Association between polycystic ovary syndrome and the risk of malignant gynecologic cancers (ovarian, endometrial, and cervical): A population-based study from the U.S.A. National Inpatient Sample 2016-2019.

OBJECTIVE: This study aimed to systematically examine the relationship between polycystic ovary syndrome and ovarian, endometrial, and cervical cancers using the National Inpatient Sample (NIS) database. METHODS: We utilized the International Classification of Diseases (ICD-10) system to identify relevant codes from the NIS database (2016-2019). Univariate and multivariable regression analyses (adjusted age, race, hospital region, hospital teaching status, income Zip score, smoking, alcohol use, and hormonal replacement therapy) were conducted to evaluate association between PCOS and gynecologic cancers. Results were summarized as odds ratio (OR) with 95% confidence intervals (CI). RESULTS: Overall, 15,024,965 patients were analyzed, of whom 56,183 and 14,968,782 patients were diagnosed with and without PCOS, respectively. Among the patients diagnosed with gynecologic cancers (n = 91,599), there were 286 with PCOS and 91,313 without PCOS. Univariate analysis revealed that PCOS was significantly associated with higher risk of endometrial cancer (OR = 1.39, 95 % CI [1.18-1.63], p < 0.0001), but lower risk of ovarian cancer (OR = 0.55, 95 % CI [0.45-0.67], p < 0.0001) and cervical cancer (OR = 0.68, 95 % CI [0.51-0.91], p = 0.009). In contrast, after Bonferroni correction, multivariable analysis depicted that PCOS remained significantly associated with higher risk of endometrial cancer (OR = 3.90, 95 % CI [4.32-4.59], p < 0.0001). There was no significant correlation between PCOS and risk of ovarian cancer (OR = 1.09, 95 % CI [0.89-1.34], p = 0.409) and cervical cancer (OR = 0.83, 95 % CI [0.62-1.11], p = 0.218). CONCLUSION: This first-ever NIS analysis showed that patients with PCOS exhibited unique gynecologic cancer risk profiles, with higher risk for endometrial cancer, and no significant risk for ovarian or cervical cancers.

Dysregulated expression of IGSF11-AS1 and BVES-AS in azoospermia and its correlation with serum hormone levels.

Aim: Azoospermia accounts for 10-20% of male infertility. In 20-30% of affected males, genetic abnormalities are the leading cause of azoospermia. LncRNAs can regulate spermatogenic cell development. Methods: This study chose 76 azoospermia patients and 36 healthy males. The gene expression was examined using the qRT-PCR technique. Results: IGSF11-AS1 and BVES-AS appeared to be considerably underexpressed in the patients; however, only IGSF11-AS1 demonstrated a significant biomarker role. Additionally, IGSF11-AS1 expression was positively correlated with testosterone but was negatively correlated with follicle-stimulating hormone (FSH) and luteinizing hormone (LH). For the BVES-AS gene, however, FSH and LH had a negative correlation. Conclusion: As a result of its low expression level in tissue samples, IGSF11-AS1 has a biomarker role for early azoospermia detection.

[Box: see text].

"An unprecedented occurrence: a case report of pulmonary hypertension manifestation in Donohue syndrome".

INTRODUCTION: Donohue syndrome (DS), also referred to as leprechaunism, is a remarkably uncommon autosomal recessive disorder that primarily affects the endocrine system. Its incidence rate is exceedingly low, with only 1 case reported per 4 million live births. The syndrome is distinguished by a series of characteristic clinical features. CASE PRESENTATION: We present a case of a twenty-month-old male with DS who experienced a range of dysmorphic and clinical features with the involvement of multiple systems. These features include skin hyperpigmentation, hypertrichosis, distinct facial features, abdominal distension, and microcephaly, with the involvement of the endocrine, renal, respiratory, and cardiac systems. CONCLUSION: The primary features of DS involve severe insulin resistance and growth abnormalities, the association with pulmonary hypertension (PHTN) has not been reported before. This finding adds more complexity to the condition. To the best of the author's knowledge, this is the first report for a patient with DS who has PHTN. Further investigation is required since the mechanisms behind the development of PHTN in DS are not entirely understood. Shedding light on this association will contribute to better management strategies and outcomes for affected patients.

Trends in female representation in cardiology and its subspecialties: The current state and the desired state.

