Effects of neutrophil extracellular traps during human respiratory syncytial virus infection in vitro

Abstract The human respiratory syncytial virus (hRSV) is the most common cause of severe lower respiratory tract diseases in young children worldwide, leading to a high number of hospitalizations and significant expenditures for health systems. Neutrophils are massively recruited to the lung tissue of patients with acute respiratory diseases. At the infection site, they release neutrophil extracellular traps (NETs) that can capture and/or inactivate different types of microorganisms, including viruses. Evidence has shown that the accumulation of NETs results in direct cytotoxic effects on endothelial and epithelial cells. Neutrophils stimulated by the hRSV-F protein generate NETs that are able to capture hRSV particles, thus reducing their transmission. However, the massive production of NETs obstructs the airways and increases disease severity. Therefore, further knowledge about the effects of NETs during hRSV infections is essential for the development of new specific and effective treatments. This study evaluated the effects of NETs on the previous or posterior contact with hRSV-infected Hep-2 cells. Hep-2 cells were infected with different hRSV multiplicity of infection (MOI 0.5 or 1.0), either before or after incubation with NETs (0.516 g/mL). Infected and untreated cells showed decreased cellular viability and intense staining with trypan blue, which was accompanied by the formation of many large syncytia. Previous contact between NETs and cells did not result in a protective effect. Cells in monolayers showed a reduced number and area of syncytia, but cell death was similar in infected and non-treated cells. The addition of NETs to infected tissues maintained a similar virus-induced cell death rate and an increased syncytial area, indicating cytotoxic and deleterious damages. Our results corroborate previously reported findings that NETs contribute to the immunopathology developed by patients infected with hRSV.

Resumo O vírus sincicial respiratório humano (hRSV) é a causa mais comum de doenças graves do trato respiratório inferior em crianças pequenas em todo o mundo, resultando em grande número de hospitalizações e gastos significativos para os sistemas de saúde. Neutrófilos são recrutados em massa para o tecido pulmonar de pacientes com doenças respiratórias agudas. No local da infecção, eles liberam armadilhas extracelulares de neutrófilos (NETs) que podem capturar e/ou inativar diferentes tipos de microrganismos, incluindo vírus. Evidências demonstraram que o acúmulo de NETs resulta em efeitos citotóxicos diretos nas células endoteliais e epiteliais. Os neutrófilos estimulados pela proteína F do vírus sincicial respiratório (hRSV-F) geram NETs que são capazes de capturar partículas virais, reduzindo assim sua transmissão. No entanto, a produção maciça de NETs obstrui as vias aéreas e aumenta a gravidade da doença. Assim, um maior conhecimento sobre os efeitos das NETs durante as infecções por hRSV é essencial para o desenvolvimento de novos tratamentos específicos e eficazes. Este estudo avaliou os efeitos das NETs no contato prévio ou posterior à infecção de células Hep-2 com hRSV. As células Hep-2 foram infectadas com diferentes quantidades de hRSV (multiplicidade de infecção ou MOI 0,5 ou 1,0), antes ou após a incubação com NETs (0,516 g/mL). Células infectadas e não tratadas mostraram redução da viabilidade celular e intensa coloração com azul de tripano, que foi acompanhada pela formação de sincícios numerosos e grandes. O contato prévio entre as NETs e as células não resultou em efeito protetor. As células em monocamadas mostraram um número e área de sincícios reduzidos, mas a morte celular foi semelhante àquela apresentada por células infectadas e não tratadas. A adição de NETs aos tecidos infectados manteve taxa de morte celular e formação de sincícios semelhantes àqueles induzidos pelo vírus em células não tratadas, indicando danos citotóxicos e deletérios. Nossos resultados corroboram achados relatados anteriormente de que as NETs contribuem para a imunopatologia desenvolvida por pacientes infectados com hRSV.

An overview on the current available treatment for COVID-19 and the impact of antibiotic administration during the pandemic

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused several problems in healthcare systems around the world, as to date, there is no effective and specific treatment against all forms of COVID-19. Currently, drugs with therapeutic potential are being tested, including antiviral, anti-inflammatory, anti-malarial, immunotherapy, and antibiotics. Although antibiotics have no direct effect on viral infections, they are often used against secondary bacterial infections, or even as empiric treatment to reduce viral load, infection, and replication of coronaviruses. However, there are many concerns about this therapeutic approach as it may accelerate and/or increase the long-term rates of antimicrobial resistance (AMR). We focused this overview on exploring candidate drugs for COVID-19 therapy, including antibiotics, considering the lack of specific treatment and that it is unclear whether the widespread use of antibiotics in the treatment of COVID-19 has implications for the emergence and transmission of multidrug-resistant bacteria.

