Exploring the phytoconstituents, antimicrobial potency, and cytotoxic effects of essential oil from Origanum punonense from Palestine.

BACKGROUND: Origanum punonense Danin is one of the old traditional medicinal plants Bedouins utilize in the Dead Sea region to treat a variety of illnesses, those caused by infections. The current study aimed to identify the phytochemical components of O. punonense essential oil (EO) and determine its antiproliferative and antimicrobial effects. METHODS: Gas chromatography and mass spectrometry were employed to detect the phytochemical constituents of O. punonense EO. Broth microdilution assay was utilized to determine the antimicrobial effects against various microbial species, including those causing diabetic foot infections. RESULTS: This study revealed that O. punonense EO contains 44 phytochemical compounds, of which 41 compounds were detectable and amounted to 99.78% of the total oil. The main chemical components of the oil were carvacrol (57.4%), p-cymene (6.66%), carvone (5.35%), pinene (4.9%), and terpinene (2.96%). The antiproliferative activity of different concentrations of O. punonense EO was noted in all of the investigated cell lines, with the best activity at the concentration of 500 µg/mL. The greatest antibacterial activity was against Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and Proteus vulgaris, with MIC values of 1.56 µL/mL. In addition, and the O. punonense EO showed strong antifungal activity against Candida albicans with a MIC value of 0.8 µL/mL. In addition, the O. punonense EO showed potent antibacterial activity against all MRSA samples obtained from the diabetic foot with a MIC value of 3.13 µL/mL. The O. punonense EO demonstrated potent activity against Carbapenem-resistant Enterobacterales, Citrobacter freundii, and K. pneumoniae, with MICs value of 6.25 µL/mL. CONCLUSION: The potent antiproliferative and broad antimicrobial activity of O. punonense EO makes it an effective strategy for treating infections, especially in immunocompromised patients with chronic comorbidities such as cancer and diabetes mellitus.

Assessing the therapeutic potential and safety of traditional anti-obesity herbal blends in Palestine.

The use of traditional herbal remedies has been a common practice for centuries across different cultures to treat various ailments. In Palestine, traditional herbal medicines are widely used, but their efficacy and safety have not been thoroughly investigated. Therefore, the purpose of this study was to assess the biological activity and toxicity of two traditional herbal blends often used to treat obesity in the West Bank region of Palestine. Two herbal blends with a total of eight plants were chosen based on their historic use and availability. The plant aqueous extracts were evaluated for their antioxidant, anti-fibrotic, anti-obesity, anti-diabetic, and cytotoxic activities. The results showed that these blends have potent antifibrotic, antioxidant, and anticancer activities. While their activities on α-amylase and lipase enzymes (main targets) showed moderate activities. Therefore, our results showed that Herbal Blend 2 was more potent than Herbal Blend 1 on all investigated targets. Herbal Blend 2 showed significant activities as an antioxidant, antifibrotic, and anticancer activities with IC50 values of 68.16 ± 2.45, 33.97 ± 1.14, and 52.53 ± 0.78 µg/mL against DPPH, LX-2, and MCF-7 cell lines, respectively. While it is IC50 values on α-amylase and lipase enzymes were 243.73 ± 1.57 and 1358.39 ± 2.04 µg/mL, respectively. However, the use of anti-cancer plants can be challenging due to their cytotoxic effects on the body. We urge individuals to exercise caution when using natural remedies and to seek medical advice before incorporating them into their health regimens. This study provides valuable insight into the potential health benefits of traditional herbal remedies and emphasizes the importance of responsible usage.

Multi-biological activity assessment and phytochemical characterization of an aqueous extract of the Cymbopogon citratus grown in Palestine.

