Impact of Different Storage Regimes on the Levels of Physicochemical Characteristics, Especially Free Acidity in Talh (Acacia gerrardii Benth.) Honey.

This study investigates how storage conditions (temperature and duration) may affect the physicochemical parameters, especially free acidity (FA), of Talh honey originating from Acacia gerrardii that have naturally high FA levels. Fresh Talh honey samples were kept at 0, 25, 35, and 45 °C, and analyzed monthly over a period of eight months. The Talh honey was monofloral with 69% A. gerrardii pollen content. The free acidity (FA) of freshly harvested Talh honey samples was higher (93 ± 0.3 meq/kg) than that of standard limits (≤50 meq/kg) and remained stable at 0 °C throughout the storage period. A significantly increase in FA started to occur after storage for 6 months at 25 °C (103 ± 0.2 meq/kg), 2 months at 35 °C (108 ± 0.3 meq/kg), and 1 month at 45 °C (112 ± 0.3 meq/kg). After 8 months of storage, the highest FA level was recorded at 45 °C (159 ± 0.5 meq/kg), followed by 127 ± 0.3 meq/kg at 35 °C, 105 ± 0.2 meq/kg at 25 °C, and 94 ± 0.3 meq/kg at 0 °C. It was found that 0 °C was an appropriate temperature for storing honey for long time. The electrical conductivity (EC) of fresh Talh samples (1.46 ± 0.0 mS/cm) was above the accepted limit (≤0.8 mS/cm), which was slightly increased (non-significant) throughout the storage period under all the storage temperatures. Hydroxymethylfurfural (HMF), diastase activity (DN), and reducing sugars (RSs) showed normal levels only at 0 °C and 25 °C throughout the storage period. However, HMF exceeded the standard limits after the first month at 45 °C (127 ± 9.6 mg/kg) and after the second month at 35 °C (90 ± 23.5 mg/kg), DA decreased below standard limits after the second month (5 ± 1 DN) under 45 °C and after the seventh month under 35 °C (7 ± 2 DN, and RSs decreased below 60% after 2 months under 45 °C and after 6 months at 35 °C. The physicochemical parameters (moisture content, pH, color, and sucrose) were the least affected and were within the standard range throughout the storage period under all the storage temperatures. The levels of FA and EC in fresh Talh samples were higher than the acceptable limits. The moisture content, pH, color, and sucrose content were not affected by storage conditions and remained within the acceptable limits. HMF, DA, and RSs were significantly affected by storage conditions only at 35 and 45 °C. The storage of honey at low temperatures (0 and 25 °C) for up to eight months presented the least amount of changes in the honey, and the honey was unchanged from its fresh status. Honey storage at 35 and 45 °C resulted in significant changes. It is recommended that Talh honey, which normally has high acidity levels, should be stored at temperatures not exceeding 25 °C.

The influence and impact of smoking on red blood cell morphology and buccal microflora: A case-control study.

BACKGROUND: Tobacco smoking is a major health issue worldwide. In addition to several health problems, smoking can also cause buccal cavity ulcers and buccal cavity cancer in case of chronic smoking. Tobacco smoking may also lead to deranged morphology of red blood cells (RBCs), which results in reduced oxygen carrying capacity of the blood. AIM: (a) To investigate and compare the changes in the RBC morphology of smokers and nonsmokers. (b) To investigate and compare the normal buccal flora of smokers and nonsmokers. METHODOLOGY: A total of 81 men were included in the study. Study population was divided into two groups: group 1; smokers (n = 50) and group 2; nonsmokers, which served as control (n = 31). After informed written consent from the study participants, a 5 mL of venous blood was drawn under sterile conditions for complete blood analysis and RBC morphology. Samples from buccal cavity were collected by cotton swab and cultured in sterile petri dishes to identify the bacterial growth. Data of RBC morphology and buccal microbiota were compared between smokers and nonsmokers. RESULTS: Buccal microflora results showed heavy growth in smokers compared with nonsmokers. Mean values of RBCs, Platelets, WBCs, HGB (hemoglobin), and MCV (mean corpuscular volume) did not differ between smokers and nonsmokers. Mean red cell distribution (RDW) width significantly was lower in smokers than nonsmokers. Macrocytic RBCs was more in smokers (60%) compared with nonsmokers (4%). CONCLUSIONS: Our results showed an increase in the percentage of macrocytic RBCs and a decrease in the red cell distribution width (RDW) in smokers compared with nonsmokers. Buccal Microflora was significantly higher in smoker group in contrast to nonsmoker group.

