The interest of Saudi Arabia in space was clear with the recent establishment of the Saudi Space Commission (SSC) on December 27, 2018, and the appointment of his royal highness Prince Sultan bin Salman (the first Saudi astronaut) as the chairman of the board of directors. The recent inauguration of SSC is an opportunity for Saudi Arabia to be a major contributor in the field of aerospace medicine, which can be achieved through a variety of endeavours. There are several limitations for Saudi Arabia to contribute in the field of aerospace medicine such as the absence of previous experience in the field and the lack of trained individuals. This article is considered a call for action and serves as the initial step for the dawn of the field of aerospace medicine in Saudi Arabia. Aerospace medicine should be a priority in the SSC national strategy, which is currently under construction.

Objective: Sedentary behavior is one of the risk factors for cardiometabolic diseases, including cardiovascular diseases, diabetes mellitus, and metabolic syndrome. High-intensity interval training (HIIT) is one effective way to reduce the risk of cardiometabolic diseases. This research studies the effects of cycling-based HIIT on vascular function and cardiorespiratory fitness in sedentary people. Methodology: Twenty-two female participants were separated into two groups, including HIIT group who receive intervention and control group who did not receive the intervention. Each of the participants was interviewed to collect and record their medical history, and medical parameters including cardio-ankle vascular index (CAVI), flow-mediated dilation (FMD) and maximal oxygen consumption (V̇O 2max ) were measured as a baseline pretest. The intervention was a cycling-based HIIT lasting 6 weeks, with three sessions per week. During each session, the participant completed a set protocol consisting of 1 min on a cycle ergometer, cycling at 80-85% maximal heart rate, followed by a 1-min rest period.  This sequence was repeated for a total of 5 times. Results: After 6 weeks of intervention, results showed that the HIIT group had significant improvements in CAVI (6.39±0.76 vs 5.91±0.58), FMD (9.26±6.5 vs 14.01±4.3%), and V̇O 2max (20.10±4.31 vs 24.34±5.71 ml/kg/min) values compared to the pretest ( P < 0.05). In addition, HIIT increased endothelial function as measured by FMD compared to the control group (14.01 ± 4.3 vs. 9.15 ± 4.16 %, P < 0.05). Conclusion: Six weeks of HIIT were found to improve vascular function and cardiorespiratory fitness in sedentary people and demonstrated the benefits of HIIT as a time-efficient exercise strategy.

Objective: Staphylococcus aureus has become an important pathogen in hospitals worldwide. Despite its differentiation into human and animal lineages, common methods are used for genotyping. While these methods are useful, they are based on the stable genome, and hence, are insensitive to host-specific subtyping. The objectives of this study were to investigate the repeat-domain of the Clumping-Factor A gene (clfA-R) as an objective and adaptation-sensitive approach. Methodology: We have used 113 isolates for susceptibility testing and genotyping by polymerase chain reaction amplification of the clfA-R regions. Of these, 105 were from King Fahad Specialist Hospital, Buraidah and eight were published sequences used as references. Isolates were further confirmed as S. aureus by the commercial Kits. Amplicon sizes were measured and the number of the 18-bp-repeating-units in each isolate was determined against that of methicillin-resistant S. aureus COL (MRSA) sequence. Results: Results showed that all 42 nasal screening isolates (100%) and all but six isolates from clinical specimens were MRSA with 37% of the former and 50% of the latter isolates showing community-acquired-MRSA susceptibility patterns. clfA-R analysis grouped 113 isolates into 14 repeat-genotypes. The two dominant types, D and X, represented the long- and short clfA-R types found in humans and animals, respectively. Linezolid, rifampicin, and vancomycin were the drugs of choice. Conclusions: clfA-R was useful in rapid genotyping and implied host-specific phenotypic properties of the ClfA. It has been recommended that the approach used in regional laboratories for uniform strain-profiling. Future work will show more insights into the gene content and origins of clones.  

Objectives : Avascular necrosis (AVN) of the femoral head is a major complication following treatment for developmental dysplasia of the hip (DDH). It is caused by excessive pressure over the femoral head, which compromises its blood supply. The rate of AVN following DDH treatment ranges from 6% to 48%. This study aimed to analyze the rate of AVN in DDH patients following different standard surgical treatments. Methodology: A retrospective cohort study was performed on patients diagnosed with DDH between January 2007 and December 2013. All idiopathic DDH patients who underwent standard surgical treatments were included in the study. Neuromuscular and teratologic patients and patients with previous surgical treatment outside the institute were excluded from the study. Results: Overall, 204 hips in 143 pediatric patients were included in the study. The majority (84.8%) of the patients were female. Most patients (82.2%) received single treatment. The most commonly used surgical treatment was open reduction with pelvic osteotomy (82.8%). Type 4 Tonnis classification of DDH was found in 62.3% of patients. AVN was found in 14.3% of our study population. The majority (57.1%) of diagnosed AVN patients showed Grade 1 (Kalamchi) AVN classification. Patients who underwent closed reduction and hip spica showed a significantly higher rate of AVN compared to other treatments (14.3%, P = 0.044). Conclusion : Close follow-up of patients treated with closed reduction is mandatory as these patients have the highest risk of AVN. We recommend the introduction of national screening programs targeting all newborn children and including systematic follow-up at well-baby clinics during the early years of life.

