Workplace resilience and compassionate care among Jordanian private sector nurses.

BACKGROUND: Compassionate care is a hallmark of the nursing profession. Yet, nursing is beset by perennial problems, not the least of which is nursing shortage and increased workload. As such, resilience becomes a critical ingredient that nurses must possess to overcome such challenges. However, there needs to be more evidence of the relationship between compassionate care and resilience within the Jordanian nursing context. AIM: To explore the relationship between workplace resilience and compassionate care among Jordanian nurses working in the private sector. METHODS: The study utilized a descriptive cross-sectional correlational design. Convenience sampling with inclusion-exclusion criteria was used to select participants from three private hospitals in Jordan. The Compassionate Care Questionnaire was used to measure levels of compassionate care, and the Resilience at Work Scale was used to measure workplace resilience. Ethical approval was obtained before data collection. RESULTS: A total of 161 nurses participated in the study. Participants had high levels of compassionate care and workplace resilience. Male nurses and nurses with lower workloads had significantly higher levels of compassionate care. Likewise, older nurses, nurses with postgraduate degrees, and nurses with experience of less than 5 years in the current area had significantly higher levels of workplace resilience. Compassionate care had a mordantly solid and significant positive relationship with workplace resilience and all its seven dimensions (living authentically, finding one's calling, maintaining perspective, managing stress, interacting cooperatively, staying healthy, and building networks. CONCLUSION: Developing workplace resilience can support nurses in implementing compassionate care. Nurse Managers and hospital administrators must consider the effects of compassionate care and workplace resilience on nurses and patients. Future research can include a longitudinal exploration of compassionate care and workplace resilience and an investigation of the levels of these variables outside a hospital setting.

Curcumin and Derivatives in Nanoformulations with Therapeutic Potential on Colorectal Cancer.

There is growing concern in the rise of colorectal cancer (CRC) cases globally, and with this rise is the presentation of drug resistance. Like other cancers, current treatment options are either invasive or manifest severe side effects. Thus, there is a move towards implementing safer treatment options. Curcumin (CUR), extracted from Curcuma longa, has received significant attention by scientists as possible alternative to chemotherapeutic agents. It is safe and effective against CRC and nontoxic in moderate concentrations. Crucially, it specifically modulates apoptotic effects on CRC. However, the use of CUR is limited by its low solubility and poor bioavailability in aqueous media. These limitations are surmountable through novel approaches, such as nanoencapsulation of CUR, which masks the physicochemical properties of CUR, thus potentiating its anti-CRC effects. Furthermore, chemical derivatization of CUR is another approach that can be used to address the above constraints. This review spans published work in the last two decades, with key findings employing either of the two approaches, in addition to a combined approach in managing CRC. The combined approach affords the possibility of better treatment outcomes but not widely investigated nor yet clinically implemented.

Therapeutic approaches in hypertriglyceridemia-induced acute pancreatitis: A literature review of available therapies and case series.

Hypertriglyceridemia-induced acute pancreatitis (HGAP) is the third most common etiology of acute pancreatitis. HGAP can be attributed to genetic disturbances in triglyceride metabolism or multiple secondary causes. Here, we presented three cases for HGAP and explored different therapeutic approaches for treating HGAP. A case series of three patients who presented with HGAP and underwent different therapeutic approaches was conducted. The first patient was a 37-year-old male who presented with nonsevere HGAP; he was treated with conservative therapy with insulin and heparin infusion, which resulted in clinical and laboratory improvement. The second patient was a 64-year-old male with human immunodeficiency virus on multiple highly active antiretroviral therapy. He presented with severe HGAP and multiorgan failure. After initiation of therapeutic plasma exchange, his HGAP resolved. The third patient was a 28-year-old male who presented with recurrent episodes of HGAP; his conservative therapy failed and was eventually escalated to therapeutic plasma exchange (TPE). HGAP can be attributed to genetic disturbances of lipid or secondary etiologies. A nonsevere form of HGAP can be managed with conventional therapy including insulin and heparin; however, severe HGAP may require TPE.

Thermal annealing gradient tailoring on ammonium nitrate-capped CdS nanospheres synthesized via green precipitation.

