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Saudi Arabia guarantees citizens the right to receive medical care and treatment during emergencies or sickness and aging. However, with the consistent increase in expenditure and inability to provide access, the transformation was an unavoidable action. Therefore, this paper aims to address the potential and risks behind the National Transformation Program (NTP) in Saudi Arabia through the lens of the Value Transformation Framework. Multiple research databases (PubMed, Web of Science, UpToDate, Google Scholar, and Summon) were searched between 2016 and 2024. Relevant articles were selected by scanning the title and abstract, yielding 34 references after the screening, exclusion, and inclusion criteria were met. Citation software was used to identify additional sources as analysis proceeded, in accordance with the hermeneutic approach in mapping and classification. The most cited concerns were the sustainability and workforce of the healthcare system. In terms of care delivery, the literature was extensive. In contrast, insufficient studies have been conducted on infrastructure and people. Furthermore, limited information is available on how to assess the transformation, which remains an unaddressed research question. NTP could meet several hurdles. However, through the measurement, assessment phases, and development tracking, success could be achieved.
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Topological indices are numerical parameters that indicate the topology of graphs or hypergraphs. A hypergraph H = ( V ( H ) , E ( H ) ) consists of a vertex set V ( H ) and an edge set E ( H ) , where each edge e ∈ E ( H ) is a subset of V ( H ) with at least two elements. In this paper, our main aim is to introduce a general hypergraph structure for the prime ideal sum (PIS)- graph of a commutative ring. The prime ideal sum hypergraph of a ring R is a hypergraph whose vertices are all non-trivial ideals of R and a subset of vertices E i with at least two elements is a hyperedge whenever I + J is a prime ideal of R for each non-trivial ideal I, J in E i and E i is maximal with respect to this property. Moreover, we also compute some degree-based topological indices (first and second Zagreb indices, forgotten topological index, harmonic index, Randic index, Sombor index) for these hypergraphs. In particular, we describe some degree-based topological indices for the newly defined algebraic hypergraph based on prime ideal sum for Z n where n = p α , p q , p 2 q , p 2 q 2 , p q r , p 3 q , p 2 q r , p q r s for the distinct primes p , q , r and s.
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Cadmium (Cd) is a dangerous heavy metal that is non-degradable in the environment. Many organs can accumulate Cd and adversely affect organ function and health. Cd is considered as a teratogenic and embryotoxic agent. This study aims to evaluate the teratogenicity of Cd at concentrations lesser than the permissible and its effects on the heart during chick embryogenesis. Fertilized eggs of the chick Gallus domesticus were divided into; control, saline injected and four experimental groups injected with single doses of 5, 25, 50 or 75 µM of CdCl2. Histological observations of the heart before hatching and the cardiomyocytes after hatching were recorded. Morphometric measurements of heart chambers were achieved at 3, 4 and 6 days of incubation. Electrocardiograph and respiratory rate were recorded at tenth day. Different cardiac problems had been brought on by Cd. In comparison to controls, the heart looked much larger, and in certain cases, growth retardation was seen. Degeneration in heart walls and malformations of dorsal aorta were noticed. Morphometrically, the width and wall thickness of heart chambers showed significant changes. Heart beats and respiratory rate significantly decreased compared to control. The cardiotoxic effect of Cd on heart compartments structure and function was dose dependent. One of Cd toxicity is its ability to induce cellular oxidative stress. The heart in particular is sensitive to oxidative stress. Cardiac oxidative stress might intensify heart failure and promote disease progression. Calcium is one of the components that is needed for normal heart work. Cd might interfere with calcium metabolism by removing it from the body.
