Performance of several clinical scoring systems as predictors of adverse outcomes in acute exposure to toxic alcohols.

Background: Toxic alcohols are chemicals with common metabolic characteristics resulting in severe morbidities and mortalities. The current study aimed to assess the efficacy of six scoring systems: The Poison Severity Score (PSS), Acute Physiology and Chronic Health Evaluation (APACHE) II score, Sequential Organ Failure Assessment (SOFA) score, Rapid Acute Physiology Score (RAPS), Rapid Emergency Medicine Score (REMS), and Modified Early Warning Score (MEWS) in stratifying the patients exposed to toxic alcohol based on liability of organ failure, prolonged hospital stay, and need for an antidote. Methods: A seven-year retrospective cross-sectional study was conducted using medical records of adult patients admitted to a poison control center. Results: About 42.6% were complicated with adverse outcomes. Methanol was the worst toxic alcohol and the only cause of blindness and death. About 27.1% of methanol-exposed patients suffered from acute kidney injury, 15.3% suffered from hemodynamic instability and neurological dysfunction, and 8.5% suffered from respiratory failure. An APACHE II score above 8 was the best predictor of unfavorable outcomes, exhibiting the highest area under the curve (0.972), followed by the SOFA score. The APACHE II score was praised for being the best discriminator of an expected prolonged hospital stay. Yet, the simple scores, including RAPS and REMS, showed good performance as unfavorable outcome predictors with no significant variations to PSS, APACHE II score, and SOFA scores. Conclusion: The current study concluded that though the APACHE II and SOFA scores were superior to others, the RAPS and REMS are good, simple, and effective alternatives, particularly when resources are restricted.

Genetic background of primary and familial HLH in Qatar: registry data and population study.

Background: Familial hemophagocytic lymphohistiocytosis (FHLH) is an inherited life-threatening disease. Five types are identified, with the addition of congenital immunodeficiency syndromes in which HLH is a typical manifestation. The literature on this disease is very scarce in the Middle East, with only a few scattered reports. Methods: We report detailed demographic, clinical, and genomic data from 28 patients diagnosed with primary and familial HLH over the last decade in Qatar. An evaluation was performed of allele frequencies of deleterious variants from 12 primary and familial HLH causative genes on the Qatar Genome Programme (QGP) cohort of 14,669 Qatari individuals. Results: The genetic diagnosis was obtained in 15 patients, and four novel mutations in Perforin 1 (PRF1), UNC13D, LYST, and RAB27A genes were found. We identified 22,945 low/high/moderate/modifier impact variants significantly enriched in the QGP in those 12 genes. The variants rs1271079313 in PRF1 and rs753966933 in RAB27A found in our patient cohort were significantly more prevalent in the QGP compared to the Genome Aggregation Database (gnomAD) database, with a high carrier frequency in the Qatari population. Conclusions: We established the first primary and familial HLH Registry in the Gulf Region and identified novel possibly pathogenic variants present at higher frequency in the Qatari population, which could be used for screening purposes. Raising awareness about primary and familial HLH and implementing screening activities in the Qatari highly inbred population could stem into more comprehensive premarital and prenatal evaluations and faster diagnosis.

Vinpocetine alleviated alveolar epithelial cells injury in experimental pulmonary fibrosis by targeting PPAR-γ/NLRP3/NF-κB and TGF-ß1/Smad2/3 pathways.

This study aimed to investigate the potential anti-fibrotic activity of vinpocetine in an experimental model of pulmonary fibrosis by bleomycin and in the MRC-5 cell line. Pulmonary fibrosis was induced in BALB/c mice by oropharyngeal aspiration of a single dose of bleomycin (5 mg/kg). The remaining induced animals received a daily dose of pirfenidone (as a standard anti-fibrotic drug) (300 mg/kg/PO) and vinpocetine (20 mg/kg/PO) on day 7 of the induction till the end of the experiment (day 21). The results of the experiment revealed that vinpocetine managed to alleviate the fibrotic endpoints by statistically improving (P ≤ 0.05) the weight index, histopathological score, reduced expression of fibrotic-related proteins in immune-stained lung sections, as well as fibrotic markers measured in serum samples. It also alleviated tissue levels of oxidative stress and inflammatory and pro-fibrotic mediators significantly elevated in bleomycin-only induced animals (P ≤ 0.05). Vinpocetine managed to express a remarkable attenuating effect in pulmonary fibrosis both in vivo and in vitro either directly by interfering with the classical TGF-ß1/Smad2/3 signaling pathway or indirectly by upregulating the expression of Nrf2 enhancing the antioxidant system, activating PPAR-γ and downregulating the NLRP3/NF-κB pathway making it a candidate for further clinical investigation in cases of pulmonary fibrosis.

