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Bacterial arthritis is an inflammation of the joints caused by an infectious etiology, usually bacterial, but there are also fungi, mycobacteria, viruses, or other rare pathogens. Both healthy and predisposed people can be infected. Nongonococcal infectious arthritis, usually a monoarticular disease, affects multiple joints in about 10% of patients and is a new form of septic arthritis. Without treatment, it can progress rapidly and cause irreversible damage to the joints. The overall incidence of bacterial arthritis is 2 to 6 per 100,000, depending on the presence of risk factors. Bacterial arthritis is more common in children than in adults. The incidence of septic arthritis peaks between the ages of 2 and 3 and is predominantly male (2: 1). Most septic joints develop as a result of hematogenous dissemination of the vascular synovium due to bacterial episodes. Osteoarthritis, rheumatoid arthritis, and corticosteroid therapy are the most common predisposing conditions. Typical symptoms of acute septic arthritis without gonorrhea include recent fever, malaise, and local findings of pain, warmth, swelling, and restricted mobility of the affected joint. Accurate history and assessment of risk factors can provide important clues for diagnosis. Careful assessment of risk factors can significantly change the likelihood of a provider developing septic arthritis prior to testing. Laboratory findings, diagnostic imaging, and synovial fluid assessment are all useful for diagnosis. Management components include early detection and treatment with joint aspiration, antibiotics, and orthopedic advice for possible surgical management. Widespread antibiotics are often needed due to the potential for rapid joint destruction. A combination of cefepime or anti-Pseudomonas aeruginosa beta-lactams and vancomycin is recommended to cover both Gram-negative and MRSA bacteria.

Abstract: The battle against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) associated coronavirus disease 2019 (COVID-19) is continued worldwide by administering firsttime emergency authorized novel mRNA-based and conventional vector-antigen-based antiCOVID-19 vaccines to prevent further transmission of the virus as well as to reduce the severe respiratory complications of the infection in infected individuals. However; the emergence of numerous SARS-CoV-2 variants is of concern, and the identification of certain breakthrough and reinfection cases in vaccinated individuals as well as new cases soaring in some low-to-middle income countries (LMICs) and even in some resource-replete nations have raised concerns that only vaccine jabs would not be sufficient to control and vanquishing the pandemic. Lack of screening for asymptomatic COVID-19-infected subjects and inefficient management of diagnosed COVID-19 infections also pose some concerns and the need to fill the gaps among policies and strategies to reduce the pandemic in hospitals, healthcare services, and the general community. For this purpose, the development and deployment of rapid screening and diagnostic procedures are prerequisites in premises with high infection rates as well as to screen mass unaffected COVID-19 populations. Novel methods of variant identification and genome surveillance studies would be an asset to minimize virus transmission and infection severity. The proposition of this pragmatic review explores current paradigms for the screening of SARS-CoV-2 variants, identification, and diagnosis of COVID-19 infection, and insights into the late-stage development of new methods to better understand virus super spread variants and genome surveillance studies to predict pandemic trajectories.

BackgroundPoisoning occurs when a person is exposed to an external substance at a too high dose for them. It is possible for young children to be exposed to chemicals. Lungs, the heart, CNS, the digestive tract, and kidneys can be poisoned. In 2004, over 45,000 children and teenagers died from acute poisoning, representing 13% of all accidental poisoning deaths worldwide. Poisoning patterns vary by exposure type, age group, poison type, and dose.AimThis study assessed the pattern of acute poisoning with drugs, chemicals, and natural toxins among children (MethodsA retrospective cohort study was done on 122 children exposed to toxic substances in Makkah. The children were 12 years old and had good health for a maximum of one year. Stratified random sampling was used to divide cases into groups of similar poisons (pharmaceutical products, household products, plant envenomation, and animal envenomation). Then each group got a random samples. The data were analysed with SPSS software.ResultsThe mean age of children was 5.2 years, with 59% being boys. The mean temperature, pulse, systolic, diastolic, and respiratory rates were 36.77, 98.29, 109.1, 69.17, and 21.49. The most documented pharmaceutical products (200 mg) were carbamazepine (5 mg), methanol, risperidone (5 mg), propranolol (5 mg), and olanzapine (5 mg). The most common poison forms were tablets (42.6%), syrups (15.6%), capsules (13.9%), and solutions (13.1%). The most common poisoning routes were ingestion (82.8%), dermal (5.7%), injection (4.9%), and inhalation (6.6%). Accidental poisoning was 83%, with a 30-minute lag for 30.3% of children, and most (69.7%) occurred at home. Benzodiazepines were the most commonly used category class drug (18%), with normal pupils and an ECG of 85.2%. Sixty-seven percent had blood tests. Sickness was 9.48, and the positive result was 213.01. The most common presenting symptoms were GIT and neurological (23.8%). 31.1% had mild, moderate, or severe toxicity. Most cases (68%) were complex. 34.4% were intubated, 9.8% had repeated-dose-activated charcoal for enhanced elimination, and 27.8% were on IV fluids. Children with GIT, CVS, respiratory, dermal, and neurological symptoms had a higher percentage of severe toxicity (p P p p > 0.05). The age of the children correlated positively with their systolic BP (r = 0.22, p ConclusionThe results show how important it is to teach the public about poisoning and make rules for tracking and dealing with poisonings in Saudi Arabia.

