW as an alternative fuel is not only saving the land space, but also reduces the carbon emissions originating from landfilling. This in fact would also support the government in achieving its aspiring goal of the net zero carbon emissions by 2050 through better utilization of these materials in production of SRF as an alternative to fossil fuel combustion. The study revealed that autoclaved HCW appears to have a high quality SRF and is classified as (NCV 4, Cl 3); which complies with the potential end users' specifications. It is estimated that the combined energy output from MSW and HCW combustible fractions could cover about 12.75% of the energy requirements for Oman cement factories. Implications: The results confirm the viability of using autoclave (HCW) as an alternative fuel due to its high thermal energy content. Based on mean Net Calorific Value (NCV) of analyzed HCW that is found around 14 (MJ/Kg (ar)), and the mean Cl level (i.e., 0.814 ± 0.213% (d)); the SRF is classified as (NCV4, Cl 3). This grade is found to be well within the end users accepted range. This opens up the opportunity for creating a market demand for HCW that not only it could boost its recovery, but it could also unlock the value that can generates. [ABSTRACT FROM AUTHOR]

Takotsubo cardiomyopathy (TCM) was first initially reported in 1990 in Japan and has been increasingly recognized in clinical practice. It is characterized by transient regional left ventricular dysfunction without evidence of obstructive coronary artery disease, often precipitated by emotional and physical stressors. Although TCM does occur in young women and men, it is most commonly seen in postmenopausal women. Sepsis induced TCM is an infrequently encountered entity. We present a case of TCM in a middle age gentleman who presented with septic shock due to acute cholecystitis. Two days later, the patient developed clinical features of acute myocardial infarction. Echocardiography revealed hypokinesis of the left ventricle. Coronary angiography revealed normal arteries without any obstruction. Diagnosis of sepsis induced TCM was finally made. The patient made a dramatic recovery and discharged home in stable condition. Follow-up echocardiography showed improvement in left ventricular systolic function.

We present a glimpse of vascular malformations seen at Sultan Qaboos University Hospital from July 2014 to December 2019. The cases are sporadic in nature. Molecular genetic studies can be conducted in patients with a family history of vascular malformations. Cultural practices relating to dress codes may lead to delays in presentation. A diagnostic/management algorithm about vascular malformations would help healthcare professionals diagnose, counsel, and refer appropriately, and a national registry would further enhance research and patient support groups.

Background: COVID-19’s emergence carries with it many uncertainties and challenges, including strategies to manage the epidemic. Oman has implemented non-pharmaceutical interventions (NPIs) to mitigate the impact of COVID-19. However, responses to NPIs may be different across different populations within a country with a large number of migrants, such as Oman. This study investigated the different responses to NPIs, and assessed the use of the time-varying reproduction number (Rt) to monitor them. Methods: Polymerase chain reaction (PCR) laboratory-confirmed COVID-19 data for Oman, from February 24 to June 3, 2020, were used alongside demographic and epidemiological information. Data were arranged into pairs of infector–infectee, and two main libraries of R software were used to estimate reproductive number (Rt). Rt was calculated for both Omanis and non-Omanis. Findings: A total of 13,538 cases were included, 44.9% of which were Omanis. Among all these cases we identified 2769 infector–infectee pairs for calculating Rt. There was a sharp drop in Rt from 3.7 (95% confidence interval [CI] 2.8–4.6) in mid-March to 1.4 (95% CI 1.2–1.7) in late March in response to NPIs. Rt then decreased further to 1.2 (95% CI 1.1–1.3) in late April after which it rose, corresponding to the easing of NPIs. Comparing the two groups, the response to major public health controls was more evident in Omanis in reducing Rt to 1.09 (95% CI 0.84–1.3) by the end of March. Interpretation: Use of real-time estimation of Rt allowed us to follow the effects of NPIs. The migrant population responded differently than the Omani population.