INTRODUCTION: Women have been historically underrepresented in Cardiology and its subspecialties. However, limited research has been done to examine the trends of representation of women in cardiology and its subspecialties over time. Our study aims to examine these trends and compare them to other internal medicine subspecialties. METHODS: We used data from the Accreditation Council for Graduate Medical Education (ACGME) to conduct a retrospective analysis of the gender trends of cardiology and its subspecialties over a decade from 2013 to 2023. Chi-square statistical testing was used to compare representation percentages across groups. A p-value <0.05 was considered statistically significant. RESULTS: Compared to all internal medicine subspecialties, cardiology and its subspecialties continues to remain the least represented by women. We found a statistically significant increase in women's representation in cardiovascular disease and interventional cardiology. However, there was no statistically significant changes in the representation of women in electrophysiology and advanced heart failure. We have found over the last decade that there was a positive trend in overall women fellows choosing cardiology and its subspecialties, especially since 2018. CONCLUSION: While strides have been made in increasing the number of female fellows in cardiology, it still lags compared to other internal medicine subspecialties. As we celebrate this minor milestone, it is crucial to emphasize the importance of persistently overcoming obstacles and fostering a supportive environment throughout all training phases to attract, retain, and mentor female trainees.

Reproducibility of MRI Diagnosis of Female Genital Anomalies.

Purpose: To assess and compare intrareader and interreader reproducibility of magnetic resonance imaging (MRI) diagnosis of female genital anomalies (FGAs) using the American Society for Reproductive Medicine-Mullerian anomalies classification 2021 (ASRM-MAC 2021) and European Society of Human Reproduction and Embryology-European Society for Gynecological Endoscopy (ESHRE-ESGE) 2016 classification. Methods: In this retrospective study, we searched our electronic MRI database from April 2021 to September 2023, selecting MRI studies with FGAs. Seventy-six consecutive studies were included and reviewed by 4 independent radiologists using both classifications. Studies were re-evaluated after 1 month. Reproducibility was assessed using kappa (κ) scores with 95% confidence intervals (CI). Results: Intrareader agreement for MRI diagnosis of FGAs was substantial to excellent, with κ scores ranging from 0.684 (95% CI, 0.534-0.834) to 0.985 (95% CI, 0.963-1.01) using the ASRM-MAC 2021 and from 0.743 (95% CI, 0.621-0.865) to 0.846 (95% CI, 0.719-0.973) using the ESHRE-ESGE 2016 classification. Pairwise interreader agreement was higher with the ASRM-MAC 2021, ranging from moderate (κ = 0.491; 95% CI, 0.341-0.642) to substantial (κ = 0.709; 95% CI, 0.597-0.821), compared to the ESHRE-ESGE 2016 classification, with weak (κ = 0.080; 95% CI, 0.068-0.228) to moderate (κ = 0.511; 95% CI, 0.344-0.678) agreement. Overall interreader agreement was moderate for both classifications (κ = 0.599; 95% CI, 0.562-0.638 for ASRM-MAC 2021 and κ = 0.429; 95% CI, 0.396-0.463 for ESHRE-ESGE 2016 classification), but with significant differences (non-overlapping CIs). Conclusion: The intrareader reproducibility was high for both classifications, whereas the interreader reproducibility was higher using the ASRM-MAC 2021, highlighting the impact of classification criteria on the reproducibility of MRI diagnosis of FGAs.

Insights Into MRI Neuroimaging Patterns of COVID-19 in Children: A Retrospective Comprehensive Analysis.

RATIONALE AND OBJECTIVES: Neurological complications associated with coronavirus disease (COVID-19) have been reported in children; however, data on neuroimaging findings remain limited. This study aimed to comprehensively examine neuroimaging patterns of COVID-19 in children and their relationship with clinical outcomes. MATERIALS AND METHODS: This retrospective cross-sectional study involved reviewing the medical records and MRI scans of 95 children who developed new neurological symptoms within 2-4 weeks of clinical and laboratory confirmation of COVID-19. Patients were categorized into four groups based on guidelines approved by the Centers for Disease Control and Prevention (CDC). Initial brain/spinal MRI was performed. Images were reviewed by three blinded radiologists, and the findings were analyzed and categorized based on the observed patterns in the brain and spinal cord. Follow-up MRI was performed and analyzed to track lesion progression. RESULTS: Encephalopathy was the most common neurological symptom (50.5%). The most common initial MRI involvement patterns were non-confluent multifocal hyperintense white matter (WM) lesions (36.8%) and ischemia (18.9%). Most patients who underwent follow-up MRI (n = 56) showed complete resolution (69.9%); however, some patients developed encephalomalacia and myelomalacia (23.2% and 7.1%, respectively). Non-confluent hyperintense WM lesions were associated with good outcomes (45.9%, P = 0.014), whereas ischemia and hemorrhage were associated with poor outcomes (44.1%, P < 0.001). CONCLUSION: This study revealed diverse neuroimaging patterns in pediatric COVID-19 patients. Non-confluent WM lesions were associated with good outcomes, whereas ischemia and hemorrhage were associated with poorer prognoses. Understanding these patterns is crucial for their early detection, accurate diagnosis, and appropriate management.

