Game-based learning in early childhood education: a systematic review and meta-analysis.

Game-based learning has gained popularity in recent years as a tool for enhancing learning outcomes in children. This approach uses games to teach various subjects and skills, promoting engagement, motivation, and fun. In early childhood education, game-based learning has the potential to promote cognitive, social, and emotional development. This systematic review and meta-analysis aim to summarize the existing literature on the effectiveness of game-based learning in early childhood education This systematic review and meta-analysis examine the effectiveness of game-based learning in early childhood education. The results show that game-based learning has a moderate to large effect on cognitive, social, emotional, motivation, and engagement outcomes. The findings suggest that game-based learning can be a promising tool for early childhood educators to promote children's learning and development. However, further research is needed to address the remaining gaps in the literature. The study's findings have implications for educators, policymakers, and game developers who aim to promote positive child development and enhance learning outcomes in early childhood education.

Coexistence of Lichen Planus Pigmentosus and Classic Lichen Planopilaris: A Case Report and Literature Review.

Lichen planus (LP) is a common inflammatory skin disorder with multiple variants. The coexistence of lichen planus pigmentosus (LPPigm) and frontal fibrosing alopecia is well-established in the literature. However, the coexistence of LPPigm and classic lichen planopilaris (LPP) is rare. We report a case of LPPigm and classic LPP in a postmenopausal woman with a literature review.

The Prevalence and Clinical Features of Skin Irritation Caused by Infection Prevention Measures During COVID-19 in Riyadh Region, Saudi Arabia.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), caused by a novel coronavirus (CoV), was reported at the end of 2019 and caused a severe public health concern. It caused high mortalities by respiratory failure among infected people and was declared a pandemic by the World Health Organization (WHO) in March 2020. This virus caused infections through air or direct contact which documented a huge number of fatalities. AIM: This study aims to examine the impact of the COVID-19 pandemic on skin eczema of the general public in the Riyadh region of Saudi Arabia. METHODS: This is a descriptive, cross-sectional, survey-based study, that was conducted via an online survey distributed to the general population of Riyadh for the period between January and February 2023. Data was collected through a questionnaire which was distributed through the social media websites. RESULTS: A total of 697 participants were involved in this study. Around one-fifth of the study participants (19.5%) reported that they suffer from some form of allergy and have family history of allergy (21.8%). Eczema was the most common type of allergy among the study participants accounting for 32.4%. A total of 116 participants (16.6%) reported that they have personal history of hand eczema or other skin disease on the hands. Cleaning and sterilization materials were reported as the most common cause of dryness and irritation of eczema (62.1%). Around 41.0% of the participants reported that they noticed a worsening of their symptoms after the pandemic, of which dryness was the most commonly reported sign noticed getting worse by 68.1% of the participants. The vast majority of the participants (89.7%) reported that new skin symptoms emerged on their hands after the beginning of the pandemic, of which dryness was reported by all the participants. CONCLUSION: A considerable proportion of participants, particularly those with a history of hand eczema, experienced dermatological difficulties, including skin damage, due to the usage of COVID-19 preventive strategies. Thus, we recommend increasing the use of innovative infection prevention approaches and skin protection measures, such as regular hand hydration and maybe the use of less toxic skin disinfectants.

Viral-Induced Rapidly Progressive Alopecia Universalis: A Case Report and Literature Review.

Alopecia areata is a common autoimmune condition that causes a non-scarring form of hair loss. It is associated with several viruses and diseases. One of the viruses that have been linked to alopecia areata is the coronavirus disease of 2019 (COVID-19). It was found to cause the onset, aggravation, or recurrence of alopecia areata in previously infected patients. We report the case of a 20-year-old woman who was medically free and presented with the severe and progressive onset of alopecia areata after one month of contracting COVID-19. This study aimed to explore the literature on COVID-19-associated severe onset alopecia areata in terms of timeline and clinical presentation.

Continuous Spikes and Waves During Sleep (CSWS), Severe Epileptic Encephalopathy, and Choreoathetosis due to Mutations in FRRS1L.

