Oleuropein Relieves Pancreatic Ischemia Reperfusion Injury in Rats by Suppressing Inflammation and Oxidative Stress through HMGB1/NF-κB Pathway.

Oleuropein (OLP) is a naturally occurring phenolic compound in olive plant with antioxidant and anti-inflammatory potential and can possibly be used in treating pancreatic injuries. This investigation aimed to follow the molecular mechanism behind the potential therapeutic effect of OLP against pancreatic injury persuaded by ischemia-reperfusion (I/R). Pancreatic I/R injury was induced by splenic artery occlusion for 60 min followed by reperfusion. Oral administration of OLP (10 and 20 mg/kg) for 2 days significantly alleviated I/R-persuaded oxidative damage and inflammatory responses in pancreatic tissue as indicated by the decreased malondialdehyde (MDA) content and increased glutathione peroxidase (GPx) activity, accompanied by the suppression of myeloperoxidase (MPO) activity and reduced levels of interleukin-1beta (IL-1ß), nuclear factor kappa B (NF-κB), and tumor necrosis factor alpha (TNF-α) in pancreatic tissues. Furthermore, OLP treatment markedly restored the serum levels of amylase, trypsinogen-activated peptide (TAP), and lipase, with concurrent improvement in pancreatic histopathological alterations. Moreover, treatment with OLP regulated the pancreatic expression of inducible nitric oxide synthase (iNOS) and high-mobility group box 1 (HMGB1) relative to rats of the pancreatic IR group. Thus, OLP treatment significantly alleviates the I/R-induced pancreatic injury by inhibiting oxidative stress and inflammation in rats through downregulation of HMGB1 and its downstream NF-κB signaling pathway.

Effect of medication adherence on quality of life, activation measures, and health imagine in the elderly people: a cross-sectional study.

BACKGROUND: Usually, old age brings a poor quality of life due to illness and frailty. To prolong their lives and ensure their survival, all elderly patients with chronic diseases must adhere to their medications. In our study, we investigate medication adherence for elderly patients and its impact on the general health of the patient. METHODS: We implemented a cross-sectional survey-based study with four sections in April 2022 in Saudi Arabia. Data about the participants' demographic characteristics, the Morisky Medication Adherence Scale, Patient Activation Measure (PAM) 13, and EQ-5D-5 L. RESULTS: A total of 421 patients participated in this study, their mean age was 60.4 years, and most of them were males. Most of our population is living independently 87.9%. The vast majority of people have a low adherence record in the Morisky Medication Adherence Scale (8-MMAS) classes (score = < 6). Moreover, the average PAM13 score is 51.93 (Level2) indicating a low level of confidence and sufficient knowledge to take action. Our analysis showed a significant correlation between socioeconomic status and medication adherence. Also, there was an association between housing status and medication adherence. On the other hand, we found no correlation between medication adherence and quality of life (QOL) by EQ-5D-5 L. CONCLUSION: Medication adherence is directly affected by living arrangements, as patients who live with a caretaker who can remind them to take their medications at the appropriate times have better medication adherence than those who live alone. Medication adherence was also significantly influenced by socioeconomic status, perhaps as a result of psychological effects and the belief of the lower-salaried population that they would be unable to afford the additional money required to cure any comorbidities that arose as a result of the disease. On the other hand, we did not find any correlation between medication adherence and quality of life. Finally, awareness of the necessity of adherence to medication for the elderly is essential.

Association of the systemic immune-inflammation index (SII) and severity of diabetic ketoacidosis in patients with type 1 diabetes mellitus: a retrospective cohort study.

