Kawarabi: Administrative Structuring of a Multicenter Research Collaborative to Study Kawasaki Disease in the Arab Countries.

Kawasaki disease (KD), the leading cause of acquired heart disease in children in developed countries, merits conducting detailed studies in Arab countries. We introduce Kawarabi, as a multicenter research collaborative effort dedicated to improving diagnosis, care, and outcome of children and adults with KD in the Arab world. During the COVID-19 pandemic, there emerged a new multisystem inflammatory syndrome in children; a disease similar to KD. This highlighted the challenges that Arab physicians face in diagnosing and managing children with KD and KD-like illnesses. Kawarabi brings together experts in North America and Arab nations to study this family of diseases in a not-for-profit, voluntary scientific collaborative setting. Bylaws addressing the vision, objectives, structure, and governance of Kawarabi were established, and vetted by the 45 organizing members in 2021. An initial scientific publication showed evidence of a decreased level of awareness of the disease in the general population, as well as the lack of access to resources available for physicians caring for children with KD in Arab countries. Kawarabi has since held several educational webinars and an inaugural yearly meeting. The groundwork for future initiatives targeted at increasing awareness and understanding of the management and the long-term outcomes of children with KD in the region was established. Data on KD in the Arab world are lacking. Kawarabi is a multicenter research collaborative organization that has the unique resources, diversified ethnic makeup, and energy, to accomplish significant advances in our understanding and management of KD and its variants.

Phytochemicals, Trace Element Contents, and Antioxidant Activities of Bark of Taleh (Acacia seyal) and Desert Rose (Adenium obesum).

Acacia seyal and Adenium obesum are used in traditional medicines by indigenous communities of the Asir region of Saudi Arabia. The present study aimed to acquire the phytochemical profiles, quantify the trace element contents and the total phenolic (TPC) and flavonoid (TFC) contents, and evaluate the antioxidant activity of the two species. Phytochemical screening was conducted to detect the presence of the phytochemical constituents. Bark samples were digested with a microwave, and ICP-MS was used for the elemental analysis. The antioxidant capacities in DPPH, H2O2, and FRAP assays and the TPC and TFC were determined by spectrophotometry, and their correlation with the IC50 of the DPPH and H2O2 and the EC50 of the FRAP capacities were analyzed by Pearson's correlation. Both plant extracts contain a variety of phytochemicals. A. obesum had the highest concentrations of all 11 elements measured. In both plants, manganese was found at the highest concentration, and cadmium exhibited the lowest concentration. The aqueous-methanolic extract of A. seyal showed the highest TPC (309.32 ± 2.15 mg gallic acid equivalent/g), whereas the aqueous-methanolic extract of A. obesum exhibited the highest TFC (32.16 ± 3.16 mg quercetin equivalent/g). Significant differences in the IC50 and EC50 values were observed among the tested plant extracts. The highest antioxidant activity was found in aqueous-methanolic extract of A. obesum. Correlation analysis showed significant correlations between the DPPH and FRAP activities and the TFC. The present findings highlight that these plants are good sources of phenolic compounds and essential elements and support their therapeutic use as antioxidant drugs.

Combined Supplementation of Nano-Zinc Oxide and Thyme Oil Improves the Nutrient Digestibility and Reproductive Fertility in the Male Californian Rabbits.

The present study aimed to determine the effects of zinc oxide nanoparticles (ZnO-NPs), thyme oil (THO), or their combination on the nutrient digestibility coefficients, reproductive parameters, and some blood metabolites of male Californian rabbits. One hundred rabbits, 29-weeks of age (initial body weight 3.48 ± 0.08 kg) were randomly distributed into four groups, 25 rabbits each. Treatment groups were fed a control diet, a control diet supplemented with ZnO-NPs (100 mg/kg), THO (500 mg/kg), or combination of ZnO-NPs (100 mg/kg) and THO (500 mg/kg). The feeding trial lasted for 35 days. Results showed improvements in dry matter, crude protein, ether extract, and crude fiber in ZnO-NPs, THO, and their combination treated groups compared to those of control. Furthermore, semen volume, sperm motility, vitality, and morphology were significantly improved (p < 0.01) in ZnO-NPs and THO groups rather than the control. Both ZnO-NPs and THO, as either individual or combined treatments significantly improved the serum alanine amino-transferase (ALT), aspartate amino-transferase (AST), urea, and creatinine compared to the control. Moreover, serum concentrations of testosterone were significantly increased in rabbits supplemented with ZnO-NPs, THO, or their combination compared to those of control (p < 0.05). In conclusion, ZnO-NPs, THO, or their combination improved the digestibility of nutrients, liver/ kidney functions, semen characteristics, and testosterone concentration in male rabbits.

Antimicrobial and Antioxidant Activities of Different Extracts from Different Parts of Zilla spinosa (L.) Prantl.