Using data from a private provider of telemedicine to assess the severity of the early 2021 Covid-19 wave in Brazil

In early 2021, Brazil saw a dramatic recurrence in Covid-19 cases associated to the spread of a novel variant of the SARS-CoV-2 virus, the P1 variant. In light of previous reports showing that this variant is more transmissible and more likely to infect people who had recovered from previous infection, a retrospective analysis was conducted to assess if the early 2021 Covid-19 wave in Brazil was associated with an increase in the number of individuals presenting with a more severe clinical course. Fifty-one thousand and fourteen individuals who underwent telemedicine consultations were divided into two groups: patients seen on or before January 31, 2021, and on or after February 1, 2021. These dates were chosen based on the spread of the P1 variant in Brazil. Referral to the emergency department (ED) was used as a marker of a more severe course of the disease. No differences were seen in the proportion of patients referred to the ED in each group nor in the odds ratio of being referred to the ED from the 1st of February 2021 (OR=0.909; 95%CI: 0.81-1.01). Considering the entire cohort, age had an impact on the odds of being referred to the ED, with individuals older than 59 years showing twice the risk of the remaining population and those less than 19 years showing a lower risk.

Behavioral effects of a low molecular weight peptide fraction from Phaseolus vulgaris in rats

Seminal studies stated that bean proteins are efficient neuronal tracers with affinity for brain tissue. A low molecular weight peptide fraction (<3kDa) from Phaseolus vulgaris (PV3) was previously reported to be antioxidant, non-cytotoxic, and capable of reducing reactive oxygen species and increasing nitric oxide in cells. We evaluated the effects of PV3 (5, 50, 100, 500, and 5000 µg/kg) on behavior and the molecular routes potentially involved. Acute and chronic PV3 treatments were performed before testing Wistar rats: i) in the elevated plus-maze (EPM) to assess the anxiolytic-like effect; ii) in the open field (OF) to evaluate locomotion and exploration; and iii) for depression-like behavior in forced swimming (FS). Catecholaminergic involvement was tested using the tyrosine hydroxylases (TH) enzyme inhibitor, α-methyl-DL-tyrosine (AMPT). Brain areas of chronically treated groups were dissected to assess: i) lipid peroxidation (LPO); ii) carbonylated proteins (CP); iii) superoxide dismutase (SOD) and catalase (CAT) enzymatic activities. Neuronal nitric oxide synthases (nNOS) and argininosuccinate synthase (ASS) protein expression was evaluated by western blotting. Acute treatment with PV3 increased the frequency and time spent in the EPM open arms, suggesting anxiolysis. PV3 increased crossing episodes in the OF. These PV3 effects on anxiety and locomotion were absent in the chronically treated group. Acute and chronic PV3 treatments reduced the immobility time in the FS test, suggesting an antidepressant effect. TH inhibition by AMPT reverted acute PV3 effects. PV3 decreased LPO and CP levels and SOD and CAT activities, whereas nNOS and ASS were reduced in few brain areas. In conclusion, PV3 displayed central antioxidant actions that are concomitant to catecholaminergic-dependent anxiolytic and antidepressant effects.

Poisonous plants for ruminants in the dairy region of Pernambuco, Northeastern Brazil

ABSTRACT: A survey carried out in the dairy region of Pernambuco was conducted to determine the most important poisonous plants for ruminants in the region. A total of 95 farmers from 19 municipalities were interviewed and the grazing areas of ruminants were inspected. According to the survey, the most important poisonous plants for ruminants were Manihot esculenta, Palicourea aeneofusca, Brachiaria decumbens, Indigofera suffruticosa, Ricinus communis and Cestrum axillare. Less reported classes of poisonous plants included nephrotoxic plants and plants that cause abortions or congenic malformations. Psychotria hoffmannseggiana, Psychotria colorata and Psychotria capitata were reported by farmers as the cause of sudden death in cattle. These plants should be better investigated to evaluate their importance as the cause of cattle deaths.

