Extra-articular Deformity Correction via Clamshell Osteotomy of the Tibia With Simultaneous Bilateral Total Knee Arthroplasty.

Total knee arthroplasty (TKA) aims to alleviate severe pain and functional impairment in advanced knee arthritis. However, extra-articular deformities must be addressed preoperatively to ensure optimal implant positioning and soft tissue balancing. We present a case of a 58-year-old man with a history of a right tibial malunion and left femoral shaft fracture, who developed progressive bilateral knee osteoarthritis. He underwent simultaneous bilateral TKA with a right tibial clamshell osteotomy to correct a 17° varus deformity and left femoral hardware removal to accommodate a long stem implant. At one year follow-up, the patient had satisfactory functional outcomes with restoration of mechanical alignment and bony union at the osteotomy site. This case demonstrates the utility of the clamshell osteotomy in correcting tibial malunion to facilitate TKA with long stems, reducing the degree of intra-articular correction required.

COVID-19 and Its Impact on Back Pain in the Eastern Province of Saudi Arabia.

Background Low back pain (LBP) is a common musculoskeletal condition that affects individuals worldwide, causing difficulties in daily tasks and social interactions. It can be categorized based on chronicity, with acute, subacute, and chronic forms. The causes of backache vary among patients and can include inflammatory conditions, radiculopathy, pregnancy, trauma, osteoporosis, nerve root compression, cancer, plexopathy, infection, and other spinal diseases. Aim The aim is to investigate the association between COVID-19 infection and LBP between all Saudi adults and foreign adults who had positive COVID-19 tests in the eastern region of Saudi Arabia. Methods A cross-sectional study was conducted in the Eastern Province of Saudi Arabia over the period from March 2023 to August 2023. Participants were selected by using a convenience sampling method, a sample (n=500) of individuals. The structured questionnaire was used to gather information on sociodemographic variables and COVID-related features. All the statistical calculations were performed using the SPSS software (by IBM) version 29.0.0. Results 482 participants completed the questionnaire. Out of 482 participants, the majority were females with a number of 372 (77.2%) aged between 20 and 29 years (38.4%). Out of the remaining participants, 110 (22.8%) were males. Most of the participants with a number of 301 (62.4%) were from the Hasa province. This was followed by Qatif (79, 16.4%), Dammam (56, 11.6%), Jubail (25, 5.2%), and others (21, 4.4%). The study revealed that 10.1% of participants reported experiencing back pain. The duration of backaches varied among respondents, with 122 (25.3%) experiencing them from a day to a week, 28 (5.8%) enduring them for six weeks, and 65 (13.5%) reporting a duration of six to 12 weeks. The majority, comprising 267 (55.4%) respondents, were uncertain about the period of their backaches. The prevalence of COVID-19 infection among the participants was 357 (74.1%), and 477 (99.0%) had been vaccinated against COVID-19. Approximately 44.4% of the participants experienced back pain, and out of those, 28.2% reported having pain during quarantine. Among the individuals with back pain, 24.7% attributed it to COVID-19. Conclusion This study highlights the significant correlation between back pain and COVID-19, even after the resolution of other symptoms. It underscores the importance of further research into the long-term effects and mechanisms of this association. The findings emphasize the need for healthcare professionals to consider back pain as a potential aspect of the post-COVID-19 symptom profile, ensuring comprehensive care for affected individuals.

Successful treatment of xanthoma disseminatum with pulsed dye laser: A case report.

Xanthoma disseminatum is a rare form of non-Langerhans cell histiocytosis with limited treatment options due to its unknown aetiology and diffuse skin lesions. This case report presents the successful treatment of a 31-year-old male with severe pan-facial xanthoma disseminatum lesions following a facial burn and traumatic brain injury resulting from a car accident. After 5 sessions of monthly pulsed dye laser treatment, there was a clinically significant reduction in the lesions. Over the course of 3 years, the patient underwent a series of monthly pulsed dye laser treatments, and the lesions were almost cleared. These findings suggest that pulsed dye laser therapy may offer an effective treatment option for managing xanthoma disseminatum. This is the first report on use of the pulsed dye laser for treatment of xanthoma disseminatum.

B-scan measurements of intraocular tumor heights intraoperatively, before and after radioactive plaque application: A comparative prospective study.

