Ameliorative impacts of gamma-aminobutyric acid (GABA) on seedling growth, physiological biomarkers, and gene expression in eight wheat (Triticum aestivum L.) cultivars under salt stress.

Plants spontaneously accumulate γ-aminobutyric acid (GABA), a nonprotein amino acid, in response to various stressors. Nevertheless, there is limited knowledge regarding the precise molecular mechanisms that plants employ to cope with salt stress. The objective of this study was to investigate the impact of GABA on the salt tolerance of eight distinct varieties of bread wheat (Triticum aestivum L.) by examining plant growth rates and physiological and molecular response characteristics. The application of salt stress had a detrimental impact on plant growth markers. Nevertheless, the impact was mitigated by the administration of GABA in comparison to the control treatment. When the cultivars Gemmiza 7, Gemmiza 9, and Gemmiza 12 were exposed to GABA at two distinct salt concentrations, there was a substantial increase in both the leaf chlorophyll content and photosynthetic rate. Both the control wheat cultivars and the plants exposed to salt treatment and GABA treatment showed alterations in stress-related biomarkers and antioxidants. This finding demonstrated that GABA plays a pivotal role in mitigating the impact of salt treatments on wheat cultivars. Among the eight examined kinds of wheat, CV. Gemmiza 7 and CV. Gemmiza 11 exhibited the most significant alterations in the expression of their TaSOS1 genes. CV. Misr 2, CV. Sakha 94, and CV. Sakha 95 exhibited the highest degree of variability in the expression of the NHX1, DHN3, and GR genes, respectively. The application of GABA to wheat plants enhances their ability to cope with salt stress by reducing the presence of reactive oxygen species (ROS) and other stress indicators, regulating stomatal aperture, enhancing photosynthesis, activating antioxidant enzymes, and upregulating genes involved in salt stress tolerance.

Mesenchymal stem cell transplantation in burn wound healing: uncovering the mechanisms of local regeneration and tissue repair.

Burn injuries pose a significant healthcare burden worldwide, often leading to long-term disabilities and reduced quality of life. To explore the impacts of the transplantation of mesenchymal stem cells (MSCs) on the healing of burns and the levels of serum cytokines, 60 fully grown Sprague-Dawley rats were randomly divided into three groups (n = 20 each): group I (control), group II (burn induction), and group III (burn induction + bone marrow (BM)-MSC transplantation). Groups II and III were further divided into four subgroups (n = 5 each) based on euthanasia duration (7, 14, 21, and 28 days post transplant). The experiment concluded with an anesthesia overdose for rat death. After 7, 14, 21, and 28 days, the rats were assessed by clinical, laboratory, and histopathology investigations. The results revealed significant improvements in burn healing potentiality in the group treated with MSC. Furthermore, cytokine levels were measured, with significant increases in interleukin (IL)-6 and interferon alpha (IFN) observed, while IL-10 and transforming growth factor beta (TGF-ß) decreased at 7 days and increased until 28 days post burn. Also, the group that underwent the experiment exhibited increased levels of pro-inflammatory cytokines and the anti-inflammatory cytokine IL-10 when compared to the control group. Histological assessments showed better re-epithelialization, neovascularization, and collagen deposition in the experimental group, suggesting that MSC transplantation in burn wounds may promote burn healing by modulating the immune response and promoting tissue regeneration.

Sensitivities of a Rapid Test Versus an ELISA Kit for Detecting Anti-SARS-CoV-2 IgM/IgG in Sera from an Egyptian Cohort.

This study aimed to compare diagnostic sensitivities of a rapid test (Rt) and an ELISA kit for detecting anti-SARS-CoV-2 IgM/IgG in virus-RT-PCR-positive (VPP) and virus-RT-PCR-unchecked (VPU) subjects in an Egyptian cohort during the first wave of SARS-CoV-2 infection. The results revealed higher sensitivity of the Rt for detecting IgM/IgG in the VPP subjects. Both the Rt and ELISA showed identical sensitivities for IgM detection in the VPU subjects. The ELISA was more sensitive for detecting IgG in the VPU subjects. Generally, within both the VPP and the VPU groups, Rt was more sensitive for detecting IgM/IgG among the symptomatic (S) compared to asymptomatic (AS) subjects than ELISA. Within the VPP group, the Rt was more sensitive for detecting both IgM/IgG among the AS subjects than ELISA. In the VPU group, the Rt was more sensitive for detecting IgM among the S subjects than ELISA. The ELISA was more sensitive for detecting IgM/IgG among AS subjects than the Rt. From these results we concluded that, despite the limitation of sample size, this study indicates suitability of the used Rt for detecting anti-SARS-CoV-2 IgM/IgG among S subjects and sheds light on possibility of relying on the used ELISA for IgG detection among AS human subjects.

