A Country on the Verge of Malaria Elimination – The Kingdom of Saudi Arabia

Significant headway has been made in the global fight against malaria in the past decade and as more countries enter the elimination phase, attention is now focused on identifying effective strategies to shrink the malaria map. Saudi Arabia experienced an outbreak of malaria in 1998, but is now on the brink of malaria elimination, with just 82 autochthonous cases reported in 2012. A review of published and grey literature was performed to identify the control strategies that have contributed to this achievement. The number of autochthonous malaria cases in Saudi Arabia decreased by 99.8% between 1998 and 2012. The initial steep decline in malaria cases coincided with a rapid scaling up of vector control measures. Incidence continued to be reported at low levels (between 0.01 and 0.1 per 1,000 of the population) until the adoption of artesunate plus sulfadoxine-pyrimethamine as first line treatment and the establishment of a regional partnership for a malaria-free Arabian Peninsula, both of which occurred in 2007. Since 2007, incidence has decreased by nearly an order of magnitude. Malaria incidence is now very low, but a high proportion of imported cases, continued potential for autochthonous transmission, and an increased proportion of cases attributable to Plasmodium vivax all present challenges to Saudi Arabia as they work toward elimination by 2015.     

Hydrogel-Forming Microneedles Prepared from “Super Swelling” Polymers Combined with Lyophilised Wafers for Transdermal Drug Delivery

We describe, for the first time, hydrogel-forming microneedle arrays prepared from “super swelling” polymeric compositions. We produced a microneedle formulation with enhanced swelling capabilities from aqueous blends containing 20% w/w Gantrez S-97, 7.5% w/w PEG 10,000 and 3% w/w Na₂CO₃ and utilised a drug reservoir of a lyophilised wafer-like design. These microneedle-lyophilised wafer compositions were robust and effectively penetrated skin, swelling extensively, but being removed intact. In in vitro delivery experiments across excised neonatal porcine skin, approximately 44 mg of the model high dose small molecule drug ibuprofen sodium was delivered in 24 h, equating to 37% of the loading in the lyophilised reservoir. The super swelling microneedles delivered approximately 1.24 mg of the model protein ovalbumin over 24 h, equivalent to a delivery efficiency of approximately 49%. The integrated microneedle-lyophilised wafer delivery system produced a progressive increase in plasma concentrations of ibuprofen sodium in rats over 6 h, with a maximal concentration of approximately 179 µg/ml achieved in this time. The plasma concentration had fallen to 71±6.7 µg/ml by 24 h. Ovalbumin levels peaked in rat plasma after only 1 hour at 42.36±17.01 ng/ml. Ovalbumin plasma levels then remained almost constant up to 6 h, dropping somewhat at 24 h, when 23.61±4.84 ng/ml was detected. This work represents a significant advancement on conventional microneedle systems, which are presently only suitable for bolus delivery of very potent drugs and vaccines. Once fully developed, such technology may greatly expand the range of drugs that can be delivered transdermally, to the benefit of patients and industry. Accordingly, we are currently progressing towards clinical evaluations with a range of candidate molecules.     

Focal Adhesion Kinase Inhibitors in Combination with Erlotinib Demonstrate Enhanced Anti-Tumor Activity in Non-Small Cell Lung Cancer