RESUMO: Neste estudo prospectivo, realizou-se um levantamento sobre a ocorrência das principais plantas tóxicas e a ocorrência de intoxicações por plantas em ruminantes na bacia leiteira de Pernambuco. Para isso, foram entrevistados 95 produtores rurais de 19 municípios e as áreas de pastagem de ruminantes foram inspecionadas. De acordo com o levantamento, as plantas tóxicas mais importantes para ruminantes foram Manihot esculenta, Palicourea aeneofusca, Brachiaria decumbens, Indigofera suffruticosa e Ricinus communis. As classes menos importantes de plantas tóxicas incluíram plantas nefrotóxicas e plantas que causam abortos e malformações congênitas. Psychotria hoffmannseggiana, Psychotria colorata e Psychotria capitata foram relatadas por produtores rurais como a causa de mortes súbitas em bovinos. Essas plantas devem ser investigadas melhor para avaliar sua importância como a causa de mortes de bovinos.

Chemical control of leaf-cutting ants: how do workers disperse toxic bait fragments onto fungus garden?

ABSTRACT Leaf-cutting ants are controlled with toxic baits. For the method's greater efficiency, the baits must be distributed and processed by workers during fungus cultivation. To test hypotheses whether the mode of action of the active ingredients, which blocks the sodium channels and interrupts the production of ATP in the mitochondria, interferes with fragment distribution in nests; the dispersion of pellets fragments during fungus cultivation by workers was assessed, spatially referencing the fragment onto the fungus garden. Pellets fragments were randomly distributed, but the amount pellets fragments was influenced by the way that the active ingredient acts in the colony.

Evaluation of Loop Mediated Isothermal Amplification (LAMP) for Diagnosis of Plasmodium falciparum in Wad Medani City, Gezira State, Sudan

Plasmodium falciparumconsidered as the most serious form of species causes malaria compared with other species. Diagnosis of falciparummalaria in Sudan remain a major problem, the laboratory diagnosis depends solely on microscopy and RDTs. Loop mediated isothermal Original Research Article amplification (LAMP) assay is a molecular technique done in isothermal temperature using simple, inexpensive instruments for detection of falciparummalaria. The aim of the study is to evaluate the diagnostic performance of loop mediated isothermal amplification (LAMP) assay for detection ofP. falciparumand compare with microscopic detection. A cross sectional hospital based study conducted on 220 blood samples collected from participants suspected to have falciparum malaria attending Wad Medani Teaching Hospitalsand 26 healthy participants during the period November 2018 to January 2019. Thick blood films were done and used for P. falciparum detection. The extracted DNA by TE buffer was amplified by LAMP assay targeting 18S rRNA gene. Data were analyzed using Medical calculator (MedCalc) programs (V. 16). The results showed that the sensitivity, specificity, positive predictive value, negative predictive values were 99.1%, 84.6%, 53.2%, 99.8% respectively. Validation of LAMP diagnostic performance revealed that area under the curve is 0.919, while Weighted Kappa is 0.866. The study concluded that the LAMP assay had the identical diagnostic performance compared with microscopy in diagnosis of Plasmodium falciparum malaria. This gives a relative effortlessness application of LAMP assay in Sudan after availing the required logistics

Seroprevalence of Treponema pallidum Infection among Cohorts of Pregnant Women Attending a Selected Hospital at Northern Nigeria

Background: Syphilis is a multifaceted disease with serious implications for the pregnant women and the foetus. Treponema pallidum, the causative agent of syphilis has been a public health challenge for centuries. Sexually transmitted infections (STIs) among pregnant women are wide spread in the developing countries, and constitute a major public health problem in sub-Saharan Africa. Information regarding the prevalence of syphilis in pregnant women is scanty from the north-west zone of Nigeria.Aims:Evaluation of seroprevalence of Treponema palliduminfection among pregnant women attending a selected hospital at Northern Nigeria was carried out, with view to assess the socio-demographic data and predisposing factors of syphilis among the study population.Methods: Exactly 200 pregnant women, who attended antenatal clinic of the selected hospital at Northern Nigeria, from July to September, 2015 were screened for syphilis using syphilis rapid immunochromatographic test for in-vitrodiagnostic technique. Patients’ demographic data and predisposing factors of syphilis were assessed using a structured questionnaire.Results: The result showed that 2.0% of the 200 pregnant women screened were positive. Basedon age, individuals who were less than or equal 20 years had the highest prevalence of 4.1% followed by those who aged 21-30 with the prevalence of 1.1%. Family type and place of the study subjects were significantly associated with the disease (Fisher’s exact test = 0.014 and 0.008 respectively). Therefore associated risk factors were age, family type and place of residence. While, educational status, employment status, gestational age and blood transfusion were not significantly associated with syphilis in the study area. While seroprevalence of 4(5.7%) was recorded in polygamous individual; no positive case was recorded among those practicing monogamy. Urban dwellers were found to have a prevalence rate of 6.6% with no infection detected among the rural dwellers. Conclusion: Theoverall prevalence of syphilis among the study population was 2.0%. The disease is more prevalent among middle aged, rural dwelling and polygamous pregnant women. Hence in a bid to control syphilis infection, both partners should be evaluated and treated. This study has further provided information on the prevalence of Treponema palliduminfection among pregnant women at Northern Nigeria

