Comparative genomic analysis of strain Priestia megaterium B1 reveals conserved potential for adaptation to endophytism and plant growth promotion.

In our study, we aimed to explore the genomic and phenotypic traits of Priestia megaterium strain B1, which was isolated from root material of healthy apple plants, to adapt to the endophytic lifestyle and promote plant growth. We identified putative genes encoding proteins involved in chemotaxis, flagella biosynthesis, biofilm formation, secretory systems, detoxification, transporters, and transcription regulation. Furthermore, B1 exhibited both swarming and swimming motilities, along with biofilm formation. Both genomic and physiological analyses revealed the potential of B1 to promote plant growth through the production of indole-3-acetic acid and siderophores, as well as the solubilization of phosphate and zinc. To deduce potential genomic features associated with endophytism across members of P. megaterium strains, we conducted a comparative genomic analysis involving 27 and 31 genomes of strains recovered from plant and soil habitats, respectively, in addition to our strain B1. Our results indicated a closed pan genome and comparable genome size of strains from both habitats, suggesting a facultative host association and adaptive lifestyle to both habitats. Additionally, we performed a sparse Partial Least Squares Discriminant Analysis to infer the most discriminative functional features of the two habitats based on Pfam annotation. Despite the distinctive clustering of both groups, functional enrichment analysis revealed no significant enrichment of any Pfam domain in both habitats. Furthermore, when assessing genetic elements related to adaptation to endophytism in each individual strain, we observed their widespread presence among strains from both habitats. Moreover, all members displayed potential genetic elements for promoting plant growth.IMPORTANCEBoth genomic and phenotypic analyses yielded valuable insights into the capacity of P. megaterium B1 to adapt to the plant niche and enhance its growth. The comparative genomic analysis revealed that P. megaterium members, whether derived from soil or plant sources, possess the essential genetic machinery for interacting with plants and enhancing their growth. The conservation of these traits across various strains of this species extends its potential application as a bio-stimulant in diverse environments. This significance also applies to strain B1, particularly regarding its application to enhance the growth of plants facing apple replant disease conditions.

Splenic artery pseudoaneurysm; a cause or consequence: a case report.

BACKGROUND: Splenic artery pseudoaneurysm is a rare complication of recurrent pancreatitis usually presenting as an incidental finding on abdominal computed tomography. CASE PRESENTATION: We present the case of a 66-year-old north African male with a known history of previous pancreatitis who presented with upper gastrointestinal bleeding along with recurrent epigastric pain for 3 days. Investigations did not reveal any particular pancreatitis etiology. Computed tomography of the abdomen with contrast showed splenic artery pseudoaneurysm along with findings suggestive of acute pancreatitis. Upper and lower endoscopies failed to identify gastrointestinal the bleed source. The patient underwent intervention radiology embolization of the aneurysm sac with multiple coils via right retrograde common femoral artery-celiac access. The patient was discharged with a plan for capsule endoscopy in outpatient setting. CONCLUSION: Splenic artery pseudoaneurysm is a life-threatening complication and carries a high mortality rate if left untreated. Prompt identification through various imaging modalities, followed by urgent intervention, is crucial to avoid adverse outcomes.

Effect of Repeated Structured Diabetes Education on Lifestyle Knowledge and Self-Care Diabetes Management in Kidney Transplant Patients With Posttransplant Diabetes.

