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HIF-1α is a key factor promoting the development of hepatocellular carcinoma (HCC). As well, AKT-AMPKα-mTOR signaling is a promising target for cancer therapy. Yet, the AKT-AMPKα-mTOR-dependent activation of HIF-1α has not been studied in livers with HCC. In addition, the mechanisms underlying the potential antineoplastic effects of sitagliptin (STGPT), an antidiabetic agent, have not yet been elucidated. For that purpose, the N-nitrosodiethylamine (NDEA)-induced HCC mouse model was used in the present study using a dose of 100 mg/kg/week, i.p., for 8 weeks. NDEA-induced HCC mice received STGPT 20, 40, or 80 mg/kg starting on day 61 up to day 120. The present study revealed that STGPT inhibited HIF-1α activation via the interference with the AKT-AMPKα-mTOR axis and the interruption of IKKβ, P38α, and ERK1/2 signals as well. Accordingly, STGPT prolonged the survival, restored the histological features and improved liver function. Additionally, STGPT inhibited angiogenesis, as revealed by a significant downregulation in the VEGF and mRNA expression of CD309 with concomitant inhibition of tissue invasion was evident by an increased ratio of TIMP-1/MMP-2. STGPT exhibited apoptotic stimulatory effect as indicated upon calculating the BCL-2/Bax ratio and by the gene expression of p53. The decrease in AFP and liver index calculation, gene expression of Ki-67 confirmed the antiproliferative activity of STGPT. The anti-inflammatory potential was revealed by the decreased TNF-α level and the downregulation of MCP-1 gene expression. Moreover, an antifibrotic potential was supported by lower levels of TGF-β. These effects appear to be GLP1R-independent. The present study provides a potential basis for repurposing STGPT for the inhibition of HCC progression. Since STGPT is unlikely to cause hypoglycemia, it may be promising as monotherapy or adjuvant therapy to treat diabetic or even normoglycemic patients with HCC., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Abd El-Fattah, Saber, Youssef, Eissa, El-Ahwany, Amin, Alqarni, Batiha, Obaidullah, Kaddah, Ahmed Gaafar, Mourad, Mostafa-Hedeab and Abdelhamid.)

Text Classification problem has been thoroughly studied in information retrieval problems and data mining tasks. It is beneficial in multiple tasks including medical diagnose health and care department, targeted marketing, entertainment industry, and group filtering processes. A recent innovation in both data mining and natural language processing gained the attention of researchers from all over the world to develop automated systems for text classification. NLP allows categorizing documents containing different texts. A huge amount of data is generated on social media sites through social media users. Three datasets have been used for experimental purposes including the COVID-19 fake news dataset, COVID-19 English tweet dataset, and extremist-non-extremist dataset which contain news blogs, posts, and tweets related to coronavirus and hate speech. Transfer learning approaches do not experiment on COVID-19 fake news and extremist-non-extremist datasets. Therefore, the proposed work applied transfer learning classification models on both these datasets to check the performance of transfer learning models. Models are trained and evaluated on the accuracy, precision, recall, and F1-score. Heat maps are also generated for every model. In the end, future directions are proposed., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Rukhma Qasim et al.)

Hypertension (HTN) is a chronic disease that affects more than 972 million people throughout the world, which is usually associated with endothelial dysfunction. Scientists are closely investigating endothelial dysfunction and have recently discovered the endothelium-derived relaxing factor (EDRF) known as NO (nitric oxide), which is derived from a semi-essential amino acid, L-arginine, by the action of endothelial nitric oxide synthase (eNOS). Production of adequate amounts of NO by vascular endothelial cells is essential to maintain normal blood pressure and prevent the development of HTN. Asymmetrical dimethylarginine (ADMA) is an endogenous NOS inhibitor that is increased in those with HTN especially in patients with renal dysfunction. In the present review, the role of L-arginine, arginine transporters, and ADMA in the pathobiology of HTN and their potential clinical significance are discussed., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Abukhodair et al.)