Cortical incisions and transcortical approaches for intra-axial and intraventricular lesions: A scoping review.

Background: Transcortical approaches, encompassing various surgical corridors, have been employed to treat an array of intraparenchymal or intraventricular brain pathologies, including tumors, vascular malformations, infections, intracerebral hematomas, and epileptic surgery. Designing cortical incisions relies on the lesion location and characteristics, knowledge of eloquent functional anatomy, and advanced imaging such as tractography. Despite their widespread use in neurosurgery, there is a noticeable lack of systematic studies examining their common lobe access points, associated complications, and prevalent pathologies. This scoping review assesses current evidence to guide the selection of transcortical approaches for treating a variety of intracranial pathologies. Methods: A scoping review was conducted using the PRISMA-ScR guidelines, searching PubMed, EMBASE, Scopus, and Web of Science. Studies were included if ≥5 patients operated on using transcortical approaches, with reported data on clinical features, treatments, and outcomes. Data analysis and synthesis were performed. Results: A total of 50 articles encompassing 2604 patients were included in the study. The most common primary pathology was brain tumors (60.6%), particularly gliomas (87.4%). The transcortical-transtemporal approach was the most frequently identified cortical approach (70.48%), and the temporal lobe was the most accessed brain lobe (55.68%). The postoperative course outcomes were reported as good (55.52%), poor (28.38%), and death (14.62%). Conclusion: Transcortical approaches are crucial techniques for managing a wide range of intracranial lesions, with the transcortical-transtemporal approach being the most common. According to the current literature, the selective choice of cortical incision and surgical corridor based on the lesion's pathology and anatomic-functional location correlates with acceptable functional outcomes.

Flawless polyaniline coating for preservation and corrosion protection of ancient steel spearheads: an archaeological study from military museum, Al-Qala, Egypt.

The purpose of this research was to examine the viability of applying a flawless polyaniline coating on steel spearheads to preserve them and protect them from corrosion. The spearpoints, thought to be archaeologically significant, were acquired from the Military Museum in Al-Qala, Egypt. X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy were used to characterize the spearheads chemical composition and microstructure (EDX). The spearheads were determined to be constructed of steel and to have a coating of ferric oxide and other corrosion products on their exteriors. After that, a flawless polyaniline coating was electrochemically deposited onto the spearpoints in a way that was both quick and cheap. Many types of corrosion tests, such as electrochemical impedance spectroscopy and potentiodynamic polarization (PDP) readings, were used to determine the coating's effectiveness. The steel spearheads' findings revealed a significant improvement in their resistance to corrosion after being coated with flawless polyaniline. The coating served as a barrier, blocking out water and other corrosive substances and slowing the buildup of corrosion byproducts on the spearpoints. In conclusion, our research shows that a flawless polyaniline coating may be an effective anti-corrosion treatment for ancient steel artifacts. The approach is straightforward, cheap, and readily scalable for massive conservation efforts.

The Effects of Vitamin D Supplementation on C-Reactive Protein and Systolic and Diastolic Blood Pressure in Postmenopausal Women: A Meta-Analysis and Systematic Review of Randomized Controlled Trials.