Perceptions of Neurosurgery among Medical Students and Interns: A National Cross-Sectional Study.

Background: Neurosurgery is considered one of the most admired surgical specializations. Still, as evidenced by observations over the years, it is not amongst the top choices of medical students in Saudi Arabia. This study will help in understanding the perception and attitudes of medical students and interns toward the neurosurgery specialization, which will aid in developing strategies to increase the interest of undergraduates in neurosurgery specialization and bridge the human resource gap in this vital specialty. Objectives: This study aimed to assess perceptions, attitudes, and gender differences of medical students and interns toward neurosurgery. The influence of demographic factors on perceptions of neurosurgery of interns and senior medical students in Saudi Arabia was also investigated. Methodology: We conducted a cross-sectional study on a convenience sample of medical students (clinical years) and interns studying in different colleges of medicine in Saudi Arabia. A total of 1014 responses were included in this study (518 males and 496 females). The questionnaire comprised of two parts: the first part carried general descriptive questions, while the second part had 24-item Likert scale-based questions. Results: Around 40% of medical students and 26% of interns agreed or strongly agreed to the statement 'I would consider a career in neurosurgery. Around 70% of both interns and students agreed or strongly agreed with the statement 'Huge prestige is attached to neurosurgery'. The responses to the statement 'Neurosurgery is a male specialty' was significantly different between genders, as 36.5% of the male respondents agreed or strongly agreed with the statement while just 12.5% of the females responded likewise (p = 0.000). Only 23% of participants reported having completed a rotation in neurosurgery. About 44.7% of respondents were interested in taking an elective rotation in neurosurgery, while the remaining respondents (55.3%) responded with a negative answer. Only 23% of participants had completed an undergraduate rotation in neurosurgery. More males (65.3%) agreed or strongly agreed with the statement 'Work as a neurosurgery specialist can impede family life as compared to females (57.5%), which was highly significant (p = 0.000). More medical students (45.1%) responded in the agreement or strong agreement in response to the statement' Neurosurgery should be a compulsory rotation during internship' as compared to interns (25.8%). Around 65% of the respondents agreed or strongly agreed that teachers/seniors have a great influence on students' specialization choices. Around 67% of the respondents foresaw a purely clinical role for themselves after graduation, while 17% were interested in a clinical-academician role. Conclusions: The study reflected a generally positive attitude towards neurosurgery amongst medical students and interns. Interest in neurosurgery as a specialization can be strengthened by enhancing the exposure of students and interns to the specialty. Teachers and seniors can be useful influencers to motivate students to consider neurosurgery specialization.

Can human IgG subclasses distinguish between confirmed and unconfirmed SARS-CoV-2 infections?

BACKGROUND: Immunoglobulin G (IgG) subclasses play a crucial role in the immune response to viral infections. While total IgG levels can generally provide an indication on the immune response, specific IgG subclasses can offer more detailed information about nature of the immune response and stage of the infection. Herein, we addressed the value of both total (t) and SARS-CoV-2-specific (s) IgG-subclasses in distinguishing between infection-confirmed virus-qRT-PCR-positive (IC; V-qRT-PCR-P) and infection-unconfirmed virus-qRT-PCR-unchecked (IU; V-qRT-PCR-UC) Egyptians. RESULTS: Both the t-IgG2 and 4 means were significantly higher (SH) among the IU subjects, whereas, the s-IgG1 and 3 means were SH among the IC ones. On the gender levels, both the t-IgG2 and 4 means were SH among the IU females, whereas, the mean of the s-IgG1 was SH among the IC females. The t-IgG4 mean was SH among the IU males, whereas, both means of the s-IgG1 and 3 were SH among the IC males. Significant positive correlations (SPC) were recorded between both the t-IgG1 and 3 with the symptom grades (SG) among the IU humans (r2 = 0.200 and 0.253, respectively). Also, SPC was noticed between the s-IgG2 and the SG among the IU females (r2 = 0.6782). SPC was recorded between both the t-IgG1 and the s-IgG2 with the SG among the IU males (r2 = 0.794 and 0.373, respectively). SPC was noticed between the t-IgG3 and the age among the IC males (r2 = 0.779). CONCLUSION: Although the limitation of the small studied sample size, our results suggest some total and SARS-CoV-2-specific IgG-subclasses as both supplemental and gender-specific immune markers to distinguish between confirmed and unconfirmed SARS-CoV-2 infections.