This study explores the impact of thermal annealing gradients on the physical properties and structural evolution of cadmium sulphide (CdS) nanospheres capped with ammonium nitrate as a modifier, which were fabricated through precipitation and subsequent annealing within 160-480 °C temperature range. The properties were characterized using X-ray diffraction (XRD), ultraviolet-visible (UV-Vis), Fourier transform infrared (FTIR), scanning electron microscopy (SEM), thermogravimetric analysis (TGA) and differential scanning calorimetry (DSC) techniques The XRD results show that the present CdS exhibits superior crystallinity compared to pure CdS without capping, transitions from a cubic to a hexagonal phase structure, and increases in crystallite size and crystallinity with increasing temperature. The FTIR spectra postulate that a vibrational band presence evidences ammonium nitrate capping on CdS, with another distinct band that represents CdS in the lower wavenumber region, both intensifying at elevated temperatures. The UV-Vis analysis reveals that CdS exhibits strong ultraviolet (UV) absorption suitable for effective photoreaction under UV light and has a broader band gap compared to bulk CdS. SEM images show an extensive distribution of homogeneous nanospheres over the surface, with increased growth in size when capped with ammonium nitrate and at higher temperatures. As validated by TGA and DSC results, CdS with a smaller crystallite size improves thermal stability and energy transfer, as evidenced by reduced weight loss and a lower endothermic temperature, respectively. Varying the annealing temperature with ammonium nitrate capping can improve the structural and physical properties of CdS, which are beneficial for varied applications such as optoelectronics, energy storage, and photocatalysts.

Experimental and computational investigation of the effect of Hsc70 structural variants on inhibiting amylin aggregation.

The misfolding and aggregation of human islet amyloid polypeptide (hIAPP), also known as amylin, have been implicated in the pathogenesis of type 2 diabetes (T2D). Heat shock proteins, specifically, heat shock cognate 70 (Hsc70), are molecular chaperones that protect against hIAPP misfolding and inhibits its aggregation. Nevertheless, there is an incomplete understanding of the mechanistic interactions between Hsc70 domains and hIAPP, thus limiting their potential therapeutic role in diabetes. This study investigates the inhibitory capacities of different Hsc70 variants, aiming to identify the structural determinants that strike a balance between efficacy and cytotoxicity. Our experimental findings demonstrate that the ATPase activity of Hsc70 is not a pivotal factor for inhibiting hIAPP misfolding. We underscore the significance of the C-terminal substrate-binding domain of Hsc70 in inhibiting hIAPP aggregation, emphasizing that the removal of the lid subdomain diminishes the inhibitory effect of Hsc70. Additionally, we employed atomistic discrete molecular dynamics simulations to gain deeper insights into the interaction between Hsc70 variants and hIAPP. Integrating both experimental and computational findings, we propose a mechanism by which Hsc70's interaction with hIAPP monomers disrupts protein-protein connections, primarily by shielding the ß-sheet edges of the Hsc70-ß-sandwich. The distinctive conformational dynamics of the alpha helices of Hsc70 potentially enhance hIAPP binding by obstructing the exposed edges of the ß-sandwich, particularly at the ß5-ß8 region along the alpha helix interface. This, in turn, inhibits fibril growth, and similar results were observed following hIAPP dimerization. Overall, this study elucidates the structural intricacies of Hsc70 crucial for impeding hIAPP aggregation, improving our understanding of the potential anti-aggregative properties of molecular chaperones in diabetes treatment.

Over-expression and characterization of NS3 and NS5A of Hepatitis C virus genotype 3a.

