Umbelliferone inhibits spermatogenic defects and testicular injury in lead-intoxicated rats by suppressing oxidative stress and inflammation, and improving Nrf2/HO-1 signaling

© 2020 Alotaibi et al. Introduction: Lead (Pb) is an environmental toxic metal that threatens human health. Umbelliferone (UMB) is a coumarin with known medicinal and protective properties against cytotoxicity. This study explored the ameliorative effect of UMB against Pb-induced testicular toxicity in rats, focusing on steroidogenesis, oxidative stress and inflammation. Materials and Methods: Rats received lead acetate (50 mg/kg) and UMB (25, 50 or 100 mg/kg) via oral gavage for 4 weeks. Results: Pb-intoxicated rats exhibited testicular tissue injury and decreased serum levels of LH, FSH and testosterone. The count, viability, motility and normal morphology of the sperms were decreased accompanied with downregulated steroidogenesis markers in Pbinduced group. UMB prevented testicular injury, increased serum levels of LH, FSH and testosterone, upregulated steroidogenesis markers and improved the semen quality. In addition, UMB attenuated oxidative stress and oxidative DNA damage, downregulated the expression of pro-inflammatory mediators and Bax, boosted antioxidant defenses and Bcl2, and upregulated Nrf2/HO-1 signaling in Pb-intoxicated rats. Conclusion: UMB prevents Pb-induced testicular injury by suppressing oxidative damage, inflammation and cell death, and boosting antioxidant defenses, Nrf2/HO-1 signaling and pituitary-gonadal axis. Thus, UMB may represent a protective and cost-effective agent against Pb testicular toxicity, pending further investigations to elucidate other underlying mechanisms.Open Access funding provided by the Qatar National Library

Farnesol attenuates cadmium-induced kidney injury by mitigating oxidative stress, inflammation and necroptosis and upregulating cytoglobin and PPARγ in rats

Heavy metals are environmental pollutants that can harm animals and humans even at low concentrations. Cadmium (Cd) is known for its serious health effects on different organs and its toxicity is associated with oxidative stress (OS) and inflammation. Farnesol (FAR), a sesquiterpene alcohol found in many vegetables and fruits, possesses promising anti-inflammatory and antioxidant activities. This study evaluated the effect of FAR on Cd-induced kidney injury, pinpointing its effect of the redox status, inflammation, fibrosis and necroptosis. Rats in this study received FAR for 14 days and Cd on day 7. Elevated serum creatinine, urea and uric acid, and several kidney histopathological alterations were observed in Cd-administered rats. Cd increased MDA, decreased antioxidants, downregulated PPARγ and upregulated NF-κB p65, IL-6, TNF-α, and IL-1β. Necroptosis mediators (RIP1, RIP3, MLKL, and caspase-8) and α-SMA were upregulated, and collagen deposition was increased in Cd-administered rats. FAR ameliorated kidney injury markers and tissue damage, attenuated OS, suppressed NF-κB and inflammatory mediators, and enhanced antioxidants. In addition, FAR suppressed RIP1, RIP3, MLKL, caspase-8, and α-SMA, and enhanced kidney cytoglobin and PPARγ. In conclusion, FAR protects against Cd nephrotoxicity by suppressing OS, inflammatory response and necroptosis, effects associated with enhanced antioxidants, cytoglobin, and PPARγ

Social and Economic Factors that Influence Health Outcomes in Family Medicine

Over the last twenty years, the social determinants of health (SDOH) have gained more and more attention in the public health community. SDOH are non-medical elements that may be significantly impacted by social policies and have an impact on health. The increasing variety that exists within our societies makes it absolutely necessary for us to incorporate into undergraduate medical education social determinants of health such as racial factors, financial instability, partner violence, insufficient accessibility to transportation, and inadequate social supports, as well as the crucial role of health education.  Nonetheless, a growing body of research indicates that a variety of health outcomes are fundamentally caused by socioeconomic variables including wealth, income, and education together. In this review we highlight the influence of socio-economic factors on health outcomes, approaches to incorporate social determinants of health in family medicine practice, and we also talk about challenges and solutions in addressing social determinants in family medicine. The objective of this research was to assess the impact of social determinants of health on family medicine practice in which socioeconomic determinants of health might have an effect on health outcomes and healthcare delivery within the context of a family medicine clinical environment

