Assessment of Indoor Air Quality in Neonatal Intensive Care Units in Government Hospitals in Gaza Strip- Palestine

This study was conducted to assess indoor air quality (IAQ) in three neonatal intensive care units (NICUs), which were chosen to geographically represent the Gaza strip. The study collected both: objective temperature and air quality measures ofcarbon dioxide (CO2), carbon monoxide (CO), temperature, relative humidity (RH%) and suspended particles (PM10, PM2.5); and clinical staff perceptions of indoor air quality and its impact. The study conducted daily air quality measurements between 4 March until 22 March 2013, and gathered 108 questionnaires. The study showed that the average concentrations of carbon dioxide were often close to the maximum standard of the United States Environmental Protection Agency, and sometimes exceed the limit, especially in the NICU of Shifa Hospital. Temperature fell within normal ranges, but approached recommended limits at Shifa Hospital. Carbon monoxide and suspended particle concentrations and relative humidity were within the standards recommended by the Environmental Protection Agency in all three NICUs. More than half of the clinical staff (60%) suffered from sick building syndrome, 83% suffer from tiredness and fatigue, and 76% suffer from headache. Nearly 85% believe that these symptoms are related to their workplace, and 71% report disappearance of the symptoms after they leave work. We conclude that indoor air quality merits more attention from the Ministry of Health, and that NICU staff be engaged around issues of environmental health.This study was conducted to assess indoor air quality (IAQ) in three neonatal intensive care units (NICUs), which were chosen to geographically represent the Gaza strip. The study collected both: objective temperature and air quality measures ofcarbon dioxide (CO2), carbon monoxide (CO), temperature, relative humidity (RH%) and suspended particles (PM10, PM2.5); and clinical staff perceptions of indoor air quality and its impact. The study conducted daily air quality measurements between 4 March until 22 March 2013, and gathered 108 questionnaires. The study showed that the average concentrations of carbon dioxide were often close to the maximum standard of the United States Environmental Protection Agency, and sometimes exceed the limit, especially in the NICU of Shifa Hospital. Temperature fell within normal ranges, but approached recommended limits at Shifa Hospital. Carbon monoxide and suspended particle concentrations and relative humidity were within the standards recommended by the Environmental Protection Agency in all three NICUs. More than half of the clinical staff (60%) suffered from sick building syndrome, 83% suffer from tiredness and fatigue, and 76% suffer from headache. Nearly 85% believe that these symptoms are related to their workplace, and 71% report disappearance of the symptoms after they leave work. We conclude that indoor air quality merits more attention from the Ministry of Health, and that NICU staff be engaged around issues of environmental health

Simplified HPLC method for identification of gingerol and mangiferin in herbal extracts

Quantification of bioactive compounds through modern analytical techniques is essential for proving authenticity, credibility, and safe use of herbal products in Ayurvedic medicine. In this study, we describe the development of a simplified method for the identification of key bioactive compounds in six commercial herbal products of various forms using High Performance Liquid Chromatography (HPLC). Marker compounds such as mangiferin 1 and [6]-gingerol 2 were examined in various extracts of mango leaves and ginger, respectively. The compounds were extracted by sonication with methanol at room temperature and were analyzed by HPLC with 0.1% acetic acid buffer (pH = 3.00)/methanol mixture used as gradient mobile phase. Eluents were monitored by a photo diode array (PDA) detector and UV detection fixed at 280/320 nm. Further characterization of each extract was performed using FTIR and UV-Vis. Mangiferin 1 eluted at 6 min (320 nm) and gingerol 2 at 16.9 min (280 nm). The proposed method provides a good resolution of the selected marker compounds in herbal products and dietary supplements that could be further used for their quantification and standardization in routine analysis and quality control. © EuroJournals Publishing, Inc. 2011

Post-traumatic stress disorder among health care providers two years following the Israeli attacks against Gaza Strip in August 2014: Another call for policy intervention

