Immunological and molecular assessment of HIV-1 mutations for antiretroviral drug resistance in Saudi Arabia.

Human Immunodeficiency Virus (HIV) is a significant threat to public health. HIV genotyping and antiretroviral resistance testing may have contributed to improved non-treated management. Immune markers might assist HIV-1 diagnosis and drug-resistant variant identification. HIV-1 immunogenicity and molecular characteristics of antiretroviral drug resistance are evaluated in 56 treatment-naive HIV patients. DNA sequencing and retroviral resistance testing identified HIV-1 genotypes. 55.4% of patients were susceptible to protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI) antiretroviral drugs, whereas 44.6% had drug-resistance mutations against at least one antiretroviral drug. 3.6% of cases had PI-resistant mutations, while 30.4% had NRTI-resistant mutations, and 30.4% had NNRTI-resistant mutations. In patients who are susceptible to PI, the mean value of human plasma sCD80 is 2.11 ± 0.65 ng/mL; in patients with mutations, it is 3.93 ± 2.91 ng/mL. Individuals who are susceptible to PI have plasma sCD27 levels of 78.7 ± 63.2 U/mL, whereas individuals who are mutant have levels of 56.5 ± 32.1 U/mL. IP-10's mean value was 363 ± 109.2 pg/mL for the susceptible patients and 429 ± 20.7 pg/mL for the mutated patients. In susceptible patients, the plasma sCD4 level is 0.163 ± 0.229 ng/mL; in mutant patients, it is 0.084 ± 0.012 ng/mL. The data showed a relative relation between immunological parameters such as sCD80, sCD27, sCD4, and IP-10 and mutation for drug resistance.

Acute Rheumatic Fever in Children: The Known and the Unknown Among Saudi Mothers in the Jazan Region.

Background Acute rheumatic fever (ARF) is a significant public health problem that causes morbidity and mortality in low and middle-income countries. Therefore, this study aims to assess mothers' knowledge of acute rheumatic fever and their attitudes in the Jazan region. Methods A cross-sectional study was conducted between the mothers using an online survey. The knowledge level was ranked as poor, fair, and good. In contrast, the attitudes were ranked as positive or negative. Association with sociodemographic variables was assessed, and statistical significance was set at p < 0.05. Results Four hundred thirty-six (436) mothers were included; 39.9% of them were aged 21-30 years, 68.8% were married, 57.3% were non-workers, and 72.2% were university-educated. Most of the mothers had a poor level of knowledge (53%); however, positive attitudes toward the disease were reported in 79.1% of mothers. The poor knowledge levels were related to age, marital status, occupation, and monthly income. Conclusion Despite having positive attitudes toward diagnosing and managing ARF, most of the mothers showed poor knowledge of acute rheumatic fever. This study highlights the situation in the Jazan region, which could be an essential basis for constructing an educational program to raise awareness and knowledge of acute rheumatic fever in the community.

Evaluation of Current Community Pharmacist Practice in Saudi Arabia: A Cross-sectional Study from Patients' Perspective (PART I).

Objective: This study aimed to evaluate the current practice of community pharmacists from patients' and pharmacists' perspectives in Saudi Arabia. This paper presents the patients' perspective. Methods: A self-administered cross-sectional survey was developed to collect responses from patients in Saudi Arabia from February to April 2021. The questionnaire comprised several statements related to the best practice in community pharmacy. Patients' responses to each statement were scored using a 5-point Likert scale. Higher scores represented the greater extent to which the pharmacists perform the best practice in a community pharmacy setting and vice versa. Findings: The data of 233 participants were included in the analysis. The majority of the participants were female (67%) and Saudi nationals (96%). The minimum mean score was related to the statement: pharmacist discusses with you about herbal medications or vitamin supplements. The maximum mean score was related to the statement: Pharmacist explains to you about the dose of medications and when to take them. Participants who were <20 years old had a significantly highest mean score, whereas those above 40 years old had the least mean score, P = 0.001. Participants from the Eastern region had a significantly highest mean score, compared to South region participants who had the least mean score, P = 0.009. Conclusion: A gap in the current practice and the best practice of community pharmacists was found. The policymakers can utilize these findings to provide targeted professional development opportunities for the practicing community pharmacists to improve the overall service and care for the patients.