PURPOSE: To assess the difference in intraocular tumors height measurements intraoperatively before and after radioactive plaque application. METHODOLOGY: Twenty-four eyes of 24 patients with intraocular tumors, candidates for radioactive therapy, were included. Each tumor was measured at the same setting before and after plaque application independently by 3 sonographers, using a 20-MHz B-scan transducer. Mean pre-plaque and post-plaque measurements were calculated and recorded. An A-scan vector aided in identification of the inner and outer tumor surfaces. RESULTS: Each patient was examined independently three times by three experienced ultrasonographers within the same setting to assess interobserver variability. There was no statistically significant difference between the 3 examiners' readings, with P-value 0.99 for pre-plaque height and 0.97 for post-plaque height. Mean pre-plaque height was 5.16±2.11mm, while post-plaque height was 5.51±2.1mm (P-value 0.001). The Spearman correlation test showed that initial tumor height was negatively correlated with the difference between both heights, but with no statistical significance. CONCLUSION: Intraocular tumor height measurement differs significantly before and after plaque application. Use of the pre-plaque height is advised until further studies are performed to assess the effect of this difference on treatment outcomes.

Prevalence and risk factors associated with drug resistant bacteria in neonatal and pediatric intensive care units: A retrospective study in Saudi Arabia.

Successful empirical antibiotic therapy for infected patients with multi drug resistant bacteria (MDR) can be challenging task in various healthcare settings, including neonatal and pediatric intensive care units (NICU and PICU, respectively), unless an up-to-date comprehensive local antibiogram data is available. Thus, this project aimed to investigate the prevalence of MDR among PICU and NICU patients as well as the identification of risk factors associated with recovered MDR bacteria. This was a retrospective study of PICU and NICU patients admitted with bacterial infection of MDR organisms between October 2020 and May 2021. Frequency distribution, Chi-square test were applied to verify the significance differences among subgroups and to identify risk factor associated with each group. About 36.4% of recruited patients were neonates, while the remaining percentage (63.6%) were pediatric. The most predominant site of infection among these patients were revealed as urinary tract (35%), followed by bloodstream (20.0%), wound/skin (12.9%) and respiratory system (11.4%). Methicillin-resistant Staphylococcus aureus (MRSA) was identified as the most common microbe across these sites of infections (30.7%), followed by Escherichia coli (25.0%), Klebsiella pneumoniae (22.9%) and Serratia (10.0%). High mortality rate was significantly associated with patients who were on mechanical ventilators (28.9%, OR 5.5; 95% CI), followed by patients had invasive operation (27.5%, OR, 8.04; 95% CI) and those who required a total parental nutrition (TPN) since almost one-half of these cases have (46.2%) died. In addition, mortality rate was relatively higher among patients infected with species of Serratia (28.6%) and Enterobacter (20.0%). These data highlighted that MRSA was the main MDR bacteria isolated from PICU and NICU followed by gram-negative bacteria, which were associated with high mortality rate. Therefore, infection control measures and continuous monitoring of emerging MDR bacteria should be applied to limit the bacterial infections in NICU and PICU patients.

NUTRISEP: Assessment of the nutritional status of patients with multiple sclerosis and link to fatigue.

BACKGROUND: Fatigue is a common complaint in patients with multiple sclerosis (PwMS) and reduces quality of life. Several hypotheses for the pathogenesis of fatigue in MS are proposed ranging from neurological lesions to malnutrition, but none has been conclusively validated through clinical research. OBJECTIVES: The goal of this study was to examine the correlation between fatigue and nutritional status and dietary habits in PwMS. METHODS: This was a cross-sectional, multicenter study conducted at 10 French MS centers and enrolling PwMS with an Expanded Disability Status Scale (EDSS) score between 0 and 7. Plasma level of albumin, magnesium, calcium, iron, vitamin D and B12 evaluated nutritional status. A semi-structured eating behavior questionnaire has been developed to evaluate dietary habits. Evaluation of fatigue used specific questionnaire (EMIF-SEP). Quality of sleep was evaluated by visual analogue scale (VAS), depression with Beck Depression Inventory (BDI-II); dysphagia by DYsphagia in MUltiple Sclerosis questionnaire (DYMUS) and taste disorders by gustometry. Association between nutritional deficiencies and different data such as socio-demographic data, disease characteristics, swallowing and taste disorders, food intake, depression and sleep quality was investigated. RESULTS: A total of 352 patients mean age: 48.1±10.1 years, mean duration of MS: 15.3±9.1 years and median EDSS: 4 were analyzed. Bivariate and multivariate analyses showed a statistically significant correlation between fatigue and depression and use of sleeping pills, while none of the variables related to dietary habits or nutritional status correlated significantly with fatigue. CONCLUSIONS: Dietary habits and nutritional status have little impact on fatigue and general population nutrition recommendations remain the rule for PwMS. In cases of fatigue, specific attention should be paid to depression and use of sleeping pills.

