Synthesis, molecular docking study and biological evaluation of new pyrrole scaffolds as potential antitubercular agents for dual targeting of enoyl ACP reductase and dihydrofolate reductase.

In this study, new series of N'-(2-(substitutedphenoxy)acetyl)-4-(1H-pyrrol-1-yl)benzohydrazides (3a-j) 4-(2,5-dimethyl-1H-pyrrol-1-yl)-N'-(2-(substitutedphenoxy)acetyl)benzohydrazides (5a-j) were synthesized, characterized and assessed as inhibitors of enoyl ACP reductase and DHFR. Most of the compounds exhibited dual inhibition against the enzymes enoyl ACP reductase and DHFR. Several synthesized substances also demonstrated significant antibacterial and antitubercular properties. A molecular docking analysis was conducted in order to determine the potential mechanism of action of the synthesized compounds. The results indicated that there were binding interactions seen with the active sites of dihydrofolate reductase and enoyl ACP reductase. Additionally, important structural details were identified that play a critical role in sustaining the dual inhibitory activity. These findings were useful for the development of future dual inhibitors. Therefore, this study provided strong evidence that several synthesized molecules could exert their antitubercular properties at the cellular level through multi-target inhibition. By shedding light on the mechanisms through which these compounds exert their inhibitory effects, this research opens up promising avenues for the future development of dual inhibitors with enhanced antibacterial and antitubercular properties. The study's findings underscore the importance of multi-target approaches in drug design, providing a strong foundation for the design and optimization of novel compounds that can effectively target bacterial infections at the cellular level.

Factors Affecting the Level of Adherence to Hypertension Medications: A Cross-Sectional Study Using the Hill-Bone Questionnaire.

Background: The adherence to antihypertensive therapy plays a significant role in determining the clinical outcomes of hypertension. We aim to evaluate the level of adherence to antihypertensive medications among patients and to assess the effect of different sociodemographic factors on the level of adherence using the Hill-Bone scale for indirect assessment. Methodology: In this cross-sectional study, we utilized a validated, face-to-face interview questionnaire to collect data on sociodemographic characteristics, participants' attitudes, and disease knowledge. The Hill-Bone questionnaire was employed to assess treatment adherence. The statistical analysis was conducted using SPSS version 28.0, where mean, standard deviation, and range were utilized for variability analysis. Results: A total of 390 patients were included in this study. The sample comprised 56.9% of females and 56.4% of participants aged 60 years or older. Approximately 80% of participants were currently married, and 46.7% had a higher education level. The average Hill-Bone CHBPTS score was 21.23± 4.95 and indicated good adherence in 63.8% of participants. The findings showed that several factors were significantly associated with higher adherence rates, including older age (COR = 3.41, 95% CI = 1.10-10.54, p = 0.03), higher educational level (COR = 1.72, 95% CI = 1.05-2.83, p = 0.03), regular blood pressure monitoring (COR = 1.90, 95% CI = 1.10-3.30, p = 0.03), and knowledge about their medications (COR = 2.12, 95% CI = 1.14-3.94, p = 0.02). Conclusion: The medication adherence within our population falls below the desired level. Enhanced counselling and further research are necessary to identify additional factors influencing adherence and develop effective strategies for promoting adherence to antihypertensive medications.

Assessment of the Impact of Lower Urinary Tract Dysfunction on Quality of Life in Multiple Sclerosis Patients in Saudi Arabia-A Cross-Sectional Study.

