Candida is a ubiquitous organism in nature which inhabits the oral cavity as part of the normal microbial flora. The oral carriage of Candida is perpetuated by several predisposing factors. This cross-sectional study was designed to investigate the carriage rate of Candida among 104 voluntary adults at the college of medicine - Jouf University. The concentrated oral rinse technique using Sabouraud Dextrose agar medium supplemented with 0.05% Chloramphenicol was used to isolate Candida. The relative factors affecting the colonization of Candida and the concentration of each type were also determined. Candida species were isolated from the oral cavity of 45 (43.4%) subjects. Of these 55.6% were identifies as C. albicans as determined by the Vitek 2 compact system. Other Candida species were represented by C. glabrata (11.1%), C. krusei (11.1%), C. dubliniensis (8.9%), C. parapsilosis (6.7%), C. tropicalis (4.4%), and C. famata (2.2%). Subjects with very poor plaque status, severe gingivitis and diabetes had significantly (P = 0.001) high concentration of Candida spp. Plague, severe gingivitis, and diabetes were found to be significantly associated with higher Candida colonization.

Cytokine storm is one of the leading causes of death in patients with COVID‑19. Metformin has been shown to inhibit the action of a wide range of proinflammatory cytokines such as IL‑6, and TNF‑α which may ultimately affect cytokine storm due to Covid‑19. The present study analyzed the anti‑inflammatory effect of oral and intraperitoneal (IP) metformin administration routes in a mouse model of lipopolysaccharide (LPS)‑induced cytokine storm. A total of 60 female BALB/c mice were randomly assigned to one of six groups: i) Control; ii) LPS model; iii) oral saline + LPS; iv) oral metformin + LPS; v) IP saline + LPS; and vi) IP metformin + LPS. Metformin or saline were administered to the mice for 30 days, after which an IP injection of 0.5 mg/kg LPS induced a cytokine storm in the five treatment groups. Mice were sacrificed and serum cytokine levels were measured. Pretreatment of mice with either oral or IP metformin significantly reduced the increase in IL‑1, IL‑6 and TNF‑α following LPS injection. Both metformin administration routes significantly reduced IL‑1 and TNF‑α levels, although IP metformin appeared to be significantly more effective at reducing IL‑6 levels compared with oral metformin. Neither the oral or IP route of administration of metformin demonstrated a significant effect on IL‑17 levels. Based on its ability to suppress the proinflammatory LPS‑induced cytokine storm, metformin may have future potential benefits in ameliorating human diseases caused by elevated cytokine levels.

Background and Objectives: Urinary tract infections are common health problem affecting millions worldwide. Antibiotic resistance among uropathogens (Ups) is prevalent in many countries. In the absence of any available data in the region, this hospital-based study investigated the pattern, frequency and susceptibility of Ups at Prince Mutaib Bin Abdulaziz Hospital, Aljouf Region, Saudi Arabia. Materials and Methods: A retrospective assessment of UPs and their antibiotics susceptibility was conducted from January 2017 to December 2017 using the fully automated Vitek2 system (BioMérieux, France). Results: Among the 415 uropathogens isolates, the most prevalent bacteria were Gram-negatives comprising 137 (51%) E. coli; 46 (17.2%) Klebsiella spp.; 30 (11.2%) Pseudomonas spp.; 25 (9.3%) Proteus spp.; 14 (5.2%) Acinetobacter baumanii and 16 (5.9%) others. On the other hand, Enterococcus spp. were predominant among Gram-positive isolates representing 54 (36.7%), 47 (32.0%) Staphylococcus spp., 22 (15.1%) Streptococcus spp., and 13 (8.8%) S. aureus, and 11 (7.5%) others. Gram-negative Ups showed multidrug resistance towards the majority of the tested antimicrobials (ampicillins, cephalospo- rins, fluoroquinolones, trimethoprim-sulfamethoxazole, fosfomycin, aztreonam, and nitrofurantoin). While high resistance patterns by Gram-positives was also seen against cephalosporins, penicillins, amoxicillin-clavulanic acid, trimethoprim-sul- famethoxazole, clindamycin, erythromycin and tetracycline. Conclusion: The observed widespread multidrug resistance clearly warrant implementing stricter control measures, local guidelines of antimicrobials usage, and continuous epidemiological surveys at hospitals and communities.

