Oral and Maxillofacial Surgery: Availability of Specialist Training and Different Training Pathways across Africa.

Background: Oral and maxillofacial surgery (OMFS) is the surgical specialty concerned with the treatment of a broad range of conditions that affect the head, face, mouth, neck, and jaw. In Africa, there is a paucity of information about the specialist training available to aspiring African Oral and Maxillofacial Surgeons. Objective: This paper aimed at shedding light on the available OMFS specialist training programmes and training pathways across Africa. Materials and Methods: The authors searched on PubMed, AJOL, and Google Scholar using the keywords "Africa," "Oral and Maxillofacial Surgery," "Residency," "Postgraduate," and "Education" and the individual African countries in English and official languages from inception till July 11, 2022. The authors utilised a questionnaire to interview native oral and maxillofacial surgeons and dentists in African countries where there were no published data on OMFS specialist training. Results: A total of 21 (38.8%) African countries had OMFS specialist training programmes (n = 69). The duration of training varies between 2 and 7 years. The number of training programmes per country ranges between one and thirteen. Countries with the most training programmes for OMFS in Africa are Nigeria, Egypt, Sudan, and Algeria. Northern Africa and Central Africa had the most and least numbers of specialist training programmes in OMFS, respectively. Conclusion: There remains a disparity in the number of specialist training programmes available to aspiring African Oral and Maxillofacial Surgeons as compared with other parts of the world. This paper is intended to function both as a means of advocacy to increase funding and resources in support of the infrastructure and development of facilities for African OMFS specialist training programmes and also serve as a valuable reference for future research in OMFS.

Knowledge and Attitudes of Obstructive Sleep Apnea among Jordanian Otolaryngologists: A Cross-Sectional Study.

Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder that affects almost one billion individuals worldwide. An estimated 16.8% of adults in Jordan have been diagnosed with OSA. Given the importance of management of OSA by otolaryngologists, we assessed the knowledge and attitudes of Jordanian otolaryngologists in managing OSA in adult and pediatric patients. A survey, conducted anonymously online, was sent present otolaryngology residents and specialist in Jordan, in the English language. The participants were given the OSA Knowledge and Attitude questionnaire (OSAKA, OSAKA-KIDS), which have been previously validated. Data were obtained and then analyzed via SPSS software. A total of 140 residents and specialist of otolaryngology were selected. A significant difference in OSAKA scores were found between otolaryngologists under 30 years of age and those above, with higher scores for the older age group. The proportion of specialists who 'agreed' or 'strongly agreed' they are confident in their ability to manage patients with OSA was significantly higher that junior residents (73.8% vs 33.3%; p = 0.008). More than 10 years at practice was associated with statistically significant higher levels of knowledge towards OSAKA scale (AOR = 0.09; p = 0.044). Additionally, being a senior resident was significantly associated with more knowledge towards OSAKA-KIDS scale (AOR = 0.19; p = 0.03). Otolaryngology residents and specialists' knowledge of OSA was very good. Further improving in the level of the knowledge toward OSA among the otolaryngology resident doctors should be implemented as possible by following the updated guidelines for the diagnosis and management OSA. Supplementary Information: The online version contains supplementary material available at 10.1007/s12070-023-04180-8.

Knowledge and Attitude of Healthcare Providers Regarding Palliative Care and Related Factors: An Online Cross-Sectional Study.

