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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.