Tale of a Blocked Chest Drain Resulting in Tension Pneumothorax: Are We Always Competent Enough to Troubleshoot a Chest Drain?

Intercostal chest drain (ICD) insertion for pleural effusion or pneumothorax is one of the most routinely performed procedures. Patients with ICDs usually remain in a respiratory, medical, or cardiothoracic ward or a critical care unit. Despite it being a common procedure, there seems to be limited competency in troubleshooting chest drain when it is not functioning. From our daily experience working with junior doctors and doctors from specialties other than respiratory medicine, we feel there is a significant lack of training and troubleshooting skills to handle a non-functioning chest drain. This is a matter of grave concern, as inappropriate assessment can lead to the insertion of additional chest drains. In the current practice in the United Kingdom, we do not have out-of-hours respiratory cover, particularly in the district general hospitals, and the on-call medical team will not always have a registrar or any other team member with respiratory work experience. Therefore, we often fall short of managing ICD-related complications which results in the incorrect assessment of the patient's condition further leading to incorrect action plans, causing more harm to the patient. We present one such case, where a young pregnant lady in the respiratory ward who underwent thoracostomy with an ICD placement developed a near-tension pneumothorax secondary to block in the drain. The medical team's inexperience in troubleshooting led to a wrong treatment plan for the patient. Although ICD-related complications are frequent, very few reviews and guidelines are available in the literature which covers it comprehensively. Therefore, we aim to enlighten this less-explored area of clinical practice along with a review of literature.

Retraction: Giant Traumatic Diaphragmatic Hernia: A Report of Delayed Presentation.

[This retracts the article DOI: 10.7759/cureus.20315.].

Assessing the suitability of pitaya plant varieties for cultivation in the arid climate of Saudi Arabia.

Pitaya, sometimes called dragon fruit, is a tropical fruit crop that has become more well-known recently because of its distinct flavor and beneficial properties. However, it has only been cultivated in tropical and subtropical areas, and nothing is known about whether it can thrive in arid climates. This study considers various pitaya plant types' morphological, physiological, and agronomic aspects to assess their viability for cultivation in desert regions. This study investigated the growth and development of two cultivars of pitaya plants, S. undatus and S. costaricensis, in the Asir region of Saudi Arabia. Different fertilisation treatments were applied to determine the most effective approach for promoting growth and productivity. Results showed that the Klebak fertiliser, which contains marine algae rich in auxins and amino acids, was the most effective treatment for S. undatus. For S. costaricensis, the Klebak fertiliser was also effective, but treating tree leaves with volcanic stone was also beneficial. The volcanic stone helped to preserve moisture in the soil and promote good drainage, while the leaves provided important organic nutrients for growth. In addition, S. costaricensis was found to be more resistant and responsive to cultivation, likely due to its original habitat in the temperate climate of Mexico. These findings can help inform the cultivation of pitaya plants in similar climatic conditions. They may have implications for other areas seeking to promote the growth and productivity of this important crop.

Injectable systems of chitosan in situ forming composite gel incorporating linezolid-loaded biodegradable nanoparticles for long-term treatment of bone infections.