From Sand to Excellence: A Deep Dive into Abu Dhabi's Rheumatology Landscape.

The Emirate of Abu Dhabi (AD) is the capital and largest emirate of the United Arab Emirates (UAE). The emirate's economic significance stems from non-oil and oil contributions to GDP. The 2022 GDP of Abu Dhabi was USD 230 billion. The government provides services to its residents through digital platforms such as official websites. The Abu Dhabi Health Insurance Law No. 23 of 2005 mandates that residents have access to necessary medical care and services. There is a paucity in the literature on the available rheumatology services in the Arab region. This review article aims to explore the status of rheumatology services in AD for both residents and visitors. It will include an overview of paediatric and adult rheumatology care, accessibility of diagnostic procedures, the integration of electronic medical records, access to medications, the status of postgraduate education, research, and suggestions on how to enhance rheumatology services in AD as a destination for medical tourism.

Perceptions and Factors That Influence the Choice of Pathology as a Career Among Medical Students in Saudi Arabia.

Introduction Pathologists play a pivotal role in diagnosing diseases and improving patient care. Nonetheless, research indicates that a mere fraction of medical school graduates opt for a career in pathology, ranging from 1% to 3%. Diverse factors influence students' perceptions of pathology, encompassing lifestyle, patient interaction, and income. Aim The aim of this study was to assess the perceptions and factors that influence students' selection of pathology as a career in Saudi Arabia. Methodology A cross-sectional, self-administered electronic questionnaire was distributed among students from various regions of Saudi Arabia. The questionnaire encompassed both quantitative and qualitative data. To ensure statistical rigor, a confidence level of 95%, response distribution of 10%, and margin of error of 5% were applied. Accordingly, the recommended sample size of 150 participants was determined. Data analysis was performed using IBM SPSS Statistics for Windows, Version 24.0 (IBM Corp., Armonk, NY), with the chi-square test applied at a significance level of P < 0.05. Results Among the 664 participating students, 130 (19.6%) indicated an interest in pathology, of whom only 19 (2.9%) regarded it as their primary choice. No statistically significant difference was found between the male and female students or between the students in foundational and clinical years. Conclusions The female students generally held a more favorable perception of pathology, acknowledging its clinical significance and role in diagnosis, prognosis, and patient management. The absence of nocturnal calls emerged as the most encouraging factor, while limited patient interaction emerged as the primary deterrent in choosing pathology.

Conserved genes regulating human sex differentiation, gametogenesis and fertilization.

The study of the functional genome in mice and humans has been instrumental for describing the conserved molecular mechanisms regulating human reproductive biology, and for defining the etiologies of monogenic fertility disorders. Infertility is a reproductive disorder that includes various conditions affecting a couple's ability to achieve a healthy pregnancy. Recent advances in next-generation sequencing and CRISPR/Cas-mediated genome editing technologies have facilitated the identification and characterization of genes and mechanisms that, if affected, lead to infertility. We report established genes that regulate conserved functions in fundamental reproductive processes (e.g., sex determination, gametogenesis, and fertilization). We only cover genes the deletion of which yields comparable fertility phenotypes in both rodents and humans. In the case of newly-discovered genes, we report the studies demonstrating shared cellular and fertility phenotypes resulting from loss-of-function mutations in both species. Finally, we introduce new model systems for the study of human reproductive biology and highlight the importance of studying human consanguineous populations to discover novel monogenic causes of infertility. The rapid and continuous screening and identification of putative genetic defects coupled with an efficient functional characterization in animal models can reveal novel mechanisms of gene function in human reproductive tissues.

