Search

South Africa is among the world's top eight tuberculosis (TB) burden countries, and despite a focus on HIV-TB co-infection, most of the population living with TB are not HIV co-infected. The disease is endemic across the country, with 80-90% exposure by adulthood. We investigated epidemiological risk factors for (TB) in the Northern Cape Province, South Africa: an understudied TB endemic region with extreme TB incidence (926/100,000). We leveraged the population's high TB incidence and community transmission to design a case-control study with similar mechanisms of exposure between the groups. We recruited 1,126 participants with suspected TB from 12 community health clinics and generated a cohort of 774 individuals (cases = 374, controls = 400) after implementing our enrollment criteria. All participants were GeneXpert Ultra tested for active TB by a local clinic. We assessed important risk factors for active TB using logistic regression and random forest modeling. We find that factors commonly identified in other global populations tend to replicate in our study, e.g. male gender and residence in a town had significant effects on TB risk (OR: 3.02 [95% CI: 2.30-4.71]; OR: 3.20 [95% CI: 2.26-4.55]). We also tested for demographic factors that may uniquely reflect historical changes in health conditions in South Africa. We find that socioeconomic status (SES) significantly interacts with an individual's age (p = 0.0005) indicating that protective effect of higher SES changed across age cohorts. We further find that being born in a rural area and moving to a town strongly increases TB risk, while town birthplace and current rural residence is protective. These interaction effects reflect rapid demographic changes, specifically SES over recent generations and mobility, in South Africa. Our models show that such risk factors combined explain 19-21% of the variance (r2) in TB case/control status.

Abstract Classification of pathogenic E. coli has been focused either in mammalian host or infection site, which offers limited resolution. This review presents a comprehensive framework for classifying all E. coli branches within a single, unifying figure. This approach integrates established methods based on virulence factors, serotypes and clinical syndromes, offering a more nuanced and informative perspective on E. coli pathogenicity. The presence of the LEE island in pathogenic E. coli is a key genetic marker differentiating EHEC from STEC strains. The coexistence of stx and eae genes within the bacterial genome is a primary characteristic used to distinguish STEC from other pathogenic E. coli strains. The presence of the inv plasmid, Afa/Dr adhesins, CFA-CS-LT-ST and EAST1 are key distinguishing features for identifying pathogenic E. coli strains belonging to EIEC, DAEC, ETEC and EAEC pathotypes respectively. Food microbiological criteria differentiate pathogenic E. coli in food matrices. ‘Zero-tolerance’ applies to most ready-to-eat (RTE) foods due to high illness risk. Non-RTE foods' roles may allow limited E. coli presence, which expose consumers to potential risk; particularly from the concerning Shiga toxin-producing E. coli (STEC) strains, which can lead to life-threatening complications in humans, including haemolytic uremic syndrome (HUS) and even death in susceptible individuals. These findings suggest that decision-makers should consider incorporating the separate detection of STEC serotypes into food microbiological criteria, in addition to existing enumeration methods. Contamination of STEC is mainly linked to food consumption, therefore, outbreaks of E. coli STEC has been reviewed here and showed a link also to water as a potential contamination route. Since their discovery in 1982, over 39,787 STEC cases associated with 1,343 outbreaks have been documented. The majority of these outbreaks occurred in the Americas, followed by Europe, Asia and Africa. The most common serotypes identified among the outbreaks were O157, the ‘Big Six’ (O26, O45, O103, O111, O121, and O145), and other serotypes such as O55, O80, O101, O104, O116, O165, O174 and O183. This review provides valuable insights into the most prevalent serotypes implicated in STEC outbreaks and identifies gaps in microbiological criteria, particularly for E. coli non-O157 and non-Big Six serotypes.