Objective: To describe the clinical and epidemiological profiles of HIV-infected Omani children before and after the implementation of the prevention of mother-to-child transmission of HIV (PMTCT) programme. Methods: A retrospective review of HIV-infected children seen at a national paediatric HIV unit between 1992 and 2015 was performed. Results: Ninety-one HIV-infected children were identified; 59 (65%) were ≤5 years of age at diagnosis, with 28 (47.5%) of these being

Hanan M Hassan,1 Lamya H Al-Wahaibi,2 Mohammed A Elmorsy,3 Yasmen F Mahran4,5 1Department of Pharmacology and Biochemistry, Faculty of Pharmacy, Delta University for Science & Technology, Gamasa City, Dakhliya, Egypt; 2Department of Chemistry, College of Sciences, Princess Nourah bint Abdulrahman University, Riyadh, KSA, 11671, Saudi Arabia; 3Department of Pharmaceutical Organic Chemistry, Faculty of Pharmacy, Mansoura University, Mansoura 35516, Egypt; 4Department of Pharmacology and Toxicology, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt; 5Department of Pharmaceutical Sciences, Faculty of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, KSA, Saudi ArabiaCorrespondence: Hanan M Hassan Tel +2 050 2770140Fax +20502770145Email hananhafila@hotmail.comPurpose: Drug-induced liver injury (DILI) is the most common cause of acute liver failure. The aim of this study was to investigate the molecular mechanisms by which Ganoderma lucidum mushroom (GLM) may ameliorate cisplatin (CP)-induced hepatotoxicity theoretically and experimentally.Materials and Methods: Thirty-six male Sprague-Dawley (SD) rats were divided into six groups, two of them are normal and Ganoderma lucidum control groups. Liver injury was induced by a single dose of CP (12 mg/kg i.p) in four groups, one of them is CP control group. Besides cisplatin injection in day 1, rats in groups (4– 6) were subjected to GLM (500 mg/kg/day) either every other day or daily oral dose or via i.p injection for 10 consecutive days.Results: In this study, GLM supplementation caused significant reduction of elevated high-mobility group box-1 (HMGB-1) with a concurrent decline in TNF-α and upregulation of IL-10 compared to the CP group (P< 0.05). The histopathological and fibrosis evaluation significantly confirmed the improvement upon simultaneous treatment with GLM. Moreover, immunohistochemical examination also confirmed the recovery following GLM treatment indicated by downregulation of NF-κB, p53 and caspase-3 along with upsurge of B-cell lymphoma 2 (Bcl-2) expression (P< 0.05). GLM treatment significantly decreased serum levels of hepatic injury markers; ALT, AST, T. bilirubin as well as oxidative stress markers; MDA and H2O2 with a concomitant increase in hepatic GSH and SOD. Also, the performed docking simulation of ganoderic acid exhibited good fitting and binding with HMGB-1 through hydrogen bond formation with conservative amino acids which gives a strong evidence for its hepatoprotective effect and may interpret the effect of Ganoderma lucidum.Conclusion: GLM attenuated hepatic injury through downregulation of HMGB-1/NF-kB and caspase-3 resulted in modulation of the induced oxidative stress and the subsequent cross-talk between the inflammatory and apoptotic cascade indicating its promising role in DILI.Keywords: drug-induced liver injury, Ganoderma lucidum mushroom, ganoderic acid, cisplatin-induced hepatotoxicity, inflammatory cytokines, high-mobility group box-1