BACKGROUND: Plants have historically been a rich source of medicinal compounds, with many modern pharmaceuticals derived from botanical origins. In contemporary healthcare, there is a resurgence in utilizing botanical substances as recognized medicinal agents. This study delved into understanding the phytochemical makeup and the multifaceted biological activities of an aqueous extract from Cymbopogon citratus (C. citratus). The investigated activities were its effect on AMPA receptors, antioxidant capacity, anti-lipase, anti-α-amylase actions, cytotoxicity, and antimicrobial properties. METHODS: The extract of C. citratus received a comprehensive investigation, which included the study of its phytochemical composition, assessment of its antioxidant and anti-lipase properties, evaluation of its capacity to inhibit α-amylase, analysis of its impact on cell viability, and assessment of its antimicrobial activity. The approaches are used to clarify the complex physiological and biochemical characteristics. RESULTS: The results were compelling; receptor kinetics had a marked impact, notably on the GluA2 subunit. Regarding its medicinal potential, the extract demonstrated potent antioxidant and anti-diabetic activities with IC50 values of 15.13 and 101.14 µg/mL, respectively. Additionally, it displayed significant inhibitory effects on the lipase enzyme and showed cytotoxicity against the Hep3B cancer cell line, with IC50 values of 144.35 and 148.37 µg/mL. In contrast, its effects on the normal LX-2 cell line were minimal, indicating selectivity. CONCLUSION: The aqueous extract of C. citratus shows promising therapeutic properties. The findings advocate for further research into its compounds for potential isolation, purification, and in-depth pharmacological studies, especially in areas like nervous system disorders, diabetes, obesity, and combating oxidative stress.

The Good, the Bad, and the Ugly of Faith Healers and Psychiatric Illnesses: A Systematic Review of the Literature in the Arab World.

Faith healing is a traditional healing method involving spiritual and faith-based practices performed by a religious medicine man referred to here as a faith healer. The practice of faith healing is widespread in the Arab World for treating a range of mental disorders. This research aims to review the literature concerned with faith healing practice in the Muslim Arab population. Based on the results of the review, there are seven distinct aspects of faith healing. These include the characteristics of persons who visit faith healers, the rate of visits, the symptoms for which visits are made, the treatment methods, the general stigma and prevalent attitudes toward mental disorders in the Arab world, and the perceived effectiveness of faith healing as applied to mental disorders. The results of the review show that many patients with mental disorders, as a first resort, prefer to seek the help of faith healers (or other non-professional trusted counselors) rather than approach mental health services. This is due to several factors: the misconceptions around causes of mental illness in Arab traditions and culture and the stigma associated with mental illness. As an overall determination derived from the literature, Arabs remain highly reliant on faith healers as helpful resources for dealing with mental health problems. In conclusion, the recommendation to public health authorities is to consider including faith healers in the support system for mental health and cease viewing them as barriers to optimal care.

Barriers to Elderly Health Care in the Occupied Palestinian Territories.

This study examined different barriers to the access and utilization of primary health care services by the elderly in the occupied Palestinians territories. We collected quantitative data from a larger convenience sample of a national survey of 1299 persons in the occupied Palestinian territories (oPt) that examined the effects of Israel's colonization and its effects on health care delivery between October 2021 and February 2022. The research tool was based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) questionnaire. The data was obtained from 76 elderly participants with a mean age of 68.33 years standard deviation (SD = 7.09 years). The majority (75%) reported having at least one chronic health issue and having limited access to health care. They had all finished at least six years of education. The participants claimed having health insurance, while 47.4 percent reported paying for out-of-pocket expenses and medical care was a burden. Access and affordability of health care was a problem for 70 percent of participants. Older persons and their families face access to care issues created by political, geographic, and economic barriers. Poor incomes, war-like conditions, a weak health care system, and a lack of comprehensive care delivery all impact their health.

A Community-Academic Partnership to Explore and Address Cancer Disparities in Southwest Chicago Arab Americans.

