ANTIBACTERIAL EFFICACY OF FIVE NATURAL ESSENTIAL OILS USED IN YEMEN: A COMPARATIVE STUDY

Background and objective: Due to the increasing resistance to synthetic antibiotics and preservatives, there is growing interest in exploring natural alternatives. This study aimed to evaluate the antibacterial potential of five commercially available essential oils in the Yemeni market Azadirachta indica (Neem), Moringa oleifera, Rosmarinus officinalis (Rosemary), Salvia officinalis, and Origanum majorana against selected Gram-positive and Gram-negative bacterial strains. Method: Agar diffusion was used to investigate the antibacterial activity of essential oils from five plants: Azadirachta indica (neem), Moringa oleifera, Rosmarinus officinalis (rosemary), Salvia officinalis, and Origanum majorana. Result:  Significant differences in the inhibitory effects of the plant oils of neem, Moringa oleifera, Rosmarinus officinalis, Salvia officinalis, and Origanum majorana against Gram-positive and Gram-negative bacteria were found during the antimicrobial screening process. Nearing the effectiveness of gentamicin (25 mm), Salvia officinalis and neem oils demonstrated the highest action against Gram-positive Staphylococcus aureus (22 mm and 20 mm inhibition zones, respectively). Rosmarinus officinalis, on the other hand, demonstrated a low level of efficacy (10 mm). Most oils were less effective against Gram-negative organisms, and E. coli showed resistance to all save Rosmarinus officinalis (12 mm). Conclusions: These results demonstrate the potential of oils produced from plants, especially Origanum majorana, neem, and Salvia officinalis, as antibacterial agents against Gram-negative bacteria highlights the need for more research into maximizing their use, either alone or in combination with other antibiotics, despite their encouraging efficacy against Gram-positive bacteria.                     Peer Review History: Received 9 April 2025;   Reviewed 14 May 2025; Accepted 20 June; Available online 15 July 2025 Academic Editor: Dr. Ahmad Najib, Universitas Muslim Indonesia,  Indonesia, [email protected] Reviewers: Antonio José de Jesus Evangelista, Federal University of Ceará, UFC, Brazil, [email protected] Prof. Abdulwahab Ismail Al-kholani, Dean of Faculty of Dentistry at 21 September University, Yemen. [email protected]

A systematic review and meta-analysis of heart rate variability in COPD

Background: Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle–Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results: The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion: COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability

Maternal hypoxia decreases capillary supply and increases metabolic inefficiency leading to divergence in myocardial oxygen supply and demand

Maternal hypoxia is associated with a decrease in left ventricular capillary density while cardiac performance is preserved, implying a mismatch between metabolism and diffusive exchange. We hypothesised this requires a switch in substrate metabolism to maximise efficiency of ATP production from limited oxygen availability. Rat pups from pregnant females exposed to hypoxia (FIO2=0.12) at days 10-20 of pregnancy were grown to adulthood and working hearts perfused ex vivo. 14 C-labelled glucose and 3 H-palmitate were provided as substrates and metabolism quantified from recovery of 14CO2 and 3 H2O, respectively. Hearts of male offspring subjected to Maternal Hypoxia showed a 20% decrease in cardiac output (P<0.05), despite recording a 2-fold increase in glucose oxidation (P<0.01) and 2.5-fold increase (P<0.01) in palmitate oxidation. Addition of insulin to Maternal Hypoxic hearts, further increased glucose oxidation (P<0.01) and suppressed palmitate oxidation (P<0.05), suggesting preservation in insulin signalling in the heart. In vitro enzyme activity measurements showed that Maternal Hypoxia increased both total and the active component of cardiac pyruvate dehydrogenase (both P<0.01), although pyruvate dehydrogenase sensitivity to insulin was lost (NS), while citrate synthase activity declined by 30% (P<0.001) and acetyl-CoA carboxylase activity was unchanged by Maternal Hypoxia, indicating realignment of the metabolic machinery to optimise oxygen utilisation. Capillary density was quantified and oxygen diffusion characteristics examined, with calculated capillary domain area increased by 30% (P<0.001). Calculated metabolic efficiency decreased 4-fold (P<0.01) for Maternal Hypoxia hearts. Paradoxically, the decline in citrate synthase activity and increased metabolism suggest that the scope of individual mitochondria had declined, rendering the myocardium potentially more sensitive to metabolic stress. However, decreasing citrate synthase may be essential to preserve local PO2, minimising regions of hypoxia and hence maximising the area of myocardium able to preserve cardiac output following maternal hypoxia

Simulation Use in Respiratory Therapy Programs in Saudi Arabia: Results of a National Survey