Distribution and the trend of airborne particles and bio-aerosol concentration in pediatric intensive care units with different ventilation setting at two hospitals in Riyadh, Saudi Arabia.

OBJECTIVE: To examine the distribution and the trend of airborne particles and bio-aerosol concentration in pediatric intensive care units (PICUs) in two tertiary care hospitals with different ventilation setting. METHODS: Hospitals A but not B is provided with a central HEPA filter. PICUs in both hospitals were categorized into protective environment (PE) with room HEPA filter, semi-protective environment (SPE) with portable air-purifier, and non-protective environment (NPE) with neither system. Fine particles (≤ 2.5 µm) and coarse particles (≤ 10.0 µm) were obtained using optical particle counter (Lighthouse Handheld 3016) and total bacterial (TBC) and fungal (TFC) counts were obtained using Andersen air sampler. RESULTS: Hospital B had significantly higher levels of fine and coarse particles (in all room), TBC (in PE), but not TFC compared with matched rooms in hospital A. In hospital B, the levels of fine particles, coarse particles, and TBC were lowest in SPE (p < 0.001, p = 0.004, and p = 0.006, respectively) while TFC was lowest in NPE (p = 0.014). Airborne particles, TBC, and TFC had variable trends with some of the indoor peaks follow outdoor peaks. Gram-positive bacteria (69 %) were the predominant bacteria in hospital A while bacterial flora (70 %) were the predominant bacteria in hospital B (p < 0.001 for each). CONCLUSIONS: The levels of airborne contaminants and microbial counts in PICUs are significantly affected by the ventilation system and to less extent by outdoor levels. The results indicated that advanced filtration system and central HEPA filters play a significant role in the reduction of indoor fine particulates and TBC.

The Role of Clinical Pharmacists in Antimicrobial Stewardship Programs (ASPs): A Systematic Review.

Antimicrobial resistance (AMR) is a major global health threat, increasing deaths and healthcare costs. Antimicrobial stewardship programs (ASPs) have been implemented to optimize antibiotic use and curb resistance. This systematic review aimed to summarize evidence on the role and impact of pharmacists in hospital ASPs. A comprehensive literature search was conducted across databases to identify relevant studies published from 2016 to 2023. Twenty-four studies met the inclusion criteria, comprising global observational and randomized clinical trials. Pharmacists performed various stewardship activities, including prospective audits, formulary management, de-escalation, guideline development, and education. Pharmacist-led interventions significantly improved antibiotic prescribing, reduced unnecessary antibiotic use, optimized therapy, and enhanced outcomes. Multiple studies found that pharmacist reviews decreased the time to optimal antibiotics and improved guideline compliance without affecting readmissions or revisits. De-escalation programs safely reduced antibiotic duration and length of stay. Acceptance rates for recommendations were high. Pharmacist stewardship curbed overall antibiotic use, costs, and duration across hospital departments, leading to savings. While most studies showed positive impacts, fewer detected significant changes in resistance or mortality over short periods. More research is needed, but current evidence demonstrates that pharmacists play critical roles in ASPs, leading to improved antibiotic use and patient outcomes. These findings support integrating pharmacists into stewardship activities, significantly extending programs to ambulatory settings.

First Arrival Picking of Zero-Phase Seismic Data by Hilbert Envelope Empirical Half Window (HEEH) Method.

First arrival travel time picking is an important step in many seismic data-processing applications. Most first arrival picking methods search for a sudden jump in seismic energy at trace onsets, which is clearly appropriate for minimum-phase data. This paper proposes a method for the first arrival picking of non-minimum phase data based on complex trace analysis. The Hilbert integral transform generates a complex seismic trace, followed by extraction of the envelope. The first arrival identification introduces an outlier detection method that uses the widely used three-sigma rule of thumb, which is commonly used in most software algorithms to identify outliers. The proposed method ultimately generates logical windows of ones (at the locations of outliers) and zeros (elsewhere). The first arrival is selected in the middle of the first outlier window. Testing the proposed method on zero-phase synthetic data with added 10% and 20% random noise, the method detected the true first arrivals accurately. Furthermore, tests on real Vibroseis data showed that the method recognizes the first arrivals with 67% accuracy within 20 milliseconds of their corresponding arrival times manually picked by an experienced geophysicist.