BACKGROUND: Despite the need to consider multiple sources of evidence to guide locally and culturally relevant interventions, few studies have documented the process by which evidence is integrated. OBJECTIVES: We leveraged a community-academic partnership to describe a participatory approach to integrating community and academic sources of evidence to inform cancer programming priorities in the Arab American (ArA) community in Southwest Chicago. METHODS: Informed by Intervention Mapping, this study comprised three phases led by community and academic partners: 1) qualitative assessment of cancer-related priorities through eight focus groups with 48 ArA community members, 2) a focused literature review to identify models of cancer interventions implemented with ArAs, and 3) integration of focus group and literature review findings and development of a strategy for a community-based cancer program administered by the community partner. RESULTS: Focus groups revealed attitudes and beliefs across the cancer control continuum. The literature review highlighted two cancer interventions utilizing education, community health workers, and patient navigation components. Through facilitated discussions with community partners, we integrated community and academic sources of evidence to develop a comprehensive cancer program plan that is informed by the data we generated as well as our community partners' preferences and organizational capacity. CONCLUSIONS: Our participatory approach for integrating community and academic sources of evidence generated a locally relevant strategy to address cancer burden in the ArA community in Chicago. We discuss the benefits and challenges of utilizing this approach in intervention development.

An ethno-botanical study of medicinal plants used for the management of respiratory tract disorders in northern parts of Palestine.

BACKGROUND: The medicinal application of natural plant remedies is well established. These medicinal plants are still in use within the Palestinian community to treat several illnesses. This research is intended to study the use of natural plants to treat different types of respiratory tract disorders. METHOD: This ethno botanical study focused on the medicinal plants that are used to treat respiratory diseases in the northern part of Palestine; Nablus, Tulkarm, Qalqilia, and Jenin. A questionnaire was distributed to 120 respondents. The data obtained included names of the plants used, the parts used, the diseases for which the products were applied, as well as the method of preparation. To evaluate results, percentages (%), Fic (factor of informant consensus), and FL (fidelity-level) were calculated. RESULTS: A total of 120 participants were selected for the final analysis. The highest percentage of herbal use was reported for flu 85.8% (103 participants) followed by cough 83.3%, while the lowest percentage of users was for bronchitis with 54.1%. The study showed that 31 plant species of 19 families were used for respiratory disorders treatment. Six species were from the Lamiaceae family, three species from the Apiaceae family, two species from Amaryllidaceae, Fabaceae, Myrtaceae, Rutaceae and Zingiberaceae, and one plant species for each of the rest of families. Leaves and fruits were the most commonly used parts of plants. Decoction was the method of preparation and was taken as a hot drink. Chamomile, mint, sage, lemon, and ginger were in the recipes for the five respiratory diseases. CONCLUSION: In Palestine, patients with respiratory diseases rely heavily on the use of herbal remedies. Leaves and fruits were the most commonly used plat elements. Age and marriage were significantly associated with the use of botanical remedies. Whereas there was no significant association between the source of information about medicinal plants and the location where medicinal plants were purchased. It is vital to conduct comprehensive clinical investigations and pharmacological assessments of these herbal remedies, in order to identify their efficacy, safety, and toxicity levels.

Qualitative Review of National Nutrition Surveillance Systems in the Eastern Mediterranean Region.

The World Food Conference in 1974 emphasized the significance of establishing global nutrition surveillance to monitor and address nutritional challenges effectively. However, many countries, especially in the EMRO region, continue to encounter substantial difficulties in regularly generating disaggregated data on nutrition. The current study aimed to review the existing nutrition surveillance systems in the region and to identify their strengths and weaknesses, as well as the challenges they face in functioning optimally. METHODS: This study focused on the functional nutrition surveillance systems in eight Arab countries; namely Kuwait, Morocco, Oman, Palestine, Saudi Arabia, Sudan, Syria, and Yemen. The study's analysis involved utilizing primary data collected from both published and unpublished reports. Additionally, a structured checklist was employed to gather information from all countries involved in the study. Furthermore, interviews were conducted with the EMRO offices to gain deeper insights into the challenges, if any, that these nutrition surveillance systems face in functioning optimally. RESULTS: All countries use health facilities as a basic source of data for their nutrition surveillance, some countries triangulate their nutrition surveillance reports with data from other sources of information such as community or school surveys. Identified nutrition surveillance approaches are closely split between those who operate in stable settings and use routine health information systems (Morocco, Saudi Arabia, Oman, and Kuwait) and other countries that operate in fragile settings; for example, Yemen, Syria, Palestine, and Sudan struggle to provide early warning reports for rapid nutritional responses. CONCLUSIONS: Nutrition surveillance systems that utilize existing health information systems are the most sustained in the EMRO region. However, by integrating data from multiple sources, such as health facilities, surveys, and population censuses, countries can provide a holistic view of the nutritional situation, enhance their response to any emergency, and can leverage the infrastructure and resources already in place for health data collection and reporting. Collaboration between countries in the region through sharing experiences and success stories is important in order to reach a standardized system that can be implemented in different settings.