Background: Diabetic ketoacidosis (DKA) is the most serious metabolic complication of type 1 diabetes mellitus (T1DM). Insulin deficiency and inflammation play a role in the pathogenesis of DKA. The authors aimed to assess the systemic immune-inflammation index (SII) as a marker of severity among T1DM patients with DKA and without infection. Methods: The authors included T1DM patients older than or equal to 12 years hospitalized because of DKA. The authors excluded patients with infection or any condition that can change SII parameters or cause metabolic acidosis. The authors compared SII, neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) between severe and non-severe DKA groups. The authors also assessed the need for an ICU, length of stay, and 90-day readmission rate between the groups. Results: The study included 241 patients with a median age of 17 (14, 24) years, and 44.8% were males. More patients with severe DKA (45%) required ICU admission (P<0.001). Median SII increased with DKA severity, and the difference was significant (P=0.033). No significant difference was observed as regards median NLR or PLR (P=0.380 and 0.852, respectively). SII, but not NLR or PLR, had a significant negative correlation with PH (r=-0.197, P=0.002) and HCO3 level (r=-0.144, P=0.026). Also, being in the highest SII quartile was an independent risk factor for DKA severity (OR, 2.522; 95% CI, 1.063-6.08; P=0.037). The authors estimated an SII cut-off value of 2524.24 to predict DKA severity with high specificity. Conclusion: Elevated SII is a risk factor for DKA severity in T1DM. It is better than NLR and PLR in prognosticating DKA patients. These findings highlight the role of inflammation in DKA. SII can help as a valuable and simple tool to assess DKA severity.

Maxillofacial Bone Fractures in Children and Adolescents in Saudi Arabia: A Systematic Review.

Facial injuries, including maxillofacial trauma (MFT), are common in children and adolescents due to their age and bone maturation stage. Children's injuries are less common than adults' due to parental supervision and the flexibility of the facial bone. Causes of maxillofacial bone fractures (MFBF) vary based on socioeconomic, cultural, and environmental factors. Management of MFBF in children and adolescents should consider their growth and development stage. A systematic review is needed to understand the prevalence, pattern, and distribution of MFBF in Saudi Arabia. This systematic review aimed to identify papers on MFBF in children and adolescents in Saudi Arabia using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. The search strategy involved searching electronic databases like PubMed/Medline, Web of Science, and Ebsco. The review included full-text original research papers, with inclusion criteria including English publications, human studies, and no restrictions on sample size, gender, date, or language. The selection process involved screening titles and abstracts, evaluating full texts, and identifying relevant studies. Data extraction involved two authors individually assessing selected studies. The PRISMA flow diagram of the literature search revealed that 26 papers were identified, of which 15 remained after excluding duplicates. After screening titles and abstracts, 10 articles were removed, and five papers were assessed for eligibility. Four papers met the inclusion criteria for the systematic review. The studies examined 1447 patients for the presence of MFBF in different regions. The majority of MFBF were caused by falls and road traffic accidents (RTAs) in children and adolescents. Mandibular fractures were the most common, followed by maxillary fractures. The majority of patients had tooth/teeth avulsions, followed by tooth luxation and crown fractures. Only one study described investigation methods for MFBF diagnosis. The systematic review reveals a high prevalence of MFBF among children and adolescents in Saudi Arabia, primarily due to falls and RTAs. The mandible is the most frequently fractured bone, and many children have concomitant teeth involvement. To reduce MFBF, effective initiatives and parental awareness strategies are recommended.

Challenges and Barriers to Medical Research Among Medical Students in Saudi Arabia.

