Phytochemical Components Analysis by Using Gas Chromatography-mass and Fourier transform- Infrared Techniques of Cressa cretica L. Flowers Extracts

تهدف هذه الدراسة الى الكشف عن المركبات الفعالة في ازهار نبات الشويل باستخدام جهاز الكروماتوغرافيا الغازية وجهار المطياف الضوئي للاشعة تحت الحمراء باستخدام مذيبات مختلفة وهي الماء المقطر الاميثانول والهكسان والاثيل اسيتيت. اظهرت النتائج وجود العديد من المركبات الفعالة مثل الفينولات, القلويدات, التربينات, الفلافونويدات والكلايكوسيدات. اظهرت نتائج الكروماتوغرافيا الغازية وجود 30 نوع من المركبات الكيميائية الفعالة في ازهار نبات الشويل, واظهرت نتائج التحليل الكيائي بجهاز المطياف الضوئي للاشعة تحت الحمراء وجود عدد كبير من المجاميع الفعالة وتختلف هذه المجاميع باختلاف نوع المذيب المستخدم , معظم هذه المجاميع هي عبارة عن فينول, كحول, الكان, الكين, الديهايد, حامض الكربوكسلك  وغيرها.This study aimed to investigate the phytochemical components of Cressa cretica L.(flowers) using Gas chromatography- Mass spectrum (GC-MS) and Fourier transform infrared spectrophotometer (FTIR) techniques. The secondary metabolites analysis of C.cretica extracts revealed the presence of phenols, alkaloids, terpenes, flavonoids and glycosides. The results of GC-MS reported thirty chemical compounds  in flower’s extract. The results of the FTIR confirmed the presence of large numbers of  functional groups in flowers of the plant and these functional groups which varied according to the solvent type. More of these functional groups were alcohols, phenols, alkanes, alkyl halides, aldehydes, carboxylic acids, aromatics, nitro compounds and amines

Method for the fast determination of bromate, nitrate and nitrite by ultra performance liquid chromatography–mass spectrometry and their monitoring in Saudi Arabian drinking water with chemometric data treatment

A rapid, sensitive and precise method for the determination of bromate (BrO3(-)), nitrate (NO3(-)) and nitrite (NO2(-)) in drinking water was developed with Ultra performance Liquid Chromatography-Mass Spectrometry (UPLC-ESI/MS). The elution of BrO3(-), NO3(-) and NO2(-) was attained in less than two minutes in a reverse phase column. Quality parameters of the method were established; run-to-run and day-to-day precisions were <3% when analysing standards at 10µgL(-1). The limit of detection was 0.04µg NO2(-)L(-1) and 0.03µgL(-1) for both NO3(-)and BrO3(-). The developed UPLC-ESI/MS method was used to quantify these anions in metropolitan water from Saudi Arabia (Jeddah, Dammam and Riyadh areas) and commercial bottled water (from well or unknown source) after mere filtration steps. The quantified levels of NO3(-) were not found to pose a risk. In contrast, BrO3(-) was found above the maximum contaminant level established by the US Environmental Protection Agency in 25% and 33% of the bottled and metropolitan waters, respectively. NO2(-) was found at higher concentrations than the aforementioned limits in 70% and 92% of the bottled and metropolitan water samples, respectively. Therefore, remediation measures or improvements in the disinfection treatments are required. The concentrations of BrO3(-), NO3(-) and NO2(-) were mapped with Principal Component analysis (PCA), which differentiated metropolitan water from bottled water through the concentrations of BrO3(-) and NO3(-) mainly. Furthermore, it was possible to discriminate between well water; blend of well water and desalinated water; and desalinated water. The point or source (region) was found to not be distinctive

A Patient Presented with High Fever and Bloody Pericardial Effusion (Hemorrhagic Pericarditis)

We report a case of hemorrhagic pericarditis caused by Mycobacterium tuberculosis infection of the pericardium which is an extremely rare diagnosis. The literature review showed that there were rare cases of tuberculosis-causing hemorrhagic pericarditis, but the diagnosis was made either postmortem or not firmly diagnosed. Our patient was diagnosed as hemorrhagic pericarditis due to M. tuberculosis, he was treated and was discharged

Depression Among Medical Students When Compared to Other Students at West Bank Universities