BACKGROUND: An inverse relationship between vitamin D supplementation and C-reactive protein (CRP) and hypertension has been reported, mostly through observational data. This inverse relationship, however, has not been confirmed in randomized controlled trials (RCTs). A meta-analysis of RCTs is needed to provide more robust evidence. OBJECTIVE: This systematic review of RCTs was conducted to assess the effect of vitamin D supplementation on CRP, systolic blood pressure (SBP), and diastolic blood pressure (DBP) in postmenopausal women. METHODS: Four databases (PubMed, Web of Science, Embase, and Scopus) were systemically searched to identify relevant RCTs published in international scientific journals up to January 2023. Changes from baseline and SDs of CRP, SBP, and DBP were compared between postmenopausal women who received vitamin D supplementation and those who did not (controls). These parameters were applied to compute the overall effect sizes using the random-effects model. Data were summarized as mean difference (MD) with 95% CI. Heterogeneity among arms was scrutinized using the Cochrane's Q test and I2 statistic. Publication bias was judged by means of funnel plots and Egger's test. RESULTS: Seven studies with 6 arms on CRP, 6 arms on SBP, and 6 arms on DBP were included in the meta-analysis. Combined effect sizes suggested a significant effect of vitamin D supplementation on CRP (MD = -0.65 mg/L; 95% CI -0.93 to -0.37 mg/L; P < .001). In addition, CRP concentrations were significantly reduced after vitamin D supplementation in studies with a duration of more than 3 months (MD = -0.91 mg/L; 95% CI -1.37 to -0.45 mg/L; P < .001) and studies involving doses of ≤1,000 IU/d (MD = -2.10 mg/L; 95% CI -2.51 to -1.68 mg/L; P < .001). Vitamin D supplementation did not reduce SBP significantly (MD = -1.06 mm Hg; 95% CI -2.43 to 0.30 mm Hg; P = .127) and DBP (MD = 0.003 mm Hg; 95% CI -0.86 to 0.86 mm Hg; P = .994) levels compared with control groups. CONCLUSIONS: This meta-analysis concluded that vitamin D supplementation is associated with reduced CRP concentrations among postmenopausal women.

Association between Endometriosis and the Risk of Ovarian, Endometrial, Cervical, and Breast Cancer: A Population-Based Study from the U.S. National Inpatient Sample 2016-2019.

OBJECTIVE: We investigated the potential relationship between endometriosis and risk of ovarian, endometrial, cervical, and breast cancers using the National Inpatient Sample (NIS) database. METHODS: We utilized the International Classification of Diseases (ICD-10) system to identify relevant codes from the NIS database (2016-2019). Univariate and multivariate regression analyses (adjusted for age, race, hospital region, hospital teaching status, income Zip score, smoking, alcohol use, and hormonal replacement therapy) were conducted to evaluate the association between endometriosis and gynecologic cancers and summarized as odds ratios (ORs) with 95% confidence intervals (CIs). RESULTS: In the examined dataset, there were 1164 and 225,323 gynecologic cancer patients with and without endometriosis, respectively. Univariate analysis showed endometriosis was significantly associated with a higher risk of ovarian (OR = 3.42, 95% CI: 3.05-3.84, p < 0.001) and endometrial (OR = 3.35, 95% CI: 2.97-3.79, p < 0.001) cancers. There was no significant association between endometriosis and cervical cancer (OR = 1.05, 95% CI: 0.85-1.28, p = 0.663). Interestingly, endometriosis was significantly associated with a low risk of breast cancer (OR = 0.12, 95% CI: 0.10-0.17, p < 0.001). Multivariate analysis after Bonferroni correction (p < 0.006) showed that endometriosis was significantly associated with a high risk of ovarian (adjusted OR = 3.34, 95% CI: 2.97-3.75, p < 0.001) and endometrial (adjusted OR = 3.61, 95% CI: 3.12-4.08, p < 0.001) cancers. Conversely, there was no significant association between endometriosis and cervical cancer (OR = 0.80, 95% CI: 0.65-0.99, p = 0.036). CONCLUSIONS: Patients with endometriosis exhibited unique gynecologic cancer risk profiles, with higher risks for ovarian and endometrial cancers, and no significant risk for cervical cancer. The observed connection between endometriosis and a reduced risk of breast cancer remains a perplexing phenomenon, which cannot be put into context to date.