Hajed M Al-Otaibi,1,2 Nabeela Abdullah Al-Abdullah,3 Abdulrahman A Naqru,4 Mohammed A Boukhari,5 Ahmed M Almohaimeed,2 Abdulaziz J Alzhrani6 1Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 2Respiratory Therapy Unit, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Public Health, Faculty of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia; 4Respiratory Therapy Department, Dr. Soliman Fakeeh Hospital, Jeddah, Saudi Arabia; 5Respiratory Therapy Department, Andalusia Group Hospital, Jeddah, Saudi Arabia; 6Respiratory Therapy Department, Bugshan Hospital, Jeddah, Saudi ArabiaCorrespondence: Hajed M Al-Otaibi, Department of Respiratory Therapy, Faculty of Medical Rehabilitation Sciences, King Abdulaziz University, P.O. Box 80200, Jeddah, 21589, Saudi Arabia, Email [email protected]: The use of simulation-based methods for teaching and learning in the education of health professions is increasing, but its prevalence in Saudi Arabia among respiratory therapy programs has yet to be investigated. The purpose of this study is to identify the use of simulation-based learning (SBL) in respiratory therapy programs in Saudi Arabia.Methods: A cross-sectional study was performed by sending Google forms survey via Email to directors of respiratory therapy programs in Saudi Arabia (N=16) to evaluate how each one used simulations as an educational tool.Results: The survey was returned with a total response of 12 out of all 16 program that were initially contacted (75% response rate). Among the respondents, approximately 75% of the programs are using SBL, while high-fidelity simulation is used by all programs. The present data show that 67% of the respiratory therapy programs has a space for simulation within the department, while 33% utilizes institutional simulation centers. For short simulation scenarios, debriefing is not conducted in 67% of the programs. There is acceptance by program directors that simulation hours should be counted towards clinical hours. About 67% of respondent programs have mandatory simulation learning activities, and 100% agree that simulations should be used more. However, lack of training and shortage of staff are among barriers to increase the use of SBL.Conclusion: SBL is commonly used and relatively varied among respiratory therapy programs. However, it requires some improvements in several aspects, including the use of debriefing and increasing the number of properly trained staff.Keywords: respiratory therapy, simulation, debriefing, medical education, Saudi Arabi

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Utilization of Renewable Energy for Power Sector in Yemen: Current Status and Potential Capabilities

A severe energy crisis has plagued Yemen for decades, and most of the population lack access to electricity. This has harmed the country’s economic, social, and industrial growth. Yemen generates electricity mainly from fossil fuels, despite having a high potential for renewable energy. Unfortunately, the situation has recently been compounded by the country’s continuing war, which has been ongoing since early 2015. It has impacted the country’s energy infrastructure negatively, resulting in power outages. Therefore, this paper aims to provide an updated perspective on Yemen’s current energy crisis and explain its key issues and potential solutions. Besides, it examines the potential, development, and current state of renewable energy sources, such as solar, wind, geothermal, and biomass. Based on the findings, Yemen is one of the world’s wealthiest countries in terms of sunlight and wind speed, and these two resources are abundant in all regions of the country. In addition, this paper sheds light on the solar energy revolution that has arisen since the war started due to the complete outage of the national electricity. Within a few years, solar energy in Yemen has increased its capacity by 50 times and has recently become the primary source of electricity for most Yemenis. Furthermore, the paper discusses the difficulties and challenges that face the implementation of renewable energy investment projects. Numerous recommendations for potential improvements in Yemen’s widespread use of renewable energy are also provided in this paper. All of the ideas presented in this paper are hoped to increase the efforts to grow renewable energy production in Yemen, thereby solving the issues of energy poverty and reducing environmental effects. The presented analysis can be used as a scientific reference for researchers and industrial companies looking for suitable solutions to advance Yemen’s renewable energy

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

The Prevalence and Risk Factors of Trichosporonosis at King Abdulaziz University Hospital