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Desenvolvimento Embrionário , Frequência Cardíaca , Coração , Estresse Oxidativo , Animais , Embrião de Galinha , Coração/efeitos dos fármacos , Coração/embriologia , Desenvolvimento Embrionário/efeitos dos fármacos , Estresse Oxidativo/efeitos dos fármacos , Frequência Cardíaca/efeitos dos fármacos , Cardiotoxicidade , Relação Dose-Resposta a Droga , Cádmio/toxicidade , Cloreto de Cádmio/toxicidade , Miócitos Cardíacos/efeitos dos fármacos , Miócitos Cardíacos/patologia , Miócitos Cardíacos/metabolismo , Taxa Respiratória/efeitos dos fármacos , Fatores de TempoRESUMO
OBJECTIVE: To highlight the possible surgical steps that could affect the neural supply of soft palate and velopharyngeal sphincter during Furlow palatoplasty and posteriorly-based myo-mucosal buccal flaps in patients with persistent velopharyngeal insufficiency after primary cleft palate repair. DESIGN: Institution-based retrospective study. SETTING: Academic Medical Center. PATIENTS: Non-syndromic patients with persistent hypernasality (after primary cleft palate repair) who had Furlow palatoplasty or posteriorly-based buccal myo-mucosal flaps and were followed up for at least 60 months after the secondary surgery. INTERVENTIONS: All patients were examined using a fiberoptic endoscopy, the movement of components of the velopharyngeal sphincter: soft palate, and lateral pharyngeal walls were traced on the monitor and given a score from 0-4. The pattern of VPS closure was reported whether coronal, circular, or sagittal for each case. MAIN OUTCOME MEASURES: Patients' characteristics, auditory perceptual assessment, the severity of hypernasality, intraoperative lengthening of the palate, and operative complications were recorded. RESULTS: At postoperative (at least 60 months) evaluation of the patients statistically non-significant differences were reported when comparing the pre-versus post-operative auditory perceptual assessment following both procedures (P value ≥0.05). A greater tendency towards improvement was noticed with BF but was non-significant. CONCLUSION: The nerve supply of the palate could be jeopardized by many techniques of primary or secondary repair of the cleft palate leaving behind a deceiving intact but weak poor-functioning palate. All efforts should be made to provide more neural-preservation techniques in primary/secondary repair of the cleft palate. Further wide-scale research is essential to have final clear conclusions.
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BACKGROUND: Arterial tortuosity syndrome is a rare Autosomal recessive disease that leads to a loss of function of the connective tissues of the body, this happens due to a mutation in the solute carrier family 2 member 10 (SLC2A10) gene. ATS is more likely to occur in Large and medium-sized arteries including the aorta and pulmonary arteries. This syndrome causes the arteries to be elongated and tortuous, This tortuosity disturbs the blood circulation resulting in stenosis and lack of blood flow to organs and this chronic turbulent flow increases the risk of aneurysm development, dissection and ischemic events. CASE PRESENTATION: A 2 years old Arabian female child was diagnosed with ATS affecting the pulmonary arteries as a newborn, underwent a pulmonary arterial surgical reconstruction at the age of 2 years old due to the development of pulmonary artery stenosis with left pulmonary artery having a peak gradient of 73 mmHg with a peak velocity of 4.3 m/s and the right pulmonary artery having a peak gradient of 46 mmHg with a peak velocity of 3.4 m/s causing right ventricular hypertension. After surgical repair the left pulmonary artery has a peak pressure gradient of 20 mmHg, with the right pulmonary artery having a peak pressure gradient of 20 mmHg. CONCLUSION: ATS is a rare genetic condition that affects the great arteries especially the pulmonary arteries causing stenotic and tortuous vessels that may be central branches or distal peripheral branches that leads to severe right ventricular dysfunction and hypertension. We believe that surgical treatment provides the optimum outcomes when compared to transcather approaches especially when the peripheral arteries are involved. Some challenges and hiccups might occur, especially lung reperfusion injury that needs to be diagnosed and treated accordingly.
