Sperm DNA fragmentation (SDF) has been linked with male infertility, and previous studies suggest that SDF can have negative influence on pregnancy outcomes with assisted reproduction. We performed a retrospective review of consecutive couples with a high SDF level that had intracytoplasmic sperm injection (ICSI) using testicular sperm (T-ICSI). We compared the T-ICSI outcomes to that of two control groups: 87 couples with failed first ICSI cycle and who had a second ICSI cycle using ejaculated sperm (Ej-ICSI), and 48 consecutive couples with high sperm chromatin structure assay (SCSA)-defined SDF (>15%) that underwent an ICSI cycle using ejaculated sperm after one or more failed ICSI cycles (Ej-ICSI-high SDF). The mean number of oocytes that were retrieved and the total number of embryos were not different among the three groups. The mean number of transferred embryos in the T-ICSI group was higher than the Ej-ICSI group but not significantly different than the Ej-ICSI-high SDF group (1.4, 1.2, and 1.3, respectively, P < 0.05). Clinical pregnancy rate in the T-ICSI group was not significantly different than the Ej-ICSI and Ej-ICSI-high SDF groups (48.6%, 48.2%, and 38.7%, respectively, P > 0.05). No significant difference was found in live birth rate when comparing T-ICSI to Ej-ICSI and Ej-ICSI-high SDF groups. The results suggest that pregnancy outcomes and live birth rates with T-ICSI are not significantly superior to Ej-ICSI in patients with an elevated SCSA-defined sperm DNA fragmentation and prior ICSI failure(s).

A total of 157 environmental samples were collected from 11 ecological regions across Saudi Arabia to isolate native Bacillus thuringiensis (Bt) strains. Bt isolates (n=103) were recovered by the 50% (v/v) ethanol treatment method with Bt index range of 0.01 to 0.4. Most of Bt isolates showed spherical crystals (54%), while, irregular, bi-pyramidal, and sporeattached crystal constituted 27, 16 and 3% respectively. PCR analysis with eight general and specific dipteran primers of Cry and Cyt genes, revealed positive amplification for cry4 & cyt1, and cry4A, cry4B and cyt2, and cry 10 and cry 11 genes in 28%, 26%, 22%, and 25% of tested strains respectively; whereas cry2 gene was not detected except with the reference Bt kurstaki HD-1 strain. Bioassays against Aedes caspuis and Culex pipiens larvae indicated that 11 strains displayed better larvicidal activity compared with Bacillus thuringiensis H14 (Bti) reference (LC50 0.6 μg/ml) strain against Ae. caspuis, but only two strains (620A & 633R1, LC50 of 0.09 μg/ml & 0.064 μg/ml) that gave significant enhancement. Additionally, one strain (633R1) showed LC50 similar to that of Bti H14 (LC50 0.064 μg/ml) against Cx. pipiens. With the exception of cyt primers, sequenced DNA of all positive primers amplicons revealed 95 to 99% identity in GenBank with Bacillus thuringiensis subsp. israelensis plasmid pBtoxis and also correlated with its SDS-PAGE expressed protein profiles analysis. It is hoped that our wild bio-insecticide Bt strains can be explored in future in the control of mosquitovector borne diseases in Saudi Arabia.

BACKGROUND Sepsis is a life-threatening inflammatory condition in which the invading pathogen avoids the host's defense mechanisms and continuously stimulates and damages host cells. Consequently, many immune responses initially triggered for protection become harmful because of the failure to restore homeostasis, resulting in ongoing hyperinflammation and immunosuppression. METHODS: A literature review was conducted to address bacterial sepsis, describe advances in understanding complex immunological reactions, critically assess diagnostic approaches, and emphasize the importance of studying bacterial bottlenecks in the detection and treatment of sepsis. RESULTS: Diagnosing sepsis via a single laboratory test is not feasible; therefore, multiple key biomarkers are typically monitored, with a focus on trends rather than absolute values. The immediate interpretation of sepsis-associated clinical signs and symptoms, along with the use of specific and sensitive laboratory tests, is crucial for the survival of patients in the early stages. However, long-term mortality associated with sepsis is now recognized, and alongside the progression of this condition, there is an in vivo selection of adapted pathogens. CONCLUSION: Bacterial sepsis remains a significant cause of mortality across all ages and societies. While substantial progress has been made in understanding the immunological mechanisms underlying the inflammatory response, there is growing recognition that the ongoing host-pathogen interactions, including the emergence of adapted virulent strains, shape both the acute and long-term outcomes in sepsis. This underscores the urgent need for novel high-throughput diagnostic methods and a shift toward more pre-emptive, rather than reactive, treatment strategies in sepsis care.