Shahd E Sharaf,1,2 Safaa Alsanosi,1 Abdullah R Alzahrani,1,2 Saeed S Al-Ghamdi,1,2 Sharaf E Sharaf,2– 4 Nahla Ayoub1,2 1Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; 2Saudi Toxicology Society, Umm Al-Qura University, Makkah, Saudi Arabia; 3Pharmaceutical Chemistry Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia; 4Clinical Research Administration, Executive Administration of Research and Innovation, King Abdullah Medical City in the Holy Capital, Makkah, Saudi ArabiaCorrespondence: Sharaf E SharafPharmaceutical Chemistry Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia, Tel +966532660411Email sesharaf@uqu.edu.saIntroduction: Bee venom acupuncture therapy (BVT) is an alternative therapy used worldwide by patients with different chronic diseases due to its therapeutic effects on conditions such as rheumatoid arthritis (RA). Previous studies have illustrated the clinical effects of BVT on RA, but such a study has yet to be performed in Saudi Arabia (SA). It is important to evaluate BVT awareness among citizens of SA to measure the feasibility of conducting clinical trials of BVT in patients with RA in SA. This study aims to measure the knowledge, attitude, and practice (KAP) of BVT on RA and other chronic diseases in SA. This will help determine whether patients with RA have sufficient knowledge to be enrolled in clinical trials.Patients and Methods: A cross-sectional study of 180 patients with RA in SA was conducted using a KAP questionnaire on BVT. Individuals completed an online questionnaire using the Survey Monkey website. Data were obtained by self-completion of the online KAP questionnaire regarding BVT.Results: A total of 180 patients with RA and other chronic diseases, with a mean age of 45 years (18– 70 years), participated in the study. The results of the questionnaire showed that 55% of the participants demonstrated a good knowledge of BVT treatment; however, they also reported a poor attitude (55%) and practice (55%). Participants with RA demonstrated higher severity of disease (80%) than those with other chronic diseases. Participants with RA showed better KAP responses towards BVT than those with other chronic diseases. Participants with school education only and those who were beekeepers demonstrated significantly better KAP responses (P < 0.05) compared to participants who had received university education and those who were not beekeepers, respectively.Conclusion: Participants with strong RA knowledge may prove that patients from SA can be enrolled in BVT clinical trials. The participants’ poor attitudes and practices may be due to BVT being expensive and unavailable in many cities in SA.Keywords: bee venom acupuncture therapy, rheumatoid arthritis, knowledge, attitude, practice, Saudi Arabia

Autism is complex and multifactorial, and is one of the fastest growing neurodevelopmental disorders. Canagliflozin (Cana) is an antidiabetic drug that exhibits neuroprotective properties in various neurodegenerative syndromes. This study investigated the possible protective effect of Cana against the valproic acid (VPA)-induced model of autism. VPA was injected subcutaneously (SC) into rat pups at a dose of 300 mg/kg, twice daily on postnatal day-2 (PD-2) and PD-3, and once on PD-4 to induce an autism-like syndrome. Graded doses of Cana were administered (5 mg/kg, 7.5 mg/kg, and 10 mg/kg, P.O.) starting from the first day of VPA injections and continued for 21 days. At the end of the experiment, behavioral tests and histopathological alterations were assessed. In addition, the gene expression of peroxisome proliferator-activated receptor γ (PPAR γ), lactate dehydrogenase A (LDHA), pyruvate dehydrogenase kinase (PDK), cellular myeloctomatosis (c-Myc) with protein expression of glucose transporter-1 (GLUT-1), phosphatase and tensin homolog (PTEN), and level of acetylcholine (ACh) were determined. Treatment with Cana significantly counteracted histopathological changes in the cerebellum tissues of the brain induced by VPA. Cana (5 mg/kg, 7.5 mg/kg, and 10 mg/kg) improved sociability and social preference, enhanced stereotypic behaviors, and decreased hyperlocomotion activity, in addition to its significant effect on the canonical Wnt/β-catenin pathway via the downregulation of gene expression of LDHA (22%, 64%, and 73% in cerebellum tissues with 51%, 60%, and 75% in cerebrum tissues), PDK (27%, 50%, and 67% in cerebellum tissues with 34%, 66%, and 77% in cerebrum tissues), c-Myc (35%, 44%, and 72% in cerebellum tissues with 19%, 58%, and 79% in cerebrum tissues), protein expression of GLUT-1 (32%, 48%, and 49% in cerebellum tissues with 30%, 50%, and 54% in cerebrum tissues), and elevating gene expression of PPAR-γ (2, 3, and 4 folds in cerebellum tissues with 1.5, 3, and 9 folds in cerebrum tissues), protein expression of PTEN (2, 5, and 6 folds in cerebellum tissues with 6, 6, and 10 folds in cerebrum tissues), and increasing the ACh levels (4, 5, and 7 folds) in brain tissues. The current study confirmed the ameliorating effect of Cana against neurochemical and behavioral alterations in the VPA-induced model of autism in rats.