Background. Biallelic pathogenic variants in the FRRS1L gene are now known to cause developmental and epileptic encephalopathy-37 (DEE37). It can also be associated with chorea and continuous spikes and waves during sleep (CSWS). CSWS is a rare age-related epileptic encephalopathy syndrome of childhood that is characterized by seizures, neurocognitive regression and electrical status epilepticus during sleep (ESES) on electroencephalogram (EEG) that evolves in four stages. Seizures start during the prodromal phase but the ESES on EEG appears only during acute stage and this is the stage when the diagnosis of CSWS can be made. Methods. We present two patients with FRRS1L mutation causing DEE37 with CSWS. We also review twenty-nine cases of DEE37 described in the literature before and discuss its association with CSWS in the total cohort of thirty-one cases. Results. Developmental regression was found in 80% of the patients, mean age of seizure onset was 18 months, ESES or slow spike and wave on the EEG were reported mostly in the older patients (median age of 11 years) and hypsarrhythmia was reported in younger patients (median age of 4 years). This could suggest that if the younger patients were followed longer their EEG would have evolved into ESES during the acute stage of this syndrome and a diagnosis of CSWS could be made. Conclusion. Recognizing ESES and the natural evolution of CSWS is important in diagnosis and proper management of these patients. More detailed report of EEG findings and the evolution of epilepsy and development are needed to further characterize this syndrome.

The psychosocial burden of androgenetic alopecia in Saudi Arabia: A cross-sectional study.

Background: The most prevalent cause of hair loss is androgenetic alopecia. Improved therapeutic modalities may result from knowing how stress affects hair growth, incorporating stress-coping methods into the treatment of hair loss disorders, and developing new pharmacotherapeutic approaches. This study aimed to examine the psychosocial burden of androgenetic alopecia in Saudi Arabia. Materials and Methods: A cross-sectional online survey study was conducted among patients with androgenetic alopecia in Saudi Arabia in February 2023. A previously developed questionnaire was adapted from a previously published tool and used in this study. This association between patients' characteristics and the level of psychosocial disease was identified using binary logistic regression analysis. Results: This study included 1230 patients. The majority of the patients (78.0%) reported that they felt embarrassed by their androgenetic alopecia. The median score of the psychosocial impact of androgenetic alopecia on the patients was 1.00 (0.00-2.00), which is equal to 10.0%, reflecting a low level of psychosocial burden on the patients by their condition. Binary logistic regression analysis identified that patients without a family history of androgenetic alopecia were 36.0% less likely to be affected psychosocially by their condition (P < 0.01). Conclusions: A low-level psychosocial effect was seen in our study among individuals with androgenetic alopecia. Further research should be done to determine how the type of alopecia affects patients' psychological results, as well as the influence of the disease's duration on those outcomes. Dermatologists are recommended to raise patients' knowledge of their disease and lessen stigmatization in the meantime.

Clinicians' and Students' Perceptions and Attitudes Regarding the Anatomical Knowledge of Medical Students.

Background: In both the preclinical and clinical sciences, anatomy is considered as the foundation of medical education. Anatomy education serves as a foundation for clinical application and future practice of medicine. Health practitioners and students are interested in the adequacy of anatomical knowledge in clinical years since it has a direct impact on medical education and professional clinical practice. Objective: To examine the opinions and attitudes of medical students and clinicians regarding the preclinical and clinical years' teaching of anatomy and anatomical knowledge to medical students. Methods: Participants in the study, including clinicians and medical students, were required to answer an 8-question, 5-point Likert scale questionnaire to assess their attitudes regarding anatomical knowledge. The maximum score was 40, and the higher the score, the more the positive attitude towards anatomical knowledge. The difference in the mean attitude score between males and females was investigated using the Independent sample t-test. Results: A total of 327 clinicians and 423 students participated in the study. Clinicians and students showed moderately high positive attitude towards anatomical knowledge. The mean statements score for clinicians' attitudes was 31.4(±3.4). There was no significant difference between total attitude score means for clinicians and students, p=0.83. Attitude statements attained a significantly higher percentages and were in favor to clinicians in comparison to students, particularly for clinical significance of anatomical knowledge to students in the clinical years, the importance of anatomical knowledge to surgical and non-surgical specialties, and re-teaching special anatomy for students in the clinical years would improve their clinical background. Both clinicians and students expressed low agreement regarding anatomical educational style and quality of study materials. Conclusion: Teaching anatomy to medical students is a continuous process. Therefore, we recommend reforming the anatomy curriculum by vertical integration of anatomy into the clinical rotations, clerkship, and specialist training.