In this paper, a detailed study on chemical characterization of essential oils (EOs) constituents of leaves and stems of Achillea fragrantissima were carried out using GC-FID and GC–MS analysis employing two different stationary phase columns. In the studied plant which is collected from the central region of Saudi Arabia, trans-sabinyl acetate and trans-sabinol have been identified as the major components. To the best of our knowledge, these components are being reported for the first time as the major constituents in the EOs of A. fragrantissima. The results showed that chief chemical components of both (leaves and stems) oils were found to be almost same, however, their contents varied noticeably from each other. Among 108 identified components in the leaves oil, the major components were trans-sabinyl acetate (20.7 ± 0.00), trans-sabinol (14.9 ± 0.13), artemisia ketone (12.7 ± 0.46), santolina alcohol (10.1 ± 1.30), β-sesquiphellandrene (5.5 ± 0.01), β-thujone (5.1 ± 0.11). Whereas, in the stem oil 85 components were identified and trans-sabinyl acetate (24.0 ± 0.19), trans-sabinol (19.2 ± 0.01), artemisia ketone (16.3 ± 0.74), santolina alcohol (10.4 ± 1.50), and β-sesquiphellandrene (4.8 ± 0.01) were found to be the major components. Among the identified components form both oils, 23 components were specific to only leaves oil, whereas 85 components were found to be common in both oils.

Objectives: Stigma and discrimination undermine the quality of life of people with HIV and their access to health services. This study aimed to assess HIV-related knowledge, attitudes and practices among healthcare workers (HCWs) in Oman. Methods: This cross-sectional study took place between July and November 2016. A questionnaire was distributed to 1,400 government HCWs to determine HIV-related knowledge, attitudes and practices. Results: A total of 1,281 HCWs participated (response rate = 92%). Routine tasks, such as dressing wounds, drawing blood and touching clothes, were a cause of concern for 24–52% of HCWs. Only 69% correctly answered questions regarding the transmission of HIV via eating/drinking and mosquito bites. Compared to other HCWs, doctors had significantly higher knowledge (mean = 0.46, 95% confidence interval [CI]: 0.19 to 0.73; P 15 years’ work experience scored significantly higher on knowledge (mean = −0.60, 95% CI: −1.12 to −0.08; P = 0.025) and attitude (mean = −0.99, 95% CI: −1.87 to −0.10; P = 0.029) compared to those with less experience. Conclusion: The high rate of HIV-related stigma among HCWs in Oman should be rectified in order to achieve the 90-90-90 target set by the Joint United Nations Programme on HIV/AIDS. Keywords: HIV; Social Stigma; Social Discrimination; Knowledge; Attitude; Professional Practice; Healthcare Providers; Oman.

The volatile chemical constituents derived from two Asteraceae species (Artemisia judaica and A. herba-alba) were analyzed and compared for the first time using gas chromatography techniques (GC–MS, GC–FID, Co-GC, LRI determination, database and literature searches) on two different stationary phase columns (polar and nonpolar). This analysis led to the identification of a total of 110 and 81 components from whole plant (stems, leaves and flowers) oils of A. judaica and A. herba-alba respectively. The major classes of compounds in both plants included oxygenated monoterpenes, sesquiterpenes and hydrocarbons. The prominent components in the oil of A. judaica were β-eudesmol, hexadecanoic acid, spathulenol, eudesma-4 (15),7-dien-1-β-ol, carvacrol and thymol which account for 67.3% of the total essential oils composition (96.7%). While the main oil constituents from A. herba-alba were piperitone, (E)-ethylcinnamate, (Z)-ethylcinnamate, thymol, isophrone which account for 78.0% of the total oil composition (99.6%). Comparison showed similar composition in thymol and spathulenol while in others major constituents, have opposite values. To the best of our knowledge, both plant species (A. judaica and A. herba-alba) from Saudi Arabia were considered for the first time in this study. In addition, the oils of these plants were screened for their bio-activities and were found to possess significant anti-microbial activities. Keywords: Artemisia judaica, A. herba-alba, Essential oils, β-eudesmol, Piperitone, (Z) and (E)-ethylcinnamate, Thymol, Anti-microbial activities