BACKGROUND: Hepatitis C virus (HCV) is a common and leading cause for liver cirrhosis and hepatocellular carcinoma. Current therapies to treat HCV infection are shown to be partially effective and poorly tolerated. Therefore, ample efforts are underway to rationally design therapies targeting the HCV non-structural proteins. Most of the work carried out in this direction has been focusing mainly on HCV genotype 1. Two direct-acting antiviral agents (DAAs) Telaprevir and Boceprevir are being used against genotype 1a infection in combination therapy with interferon and ribavirin. Unfortunately these DAAs are not effective against genotype 3a. Considering the wide spread infection by HCV genotype 3a in developing countries especially South Asia, we have focused on the recombinant production of antiviral drug targets NS3 and NS5A from HCV genotype 3a. These protein targets are to be used for screening of inhibitors. RESULTS: High-level expression of NS3 and NS5A was achieved at 25°C, using ~1 and 0.5 mM Isopropyl ß-D-1-thiogalactopyranoside (IPTG), respectively. Yields of the purified NS3 and NS5A were 4 and 1 mg per liter culture volume, respectively. Although similar amounts of purified NS3 were obtained at 25 and 14°C, specificity constant (Kcat/Km) was somewhat higher at expression temperature of 25°C. Circular dichroism (CD) and Fourier-transform infrared (FT-IR) spectroscopy revealed that both NS3 and NS5A contain a mixture of alpha-helix and beta-sheet secondary structures. For NS3 protein, percentages of secondary structures were similar to the values predicted from homology modeling. CONCLUSIONS: NS3 and NS5A were over-expressed and using Nickel-affinity method both proteins were purified to ~ 95% purity. Yield of the purified NS3 obtained is four fold higher than previous reports. CD spectroscopy revealed that difference in activity of NS3 expressed at various temperatures is not related to changes in global structural features of the protein. Moreover, CD and FT-IR analysis showed that NS3 and NS5A contain both alpha-helical and beta-sheet structures and for NS5A, the proportion is almost equal. The production of NS3 and NS5A in milligram quantities will allow their characterization by biophysical and biochemical means that will help in designing new strategies to fight against HCV infection.

Microscopic dysgerminoma associated with anti-Ma2 paraneoplastic encephalitis in a patient with gonadal dysgenesis.

We present a 27-yr-old female with gonadal dysgenesis (46, XY), who presented to our hospital with poor consciousness, aphasia, restlessness, and visual hallucination. Physical examination revealed normal breast development and normal external female genetalia. Computed tomography scan of the head and neck revealed the presence of brain edema, hydrocephalous, and a localized hypodense lesion in the hypothalamus. Her serum was positive for the anti-Ma2, which is associated with paraneoplastic encephalitis syndrome. Computed tomography of the abdomen revealed the presence of a 7.5×5.3×3.0 cm solid pelvic mass. Interestingly, a single microscopic focus of dysgerminoma was identified in a background of stromal fibrosis and focal dystrophic calcifications. No ovarian stroma or testicular tissue was identified. To our knowledge, this is the first case of gonadal dysgenesis presenting with anti-Ma2 paraneoplastic encephalitis with dysgerminoma. A discussion about paraneoplastic encephalitis with a microscopic dysgerminoma associated with anti-Ma2 antibody is presented.

Application of the Bethesda System for Reporting Thyroid Cytopathology in the Eastern Province of Saudi Arabia: phase I pilot retrospective analysis.

We analyzed and evaluated our adequacy rate and the classification of our thyroid aspirates using the Bethesda System for Reporting Thyroid Cytopathology (BSRTC). All thyroid fine needle aspirates that were collected or referred to our institution were reviewed and reclassified according to the BSRTC. The results were tabulated and analyzed. Those with histological resection were correlated with our revised cytopathological evaluation using the BSRTC. A total of 205 thyroid aspirates from 186 patients were reviewed. There were 149 females (80%) and 37 males (20%) ranging in age from 23 to 81 (average age 48) years. All slides were reclassified using the BSRTC. The previous interpretations were not consistent with any apparent standards. The nondiagnostic rate was found to be 22%. Five cases were considered false negative and were upgraded to a more serious category with higher risk of malignancy. The high unsatisfactory rates can be reduced by an adequacy interpretation at the time of the procedure. The risk of malignancy in our cohort increased with each increase in the BSRTC category (I-VI). Communication about and awareness of the BSRTC and its implications by all our clinicians is a prime target of this study and is still work in progress. Hopefully, this study will increase the awareness of the BSRTC and its intended benefits in our region.

A suggested scientific research environment measure SREM in medical faculties.