Physical Activity Behavior and Measurement in Arab American Women: An Integrative Review.

Physical activity (PA) is associated with cardiovascular health; however, in the U.S., only 20% of women are physically active, compared to 28% of men. Arab American women (AAW) experience unique barriers to engaging in the recommended PA. This review examines quantitative PA studies conducted with AAW with a specific focus on how PA outcomes were assessed. Studies were analyzed to explore: (a) types of PA behavior, (b) components of PA interventions/interest (if conducted), (c) PA measurement, and (d) translation of PA tools. After screening titles, abstracts, and a full-text review of articles from five different databases, 12 studies met the inclusion criteria. Leisure-time PA was the most readily used PA measure. Only two out of the 12 studies included women-only participants. There was a total of 10 cross-sectional studies and two quasi-experimental studies. All the studies used a self-report PA questionnaire; one study used a pedometer to measure PA. Six PA questionnaires were translated into Arabic. Future studies must explore the use of reliable and valid translated instruments, objective PA measures, and randomized controlled trial designs.

Dietary Calcium Intake and Osteoporosis Risk in Arab Adults.

Osteoporosis is a major public health concern in Saudi Arabia's aging population. There is particularly limited information on how diet affects bone loss in this ethnic group. The purpose of this study was to examine the association between dietary calcium (Ca) intake and osteoporosis risk in Saudi adults. A total of 1950 patients (416 males and 1534 females) with known risk factors for osteoporosis participated in this cross-sectional study. A short questionnaire (CaQ) was used to assess dietary Ca intakes in patients attending tertiary hospitals in Riyadh City. The prevalence of osteoporosis was 21.3% and was more common in females (93.5%). Patients with osteoporosis were older (p < 0.001) and had lower BMI (p < 0.001). Results showed that the overall mean Ca intake was only 445.1 mg/day (recommended dietary intake of 1300 mg/day). Tea intake (OR = 0.8 95%CI: 0.7-1.0; p = 0.02) and consumption of fish and eggs (OR = 0.9 95%CI: 0.8-1.0; p = 0.01) were significantly associated with a lower risk of osteoporosis. Furthermore, consumption of biscuits, cake and bread slices were significantly associated with higher incidence of osteoporosis (OR = 1.3 95%CI: 1.0-1.5; p = 0.02). In conclusion, extremely low dietary Ca intake was observed among Saudi adults already at risk of osteoporosis. A balanced diet including high amount of Ca, vitamin D and omega-3 fatty acids accompanied by limiting consumption of foods high in saturated fats and glycemic index may be helpful in reducing osteoporosis risk in the Saudi adult population.

Very low Omega-3 Index in young healthy students from Palestine.

