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Plant-mediated silver nanoparticles are unique and are considered one of the best nanomaterials used in cancer research. We report a low-cost, eco-friendly process of green synthesis of AgNPs from Commiphora gileadensis stem extracts and evaluated their anticancer potential against colon cancer cell lines HCT-116, HT 29, and SW620. Anticancer activities were performed by an MTT assay and gene expression levels of four genes CHEK1, CHEK2, ATR, and ATM by the real-time polymerase chain reaction. Particles were initially confirmed by UV-visible spectroscopy. The morphology and stability of the particles were examined through TEM, zeta potential, and zeta sizer. GC-MS and FTIR were performed to examine the functional groups. The absorption peak was recorded at 430 nm; the average size recorded by TEM images was 13 nm, while the zeta potential and zeta sizer study showed aggregation in nanoparticles. Compared to C. gileadensis extracts, some of the FT-IR spectrum peaks were sight shifted with some new peaks in C. gileadensis AgNPs. C. gileadensis AgNPs were more toxic against HT29 followed by HTC116 and SW620. Expression levels of most of the genes in HCT116 and HT29 were increased by treatment whereas the gene expression level was least affected in SW620. C. gileadensis AgNPs have anticancer potential and need to be explored in cancer research.

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by deficiencies in social interaction and repetitive behaviors. Multiple studies have reported abnormal cell membrane composition and autoimmunity as known mechanisms associated with the etiopathogenesis of ASD. In this study, multiple regression and combined receiver operating characteristic (ROC) curve as statistic tools were done to clarify the relationship between phospholipase A2 and phosphatidylethanolamine (PE) ratio (PLA2/PE) as marker of lipid metabolism and membrane fluidity, and antihistone-autoantibodies as marker of autoimmunity in the etiopathology of ASD. Furthermore, the study intended to define the linear combination that maximizes the partial area under an ROC curve for a panel of markers. Forty five children with ASD and forty age- and sex-matched controls were enrolled in the study. Using ELISA, the levels of antihistone-autoantibodies, and PLA2 were measured in the plasma of both groups. PE was measured using HPLC. Statistical analyses using ROC curves and multiple and logistic regression models were performed. A notable rise in the area under the curve was detected using combined ROC curve models. Additionally, higher specificity and sensitivity of the combined markers were documented. The present study indicates that the measurement of the predictive value of selected biomarkers related to autoimmunity and lipid metabolism in children with ASD using a ROC curve analysis should lead to a better understanding of the pathophysiological mechanism of ASD and its link with metabolism. This information may enable the early diagnosis and intervention., (© 2022. The Author(s).)

Objectives: To study the impact of curfews during the COVID-19 pandemic, on the physical activity in patients of heart failure implanted withcardiac implantable electronic devices (CIEDs)., Methods: This was a retrospective single-center study of heart failure patients inserted with remote monitoring (RM)-capable CIED. We analyzed the transmitted data of physical activity and fluid volume status of all patients, before, and during the lockdown periods between February and April 2020. The clinical status of the patients was also evaluated.  Results: Device data from 429 patients implanted with CIED capable of RM were initially evaluated. Patients with an implantable loop recorder, Brugada or Long QT syndromes, and patients with incomplete transmissions were excluded. Eighty-two patients with heart failure were included. The median age was 65 years (58-72), and 53 (64.6%) subjects were men. There was a 27.1% decline in physical activity, and the median physical activity of patients significantly declined from 2.4 to 1.8 hours/day (p=0.000010).  Conclusion: Data obtained by remotely monitored CIED in heart failure patients suggests a significant decline in physical activity during the country lockdown due to the pandemic. Awareness of the future potential hazards in this group of patients is warranted.

With the recent pandemic of Coronavirus disease-2019 (COVID-19), there has been a higher number of reported cases in children more than to the prior Corona Virus-related diseases, namely, severe acute respiratory syndrome and the Middle East respiratory syndrome. The rate of COVID-19 in children is lower than adults; however, due to high transmission rate, the number of reported cases in children has been increasing. With the rising numbers among children, it is imperative to develop preparedness plans for the pediatric population at the hospital level, departmental level, and patient care areas. This paper summarizes important considerations for pediatric hospital preparedness at the hospital level that includes workforce, equipment, supply; capacity planning, and infection prevention strategies, it also span over the management of COVID-19 pediatric patients in high-risk areas such as critical care areas, Emergency Department and operative rooms., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Annals of Thoracic Medicine.)