Background: Creating a supportive environment for scientific research is vital to improve the quality of research and its impact on development of society. This study outlines the development of a new scale that can measure the scientific research environment of postgraduate medical students. This tool aimed to allow medical institutions to measure their scientific research environment from the researchers' point of view. This may ensure an appropriate scientific research environment for researchers by identifying and overcoming obstacles. Methods: Based on literature, an initial list with 58 items was formulated. After discussing with postgraduate students and academic staff members from Damascus University and the Syrian Virtual University, A 38-item scale remained from the initial list of 58 items. To test the scale, postgraduate medical students (n = 30) were asked to fill the scale and answer 38 questions-with a 5-point Likert scale-twice in two separate occasions. The Pearson's correlation coefficient was performed to study the internal correlation. The internal consistency test was performed with Cronbach's Alpha, and the Test-Retest Reliability was conducted to study the reliability of the scale. Moreover, factor analysis was used to determine the sampling adequacy. Results: Thirty postgraduate medical students at Damascus University completed the 38-item scale. Scale scores in the sample displayed good reliability in relation to published results. Findings, showed an internal correlation among its sub-scales. The results showed an acceptable reliability values such as internal consistency (α = 0.863) and test-retest reliability (ICC = 0.093). KMO had a value bigger than 0.7 (KMO = 0.849) which indicate sampling adequacy, also, Bartlett's test of the sphericity was (1142.76, Df = 91, P-value = 0.000) which prove meaningful of the factor analysis. The results of varimax rotation found that five main factors were retained. Conclusions: The Scientific Research Environment Measure (SREM), can be suggested as an effective evaluation instrument which can be applied easily to assess the scientific research environment of postgraduate medical students. This would help the decision makers to support teaching, learning, and research environment through implementing new strategies that inspire postgraduate medical students and increase their engagement.

Does Gender, Academic Status, Years of Teaching Experience, and Discipline Affiliation Affect Strategies Used to Promote Creativity in Medical Education at King Abdulaziz University?

Background This study aimed to explore the effect of gender, academic status, years of teaching experience, and discipline affiliation on strategies used to promote creativity in medical education. Methodology This study was conducted in the Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. Faculty teaching in both the basic sciences and clinical disciplines was included. A 15-item electronic survey was created. The frequencies were obtained for the demographic and academic characteristics of the participants. For each question (Q5-Q15), the mean and SD of participant responses were obtained. The chi-square test was used to compare all categorical variables. This included the comparison of the participants' demographic characteristics with their academic characteristics. The chi-square test was also used for the comparison of participant characteristics among the categorical questions (Q5-Q15). Results A statistically significant association was determined between academic status, years of teaching experience, faculty's perception of the curriculum, tasks used in teaching, and the suitability of the used assessment strategies in promoting creativity. Teaching in clinical disciplines was statistically associated with using real-life problems, challenging students, and deliberately creating chaos or disorder in the classroom. Conclusions Academic status, years of teaching experience, and discipline affiliation are more likely to affect how faculty members promote creativity in medical education.

Omental infarction mimicking acute appendicitis with negative radiological findings.

A male in his 30s presented to the emergency department with a 1-day history of supra-umbilical pain migrating to the right iliac fossa. On examination, his abdomen was soft but tender with localised guarding in the right iliac fossa and a positive Rovsing's sign. The patient was admitted under a presumptive diagnosis of acute appendicitis. A CT scan and ultrasound scan of the abdomen and pelvis showed no acute intra-abdominal pathology. He stayed in hospital for 2 days for observation without improvement of symptoms. A diagnostic laparoscopy was therefore performed that revealed an infarcted omentum adherent to the abdominal wall and ascending colon causing congestion of the appendix. The infarcted omentum was resected, and the appendix was removed. The CT images were reviewed by multiple consultant radiologists, but no positive findings were appreciated. This case report demonstrates the potential difficulty in diagnosing omental infarction clinically and radiologically.

pH-induced wurtzite-zinc blende heterogeneous phase formation, optical properties tuning and thermal stability improvement of green synthesized CdS nanoparticles.