Aim: To assess the prevalence of peripheral arterial occlusive disease (PAOD) in human immunodeficiency virus (HIV)-infected Omani patients and to assess the potential risk factors in this group. Methodology: This was a single-center, cross-sectional study. All patients attending the infectious disease clinic between July 2017 and March 2018 were included in the study; their peripheral pulses were examined and pre- and postexercise ankle–brachial pressure index (ABPI) was measured. Normal ABPI was considered as being in the range of 1.0 ± 0.1, and a reduction of >15% postexercise ABPI was considered as a cutoff limit to define PAOD. The Edinburgh Claudication Questionnaire was answered by all patients, and CD4 count, viral load, albumin and Vitamin D (25-OH) levels, and glycated hemoglobin (HbA1c) were measured. The data were analyzed using IBM SPSS Statistics version 22. Results: Eighty-eight patients who were retroviral positive were enrolled in the study. Fifty-three (60.2%) patients were male and 35 (39.8%) were female, with a mean age of 43 years (24–71). The dorsalis pedis artery pulsation was absent bilaterally in 3 (3.4%) patients. None of the patients had a history of claudication; 1 (1.1%) had an abnormal ABPI; 17 (19.2%) had a reduction of >15% postexercise ABPI; 7 (8%) had CD4 count

Background: In December 2018, routine surveillance identified an autochthonous outbreak of dengue fever in Muscat Governorate, Oman, a region previously free of dengue fever. Methods: Routine surveillance confirmed locally acquired cases in the second week of December, leading to a rapid public health response including case management guidance and epidemiological investigations. The main activity was the vector survey using systematic sampling to assess extent of previously unreported Aedes aegypti presence followed by a campaign aimed to eliminate breeding sites of A. aegypti”. Results: During a 5-month period, 343 suspected cases were reported from Muscat Governorate with 122 from the outbreak affected area. Out of 207 probable cases eligible for laboratory testing as per guidelines issued, 59 cases were confirmed. The vector elimination campaign started on January 8, 2019 after a media advocacy using television and social media and concluded on January 23. By the end of campaign, the case load had decreased significantly in the affected area with no reports of locally acquired cases from adjoining areas of Muscat Governorate, indicating no further spread. Conclusions: Rapid notification and early community-wide, extensive vector control activities effectively contained the autochthonous dengue fever virus outbreak. Keywords: Dengue fever, Autochthonous outbreak, Oman, Aedes aegypti, Vector-borne illness, Disease surveillance

Mutant EGFR/BRAF pathways are thought to be crucial targets for the development of anticancer drugs since they are over-activated in several malignancies. We present here the development of a novel series of 5-chloro-indole-2-carboxylate 3a–e, 4a–c and pyrrolo[3,4-b]indol-3-ones 5a–c derivatives as potent inhibitors of mutant EGFR/BRAF pathways with antiproliferative activity. The cell viability assay results of 3a–e, 4a–c, and 5a–c revealed that none of the compounds tested were cytotoxic, and that the majority of those tested at 50 µM had cell viability levels greater than 87%. Compounds 3a–e, 4a–c, and 5a–c had significant antiproliferative activity with GI50 values ranging from 29 nM to 78 nM, with 3a–e outperforming 4a–c and 5a–c in their inhibitory actions against the tested cancer cell lines. Compounds 3a–e were tested for EGFR inhibition, with IC50 values ranging from 68 nM to 89 nM. The most potent derivative was found to be the m-piperidinyl derivative 3e (R = m-piperidin-1-yl), with an IC50 value of 68 nM, which was 1.2-fold more potent than erlotinib (IC50 = 80 nM). Interestingly, all the tested compounds 3a–e had higher anti-BRAFV600E activity than the reference erlotinib but were less potent than vemurafenib, with compound 3e having the most potent activity. Moreover, compounds 3b and 3e showed an 8-fold selectivity index toward EGFRT790M protein over wild-type. Additionally, molecular docking of 3a and 3b against BRAFV600E and EGFRT790M enzymes revealed high binding affinity and active site interactions compared to the co-crystalized ligands. The pharmacokinetics properties (ADME) of 3a–e revealed safety and good pharmacokinetic profile.