PURPOSE: . The purpose of this study was to evaluate the influence of different palatal vault configurations on the accuracy and scan speed of intraoral scans (IO) of completely edentulous arches. MATERIALS AND METHODS: . Three different virtual models of a completely edentulous maxillary arch with different palatal vault heights- Cl I moderate (U-shaped), Cl II deep (steep) and Cl III shallow (flat)-were digitally designed using CAD software (Meshmixer; Autodesk, USA) and 3D-printed using SLA-based 3D-printer (XFAB; DWS, Italy) (n = 30; 10 specimens per group). Each model was scanned using intraoral scanner (Trios 3; 3Shape™, Denmark). Scanning time was recorded for all samples. Scanning accuracy (trueness and precision) were evaluated using digital subtraction technique using Geomagic Control X v2020 (Geomagic; 3DSystems, USA). One-way analysis of variance (ANOVA) test was used to detect differences in scanning time, trueness and precision among the test groups. Statistical significance was set at α = .05. RESULTS: . The scan process could not be completed for Class II group and manufacturer’s recommended technique had to be modified. ANOVA revealed no statistically significant difference in trueness and precision values among the test groups (P =.959 and P =.658, respectively). Deep palatal vault (Cl II) showed significantly longer scan time compared to Cl I and III. CONCLUSION . The selection of scan protocol in complex cases such as deep palatal vault is of utmost importance. The modified, adopted longer path scan protocol of deep vault cases resulted in increased scan time when compared to the other two groups.

Nucleosome positioning is critical for gene expression and of major biological interest. The high cost of experimentally mapping nucleosomal arrangement signifies the need for computational approaches to predict nucleosome positions at high resolution. Here, we present a web-based application to fulfill this need by implementing two models, YR and W/S schemes, for the translational and rotational positioning of nucleosomes, respectively. Our methods are based on sequence-dependent anisotropic bending that dictates how DNA is wrapped around a histone octamer. This application allows users to specify a number of options such as schemes and param-eters for threading calculation and provides multiple layout formats. The nuMap is implemented in Java/Perl/MySQL and is freely available for public use at http://numap.rit.edu. The user manual, implementation notes, description of the methodology and examples are available at the site.

OBJECTIVETo explore the prevention of recurrent candiduria using natural based approaches and to study the antimicrobial effect of Hibiscus sabdariffa (H. sabdariffa) extract and the biofilm forming capacity of Candida albicans strains in the present of the H. sabdariffa extract.

METHODSIn this particular study, six strains of fluconazole resistant Candida albicans isolated from recurrent candiduria were used. The susceptibility of fungal isolates, time-kill curves and biofilm forming capacity in the present of the H. sabdariffa extract were determined.

RESULTSVarious levels minimum inhibitory concentration of the extract were observed against all the isolates. Minimum inhibitory concentration values ranged from 0.5 to 2.0 mg/mL. Time-kill experiment demonstrated that the effect was fungistatic. The biofilm inhibition assay results showed that H. sabdariffa extract inhibited biofilm production of all the isolates.

CONCLUSIONSThe results of the study support the potential effect of H. sabdariffa extract for preventing recurrent candiduria and emphasize the significance of the plant extract approach as a potential antifungal agent.

Objectives: A single-blinded randomized controlled trial was designed to compare and evaluate the effectiveness of the periotome and piezotome as aids for atraumatic extraction and its sequalae. Materials and Methods: The study sample comprised 48 teeth, equally allotted to the piezotome or periotome groups by random allocation, in par-ticipants aged 19-62 years. All samples in both groups had either complete tooth structure or intact roots without crowns and had mobility ≤grade II.Clinical parameters of operative duration, presence or absence of gingival laceration, reported operative and postoperative pain, and intake of analgesics following extraction were recorded. IBM SPSS software package version 22 was used for data entry and analysis. Results: The mean operation time was significantly (P≤0.05) longer in the piezotome group than in the periotome group. However, fewer gingival lac-erations were observed with use of a piezotome than with a periotome, although no significant difference was observed. The piezotome group reported significantly (P≤0.05) higher visual analog scale (VAS) pain scores during the procedure and non-significantly higher scores thereafter until the third postoperative day. In the piezotome group, the dosage of analgesic was higher, although the periotome group had a higher percentage of participants who used analgesics postoperatively; however, these differences were not statistically significant. Conclusion The present clinical trial favors the use of periotome over piezotome for atraumatic extraction due to shorter operating time, lower postoperative VAS pain scores, and lower dosage of analgesics despite the superior ability of the piezotome to prevent gingival laceration.