Background: Sterculia tragacantha is a medicinal plant commonly used in the western part of Nigeria, for managing diabetes mellitus. However, there is a dearth of scientific information on the antidiabetic and neuroprotective properties of the plant., Methods: The in silico, in vitro and in vivo models were used to evaluate the antioxidants, antidiabetic, anti-inflammatory and neuroprotective potential of aqueous extract of Sterculia tragacantha leaf (AESTL) in streptozotocin (STZ)-induced diabetic rats. Thirty (30) male albino rats (155.34±6.33 g) were intraperitoneal injected with 40 mg/kg of freshly prepared streptozotocin and were divided into 5 groups (A-E) of 6 animals each. Groups A-D were treated with 0, 150 and 300 mg/kg of AESTL, and 200 mg/kg body weight of metformin respectively, while group E serve as the normal control., Results: The results of in vitro analysis revealed dose-dependent antioxidant activities; ABTS (IC 50 = 63.03±2.57 μg/mL), DPPH (117.49±2.35 μg/mL), FRAP (15.19±0.98 mmol/100g), TAC (43.38±0.96 mg/100g), hypoglycaemic effect; α-amylase (IC 50 = 77.21±4.35 μg/mL) and α-glucosidase (IC 50 = 443.25±12.35), and anti-cholinesterase; AChE (IC 50 = 113.07±3.42 μg/mL) and BChE (IC 50 = 87.50±4.32 μg/mL) activities of AESTL. In vivo study revealed dose-dependent hypoglycemic effect and body weight improvement in rats treated with the AESTL. In addition, AESTL improved the antioxidant status and attenuated STZ-induced dysregulations of Na + -K + -ATPase, cholinesterases and neurotransmitters in the brain tissue of experimental rats. The results also demonstrated that AESTL could regulate anti-inflammatory response via inhibition of COX-2/NO signaling axis in the brain of diabetic rats. Molecular docking analysis revealed that epicatechin and procyanidin B2, the bioactive compounds from AESTL, docked well to the binding cavities of acetylcholinesterase, butyrylcholinesterase, α-amylase and α-glucosidase with binding affinities ranges between -8.0 and -11.4 kcal/mol, suggesting that these compounds are the bioactive component that could be responsible for the antidiabetic and neuroprotective activities of AESTL., Conclusion: The results of the present study strongly suggested that the AESTL extract could be very useful for halting diabetes progression and its associated neuroinflammation complications., Competing Interests: The authors declare no conflicts of interest for this work., (© 2021 Onikanni et al.)

Introduction:  The 2020 world pandemic caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was initially reported in December 2019 in Wuhan, China, which has since then spread globally. Several studies on patients with coronavirus disease 2019 (COVID-19) describe a high risk of pulmonary embolism (PE). The majority of PEs in patients with COVID-19 were in the segmental arteries. Therefore, this study aims to determine the rate of PE in patients with COVID-19 at King Abdulaziz Medical City in Jeddah, Saudi Arabia. Other risk factors of PE were taken into consideration., Patients and Methods:  This study is a single-center, retrospective, cross-sectional study that used a non-probability consecutive sampling technique to select the patients. The local institutional review boards approved the study protocol. Overall, 91 consecutive patients who were older than 18 years of age and who had a computerized tomography (CT) pulmonary angiography were included in this study., Results:  Ninety-one patients met the inclusion and exclusion criteria, of whom 46 (50.5%) were females and 45 (49.5%) were males. The study population's age ranged from 19 to 87 with a mean age of 59 ± 15 years. PE was documented in 11 patients (12.1%). Seventy-three patients underwent CT scan angiography during COVID-19 manifestation, while 18 patients had it after recovering from COVID-19. Out of the 11 patients with PE, eight were diagnosed with PE while being COVID-19 positive, and three were diagnosed with PE after recovery from COVID-19., Conclusion: Several potential clinical implications can be concluded for this study. Firstly, effective evaluation of the risk of PE in patients with COVID-19 is based on clinical findings such as chest pain, hemoptysis, lower limb edema, and, most significantly, shortness of breath. Secondly, measuring D-dimer remains an effective test for ruling out PE in patients with COVID-19 as in patients without COVID-19., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bukhari et al.)

Background:  Leukemia is a neoplastic disorder that affects blood and bone marrow and is characterized by white blood cells' abnormal proliferation. Leukemia patients may present with different ophthalmic manifestations. This study aims to provide an updated data about the prevalence and types of ocular manifestations in acute leukemia patients and their relation with the hematological parameters., Methods:  This retrospective cross-sectional study included all acute leukemia patients diagnosed from 2015 to 2020 and underwent an ophthalmic examination during this period at King Abdulaziz Medical City in Jeddah., Results: Eighty-one patients met the inclusion and exclusion criteria and had ophthalmic examinations. Forty-three (53.1%) patients were males, and 38 (46.9%) patients were females. Acute lymphocytic leukemia (ALL) was diagnosed in 55 (67.9%) patients, while acute myelogenous leukemia (AML) was diagnosed only in 26 (32.1%). Ophthalmic manifestations were observed in 23 patients with a prevalence of 28.4%. AML patients had more manifestations with a rate of 38.5%. ALL had a rate of 23.6% (p=0.1). Retinal hemorrhage was the most commonly seen manifestation in six patients., Conclusion:  Ophthalmic manifestations are not uncommon in acute leukemia patients. Low hemoglobin and RBC could give an idea about the type of ophthalmic manifestation, not the presence or absence. It is highly recommended to examine acute leukemia patients routinely prior, during, and after the treatment to prevent serious ocular damage and monitor the course of the disease., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bukhari et al.)

