Mohammed Ibrahim Hajelbashir

Background: The maternal microbiome represents the first microbial environment for the developing infant, with emerging evidence linking maternal dysbiosis to adverse pregnancy outcomes and lifelong offspring health. Aims: This review synthesizes evidence on the maternal-infant microbial continuum, examining microbial dynamics during pregnancy, vertical transmission pathways, infant microbiome trajectories, and intervention strategies. Key Findings: Dynamic changes in maternal gut, vaginal, and oral microbiomes during pregnancy influence fetal development through mechanisms including hormonal modulation (e.g., Clostridium innocuum-mediated 17β-estradiol degradation), immune programming via short-chain fatty acids, and barrier integrity maintenance. Delivery mode exerts persistent effects, with Cesarean-section associated with higher allergy risk (OR=1.5-2.2), while probiotic supplementation may mitigate this risk (RR=0.6-0.8). Conclusion: The maternal-infant microbiome continuum represents a critical therapeutic target. Standardized longitudinal research and personalized intervention strategies are urgently needed to translate mechanistic insights into clinical practice.

The ongoing panzootic of the highly pathogenic avian influenza (HPAI) H5N1 virus, dominated by clade 2.3.4.4b, constitutes a significant global threat to wildlife, animal health, and public health. Once characterized by sporadic outbreaks, H5N1 has evolved into a sustained, year-round infection with an expanded host range that now includes numerous mammalian species. Its high pathogenicity is primarily driven by the acquisition of a polybasic haemagglutinin cleavage site, enabling systemic viral spread, alongside emerging endothelial and neurotropic properties that contribute to severe disease and high mortality in mammals. Although zoonotic transmission remains limited, H5N1 continues to accumulate mutations associated with mammalian adaptation, particularly within the haemagglutinin and polymerase complex. Notably, recent outbreaks in U.S. dairy cattle highlight the emergence of novel mammalian reservoirs with increased human exposure risk. Concurrently, vaccination strategies are advancing beyond traditional adjuvanted inactivated vaccines toward next-generation platforms, including mRNA and virus-like particle vaccines, designed for rapid deployment and broader immune protection. However, ongoing viral evolution, constrained vaccine availability, and gaps in coordinated surveillance underscore the urgent need for an integrated One Health approach to reduce panzootic risk.

Osteomyelitis is a bacterial infection of the bone that affects millions globally. Due to problems in drug delivery, bacterial resistance through biofilm formation, adverse effects of the medications in use, etc, the scientists are searching for novel antimicrobial agents. As drug repurposing is an excellent method to develop new antimicrobials, this study evaluates the antibacterial and antibiofilm effects of the antidepressant paroxetine, combined with hydroxyapatite (HA), against drug-resistant, biofilm-forming Staphylococcus aureus . The antibacterial activity of paroxetine was assessed using the agar diffusion assay, and the minimum inhibitory concentration (MIC) was determined by the microdilution method. The antibiofilm potential of paroxetine was quantified through the crystal violet assay and further examined using scanning electron microscopy and confocal laser scanning microscopy. The bacterial load on drug-loaded hydroxyapatite was determined using the viable colony count method. The expression of bacterial adhesion genes following paroxetine treatment was analyzed using real-time polymerase chain reaction. Molecular docking studies were performed to evaluate the binding affinity of paroxetine to bacterial adhesion proteins and penicillin-binding proteins. The study demonstrated promising antibacterial properties of the drug and the drug-HA combination against S aureus with a MIC of 18.75 µg/mL. Paroxetine prevented the biofilms formation by S aureus , and could eradicate mature biofilms, with 83%, 86%, and 89% efficacy after 1X MIC, and 2X treatment. The antibiofilm effect was further confirmed by in silico, in vitro methods, wherein a strong affinity was noted for biofilm adhesion protein and paroxetine. Paroxetine treatment revealed downregulation of biofilm-adhering genes, like icaA, clfA, cna, fnbpA, and fib, using RT-PCR. When combined with HA, paroxetine displayed synergistic activity, and this was visualized using confocal laser scanning microscopy, which showed 81% and 19% dead/live cells after treatment, respectively. Furthermore, the scanning electron microscopy analysis displayed the impact of the drug paroxetine on S aureus cell morphology, which showed remarkable damage to the bacterial cells. In silico docking revealed that paroxetine’s mode of action was mediated through binding with proteins and penicillin-binding protein, thereby inducing cell death. These results suggest that the paroxetine–HA combination may serve as a promising adjunctive strategy for treating biofilm-associated infections caused by S aureus .