Background: Depression has been an inconspicuous yet crucial concern in our society, particularly among medical students, who are the future health care providers. Therefore, our research investigated the following question: “What influence do socio-demographic and academic factors have on depression levels among medical students compared to other students, at West Bank Universities?” Objectives: This research aimed to assess the previous influence, identify and compare the prevalence of depression among medical and non-medical students. More importantly, to investigate whether medical students have the propensity for depression, or it is just a false perception of depression symptoms? Methods: A quantitative, cross-sectional study was conducted on a sample of 714 medical and non-medical students (comparative group), from Al-Quds and Al-Najah Universities. Data was collected using a questionnaire that includes: the investigation of research questions and related factors, and the computations of depression using Beck Depression Inventory. The data were analyzed using SPSS (VER:20). Results: About one-third of our sample’s medical students suffered from some form of depression; in particular, moderate depression appeared to be relatively high (18.7% and 25.5% in medical and control, respectively). At all depression levels, there appeared to be a significant difference, with a lower prevalence of depression in medical students compared to the control group, except that medical students suffered from a higher rate of mild mood disturbances (25.1%) than non-medical students (14.6%). Furthermore, there was a significant relationship (α ≤0.05) between higher prevalence of depression and female gender, lower GPA, low economic status, and lack of psychological support. Other variables, such as accommodation and year of study, showed insignificant relationships with depression. Conclusion: Based on these results, we conclude that the prevalence of depression appears to be high regardless of university or specialty, reflecting the high depression rates in Palestinian society. Higher prevalence of depression among non-medical students can be attributed to medical students’ adaptation to stress from high school, as both universities accept high scores. The researchers recommend medical students to practice their hobbies and participate in extracurricular activities as both factors showed a significant decrease in depression. Finally, the perception of higher depression among medical students seems to be false, according to our results

Compliance with antimicrobials de-escalation in septic patients and mortality rates: an old subject revisited

Background To compare the recent de-escalations rates with a six-year earlier study, and mortality associated with de-escalation. Methods Settings A prospective multicenter study including septic patients, all were on broad-spectrum antimicrobials (BSA). Excluded from the study patients on antimicrobial prophylaxis, and patients without a microbiological diagnosis, or bacteria were solely BSA-susceptible. The study team made recommendations for antimicrobials de-escalation to the treating physician(s) must an opportunity loomed. Results 182 patients were available for analysis. De-escalation was achieved in 43 (24%) patients. The clinical diagnoses, comorbidities, commonly used antimicrobials, the microbiological diagnoses were not different between the two groups (patients with and without de-escalation). Logistic regression analysis showed no correlation between bacterial species and de-escalation (Nagelkerke R2 = 0.076). Relapsing sepsis and reinfection were not different (P &gt; 0.05). The in-hospital mortality rates for the de-escalated patients were lower (P = 0.015), not on day 30 (P = 0.354). The length of the ICU stay and ward stay were not different (P &gt;0.05), but more de-escalated patients were discharged home from the ICU (P = 0.034), however, patients without de-escalation were discharged more from the ward (P = 0.002). Conclusion De-escalation rates increased within six years from 6.7% - 24% (P = 0.000), with added benefits of shorter ICU stay and less in-hospital mortalit

Modern Techniques in Hospital Infection Control

A rapid increase has been observed in nosocomial (hospital-acquired) infections due to a growing population of immunocompromised hosts and those taking invasive measures to prolong life. Many advances have been made in the control of nosocomial infections, but the sheer magnitude of the problem dictates the continued search for better methods. The papers in this series are based on a conference sponsored by the Section on Hospital Epidemiology of the Society for Pediatrician, 15-17 November 1981, and are intended to provide guidelines for infection control practices in different hospital areas. Given the wide variety of hospitals and the differences in patient populations, it is understood that the practical application of these guidelines will vary considerably. The continued effort to assess the efficacy and utility of the methods suggested in the following papers is necessary to gauge their merit and to search for even better methods

The need for national medical licensing examination in Saudi Arabia

<p>Abstract</p> <p>Background</p> <p>Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate.</p> <p>Discussion</p> <p>We are arguing for the need for a Saudi national medical licensing examination that consists of two parts: Part I (Written) which tests the basic science and clinical knowledge and Part II (Objective Structured Clinical Examination) which tests the clinical skills and attitudes. We propose this examination to be mandated as a licensure requirement for practicing medicine in Saudi Arabia.</p> <p>Conclusion</p> <p>The driving and hindering forces as well as the strengths and weaknesses of implementing the licensing examination are discussed in details in this debate.</p

Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990–2017 : a systematic analysis for the Global Burden of Disease Study 2017