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Artéria Pulmonar , Dermatopatias Genéticas , Malformações Vasculares , Humanos , Artéria Pulmonar/cirurgia , Artéria Pulmonar/anormalidades , Feminino , Malformações Vasculares/cirurgia , Malformações Vasculares/complicações , Pré-Escolar , Dermatopatias Genéticas/cirurgia , Dermatopatias Genéticas/complicações , Dermatopatias Genéticas/genética , Procedimentos Cirúrgicos Vasculares/métodos , Estenose de Artéria Pulmonar/cirurgia , Instabilidade Articular/cirurgia , Instabilidade Articular/genética , Procedimentos de Cirurgia Plástica/métodos , Artérias/anormalidadesRESUMO
The sample strategy employed in statistical parameter estimation issues has a major impact on the accuracy of the parameter estimates. Ranked set sampling (RSS) is a highly helpful technique for gathering data when it is difficult or impossible to quantify the units in a population. A bounded power logarithmic distribution (PLD) has been proposed recently, and it may be used to describe many real-world bounded data sets. In the current work, the three parameters of the PLD are estimated using the RSS technique. A number of conventional estimators using maximum likelihood, minimum spacing absolute log-distance, minimum spacing square distance, Anderson-Darling, minimum spacing absolute distance, maximum product of spacings, least squares, Cramer-von-Mises, minimum spacing square log distance, and minimum spacing Linex distance are investigated. The different estimates via RSS are compared with their simple random sampling (SRS) counterparts. We found that the maximum product spacing estimate appears to be the best option based on our simulation results for the SRS and RSS data sets. Estimates generated from SRS data sets are less efficient than those derived from RSS data sets. The usefulness of the RSS estimators is also investigated by means of a real data example.
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Aflatoxins (AFs) are hazardous carcinogens and mutagens produced by some molds, particularly Aspergillus spp. Therefore, the purpose of this study was to isolate and identify endophytic bacteria, extract and characterize their bioactive metabolites, and evaluate their antifungal, antiaflatoxigenic, and cytotoxic efficacy against brine shrimp (Artemia salina) and hepatocellular carcinoma (HepG2). Among the 36 bacterial strains isolated, ten bacterial isolates showed high antifungal activity, and thus were identified using biochemical parameters and MALDI-TOF MS. Bioactive metabolites were extracted from two bacterial isolates, and studied for their antifungal activity. The bioactive metabolites (No. 4, and 5) extracted from Bacillus cereus DSM 31T DSM, exhibited strong antifungal capabilities, and generated volatile organic compounds (VOCs) and polyphenols. The major VOCs were butanoic acid, 2-methyl, and 9,12-Octadecadienoic acid (Z,Z) in extracts No. 4, and 5 respectively. Cinnamic acid and 3,4-dihydroxybenzoic acid were the most abundant phenolic acids in extracts No. 4, and 5 respectively. These bioactive metabolites had antifungal efficiency against A. flavus and caused morphological alterations in fungal conidiophores and conidiospores. Data also indicated that both extracts No. 4, and 5 reduced AFB1 production by 99.98%. On assessing the toxicity of bioactive metabolites on A. salina the IC50 recorded 275 and 300 µg/mL, for extracts No. 4, and 5 respectively. Meanwhile, the effect of these extracts on HepG2 revealed that the IC50 of extract No. 5 recorded 79.4 µg/mL, whereas No. 4 showed no cytotoxic activity. It could be concluded that bioactive metabolites derived from Bacillus species showed antifungal and anti-aflatoxigenic activities, indicating their potential use in food safety.