Clinical and epidemiological profile of cerebral venous thrombosis. A Multicenter retrospective study in Aseer Region Saudi Arabi.

OBJECTIVE: To assess the epidemiological pattern and correlates with the clinical outcome of Cerebral venous thrombosis (CVT) in Abha, Kingdom of Saudi Arabia. METHODS: A retrospective record_based cohort design was conducted including all patients admitted with diagnosis of CVT in 2 main tertiary hospitals in Aseer Region between 2015 to the end of 2018. The study hospitals were Aseer Central Hospital and Armed Forces Hospitals Southern Region. The data were collected by structured data sheets, including sociodemographic data. Assessment of known risk factors for CVT, clinical presentation, treatment received, and clinical outcome after treatment were extracted. RESULTS: The study included 119 patients with CVT, whose ages ranged from 15 to 97 years, with a mean age of 35.5-/+14.1 years. Majority of the patients were females (81.5%). Headache was the most presenting (82.4%) symptom, followed by vomiting (30.3%) and a decreased level of consciousness. Thirty_three cases (27.7%) had complications, and recanalization was recorded among 92 cases (94.8%) based on follow up vascular imaging. CONCLUSION: The study revealed that most of the cases of CVT had favorable clinical outcome and recanalization, especially those who had a shorter duration untildiagnosis. Young females were the most affected group.

Prevalence and factors associated with low back pain among health care workers in southwestern Saudi Arabia.

BACKGROUND: The purpose was to measure the prevalence and related risk factors of low back pain (LBP) among health care workers (HCWs) at different levels of health care in southwestern Saudi Arabia. METHODS: A cross-sectional study using a self-administered questionnaire was conducted among HCWs providing primary, secondary and tertiary health care services in the Aseer region, southwestern Saudi Arabia. The questionnaire collected data regarding having LBP in the past 12 months, socio-demographics, work conditions and history of chronic diseases, regular physical exercise and overexertional back trauma. Univariate and multivariable logistic regression analyses were performed. RESULTS: Out of 740 participants, the overall prevalence of LBP in the past 12 months amounted to73.9% (95% CI: 70.7-77.0). The prevalence of LBP with neurological symptoms reached 50.0%. The prevalence of LBP necessitating medications and or physiotherapy was 40.5%, while the prevalence of LBP requiring medical consultation was 20%. Using multivariable logistic regression, the following risk factors were identified: working in secondary and tertiary hospitals (aOR = 1.32, 95% CI:1.01-1.76), increased BMI (aOR = 1.10, 95% CI:1.01-3.65), and positive history of overexertional back trauma (aOR = 11.52, 95% CI:4.14-32.08). On the other hand, practising regular physical exercise was a significant protective factor (aOR = 0.61, 95% CI: 0.42-0.89). CONCLUSIONS: LBP is a common problem among HCWs. Many preventable risk factors have been identified, including exertional back trauma, increased BMI and lack of regular physical exercise. Occupational health and safety programmes to build ergonomically safe working conditions and encourage regular physical exercise are needed.

Population genomics of the honey bee reveals strong signatures of positive selection on worker traits.

Most theories used to explain the evolution of eusociality rest upon two key assumptions: mutations affecting the phenotype of sterile workers evolve by positive selection if the resulting traits benefit fertile kin, and that worker traits provide the primary mechanism allowing social insects to adapt to their environment. Despite the common view that positive selection drives phenotypic evolution of workers, we know very little about the prevalence of positive selection acting on the genomes of eusocial insects. We mapped the footprints of positive selection in Apis mellifera through analysis of 40 individual genomes, allowing us to identify thousands of genes and regulatory sequences with signatures of adaptive evolution over multiple timescales. We found Apoidea- and Apis-specific genes to be enriched for signatures of positive selection, indicating that novel genes play a disproportionately large role in adaptive evolution of eusocial insects. Worker-biased proteins have higher signatures of adaptive evolution relative to queen-biased proteins, supporting the view that worker traits are key to adaptation. We also found genes regulating worker division of labor to be enriched for signs of positive selection. Finally, genes associated with worker behavior based on analysis of brain gene expression were highly enriched for adaptive protein and cis-regulatory evolution. Our study highlights the significant contribution of worker phenotypes to adaptive evolution in social insects, and provides a wealth of knowledge on the loci that influence fitness in honey bees.