Role of Aromatherapy as a Natural Complementary and Alternative Therapy in Cardiovascular Disease: A Comprehensive Systematic Review.

Background: The purpose of this study was a comprehensive review of studies on the effect of aromatherapy with plant essential oils on the improvement of some conditions, for example, anxiety, stress, sleep quality, fatigue, and pain in people with cardiovascular disease. Materials and Methods: We carried out this systematic review based on the instructions of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Ethical agreement was not necessary as main data have not been collected. During March 2022, we searched the main English databases, for example, Google Scholar, Web of Sciences, EMBASE, EBSCO, ScienceDirect, Scopus, and PubMed/MEDLINE, with limitation to human clinical trials. For this study, no time limit was applied for the publication of articles. Results: Out of 1380 papers, 52 papers up to March 2022 were eligible for review in this systematic review. Based on the obtained results, the most widely used medicinal plants for aromatherapy in patients with cardiovascular diseases were Lavandula angustifolia (lavender, 55.7%), Rosa damascena (Damask rose, 11.5%), and Mentha piperita (peppermint, 5.8%), respectively. Most studies have been performed on the effect of aromatherapy on coronary angiography (21 papers, 40.4%), followed by artery bypass graft surgery (14 studies, 26.9%), and cardiac patients (5 studies, 9.6%). Most studies on the effect of aromatherapy in cardiovascular diseases were performed on anxiety (31 papers, 59.6%), sleep quality (8 studies, 15.4%), and hemodynamic parameters (6 studies, 11.5%), respectively. Conclusion: This study systematically reviewed the effects of aromatherapy in patients with cardiovascular diseases. The review of studies showed that lavender, Damask rose, and peppermint are the most frequents plants used for aromatherapy, whereas they significantly improved some illnesses and conditions, especially anxiety and sleep quality. Therefore, it can be concluded that cardiologist can used aromatherapy as a natural complementary and alternative therapy particularly with lavender, Damask rose, and peppermint to improve quality of life and some conditions such as anxiety and sleep quality.

A systematic review of the efficacy of perampanel as treatment for myoclonic seizures and symptomatic myoclonus

Epileptic myoclonus or myoclonic seizures can occur in idiopathic generalized epilepsy (IGE) and progressive myoclonus epilepsy (PME). However, symptomatic myoclonus which is stimulus-sensitive and provoked by movement is typically seen in PME and Lance-Adams syndrome. Symptomatic myoclonus is not always associated with epileptiform discharges on the electroencephalogram. Therapeutic interventions such as anti-seizure medications (ASMs), the ketogenic diet and vagus nerve stimulation are not always effective. There is emerging evidence that perampanel (PER), an α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist, may be effective for the treatment of myoclonic seizures and symptomatic myoclonus. We performed a systematic review of the literature to assess the efficacy of PER as treatment for myoclonic seizures and symptomatic myoclonus. Twenty-seven studies with a total sample size of 260 patients were included. The efficacy of PER was analysed separately for myoclonic seizures and symptomatic myoclonus. In the group with myoclonic seizures, 50% responder, 75% responder and seizure freedom rates were reported as 74.3% (101/ 136), 60.3% (82/136) and 57.4% (78/136), respectively, with a follow-up duration of 6-12 months. However, in one post-hoc analysis of data from patients with IGE, the efficacy of PER as treatment for myoclonic seizures during the double-blind phase showed no significant difference compared to placebo. The efficacy of PER for symptomatic myoclonus was reported in a total of 119 patients. Four studies (n=88 patients) reported the efficacy of PER as a decrease in myoclonus score/scale. In the remaining 31 patients, symptomatic myoclonus resolved in three patients, decreased in 21 patients and seven patients showed no improvement. We also analysed the number of patients who were already on levetiracetam (LEV) or valproic acid (VPA) at the time of PER initiation; these data were available for 153 patients. Of these, 56.8% were on LEV and 75.1% were on VPA when PER was initiated. This systematic review suggests that PER maybe effective as treatment for drug-resistant myoclonic seizures and symptomatic myoclonus. It may also be effective in patients who have already failed to respond to LEV and VPA. These findings are preliminary yet encouraging. This study has several limitations, particularly given the scarcity of high-quality randomized controlled trials and marked heterogeneity regarding the type and results of the studies. Hence, the findings of this review should be viewed with considerable reservation.