Blockade of epidermal growth factor receptor (EGFR) activity has been a primary therapeutic target for non-small cell lung cancers (NSCLC). As patients with wild-type EGFR have demonstrated only modest benefit from EGFR tyrosine kinase inhibitors (TKIs), there is a need for additional therapeutic approaches in patients with wild-type EGFR. As a key component of downstream integrin signalling and known receptor cross-talk with EGFR, we hypothesized that targeting focal adhesion kinase (FAK) activity, which has also been shown to correlate with aggressive stage in NSCLC, would lead to enhanced activity of EGFR TKIs. As such, EGFR TKI-resistant NSCLC cells (A549, H1299, H1975) were treated with the EGFR TKI erlotinib and FAK inhibitors (PF-573,228 or PF-562,271) both as single agents and in combination. We determined cell viability, apoptosis and 3-dimensional growth in vitro and assessed tumor growth in vivo. Treatment of EGFR TKI-resistant NSCLC cells with FAK inhibitor alone effectively inhibited cell viability in all cell lines tested; however, its use in combination with the EGFR TKI erlotinib was more effective at reducing cell viability than either treatment alone when tested in both 2- and 3-dimensional assays in vitro, with enhanced benefit seen in A549 cells. This increased efficacy may be due in part to the observed inhibition of Akt phosphorylation when the drugs were used in combination, where again A549 cells demonstrated the most inhibition following treatment with the drug combination. Combining erlotinib with FAK inhibitor was also potent in vivo as evidenced by reduced tumor growth in the A549 mouse xenograft model. We further ascertained that the enhanced sensitivity was irrespective of the LKB1 mutational status. In summary, we demonstrate the effectiveness of combining erlotinib and FAK inhibitors for use in known EGFR wild-type, EGFR TKI resistant cells, with the potential that a subset of cell types, which includes A549, could be particularly sensitive to this combination treatment. As such, further evaluation of this combination therapy is warranted and could prove to be an effective therapeutic approach for patients with inherent EGFR TKI-resistant NSCLC.     

Combinational therapeutics to combat cancer

Mono-therapeutics is rarely effective as a treatment option, which limits the survival of patients in advanced grade aggressive cancers. Combinational therapeutics (multiple drugs for multiple targets) to combat cancer is gaining momentum in recent years. Hence, it is of interest to document known data for combinational therapeutics in cancer treatment. An amalgamation of therapeutic agents enhances the efficacy and potency of the therapy. Combinational therapy can potentially target multiple pathways that are necessary for the cancer cells to proliferate, and/or target molecules, which may help cancer to become more aggressive and metastasize. In this review, we discuss combinational therapeutics, which include human γδ T cells in combinations with biologically active anti-cancer molecules, which synergistically may produce promising combinational therapeutics.     

Identification of physiological and biochemical markers for salt (NaCl) stress in the seedlings of mungbean [Vigna radiata (L.) Wilczek] genotypes

Salt stress, which is dominant among environmental stresses, poses challenges to global agriculture. We studied the role of exogenous application of sodium chloride (NaCl) in three arid and three semi-arid genotypes of mungbean [Vigna radiata (L.) Wilczek] by examining some physiological and biochemical stress indicators. Ten-day old seedlings were subjected to salt stress (00–250 mM) by split application along with the half strength Hoagland’s medium. The salt stress caused a decline in the fresh weight, dry weight, relative water content, photosynthetic pigments (chlorophyll and carotenoids) and glutathione content of the seedlings. On the other hand, it increased the electrolyte leakage, lipoxygenase activity, and the proline, protein and total soluble sugar contents. Osmolyte accumulation was relatively higher in the arid genotypes revealing that they are more tolerant to NaCl stress. The physiological and biochemical screening provides a basic platform for selecting the stress-tolerant genotypes in the absence of suitable salt-tolerance markers in mungbean.     

Exogenous Selenium Mitigates Salt Stress in Soybean by Improving Growth,Physiology, Glutathione Homeostasis and Antioxidant Defense

The mechanism of selenium (Se)-induced salt tolerance was studied in moderately sensitive soybean (Glycine max L.) plants. To execute this view, soybean plants were imposed with salt stress (EC 6 dS m⁻¹ ) applying NaCl. In other treatments, Se (0, 25, 50 and 75 µM Na₂SeO₄) was sprayed as co-application with that level of salt stress. Plant height, stem diameter, leaf area, SPAD value decreased noticeably under salt stress. Altered proline (Pro) level, together with decreased leaf relative water content (RWC) was observed in salt-affected plants. Salt stress resulted in brutal oxidative damage and increased the content of H₂O₂, MDA level and electrolyte leakage. Exogenous Se spray alleviated oxidative damage through boosting up the antioxidant defense system by increasing the activity of antioxidant enzymes such as catalase (CAT), peroxidase (POD) and glutathione reductase (GR), as well as by improving non-enzymatic antioxidants like glutathione (GSH) and GSH/glutathione disulfide (GSSG). The upregulated antioxidant defense system, restored Pro and leaf RWC, higher SPAD value conferred better growth and development in Se-sprayed salt-affected soybean plants which altogether put forth for the progressive yield contributing parameters and finally, seed yield. Among different doses of Se, soybean plants sprayed with 50 µM Na₂SeO₄ showed better salt tolerance.     