Public knowledge and awareness of stroke among adult population in Taif city, Saudi Arabia.

OBJECTIVES: To evaluate the knowledge and awareness of stroke in adult population in Taif, Kingdom of Saudi Arabia and to address the association between several sociodemographic variables of participants and their knowledge regarding stroke. METHODS: A cross-sectional study was conducted among adult residents in Taif, Kingdom of Saudi Arabia, during the period of December, 2020 to February, 2021 using an online questionnaire. RESULTS: Our study included 3456 participants (43.6% males, 56.4% females). Analysis showed that 61.7% of the participants were aware of stroke. Participants who were 15-39 years-old had good knowledge. Male participants had better knowledge than females. The most identified risk factor was 'unhealthy lifestyle' (84.5%) and the least identified one was 'epilepsy' (34.8%). The most identified symptom was 'slurred speech' (57.5%), and the least identified one was 'dizziness' (36.2%). Approximately 86.6% of the participants agreed that stroke was a medical emergency. A total of 41.5% of the participants agreed that stroke was treatable and 42.6% agreed that stroke was a preventable disease. CONCLUSION: Although the participants recognize that stroke is a medical emergency and that early intervention is crucial, the obtained results show that there is a large gap in the knowledge of the warning signs and symptoms of stroke. Increasing community awareness about these warnings may affect how quickly the patient is treated.

Interactive effects of dietary amino acid density and environmental temperature on growth performance and expression of selected amino acid transporters, water channels, and stress-related transcripts.

Exposure to heat stress (HS) is one of the challenges facing the broiler industry worldwide. Various nutritional strategies have been suggested, such as altering dietary concentrations of some nutrients. Thus, we evaluated feeding different amino acid (AA) densities on live performance, Pectoralis (P.) muscles, and expression of selected AA transporters, water channels, and stress-related transcripts in a fast-growing broiler strain. Ross 308 chicks (n = 576) were randomly assigned to 4 dietary treatments (24 reps, 6 chicks per rep), differing in AA density (110, 100, 90, and 80% of a breeder's AA specifications). During 24 to 36 days of age, half of the birds were kept at a thermoneutral (TN) temperature of 20°C, whereas the other half were subjected to HS at 32° C for 8 h daily, making the treatment design a 4 × 2. The results revealed no interaction between housing temperature and AA density on growth performance or P. muscles weights. Feeding 80% AAs depressed BWG, FCR, and P. muscles at 36 d (P < 0.001). There was an interaction (P < 0.001) between AA density and temperature on the expression of all examined genes. Reducing the AA density beyond 100% upregulated the expression of AA transporter (CAT1, B0AT, b0,+AT, SNAT1, LAT1), HSP70, HSP90, glucocorticoid receptor (GR), and AQP3 in the TN birds' jejunum. Whereas in the HS birds, inconsistent expressions were observed in the jejunum, of which CAT1, B0AT, and LAT1 were markedly downregulated as AA density was reduced. In P. major of TN birds, reducing AA density resulted in upregulating the expression of all AA transporters, HSP70, GR, and AQP1, while downregulating HSP90 and AQP9. In contrast, AA reduction markedly downregulated CAT1, B0AT, and LAT1 in the P. major of HS birds. These findings indicate that the dietary AA level alters the expression of various genes involved in AA uptake, protein folding, and water transport. The magnitude of alteration is also dependent on the housing temperature. Furthermore, the results highlight the importance of adequate AA nutrition for fast-growing chickens under HS.

Recurrent Inguinal Hernia Post Laparoscopic Repair: A Retrospective Single-Center Study in Qassim Region, Saudi Arabia.