Several COVID-19 vaccines have been developed in unprecedented time by research centers and pharmaceutical companies. This study aimed to determine COVID-19 vaccine acceptance and hesitancy rates and investigated the factors that influence vaccine acceptance and hesitancy. A cross-sectional research was conducted among adults in Saudi Arabia between January and March 2021 to determine willingness to receive a COVID-19 vaccine. A self-administered questionnaire was designed to explore the participants' COVID-19 vaccine acceptance and hesitancy. Categorical variables are described by frequency and percentage. A cross-tabulation analysis using the chi-squared test was performed to find associations between sociodemographic characteristics and vaccine acceptance and hesitancy. Logistic regression analysis was performed for variables that were found to be significant by the chi-squared test. A descriptive analysis of the 531 participants showed that 61.8% were willing to get the COVID-19 vaccine, while 38.2% were not. COVID-19 vaccine hesitancy was higher among women (44.9%), those 34-49 years of age (47.9%), those who were married (41.9%), employed (39.7%), had lower educational attainment (40%), and urban dwellers (40.8%). The main reason for COVID-19 vaccine acceptance was to protect oneself and others, while concerns about vaccine safety were the main reason for vaccine hesitancy. Statically significant associations were found between vaccine acceptance and age ( p = .002) and gender ( p = .03). Our study revealed a high prevalence of COVID-19 vaccine hesitancy (38.2%). Several sociodemographic characteristics were related to hesitancy, which may hinder the promotion of vaccine uptake. Public health campaigns is recommended to promote COVID-19 vaccine uptake.

Background Invasive coronary angiography (ICA) is the gold standard procedure for the diagnosis of coronary artery disease (CAD). ICA allows for clear visualization of the coronary arterial blood flow. Single-photon emission computed tomography (SPECT) is currently in widespread use to non-invasively evaluate patients known or suspected of coronary artery disease (CAD). This study aimed to examine the association between (SPECT) stress test and elective ICA in terms of diagnostic value in patients suspected of coronary artery disease at the King Faisal Cardiac Center (KFCC), Jeddah, Saudi Arabia. Methods This study is a retrospective diagnostic validation study using a consecutive sampling technique to select the study sample at KFCC. The study included all patients who presented with chest pain that were investigated with either exercise or pharmacologic myocardial perfusion SPECT study followed by elective ICA within six months from January 2015 to January 2020. Results A total of 207 patients met the inclusion criteria, where 43% (n = 90) of patients were females and 57% (n = 117) were males; 68% (n = 141) of the patients had both test results concordant (both SPECT and ICA results were in agreement). In 32% of the patients (n = 66), there was a discordant result (discrepant result between SPECT and ICA). SPECT had a sensitivity of 92.4% and a specificity of 26.3%. SPECT had a negative predictive value of 0.68 and a positive predictive value of 0.66 compared to ICA. There was a low degree of reliability between SPECT and ICA. Conclusion Reliability between the SPECT and ICA in exclusion of significant CAD is high. The rate of false-positive tests was high while the accuracy of SPECT in detecting CAD in patients with diabetes and hypertension was high. The overall reliability of SPECT to ICA in the Saudi population was low., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Alqarni et al.)

Background: Medical research is a systematic method to obtain new knowledge, reduce diagnosis problems, discover the latest or best treatment for a disease, and also used for disease prevention. Objective: The study aims to assess the challenges and barriers to conduct medical research among medical and dentistry students and determine the reasons that hinder the conduct of the study. Methods: In this cross-sectional study, the research population consisted of medical and dental students affiliated with King Khalid University in Saudi Arabia in 2020. The study followed a descriptive approach based on quantitative analysis. The Statistical Package of the Social Sciences (SPSS) program (V. 16.0, SPSS Inc., Chicago, IL, USA) was used for data analysis. Results: A total of 327 students participated in this study, and the response rate was 100%. Among them, 61.5% were females. In this study majority (63.3%) had a moderate attitude toward conducting medical research and the average was 56.17. The majority (53.8%) had a reasonable behavior toward conducting medical research, and the average was 29.06. Lack of time, skills, funding, facilities, and limited access to medical journals and related databases were the significant barriers found. Most of the students had positive attitudes, except that they are not awarded on their research, do not attend the sessions, and do not speak their thoughts. A significant relationship between demographic characteristics (age, level, and Grade Percentage Average), attitudes & perceived barriers toward research was found (<0.05). Conclusion: The majority of the students demonstrated a positive attitude toward and moderate behavior of research. However, most are not awarded on their research, do not attend the sessions, and do not speak their thoughts. Intensive training and adequate support in research activities of medical and dental students at the undergraduate level may help reduce these challenges and barriers toward research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer AM declared a shared affiliation, though no other collaboration, with several of the authors to the handling editor., (Copyright © 2021 Alsaleem, Alkhairi, Alzahrani, Alwadai, Alqahtani, Alaseri, Alqarni, Assiri, Alsaleem and Mahmood.)

