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Background The Kingdom of Saudi Arabia is seeking malaria eradication. Malaria transmission has been very low over the last few years. Discovered cases of Plasmodium falciparum infection are assigned a treatment protocol of artemisinin-based combination therapy, which consists of artesunate in addition to sulfadoxine-pyrimethamine rather than the traditional chloroquine, which has high resistance rates worldwide. This study aims to investigate the presence of different gene mutations concerning anti-malarial drug resistance ( pfdhfr, pfdhps, pfmdr1, pfcrt, pfcytb, pfketch13 ) to identify whether drug-resistant alleles are present in this area of the Kingdom and whether the country’s treatment protocol is still suitable for Plasmodium bearing a resistance mutation. Methods Blood samples were collected from patients suffering from symptoms suggesting malaria coming to King Faisal Hospital, Taif, from February to August 2016. Diagnosis was performed by Giemsa-stained thin and thick blood films, rapid diagnostic test and PCR. Positive P. falciparum samples were further subjected to series of PCR amplification reactions targeting genes related with drug resistance ( pfdhfr, pfdhps, pfmdr1, pfcrt, pfcytb , pfketch13 ). Results Twenty-six cases were positives, 13 infected with P. falciparum , of those, 4 cases were autochthonous, and 13 with Plasmodium vivax . The results of the gene mutation detection confirmed that there was no mutation related to resistance to artemisinin or atovaquone, on the other hand chloroquine resistance alleles were detected in 31% of samples. Moreover, point mutations in the pfdhfr and pfdhps genes, related resistance to antifolate drugs, were detected in all characterized samples. Conclusions Haplotypes of P. falciparum in the western region of the Kingdom of Saudi Arabia exhibit high resistance against antifolate drugs. These results should be extensively discussed when planning to modify anti-malarial drug protocols in the future.

BackgroundCurrently, little is known regarding the association of metabolic comorbidities and disability among multiple sclerosis (MS) patients.ObjectivesTo evaluate insulin resistance (IR) and metabolic syndrome (MetS) in multiple sclerosis patients and their effect on disease progression and disability.Subjects and methodsThis case-control study was conducted on 50 MS patients and 25 healthy individuals. They were subjected to clinical evaluation and laboratory assessment for metabolic syndrome and insulin resistance. The homeostasis model assessment (HOMA) was used as a measurement of insulin sensitivity. Disability was evaluated by the Extended Disability Status Scale (EDSS).ResultsAs compared to control group, MS patients had a significantly higher prevalence of metabolic syndrome (22% vs 8%, p = 0.04) and insulin resistance (46% vs 0%, p < 0.001). Patients group had significantly higher systolic blood pressure (p = 0.005), waist circumference (p < 0.001), fasting blood sugar (p < 0.001), insulin level (p = 0.001), low-density lipoproteins (p = 0.01), triglycerides (p = 0.02), HOMA-IR (p < 0.001), and significantly lower high-density lipoproteins (p = 0.01). No differences in neurological disability was reported between patients who have MetS (p = 0.7) or IR (p = 0.3) and those who do not.ConclusionInsulin resistance and metabolic syndrome are more prevalent among MS patients; however, their association with disability and disease progression is questionable.

Objective In epilepsy, early diagnosis, accurate determination of epilepsy type, proper selection of antiseizure medication, and monitoring are all essential. However, despite recent therapeutic advances and conceptual reconsiderations in the classification and management of epilepsy, serious gaps are still encountered in day‐to‐day practice in Egypt as well as several other resource‐limited countries. Premature mortality, poor quality of life, socio‐economic burden, cognitive problems, poor treatment outcomes, and comorbidities are major challenges that require urgent actions to be implemented at all levels. In recognition of this, a group of Egyptian epilepsy experts met through a series of consecutive meetings to specify the main concepts concerning the diagnosis and management of epilepsy, with the ultimate goal of establishing a nationwide Egyptian consensus. Methods The consensus was developed through a modified Delphi methodology. A thorough review of the most recent relevant literature and international guidelines was performed to evaluate their applicability to the Egyptian situation. Afterward, several remote and live rounds were scheduled to reach a final agreement for all listed statements. Results Of 278 statements reviewed in the first round, 256 achieved ≥80% agreement. Live discussion and refinement of the 22 statements that did not reach consensus during the first round took place, followed by final live voting then consensus was achieved for all remaining statements. Significance With the implementation of these unified recommendations, we believe this will bring about substantial improvements in both the quality of care and treatment outcomes for persons with epilepsy in Egypt. Plain Language Summary This work represents the efforts of a group of medical experts to reach an agreement on the best medical practice related to people with epilepsy based on previously published recommendations while taking into consideration applicable options in resource‐limited countries. The publication of this document is expected to minimize many malpractice issues and pave the way for better healthcare services on both individual and governmental levels.