Introduction Inguinal hernia is the most common hernia among the abdominal wall hernias. This study aims to estimate the long-term recurrence rate and laparoscopy-related risk factors for inguinal hernia at King Fahad Specialist Hospital in Buraidah, Al Qassim region, Saudi Arabia. Methods A single-center retrospective study of all laparoscopic hernia repair patients admitted in the surgical department of King Fahad Specialist Hospital in Buraidah, Al Qassim region, Saudi Arabia from January 2016 to July 2020. Results A total of 64 patients were included in the present study. All patients were male with a mean age 42.27±15.79 years. Out of 64 patients, 71.9% were married and 11 (17.2%) were smokers. Most patients were found to be in the elective priority (89.1%) and the emergency cases were 10.1%. A total of 6.3% had a recurrent hernia and 93.7% had a primary hernia. After testing the association of hernia repair and the patient-related factors, it was observed that there is no significant association between recurrent hernia repair and the mean age (p=0.072), body mass index (BMI) (p=0.962), smoking (p=0.347), married patients (p=0.196), and diabetes (p=0.446). Conclusion A total of 6.3 % of patients developed a recurrent inguinal hernia after laparoscopic repair. In contrast to the literature, this study showed that patient-related risk factors were not statically significant among our patients. However, the reasons behind the recurrence rate tend to be multifactorial, including surgical, technical, hospital capability, and patients factors. Therefore, early recognization and management of these risk factors are essential to prevent further cases.

[Proliferative vitreoretinopathy prophylaxis : Mission (im)possible]. / Proliferative Vitreoretinopathieprophylaxe : Mission (im)possible.

BACKGROUND: Proliferative vitreoretinopathy (PVR) is one of the most important complications following vitreoretinal surgery. So far, surgical strategies have been the gold standard in treatment. Pharmacological approaches for prevention and treatment of PVR are under clinical investigation and intervene in different phases of the PVR cascade. METHODS: The relevant literature as well as own data and experience with PVR are discussed in this review article. The most important aspects of pharmacological approaches for PVR prophylaxis and treatment are explained. RESULTS: A prophylactic use of systemic prednisone administration as an anti-inflammatory substance showed contradictory results, while there was no additional benefit for intravitreal triamcinolone. Orally administered isotretinoin also seems to be able to minimize the formation of PVR after retinal reattachment surgery, whereas there was no improvement in the success rate in established PVR. Cell proliferation inhibitors have already been extensively studied. The combined intravitreal prophylactic approach of 5­fluorouracil and low molecular weight heparin was recently further investigated in a multicenter, placebo-controlled study and showed a positive effect in some studies. New preclinical and experimental approaches include the inhibition of growth factors, modulation of integrin activity and the induction of apoptosis. CONCLUSION: Most clinical studies dealt with an anti-inflammatory or antiproliferative approach. So far, no pharmacological substance has been established for the treatment of PVR but there are promising approaches for prophylaxis.

Induced in vitro adaptation for salt tolerance in date palm (Phoenix dactylifera L.) cultivar Khalas.

BACKGROUND: Soil salinity causes huge economic losses to agriculture productivity in arid and semiarid areas worldwide. The affected plants face disturbances in osmotic adjustment, nutrient transport, ionic toxicity and reduced photosynthesis. Conventional breeding approaches produce little success in combating various stresses in plants. However, non-conventional approaches, such as in vitro tissue culturing, produce genetic variability in the development of salt-tolerant plants, particularly in woody trees. RESULTS: Embryogenic callus cultures of the date palm cultivar Khalas were subjected to various salt levels ranging from 0 to 300 mM in eight subcultures. The regenerants obtained from the salt-treated cultures were regenerated and evaluated using the same concentration of NaCl with which the calli were treated. All the salt-adapted (SA) regenerants showed improved growth characteristics, physiological performance, ion concentrations and K+/Na+ ratios than the salt non-adapted (SNA) regenerants and the control. Regression between the leaf Na+ concentration and net photosynthesis revealed an inverse nonlinear correlation in the SNA regenerants. Leaf K+ contents and stomatal conductance showed a strong linear relationship in SA regenerants compared with the inverse linear correlation, and a very poor coefficient of determination in SNA regenerants. The genetic fidelity of the selected SA regenerants was also tested using 36 random amplified polymorphic DNA (RAPD) primers, of which 26 produced scorable bands. The primers generated 1-10 bands, with an average of 5.4 bands per RAPD primer; there was no variation between SA regenerants and the negative control. CONCLUSION: This is the first report of the variants generated from salt-stressed cultures and their potential adaptation to salinity in date palm cv. Khalas. The massive production of salt stress-adapted date palm plants may be much easier using the salt adaptation approach. Such plants can perform better during exposure to salt stress compared to the non-treated date palm plants.

