Antibacterial Activities of Yansoon (Pimpinella anisum L.), Ginger (Zingiber officinale L.) and Cinnamon (Cinnamomum zeylanicum L.) Extracts

There is an increasing demand for the biologically active substances from plant origin which is of current interest and focus for new research approach. The synthetic pharmaceuticals compounds showed various side effects on functions of different parts of the human body, both internally and externally. Therefore, the present study was investigating the antimicrobial activity of three important herbs, Ginger (Zingiber officinale L.), Yansoon (Pimpinella anisum L.) and Cinnamon (Cinnamomum zeylanicum L.). The cup- plate agar (inhibition zone) method was used for studying the effects of the extracts against Streptococcus sp, Staphylococcus aureus and  Enterococcus faecalis. The results showed that, the ethanol extracts of cinnamon and the combination of ginger and cinnamon were highly effective on Streptococcus sp (24mm and 21mm, respectively), compared to the water extracts (15mm and16mm, respectively). However, the water and the ethanol extracts of ginger and yansoon were less effective (11mm, 9mm, 8.5mm and 8mm, respectively). The ethanol extracts of cinnamon and the combination of ginger and cinnamon were highly effective on Staphylococcus aureus giving (24mm and 21.5 mm, respectively) followed by water extract (20mm and 21 mm, respectively). While, the ethanol and water extracts of ginger and yansoon were less effective (11mm, 10.5mm, 9mm and 9.5mm, respectively). The ethanol and water extracts of cinnamon were highly effective on E. faecalis giving (21mm and 20.5 mm, respectively). The ethanol extracts of the combination of ginger and cinnamon were effective (20 mm) followed by water extract (18mm). The water and ethanol extracts of ginger and yansoon were less effective giving (15 mm, 12 mm, 8 mm and 9 mm, respectively). From the results it could be concluded that, the extracts of (Cinnamon, Yansoon and Ginger) can be used as antimicrobial agents. It could be suggested that the active antimicrobial components need to be verified in any further study and more microorganism are to be tested                                                                                          . &nbsp

Detection of FXIII gene V34L and fibrinogen β-gene -455G/A polymorphisms among Saudi Arabia population via polymerase chain reaction-reverse hybridization technique

FXIII gene Val34Leu variant appears to be associated with decreased risk of myocardial infarction and venous thromboembolism as well as with increased risk of intracerebral hemorrhage. Fibrinogen β-gene SNP -455G/A are associated with differences in the plasma levels of fibrinogen and severity of arterial disease. The aim of the present work was to study the prevalence of FXIII gene V34L and Fibrinogen β-gene -455G/A SNPs in Saudi population. Among 200 blood samples randomly collected from unrelated healthy Saudi subjects, FXIII gene V34L and Fibrinogen β-gene -455G/A SNPs were genotyped via cardiovascular disease (CVD) StripAssay (ViennaLab, Austria. Homozygous (V/V) and heterozygous (V/L) genotypes were detected with 96 and 4%, respectively, among FXIII gene V34L genotypes, whereas (L/L) genotype was not found. The allele frequency was 0.98 for V allele and 0.02 for L allele. Three genotypes of Fibrinogen β-gene -455G/A SNP (GG, GA and AA) were obtained and its prevalence (%) was 70, 25 and 5, respectively. The frequency of G allele was 0.825 and 0.175 for A allele. Prevalence of FXIII gene Vl34L polymorphism and its allele frequency are in line with other Asian populations. Distribution of β-gene -455G/A genotypes and allele frequency are in accordance with previous reports in different ethnic groups. This is the first time to report these polymorphisms in Saudi Arabia population. This study provides valuable information on Saudi genetic background in comparison with other populations. In addition, it serves as a template for future clinical research involving cardiovascular and cerebrovascular diseases.Key words: FXIII gene V34L, fibrinogen β-gene -455G/A, polymorphisms, Saudi Arabia

Association between polymorphisms of SLC6A3 and DRD1 genes and autism among Saudi Arabia Taif population using PCR-restriction fragment length polymorphism (PCR- RFLP)

The prevalence of autism in Saudi Arabia is 18 per 10,000, higher than the 13 per 10,000 reported in developed  countries. The etiology of autism is still not completely understood. Different studies support the involvement  of dopaminergic neurotransmitter system in the etiology of autism. Several lines of evidences suggest the role of some dopamine related genes, such as DRD1 and SLC6A3 in the etiology of autism. The aim of the present  work was to study the possible role of rs2550936 A/C polymorphism at SLC6A3 locus as well as rs4532 A/G  polymorphism at DRD1 locus in the etiology of autism among Saudi population. The polymorphisms of DRD1  and LC6A3 were genotyped in the case-control study using polymerase chain reaction-restriction fragment  length polymorphism (PCR-RFLP) technique. Significant association as risk factor was found between autism  and GA genotype of DRD1 [OR = 3.5 CI (1.04, 12.41*)] as well as CA genotype of SLC6A3 [OR = 2.53 CI  (1.03, 6.26*)], while CC genotype of SLC6A3 revealed protective effect. In conclusion, possible risk  genotypes  for autism in the DRD1 and SLC6A3 genes were observed. This is the first report in Saudi Arabia  population and Arab world. Therefore further investigations of these markers and other SNPs of SLC6A3 and  DRD1 genes are considered in large replication samples with other causal factors to enable positive  identification of risk genotypes and generalize obtained results.Key words: Etiology, polymorphism, autism, genotype

Quantifying risks and interventions that have affected the burden of diarrhoea among children younger than 5 years : an analysis of the Global Burden of Disease Study 2017