This is the first paper to report on the pH response to heterogeneous wurtzite/zinc blende phase transformation, optical tunability and thermal stability advancement of the CdS nanoparticles synthesized via co-precipitation, followed by subsequent thermal treatment at a desired annealing temperature of 320 °C, while the solution pH was varied during CdS synthesis by adjusting the ammonium salt concentration. The surface morphology, crystalline structure, functional groups, optical properties and thermal stability of CdS were characterized by scanning electron microscopy (SEM), X-ray diffractometer (XRD), Fourier-transform infrared spectroscopy (FTIR), UV-visible spectrophotometer, thermal gravimetric analysis (TGA) and differential scanning calorimetry (DSC), respectively. The results show that a dominant sharp band occurs in the FTIR spectra, which authenticates the presence of Cd-S bonds. XRD results reveal that as the pH declines, CdS in the initial cubic phase has gradually transformed into a heterogeneous phase with the coexistence of cubic and hexagonal structures. As observed from the SEM images, the CdS nanoparticles display a homogeneous, smooth and spherically shaped morphology. Optical absorption characterized by UV-visible spectrophotometry denotes that the band gap decreases proportionally with pH, which could be attributed to the formation of larger grain sizes from the aggregation of many small nanocrystallites. TGA and DSC analyses demonstrate an improvement in the thermal stability of CdS with increasing pH values. Consequently, the present findings dictate that pH tunability could be a valuable approach to procuring the desired properties for the respective applications of CdS in diverse fields.

Deep Brain Stimulation beyond the Clinic: Navigating the Future of Parkinson's and Alzheimer's Disease Therapy.

Deep brain stimulation (DBS) is a surgical procedure that uses electrical neuromodulation to target specific regions of the brain, showing potential in the treatment of neurodegenerative disorders such as Parkinson's disease (PD) and Alzheimer's disease (AD). Despite similarities in disease pathology, DBS is currently only approved for use in PD patients, with limited literature on its effectiveness in AD. While DBS has shown promise in ameliorating brain circuits in PD, further research is needed to determine the optimal parameters for DBS and address any potential side effects. This review emphasizes the need for foundational and clinical research on DBS in different brain regions to treat AD and recommends the development of a classification system for adverse effects. Furthermore, this review suggests the use of either a low-frequency system (LFS) or high-frequency system (HFS) depending on the specific symptoms of the patient for both PD and AD.

Emergency Medical Service Response Time for Road Traffic Accidents in the Kingdom of Saudi Arabia: Analysis of National Data (2016-2020).

Despite preventive measures and initiatives, road traffic accidents are on the rise in the Kingdom of Saudi Arabia. This study aimed to investigate the emergency medical service unit's response to RTA by socio-demographic and accident-related variables in the Kingdom of Saudi Arabia. This retrospective survey included Saudi Red Crescent Authority data on road traffic accidents between 2016 and 2020. As part of the study, information on sociodemographic characteristics (e.g., age, sex, and nationality), accident-related data (type and place of the accident), and response time to road traffic accidents were extracted. Our study included 95,372 cases of road traffic accidents recorded by the Saudi Red Crescent Authority in the Kingdom of Saudi Arabia between 2016 and 2020. Descriptive analyses were performed to explore the emergency medical service unit's response time to road traffic accidents, and linear regression analyses were performed to investigate the predictors of response time. Most of the road traffic accident cases were among males (59.1%), and the age group of 25-34 years accounted for about a quarter (24.3%), while the mean age of the road traffic accident cases was 30.13 (±12.86) years. Among the regions, the capital city of Riyadh experienced the highest proportion of road traffic accidents (25.3%). In most road traffic accidents, the mission acceptance time was excellent (0-60 s; 93.7%), movement duration was excellent (<120 s; 91.1%), reaching site duration was excellent (<12 min; 57.9%), treatment start time was excellent (<120 s; 76.4%), duration at the scene was poor (>15 min; 40.8%), reaching hospital duration was good (30-60 min; 52.7%), and in-hospital duration was poor (>15 min; 44.1%). Regions, places and types of accidents, age, gender, and nationality of victims were significantly associated with different parameters of response time. Excellent response time was observed in most of the parameters except the duration at the scene, reaching hospital duration, and in-hospital duration. Apart from the initiatives to prevent road traffic accidents, policymakers should focus on strategies to improve accident response time to save lives.

The Epidemiology of Prehospital Ambulance Crashes: A National Experience Across Saudi Red Crescent Authority.