Ghassan J Alboloshi,1 Asif A Jiman-Fatani,2,3 Dalya Attallah,3 Jawahir A Mokhtar,2– 4 Nabeela Abdullah Al-Abdullah,5,6 Khalil Alkuwaity,4,7 Reham Kaki,6,8 Mohammed W Al-Rabia,2 Abdelbagi Alfadil,2,9 Karem Ibrahem,2 Addisu D Teklemariam,10,11 Steve Harakeh12,13 1Department of Medical Laboratories, King Abdullah Medical Complex Jeddah, Ministry of Health, Jeddah, Saudi Arabia; 2Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 3Department of Clinical and Molecular Microbiology Laboratory, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 4Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Public Health, College of Nursing, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Infection Control and Environmental Health, King Abdulaziz University Hospital, Jeddah, Saudi Arabia; 7Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 8Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 9Center of Research Excellence for Drug Research and Pharmaceutical Industries, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia; 10Department of Biological Sciences, Faculty of Science, King Abdulaziz University, Jeddah, 21589, Saudi Arabia; 11Department of MIVP, College of Veterinary Medicine and Agriculture, Addis Ababa University, Addis Ababa, Ethiopia; 12King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia; 13Yousef Abdul Latif Jameel Scientific Chair of Prophetic Medicine Application, Faculty of Medicine, King Abdulaziz University, Jeddah, 21589, Saudi ArabiaCorrespondence: Abdelbagi Alfadil, Department of Clinical Microbiology and Immunology, Faculty of Medicine, King Abdulaziz University, P.O. Box 80205, King Abdulaziz University, 21589, Saudi Arabia, Tel +96612 6952000 Ext 21062, Email [email protected]: Fungal infections, especially those caused have emerged as a significant medical concern over the past three decades, particularly among immunocompromised patients. However, recent studies have highlighted the increasing prevalence of fungal infections resembling yeast other than Candida, such as trichosporonosis, especially among immunosuppressed individuals worldwide. Trichosporon has been identified as a significant contributor to superficial and invasive infections. Invasive trichosporonosis, primarily affecting immunocompromised patients, poses a significant threat with high mortality rates.Purpose: The current study aimed to explore the clinical epidemiology of Trichosporon spp at King Abdulaziz University Hospital (KAUH) in Saudi Arabia.Methods: This retrospective study aimed to assess the clinical epidemiology of Trichosporon spp. infections in microbiology cultures obtained from KAUH in Saudi Arabia. The study analyzed data from patients over a five-year period, focusing on demographic, clinical, and microbiological characteristics.Results: This study encompassed 21 participants, categorized into four distinct age groups. Moreover, this study indicated T. asahii as the predominant species isolated, accounting for 90.5% of infections, followed by T. mucoides (9.5%). ICU hospitalization, diabetes mellitus, taking immunosuppressive drugs, and antifungal drugs, and the use of invasive medical equipment were identified as prominent risk factors for trichosporonosis. Urinary tract infections were the most common clinical presentation, particularly among male and elderly patients. Mortality rates were high, especially among older individuals.Conclusion: This study contributes valuable epidemiological insights into trichosporonosis, highlighting the need for enhanced surveillance and preventive strategies in healthcare settings. Further research is warranted to optimize treatment approaches and infection control measures, ultimately reducing the burden of Trichosporon infections on patient outcomes.Keywords: fungal infection, trichosporonosis, Trichosporon spp, Trichosporon asahii, invasive, risk factor

Immigrants and health system challenges to TB control in Oman

<p>Abstract</p> <p>Background</p> <p>During the past three decades, Oman has made significant progress in controlling TB within it's borders. However, the national TB control program elimination target has yet to be reached. This study aims to explore the perceived roles played by the immigrant population and the private health sector in relation to TB control in Oman.</p> <p>Methods</p> <p>We conducted seventeen interviews with different health care providers. The verbatim transcripts were processed using content analysis.</p> <p>Results</p> <p>Three main themes emerged. Firstly the threat of repatriation faced by underprivileged expatriates, secondly the criticized and forgotten private health sector as a key player and thirdly the user and provider barriers faced by Omani patients in the Omani public health system.</p> <p>Conclusions</p> <p>The study has identified some of the challenges and barriers to TB control in Oman. These challenges are mainly related to unintended negative consequences arising from the current repatriation policy of immigrants and to and the lack of involvement of the private sector in TB control. TB control strategies designed to address these challenges are needed, for Oman to reach its TB elimination targets.</p

Optimisation of biomass, exopolysaccharide and intracellular polysaccharide production from the mycelium of an identified Ganoderma lucidum strain QRS 5120 using response surface methodology

Wild-cultivated medicinal mushroom Ganoderma lucidum was morphologically identified and sequenced using phylogenetic software. In submerged-liquid fermentation (SLF), biomass, exopolysaccharide (EPS) and intracellular polysaccharide (IPS) production of the identified G. lucidum was optimised based on initial pH, starting glucose concentration and agitation rate parameters using response surface methodology (RSM). Molecularly, the G. lucidum strain QRS 5120 generated 637 base pairs, which was commensurate with related Ganoderma species. In RSM, by applying central composite design (CCD), a polynomial model was fitted to the experimental data and was found to be significant in all parameters investigated. The strongest effect (p lt 0.0001) was observed for initial pH for biomass, EPS and IPS production, while agitation showed a significant value (p lt 0.005) for biomass. By applying the optimized conditions, the model was validated and generated 5.12 g/L of biomass (initial pH 4.01, 32.09 g/L of glucose and 102 rpm), 2.49 g/L EPS (initial pH 4, 24.25 g/L of glucose and 110 rpm) and 1.52 g/L of IPS (and initial pH 4, 40.43 g/L of glucose, 103 rpm) in 500 mL shake flask fermentation. The optimized parameters can be upscaled for efficient biomass, EPS and IPS production using G. lucidum