BACKGROUND: Palliative care alleviates pain and enhances the quality of life of patients with life-threatening illnesses. Training programs are required to provide patients with proper care and advance their health because the expertise of healthcare personnel in palliative care is inadequate. AIM: We aimed to assess healthcare professionals' knowledge of palliative care because palliative care programs are infrequently used in Syria. METHODS: An online cross-sectional study was conducted between July 24, 2022, and August 28, 2022, to assess palliative care knowledge and applications among Syrian healthcare workers. The study questionnaire was designed in accordance with a previous study, and the inclusion criteria included Syrian healthcare workers, physicians, and nurses, as well as medical and nursing students. The first section of the questionnaire included sociodemographic information, while the second, third, and fourth sections assessed healthcare workers' experiences, knowledge, and attitudes toward palliative care, respectively. RESULTS: Of the 602 participants, 66.2% of the sample study were females. The majority of the respondents (72.9%) were medical students, with 18.8% residents and 8.3% nurses or nursing students. The majority of the participants (84%) correctly answered the question about pain treatment goals, while only a small percentage (5.3%) correctly answered the question about whether long-term opioid use was addictive. There were no statistically significant differences in the overall knowledge levels across demographic areas, genders, or specialties. Only 14 participants were considered knowledgeable about palliative care. Regarding attitudes toward palliative care, the three responses that received the greatest degree of agreement were "Pain relievers should be given as needed to terminally ill patients" (89.7%) and "Patients have the right to determine their own degree of psychosocial intervention" (81%). Residents in urban and rural areas scored markedly different in their attitudes. Students in their fifth year were 8.06 times more likely to have a positive attitude when compared to those in their first year. CONCLUSIONS: Our findings show that Syrian healthcare providers lack knowledge of palliative care. It is important to integrate palliative care into Syria's healthcare system to enhance the quality of life of patients who are approaching the end of their lives and to provide care for those who require it.

Guiding principles for the conduct of the Violence Study of Healthcare Workers and System (ViSHWaS): Insights from a global survey.

Background: Although many studies worldwide have reported on violence against health care workers, there is a lack of homogeneous data for understanding the current state of the issue. Conducting a global survey required a robust team organisation structure, unique dissemination strategies, and continual networking to maintain and propagate the pool of survey collaborators and responders. Here we aimed to describe the strategies that helped us carry out a global survey-based study, the lessons learned, and provide a practical roadmap for future large-scale cross-sectional studies. Methods: We conducted this cross-sectional survey-based study from 6 June to 9 August 2022, basing it on the 'Hub and Spoke' model, with a single core team and subgroups in different regions managed by country leads. The key steps included team organisation, strategy formulation for survey dissemination and data collection, social media launch, and conducting a post-survey analysis amongst the collaborators. The core team convened weekly via video conference to discuss the modus operandi. The language barrier was managed through audio translation or by shifting to 'an interviewer-administered' questionnaire. Results: The core team included 11 members from seven countries, followed by 28 country leads from 110 countries. We also gathered 80 regional collaborators who provided feedback and spread the message. The Violence Study of Healthcare Workers and Systems (ViSHWaS) returned 5500 responses globally. Guiding principles garnered through this collaborative project include focusing on effective team organisation, ensuring external validation of survey tool, personalised communication, global networking, timely communication for maintaining momentum, and addressing regional limitations. The post-survey analysis showed that WhatsApp messaging was the most common modality used for survey dissemination, followed by in-person meetings and text messaging. We noted that the successful techniques were direct communication with respondents, regular progress updates, responsiveness to regional and country lead needs, and timely troubleshooting. The most common barriers for the respondents were limitations in language proficiency, technical fallouts, lack of compliance with, and difficulty understanding the questionnaire. Conclusions: In this global survey-based study of more than 5500 responses from over 110 countries, we noted valuable lessons in team management, survey dissemination, and addressing barriers to collaborative research.

ViSHWaS: Violence Study of Healthcare Workers and Systems-a global survey.

OBJECTIVE: To provide insights into the nature, risk factors, impact and existing measures for reporting and preventing violence in the healthcare system. The under-reporting of violence against healthcare workers (HCWs) globally highlights the need for increased public awareness and education. METHODS: The Violence Study of Healthcare Workers and Systems study used a survey questionnaire created using Research Electronic Data Capture (REDCap) forms and distributed from 6 June to 9 August 2022. Logistic regression analysis evaluated violence predictors, including gender, age, years of experience, institution type, respondent profession and night shift frequency. A χ2 test was performed to determine the association between gender and different violence forms. RESULTS: A total of 5405 responses from 79 countries were analysed. India, the USA and Venezuela were the top three contributors. Female respondents comprised 53%. The majority (45%) fell within the 26-35 age group. Medical students (21%), consultants (20%), residents/fellows (15%) and nurses (10%) constituted highest responders. Nearly 55% HCWs reported firsthand violence experience, and 16% reported violence against their colleagues. Perpetrators were identified as patients or family members in over 50% of cases, while supervisor-incited violence accounted for 16%. Around 80% stated that violence incidence either remained constant or increased during the COVID-19 pandemic. Among HCWs who experienced violence, 55% felt less motivated or more dissatisfied with their jobs afterward, and 25% expressed willingness to quit. Univariate analysis revealed that HCWs aged 26-65 years, nurses, physicians, ancillary staff, those working in public settings, with >1 year of experience, and frequent night shift workers were at significantly higher risk of experiencing violence. These results remained significant in multivariate analysis, except for the 55-65 age group, which lost statistical significance. CONCLUSION: This global cross-sectional study highlights that a majority of HCWs have experienced violence, and the incidence either increased or remained the same during the COVID-19 pandemic. This has resulted in decreased job satisfaction.