The objective of the current study was to create an efficient, minimally invasive combined system comprising in situ forming hydrogel loaded with both spray-dried polymeric nanoparticles encapsulating linezolid and nanohydroxyapatite for local injection to bones or their close vicinity. The developed system was designed for a dual function namely releasing the drug in a sustained manner for long-term treatment of bone infections and supporting bone proliferation and new tissues generation. To achieve these objectives, two release sustainment systems for linezolid were optimized namely a composite in situ forming chitosan hydrogel and spray-dried PLGA/PLA solid nanoparticles. The composite, in situ forming hydrogel of chitosan was prepared using two different gelling agents namely glycerophosphate (GP) and sodium bicarbonate (NaHCO3) at 3 different concentrations each. The spray-dried linezolid-loaded PLGA/PLA nanoparticles were developed using a water-soluble carrier (PVP K30) and a lipid soluble one (cetyl alcohol) along with 3 types of DL-lactide and/or DL-lactide-co-glycolide copolymer using nano-spray-drying technique. Finally, the optimized spray-dried linezolid nanoparticles were incorporated into the optimized composite hydrogel containing nanohydroxy apatite (nHA). The combined hydrogel/nanoparticle systems displayed reasonable injectability with excellent gelation time at 37 °C. The optimum formulae sustained the release of linezolid for 7-10 days, which reveals its ability to reduce the frequency of injection during the course of treatment of bones infections and increase the patients' compliance. They succeeded to alleviate the bone infections and the associated clinical, biochemical, radiological, and histopathological changes within 2-4 weeks of injection. As to the state of art in this study and to the best of our knowledge, no such complete and systematic study on this type of combined in situ forming hydrogel loaded with spray-dried nanoparticles of linezolid is available yet in literatures.

Gellan gum-based bi-polymeric hydrogel scaffolds loaded with Rosuvastatin calcium: A useful tool for tendon tissue regeneration.

Statins have been long used in tissue engineering, besides their marketed hypolipidemic benefits. The aim of this research was to sustain the release of rosuvastatin calcium from bi-polymeric hydrogel scaffolds. A bi-polymer blend technique was used to enhance the mechanical properties of the fabricated hydrogels. Briefly, hydrogels were prepared via crosslinking gellan gum as the main polymer together with a secondary polymer in the presence of Ca2+. The fabricated hydrogels were assessed in terms of % swelling capacity, hydrolytic degradation and % drug released to determine the most efficient carrier system. The selected hydrogel exhibited a swelling capacity of 131.45±1.49 % following 3 weeks in an aqueous environment with a % weight loss of 15.73±1.86 % after 4 weeks post-equilibrium in aqueous medium. The results ensure a proper window for adequate drug diffusion and nutrient exchange. Sustained release was attained where 94.61±2.77 % of rosuvastatin was released at the 4-week mark. Later, FT-IR and DSC, were carried out and suggested the successful crosslinking and formation of new matrix. SEM images demonstrated the porous surface of the hydrogel while a Young's modulus of 888.558±73.549 kPa indicated the suitability of the hydrogel for soft tissue engineering. In-vivo testing involved implanting the selected hydrogel at precisely surgical cuts in the Achilles tendon of male Wistar Albino rats. Upon visual and microscopic evaluation, enhanced rates of fibrous tissue formation, vascularization and collagen expression were clearly noticed in the treatment group.

Malignancy Rates in Thyroid Imaging Reporting and Data System Category 3 (TI-RADS 3) Thyroid Nodules: A Retrospective Study.

Introduction Thyroid cancer, one of the most frequently diagnosed endocrine malignancies, has witnessed a discernible global surge, predominantly among young adults. The etiological spectrum of thyroid cancer ranges from genetic mutations to environmental triggers. The early and precise detection of thyroid nodules (TNs) is crucial, given their latent potential for malignancy. Thyroid Imaging Reporting and Data System (TI-RADS) is an evidence-based stratification tool designed to standardize the assessment of TNs. Within this system, nodules categorized as TI-RADS 3 present an intermediate risk of malignancy, thereby necessitating meticulous evaluation. The objective of this study is to investigate the rates of cancer within thyroid nodules classified as TI-RADS 3, to determine the accuracy and effectiveness of the TI-RADS classification system in predicting malignancy at this intermediate-risk level, and to improve the diagnostic process and management strategies for these nodules. Methods A retrospective study was carried out on patients diagnosed with TI-RADS-3 thyroid nodules at King Fahad Hospital, Al-Hufof, between January 2019 and May 2023. Data were extracted from electronic medical records and encompassed patient demographics, and clinical and pathological details. Statistical analyses were performed using SPSS software version 27.0.1 (IBM Corp., Armonk, NY) examining the relationship between clinical characteristics and biopsy outcomes. Results The study involved 162 participants, mostly females (82.1%), with a median age of 43 years. Thyroid nodule analysis revealed 92.0% benign and 8.0% malignant cases, with the most common nodule size ranging from 2 to 2.4 cm. No significant correlation was found between clinical characteristics and biopsy results, indicating neither age nor gender significantly predicts malignancy in thyroid nodules within this cohort. Conclusion The majority of TI-RADS 3 nodules at King Fahad Hospital were benign. Yet, relying solely on TI-RADS for clinical decisions is not advised. An integrated approach, encompassing TI-RADS gradings and other nodule features, is essential for balanced patient management between intervention and observation.