Onosma species (Boraginaceae) are well known as medicinal plants due to their wide range of pharmaceutical potential. The present study aims to investigate the anticancer (in vitro) and chemo-protective (in vivo) efficacies of Onosma mutabilis extract (OME) in the azoxymethane (AOM)-induced aberrant crypt foci (ACF) in rats. The in vitro antiproliferative effects of OME were determined on two human tumor cell lines (Caco-2 and HT-29) via MTT assay. The in vivo chemoprotective effects of OME were investigated by performing various biochemical analyses in serum and tissue homogenates of albino rats, along with determining oxidative stress biomarkers. Inflammatory biomarkers of colon, colonic gross morphology (by methylene blue), ACF formation, and colonic histopathology (H & E stain) were determined. The immunohistochemistry of colonic tissues was also assessed by Bax and Bcl-2 protein expression. The results showed that the antitumor activity of OME against Caco-2 and HT-29 colorectal cancer cells ranged between 22.28–36.55 µg/mL. OME supplementation caused a significant drop in the ACF values and improved the immunohistochemistry of the rats shown by up-regulation of Bax and down-regulation of Bcl-2 protein expressions. These outcomes reveal that O. mutabilis may have chemoprotective efficiency against AOM-induced colon cancer represented by the attenuation of ACF formation possibly through inhibition of free radicals, inflammation, and stimulation of the colon antioxidant armory (SOD, CAT, and GPx) and positive regulation of the Nrf2-Keap1 pathway.

Background: Children and adolescents healthy life and healthy diet is parents’ responsibilities. Parents should provide healthy options for their children for healthy life. There is paucity of studies on the role of parents in their children healthy life. This research emerged to investigate parents’ awareness regarding healthy life and diet for children aged 15 years or less in the Kingdom of Saudi Arabia. Methods: A descriptive, correlational cross-sectional design was employed for this study. Since this study aimed to assess parents’ awareness about healthy life and diet for children at a single point of measurement, this is the most appropriate design. Population were parents of children aged 15 years or less in KSA. Study instrument consisted of two domains. First is sociodemographic characteristics of participants. Second is awareness assessment. Results: Study included 450 parents’ interviews. The interview was with father among 79 participants (17.6%) while it was with the mother among 276 (61.3%) participants. Both parents were present in 95 interviews (21.1%). The mean father age was 35.96 + 5.78 years and ranged from 23 to 47 years. On the other hand, the mean mother age was 30.43 + 4.95 and ranged from 23 to 39 years. The most frequent level of education among fathers was school (n= 205, 45.6%) while among mothers was university level (n= 209, 46.4%). Participants had high knowledge regarding the frequency of dairy, fruit, vegetables and cereals and grains food groups and they lack knowledge regarding meat, fish, egg and nuts. Furthermore, most participants had good attitudes toward food groups that should be eaten more and food groups that should be eaten less. There were 11.1% of participants showed high attitude (n= 50). Knowledge and attitude were statistically significant with higher educational level (P= 0.034), rural residency (P Conclusion: Many public health initiatives aim to change how parents think about a certain issue. In this sample, families understood the importance of a balanced diet to their health. Training and professional developing of parents to take a more proactive approach to addressing juvenile obesity would be a wise use of KSA’s ample resources. &nbsp

The goal of this study is to see if there's a link between age, gender, and risk factors including having a smoking parent, allergic rhinitis, skin allergies, food allergies, and a family history of atopy with the diagnosis of childhood asthma. The goal is also to evaluate the prevalence of asthma in the study's pediatric sample, as well as the prevalence of other symptoms and complications in this group. A link was discovered between childhood asthma and age, allergic rhinitis, skin allergies, food allergies, and atopy in the family. In most areas of this investigation, the findings are consistent with earlier studies conducted at various periods and in other places for almost identical aims.