Introduction: Sickle cell disease (SCD) is a haemoglobinopathy that leads to the formation of distorted sickle-shaped red blood cells that are prone to vaso-occlusion. This may lead to vaso-occlusive crises that may affect any organ. Acute pancreatitis (AP) in SCD patients may be mimicked by a vaso-occlusive crisis in the abdomen. The objective of this article is to analyse the clinical profiles of SCD patients with AP and understand the differences in the presentation of AP compared to an abdominal vaso-occlusive crisis and the difference between its presentation in SCD patients in comparison to other patients. Materials and Methods: Twenty-eight SCD patients who were diagnosed with AP during their admission to the paediatric department at a tertiary hospital between January 2012 and December 2020 were retrospectively studied. Patients aged older than 14 years were excluded. The data collected concerned: demographics, the clinical course and the hospital course. The diagnosis and severity protocols followed the revised Atlanta Criteria. Results: The patients were aged with a mean of 9.61 years. There were 15 males and 13 females. Demographics were not significantly correlated to complication rates (P > 0.05). The mean duration of hospitalisation was 6.43 days. The most common clinical presentations were abdominal pain, fever, then vomiting and nausea. Three patients experienced complications and they were all cases of cholangitis (10.71%). There were no cases of pseudocysts, acute necrotic collections, pancreatic or peripancreatic necrosis or walled-off necroses. All of the cases of AP in SCD children were mild according to the revised Atlanta classification. Leucocytosis was present in 29.29% of patients and 17.8% of patients had high C-reactive proteins (CRPs). There was no significant correlation between leucocyte counts, CRP levels, serum or urinary amylase levels and complications (P > 0.05). All patients had haemoglobin (Hb) levels above 7 g/dL. The levels of sickle Hb ranged from 40 to 70 g/dL and reticulocyte counts averaged at 3.57%. Haematologic parameters were not significantly correlated with complication rates (P > 0.05). There were no recurrences. Conclusion: AP in SCD patients presented with classic signs and symptoms. There were no associations between demographics and complications. The levels of leucocytes, CRP counts and serum and urinary amylase were not correlated with complications. The level of Hb and sickle cell Hb was not associated with complication rates. Reticulocytes were slightly elevated in SCD patients with AP. More studies are needed to demarcate factors distinguishing AP in SCD from abdominal vaso-occlusive crises.

Respiratory syncytial virus (RSV) is the major cause of bronchiolitis among children under 5 years of age worldwide, accounting for a prevalence of 25%–88% in Saudi Arabia. Although no effective treatment for the virus exists, passive immunoprophylaxis reduced RSV hospitalizations in high-risk children. With recent advances in immunization, the Saudi Initiative of Bronchiolitis Diagnosis, Management, and Prevention panel screened recent relevant international guidelines, locally published data, and expert consensus to update guidelines for RSV prevention, taking into consideration the resources, timing, varying health profiles, and RSV burden in Saudi Arabia. The panel updated its recommendations to include immunization of infants, mothers, and older adults. Practical guidelines were prepared to facilitate the administration of the short-acting and newly developed long-acting RSV monoclonal antibodies (mAb) during the regular follow-ups of high-risk infants in specialized clinics. In addition, long-acting mAb was highlighted as all-infant protection in the routine immunization calendar.

Zinc (Zn) is a vital trace element that plays a pivotal role in protein synthesis, cellular growth, and differentiation and is involved as a cofactor of metalloenzymes, performing a wide variety of metabolic, immune, and synthesis roles. Zn is required at all stages of an infant’s and child’s development, and severe Zn deficiency has been reported to lead to slower physical, cognitive, and sexual growth. Preterm neonates are at a higher risk of developing zinc deficiency for a variety of reasons, including low Zn intake from enteral feeds containing breast milk, relative malabsorption due to immaturity of the gastrointestinal tract with limited absorptive capacity, increased urinary loss of zinc, and increased demand during the early developmental stages. Moreover, premature infants are at risk of gastrointestinal diseases like necrotizing enterocolitis (NEC), which can limit absorption capacity and potentially lead to malabsorption. TPN is frequently used in preterm infants to provide them with sufficient nutrients and calories. However, it has its own complications, including cholestasis, especially if used for prolonged periods. In this case report, we are presenting the case of a male preterm infant who was delivered by caesarean section at 26 weeks’ gestation. The baby developed an intestinal perforation due to NEC, for which he underwent surgery for resection of the necrotic bowel and the creation of a high ileal stoma and was put on prolonged total parenteral nutrition (TPN), which led to the development of zinc deficiency.