Evaluating The Application Of Infection Control Standards In Health Facilities In Mecca

The study aims to determine the seriousness or continuity of applying infection control standards in health facilities, and the extent of the importance of applying them to workers in health facilities even after health centers have obtained the accreditation certificate for quality standards in health facilities (CBAHI) for more than 6 years. The questionnaire was distributed electronically via social media, in order to prevent crowding and avoid the spread of the Coronavirus-19. 700 questionnaires were distributed to employees who work in health facilities, and only 680 questionnaires were answered

Patient Experience with Quality of Health Care Perception to Patient Satisfaction in Saudi Arabian Cross-Sectional Study 2022

Background Globally, unsafe medical practices cause injury, disability, and death to millions of patients annually. Patient safety has gained wider recognition over the past decade, and the involvement of patients in the prevention or reduction of adverse events and harm has shown potential benefits. The World Health Organization (WHO) defines patient safety as ‘the prevention of errors and adverse effects on patients associated with healthcare’ and ‘to do no harm to patients’. Patients can provide diverse perspectives on adverse events, and their observations play a crucial role in the planning and delivery of safe and effective healthcare. Based on patient-reported information, effective strategies can be implemented to make healthcare systems safer for patients. However, most studies on patient-reported safety incidents have been conducted in hospital settings, with little attention paid to primary healthcare (PHC).  . Aim of the study: To assess  Patient experience with quality of health care perception to patient satisfaction in Saudi Arabian 2022 Method: cross-sectional study to determine the relationship between quality of health care  system  on the quality of services providing in primary healthcare center and the satisfaction of Saudi patient .The study was conducted at primary healthcare centers in the Saudi . Total of 200 eligible patients participated in this study .  Results: factors entered the regression model of total attitude were: Socio demographic variables (Age, gender, occupation, education, marital status, family income) and total satisfaction level And 6 out of 7 factors had predicted total attitude of the: (Age, gender, occupation, education, marital status, family income).The 6 factors together explained 12.5 % of the variation of the total attitude score of the studied patients towards primary health care services. Female, single, being older, low educational level and students, low family Income had higher total attitude score Conclusion. This review exemplifies the need for further improvement in the quality of healthcare in primary health care in KSA and patient satisfaction was influenced by health service quality. Many of the problems identified in this review could be addressed by establishing an independent body in KSA, which could monitor healthcare services and push for improvements in efficiency and quality of care

Diallyl Disulfide Mitigates Cadmium Hepatotoxicity by Attenuating Oxidative Stress and TLR-4/NF-κB Signaling and Upregulating PPARγ

Background: Heavy metals can cause serious health problems that affect different organs. Cadmium (Cd) is an environmental contaminant known for its toxicological consequences on different organs. Hepatotoxicity is a serious effect of exposure to Cd with oxidative stress (OS) and inflammation playing a central role. Diallyl disulfide (DADS), an organo-sulfur compound found in garlic, is known for its cytoprotective and antioxidant effects. In this study, the effect of DADS on Cd-induced inflammation, oxidative stress and liver injury was investigated. Methods: DADS was supplemented for 14 days via oral gavage, and a single intraperitoneal dose of Cd (1.2 mg/kg body weight) was administered to rats on day 7. Blood and liver samples were collected at the end of the experiment for analyses. Results: Cd administration resulted in remarkable hepatic dysfunction, degenerative changes, necrosis, infiltration of inflammatory cells, collagen deposition and other histopathological alterations. Cd increased liver malondialdehyde (MDA) and nitric oxide (NO) (p < 0.001), upregulated toll-like receptor (TLR)-4, nuclear factor-kappaB (NF-κB), pro-inflammatory mediators, and caspase-3 (p < 0.001) whereas decreased glutathione (GSH) and antioxidant enzymes (p < 0.001). Cd downregulated peroxisome proliferator activated receptor gamma (PPARγ), a transcription factor involved in inflammation and OS suppression (p < 0.001). DADS ameliorated liver injury and tissue alterations, attenuated OS and apoptosis, suppressed TLR-4/NF-κB signaling, and enhanced antioxidants. In addition, DADS upregulated PPARγ in the liver of Cd-administered rats. Conclusions: DADS is effective against Cd-induced hepatotoxicity and its beneficial effects are linked to suppression of inflammation, OS and apoptosis and upregulation of PPARγ. DADS could be valuable to protect the liver in individuals at risk of Cd exposure, pending further studies to elucidate other underlying mechanism(s)