Background: Diabetic ketoacidosis (DKA) is a common emergency and life-threatening illness. Also, if not detected early, early treatment in the emergency room can cause serious complications. The goal of managing type 1 diabetes is to maintain the correct levels of blood sugar, glycated hemoglobin (HbA1c), blood pressure, lipid levels, and body weight while avoiding hypoglycemia. Treatment of type 1 diabetes requires proper insulin treatment, proper nutrition, physical activity, preventive education, and patient self-care Objective: The purpose of this study is to determine parental perceptions of DKA symptoms in children with type 1 diabetes in the Northern Region of Saudi Arabia. Methods: In the Northern Region of Saudi Arabia, a cross-sectional study was conducted from November 2020 to May 2021 among parents with diabetic children at the Diabetes Center in the Northern Region of Saudi Arabia using a pre-designed online questionnaire distributed on social media web-sites to collect data. Data was analyzed by using statistical package for the social sciences (SPSS, version 23) and results was presented by tabular and graphical presentation according to the study objectives. Results: only 42.9% of our participants responded that they have good knowledge about DKA. 19.2% thought it only occurs in children. 43.3% of our participants knew that DKA is a complication of diabetes due to hyperglycemia. Regarding the source of information about DKA among our participants, our data demonstrated that only 22.9% of our participants got their information about DKA from the doctors, and 31.8% of the participants had the internet as their source of information regarding DKA. In the current study, 14% of the participants said that they had a child had DKA at least one, and 91.6% of them were admitted to the hospital. There was a significant relation with gender, age of the parent, and educational level, while it showed insignificant relation with marital status. Conclusion: In conclusion, knowledge of most of parents of diabetic children about diabetic ketoacidosis is poor. Their main knowledge source is not trustful or adequate. Their main knowledge source is not trustful or adequate. Therefore, we recommend policy makers to held health education to parents and/or caregivers of type 1 diabetic children regarding all aspects of DKA. It must be properly achieved in a structured manner based on a general outline that should include education at the onset of treatment and then repeated based upon an annual assessment of patients’ training needs or upon their own request. Areas of poor knowledge related to diabetes and diabetic ketoacidosis should be emphasized during health education sessions.

Acute poststreptococcal glomerulonephritis (APSGN) is the most common kind of post-infectious glomerulonephritis and is caused by group A streptococcus (Streptococcus pyogenes). Although the prevalence of PSGN has decreased in affluent nations, non-streptococcal species are becoming more common. and it is still the major cause of glomerulonephritis in children. APSGN can manifest itself in epidemic outbreaks or clusters of instances, as well as in single persons. Epidemic outbreaks have previously been documented as a result of upper respiratory or cutaneous streptococcal infections in various parts of the world. In developed nations, APSGN is now mostly a disease of the elderly, who are more likely to have disabling illnesses such as cancer, alcoholism, or diabetes. Children between the ages of 3 and 12 (with a peak incidence between the ages of 5 and 6 years) and seniors over the age of 60 are the most commonly affected. The pathophysiology of APSGN is complicated by inflammation. (APSGN) often occurs one to two weeks after a throat infection and three to five weeks after a skin infection. Hematuria, edoema, azotemia, and hypertension are the most common clinical signs. Loop or thiazide diuretics, are the most effective therapy for hypertension and edoema in PSGN. In this review we’ll be looking at the disease causes, epidemiology, presentation and treatment.

We created thiazole and oxazole analogues of diaminopimelic acid (DAP) by replacing its carboxyl groups and substituting sulphur for the central carbon atom. Toxicity, ADME, molecular docking, and in vitro antimicrobial studies of the synthesized compounds were carried out. These compounds displayed significant antibacterial efficacy, with MICs of 70–80 µg/mL against all tested bacteria. Comparative values of the MIC, MBC, and ZOI of the synthesized compound were noticed when compared with ciprofloxacin. At 200 µg/mL, thio-DAP (1) had a ZOI of 22.67 ± 0.58, while ciprofloxacin had a ZOI of 23.67 ± 0.58. To synthesize thio-DAP (1) and oxa-DAP (2), l-cysteine was used as a precursor for the L-stereocenter (l-cysteine), which is recognized by the dapF enzyme’s active site and selectively binds to the ligand’s L-stereocenter. Docking studies of these compounds were carried out using the programme version 11.5 Schrodinger to reveal the hydrophobic and hydrophilic properties of these complexes. The docking scores of compounds one and two were −9.823 and −10.098 kcal/mol, respectively, as compared with LL-DAP (−9.426 kcal/mol.). This suggests that compounds one and two interact more precisely with dapF than LL-DAP. Chemicals one and two were synthesized via the SBDD (structure-based drug design) approach and these act as inhibitors of the dapF in the lysine pathway of bacterial cell wall synthesis.