Oily fish is rich in long-chain omega-3 polyunsaturated fatty acids, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which have been associated with several health benefits. However, fish consumption is generally low in many countries, including the Middle East, resulting in low omega-3 blood levels. In Palestine, no data on the omega-3 blood status is available. The aim of this cross-sectional study was to assess the omega-3 status and related factors in young healthy subjects from Palestine. Omega-3 status was assessed using the Omega-3 Index-defined as the sum of EPA + DHA in relation to the total fatty acid content of erythrocytes. A total of 149 subjects, 50 males and 99 females (age range: 18-24 years), were included in the study. In addition to the Omega-3 Index, data on anthropometrics, physical activity, smoking status, fish intake, dietary supplement intake, blood lipid profile, and whole erythrocyte fatty acid pattern were collected. The mean (SD) Omega-3 Index was 2.56 (0.57)%, with 97.9% of subjects having an index below 4%. The majority of participants (91.8%) consumed less than two portions of fish per week, and only 4% reported taking omega-3 supplements, mostly irregularly. Our findings show that young Palestinian students have an alarmingly low omega-3 status. Further studies are needed to investigate whether the omega-3 status is also low in the general Palestinian population.

The impact of vitamin D deficiency on some biochemical parameters and clinical outcome in Palestinian pregnant women during the first trimester.

BACKGROUND AND AIM: Vitamin D deficiency is widespread worldwide and associated with negative effects on maternal and neonatal health. This study aimed to evaluate the relationship between vitamin D and thyroid and parathyroid hormone levels in the first trimester of pregnancy. MATERIAL AND METHODS: This case control study included 200 participants aged (18-40) years divided into two groups; 100 pregnant females at the first trimester as case group, attending the main general clinical centers in Gaza strip, Palestine and 100 apparently healthy non-pregnant females as control group. Vitamin D, free thyroxine, free triiodothyronine, thyroid stimulating hormone, parathyroid, and the autoantibodies specific for thyroglobulin and thyroid peroxidase in serum were measured in all mothers and statistically analyzed using SPSS version 21 software. RESULTS: Serum vitamin D, TSH, anti-TPO, and anti-TG levels were significantly decrease while, parathyroid levels were non-significantly decreased in the first trimester of pregnancy compered to control group. The levels of fT4 were significantly increased and level of fT3 were non significantly increased among pregnant mothers compered to control group. Analyses using Pearson correlation coefficients showed positive correlations between vitamin D with fT4, fT3, Anti-TPO with P -value < 0.05 and negative correlations with mother age, TSH, PTH with P-value < 0.05 in early pregnancy. CONCLUSIONS: Vitamin D deficiency among pregnant women in the first-trimester can be associated with thyroid, parathyroid parameters and thyroid autoantibodies with potential adverse consequences for overall health, emphasizing a routine monitoring and vitamin D supplementation prevention strategies to optimize maternal and fetal outcomes.

Exposing the Secret: Listening to Bedouin Men Who Have Experienced Sexual Violence.

There are few indigenous men's voices regarding sexual violence against them, particularly concerning Bedouin men's views. How do Bedouin men who have experienced SV describe, perceive, and interpret their experiences in their cultural context? Seventeen Bedouin men, residents of either recognized or unrecognized Bedouin settlements in the Negev, Israel. Phenomenological semi-structured interviews were recorded, transcribed verbatim, and then translated into English. Themes were generated using thematic analysis. Three main themes were found: descriptions of the incidents, reactions to the experiences, and the need for keeping incidents of SV secret due to the stigma involved as a result of patriarchal, political (i.e., tribal hierarchy), and private (i.e., family loyalty) norms, and the matrix of multiple and often conflicting roles and identities that Bedouin men must assume despite their experiences. The incidence of SV against men in the Bedouin community is alarming and must be acknowledged by the research community and public health practitioners as a serious health issue that requires more holistic research to better understand the men's experiences. More efforts are needed on the local, regional, and global levels to provide post-violence care for survivors and to prevent SV. In particular, there is a need to reduce the stigma associated with SV so that young men will be willing to speak up about their trauma without shame and receive help.

The effects of positive psychology interventions in Arab countries: A systematic review.