Introduction Road traffic injuries (RTIs) have a significant impact on the healthcare system as well as the global economy. RTIs involving ambulance crashes not only cause delays in patient transfers but also endanger ambulance occupants and other road users. Due to the rising numbers of RTIs in the Kingdom of Saudi Arabia (KSA), the country's primary provider of prehospital services the Saudi Red Crescent Authority (SRCA) has established a new Trauma Epidemiology Center (TEC) following the KSA 2030 vision. Objective This current study was conducted to determine the causes and management-related aspects of RTIs involving ambulance crashes in KSA. We aim to highlight the current status and guide further efforts to fill gaps in knowledge and on-ground changes to prevent ambulance crashes, enhance patient care, and reduce morbidity and mortality. Method This is a descriptive, retrospective cross-sectional observational study of ambulance crashes in Saudi Arabia between January 2020 and July 2022. The data was extracted from the SRCA electronic database platform. Results One hundred and sixty accidents were recorded between 2020 and 2022 with the highest proportion of accidents recorded in Riyadh 44.29%; followed by the Eastern Province and Makkah, 15% and 12%, respectively. Ninety percent of ambulance crashes were due to direct collisions and caused by other parties in 58% of cases. It is worth mentioning that ambulance drivers fastened their seat belts in 99% of crashes. Conclusion This study highlights the epidemiology and distribution of prehospital ambulance crashes in the KSA. Most crashes occurred in urban areas with a reasonable contribution of the public in such crashes. Understanding contributing factors related to the vector, driver behaviors, and the surrounding environment is crucial to guide national preventive measures and help decision-makers to implement proper corrective actions.

Chitosan oligosaccharide as potential therapy of inflammatory bowel disease: therapeutic efficacy and possible mechanisms of action.

Inflammatory bowel disease (IBD) results from intestinal epithelial barrier defect and dysregulated mucosal immune response. This study aimed to evaluate the therapeutic potential of chitosan oligosaccharide (COS), a biodegradation product of dietary fiber chitosan, in the treatment of IBD and to elucidate its possible mechanisms of action. Oral administration of COS protected against mortality and intestinal inflammation in a mouse model of acute colitis induced by 5% dextran sulfate sodium (DSS). The most effective dose range of COS was 10-20 mg/kg/day. In addition, nuclear factor kappa B (NF-κB) activation, and levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in colonic tissues were suppressed in mice receiving COS. Similar protective effect of COS against mortality and intestinal inflammation was observed in another mouse model of acute colitis induced by rectal instillation of 4% acetic acid. Importantly, COS administration after colitis induction was effective in ameliorating intestinal inflammation in both acute colitis models induced by 5% DSS and chronic colitis models induced by cycles of 2.5% DSS. In human colonic epithelial cells (T84 cells), COS treatment prevented NF-κB activation, production of TNF-α and IL-6, and loss of epithelial barrier integrity under both lipopolysaccharide (LPS) and TNF-α-stimulated conditions. Furthermore, binding of LPS to T84 cells, and TNF-α and oxidative stress-induced apoptosis of T84 cells were prevented by treatment with COS. These results suggest that COS may be effective in the treatment of IBD through inhibition of NF-κB signaling and apoptosis of intestinal epithelial cells.

A 3D structure model of the melibiose permease of Escherichia coli represents a distinctive fold for Na+ symporters.

The melibiose permease of Escherichia coli (MelB) catalyzes the coupled stoichiometric symport of a galactoside with a cation (either Na(+), Li(+), or H(+)), using free energy from the downhill translocation of one cosubstrate to catalyze the accumulation of the other. Here, we present a 3D structure model of MelB threaded through a crystal structure of the lactose permease of E. coli (LacY), manually adjusted, and energetically minimized. The model contains 442 consecutive residues ( approximately 94% of the polypeptide), including all 12 transmembrane helices and connecting loops, with no steric clashes and superimposes well with the template structure. The electrostatic surface potential calculated from the model is typical for a membrane protein and exhibits a characteristic ring of positive charges around the periphery of the cytoplasmic side. The 3D model indicates that MelB consists of two pseudosymmetrical 6-helix bundles lining an internal hydrophilic cavity, which faces the cytoplasmic side of the membrane. Both sugar and cation binding sites are proposed to lie within the internal cavity. The model is consistent with numerous previous mutational, biochemical/biophysical characterizations as well as low-resolution structural data. Thus, an alternating access mechanism with sequential binding is discussed. The proposed overall fold of MelB is different from the available crystal structures of other Na(+)-coupled transporters, suggesting a distinctive fold for Na(+) symporters.

