Immunomodulatory Efficacy-Mediated Anti-HCV and Anti-HBV Potential of Kefir Grains; Unveiling the In Vitro Antibacterial, Antifungal, and Wound Healing Activities.

The utilization of fermented foods with health-promoting properties is becoming more popular around the world. Consequently, kefir, a fermented milk beverage made from kefir grains, was shown in numerous studies to be a probiotic product providing significant health benefits. Herein, we assessed the antibacterial and antifungal potential of kefir against a variety of pathogenic bacteria and fungi. This study also showed the effectiveness of kefir in healing wounds in human gastric epithelial cells (GES-1) by (80.78%) compared with control (55.75%) within 48 h. The quantitative polymerase chain reaction (qPCR) results of kefir-treated HCV- or HBV- infected cells found that 200 µg/mL of kefir can eliminate 92.36% of HCV and 75.71% of HBV relative to the untreated infected cells, whereas 800 µg/mL (the highest concentration) completely eradicated HCV and HBV. Moreover, the estimated IC50 values of kefir, at which HCV and HBV were eradicated by 50%, were 63.84 ± 5.81 µg/mL and 224.02 ± 14.36 µg/mL, correspondingly. Kefir can significantly suppress the elevation of TNF-α and upregulate IL-10 and INF-γ in both treated HCV- and HBV-infected cells. High-performance liquid chromatography (HPLC) and gas chromatography-mass spectrometry (GC-MS) analysis of kefir revealed the presence of numerous active metabolites which mainly contribute to the antimicrobial, antiviral, and immunomodulatory activities. This study demonstrated, for the first time, the anti-HBV efficacy of kefir while also illustrating the immunomodulatory impact in the treated HBV-infected cells. Accordingly, kefir represents a potent antiviral agent against both viral hepatitis C and B, as well as having antimicrobial and wound healing potential.

Outcomes of Corneal Topography among Progressive Keratoconus Patients 12 months following Corneal Collagen Cross-Linking.

PURPOSE: This study aimed to assess the overall and specific topographic changes among patients who underwent corneal collagen cross-linking (CXL) due to progressive keratoconus. METHODS: This retrospective case series study was conducted at a single-arm hospital in King Abdulaziz Medical City, Riyadh. All progressive keratoconus patients who underwent CXL between January 2017 and December 2018 were included consecutively. The epi-off crosslinking technique (Dresden protocol) was applied in all patients. The topographic values were measured preoperatively and 12 months postoperatively. Patients with a history of a previous corneal procedure, corneal trauma, or any corneal scarring were excluded. RESULTS: Among our population (29 eyes of 24 patients), 58.6% of eyes were for male patients, and the mean age of the population was 27.76 ± 4.21 years. Based on the topography results, the mean values of corneal thickness at central 3 mm decreased from 473.45 ± 38 µm to 465.72 ± 41.78 µm following CXL (Z = -1.93, 95% confidence interval [CI] = 0.048-0.057, p= 0.053). Clinically significant astigmatism measurements were present in 28 (96.6%) eyes before CXL compared to 26 (89.7%) eyes after CXL. The mean values of astigmatism among the patients were 3.37 ± 2.25 diopters before and 3.67 ± 2.61 diopters after CXL (Z = -1696, 95% confidence interval [CI] = 0.085-0.096, p = 0.09). After CXL, the mean values of the front elevation at the apex changed from 33.90 ± 20.13 µm to 36.10 ± 21.09 µm (Z = -2.792, 95% [CI] = 0.003-0.006, p = 0.005). The mean values of the back elevation at the apex changed from 68.4 ± 35.66 µm to 69.90 ± 35.89 µm (Z = -0.934, 95% CI = 0.343-0.366, p = 0.35). CONCLUSION: The topographic corneal parameters improved significantly in the patients with corneal ectasia after CXL. These results revealed the safety and efficacy of CXL in stabilizing keratoconus progression among Saudi patients at 1 year of follow-up.

Computer Vision Syndrome Among Health Sciences Students in Saudi Arabia: Prevalence and Risk Factors.