Apolipoproteins have a major role in cellular tumor dormancy in triple negative breast cancer: In-silico study.

Triple-negative breast cancer (TNBC) lacks estrogen, progesterone, and human epidermal growth factor receptors and has a poor prognosis as it is resistant to chemotherapy. A new treatment option for this type of cancer may be by putting these malignant cells into dormancy. The oocyte's embryonic milieu presents a unique tumor reversion microenvironment by inducing growth arrest and changing cells' phenotypes. We conducted an in-silico study to determine the most likely oocyte extract (OE) proteins involved in inducing dormancy using HDock, CluPro, and molecular dynamic (MD) simulation. Results showed low energy scores for complexes between OE proteins and four surface markers: K1C14, CLD3, CLD4, and ITA6. Apolipoprotein A1 (APOA1) and Apolipoprotein C3 (APOC3) showed the highest stability and affinity with these four surface markers: K1C14, CLD3, CLD4, and ITA6. These proteins are involved in key tumor-related pathways such as angiogenesis, proliferation, apoptosis, and migration. This will pave the way for exploring novel therapeutic options to induce dormancy in TNBC cells.

Egypt Genome: Towards an African new genomic era.

BACKGROUND: Studying the human genome is crucial to embrace precision medicine through tailoring treatment and prevention strategies to the unique genetic makeup and molecular information of individuals. After human genome project (1990-2003) generated the first full sequence of a human genome, there have been concerns towards Northern bias due to underrepresentation of other populations. Multiple countries have now established national genome projects aiming at the genomic knowledge that can be harnessed from their populations, which in turn can serve as a basis for their health care policies in the near future. AIM OF REVIEW: The intention is to introduce the recently established Egypt Genome (EG) to delineate the genomics and genetics of both the modern and Ancient Egyptian populations. Leveraging genomic medicine to improve precision medicine strategies while building a solid foundation for large-scale genomic research capacity is the fundamental focus of EG. KEY SCIENTIFIC CONCEPTS: EG generated genomic knowledge is predicted to enrich the existing human genome and to expand its diversity by studying the underrepresented African/Middle Eastern populations. The insightful impact of EG goes beyond Egypt and Africa as it fills the knowledge gaps in health and disease genomics towards improved and sustainable genomic-driven healthcare systems for better outcomes. Promoting the integration of genomics into clinical practice and spearheading the implementation of genomic-driven healthcare and precision medicine is therefore a key focus of EG. Mining into the wealth of Ancient Egyptian Genomics to delineate the genetic bridge between the contemporary and Ancient Egyptian populations is another excitingly unique area of EG to realize the global vision of human genome.

Are Measles-Mumps-Rubella (MMR) Antibodies Friends or Foes for Covid-19 Disease?

Many factors have been implicated in the pathogenesis and severity of COVID-19 pandemic. A wide variation in the susceptibility for SARS-CoV-2 infection among different population, gender and age has been observed. Multiple studies investigated the relationship between the antibody's titre of previously vaccinated individuals and the susceptibility of coronavirus infection, to find a rapid effective therapy for this pandemic. This study focused on the association between measles-mumps-rubella (MMR) antibodies titre and the severity of COVID-19 infection. We aimed to investigate the correlation between the antibody's titre of MMR and the SARS-CoV-2 infection susceptibility and disease severity, in a cohort of COVID-19 Egyptian patients, compared to a control group. MMR antibody titre was measured using enzyme Linked Immune Sorbent Assay; (ELISA) for 136 COVID-19 patients and 44 healthy individuals, as control group. There were high levels of measles and mumps antibodies titer in the deteriorating cases, which could not protect from SARS-CoV-2 infection. However, the rubella antibodies might protect from SARS-CoV-2 infection, but once the infection occurs, it may aggravate the risk of case deterioration. MMR antibodies could be used as a guideline for COVID-19 symptom-severity and, in turn, may be considered as an economic prognostic marker used for early protection from multiple autoimmune organ failure.

Proinflammatory Cytokine Profiles in Both Mild Symptomatic and Asymptomatic SARS-CoV-2-Infected Egyptian Individuals and a Proposed Relationship to Post-COVID-19 Sequela.

Severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) infection is associated with proinflammatory cytokine release as mediators of host antiviral response to the infection. Cytokine persistent elevation leads to post-Coronavirus disease-2019 (COVID-19) post-COVID-19 sequela (PCS) reported in about 60% of patients affecting individual's normal life after recovery. This study evaluates relationship of cytokines and chemokines pattern during and postinfection to PCS events. Serum samples collected from 82 individuals with symptomatic, asymptomatic, or no SARS-CoV-2 infection were classified as recently or formerly infected groups according to levels of anti-2019nCoV Immunoglobulin G/Immunoglobulin M. Levels of interleukin (IL)-1α, IL-1ß, IL-6, IL-8, interferon alpha (IFN-α), tumor necrosis factor alpha (TNF-α), granulocyte macrophage colony-stimulating factor (GM-CSF), and monocyte chemoattractant protein-1 were assessed via ELISA for each individual. All asymptomatic groups showed nonsignificant differences in cytokines' levels than control group. Significant elevation of IFN-α, TNF-α, and GM-CSF levels were observed in recent symptomatic, while IFN-α and TNF-α levels were significant in former symptomatic groups. We observed an association between fever with IL-1α and IFN-α levels, fatigue with TNF-α and GM-CSF, dyspnea with IFN-α, TNF-α, and GM-CSF, and chest-wheezing with GM-CSF. Individuals were surveyed 12 months postsampling for PCS events. Among 35 responders to survey, 8 (22.8%) reported PCS events, 6 of which were females. Upon studying PCS events, IL-8, IFN-α, TNF-α, and GM-CSF levels showed significant elevation in active infection, that was not seen in a resolved state of infection. Cytokines patterns suggest that either a persistent elevation in levels or damage caused during infection contributes to PCS. Although with the limited sample size, our study emphasizes the importance to conduct medical approaches targeting the associated cytokines to improve the PCS symptoms.

Surgical Intervention for Spinal Lesions Due to Multiple Myeloma: A Case Report.

Vertebral disease is a main source of morbidity (MM) in individuals with multiple myeloma. The effects of associated osteolytic lesions and vertebral fractures on severe pain, functional limits, spinal deformity, and cord compression are well recognized. Systemic therapy, radiation, cementoplasty (vertebroplasty/kyphoplasty), and radiofrequency ablation are now available therapeutic options for severe MM spinal pain. We here reported a case of a 45-year-old male who had complained of progressive symptoms of pathological spine fractures. He had been examined and investigated for the cause of lytic lesions and found to have multiple fractures in the spine. A computed tomography (CT) revealed multiple osteolytic lesions noted in the thoracolumbar spine, ribs (bilaterally), and pelvic bones. Magnetic resonance imaging (MRI) showed a compression fracture of the T8 vertebral body with evidence of retro-bulging and a spinal canal narrowing. However, there was no evidence of spinal cord abnormal signal intensity. T2 weighted image (T2WI) keeping with edema is noted. A surgical intervention fixed the fracture and improved the quality of life. Vertebroplasty, a minimally invasive procedure, as a treatment option for vertebral lesions and pathologic fractures in the MM, showed good clinical improvement in the patient.

Assessment of the Impact of Lower Urinary Tract Dysfunction on Quality of Life in Multiple Sclerosis Patients in Saudi Arabia-A Cross-Sectional Study.

BACKGROUND: Lower urinary tract dysfunction (LUTD) is caused by neurogenic factors that could lead to permanent injury in affected patients, and therefore result in substantial annual healthcare expenses. LUTD is very prevalent in multiple sclerosis (MS) patients and has a drastic impact on their quality of life (QOL). This study aimed to assess the effect of LUTD on the QOL of Saudi MS patients. METHODS: A cross-sectional study was carried out in Saudi Arabia using a self-administered questionnaire that included the World Health Organization Quality of Life (WHOQOL-BREF) and LURN Symptom Index (LURN SI-29). Data were analyzed and presented as frequencies and percentages. RESULTS: There were 428 patients who participated in this study; 270 were females and 158 were males. Most of the patients received a low score in all sections of the LURN part of the questionnaire. The highest scores (urgent need to urinate and excessive urination at night) were recorded in the urgency domain (47.20 ± 36.88) rather than the nocturia domain (44.74 ± 32.91). Meanwhile, the lowest score (complete control of bladder) was recorded in the incontinence domain (22.80 ± 26.80). For the WHOQOL-BREF score, the highest score (more social stability) was in the social domain (65.07 ± 21.16 for females, 60.41 ± 21.54 for males), and the lowest score (less psychological stability) was in the psychological domain (46.36 ± 9.84 for females, 46.20 ± 10.03 for males). However, there was no significant association between the four domains of the WHOQOL-BREF and the gender of the MS patients. CONCLUSIONS: LUTD is significantly associated with a lowered quality of life. Therefore, patients are recommended to consult with and be evaluated by appropriately experienced healthcare providers and clinicians. This ensures that the patients receive the best advice, accurate and effective treatment, and long-term analysis that can lead to an improvement in their quality of life.