3D structural modeling using seismic data and well logs for Khatatba reservoir in Matruh-Shushan Basin, North Western Desert, Egypt.

Middle Jurassic reservoirs present challenges in the northern segment of the Western Desert due to geometric uncertainties arising from structural configurations, lateral facies variations, diverse lithologies, and heterogeneous reservoir quality. Consequently, this study employed an intricate approach, constructing detailed 3D geostatic models by amalgamating diverse datasets, including 2D seismic sections and digital well-logs. The focus of these 3D models was on the Khatatba Formation (Upper-Safa Member, Kabrit Member, and Lower-Safa Member) in Matruh-Shushan Basin in the North Western Desert. The objectives encompassed assessing hydrocarbon potential, precisely estimating reserves, formulating development and exploration strategies, and identifying prospective drilling locations. The resultant structural model revealed a compartmentalized region marked by major and minor NE-SW trending normal faults, establishing structurally advantageous locations for hydrocarbon trapping within the study area. Petrophysical analyses highlighted the promising potential of the Upper-Safa Member as a reservoir, featuring porosity values ranging from 10 to 18%, peaking in the northeast sector, volume of shale (Vsh) between 15 and 24%, water saturation (Sw) spanning from 18 to 53%, and increased sand thickness towards the eastern section. Similarly, the Lower-Safa Member demonstrated favorable reservoir attributes, including porosity values ranging from 10 to 16%, with higher values in the southeastern part, Vsh between 17 and 28%, and Sw varying from 15 to 47%. The study findings underscored the hydrocarbon potential in the northeast block of the study area for the Middle Jurassic Khatatba Formation. These insights contribute valuable information for decision-making in exploration and production endeavors within the basin.

Polymeric nanocomposite hydrogel scaffold for jawbone regeneration: The role of rosuvastatin calcium-loaded silica nanoparticles.

Bones are subject to different types of damages ranging from simple fatigue to profound defects. In serious cases, the endogenous healing mechanism is not capable of healing the damage or restoring the normal structure and function of the bony tissue. The aim of this research was to achieve a sustained delivery of rosuvastatin and assess its efficacy in healing bone tissue damage. Rosuvastatin was entrapped into silica nanoparticles and the system was loaded into an alginate hydrogel to be implanted in the damaged tissue. Silica nanoparticles were formulated based on a modified Stöber technique and alginate hydrogel was prepared via sprinkling alginate onto silica nanoparticle dispersion followed by addition of CaCl2 to promote crosslinking and hydrogel rigidification. The selected nanoparticle formulation possessed high % drug content (100.22±0.67%), the smallest particle size (221.00±7.30 nm) and a sustained drug release up to 4 weeks (98.72±0.52%). The fabricated hydrogel exhibited a further delay in drug release (81.52±4.81% after 4 weeks). FT-IR indicated the silica nanoparticle formation and hydrogel crosslinking. SEM visualized the porous and dense surface of hydrogel. In-vivo testing on induced bone defects in New Zealand rabbits revealed the enhanced rate of new bone tissue formation, its homogeneity in color as well as similarity in structure to the original tissue.