Background: Growth differentiation factor 15 (GDF-15), a member of the transforming growth factor-β (TGF-β) superfamily, is upregulated under cellular stress conditions and has emerged as a potential biomarker for metabolic disorders. However, its expression in relation to diabetes and obesity across different demographic groups remains understudied. This study investigated the association between plasma GDF-15 levels, diabetes mellitus, and obesity in individuals of varying ages, ethnicities, and genders. Methods: In a cross-sectional study, plasma GDF-15 concentrations were measured in 2083 participants enrolled in the Kuwait Diabetes Epidemiology Program (KDEP). The dataset included anthropometric, clinical, biochemical, and glycemic markers. Multivariate regression analysis was used to examine associations between GDF-15 levels and metabolic phenotypes. Results: Mean plasma GDF-15 levels were significantly higher in males than females (580.6 vs. 519.3 ng/L, p < 0.001), and in participants >50 years compared to those <50 years (781.4 vs. 563.4 ng/L, p < 0.001). Arab participants had higher GDF-15 levels than South and Southeast Asians (597.0 vs. 514.9 and 509.9 ng/L, respectively; p < 0.001). Positive correlations were found with BMI, waist and hip circumferences, blood pressure, insulin, and triglycerides; negative correlations were observed with HDL cholesterol. Median regression indicated that elevated GDF-15 levels were independently and significantly associated with male gender, older age, obesity, diabetes, and insulin resistance. Adjusted median regression indicated that male gender (β = 30.1, 95%CI: 11.7, 48.5), older age (β = 9.4, 95%CI: 8.0, 10.7), and insulin resistance (β = 7.73, 95%CI: 1.47, 14.0) indicated a significant positive association with GDF-15. South Asian participants (β= −41.7, 95%CI: −67.2, −16.2) had significantly but Southeast Asian participants (β= −23.3, 95%CI: −49.2, 2.56) had marginally significantly lower GDF-15 levels compared to participants of Arab ethnicity. Conclusions: Higher GDF-15 levels are associated with age, male gender, Arab ethnicity, obesity, and diabetic traits. These findings support the potential role of GDF-15 as a biomarker for metabolic disorders, particularly in high-risk demographic subgroups.

Background: Angiopoietin-like protein 8 (ANGPTL8) is known to regulate lipid metabolism and inflammation. It interacts with ANGPTL3 and ANGPTL4 to regulate lipoprotein lipase (LPL) activity and with IKK to modulate NF-κB activity. Further, a single nucleotide polymorphism (SNP) leading to the ANGPTL8 R59W variant associates with reduced low-density lipoprotein/high-density lipoprotein (LDL/HDL) and increased fasting blood glucose (FBG) in Hispanic and Arab individuals, respectively. In this study, we investigate the impact of the R59W variant on the inflammatory activity of ANGPTL8. Methods: The ANGPTL8 R59W variant was genotyped in a discovery cohort of 867 Arab individuals from Kuwait. Plasma levels of ANGPTL8 and inflammatory markers were measured and tested for associations with the genotype; the associations were tested for replication in an independent cohort of 278 Arab individuals. Impact of the ANGPTL8 R59W variant on NF-κB activity was examined using approaches including overexpression, luciferase assay, and structural modeling of binding dynamics. Results: The ANGPTL8 R59W variant was associated with increased circulatory levels of tumor necrosis factor alpha (TNFα) and interleukin 7 (IL7). Our in vitro studies using HepG2 cells revealed an increased phosphorylation of key inflammatory proteins of the NF-κB pathway in individuals with the R59W variant as compared to those with the wild type, and TNFα stimulation further elevated it. This finding was substantiated by increased luciferase activity of NF-κB p65 with the R59W variant. Modeled structural and binding variation due to R59W change in ANGPTL8 agreed with the observed increase in NF-κB activity. Conclusion: ANGPTL8 R59W is associated with increased circulatory TNFα, IL7, and NF-κB p65 activity. Weak transient binding of the ANGPTL8 R59W variant explains its regulatory role on the NF-κB pathway and inflammation.

Introduction: The Ministry of Health in Saudi Arabia provides comprehensive antenatal care for all pregnant women with all required investigations. However, it does not include urine culture for diagnosis of asymptomatic bacteriuria (ASB). This is the first study to evaluate the prevalence of ASB among pregnant females, identify the causative organisms and determine their antibiotic susceptibility patterns in the Maternity and Children’s Hospital, Arar, Saudi Arabia. Methodology: This cross-sectional study included 400 pregnant women attending an antenatal clinic. Two midstream urine samples were aseptically collected and screened using standard microbiological techniques including microscopic examination, dipstick testing, and urine culture. In order to interpret the urine culture results, ≥ 105 CFUs/mL was considered significant bacteriuria. Identification of the isolates and their antibiotic sensitivity testing was performed using the Vitek 2 system (BioMérieux, Marcy l'Etoile, France) with the available test kits. Results: The prevalence of ASB was 8.25% (35/400). Significant positive correlations (p ˂ 0.05) were detected between positive urine culture results and random blood sugar, leucocytes, nitrites, pus cells, urine red blood cells, epithelial cells, and mucus. Escherichia coli was the most common causative organism (45.7%), followed by Staphylococcus aureus (22.9%). Klebsiella pneumoniae represented 11.4% of the isolates. Most of the isolated Gram-positive organisms were sensitive to many of the tested antibiotics; most of the detected Gram-negative isolates were resistant. Conclusions: ASB caused by antibiotic resistant organisms is alarming. Screening for ASB during pregnancy using urine culture and sensitivity testing is of vital importance to improve the maternal and neonatal outcome.