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Ahmad Aljohani,1,2,* Saeed Alqahtani3,* 1Pharmaceutical Care Services, King Fahd General Hospital, Ministry of Health, Jeddah, Saudi Arabia; 2Department of Pharmacy, College of Pharmacy, Nursing and Medical Sciences, Riyadh Elm University, Riyadh, Saudi Arabia; 3Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia*These authors contributed equally to this workCorrespondence: Saeed Alqahtani, Department of Clinical Pharmacy, College of Pharmacy, King Saud University, P. O. Box2457, Riyadh, Saudi Arabia, Tel +966114677471, Fax +966114677486, Email saeed@ksu.edu.saIntroduction: Echinocandins are used to treat invasive candidiasis (IC), with FDA-approved doses indicated for both obese and non-obese patients. Pharmacokinetic (PK) studies have identified subtherapeutic exposure in obese patients receiving standard doses (SDs) of echinocandins. However, research on clinical outcome differences of echinocandins’ SDs between obese and non-obese patients is lacking. Therefore, this study aimed to evaluate the effectiveness of echinocandins’ SDs in obese compared to normal-weight patients with IC.Patients and Methods: This retrospective cohort study was conducted at King Saud University Medical City (KSUMC) from Jan 2017 to Feb 2023. The study included adult patients diagnosed with Candida infections who received ≥ 4 doses of echinocandins. Patients with body mass index (BMI) less than 18 kg/m2 were excluded from the study. The primary and secondary outcomes included the total length of stay (LOS), IC duration, frequency of clinical resolution and all-cause mortality.Results: This study included 132 patients (47 obese; 85 non-obese) with a median age of 61 years. The median BMI and weight were different between the obese (34.5 kg/m2, 88 kg) and non-obese (24 kg/m2, 65 kg) groups (P= 0.01). Micafungin and caspofungin were used in 63.6% and 36.4% of patients, respectively. The total LOS and length of IC infections were similar between both groups, with median values of 29.5 days (P= 0.896) and 18 days (P = 0.160), respectively. The clinical improvement percentages were 68.1% for obese and 65.9% for non-obese patients (P= 0.797), with all-cause mortality rates at 44.7% and 42.4%, respectively (P= 0.796).Conclusion: The study found no clinical outcome differences between obese and non-obese patients, with Similar effectiveness of the echinocandins’ SDs in both groups. Further research in multi-centre settings is recommended to detect any potential differences between the two groups.Keywords: echinocandins, candida, obesity, effectiveness

Ahmed M Al-Wathinani,1 Yahia O Dhafar,2 Salah A Aljarallah,3 Muqbil Saad Alqahtani,4 Fahad Abdullah Alamri,5 Awad O Aljohani,6 Majed D Alanazi,7 Turky J Arbaein,8 Amal M Zaidan,9 Mohammed Aljuaid,10 Krzysztof Goniewicz11 1Department of Emergency Medical Services, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, 11541, Saudi Arabia; 2SEHA Virtual Hospital, Ministry of Health, Riyadh, 1154, Saudi Arabia; 3Department of Family Medicine, King Khaled University Hospital, King Saud University, Riyadh, Saudi Arabia; 4Department of Dentistry, College of Dentistry, King Faisal University, Alhafouf, 36932, Saudi Arabia; 5Ambulatory Care Administration, Ministry of Health, Riyadh, 11525, Saudi Arabia; 6Fresenius Kabi Scientific Office Alsaif Building, Riyadh, 1141, Saudi Arabia; 7Department of Family Medicine, General Directorate of Health Affairs in Riyadh Region, Ministry of Health, Riyadh, 12822, Saudi Arabia; 8Department of Health Administration and Hospitals, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia; 9College of Public Health and Health Informatics, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia, King Abdullah International Medical Research Center’s (KAIMRC), Riyadh, Saudi Arabia; 10Department of Health Administration, College of Business Administration, King Saud University, Riyadh, Saudi Arabia; 11Department of Security, Polish Air Force University, Deblin, PolandCorrespondence: Ahmed M Al-Wathinani, Email ahmalotaibi@ksu.edu.saIntroduction: This cross-sectional descriptive study evaluates the experiences and perceptions of healthcare providers (HCPs) regarding the 937 medical call center in Saudi Arabia, a key telemedicine initiative.Aim: To assess HCP satisfaction, identify challenges, and provide recommendations for improvement.Methods: Conducted from November 20th to December 15th, 2022, the study surveyed 454 HCPs, achieving a 90.5% response rate.Results: A majority (86.8%) of respondents were satisfied with the call center, valuing its ease of use and effectiveness in healthcare delivery. However, challenges such as the accuracy of remote medical assessments, the need for clearer telehealth regulations, and concerns over management support and consultation overlaps were identified. The study also highlights the importance of ongoing support and updates, comprehensive telehealth regulations, integration of more medical specialties, and improvements in system integration and data confidentiality.Conclusion: The study underscores the need for strategic enhancements to the 937 call center to further improve healthcare accessibility and efficiency in Saudi Arabia. These enhancements are vital for aligning telehealth services with Saudi Arabia’s healthcare objectives under Saudi Vision 2030.Keywords: telemedicine, Saudi Arabia, health care providers, patient satisfaction, health services accessibility, telehealth, medical informatics, health policy