Effects of intermittent fasting regimens on glycemic, hepatic, anthropometric, and clinical markers in patients with non-alcoholic fatty liver disease: Systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: Intermittent fasting (IF) regimens have been hypothesized to influence several markers of cardiometabolic and liver function. The objective of our meta-analysis was to investigate the impact of IF regimens on cardiometabolic and liver markers in subjects diagnosed with non-alcoholic fatty liver disease (NAFLD). METHODS: We searched several online databases (PubMed/Medline, Web of Science, Scopus and Embase) in order to identify suitable publications for inclusion in the meta-analysis. Results were expressed as weighted mean differences (WMD). RESULTS: From 12343 articles identified in different databases, a total of 7 RCT arms were entered into the quantitative synthesis. The manuscripts were published between 2019 and 2023. IF regimens (the 5:2 diet, 16/8 time-restricting feeding, and alternate day fasting) varied from 2 months to 3 months. IF regimens reduced steatosis scores (WMD: -33.22 CAP dB/m, 95 % CI: -50.72 to -15.72), anthropometric characteristics of obesity (WMD: -0.77 kg/m2, 95 % CI: -1.38 to -0.17 for body mass index; WMD: -3.16 kg, 95 % CI: -4.71 to -1.61 for body weight; WMD: -1.90 kg, 95 % CI: -3.51 to -0.29 for waist circumference), as well as ALT (WMD: -9.10 U/L, 95 % CI: -12.45 to -5.75), triglyceride (WMD: -20.83 mg/dl, 95 % CI: -39.01 to -2.66), total cholesterol (WMD: -7.80 mg/dl, 95 % CI: -15.18), HbA1c (WMD: -0.14 %, 95 % CI: -0.20 to -0.08) and HOMA-IR (WMD: -1.21, 95 % CI: -2.08 to -0.34) levels versus controls. Nevertheless, no between-group differences were detected for other biomarkers, e.g., fasting blood glucose, insulin, AST, HDL-C or LDL-C values, and fibrosis scores. CONCLUSION: IF regimens can improve some markers of cardiometabolic and liver function in patients with NAFLD. However, the available evidence to support the benefits of IF regimens is limited and derived from a small number of studies, thus further research is needed to clarify the impact of IF on the cardiometabolic health of NAFLD patients.

The effect of alpha-lipoic acid supplementation on anthropometric, glycemic, lipid, oxidative stress, and hormonal parameters in individuals with polycystic ovary syndrome: a systematic review and meta-analysis of randomized clinical trials.

This systematic review and meta-analysis aimed to examine the effect of the antioxidant alpha-lipoic acid (ALA) on various cardiometabolic risk factors and hormonal parameters in patients with polycystic ovary syndrome (PCOS). We searched PubMed, EMBASE, SCOPUS, Cochrane Library, and Web of Science databases without language restrictions until May 2023 to find randomized controlled trials (RCTs) that assessed the impact of ALA supplementation on anthropometric, glycemic, lipid, oxidative stress, and hormonal parameters in women with PCOS. Outcomes were summarized using the standardized mean difference (SMD) and 95% confidence interval (CI) in a random-effects model. An I2 statistic of >60% established significant between-study heterogeneity. The overall certainty of the evidence for each outcome was determined using the grading of recommendations, assessment, development, and evaluations system. Seven RCTs met the inclusion criteria. The ALA group had significant reductions in fasting blood sugar (fasting blood sugar (FBS), n=7 RCTs, SMD, -0.60; 95% CI, -1.10 to -0.10; I2=63.54%, moderate certainty of evidence) and homeostatic model assessment for insulin resistance (homeostatic model assessment of insulin resistance (HOMA-IR), n=4 RCTs, SMD, -2.03; 95% CI, -3.85 to -0.20; I2=96.32%, low certainty of evidence) compared with the control group. However, significant differences were observed between the groups in body mass index, insulin, estrogen, follicle-stimulating hormone, luteinizing hormone, testosterone, low-density lipoprotein, highdensity lipoprotein, triglyceride, total cholesterol, malondialdehyde, or total antioxidant capacity profiles. ALA supplementation improves FBS and HOMA-IR levels in women with PCOS. ALA consumption is an effective complementary therapy for the management of women with PCOS.

Endoscopic thyroidectomy using the axillo-breast approach in patients with lactating and/or large ptotic breasts.