OBJECTIVES: Diabetes knowledge among kidney transplant recipients with posttransplant diabetes has not been clearly assessed. We evaluated whether diabetes education in kidney transplant recipients with posttransplant diabetes affected self-care, metabolic control variables, and reversibility of early diabetic microangiopathies. MATERIALS AND METHODS: In this prospective randomized controlled study, we enrolled 210 renal transplant recipients with posttransplant diabetes. Group 1 patients (n = 140) received structured diabetes education, and group 2 patients (n = 70) received conventional education. Patient data were collected through patient identification and metabolic control parameter forms and a diabetes self-care scale questionnaire (scores between 0 and 7). RESULTS: Diet knowledge improved and waist circumference was reduced with mild to moderate exercise in group 1 (P < .001), despite no differences between the 2 groups in mean body weight or body mass index. Patients in group 1 (structured diabetes education with repeated reinforcement) showed significant improvement in healthy lifestyle parameter scores versus group 2 (P < .05) and versus values before education (P < .05). At end of study, these achievements were translated into proper blood sugar monitoring, management of both hypoand hyperglycemia, improvements in logbook use and healthy sharp disposal, Ramadan fasting, sick day management, and knowledge on the importance of HbA1c (P < .05), which translated to decrease of HbA1c in group 1 by 1.35%. In group 1, proteinuria decreased significantly compared with before education and compared with group 2 values (P = .016). Diabetic retinopathy and neuropathy remained comparable between groups (P > .05). CONCLUSIONS: Structured diabetes education improved lifestyle knowledge, self-care diabetes management, and metabolic control variables among kidney transplant recipients with posttransplant diabetes. Structured diabetes education also resulted in partial reversibility of the present early diabetic nephropathy. We recommended such education to be delivered to all kidney transplant recipients with diabetes.

Circulating miR-206, miR-181b, and miR-21 as promising biomarkers in hypothyroidism and their relationship to related hyperlipidemia and hepatic steatosis.

Background: Thyroid hormones (THs) signaling has profound effects on many physiological processes. The regulation of THs signaling in various tissues involves the action of microRNAs (miRNAs) on thyroid deiodinases and receptors. THs regulate the expression of certain miRNAs and their target messenger RNAs (mRNAs) in various tissues and cells. The modulation of miRNA levels by THs affects their functions in processes such as liver lipid metabolism, skin physiology, and muscle and heart performance. Aim: This research aimed to investigate miR-181b, miR-206, and miR-21 in the serum of patients with subclinical and overt hypothyroidism to determine their possible role in the diagnosis of the disease and their relationship to clinical disorders related to hypothyroidism. Methods: This study included ninety participants, divided evenly into three groups as follows: patients with overt hypothyroidism diagnosed clinically, radiologically, and by investigation, subclinical hypothyroid patients, and healthy volunteers. The patients had a thorough medical history and underwent a clinical examination. Laboratory tests included plasma cholesterol, LDL, HDL, TGs, liver and renal function tests, CBC, fasting insulin, HOMA-IR, HbA1c, TSH, and free T4. The serum levels of miR-21, miR-206, and miR-181b were measured using qRT-PCR. Results: miR-206 and miR-181b levels were higher in the subclinical group, followed by the hypothyroid and control groups. For miR-21, there was a significantly lower mean value in both the hypothyroid and subclinical groups than in the control group, with no difference between the two groups. Both miR-206 and miR-181b showed a significant negative association with albumin and free T4 levels and a significant direct association with GGT, ALT, AST, creatinine, uric acid, TGs, TC, LDL, TSH, thyroid volume, and CAP score. The same correlation pattern was observed for miR-181b, except that it was not significantly correlated with the TGs. For miR-21 levels, there was a significant positive correlation with albumin, free T4 level, and kPa score and a negative correlation with GGT, ALT, AST, creatinine, uric acid, HOMA-IR, HbA1c, TC, LDL, TSH, and CAP score. Cases with F1 kPa score and S2 CAP scores had significantly higher averages for miR-206 and miR-181b, with a p-value of 0.05. Moreover, miR-21 levels were significantly lower in the S2 CAP score group. Conclusion: These miRNAs (miR-206, miR-181b, and miR-21) may be used as diagnostic biomarkers for hypothyroidism. They may be used as therapeutic targets to control dyslipidemia and hepatic steatosis during hypothyroid disease.

Circulating miR-199a and long noncoding-RNA ANRIL as Promising Diagnostic Biomarkers for Inflammatory Bowel Disease.