BACKGROUND: Lower urinary tract dysfunction (LUTD) is caused by neurogenic factors that could lead to permanent injury in affected patients, and therefore result in substantial annual healthcare expenses. LUTD is very prevalent in multiple sclerosis (MS) patients and has a drastic impact on their quality of life (QOL). This study aimed to assess the effect of LUTD on the QOL of Saudi MS patients. METHODS: A cross-sectional study was carried out in Saudi Arabia using a self-administered questionnaire that included the World Health Organization Quality of Life (WHOQOL-BREF) and LURN Symptom Index (LURN SI-29). Data were analyzed and presented as frequencies and percentages. RESULTS: There were 428 patients who participated in this study; 270 were females and 158 were males. Most of the patients received a low score in all sections of the LURN part of the questionnaire. The highest scores (urgent need to urinate and excessive urination at night) were recorded in the urgency domain (47.20 ± 36.88) rather than the nocturia domain (44.74 ± 32.91). Meanwhile, the lowest score (complete control of bladder) was recorded in the incontinence domain (22.80 ± 26.80). For the WHOQOL-BREF score, the highest score (more social stability) was in the social domain (65.07 ± 21.16 for females, 60.41 ± 21.54 for males), and the lowest score (less psychological stability) was in the psychological domain (46.36 ± 9.84 for females, 46.20 ± 10.03 for males). However, there was no significant association between the four domains of the WHOQOL-BREF and the gender of the MS patients. CONCLUSIONS: LUTD is significantly associated with a lowered quality of life. Therefore, patients are recommended to consult with and be evaluated by appropriately experienced healthcare providers and clinicians. This ensures that the patients receive the best advice, accurate and effective treatment, and long-term analysis that can lead to an improvement in their quality of life.

Periodontal-Systemic Disease: A Study on Medical Practitioners' Knowledge and Practice.

OBJECTIVE: Oral health is intricately linked with systemic health. However, the knowledge and practice levels of medical practitioners (MPs) about this concern are extremely variable. The current study, therefore, sought to assess the status of knowledge and practice of MPs concerning the link between periodontal disease and different systemic conditions as well as the efficacy of a webinar as an interventional tool in enhancing knowledge of MPs of Jazan Province of Saudi Arabia. METHODS: This prospective interventional study involved 201 MPs. A 20-item questionnaire on evidence-based periodontal/systemic health associations was used. The participants answered the questionnaire before and 1 month after a webinar training that explained the mechanistic interrelation of periodontal and systemic health. McNemar test was performed for statistical analysis. RESULTS: Out of the 201 MPs who responded to the pre-webinar survey, 176 attended the webinar and hence were included in the final analyses. Sixty-eight (38.64%) were female, and 104 (58.09%) were older than 35 years. About 90% of MPs reported not being trained on oral health. Pre-webinar, 96 (54.55%), 63 (35.80%), and 17 (9.66%) MPs rated their knowledge about the association of periodontal disease with systemic diseases as limited, moderate, and good, respectively. Post-webinar, these figures improved remarkably: 36 (20.45%), 88 (50.00%), and 52 (29.55%) MPs rated their knowledge as limited, moderate, and good, respectively. Around 64% of MPs had relatively good levels of knowledge about the positive influence of periodontal disease treatment on diabetic patients' blood glucose levels. CONCLUSIONS: MPs revealed low levels of knowledge on the oral and systemic disease interrelationship. Conducting webinars on the oral-systemic health interrelationship seems to improve the overall knowledge and understanding of MPs.

SLE initially presenting with neuropsychiatric manifestations and seizure, case report.

Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder exhibiting variable disease courses and multiple clinical manifestations. SLE's aetiology remains unclear; however, different environmental (e.g., ultraviolet light, infections, drugs, etc.), genetic, and hormonal factors are potentially involved. A positive family history and history of having other autoimmune illnesses are considered high-risk factors for SLE; nevertheless, most SLE cases are scattered. The 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for SLE include at least one positive antinuclear antibody test as a mandatory entry criterion, followed by additive weighted standards grouped in seven clinical (constitutional, haematological, neuropsychiatric, serosal, musculoskeletal, renal, and mucocutaneous) and three immunological (antiphospholipid antibodies, complement proteins, and SLE-specific antibodies) domains weighted from 2 to 10, with patients accumulating ≥10 points being diagnosed with SLE. Herein, we report a case of neuropsychiatric lupus, a rare and severe form of SLE.

Antibacterial Activity of Some Medicinal Plants in Al Baha Region, Saudi Arabia, Against Carcinogenic Bacteria Related to Gastrointestinal Cancers.