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Antifúngicos , Artemia , Antifúngicos/farmacologia , Antifúngicos/química , Animais , Humanos , Artemia/efeitos dos fármacos , Células Hep G2 , Bacillus/metabolismo , Aflatoxinas/metabolismo , Aflatoxinas/toxicidade , Metabolismo Secundário , Compostos Orgânicos Voláteis/farmacologia , Compostos Orgânicos Voláteis/metabolismo , Compostos Orgânicos Voláteis/química , Bacillus cereus/efeitos dos fármacos , Bacillus cereus/metabolismo , Testes de Sensibilidade MicrobianaRESUMO
Chronic exposure to heavy metals as aluminum chloride (AlCl3) could result in severe health hazards such as chronic renal injury. The present study aimed to evaluate the therapeutic potential of adipose tissue-derived stem cells (ASCs) in comparison to their microvesicles (MV) in AlCl3-induced chronic renal injury. Forty-eight adult male Wistar rats were divided into four groups: Control group, AlCl3-treated group, AlCl3/ASC-treated group, and AlCl3/MV-treated group. Biochemical studies included estimation of serum urea and creatinine levels, oxidative biomarkers assay, antioxidant biomarkers, serum cytokines (IL-1ß, IL-8, IL-10, and IL-33), real time-PCR analysis of renal tissue MALT1, TNF-α, IL-6, and serum miR-150-5p expression levels. Histopathological studies included light and electron microscopes examination of renal tissue, Mallory trichrome stain for fibrosis, Periodic acid Schiff (PAS) stain for histochemical detection of carbohydrates, and immunohistochemical detection of Caspase-3 as apoptosis marker, IL-1B as a proinflammatory cytokine and CD40 as a marker of MVs. AlCl3 significantly deteriorated kidney function, enhanced renal MDA and TOS, and serum cytokines concentrations while decreased the antioxidant parameters (SOD, GSH, and TAC). Moreover, serum IL-10, TNF-α, miR-150-5p, and renal MALT1 expression values were significantly higher than other groups. Kidney sections showed marked histopathological damage in both renal cortex and medulla in addition to enhanced apoptosis and increased inflammatory cytokines immunoexpression than other groups. Both ASCs and MVs administration ameliorated the previous parameters levels with more improvement was detected in MVs-treated group. In conclusion: ASCs-derived MVs have a promising ameliorating effect on chronic kidney disease.
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Ratos Wistar , Animais , Masculino , Ratos , Micropartículas Derivadas de Células/metabolismo , Insuficiência Renal Crônica/terapia , Insuficiência Renal Crônica/metabolismo , Insuficiência Renal Crônica/patologia , Citocinas/metabolismo , Citocinas/sangue , Rim/patologia , Rim/metabolismo , Cloreto de Alumínio/efeitos adversos , Estresse Oxidativo , Células-Tronco/metabolismo , Tecido Adiposo/metabolismo , Transplante de Células-Tronco , Biomarcadores/sangueRESUMO
BACKGROUND: Cost-effectiveness analyses rarely offer useful insights to policy decisions unless their results are compared against a benchmark threshold. The cost-effectiveness threshold (CET) represents the maximum acceptable monetary value for achieving a unit of health gain. This study aimed to identify CET values on a global scale, provide an overview of using multiple CETs, and propose a country-specific CET framework specifically tailored for Egypt. The proposed framework aims to consider the globally identified CETs, analyze global trends, and consider the local structure of Egypt's healthcare system. METHODS: We conducted a literature review to identify CET values, with a particular focus on understanding the basis of differentiation when multiple thresholds are present. CETs of different countries were reviewed from secondary sources. Additionally, we assembled an expert panel to develop a national CET framework in Egypt and propose an initial design. This was followed by a multistakeholder workshop, bringing together representatives of different governmental bodies to vote on the threshold value and finalize the recommended framework. RESULTS: The average CET, expressed as a percentage of the gross domestic product (GDP) per capita across all countries, was 135%, with a range of 21 to 300%. Interestingly, while the absolute value of CET increased with a country's income level, the average CET/GDP per capita showed an inverse relationship. Some countries applied multiple thresholds based on disease severity or rarity. In the case of Egypt, the consensus workshop recommended a threshold ranging from one to three times the GDP per capita, taking into account the incremental relative quality-adjusted life years (QALY) gain. For orphan medicines, a CET multiplier between 1.5 and 3.0, based on the disease rarity, was recommended. A two-times multiplier was proposed for the private reimbursement threshold compared to the public threshold. CONCLUSION: The CET values in most countries appear to be closely related to the GDP per capita. Higher-income countries tend to use a lower threshold as a percentage of their GDP per capita, contrasted with lower-income countries. In Egypt, experts opted for a multiple CET framework to assess the value of health technologies in terms of reimbursement and pricing.
