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Abstract Cystinosis is a rare lysosomal storage disorder caused by a variant in the CTNS gene that leads to the accumulation of cystine in the body’s tissues. It has been classified into three subtypes based on its clinical presentation: severe infantile nephropathic cystinosis, intermediate mild form, and ocular non-nephropathic adult form. We report a teenage girl who presented with end stage kidney disease as her first presentation and was found to have corneal cystine crystals upon ophthalmic evaluation. Genetic testing confirmed that she has a CTNS variant, a CTNS variant c.520A > C p.(Ser174Arg) never described in the literature previously. Full family genetic screening supported the diagnosis. She was started on oral and ocular cysteamine and maintained on peritoneal dialysis for a few months and eventually underwent a successful deceased donor kidney transplantation. These findings expand the spectrum of CTNS gene variants and highlight the potential of atypical and severe presentations of this variant during adolescence.

BACKGROUND: One common and blinding consequence of diabetes is diabetic retinopathy. However, adherence to regular screening remains a challenge for Saudi adults. The goal of this study is to investigate and identify the barriers that hinder Saudi diabetic adults from adhering to screening for diabetic retinopathy. MATERIALS AND METHODS: This cross-sectional study was conducted in a sample of adult diabetic patients throughout Saudi Arabia. Data was collected using a self-administered validated questionnaire comprising following five primary sections: sociodemographic information, profile of diabetes, knowledge of diabetic retinopathy, behaviors, and hurdles to diabetic retinopathy screening. Sample selected using snowball sampling technique. Questionnaire was converted into Google Forms and was shared with study participants via E-mail and several social media sites, including Facebook and WhatsApp during November and December 2023. Data analyzed using SPSS; mean and standard deviation were calculated for continuous variables, whereas categorical data was presented as frequency and percentage. Logistic regression analysis determined barriers for adherence to screening for diabetic retinopathy. RESULTS: The mean age of the study group was 61.6 ± 15 years, and 58.3% were female. Out of 393 respondents, 71% had undergone retinopathy screening in the past few months; 29.0% had a history of diabetic retinopathy. Participants who knew about retinopathy were eight times more likely to have eye screening compared to those who did not know about retinopathy (odds ratio = 8.05, P < 0.001). Less screening chance was observed among those who had acquired their knowledge from the Internet (odds ratio = 0.23, P = 0.002) or relatives (odds ratio = 0.21, P = 0.002) compared to those who had been advised by their physicians. CONCLUSION: These findings underscored the multifaceted nature of barriers to regular screenings within the Saudi Arabian healthcare system. By understanding and addressing these barriers, healthcare systems can enhance the effectiveness of screening programs and improve health outcomes.

Abstract Background Virtual journal clubs (VJCs) are innovative technologies with the potential to foster collaboration, facilitate multilingual communication, improve cultural competencies, and expand global professional networks. This allowed participants to be exposed to critical appraisal of the articles. However, its long-term impact on competency development has been debated. This study aimed to investigate the impact of implementing VJCs on developing competencies for critical appraisal among postgraduate nursing students. Methods A quasi-experimental (pretest/posttest one-group) research design was used with a convenience sample of 40 participants from the community health nursing department, Faculty of Nursing, Mansoura University, Egypt who agreed to participate. The participants received an online self-administered knowledge and attitude data collection tool through Google Forms. However, critical appraisal skills were evaluated by an observational checklist with a rubric through synchronized mode. Eleven VJC sessions were conducted for each participant. Descriptive analysis served as the primary method for analyzing participants’ responses. Students’ t-test and one-way analysis of variance (ANOVA) were used to measure differences between the pretest and post-test. The study also used a correlation test to assess the relationship of variables. Results The findings indicated a highly statistically significant difference among the participants regarding knowledge, critical appraisal skills, and attitudes toward VJC before, immediately, and six months after VJC session implementation. In addition, a positive significant correlation with a highly statistically significant difference between the participants’ total knowledge score levels, total practice score levels, and total attitude score levels in the immediate post and after six months of VJC session implementation (p