Salvadora persica L. (S. persica, Siwak) is an ethnic plant that is widely used for improving oral hygiene. This study aimed to provide a phytochemical profiling of S. persica ethyl acetate fraction (SPEAF) and to evaluate the healing activity of a muco-adhesive formula of the fraction against acetic acid-induced oral ulcers in rats. HPLC-ESI-QTOF-MS-MS analysis of SPEAF resulted in the tentative identification of 56 metabolites containing fatty acids (23%), urea derivatives (10.5%) and sulphur compounds (10%), in addition to several amides, polyphenols and organic acids (6.5%, 5% and 2%, respectively). For the first time, 19 compounds were identified from S. persica. In vitro and in vivo experiments indicated that the extract is non-toxic. SPEAF exhibited superior healing activities compared to both the negative and positive control groups on days 7 and 14 of tongue ulcer induction. This was confirmed by histopathological examinations of haematoxylin and eosin-stained (H&E) and Masson’s trichrome-stained tongue sections. Moreover, SPEAF showed potent anti-inflammatory activities, as evidenced by the inhibited expression of interleukin-6 (IL-6) and tumour necrosis alpha (TNF-α). Moreover, SPEAF exhibited potent antioxidant activity, as it prevented malondialdehyde (MDA) accumulation, reduced glutathione (GSH) depletion and superoxide dismutase (SOD) exhaustion. SPEAF significantly enhanced hydroxyproline tongue content and upregulated collagen type I alpha 1 (Col1A1) mRNA expression. SPEAF also improved angiogenesis, as shown by the increased mRNA expression of the angiopoietin-1 (Ang-1). In conclusion, S. persica has a wide range of secondary metabolites and ameliorates acetic acid-induced tongue ulcers in rats. This can be attributed, at least partly, to its anti-inflammatory, antioxidant, procollagen and angiogenic activities. These findings provide support and validity for the use of S. persica as a traditional and conventional treatment for oral disorders.

The short non-coding microRNAs (miRNAs) have emerged as reliable modulators of various pathological conditions including autoimmune diseases in mammals. The current study, aims to identify new potential differential expressed miRNAs and their downstream mRNA targets of the autoimmune disease, Multiple sclerosis (MS). The study identifies a new set of miRNA(s) that are probably implicated in MS using computational tools. The study further carried-out different in vivo and in vitro experiments to check these identified miRNAs could be role in as therapeutic and prognostic applications. Preliminary insilico screening revealed that miR-659-3p, miR-659-5p, miR-684, miR-3607-3p, miR-3607-5p, miR-3682-3p, miR-3682-5p miR-4647, miR-7188-3p, miR-7188-5p and miR-7235 are specifically elevated in the secondary lymphoid cells of EAE mice. In addition, expression of the downstream target mRNA of these miRNAs such as FXBO33, SGMS-1, ZDHHC-9, GABRA-3, NRXN-2 were reciprocal to miRNA expression in lymphoid cells. These confirmed by applying the mimic and silencing miRNA models, suggesting new inflammatory target genes of these promising miRNA markers. The in vivo adoptive transfer model revealed that the suppression of miRNA-7188-5p and miR-7235 changed the pattern of astrocytes and CNS pathophysiology. The current study opens a new miRNA and their mRNA targets in MS disease. The absence of miRNA-7188-5p and miR-7235 enhanced the disease alleviation, confirms the regulatory effect of these targets. These optimized results highlights new set of miRNA’s with therapeutic potential in experimental MS. Further studies are required to confirm these miRNA as therapeutic biomarker.

An effective green one-pot and catalyst-free synthesis of a series of novel 5-(thiophene-2-carbonyl)-6-(trifluoromethyl)pyrano[2,3-c]pyrazoles and 6-(thiophene-2-carbonyl)-7-(trifluoromethyl)pyrano...

AMP-activated protein kinase (AMPK) signaling shows an important role in energy metabolism and has recently been involved in osteogenic and adipogenic differentiation. In this study we aimed to investigate the role of AMPK activator, A-769662, in regulating the differentiation of mesenchymal stem cells derived from bone marrow (BMSCs) into osteoblastic and adipocytic cell lineage. The effect of A-769662 on osteogenesis was assessed by quantitative alkaline phosphatase (ALP) activity, matrix mineralization stained with Alizarin red, and gene expression analysis by quantitative polymerase chain reaction (qPCR). Adipogenesis was determined by Oil Red O staining for fat droplets and qPCR analysis of adipogenic markers. A-769662 activated the phosphorylation of AMPKα1 during the osteogenesis of mBMSCs as revealed by western blot analysis. A-769662 promoted the early stage of the commitment of mouse (m) BMSCs differentiation into osteoblasts, while inhibiting their differentiation into adipocytes in a dose-dependent manner. The effects of A-769662 on stimulating osteogenesis and inhibiting adipogenesis of mBMSCs were significantly eliminated in the presence of either AMPKα1 siRNA or Compound C, an inhibitor of AMPK pathway. In conclusion, we identified A-769662 as a new compound that promotes the commitment of BMSCs into osteoblasts versus adipocytes via AMPK-dependent mechanism. Thus our data show A-769662 as a potential osteo-anabolic drug for treatment of osteoporosis.