Surveillance and treatment of primary hepatocellular carcinoma (aka. STOP HCC): protocol for a prospective cohort study of high-risk patients for HCC using GALAD-score.

BACKGROUND: Vietnam and Saudi Arabia have high disease burden of primary hepatocellular carcinoma (HCC). Early detection in asymptomatic patients at risk for HCC is a strategy to improve survival outcomes in HCC management. GALAD score, a serum-based panel, has demonstrated promising clinical utility in HCC management. However, in order to ascertain its potential role in the surveillance of the early detection of HCC, GALAD needs to be validated prospectively for clinical surveillance of HCC (i.e., phase IV biomarker validation study). Thus, we propose to conduct a phase IV biomarker validation study to prospectively survey a cohort of patients with advanced fibrosis or compensated cirrhosis, irrespective of etiologies, using semi-annual abdominal ultrasound and GALAD score for five years. METHODS: We plan to recruit a cohort of 1,600 patients, male or female, with advanced fibrosis or cirrhosis (i.e., F3 or F4) and MELD ≤ 15, in Vietnam and Saudi Arabia (n = 800 each). Individuals with a liver mass ≥ 1 cm in diameter, elevated alpha-fetoprotein (AFP) (≥ 9 ng/mL), and/or elevated GALAD score (≥ -0.63) will be scanned with dynamic contrast-enhanced magnetic resonance imaging (MRI), and a diagnosis of HCC will be made by Liver Imaging Reporting and Data System (LiRADS) assessment (LiRADS-5). Additionally, those who do not exhibit abnormal imaging findings, elevated AFP titer, and/or elevated GALAD score will obtain a dynamic contrast-enhanced MRI annually for five years to assess for HCC. Only MRI nearest to the time of GALAD score measurement, ultrasound and/or AFP evaluation will be included in the diagnostic validation analysis. MRI will be replaced with an abdominal computed tomography scan when MRI results are poor due to patient conditions such as movement etc. Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced MRI will not be carried out in study sites in both countries. Bootstrap resampling technique will be used to account for repeated measures to estimate standard errors and confidence intervals. Additionally, we will use the Cox proportional hazards regression model with covariates tailored to the hypothesis under investigation for time-to-HCC data as predicted by time-varying biomarker data. DISCUSSION: The present work will evaluate the performance of GALAD score in early detection of liver cancer. Furthermore, by leveraging the prospective cohort, we will establish a biorepository of longitudinally collected biospecimens from patients with advanced fibrosis or cirrhosis to be used as a reference set for future research in early detection of HCC in the two countries. TRIAL REGISTRATION: Name of the registry: ClinicalTrials.gov Registration date: 22 April 2022 Trial registration number: NCT05342350 URL of trial registry record.

A Rare Case of Diabetic Nephropathy and Type III Collagen Glomerulopathy.

Collagenofibrotic glomerulopathy (CG) is a poorly understood kidney disease characterized by extensive deposition of abnormal type III collagen within the glomeruli. We report the case of a 25-year-old man with known type I diabetes mellitus who presented to the emergency department with diaphoresis, nephrotic-range proteinuria, hypertension, and elevated creatinine. Renal biopsy revealed combined collagenofibrotic glomerulopathy and diabetic nephropathy. This case highlights the clinicopathological features of type III collagen glomerulopathy and its possible association with diabetic nephropathy.

A multinational cross-sectional study on the awareness and concerns of healthcare providers toward monkeypox and the promotion of the monkeypox vaccination.