While there is evidence for the effects of positive psychology interventions (PPIs) in the Western world, we know little about their effects on Arab cultures. This review aimed to assess the effects of PPIs on well-being and mental health across Arab countries. Systematic searches of randomised controlled trials (RCTs) and quasi-experimental studies investigating PPIs in Arabia were conducted in six English and Arabic databases from the inception of positive psychology in 1998 to 28 February 2022. The quality of the studies was assessed using the Cochrane risk-of-bias tools. The protocol was published in the BMJ Open. Forty-four studies from 10 Arab countries (n = 3598 participants) were included. Of these, 12 were RCTs and 32 were quasi-experimental. The studies mainly focused on adults (73%) and healthy populations (86%). PPIs included mindfulness, positive thinking, strengths, hope, optimism, self-compassion, positive traits, and multiple PPIs. Nearly all studies (91%) mentioned cultural adaptation; however, little detail was given. This is the first review in Arabia. PPIs appear to be effective for promoting well-being and reducing mental health issues. However, there were some risks of bias concerns. Future research should include younger and clinical populations, using larger samples and providing more details about adaptation.

Assessment of the vitamin D status and its determinants in young healthy students from Palestine.

The global prevalence of vitamin D deficiency is high. Poor vitamin D status, especially in women, has been reported in several countries in the Middle East despite adequate year-round sunlight for vitamin D synthesis. However, data on vitamin D status in Palestine are scarce. The aim of this cross-sectional study was to evaluate vitamin D status based on serum concentrations of 25-hydroxycholecalciferol [25-(OH)D] among young healthy Palestinian students (18-27 years) and to assess associations between 25-(OH)D concentrations and several predictors. The mean 25-(OH)D concentration of women (n 151) was 27⋅2 ± 14⋅5 nmol/l, with the majority having insufficient (31⋅1 %) or deficient (<60 %) 25-(OH)D status. Only 7 % of women achieved sufficient or optimal 25-(OH)D status. In contrast, men (n 52) had a mean 25-(OH)D concentration of 58⋅3 ± 14⋅5 nmol/l, with none classified as deficient, and most obtaining sufficient (55⋅8 %) or even optimal 25-(OH)D status (11⋅5 %). Among women, 98 % wore a hijab and 74 % regularly used sunscreen. Daily dietary vitamin D intake (3-d 24-h recalls) was 45⋅1 ± 36⋅1 IU in the total group (no sex differences). After adjustment, multiple linear regression models showed significant associations between 25-(OH)D concentrations and the use of supplements (B = 0⋅069; P = 0⋅020) and dietary vitamin D (B = 0⋅001; P = 0⋅028). In gender-stratified analysis, the association between supplement use and 25-(OH)D concentrations was significant in women (B = 0⋅076; P = 0⋅040). The vitamin D status of women in the present cohort is critical and appears to be mainly due to wearing a hijab, regular use of sunscreen and low dietary vitamin D intake. The vitamin D status of the women should be improved by taking vitamin D containing supplements or fortified foods.

Variation of caesarean section rates in Palestinian governmental hospitals.

BACKGROUND: Globally, the increased use of cesarean sections has become prevalent in high-income and low and middle-income countries. In Palestine, the rate had risen from 20.3% in 2014 to 25.1% in 2018. We have rates as high as 35.8% in some governmental hospitals and some as low as 15%. This study aimed to understand better why there is a variation in cesarean rates in governmental hospitals that use the same guidelines. METHODS: A qualitative and quantitative research approach was used. In-depth interviews were conducted with 27 specialists, obstetrics and gynecologists, and midwives in five government hospitals. The hospitals were selected based on the 2017 Annual Health Report reported cesarean section rates. The interview guide was created with the support of specialists and researchers and was piloted. Questions focused mainly on adherence to the obstetric guidelines and barriers to the use, sources of information, training for healthcare providers, the hospital system, and the factors that affect decision-making. Each hospital's delivery records for one month were analyzed to determine the reason for each cesarean section. RESULTS: The results indicated that each governmental hospital at the system level had a different policy on cesarean sections. The National Guidelines were found to be interpreted differently among hospitals. One obstetrician-gynecologist decided on a cesarean section at high-rate hospitals, while low-rate hospitals used collective decision-making with empowered midwives. At the professional level, all hospitals urged the importance of a continuous training program to refresh the medical team knowledge, in-house training of new members joining the hospital, and discussion of cases subjective to obstetrician-gynecologists interpretations. CONCLUSION: Several institutional factors were identified to strengthen the implementation of the national obstetric guidelines. For example, encouraging collective decision-making between obstetrician-gynecologists and midwives, promoting the use of a second opinion, and mandatory training.