Introduction: Cardiac surgery is associated with significant morbidity and longer length-of-stay (LOS) than most other surgeries. Regional cerebral oximetry (rSO 2 ) using near-infrared spectroscopy (NIRS) on the patient's forehead monitors cerebral oxygenation during surgery and cardiopulmonary bypass (CPB). Its purpose is to detect and manage periods of cerebral hypoxia which may otherwise go undetected, thereby reducing morbidity. But outcomes have been inconsistent, and not all cardiac departments have adopted this non-invasive, simple-to-use technology. We aimed to study the efficacy of our use of rSO 2 by recording seven outcomes for each patient according to their preoperative rSO 2 , the mean intraoperative rSO 2 , and four ischemic thresholds during surgery., Method: This is a retrospective audit of cardiac surgical patients in whom a protocol was used to maintain rSO 2 above the preoperative value and studied seven major morbidity outcomes. Cerebral oximetry data were recorded for each patient and analyzed for six variables: preoperative baseline rSO 2 , mean intraoperative rSO 2, and four ischemic thresholds defined as an area under the curve (AUC) in minutes% below the baseline rSO 2 ,minus 10% below the baseline, minus 20% the below baselineand minus 50% below baseline. Outcomes examined were: delirium, stroke, postoperative rise in creatinine of 50 mmol, absolute creatinine of 200 mmol, need for new renal replacement therapy (RRT), hospital LOS and inpatient mortality., Results: Complete data were available for 166 patients. Lower mean preoperative rSO 2 was associated with stroke (p=0.031), mild and severe renal dysfunction (p=0.045 and p=0.036), death-in-hospital (p=0.027) and prolonged hospital LOS (p=0.005). Lower mean intraoperative rSO 2 during surgery was associated with the outcomes of renal dysfunction, mild (p=0.027), moderate (p=0.003) or severe (p=0.002), death-in-hospital (p=0.003) and prolonged hospital LOS (p=0.015). Of the four ischemic thresholds defined, only new RRT occurring at minus 20% and minus 50% below baseline was significant., Conclusion: Lower preoperative rSO 2 and mean intraoperative rSO 2 were associated with poor outcomes, notably leading to a significant increase in hospital LOS. Mild degrees of cerebral ischemia below the baseline and minus 10% of the baseline during surgery were well tolerated., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Bennett et al.)

Coronavirus disease (COVID-19) is a global health challenge, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) triggers a plethora of respiratory disturbances and even multiple organs failure that can be fatal. Nutritional intervention is one of the key components toward to a proper management of COVID-19 patients, especially in those requiring medication, and should thus be considered the first-line treatment. Immuno-modulation and -stimulation are currently being explored in COVID-19 management and are gaining interest by food and pharmaceutical industries. Various dietary combinations, bioactive components, nutrients and fortified foods have been reported to modulate inflammation during disease progression. Dietary combinations of dairy-derived products and eggs are gaining an increasing attention given the huge immunomodulatory and anti-inflammatory properties attributed to some of their chemical constituents. Eggs are complex dietary components containing many essential nutrients and bioactive compounds as well as a high-quality proteins. Similarly, yogurts can replenish beneficial bacteria and contains macronutrients capable of stimulating immunity by enhancing cell immunity, reducing oxidative stress, neutralizing inflammation and regulating the intestinal barriers and gut microbiome. Thus, this review highlights the impact of nutritional intervention on COVID-19 management, focusing on the immunomodulatory and inflammatory effects of immune-enhancing nutrients., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Batiha, Alqarni, Awad, Algammal, Nyamota, Wahed, Shah, Amin, Adetuyi, Hetta, Cruz-Martins, Koirala, Ghosh, Echeverría, Pagnossa and Sabatier.)

Introduction Falls in elderlies are one of the leading causes of emergency visits worldwide. It is also a major cause of morbidity and mortality and imposes a significant burden on health care costs. This study investigates risk factors in elderlies aged 65 and above that contribute to falls. Methodology This study is a cross-sectional study using a non-probability consecutive sampling technique. The records of 300 clinical data of elderly who underwent falls were collected from all confirmed cases of falls from January 2015 to January 2020, at National Guard Hospital in Jeddah, Kingdom of Saudi Arabia. Results Patients included in this study were ranged in age from 65 to 85 years with a mean age of 77.6 years (SD = 8.1 years). Among our population, 149 (53.4%) were males, and 130 (46.6%) were females. Some comorbidities were associated with our population such as diabetes mellitus (69.2%, n = 193), hypertension (75.3%, n = 210), smoking (6.1%, n = 6.1), and polypharmacy (18.3%, n = 51). Conclusion Understanding and evaluating risk factors can help to decrease or even prevent falls. Smoking and dementia are strongly related to increased mortality rate. Some outcomes of falls such as head injuries and ICU admission had a strong association to increased mortality. Physical therapy or occupational therapy found to be a strong factor to decrease fall recurrence., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Attar et al.)