BACKGROUND:  The pivotal role of research in medicine is undeniable, as it is vital for the progress of healthcare methods and patients' well-being. This notwithstanding, medical and dental students in Saudi Arabia face many barriers that prevent them from participating in research activities. This research aims to reveal the impediments that are particularly relevant, with select challenges and barriers being mentioned, such as time issues, the inadequate supply of resources, and insufficient training and guidance. MATERIALS AND METHODS:  By using a cross-sectional study, the researchers have provided a questionnaire for medical students across multiple Saudi Arabian medical colleges via the online platform. The IBM SPSS Statistics for Windows, Version 23 (Released 2015; IBM Corp., Armonk, New York, United States) was used for data analysis, which leaned clearly on the descriptive statistical part, using a chi-square test to investigate the association between two categorical variables. RESULTS:  There were 469 total participants, and data analysis clearly showed that lack of statistical skills (74.2%), time constraints (73.3%), and research topic selection (71.4%) were the most major obstacles to research participation. Even though the same barriers existed, a significant percentage of students (75.5%) definitely showed interest in the research, with 89.6% of the students recognizing the importance of research in the medical field. Furthermore, it should be highlighted that the female students showed a stronger positive attitude toward research than the male students (70% vs. 58.3%). CONCLUSION:  The results highlight the necessity for the improvement of the medical education curriculum within Saudi Arabia, including the creation of a research participation system for the students. Through learning strategies emphasizing the importance of research, mentorship programs, and providing resources to the students, there will be an increase in their participation and success in the research. This will lead to an enriching medical research environment.

Knowledge and Awareness of Varicose Veins and Its Risk Factors in Al-Qunfudah, Saudi Arabia.

Background Varicose veins are defined as visibly swollen and twisted veins, surrounded sometimes by patches of flooded capillaries. Varicose veins are a relatively common condition. For many people, they are a family trait. Women are at least twice as likely as men to develop them. Aim This study aims to assess the public knowledge and awareness of varicose veins in Al-Qunfudah, Saudi Arabia. Methods A correlational cross-sectional study was conducted among a sample of people in Al-Qunfudah, Saudi Arabia. An online questionnaire was used for data collection. The data collection sheet included socioeconomic-demographic information. Varicose vein knowledge was assessed in the second portion using three-point ratings. The final section had multiple-choice questions about risk factors and complications, including symptoms, diagnostic techniques, and risk factors for varicose veins. Results Participants were included in the study after excluding individuals aged less than 18 years old, with a majority being males (319; 79.9%). Regarding age distribution, participants aged 36-45 years constituted the largest group (132; 33.1%). Out of 399 participants, 369 (92.5%) had not been diagnosed with varicose veins. Most participants (271, 67.9%) had heard of varicose veins, with the primary sources of information being someone they knew with varicose veins (106, 39.11%). Family history was considered an important factor by 141 (35.3%) of respondents while 217 (54.4%) were unsure. Female gender and old age showed significantly higher knowledge levels (p< 0.05). Conclusion The current study concluded that while there was a fair level of public awareness of varicose veins in general, there was a noticeable lack of knowledge regarding clinical symptoms and diagnostic techniques. Younger females demonstrated noticeably greater awareness and comprehension of the illness.

Relationship Between Personality Traits and Workplace Bullying Victims in Saudi Arabia.

Background Workplace bullying is persistent aggressive behavior, including verbal or physical abuse, exhibited in a working environment. The impact of workplace bullying in any industry leads to negative outcomes in multiple dimensions, such as issues with mental health, problems with physical health, and a reduction in productivity in the workplace. This study aims to measure the relationship between personality traits and workplace bullying victims. Moreover, it explores how personality traits predict being a victim of workplace bullying. Methodology A cross-sectional study was conducted among 625 participants from various regions of Saudi Arabia. Data was collected using a self-administered survey, which included sociodemographic questions, the Negative Acts Questionnaire-Revised (NAQ-R) for bullying assessment, and the Big Five Personality Inventory (BFI-10) for personality trait assessment. The statistical analysis encompassed descriptive statistics and inferential tests such as the correlation test, Mann-Whitney U test, and Kruskal-Wallis test. These analyses were conducted using the SPSS software version 27.0.1 (IBM Corp., Armonk, NY, USA). Results Personal-related bullying was more prevalent compared to work-related bullying, particularly "facing disregard of opinion" was the most frequent type of bullying. Moreover, conscientiousness, agreeableness, and openness to experience were demonstrated as major self-perceived personality traits among participants. Some sociodemographic factors were reported to be significantly associated with both bullying and personality trait scores. Personality traits such as conscientiousness, agreeableness, and extraversion were adversely correlated while openness to experience and neuroticism were positively correlated with bullying. Conclusions Our study illustrates the current prevalence of workplace bullying in Saudi Arabia and its impact on participants' mental health and productivity. We identified a significant correlation between self-perceived personality traits and the risk of experiencing workplace bullying. These findings offer valuable insights for policymakers, enabling them to develop targeted interventions to reduce bullying within work settings in Saudi Arabia.