Zilla spinosa is commonly used in traditional medicine to treat gastrointestinal disorders and diabetes. In this study, aqueous ethanol (AE) and aqueous methanol (AM) extracts from aerial parts and roots of Z. spinosa were investigated. The total phenolic (TPC) and flavonoid (TFC) contents and antioxidant capacities in terms of 1,1-diphenyl-2-picrylhydrazyl (DPPH) scavenging, hydrogen peroxide (H2O2), and ferric reducing antioxidant power (FRAP) assays were determined, and the correlations among the results were assessed using Pearson's correlation. The antimicrobial activity was assessed through agar disc diffusion and broth microdilution assays. Phytochemical screening showed that Z. spinosa extracts had alkaloids, glycosides, saponins, triterpenoids, phenols, and flavonoids in different abundances. The aerial part-AE extract contained low TPC (30.17 ± 4.24 mg GAE/g) and TFC (7.40 ± 1.02 mg QE/g) and displayed significant antioxidant capacity in the DPPH (IC50 = 52.17 ± 7.30 µg/mL), H2O2 (91.22 ± 2.60 µg/mL), and FRAP (EC50 = 98.70 ± 2.21 µg/mL) assays. By contrast, the root-AM extract contained high amounts of TPC (87.72 ± 7.75 mg GAE/g) and TFC (25.60 ± 1.57 mg QE/g). It showed significantly high antioxidant activity with IC50 values of 12.33 ± 1.88 µg/mL in the DPPH and 39.37 ± 2.59 µg/mL in the H2O2 assays, as well as reducing power capacity with an EC50 value of 20.82 ± 1.14 µg/mL in the FRAP assay. Both TPC and TFC were exhibited negative correlations (p < 0.01) with the IC50 and EC50 values obtained in the applied antioxidant assays. The aerial part-AM extract showed the highest inhibitory activity against Staphylococcus aureus (26.5 ± 0.20 mm), followed by Shigella flexneri (19.4 ± 0.40 mm) and Proteus mirabilis (17.7 ± 0.49 mm). S. aureus was the most affected microorganism with a minimum inhibitory concentration of 128 µg/mL against the aerial part-AM extract. Interestingly, all evaluated extracts showed potent antifungal activity against Candida albicans. However, aerial part-AM was the most effective, with an inhibition zone of 12.6 ± 0.17 mm. The results concluded that Z. spinosa possesses different phytochemicals displaying significant antioxidant and antimicrobial activities, thus lending credence to its use in traditional medicine.

Acacia honey from different altitudes: total phenols and flavonoids, laser-induced fluorescence (LIF) spectra, and anticancer activity.

OBJECTIVE: To investigate Acacia honey from different altitudes regarding total phenols and flavonoids, laser-induced fluorescence (LIF) spectra and anticancer activity against human cancer cell lines. METHODS: Anticancer activity was investigated using sulforhodamine B cytotoxicity assays in the following human cancer cell lines: HCT116 (colon); MCF7 (breast), and HepG2 (liver). Total phenols and flavonoids were measured using spectrophotometric methods and LIF was used to differentiate between low and high-altitude honey. RESULTS: The LIF spectra differed between low and high-altitude Acacia honey. High altitude Acacia honey was characterized by significantly lower total phenol content (81.47 ± 1.25 mg gallic acid equivalent [GAE]/100 g) and increased total flavonoids (10.63 ± 0.53 mg quercetin equivalent [QE]/100 g) versus low altitude Acacia honey (91.33 ± 0.96 mg GAE/100 g and 8.78 ± 0.23 mg QE/100 g, respectively). Low altitude Acacia honey displayed increased IC50 values against HCT116 and MCF7 cells (264.17 ± 10.5 and 482.65 ± 20.3 µg/ml, respectively) versus high altitude Acacia honey (117.99 ± 12.7 and 189.82 ± 15.8 µg/ml, respectively). CONCLUSIONS: High altitude Acacia honey had significantly more effective anticancer activity against HCT116 and MCF7 cells compared with low altitude honey.

An ethnobotanical survey of medicinal plants used by communities of Northern Kordofan region, Sudan.