BACKGROUND: Gastrointestinal cancers are the most dangerous cancers all over the world. The gut microbiota dysbiosis increases the risk of GI cancers and induces the host's susceptibility to carcinogenic bacteria. Antibiotic resistance is rising in these bacteria. Thus, discovering new safe and effective antibacterial agents is a worldwide concern. This study evaluates the antibacterial activity of six wild medicinal plants from the Al Bahah region in Saudi Arabia. METHODS: Arial parts of Cissus quadrangularis, Aloe castellorum, Psiadia punctulata, Aloe pseudorubroviolacea, Barbeya oleoides, Teucrium yemense were collected and dried for extraction with ethanol. The minimum inhibitory concentrations (MIC) of these ethanolic extracts against carcinogenic bacteria Bacteroides fragilis, Clostridium ssp., Cutibacterium acnes, Escherichia coli, Fusobacterium nucleatum, Helicobacter pylori, Mycoplasma spp., Neisseria gonorrhoeae, Porphyromonas gingivalis, Salmonella enterica, and Treponema pallidum were evaluated to determine its antibacterial activity. RESULTS: All extracts showed antibacterial activity with MIC lower than 1 mg/ml. Psiadia punctulata showed higher antibacterial activity, while the Aloe species showed the lowest antibacterial activity. CONCLUSION: The studied plants' extracts showed high effectiveness as antibacterial activity against the carcinogenic bacteria related to gastrointestinal cancers due to their high content of pharmaceutical components. These plants could be explored further for the development of new antibacterial products against these carcinogenic bacteria.

Prevalence of and Risk Factors for Skin Picking Disorder Symptoms Among Adults in an Arab Middle Eastern Population: A Cross-Sectional Study.

Introduction: Skin Picking Disorder (SPD) is a skin-related disease, also recognized as psychogenic excoriation, dermatillomania, or excoriation disorder. SPD is defined as a habitual picking of skin, which in turn harms skin tissue. Given the paucity of information on SPD symptoms, their prevalence, and risk factors in Saudi Arabia, the present study seeks to fill this gap by investigating these factors in a community sample from Jeddah. Methods: This descriptive cross-sectional study was conducted in the city of Jeddah. The Skin Picking Scale-Revised (SPS-R) scale was administered to a convenience sample of 520 respondents. A partial least squares path model (PLS-PM) for "impairment" and "symptoms severity" subscales was assessed by evaluating the validity of measurement and structural models. Results: Skin picking behavior was reported by 28.8% (n=150). A significant level of skin picking disorder symptoms was present in 1.2% (n=6). Skin picking visual effect, depressive symptoms, and being unmarried were the only positive independent predictors of the total SPS-R score. Conclusion: SPD symptoms are relatively common among the adult population in Jeddah, but those with threshold symptoms indicative of SPD are relatively few. Such behavior is particularly common in vulnerable groups such as those with depressive symptoms and the unmarried. More attention to this condition by clinicians will improve the quality of life of those affected, and reduce the emotional and physical health consequences of this often unrecognized condition.

Quality of life among caregivers of epileptic children with degree of controlling seizures in Aseer region.

Epilepsy affects nearly 50 million people worldwide. Epilepsy can affect the quality of life of both the child and the caregiver leaving them unable to function in other areas of life. This quality of life is highly dependent on treatment adherence and how individuals feel about taking their medication. In our study, we aimed to investigate the frequency of medication adherence and the quality of life of caregivers of children with epilepsy. For this purpose, we conducted a cross-sectional survey at the Abha Maternity and Children's Hospital. We enrolled 133 consecutive participants and asked them to complete a questionnaire. The results showed that 37.6% of the participants forgot to take their medications, 9.8% of the participants reported that they were sometimes careless about giving their children medications and sometimes stopped giving them when the children were feeling better, 15.8% of the participants indicated that they sometimes stopped giving the medication when they felt that their children were getting worse when they took the medication., and 26.3% of the participants agreed that they only administered the medication when the children were sick. It was also found that the quality of life of the caregivers decreased when they forgot to give their children the medication and the quality of life of the caregivers increased when they continued to take the medication. In conclusion, quality of life increases as adherence to treatment increases, indicating that more intervention programs are needed to improve the adherence of epilepsy patients.

Anxiety and Stress among Day Traders in Saudi Arabia.