Qualitative, Quantitative, Cytotoxic, Free Radical Scavenging, and Antimicrobial Characteristics of Hypericum lanuginosum from Palestine.

Hypericum lanuginosum is one of the traditional medicinal plants that grows in the arid area of the Al-Naqab desert in Palestine and is used by Bedouins to heal various communicable and non-communicable illnesses. The purpose of this investigation was to estimate the total phenolic, flavonoid, and tannin contents of aqueous, methanol, acetone, and hexane H. lanuginosum extracts and evaluate their cytotoxic, anti-oxidative, and antimicrobial properties. Qualitative phytochemical tests were used to identify the major phytochemical classes in H. lanuginosum extracts, while total phenol, flavonoid, and tannin contents were determined using Folin-Ciocalteu, aluminum chloride, and vanillin assays, respectively. Moreover, a microdilution test was employed to estimate the antimicrobial activity of H. lanuginosum extracts against several microbial species. At the same time, the cytotoxic and free radical scavenging effects were evaluated using 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) and 2, 2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) assays, respectively. Quantitative examinations showed that the highest amounts of phenols, flavonoids, and tannins were noticed in the H. lanuginosum aqueous extract. Moreover, H. lanuginosum aqueous extract showed potent activity against methicillin-resistant Staphylococcus aureus even more than Amoxicillin and Ofloxacin antibiotics, with Minimum Inhibitory Concentrations (MICs) of 0.78 ± 0.01, 0, and 1.56 ± 0.03 µg/mL, respectively. Additionally, the aqueous extract exhibited the highest activity against Candida albicans and Epidermatophyton floccosum pathogens, with MIC values of 0.78 ± 0.01 µg/mL. Actually, the aqueous extract showed more potent antimold activity than Ketoconazole against E. floccosum with MICs of 0.78 ± 0.01 and 1.56 ± 0.02 µg/mL, respectively. Furthermore, all H. lanuginosum extracts showed potential cytotoxic effects against breast cancer (MCF-7), hepatocellular carcinoma (Hep 3B and Hep G2), and cervical adenocarcinoma (HeLa) tumor cell lines. In addition, the highest free radical scavenging activity was demonstrated by H. lanuginosum aqueous extract compared with Trolox with IC50 doses of 6.16 ± 0.75 and 2.23 ± 0.57 µg/mL, respectively. Studying H. lanuginosum aqueous extract could lead to the development of new treatments for diseases such as antibiotic-resistant microbes and cancer, as well as for oxidative stress-related disorders such as oxidative stress. H. lanuginosum aqueous extract may help in the design of novel natural preservatives and therapeutic agents.

Bacterial and fungal co-infections among ICU COVID-19 hospitalized patients in a Palestinian hospital: a retrospective cross-sectional study.