Objective: The expression of human leukocyte antigen (HLA)-ABC and HLA-DR is linked to the inflammatory disorders and this includes the development of breast cancer. This study was aimed to determine the effect of bacillus bacterial extracts on the expression of the major histocompatibility complexes (MHC) Class I and Class II receptors on breast cancer cells. Methods: The expression of HLA-ABC and HLA-DR was assessed by flow cytometry and confocal microscope on the human breast tumor cell lines MDA-MB-231, which used a readily accessible model system. It is postulated that the HLA-ABC and HLA-DR receptors might be regulated by bacillus bacterial extracts designated (RA10, RA4, RA7, and RA16). Results: It was observed that the treatment of cell line MDA-MB-231 with the RA10 resulted in an upregulation of the cell surface expression of the HLA-A,B,C receptors. It was observed that RA10 has the capacity to reduce the expression of HLA-A,B,C, it also shows a detectable degree of cytotoxicity when used at high concentrations. The data shows that the cell surface expression of HLA-ABC is higher than HLA-DR. No significant changes of HLA-DR expression was observed on MDA-MB-231 cell lines. Conclusions:  Improved understanding of the connection between HLA-ABC, HLA-DR, and bacterial extracts such as RA10 may lead to the development of drug design and therapies related to breast cancer condition in which these receptors are involved.

Objective: The aim of this systematic review and meta-analysis was to estimate the pooled magnitude of birth asphyxia and its determinants in Ethiopia. Methods: The databases, including PubMed, Medline, CINAHL, EMBASE, and other relevant sources, were used to search relevant articles. Both published and unpublished studies, written in English and carried out in Ethiopia, were included in the study. Quality of evidence was assessed by the relevant of the Joanna Briggs Institute tool. RevMan v5.3 statistical software was used to undertake the meta-analysis using a Mantel-Haenszel random-effects model. Heterogeneity was evaluated using the Cochran Q test, and I 2 statistics was considered to assess its level. The outcome was measured using a 95% confidence interval (CI). Results: The pooled prevalence of birth asphyxia was 22.8% (95% CI: 13–36.8%]. Illiterate mothers (adjusted odds ratio [AOR]; 1.96, 95% CI: 1.44–2.67), antepartum hemorrhage (APH) (AOR; 3.43, 95% CI: 1.74–6.77), cesarean section (AOR; 3.66, 95% CI: 1.35–9.91), instrumental delivery (AOR; 2.74, 95% CI: 1.48–5.08), duration of labor (AOR; 3.09, 95% CI: 1.60–5.99), pregnancy induced hypertension (AOR; 4.35, 95% CI: 2.98–6.36), induction of labor (AOR; 3.69, 95% CI: 2.26–6.01), parity (AOR; 1.29, 95% CI: 1.03–1.62), low birth weight (LBW) (AOR; 5.17, 95% CI: 2.62–10.22), preterm (AOR; 3.98, 95% CI: 3.00–5.29), non-cephalic presentation (AOR; 4.33, 95% CI: 1.97–9.51), and meconium staining (AOR; 4.59, 95% CI: 1.40–15.08) were significantly associated with birth asphyxia. Conclusion: The magnitude of birth asphyxia was very high. Maternal education, APH, mode of delivery, prolonged labor, induction, LBW, preterm, meconium-staining, and non-cephalic presentation were determinants of birth asphyxia. Hence, to reduce birth asphyxia and associated neonatal mortality, attention should be directed to improve the quality of intrapartum service and timely communication between the delivery team. In addition, intervention strategies aimed at reducing birth asphyxia should target the identified determinants.

A 32-year-old female presented to the emergency room with severe right loin pain. Abdominal color Doppler ultrasound (CDUS) observed a large thrombus in the inferior vena cava (IVC). Computed tomography with contrast described a large floating thrombus in the IVC with no visible wall attachment. Emergency transjugular suprarenal IVC filter was inserted and overnight infusion thrombolysis over 24 h. The patient started to show constitutional symptoms of pyelonephritis such as high-grade fever and pyuria post-thrombolysis. Immediate empiric antibiotic coverage was started. Overnight infusion thrombolysis resulted in resolution of the floating thrombus and the IVC filter was removed in the next day. Urine culture grew Escherichia coli and tailored antibiotic therapy was completed. Three months CDUS confirmed complete resolution of the IVC thrombosis.