Contamination of water resources by active pharmaceutical ingredient wastes is among major environmental concerns. To prevent major disruptions of aquatic life, an efficient and environmentally-friendly turbidity removal procedure of common contaminants such as paracetamol should be established. In this study, several natural deep eutectic solvents (NADESs) were screened to reduce the turbidity of simulated water contaminated with paracetamol below the standard turbidity limit recommended by the National Water Quality Standards for Malaysia (50 NTU). The optimal operating parameters (NADES dosage, stirring time and operating pH) were determined. Under optimized conditions, stearic acid-based NADES achieved the highest turbidity removal of 97.5 %. High coagulation performances were investigated based on molecular interaction using COSMO-RS (COnductor like Screening MOdel for Real Solvents) σ-profile and σ-potential (histogram of charge density distribution over molecular surface) and showed high affinity between the NADES compounds and paracetamol. Thus, NADESs are promising candidates for turbidity removal of paracetamol from water and are viable in further investigations for effluent treatment applications.

Mucormycosis (MCM) is a rare fungal disorder that has recently been increased in parallel with novel COVID-19 infection. MCM with COVID-19 is extremely lethal, particularly in immunocompromised individuals. The collection of available scientific information helps in the management of this co-infection, but still, the main question on COVID-19, whether it is occasional, participatory, concurrent, or coincidental needs to be addressed. Several case reports of these co-infections have been explained as causal associations, but the direct contribution in immunocompromised individuals remains to be explored completely. This review aims to provide an update that serves as a guide for the diagnosis and treatment of MCM patients’ co-infection with COVID-19. The initial report has suggested that COVID-19 patients might be susceptible to developing invasive fungal infections by different species, including MCM as a co-infection. In spite of this, co-infection has been explored only in severe cases with common triangles: diabetes, diabetes ketoacidosis, and corticosteroids. Pathogenic mechanisms in the aggressiveness of MCM infection involves the reduction of phagocytic activity, attainable quantities of ferritin attributed with transferrin in diabetic ketoacidosis, and fungal heme oxygenase, which enhances iron absorption for its metabolism. Therefore, severe COVID-19 cases are associated with increased risk factors of invasive fungal co-infections. In addition, COVID-19 infection leads to reduction in cluster of differentiation, especially CD4+ and CD8+ T cell counts, which may be highly implicated in fungal co-infections. Thus, the progress in MCM management is dependent on a different strategy, including reduction or stopping of implicit predisposing factors, early intake of active antifungal drugs at appropriate doses, and complete elimination via surgical debridement of infected tissues.

Our key objective in the present work is to elaborate the concept of activation energy in chemically reactive flow with the help of modeling and computation. The model investigated is fluid flow over a vertical cylinder in the porous medium with chemical reaction and radiation effect. The similarity transform converted the resulting constitutive equations and partial differential equations (PDEs) into ordinary differential equations (ODEs). The resulting non-linear momentum, heat transfer, and mass transfer coupled equations are computed with the Range–Kutta–Fehlberg method. Both assisting and non-assisting buoyant flow conditions are considered, and observed numeric solutions vary with the transport properties. Characteristics of momentum, heat, and concentration under the applied boundary conditions are analyzed. In addition, the increment in activation energy parameters boosts the Lorentz force and mass transfer rate.