BACKGROUND: People nowadays are more concerned about their financial status and how to improve their quality of life; one method is day trading. This study aims to investigate the association between stress or anxiety and day trading among day traders in Saudi Arabia. METHODS: We collected the data through DASS-21, a set of three self-report scales designed to measure the emotional states of depression, anxiety, and stress. It tells if the person has mild, moderate, severe, or extremely severe emotional status. Our study will focus on two domains: stress and anxiety. Day traders scoring between 0 and 7 on the anxiety scale were classified as normal anxiety. Scoring between 8 and 9 on the anxiety scale, mild anxiety, and between 10 and 14 on the anxiety scale as moderate anxiety. Those scoring between 15 and 19 were classified as severe, and those scoring >20 as extremely severe. RESULTS: Our results showed that out of 387 valid surveys, day traders scoring < 14 on the stress scale were classified as everyday stress (N = 249, 64.3%), and those scoring between 15 and 18 as mild (N = 49, 12.7%) and those scoring between 19 and 25 as moderate (N = 46, 11.9%), those scoring between 26 and 33 as severe (N = 34, 8.8%), and those scoring > 34 were classified as extremely severe (N = 9, 2.3%). CONCLUSIONS: The prevalence of anxiety and stress is considerable among day-traders. Therefore, it is fundamental to develop more effective health promotion strategies for the target population to make them aware of and learn how to control and prevent these harmful emotional feelings.

Evidence-based clinical practice guidelines for the management of psoriasis: systematic review, critical appraisal, and quality assessment with the AGREE II instrument.

BACKGROUND: Psoriasis is considered one of the stubborn lifelong dermatologic diseases, making the patients seized in their social cage. Evidence-based clinical practice guidelines (CPGs) and expert opinions ensure that patients with psoriasis render the most recent and developed care. This systematic review assessed and compared the most recently approved international CPGs with the AGREE II instrument. METHODS: After we identified our research question, we searched the bibliographic international databases to identify and screen for relevant and eligible guidelines that address the topic of interest. Four independent reviewers (Senior Expert Dermatologist in Psoriasis) have critically appraised the selected guidelines via the AGREE II instrument. We conducted inter-rater analysis and percent agreement among raters and calculation of intra-class correlation coefficient (ICC) 'Kappa'. RESULTS: Out of 33 articles for CPGs, only Four eligible CPGs fulfill the inclusion criteria. Selected CPGs were critically appraised; first from the American College of Rheumatology that is also National Psoriasis Foundation (ACR/NPF-2018), second from the UK's National Institute for Health and Care Excellence (NICE-2017) for Psoriasis: Assessment and Management, third from the Saudi practical guidelines on the biologic treatment for Psoriasis (Saudi CPGs, 2015), and lastly from the American Academy of Dermatology (AAD/NPF-2019) Management and Treatment of Psoriasis with Awareness and Attention to Comorbidities. The complete assessments (OA) of two CPGs (AAD/NPF and NICE) scored greater than 80%; 'six domains' of AGREE II had greater score that is congruent with results; (1) scope and motive, (2) shareholder involvement, (3) rigor of growth, (4) clarity of speech, (5) validity, and (6) journalistic independence domains. Domain (3) scored (84, 71, and 90%), domain (5) (51%, 47, and 90%), domain (6) (70, 52, and 90%) for (Saudi CPGs, AAD/NPF, and NICE), respectively. Generally, the clinical recommendations were significantly better for NICE CPGs. CONCLUSIONS: Four evidence-based 'CPGs' introduced a high-quality methodological analysis. NICE indicated the greatest quality followed by Saudi CPGs and AAD/NPF and all four CPGs were suggested for practice.

Urothelial carcinoma arising within a congenital bladder diverticulum in an adult male: A rare case report and literature review.

Introduction and importance: Neoplasms arising from vesical diverticula are rare clinical entities known as intradiverticular bladder tumors. The bladder diverticulum harboring these tumors can be congenital or acquired. Congenital diverticula are predominantly found in children and are extremely rare in adults. Case presentation: A 56-year-old male admitted to our hospital with a 10-days history of painless gross hematuria and blood clots. Physical examination and vital signs were unremarkable. Radiologic examination revealed a bladder diverticulum with a mass inside it. Pathological examination confirmed the diagnosis of TCC tumor arising from congenital bladder diverticula. Clinical discussion: While intradiverticular bladder tumors account for only 1% of all bladder tumors، and the finding of a congenital bladder diverticulum is a rare anomaly in adults, the concurrence of a tumor arising within a congenital bladder diverticulum is almost non-existent in adults. Conclusion: We aimed to present a rare case of urothelial carcinoma arising from a congenital diverticulum in an adult while highlighting the diagnostic and therapeutic options used in managing such tumors.