Despite the apparent challenges inflicted by COVID-19 globally, the pandemic provided an opportunity to utilize and expand existing public health capacities for a more adaptive and resilient system during and after each wave of the disease. This paper provides a narrative review of Oman's public health response to the COVID-19 pandemic from January 2020 to July 2021, and the challenges it faced for a more rapid and efficient response. The review demonstrates that the three main pillars influencing the direction of the pandemic and aiding the control are Oman's unified governmental leadership, the move to expand the capacity of the health care system at all levels, and community partnership in all stages of the response including the COVID-19 vaccination campaign. The opportunities identified during response stages in the harmonization of the multisectoral response, streamlining communication channels, addressing vulnerable communities (dormitories, residences at border regions), and providing professional technical leadership provide an excellent precursor for expediting the transformation of Oman's health care system to one with a multisectoral holistic approach. Some of the major challenges faced are the shortage of the public health cadre, lack of a fully integrated digital platform for surveillance, and the scarcity of experts in risk communication and community engagement. A future health system where the center for diseases surveillance and control acts as a nucleus for multisectoral expertise and leadership, which includes community representatives, is crucial to attain optimum health. The destruction inflicted by this prolong COVID-19 pandemic at all levels of human life had valued the importance of investing on preventive and preparedness strategies.

Affordable and clean energy for any rural community is crucial for the sustainable development of the community and the nation at large. The utilization of diesel-based power generation is one of the barriers to the sustainable development of these communities. Such generations require fuel that has a volatile market price and emits massive greenhouse gas emissions. This paper presents the design, modeling, and simulation of a hybrid power system for a rural area in the Sultanate of Oman that aims to reduce daily consumption of diesel fuel and greenhouse gas emissions. Hybrid Optimization of Multiple Energy Resources (HOMER) is utilized to model multiple energy mix hybrid systems and to propose the best optimal energy mix system for a selected community. In addition, Electrical Transient Analyzer Program (ETAP) software is employed to assess hybrid system operational performances, such as bus voltage profiles and active and reactive power losses. This study revealed that the PV–wind–diesel system is the optimal energy mix hybrid microgrid for the Al-Dhafrat rural area in Oman, with a net present cost of USD 14.09 million. Compared to the currently operating diesel-based system, the deployment of this microgrid can reduce the levelized cost of energy, diesel fuel consumption, and greenhouse gas emissions per year by 54.56%, 70.44%, and 70.40%, respectively. This study confirms that the Sultanate of Oman has a substantial opportunity to install a hybrid microgrid system for rural diesel-based communities to achieve sustainable development in the country.

Two biologically active adamantane-linked hydrazine-1-carbothioamide derivatives, namely 2-(adamantane-1-carbonyl)-N-(tert-butyl)hydrazine-1-carbothioamide) 1 and 2-(adamantane-1-carbonyl)-N-cyclohexylhydrazine-1-carbothioamide 2, have been synthesized. X-ray analysis was conducted to study the effect of the t-butyl and cyclohexyl moieties on the intermolecular interactions and conformation of the molecules in the solid state. X-ray analysis reveals that compound 1 exhibits folded conformation, whereas compound 2 adopts extended conformation. The Hirshfeld surface analysis indicates that the contributions of the major intercontacts involved in the stabilization of the crystal structures do not change much as a result of the t-butyl and cyclohexyl moieties. However, the presence and absence of these contacts is revealed by the 2D-fingerprint plots. The CLP–Pixel method was used to identify the energetically significant molecular dimers. These dimers are stabilized by different types of intermolecular interactions such as N–H···S, N–H···O, C–H···S, C–H···O, H–H bonding and C–H···π interactions. The strength of these interactions was quantified by using the QTAIM approach. The results suggest that N–H···O interaction is found to be stronger among other interactions. The in vitro assay suggests that both compounds 1 and 2 exhibit urease inhibition potential, and these compounds also display moderate antiproliferative activities. Molecular docking analysis shows the key interaction between urease enzyme and title compounds.