Abstract Background Endovascular thrombectomy (EVT) has emerged as the established standard of care for the treatment of anterior circulation large-vessel occlusion (LVO). However, its benefits remain unclear in specific patient populations. Herein, we present an updated systematic review and meta-analysis aimed at thoroughly assessing the effectiveness and safety of combining EVT with medical treatment (MT) compared with MT alone. Methods This systematic review was performed in accordance with the PRISMA guideline. The MEDLINE, Embase, and Cochrane databases were systematically searched to identify relevant articles published until December 30, 2023. The inclusion criteria restricted articles to randomized clinical trials (RCTs). We pooled odds ratios (OR) and their respective 95% confidence intervals (CIs). Results Fifteen RCTs involving 3897 patients were included in the study. EVT plus MT was associated with a significant reduction in disability at 90 days (OR = 1.91, [1.61–2.26]), improved functional independence (modified Rankin Scale [mRS] 0–2) (OR = 2.19 [1.81–2.64]), excellent functional outcomes (mRS 0–1) (OR = 2.37, [1.45–3.87]), improved independent ambulation (mRS 0–3) (OR = 2.17, [1.75–2.69]), and higher rates of partial/complete recanalization (OR = 2.18, [1.66–2.87] compared with EVT. Efficacy outcomes for both large and small infarct cores were statistically favorable following EVT. Safety outcomes showed comparable rates, except for intracerebral and subarachnoid hemorrhage, which favored MT alone. Conclusion This meta-analysis supports the use of EVT plus MT as the standard of care for acute ischemic stroke patients with LVO of any infarct core size, as it offers substantial improvements in functional outcomes and recanalization. Safety considerations, particularly the risk of hemorrhage, warrant careful patient selection. These findings provide valuable insights for optimizing stroke management protocols and enhancing patient outcomes.

As a last option, multidrug-resistant Gram-negative infections (caused by Enterobacteriaceae) are treated with the antibiotic colistin, also known as polymyxin E. Colistin-resistant superbugs predispose people to untreatable infections, possibly leading to a high mortality rate. This project aims to study the effect of Acacia nilotica aqueous extract and zinc oxide nanoparticles (ZnO-NPs) on colistin-resistant Klebsiella pneumonia (CRKP).

Abstract Background Palm kernel meal (PKM) is a by-product of oil palm kernel after oil extraction, which is widely used in animal feeds due to its high energy content. This study aimed to investigate the impact of supplementing Tibetan sheep with PKM on their hepatic phenotype, oxidative stress and immune response. A total of 120 Tibetan lambs (Initial weight = 12.37 ± 0.92 kg) were randomly assigned into four groups: control group (C group, 0% PKM diet), low group (L group, 15% PKM diet), middle group (M group, 18% PKM diet), and high group (H group, 21% PKM diet) on a dry matter basis. The feeding experiment was performed for 130 d, including a 10 d adaption period. Results Results showed that the level of GSH-Px were higher in the H and M groups than in the C and L groups (P