ETHNOPHARMACOLOGICAL RELEVANCE: The present study provides significant ethnopharmacological information on plant species used in North Kordofan region, western Sudan. The study was undertaken with an aim to document the medicinal uses of the species known to some Northern Kordofan communities. MATERIAL AND METHODS: The study was conducted between 2012 and 2013. The plants were identified and voucher specimens prepared. Information was collected by means of semi-structured interviews with 258 informants (195 men and 63 women). In addition, the use value (UV) of the species was determined and the informant consensus factor (ICF) was calculated for the medicinal plants researched in the study. Further analysis was carried out to compare results with previous studies from the study area and other regions of Sudan. RESULTS: A total of 44 plant species representing 24 families were found to be commonly used in the treatment of 73 different human health problems. The families most represented were Leguminosae (18%), Caesalpiniaceae (9%), Malvaceae (9%), Asclepiadaceae (6.8%) and Combretaceae (6.8%). The highest number of plant species are used against digestive system disorders (23 species) followed by microbial infections (21 species) and dermatology (19 species). Among all the plant parts leaves (20%), roots (19%), fruits and bark (14% each) were the most preferred plant parts used by the informants. There was strong agreement among the informants as to the usages of the plants (informant consensus factor 0.63-0.93). The most important plants on the basis of use-value were Acacia nilotica, Acacia seyal, Balanites aegyptiaca, Cassia occidentalis, Cassia senna, Guiera senegalensis and Tamarindus indica. CONCLUSION: This study has helped to document information that may otherwise be lost to future generations. This is the first ethnobotanical study in which statistical calculations about plants are carried out by means of the ICF and UV methods in the study area. Plants with high ICF and UV values should be subjected for further phytochemical and pharmacological investigation for scientific validation.

Safety climate in dialysis centers in Saudi Arabia: a multicenter study.

OBJECTIVE: The aim of this study was to assess the safety climate as perceived by nurses and physicians in the dialysis units in Saudi Arabia. METHODS: This is a cross-sectional survey-based multicenter study using the Safety Climate Scale, which assesses the perception by staff of the prevailing climate of safety. We used 17 items in this survey. These could be further divided into 3 summative categories: (a) handling of errors and safety concerns (9 items), (b) leadership emphasis of safety (7 items), and (c) overall safety recommendation (1 item). The survey uses 5 Likert scale options (1, disagree strongly; 2, disagree slightly; 3, neutral; 4, agree slightly; and 5, agree strongly). RESULTS: There were 509 respondents--a response rate of 76.6% and 53.3% among nurses and physicians, respectively. The internal consistency using Cronbach α was 0.899. The overall mean (SD) of satisfaction with safety climate was higher among the nurses than the physicians (4.13 [1.1] and 4.05 [1.7], respectively; P = 0.029). The overall agreement rate was 73.8%, with more nurses than physicians agreeing that safety climate prevails the dialysis center (75.4% versus 72.1%, respectively; P = 0.047).The respondents perceived a stronger commitment to safety from their clinical area leaders than from senior leaders in the organization (76.2% and 72.4%, respectively). In addition, the physicians gave lower scores to more questions than the nurses particularly in 3 areas, namely, "leadership is driving us to be a safety-centered institution" (71.5% versus 76.5%; P = 0.037), "I am encouraged by my colleagues to report any patient safety concerns I may have" (67.4% versus 84.7%; P = 0.03), and "I know proper channels to ask questions about safety" (69.6% versus 87.2%; P = 0.002).The scores by the physicians in all the 3 summative categories were again less than the scores by the nurses, but this did not reach a statistical significance. CONCLUSIONS: The nurses had higher perceptions of a prevailing safety climate than the physicians. There was a perception of a stronger commitment to safety from their clinical area leaders than from senior leaders in the organization. Senior management needs to relay their commitments to safety more effectively especially to physicians and to open clear and easily accessible channels for communication for safety issues.

Proliferative glomerulonephritis and primary antiphospholipid syndrome.

Little is known regarding the association of primary antiphospholipid syndrome APLS and proliferative glomerulonephritis GN. We describe a biopsy-documented case with primary APLS and proliferative GN with no evidence of thrombotic microangiopathy TMA, and in the absence of other manifestations of systemic lupus erythematosus SLE. She presented initially with left popliteal deep venous thrombosis and nephrotic syndrome. Her first pregnancy at the age of 26 years resulted in intra-uterine fetal death at term. Two subsequent pregnancies ended up with miscarriages at 3 and 4 months of gestation. Urinalysis revealed glomerular red blood cells of 1.0000.000/ml and granular cast; proteinuria of 13.4 grams/24 hours, which was non-selective; hemoglobin 12 gm/dl, normal white blood cell and platelets; serum albumin 2.6 gm/dl; anti-nuclear antibody ANA and anti DNA were negative and complement levels normal. Lupus anticoagulant was positive leading to a diagnosis of primary APLS. The biopsy findings were consistent with membranoproliferative GN. She continued to have steroid-resistant proteinuria, but stable renal function after a 12-year follow up period. She had 2 pregnancies during this period and was delivered at term using caesarian section. She received heparin during the pregnancies. Later she developed hypertension easily controlled by atenolol. This case provides evidence that primary APLS can be associated with proliferative GN due to immune deposits and not only TMA as previously reported, and in the complete absence of SLE. Performing more renal biopsies in this group of patients may disclose a greater prevalence of proliferative GN and may help in devising a rationale for treatment.