Formation evaluation of Abu Madi reservoir in Baltim gas field, Nile Delta, using well logs, core analysis and pressure data.

Baltim Eastern and Northern gas fields in the offshore Nile Delta have very high gas condensate accumulations. Therefore, the present research evaluates Abu Madi and Qawasim Formations and defines the petrophysical parameters for them using various data from five wells composed of wireline logs (gamma-ray, density, neutron, sonic, resistivity), core data, pressure data, and cross-plots. In the current study, the formations of the main reservoirs were evaluated qualitatively and quantitatively based on the petrophysical analysis to assess the production potential. Based on the lithological identification, the two main reservoirs (Abu Madi and Qawasim Formations) are composed of sandstone, calcareous shale, and siltstone. The main petrophysical parameters (Shale volume, effective porosity, net thickness, and fluid saturations) were mapped to track the areal petrophysical variations in the field. The results of the petrophysical analysis reveal that the main reservoirs are promising for the hydrocarbon potential with effective porosity of 18%, low shale content with an average value of about 21%, higher gas saturation of average value of nearly 58%, net reservoir thickness ranges from 25.5 to 131.5 m, net pay thickness (effective thickness) ranges from 6 to 61 m. Also, the conventional core analysis affirms that the main reservoirs are of good effective porosity with high horizontal and vertical permeability values. There is a good match between the well-log results and the pressure data with the production data (DST "perforation tests"). Baltim East (BE3) well has the most desired petrophysical characteristics in the Baltim East gas field, while, the Baltim North-1 (BN1) well showed the most favorable petrophysical parameters in the Baltim North gas field. Different fluid contacts (gas water contact GWC) were detected by integrating all reservoir pressures. The integration of different data in our present work (well logs, core measurements, and pressure data) could reduce the drilling risks and help to determine the best locations for future exploration and development, which is considered a big challenge in the petroleum industry.

Inter-Arm Blood Pressure Difference an Indicator of Coronary Artery Disease.

INTRODUCTION: Considering the scarcity of the literature on the association between inter-arms blood pressure difference (IABPD) and coronary artery disease (CAD). AIM: We performed this study to investigate the prevalence of IABPD within the Jordanian population and to assess if it has an association with CAD. METHODS: We sampled patients visiting the cardiology clinics at the Jordan University Hospital between October, 2019 and October 2021 into two groups. Participants were divided into two groups; patients with severe CAD and control group who had no evidence of CAD. RESULTS: We measured the blood pressure for a total of 520 patients. Of the included patients, 289 (55.6 %) had CAD while 231 (44.4%) were labeled as controls who were normal. A total of 221 (42.5%) participants had systolic IABPD above 10 mmHg, while 140 (26.9%) had a diastolic IABPD above 10 mmHg. Univariate analysis demonstrated that patients with CAD were significantly more likely to be older (p < 0.001), of the male gender (p < 0.001), hypertensive (p < 0.001), and having dyslipidemia (p < 0.001). Moreover, they had significantly higher IABPD differences in terms of both systolic and diastolic blood pressure (p < 0.001 and p = 0.022, respectively). Multivariate analysis showed that CAD was a positive predictor of abnormal systolic IABPD. CONCLUSION: In our study, elevated systolic IABPD was associated with a higher prevalence of severe CAD. Patients with abnormal IABPD might be subjected to more specialist investigation as IABPD consistently predicts coronary artery disease, peripheral arterial disease or other vasculopathy throughout the literature.

Diagnostic Yield of Neuroimaging for Headache in a Pediatric Emergency Department: A Single Tertiary Centre Experience.