Following publication of the original article [1], it was flagged by one of the authors that the name of the P. falciparum gene marker of artemisinin resistance 'pfkelch13' was (incorrectly) written as \"pfketch13\", which was repeated seven times in different parts of the published paper.

Biosorption is a simple and economical method utilized to remove hazardous elements from a waste solution. In this study, a low-cost agricultural waste, Salvadora Persica, was modified with iron oxyhydroxide and evaluated as an economic biosorbent to remove cesium and europium radionuclides from their aqueous solutions. The modified biosorbent was characterized by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), X-ray diffraction (XRD), elemental analysis as well as thermogravmetirc analysis (TGA). The sorption of 134 Cs and 152+154 Eu radioisotopes was investigated singly in a batch mode as a function of the solution pH, contact time, and the initial concentrations of the studied ions. The kinetic of the removal process was examined and it was found that the reaction obeys a pseudo-first-order model and the intraparticle diffusion is not the sole mechanism dominating the reaction. Temkin and Sips isotherm models provide the best fit for the equilibrium data. In addition, the sorption of cesium and europium ions was a spontaneous and endothermic process as inferred from thermodynamic studies. The reusability for the sorption of cesium and europium ions reveals the feasibility and efficacy of the modified biosorbent.

New ecofriendly Biginelli reaction procedures have been adapted to prepare new dihydropyrimidines (DHPMs) using a multicomponent one-pot reaction. All the synthesized compounds were evaluated for their anticancer activity against 59 human cancer cell lines and evaluated for their antimicrobial activities against representatives of both Gram-positive and Gram-negative bacteria. Compound 4 showed marked wide spectrum anticancer activity towards most of the tested cancer cell lines with a percentage of growth inhibition of 29.04-71.68% against leukemia cell line (K-562 and SR), lung cancer cell line (NCI-H522), five colon cancer cell lines (HCT-116, HCT-15, HT29, KM12 and SW-620), CNS cancer cell line (SF-295 and SNB-75), melanoma cell lines (MALME-3M and M14), renal cancer cell line (CAKI-1) and breast cancer cell lines (MCF7 and MDA-MB-468). The highest observed anticancer activity was against leukemia cell lines K-562 and SR with inhibition percentages of 64.97 and 71.68%, respectively. The renal cancer cell line (UO-31) was particularly sensitive towards all the evaluated compounds. Compounds including 2b and 5c exhibited antibacterial activity against S. aureus while 2a and 5b exhibited antifungal activity against C. albicans. The results also showed that compounds 2c and 5e exhibited both antibacterial and antifungal activity against S. aureus and C. albicans respectively.

Background Pulmonary hypertension “PH” is considered a serious cardiovascular disease. World Health Organization divided PH into groups depending on many factors like pathological, hemodynamic, and clinical pictures. Lately, various micro-RNAs “miRNAs” and other novel biomarkers like endoglin and asymmetric dimethylarginine “ADMA” might have a role in diagnosis of PH and may differentiate between pulmonary arterial hypertension “PAH” and non-PAH. The purpose of the study is to show the role of miR-21, miR-124, endoglin and ADMA in the diagnosis of PH and distinguishing between WHO group 1 PH and WHO group 2 and 3 PH and to identify patients who might benefit from non-invasive and inexpensive tools to diagnose PAH. Results miR-21 was upregulated in group 1 PH, and there was significant difference between group 1 PH as compared with group 2 PH, group 3 PH and control; miR-124 was down-regulated in group 1 PH with highly significant difference between group 1 and group 2 PH and control but no significant difference with group 3 PH, endoglin was elevated in group 1 PH with a significant difference as compared to group 2 PH, group 3 PH and control. ADMA was elevated in group 1 PH as compared to control; however, there was no significant difference between it and group 2, 3 PH. Conclusions miR-21, miR-124, endoglin and ADMA are good biomarkers to diagnose PH; however, only miR-21 and endoglin could distinguish group 1 PH from group 2 and 3 PH.