BACKGROUND & AIMS: Inflammatory bowel disease (IBD), involving both Crohn's disease (CD) and ulcerative colitis (UC), represents a chronic, immune-mediated inflammatory disease due to an uncontrolled, ongoing inflammatory response to intestinal bacteria in those with genetic susceptibility. MicroRNA (miRNA) extrusion from relevant remote organs or tissues is reflected in the expression of miRNAs in serum and plasma. Both UC and CD patients had higher blood levels of expressed miR-199a. Long noncoding RNA (lncRNA) ANRIL is a proinflammatory gene that mediates nuclear factor κB to play a role in inflammatory diseases, such as IBD. The aim of the current study is to investigate the potential role of both miR-199a and ANRIL in diagnosing IBD in adult patients. METHODS: Sixty-seven IBD patients diagnosed clinically, radiologically, endoscopically, and histologically were included in this prospective cohort study. Participants were classified into 3 groups: the UC group (n = 35), the CD group (n = 32), and the control group (n = 30). Demographics, history taking, laboratory characteristics, and treatments were recorded. Tumor necrosis factor α , miR-199a, and ANRIL were measured. RESULTS: The findings suggested that miR-199a and ANRIL might be associated with the occurrence or progression of IBD because both genes were substantially expressed in the peripheral blood of patients with this condition. Receiver-operating characteristic curve analysis indicated that the detection of miR-199a and ANRIL had a predictive sensitivity of 62.9% and 88.6% and a specificity of 70.7% and 96.7% for the occurrence of UC cases, respectively, and a predictive sensitivity of 72.4% and 46.9% and a specificity of 96.7% and 34.7% for the occurrence of CD cases, respectively. CONCLUSIONS: Both miR-199a and ANRIL are abundant in the sera of IBD adult Egyptian patients (UC and CD). Both can represent a noninvasive marker for early disease diagnosis.

This study investigated the relation between tumor necrosis factor α, ANRIL, and miR-199a in inflammatory bowel disease patients to determine the probability of using them as prognostic and diagnostic biomarkers, as well as distinguishing between Crohn's disease and ulcerative colitis patients. Our findings showed that ANRIL and miR-199a can represent noninvasive biomarkers for early disease diagnosis.

Combined Infraclavicular-Suprascapular Nerve Blocks Compared With Interscalene Block for Arthroscopic Rotator Cuff Repair: A Prospective, Randomized, Double-blind, and Comparative Clinical Trial.

BACKGROUND: The gold standard postoperative analgesia protocol for arthroscopic rotator cuff repair procedures is the interscalene block (ISB), which prevents the significant consequences of phrenic nerve block associated with hemidiaphragmatic paralysis (HDP). The infraclavicular brachial plexus block (BPB) combined with the suprascapular nerve block (SSNB) had the same analgesic efficacy as the infraclavicular BPB alone, with no effect on respiration. OBJECTIVES: Therefore, the study aimed to assess the HDP and analgesic efficacy of both approaches in controlling pain following arthroscopic rotator cuff repair surgeries. STUDY DESIGN: A prospective, randomized, double-blind, and comparative clinical trial. SETTING: The study comprised 66 patients. They were separated into 2 equal parallel groups 33 patients each: the ISB group and the costoclavicular and suprascapular block (CSB) group. METHODS: The ISB group obtained the ISB followed by the general anesthesia. The CSB group received infraclavicular blockade using the costoclavicular approach and SSNB followed by general anesthesia. RESULTS: Considering morphine utilization during the first day following the operation, the groups demonstrated an insignificant difference. The CSB group showed a decreased rate of diaphragmatic paralysis. LIMITATIONS: There was no control group. And, the blocks might take a long time to be performed up to 30 minutes. Also, there were no validated criteria to define HDP based on M-mode ultrasound measurements. CONCLUSIONS: The employment of the costoclavicular block in combination with the suprascapular block may provide a comparable analgesic potency to the sole use of the standard ISB with no HDP.