OBJECTIVES: This study aimed to examine headache neuroimaging findings among the pediatric population visiting the emergency department in Saudi Arabia. METHODS: This was a cross-sectional retrospective study of pediatric patients who presented to the emergency department with a headache as their primary complaint. Data were extracted from the electronic medical files of the patients at King Abdullah Specialized Children Hospital (KASCH) between 2015 and 2020. The diagnosis of headache was confirmed using a computerized tomography (CT) scan or magnetic resonance imaging (MRI) upon the patients' presentation. RESULTS: A total of 263 patients met the inclusion criteria, and their data were extracted. The CT scans were abnormal in 50% of the patients. The MRI showed abnormal findings for 26% of the patients. CT scans and MRI identified that abnormalities were predominantly among patients with the secondary type of headache. The most common abnormal findings on CT were sinusitis (16%), masses (7%), and hydrocephalus (7%). The most common abnormal findings on MRI were masses (8%), cysts (5%), and hydrocephalus (3%). Of all patients with headaches, 10% had a prior diagnosis of headache, and 12% had a family history of headache. A significantly higher percentage of patients with secondary headache were prescribed NSAID and required admission compared to patients with primary headache (p ≤ 0.05). There was no statistically significant differences in the proportion of patients diagnosed with primary and secondary headache in terms of their neurological examination and headache types (p = 0.43). CONCLUSIONS: Neuroimaging is essential for diagnosing headaches in children. Headaches were associated with sinusitis in children. The secondary type was more likely to have abnormal CT and MRI results. Primary type headaches were more common in those with a family history. CT scans and MRIs are needed when a headache is accompanied by an abnormal clinical evaluation. Neuroimaging and mild CT usage may be explored if there are clinical abnormalities or family history.

Identification and Biocontrol Potential of Entomopathogenic Nematodes and Their Endosymbiotic Bacteria in Apple Orchards against the Codling Moth, Cydia pomonella (L.) (Lepidoptera: Tortricidae).

The codling moth, Cydia pomonella (L.) (Lepidoptera: Tortricidae), is one of the major pests in pome fruit production worldwide. Heavy treatment of the larvae of C. pomonella with insecticides triggered the development of resistance to many groups of insecticides. In addition, the increasing concern about the adverse effects of synthetic insecticides on human health and the environment has led to the development of sustainable and eco-friendly control practices for C. pomonella. The entomopathogenic nematodes (EPNs) (Steinernema and Heterorhabditis spp.) and their endosymbionts (Xenorhabdus and Photorhabdus spp.) represent a newly emerging approach to controlling a wide range of insect pests. In the present study, field surveys were conducted in apple orchards to isolate and identify EPNs and their endosymbionts and evaluate their insecticidal efficacy on the larvae of C. pomonella. EPNs were isolated from 12 of 100 soil samples (12%). Seven samples were identified as Steinernema feltiae (Filipjev, 1934) (Rhabditida: Steinernematidae), whereas five samples were assigned to Heterorhabditis bacteriophora (Poinar, 1976) (Rhabditida: Heterorhabditidae). The pathogenicity of the EPN species/isolates was screened on the last instar larvae of G. mellonella. The two most pathogenic isolates from each EPN species were tested against fifth instar larvae of C. pomonella under controlled conditions. The maximum mortality (100%) was achieved by all EPN species/isolates at a concentration of 100 IJs/larva 96 h after treatment. The endosymbionts of selected H. bacteriophora and S. feltiae species were identified as Photorhabdus luminescens subsp. kayaii and Xenorhabdus bovienii, respectively. The mortality rates ranged between 25 and 62% when the fifth larval instar larvae of C. pomonella were exposed to the treatment of cell-free supernatants of symbiotic bacteria. In essence, the present survey indicated that EPNs and their symbiotic bacteria have good potential for biological control of C. pomonella.

Crataegus sinaica defatted methanolic extract ameliorated monosodium iodoacetate-induced oxidative stress andinhibited inflammation in a rat model of osteoarthritis.