Cryptocurrencies such as Bitcoin (BTC) have seen a surge in value in the recent past and appeared as a useful investment opportunity for traders. However, their short term profitability using algorithmic trading strategies remains unanswered. In this work, we focus on the short term profitability of BTC against the euro and the yen for an eight-year period using seven trading algorithms over trading periods of length 15 and 30 days. We use the classical buy and hold (BH) as a benchmark strategy. Rather surprisingly, we found that on average, the yen is more profitable than BTC and the euro; however the answer also depends on the choice of algorithm. Reservation price algorithms result in 7.5% and 10% of average returns over 15 and 30 days respectively which is the highest for all the algorithms for the three assets. For BTC, all algorithms outperform the BH strategy. We also analyze the effect of transaction fee on the profitability of algorithms for BTC and observe that for trading period of length 15 no trading strategy is profitable for BTC. For trading period of length 30, only two strategies are profitable., Competing Interests: The authors declare there are no competing interests., (©2021 Ahmad et al.)

More than 65% of all human bacterial infection are associated with biofilm. Bacteria in such biofilms are 10 to 1000-fold more resistant to antibiotics than free living bacteria cells. Organisms such as S. aureus and P. aeruginosa are responsible for a significant number of biofilm related infections. In this study, we investigated the antimicrobial and anti-biofilm activity of C. longa L. rhizome extract against biofilm producing S. aureus and P. aeruginosa isolates. The results of MIC and MBC demonstrated promising antibacterial activity of the rhizome extract. TLC and column chromatography detected various curcuminoids while phytochemical analysis also reveals presence of number of bioactive compounds such as alkaloids, flavonoids, phenolics, terpenoids, etc. Micro titer plate assay indicated significant inhibition of biofilm formation in clinical isolates treated with turmeric extract. Thus, on basis of our results turmeric extracts can be considered as natural antibiofilm and antibacterial agent.

The present research work has been performed to evaluate the phenolic content, flavonoids content, and cytotoxicity of a multidimensional medicinal plant; Tinospora cordifolia and as well as to determine nutritive value by proximate analysis. The total phenolic and flavonoids contents of Tinospora cordifolia were found to be significantly greater in methanol extract as compared to corresponding hexane extract. Brine shrimp bioassay indicated Tinospora cordifolia is pharmacologically active. The percentage composition of different nutrition parameters namely moisture, total ash, crude fat, protein, fibre, carbohydrate, and vitamin C were assessed. The nutritive values of fresh and dried stem samples were evaluated as 156.44 Kcal/100g and 232.61 Kcal/100g respectively. From Gas column mass spectrometry analysis, it can be reported that inositol, 1-deoxy-, trans-sinapyl alcohol, n-hexadecanoic acid were present in the major amount in methanol stem extract. The findings from this study reveal Tinospora cordifolia contains an adequate amount of phenolic and flavonoids content, vital bioactive antioxidant compounds, and a good source of carbohydrates and fibers which potentially adds to the overall value of the plant.

Reinwardtia indica is traditionally used for wound healing. The main aim of this study was to evaluate the wound healing activity of leaves extracts of R. indica using the excision wound model in rats. The leaves of R. indica were collected from Gondrang, Chitwan, Nepal.  Leaves were shade dried, extracted by double maceration and subjected to phytochemical screening. Then, the fusion method was used for the formulation of ointment and evaluated. Rats (n=24) were divided into four groups with 6 in each. Excision wound model was used, 2 cm diameter (314 mm2), 2 mm depth wound was created. The treatment was given daily topically to all groups and the % mean wound contraction rate was calculated on days 4, 8, 12 and 16.  The result was analyzed statistically using Graph pad prism version 5. Phytochemical test revealed the presence of alkaloid, flavonoid, tannin, phenol, terpenoid, carbohydrate, etc.  All the evaluation parameters showed satisfactory results. The extract of R. indica ointment (2% w/w and 5% w/w) increased the wound contraction rate day by day. The % means wound contraction rate, on day 12, (80% and 88%), and on day 16, (97% and 100%) and statistically significant difference was at p<0.0001. The R. indica extract ointment showed an increased wound contraction rate. So, in further R. indica could be used for commercial production of wound healing ointment.