Grade III and IV obese patients had higher levels of depression than grade II obese patients, lower self-esteem, and lower quality of life. Thus, an important but often overlooked outcome is the assessment of the impact of surgery on mental health. This is an important outcome measure because it can contribute to a patient's concept of overall well-being. Although British Columbia has an edge in managing obesity, psychosocial and behavioral factors can influence postoperative outcomes. According to some authors, mental illness severe enough to require treatment may be a negative predictor of surgical outcome. This review reviews the literature on the impact of liposuction surgery on the psychological functioning of patients with obesity. Most studies have shown that people with obesity, especially those requiring surgery, report significantly worse quality of life. This may be due to impaired physical and psychosocial functioning, discrimination and psychiatric consequences, or it may be due to overweight and associated morbidity. Finally, most research and clinical experience shows that people with obesity who seek surgical treatment for obesity are more likely to have psychological problems, abnormal eating behaviors, and quality of life. Life declines more than the average person, but bariatric surgery can help improve your mental state. Patients, improve the patient's quality of life.

This study aimed to examine the antidepressant properties of apigenin in an experimental mouse model of chronic mild stress (CMS). Three weeks following CMS, albino mice of either sex were tested for their antidepressant effects using the tail suspension test (TST) and the sucrose preference test. The percentage preference for sucrose solution and the amount of time spent immobile in the TST were calculated. The brain malondialdehyde (MDA) levels, catalase activity, and reduced glutathione levels were checked to determine the antioxidant potential of treatments. When compared to the control, animals treated with apigenin during the CMS periods showed significantly shorter TST immobility times. Apigenin administration raised the percentage preference for sucrose solution in a dose-dependent manner, which put it on par with the widely used antidepressant imipramine. Animals treated with apigenin displayed a significantly (p ˂ 0.05) greater spontaneous locomotor count (281) when compared to the vehicle-treated group (245). Apigenin was also highly effective in significantly (p ˂ 0.01) lowering plasma corticosterone levels (17 vs. 28 µg/mL) and nitrite (19 vs. 33 µg/mL) produced by CMS in comparison to the control group. During CMS, a high dose (50 mg/kg) of apigenin was given, which greatly increased the reduced glutathione level while significantly decreasing the brain’s MDA and catalase activity when compared to the control group. As a result, we infer that high doses of apigenin may have potential antidepressant effects in animal models via various mechanisms.

Introduction Most computerized physician order entry (CPOE) software come with clinical decision-support components (CDS) that provide prescribers assistance and notify them about adverse drug reactions. An excessive number of alerts in a repeated and non-relevant manner leads to alert fatigue and enforces physicians and pharmacists to alert overrides. King Abdulaziz Medical City (KAMC) in Jeddah still reports a higher percentage of drug alerts overridden by clinicians and pharmacists. Thus, this study was conducted to evaluate CDS alerts overriding and to determine which alerts are clinically irrelevant and need modifications. Methods The study was carried out in the inpatient setting at KAMC in Jeddah, from September 1, 2020, to December 31, 2020. It was designed as a retrospective chart review study that included all red alerts that required comments and were overridden by a physician and pharmacist. Results Among 11350 red alerts, potential drug-drug interaction (pDDI), dose, and allergy alerts represent 57%, 41%, and 2%, respectively, of the total alerts. The most common drug-drug interactions (DDIs) in category X were proton pump inhibitors and clopidogrel (9.9%). The appropriate response by prescribers and pharmacists toward allergy alerts was associated with the highest odds compared with the other alerts (p0.05) while there is a significant decrease in the odds of appropriate action being taken by both prescribers and pharmacists in the dose screen alerts (p0.05). Among all clinical specialties, there is an increased odds of appropriate action being taken by residents and fellows for allergy and dose alerts, respectively, compared to other groups (p0.05). For diminishing the unnecessary alerts, we provided 14 alert refinements strategies and advised turning off four alerts. Applying this will terminate 32% of irrelevant alerts. Conclusion Our study's findings indicated that a substantial number of alerts are ignored, and the rate of appropriateness varies significantly by alert type and prescriber level.

The present work focuses on a numerical investigation of nanofilms’ (water/copper and water/aluminium) evaporation inside a heat exchanger by mixed convection flowing down on one channel plate. The channel was composed of two parallel vertical plates. The wetted plate was heated while the other plate was maintained isothermal and dry. The impact of the dispersion of different types of nanoparticles in the liquid film and their volume fraction in mass and heat exchange and the evaporation process has been analysed in this work. The results show that an increase of the nanoparticle inlet volume fraction enhances the efficiency of evaporation in heat exchangers. It is shown that an enhancement of 22% in evaporation rate has been recorded when the inlet nanoparticle volume fraction is elevated by 5%. The results show that the water–copper nanofluid had higher evaporation rate compared to water–aluminium nanofluid.