Background and purpose: Osteoarthritis is a degenerative joint disease without definite treatment. It is characterized by intra-articular inflammation, cartilage degeneration, subchondral bone remodeling, and joint pain. The objective of the current study was to assess the anti-osteoarthritic effect and the possible underlying mechanism of action of Crataegus sinaica extract (CSE). Experimental approach: Intra-articular injection of monosodium iodoacetate in the right knee joint of all rats was done except for the sham group. One week later, the anti-inflammatory efficacy of CSE (100, 200, 300 mg/kg, daily p.o) for 4 successive weeks versus ibuprofen (40 mg/kg, p.o) was assessed. Serum inflammatory cytokines; as well as weekly assessment of knee joint swelling, joint mobility, and motor coordination were done. At the end of the experiment, a histopathological investigation of the affected knee joints and an x-ray investigation were also executed. Findings / Results: CSE significantly decreased joint swelling, pain behaviors, and serum levels of TNF-α, IL6, hyaluronic acid, and CTX-II. The radiographic findings revealed almost normal joint space with normal radiodensity and diameter in CSE-treated rats. As well, the histopathological and immunohistochemical investigations of the knee joints in CSE-treated groups retained the cartilage structure of knee joints. A significant reduction in the percentage of caspase-3-stained chondrocytes and a decrease in TGF-ß1 immuno-positive areas in the synovial lining and sub lining were recorded in CSE-treated rats, compared to the osteoarthritis control group. Conclusion and implications: This study approved the chondroprotective effects of CSE, and its ability to inhibit the pain associated with osteoarthritis.

The challenges in diagnosis and management of osteitis pubis: An algorithm based on current evidence.

Objective: The objective of this study is to summarise the contemporary evidence regarding the prevalence, diagnosis, and management of osteitis pubis (OP) specially from urological point of view, while proposing an algorithm for the best management based on the current evidence. Methods: We performed a literature search using the PubMed database for the term 'osteitis pubis' until December 2020. We assessed pre-clinical and clinical studies regarding the aetiology, pathophysiology, and management of OP. Case reports and case series were evaluated by study quality and patient outcomes to determine a potential clinical management algorithm. Results: Osteitis pubis is a chronic painful condition of the symphysis pubis joint and its surrounding structures. Still, there is a paucity of data outlining the management plan and the possible triggers. The aetiology seems to be multifactorial with different proposals trying to explain the pathophysiology and correlate the findings to the outcome. The diagnosis is usually based on high suspicion index and clinical experience. The infective variant of the disease is aggressive and requires strict and active management. Universal consensus is still lacking regarding a formal algorithm of management of the condition, especially due to multiple specialities involved in the decision-making process. Conservative management remains the cornerstone; nevertheless, surgical interventions may be needed in special settings. Hence, a multi-disciplinary approach is of pivotal value in fashioning the plan for each case. The prognosis is usually satisfactory; however, a longstanding debilitating disease form is not uncommon. Conclusion: OP remains a rare condition with real challenges in its diagnosis. The current management is focused on conservative management; however, surgical intervention is still needed in some difficult scenarios. Continued research into the triggers of OP, multidisciplinary approach, and standardised clinical pathways can improve the quality of care for patients suffering from this condition.

Fungal Pathogens Associated with Crown and Root Rot of Wheat in Central, Eastern, and Southeastern Kazakhstan.