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The potential of plant-based diets and drugs to prevent and control obesity has been attributed to the presence of several biologically active phytochemicals. The study aimed to assess herb consumption's impact on alleviating the risks and hazards associated with obesity induced by a high-fat diet (HFD) and the promotion of fertility. Eighty rats were allocated into four distinct groups. Group 1 (G1) was provided with a basal diet and acted as the control group. Group 2 (G2) was provided with an HFD. Group 3 (G3) was provided with HFD supplemented with chia seeds and Hibiscus sabdariffa L. The fourth group of subjects was provided with HFD supplemented with Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander). The feeding session was sustained for 10 weeks, and the biochemical parameters were evaluated. The administration of Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander) (G4) resulted in a more significant reduction in all biochemical parameters compared to G3, which received a diet consisting of chia seeds and Hibiscus sabdariffa L. Additionally, the average number of embryonic lobes and the average number of offspring after birth were found to be considerably more significant in the normal control group (G1) and group (G4) compared to the HFD group (G2) and group (G3) (P < 0.01). Group 4 (G4) was administered a diet enriched with Foeniculum vulgare (fennel) and Coriandrum sativum L. (coriander), which demonstrated superior outcomes in many biochemical indicators and the promotion of fertility in obese female rats.
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AIM: Different remineralizing pretreatments Casein phosphopeptide-amorphous calcium phosphate fluoride (CPP-ACPF), tricalcium phosphate fluoride (TCP-F), self-assembling peptide (SAP) P11-4 and 10 % Nanohydroxyapatite (nHA) gel activation via invisible infrared light on the dentin microhardness (MH) and micro shear bond strength (µSBS) of composite restoration. METHODS: Seventy-five human molar teeth were collected and the dentinal surface of all the samples was exposed to different demineralizing solutions. (n = 15) Group 1 (demineralized dentin), Group 2 (CPP ACP), Group 3 (TCP-F), Group 4 (SAP P11-4), Group 5 (nHA gel activation via invisible infrared light). MH assessment was performed using Vickers hardness. Each group of 10 samples was subjected to composite restoration buildup and µSBS were tested. The debonded samples were then observed under a stereo-microscope for failure analysis. ANOVA was conducted, along with Tukey's post hoc analysis, to examine the µSBS of composite and MH of the remineralized surface. RESULTS: nHA gel activation via invisible infrared light pretreated specimens showed the maximum outcomes of surface hardness (331.2 ± 77.3) and bond strength (10.38 ± 2.77). However, Group 4 (SAP P11-4) (148.3 ± 29.2) remineralized dentin displayed minimum scores of MH and µSBS (5.88 ± 1.01). CONCLUSION: Remineralizing pretreatment nHA gel activation via invisible infrared light and casein phosphopeptide-amorphous calcium phosphate fluoride seem to improve the dentin MH and µSBS of the composite restoration.