Cardiovascular Morbidity in Systemic Lupus Erythematosus: A Single-Center Retrospective Study.

BACKGROUND: Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory condition affecting multiple systems. Cardiovascular morbidity is a significant concern, with around 25% of SLE patients experiencing cardiac complications. OBJECTIVE: This study aims to determine the prevalence of cardiovascular morbidity in SLE patients in King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia. METHODOLOGY: This retrospective record-based research was conducted at KFMC from January 2015 to October 2023. A review of the medical files of all SLE patients was accomplished. RESULTS: The vast majority of the patients (90.9%) were females. The mean age for the patients was 36.5 years. The most common comorbidities were lupus nephritis (34.6%), hypothyroidism (18.4%), and anti-phospholipid syndrome (9.2%). The most commonly used medications were hydroxychloroquine (81.8%), corticosteroids (prednisolone) (43.0%), and mycophenolate mofetil (27.9%). Around 45.2% (n= 176) of the patients with SLE developed cardiovascular complications. The most commonly reported cardiovascular diseases that developed after diagnosing patients with SLE were hypertension (22.4%), valvular heart diseases (13.2%), and dyslipidemia (9.2%). The study also found that anti-dsDNA antibodies can reduce the likelihood of developing hypertension by 40%. This research contributes to the medical literature on SLE and sets the stage for future research on personalized healthcare strategies for managing SLE and its complications. CONCLUSION: This study highlights that a considerable proportion of SLE patients(~50%) develop cardiovascular complications, with hypertension, valvular heart diseases, and dyslipidemia being the most common. We also discovered that anti-double-stranded deoxyribonucleic acid antibodies (Anti-dsDNA) reduce the likelihood of developing hypertension.

Recuperative Effects of Cinnamon (Cinnamomum zeylanicum) in Catla catla After Sub-Lethal Exposure to Lead.

This research was conducted to validate the beneficial effects of incorporating dietary cinnamon (Cinnamomum zeylanicum) powder (CzP) in alleviating lead (Pb) poisoning in fish. Healthy Catla catla individuals (16.36 ± 0.19 g/fish) were distributed across 18 tanks in triplicate groups. The experimental groups were as follows: Control group: fish without supplementation or exposure to Pb; positive control group: fish without supplementation but exposed to 1 mg/L Pb; 5 g/kg CzP along with 1 mg/L Pb exposure; 10 g/kg CzP along with 1 mg/L Pb exposure; 15 g/kg CzP along with 1 mg/L Pb exposure; and 20 g/kg CzP along with 1 mg/L Pb exposure. The trial continued for a period of 60 days. Waterborne Pb had a deleterious effect on fish growth performance, body composition, blood profile, and digestive enzyme activity, along with elevated Pb accumulation in various tissues. Conversely, consumption of cinnamon effectively mitigated the toxic potential of Pb and enhanced fish longevity. Notably, 10 g/kg CzP boosted growth, improved carcass quality, reversed blood indices, restored enzyme function in the gut, and mitigated Pb accumulation in tissues. In summary, the findings revealed that incorporating 10 g/kg of CzP as a dietary supplement in C. catla aquaculture could effectively counteract heavy metal toxicity.

Proposing a strategy based on body-thermal status to improve the welfare of heat-stressed and water-deprived goats (Capra hircus).