Evaluation of Current Community Pharmacist Practice in Saudi Arabia-A Cross-Sectional Study from Pharmacists' Perspective (Part II).

This study aimed to evaluate the current practice of community pharmacists from patients' and pharmacists' perspectives in Saudi Arabia. This paper presents the pharmacist's perspective. A cross-sectional self-administered online survey was designed to collect responses from community pharmacists in Saudi Arabia from February to April 2021. The questionnaire consisted of several statements related to best practice in community pharmacy. Pharmacists' responses to each statement were scored using a 5-point Likert scale. Higher scores represented a greater extent to which they adhered to best practice in the community pharmacy setting and vice versa. Data of 164 participants were included in the analysis. The minimum median score was related to the statement: Pharmacist explains the main side effects. The maximum median score was related to the statement: Pharmacist explains dosage regimen. Pharmacists aged 30 years or above and non-Saudi pharmacists had significantly higher median scores compared with pharmacists less than 30 years of age (p = 0.016) and Saudi pharmacists, respectively (p = 0.001). A gap between best practice and current practice of community pharmacists was observed. Policymakers can utilize these findings to provide targeted professional development opportunities for the practicing community pharmacists in order to improve the overall service and care for patients.

Synthesis and Evaluation of Novel 2,2-Dimethylthiochromanones as Anti-Leishmanial Agents.

Within this work, we describe the design and synthesis of a range of novel thiochromanones based on natural products reported to possess anti-leishmanial action, and their synthetic derivatives. All compounds were elaborated via the key intermediate 2,2,6-trimethoxythiochromanone, which was modified at the benzylic position to afford various ester, amine and amide analogues, substituted by chains of varying lipophilicity. Upon testing in Leishmania, IC50 values revealed the most potent compounds to be phenylalkenyl and haloalkyl amides 11a and 11e, with IC50 values of 10.5 and 7.2 µM, respectively.

Genotyping and antiretroviral drug resistance of human immunodeficiency Virus-1 in Jazan, Saudi Arabia.

Determination of human immunodeficiency virus-1 (HIV-1) genotypes and identification of antiretroviral drug-resistant mutations. Among treatment naïve HIV patients in Jazan, Saudi Arabia. HIV is a major public health problem. HIV genotyping and antiretroviral resistance testing is an important guide for better management of treatment-naive. Antiretroviral resistance testing before starting of treatment regimen leads to a better virological response. A total of 57 samples of treatment-naive patients were collected from King Fahd Central Hospital in Jazan, Saudi Arabia. Samples were tested for HIV-1 antibodies, western blot, viral load, HIV-1 genotypes through direct sequencing, and antiretroviral resistance testing. The HIV-1 Genotypes were as follow; C: 66.6%, D: 10.5%, G: 8.8%, B: 7.0%, CRF01_AE: 3.5%, A and CRF02_AG: 1.8% each. 77.2% of cases showed susceptibility to the 3 major classes of antiretroviral drugs; Protease inhibitor (PI), Nucleoside reverse transcriptase inhibitor (NRTI), and non-nucleoside reverse transcriptase inhibitors (NNRTI); while 8.8% had mutations conferring resistance to NRTI. Mutations conferring resistance to PI were detected in 7.0% of cases, and 1.8% of cases had mutations conferring resistance to both NRTI and PI. Mutations conferring resistance to NNRTI were detected in 5.3% of cases. Mutations associated with antiretroviral drugs include (V82A+I84IV), (L10F+Q58E), (L10F+V82Y), L10FV, L33LF, L89LMV, M184V, E138A, V106I, and V179VD. The prevalence of HIV-1 antiretroviral resistance mutations is 22.8% in the studied population, which may warrant antiretroviral drug resistance testing as a pretreatment to help and guide physicians for the proper HIV treatment.