Glycation of proteins is often considered as a method to improve their functional properties for promising applications in wound healing. Furthermore, a marked increase in percentage of radical scavenging activity of the conjugates makes it an effective antioxidant synthetic strategy. A simple conjugation process was employed to develop bovine serum albumin-dextran conjugates (BSA-dextran) using Maillard reaction. Higher electrophoretic mobility and surface charge in the prepared conjugates was observed in native PAGE electrophoresis and zeta potential. Moreover, the fluorescence, FTIR and Raman analysis of the BSA-dextran conjugates shows significant shift in the fluorescence and wavelength as a consequence of conjugate formation. In vitro wound healing assay showed increased cell proliferation and migration effect. These finding suggests that BSA-dextran conjugate could open up a new practical way for exploration in the area of wound healing., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

In this research, an antiviral drug emtricitabine (ECT) was quantified using the validated green reversed-phase high-performance thin-layer chromatography (RP-HPTLC) and routine normal-phase HPTLC (NP-HPTLC) methods in the marketed oral solutions and capsules. Green RP-HPTLC-densitometry quantification was performed using the acetone/water (70:30, v/v) solvent system as the mobile phase. Routine NP-HPTLC-densitometry quantification was performed using the chloroform/methanol (85:15, v/v) solvent system as the mobile phase. The detection was performed at λ max -285 nm for both of the methods. Both densitometry methods were validated for different parameters. Most of the validation parameters including linearity, precision, accuracy, detection, and quantification limits for the green densitometry method were found to be superior compared to the routine densitometry technique. The ECT contents of commercial oral solution and commercial capsules were found to be 100.85 and 98.27%, respectively, using the green densitometry technique. The ECT contents of oral solutions and capsules were 97.16 and 95.54%, respectively, using the routine densitometry technique. Accordingly, the green densitometry technique was found to be better than the routine densitometry technique for ECT assays. Thus, the green densitometry technique can be successfully applied for the quantitation of ECT in the marketed formulations., Competing Interests: The authors declare no competing financial interest., (© 2020 The Authors. Published by American Chemical Society.)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by severe cytokine storm syndrome following inflammation. SARS-CoV-2 directly interacts with angiotensin-converting enzyme 2 (ACE-2) receptors in the human body. Complementary therapies that impact on expression of IgE and IgG antibodies, including administration of bee venom (BV), have efficacy in the management of arthritis, and Parkinson's disease. A recent epidemiological study in China showed that local beekeepers have a level of immunity against SARS-CoV-2 with and without previous exposure to virus. BV anti-inflammatory properties are associated with melittin and phospholipase A2 (PLA2), both of which show activity against enveloped and non-enveloped viruses, including H1N1 and HIV, with activity mediated through antagonist activity against interleukin-6 (IL-6), IL-8, interferon-γ (IFN-γ), and tumor necrosis factor-α (TNF-α). Melittin is associated with the underexpression of proinflammatory cytokines, including nuclear factor-kappa B (NF-κB), extracellular signal-regulated kinases (ERK1/2), and protein kinase Akt. BV therapy also involves group III secretory phospholipase A 2 in the management of respiratory and neurological diseases. BV activation of the cellular and humoral immune systems should be explored for the application of complementary medicine for the management of SARS-CoV-2 infections. BV "vaccination" is used to immunize against cytomegalovirus and can suppress metastases through the PLA2 and phosphatidylinositol-(3,4)-bisphosphate pathways. That BV shows efficacy for HIV and H1NI offers opportunity as a candidate for complementary therapy for protection against SARS-CoV-2., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2020 Kasozi, Niedbała, Alqarni, Zirintunda, Ssempijja, Musinguzi, Usman, Matama, Hetta, Mbiydzenyuy, Batiha, Beshbishy and Welburn.)

Background: Glycated haemoglobin (HbA1c) is a marker that reflects the control of diabetes mellitus (DM) over a three-month period. We sought to compare cardiovascular outcomes of diabetic patients with and without controlled levels of HbA1c post percutaneous coronary intervention (PCI) presenting to King Faisal Cardiac Center.   Methods: A retrospective single-center study of all patients with type two DM who were treated with PCI during the period between January 2015 and January 2018. All data were obtained from health informatics system. Demographics, clinical data, and major adverse cardiovascular and cerebrovascular events (MACCE) were collected to compare outcomes among diabetic patients with and without controlled HbA1c., Results: The study included 177 patients with type two DM who underwent PCI. The mean age was 63.3 (SD±12). Males represented 73.4% and 26.6% were females. The mean HbA1c on admission was 8.7%. At presentation 31% of the patients had relatively controlled blood sugar (HbA1c mean 7.5%, SD±0.5) and 69% presented with poorly controlled type two DM (mean HbA1c 9.1%, SD±0.25). The prevalence of hypertension and dyslipidaemia were higher among the uncontrolled group, but there were no differences between both groups in the control of blood pressure or dyslipidaemia. Patients in the uncontrolled group had higher rate of prior PCI (36.6%) compared to the controlled arm (16%, p=0.0195) The prevalence of cerebrovascular, cardiovascular, and renal impairment was similar. The use of insulin was higher among the uncontrolled arm. Patients in the controlled arm had lower incidence of composite endpoints of death and non-fatal myocardial infarction and stroke (MACCE) (14% vs 41%, p=0.001) compared to the uncontrolled arm., Conclusion: Among patients with type two DM that were treated with PCI, achieving targets of blood sugar control reflected by glycated haemoglobin is associated with improved survival and lower incidence of composite MACCE., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Albugami et al.)

