Patient perceptions and preferences of physicians’ attire in Saudi primary healthcare setting

Background: Since the time of Hippocrates, dress of the care-giver has been known to influence patient’s perception about the physician. Objectives: To explore patient’s preference about physician’s dress in Saudi primary healthcare, and how it influences their perception, regarding professionalism, competence, and confidence in the physician. Methods: A cross sectional study conducted in primary care clinics in Riyadh, enrolling 443 patients, who filled a self-administered Arabic questionnaire, enquiring about physician clothes such as white coat, scrubs and ‘thob (white-robe) shomagh (head cover)’ for males, ‘veil-skirt’ for females, and shoes. Patients’ preferences about physicians’ dresses were explored and influence of favorable dress on professionalism and trustworthiness were explored, using Chi-sq, Mann Whitney, with p ≤ .05 as significant. Principle component analysis was used to search themes in attire commonly used. Results: Over 80% of patients visiting Saudi primary care, liked seeing their physician in white coat. Traditional dress ‘thob and shomagh’ was approved by 47% whereas ‘veil and skirt’ got acceptance of 62%. Dress of physician was significantly (p < .005) more important to patients, who were male (Chi-sq 14.95), working (Chi-sq 9.39), educated (Chi-sq 9.84), urbanites (Chi-sq 18.34) and married (Chi-sq 7.89). Patients who valued physician attire (70%) perceived it positively influencing doctor-patient relationship: Mann Whitney U score = 6879, p-value <0.001. Four dress-themes emerged: ‘Professional modest’, ‘Expensive modern’, ‘Traditional formal’ and ‘Casual shoes’. Conclusion: Patients preferred white coats for their doctors. Half of participants accepted traditional dresses. Majority valued physician’s attire as a positive influence

Prophylactic influences of prebiotics on gut microbiome and immune response of heat-stressed broiler chickens

Abstract Climatic changes and elevated ambient temperature are significant environmental stressors with a negative impact on birds’ physiological, immunological, and behavioral status, increasing their susceptibility to stressors and immunosuppression and consequently increasing intestinal permeability (leaky gut). Prebiotics have been utilized to stop or diminish the harmful effects of stress in chickens. We aimed to evaluate the role of mannan-oligosaccharides, and beta-d-glucan prebiotics supplements in drinking water against experimentally induced heat stress (HS) on broiler chickens and study their impact on birds’ performance, gut microbiome, and immune response. A total of 120 1-day-old Ross broiler chicks were allocated into four groups (30 birds/group), and each group was subdivided into triplicates (10 birds each). The experimental groups were classified as follows; the 1st (G1) control birds, the 2nd (G2) birds exposed experimentally to HS, the 3rd (G3) birds administered prebiotics in drinking water without exposure to HS, and the 4th (G4) birds exposed to HS and administered prebiotics in drinking water. After each vaccination, blood samples and serum samples were collected to evaluate the birds’ immune status. Fecal samples were also collected for the molecular evaluation of the gut microbiome based on the genetic analyses and sequencing of 16S rRNA gene. The results showed that HS has reduced the birds’ performance and badly affected the birds’ immune response and gut microbiome. However, the addition of prebiotics to drinking water, with or without stress, enhanced the growth rate, maintained a normal gut microbiome, and improved immune parameters. Moreover, the usage of prebiotics improved the chicken gut microbiome and alleviated the negative effect of heat stress. Administering prebiotics significantly (p < 0.05) increased the relative abundance of beneficial bacteria and eradicated pathogenic ones in the birds’ gut microbiome. Prebiotics showed a positive effect on the gut microbiome and the immune status of chickens under HS in addition to their efficacy as a growth promoter

Phenotypic and Genotypic Characteristics of Antimicrobial Resistance of Gram-negative Bacteria isolated From Pet Animal

Most animal feeds are set from protein-rich raw materials. These protein constituents may possess various hazards, particularly highly drug-resistant pathogens, causing a bad impact not only on the pet's health, but also on their owners. In the current study, a total of 2100 pet food and 100 pets’ fecal swabs were collected and bacteriologically examined from 2017 to 2020. It was revealed that the percentage of Gram-negative bacteria isolated from pet food and fecal swabs was 49% and 56% respectively. E. coli, Proteus sp., and K. pneumoniae were the most isolated bacteria in percentages of 12.4%, 8.4%, and 4.9% respectively from Pet food and 25%, 7%, 12% respectively from pet fecal swabs. In addition, Enterobacter cloacae, P. aeruginosa, Aeromonas hydrophila, Citrobacter sp., P. fluorecens, and Y. enterocolitica were isolated from pet food in order to 3.8%, 3.5%, 3.2%, 2.6%, 2.6% and 2.1% respectively. Salmonella sp. isolated from pet food was 0.6% while it was 5% from pet fecal swabs. The most predominant salmonella serotype isolated from pet food and pet fecal swabs was S. Typhimurium. Furthermore, S. Virchow, S. Anatum, S. Kentucky, S. Kedougou and S. Infantis were isolated serotypes from Pet food in percentages of 15.7%, 23.1%, 15.4%, 7.7%, and 7.7% respectively. While S. Nitra, S. Ibargi, S. Enteritidis and S. Boecker were isolated from pet fecal swabs at a percentage of 20% for each. On the other hand, O158 was the most predominant E. coli serogroup isolated from pet food and pet fecal swabs in percentages of 30.4% and 30.8% respectively followed by O157 in percentages of 21.7% and 26.9% respectively. O26 was isolated from pet food and pet fecal swabs in percentages of 13% and 7.7% for each. O119 was isolated from pet food and pet fecal swabs in percentages of 4.3% and 3.8% respectively. O86, O27, O44, O55, and O78 were isolated from pet food in the percentage of 4.3%, 8.7%, 4.3%, 4.3%, and 8.7%respectively. While O114, O111, and O125 were isolated serotypes from pet fecal swabs in percentages of 15.4%, 3.8%, and 11.5% respectively. This study revealed that the antimicrobial sensitivity test of 80% of Salmonellae were resistant to Cefotaxime and Colistin sulphate while 50%, 30, and 20% of isolates were resistant to Gentamicin, Tetracycline, and Cefepime respectively, while 40% of Salmonellae were resistant to Chloramphenicol, Enrofloxacin, and Amoxicillin-clavulanate. Also 60% of Salmonellae showed resistance to Trimethoprim sulfamethoxazole and Ciprofloxacin. Detection of Extended-spectrum ß-lactamase resistance genes (blaTEM, blaSHV, and blaCTX-M) in Pets using Polymerase chain reaction (PCR) showed the presence of blaTEM and blaSHV genes in all tested isolates in 12 samples out of 12 (100%) and has shown that the ratio of blaCTX-M is 5 out of 12samples (41.6 %)

Origin and Global Expansion of Complex Lineage 3.

complex (MTBC) Lineage 3 (L3) strains are abundant in world regions with the highest tuberculosis burden. To investigate the population structure and the global diversity of this major lineage, we analyzed a dataset comprising 2682 L3 strains from 38 countries over 5 continents, by employing 24-loci mycobacterial interspersed repetitive unit-variable number of tandem repeats genotyping (MIRU-VNTR) and drug susceptibility testing. We further combined whole-genome sequencing (WGS) and phylogeographic analysis for 373 strains representing the global L3 genetic diversity. Ancestral state reconstruction confirmed that the origin of L3 strains is located in Southern Asia and further revealed multiple independent introduction events into North-East and East Africa. This study provides a systematic understanding of the global diversity of L3 strains and reports phylogenetic variations that could inform clinical trials which evaluate the effectivity of new drugs/regimens or vaccine candidates