Group B streptococcus infection in a sudden unexpected death of infancy – the importance of microbiological investigation at post-mortem

@#Group B streptococcus (GBS) is a common cause of infection in newborns and in early infants. However, GBS infection in an infant older than three months is infrequently reported in the literature. We reported a case of an apparently well six-month-old infant who died of sudden death due to GBS pneumonia, diagnosed at autopsy. The six-month-old, apparently well male infant was brought in dead to the Emergency Department. He underwent medicolegal autopsy four hours after death, as part of an overall sudden unexpected death in infancy investigation (SUDI). Apart from whitish froth oozing out of both nostrils, he appeared to be well-nourished infant without any deformity, syndromic features or obvious suspicious marks of injury externally. Internal examination showed generalized hyperinflated with patchy consolidation of upper and middle lobes of bilateral lung. Multiple matted mesenteric lymphadenopathy were also detected. Blood and lung tissue specimens collected under aseptic technique yielded growth of GBS. Post-mortem histology from consolidated lungs confirmed pneumonic features while mesenteric lymph nodes showed reactive changes inkeeping with underlying infective process. Death was attributed to GBS pneumonia. This case highlights the importance of a detailed autopsy in sudden unexpected death in infancy (SUDI) and the crucial role of post-mortem microbiological study in such cases. Relevant autopsy protocols that need to be employed during microbiological sampling are briefly discussed.

Comparison between placental site injection of vasopressin and bilateral internal iliac artery ligation to reduce blood loss during cesarean section for placenta praevia, a randomized controlled trial

Background: placenta praevia is an obstetric complication in which the placenta is inserted partially or completely in the lower uterine segment, A significant proportion of these cases is associated with life threatening hemorrhage during delivery, often by caesarean section in the vast majority of cases, many procedures introduced to overcome this problems, none of them is completely successful

Aim of the work: this study aimed to compare between local vasopressin injection in the placental bed and bilateral internal iliac artery ligation on the blood loss during caesarean section for placenta praevia

Patients and Methods: this a randomized-controlled prospective trial included 60 pregnant women with a diagnosis of placenta praevia, they were categorized into 3 equal groups according to methods to control blood loss during cesarean section for placenta praevia. Group 1 included 20 pregnant women who underwent vasopressin injection at placental site. Group 2 included 20 pregnant women who underwent bilateral internal iliac artery ligation. Group 3 included 20 pregnant women who underwent caesarean section without internal iliac artery ligation or local injection of vasopressin [The control group], comparison between groups were done and statistically analyzed

Results: there were statistical significant differences between the intervention and the control groups as regard estimated blood loss, P value was <0.001; group 3[Control] had more amounts of blood loss, there were no statistical significant differences between group 1 and group 2 as regard estimated blood loss, P value was > 0.05 . Comparison between group1 and group 2 showed that internal iliac artery ligation was significantly associated with prolonged operative time than vasopressin injection[P value was <0.001]

Conclusion and Recommendation: local injection of vasopressin at placental site seemed to be a promising modality for reducing blood loss during cesarean delivery for placenta praevia and was associated with similar reduction of blood loss and less operative time when compared with internal iliac artery ligation, may be done first before trying internal iliac artery ligation and needs no experience

Lumbar kinematics, functional disability and fear avoidance beliefs among adults with nonspecific chronic low back pain

Objectives: This study aimed to examine correlations between lumbar kinematics, functional disability and fear avoidance beliefs among adults with nonspecific chronic low back pain [LBP]