Combined' Neck/Back Pain and Psychological Distress/Morbidity Among the Saudi Population: A Cross-Sectional Study.

Background: Psychological distress/morbidity is amongst the primary reason for the cause of pain at multiple sites, its progression, and recovery. Though still not very clear if physical pain in the neck or the back may predict psychological morbidities or not. Thus, we investigated the association between combined neck or back pain and psychological distress/morbidity. Methods: A cross-sectional study was conducted in Al-Kharj, Saudi Arabia, including 1,003 individuals. The questionnaire comprised of General Health Questionnaire-12 (GHQ-12) and some questions about neck and back pain. Data analysis was done using statistical software SPSS version 26.0. Results: The results of the multivariate analysis revealed a significant positive association between neck/back pain status and total GHQ score (unstandardized Beta = 2.442, P ≤ 0.0001). Having neck/back pain had almost a 2.5 times greater risk of psychological distress/morbidity. Further, females were more likely to have a higher risk of psychological distress/morbidity (unstandardized Beta = 1.334, P = 0.007) than males while adjusting for sociodemographic and clinical characteristics. Conclusion: The combination of neck and back pain was significantly associated with the Saudi population's psychological problems. Therefore, the Saudi government needs to devise high-risk strategies and allocate adequate resources to the cause so that at-risk people can be shielded from the adverse complications arising from this condition in the long run.

COVID-19 and Vaccine Hesitancy: Individual Determinants Among Saudis in Asir Region.

Background Coronavirus disease 2019 (COVID-19) is a highly contagious and quickly spreading disease, especially if associated with poor awareness and unwanted behavioral practices. Unvaccinated people are at high risk of infection, mortality, and morbidity. Practices and intent toward the COVID-19 vaccine are mainly influenced by the perception of vaccine safety. This study aimed to assess the perception, practices, intent, and challenges toward the COVID-19 vaccine in Asir region, Saudi Arabia. Methodology A quantitative, cross-sectional study was conducted among the available population in Asir region, southwest of Saudi Arabia. Data were collected from participants using a semi-structured electronic questionnaire. The questionnaire included sections on participants' socio-demographic data and their family and personal history of COVID-19 infection. Additionally, the effects of the COVID-19 pandemic on their daily life were assessed. The second section of the questionnaire included knowledge questions regarding the COVID-19 vaccine with only one correct answer for each question. The last section covered participants' attitudes toward the COVID-19 vaccine and their intent to take the vaccine with their previous vaccination practice. Results A total of 756 participants who met the inclusion criteria participated in the study. Participants' ages ranged from 18 to 65 years, with a mean age of 22.6 ± 12.8 years. A total of 518 respondents were females. Regarding the level of education, 72.2% were university graduates or postgraduates, and 195 (25.8%) were in high school. Regarding the overall knowledge level toward the COVID-19 vaccine among study participants, 420 (55.6%) participants had good knowledge regarding the COVID-19 vaccine. In total, 158 (20.9%) participants were of the view that the COVID-19 vaccine is risky. Approximately 26.9% of the participants were told by their doctor that vaccination is necessary, and 49.3% thought that they need more information about the COVID-19 vaccine. Conclusions This study revealed that public awareness regarding the COVID-19 vaccine was satisfactory, especially concerning its benefit in reducing infection and associated complications; however, poor awareness was reported regarding their perception of the pandemic and COVID-19 vaccine definition.

Incidence of type 1 diabetes among children and adolescents during peace and war times in Yemen.

AIM: To calculate a 30-year incidence rates of type 1 diabetes (T1D) in Sana'a city, Yemen during peace and wartimes. METHODS: A total of 461 patients aged between 8 months and 18 years with newly diagnosed diabetes were registered between 1989 and 2018. We used a standardized protocol for counting cases over time. The annual incidence rates (cases/100,000/year) were calculated from the number of new reported cases for each year divided by the estimated number of person-years "at risk" resident in Sana'a city, Yemen according to age and sex of the participants of that year. RESULTS: The mean annual incidence rate of T1D in children aged 0-14 years was 1.83/100,000/year. With the use of 3-year time-periods, the mean annual incidence rate was (5/100,000/year) in the first time-period, fluctuated between 1.2 and 2.3 during subsequent seven time-periods, and declined to (0.5/100,000/year) during the conflict years. The age-specific mean annual incidence rates for age-groups 0-4, 5-9, 10-14, and 15-18 years were 0.83, 1.82, 3.14, and 2.31/100,000/year, respectively. CONCLUSION: The mean annual incidence rate of T1D in children and adolescents over the observation period in Sana'a city was low. In children aged 0-14 years in particular, the incidence declined to a very low rate during wartime. Interpretation is partly limited by lack of recent census data, and the possibility of death from nondiagnosis at onset.