INTRODUCTION: The purpose of this study is to evaluate the outcomes of endoscopic hemithyroidectomy (EH) performed via the modified unilateral axillo-breast approach (UABA) in patients with lactating and/or large ptotic breasts. METHODS: Between 2019 and 2021, we studied the records of twenty-three eligible female patients with lactating and/or large ptotic breasts who were presented with benign unilateral thyroid nodule (s) and who were treated by EH using modified UABA at Mansoura University Oncology Center or Meet Ghamr oncology center. The demographic data, clinicopathological parameters, operative and the esthetic outcomes were collected and analyzed. RESULTS: Nine patients (39%) were lactating. All patients were obese (the mean BMI was 37.82 ± 4.37). All patients were having large breasts, cup C and D sizes (34% of patients & 56% of patients respectively), except for only two lactating female patients who had Cup B breasts. All patients were having ptotic breasts. The thyroid nodules greatest dimension ranged from 2.1-6 cm. All procedures were completed successfully endoscopically without any perioperative adverse events except for one case with temporary hoarseness of voice and three cases with axillary port sites cellulitis. The mean operative time was 83.26 ± 7.92 min. The patient satisfaction scores were high. CONCLUSION: EH via modified UABA in patients with lactating and/or large ptotic breasts is safe, feasible and effective procedure without adverse events. It should be offered to this group of patients as an alternative to conventional open thyroidectomy if there is no other contraindication.

Surgical resection of pericallosal tuberculoma through contralateral approach: A case report.

Background: Pericallosal tuberculoma, a rare form of intracranial tuberculoma, affects the corpus callosum and results from tuberculosis (TB), a bacterial infection that can cause a myriad of symptoms. Diagnosing this condition can be challenging but can be confirmed through imaging studies and biopsy. Treatment involves a combination of antitubercular medications and surgical removal of the lesion if it is in a critical location or causing significant symptoms. This article describes the surgical management and imaging characteristics approach to a patient with intracranial tuberculoma. Case Description: A 17-year-old female with a history of TB meningitis nine years ago presented with one week of recurrent seizures and mild third nerve palsy, later diagnosed as a tuberculoma of the corpus callosum through radiological imaging and biopsies. A total surgical resection of the lesion was performed using a contralateral interhemispheric frontal parasagittal approach. The patient went under observation and suitable follow-up plans. Conclusion: Surgical management can effectively treat cerebral granulomas and improve neurological deficits in patients with recurring TB. Despite the possibility of complications, the benefits of such measures are highlighted in this case, suggesting that surgical intervention can be a viable option for achieving optimal outcomes in these patients.

Impact of Ambient Air Pollution Exposure on Long COVID-19 Symptoms: A Cohort Study within the Saudi Arabian Population.

Evidence suggests that air pollution, specifically the particulate matters PM2.5 and PM10, plays a key role in exacerbating the risk of prolonged symptoms following COVID-19 infection. AIM: This study endeavors to elucidate the potential interaction between chronic air pollution exposure and the manifestation of long COVID symptoms within a cohort based in Makkah, Saudi Arabia. METHODS: Participants included residents from the Makkah region who had recovered from COVID-19 between 2022 and 2023. A comprehensive questionnaire was utilized to gather detailed demographic data and assess the persistent symptoms seen during the post-COVID period. To gauge the environmental exposure to potential risk factors, air sampling for PM10 and PM2.5 was systematically conducted in various locations in Makkah over a year. RESULTS: Significant positive associations were found between PM2.5 and PM10 exposure and long COVID. Furthermore, specific symptom analysis revealed a significant association between air pollution and shortness of breath (for PM2.5). Only PM2.5 exposure remained statistically significant (RR = 1.32, 95% CI: 1.05, 1.67). In contrast, the association with PM10 remained on the cusp of significance, with an RR of 1.27 (95% CI: 1.00, 1.61). CONCLUSION: This study highlights the importance of reducing air pollution levels to mitigate the long-term health consequences of COVID-19.

Post COVID-19 Symptoms Among Infected Vaccinated Individuals: A Cross-Sectional Study in Saudi Arabia.