This study aimed to assess the level of empowerment experienced by Saudi women through the vocational skills taught in educated neighbourhood programs during the COVID-19 pandemic. Additionally, the research sought to determine whether there were statistically significant differences in empowerment levels based on marital status and the number of courses under-taken. The research uncovered the challenges faced by women during the pandemic, utilising descriptive statistics to collect data. The sample consisted of Saudi females enrolled in Makkah, Saudi Arabia. The results indicated that Saudi women experienced empowerment through the vocational skills acquired in educated-neighbourhood programs. Furthermore, the findings revealed no statistically significant differences in empowerment levels among women based on marital status. However, there were statistically significant differences in the empowerment levels of the participants based on the number of courses taken. The results illustrated that the various challenges faced by women during the pandemic, included isolation at home, psychological coping, dis-continued economic activities, adherence to safety precautions, and access to healthcare.

Ayman M Mousa,1,2 Khaled S Allemailem,1,3 Fahad A Alhumaydhi,3 Faris Alrumaihi,3 Ahmad Almatroudi,3 Ameen S Alwashmi,3 Mohammad Aljasir,3 Osamah Al Rugaie,4 Abdullah SM Aljohani,5 Khaled EA Soliman,4,6 Mohamad Y Rezk,4,7 Ahmed MS Hegazy,8,9 Hanan S Seleem4,10 1Department of Basic Health Sciences, College of Applied Medical Sciences, Qassim University, Buraydah, 51452, Saudi Arabia; 2Department of Histology and Cell Biology, Faculty of Medicine, Benha University, Benha, 13518, Egypt; 3Department of Medical Laboratories, College of Applied Medical Sciences, Qassim University, Buraydah, 51452, Saudi Arabia; 4Department of Basic Medical Sciences, College of Medicine and Medical Sciences, Qassim University, Unaizah, 51452, Saudi Arabia; 5Department of Veterinary Medicine, College of Agricultural and Veterinary Medicine, Qassim University, Buraydah, 51452, Saudi Arabia; 6Department of Forensic Medicine and Clinical Toxicology, Faculty of Medicine, Sohag University, Sohag, 82524, Egypt; 7Department of Medical Physiology, Faculty of Medicine, Zagazig University, Al-Sharquia, 44519, Egypt; 8Department of Anatomy, Faculty of Medicine, Northern Border University, Arar, Saudi Arabia; 9Department of Anatomy and Embryology, Faculty of Medicine, Benha University, Benha, 13518, Egypt; 10Department of Histology and Cell Biology, Faculty of Medicine, Menoufia University, Shebin Elkoum, EgyptCorrespondence: Ayman M MousaDepartment of Basic Health Sciences, College of Applied Medical Sciences, Qassim University, Buraydah, Saudi ArabiaTel +966 598146171Email a.mousa@qu.edu.saBackground: Ifosfamide (IFS) has potential complications such as nephropathy and hemorrhagic cystitis (HC). Although mesna can prevent IFS-induced cystitis by direct binding and neutralization of acrolein, HC symptoms have still been observed clinically in most of these cases. Celery is a powerful healing vegetable that has antioxidant, anti-inflammatory, and anticancer effects. The current study evaluated the synergistic effects of mesna and celery seed on IFS-induced HC in rabbits.Methods: Twenty male rabbits (four groups) were administered distilled water, IFS, mesna, and mesna+celery seed cotherapy (MCC) for three weeks. The serum and urinary bladder of experimental rabbits underwent biochemical (TNF-α, MDA, iNOS, SOD, GPx, and CAT), histopathological and ultrastructural investigations to evaluate the structural changes of the urinary bladder (UB).Results: IFS injection resulted in severe cystitis with a remarkable increase in the scale of hematuria, elevations of TNF-α, MDA, and iNOS activity, and reduced activity of SOD, GPx, and CAT antioxidants. Additionally, the structure of UB exhibited evident mucosal edema and ulceration. In contrast, the MCC regimen group revealed partial synergistic improvement of all mentioned parameters.Conclusion: IFS induced cystitis by releasing acrolein, which exerted a significant role in the pathogenesis of HC. In contrast, the MCC intake partially ameliorated the UB damage through its antioxidant and anti-inflammatory effects.Keywords: ifosfamide, mesna, celery, hemorrhagic cystitis, antioxidants, anti-inflammatory