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Caseínas , Remineralização Dentária , Caseínas/farmacologia , Caseínas/química , Humanos , Remineralização Dentária/métodos , Dentina/efeitos dos fármacos , Dureza , Raios Infravermelhos , Resistência ao Cisalhamento , Durapatita/química , Durapatita/farmacologia , Dente Molar , Fosfatos de Cálcio/farmacologia , Fosfatos de Cálcio/química , Restauração Dentária Permanente/métodosRESUMO
Acute anticholinesterase pesticide poisoning is a serious clinical problem, particularly in developing countries. Atropine is the most acceptable treatment for acute anticholinesterase poisoning. However, it only stops fluid production. Albuterol is a beta-2 receptor agonist that can increase fluid removal and speed the return of effective oxygen exchange. This study aims to evaluate the safety and efficacy of nebulized albuterol as an adjuvant therapy in patients with acute anticholinesterase poisoning. This stratified block randomized, single-blinded, placebo-controlled, parallel-group clinical trial was conducted between November 2020 and October 2021. It enrolled 80 patients with acute anticholinesterase pesticide poisoning who were admitted to Tanta University Poison Control Center. Patients were allocated into two groups (40 patients each). The strata were based on the severity of poisoning (moderate and severe). Patients in group I received 10 mg of nebulized albuterol. Group II received an equivalent volume of nebulized normal saline. Additionally, standard treatment was provided to both groups. Outcomes included oxygenation, mortality, need for endotracheal intubation and mechanical ventilation, hospital stay duration, time to atropinization, and total doses of atropine and oxime. We found insignificant differences in sociodemographics, exposure characteristics, clinical manifestations, or routine laboratory tests between the studied groups. The median values of oxygen saturation by pulse oximetry were 99% in the albuterol moderate toxicity group and 98% in the control moderate toxicity group. Albuterol significantly improved oxygen saturation in moderate intoxicated patients (P = 0.039). Therefore, nebulized albuterol is a safe drug. Moreover, it may improve oxygenation in acute anticholinesterase pesticide poisoning.
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Background Thrombocytopenia is the most prevalent hematological condition in neonates that develops in the neonatal intensive care unit (NICU). This set of illnesses is caused by either decreased platelet production due to placental insufficiency, increased platelet breakdown (consumption), or a combination of the two causes. Based on platelet count, it is defined as mild, moderate, or severe thrombocytopenia, with early and late onset. Purpose The purpose of this study is to determine the prevalence of thrombocytopenia and the factors that contribute to it in newborns hospitalized in the neonatal critical care unit at the Maternity and Children Hospital in Al Ahsa, Saudi Arabia. Methods This descriptive retrospective cross-sectional study was carried out at the NICU of the Maternity and Children Hospital in Al Ahsa, Saudi Arabia, over the span of one year (August 2022 to August 2023) among hospitalized neonates with thrombocytopenia. Thrombocytopenia is defined as a platelet count of 150,000 or less. These patients were monitored until they recovered or died. Results The inclusion criteria were met by a total of 242 newborns with thrombocytopenia. Half of the neonates (57%) were full-term, with Apgar scores greater than 5 at the first (84%) and fifth (93%) minutes, respectively. The great majority of individuals (84%) experienced early-onset thrombocytopenia of mild severity (62%) and were asymptomatic (93%). The majority of the cases resolved spontaneously, with only 21% requiring platelet transfusion. There was a significant relationship discovered between gestational age and the severity of thrombocytopenia, with very preterm infants having moderate to severe thrombocytopenia, as well as birth weight (p=0.001). Furthermore, neonates with severe thrombocytopenia had a considerably higher mortality rate (p=0.001). Conclusion The mortality and morbidity of newborns with perinatal risk for neonatal thrombocytopenia can be reduced with timely detection of the cause and development of thrombocytopenia, as well as adequate and early care.
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Some studies suggested that gastrointestinal (GIT) decontamination with oil may improve the prognosis of patients who ingested aluminum phosphide (AlP). The aim of this study is to compare the efficacy and safety of gastric lavage with oil-based solutions to any method of gastric decontamination not using oils in patients presenting with acute AlP poisoning. The literature was searched for English-published randomized controlled trials (RCTs) from inception to 16 September 2023. The searched electronic databases included MEDLINE/PubMed, Cochrane Library, Web of Science, Egyptian Knowledge Bank, Scopus, and Google Scholar. Data were extracted and pooled by calculating the risk ratio (RR) for categorical outcomes and standardized mean difference (SMD) for numerical outcomes, with 95% confidence intervals (CI). Seven RCTs were included. Paraffin oil was significantly associated with a lower risk of mortality (RR = 0.59 [95% CI: 0.45, 0.76], p < .001), intubation (RR = 0.59 [95% CI: 0.46, 0.76], p < .001) and vasopressor need (RR = 0.71 [95% CI: 0.56, 0.91], p = .006). Survival time was significantly prolonged with paraffin oil (SMD = 0.72 [95% CI: 0.32, 1.13], p < .001). Coconut oil was significantly associated with prolonged survival time (SMD = 0.83 [95% CI: 0.06, 1.59], p = .03) as well as decreased risk of requiring intubation (RR = 0.78 [95% CI: 0.62, 0.99], p = .04). Oil-based GIT decontamination using paraffin oil showed benefits over conventional lavage regarding the incidence of in-hospital mortality and endotracheal intubation, and survival time. Coconut oil showed some benefits in terms of the intubation incidence and survival time. Decontamination using paraffin oil is recommended. Future clinical trials are warranted with larger sample sizes and focusing on cost-benefit and safety.