Background: The aim of this study was to explore potential healthcare workers' (HCWs) concerns about the monkeypox virus in order to create practical solutions to manage this disease. Methods: Online cross-sectional research was conducted in 11 Arabic countries (Egypt, Saudi Arabia, Yemen, Syria, Libya, Algeria, Tunisia, Iraq, Palestine, Jordan, and Sudan) from 2 August 2022 to 28 December 2022. Results: Approximately 82% of respondents felt the need to acquire further information. The acceptability of the vaccine against monkeypox has been indicated by more than half of the participants (54.5%). Furthermore, we state that 45% of the participants are knowledgeable about the monkeypox virus, and 53.1% of the participants have never been affected with COVID-19 before are more worried about COVID-19 than about monkeypox. Participants diagnosed with COVID-19 were 0.63 times less likely to worry about monkeypox than those who were not diagnosed with COVID-19. A greater willingness to get the monkeypox vaccination was seen among the age group 21-30 years (42.4%) compared to the other age groups. Conclusion: Most healthcare professionals have a moderate knowledge of the monkeypox virus. Furthermore, they demonstrated a low willingness to get the vaccination against the monkeypox virus.

Omicron (B.1.1.529) variant and its subvariants and lineages may lead to another COVID-19 wave in the world? -An overview of current evidence and counteracting strategies.

The highly contagious Omicron variant of SARS-CoV-2 is a recent cause of concern during the COVID-19 pandemic. The World Health Organization (WHO) has classified SARS-CoV-2 variants into variants of concern (VOCs), variants of interest (VOIs), and variants under monitoring (VUMs). VOCs were categorized as Alpha (B.1.1.7), Beta (B.1.351), Gamma (P.1), and Delta (B.1.617.2). Omicron (B.1.1.529) was a further modified strain that has a short incubation period; it was called VOC by the WHO, and it became fifth on the list of variants. Omicron has spread faster than any other variant since its emergence in late 2021. Omicron is currently the only circulating VOC. The various subvariants of Omicron are BA.1 (B.1.1.529.1), BA.2 (B.1.1.529.2), BA.3 (B.1.1.529.3), BA.4, BA.5, and descendent lineages. More recently, identified Omicron subvariants and sublineages BQ.1, BQ.1.1, BA.4.6, BF.7, BA.2.75.2, XBB.1, and BF.7 have also attracted global attention. The BA.5 strain of Omicron is the most contagious and dominant subvariant globally. Recent spikes in cases in China are due to the BF.7 subvariant. With the large increase in the number of cases, there has been an increase in hospitalisations in countries worldwide. In many countries, the lifting of infection prevention protocols, such as the use of masks and physical distancing, contributes to the spread of the virus. This article highlights the potential impacts of SARS-CoV-2 variants and subvariants, which have made the pandemic far from over. Effective vaccination remains the safest option to kerb transmission of these variants. Therefore, people must be vaccinated, wear masks, perform regular hand hygiene, and observe social distancing. Additionally, genome sequencing of positive samples can help detect various virus variants; thus, mapping cases in a particular area can be performed.

Syrians' awareness of cardiovascular disease risk factors and warning indicators: a descriptive cross-sectional study.

The awareness of cardiovascular diseases (CVDs) contributes to the complications and fatality rates from these diseases among individuals; however, no previous study in Syria was conducted on this topic; thus, this study aims to assess Syrians' awareness of CVDs warning symptoms and risk factors. This online cross-sectional study was performed in Syria between the 1st and 25th of August 2022. The inclusion criteria for the sample were citizens of Syria over 18 who currently reside in Syria. The questionnaire included open- and closed-ended questions to assess the awareness of CVDs. A total of 1201 participants enrolled in the study with a response rate of 97.2%; more than half of the participants (61.4%) were aged 18-24. The most recognizable risk factors and warning signs when asking close-ended and open-ended questions were smoking (95.2%, 37.1%) and chest pain (87.8%, 24.8%), respectively. Overall knowledge scores for risk factors and warning signs were (61.5%). Regarding knowledge score of CVDs risk factors and warning signs, participants aged 45-54 scored higher than other age groups, and respondents with a university education level had a higher score than other educational levels (15.7 ± 0.3), (14.5 ± 0.1), respectively. Participants aged 45-54 have a higher probability of good knowledge of CVDs risk factors and warning signs than participants aged 18-24 (OR = 4.8, P value < 0.001), while participants living in the countryside were less likely to have good knowledge of CVDs risk factors and warning signs than city residents (OR = 0.6, P value < 0.05). According to our results, there is inadequate knowledge of the risk factors and warning signs of CVDs. Consequently, there is a greater need to raise CVD awareness and learning initiatives on the disease's risk factors and symptoms.