Currently, nanotechnology is gaining massive attention compared to conventional methods as the biosynthesis of plant-based nanoparticles is considered safe, effective, and ecofriendly. Therefore, keeping in view the importance of nanotechnology, the present study was designed to synthesize, characterize, and evaluate the biological effectiveness of saffron stigma-based gold nanoparticles (SS-AuNPs) for their in vitro and in vivo biological properties. These gold nanoparticles were characterized by UV–Vis spectroscopy, Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), energy-dispersive X-ray spectroscopy (EDX), and X-ray diffraction (XRD). The highest antibacterial effect was observed by the saffron extract against Escherichia coli (22 mm). SS-AuNPs significantly inhibited the activity of enzyme urease (54.98%) and CA-II (64.29%). However, the nonsignificant inhibitory effect was observed in the case of α-chymotrypsin. Maximum analgesic (84.98%) and antiinflammatory (88.98%) effects were observed for SS-AuNPs (10 mg/kg). Similarly, SS-AuNPs demonstrated a significant (P < 0.01) sedative effect at all tested doses.

Ahmed AH Abdellatif,1,2 Zafar Rasheed,3 Ahmad H Alhowail,4 Abdulmajeed Alqasoumi,5 Mansour Alsharidah,6 Riaz A Khan,7 Abdullah SM Aljohani,8 Maha A Aldubayan,4 Waleed Faisal9,10 1Department of Pharmaceutics, College of Pharmacy, Qassim University, Buraydah 51452, Kingdom of Saudi Arabia; 2Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut 71524, Egypt; 3Department of Medical Biochemistry, College of Medicine, Qassim University, Buraydah 51452, Kingdom of Saudi Arabia; 4Department of Pharmacology and Toxicology, College of Pharmacy, Qassim University, Buraydah 51452, Kingdom of Saudi Arabia; 5Department of Pharmacy Practice, College of Pharmacy, Qassim University, Buraydah 51452, Kingdom of Saudi Arabia; 6Department of Physiology, College of Medicine, Qassim University, Buraydah 51452, Kingdom of Saudi Arabia; 7Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, Qassim University, Buraydah 51452, Kingdom of Saudi Arabia; 8Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah, Kingdom of Saudi Arabia; 9School of Pharmacy, University College Cork, Cork, Ireland; 10Faculty of Pharmacy, Minya University, Minya, EgyptCorrespondence: Ahmed AH AbdellatifCollege of Pharmacy, Qassim University, Buraydah 51452, Kingdom of Saudi ArabiaEmail a.abdellatif@qu.edu.saBackground: The nuclear factor kappa-B (NF-κB) is a major transcription factor responsible for the production of numerous inflammatory mediators, including the tumor necrosis factor (TNFα), which has a lethal association with cancer’s onset. The silver nanoparticles (AgNPs) are widely used in cancer treatment and several other biomedical applications.Objective: The study aimed to determine the effects of silver citrate nanoparticles (AgNPs-CIT) on NF-κB activation together with TNFα mRNA/protein expressions in the phorbol myristate acetate (PMA)-stimulated MCF-7 human breast cancer cell-lines.Methods: The AgNPs-CIT were synthesized by the reduction method, and the prepared AgNPs-CIT were characterized for their shape, absorption in UV-VIS electromagnetic radiations, size distribution, ζ-potential, and antioxidant activity. The MCF-7 cell-lines were pretreated with AgNPs-CIT and stimulated with PMA. The TNFα mRNA expressions were determined by real-time PCR, whereas the protein production was determined by the ELISA. The NF-κB activity was distinctly observed by highly-specific DNA-based ELISA, and by NF-κB-specific inhibitor, Bay 11– 7082.Results: The prepared AgNPs-CIT were spherical and have an absorption wavelength range of 381– 452 nm wherein the particles size ranged between 19.2± 0.1 to 220.77± 0.12 nm with the charge range − 9.99± 0.8 to − 34.63± 0.1 mV. The prepared AgNPs-CIT showed comparative antioxidant activity at > 40% inhibitions level of the DPPH radicals. The AgNPs-CIT were found to be non-toxic to MCF-7 cell-lines and inhibited PMA-induced activation of the NF-κBp65, and also the mRNA/protein expression of TNFα.Conclusion: This is the first report that showed AgNPs-CIT inhibited TNFα expression via deactivation of the NF-κB signaling event in stimulated breast cancer cells. The results have important implications for the development of novel therapeutic strategies for the prevention/treatment of cancers and/or inflammatory disorders.Keywords: phorbol myristate acetate, PMA, TNFα, NF-κB, silver citrate nanoparticles, MCF-7 cell lines, cancer, inflammatory cytokines