Papaver decaisnei (P. decaisnei) has been used as folkloric medicine for many health issues including gastric problems. The current study investigates the gastroprotective roles of P. decaisnei against ethanol-induced ulcers in rodents. Sprague Dawley rats (30) were separated into five groups: the normal group (G1) and the ulcer control group (G2) were orally administered 0.5% carboxymethylcellulose (CMC); the reference group (G3) was administered 20 mg/kg of Omeprazole; two experimental groups were fed with 200 mg/kg (G4) and 400 mg/kg (G5) of the P. decaisnei extract (PDE), respectively. Next, the rats were given absolute ethanol and sacrificed for the analysis of the gastric mucosal injury through microscopic, enzymatic, histologic, and immunohistochemistry assays. The ulcer controls showed significant superficial hemorrhagic gastric mucosal lesions, with a decreased gastric wall mucus and edema production, whereas fewer were found for the reference and plant-treated rats. Furthermore, the PDE pre-treated rats had a significantly reduced the periodic acid-Schiff (PAS) staining intensity, produced the upregulation of the HSP70 protein, and the downregulation of the Bax protein expressions in the stomach epithelium. P. decaisnei displayed a significant role in the upregulation of endogenous antioxidant enzymes (SOD, CAT, and PGE2), significantly reduced malondialdehyde (MDA), TNF-a, IL-6, and upraised the IL-10 levels. Based on the positive impacts, the PDE can be proposed as the protective/treatment agent against gastric ulcers and stomach lesions.

Vancomycin administration in individuals with hematological malignancy or neutropenia is associated with a suboptimal trough concentration. Nonetheless, most studies did not distinguish whether low vancomycin trough concentrations were due to hematological malignancies or neutropenia. This study aimed to determine the association between types of hematological malignancy and febrile neutropenia with low vancomycin concentrations.The present retrospective chart review study was conducted by using clinical data adopted from computerized physician order entries (BestCare®) for all of the patients who received intravenous vancomycin treatment between January 2017 and December 2020 at King Abdulaziz Medical City in Jeddah.Out of the 296 patients, 217 were included. There was no significant association between the type of hematological malignancy and the incidence of a low trough concentration (p0.05), while a significant association between febrile neutropenia and the incidence of a low trough concentration was observed (p0.05). Furthermore, the predictors for a low trough among febrile neutropenic patients were creatinine clearance (CrCI) and a low albumin concentration. In addition, there was a significant association between febrile neutropenia and augmented renal clearance (p0.05).The findings of this study conclude that febrile neutropenia is associated with low vancomycin concentrations. Interestingly, augmented renal clearance was observed in most of the febrile neutropenia patients with a significant association, which is considered the main driver for a low trough in neutropenic patients.

This study aimed to determine the pattern of alcohol consumption and its poisoning among the Saudi population in the city of Hail, KSA. Data from a retrospective cohort were collected qualitatively at King Khalid Hospital (KKH) and Hail General Hospital (HGH), covering 550 participants from 2015 to 2022. Two groups were formed comprising patients admitted to the emergency room (ER) and community members; their ages ranged from 19 to 75 years. Group 1 contained 400 participants, of which 250 were patients (244 males, six females) who came to the (ER) with a suspected alcohol overdose or poisoning, and 150 were patients (128 males and 22 females) who were discharged from the (ER) with minimal complaints because of their drinking. Group 2 comprised 150 participants (128 males, 22 females) who were community members, who were surveyed using a questionnaire or interview. In Group 1, 30% of patients reported an altered state of consciousness as a major complaint, 28.8% of patients exhibited abnormal liver function tests (LFTs), 27% had abnormal renal function tests (RFT) with decreased glomerular filtration rates (GFR) and elevated levels of urea and creatinine or low levels of electrolytes or calcium, and 35.6% patients showed elevated levels of pancreatic enzymes. One death was reported due to high alcohol consumption. In Group 2, the community participants reported that they started drinking alcohol due to the influence of other people (29%), stress (11%), depression (10.8%), curiosity (4.4%), and boredom (4%). In addition, 77% of participants were frequent alcohol drinkers and 20% consumed it daily. Further, 68.7% claimed to drink alcohol for more than one hour at a time, while 83.3% experienced blackouts and 70% had problems related to their liver. Moreover, 72.7% of the participants ended up in the hospital and 34.6% suffered from multiple chronic diseases. It is concluded that social influences and stress contributed to the initiation of alcohol use. Despite data gaps, the findings of this study provide a practical understanding of alcohol consumption among the Saudi population and guidance for policymakers.

Virtual phone clinics were adopted at King Abdulaziz Medical City, Jeddah, Saudi Arabia, as an alternative to in-person routine outpatient visits amid the COVID-19 pandemic. This study aimed to assess primary caregiver perceptions of the virtual phone clinics towards routine care of pediatric patients with type 1 diabetes mellitus (T1DM).A cross-sectional research design was employed through a web-based research tool where the primary caregivers of pediatric patients with T1DM participated. Data were analyzed descriptively and statistically using independent t-tests and one-way analysis of variance.In total, 214 participants were included in this study. The average primary caregiver perception value towards virtual phone clinics was 66.71 ± 23.1%, which suggested a satisfactory perception of their experience. Statistically significant differences (This study revealed a generally acceptable primary caregiver perception regarding virtual clinics. Telemedicine is recommended for routine treatment alongside regular in-clinic appointments to improve the quality of care for pediatric patients with T1DM.