INTRODUCTION: Multiple studies investigated the endurance and occurrence of symptoms three months after SARS-CoV-2 infection. This study examines the possible effects of COVID-19 vaccination on the persistence of post-recovery symptoms. PATIENTS AND METHODS: A cross-sectional survey was conducted in Saudi Arabia to evaluate 14 prevalent long COVID-19 symptoms among vaccinated individuals. Patients self-reported their acute COVID-19 experience, demographic information, chronic conditions, vaccine history, and persistent symptoms. RESULTS: Of the 484 patients, four respondents were excluded from the study as they had not received the vaccine, and 111 (23.1%) were vaccinated but did not get infected and were also excluded. The remaining 369 (76.9%) reported COVID-19 and a vaccination and thus they were included in the study. The occurrence of post-COVID-19 symptoms was reported in 59 (16.1%) for ≤ 3 months, 202 (54.8%) experienced persistent symptoms 3-6 months, and 108 (29.1%) reported symptoms lasting > 6 months. In relation to age group, persistent symptoms 3-6 months after recovery was more common in those > 50 years and symptoms lasting > 6 months were more common in 30-50 years of age (p < 0.001). Persistence of symptoms for 3-6 months was more common in those who were infected prior to vaccination compared to those who were infected after vaccination (P < 0.001). Of the included patients, 323 (87.5%) rated their health as good, 41 (11.1%) considered it fair, and 5 (1.4%) described their well-being as poor or terrible. CONCLUSION: The study provides information of persistent symptoms in vaccinated individuals who had recovered from COVID-19 and highlights the need for targeted interventions to alleviate post-COVID-19 symptoms. The study is limited by its reliance on self-reported data and potential selection bias. Future research is needed to understand the mechanisms underlying persistent symptoms in vaccinated individuals and to identify effective interventions for long COVID.

Dexpanthenol improved stem cells against cisplatin-induced kidney injury by inhibition of TNF-α, TGFß-1, ß-catenin, and fibronectin pathways.

Introduction: Cisplatin interacts with DNA and induces an immunological response and reactive oxygen species, which are nephrotoxic mediators. Stem cells self-renew through symmetric divisions and can develop into other cell types due to their multipotency. Dexpanthenol has been proven to protect against renal injury. Aim: This study aims to demonstrate that dexpanthenol could improve the effect of adipose-derived mesenchymal stem cells (ADMSC) against cisplatin-induced acute kidney injury. Methods: Sixty male Sprague-Dawley rats were divided into 5 groups (N = 12): control, cisplatin, cisplatin & dexpanthenol, cisplatin & ADMSC, and cisplatin & dexpanthenol & ADMSCs. On the 5th day following cisplatin injection, half the rats in each group were sacrificed, and the other half were sacrificed on the 12th day. Histopathological examination, molecular studies (IL-6, Bcl2, TGFß-1, Caspase-3, Fibronectin, and ß-catenin), antioxidants (superoxide dismutase and catalase), and renal function were all investigated. Results: In contrast to cisplatin group, the dexpanthenol and ADMSCs treatments significantly decreased renal function and oxidative stress while significantly enhancing antioxidants. Dexpanthenol improved stem cells by significantly down-regulating caspase-3, IL-6, TGF-ß1, Fibronectin, and ß-catenin and significantly up-regulating Bcl2 and CD34, which reversed the cisplatin effect. Conclusion: Dexpanthenol enhanced ADMSCs' ability to protect against cisplatin-induced AKI by decreasing inflammation, apoptosis, and fibrosis.

The Impact of Vitamin D Supplementation on Improving Blood Pressure: Evidence Obtained From an Umbrella Meta-analysis.

PURPOSE: The results of meta-analyses regarding the effect of vitamin D on blood pressure are conflicting. The present umbrella meta-analysis was conducted to provide definite and conclusive results. METHODS: Systematically, Scopus, EMBASE, PubMed, and Web of Science databases and Google Scholar were searched for relevant literature published up to July 2022. All meta-analyses of clinical trials addressing the effect of vitamin D on blood pressure were included. Random effects analysis was performed to obtain the overall effect size based on the standardized mean differences (SMDs) and weighted mean differences (WMDs) separately. The quality of included meta-analyses was assessed by using the Measurement Tool for Assessing Multiple Systematic Reviews 2 questionnaire. FINDINGS: Overall, 21 meta-analyses were enrolled in the umbrella review. The results indicated that systolic blood pressure was significantly reduced after the intervention based on WMD effect size analysis (ESWMD = -0.69 mm Hg; 95% CI, -1.35 to -0.04 [P < 0.038]; I2 = 46.7%, P = 0.021); however, no considerable impact was observed based on analysis of SMD effect sizes (ESSMD = -0.05 mm Hg; 95% CI, -0.24 to 0.14; P = 0.615). Also, vitamin D supplementation indicated a significant improvement in diastolic blood pressure based on WMD effect sizes (ESWMD = -0.66 mm Hg; 95% CI, -1.05 to -0.27 [P < 0.001]; I2 = 56.4%, P = 0.004) but not SMD analysis (ESSMD = -0.04 mm Hg; 95% CI, -0.13 to 0.04 [P = 0.328]; I2 = 53.4%, P = 0.057). IMPLICATIONS: Based on obtained evidence, vitamin D could be considered an efficient adjuvant for improving blood pressure.