Coronavirus disease 2019 vaccine in pediatric post-kidney transplantation.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and the resulting disease, coronavirus disease 2019 (COVID-19), have spread to millions of persons worldwide. Many vaccines have been developed; however, their efficacy in pediatric solid organ transplant recipients is yet to be determined. METHODS: This is a prospective observational, non-interventional single-center study on the safety and efficacy of a COVID-19 vaccine (BNT162b2) in pediatric kidney transplant recipients. The primary aim of this study was to evaluate immunogenicity according to SARS-CoV-2-specific neutralizing antibody titer after two vaccine doses. The secondary aims were to investigate the safety of the vaccines, solicited local and systemic adverse reactions, incidence of COVID-19 post-vaccination, and effects on transplant graft function. Baseline investigations were conducted on pediatric renal transplant recipients, and recruited participants were advised to have the Comirnaty® mRNA vaccine according to protocol. RESULTS: A total of 48 patients (male, n = 31, 64.6%; female, n = 17, 35.4%), median age 14 [12-16] years were included, and all received two doses of the vaccine. The vaccine had a favorable safety and side-effect profile. The S-antibody titer of all patients ranged between .4 and 2,500 U/ml and was > 50 U/ml in 89% of the patients. No difference in the measured antibody immune response was noted between infected and uninfected children. No major side effects were reported. CONCLUSION: The vaccine had a favorable safety profile in 12- to 15-year-old kidney transplant recipients, producing a greater measured antibody response than that in older transplant recipients.

Assessment the awareness toward hypertension and diabetes mellitus: Syrian cross sectional study.

BACKGROUND: Diabetes and arterial hypertension are the two most common types of non-communicable diseases (NCDs) impacting people globally. There is no prior research on the Syrian population's knowledge and treatment of hypertension and diabetes. It is crucial to investigate how the Syrian public understands and perceives these disorders in order to address the increased incidence and prevalence of hypertension and diabetes. This research intends to assess the level of hypertension and diabetes-related awareness, knowledge, attitude, and practices among Syrian individuals. METHODS: A cross-sectional survey was conducted online between 1 August and 25 August 2022. The questionnaire for the study was developed based on previous research, and the inclusion criteria for the sample were Syrian residents older than 18 who presently live in Syria. The survey consisted four sections: sociodemographics information, WHO STEPS survey instrument on knowledge of and lifestyle determinants for hypertension and diabetes, respondents' knowledge of and comprehension of hypertension and diabetes, and respondents' awareness of these disorders. RESULTS: Among 976 participants, 65.8% were females. the most common causes for hypertension from the perspective of participants were (90.1%) for stress, (87%) High salt consumption, (82.1%) genetics, (78.2%) old age, (78%) obesity (69%) anxiety, and (38.6%) for drug usage. Primary and middle school educational status participants had greater hypertension knowledge (92.3%) than other educational levels. There was a statistical significant difference between the knowledge toward the hypertension and the drinking alcohol, which the nonalcoholic knowledgeable persons were the most common (819 / 976)(P < 0.05). Participants whose lifestyles did not include alcohol use had a higher hypertension knowledge level (90.3%). Participants who do not consume alcohol have shown better hypertension knowledge (90.3%) than those who do (81.9%). Almost age groups have shown good knowledge of diabetes, especially participants aged above 55 (93.8%). However, most individuals have examined blood pressure (82.3%), whereas fewer than half had screened for blood sugar (64.4%). About 82.2% of individuals check their blood pressure frequently, whereas 6.2% monitor their blood sugar. There were significant associations between hypertension knowledge and gender, education, employment, and economic position (P value < 0.05). Men (mean = 8.39, SD = 2.02, P-value < 0.05) have a higher hypertension knowledge than females, and knowledge of hypertension among participants was shown to be higher among those in good income status than other economic levels (mean = 8.34, SD = 1.98). Age, gender, education, employment, and marital status were all associated with diabetes knowledge. Participants between the ages of 40 and 55 showed better knowledge of diabetes compared to other age groups (mean = 11.32, SD = 2.54); also, men demonstrated greater knowledge of diabetes than females (mean = 10.76, SD = 2.79). CONCLUSION: We indicated that the Syrian population has a good to moderate understanding of hypertension and diabetes. However, there is still a shortage of standardized, regular screening practices. Since individuals remain involved in unhealthy lifestyle habits, it is vital to provide accurate information about hypertension and diabetes to encourage them to make healthy changes.