Kelch 13-propeller polymorphisms in Plasmodium falciparum from Jazan region, southwest Saudi Arabia.

BACKGROUND: Artemisinin-based combination therapy (ACT) is recommended at the initial phase for treatment of Plasmodium falciparum, to reduce morbidity and mortality in all countries where malaria is endemic. Polymorphism in portions of P. falciparum gene encoding kelch (K13)-propeller domains is associated with delayed parasite clearance after ACT. Of about 124 different non-synonymous mutations, 46 have been identified in Southeast Asia (SEA), 62 in sub-Saharan Africa (SSA) and 16 in both the regions. This is the first study designed to analyse the prevalence of polymorphism in the P. falciparum k13-propeller domain in the Jazan region of southwest Saudi Arabia, where malaria is endemic. METHODS: One-hundred and forty P. falciparum samples were collected from Jazan region of southwest Saudi Arabia at three different times: 20 samples in 2011, 40 samples in 2016 and 80 samples in 2020 after the implementation of ACT. Plasmodium falciparum kelch13 (k13) gene DNA was extracted, amplified, sequenced, and analysed using a basic local alignment search tool (BLAST). RESULTS: This study obtained 51 non-synonymous (NS) mutations in three time groups, divided as follows: 6 single nucleotide polymorphisms (SNPs) '11.8%' in samples collected in 2011 only, 3 (5.9%) in 2011and 2016, 5 (9.8%) in 2011 and 2020, 5 (9.8%) in 2016 only, 8 (15.7%) in 2016 and 2020, 14 (27.5%) in 2020 and 10 (19.6%) in all the groups. The BLAST revealed that the 2011 isolates were genetically closer to African isolates (53.3%) than Asian ones (46.7%). Interestingly, this proportion changed completely in 2020, to become closer to Asian isolates (81.6%) than to African ones (18.4%). CONCLUSIONS: Despite the diversity of the identified mutations in the k13-propeller gene, these data did not report widespread artemisinin-resistant polymorphisms in the Jazan region where these samples were collected. Such a process would be expected to increase frequencies of mutations associated with the resistance of ACT.

The effect of caster types on global rolling resistance in manual wheelchairs on indoor and outdoor surfaces.

An important aspect of reducing the strain of wheeling is to decrease rolling resistance. Previous laboratory research, using a treadmill, determined that smaller casters significantly increased rolling resistance. The purpose of this study was to determine the effect of caster size on various indoor and outdoor surfaces on global wheelchair rolling resistance. Three caster types with sizes 4 in, 5 in, and 6 in, three indoor surfaces, and three outdoor surfaces were studied. A manual wheelchair was passively pulled along each surface at 1.11 m/s (3.64 ft/s) by a power wheelchair, and the global rolling resistance of the manual wheelchair was measured using a calibrated force transducer. A 3×3 repeated measures analysis of variance (ANOVA) was conducted for both indoor and outdoor environments. The 4-in casters resulted in the highest global rolling resistance on most surfaces. The 5-in casters had the least rolling resistance on most indoor surfaces, and the 6-in casters had the least rolling resistance on most outdoor surfaces. Although 4-in casters are more popular among active wheelchair users, larger casters were shown to have lower rolling resistance on most surfaces. This study may help users select the best caster size depending upon their daily activities and lifestyle.

Synthesis and biocompatibility assessment of sugarcane bagasse-derived biogenic silica nanoparticles for biomedical applications.