Draft Genome Sequence of the Bacterial Endophyte Priestia megaterium B1, Isolated from Roots of Apple (Malus domestica).

Over the past years, a number of important traits supporting plant growth have been shown for different strains of Priestia megaterium (formerly known as Bacillus megaterium). Here, we report the draft genome sequence of the endophytic bacterial strain Priestia megaterium B1, which was isolated from surface-sterilized roots of apple plants.

Canagliflozin-loaded chitosan-hyaluronic acid microspheres modulate AMPK/NF-κB/NLRP3 axis: A new paradigm in the rectal therapy of ulcerative colitis.

Ulcerative colitis is an idiopathic disease that is widely incident worldwide. Canagliflozin, antidiabetic agent, exhibited significant anti-inflammatory effects in a variety of animal models. Additionally, hyaluronic acid is considered one of the key players in the tissue regeneration process. It has been proven to modulate inflammation and cellular migration, which are the main phases of wound healing. The combination of hyaluronic acid with chitosan in microsphere fabrication was anticipated to reveal a synergistic muco-adhesiveness potential with additional advantage of the chitosan penetration enhancing effect. The current study aimed to explore the potential of canagliflozin-loaded chitosan-hyaluronic acid microspheres intrarectal administration to mitigate acetic acid-induced colitis in rats. Colon tissues were examined for macroscopic and microscopic pathological changes. ELISA and qRT-PCR techniques were applied for the detection of cytokines involved in the AMPK/NF-κB/NLRP3 axis. Intrarectal administration of this formula alleviated colitis severity, which was reflected by the reduced DAI, MES, colonic weight/length ratio and histopathological scoring values. Interestingly, canagliflozin-loaded chitosan-hyaluronic acid microspheres significantly enhanced AMPK phosphorylation and depressed NF-κB and NLRP3 expression leading to a subsequent reduction in caspase-1 cleavage and the inhibition of several inflammatory cytokines, including IL-1ß, and IL-18. Overall, the current study revealed that the protective effects of the formula against acetic acid-induced colitis are primarily mediated via augmenting AMPK phosphorylation and its consequences of NF-κB inactivation. Since canagliflozin is not associated with hypoglycemic effects, clinical application of canagliflozin-loaded chitosan-hyaluronic acid microspheres represent a novel therapeutic option for the treatment of patients with ulcerative colitis.

Morphological and functional relationship between the orbital gland and olfaction in Upupa epops (hoopoe) and Bubulcus ibis (cattle egret).

This study used both anatomical and histological techniques to investigate the orbital gland's topographic relationship with the surrounding system, using the hoopoe and cattle egret as biological models. Hoopoe has a spindle-shaped lacrimal gland that is suspended on the lateral edge of the frontal bone, whereas cattle egret has a tiny lacrimal gland that is embedded posteriorly within the periorbital fascia. The hoopoe's lacrimal gland has a single duct that runs parallel to the nasolacrimal duct and opens into the posterior nostril hole. In the cattle egret, the tubule-alveolar secretory components comprise neutral and acid glycosaminoglycan. In addition, the Harderian gland is found in both these species, but their draining ducts differ; the Harderian gland of the hoopoe opens into the anterodorsal to the conjunctival fornix, whereas the Harderian gland of the egret opens anteriorly. In both hoopoe and egret, the secretions of Harderian gland include neutral and acid glycosaminoglycan. The Harderian gland is categorized as type II in hoopoe and type I in cattle egrets. The present results concluded that both orbital glands of two bird species studied play an essential role in eye health, where cleaning and lubrication of the cornea surface. Furthermore, the lacrimal gland's location and secretory features may strengthen the olfactory sensitivity of hoopoe, which relies heavily on scent to locate their food, whereas egret relies heavily on visual cues.

Toxicological assessment of sublethal dose of acetamiprid in male mice and the efficacy of quercetin.