Background Many countries have shown marked declines in diarrhoea! disease mortality among children younger than 5 years. With this analysis, we provide updated results on diarrhoeal disease mortality among children younger than 5 years from the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017) and use the study's comparative risk assessment to quantify trends and effects of risk factors, interventions, and broader sociodemographic development on mortality changes in 195 countries and territories from 1990 to 2017. Methods This analysis for GBD 2017 had three main components. Diarrhoea mortality was modelled using vital registration data, demographic surveillance data, and verbal autopsy data in a predictive, Bayesian, ensemble modelling tool; and the attribution of risk factors and interventions for diarrhoea were modelled in a counterfactual framework that combines modelled population-level prevalence of the exposure to each risk or intervention with the relative risk of diarrhoea given exposure to that factor. We assessed the relative and absolute change in diarrhoea mortality rate between 1990 and 2017, and used the change in risk factor exposure and sociodemographic status to explain differences in the trends of diarrhoea mortality among children younger than 5 years. Findings Diarrhoea was responsible for an estimated 533 768 deaths (95% uncertainty interval 477 162-593 145) among children younger than 5 years globally in 2017, a rate of 78.4 deaths (70.1-87.1) per 100 000 children. The diarrhoea mortality rate ranged between countries by over 685 deaths per 100 000 children. Diarrhoea mortality per 100 000 globally decreased by 69.6% (63.1-74.6) between 1990 and 2017. Among the risk factors considered in this study, those responsible for the largest declines in the diarrhoea mortality rate were reduction in exposure to unsafe sanitation (13.3% decrease, 11.2-15.5), childhood wasting (9.9% decrease, 9.6-10.2), and low use of oral rehydration solution (6.9% decrease, 4-8-8-4). Interpretation Diarrhoea mortality has declined substantially since 1990, although there are variations by country. Improvements in sociodemographic indicators might explain some of these trends, but changes in exposure to risk factors-particularly unsafe sanitation, childhood growth failure, and low use of oral rehydration solution-appear to be related to the relative and absolute rates of decline in diarrhoea mortality. Although the most effective interventions might vary by country or region, identifying and scaling up the interventions aimed at preventing and protecting against diarrhoea that have already reduced diarrhoea mortality could further avert many thousands of deaths due to this illness. Copyright (C) 2019 The Author(s). Published by Elsevier Ltd.Peer reviewe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Can real-time ultrasound elastography using the color score and strain ratio differentiate between benign and malignant solitary thyroid nodules?

Background: Solitary thyroid nodule may represent a multitude of thyroid disorders; therefore, detection of whether these nodules are benign or malignant is crucial for patient’s triage. Objective: To evaluate the diagnostic performance of the latest generation of real-time ultrasound elastography (USE) in differentiation between benign and malignant solitary thyroid nodules. Materials and methods: Thirty consecutive patients who were referred for surgical treatment were prospectively examined by real-time USE. Tissue stiffness on real-time USE was determined with light compression using the standard elastography color scoring system according to Rago criteria ranging from 1 (low stiffness over the entire nodule) to 5 (high stiffness over the entire nodule and surrounding tissue). The strain ratio (normal tissue to lesion strain ratio) was calculated. The histopathological examination of these resected nodules was used as the diagnostic standard of reference. Results: Scores of 1 and 2 with Rago criteria were highly significant seen in benign nodules, whereas, scores of 4 and 5 with Rago criteria were highly significant seen in malignant nodules (p < 0.001) with a sensitivity, specificity and diagnostic accuracy of 78.6%, 78.9% and 78.8% respectively. Additionally, the best strain ratio cut-off value for discrimination between benign and malignant nodules by using receiver operating characteristic analysis was 2.20 (area under the curve of 0.861; p value <0.001) with a consequential sensitivity, specificity and diagnostic accuracy of 85.7%, 90.5% and 88.6% respectively. Conclusion: Both the color score and the strain ratio are higher in malignant solitary thyroid nodules than those in benign ones. Consequently, real-time USE can be used for the differentiation of benign and malignant solitary thyroid nodules. Eventually, this reduces the number of superfluous surgical procedures on benign thyroid nodules

Uterine CD56dim and CD16+ Cells in Refractory Antiphospholipid Antibody-Related Pregnancy Loss and Chromosomally Intact Abortuses: A Case–Control Study

Aim: To evaluate the role of uterine natural killer (uNK) CD56dim and CD16+ cells in patients with refractory antiphospholipid, antibody-mediated, recurrent, pregnancy loss. Settings and Design: A case–control study was conducted between 2012 and 2015 at a university hospital. Patients and Methods: A group of 118 women with a history of antiphospholipid antibody syndrome experiencing fetal loss in spite of low dose aspirin (LDA) and low molecular weight heparin (LMWH) treatment in the current pregnancy were included in this study. A group of 32 patients undergoing an elective termination of viable pregnancies before 20 weeks were taken as controls. Suction evacuation was performed to collect abortus specimens, and uterine wall curettage was performed to collect decidua specimens, which were then stained using monoclonal antibodies specific to CD56 and CD16. Statistics: Statistical analyses were performed using the Statistical Package for the Social Sciences version 18 software. Chi-square and Fisher exact tests were used for making comparison between the groups. Results: Abnormal fetal karyotype was found in nine (9/97) cases of the study group, which means that abnormal karyotype accounts for only 9.3% of the causes of failure of treatment. Abnormal karyotype was found in four cases of the control group. Only cases with normal karyotyping were subjected to decidual uNK cells analysis. We found that CD56dim and CD16+ were found in the decidua of 79 cases (79/97), which means that aberrant natural killer cells expression might account for 81.4% of the cases of refractory antiphospholipid antibody (APA)-mediated recurrent pregnancy loss. Conclusion: CD56dim and CD16+uNK cells might be correlated with refractory APA-mediated recurrent pregnancy loss