Factors such as subsistence turnover, warfare, or interaction between different groups can be major sources of cultural change in human populations. Global demographic shifts such as the transition to agriculture during the Neolithic and more recently the urbanization and globalization of the twentieth century have been major catalysts for cultural change. Here, we test whether cultural traits such as patri/matrilocality and postmarital migration persist in the face of social upheaval and gene flow during the past 150 years in postcolonial South Africa. The recent history of South Africa has seen major demographic shifts that resulted in the displacement and forced sedentism of indigenous Khoekhoe and San populations. During the expansion of the colonial frontier, the Khoe-San admixed with European colonists and enslaved individuals from West/Central Africa, Indonesia, and South Asia, introducing novel cultural norms. We conducted demographic interviews among Nama and Cederberg communities representing nearly 3,000 individuals across three generations. Despite the history of colonial expansion, and the subsequent incorporation of Khoe-San and Khoe-San-descendant communities into a colonial society with strong patrilocal norms, patrilocality is the least common postmarital residence pattern in our study populations today. Our results suggest that more recent forces of integration into the market economy are likely the primary drivers of change in the cultural traits examined in our study. Birthplace had a strong effect on an individual's odds of migration, distance moved, and postmarital residence form. These effects are at least partially explained by the population size of the birthplace. Our results suggest that market factors local to birthplaces are important drivers of residence decisions, although the frequency of matrilocal residence and a geographic and temporal cline in migration and residence patterns also indicate the persistence of some historic Khoe-San cultural traits in contemporary groups.

Water contamination with pharmaceuticals such as Carbamazepine (CBZ) presents a significant environmental challenge. This study investigates the use of activated carbon derived from waste date pits (DPAC) for the removal of CBZ from water. The impact of several parameters such as pH, temperature, CBZ concentration, and flow rate on the adsorption were assessed. The generated DPAC demonstrated a specific surface area of 309 m2/g, a pore volume of 0.264 cm³/g, and the pores are mainly distributed at 1.86, 2.73, and 3.43 nm. The Langmuir, Freundlich, Sips, and Toth isotherms were used to fit the experimental data, and the results indicate the occurrence of monolayer adsorption and heterogeneous surface conditions. The Linear Driving Force model was used for kinetic analysis, showing improved fit at higher concentrations. Thermodynamic analyses revealed the process to be endothermic, spontaneous, and entropically driven. The DPAC achieved an adsorption capacity of 14.89 mg/g and maintained 94 % effectiveness after the first regeneration cycle and 70 % after four cycles. This study highlights the potential of DPAC as a sustainable adsorbent for advanced water purification.

Objectives. Post exposure prophylaxis (PEP) with the hepatitis B vaccine (HBVac) in combination with HBV immunoglobulins (HBIG) significantly minimizes the odds of vertical transmission of HBV to newborn infants. In this retrospective study, we aimed to evaluate the compliance and efficacy of PEP in a tertiary care center in Saudi Arabia. Methods. Infants were tested with HBV serological markers at 7 months of age to assess their PEP protection rate. Results. Out of 13,125 mothers who delivered in KAMC, 105 (0.8%) mothers were found to have HBsAg positive, with a prevalence of 8 per 1000 live births. All infants (n = 100) completed their PEP as per protocol before discharge from the hospital (2 days after delivery). Among infants (n = 59; 56.2%) who were tested at 7 months of age, all (100%) were found to be negative for HBV. Conclusion. PEP achieved 100% efficacy among infants who complied with the study protocol at 7 months of follow-up. The prevalence of hepatitis B among pregnant women was 8 per 1000 live births.

Abstract Background Postgraduate pediatric dental residents' competency, to perform dental rehabilitation procedures under General anesthesia (GA), at different levels of training is challenging for operation time control. An adequate operation time (OT) for children decreases morbidity risk and improves hospital time utilization efficiency. The aim of the study is to assess the effect of pediatric dental resident training level on OT for pediatric dental rehabilitation procedures under GA at King Abdulaziz Medical City (KAMC). Methods A cross-sectional study included pediatric dental rehabilitation performed under GA by pediatric dental residents at (KAMC) -Jeddah from October/2015 to September/2022. The primary outcome was OT, and the predictive variable was resident training levels. A linear regression analysis was used to compare OT between procedures performed by junior (years 1–2) or senior (years 3–4) trainees, adjusting for patient and operative factors. Results One thousand seven pediatric dental rehabilitation cases were performed under GA by junior (13) and senior (31) residents. The univariant analysis indicated that OT for senior residents was significantly longer (13 min) than for junior residents. However, the linear regression analysis showed that senior residents had a significantly shorter OT when considering the more dental procedures performed per case under GA than junior residents. Senior residents took significantly more radiographs and performed more primary pulp therapies and multi-surface anterior colored restorations under GA than junior residents. Conclusions The OT for pediatric dental rehabilitation procedures under GA is associated with resident training level. The total OT was significantly longer based on procedure number, type, and resident level. The study indicated that senior residents could manage more complex cases in a shorter time. The finding emphasizes the importance of assigning GA cases to residents based on their level and the case's complexity. Additionally, it helps standardize the resident privileges under GA and understand the impact of residency training on hospital efficiency.