Double diffusion inside a square porous cavity being subjected to conjugate heat transfer arising because of the square solid block at the center is studied under homogeneous properties. The double diffusive equations along with the conjugate effect due to square block are subjected to solution through finite element method (FEM). The right vertical surface of cavity remains at cool temperature (Tc) and concentration (Cc), whereas the hot temperature (Th) and higher concentration (Ch) is maintained at the left surface of the cavity. The investigated parameters considered are the Rayleigh number (Ra), Thermal conductivity ratio (Kr), Lewis number (Le), Buoyancy ratio (N) and the height of solid block (B). The outcomes are presented in terms of contours of concentration, isotherms and streamlines, along with local Sherwood number (Sh) and Nusselt number (Nu). The fluid is found to rush around the top left corner of solid. The mass transfer has sharp rise around the top left corner of the solid block.

This study compared the use of delivering a single instruction (e.g., Who is it?) versus varied instructions (e.g., What's their name? Who is this? What about this one?) when teaching three children diagnosed with autism spectrum disorder (ASD) novel expressive label targets via direct telehealth. The present investigation utilized an adapted alternating treatments design nested into a multiple probe design, to teach participants to expressively label pictures of cartoon characters using either a single instruction or varied instructions. The goal of this study was to evaluate the acquisition, effectiveness, and efficiency of the two different procedures for each participant. The results demonstrated that while students learned all targets in both conditions, skill acquisition rates were slightly higher for the majority of participants using varied instructions via telehealth.

Primary school students with both giftedness and learning disabilities (SGLD) in inclusive educational settings may not always receive a differentiated curriculum. Differentiation in all-level classrooms is necessary for consistently meeting the needs of SGLD. There is insufficient research on teachers' knowledge of SGLD and differentiation in Saudi Arabia and the Middle East. To fill this knowledge gap, we interviewed 9 primary school teachers in Madinah, Saudi Arabia. The interview data were analysed using content analysis. Our conceptual framework is based on the theories of Howard Gardner, who believe that all students learn in different ways. We also considered Lev Vygotsky's view that students learn best with instructions that meet their individual developmental level and address their zone of proximal development. Our findings suggest that teachers are willing to teach SGLD along with other students in the same classroom. Although they understand that differentiation is important, they were not implementing it for SGLD. Professional training and development related to teaching SGLD can improve the educational outcomes for SGLD. These results can assist teachers and educational personnel to seek optimal methods to identify and assist SGLD in Saudi Arabia and other regions. Finally, we provide recommendations for accommodations, strategies, and a differentiated curriculum for SGLD in primary schools.

In today's world of accelerated progress and change, the skills to solve problems, think critically, communicate effectively, and manage lives are essential for people to flourish in the 21st century. The purpose of the study is to explore the role of Learning Neighborhood Programme for achieving the necessary life skills that adult learners need to help them during the present pandemic. The research also investigates if there is a difference, by gender and number of courses, to confront the COVID-19 crisis and the benefits that participants received during the pandemic. A self-administered questionnaire was utilized. The results illustrated that the adult learners who enrolled in the Learning Neighborhood Programme perceived the benefit of life skills by practicing these skills during the crisis. Additionally, the results revealed differences for both life skills based on the number of courses that learners had taken during the present pandemic for people who took five or more courses.