Introduction Computer vision syndrome (CVS) is defined as a group of vision-related symptoms that result from the continuous use of devices with digital displays, such as computers, tablets, and smartphones. Students nowadays can find resources and books online on their smartphones easily, hence, reducing the use of paper-based reading materials. This might lead to a number of ocular symptoms. In this study, we aim to assess the prevalence and determine the risk factors of CVS among students at King Saud Bin Abdulaziz University for Health Sciences (KSAUHS) in Jeddah. Materials and methods This is an observational descriptive cross-sectional study design. Students of Colleges of Medicine, Applied Medical Sciences, and Science and Health Professions at KSAUHS were asked to fill an electronic self-administered survey. The survey instrument included questions on demographic information, digital devices using habits, frequency of eye symptoms, and ergonomic practices.  Results The sample size was 334 students, 55% of whom were males. The most used device was the mobile phone (78%), and the most common reason for using an electronic device was for entertainment (80%). The frequency of reported eye symptoms was as follows: headache (68%), feeling of an affected eyesight (short- or long-sightedness (65%)), eye itchiness (63%), burning sensation (62%), excessive tearing (58%), unclear vision (52%), redness (51%), dryness (48.3%), photophobia (47%), painful eye (44%), foreign body sensation (40%), excessive blinking (40%), difficulty in focusing on near objects (31%), halos around objects (28%), double vision (21%), and difficulty moving eyelids (9%). The most commonly applied ergonomic practice was adjusting display brightness based on the surrounding light brightness (82%). The rest of the ergonomic practices were less applied as follows: taking breaks while using the device (66%), sitting with the screen on face level (59%), sitting while the top of the screen on eye level (43%), sitting with the screen more than 50 cm away (32%), using antiglare filter (16%). The number of eye symptoms reported was significantly greater in female students (using Mann-Whitney U test) (U= 11056.500, p= 0.002), students who wear glasses (U= 11026, 0.002), and students who observe glare on their screens (U= 8363, p= 0.043). Conclusion CVS symptoms are commonly reported among health sciences students who use different electronic devices. The occurrence of CVS symptoms was significantly higher among female students, those who observe glare on screens, and those who wear eyeglasses. However, long duration of device use was not significantly associated with increased CVS symptoms. Ergonomic practices are not usually applied by most of the students, which necessitates more efforts to increase their awareness of the correct way of using devices.

Prevalence and risk factors of gestational diabetes mellitus among pregnant patients visiting National Guard primary health care centers in Saudi Arabia.

OBJECTIVES: To measure the prevalence of gestational diabetes mellitus (GDM) and its risk factors in Saudi Arabia, in comparison with developed and developing countries worldwide.  Methods: We enrolled pregnant women aged 15-45 years who visited 3 National Guard-Health Affairs' primary health care centers in Jeddah, Saudi Arabia between January 2017 and December 2017. We used stratified samples and computer-generated random numbers to collect data. This data includes demographics, obstetric history, blood pressure, non-fasting 1-hour glucose challenge test (GCT), 3-hour oral glucose tolerance test (OGTT), hemoglobin level, rubella immunization status, hepatitis B surface antigen status, urinalysis results, and labor, and delivery notes. We categorized the patients into 2 groups, GDM and non-GDM, based on GCT and OGTT. Results: We enrolled 347 women in the study (mean age, 28.8±6 years; range, 18-45 years). On GCT, 36.6% of women showed abnormal values and 6.9% exhibited diagnostic values. Oral glucose tolerance test indicated impairment in 18.7% of patients and a diagnostic finding in 15% of patients. Women diagnosed with GDM tended to be older and have greater body mass index (BMI) values. Conclusion: The prevalence of GDM in Saudi Arabia is high compared to other countries. Advanced maternal age and higher BMI values were associated with increased prevalence of GDM. Thus, early prevention and management of GDM is vital to minimize the risks to both the mother and fetus.

One of the First Cases with PIK3CA-related Overgrowth Spectrum (PROS) in Saudi Arabia: A Case Report and Literature Review.