Rhus coriaria extracts inhibit quorum sensing-related virulence and biofilm production in drug-resistant Pseudomonas aeruginosa recovered from burn wounds.

Objectives: Numerous studies have confirmed sumac's ability to inhibit pathogens and even eradicate chronic drug-resistant infections. Current research was conducted to demonstrate the action of various sumac extracts at sub-inhibitory concentrations in modulating pathogen-related characteristics instead of killing them. Materials and Methods: The influence of sumac extracts on the quorum sensing dependent virulence of multidrug-resistant isolates of Pseudomonas aeruginosa recovered from burn wounds was considered by detecting the effect on biofilm development, various virulence factors, and expression of bacterial exotoxin A and quorum sensing related genes. Results: Experiments to characterize and measure sumac extract's impact on the P. aeruginosa growth, biofilm, exoproteases, pyocyanin, motility, and the quorum sensing networks revealed that all studied characteristics were reduced by concentrations below inhibition without affecting bacterial growth. Furthermore, the expression of exotoxin A, rhl, and las glucons was declined or even inhibited by lower levels of sumac fruit fractions. Conclusion: The findings revealed that sumac fights infections either by its inhibitory effect on the bacterial cells or by reducing bacterial signaling and virulence by disruption of the bacterial signal system.

A combined model for COVID-19 pandemic control: The application of Haddon's matrix and community risk reduction tools combined.

INTRODUCTION: To mitigate morbidity, mortality, and impacts of COVID-19 on health, it was essential to implement a comprehensive framework for COVID-19 control and prevention. A well-recognized tool from the field of injury prevention known as the Haddon matrix was utilized. The matrix states that any accident is affected by the host, agent, and environment. Another well-recognized tool used by the national fire protection association known as the Community risk reduction tool (CRR). The (CRR) tool utilizes the Five E's of Community Risk Reduction. AIM OF THE STUDY: To describe the risk factors that increase the susceptibility and the severity of COVID-19 infection based on the Haddon matrix and the proposed prevention strategies by the CRR tool by using the combined model. METHODOLOGY: We reviewed the literature to assess known factors contributing to COVID-19 susceptibility, infection, and severity of infection. We then used the Haddon matrix to structure, separating human factors from technical and environmental details and timing. We then used the community risk reduction (CRR) model to set all responses and control measures for each element obtained from the Haddon matrix tool. Subsequently, we incorporated both tools to develop the combined model. CONCLUSION: we proposed and implemented a combined model that utilizes the CRR model as the systematic strategy for the more theoretical framework of Haddon's matrix. Combining both models was practical and helpful in planning the preparedness and control of the COVID-19 pandemic in Saudi Arabia that can be generalized to national and international levels.

Late-Term Complications of COVID-19: Retropharyngeal Infection and Myocarditis in a 26-Year-Old Patient.

Deep neck space infection and viral myocarditis related to coronavirus disease 2019 (COVID-19) have both been described in the medical literature. However, there are only three reported cases of retropharyngeal infection as a presenting pathology in the setting of COVID-19. A 26-year-old woman presented to the emergency room with fever and neck swelling and pain 1 month after COVID-19 infection. A computed tomography scan of the neck demonstrated tonsillitis with retropharyngeal infection. She was also found to have heart failure with an ejection fraction (EF) of <20% due to acute myocarditis. Her infection resolved and the EF improved to 40% prior to discharge. Our case is the first to describe retropharyngeal infection as a late complication in an adult with a history of COVID-19 several weeks previously. It also presented a clinical challenge in terms of tailoring goal-directed medical therapy to manage severe left ventricular dysfunction caused by myocarditis. LEARNING POINTS: Deep neck space infections may be a long-term complication of SARS-CoV-2 infection.Fever, neck swelling and pain should arouse suspicion of deep neck space infection even in adults.Acute viral myocarditis in the setting of SARS-CoV-2 can present many weeks after the initial infection.