Association of Diabetes Mellitus With Increased Mortality in Carbapenem-Resistant Enterobacterales Infections.

Introduction Carbapenem-resistant Enterobacterales (CRE) infections have high mortality. We aimed to examine the diabetes mellitus (DM) association with CRE mortality. Methodology Our study is a retrospective cohort study including patients who were admitted to the medical wards in the main district hospital (New Jahra Hospital, Kuwait) between January 1, 2022, and January 1, 2023, and diagnosed with CRE infections during hospitalization. The patients were divided into diabetic and non-diabetic groups. Clinical and laboratory data were collected. The presence of carbapenemase genes was detected. The primary outcome was 30-day hospital mortality. We assessed the effect of glycemic control on the outcomes. Results We included 47 patients in the diabetic group and 39 patients in the non-diabetic group. Females represented 54.7% of patients, and the median age was 73 and 55 years in the two groups, respectively. Klebsiella pneumonia (86%) and Escherichia coli (12.8%) were the most frequently isolated CRE. Carbapenemase genes were detected in all patients: NDM-1 in 67.4%, OXA-48 in 18.6%, and both genes coexisted in 14%. The 30-day hospital mortality was significantly higher in the diabetic group compared to the non-diabetic group (48.9% vs. 28.2%, P = 0.041). Among the diabetic patients, there was no significant difference between survivors and non-survivors regarding median glucose or glycated hemoglobin (HbA1c) levels (P = 0.465 and 0.932, respectively). Moreover, levels of glucose (odds ratio (OR) 0.928, confidence interval (CI) 0.763-1.13, P = 0.457) and HbA1c (OR 0.89, CI 0.63-1.26, P = 0.507) were not risk factors for increased mortality among diabetic patients.  Conclusion We demonstrated the association between DM and increased CRE mortality regardless of the level of glycemic control. This study demonstrates the interaction between communicable and non-communicable diseases.

The Safety Profile of Common COVID-19 Vaccines in Patients With Multiple Sclerosis.

Background and objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19). In light of the COVID-19 pandemic that emerged in late 2019, the World Health Organization (WHO) has endorsed mass immunization to enhance the population's immunity against the virus. However, certain concerns have been raised about the safety of COVID-19 vaccines among patients with autoimmune disorders, including those with multiple sclerosis (MS). Further research is required to address these concerns and to gain deeper insights into the possible complications of COVID-19 vaccines among MS patients. This study aimed to assess the side effects of COVID-19 vaccines among MS patients. Methods An observational cross-sectional study was conducted between May and November 2023 at the National Guard Hospital, Jeddah, Saudi Arabia. All MS patients enrolled in our local registry system and provided phone numbers were included in the study. A total of 208 MS patients were surveyed via phone interviews, and data were collected regarding their demographics, MS history, COVID-19 history, SARS-CoV-2 vaccination status, and their exposure to disease-modifying therapies (DMTs). All results were analyzed using Stata software. Statistical significance was set at a CI of 95% and a p-value <0.05. Results In our cohort, 128 (61.5%) patients had received three doses of the COVID-19 vaccine, while 68 (32.7%) had received two doses; four patients (2.0%) had received only one dose, five (2.4%) had not received the vaccine, and the number of doses was unknown for the remaining three patients (1.4%). The BNT162b2 mRNA COVID-19 Vaccine from Pfizer-BioNTech was the most commonly administered (n=136 patients, 66.0%), followed byChAdOx1 nCoV-19 Vaccine from Oxford-AstraZeneca (n=47 patients, 22.8%), and mRNA-1273 SARS-CoV-2 Vaccine from Moderna (n=5 patients, 2.4%). Of note, 139 patients (69.5%) reported experiencing adverse events after receiving the vaccine, and the ChAdOx1 nCoV-19 Vaccine from Oxford-AstraZeneca was significantly associated with higher rates of side effects, in 87.8% of the patients. Conclusion A sizable proportion of MS patients experienced self-limiting side effects from exposure to the COVID-19 vaccine. The rates and incidence of side effects were similar to those encountered in the general population. None of the adverse effects recorded in our population of MS patients were serious or life-threatening. We recommend that physicians encourage patients with MS who have never received COVID-19 vaccination to get promptly vaccinated as the risks of COVID-19 infection far outweigh the minor risks associated with COVID-19 vaccination.