Highly Pathogenic Avian Influenza (HPAI) viruses, particularly IAV (H5N1), continue to pose a major global threat due to their widespread circulation and high mortality rates in birds. Management of HPAI is complicated by challenges in conserving migratory bird populations, sustaining poultry production, and uncertainties in disease dynamics. Structured decision-making frameworks, such as those based on the PrOACT model, are recommended to improve outbreak response and guide critical actions, especially when HPAI virus (HPAIV) detections occur in sensitive areas like wildlife refuges. Surveillance data from late 2024 to early 2025 show persistent HPAI activity, with 743 detections across 22 European countries and beyond, and notable outbreaks in poultry in nations like Hungary, Iceland, and the UK. The proximity of poultry farms to water sources increases environmental contamination risks. Meanwhile, HPAI A(IAV (H5N1)) and other H5Nx viruses have been detected in a wide range of mammalian species globally, raising concerns about mammalian adaptation due to mutations like E627K and D701N in the PB2 protein. Human infections with IAV (H5N1) have also been reported, with recent cases in North America highlighting zoonotic transmission risks. Molecular studies emphasize the importance of monitoring genetic variations associated with increased virulence and antiviral resistance. Preventive strategies focus on biosafety, personal protective measures, and vaccine development for both avian and human populations. Ongoing genetic characterization and vigilant surveillance remain critical to managing the evolving threat posed by HPAI viruses.

Background: This study examines the profound personal and professional impact of the armed conflict in Sudan since April 2023 on pediatricians, particularly focusing on their displacement from Khartoum and the resultant challenges in providing essential health services to children in conflict-affected areas. Methods: Utilizing a mixed-methods approach, this study targeted displaced pediatricians from Khartoum identified via purposive sampling. Data were collected through a semi-structured questionnaire, featuring both quantitative items and an open-ended question for qualitative insights, administered electronically. The analysis combined descriptive statistics and thematic analysis with ethical oversight provided by the IRB of Prince Sattam Bin Abdulaziz University. Results: In a study of 42 displaced pediatricians from Sudan, 66.67% were female and the majority were aged between 30 and 45 years. Despite facing adversities due to armed conflict, these pediatricians displayed remarkable resilience and continued to provide pediatric care under challenging conditions. Key themes emerged from their narratives, including professional commitment amid scarcity, emotional turmoil coupled with spiritual reflection, and relentless pursuit of providing care. Safety concerns primarily drove displacement, with 95.24% citing this as a reason. While 61.90% of the respondents relocated within Sudan, 38.10% moved abroad, reflecting the profound personal and professional impact of the conflict. Conclusion: The armed conflict in Sudan has severely disrupted the pediatric healthcare system, leading to widespread displacement of pediatricians and jeopardizing child healthcare. The study highlights the resilience of healthcare professionals amidst adversity, their struggle to maintain care delivery, and the critical need for support and strategic planning to restore healthcare services in conflictaffected areas.

Background. Congenital diaphragmatic hernia (CDH) is a life-threatening condition with long-term complications including respiratory tract infections, respiratory muscle weakness, and abnormal lung functions. This study was designed to ascertain the effects of chest resistance and chest expansion exercises on respiratory muscle strength, lung function, and chest mobility in children with post-operative CDH. Methods. This randomized controlled clinical study was conducted in the outpatient physiotherapy clinic at Prince Sattam bin Abdulaziz University. Thirty-two children with CDH aged 10–14 years between May 2020 and February 2021 were randomly allocated to the study group (n = 16) and the control group (n = 16). The control group underwent a usual chest physiotherapy program; however, the study group underwent a 12-week chest resistance exercise combined with chest expansion exercise in addition to usual chest physiotherapy, with three sessions per week. Respiratory muscle strength, lung function, and thoracic excursion were assessed pre- and post-treatment. Results. Using the 2 × 2 repeated ANOVA, significant time × group interactions were detected in favor of the study group, FVC (F = 4.82, 95% CI = −15.6 to −0.97, p = 0.005, and η² = 0.16), FEV1 (F = 4.54, 95% CI = −11.99 to −2.8, p ˂ 0.001, and η² = 0.14), PImax (F = 5.12, 95% CI = −15.71 to −5.3, p ˂ 0.001, and η² = 0.15), and thoracic excursion (F = 4.41, 95% CI = −2.04 to −0.16, p = 0.036, and η² = 0.17). Conclusions. Concurrent chest resistance and expansion exercises may improve respiratory muscle strength, lung function, and thoracic excursion in children with post-operative CDH. The study findings suggest that concurrent chest and chest expansion exercises be part of an appropriate pulmonary rehabilitation program in children with a history of CDH.