The journal retracts the article, “Isolation and Characterization of a Novel Lytic Phage, vB_PseuP-SA22, and Its Efficacy against Carbapenem-Resistant Pseudomonas aeruginosa”, cited above [...]

This article investigates the role of the Israeli border in the process of criminalising Palestinians. Defining Israel in contrast to the Arab ‘terrorists’, waiting to attack, necessitates a grand, looming settler- colonial border and the sequestration of an entire population behind a manufactured prison. The justification for this form of border ‘control’ is made possible by the historic truths established by the West in the colonial era. The paper outlines this understanding of Arabs as a ‘bestial’, ‘bellicose’ group that thrives in conflict situations. It moves on to note that the consequence of this characterisation is the global, all-encompassing understanding of the Arab threat. It finally narrows the border wall down as an Israeli tool of segregation, justified by understandings of a racialised, ‘threatening Arab’. The Israeli ‘defence’ of its borders will be reimagined from a Southern perspective as an oppressive system of segregation justified by the ways in which Arabs have historically been constructed.

الملخص: أهداف البحث: النوع ذو الأهمية غير المحددة أو الآفة الجريبية ذات الأهمية غير المحددة هي فئة غير متجانسة في علم الخلايا الشفط بالإبرة الدقيقة ، والتي لا تزال إدارتها مثيرة للجدل. تكمن الأهمية السريرية لهذه المجموعة في استبعاد الأورام الخبيثة. هدفت الدراسة الحالية إلى تحديد مدى صلاحية إرشادات نظام البيانات وتقارير التصوير الدرقي للكلية الأمريكية للأشعة (2017) في التنبؤ بالأورام الخبيثة على وجه التحديد في هذه الفئة. طريقة البحث: استخدمت هذه الدراسة مجموعة من دراسة سابقة بأثر رجعي من قبل المؤلفين. تضمنت هذه الدراسة الأتراب بأثر رجعي التي مدتها أربع سنوات جميع الحالات التي تم تشغيلها مع تشخيص خلوي لأنماط ذات أهمية غير محددة أو آفة جرابية ذات أهمية غير محددة. ضمت الدراسة 110 حالة مع التشخيصات النسيجية المرضية النهائية الموثقة والفحوصات بالموجات فوق الصوتية. النتائج: شملت الدراسة 83 أنثى (75.5٪) و 27 ذكر (24.5٪) مريض. كان الخطر الإجمالي للأورام الخبيثة في النوع ذي الأهمية غير المحددة أو الآفة الجريبية ذات الأهمية غير المحددة لعقيدات الغدة الدرقية 47.3 ٪. كانت نسبة الأورام الخبيثة في نظام الإبلاغ والتصوير بالغدة الدرقية بالكلية الأمريكية للأشعة 3، و 4، و 5 كالتالي: 43.5٪ ، 49.4٪ ، 40٪ على التوالي. لم تحقق العلاقة بين الإبلاغ عن تصوير الغدة الدرقية ونظام البيانات وعلم الأمراض النهائي دلالة إحصائية. الاستنتاجات: يعد فحص الخلايا بالإبرة الدقيقة المتكرر مع وجود نوع أولي ذي أهمية غير محددة أو آفة جرابية ذات عقيدات ذات أهمية غير محددة أمرا بالغ الأهمية. أشارت النتائج التي توصلنا إليها إلى أن نظام بيانات وتقارير تصوير الغدة الدرقية بالكلية الأمريكية للأشعة لم يساهم في التقسيم الطبقي لمخاطر الإصابة بالسرطان لأنواع ذات أهمية غير محددة أو آفة جرابية من عقيدات ذات أهمية غير محددة. مطلوب دراسة مستقبلية كبيرة متعددة المؤسسات لتحديد مدى صحتها وما إذا كانت الأدوات السريرية أو الخلوية أو الجزيئية أو البيوكيميائية الأخرى المساعدة يمكن أن تساعد في إدارة هذه العقيدات غير المتجانسة. Abstract: Objectives: Atypia of undetermined significance (AUS) or follicular lesion of undetermined significance (FLUS) is a heterogeneous category of fine needle aspiration cytology (FNAC); the management of this condition remains controversial. The clinical significance of such patients relies on the exclusion of malignancy. In this study, we aimed to determine the validity of the American College of Radiology Thyroid Imaging Reporting and Data System (ACR TI-RADS) (2017) for predicting malignancy in this specific category of patients. Methods: In this study, we analysed a cohort of patients from our previous retrospective study. This four-year retrospective cohort study included all cases undergoing surgery with a cytological diagnosis of AUS/FLUS. We enrolled 110 cases with documented final histopathological diagnoses and ultrasound examinations. Results: The study included 83 females (75.5%) and 27 males (24.5%). The overall risk of malignancy (ROM) for AUS/FLUS thyroid nodules was 47.3%. The ROMs of TI-RADS 3 (TR3), TI-RADS 4 (TR4), and TI-RADS 5 (TR5) were 43.5%, 49.4% and 40%, respectively. There was no significant association between TI-RADS and final pathological analysis. Conclusions: Repeated FNAC with initial AUS/FLUS nodules is crucial. Our findings showed that ACR TI-RADS did not contribute to the cancer risk stratification of AUS/FLUS nodules. A large prospective multi-institutional study is now required to determine the validity of ACR TI-RADS and whether other adjunct clinical, cytological, molecular, or biochemical tools could facilitate the management of patients with these heterogeneous nodules.