Retraction: Lemierre's Syndrome: A Case of Life-Threatening Infection From Family Medicine Practice.

[This retracts the article DOI: 10.7759/cureus.20684.].

Retraction: Emphysematous Cystitis: A Radiological Diagnosis of Potentially Life-Threatening Infection.

[This retracts the article DOI: 10.7759/cureus.20201.].

Antifungal and Antiproliferative Activity of Pistagremic Acid and Flavonoids Extracted from the Galls of Pistacia chinensis subsp. integerrima.

Pistacia chinensis subsp. integerrima (J.L. Stewart) Rech. f. is a plant known for its therapeutic applications in traditional medicine, which are related to its antimicrobial, anticancer, antioxidant, anti-inflammatory, analgesic, antidiarrheal, and muscle relaxant properties. The galls of P. chinensis are rich in triterpenes and flavonoids, and we here report the extraction of pistagremic acid (1), apigenin (2) and sakuranetin (3) from this source. The isolated compounds were tested against Aspergillus flavus, Candida albicans, Candida glabrata, Fusarium solani, Microsporum canis and Trichoderma longibrachiatum. The results highlighted the antimicrobial activity of flavonoids 2 and 3, suggesting that this class of molecules may be responsible for the effect related to the traditional use. On the other hand, when the compounds and the extract were tested for their antiproliferative activity on a panel of 4 human cancer cell lines, the triterpene pistagremic acid (1) showed a higher potential, thus demonstrating a different bioactivity profile. Structure-based docking and molecular dynamics simulations were used to help the interpretation of experimental results. Taken together, the here reported findings pave the way for the rationalization of the use of P. chinensis extracts, highlighting the contributions of the different components of galls to the observed bioactivity.

Impact of sodium-glucose cotransporter-2 inhibitors on kidney outcomes in type 2 diabetes: A tertiary center experience.

BACKGROUND: Diabetic nephropathy (DN) is a complication of chronic hyperglycemia associated with diabetes mellitus (DM). Several studies have demonstrated the positive impact of sodium-glucose cotransporter-2 (SGLT2) inhibitors on kidney outcomes. The objective of the study was to evaluate the effects of dapagliflozin, an SGLT2 inhibitor, on kidney outcomes in Saudi patients with type 2 DM. MATERIALS AND METHODS: Study included all Saudi patients with type 2 DM who visited our center from August 1, 2021, to July 31, 2022, and had been on dapagliflozin for at least 3 months. Data was abstracted through chart review for all patients included in the study. Paired t-test or Wilcoxon signed-rank test were used to compare the results before and after treatment for continuous variables and the McNemar test was used to compare the results for categorical data. RESULTS: Study included 184 Saudi patients with type 2 diabetes with a mean age of 61.32 years (SD=9.37). Dapagliflozin 10 mg/day significantly reduced hemoglobin A1C (HbA1C) from a mean (SD) of 9.00 to 8.40 (P < 0.001). Among a subgroup of patients with significant proteinuria (n = 83), dapagliflozin significantly reduced ACR from a median of 93.1 to 64.9 mg/g (P = 0.001). Following treatment, the estimated glomerular filtration rate improved from a mean of 69.83 to 71.68 mL/min and the mean arterial pressure (MAP) fell from 90.03 to 89.06 mmHg, both were not statistically significant. Despite a statistically insignificant increase in the episodes of urinary tract infections (UTIs), the hospitalization rate declined. No episodes of amputations or ketoacidosis occurred during the study period. CONCLUSION: SGLT2 inhibitors had beneficial effects among Saudi patients with type 2 diabetes by improving diabetic control and lowering proteinuria. Dapagliflozin did not result in significant harm, including UTIs, amputations, and ketoacidosis.