Decoupling of mRNA and Protein Expression in Aging Brains Reveals the Age-Dependent Adaptation of Specific Gene Subsets.

During aging, changes in gene expression are associated with a decline in physical and cognitive abilities. Here, we investigate the connection between changes in mRNA and protein expression in the brain by comparing the transcriptome and proteome of the mouse cortex during aging. Our transcriptomic analysis revealed that aging mainly triggers gene activation in the cortex. We showed that an increase in mRNA expression correlates with protein expression, specifically in the anterior cingulate cortex, where we also observed an increase in cortical thickness during aging. Genes exhibiting an aging-dependent increase of mRNA and protein levels are involved in sensory perception and immune functions. Our proteomic analysis also identified changes in protein abundance in the aging cortex and highlighted a subset of proteins that were differentially enriched but exhibited stable mRNA levels during aging, implying the contribution of aging-related post- transcriptional and post-translational mechanisms. These specific genes were associated with general biological processes such as translation, ribosome assembly and protein degradation, and also important brain functions related to neuroplasticity. By decoupling mRNA and protein expression, we have thus characterized distinct subsets of genes that differentially adjust to cellular aging in the cerebral cortex.

Mpox Perceptions and Vaccine Advocacy among the Healthcare Workers of Solid Organ Transplant Centers: A Multicenter, Cross-Sectional Survey in Saudi Arabia.

BACKGROUND: In response to the global Mpox outbreaks, this survey aimed to assess the knowledge, perceptions, and advocacy of Mpox vaccines among solid organ transplant healthcare workers (HCWs) in Saudi Arabia. METHODS: A cross-sectional survey was conducted among solid organ transplant HCWs in Saudi Arabia from 15 August to 5 September 2022. A total of 199 responses were received from participants primarily working in the kidney (54.8%) and liver (14.6%) transplant units. RESULTS: The survey found that most participants were aware of the 2022 Mpox outbreak, but the majority were more concerned about COVID-19 than Mpox. While the majority of participants thought laboratory personnel and HCWs in direct contact with Mpox patients should receive the vaccine, less than 60% believed that all HCWs should be vaccinated. Additionally, over half of the participants lacked knowledge of animal-human transmission of the virus. CONCLUSION: The results highlight the need for increased education on Mpox among transplant HCWs in Saudi Arabia, particularly regarding the virus's transmission dynamics and vaccines. This education is crucial to improve HCWs' understanding of this emerging disease, especially given their vulnerability during the COVID-19 pandemic.

Seasonal Variation and Geographical Distribution of COVID-19 across Nigeria (March 2020-July 2021).

Globally, the novel corona virus infection has continued to witness a growing number of cases since December 2019 when the outbreak was discovered and noted in China. Despite this has not been well studied for the case of COVID-19, human contact, public moveableness and environmental variables could have an impact onairborne'spropagation and virus continuance, such as influenza virus. This study aimed to determine the seasonal variation and geographical distribution of COVID-19 across Nigeria. An internet based archival research design was employed for this study on the seasonal variation and geographical distribution of COVID-19 across Nigeria. This involved the use of goggle mobility data and world map on Corona Virus Infection (COVID-19). The search strategy for getting information for this research was done electronically. The keywords in the case search using the goggle mobility software was "COVID-19 Update", "COVID-19 Update in Nigeria", 'COVID-19 Winter Report', "COVID-19 Case Fatality March 2020-July 2021", "COVID-19 Case Fatality in Nigeria". The data gotten from the goggle motor updates were entered into Statistical Package for the Social Sciences (SPSS) which was used in the analysis of the study. Results from the study, reported that official COVID-19 cases number was significantly higher in the Dry season (October 2020-April 2021) with 59.0% (127,213) compared to 41.0% (85,176) in the wet/rainy season (May-September) it revealed that the dry and rainy seasons had a COVID-19 prevalence of 0.063 and 0.041 respectively. Further results from the study showed that the prevalence of COVID-19 was 0.07% in the North-Central, 0.04% in both the North-East and North-West, 0.03% in the South-West, 0.09% in the South-South, and the highest prevalence of 0.16% in the South-East. Considering the case Fatality rate of COVID-19 during the Dry and Wet Seasons. The study revealed that North-Central had a death toll of 196 (10.4%) out of 9457 confirmed COVID-19 cases hence a fatality of 2.07. Fatality rate of 1.49% in South western Nigeria, South-South Nigeria, 1.49%, South-East accounted to a fatality rate of 1.25%. Nigeria based on the finding of this study records increased fatality in Dry season over wet seasons. The study concluded that prevalence of COVID-19 varies in seasons in Nigeria Hence; further Data and Meteorological analysis on weather variations towards the SARS-CoV-2 Virus spread should be evaluated by future researchers. It is imperative to ensure strict and controlled application of social measures, such as social distancing, mandatory wearing of non-medical masks to prevent droplets from entering the respiratory tract, screening of affected patients along with quarantine is essential to defeat and improve infection control.