The prevalence of doping among Saudi athletes: Results from the National Anti-Doping Program.

OBJECTIVES: The abuse of substances banned by anti-doping authorities is a significant problem in sports. Recently, several doping cases have been reported by the media. Additionally, a large number of athletes have been found guilty of using banned substances. Although athletes believe that doping is against the spirit of sports and are aware of its consequences, they continue to use these substances. The consumption of banned substances among Saudi athletes is rising. This study aimed to investigate the abuse of drugs among Saudi athletes. METHODS: A systematic random sampling cross-sectional survey was administered to all 15-45-year-old Saudi male athletes who were registered with Saudi Sports Federations and the General Sports Authority. From 2009 to 2018, 388 doping control officers participated in the National Anti-Doping Program across 460 facilities. The study necessitated 171 city visits for data collection. RESULTS: A total of 6306 samples were tested during the study period. There were 6165 negative and 141 (2.24%) positive samples for doping. We report a doping prevalence of 2.24% among Saudi athletes. During the study period, Saudi athletes from all types of sports were tested positive for doping. The number of positive samples was significantly higher among competing athletes than non-competing athletes. CONCLUSION: Doping is a significant problem in KSA. For safe and fair play by all Saudi athletes, the National Anti-Doping Program should enhance the educational campaigns for all athletes in the country.

Induced in vitro adaptation for salt tolerance in date palm (Phoenix dactylifera L) cultivar Khalas

BACKGROUND: Soil salinity causes huge economic losses to agriculture productivity in arid and semiarid areas world-wide. The affected plants face disturbances in osmotic adjustment, nutrient transport, ionic toxicity and reduced photosynthesis. Conventional breeding approaches produce little success in combating various stresses in plants. However, non-conventional approaches, such as in vitro tissue culturing, produce genetic variability in the development of salt-tolerant plants, particularly in woody trees. RESULTS: Embryogenic callus cultures of the date palm cultivar Khalas were subjected to various salt levels ranging from 0 to 300 mM in eight subcultures. The regenerants obtained from the salt-treated cultures were regenerated and evaluated using the same concentration of NaCl with which the calli were treated. All the salt-adapted (SA) regenerants showed improved growth characteristics, physiological performance, ion concentrations and K+/Na+ ratios than the salt non-adapted (SNA) regenerants and the control. Regression between the leaf Na+ concentration and net photosynthesis revealed an inverse nonlinear correlation in the SNA regenerants. Leaf K+ contents and stomatal conductance showed a strong linear relationship in SA regenerants compared with the inverse linear correlation, and a very poor coefficient of determination in SNA regenerants. The genetic fidelity of the selected SA regenerants was also tested using 36 random amplified polymorphic DNA (RAPD) primers, of which 26 produced scorable bands. The primers generated 1-10 bands, with an average of 5.4 bands per RAPD primer; there was no variation between SA regenerants and the negative control. CONCLUSION: This is the first report of the variants generated from salt-stressed cultures and their potential adaptation to salinity in date palm cv. Khalas. The massive production of salt stress-adapted date palm plants may be much easier using the salt adaptation approach. Such plants can perform better during exposure to salt stress compared to the non-treated date palm plants.

Identification and sequencing of Date-SRY Gene: A novel tool for sex determination of date palm (Phoenix dactylifera L.).

Dioecism has always been an issue in many plant species with its numerous disadvantages, especially in woody trees such as date palms. As one of the most important crops in the Middle Eastern countries, researchers are having problems identifying of sex of the plant in its early stages of development. Hence, proper population stands in the male: female ratio for maintenance is almost impossible in the field for better production. In this study, sex determination of date palm (Phoenix dactilyfera L.) were identified in regions of the Y chromosome (Date-SRY) gene, the pivotal gene that initiates sex determination, using a new technique and thus an economically desirable objective, which will significantly impact profits in seed based cultivations. Partial sequences of the Date-SRY were taken and amplified by nested polymerase chain reaction (PCR). According to the results, the exact sex of date palm was identified in all the tested plants, while amplified regions of the Date-SRY gene closely matched with the human and papaya sequences. In addition, a primer pair was designed to amplify the sequences of the SRY-date gene with confidence that it will identify male date palms. These primer sequences include SRY-date Forward 5'- cggccctctaagtatctgtgcgcaacg-3' (SRY-date F) and the SRY-date Reverse 5'- gtttgcacttcgaagcagag-3' (SRY-date R). The complete sequence of the DNA has been registered and deposited in GenBank (BankIt1598036 DPSRY1 KC577225 thenKJ873056).