Exploring the impact of chronic medical conditions on maternal mental health: A National Inpatient Sample analysis.

BACKGROUND: Pregnancy and postpartum period are associated with stress and pain. Chronic medical conditions can aggravate depressive and psychotic mental illnesses in the peripartum period. AIM: The study aimed to investigate the association between different chronic medical conditions and mental illnesses during pregnancy and the postpartum period using the National Inpatient Sample (NIS). METHODS: Pregnant women or women in the postpartum period were retrieved from the NIS 2016-2019 database using the International Classification of Diseases (ICD)-10 and set as our targeted population. Postpartum depression, puerperal psychosis, and mental illnesses related to pregnancy were also retrieved as our outcomes of interest. STATA 15 was used to analyze the data and investigate the relationship between chronic medical conditions and pregnancy-related mental illnesses. RESULTS: 2,854,149 admissions were retrieved from the database with a mean age of 29 ± 6 years old. Univariate and multivariate analyses showed a significant association between chronic medical conditions and postpartum depression, puerperal psychosis, and other mental illnesses. On univariate analysis, heart failure (odds ratio [OR] = 13.9; 95% confidence interval [CI] = 3.5-55.88; P < 0.001), alcohol misuse (OR = 5.3; 95% CI = 1.7-16.4; P = 0.004), and migraine (OR = 3.9; 95% CI = 2.8-5.3; P < 0.001) showed high association with postpartum depression. Epilepsy (OR = 54.37; 95% CI = 7.4-399.34; P < 0.001), systemic lupus erythematosus (OR = 24.66; 95% CI = 3.36-181.1; P = 0.002), and heart diseases (OR = 15.26; 95% CI = 3.6-64.5; P < 0.001) showed the highest association with puerperium psychosis. Alcohol misuse (OR = 8.21; 95% CI = 7.4-9.12; P < 0.001), osteoarthritis (OR = 6.02; 95% CI = 5.41-6.70; P < 0.001), and migraine (OR = 5.71; 95% CI = 5.56-5.86; P < 0.001) showed the highest association with other mental illnesses during pregnancy and the postpartum period. CONCLUSION: Heart diseases, alcohol misuse, migraine, systemic lupus erythematosus, and epilepsy were the most important chronic medical conditions associated with mental diseases during pregnancy and the postpartum period. This investigation recommends integrating management of chronic diseases and mental health care together. Specifically, screening for mental illnesses should be a routine part of care for patients with chronic medical conditions, especially during pregnancy and early postpartum. By identifying and addressing mental health issues early on, healthcare providers can improve the overall health and well-being of these patients, ultimately leading to better maternal and fetal outcomes.

A systematic review and meta-analysis of the omega-3 fatty acids effects on brain-derived neurotrophic factor (BDNF).

BACKGROUND: Omega-3 fatty acids (omega-3 FAs) have attracted the attention of researchers because of their influence on circulatory levels of brain-derived neurotrophic factor (BDNF). Our objective was to review systematically and Meta-analyze randomized controlled trials (RCTs) to assess the effects of omega-3 FAs supplementation on serum BDNF concentration. METHODS: Scopus, PubMed, Web of Science, and Cochrane Library were systematically searched until April 2023. The Cochrane risk of bias assessment tool was utilized to evaluate the quality of the studies. A random-effects model was employed to estimate the overall effect size of BDNF levels, using the Standard Mean Difference (SMD) and a 95% confidence interval (CI). The heterogeneity among the studies was assessed using chi-squared and I2 statistics. RESULTS: A total of 12 studies involving 587 subjects were included. The supplementation of PUFA was found to be associated with a significant increase in serum levels of BNDF in the group receiving the supplements, as compared to the placebo group (SMD: 0.72 pg/mL, 95% CI: 0.28, 1.15; P < 0.001) (I2 = 84.39%, P < 0.001). Sub-group analyses revealed similar findings in trials with fewer than 10 weeks, which utilized both animal (fish oil) and herbal (flaxseed) forms of omega-3 supplements with a high daily dosage of 2000mg. CONCLUSION: The present systematic review and meta-analysis indicate the efficacy of omega-3 FAs in increasing the serum concentration of BDNF. Therefore, omega-3 FAs should be prioritized as agents for increasing BDNF in interventions.