Objective: To examine the impact of telerehabilitation training on exercise capacity, lung function, and health-related quality of life (HRQOL) in comparison to no rehabilitation for post-COVID-19 symptoms in adult females. Methods: A randomized controlled trial of 48 females after mild to moderate COVID-19 survival were equally and randomly assigned to one of two groups: intervention group or control group. Three sessions per week for 6 weeks of a telerehabilitation program provided via a smartphone to the intervention group. Spirometry was used to quantify lung function, a 6-minute walk test (6MWT) measured in meters to measure exercise capacity, and the Short Form Health Survey-36 was used to assess HRQOL. Results: After treatment, there was no statistically significant difference in forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) between groups (p>0.05), but the 6MWT of the intervention group increased significantly more than that of the control group (p=0.001). The percent of change in 6MWT for the intervention group and control group was 14.22% and 4.21%, respectively. After therapy, the intervention group’s HRQOL significantly improved when compared to the control group’s (p=0.001). Conclusion This study showed that a telerehabilitation programs improved exercise capacity and HRQOL in young females post-COVID-19 compared to no rehabilitation.

BACKGROUNDS/AIMS: We report our experience with day-surgery laparoscopic cholecystectomy and assess its feasibility and safety. METHODS: Data was collected on all the patients who underwent day-surgery laparoscopic cholecystectomy between February 2009 and February 2014 at Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia. All patients had symptomatic cholelithiasis that was proven on imaging studies with clearance of the common bile duct. The patient biographical data (age, gender, American Society of Anaesthesiology status, medical comorbidities) and surgical outcomes were then obtained. There was an evaluation of the success rate of day-surgery laparoscopic cholecystectomy, reasons for unexpected admission, and the re-admission rate. RESULTS: A total of 1,140 patients were included in this study. The success rate for day-surgery laparoscopic cholecystectomy was 96%. The reasons for unexpected hospital admission for 46 patients (4%) included persistent abdominal pain and postoperative emesis. The postoperative re-admission rate was 0.4% (5 patients). There were no major complications, and the conversion rate was 0.5% (6 patients). CONCLUSIONS: We suggest that day-surgery laparoscopic cholecystectomy is both safe and feasible in a local setting. Careful patient selection is essential in ensuring a high success rate.
Abdominal Pain ; Ambulatory Surgical Procedures ; Cholecystectomy, Laparoscopic* ; Cholelithiasis ; Common Bile Duct ; Humans ; Military Personnel ; Patient Selection ; Postoperative Nausea and Vomiting ; Saudi Arabia

There is a paucity of detailed data related to the effect of senescence on the mitochondrial antioxidant capacity and redox state of senescent human cells.Activities of TCA cycle enzymes, respiratory chain complexes, hydrogen peroxide (H 2 O 2 ), superoxide anions (SA), lipid peroxides (LPO), protein carbonyl content (PCC), thioredoxin reductase 2 (TrxR2), superoxide dismutase 2 (SOD2), glutathione peroxidase 1 (GPx1), glutathione reductase (GR), reduced glutathione (GSH), and oxidized glutathione (GSSG), along with levels of nicotinamide cofactors and ATP content were measured in young and senescent human foreskin fibroblasts. Primary and senescent cultures were biochemically identified by monitoring the augmented cellular activities of key glycolytic enzymes including phosphofructokinase, lactate dehydrogenase, and glycogen phosphorylase, and accumulation of H2O2 , SA, LPO, PCC, and GSSG. Citrate synthase, aconitase, α-ketoglutarate dehydrogenase, succinate dehydrogenase, malate dehydrogenase, isocitrate dehydrogenase, and complex I-III, IIIII, and IV activities were significantly diminished in P25 and P35 cells compared to P5 cells. This was accompanied by significant accumulation of mitochondrial H2O2 , SA, LPO, and PCC, along with increased transcriptional and enzymatic activities of TrxR2, SOD2, GPx1, and GR. Notably, the GSH/GSSG ratio was significantly reduced whereas NAD+ /NADH and NADP+ /NADPH ratios were significantly elevated. Metabolic exhaustion was also evident in senescent cells underscored by the severely diminished ATP/ ADP ratio. Profound oxidative stress may contribute, at least in part, to senescence pointing at a potential protective role of antioxidants in aging-associated disease.