Acetamiprid (ACP) is a neonicotinoid insecticide that is the most effective pesticide for crop protection as well as flea control in agricultural animals and pets in the world. The goal of this study was to look at the in vivo effects of a sublethal dose of ACP on hematotoxicity, oxidative stress, hepatotoxicity, nephrotoxicity, immunotoxicity, and histological alterations, as well as the role of quercetin (QE) in alleviating these effects. Twenty adult male mice were divided into four equal groups orally administered corn oil (control), QE (50 mg kg-1 b.wt.), ACP (1/10 LD50) or ACP plus QE for two weeks. The results showed that ACP significantly lowered the body weight gain, hematological indices, glutathione (GSH), and both cellular and humoral immunity, On the other hand, levels of lipid peroxidation (LPO), glutathione peroxidase (GPx), and liver and kidney marker values were considerably increased in male mice exposed to ACP. In addition, examination under light microscopic showed that ACP induces histological alterations in liver and kidney tissues. The results also revealed that treating intoxicated mice with QE significantly reduced the deleterious effects of ACP. In conclusion, current results show that ACP at the sub lethal dose poses toxic risks to the liver and kidneys, and QE as a natural material enhances antioxidant defenses, which can be used as a potential interventional therapy against negative effects of pesticides like ACP.

Effect of Structured Diabetes Education on Diabetic Angiopathies Among Kidney Transplant Recipients With Posttransplant Diabetes: Kuwait Experience.

OBJECTIVES: Diabetes knowledge among kidney transplant recipients with posttransplant diabetes has not been exhaustively assessed. Here, we evaluated the effects of structured diabetes education on development of diabetic micro- and macroangiopathies in kidney transplant patients with posttransplant diabetes. MATERIALS AND METHODS: This prospective randomized controlled study categorized 210 renal transplant patients with posttransplant diabetes mellitus into 2:1 groups according to type of diabetes education. Group 1 (n = 140) received structured education, and group 2 (n = 70) received conventional education. Patient data were collected through patient identification and metabolic control parameter forms. RESULTS: Most patients in groups 1 and 2, respectively, were Kuwaiti (60.7% vs 58.6%), men (57.9% vs 68.6%), and had high school-level education (43.6% vs 48.6%). Chronic glomerulonephritis was the original disease in 36.4% versus 35.4% of patients. Most patients (72.8% vs 78.6% in group 1 vs 2) received pretransplant hemodialysis. At study start, the rate of patients with diabetic neuropathy was comparable between groups (32.4% vs 27.9%). Moreover, after completion of 24 months of education, neurological evaluation by electromyograph and nerve conduction studies did not show any significant differences between the groups (P > .05). Similarly, the number of patients with fundus imaging showing retinopathy was comparable between groups at start and end of study (P > .05). Although macroangiopathic events were higher in group 1, this finding was not significant (P > .05). However, although the percentage of patients with nephropathy was comparable in both groups at start of study, the percentage decreased significantly in group 1 at 24 months after completion of education compared with group 2 and baseline value (P = .016). CONCLUSIONS: Structured diabetes education was associated with reduced diabetic nephropathy but had no significant effects on other micro- or macroangiopathies. However, we recommend education for all kidney transplant recipients with diabetes.

Seasonal Variations in the Digestive Tract of the Little Owl, Athene noctua: Anatomical, Histological, and Scanning Electron Microscopical Studies.

The digestive tract of the little owl, Athene noctua (Strigiformes: Strigidae), is described in two different seasons. The digestive tract of this bird follows the basic model for that of a predatory bird. The cervical esophagus is not expanded to form a crop. The internal surface of the esophagus forms numerous longitudinal folds provided with numerous mucous glands. These longitudinal folds increase in number and vary in depth posteriorly. The folds of the proventriculus are composed of simple branched tubular glands. The ventriculus is lined by a thin layer of koilin. The number of goblet cells gradually increases from the duodenum to the rectum, and the lymphatic tissue diffuses within the lamina propria. The esophageal glands secrete acid mucopolysaccharides, while the gastric glands of the stomach, the goblet cells, and crypts of Lieberkühn secrete acid mucopolysaccharides. Proteins were observed in the different histological structures of the digestive tract. Morphometric and histometric studies showed differences between summer and winter in the esophagus and glandular stomach (especially in winter), but no seasonal differences were seen in the muscular stomach, or small and large intestines.

