Salmonella enterica serovar Typhimurium (S. typhimurium) is known for its intracellular survival, evading the robust inflammation and adaptive immune response of the host. The emergence of decreased ciprofloxacin (CIP) susceptibility (DCS) requires a prolonged antibiotic course with increased dosage, leading to threatening, adverse effects. Moreover, antibiotic-resistant bacteria can persist in biofilms, causing serious diseases. Hence, we validated the in vitro and in vivo efficacy of ciprofloxacin-loaded mesoporous silica nanoparticles (CIP–MSN) using a rat model of salmonella infection to compare the oral efficacy of 5 mg/kg body weight CIP–MSN and a traditional treatment regimen with 10 mg/kg CIP postinfection. Our results revealed that mesoporous silica particles can regulate the release rate of CIP with an MIC of 0.03125 mg/L against DCS S. typhimurium with a greater than 50% reduction of biofilm formation without significantly affecting the viable cells residing within the biofilm, and a sub-inhibitory concentration of CIP–MSN significantly reduced invA and FimA gene expressions. Furthermore, oral supplementation of CIP–MSN had an insignificant effect on all blood parameter values as well as on liver and kidney function parameters. MPO and NO activities that are key mediators of oxidative stress were abolished by CIP–MSN supplementation. Additionally, CIP–MSN supplementation has a promising role in attenuating the elevated secretion of pro-inflammatory cytokines and chemokines in serum from S. typhimurium-infected rats with a reduction in pro-apoptotic gene expression, resulting in reduced S. typhimurium-induced hepatic apoptosis. This counteracted the negative effects of the S. typhimurium challenge, as seen in a corrected histopathological picture of both the intestine and liver, along with increased bacterial clearance. We concluded that, compared with a normal ciprofloxacin treatment regime, MSN particles loaded with a half-dose of ciprofloxacin exhibited controlled release of the antibiotic, which can prolong the antibacterial effect.

Oxidative stress is considered the main etiologic factor involved in inflammatory bowel disease (IBD). Integration of nanocarriers for natural therapeutic agents with antioxidant and anti-inflammatory potential is a novel promising candidate for curing IBD. Herein, the colonic antioxidant and anti-inflammatory effects of different concentrations of quercetin nanoparticles (QT-NPs) were evaluated using a dextran sulfate sodium (DSS)-induced colitis model. Following colitis induction, the efficacy and mechanistic actions of QT-NPs were evaluated by assessing lesion severity, molecular aids controlling oxidative stress and inflammatory response, and histopathological and immunohistochemistry examination of colonic tissues. Administration of QT-NPs, especially at higher concentrations, significantly reduced the disease activity index and values of fecal calprotectin marker compared to the colitic group. Colonic oxidant/antioxidant status (ROS, H₂O₂, MDA, SOD, CAT, GPX and TAC) was restored after treatment with higher concentrations of QT-NPs. Moreover, QT-NPs at levels of 20 mg/kg and, to a lesser extent, 15 mg/kg reduced Nrf2 and HO-1 gene expression, which was in line with decreasing the expression of iNOS and COX2 in colonic tissues. Higher concentrations of QT-NPs greatly downregulated pro-inflammatory cytokines; upregulated genes encoding occludin, MUC-2 and JAM; and restored the healthy architectures of colonic tissues. Taken together, these data suggest that QT-NPs could be a promising alternative to current IBD treatments.

Background: Rabies is a fatal yet preventable zoonosis. In Saudi Arabia, uneven surveillance and limited public awareness may delay post-exposure prophylaxis (PEP). In Makkah, where residents regularly encounter free-roaming dogs, knowledge gaps could elevate exposure risks. Objectives: This study aims to assess public knowledge, attitudes, and post-bite practices regarding rabies, including wound washing and access to PEP among adult residents of the Makkah Region, and to examine associations with pet dog ownership. Methods: A cross-sectional survey was conducted in the Makkah Region (March–June 2025). An online validated bilingual questionnaire targeted residents ≥ 18 years via social media. Descriptive statistics, chi-square tests, 95% confidence intervals, and binomial logistic regression were applied in IBM SPSS v26; p < 0.05 was significant. Results: Of 523 respondents, 91.8% lived in Makkah city, 52.8% were female, and the age distribution was 18–24 years (44.2%), 25–34 years (35.6%), 35–44 years (12.0%), and ≥45 years (8.2%). Pet dog ownership was rare (1.9%), yet 39.4% reported stray dogs in their communities. Overall, 60.6% knew what rabies is and 63.7% knew it is vaccine-preventable, but 52.2% wrongly believed that transmission occurs only via dog bites. Hospitals (79.7%) and health centers (79.2%) were the most cited vaccination sites; social media was the dominant information source (74.6%). No significant association was found between pet ownership and rabies awareness (all p > 0.05). In multivariable regression (n = 509), adequate rabies knowledge increased the odds of an appropriate intended response (AOR 1.85, 95% CI: 1.27–2.68). Participants aged 30–40 years and those >50 years had significantly lower odds (AOR 0.45, 95% CI: 0.24–0.85 and AOR 0.23, 95% CI: 0.09–0.56, respectively). Conclusions: Despite moderate awareness, critical misconceptions and inconsistent first aid intentions persist. Priority actions include clear, locally adapted education on immediate wound washing and prompt PEP, standardized bite management pathways across facilities, reliable access to vaccines and immunoglobulin, and targeted social media micro-campaigns. By identifying public misconceptions, knowledge gaps, and preferred communication channels, this study provides baseline evidence to guide community awareness programs, intersectoral collaboration, and One Health-based surveillance essential for Saudi Arabia’s progress toward the global “Zero rabies by 2030” goal.