Kazakhstan is the fourteenth largest wheat producer in the world. Despite this fact, there has not been a comprehensive survey of wheat root and crown rot. A quantitative survey was conducted for the purpose of establishing the distribution of fungi associated with root and crown rot on wheat (Triticum spp.). During the 2019 growing season, samples were taken from the affected plants' roots and stem bases. A total of 1221 fungal isolates were acquired from 65 sites across the central (Karagandy region), eastern (East Kazakhstan region), and southeastern (Almaty region) parts of the country and identified using morphological and molecular tools. The internal transcribed spacer (ITS), translation elongation factor 1-alpha (EF1-α), and glyceraldehyde-3-phosphate dehydrogenase (GAPDH) sequences were successfully used to identify the species of fungal isolates. It was found that Bipolaris sorokiniana (44.80%) and Fusarium acuminatum (20.39%) were the most predominant fungal species isolated, which were present in 86.15 and 66.15% of the fields surveyed, respectively, followed by F. equiseti (10.16%), Curvularia spicifera (7.62%), F. culmorum (4.75%), F. oxysporum (4.10%), F. redolens (2.38%), Rhizoctonia solani AG2-1 (1.06%), Nigrospora oryzae (0.98%), C. inaequalis (0.90%), F. pseudograminearum (0.74%), F. flocciferum (0.74%), Macrophomina phaseolina (0.66%), F. cf. incarnatum (0.33%), Fusarium sp. (0.25%), and F. torulosum (0.16%). A total of 74 isolates representing 16 species were tested via inoculation tests on the susceptible Triticum aestivum cv. Seri 82 and the results revealed that F. culmorum and F. pseudograminearum, B. sorokiniana, Fusarium sp., R. solani, F. redolens, C. spicifera, C. inaequalis, and N. oryzae were virulent, whereas others were non-pathogenic. The findings of this investigation demonstrate the presence of a diverse spectrum of pathogenic fungal species relevant to wheat crown and root rot in Kazakhstan. To the best of our knowledge, this is the first report of F. pseudograminearum, Fusarium sp., C. spicifera, and C. inaequalis as pathogens on wheat in Kazakhstan.

Occurrence and Geographic Distribution of Plant-Parasitic Nematodes Associated with Citrus in Morocco and Their Interaction with Soil Patterns.

Plant-parasitic nematodes (PPNs) are found in citrus plantations throughout the world, but they are considered to be the most problematic pest in Morocco. Citrus fruit quality and yield have been adversely affected by PPNs. Due to data unavailability of nematodes associated with citrus, a detailed survey was conducted in the main citrus-growing regions of Morocco during 2020-2021 to assess the occurrence, distribution, and diversity of PPNs associated with rhizospheres of citrus trees. In addition, some soil properties have also been assessed for their impact on soil properties. Plant-parasitic nematode diversity was calculated using two ecological indexes, the Shannon diversity index (H') and the Evenness index (E). The collected soil and root samples were analyzed, and eleven genera and ten species of plant-parasitic nematodes were identified. The results show that the most predominant PPN species were Tylenchulus semipenetrans (88%), Helicotylenchus spp. (75%), Pratylenchus spp. (47%), Tylenchus spp. (51%), and Xiphinema spp. (31%). The results showed that PPN distributions were correlated with soil physicochemical properties such as soil texture, pH levels, and mineral content. Based on the obtained result, it was concluded that besides the direct effects of the host plant, physicochemical factors of the soil could greatly affect PPN communities in citrus growing orchards.

Vitamin D Serum Levels in Type 2 Diabetic Patients: A Cross-Sectional Study.

Background and objective Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by hyperglycemia. It is linked with an increase in morbidity (e.g., blindness, kidney failure, stroke, cardiovascular diseases, limb amputations), premature mortality, high healthcare costs, and is quickly becoming a global epidemic disorder. Several studies have shown that vitamin D supplements reduce insulin resistance in T2DM and improve insulin secretion and sensitivity. In this study, we aimed to determine the prevalence of vitamin D deficiency in T2DM patients in Saudi Arabia. Methods This was a retrospective cross-sectional study conducted at the King Faisal University Health Centre in Saudi Arabia. The study used patient data during the period from October 2014 to January 2021. After obtaining approval from the King Faisal University Polyclinic Administration, we collected patient data from the King Faisal University Health Centre. The Ethics and Research Committee at the College of Medicine of King Faisal University granted ethical approval with the approval number (2020-11-82). The relevant patient data were collected, including age, gender, nationality, and blood test findings (vitamin D and HbA1c levels). Results A total of 191 T2DM patients participated in this study. The mean age of the patients was 56.1 ± 11.4 years (range: 21-85 years); 107 (56%) patients were females, and 137 (71.7%) were Saudis. There were 134 (70.2%) patients with vitamin D deficiency, 53 (27.7%) with vitamin D insufficiency, and only four (2.1%) with normal vitamin D levels. Conclusion Based on our findings, the prevalence of vitamin D deficiency among T2DM patients is highly associated with poor diabetic control.