Introduction: Oncology patients are predisposed to incidental-asymptomatic Pulmonary Embolism (PE) which has a substantial morbidity and mortality in untreated patients. As the cancer patients frequently undergo contrast enhanced Computed Tomography (CT) scanning for staging their primary disease, there is a higher chance of detecting unsuspected PE., Methodology: Our sample included a retrospective review of one-thousand consecutive oncology patients who had CT scan of the chest for reasons other than PE. We excluded females on oral contraceptives, patients who had a prior history of PE or deep veins thrombosis, and history of intensive care unit admission, surgery, trauma, or lower limb fractures within 6 months prior to the CT study. A positive case of incidental PE is considered if it was confirmed by CT pulmonary angiogram study within 24 hours of the staging CT or if there is an agreement for positive PE by two experienced radiologists. The overall incidence of asymptomatic PE in cancer patients, rate of incidental PE in different types and stages of cancer, and location of the PE within the pulmonary vasculature are described., Discussion: The true incidence, prevalence, and mortality rates of incidental PEs in oncology patients is underestimated due to its silent nature. Since the mortality and morbidity are exceptionally high in cancer patients with incidental pulmonary embolism, staging CT chest examinations should include a meticulous search for incidental PE., Conclusion: The rate of pulmonary embolism in oncology patients is higher in female and in the advanced stage of the disease. There are certain tumors associated with a higher rate of incidental PEs, which may be related to tumors characteristics or to its treatment.

Introduction Renal dysfunction is a significant variable in determining the outcome of surgery, such as cardiopulmonary bypass graft and valvular replacement, used to treat cardiovascular diseases. In Saudi Arabia, the incidence of renal failure and diabetes is higher than in most western populations. Our aim is to determine the renal outcome of patients who underwent cardiac surgery at King Faisal Cardiac Center from 2014 to 2017. Methods This a retrospective cohort study using a non-probability consecutive sampling technique for selection of the study population to assess the renal outcome in cardiac surgery patients using cardiopulmonary bypass from May 2014 to June 2017 in King Faisal Cardiac Center, Jeddah. Patients older than 18 years of age undergoing cardiac surgery, with available data, were included. Categorical variables were summarized by percentages and frequencies, and continuous variables by means and standard deviations, or medians and interquartile ranges if their distributions were skewed. Logistic regression was done with post-op renal impairment as the dependent variable and pre-op renal dysfunction, age, gender, smoking status, diabetes, hypertension, dyslipidemia, and cardiopulmonary bypass time as independent variables. Results Our sample size included 244 patients who underwent cardiac surgery in this study period; their mean age was 60.5 (SD =7.5) with a mean body mass index (BMI) of 28.62 (SD=5.19). Among our population, 73% (n = 179) were males and 27% (n =66) were females. Two percent (2%) of patients (n = 5) died within 30 days, 4% of patients (n = 10) with temporary dialysis, 8% of patients (n = 19) with postoperative renal dysfunction, and no patients with permanent dialysis. The data showed a significant relationship between levels of creatinine preoperatively and postoperative renal dysfunction (p-value = 0.0001, OR=1.05, 95% CI of 1.031 to 1.064). Conclusion The main predictor of poor renal outcomes for cardiac surgery is preoperative creatinine. While other factors, such as age, gender, body mass index, cardiopulmonary bypass time, diabetes, hypertension, and dyslipidemia, did not show any risk to the postoperative renal outcome., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Alqarni et al.)