Conferring of Drought and Heat Stress Tolerance in Wheat (Triticum aestivum L.) Genotypes and Their Response to Selenium Nanoparticles Application.

In this study, the role of selenium nanoparticles (SeNPs, 10 mg·L-1) has been investigated in modulating the negative effects of drought and heat stresses on eight bread wheat (Triticum aestivum L.) genotype seedlings. Those genotypes included Giza-168, Giza-171, Misr-1, Misr-3, Shandweel-1, Sids-1, Sids-12, and Sids-14. The study included six treatments as follows: regular irrigation with 100% Field Capacity (FC) at a temperature of 23 ± 3 °C (T1), drought stress with 60% FC (T2), heat stress of 38 °C for 5 h·day-1 (T3), foliar spray of 10 mg·L-1 of SeNPs only (T4), a combination of drought stress with foliar spray of 10 mg·L-1 of SeNPs (T5), and heat stress with foliar spray of 10 mg·L-1 of SeNPs (T6). The experiment continued for 31 days. Foliar application of SeNPs improved the plant growth, morpho-physiological and biochemical responses, and expression of stress-responsive genes in wheat (T. aestivum L.) seedlings. Overall, morpho-physiological traits such as plant height (PH), shoot fresh weight (SFW), shoot dry weight (SDW), root fresh weight (RFW), and root dry weight (RDW) of wheat genotypes grown under different conditions ranged from 25.37-51.51 cm, 3.29-5.15 g, 0.50-1.97 g, 0.72-4.21 g, and 0.11-1.23 g, respectively. From the morpho-physiological perspective, drought stress had a greater detrimental impact on wheat plants than heat stress, whereas heat stress significantly impacted the expression of stress-responsive genes. Stress responses to drought and heat varied between wheat genotypes, suggesting that different genotypes are more resilient to stress. Exogenous spraying of 10 mg·L-1 of SeNPs improved the photosynthetic pigments, photosynthetic rate, gas exchange, and transpiration rate of wheat plants and enhanced drought and heat tolerance by increasing the activity of antioxidant enzymes including catalase (CAT), ascorbate peroxidase (APX), and superoxide dismutase (SOD) and the expression level of stress-responsive genes. Our results showed that spraying wheat seedlings with 10 mg·L-1 of SeNPs enhanced SOD activity for all genotypes as compared to the control, with the Sids-12 genotype having the highest value (196.43 U·mg-1 FW·min-1) and the Giza-168 genotype having the lowest (152.30 U·mg-1 FW·min-1). The expression of PIP1, LEA-1, HSP70, and HSP90 stress-responsive genes was more significant in tolerant genotypes (Giza-171 and Giza-168) than in sensitive ones (Misr-1 and Misr-3) in response to drought and heat stresses. Under stress conditions, the shoot and root fresh weights, photosynthetic pigment content, stomatal conductance (SC), and transpiration rate (TR) were positively correlated with plant height (PH), while root and shoot dry weights, malondialdehyde (MDA), proline, hydrogen peroxide (H2O2), and APX were negatively correlated. Multivariate analysis and biplot results revealed that genotypes Giza-168, Giza-171, Sids-12, and Sids-14 performed well in both stress situations and were classified as stress-tolerant genotypes. These best genotypes may be employed in future breeding projects as tools to face climate change. This study concluded that various physio-biochemicals and gene expression attributes under drought and heat stress could be modulated by foliar application of SeNPs in wheat genotypes, potentially alleviating the adverse effects of drought and heat stress.

Genomic characterization of SARS-CoV-2 in Egypt: insights into spike protein thermodynamic stability.

The overall pattern of the SARS-CoV-2 pandemic so far has been a series of waves; surges in new cases followed by declines. The appearance of novel mutations and variants underlie the rises in infections, making surveillance of SARS-CoV-2 mutations and prediction of variant evolution of utmost importance. In this study, we sequenced 320 SARS-CoV-2 viral genomes isolated from patients from the outpatient COVID-19 clinic in the Children's Cancer Hospital Egypt 57357 (CCHE 57357) and the Egypt Center for Research and Regenerative Medicine (ECRRM). The samples were collected between March and December 2021, covering the third and fourth waves of the pandemic. The third wave was found to be dominated by Nextclade 20D in our samples, with a small number of alpha variants. The delta variant was found to dominate the fourth wave samples, with the appearance of omicron variants late in 2021. Phylogenetic analysis reveals that the omicron variants are closest genetically to early pandemic variants. Mutation analysis shows SNPs, stop codon mutation gain, and deletion/insertion mutations, with distinct patterns of mutations governed by Nextclade or WHO variant. Finally, we observed a large number of highly correlated mutations, and some negatively correlated mutations, and identified a general inclination toward mutations that lead to enhanced thermodynamic stability of the spike protein. Overall, this study contributes genetic and phylogenetic data, as well as provides insights into SARS-CoV-2 viral evolution that may eventually help in the prediction of evolving mutations for better vaccine development and drug targets.