Metabolites of proper fatty acids modulate the inflammatory response and are essential for normal brain development; equally, abnormal fatty acid metabolism plays a critical role in the pathology of autism. Currently, dietary supplements are often used to improve the core symptoms of Autism spectrum disorder (ASD). The present study analyzed the effects of orally supplemented omega-3 (ω-3) and vitamin B12 on ameliorating oxidative stress and impaired lipid metabolism in a propionic acid (PPA)-induced rodent model of autism, together with their effect on the gut microbial composition, where great fluctuations in the bacterial number and strains were observed; interestingly, polyunsaturated fatty acids such as omega-3 induced higher growth of the gram-positive bacterium Staphylococcus aureus and decreased the survival rates of Clostridia sp. as well as other enteric bacterial strains. Thirty-five young male western albino rats were divided into five equal groups. The first group served as the control; the second group was given an oral neurotoxic dose of PPA (250 mg/kg body weight/day) for 3 days. The third group received an oral dose of ω-3 (200 mg/kg body weight/day) for 30 days after the 3-day PPA treatment. Group four was given an oral dose of vitamin B12 (16.7 mg/kg/day) for 30 days after PPA treatment. Finally, group five was given a combination of both ω-3 and vitamin B12 at the same dose for the same duration after PPA treatment. Biochemical parameters related to oxidative stress and impaired fatty acid metabolism were investigated in the brain homogenates of each group. The effects of the dietary supplements on the gut microbiota were also observed. The PPA-treated autistic model expressed significantly higher levels of lipid peroxides and 5-lipoxygenase (5-LOX) and significantly less glutathione (GSH), glutathione S-transferase (GST), and cyclooxygenase 2 (COX2) than the control group. However, a remarkable amelioration of most of the impaired markers was observed with oral supplementation with ω-3 and vitamin B12, either alone or in combination. Our results concluded that impairment at various steps of the lipid metabolic pathways may contribute to the development of autism; however, supplementation with ω-3 and vitamin B12 can result in a positive therapeutic effect.

Prolonged waiting times and length of stay in Pediatric Emergency Department, are the two of the most challenging patient and clinical outcomes of healthcare institution. These emerged due to various reasons, namely: the use of triaging process and patient flow criteria that eventually lead to bottlenecks and overcrowding in the ED. After realizing the root causes of the prolonged waiting times and length of stay, the KASCH ED instigated a team to study the factors and thereby arrive at a considerable conclusion that will result in an improvement. The quality improvement project was initiated and steps were undertaken to improve the flow, reduce the waiting times, and reduce the overcrowding in Pediatric Emergency Acute Care Unit. The primary cause identified was inadequate team awareness and lack of the ED process flow, thus creating confusion as to where the type of patients based on the triage level will be assessed, managed and treated. Using the Canadian Triage and Acuity Scale (CTAS) as guide in triaging patients, a theory called Pediatric Rapid Assessment and Management (PRAM) was introduced in the Acute Care Unit. This certain model is basically aimed to rapidly assess and managed the patients who were triaged as Level III and Level IV within a period of 30 minutes. Several PDSA cycles were tested and implemented in order to assure that the process fit the criteria and the process flow will be improved. Following the completion of each cycle, significant improvements were noted, such as patients being assessed in Initial Assessment Room on average time less than the target of 15 minutes. In like manner, patients' length of stay on average less than 15 minutes in PRAM bed. The total time for assessment and plan of management is with a target time of less than 30 minutes. The team continuously drive th process and monitored the key performance indicators of the PRAM during the study period and subsequent improvement strategies were likewise implemented., Competing Interests: Declaration of interests: Nothing to declare.

Objective: To determine the use of information technology (IT) among students of Medicine, Dentistry, and Pharmacy in Prince Sattam Bin AbdulAziz University, Al-Khraj, Saudi Arabia (PSAU)., Study Design: Across-sectional survey., Place and Duration of Study: From September 2014 to January, 2015., Methodology: Aclose-ended questionnaire consisting of 30 multiple choice questions (MCQs) was distributed to the students. The questions were related to their access to computers, skills and training, computer activities, and internet access. Data analyses and descriptive analyses for various variables were performed using SPSS version 17.0., Results: An overall response rate of 84.9% (488 out of 575) was obtained. All of the students (100%) had an access to the computers. Most of the students (61.9%) used computers for academic purposes. Amajority of the students (74.4%) preferred the use of powerpoint presentations aided by marker-and-board method for teaching. For communication from the colleges, 62.9% of the respondents preferred it through the email; 100% of the students had an email account. All of the students (100%) used internet; 83.1% considered the information as accurate. The internet was used by 47.6% of the students for seeking the medical information., Conclusion: All of the students had an access to ITand used it for their educational purposes.

Introduction: We aimed to assess the empathy level of healthcare providers as perceived by hemodialysis (HD) patients and its determinants., Method: This survey included 100 hemodialysis patients from two major dialysis units in Riyadh, Saudi Arabia (Units A and B). Patients were asked to score their perception of empathy by health care providers in 13 areas using 1 to 5 Likert Scale., Results: Unit "A" contained more patients with diabetic nephropathy than unit "A". Unit "B" contained a higher number of native Arabic speaking nurses and its patients had longer mean duration on dialysis compared to unit "A". The overall score given for doctors empathy was 81.6% (84.5% for Unit "A" doctors and 78.8% for Unit "B" doctors (P=0.01). The overall score given for nurses empathy was 73.6% (76.2% for Unit "A" nurses and 70.9% for Unit "B" nurses (P=0.002). Female patients' perception of empathy was significantly greater than male patients in 8 out of 13 questions. Older patients gave higher score than younger patients. Patients with lower educational level perceived higher empathy levels than patients with higher education. Significantly lower scores were given by patients who received their dialysis treatment at night. We observed no differences in scores in relation to patients' duration on dialysis, diabetic status or Charlson Co-morbidity Index (CCI)., Conclusion: Empathy goes beyond the language barrier. Patients dialyzed in evening shifts perceive less empathy from healthcare workers. The higher scores given by older, female and less educated patients might simply reflect their lower expectation of empathy.