This study aimed to assess the level of posttraumatic stress disorder and to examine the relationship between exposure to war stress and posttraumatic symptoms among health care providers two years following Israeli offensives against Gaza Strip in 2014. Methodology: A cross-sectional design was used for this study. We targeted all nurses and doctors working in three governmental hospitals in the Gaza Strip who worked with victims of the 2014 war, more specifically, those who were working in emergency departments, intensive care units, operating rooms, surgical departments, and burn units. A demographic sheet and Impact Event Scale-Revised were used in this study. The Impact Event Scale-Revised has three sub-scales; intrusion, avoidance, and hyper-arousal. Results: The results showed that 291 (89.3%) out of 2444 participants had scores more than 35 (threshold cut-off point) on Impact Event Scale-Revised. Scores ranged from eight to 80 with a mean of 52.71. Females had higher levels of stress (55.33) than males (50.82) and nurses (52.67) had more stress than physicians (47.38). The most frequent symptoms of trauma subscales was “Intrusion” (mean=19.99), followed by “Avoidance” (mean=17.60), and then “Hyper-arousal” (mean=14.12). Level of trauma symptoms were not affected by place of living, hospital of work, while level of education had impacted level of trauma. Conclusion: The findings showed that health care providers still suffer from severe posttraumatic symptoms two years after exposure to a prolonged war stress. This level of trauma among health care providers warrants intervention programs to reduce stress and trauma among Gaza health care providers after the war.This study aimed to assess the level of posttraumatic stress disorder and to examine the relationship between exposure to war stress and posttraumatic symptoms among health care providers two years following Israeli offensives against Gaza Strip in 2014. Methodology: A cross-sectional design was used for this study. We targeted all nurses and doctors working in three governmental hospitals in the Gaza Strip who worked with victims of the 2014 war, more specifically, those who were working in emergency departments, intensive care units, operating rooms, surgical departments, and burn units. A demographic sheet and Impact Event Scale-Revised were used in this study. The Impact Event Scale-Revised has three sub-scales; intrusion, avoidance, and hyper-arousal. Results: The results showed that 291 (89.3%) out of 2444 participants had scores more than 35 (threshold cut-off point) on Impact Event Scale-Revised. Scores ranged from eight to 80 with a mean of 52.71. Females had higher levels of stress (55.33) than males (50.82) and nurses (52.67) had more stress than physicians (47.38). The most frequent symptoms of trauma subscales was “Intrusion” (mean=19.99), followed by “Avoidance” (mean=17.60), and then “Hyper-arousal” (mean=14.12). Level of trauma symptoms were not affected by place of living, hospital of work, while level of education had impacted level of trauma. Conclusion: The findings showed that health care providers still suffer from severe posttraumatic symptoms two years after exposure to a prolonged war stress. This level of trauma among health care providers warrants intervention programs to reduce stress and trauma among Gaza health care providers after the war

METHOD DEVELOPMENT AND VALIDATION OF THE CHROMATOGRAPHIC ANALYSIS OF FLUTICASONE PROPIONATE AND SALMETEROL XINAFOATE COMBINATION IN SOLUTIONS AND HUMAN PLASMA USING HPLC WITH UV DETECTION

Objective: A simple, Rapid, and sensitive HPLC method utilizing UV detection was developed and validated for the simultaneous estimation of Fluticasone propionate (FP) and Salmeterol xinafoate (SX) in solutions and in vitro human plasma. Methods: Chromatographic analysis was done on SUPELCO® RP-C18 column (150 x 4.6 mm, 5 μm particle size) with an isocratic mobile phase composed of methanol, acetonitrile, and water (50:20:30, v/v) mixture while flow rate was set to 1 ml/min. Detection with UV at maximum absorbance wavelength (ʎmax) values of 236 and 252 for FP and SX, respectively. Spiked plasma samples were liquid-liquid extracted by diethyl ether and reconstituted using methanol. Results: Method was accurate and precise over a linear (R2>0.995) range of (0.067-100 µg/ml) and (0.0333-50 µg/ml) for FP and SX, respectively. LOD/lOQ values were 0.13/0.6 and 0.06/0.3 µg/ml for FP and SX, respectively. The developed method was successfully applied for the analysis of FP and SX in spiked human plasma samples. The method is considered to be accurate and precise over a linear (R2>0.9969) range of (6.67-66.67 µg/ml) and (3.33-33.3 µg/ml) for FP and SX, respectively. Extraction efficiency was approved by recovery values of (94.98–102.46 %) and (96.54–102.62 %) for FP and SX, respectively. Conclusion: This validated method revealed simple and cheap extraction procedures and detectors, non-buffered mobile phase, and short retention times with excellent resolution

