Abstract Salmonella is recognized as a common foodborne pathogen, causing major health problems in Saudi Arabia. Herein, we report epidemiology, antimicrobial susceptibility and the genetic basis of resistance among S. enterica strains isolated in Saudi Arabia. Isolation of Salmonella spp. from clinical and environmental samples resulted in isolation of 33 strains identified as S. enterica based on their biochemical characteristics and 16S-rDNA sequences. S. enterica serovar Enteritidis showed highest prevalence (39.4%), followed by S. Paratyphi (21.2%), S. Typhimurium (15.2%), S. Typhi and S. Arizona (12.1%), respectively. Most isolates were resistant to 1st and 2nd generation cephalosporin; and aminoglycosides. Moreover, several S. enterica isolates exhibited resistance to the first-line antibiotics used for Salmonellosis treatment including ampicillin, trimethoprim-sulfamethoxazole and chloramphenicol. In addition, the results revealed the emergence of two S. enterica isolates showing resistance to third-generation cephalosporin. Analysis of resistance determinants in S. enterica strains (n = 33) revealed that the resistance to β-lactam antibiotics, trimethoprim-sulfamethoxazole, chloramphenicol, and tetracycline, was attributed to the presence of carb-like, dfrA1, floR, tetA gene, respectively. On the other hand, fluoroquinolone resistance was related to the presence of mutations in gyrA and parC genes. These findings improve the information about foodborne Salmonella in Saudi Arabia, alarming the emergence of multi-drug resistant S. enterica strains, and provide useful data about the resistance mechanisms.

Abstract INTRODUCTION: We studied the potential in vitro antischistosomal activity of Cerastes cerastes venom on adult Schistosoma mansoni worms. METHODS: Live specimens of the horned viper snake, C. cerastes were collected from the Aswan Governorate (Egypt). Venom was collected from snakes by manual milking. Worms of S. mansoni were obtained from infected hamsters by perfusion and isolated from blood using phosphate buffer. Mortality rates of worms were monitored after 3 days of exposure to snake venom at LC50 and various sublethal concentrations (10, 5, 2.5µg/ml). Scanning electron microscopy was used to investigate tegumental changes in treated worms after exposure to LC50 doses of venom. RESULTS: The LC50 of C. cerastes venom was 21.5µg/ml. The effect of C. cerastes venom on Schistosoma worms varied according to their sex. The mortality rate of male and female worms after 48-h exposure was 83.3% and 50%, respectively. LC50 of C. cerastes venom induced mild to severe tegumental damage in Schistosoma worms in the form of destruction of the oral sucker, shrinkage and erosion of the tegument, and loss of some tubercle spines. CONCLUSIONS: The present study demonstrated that C. cerastes venom exerts potential in vitro antischistosomal activity in a time and dose-dependent manner. These results may warrant further investigations to develop novel schistosomicidal agents from C. cerastes snake venom.

OBJECTIVES: To study the potential factors include gene mutation, efflux pump and alteration of permeability associated with quinolone-resistance of Salmonella enterica strains isolated from patients with acute gastroenteritis and to evaluate the degree of synergistic activity of efflux pump inhibitors when combined with ciprofloxacin against resistant isolates. METHODS: Antimicrobial resistance patterns of fifty-eight Salmonella isolates were tested. Five isolates were selected to study the mechanism of resistance associated with quinolone group, including mutation in topoisomerase-encoding gene, altered cell permeability, and expression of an active efflux system. In addition, the combination between antibiotics and efflux pump inhibitors to overcome the microbial resistance was evaluated. RESULTS: Five Salmonella isolates totally resistant to all quinolones were studied. All isolates showed alterations in outer membrane proteins including disappearance of some or all of these proteins (Omp-A, Omp-C, Omp-D and Omp-F). Minimum inhibitory concentration values of ciprofloxacin were determined in the presence/absence of the efflux pump inhibitors: carbonyl cyanide m-chlorophenylhydrazone, norepinephrin and trimethoprim. Minimum inhibitory concentration values for two of the isolates were 2-4 fold lower with the addition of efflux pump inhibitors. All five Salmonella isolates were amplified for gyrA and parC genes and only two isolates were sequenced. S. Enteritidis 22 had double mutations at codon 83 and 87 in addition to three mutations at parC at codons 67, 76 and 80 whereas S. Typhimurium 57 had three mutations at codons 83, 87 and 119, but no mutations at parC. CONCLUSIONS: Efflux pump inhibitors may inhibit the major AcrAB-TolC in Salmonella efflux systems which are the major efflux pumps responsible for multidrug resistance in Gramnegative clinical isolates.

Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists' ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden. Objective: To evaluate community pharmacists´ practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan. Method: Three hundred community pharmacies located around the three major hospitals in the capital city (Khartoum) and four other provinces were approached, and four asthma devices were assessed: Metered-dose inhaler (MDI) (n=105), MDI with Spacer (n=83), Turbuhaler (n=61), and Diskus (n=51). Investigator (a pharmacist) acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know. Results: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct) all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an "optimal technique". The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus) either did not know proper technique or were totally unfamiliar with the devices. Conclusion: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge of proper use of commonly dispensed asthma inhaler devices.