Caffeine Consumption and Depression, Anxiety, and Stress Levels Among University Students in Medina: A Cross-Sectional Study.

Introduction Caffeine is a psychoactive stimulant frequently found in coffee, tea, energy drinks, and some medications. Various mental health challenges, including stress, anxiety, and depression, commonly affect college students. Moreover, an individual's mental and physical health can be significantly impacted by stress, anxiety, and depression. However, the impact of caffeine on mental health, particularly its association with depressive and anxiety symptoms, remains inconclusive. Thus, this study aimed to evaluate the amount of caffeine consumed by university students and its association with depression, anxiety, and stress levels. Material and method This cross-sectional study was performed on Taibah University students in Medina from both health-related and non-health-related colleges. We used a self-administrated questionnaire composed of four sections: the informed consent section; sociodemographic information; the Depression, Anxiety, and Stress Scale (DASS-21), which assessed the depression, anxiety, and stress levels; and a caffeine-measuring questionnaire, which reported daily caffeine intake in milligrams per day. Result This cross-sectional study examined a 520 convenience sample of Taibah University students with an age range from 17 to 29 years. The majority of the participants were single (95.2%), most of them were female (73.8%), and slightly more than half (51.5%) were recruited from health-related colleges. According to the study's DASS-21 score results, 45.8% of the students had extremely severe stress, 61% had extremely severe anxiety, and 51% had extremely severe depression. The most frequently reported sources of daily caffeine among the participants were Arabic coffee (69.6%), specialty coffee (57.5%), black tea (56.3%), cola (48.7%), and regular coffee (48.5%). The overall daily amount of consumed caffeine ranged from zero to 4276.7 mg/oz. However, no significant association was found between the severity of the DASS-21 score and the daily consumption of caffeine among Taibah University students. Conclusion Our study shows no significant association between the severity of depression, anxiety, and stress and daily caffeine consumption among university students. This proves the opposite of the theory that high levels of caffeine consumption can be correlated to high levels of depression, stress, and anxiety.

Knowledge, Attitudes, and Practices Toward the Prevention of Hepatitis B Virus Infection Among Medical Students in Medina City, Kingdom of Saudi Arabia.

INTRODUCTION: This study focuses on assessing the knowledge, attitudes, and practices related to Hepatitis B virus (HBV) prevention among medical students in Medina, Saudi Arabia. HBV is a significant global health concern, with a high prevalence in Saudi Arabia. Medical students due to their field, are at higher risk of exposure. Prior studies in Saudi Arabia show varied levels of awareness. This research aims to provide insights that can inform educational initiatives for this specific population. METHODS: This was a cross-sectional study conducted from June 2023 to September 2023 by using a pre-designed online questionnaire that was distributed among medical students in Medina. Data was analyzed using IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp. RESULTS: This study included 307 participants. 67.8% of the participants correctly identified the link between HBV and liver cancer, and 77.5% recognized the transmission risk from carriers. 91.9% acknowledged the transmission via contaminated blood and fluids, and 88.9% recognized the risk from unsterilized instruments. Positive attitudes were observed, with 92.2% agreeing that following infection control guidelines would protect them at work. Practice scores were generally positive, including high rates of screening (57.3%) and adherence to infection control measures (90.2%). Knowledge scores correlated positively with attitude (rho = 0.204) and practice scores (rho = 0.390). CONCLUSION: A significant proportion of participants had a strong understanding of HBV transmission and the importance of infection control measures. Positive attitudes towards infection control were prevalent, although some reluctance to provide care to HBV-infected individuals was noted.