The Relationship of ABO and Rh Blood Group Types With Severe COVID-19 Disease Mortality in ICU Patients: Insights From a Single-Center Experience in Southern Saudi Arabia.

Introduction The global COVID-19 pandemic has triggered an unprecedented public health crisis, emphasizing the need to understand factors influencing disease outcomes. This study explores the role of genetic variations in blood group antigens, particularly ABO and RhD, in shaping mortality rates among critically ill COVID-19 patients in the southern region of Saudi Arabia. Methods Utilizing a retrospective, noninterventional approach, we analyzed medical records of 594 COVID-19 patients admitted to the intensive care unit (ICU) at Aseer Central Hospital from August 2020 to April 2021. The cohort, with a mean age of 60.5 years, consisted of a predominantly male population. Results The study encompassed a diverse age range of 18 to 103 years, with a mean age of 60.5 ± 17.3 years. Of the 594 patients, 398 (67%) were male, and only 5 (0.8%) had a history of smoking. Blood group distribution revealed 275 (48.4%) with O-, 189 (33.3%) with A+, and 51 (9%) with AB- types. Predominant chronic conditions included diabetes mellitus (35.5%). Tragically, 320 patients (54.6%) experienced mortality, with a 100% mortality rate for the B+ blood group and 92.9% for O- blood group. Conclusion This analysis establishes significant statistical links, underscoring the pivotal role of blood type, particularly the Rh factor, in influencing mortality risk among critically ill COVID-19 patients. These findings contribute valuable insights into risk stratification and personalized care for severe cases, emphasizing the importance of genetic considerations in understanding disease outcomes.

Association of Ultrasonography With Final Histopathology in Diagnosing Thyroid Malignancy: A Single-Institute Retrospective Study.

Background Thyroid nodules are well-defined regions of aberrant echogenicity within the thyroid parenchyma that are radiologically distinct from the normal thyroid gland. The most common incidental finding in imaging scans that include the neck is a thyroid nodule. Rarely are thyroid nodules cancerous, as the majority are benign. Aim The current study aims to assess the concordance between ultrasound (US) of thyroid nodules and final histopathology results to identify the different types of detected thyroid lesions. Methodology A retrospective study reviewed the medical files of all patients presenting to the Armed Forces Hospital, Southern Region, with suspected thyroid nodules from April 2018 to January 2020. Data were extracted using pre-structured proforma to avoid inconsistency. Data extracted included patient demographic, swelling laterality, size, and US and histopathological findings. Results In the present study, 47 samples had a mean age of 44.27 (SD = ±13.5) years, 85.1% were of the female gender, the majority (85.1%) had multiple nodules, 38.3% were with Thyroid Imaging Reporting and Data System (TI-RADS) TR4 US score, and the median size of the nodule on US was 3 cm with a range of 0.6 to 14 cm. The study showed that 10% of TR1 samples were lymphocytic in histopathology, 66.7% of TR3 samples were benign multinodular goiter in histopathology, and 55.6% of samples of TR4 were malignant in histopathology. Conclusions The current study showed that the malignancy rate of the examined nodules was not uncommon both by US and histopathology, where papillary carcinoma was the most detected malignancy. The study showed a satisfactory agreement rate between TI-RADS classification by US sonography and histopathological reporting, where TR4 and TR5 by the US were mainly categorized as pre-malignant/malignant lesions by histopathology.

Assessment of Multiple Sclerosis Patients' Knowledge and Behavioral Practice Regarding COVID-19 in Saudi Arabia.