Within-day and between-days reliability of quadriceps isometric muscle fatigue using mechanomyography on healthy subjects

This study aimed to examine within-day and between-days intratester reliability of mechanomyography (MMG) in assessing muscle fatigue. An accelerometer was used to detect the MMG signal from rectus femoris. Thirty one healthy subjects (15 males) with no prior knee problems initially performed three maximum voluntary contractions (MVCs) using an ISOCOM dynamometer. After 10 min rest, subjects performed a fatiguing protocol in which they performed three isometric knee extensions at 75% MVC for 40 s. The fatiguing protocol was repeated on two other days, two to four days apart for between-days reliability. MMG activity was determined by overall root mean squared amplitude (RMS), mean power frequency (MPF) and median frequency (MF) during a 40 s contraction. RMS, MPF and MF linear regression slopes were also analysed. Intraclass Correlation Coefficients (ICC); ICC1,1 and ICC1,2 were used to assess within-day reliability and between-days reliability respectively. Standard error of measurement (SEM) and smallest detectable difference (SDD) described the within-subjects variability. MMG fatigue measures using linear regression slopes showed low reliability and large between-days error (ICC1,2 = 0.43–0.46; SDD = 306.0–324.8% for MPF and MF slopes respectively). Overall MPF and MF, on the other hand, were reliable with high ICCs and lower SDDs compared to linear slopes (ICC1,2 = 0.79–0.83; SDD = 21.9–22.8% for MPF and MF respectively). ICC1,2 for overall MMG RMS and linear RMS slopes were 0.81 and 0.66 respectively; however, the SDDs were high (56.4% and 268.8% respectively). The poor between-days reliability found in this study suggests caution in using MMG RMS, MPF and MF and their corresponding slopes in assessing muscle fatigue.     

Biological yields through agricultural extension activities and services: A case study from Al-Baha region – Kingdom of Saudi Arabia

PurposeThis research determines the extent to which farmers benefit from agricultural extension activities and services through realizing higher biological crop yields in the Al-Baha region of the Kingdom of Saudi Arabia. Additionally, the nature of the relationship between the personal, economic and social characteristics of farmers and the degree to which they benefit from agricultural extension activities and services are studied.MethodologyA simple random sample representing the community of 315 farmers was drawn. Data were collected through a personal interview with a pre-tested questionnaire to satisfy the objectives of the study. Data are subjected to analyses and are interpreted in terms of percentages, arithmetic averages, and standard deviations in addition to the simple Pearson correlation coefficients.ResultsThe results show that most of the respondents depend on personal experience, friends, family and neighbors, merchants and sellers of agricultural production supplies as sources of agricultural information for enhanced crop yields. Multiple regression analysis reveals that both the educational status and the agricultural information sources are important factors that increase farmers benefit from extension activities. Farmers receive most benefits from the extension activities and services from bringing in foreign workers, conducting field trips to farms, and identifying problems faced by farmers.Research limitations/implicationsThe outcome of this questionnaire limits generalization of the findings for other parts of the Kingdom due to geographical and natural resources variations.Practical implicationsThe personal and socio-economic characteristics of the surveyed population provide the extension service with insight into their composition – a basis to formulate workable extension programs. For the extension planners of the area, this effort provides a baseline study and may assist with targeting the appropriate farmers and catering the right solutions to the problems. Such a study will help devise meaningful extension programs and save time and resources.Originality/valueLittle previous research on the usefulness of the Extension Service has been conducted in the region.ConclusionsEffective, well-planned extension programs targeting the educated and mature farmers provided more benefits and helped them obtain higher crop yields.