Methods: This crosssectional study was conducted between March and December 2014. A total of 32 adults diagnosed with nonspecific chronic LBP were recruited from outpatients attending either an orthopaedic clinic at a university hospital or a private physiotherapy clinic in Malaysia. Lumbar kinematics were measured using sensors attached at the first lumbar [L1] and second sacral [S2] vertebrae levels. The Oswestry Disability Index [ODI] and Fear-Avoidance Beliefs Questionnaire [FABQ] were used to assess degree of functional disability and fear avoidance beliefs, respectively

Results: For maximum range of motion, positive correlations were observed between ODI scores and right lateral flexion and right rotation [P = 0.01 each], although there was a negative correlation with left rotation [P = 0.03]. With maximum angular velocity, ODI scores were positively correlated with right and left lateral flexion L1 [P = 0.01 and <0.01, respectively] but negatively correlated with left lateral flexion L2 [P = 0.04]. Regarding minimum angular velocity, ODI scores were positively correlated with left lateral flexion S2 [P <0.01] but negatively correlated with right and left lateral flexion L1 [P = 0.02 each], right rotation L1 [P = 0.02] and left rotation S2 [P = 0.01]. No significant correlations were found between lumbar kinematics and FABQ scores

Conclusion: These findings suggest that certain lumbar kinematic parameters are correlated with functional disability, but not with fear avoidance beliefs

operation, products and promotion of waterpipe businesses in New York City, Abu Dhabi and Dubai

We evaluated the customers, operations, products and advertising of these businesses to explore the unique policy challenges created by the suppliers of waterpipes. We completed a cross-sectional survey consisting of structured site observations and in-person interviews of businesses in New York City, Abu Dhabi and Dubai identified using Google, Yelp, Timeout Dubai and Timeout Abu Dhabi and neighbourhood visits in 2014. Regular customers made up 59% of customers. Franchises or chains were 28% of businesses. Waterpipes made up 39% of sales with 87% of businesses offering food within their menu. Flavoured tobacco made up 94% of sales. Discounts were offered by 47% of businesses and 94% of businesses used advertising, often through social media. The market consists of largely independent businesses, with a large regular customer base, frequently offering diversified services beyond waterpipes. These businesses advertise using both traditional and social media. The economics of waterpipe businesses is very different from the economics of cigarettes, and unique regulatory strategies are needed to control this epidemic

Effect of Heavy Metals on Liver, Kidney, Gills and Muscles of Cyprinus carpio and Wallago attu inhabited in the Indus

ABSTRACT: The present study was aimed to evaluate the effect of heavy metals on an important tissue of two fish species Cyprinus carpio and Wallago attu, sampled from the Indus river, Mianwali District, Pakistan. The concentration of selected heavy metals Fe, Cr, Cu, and in gills, muscles, kidney and liver was compared with an International standard of food fish. The overall metal concentrations among different weight categories in C. carpio were in the order of Fe > Cu > Cr >. In W. attu the overall accumulation of these metals were, in order of Fe > Cu > Cr > Pb The order of accumulation of metals in gills and muscle of C. carpio was Fe > Cr > Pb > Cu; kidney and muscles of W. attu was Fe > Cr > Cu > Pb; liver Fe > Cu > Cr > Pb. An increasing trend of concentration of iron, copper, chromium and lead occurred with an increase in weight of C. carpio and W. attu. There was a significant difference in the accumulation of heavy metals in different organs of both species (p<0.01). All studied heavy metals except Cr were within permissible limits described by various international agencies like WHO, FAO and FEPA in edible tissues of C. carpio and W. attu.

Cowden syndrome with Lhermitte–Duclos disease presenting as ataxia.

Cowden syndrome or multiple hamartoma syndrome is a rare genodermatosis of autosomal dominant inheritance characterized by multiple hamartomatous lesions of ectodermal, mesodermal and endodermal origin. A 45-year-old man presented to us with a history of dural arteriovenous fistula and intracerebral bleed in the past with gradually progressive difficulty in walking. Magnetic resonance imaging (MRI) of the brain showed a heterogeneous lesion in the cerebellum which was diagnosed as adult Lhermitte–Duclos disease which is considered a component of Cowden syndrome. On examination we found florid skin and mucosal manifestations of Cowden syndrome. A family history of thyroid malignancy was also present. Using the Cleveland Clinic web calculator, the patient had an 82% chance of having a phosphatase and tensin homologue (PTEN) mutation.