Background Blood transfusion is a commonly used therapy in cardiac surgery, whether it is given during the surgery or in the intensive care unit. It is important to evaluate the risks and benefits of exposure to blood transfusion. The use of blood transfusions can influence patient outcome. Previous studies have implicated blood transfusion as a causative factor in post-operative infection. Objectives We aim to determine the effect of blood transfusion on post-operative infection in cardiac surgery patients at the King Faisal Cardiac Center, Jeddah, Saudia Arabia, from January 2017 to January 2019. Methods The regular six-week follow-up of cardiac surgery patients allowed us to maintain a six-week infection span. The main variables included patient characteristics, operative characteristics, pre-operative hemoglobin, six-week infection, blood transfusion, and clinical outcomes. A logistic regression model was developed to identify patient and procedure variables that were associated with blood transfusion and infection. The baseline variables were entered into the model. Variables with p-value less than 0.05 were considered significant. Results The incidence of transfusion out of 197 patients was 93.4% (n = 184). The occurrence of infection was 31.82% (n = 63). There was no difference in post-operative infection for patients who received blood transfusions compared with those who did not receive blood transfusions (p = 0.902). In comparing patients receiving 1-2 units of red blood cells (RBCs) (48%) and those receiving >2 units of RBCs (52%), there was no significance (p = 0.549). Conclusions There was no association between the incidence of infection and blood transfusion. While there are other reasons for withholding blood, it would not be recommended to do so based on the concern of infection., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Abukhodair et al.)

Introduction Head and neck malignancies are considered among the most common cancers that arise from different anatomical sites in the region. The number of new cases diagnosed worldwide each year is estimated to be more than 550,000 resulting in about 380,000 deaths. One of these head and neck cancers that may affect patient quality of life is the nasopharyngeal carcinoma (NPC). The purpose of our study is to assess the outcome, and the quality of life of these patients. Our study reviews NPC patients treated at Princess Norah Oncology Center, Jeddah, retrospectively over the past 15 years to provide additional information on this disease in Saudi Arabia. Methods We included all histologically confirmed cases of NPC seen at National Guard Hospital in Jeddah between 2002 and 2017. The data was collected retrospectively from the BestCare system, hospital information system, and the medical records. The created table included demographics, comorbidities, and first symptoms. The research table also contained stage at presentation and treatment modalities. Moreover, 25 patients were asked to complete the Arabic versions of European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC HN-35) module questionnaire to assess the quality of life. All results were computed using IBM SPSS version 23 (IBM Corp., Armonk, NY), which was provided by College of Medicine at KSAU. Results A total of 107 patients with adequate documentation were identified. There were 72.9% males and 27.1% females; 81.3% of patients were alive and in remission and 18.7% were dead. Neck mass was the most common clinical manifestation present in 84.1% of patients. Radiotherapy and chemotherapy were the most used modality by 96.3%. The five-year survival rate year was 81.3%. Moreover, the H&N-35 questionnaire showed that the NPC survivors suffered mostly poor social contact. Conclusion A large proportion of the identified patients were in remission. Quality of life assessment shows that the main impact of the disease and treatment was on social contact., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Alsafadi et al.)

The hepatoprotective activity of the total extract of Juniperus sabina L. against CCl 4 induced toxicity in experimental animals was previously reported and indicated promising results. Essential oil of J. Sabina was prepared by hydrodistillation method. Components of the oil were identified by comparison of GC-MS and retention indexes with reported data. The hepatoprotective effect of the essential oil against CCl 4 induced toxicity was studied using male Wistar rats and silymarin at 10 mg/kg p.o as standard drug. The protective effect was evaluated via serum biochemical parameters such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyltranspeptidase (GGT), and total bilirubin as well as tissue parameters including non-protein sulfhydryl groups (NP-SH), malonaldehyde (MDA) and total protein (TP). Histopathological study was applied on the liver tissues using Mayer's hematoxylin stain, Periodic Acid Schiff - Hematoxylin (PAS-H) and Masson trichrome technique on light microscope. Electron microscope images were also obtained for more detailed study., Competing Interests: The authors declare that; there is no conflict of interest., (© 2019 The Authors.)

Background: Oral health is an important component of general health and is associated with the development of a healthy personality. The malocclusion has been shown to affects oral health, leads to increased prevalence of dental caries and may result in temporo-mandibular joint disorders. Hence, the present study was conducted to evaluate the malocclusion in subjects reporting for orthodontic treatment among Saudi population in Asser region by using Dental Aesthetic Index (DAI)., Materials and Methods: A cross-sectional survey was designed. A total of 162 study samples was participated in the study. A pre-designed proforma was used to evaluate various parameters determining malocclusion and DAI was used., Results: The mean age of 27.07 ± 9.76 years. The mean DAI score of the study participants was 27.27 ± 13.83. Maximum (75%) of the participants had Angle's Class I molar relation followed by Angle's Class II and II. Comparison of mean over jet and DAI score in the various age groups using one-way ANOVA there was a statistically significant difference in the mean DAI score between the participants in the various age groups., Conclusion: Knowing the prevalence of malocclusion in a community is of utmost importance, so that appropriate steps can be taken to prevent and treat the dentofacial irregularities.