Aunque los farmacéuticos comunitarios se han involucrado en el cuidado de los pacientes con asma, varios estudios han evaluado las capacidades de los farmacéuticos para ilustrar apropiadamente la técnica de inhalación de los diferentes dispositivos. Muchos estudios encararon el uso inapropiado de los inhaladores por pacientes y farmacéuticos, además de su daño clínico, humanístico y económico. Objetivo: Evaluar en los farmacéuticos comunitarios el conocimiento práctico y las habilidades para demostrar la técnica de inhalación apropiada de los dispositivos para asma disponibles en Sudan. Métodos: Se abordó a 300 farmacéuticos comunitarios situados alrededor de 3 hospitales principales de la ciudad de Kartum y de otras 4 provincias, y se evaluaron 4 dispositivos para el asma: Inhaladores dosificadores (MDI) (n=105), MDI con cámara espaciadora (n=83), Turbuhaler (n=61), y Diskus (n=51). Un investigador (farmacéutico) actuó como un paciente simulado. Seleccionaba un dispositivo y pedía al farmacéutico que le demostrase como utilizarlo. El investigador rellenaba un check-list de 9 pasos sobre el uso del inhalador inmediatamente después de abandonar la farmacia. Los pasos esenciales extraídos de la literatura fueron previamente especificados para cada dispositivo. Se crearon 5 categorías de evaluación: técnica óptima; técnica adecuada; técnica pobre; dispositivo totalmente extraño; y no sabía. Resultados: Más de la mitad de los farmacéuticos abordaos con el dispositivo no conocían la técnica óptima de uso (i.e. todos los pasos correctos). Un tercio demostraba pobremente la técnica y solo un farmacéutico fue calificado como capaz de demostrar la "técnica óptima". La mayoría de los farmacéuticos abordados con cámara espaciadora o con inhaladores de polvo seco (Turbuhaler y Diskus) o no sabían la técnica apropiada o desconocían totalmente los dispositivos. Concusión: La mayoría de los farmacéuticos comunitarios, de los que se esperaba que educasen a los pacientes con asma sobre los inhaladores dispensados, carecían de conocimientos básicos sobre el uso apropiado de los inhaladores para asma comúnmente dispensados.

Devido à atividade farmacológica dos flavonóides, na presente investigação, foi desenvolvido um método eficiente e econômico para a determinação de traços dos mesmos. Neste contexto, o comportamento interfacial de três flavonóides, 3-hidroxiflavona (3HF), morin e hesperidina (Hesp) foi estudado em eletrodo de gota pendente de mercúrio (HMDE) por voltametria ac (fase sensível) e voltametria cíclica (CV). Os flavonóides investigados mostraram-se fortemente absorvidos, o que é um pré-requisito para a aplicação de voltametria adsortiva de redissolução catódica, na determinação de alguns flavonóides. Baseado no caráter de adsorção dos flavonóides investigados, na superfície de HMDE, foi descrito um procedimento de voltametria adsortiva de redissolução catódica com onda quadrada (SWCASV), validado, simples, rápido e sensível, para a quantificação dos flavonóides sob investigação na forma granel e em fluidos biológicos. Além disso, a acumulação adsortiva controlada do complexo de Cu(II) de flavonóides foi também obtida e usada para a determinação indireta de 3HF, morin e Hesp via redução do complexo formado. As condições operacionais e de solução para a determinação quantitativa ultra-traço dos compostos flavonóides investigados, foram otimizadas na ausência e presença de Cu(II). Os limites de detecção de 4,4 × 10-9, 7,19 × 10-9 e 7,54 × 10-9 mol L-1 para 3HF, morin e Hesp, respectivamente, na forma granel, foram atingidos usando SWCASV.

As flavonoids show pharmacological activity, in the present investigation, an economical and efficient method for their trace determination was developed. In this context, the interfacial behavior of three flavonoids, 3-hydroxyflavone (3HF), morin and hesperidin (Hesp) was studied on the hanging mercury dropping electrode (HMDE) by phase sensitive ac voltammetry and cyclic voltammetry (CV). The investigated flavonoids were strongly adsorbed which is the prerequisite step for applying the cathodic adsorption stripping voltammetric determination of some flavonoids. Based on the adsorption character of investigated flavonoids onto the surface of the HMDE, validated, simple, fast and sensitive square-wave cathodic adsorptive stripping voltammetric (SWCASV) procedure for the quantification of the flavonoids under investigation in bulk form and in biological fluids was described. Moreover, controlled adsorptive accumulation of the Cu(II) complex of flavonoids was also achieved to assay indirect determination of 3HF, morin and Hesp via the reduction of the formed complex. Operational and solution conditions for the quantitative ultra-trace determination of the investigated flavonoids were optimized in the absence and presence of Cu(II). Limits of detection of 4.4 × 10-9, 7.19 × 10-9 and 7.54 × 10-9 mol L-1 3HF, morin and Hesp in bulk form were achieved using SWCASV, respectively.