Khalid Al Sulaiman,1– 5 Ohoud Aljuhani,6 Ghazwa B Korayem,7 Mashael AlFaifi,8 Abdullah F Alharthi,9 Asma Alshehri,1,10 Mashael S Alaboud,11 Ibtesam Saeed Alzahrani,2 Batoul Abdullah Alenazi,2 Fai Farhan Alanazi,2 Hessah Alrashidi,2 Sara Mohammad Alotaibi,2 Khuld Aloufi,1,3 Rawan M Alotaibi,2 Mai Alalawi,11 Ali Faris Altebainawi,12,13 Mohammad Y Alshami,14 Abeer A Alenazi,10 Ghaida A Abalkhail,2 Renad Bin Naheet,1 Rawan Mohammed Abu Alnasr,15 Mohammed Alrashed,1– 3 Faisal E Al Mutairi,1 Khalid J Albarqi,2 Rawan S Alshammari,13 Norah M Abunayyan,13 Wadha J Aldhmadi,13 Ramesh Vishwakarma16 1Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; 2College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 3King Abdullah International Medical Research Center-King Saud Bin Abdulaziz University for Health Sciences, Ministry of National Guard – Health Affairs, Riyadh, Saudi Arabia; 4Saudi Critical Care Pharmacy Research (SCAPE) Platform, Riyadh, Saudi Arabia; 5Saudi Society for Multidisciplinary Research Development and Education (SCAPE Society), Riyadh, Saudi Arabia; 6Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; 7Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia; 8Pharmaceutical Care Department, King Saud Medical City, Riyadh, Saudi Arabia; 9Department of Clinical Pharmacy, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Al-D, Al-Dawadmi, 11961 Saudi Arabia; 10Pharmaceutical Care Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia; 11Pharmaceutical Care Department, King Abdulaziz Medical City, Jeddah, Saudi Arabia; 12Pharmaceutical Care Services, King Salman Specialist Hospital, Hail Health Cluster, Hail, Saudi Arabia; 13Department of Clinical Pharmacy, College of Pharmacy, University of Hail, Hail, Saudi Arabia; 14Pharmaceutical Care Services, King Abdulaziz Hospital, Ministry of National Guard Health Affairs, Al-Ahsa, Saudi Arabia; 15Pharmaceutical Care Department, King Fahad Medical City, Riyadh, Saudi Arabia; 16Norwich Medical School, University of East Anglia, Norwich, UKCorrespondence: Khalid Al Sulaiman, King Abdulaziz Medical City (KAMC) - Ministry of National Guard Health Affairs (MNGHA), King Abdullah International Medical Research Center/King Saud bin Abdulaziz University for Health Sciences, PO Box 22490, Riyadh, 11426, Saudi Arabia, Email alsulaimankh@hotmail.com Abdullah F Alharthi, Department of Clinical Pharmacy, College of Pharmacy, Shaqra University, Al-Dawadmi Campus, Al-Dawadmi, 11961, Saudi Arabia, Email A_alharthi@su.edu.saBackground: There is increasing evidence suggesting that ABO blood type may play a role in the immunopathogenesis of COVID-19 infection. In addition to ABO blood type, the Rhesus (Rh) factor has also been implicated in various disease processes. Therefore, our study aimed to assess the association between both ABO and Rh blood types in critically ill patients with COVID-19 and their clinical outcomes.Methods: A multicenter retrospective cohort study conducted in Saudi Arabia between March 1, 2020, and July 31, 2021, involving adult COVID-19 patients admitted to Intensive Care Units, aimed to explore potential associations between rhesus blood group types (Positive versus Negative) and clinical outcomes. The primary endpoint assessed was the hospital length of stay (LOS). Other endpoints were considered secondary.Results: After propensity score matching (3:1 ratio), 212 patients were included in the final analysis. The hospital length of stay was longer in a negative Rh blood group compared with patients in the Rh-positive group (beta coefficient 0.26 (0.02, 0.51), p = 0.03). However, neither 30-day mortality (HR 0.28; 95% CI 0.47, 1.25, p = 0.28) nor in-hospital mortality (HR 0.74; 95% CI 0.48, 1.14, p = 0.17) reached statistical significance. Additionally, among the different ABO types, the A+ blood group exhibited a higher proportion of thrombosis/infarction and in-hospital mortality (28.1% and 31.2%, respectively).Conclusion: This study highlights the potential impact of blood group type on the prognosis of critically ill patients with COVID-19. It has been observed that patients with a negative Rh blood group type tend to have a longer hospital stay, while their mortality rates and complications during ICU stay are similar to the patients with a Rh-positive group.Keywords: rhesus blood group, Blood group, ABO, length of stay, intensive care units, Critically ill, COVID-19, SARS-CoV-2, acute kidney injury, mortality, MV duration

Aim: This study aimed to evaluate dental esthetic screening index (DESI) Intraoral component scores among patients attending Qassim University dental clinics and the factors affecting these scores. Materials and methods: This was a retrospective study that included 150 participants aged 18 years or older with full upper and lower anterior dentitions. Standardized intraoral frontal photographs of the patients’ upper and lower dentitions were acquired from their dental records, and the mean rank DESI intraoral scores were evaluated and compared across the demographic and dental characteristics of the study patients.The mean age of the patients sampled was 33.56; 57 % were female and 43 % were male. The mean DESI Intraoral score was 15.33. DESI scores were significantly higher in patients older than 35 years compared with subjects 35 years old or younger (p = 0.015). DESI scores were increased in patients who had anterior restorations compared with those who did not (p = 0.016). Conclusions: This was the first study of its kind to use the DESI in a large clinical setting. According to the DESI, most patients attending Qassim University dental clinics had good dentofacial aesthetics. Age and the presence of anterior restorations negatively impacted patients' dentofacial aesthetics. Sex, the nature of the chief complaint, a history of orthodontic treatments, and teeth bleaching did not affect the DESI scores.