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Compostos de Alumínio , Lavagem Gástrica , Fosfinas , Humanos , Compostos de Alumínio/intoxicação , Lavagem Gástrica/métodos , Óleos , Parafina , Praguicidas , Fosfinas/intoxicação , Intoxicação , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Excessive consumption of antibiotics is considered one of the top public health threats, this necessitates the development of new compounds that can hamper the spread of infections. A facile green technology for the biosynthesis of Zinc oxide nanoparticles (ZnO NPs) using the methanol extract of Spirulina platensis as a reducing and stabilizing agent has been developed. A bunch of spectroscopic and microscopic investigations confirmed the biogenic generation of nano-scaled ZnO with a mean size of 19.103 ± 5.66 nm. The prepared ZnO NPs were scrutinized for their antibacterial and antibiofilm potentiality, the inhibition zone diameters ranged from 12.57 ± 0.006 mm to 17.33 ± 0.006 mm (at 20 µg/mL) for a variety of Gram-positive and Gram-negative pathogens, also significant eradication of the biofilms formed by Staphylococcus aureus and Klebsiella pneumoniae by 96.7% and 94.8% respectively was detected. The free radical scavenging test showed a promising antioxidant capacity of the biogenic ZnO NPs (IC50=78.35 µg/mL). Furthermore, the anti-inflammatory role detected using the HRBCs-MSM technique revealed an efficient stabilization of red blood cells in a concentration-dependent manner. In addition, the biogenic ZnO NPs have significant anticoagulant and antitumor activities as well as minimal cytotoxicity against Vero cells. Thus, this study offered green ZnO NPs that can act as a secure substitute for synthetic antimicrobials and could be applied in numerous biomedical applications.
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Nanopartículas Metálicas , Nanopartículas , Spirulina , Óxido de Zinco , Animais , Chlorocebus aethiops , Óxido de Zinco/farmacologia , Óxido de Zinco/química , Células Vero , Nanopartículas/química , Antibacterianos/farmacologia , Antibacterianos/química , Biofilmes , Nanopartículas Metálicas/química , Testes de Sensibilidade Microbiana , Extratos Vegetais/farmacologia , Extratos Vegetais/químicaRESUMO
Intermittent left bundle branch block (LBBB) is an unusual phenomenon, with very few cases documented in the literature. It is often considered a reflection of underlying conditions known to increase the risk of cardiovascular morbidity and death, including coronary artery disease (CAD), cardiomyopathy, hypertensive heart disease, and aortic valve disease. In rare instances, coronary vasospasm is the sole underlying condition. It is typically diagnosed by ECG and managed according to the underlying cause. We describe a case of intermittent LBBB presenting with chest pain. The ECG showed dynamic changes with transient/intermittent LBBB. An angiogram was performed, revealing significant coronary lesions. The patient was eventually managed conservatively and discharged on dual antiplatelet therapy for a duration of one year with a one-month clinic follow-up where his condition improved. Intermittent LBBB represents a transient disturbance in the intraventricular conduction system, where diseased conduction occurs secondary to an underlying cause, but normal conduction eventually restores. This results in complexes where LBBB appears alongside normally conducted beats in a single ECG tracing. There is limited knowledge about the prognosis of patients with intermittent LBBB; therefore, patients with LBBB should undergo careful evaluation due to the known association with serious cardiac pathologies, particularly cardiac ischemia. It is important to consider the potential adverse effects on ventricular function.