Constitutively Active Canonical NF-κB Pathway Induces Severe Bone Loss in Mice

Physiologic osteoclastogenesis entails activation of multiple signal transduction pathways distal to the cell membrane receptor RANK. However, atypical osteoclastogenesis driven by pro-inflammatory stimuli has been described. We have reported recently a novel mechanism whereby endogenous mutational activation of the classical NF-κB pathway is sufficient to induce RANKL/RANK-independent osteoclastogenesis. Here we investigate the physiologic relevance of this phenomenon in vivo. Using a knock-in approach, the active form of IKK2, namely IKK2SSEE, was introduced into the myeloid lineage with the aid of CD11b-cre mice. Phenotypic assessment revealed that expression of IKK2SSEE in the myeloid compartment induced significant bone loss in vivo. This observation was supported by a dramatic increase in the number and size of osteoclasts in trabecular regions, elevated levels of circulating TRACP-5b, and reduced bone volume. Mechanistically, we observed that IKK2SSEE induced high expression of not only p65 but also p52 and RelB; the latter two molecules are considered exclusive members of the alternative NF-κB pathway. Intriguingly, RelB and P52 were both required to mediate the osteoclastogenic effect of IKK2SSEE and co-expression of these two proteins was sufficient to recapitulate osteoclastogenesis in the absence of RANKL or IKK2SSEE. Furthermore, we found that NF-κB2/p100 is a potent inhibitor of IKK2SSEE-induced osteoclastogenesis. Deletion of p52 enabled more robust osteoclast formation by the active kinase. In summary, molecular activation of IKK2 may play a role in conditions of pathologic bone destruction, which may be refractory to therapeutic interventions targeting the proximal RANKL/RANK signal

GC/MS and LC-MS/MS phytochemical evaluation of the essential oil and selected secondary metabolites of Ajuga orientalis from Jordan and its antioxidant activity

The current investigation aimed to shed light in the volatile and non-volatile secondary metabolites of Ajuga orientalis L. from Jordan. GC/MS and GC/FID analysis of the hydrodistilled essential oil obtained from aerial parts of the plant revealed tiglic acid (18.90 %) as main constituent. Each of the methanol and butanol fractions of A. orientalis were screened for their total phenol content (TPC), total flavonoid content (TFC), and antioxidant activity determined by DDPH and ABTS methods. The extracts were then analyzed by LC-ESI-MS/MS to unveil their chemical constituents, especially phenols and flavonoids. Results showed that the AO-B extract had the highest TPC (217.63 ± 2.65 mg gallic acid/g dry extract), TFC (944.41 ± 4.77 mg quercetin /g dry extract), highest DPPH and ABTS antioxidant activity ((4.00 ± 0.20) × 10-2; (3.00 ± 0.20) × 10-2 mg/mL, respectively) as compared to the AO-M extract. LC-ESI-MS/MS analysis of both extracts revealed the presence of several phenolics, flavonoids and nonphenolic acids

Ballota saxatilis from Jordan: Evaluation of Essential Oil Composition and Phytochemical Profiling of Crude Extracts and Their In-Vitro Antioxidant Activity

The chemical composition of essential oil extracted from the aerial parts of Ballota saxatilis Sieber ex C.Presl from Jordan has been elucidated by gas chromatography–mass spectrometry (GC-MS). Additionally, aqueous methanol (BsA), Butanol (BsB) and water (BsW) extracts were screened for their total phenol content (TPC), total flavonoid content (TFC), and antioxidant activities using the 2,2 Diphenyl-1-picrylhydrazyl (DPPH) and 2,2-Azino-bis (3-ethylbenzthiazoline-6-sulphonic acid) diammonium salt (ABTS) methods. The most potent extracts were screened for their phenolic acids and flavonoid content using liquid the chromatography–mass spectrometry (LC-MS) technique. The results indicated that the essential oil predominantly contained cis-pinane (14.76%), β-caryophyllene (8.91%) and allo-aromadendrene epoxide (6.39%). Among the different extracts investigated, the BsB fraction had the most TPC and TFC (455.79 ± 1.03 µg gallic acid/g dry extract; 272.62 ± 8.28 µg quercetin/g dry extract, respectively) and had the best radical and radical cation scavenging activities, as determined using the DPPH and ABTS methods. Quantitative and qualitative LC-MS analyses of BsA and BsB using LC-MS revealed each of the kaempferol-3-O-rutinoside (30.29%), chrysoeriol-7-glucoside (7.93%) and luteolin 7-o-glucoside (7.76%) as the main constituents of the BsA fraction. The BsB fraction was rich in 7,4′-dimethoxy-3-hydroxyflavone (34.68%), kaempferol-3,7,4′-trimethyl ether (29.17%) and corymbosin (9.66%) and lower concentration levels of kaempferol-3-O-rutinoside (1.63%) and chrysoeriol-7-glucoside (0.51%)