Bioactivities of endophytic actinobacteria inhabiting Artemisia herba-alba emphasizing differences from free-living strains.

The endophytic actinobacteria associated with Artemisia herba-alba (synonym: Seriphidium herba-alba) are highly diverse. This study aimed to illustrate the extent of their differences from the free-living actinobacteria in the surrounding environment. A selection of eighteen actinobacteria inhabiting A. herba-alba were compared with twenty and ten actinobatceria isolates from the surrounding desert and groundwater, respectively, representing six genera. Antagonistic and enzymatic activities, plant growth-promoting traits, and the occurrence of biosynthetic genes were compared among the isolates. Data were analyzed statistically using principal component analysis (PCA) and were visualized using heat map. Endophytic strains showed higher antimicrobial activity and production of plant growth promoters compared to desert and groundwater strains. Polyketide synthase and non-ribosomal peptide synthetase gene clusters were detected at higher frequencies in the endophytic strains (8 and 11 strains, respectively) than the desert strains (1 and 2 strains, respectively). In contrast, both gene clusters were not detected in the groundwater strains. The PCA revealed unique metabolic characteristics of the endophytes. The heatmap clustered the endophytic strains apart from the free-living strains, indicating distinctive qualitative and quantitative bioactivities. Analysis of 16S rRNA genes confirmed the chemotaxonomic identity of all but two strains, with > 94.5% similarity. Six endophytes displayed < 99.5% similarity with their closest type strains, which might indicate species novelty. This study provides an evidence of functional differences and possible species novelty of the endophytic actinobacteria inhabiting A. herba-alba, compared with the free-living species.

Seroprevalence of Besnoitia besnoiti in Assiut Governorate, Egypt.

Background: Bovine besnoitiosis is a widespread disease caused by Besnoitia besnoiti with significant economic losses in cattle production. There is a lack of knowledge about it in Egypt. Aim: This study was conducted to detect the seroprevalence of B. besnoiti in cattle and to find out the presence of the disease and the most important symptoms of besnoitiosis in cattle in Assiut Governorate, Egypt. Methods: A total of 190 cattle from Assiut city and its different rural centers were examined clinically and serologically for the presence of B. besnoiti. The serological examination was carried out by using the indirect enzyme-linked immunosorbent assay (ELISA) kit in serum (ID.Vet Innovative Diagnostics Louis Pasteur. Grabeis, France). The results were analyzed statistically using the chi-square test to assess the association between seroprevalence and different parameters (age, sex, season, housing, and health status). Result: Thirteen cattle were seropositive for B. besnoiti by ELISA and showed symptoms of besnoitiosis. Acute symptoms included fever, tachycardia, edematous swellings of intermandibular space and limbs with polyarthritis, diarrhea, ruminal atony, and enlarged lymph nodes. The chronic symptoms included cough, mastitis, exophthalmia, cysts on the sclera and conjunctiva, nodules in the skin, and alopecia associated with tick infestation. The overall seroprevalence of B. besnoiti was 22.1%. Regarding sex, the seroprevalence was higher for females 34.6% than for males 6.97%. While, according to age susceptibility, the seroprevalence was highest (50.9%) with age ≥5 years, followed by age >1 to <5 years (14.6%), and only one animal of age ≤1 year was recorded at 2.2%. Concerning seasonal variations, the seroprevalence was highest in spring 42.9%, followed by autumn 29.3%, winter 13.6%, and summer 7.5%. Whereas, according to the housing system, it was 60% and 8.6% in farm and household rearing, respectively. Depending on the health status, the seroprevalence was 21.6% of clinically healthy and 23.2% of clinically diseased cattle. Conclusion: The existence of B. besnoiti antibodies has been demonstrated in clinical and subclinical infected cattle in Assiut Governorate, Egypt. The ELISA test is considered to be a good diagnostic method for detecting infection. Furthermore, additional studies are essential to minimize and prevent the spread of infection.