Guillain-Barré syndrome post-SARS-CoV-2 vaccine: a systematic review and data analysis on its clinical, laboratory, electrophysiological, and radiological features.

Introduction: Guillain-Barré syndrome (GBS) is a rare disease that affects almost 0.8-1.9 cases per 100,000 people worldwide every year. This is the most prevalent cause of subacute flaccid paralyzing illness today. It is a subacute inflammatory demyelinating polyradiculoneuropathy; the typical scenario involves ascending symmetrical flaccid paralysis, but in some circumstances, sensory, autonomic, and cranial neuropathy may also be involved. Several vaccines have been found to have complications since the previous century. Numerous case reports of GBS in the literature have been reported following COVID-19 vaccines in recent times. Objective: This study aimed to conduct a comprehensive examination of GBS cases that have been reported after COVID-19 vaccines; to analyze the descriptive statistical analysis of data gathered regarding clinical, laboratory, electrophysiological, and radiological characteristics; to discuss, based on the available evidence, whether the disease has a preference for a particular vaccine type; and to speculate on the potential pathogenesis. Methodology: This review has been carried out by recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Result: Reviewing 60 case reports illustrated that most of them are from the USA (18.1%) and the majority of affected individuals were males (60%). The results favored the association between vector-based SARS-CoV-2 vaccine, particularly AstraZeneca vaccine, and the GBS. The mean of symptoms onset is 11.4 days. The results of diagnostic tests such as LP are consistent mostly with albumin-cytological dissociation (81.81%), where brain and spine MRI was unremarkable in 59.52%. Regarding electrodiagnostic tests, AIDP is the most common variant (61.81%). The management was not consistent among the case reports. However, IVIG is the most frequent way of treating these patients (68.33%). The functional outcome was documented in 47 patients; 65% improved with medical management. Conclusion: This study aimed to conduct a systematic review of reported cases of GBS following COVID-19 vaccines and descriptive statistical analysis of collected data on clinical, laboratory, electrophysiological, and radiological features, to discuss, based on available results, whether the disease has a predilection to a specific vaccine type and to speculate the potential pathogenesis.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy: Atypical clinical presentation with isolated frontotemporal dementia.

Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is a hereditary syndrome caused by heterozygous mutations in the NOTCH3 gene that manifests in adulthood and is characterized by recurrent transient ischemic attacks and strokes, migraine-like headaches, psychiatric disturbance, and progressive dementia. The current study reports an interesting case of CADASIL in a Saudi patient with a heterozygous mutation in exon 18 of the NOTCH3 gene presenting only with cognitive decline without migraine or stroke. The diagnosis was suspected mainly because of the typical brain magnetic resonance imaging (MRI) features that led to performing genetic testing to confirm the diagnosis. This illustrates the importance of brain MRI in the diagnosis of CADASIL. Increased awareness of neurologists and neuroradiologists about the typical MRI features of CADASIL is of paramount importance to reach the diagnosis in a timely manner. Awareness of the atypical presentations of CADASIL will lead to identifying more CADASIL cases.

Physicochemical Composition of Local and Imported Honeys Associated with Quality Standards.