Cardiovascular Manifestation in Tuberculosis Cases: A Systematic Review and Meta-Analysis.

A considerable epidemiological and pathogenetic overlap exists between tuberculosis (TB) and cardiovascular diseases (CVD). The objective of this study was to establish the prevalence of CVD in the TB population. A systematic literature search was performed using Scopus, PubMed, EBSCO, ProQuest, Web of Science on January 25, 2023 using the keywords: "Tuberculosis," "TB," "mycobacterium tuberculosis," and "cardiovascular disease," "CVD" and with individual terms of various CVDs. Observational Studies were included if they reported the prevalence of CVD in the presence of TB in an adult population. The Newcastle-Ottawa Scale was used for quality evaluation. Statistical analyses were performed using STATA version 17. From 10 studies involving 46715 TB patients, a combined prevalence of CVDs was found to be 11% (CI: 95%, 5-16) with significant heterogeneity across studies (I2 = 96.72%). This study showed a considerable prevalence of CVD among TB patients suggesting TB patients to consider cardiac examination.

A rare case of left parapharyngeal space large schwannoma of unknown origin.

Schwannoma, also called neurilemmoma, is a rare neurogenic tumor exclusively benign that develops from a variety of glial nerve cells called Schwann cells. We present a 26-year-old female patient who was admitted with a history of dysphagia, headache and swelling going from the lower limit of the ear to the floor of the neck on the left side, which has been slowly progressing for 5 years. Upon local clinical examination, a well-defined mass was revealed, 6 × 5 cm in size, non-painful spontaneously, painful on direct palpation of the left neck. Computed tomography scan has shown a well-circumscribed large mass with heterogenous areas of enhancement in the left parapharyngeal space displacing the submandibular gland superiorly and the carotid sheath anterolaterally and compressing the oropharyngeal airway. Excision of the tumor was done by a combined route without post-operative complications noted. Histopathological examination revealed a benign schwannoma without the identification of the nerve of origin.

RNA regulation of inflammatory responses in glia and its potential as a therapeutic target in central nervous system disorders.

A major hallmark of neuroinflammation is the activation of microglia and astrocytes with the induction of inflammatory mediators such as IL-1ß, TNF-α, iNOS, and IL-6. Neuroinflammation contributes to disease progression in a plethora of neurological disorders ranging from acute CNS trauma to chronic neurodegenerative disease. Posttranscriptional pathways of mRNA stability and translational efficiency are major drivers for the expression of these inflammatory mediators. A common element in this level of regulation centers around the adenine- and uridine-rich element (ARE) which is present in the 3' untranslated region (UTR) of the mRNAs encoding these inflammatory mediators. (ARE)-binding proteins (AUBPs) such as Human antigen R (HuR), Tristetraprolin (TTP) and KH- type splicing regulatory protein (KSRP) are key nodes for directing these posttranscriptional pathways and either promote (HuR) or suppress (TTP and KSRP) glial production of inflammatory mediators. This review will discuss basic concepts of ARE-mediated RNA regulation and its impact on glial-driven neuroinflammatory diseases. We will discuss strategies to target this novel level of gene regulation for therapeutic effect and review exciting preliminary studies that underscore its potential for treating neurological disorders.