Clinical and biochemical characteristics of people experiencing post-coronavirus disease 2019-related symptoms: A prospective follow-up investigation

BackgroundPost-acute coronavirus disease 2019 (COVID-19) syndrome, also known as long COVID, is a prolonged illness after the acute phase of COVID-19. Hospitalized patients were known to have persisting symptoms of fatigue, headache, dyspnea, and anosmia. There is a need to describe the characteristics of individuals with post-COVID-19 symptoms in comparison to the baseline characteristics.PurposeTo investigate the clinical and biochemical characteristics of people who recovered from COVID-19 after 6 months of discharge from the hospital.MethodsThis was a prospective follow-up investigation of hospitalized and discharged COVID-19 patients. Adult patients admitted to King Saud University Medical City, Riyadh, Saudi Arabia, with laboratory-confirmed COVID-19 and discharged were recruited. The baseline demographic information, comorbidities, vital signs and symptoms, laboratory parameters, COVID-19 therapy, and outcomes were collected from the medical records. Blood samples were collected for cytokines estimation. A detailed interview about signs and symptoms was undertaken during the follow-up.ResultsHalf of the followed-up people reported experiencing at least one of the COVID-19-related symptoms. The mean blood pressure was found higher in follow-up. People with the symptoms were characterized by low lymphocyte count, lower serum calcium levels, and hyperglycemia compared to people without any post-COVID-19 symptoms. Cytokines IL-8, VEGF, and MCP-1 were higher in people with the most frequent symptoms.ConclusionPeople with post-COVID-19 symptoms were characterized by lower lymphocyte count, lower serum calcium levels, and hyperglycemia compared to people without symptoms. Individuals with the most frequent post-COVID-19 symptoms had higher baseline pro-inflammatory, chemotactic, and angiogenic cytokines

The socioeconomic burden of spinal muscular atrophy in Saudi Arabia: a cross-sectional pilot study

BackgroundSpinal muscular atrophy (SMA) is a rare debilitating condition with a significant burden for patients and society. However, little is known about how it affects Saudi Arabia's population. The socioeconomic and medical characteristics of affected SMA patients and their caregivers are lacking.PurposeThis study aimed to describe the socioeconomic and medical characteristics of SMA patients and caregivers in Saudi Arabia.Patients and methodsA cross-sectional questionnaire-based study was conducted using snowball sampling. Assessment tools including EuroQol (EQ-5D-5L) and visual analog scale (EQ-VAS), Generalized Anxiety Disorder 7-item (GAD-7), Patient Health Questionnaire (PHQ-9), and Costs for Patients Questionnaire (CoPaQ) were used to assess the quality of life (QoL), anxiety, depression, and out-of-pocket expenditures.ResultsSixty-four caregivers of SMA patients participated. Type I patients had higher sibling concordance, ICU hospitalization, and mechanical support needs. Type III patients had better QoL. Type I patients' caregivers had higher depression scores. Type III patients' caregivers had higher out-of-pocket expenditures. Forty-eight percent received supportive care, while others received SMA approved therapies.ConclusionSMA imposes a significant socioeconomic burden on patients and caregivers, requiring more attention from the healthcare system. Access to innovative therapies varied across SMA types. Pre-marital screening and early detection are crucial to reduce disease incidence and ensure timely treatment

Role of Nemolizumab and Omalizumab in management of atopic dermatitis: A review

BackgroundNemolizumab (CIM331) is a monoclonal antibody that binds the IL-31 receptor α component. This inhibits IL-31 from acting on neurons that constrains the initialization of the sense of pruritus in cases of atopic dermatitis.AimsTo summarize the results of reported studies evaluating the role of nemolizumab and omalizumab in management of atopic dermatitis.Methods This is a systematic review was carried out, including PubMed, Google Scholar, and EBSCO that examining randomized controlled trials, observational, and experimental studies which study role of nemolizumab in management of atopic dermatitis.Results The review included 8 randomized studies reported efficacy of both nemolizumab and omalizumab for management of atopic dermatitis.ConclusionOther studies with large numbers of patients with AD are necessary to define the adverse effects of both drugs in the treatment of AD

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020