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Toxoplasmosis continues to be a prevalent parasitic zoonosis with a global distribution. This disease is caused by an intracellular parasite known as Toxoplasma gondii, and the development of effective novel drug targets to combat it is imperative. There is limited information available on the potential advantages of wheat germ oil (WGO) and propolis, both individually and in combination, against the acute phase of toxoplasmosis. In this study, acute toxoplasmosis was induced in Swiss albino mice, followed by the treatment of infected animals with WGO and propolis, either separately or in combination. After 10 days of experimental infection and treatment, mice from all groups were sacrificed, and their brains, uteri, and kidneys were excised for histopathological assessment. Additionally, the average parasite load in the brain was determined through parasitological assessment, and quantification of the parasite was performed using Real-Time Polymerase Chain Reaction targeting gene amplification. Remarkably, the study found that treating infected animals with wheat germ oil and propolis significantly reduced the parasite load compared to the control group that was infected but not treated. Moreover, the group treated with a combination of wheat germ oil and propolis exhibited a markedly greater reduction in parasitic load compared to the other groups. Similarly, the combination treatment effectively restored the histopathological changes observed in the brain, uterus, and kidney, and the scoring of these reported lesions confirmed these findings. In summary, the present results reveal intriguing insights into the potential therapeutic benefits of wheat germ oil and propolis in the treatment of acute toxoplasmosis.
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Background: Patients with uncontrolled type 2 diabetes mellitus (T2DM) require close follow-up, support, and education to achieve glycemic control, especially during the initiation or intensification of insulin therapy and self-care management. This study aimed to describe and evaluate the impact of implementing a hybrid model of in-person and telemedicine care and education on glycemic control for patients with uncontrolled T2DM (hemoglobin A1c [HbA1c] ≥9%) during the coronavirus disease pandemic. Methods: This prospective multicenter-cohort pre-/post-intervention study was conducted on patients with uncontrolled T2DM. This study included three chronic illness centers affiliated with the Family and Community Medicine Department at Prince Sultan Military Medical City in Riyadh, Saudi Arabia. A hybrid model of in-person (onsite) and telemedicine care and education was developed. This involved implementing initial in-person care at the physicians' clinic and initial in-person education at the diabetes education clinic, followed by telemedicine services of tele-follow-ups, support, and education for an average 4-month follow-up period. Results: Of the enrolled 181 patients, more than half of the participants were women (n = 103, 56.9%). The mean age of participants (standard deviation) was 58.64 ± 11.23 years and the mean duration of diabetes mellitus was 13.80 ± 8.55 years. The majority of the patients (n = 144; 79.6%) were on insulin therapy. Overall, in all three centers, the hybrid model had significantly reduced HbA1c from 10.47 ± 1.23% to 7.87 ± 1.59% (mean difference of reduction 2.59% [95% confidence interval (CI) = 2.34-2.85%], p < 0.001). At the level of each center, HbA1c was reduced significantly with mean differences of 3.17% (95% CI = 2.81-3.53%), 2.49% (95% CI = 1.92-3.06%), and 2.16% (95% CI = 1.76-2.57%) at centers A, B, and C, respectively (all p < 0.001). Conclusion: The findings showed that the hybrid model of in-person and telemedicine care and education effectively managed uncontrolled T2DM. Consequently, the role of telemedicine in diabetes management could be further expanded as part of routine diabetes care in primary settings to achieve better glycemic control and minimize nonessential in-person visits when appropriate.
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[This corrects the article DOI: 10.3389/fvets.2023.1340964.].
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The digger wasp genus Miscophus Jurine, 1807 from the Indian subcontinent is reviewed with descriptions of two new species from India, Miscophus kaleshi Girish Kumar and Miscophus prasanthi Girish Kumar. A key to Miscophus of the Indian subcontinent is provided.