Background Heat-related illnesses (HRIs) remain a significant health concern during mass gatherings (MGs), where high temperatures and physical exertion exacerbate physiological stress. This study examines the clinical spectrum, management practices, and treatment outcomes of HRIs among pilgrims during the 2024 Hajj season, to inform public health responses and mitigation strategies. Methods A cross-sectional study was conducted across nine healthcare facilities in Makkah and the Mashaer region during the 2024 Hajj. Data were retrospectively extracted from medical health care facilities registries using a standardized form to capture demographic characteristics, clinical presentation, management interventions, and in-hospital outcomes of patients diagnosed with heat-related illness. Results Of the 2,785 screened patients, 2,551 had complete clinical records, and 1,576 met the diagnostic criteria for heat exhaustion or heatstroke, with outcome data available. Most of the patients were male (1,171; 74.3%), with nearly half aged 60 years or older (776; 49.2%) and a large proportion aged 39–59 years (693; 44.0%). The majority were non-Saudi pilgrims (1,419; 90%), primarily from Arab countries, with 793 (50.3%) from these regions. A total of 1,094 patients (69.4%) had no prior history of HRIs. Common symptoms included altered mental status in 635 (40.3%) patients, dizziness in 486 (30.8%), and management interventions included intravenous fluid administration in 569 cases (36.1%) and the application of cooling measures in emergency settings for 1,105 patients (70.1%). The overall mortality rate was 77 (4.9%) cases. Intensive care unit (ICU) admission and elevated lactic acid levels were significantly associated with poor outcomes. Conclusion Heat-related illness during the Hajj remains a major public health concern, with a substantial clinical burden and potentially severe outcomes. Early recognition, timely intervention, and targeted education are essential for high-risk groups. Strengthening frontline preparedness and resource deployment is crucial to reducing its potential impact.

Antimicrobial resistance (AMR) among Gram-negative bacteria (GNB) poses an escalating threat to public health worldwide, including in Saudi Arabia. The country’s healthcare system is under increasing pressure from multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains, particularly Escherichia coli , Klebsiella pneumoniae , Pseudomonas aeruginosa , and Acinetobacter baumannii . These pathogens are major culprits in hospital-acquired infections (HAIs), especially in intensive care units (ICUs), where vulnerable patients face the highest risks. This review aims to consolidate current data on the prevalence, resistance patterns, mechanisms of resistance, and key contributing factors associated with GNB in Saudi hospitals. It also explores strategic directions for improving clinical management and public health interventions. We conducted a comprehensive review of peer-reviewed literature published sourcing information from PubMed, Google Scholar, and official Saudi health databases. The data were categorized by bacterial species, geographic region, infection type, and resistance profiles. Findings highlight alarmingly high resistance rates to commonly used antibiotics such as carbapenems, aminoglycosides, fluoroquinolones, and third-generation cephalosporins. The problem is particularly severe with A. baumannii and P. aeruginosa . Additionally, the spread of extended-spectrum beta-lactamase (ESBL)-producing E. coli and K. pneumoniae further limits treatment options. Frequently identified resistance genes include blaKPC , blaNDM , and blaOXA-48 . Contributing factors range from the overuse and misuse of antibiotics to gaps in antimicrobial stewardship programs. Unique regional factors, such as the influx of international pilgrims during Hajj, add further complexity. Resistance levels also vary by region, with central and western areas reporting the highest rates. Addressing AMR in Saudi Arabia calls for a coordinated, multi-pronged approach. This includes enhancing nationwide surveillance, reinforcing antimicrobial stewardship, adopting rapid diagnostic tools, and tightening infection control measures. Future efforts should also explore alternative therapies, such as bacteriophage treatments and novel antibiotic combinations. Tackling this public health crisis will require sustained collaboration at both the national and global levels to ensure better clinical outcomes and safeguard public health.