Background Coronavirus disease 2019 (COVID-19) is caused by a coronavirus subtype called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is crucial to control the spread of coronavirus by understanding the disease and practicing the measures adopted during the COVID-19 pandemic. Multiple sclerosis (MS) is a central nervous system immune-mediated inflammatory demyelinating disease. COVID-19 infection may exacerbate the MS disease and its relapses. Therefore, MS patients are more susceptible to infection because of their immunosuppressive or immunomodulatory medications. Objective We aimed to evaluate the knowledge, attitude, and behaviors of patients with MS in Saudi Arabia regarding the COVID-19 pandemic. Method A quantitative observational cross-sectional study was conducted. MS patients in Saudi Arabia were included in the study population. Data were collected via an online self-reported questionnaire from 214 participants from November 2020 to June 2021. Results A total of 214 MS patients participated in this study. The gender distribution showed that the male participants represented 38.3% (n = 82), while female participants accounted for 61.7% (n = 132). Most MS patients understood the COVID-19 preventive measures. The mean knowledge score was 15.7 (SD = 2.34, range: 1-20), showing an appropriate level of knowledge. While the mean behaviors score was 6.1 (SD = 1.2, range: 2-9), showing good behaviors. The mean score for attitude was 5.4 (SD = 1.77, range: 1-8), showing optimistic attitudes. However, a closer analysis of the participants' answers showed that 74.3% of the patients agreed that the treatment plan should be discussed with their doctors during the pandemic. In addition, almost half of the participants (49.1%) agreed that being an MS patient means they are at higher risk of getting infected by the virus. Data also showed that 17% of patients continued to attend social events involving many people. Also, 28.0% of the patients reported being in crowded places. Conclusion MS patients' risk of COVID-19 might be linked to their knowledge, attitude, and behaviors. Our results suggest that although MS patients have a high knowledge and good attitude and behaviors, it is still essential to have health education programs among MS patients to reduce the risk of SARS-CoV-2 infection and the impact of the COVID-19 pandemic on MS patients' care. Knowledge, attitude, and behaviors toward the COVID-19 pandemic can highlight the importance of education programs and translate the findings into action to minimize the disease risk.

Quality of life among caregivers of epileptic children with degree of controlling seizures in Aseer region.

Epilepsy affects nearly 50 million people worldwide. Epilepsy can affect the quality of life of both the child and the caregiver leaving them unable to function in other areas of life. This quality of life is highly dependent on treatment adherence and how individuals feel about taking their medication. In our study, we aimed to investigate the frequency of medication adherence and the quality of life of caregivers of children with epilepsy. For this purpose, we conducted a cross-sectional survey at the Abha Maternity and Children's Hospital. We enrolled 133 consecutive participants and asked them to complete a questionnaire. The results showed that 37.6% of the participants forgot to take their medications, 9.8% of the participants reported that they were sometimes careless about giving their children medications and sometimes stopped giving them when the children were feeling better, 15.8% of the participants indicated that they sometimes stopped giving the medication when they felt that their children were getting worse when they took the medication., and 26.3% of the participants agreed that they only administered the medication when the children were sick. It was also found that the quality of life of the caregivers decreased when they forgot to give their children the medication and the quality of life of the caregivers increased when they continued to take the medication. In conclusion, quality of life increases as adherence to treatment increases, indicating that more intervention programs are needed to improve the adherence of epilepsy patients.

Patterns of Urinary Incontinence Among Women in Asir Region, Saudi Arabia.

Background Urinary incontinence among women is a widespread clinical condition that is frequently associated with marked physical, social, and psychological adverse impact that significantly worsens their quality of life. This study is conducted to identify the prevalence of urinary incontinence and associated risk factors among Saudi women in Asir Region, Saudi Arabia. Methods Following a cross-sectional design, 1,964 healthy non-pregnant females aged above 13 years attending primary healthcare centers in Asir Region, Saudi Arabia were included. A self-administered semi-structured questionnaire was used, which included sociodemographic and clinical characteristics, questions related to voiding habits, and the validated Arabic version of the International Consultation on Incontinence Questionnaire (ICIQ). Results Almost half of the participants (47.5%) had urinary incontinence, of which 26.8% was slight, 16.3% was moderate, and 4.3% was severe. About 15.2% used to leak urine once a week or less, 3.6% used to leak two to three times a week, and 5.6% leaked daily. The leaked amount of urine was small in 26% of participants, while it was moderate and large in 8% and 1.4% of participants, respectively. Leaking urine moderately affected the daily life of 21.9% of participants, while it severely affected 14.7% of participants. Their grades of urinary incontinence differed significantly according to their age group, with the highest prevalence of severe incontinence among those aged 50 years or more (p < 0.001). Grades of urinary incontinence also differed significantly according to participants' marital status, with those married or widowed having the highest prevalence of severe incontinence (8.5% and 19%, respectively; p < 0.001). Moreover, its grades differed significantly according to participants' number of pregnancies, with severe incontinence being highest among those with twice gravidity or three times or more (8.3% and 7.9%, respectively; p = 0.004). Grades of urinary incontinence also differed significantly according to the presence of associated diabetes mellitus and renal/urinary tract diseases (p = 0.001 for both). Conclusions Urinary incontinence is common among Saudi females. Older age, multiparty, and menopause are significant risk factors for urinary incontinence.