The compliance with honey standards is crucial for its validity and quality. The present study evaluated the botanical origin (pollen analysis) and physicochemical properties: moisture, color, electrical conductivity (EC), free acidity (FA), pH, diastase activity, hydroxymethylfurfural (HMF), and individual sugar content of forty local and imported honey samples. The local honey exhibited low moisture and HMF (14.9% and 3.8 mg/kg, respectively) than imported honey (17.2% and 23 mg/kg, respectively). Furthermore, the local honey showed higher EC and diastase activity (1.19 mS/cm and 11.9 DN, respectively) compared to imported honey (0.35 mS/cm and 7.6 DN, respectively). The mean FA of local honey (61 meq/kg) was significantly naturally higher than that of imported honey (18 meq/kg). All local nectar honey that originated from Acacia spp. exhibited naturally higher FA values that exceeded the standard limit (≤50 meq/kg). The Pfund color scale ranged from 20 to 150 mm in local honey and from 10 to 116 mm in imported honey. The local honey was darker, with a mean value of 102.3 mm, and was significantly different from imported honey (72.7 mm). The mean pH values of local and imported honey were 5.0 and 4.5, respectively. Furthermore, the local honey was more diverse in pollen grain taxa compared to imported honey. Local and imported honey elicited a significant difference regarding their sugar content within individual honey type. The mean content of fructose, glucose, sucrose, and reducing sugar of local honey (39.7%, 31.5%, 2.8%, and 71.2%, respectively) and imported honey (39.2%, 31.8%, 0.7%, and 72.0%, respectively) were within the permitted quality standards. This study indicates the necessity of increasing the awareness regarding quality investigations for healthy honey with good nutritional value.

Acute Disseminated Encephalomyelitis Post COVID-19 Pneumonia.

Acute disseminated encephalomyelitis (ADEM) is a monophasic condition characterized by inflammation of the central nervous system. Besides multiple sclerosis, optic neuropathy, acute transverse myelitis, and neuromyelitis optica spectrum disorder, ADEM is a primary inflammatory demyelinating disorder of the central nervous system. It is estimated that approximately three-quarters of cases of encephalomyelitis occur after an infection or immunization, where the onset of neurological disease is coincident with a febrile event. Here, we report an 80-year-old woman with coronavirus disease pneumonia who developed sudden onset of decreased level of consciousness, focal seizure, and right-side weakness. Magnetic resonance imaging (MRI) of the brain showed a multifocal hemorrhagic lesion with surrounding edema, suggesting ADEM. An electroencephalogram (EEG) revealed moderate generalized encephalopathy. The patient received alternating pulse steroids with plasma exchange for five days. Subsequently, her Glasgow coma scale score continued to decrease, and thus, she required inotropic support until she expired.

Cerebral Radiation-Induced Vasculopathy Mimicking Primary Central Nervous System Vasculitis.

Cranial irradiation is one of the main treatment modalities for tumors of the CNS. However, it can lead to significant damage to the treated region. Among the late complications of radiation therapy to the brain is vasculopathy of the small and/or large arteries. In this article, we report a case of CNS radiation-induced vasculopathy presenting 30 years after cranial irradiation and mimicking primary CNS vasculitis. The present case illustrates the importance of monitoring and carefully evaluating delayed side effects of radiotherapy as well as emphasizes the importance of obtaining a detailed history of any patient presenting with sudden unexplained symptoms. If a complete proper history of the patient's past medical diagnoses and procedures was taken, medical professionals would not have needed to conduct extensive investigations and implement treatment plans for a less likely diagnosis, in this case, aggressive treatment of a possible primary CNS vasculitis with high-dose steroids. Therefore, it is imperative to raise the possibility of radiation-induced vasculopathy after excluding all possible causes of deterioration in patients with a history of cranial radiation therapy.

Olfactory Learning Behavior and Mortality of the Honey Bee Apis mellifera jemenitica in Response to Pyrethroid Insecticide (Deltamethrin).

Honey bees are constantly threatened due to the wide use of pesticides. This study presents the effects of deltamethrin on the mortality, olfactory learning, and memory formation of the native Saudi bee Apis mellifera jemenitica. Topical and oral application of realistic field and serial dilutions of deltamethrin (250, 125, 62.5, and 25 ppm) caused significant mortality at 4, 12, 24, and 48 h posttreatment. Bee mortality increased with the increasing concentration of insecticide at all tested posttreatment times. Highest mortality was observed at 24 h and 48 h after both exposure routes. Food consumption gradually decreased with increasing concentration of deltamethrin during oral exposure. The LC50 of deltamethrin was determined at 12, 24, and 48 h for topical (86.28 ppm, 36.16 ppm, and 29.19 ppm, respectively) and oral (35.77 ppm, 32.53 ppm, and 30.78 ppm, respectively) exposure. Oral exposure led to significantly higher bee mortality than topical exposure of deltamethrin at 4 h and 12 h, but both exposure routes were equally toxic to bees at 24 h and 48 h. The sublethal concentrations (LC10, LC20, and LC30) of deltamethrin significantly impaired the learning during conditioning trials, as well as the memory formation of bees at 2, 12, and 24 h after topical and oral exposure. Thus, deltamethrin inhibits learning, and bees were unable to memorize the learned task.