Ion-acoustic waves in weakly ionized plasmas with charge-exchange collisions.

Ion-neutral charge-exchange collisions in plasmas of laboratory, space, and astrophysical origins are fundamental to understanding wave dissipation and wave generation phenomena. This paper implements a charge-exchange collision operator in the Boltzmann-Poisson system equations for a weakly ionized plasma. When considering an electric field perturbation, the governing kinetic equations provide significant results concerning the plasma conductivity and the dielectric function, appearing in simple, sensible forms. The present analysis reveals a backward wave propagation phenomenon at maximum conductivity when the wavenumber of the plasma wave is smaller than the reciprocal of the ion-neutral collisions mean free path. In addition, it is shown that ion-neutral coupling resulting from charge-exchange collisions enhances ion-acoustic waves below and beyond the ion plasma frequency and leads to the onset of a fundamental instability that overcomes Landau damping under certain circumstances. The collisionless model is recovered as a limiting case, i.e., in the asymptotic limit of a long mean free path.

Clinical Characteristics and Treatment Strategies for Group B Streptococcus (GBS) Infection in Pediatrics: A Systematic Review.

Background and Objectives: Group B streptococcus (GBS) is the leading cause of infections in neonates with high fatality rates. GBS is caused by the streptococcus bacterium known as streptococcus agalactiae, which is highly contagious and can be transmitted from pregnant women to infants. GBS infection can occur as an early onset or late-onset infection and has different treatment strategies. Antibiotics are effective in treating GBS infections at early stages. The aim of this systematic review was to summarize the clinical characteristics and treatment strategies for GBS, with a focus on antibiotics. Material and Methods: The findings of this review were reported in accordance with the PRISMA 2020 guidelines and a flow diagram of the study selection process, a summary of the included studies, a description of the study characteristics, a summary of the results, a discussion of the implications of the findings, and a conclusion are included. Overall, the authors followed a rigorous methodology to ensure that this review is comprehensive and inclusive of relevant studies on GBS infection and its treatment. Results: Overall, 940 studies were reviewed and only the most relevant 22 studies were included in the systematic review. This review describes the characteristics of patients in different studies related to early onset GBS disease and presents various treatment strategies and outcomes for GBS infection in pediatrics. The studies suggest that preventive measures, risk-based intrapartum antibiotic prophylaxis, and maternal vaccination can significantly reduce the burden of GBS disease, but late-onset GBS disease remains a concern, and more strategies are required to decrease its rate. Improvement is needed in the management of the risk factors of GBS. A conjugate vaccine with a serotype (Ia, Ib, II, III, and V) has been proven effective in the prevention of GBS in neonates. Moreover, penicillin is an important core antibiotic for treating early onset GBS (EOD). Conclusions: This systematic review summarizes the treatment comparison for GBS infections in neonates, with a primary focus on antibiotics. IAP (intrapartum antibiotic prophylaxis) according to guidelines, antenatal screening, and the development of a conjugate vaccine may be effective and could lower the incidence of the disease.

Bilateral Testicular Torsion: A Systematic Review of Case Reports.

Bilateral testicular torsion is a rare but serious condition characterized by twisting both testicles around their respective spermatic cords, leading to reduced blood flow and potential loss of the testicles. Treatment of this condition may involve surgical detorsion of the affected testicles and fixation to prevent recurrence and, in some cases, removal of severely damaged testicles. In April 2023, a systematic review of case reports was performed to examine the presentation, clinical features, diagnostic process, and management of bilateral testicular torsion. Our search encompassed the following databases: PubMed, ScienceDirect, and Google Scholar. Out of 340 studies, only eight cases met our criteria. However, this review discusses bilateral testicular torsion symptoms, investigation, and outcome.