COVID-19 and Vaccine Hesitancy: Individual Determinants Among Saudis in Asir Region.

Background Coronavirus disease 2019 (COVID-19) is a highly contagious and quickly spreading disease, especially if associated with poor awareness and unwanted behavioral practices. Unvaccinated people are at high risk of infection, mortality, and morbidity. Practices and intent toward the COVID-19 vaccine are mainly influenced by the perception of vaccine safety. This study aimed to assess the perception, practices, intent, and challenges toward the COVID-19 vaccine in Asir region, Saudi Arabia. Methodology A quantitative, cross-sectional study was conducted among the available population in Asir region, southwest of Saudi Arabia. Data were collected from participants using a semi-structured electronic questionnaire. The questionnaire included sections on participants' socio-demographic data and their family and personal history of COVID-19 infection. Additionally, the effects of the COVID-19 pandemic on their daily life were assessed. The second section of the questionnaire included knowledge questions regarding the COVID-19 vaccine with only one correct answer for each question. The last section covered participants' attitudes toward the COVID-19 vaccine and their intent to take the vaccine with their previous vaccination practice. Results A total of 756 participants who met the inclusion criteria participated in the study. Participants' ages ranged from 18 to 65 years, with a mean age of 22.6 ± 12.8 years. A total of 518 respondents were females. Regarding the level of education, 72.2% were university graduates or postgraduates, and 195 (25.8%) were in high school. Regarding the overall knowledge level toward the COVID-19 vaccine among study participants, 420 (55.6%) participants had good knowledge regarding the COVID-19 vaccine. In total, 158 (20.9%) participants were of the view that the COVID-19 vaccine is risky. Approximately 26.9% of the participants were told by their doctor that vaccination is necessary, and 49.3% thought that they need more information about the COVID-19 vaccine. Conclusions This study revealed that public awareness regarding the COVID-19 vaccine was satisfactory, especially concerning its benefit in reducing infection and associated complications; however, poor awareness was reported regarding their perception of the pandemic and COVID-19 vaccine definition.

Are Saudis Equipped to Provide Adequate First Aid to Someone Having a Seizure?

Background and aim Epilepsy is one of the most common neurological disorders with a huge impact on the physical and psychological well-being of the individuals affected. Unwanted behavioral practices regarding epilepsy emergencies result in poor management, costly clinical interventions, and frequent unnecessary visits to the emergency departments. We aimed at conducting a large-scale investigation of behavioral practices, beliefs, and perceptions regarding epilepsy first aid measures among the Saudi public. Methods This is a descriptive questionnaire-based cross-sectional study of the general public residing in the Southwestern region of Aseer in Saudi Arabia. Results The study included 1230 participants. There were about 70.4% shows good knowledge about epilepsy and 74.2% with good knowledge about epilepsy first-aid. About 87.1% reported that they know what epilepsy really is, and nearly 38.1% know somebody diagnosed with epilepsy. Only 25.4 sought doctors for epilepsy-related knowledge. About 16.7% thought spirit possession to be the aetiology for epilepsy and about 14.1% believed that evil eye was the cause. In terms of the adjusted impact for background factors on epilepsy knowledge, high education, attending seminars, or getting information from doctors was associated with a better knowledge score. However, housewives were less knowledgeable in terms of epilepsy-related knowledge. Conclusion We uncovered in our present investigation the upward trend for behavioral practices regarding epilepsy during the last few years among the Saudi public. We noted that behavioral practices and knowledge levels about epilepsy were far better among highly educated graduates. One concerning finding is the huge reliance on media for information about epilepsy. The media may not be the ideal channel for the dissemination of health-wise information about epilepsy. Our study results showed that there was a very low level of first-hand experience of knowing some acquaintances living with epilepsy, likely because of stigma. Spirit possession and evil-eye beliefs are embedded in the Saudi culture. It was notable that 25% and 19% of minorities reported getting information about epilepsy from doctors and seminars, respectively. These were the two groups with the highest adjustable knowledge score though. Knowledge about first aid for epilepsy was satisfactory in several aspects. Sadly, housewives were less knowledgeable in terms of epilepsy-related knowledge than other categories of employment. Public healthcare facilities should be more proactive. Health education should be provided to the general public using simple and understandable language to help improve knowledge and attitudes towards epilepsy and all related chronic illnesses.