Onion Extract Encapsulated on Nano Chitosan: a Promising Anticancer Agent.

BACKGROUND: Onion (Allium cepa) is very rich in nutritional and pharmaceutical components, such as saponins, tannins, alkaloids, steroids, and phenols. Many recent researches approved its anticancer activity against various cancer cell lines. In this paper, we attempt to improve its anticancer activity with encapsulation on nano chitosan. On the best of our knowledge, this is considered the first study that tries to increase the anticancer activity of the onion extract on nano chitosan. METHODS: An aqueous extract of the onion was prepared and the extract efficiency as anticancer agent was enhanced by encapsulating the extract on nano chitosan. The antioxidant capacity and the functional ingredients such as alkaloid, tannin, saponin, steroid, phenolic, and flavonoid in either the free or encapsulated one were estimated. Also, the anticancer activity of the two extracts was tested against different cell lines. RESULTS: Encapsulation of the extract on chitosan nano particles decreased IC50 in different cell lines and induced apoptosis through decreasing BCL-2 level and increasing caspase-3 and caspase-9 activity. CONCLUSION: Onion extract encapsulated on nano chitosan can be used as protective agents from cancer, antitumor, or act synergistically with the cancer chemotherapy. This greatly participates in improving the use of natural products in cancer therapy instead of chemotherapy.

Pattern of traumatic occupational injuries in Saudi Arabia: A cross-sectional study.

Background: In the Kingdom of Saudi Arabia (KSA), the labor market is thriving, employing a large workforce in occupations that carry a high risk for traumatic injuries such as construction, transportation, and manufacturing. These jobs usually involve physical exertion, power tools, high-voltage electricity, working at heights, and exposure to bad weather conditions that could potentially lead to injury. This study aimed to determine patterns of traumatic occupational injuries in Riyadh, KSA. Methods: A cross-sectional study was conducted at King Khalid Hospital and Prince Sultan Centre for Healthcare, Prince Sattam bin Abdulaziz University Hospital, and the Al-Kharj Military Industries Corporation Hospital in Al-Kharj City in the KSA between July 2021 and 2022. Descriptive analysis elucidated the type, severity, and patterns of management of non-fatal traumatic occupational injuries. A Kaplan-Meier survival curve and Weibull model for length of hospital stay adjusted for age, gender, nationality, cause for injury, and injury severity scale (ISS) scores were constructed. Results: A total of 73 patients with a mean age of 33.8 ± 14.1 years were included in the study. The most common cause of occupational injury was falling from height (87.7%). The median length of hospital stay was 6 days (IQR: 4 - 7), with no mortalities. In the adjusted survival model, compared to migrants, Saudi nationals had a 45% lower median hospital stay (-62 to - 21), P < 0.01, and every 1-point increase in ISS was associated with a 5% increase in median length of hospital stay (CI: 3 - 7, P < 0.01). Conclusion: Being a Saudi national and having lower ISS scores were associated with shorter durations of hospital stay. Our findings indicate the need for improved occupational safety measures, especially among migrant, foreign-born, and ethnic minority workers.

Salivary pH changes under the effect of stainless steel versus elastomeric ligatures in fixed orthodontic patients: a single-center, randomized controlled clinical trial.