Development and optimization of natural deep eutectic solvent-based dispersive liquid-liquid microextraction coupled with UPLC-UV for simultaneous determination of parabens in personal care products: evaluation of the eco-friendliness level of the developed method.

Dispersive liquid-liquid microextraction (DLLME) combined with ultra-high performance liquid chromatography-diode array detector (UHPLC-DAD) method has been developed and validated for the determination of parabens in personal care products. In this study, a natural deep eutectic solvent (NADES) composed of menthol and formic acid at a molar ratio of 1 : 2 was prepared and used as an extraction solvent. The influencing variables on the extraction efficiency such as extraction solvent type and volume, composition of NADES, salt addition, vortex and centrifugation time were investigated. The proposed method exhibited good linearity with determination coefficients of ≥0.9992. The relative recoveries for the studied analytes ranged from 82.19 to 102.45%. Limits of detection and limits of quantification were in the range of 0.17-0.33 ng mL-1 and 0.51-0.99 ng mL-1, respectively. To evaluate the applicability of the developed method, it was successfully applied to determine four parabens in personal care products. Additionally, the eco-friendliness level of the presented method was evaluated using Eco-Scale Assessment, Green Analytical Procedure Index and Analytical GREEnness metric. The developed method is simple, environmentally friendly and cost effective and it could be employed for determination of parabens in personal care products without harming the environment.

An Exploration of Dietary Strategies for Hypertension Management: A Narrative Review.

This review aims to clarify the influence of various nutritional approaches in the management of hypertension. An extensive search of databases, namely, PubMed, Cochrane Library, Scopus, and Web of Science, was performed, covering the period from January 2012 to October 2023. We used keywords, such as "hypertension," "nutrition," "nutritional management," "nutrient intake," "dietary strategies," "DASH diet," "Mediterranean diet," and related terms. Hypertension, a grave global health concern, affects more than one billion people worldwide. Lifestyle modifications, including nutritional strategies, are important in non-pharmacological interventions. Dietary patterns, such as the DASH (Dietary Approaches to Stop Hypertension) and Mediterranean diets, which emphasize fruit and vegetable consumption, have demonstrated efficacy in reducing blood pressure. Certain nutrients, such as potassium, calcium, and magnesium, have significant effects on blood pressure. The mechanisms underlying these dietary strategies include vasodilation, improvement in endothelial function, regulation of sodium balance, and mitigation of oxidative stress. However, successful implementation of these strategies can be hindered by various factors, such as adherence challenges, socioeconomic disparities, and cultural preferences. In conclusion, robust evidence supports the effectiveness of nutritional strategies in the management of hypertension. DASH and Mediterranean diets, along with an increased intake of specific nutrients, contribute to blood pressure reduction. Hence, comprehensive lifestyle modifications, with a focus on nutritional changes, are recommended as primary or complementary treatments for hypertension. Addressing the identified barriers could enhance the efficacy and use of these dietary approaches in clinical practice.

Temporal Muscle Cavernous Hemangioma: A Case Report and Literature Review.

Hemangiomas are nonmalignant vascular lesions commonly seen in both the skin and mucosa that rarely occur in skeletal muscles. According to the type of vessel, a hemangioma can be differentiated into capillary, cavernous, or mixed types. The following report describes a case of temporalis muscle hemangioma in a 45-year-old female who presented with painful swelling in the left outer orbital wall, which had been growing in size over the past 12 months. CT scan and MRI revealed a well-demarcated lesion in the temporalis muscle measuring 10 mm × 13 mm × 15 mm. Surgical resection of the lesion was performed, allowing a definitive diagnosis of cavernous hemangioma to be made histologically. As radiological images are mainly inadequate for definitively diagnosing these lesions, surgical intervention is usually required. The recurrence rate differs among the three subtypes; thus, clinical follow-up and radiological imaging as needed are recommended.