In order to study the impact of seasonality on Zika virus dynamics, we analyzed a non-autonomous mathematical model for the Zika virus (ZIKV) transmission where we considered time-dependent parameters. We proved that the system admitted a unique bounded positive solution and a global attractor set. The basic reproduction number, $ \mathcal{R}_0 $, was defined using the next generation matrix method for the case of fixed environment and as the spectral radius of a linear integral operator for the case of seasonal environment. We proved that if $ \mathcal{R}_0 $ was smaller than the unity, then a disease-free periodic solution was globally asymptotically stable, while if $ \mathcal{R}_0 $ was greater than the unity, then the disease persisted. We validated the theoretical findings using several numerical examples.

Objective: The aim of this systematic review was to assess the prevalence of periodontal disease among Saudi Arabian adults based on studies conducted from 1992 to 2023. Methods: The study protocol was registered in PROSPERO. Three databases (MEDLINE, EMBASE and Cochrane library) and the Saudi Dental Journal were searched for published literature up to June 2023 using prespecified search strategy. Quality of included studies was checked using the risk of bias in population-based prevalence studies tool. Results: The systematic review included 15 studies that assessed the prevalence of periodontal disease in Saudi Arabia. Most of the studies used non-confident case definitions. The pooled estimate of periodontal disease prevalence in Saudi Arabia based on the data of 14 which included 6,596 individuals is 51% (95% CI: 35.99, 73.05). Conclusion: Periodontal disease is a significant public health issue in Saudi Arabia, with a substantial prevalence among the included participants. Nevertheless, the existing studies exhibit methodological disparities and regional limitations. Therefore, while the results shed light on the pressing nature of periodontal disease in Saudi Arabia, further comprehensive research is imperative. A more accurate estimate, coupled with effective strategies, can be achieved through broader, multidisciplinary collaborations and the prioritization of a national oral health survey in Saudi Arabia.

Introduction Radiography is a crucial healthcare specialty that requires ongoing research to advance imaging technologies and techniques. Despite this, radiographers are faced with obstacles such as time constraints, lack of resources, and the need for training on new technologies, which can discourage their research involvement. This study aims to provide a more representative understanding of the radiography research culture in Saudi Arabia, building upon previous studies. Methods Following the approval of an ethics committee at Taibah University (2024/173/302 DRD), a cross-sectional survey was conducted from January to March 2024 among registered radiographers in Saudi Arabia. An online questionnaire was distributed via social media platforms using a snowball sampling strategy to reach a diverse group of radiographers across different regions and institutions. Participants provided informed consent before completing the questionnaire. The questionnaire, originally in English, was translated into Arabic and validated by two bilingual academics. It included sections on demographics, previous research experience, barriers to research involvement, factors encouraging research engagement, and self-assessment of research competencies. Descriptive statistics and Cronbach’s alpha were used to analyze the data. Results A total of 105 radiographers participated in the study, with 41% having prior research involvement. Among those engaged, the most common activity was data collection (65%), followed by preparation of scientific articles (49%). Challenges such as the lack of a research-focused culture (48%), insufficient awareness of opportunities (36%), and time constraints (34%) were prominent barriers to research participation. Encouraging factors included the need for research training (63%), support from research groups (51%), and allocated research time (50%). Respondents assessed their research skills, with confidence varied across skills, with 50% feeling capable of initiating research and 51% of participating, yet a significant proportion expressed uncertainties, especially in statistical knowledge and research methodology. Conclusion Most of the surveyed radiographers did not engage in research. However, there is a substantial interest in enhancing research involvement, with training, collaborative groups, and organizational support identified as key factors encouraging participation. The findings suggest that addressing these barriers can foster a more robust research culture, leading to improved diagnostic practices.

ABSTRACT An eco-friendly method of extraction for chitin and chitosan extracted from crawfish was our goal. Chitin is always present with proteins, minerals, and other components. This study used an eco-accommodating, novel technique for chitin and chitosan extraction. Lactobacillus lactis was used for the deproteinization and demineralization of chitin in a single stage by Saccharomyces cerevisiae (BB: biological-biological extraction) to convert chitin into chitosan. BB is a more environmentally friendly method of producing chitosan than deacetylation with NaOH (BC: biological-chemical extraction). Chitosan was characterized by FTIR. A high degree of deacetylation (%) was observed. The UV spectrum for chitosan was similar at 0.788, 0.415, and 1.150 for CC, BC, and BB, respectively. The results show that chitosan (BB) has potential applications in the biomedical fields such as antioxidant activity, anticancer activity against human liver cancer (HepG2), breast cancer (MCF-7) and human hepatocellular carcinoma (HCT) cell lines. The results in terms of water treatment and removal of dyes using chitosan (BB) are valuable in terms of its application in industrial wastewater treatment and demonstrate that it can be used as a biosorbent.