Host Factors Required for Modulation of Phagosome Biogenesis and Proliferation of Francisella tularensis within the Cytosol

Francisella tularensis is a highly infectious facultative intracellular bacterium that can be transmitted between mammals by arthropod vectors. Similar to many other intracellular bacteria that replicate within the cytosol, such as Listeria, Shigella, Burkholderia, and Rickettsia, the virulence of F. tularensis depends on its ability to modulate biogenesis of its phagosome and to escape into the host cell cytosol where it proliferates. Recent studies have identified the F. tularensis genes required for modulation of phagosome biogenesis and escape into the host cell cytosol within human and arthropod-derived cells. However, the arthropod and mammalian host factors required for intracellular proliferation of F. tularensis are not known. We have utilized a forward genetic approach employing genome-wide RNAi screen in Drosophila melanogaster-derived cells. Screening a library of ∼21,300 RNAi, we have identified at least 186 host factors required for intracellular bacterial proliferation. We silenced twelve mammalian homologues by RNAi in HEK293T cells and identified three conserved factors, the PI4 kinase PI4KCA, the ubiquitin hydrolase USP22, and the ubiquitin ligase CDC27, which are also required for replication in human cells. The PI4KCA and USP22 mammalian factors are not required for modulation of phagosome biogenesis or phagosomal escape but are required for proliferation within the cytosol. In contrast, the CDC27 ubiquitin ligase is required for evading lysosomal fusion and for phagosomal escape into the cytosol. Although F. tularensis interacts with the autophagy pathway during late stages of proliferation in mouse macrophages, this does not occur in human cells. Our data suggest that F. tularensis utilizes host ubiquitin turnover in distinct mechanisms during the phagosomal and cytosolic phases and phosphoinositide metabolism is essential for cytosolic proliferation of F. tularensis. Our data will facilitate deciphering molecular ecology, patho-adaptation of F. tularensis to the arthropod vector and its role in bacterial ecology and patho-evolution to infect mammals

Nutritional and Metabolic Requirements for the Infection of HeLa Cells by Salmonella enterica Serovar Typhimurium

Salmonella is the causative agent of a spectrum of human and animal diseases ranging from gastroenteritis to typhoid fever. It is a food - and water - borne pathogen and infects via ingestion followed by invasion of intestinal epithelial cells and phagocytic cells. In this study we employed a mutational approach to define the nutrients and metabolic pathways required by Salmonella enterica serovar Typhimurium during infection of a human epithelial cell line (HeLa). We deleted the key glycolytic genes, pfkA and pfkB to show that S. Typhimurium utilizes glycolysis for replication within HeLa cells; however, glycolysis was not absolutely essential for intracellular replication. Using S. Typhimurium strains deleted for genes encoding components of the phosphotransferase system and glucose transport, we show that glucose is a major substrate required for the intracellular replication of S. Typhimurium in HeLa cells. We also deleted genes encoding enzymes involved in the utilization of gluconeogenic substrates and the glyoxylate shunt and show that neither of these pathways were required for intracellular replication of S. Typhimurium within HeLa cells

Activation of Akt by the Bacterial Inositol Phosphatase, SopB, is Wortmannin Insensitive

Salmonella enterica uses effector proteins translocated by a Type III Secretion System to invade epithelial cells. One of the invasion-associated effectors, SopB, is an inositol phosphatase that mediates sustained activation of the pro-survival kinase Akt in infected cells. Canonical activation of Akt involves membrane translocation and phosphorylation and is dependent on phosphatidyl inositide 3 kinase (PI3K). Here we have investigated these two distinct processes in Salmonella infected HeLa cells. Firstly, we found that SopB-dependent membrane translocation and phosphorylation of Akt are insensitive to the PI3K inhibitor wortmannin. Similarly, depletion of the PI3K regulatory subunits p85α and p85ß by RNAi had no inhibitory effect on SopB-dependent Akt phosphorylation. Nevertheless, SopB-dependent phosphorylation does depend on the Akt kinases, PDK1 and rictor-mTOR. Membrane translocation assays revealed a dependence on SopB for Akt recruitment to Salmonella ruffles and suggest that this is mediated by phosphoinositide (3,4) P2 rather than phosphoinositide (3,4,5) P3. Altogether these data demonstrate that Salmonella activates Akt via a wortmannin insensitive mechanism that is likely a class I PI3K-independent process that incorporates some essential elements of the canonical pathway