Prevalence, Reasons and Determinants of Patients' Nondisclosure to Their Doctors in Saudi Arabia: A Community-Based Study.

INTRODUCTION: Patient-doctor communication is a fundamental component of patients' care. Withholding important information to the doctor can negatively affect the patients' health and patient-doctor communication. AIM: This study aimed to explore the fundamental types of information that patients hide from doctors, eg, the use of medication, health-related lifestyle, or disagreement with the doctor's plan. In addition, this study examines the prevalence and reasons for this nondisclosure and factors associated with it. METHODOLOGY: An online survey was conducted using a self-designed questionnaire, which was distributed to social media, targeting the residents of Saudi Arabia from February 1, 2021 to February 28, 2021. Respondents under 18 years of age and those who provided incomplete/incorrect data were excluded from the study. Types of nondisclosed information and their reasons were evaluated. RESULTS: A total of 2725 participants completed the questionnaire, and 1392 (51.1%) were males. About 43.2% of the participants were 18-29 years. Most (82%) responded "yes" to the question "Have you ever withheld any information from your doctor?" Nondisclosed information commonly involved disagreements with the recommendation (44.7%), not taking prescription medication as instructed (40.6%), and not understanding the instructions (37.4%). The most frequent reasons (68.7%) for nondisclosure were that the participants wanted to undergo further tests, did not like the doctor's attitude (48.7%) and felt it did not matter to the doctor (43.2%). Those under 40 were more apt to withhold information (70.4%) than older participants (29.6%) p value = 0.0034. Other factors like gender, education level, and marital status were not associated with nondisclosure. CONCLUSION: The prevalence of nondisclosure to doctors is high. Effective communication skills and sound doctor-patient relationships may reduce this risk and improve the care delivered to the patients.

Atypical Familial Amyotrophic Lateral Sclerosis Secondary to Superoxide Dismutase 1 Gene Mutation With Coexistent Axonal Polyneuropathy: A Challenging Diagnosis.

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a neurodegenerative disease that involves both the upper and lower motor neurons. Familial ALS, including superoxide dismutase 1 (SOD1) mutation, accounts for 5-10% of all cases of ALS. Typically, the symptoms of ALS are purely motor, though coexistent sensory symptoms have been reported in rare cases. In this report, we describe the case of a 47-year-old man who presented with progressive bilateral lower limb weakness and numbness for the last four years. A nerve conduction study (NCS) showed evidence of coexistent axonal sensorimotor polyneuropathy in addition to the typical findings of ALS in needle electromyography. Genetic testing confirmed the diagnosis of familial ALS secondary to the SOD1 genetic mutation. This report highlights that the presence of sensory symptoms should not exclude the possibility of ALS in an appropriate clinical setting.

Structural Changes in Primary Teeth of Diabetic Children: Composition and Ultrastructure Analysis.

Diabetes affects the developing enamel by altering the mineralization process, which can have a detrimental effect on oral health. The objectives of this study were to examine the ultrastructure and composition of surface enamel in primary teeth of diabetic children and its clinical implications. Hundred extracted primary teeth from diabetic children (Test group: n = 50) and healthy children (Control group: n = 50), between 6 and 12 years of age, were subjected to scanning electron microscopy to qualitatively examine the enamel surface. Energy dispersive X-ray (EDX) analysis was performed to investigate the mass percentage of calcium (Ca) and phosphorous (P) in the surface enamel. Ultrastructural aberrations of surface enamel were observed in the test group teeth. Additionally, prism perforations were seen at the junction of rod and inter-rod enamel and the prisms were loosely packed. An even aprismatic layer of surface enamel was evident in the control group teeth. There was a statistically significant difference (p < 0.05) of Ca and P mass percentage between the test and control group teeth. The mean mass percentage rates of Ca and P were 33.75% and 16.76%, respectively. A poor surface characteristic and elemental composition of the enamel surface of primary teeth is observed in diabetic children. Therefore, appropriate caries preventive measures are mandatory to maintain the structural integrity of the tooth in these patients.

Proboscis behavioral response of four honey bee Apis species towards different concentrations of sucrose, glucose, and fructose.