Dual-Drug Delivery via Zein In Situ Forming Implants Augmented with Titanium-Doped Bioactive Glass for Bone Regeneration: Preparation, In Vitro Characterization, and In Vivo Evaluation.

In situ forming implants (IFIs) are non-surgical approach using biodegradable polymers to treat bone fractures. The study aimed at preparing dual-drug-loaded IFIs to deliver pitavastatin (osteogenic drug) and tedizolid (antibiotic) using zein as the implant matrix via solvent-induced phase inversion method. At first, several investigations were done on pitavastatin-loaded zein IFIs, where three concentrations of zein were used (10, 20, and 30% w/v). IFIs were evaluated for their solidification time, rheological properties, injectability, and in vitro release. IFIs containing bioactive glass nanoparticles were prepared by the addition of non-doped bioactive glass nanoparticles (BGT0; 1, 3, 5, and 10% w/v) or titanium-doped bioactive glass nanoparticles (BGT5; 1% w/v) to the selected concentration of zein (30% w/v) and then evaluated. The optimized dual-medicated implant (D-ZIFI 1) containing pitavastatin, tedizolid, sodium hyaluronate (3% w/v), and BGT5 (1% w/v) was prepared and compared to IFI lacking both sodium hyaluronate and BGT5 (D-ZIFI 2). D-ZIFI 1 and 2 sustained the release profiles of both drugs for 28 days. SEM images proved the interconnected porous structure of D-ZIFI 1 due to sodium hyaluronate. In vivo studies on surgically induced bone defects in Sprague-Dawley rats signified the proper accelerated bone healing ability of D-ZIFI 1 over D-ZIFI 2. Results presented D-ZIFI 1 as a promising, effective, non-surgical approach for bone healing.

Repair of experimentally induced femoral chondral defect in a rabbit model using Lyophilized growth promoting factor extracted from horse blood platelets (L-GFequina).

Lyophilized equine platelet derived growth factors (LGF) is a novel advanced platelet rich protein growth factor. It has been successfully applied in various fields of regenerative medicine to treat a variety of inflammatory and degenerative musculoskeletal conditions. Our study aimed to evaluate the efficacy of intraarticularly injected LGF for the remedy of articular cartilage injury, commonly characterized by progressive pain and loss of joint function in osteoarthritic rabbits. Full-thickness cylindrical cartilage defects were generated in both femoral condylar articular surfaces in twenty rabbits. The left joint of all animals was injected with the adjuvant as a self-control negative, while the right joint was injected by LGF. Four- and eight-weeks post-surgery, the femoral condyles were harvested, and assessed grossly, microscopically and immunohistochemically. Cytokines (TNF-α, IL-1ß, PDGF and TGF-ß1) contents of the chondral defects were quantified by ELISA as well as the gene expression of Col I and Col II via RT-qPCR. The LGF treated defects showed significant higher ICRS (International cartilage repair society) healing scores of cartilaginous regeneration with a significant higher histological healing score on using O'Driscoll histological scoring system. Additionally, LGF significantly lowered the levels of the pro-inflammatory cytokines TNF-α and IL-1ß. It also significantly increased the anabolic and angiogenic growth factors (PDGF and TGF-ß1), and significantly elevated the expression of chondrogenic-related marker genes; Col I and Col II. The current study reveals that LGF improves chondral healing and thus it can be a superior nominee as an adjunctive therapy to positively influence regeneration of chondral defects in osteoarthritic patients.