CRISPR/Cas9: A Practical Approach in Date Palm Genome Editing.

The genetic modifications through breeding of crop plants have long been used to improve the yield and quality. However, precise genome editing (GE) could be a very useful supplementary tool for improvement of crop plants by targeted genome modifications. Various GE techniques including ZFNs (zinc finger nucleases), TALENs (transcription activator-like effector nucleases), and most recently clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 (CRISPR-associated protein 9)-based approaches have been successfully employed for various crop plants including fruit trees. CRISPR/Cas9-based approaches hold great potential in GE due to their simplicity, competency, and versatility over other GE techniques. However, to the best of our knowledge no such genetic improvement has ever been developed in date palm-an important fruit crop in Oasis agriculture. The applications of CRISPR/Cas9 can be a challenging task in date palm GE due to its large and complex genome, high rate of heterozygosity and outcrossing, in vitro regeneration and screening of mutants, high frequency of single-nucleotide polymorphism in the genome and ultimately genetic instability. In this review, we addressed the potential application of CRISPR/Cas9-based approaches in date palm GE to improve the sustainable date palm production. The availability of the date palm whole genome sequence has made it feasible to use CRISPR/Cas9 GE approach for genetic improvement in this species. Moreover, the future prospects of GE application in date palm are also addressed in this review.

Transient GUS Gene Expression in Date Palm Fruit Using Agroinjection Transformation Technique.

Transient expression of foreign genes in plant tissue is a valuable tool for testing the efficacy of transformation methods. In this work, we present, for the first time, the utilization of agroinjection as an efficient transformation system for gene delivery in date palm fruit. The research utilized Agrobacterium tumefaciens strain LBA4404 harboring the binary vector pRI201-AN-GUS carrying the beta-glucuronidase (GUS) gene, under the control of a CaMV 35S and kanamycin (NPTII) as an antibiotic gene under the control of a NOS promoter. Based on histochemical assay of agroinjected fruit for the GUS gene expressions, this protocol has proved to be an efficient and reliable tool for transgene expression in date palm. PCR for plasmid DNA, extracted from the transformed Agrobacterium, demonstrated the generation of the expected amplicon, corresponding to the GUS gene using GUS primers.

In vitro response of date palm (Phoenix dactylifera L.) to K/Na ratio under saline conditions.

BACKGROUND: Salinity is a serious factor limiting the productivity of agricultural plants. One of the potential problems for plants growing under saline conditions is the inability to up take enough K(+). The addition of K(+) may considerably improve the salt tolerance of plants grown under salinity. It is assumed that increasing the K(+) supply at the root zone can ameliorate the reduction in growth imposed by high salinity. The present study aims to determine whether an increase in the K/Na ratio in the external media would enhance the growth of date palm seedlings under in vitro saline conditions. METHODS: Date palm plants were grown at four concentrations of Na + K/Cl (mol/m(3)) with three different K/Na ratios. The 12 salt treatments were added to modified MS medium. The modified MS medium was further supplemented with sucrose at 30 g/l. RESULTS: Growth decreased substantially with increasing salinity. Growth expressed as shoot and root weight, enhanced significantly with certain K/Na ratios, and higher weight was maintained in the presence of equal K and Na. It is the leaf length, leaf thickness and root thickness that had significant contribution on total dry weight. Na(+) contents in leaf and root increased significantly increased with increasing salinity but substantial decreases in Na(+) contents were observed in the leaf and root with certain K/Na ratios. This could be attributed to the presence of a high K(+) concentration in the media. The internal Na(+) concentration was higher in the roots in all treatments, which might indicate a mechanism excluding Na(+) from the leaves and its retention in the roots. K/Na ratios up to one significantly increased the leaf and root K(+) concentration, and it was most pronounced in leaves. The K(+) contents in leaf and root was not proportional to the K(+) increase in the media, showing a high affinity for K(+) uptake at lower external K(+) concentrations, but this mechanism continues to operate even with high external Na(+) concentrations. CONCLUSION: Increasing K/Na ratios in the growing media of date plam significantly reduced the absorption of Na(+) less than 200 mM and also balance ions compartmentalization.