Patterns of antibiotic prescriptions in the outpatient department and emergency room at a tertiary care center in Saudi Arabia

Objectives: The aim of this study was to evaluate the extent and patterns of antibiotic prescription in the outpatient and the emergency departments of a tertiary care center in Makkah, Kingdom of Saudi Arabia

Materials and Methods: A cross-sectional study was carried out by reviewing the pharmacy electronic database from March to May 2013. The World Health Organization core drug use indicators were used. A random sample of 200 OPD and ER antibiotic prescriptions was obtained for detailed patient file review

Results: A total of 3872 antimicrobial prescriptions were identified. This constituted 16.2% of all OPD and ER prescriptions; 10% of OPD prescriptions and 47% of ER prescriptions contained at least one antibiotic. More than 50% of antibiotic prescriptions were not associated with the type of infection on the database. Co-amoxiclav and fluoroquinolones were the most frequently prescribed antibiotics

Conclusions: The overall percentage of antibiotic prescriptions in the OPD and the ER at the tertiary care center in Makkah are acceptable, but the percentage in the ER far exceeded the overall rate. Guidelines are needed to rationalize the prescription of antibiotics in the OPD and the ER

Anaesthesia, surgery, obstetrics, and emergency care in Guyana

The surgical and anaesthesia needs of low-income countries are mostly unknown due to the lack of data on surgical infrastructure and human resources. The goal of this study is to assess the surgical and anaesthesia capacity in Guyana. A survey tool adapted from the WHO Tool for Situational Analysis to Assess Emergency and Essential Surgical Care was used to survey nine regional and district hospitals within the Ministry of Health system in Guyana. In nine hospitals across Guyana, there were an average of 0.7 obstetricians/gynaecologists, 3.5 non-OB surgeons, and 1 anaesthesiologist per hospital. District and regional hospitals performed an annual total of 1520 and 10,340 surgical cases, respectively. All but 2 district hospitals reported the ability to perform surgery. An average hospital has two operating rooms; 6 out of 9 hospitals reported routine medication shortages, and 4 out of 9 hospitals reported routine water or electricity shortages. Amongst the three regional hospitals, 16.1% of pregnancies resulted in Caesarean section. Surgical capacity varies by hospital type, with district hospitals having the least surgical capacity and surgical volume. District level hospitals routinely do not perform surgery due to lack of basic infrastructure and human resources

Self-management practices among type 2 diabetes patients attending primary health-care centres in Medina, Saudi Arabia

The purpose of this study was to estimate the frequency of self-management activities among people who have type 2 diabetes in Saudi Arabia. The Arabic version of the Summary of Diabetes Self-care Activities questionnaire was used to identify self-management practices among 210 patients with type 2 diabetes mellitus. Only 15% of participants had a blood glucose level indicative of good glycaemic control [glycosylated haemoglobin

Air quality and seasonal variations in consultations for respiratory, allergic, dermatological and gastrointestinal diseases in Bahrain, 2007

Environmental health data in Bahrain are scarce. This study in 4 governorates of Bahrain aimed to establish baseline data on the seasonal prevalence of certain disease groups that are sensitive to climate [respiratory, allergic, dermatological and non-specific gastrointestinal diseases] over a 1-year period and to record local climate and air pollutant data for the same year. A 5% sample of medical records for those who attended primary health-care centres during 2007 was taken. Visit rates for all 4 diseases had peaks, in spring and in autumn, with the lowest rates in the summer season when the average temperatures were highest and average humidity was lower. Respiratory-related visits were highest when the air concentrations of SO[2] were highest. An ongoing surveillance system for climate-sensitive diseases should be initiated to monitor and relate health and environmental trends

Adverse health effects of spousal violence among women attending Saudi Arabian primary health-care clinics

This study aimed to investigate the frequency of spousal violence among Saudi women and document the related health effects and injuries, as well as their attitudes to gender and violence. Structured interviews were conducted with 200 ever-married women recruited from primary-care centres in Jeddah. Nearly half of the surveyed women [44.5%] reported ever experiencing physical violence from their spouse. Although 37 women [18.5%] had received violence-related injuries, only 6.5% had reported these injuries to a health-care provider. Victims of spousal violence had poor perceptions of their overall health, and reported pain or discomfort, antidepressant use and suicidal thoughts. Women mostly disagreed with the presented justifications for wife- beating. However, the association between gender attitudes and spousal violence was not significant. The results of this study support calls for integration of education about partner violence into health-care curricula to enhance the access and quality of services