Background: Alopecia areata (AA) is an autoimmune disease that causes non-scarring hair loss. Significant epidemiological differences among the population observed throughout the investigation in the literature. The Kingdom of Saudi Arabia (KSA ) was found to have a greater burden of disease than other countries, but the information is lacking in Al Baha region, the southwestern area of KSA . Aim: The aim of the present study was to determine the clinico-epidemiological profile and burden of AA in the Al Baha region and to subsequently highlight the factors affecting disease prevalence. Methodology: A well-structured quantitative questionnaire was developed and distributed using an online standardized questionnaire targeting 385 Albaha patients diagnosed with AA. The diagnosis of AA was confirmed clinically by consultant dermatology before patient recruitment into the study and resulted in sufficient accuracy. The responses were collected and analyzed using SPSS statistical analysis software. The frequency of disease prevalence, patients’ ages, disease duration, impact on quality of life, risk factors, and associated diseases were analyzed. Results: A total of 385 AA patients completed the questionnaire to achieve 100% response accuracy. Most of them were located in Al-Baha center (36.1%) followed by Baljurashi city (17.1%). The most frequent age of AA diagnosis was 21–30 years old (41.3%), and the disease duration was 3–6 months in the majority of the patients (26.8%). The most common type is patchy scalp AA in 57.1% of the patients followed by AA involving more than one site (24.4%). Diabetes mellitus and chronic anemia were the associated diseases 10.9% (for both) followed by thyroid diseases in 5.2% of the patients. Conclusion: Overall, AA as a disease presents a significant concern for the population of Al-Baha region in Saudi Arabia considering the variable prevalence in different cities, especially in Al-Baha center itself. Onset occurs during adult working ages. Therefore, quality of life can be negatively affected, and outcomes can be severe. This study potentially adds more knowledge and theoretical understanding of AA clinico-epidemiology in our region. Keywords: hair loss, Al-Baha, Saudi Arabia, Epidemiology

New series of thiazole derivatives were synthesized using 5-(aryldiazo)salicylaldehyde thiosemicarbazones 2a–i. Cyclocondensation of thiosemicarbazones 2a–i with chloroacetone afforded the correspo...

ObjectivesSpirulina platensis (SP) is an edible Cyanobacterium with ethnomedicinal significance. This study aims at evaluating the beneficial effect of SP against carbon tetrachloride (CCl4)-induced liver toxicity in male rats.MethodsRats received intraperitoneal injections of CCl4 (2 ml/kg body weight [b.w.] per every other day) for 40 days, alone or in combination with oral treatments of SP (400 mg/kg b.w. per day).Key findingsSP attenuated haematological disturbances, serum liver markers, hepatic necrosis and inflammation, and dyslipidemia in CCl4-intoxicated rats. SP also reduced CCl4-induced oxidative stress by increasing the activities of antioxidant enzymes, such as glutathione peroxidase, superoxide dismutase and catalase and glutathione content, and inhibiting lipid peroxidation products and nitric oxide levels in the rat liver. Further investigations revealed that SP counteracted CCl4-induced increased hepatic levels of Ki-67 (a parameter of cell proliferation), interleukin-6, and tumour necrosis factor-alpha and cyclooxygenase-2 messenger RNA expression. Noticeably, the supplementation of SP restored the decrease of proapoptotic p53 protein levels in the liver of rats treated with CCl4.ConclusionsSP prevented liver damage in CCl4-treated rats via augmentation of antioxidant defense mechanisms and inhibition of inflammatory cytokines/mediators and antiproliferative effects.

New series of diazenylschiff’s bases of salicylaldehydes were synthesized. The new diazenylschiff’s bases were synthesized by condensation reaction of 5-(3-bromophenyldiazo)salicylaldehyde with var...

Levothyroxine is a synthetic T4 hormone that is biochemically and physiologically identical to the natural hormone, and it is used when the body is deficient in the natural hormone. This study was conducted to summarize the current evidence that compare evidence supporting morning dose to evening dose of levothyroxine in patients with hypothyroidism‎. A simple systematic review was carried out, searching databases PubMed, Google Scholar, and EBSCO. The authors extracted the needed data. There is conflicting data regarding effectiveness of morning dose versus evening dose in management of levothyroxine. More studies reported effectiveness of bedtime dose more than breakfast dose in hypothyroidism management. Numerous studies reported effectiveness of bedtime dose more than breakfast dose in hypothyroidism management. The most resent evidences recommended that, if possible, L‐T4 be consistently taken either 60 minutes before breakfast or at bedtime (3 or more hours after the evening meal), for optimal, consistent absorption.