Olive-Derived Triterpenes Suppress SARS COV-2 Main Protease: A Promising Scaffold for Future Therapeutics.

SARS CoV-2 pandemic is still considered a global health disaster, and newly emerged variants keep growing. A number of promising vaccines have been recently developed as a protective measure; however, cost-effective treatments are also of great importance to support this critical situation. Previously, betulinic acid has shown promising antiviral activity against SARS CoV via targeting its main protease. Herein, we investigated the inhibitory potential of this compound together with three other triterpene congeners (i.e., ursolic acid, maslinic acid, and betulin) derived from olive leaves against the viral main protease (Mpro) of the currently widespread SARS CoV-2. Interestingly, betulinic, ursolic, and maslinic acids showed significant inhibitory activity (IC50 = 3.22-14.55 µM), while betulin was far less active (IC50 = 89.67 µM). A comprehensive in-silico analysis (i.e., ensemble docking, molecular dynamic simulation, and binding-free energy calculation) was then performed to describe the binding mode of these compounds with the enzyme catalytic active site and determine the main essential structural features required for their inhibitory activity. Results presented in this communication indicated that this class of compounds could be considered as a promising lead scaffold for developing cost-effective anti-SARS CoV-2 therapeutics.

The Burden of Surgical Cancellations and No-Shows: Quality management study from a large regional hospital in Oman.

OBJECTIVES: The operating theatre (OT) is a vital facility that utilises a considerable portion of the hospital's budget; thus proper OT utilisation is essential. Surgical cancellation is a leading cause of OT underutilisation. This study aimed to report the rate and reasons for surgical cancellations and no-shows in a large regional hospital in Oman. METHODS: This study took place as part of a retrospective quality management project at the Ibri Regional Hospital, Ibri, Oman. All elective surgical procedures scheduled between January and December 2014 were included. Cancelled procedures were reviewed to determine the reasons for cancellation. RESULTS: A total of 4,814 elective procedures were scheduled during the study period; of these, 1,235 (26%) were cancelled. Patient no-shows were the most prevalent reason for surgical cancellation (63%), followed by surgical reasons (17%); in contrast, OT-associated reasons were responsible for only 2% of cancellations. According to speciality, general surgery had the highest percentage of total cancellations (65%), while ear, nose and throat had the highest rate of surgical cancellations among their scheduled cases (42%). CONCLUSION: Ibri Regional Hospital had a higher surgical cancellation rate due to no-shows than those reported in the literature. Regular audits, quality management projects and the appointment of a dedicated procedure booking coordinator may enhance proper utilisation of the OT, potentially saving funds, conserving resources and alleviating the burden of cancellations.