Honey bees forage for pollen and nectar. Sugar is an important stimulus for foraging and a major source of energy for honey bees. Any differential response of bees to different concentrations of sugary nectar can affect their foraging. The sugar responsiveness of Apis species (Apis dorsata, Apis florea, and Apis cerana) was determined in comparison to that of Apis mellifera by evaluating the proboscis extension response (PER) with eight serial concentrations (0.00001, 0.0001, 0.001, 0.01, 0.1, 0.5, 1.0, and 1.5 M) of sucrose, glucose and fructose. Nectar foragers of bee species (A. dorsata, A. florea, A. cerana, and A. mellifera) exhibited an equal response for sucrose, glucose, and fructose, with no significant differences in their PER at all tested concentrations of these sugars within the same species. The inter-species comparison between Apis species revealed the differential responsiveness to the different concentrations of sugars, and the lowest concentration at which a response occurs was considered as the response threshold of these bee species for sugar solutions. A. mellifera presented significantly higher responsiveness than A. dorsata to low concentrations (0.00001, 0.0001, 0.001, 0.01, and 0.1 M) of sucrose, glucose and fructose. A. mellifera displayed a significantly higher response to water than A. dorsata. A. florea and A. mellifera presented no significant difference in their responsiveness to sucrose, glucose, and fructose at all tested concentrations, and their water responsiveness was also significantly at par but relatively higher in A. mellifera than in A. florea. Likewise, the responsiveness of A. cerana and A. mellifera to different concentrations of sucrose, glucose and fructose was significantly at par with no difference in their water responsiveness. This study represents preliminary research comparing the response of different honey bee species to three sugar types at different concentrations. The results imply that the native species are all better adapted than A. mellifera under local climate conditions.

Familial Hemophagocytic Lymphohistiocytosis Secondary to PRF1 Mutation.

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome that causes systemic inflammation which can progress to multiorgan failure and death. Symptoms and signs commonly seen in HLH include high fever, hepatosplenomegaly, pancytopenia, and hypertriglyceridemia. This report describes the 8-month clinical course of a 17-year-old male with G6PD deficiency who presented with intermittent high fever of unknown origin for 8 months accompanied by pancytopenia and bilateral lower limb weakness. A pathogenic homozygous missense mutation (c.1081A > T p.(Arg361Trp)) in the PRF1 gene was detected by whole exome sequencing (WES). The brain and the whole spine MRI showed leptomeningeal enhancement at different levels involving both the brain and the spine. Therefore, a diagnosis of familial HLH type 2 with CNS involvement was confirmed. Accordingly, treatment with dexamethasone, cyclosporin, and etoposide in addition to intrathecal methotrexate and hydrocortisone was given. The patient showed a dramatic response with significant neurological improvement of the bilateral lower limb weakness. Genetic analysis has helped the patient's family with appropriate genetic counselling. This case highlights the importance of immediate treatment with immunosuppressants and the high clinical suspicion of physicians regarding HLH in areas where consanguinity is common.

Knowledge, attitude, and practices regarding dietary habits among medical and non-medical university students.

BACKGROUND: Medical students even though being aware of the importance of well-balanced nutrition do tend to have laxity in practicing it themselves leading to poor nutrition. The aim of this study was to compare the awareness and knowledge of dietary habits among medical and non-medical students. METHODS: This cross-sectional study was carried out in two universities in the Jeddah province, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and King Abdulaziz University (KAU), Jeddah over 6 months. A self-administered online questionnaire was employed to assess the knowledge and attitude of the dietary habits among the students. RESULTS: The number of students who responded positively to the survey was 386, the mean age was 21.5 ± 2.10. 310 (80.3%) of which were males while 76 (19.7%) were females by a ratio of 4.07:1. Most of the participants were single (95.9%); 238 (87.6%) participants lived with their family and 272 (70.5%) participants were in the college of medicine. Among the medical students, 41.9% did exercise "sometimes," 57.4% identified breakfast as an important meal of the day, and 14.7% were smokers. CONCLUSION: In our study, we found that the medical students were having a higher level of awareness about the dietary and lifestyle habits but it was not reflected in their practice which needed to be taken care of.