Background: Diagnosis of co-infections with multiple pathogens among hospitalized coronavirus disease 2019 (COVID-19) patients can be jointly challenging and essential for appropriate treatment, shortening hospital stays and preventing antimicrobial resistance. This study proposes to investigate the burden of bacterial and fungal co-infections outcomes on COVID-19 patients. It is a single center cross-sectional study of hospitalized COVID-19 patients at Beit-Jala hospital in Palestine. Methods: The study included 321 hospitalized patients admitted to the ICU between June 2020 and March 2021 aged ≥20 years, with a confirmed diagnosis of COVID-19 via reverse transcriptase-polymerase chain reaction assay conducted on a nasopharyngeal swab. The patient's information was gathered using graded data forms from electronic medical reports. Results: The diagnosis of bacterial and fungal infection was proved through the patient's clinical presentation and positive blood or sputum culture results. All cases had received empirical antimicrobial therapy before the intensive care unit (ICU) admission, and different regimens during the ICU stay. The rate of bacterial co-infection was 51.1%, mainly from gram-negative isolates ( Enterobacter species and K.pneumoniae). The rate of fungal co-infection caused by A.fumigatus was 48.9%, and the mortality rate was 8.1%. However, it is unclear if it had been attributed to SARS-CoV-2 or coincidental. Conclusions: Bacterial and fungal co-infection is common among COVID-19 patients at the ICU in Palestine, but it is not obvious if these cases are attributed to SARS-CoV-2 or coincidental, because little data is available to compare it with the rates of secondary infection in local ICU departments before the pandemic. Comprehensively, those conclusions present data supporting a conservative antibiotic administration for severely unwell COVID-19 infected patients. Our examination regarding the impacts of employing antifungals to manage COVID-19 patients can work as a successful reference for future COVID-19 therapy.

My Wife Has Breast Cancer: The Lived Experience of Arab Men.

OBJECTIVES: Breast cancer is a leading cause of mortality and morbidity among women in Middle Eastern countries. In Bahrain, breast cancer is the second-leading cause of death and first among women. Prior research has shown that Middle Eastern women will often delay seeking treatment for breast cancer and subsequently hide the diagnosis from friends and family. As a result, women rely heavily on their spouses for support and care. There is limited research on spouses' experience of breast cancer, especially in the Middle East. This study explored the lived experience of Arab men following their wives' diagnosis and treatment for breast cancer in Bahrain. DATA SOURCES: Data from semi-structured interviews with Arab men (n = 6) were analyzed using the interpretative phenomenological approach (IPA). Participants' wives had completed their treatment 3 to 6 months prior to the interviews. CONCLUSION: Three main themes emerged: Perceptions of breast cancer diagnosis and treatment, coping strategies, and impact on quality of life. Findings revealed that Arab men in Bahrain relied on family and friends for support and drew on religious beliefs to give them hope so they could better support their wives. Findings also highlighted the unique culturally related coping strategies used by Arab men. This study highlights the specific needs of Arab men following their wives' diagnosis and treatment for breast cancer. Faith and beliefs were overwhelmingly a foundation for coping and support. Therefore, this must be considered within the health care service to improve support strategies for Arab patients and their spouses in treatment and care plans encompassing a holistic interprofessional, multidisciplinary, and communicative approaches including the need for culturally sensitive care pathways that are cognizant of the care needs through help-seeking and information-sharing throughout the illness. Nurses should provide the education and encourage open communication among the couple and their family. IMPLICATIONS FOR NURSING PRACTICE: Findings can be used by nurses and other health care professionals to provide better support and holistic care to Arab women with breast cancer and their spouses.

Vitamin B12 Deficiency in Patients with Diabetes on Metformin: Arab Countries.

BACKGROUND: Diabetes is a global pandemic, especially in Arab countries. AIM: The goal of this study was to review the published studies that were conducted to determine the relationship between metformin treatment for type 2 diabetes mellitus (T2DM) and vitamin B12 deficiency and to identify possible complications in this relationship. METHODS: I searched for all relevant studies published in English before 2020 on the PubMed and Web of Knowledge databases using the following terms: "metformin", "vitamin B12", "neuropathy", "diabetes mellitus", and Middle Eastern countries. RESULTS: Eleven studies were included in this review which indicated an association between taking metformin and B12 deficiency in patients with T2DM in Arab countries. This B12 deficiency was found to be negatively associated with the dose and duration of metformin therapy. The physician's knowledge of current ADA recommendations regarding supplementation with and screening of the B12 level for T2DM patients on metformin was also found to have an effect. CONCLUSION: Metformin therapy is associated with B12 deficiency among people with T2DM in Arabic countries. Thus, diabetes must be managed in compliance with current guidelines and recommendations, and B12 levels must be routinely monitored, particularly in those who have been long-term takers of metformin, to ensure the suitable management of diabetes and its complications.