Sugarcane bagasse is a fibrous material and an excellent bioresource for biogenic silica. Moreover, sugarcane bagasse has low production costs and is a sustainable precursor for the synthesis of biogenic silica nanoparticles (BSNPs). In this study, we synthesized BSNPs using sugarcane bagasse. The acid pretreatment of sugarcane was carried out in an autoclave, which eliminates metal ions and promotes the hydrolysis of organic substances. Residues of the acid pretreatment were incinerated at different temperatures to determine the role of temperature on the formation of BSNPs. The crystalline nature and morphology of the prepared BSNPs were analyzed using X-ray diffraction analysis and transmission electron microscopy. The X-ray diffraction analysis result indicates that the prepared BSNPs have an amorphous nature. Transmission electron microscopy images confirmed that the BSNPs have an irregular shape with a porous morphology. The biocompatibility of BSNPs was studied by assessing their effect on human lung fibroblast cell viability, morphology, mitochondrial function, reactive oxygen species, and gene expression. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assays and microscopy studies suggested that BSNPs do not affect cell viability or morphology. BSNPs slightly affect the mitochondrial membrane potential at high doses. In addition, BSNPs decreased the percentage of human lung fibroblast cell in G1 and G2/M phases and increased the S population. These studies revealed that the BSNPs were biocompatible, indicating that they may be applicable for biomedical applications. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 340-349, 2017.

Fe3 O4 nanoparticle redox system modulation via cell-cycle progression and gene expression in human mesenchymal stem cells.

The use of engineered nanoparticles (NPs) across multiple fields and applications has rapidly increased over the last decade owing to their unusual properties. However, there is an increased need in understanding their toxicological effect on human health. Particularly, iron oxide (Fe3 O4 ) have been used in various sectors, including biomedical, food, and agriculture, but the current understanding of their impact on human health is inadequate. In this investigation, we assessed the toxic effect of Fe3 O4 NPs on human mesenchymal stem cells (hMSCs) adopting cell viability, cellular morphological changes, mitochondrial transmembrane potential, and cell-cycle progression assessment methodologies. Furthermore, the expression of oxidative stress, cell death, and cell-cycle regulatory genes was assessed using quantitative polymerase chain reaction. The Fe3 O4 NPs induced cytotoxicity and nuclear morphological changes in hMSCs by dose and time exposure. Cell-cycle analysis indicated that Fe3 O4 NPs altered the cell-cycle progression through a decrease in the proportion of cells in the G0 -G1 phase. The hMSC mitochondrial membrane potential loss increased with an increase in the concentration of Fe3 O4 NPs exposure. The observed expression levels of the CYP1A, TNF3, TNFSF10, E2F1, and CCNC genes were significantly upregulated in hMSCs in response to Fe3 O4 NPs exposure. Our findings suggest that Fe3 O4 NPs caused metabolic stress through altered cell cycle, oxidative stress, and cell death regulatory gene expression in hMSCs. The results of this investigation revealed that Fe3 O4 NPs exhibited moderate toxicity on hMSCs and that Fe3 O4 NPs may have biomedical applications at low concentrations. © 2014 Wiley Periodicals, Inc. Environ Toxicol 31: 901-912, 2016.

Isolation of Aeromonas spp. from Food Products: Emerging Aeromonas Infections and Their Significance in Public Health.

Aeromonas spp. are opportunistic pathogens causing a broad spectrum of human illnesses like gastroenteritis, chronic diarrhea, wound infections, peritonitis, urinary tract infections, and septicemia. Their ability to grow in foods stored in a refrigerator poses a substantial threat for human consumption. We investigated the prevalence of Aeromonas from commercial food products across Riyadh, Saudi Arabia. A total of 250 samples were randomly collected and processed for the isolation and identification of Aeromonas by morphological and biochemical means and for their identification by PCR. A total of 102 strains of Aeromonas were isolated, including 47% from raw meat samples, 34% from raw fish samples, and 18.6% from milk and dairy products; 56.8% were identified as A. hydrophila and 43.1% as A. sobria. Antibiotic susceptibility tests done revealed 100% sensitivity to chloramphenicol, colistin, ciprofloxacin, and nitrofurantoin. 16S rDNA PCR revealed the presence of the 953 bp fragment in all the strains. The present investigation suggested the occurrences of A. sobria and A. hydrophila in human consumable stored and refrigerated foods.

Assessment of infection control knowledge, attitude and practice among healthcare workers during the Hajj period of the Islamic year 1423 (2003).