Awareness and Acceptance for COVID-19 Booster Dose Vaccination among Residents of Saudi Arabia: Findings of a Cross-Sectional Study.

BACKGROUND: In the global effort to combat SARS CoV2 infection, adoption of the vaccination has been an essential component. The goal of this research was to determine the quality of web-based information gathered during COVID-19 and participants' awareness and acceptance for the booster dose for COVID-19. METHODS: This cross-sectional study was carried out to gauge interest in and willingness for a booster dose, as well as the satisfaction with the availability and accuracy of Internet resources. This study included 631 people from the cities of Riyadh, Al Majma'ah, Al Ghat, and Zulfi in the Riyadh Area. Chi-square and Fischer's exact tests, with a 95% confidence interval, and a threshold of p < 0.05, were used to analyze the significance of associations between variables. RESULTS: Out of 631 respondents, 347 people who reported willingness to receive the immunization were women (319, 91.9%), with only 28 (8.1%) being men. There was a statistically significant correlation between individuals who worried about booster dosage adverse effects and those who did not receive the immunization. Knowledge of the efficacy of the vaccine, confidence in the capacity of the vaccine to avert problems, and willingness to receive a third dosage were all shown to be substantially correlated (p < 0.001). Attitude and behavior ratings were substantially correlated with prior COVID-19 immunization status (p < 0.005). CONCLUSIONS: There was a significant correlation between vaccination knowledge, confidence in the capacity of the vaccine to prevent problems, and willingness to receive a third dose. Therefore, our research can help policymakers develop more precise and scientific roll-out strategies for the COVID-19 booster vaccination.

Prevalence of Attention Deficit Hyperactivity Disorder Among Children in Makkah Region, Saudi Arabia.

Introduction Attention-deficit/hyperactivity disorder (ADHD) is the most common behavioral disorder in children and is described as a disease involving loss of self-control. The core symptoms of ADHD are inattentiveness, impulsivity, and motor unrest. Furthermore, poor concentration, distraction, hyperactivity, and poor academic achievement at school or at home are other symptoms. ADHD, like other prevalent medical disorders such as asthma and schizophrenia, may be impacted by several genes and has multiple contributing causes that are not all related to each other. The management of ADHD contains multimodal treatments, starting with psycho-education for parents and the child or adolescent patient in an age-appropriate manner called cognitive behavioral therapy. The worldwide prevalence rate of ADHD among children is 7.2% and, in some countries, can be higher and reach 15.5%; studies show the average prevalence of ADHD in the Kingdom of Saudi Arabia (KSA) is 9.2%. Method A descriptive cross-sectional study was conducted from December 2022 to January 2023 among children who live in Makkah between the ages of 4 and 14 years old via an online survey that contained the ADHD Rating Scale-IV for parents/teachers, and caregivers based on Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV criteria. The scale was translated into Arabic and contains 18 questions about ADHD symptoms. Result The overall prevalence of combined ADHD among children in Makkah is 52.5% (n=203 out of 387); most of them were males (30.8%) and 21.7% were females (P=0.09), and most of the combined ADHD prevalence was between the ages of 11 and 14 (20.4%), then the age of 4-7 (16.8%), and 15.3% of them were between 8 and 10 years old. Additionally, the results show a higher prevalence of combined ADHD in Makkah city (33.1%) (n=121) in comparison to rural areas 19.4% (n=82) (P=0.132). Conclusion The aim of the study was to measure the prevalence rate of ADHD in the Makkah region. The study showed a high prevalence rate of ADHD (52.5%) among children in Makkah; the study was carried out online using an ADHD scale, and more accurate results could be found by using face-to-face interviews and including both parents and teachers.