Autoantibody Profile of Egyptian Juvenile Systemic Lupus Erythematosus Patients and Its Association with Clinical Characteristics and Disease Activity.

OBJECTIVE: This study was conducted to estimate the frequency of anti-nuclear antibodies (ANAs), anti-dsDNA, and anti-extractable nuclear antigen (ENA) antibodies in juvenile systemic lupus erythematosus (JSLE) patients and their association with different clinical manifestations and disease activity. PATIENTS AND METHODS: A cross-sectional study that includes 100 JSLE patients from Ain Shams University Hospital was conducted. All subjects underwent history taking, clinical examination, assessment of disease activity based on the SLE disease activity index (SLEDAI), laboratory investigations, and tests for autoantibodies, namely ANA, anti-dsDNA, and anti-ENA antibodies, including anti-Ro (SSA), anti-La (SSB), anti-Smith (Sm), and anti-U1-ribonucleoprotein (U1-RNP). RESULTS: The most common clinical features were polyarthralgia (71%), haematological manifestations (65%), malar rash (54%), and nephritis (51%), respectively. All patients had positive ANA (100%), while anti-dsDNA frequency was 83%. The most common anti-ENA antibodies were anti-RNP (41%), anti-Sm (31%), anti-SSA (27%), and anti-SSB (20%), respectively. Anti-RNP had a clinical association with oral ulcer, Raynaud' phenomena, haematological, neuropsychiatric and thromboembolic manifestations. Meanwhile, anti-Sm had a significant association with serositis, mucocutaneous, constitutional, and neuropsychiatric manifestations. Anti-SSA was associated with mucocutaneous, musculoskeletal, Raynaud' phenomena, renal, haematological and cardiac manifestations, while anti-SSB was significantly associated with malar rash, serositis, thromboembolic, musculoskeletal, and neuropsychiatric manifestations. Concerning SLEADI score, anti-dsDNA antibody was significantly associated with moderate disease activity score (p=0.032) while anti-SSA significantly associated with high disease activity (p=0.045). Both anti-SSB and anti-Sm were significantly associated with both moderate and high disease activities, meanwhile anti-U1-RNP was associated with moderate disease activity (p=0.014). CONCLUSION: Anti-dsDNA and anti-ENAs antibodies were frequently found in JSLE patients (83%, 63%), respectively. They were significantly associated with variable clinical manifestations and could be used as predictors for assessment of disease activity.

Rebuilding Graduate Medical Education After a Crisis: Perspectives of Medical Residents in the United Arab Emirates.

Pandemics create unprecedented public health challenges that require comprehensive and coordinated responses from health care systems and can, thereby, cause substantial and prolonged disruption to residency training. The coronavirus 2019 (COVID-19) pandemic has impacted medical education worldwide. Currently, there is a gap in the literature from the trainee's perspective, and little advice on resuming post-pandemic operations. As internal medicine residents serving on the frontlines of a COVID-19 designated government hospital in the United Arab Emirates, we also faced significant challenges and uncertainties during the pandemic. We are fortunate to have overcome the initial surges and have spent the past 6 months navigating a new reality. We believe that the COVID-19 crisis provides an opportunity for graduate medical education programs worldwide to implement targeted changes that can lead to sustainable improvements in the system. In supporting learning during these times, our residency program has adopted flexible scheduling, focused on frequent and transparent communication, incorporated different strategies to build community and promote psychological wellbeing, and advanced virtual teaching modalities. The aim of this article is to share the strategies that have helped us to move forward in the aftermath of the first phases of the pandemic, whilst we prepare for the uncertainty of the future. We hope that the lessons we have learned can help inform other programs as they react and adapt to the global after-effects of this crisis.