We assessed hospital infection control knowledge, attitude, and practice (KAP) of healthcare workers (HCWs) during the Hajj season of the Islamic y 1423 (2003). A self-administered structured questionnaire was used to collect the data. A total of 392 HCWs was studied, of whom 215 (54.8%) were nurses and 177 (45.2%) were doctors. 315 (80.4%) HCWs worked in hospitals, whereas 77 (19.6%) worked in primary healthcare centres. Of the 392 HCWs, 164 (41.8%) were from Makkah, and the remaining 228 (58.2%) were recruited from other regions in Saudi Arabia. A good proportion (81.8%) of HCWs correctly answered at least 5 of the 11 knowledge statements. However, obvious deficiency of knowledge appeared concerning other important hospital infection control measures. A smaller proportion (61.9%) of HCWs achieved a score of at least 4 out of 7 for attitude statements with unacceptable attitude for the remaining 3 areas. Response to questions concerning practice showed that nurses tended to be better than doctors (p-value=0.204), but both groups reported variable compliance to hospital infection control practices in terms of strict or near-strict adherence. In conclusion, training of HCWs is needed to improve KAP in infection control.

Causes of admission to intensive care units in the Hajj period of the Islamic year 1424 (2004).

BACKGROUND: Approximately 2 to 3 million pilgrims perform Hajj every year. We describe the pattern of diseases, complications, and outcome of pilgrims who required admission to intensive care units (ICUs) during the Hajj period of the Islamic year 1424 (2004). METHODS: This was a cross-sectional study of all patients admitted to 104 ICU beds in four hospitals in Mena and three hospitals in Arafat during the Hajj. RESULTS: Of 140 patients admitted to ICUs, 75 (54%) patients were older than 60 years. The risk of complications and death increased with age, with the highest risk noticed among pilgrims older than 80 years. Ninety-four (67.6%) patients were men. Eighty-nine (63.6%) patients were admitted with cardiovascular diseases and 37 (26.4%) patients with infections. Myocardial infarction (25%) and pneumonia (22%) were the most common admitting diagnoses. Trauma accounted for only 6.4% (9 patients) of admissions. Sixty-three (45.0%) patients recovered and were discharged or transferred to hospital wards in stable condition, 40 (28.6%) were transferred to tertiary care centers for specialized services, 21 (15.0%) were transferred to tertiary care centers after closure of the temporary hospitals in Mena and Arafat, 15 (10.7%) patients died, and one (0.7%) patient was ddischarged against medical advice. CONCLUSION: This study revealed information oo the pattern of diseases and the most common causes of admission of pilgrims to ICUs and the required medical services during Hajj. It is hoped that this information will be of help to health care planners and officials to provide optimal and cost effective health care services to pilgrims in Hajj.

Steady improvement of infection control services in six community hospitals in Makkah following annual audits during Hajj for four consecutive years.

BACKGROUND: The objective of this study was to evaluate the impact of annual review of the infection control practice in all Ministry of Health hospitals in the holy city of Makkah, Saudi Arabia, during the Hajj period of four lunar Islamic years, 1423 to 1426 corresponding to 2003 to 2006. METHODS: Audit of infection control service was conducted annually over a 10-day period in six community hospitals with bed capacities ranging from 140 to 557 beds. Data were collected on standardized checklists on various infection control service items during surprise visits to the medical, pediatric, surgical, and critical care units, and the kitchens. Percentage scores were calculated for audited items. The results of the audit for hospitals were confidentially sent to them within four weeks after the end of Hajj. RESULTS: Deficiencies observed in the first audit included lack of infection control committees, infection control units, infection control educational activities, and surveillance system and shortage of staff. These deficiencies were resolved in the subsequent audits. The average (range) scores of hospitals in 11 infection control items increased from 43% (20-67%) in the first audit to 78% (61-93%) in the fourth audit. CONCLUSION: Regular hospital infection control audits lead to significant improvement of infection control practice. There is a need to build a rigorous infection control audit into hospitals' ongoing monitoring and reporting to the Ministry of Health and to provide these hospitals with feed back on such audits to continuously strengthen the safety standards for patients, visitors, and employees.