Plant growth-promoting bacteria (PGPB) are considered a promising tool for triggering the synthesis of bioactive compounds in plants and to produce healthy foods. This study aimed to demonstrate the impact of PGPB on the growth, accumulation of primary and secondary metabolites, biological activities, and nutritional qualities of Eruca sativa (arugula), a key leafy vegetable worldwide. To this end, Jeotgalicoccus sp. (JW0823), was isolated and identified by using partial 16S rDNA-based identification and phylogenetic analysis. The findings revealed that JW0823 significantly boosted plant biomass production by about 45% (P

Klebsiella pneumoniae is a Gram-negative bacterium known for causing infections such as pneumonia, urinary tract infections, and bloodstream infections in humans. Its increasing drug resistance poses a significant threat. Understanding the effects of climate change on this bacterium is crucial to managing its impacts effectively. In this study, we employed MaxEnt modeling to explore the current and future distribution of K. pneumoniae under different climate change scenarios for 2050 and 2070. Our models utilized 280 valid occurrence points and 19 bioclimatic variables, with Mean Annual Temperature and Mean Annual Precipitation being the most influential variables. The models demonstrated high accuracy, with an AUC of 0.889. Our findings revealed that K. pneumoniae has a cosmopolitan distribution, with the highest suitability observed in Southeastern Asia, Central Africa, and Southern Europe. Future predictions indicated an apparent expansion of its range across almost all continents, particularly in the RCP 8.5 2070 scenario. Results have crucial implications for epidemiology, as they enable the identification of current and potential future disease hotspots and geographical patterns. This knowledge can inform the development of effective infection control strategies. Furthermore, it provides valuable insights for decision-makers and policymakers in allocating resources efficiently for medical control and prevention strategies.

ABSTRACT Among marine creatures including squids, cephalopods and Octopus, one of the most unique features is production of ink which is an extremely valuable source of pharmaceuticals. The current study investigates the ink produced from Octopus vulgaris chemically as well as its potential antioxidant, anticancer, antimicrobial, and anti-schistosomal activities in vitro. Twenty-one different compounds were identified by GC-MS analysis of Octopus vulgaris ink. Results revealed that O. vulgaris ink had antioxidant capability to cover DPPH free radical when compared to ascorbic acid. Moreover, Octopus vulgaris ink exhibited antibacterial activity against Bacillus subtilis followed by Escherichia coli and Pseudomonas aeuroginosa and exhibited a molluscicidal activity against adult Biomphalaria alexandrina snails and had a distinguished mortal effect on free larval phases of Schistosoma mansoni. Furthermore, its anticancer activity was confirmed, where IC50 value of breast cancer cell line MCF-7, human hepatocellular carcinoma (HCT) and human liver cancer cell line (HepG2) were 29.8, 38.29 and 30.38μg/mL, respectively. In conclusion, ink extracted from O. vulgaris may be considered as source of valuable compounds that can be used as molluscicidal, antioxidant, antimicrobial, anticancer and anti-schistosomal agents.

Soil fertility and crop productivity in the Nile Delta are severely threatened by soil salinization. Hence, the development of reliable techniques to enhance the salinity tolerance of plants is an essential prerequisite for the desirable sustainable agricultural development in Egypt. In the present study, we evaluated the influence of seeds priming using a magnetic field (MF) at different exposure times (0, 15, 30, and 45 min), either alone or combined with seeds pre-soaking or foliar spraying with seaweed extracts of Hydroclathrus clathratus and Acanthophora spicifera. The effects on soil properties, growth, yield, and seed quality of Vicia faba grown in saline soil were assessed. Results indicated that MF-treated seeds (MFTS), either alone or coupled with seaweed treatments, distinctly improved soil characterization by decreasing EC and pH niches, and also increased the availability of soil macro- and micronutrient elements, particularly at MF long exposure time (≥30 min). MFTS and/or MFTS with seaweed treatments at 30 min improved soil fertility indices (CO2 evolution and nitrogenase activity) and induced the highest increases of macro- and micro-nutrient contents in seeds, plant growth and seed quality. Additionally, enhancement of chlorophyll a and b, carbohydrates and amino acids, and decreasing proline levels were the bases of salinity stress alleviation. Conclusively, seed priming in the MF coupled with foliar spraying of seaweed extracts could be a sustainable and affordable approach for cultivating V. faba plants under salinity stress conditions.