Soya milk alleviates toxicity caused by citric acid in male mice: Histopathological and hematological studies.

This study evaluated the toxicity of citric acid and the benefits of soya milk (SM) for preventing damage in mice. Thirty-five mice were divided into groups: control, mice administered citric acid (CA group) for 30 days, mice administered SM before the administration of citric acid for 30 days (SM + CA group), mice administered citric acid for 15 days and left for recovery (R group), and mice in recovery receiving SM for 15 days (R + SM). Mice in CA and R groups displayed downregulated p53, increased cleavage of caspase 3, and upregulation of Nrf2, CYP1A1, ALT, and AST activity in the liver. In contrast, SM + CA and R + SM treated mice were protected against CA toxicity and showed reversal of p53 downregulation, reduced cleavage of caspase 3, downregulation of Nrf2, and an increase in liver function enzymes. SM administration also restored blood cell and hemoglobin content and general histology of hepatocytes. PRACTICAL APPLICATIONS: CA causes liver damage, increases inflammation, decreases blood cell numbers, and induces apoptosis. Some natural products, such as SM, have been used to scavenge free radicals that can cause liver damage and hemolysis. This study focuses on the effectiveness of SM in ameliorating CA toxicity and may be helpful in the food industry for managing oxidative stress that may be induced by common dietary constituents. SM may help suppress liver damage and inflammation.

Ultrastructural comparison between the tongue of two reptilian species endemic in Egyptian fauna; Bosc's fringe-toed lizard Acanthodactylus boskianus and Sinai fan-fingered gecko Ptyodactylus guttatus.

The current observations focused on the ultrastructure comparison between the tongue of two reptile species endemic the Egyptian fauna; Bosc's fringe-toed lizard Acanthodactylus boskianus and Sinai fan-fingered gecko Ptyodactylus guttatus to exhibit the relationship between the lingual epithelium and its function according to their specific feeding strategy. A. boskianus possessed triangular elongated tongue with bifurcated tapering apex and wide base while; the P. guttatus had a triangular flattened tongue with conical shallow bifurcated apex and broad base. The ventral surface of the lingual apex of A. boskianus had transverse while in P. guttatus had two oval pads and median ventral groove. Both surfaces of the tongue of both examined species are covered by stratified squamous epithelium with great variability of degree of keratinization. The dorsal epithelium formed flattened and conical filiform papillae in A. boskianus, while in P. guttatus formed cylindrical papillae, conical, and tall filiform ones. Few taste buds are observed on the fore-tongue but increase on the mid-tongue of A. boskianus, while in P. guttatus, numerous taste buds are distributed on the fore-tongue and mid-tongue. Both surfaces of the laryngeal mound of both examined species provided with numerous of cilia and orifices of laryngeal gland. The present results confirmed that the tongue of A. boskianus acts as a chemoreceptor organ to follow pheromone trails of prey and mates. While in P. guttatus the tongue may play an important role in the feeding mechanism and act as a chemoreceptor organ.

Neisseria meningitidis pneumonia with bacteremia without meningitis: An atypical presentation.

Neisseria meningitidis remains the most important cause of bacterial meningitis worldwide. The second most common and potentially severe end-organ manifestation of invasive meningococcal disease is meningococcal pneumonia. It occurs between 5 % and 15 % of all patients with invasive meningococcal disease. N. meningitidis sepsis and meningitis continue to be associated with high morbidity and mortality, however, meningococcal pneumonia is uncommon and often underreported. We describe a case of sepsis secondary to pneumonia with N. meningitidis bacteremia, without any evidence of meningitis. This case reports aims at highlighting pneumonia as a presentation of N. meningitidis bacteremia, and the need for a high level of clinical suspicion to establish the diagnosis.