South Africa is among the world's top eight tuberculosis (TB) burden countries, and despite a focus on HIV-TB co-infection, most of the population living with TB are not HIV co-infected. The disease is endemic across the country, with 80-90% exposure by adulthood. We investigated epidemiological risk factors for (TB) in the Northern Cape Province, South Africa: an understudied TB endemic region with extreme TB incidence (926/100,000). We leveraged the population's high TB incidence and community transmission to design a case-control study with similar mechanisms of exposure between the groups. We recruited 1,126 participants with suspected TB from 12 community health clinics and generated a cohort of 774 individuals (cases = 374, controls = 400) after implementing our enrollment criteria. All participants were GeneXpert Ultra tested for active TB by a local clinic. We assessed important risk factors for active TB using logistic regression and random forest modeling. We find that factors commonly identified in other global populations tend to replicate in our study, e.g. male gender and residence in a town had significant effects on TB risk (OR: 3.02 [95% CI: 2.30-4.71]; OR: 3.20 [95% CI: 2.26-4.55]). We also tested for demographic factors that may uniquely reflect historical changes in health conditions in South Africa. We find that socioeconomic status (SES) significantly interacts with an individual's age (p = 0.0005) indicating that protective effect of higher SES changed across age cohorts. We further find that being born in a rural area and moving to a town strongly increases TB risk, while town birthplace and current rural residence is protective. These interaction effects reflect rapid demographic changes, specifically SES over recent generations and mobility, in South Africa. Our models show that such risk factors combined explain 19-21% of the variance (r2) in TB case/control status.

Background and aim: Inflammatory bowel disease (IBD) is a chronic and relapsing disorder that is strongly linked to intestinal microbiota alteration (dysbiosis). Anti-tumor necrosis factor-alpha (anti-TNF-α) therapies have revolutionized IBD treatment over the last two decades. Clinical response to anti-TNF-α treatment generally involves alteration of the gut microbiota composition, although change in the microbiome following therapy has generated some contradictory theories. We examine the composition and function of the intestinal microbiota following treatment with TNF-α inhibitors and examine this relationship in the context of clinical and endoscopic response in a cohort of IBD patients in Saudi Arabia. Method: An analysis of fecal-derived microbiota in 20 human samples was performed using 16S rRNA gene-based microbiota profiling and next generation sequencing, utilizing Illumina MiSeq. Ten samples were collected at baseline prior to treatment with TNF-α antagonists and ten samples were collected following treatment. Inter- and intra-species variation was tested using ɑ-diversity and β-diversity metrics along with appropriate statistical analysis. An examination of functional metagenomic profile variation was performed following biologics exposure. Results: A total of 5 087 721 clean-paired sequence reads were generated across subjects before and after biologics treatment and assigned to 401 different operational taxonomic units (OTUs). The two taxonomic microbial groups (before and after treatment) demonstrated no clear separation. Anti-TNF-α treatments induced more specific variation, rather than involving a global impact on the gastrointestinal (GI) microbiota profiles, with a statistically significant increase in the Firmicutes (P = 0.01) and a statistically significant decrease in Proteobacteria (P = 0.04). This was accompanied by a remarkable increase in protective taxa, responsible for short-chain fatty acids production, such as the Lachnospiraceae family, which belongs to the Clostridiales order (P = 0.005). A notable increase in F. prausnitzii and a decrease in the relative abundance of E. coli were observed. At the functional level, an up-regulation in the carbohydrate metabolism pathway was shown in addition to a down-regulation in cellular process and signaling pathways (P = 0.04, P = 0.006, respectively). Conclusion: TNF-α antagonists reduced GI microbiota with pro-inflammatory capacity enabling protective bacteria to thrive. The biologics caused specific compositional and functional variation rather than a global alteration of the gut microbiota profile in biologic-responsive IBD patients, leading to an improvement in treatment efficacy.