BACKGROUND: Fluctuations in pH of saliva during a prolonged treatment course influences the enamel demineralization progress, which is one of the complications of fixed orthodontic treatment. This randomized clinical trial aimed to evaluate and compare the short-term effects of stainless steel (SS) versus elastomeric (EM) ligatures on salivary pH in patients scheduled for fixed orthodontic treatment. METHODS: Seventy participants were enrolled in the study (54 female, 16 male) aged 19-36 years who met specific inclusion criteria. They were randomly selected and allocated into two equal groups through computer-generated randomization. All patients received fixed orthodontic treatment using conventional orthodontic brackets. Two commonly used archwire ligature methods were used: SS and EMs. An unstimulated (resting) salivary sample was collected before tying of the ligatures at T0 (baseline), 2 weeks, 6 (weeks), and 12 (weeks). Salivary pH was measured using a digital pH meter. The level of significance was set at p value < 0.05. RESULTS: The salivary pH level was stable between T0 and T1 (6.72 ± 0.14), then significantly and progressively increased from T1 to T2 (6.78 ± 0.13) and from T2 to T3 (6.81 ± 0.14) with (p < 0.05) in the SS group. In the EM group, the salivary pH level was significantly decreased in all follow-up periods; T0 (6.77 ± 0.16), T1 (6.72 ± 0.14), T2 (6.67 ± 0.13) and T3 (6.64 ± 0.13). CONCLUSION: The EM ligatures showed a significant decrease in salivary pH to an unfavorable level, which increased the risk of enamel demineralization. Therefore, EMs as ligature material is preferably should not be recommended in patients with high caries index or inadequate oral hygiene. Trial registration ANZCTR.org. (ACTRN12618001647224) http://www.anzctr.org.au/ACTRN12618001647224.aspx . Registration Date: 5/10/2018, "Retrospectively registered".

Performance Characteristics of Ankistrodesmus falcatus in Different Culture Media and Concentration.

This study determined the effect of growth media and culture concentration on the growth, proximate, and microelement composition of Ankistrodesmus falcatus. The culture of A. falcatus was done using three media, namely Modified COMBO Medium (COMBO), Bold's Basal Medium (BBM), and Bristol, at two concentrations (50% and 100%). The results obtained show that the cell density (>3.5 × 107 cells/mL), optical density (>0.24), and specific growth rate (>0.429%/day) were significantly higher (p ≤ 0.05) in BBM and COMBO than in Bristol (<3.1 × 107 cells/mL; <0.23; <0.416%/day, respectively) at both concentrations. However, biomass was higher in BBM (>2.20 g/L) than in COMBO (1.87-2.13 g/L), while Bristol had the lowest value observed (1.70-1.73 g/L). Biochemical and microelement composition showed variations between media and at the different concentrations, with higher values observed in BBM and COMBO. Based on the growth parameters and nutritional composition, it was concluded that BBM and COMBO were better media for the propagation of A. falcatus growth than Bristol. The study also demonstrated that the microalgae can be cultured using half of the media's concentration to lower production costs.

Non-Invasive Prenatal Fetal Blood Group Genotype and Its Application in the Management of Hemolytic Disease of Fetus and Newborn: Systematic Review and Meta-Analysis.

Hemolytic disease of fetus and newborn (HDFN) imposes great healthcare burden being associated with maternal alloimmunization against parental-inherited fetal red blood cell antigens causing fetal anemia or death. Noninvasive prenatal analysis (NIPT) provides safe fetal RHD genotyping for early identification of risk pregnancies and proper management guidance. We aimed to conduct systematic review and meta-analysis on NIPT's beneficial application, in conjunction with quantitative maternal alloantibody analysis, for early diagnosis of pregnancies at risk. Search for relevant articles was done in; PubMed/Medline, Scopus, and Ovid (January 2006April 2020), including only English-written articles reporting reference tests and accuracy data. Nineteen eligible studies were critically appraised. NIPT was estimated highly sensitive/specific for fetal RHD genotyping beyond 11-week gestation. Amplifications from ≥2 exons are optimum to increase accuracy. NIPT permits cost-effectiveness, precious resources sparing, and low emotional stress. Knowledge of parental ethnicity is important for correct NIPT result interpretations and quantitative screening. Cut-off titer ≥8-up-to-32 is relevant for anti-D alloantibodies, while, lower titer is for anti-K. Alloimmunization is influenced by maternal RHD status, gravida status, and history of adverse obstetrics. In conclusion, NIPT allows evidence-based provision of routine anti-D immunoprophylaxis and estimates potential fetal risks for guiding further interventions. Future large-scale studies investigating NIPT's non-RHD genotyping within different ethnic groups and in presence of clinically significant alloantibodies are needed.