PIK3CA-related overgrowth spectrum (PROS) is an umbrella that includes a broad range of rare disorders, ranging from isolated digit enlargement to extensive overgrowth of the limbs, abdomen, or brain. One of these disorders is megalencephaly capillary malformation polymicrogyria syndrome (MCAP), which is characterized by cutaneous capillary malformations, megalencephaly, cortical brain malformations, abnormalities of somatic growth with body and brain asymmetry, developmental delay, and characteristic facial dysmorphism. The diagnosis of PROS syndrome is based on the clinical features of a patient and confirmed by a pathogenic variant in one PIK3CA allele in a biopsy of the affected tissue. However, MCAP may be diagnosed by testing a blood or saliva sample. The management of patients with MCAP syndrome includes evaluation after the initial diagnosis, treatment of manifestations, and surveillance for potential complications. To date, there is no curative treatment for patients with MCAP syndrome. Therefore, reporting such cases will help us understand them and thus develop an appropriate treatment for them. Our patient was a 46-month-old boy, who is diagnosed with MCAP syndrome. The diagnosis was based on clinical presentation, imaging studies, and whole-exome sequencing (WES). Clinically, the patient had speech and developmental delay, macrocephaly, joint hyperlaxity, unsteady gait, and subtle dysmorphic facial features. The facial features include low-set ears, frontal bossing, depressed nasal bridge, and bilateral esotropia. MRI studies showed megalocephaly, bilateral perisylvian polymicrogyria, bilateral peri-regional, high T2 signal intensities, and cerebellar tonsil ectopia with crowding of the posterior fossa. Finally, the diagnosis was confirmed by WES, which detected changes in the PIK3CA gene. The patient is on overgrowth protocol for PIK3CA, which includes alpha-fetoprotein and abdominal ultrasound every three months until the age of eight years. To the best of our knowledge, this is one of the first cases of PROS in Saudi Arabia, which illustrates the classical findings of MCAP syndrome. Further studies and investigations on PROS syndrome are needed to aid in making a definitive classification and treatment of such complex and rare diseases.

Isolation and antimicrobial resistance of Escherichia coli isolated from farm chickens in Taif, Saudi Arabia.

OBJECTIVES: Poultry is one of the main sources of food in the world. Antimicrobial-resistant Escherichia coli can be transmitted to humans by contact with poultry waste or by contaminated poultry products, contributing to the increasing crisis of antimicrobial resistance. This study aimed to determine the incidence of antimicrobial resistance in E. coli isolated from chickens in Taif province, Saudi Arabia, and to identify the genes responsible for any resistance observed. METHODS: A total of 150 cloacal swabs were aseptically obtained from chickens from different farms, from which 180 colonies of E. coli were identified using standard microbiology procedures. Antimicrobial susceptibility testing was performed by the Kirby-Bauer disk diffusion method. The genes blaSHV, aac(3)-IV, tet(A), tet(B), aadA1, catA1, cmlA, ere(A) and sul1 were detected by PCR. RESULTS: Most of the E. coli isolates showed resistance to oxacillin (99%), lincomycin (98%) and oxytetracycline (97%). The prevalence of resistance to chloramphenicol (73%), ciprofloxacin (59%) and ampicillin (51%) was lower. Genes conferring resistance to ß-lactams (blaSHV) and tetracyclines [tet(A) and tet(B)] were observed at prevalences of 96% and 95%, respectively, among the E. coli isolates. Chloramphenicol (catA1 and cmlA) and erythromycin [ere(A)] resistance genes showed prevalences of 72% and 15%, respectively, whereas gentamicin [aac(3)-IV], streptomycin (aadA1) and sulfonamide (sul1) resistance genes were detected in 20%, 20% and 10% of the studied isolates, respectively. CONCLUSION: A significant prevalence of antimicrobial resistance genes was observed among E. coli isolates from farm chickens, supporting strict regulatory procedures for the use of antimicrobial agents.

Antimicrobial Activities of Some Actinomycetes Isolated from Different Rhizospheric Soils in Tunisia.

Fifty four isolates of actinomycetes were collected from four different rhizospheric soils: 18 strains from palm tree bark and soil, 12 strains from an olive field soil, 9 strains from a coastal forest, and 15 strains from an agriculture soil situated in the Algerian-Tunisian border (Oum Tboul). Based on morphological and cultural characters, the isolates were classified as Streptomyces (42 strains), Micromonospora (4 strains), Pseudonocardia (1 strain), Actinomadura (1 strain), Nocardia (1 strain), and non-Streptomyces (5 strains). More than half of the isolates inhibited at least one tested pathogenic microorganisms in liquid culture. In addition, antimicrobial activities of some strains were tested on solid culture. Several bioactive compounds were identified by liquid chromatography joined with low-resolution mass spectroscopy (LC/MS) and analysed by MEDINA's database and by the dictionary of natural products Chapman & Hall. An interesting chlorinated compound with the molecular formula C20H37ClN2O4, produced by three different strains (SF1, SF2, and SF5), was subject of an attempted purification. However, it was demonstrated using confocal microscopy and LC/MS high resolution that this compound is produced only on solid culture. These three potential antimicrobial isolates showed high similarity with Streptomyces thinghirensis and Streptomyces lienomycini, in terms of morphological characteristics and 16S rRNA gene sequences (bootstrap 97 %). All these findings prove the high antimicrobial diversity of the studied soils. The potential of the selected and other relatively unexplored extreme environments constitute a source of interesting actinomycete strains producing several biologically active secondary metabolites.