ContextGermline succinate dehydrogenase subunit B (SDHB) pathogenic variants are characteristic of familial paraganglioma (PGL) syndrome type 4. This syndrome frequently presents with abdominal PGL and has high tendency for locally aggressive behavior and distant metastasis. The vast majority of pituitary adenomas (PAs) are sporadic. However, PAs can be part of a number of familial tumor syndromes such as multiple endocrine neoplasia type 1 (MEN 1) or more rarely in association with pheochromocytoma and PGL (referred to as 3P syndrome). Only a limited number of PAs in association with SDHB-related PGL has been reported and the vast majority occurred subsequently or simultaneously with pheochromocytoma/PGL (collectively abbreviated as PPGL). In this report, we describe a young patient who had a giant pituitary macroprolactinoma resistant to large doses of cabergoline (CBG) and external beam radiotherapy (XRT). The patient did not have personal history of PPGL but was found to carry a germline SDHB pathogenic variant.Case reportA 38-year-old woman presented with headache, visual disturbances and galactorrhea and was found to have a 34-mm macroprolactinoma. She was treated with CBG 3-4 mg per week but PA continued to grow and caused significant cranial pressure symptoms. She underwent two transsphenoidal surgeries with rapid tumor recurrence after each one. She received XRT but PA continued to grow. She was finally treated with temozolomide with excellent response. Whole exome and subsequent Sanger sequencing confirmed that she has a pathogenic monoallelic SDHB mutation (NM_003000:c.C343T, p.R115*). PA tissue showed loss of heterozygosity for the same mutation and absent SDHB immunostaining confirming the pathogenic role of this SDHB mutation.ConclusionGermline SDHB mutations can rarely cause PA in the absence of PPGL. They should be considered as a possible cause of aggressiveness and resistance to dopamine agonists in similar cases.

Conclusions: The results of this study provide an overview of the variations in microbiota diversity present in Saudi IBD patients compared to healthy controls. Results: The key finding was three negative bacterial biomarkers, Paraprevotellaceae, the Muribaculaceae families of Bacteroidetes phylum, and the Leuconostocaceae family of Firmicutes phylum, which had a higher relative abundance in healthy individuals compared to IBD patients. It was also found that primary microbiota signatures at certain genera and species levels, including Prevotella copri, Bifidobacterium adolescentis, Ruminococcus callidus, Coprococcus sp., Ruminococcus gnavus, Dorea formicigenerans, Leuconostoc, Dialister, Catenibacterium, Eubacterium biforme, and Lactobacillus mucosae, were absent in almost all IBD patients, while Veillonella dispar was absent in all healthy individuals. Methods: After obtaining an informed consent, fecal samples were collected from 11 participants with IBD (patients) and 10 healthy individuals (controls). The bacterial components of the microbial population were identified by next-generation sequencing of partial 16S rRNA. Statistically significant dissimilarities were observed between samples for all metrics. Background: Inflammatory bowel disease (IBD) is a chronic intestinal inflammatory condition attributed to a complex interaction between imbalances in the gut microbiome, environmental conditions, and a deregulated immune response. The aim of the study was to investigate the composition of the gut microbiome of Saudi patients with IBD.