Biotransformation plays a significant role in sustainable agriculture. This process involves utilizing microorganisms, such as bacteria and fungi, to transform organic compounds and metabolites into bioactive compounds which have beneficial effects on plant growth, yield, and soil characters. Accordingly, the present study aims to explore the role of biotransformation of Acacia nilotica metabolites by Aspergillus subolivaceus in boosting L. termis yield, as an important strategy in agricultural sustainability. A pilot experiment was performed on five fungal strains (Fusarium oxysporium A. aculeatus, Aspergillus. subolivaceus, Rhizopus oryzae and Trichoderma viride) which were grown on different parts of plants (A. nilotica leaves; green tea leaves, green pepper fruits and pomegranate fruits), and the results indicated that the most active metabolite for the growth of L. termis seeds was the fungal metabolite of A. subolivaceus growing on A. nilotica. More specifically, we assess how metabolites produced by Aspergillus subolivaceus using A. nilotica leaves affect the biochemical properties and chemical composition of L. termis seeds. A. subolivaceus was grown on leaves from A. nilotica to obtain metabolites and fractionated into four extracts. Two concentrations of each extract were examined by pretreating the seeds of L. termis. The study found that all four extracts contributed to an increase in yield and some biochemical properties of the yielded seeds. The best results were obtained by treating the L. termis seeds with an extract obtained from diethyl ether, which led to a significant increase in total nitrogen, amino nitrogen, glucose and protein contents of the seeds. According to 1H NMR guided GC/MS analysis, our results showed an increase in phytochemicals such as terpenes, fatty materials, and flavonoids including 3′,4′,7-trimethoxyquercetin and 4-methyl-p-menth-8-en-3-one, which have not been stated before from A. nilotica suggesting that biotransformation may have occurred due to the presence of A. subolivaceus.

Background Endocrine-disrupting chemicals have currently drawn attention to causing metabolic aberrations to obesity, insulin resistance and type 2 diabetes mellitus (T2DM). The present study aimed to study serum bisphenol-A, relative expressions of P16, interleukin-6, apelin, and peroxisome proliferator-activated receptor gamma (PPAR-γ) messenger ribonucleic acids and determine their association with glycemic control in T2DM patients. Methods A case–control study included 80 T2DM patients in addition to 80 controls. Serum bisphenol-A was measured by enzyme-linked immunosorbent assay technique. Relative quantification of P16, interleukin-6, apelin, and PPAR-γ were measured by real-time polymerase chain reaction. Results Serum bisphenol-A in patients with diabetes was significantly higher compared to controls (mean 94.10 ± 55.46, 57.03 ± 24.98, respectively, p < 0.001) and had a significant positive correlation with glycemic parameters. There was a significant increase in relative expression of p16 (mean 10.06 ± 25.79, 1.40 ± 0.98, p  < 0.001) and interleukin-6 in diabetic patients compared to controls (mean 6.68 ± 9.48, 1.45 ± 1.18, p  < 0.001). There was a significant decrease in relative expressions of apelin and PPAR-γ in diabetic patients compared to controls ( p  < 0.001), and BPA was positively correlated to p16 ( r  = 0.252, p  = 0.001) and negatively correlated with apelin ( r  = -0.180, p  = 0.022). Conclusions Elevated serum bisphenol-A in T2DM patients correlates with poor glycemic control, increased inflammation (IL-6), cellular senescence (p16), and metabolic dysregulation (apelin, PPAR-γ). These findings highlight BPA as a modifiable risk factor and potential biomarker for diabetes progression.

Background. COVID-19 infection is more likely to be acquired and transmitted by healthcare workers (HCWs). Furthermore, they serve as role models for communities in terms of COVID-19 vaccination attitudes. As a result, HCWs’ reluctance to vaccinate could have a significant impact on pandemic containment efforts. Aim. To characterize the current COVID-19 vaccine approval situation among healthcare workers and to determine the most likely reason for agreement or disagreement with COVID-19 vaccination. Methods. This cross-sectional design included 451 HCWs from COVID-19 treatment institutions, with COVID-19 exposure risk changing depending on job function and working location. Results. The study recruited 156 physicians and 295 nurses, of whom 58.1% were female and 41.9% were male. Physicians had a significantly higher rate of participation in COVID-19 pandemic prevention and control, with a rate of 69.9% versus 55.3% of nurses. Acceptance of COVID-19 vaccination was reported by 40.8% of HCWs. The rate of acceptance was significantly higher among physicians (55.1%) than among nurses (33.2%) (p<0.001). Most HCWs (67.8%) believed the vaccine was not effective. Physicians showed more significant trust in the effectiveness of the vaccine than nurses (41% and 27.5, respectively) (p=0.003). Concerning vaccine safety, only 32.8% of HCWs believed it was safe. This was significantly higher in physicians (41.7%) than in nurses (28.1%) (p=0.004). Conclusion. Vaccination uncertainty is common among healthcare personnel in Egypt, and this could be a significant barrier to vaccine uptake among the public. Campaigns to raise vaccine knowledge are critically needed.