Bacterial load of fresh vegetables and their resistance to the currently used antibiotics in Saudi Arabia.

This study was carried out to describe the bacterial load and the occurrence of some disease-causing enteric bacteria on raw vegetables sold in Saudi markets. The study further aimed to analyze antibiotic resistance rates, production of extended-spectrum beta lactamase, and plasmid carriage among bacterial population of raw vegetables. Results revealed that none of them contained Bacillus cereus, Salmonella, and Escherichia coli O157:H7. However, Staphylococcus aureus and Shigella were detected in 11.8% and 4.4% of the samples, respectively. The bacterial loads ranged from 3 to 8 log(10) CFUg(-1) for aerobic bacteria and 1 to 4 log(10) CFUg(-1) for coliforms as well as Enterobacteriaceae. The isolates exhibited resistance in decreasing order for ampicillin (76.5%), cephalothin (69.5%), trimethoprime-sulfamethoxazole (36.7%), aminoglycosides (21.9%), tetracycline (17.2%), fluoroquinolones (17.2%), amoxycillin-clavulanic acid (13.3%), and chloramphenicol (7.8%). Maximum resistance to extended-spectrum beta-lactam antibiotics occurred in 14.8% of isolates and the production of extended-spectrum beta-lactamase was achieved by 2.3% of isolates. Multiple resistances to four or more antimicrobial agents along with plasmid with varied sizes were documented. These investigations indicate the occurrence of antibiotic resistance and plasmid carriage among bacterial isolates populating raw vegetables.

Antibiotic resistance in Escherichia coli isolated from retail raw chicken meat in Taif, Saudi Arabia.

The present study was carried out to screen and analyze the genetic characteristics of antibiotic resistance in Escherichia coli strains isolated from chicken meat marketed in the local markets of the Taif region in Saudi Arabia. A total of 119 samples were purchased from various supermarkets and examined for bacterial contamination with resistant E. coli. Thirty-seven E. coli isolates were evaluated for their antibiotic susceptibilities and the presence of class 1 integrons and antibiotic resistance genes. Results of antibiograms revealed that E. coli isolates were resistant to one or more of the antibiotics tested. Resistance was most frequently observed against sulphafurazole (89.2%), ampicillin (78.4%), nalidixic acid (70.3%), streptomycin (48.6%), chloramphenicol (32.4%), and gentamicin (24.3%). Fifteen E. coli strains have multidrug resistance phenotypes and harbored at least three antibiotic resistance genes. The bla(TEM) (beta-lactamase) and sul (sulfonamide) resistance encoding genes were detected in all the tested isolates. Polymerase chain reaction screening detected class 1 integrons in all multiresistant E. coli isolates. The present study provides an assessment of the occurrence of multidrug resistance of E. coli from raw chicken meat collected from local markets.

Optimization of bacteriocin production by Lactobacillus plantarum AA135.

Growth of Lactobacillus plantarum AA135 in MRS broth at 30 degrees C yielded maximal plantaricin AA13 activity of 10000 AU/ml at pH 3.8 after 16 hours. Maximal activity (10000 AU/ml) of plantaricin AA13 was recorded in MRS broth at initial pH of 5 or 5.5. Optimal production (10000 AU/ml) was recorded in the presence of tryptone (20 g/l), a combination of tryptone plus meat extract (1:0.6) or tryptone with yeast extract (1:0.6) as sole nitrogen source. Growth of Lactobacillus plantarum AA135 in the presence of 20 g/l glucose yielded bacteriocin activity of 10000 AU/ml. Moreover, when 40 g/l glucose was added, the plantaricin AA13 levels doubled to 20000 AU/ml. Concentrations of 5, 10 and 20 g/l K2HPO4 lowered bacteriocin activity by 60%. Supplementing MRS with 1 g/l or more glycerol repressed bacteriocin production. Maximal activity of 20000 AU/ml was recorded in MRS supplemented with Vitamin DL-6,8-thioctic acid.