Background: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 comparative risk assessment (CRA) is a comprehensive approach to risk factor quantification that offers a useful tool for synthesising evidence on risks and risk outcome associations. With each annual GBD study, we update the GBD CRA to incorporate improved methods, new risks and risk outcome pairs, and new data on risk exposure levels and risk outcome associations. Methods: We used the CRA framework developed for previous iterations of GBD to estimate levels and trends in exposure, attributable deaths, and attributable disability-adjusted life-years (DALYs), by age group, sex, year, and location for 84 behavioural, environmental and occupational, and metabolic risks or groups of risks from 1990 to 2017. This study included 476 risk outcome pairs that met the GBD study criteria for convincing or probable evidence of causation. We extracted relative risk and exposure estimates from 46 749 randomised controlled trials, cohort studies, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. Using the counterfactual scenario of theoretical minimum risk exposure level (TMREL), we estimated the portion of deaths and DALYs that could be attributed to a given risk. We explored the relationship between development and risk exposure by modelling the relationship between the Socio-demographic Index (SDI) and risk-weighted exposure prevalence and estimated expected levels of exposure and risk-attributable burden by SDI. Finally, we explored temporal changes in risk-attributable DALYs by decomposing those changes into six main component drivers of change as follows: (1) population growth; (2) changes in population age structures; (3) changes in exposure to environmental and occupational risks; (4) changes in exposure to behavioural risks; (5) changes in exposure to metabolic risks; and (6) changes due to all other factors, approximated as the risk-deleted death and DALY rates, where the risk-deleted rate is the rate that would be observed had we reduced the exposure levels to the TMREL for all risk factors included in GBD 2017. Findings: In 2017,34.1 million (95% uncertainty interval [UI] 33.3-35.0) deaths and 121 billion (144-1.28) DALYs were attributable to GBD risk factors. Globally, 61.0% (59.6-62.4) of deaths and 48.3% (46.3-50.2) of DALYs were attributed to the GBD 2017 risk factors. When ranked by risk-attributable DALYs, high systolic blood pressure (SBP) was the leading risk factor, accounting for 10.4 million (9.39-11.5) deaths and 218 million (198-237) DALYs, followed by smoking (7.10 million [6.83-7.37] deaths and 182 million [173-193] DALYs), high fasting plasma glucose (6.53 million [5.23-8.23] deaths and 171 million [144-201] DALYs), high body-mass index (BMI; 4.72 million [2.99-6.70] deaths and 148 million [98.6-202] DALYs), and short gestation for birthweight (1.43 million [1.36-1.51] deaths and 139 million [131-147] DALYs). In total, risk-attributable DALYs declined by 4.9% (3.3-6.5) between 2007 and 2017. In the absence of demographic changes (ie, population growth and ageing), changes in risk exposure and risk-deleted DALYs would have led to a 23.5% decline in DALYs during that period. Conversely, in the absence of changes in risk exposure and risk-deleted DALYs, demographic changes would have led to an 18.6% increase in DALYs during that period. The ratios of observed risk exposure levels to exposure levels expected based on SDI (O/E ratios) increased globally for unsafe drinking water and household air pollution between 1990 and 2017. This result suggests that development is occurring more rapidly than are changes in the underlying risk structure in a population. Conversely, nearly universal declines in O/E ratios for smoking and alcohol use indicate that, for a given SDI, exposure to these risks is declining. In 2017, the leading Level 4 risk factor for age-standardised DALY rates was high SBP in four super-regions: central Europe, eastern Europe, and central Asia; north Africa and Middle East; south Asia; and southeast Asia, east Asia, and Oceania. The leading risk factor in the high-income super-region was smoking, in Latin America and Caribbean was high BMI, and in sub-Saharan Africa was unsafe sex. O/E ratios for unsafe sex in sub-Saharan Africa were notably high, and those for alcohol use in north Africa and the Middle East were notably low. Interpretation: By quantifying levels and trends in exposures to risk factors and the resulting disease burden, this assessment offers insight into where past policy and programme efforts might have been successful and highlights current priorities for public health action. Decreases in behavioural, environmental, and occupational risks have largely offset the effects of population growth and ageing, in relation to trends in absolute burden. Conversely, the combination of increasing metabolic risks and population ageing will probably continue to drive the increasing trends in non-communicable diseases at the global level, which presents both a public health challenge and opportunity. We see considerable spatiotemporal heterogeneity in levels of risk exposure and risk-attributable burden. Although levels of development underlie some of this heterogeneity, O/E ratios show risks for which countries are overperforming or underperforming relative to their level of development. As such, these ratios provide a benchmarking tool to help to focus local decision making. Our findings reinforce the importance of both risk exposure monitoring and epidemiological research to assess causal connections between risks and health outcomes, and they highlight the usefulness of the GBD study in synthesising data to draw comprehensive and robust conclusions that help to inform good policy and strategic health planning

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery - a comprehensive systematic review and meta-analysis.

This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 antibodies and T and B memory cells after recovery. In addition, the prevalence of COVID-19 reinfection and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. A synthesis of existing research was conducted. The Cochrane Library, the China Academic Journals Full Text Database, PubMed, and Scopus, and preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. Included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity was assessed using the I and Cochran's Q statistics and publication bias was assessed using Doi plots. Fifty-four studies from 18 countries, with around 12,000,000 individuals, followed up to 8 months after recovery, were included. At 6-8 months after recovery, the prevalence of SARS-CoV-2 specific immunological memory remained high; IgG - 90.4% (95%CI 72.2-99.9, I = 89.0%), CD4+ - 91.7% (95%CI 78.2-97.1y), and memory B cells 80.6% (95%CI 65.0-90.2) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0-0.7, I = 98.8). Individuals previously infected with SARS-CoV-2 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1-0.3, I = 90.5%). Around 90% of recovered individuals had evidence of immunological memory to SARS-CoV-2, at 6-8 months after recovery and had a low risk of reinfection