Objectives: Salmonella is a well-known foodborne pathogen that is spread around the world. It causes diseases both in animals and humans. The development of antibiotic-resistant Salmonella strains results in the failure of formerly effective drugs in humans and animals and poses a serious threat to world health. In the Kingdom of Saudi Arabia, the rise in Salmonella prevalence in poultry is seen as a serious problem. Saudi Arabia has endured several epidemics of Salmonella infections with varied patterns of drug resistance in the last few decades. Methods: A total of 112 chilled chicken carcass of five different local poultry companies were procured from retail outlets in Jeddah. The ISO 6579:2002 standard was followed to isolate and identify Salmonella. The isolates were identified using cultural and biochemical features and were further confirmed using (MALDI-TOF MS). Antibiotic susceptibility for each Salmonella isolate was determined using the automated MicroScan WalkAway plus System. Results: Out of the 112 samples, 35 (31.25%) samples harboured Salmonella spp. According to MALDI-TOF MS identification, 34 isolates were recognized as S. Typhimurium or S. Enteritidis with high confidence levels (log (score) values between 2.00 and 3.00), while one isolate was characterized as a Salmonella sp. with a low confidence level (log (score)

The noninvasive neurally adjusted ventilatory assist (NIV-NAVA) is a newly developed noninvasive ventilation technique with promising clinical and ventilatory outcomes for preterm infants. This systematic review and meta-analysis aimed to investigate whether NIV-NAVA has better clinical and ventilatory outcomes than nasal continuous airway pressure (NCPAP) or noninvasive positive pressure ventilation (NIPP) on premature infants. MEDLINE, Embase, and CENTRAL were searched, and randomized controlled trials (RCTs) that compared NIV-NAVA with NCPAP or NIPP for preterm infants (gestational age:

Abstract Background The optimal timing of pars plana vitrectomy (PPV) following ocular trauma is an ongoing debate. Early vitrectomy post-trauma enables the rapid assessment of retinal disease by removing the scaffold that fosters proliferative vitreoretinopathy. On the other hand, late vitrectomy is less challenging as there is a lower risk of bleeding and posterior vitreous detachment induction is easier. The purpose of this work is to report the functional and anatomical outcomes following ocular traumatic injuries in a United States-based cohort, emphasizing the time of intervention. Methods This was a retrospective case series of 110 patients with traumatic ocular injuries who underwent PPV between 2008 to 2020. Patients were grouped into four timing categories: same day (0 days), early (1–7 days), delayed (8–14 days), and late (> 14 days). Multivariable regression models controlling for confounding were implemented to assess the impact of vitrectomy timing on anatomical and functional outcomes. Visual acuity (VA) at baseline and after surgery, proliferative vitreoretinopathy (PVR), and enucleation for each vitrectomy timing category were recorded. Results Patient demographics and severity of ocular trauma were comparable across timing categories. Final VA in LogMAR was found to have a stepwise worsening as the time of ocular trauma to vitrectomy was increased (p

Abstract Background Implantable vascular access devices (IVADs) provide durable routes for administering long-term treatments in patients. However, their associated complications pose a problem. One technique variation that can influence complication rates is the method of securing the IVADs, which is either by ligation or a purse-string suture. Objective To compare the two port-a-cath securing techniques, ligation and purse string, in terms of complication rates and types. Study design We prospectively included 67 paediatric patients who had port-a-cath insertions secured either by ligation or a purse-string suture at Salmaniya Medical Complex in Bahrain from January 2018 to June 2021. We recorded demographics, diagnoses, port-a-cath site of insertion and securing technique, operative time, follow-up duration, and complications. Patients who had previous port-a-cath insertions or other chemotherapy lines were excluded. Results Port-a-caths were secured by ligation in 35 cases and by a purse-string suture in 32 cases. There were 58.9% males and 41.8% females; sex was not correlated with complications (P = 0.11). Patients’ ages ranged from 2 months to 13 years. The overall complication rate of port-a-cath insertions was 16.42%. Complications occurred in 25.7% of ligation-secured port-a-caths and 6.3% of purse-string-secured port-a-caths. In the ligation-secured IVADs, complications included malfunction, infections, removal difficulty and blockage, malposition, and haematoma. Meanwhile, only leakage occurred in the purse-string-secured IVADs. Conclusion The port-a-cath securing technique was significantly correlated with complication rates. The complication types and rates in purse-string-secured catheters were lower than those reported in the literature. Leakage was the only complication that occurred in purse-string-secured port-a-caths.