Objective: Despite the considerable body of research on the effects of heat stress coupled with water scarcity (either through restriction or deprivation) on goats, aimed at enhancing their welfare, there remains a notable gap in the literature regarding the subsequent period following water restoration, during which the cumulative impact is fully alleviated. In response to this gap, we propose a strategy grounded in the assessment of body-thermal status to improve the welfare of heat-stressed and water-deprived goats. Specifically, our strategy seeks to determine the minimally required recovery interval necessary to completely mitigate the residual effects of water deprivation endured for a duration of 72 hours. Methods: Eight healthy Aardi bucks, aged 10 months and weighing 30 kg, were subjected to three distinct stages: euhydration, dehydration, and rehydration. Each stage spanned for 72 hours except for the rehydration stage, which was left unrestricted. Various meteorological, biophysiological, and thermophysiological measurements were subsequently recorded. Results: Exposure of heat-stressed goats, as indicated by the temperature-humidity index values, to a 72 hours deprivation period resulted in noticeable (p<0.05) alterations in their biophysiological (daily feed intake, body weight, and feces water content) and thermophysiological responses (core, rectal, skin, and surface temperatures, respiratory and heart rates, internal, external, and total body-thermal gradients, heat tolerance and adaptability coefficients, heterothermial total body-heat storage, and total water conservation). Remarkably, our findings demonstrate that all assessed variables, whether measured or estimated, returned to their baseline euhydration levels within 10 days of commencing the rehydration phase. Conclusion: In order to improve the welfare of heat-stressed and 72 hours water-deprived goats, it is imperative to allow a recovery period of no less than 10 days following the restoration of water access prior to initiating any subsequent experiments involving these animals. Such experiments, addressing these critical aspects, serve to advance our understanding of goat welfare and obviously hold promise for contributing to future food security and economic viability.

Deciphering the complex interplay of obesity, epithelial barrier dysfunction, and tight junction remodeling: Unraveling potential therapeutic avenues.

Obesity stands as a formidable global health challenge, predisposing individuals to a plethora of chronic illnesses such as cardiovascular disease, diabetes, and cancer. A confluence of genetic polymorphisms, suboptimal dietary choices, and sedentary lifestyles significantly contribute to the elevated incidence of obesity. This multifaceted health issue profoundly disrupts homeostatic equilibrium at both organismal and cellular levels, with marked alterations in gut permeability as a salient consequence. The intricate mechanisms underlying these alterations have yet to be fully elucidated. Still, evidence suggests that heightened inflammatory cytokine levels and the remodeling of tight junction (TJ) proteins, particularly claudins, play a pivotal role in the manifestation of epithelial barrier dysfunction in obesity. Strategic targeting of proteins implicated in these pathways and metabolites such as short-chain fatty acids presents a promising intervention for restoring barrier functionality among individuals with obesity. Nonetheless, recognizing the heterogeneity among affected individuals is paramount; personalized medical interventions or dietary regimens tailored to specific genetic backgrounds and allergy profiles may prove indispensable. This comprehensive review delves into the nexus of obesity, tight junction remodeling, and barrier dysfunction, offering a critical appraisal of potential therapeutic interventions.

Exploring the Enigmatic Link: Unraveling the Relationship Between Obesity and Cigarette Smoking Among Diverse College Students at Imam Mohammed Ibn Saud Islamic University in Riyadh, Saudi Arabia.

BACKGROUND: Obesity is defined as an excess of body fat. This medical condition frequently results in a high BMI and an increased risk of a variety of health problems, including diabetes, cardiovascular disease, and certain types of cancer. Cigarette smoking includes inhaling smoke created by the combustion of tobacco. It is linked to a variety of health issues, including lung cancer, heart disease, and respiratory ailments, and is a primary cause of preventable disease and premature death worldwide. The association between obesity and cigarette smoking is complex and incompletely understood. This study aims to investigate the intriguing association between obesity and cigarette smoking among diverse college students at Imam Mohammed Ibn Saud Islamic University in Riyadh, Saudi Arabia. METHODOLOGY: The study was conducted as an observational study, specifically an analytical cross-sectional study, to measure the prevalence of cigarette smoking and obesity and their association. This type of study is chosen because of its advantages including targeting a large sample in a short time and inexpensive way, with no loss to follow-up, unlike some other study designs. RESULTS: In this study, we were able to collect data from 603 participants, of which 57.4% were male and 67.8% of them aged between 20 and 24 years old. Moreover, we found that 39.6% had normal weight; however, the prevalence of obesity, overweight, and underweight were 24%, 28.1%, and 8.3%, respectively. Considering the prevalence of smoking, we found that 22.6% of the participants reported being current smokers, while 5.3% were former smokers. There is a significant difference between participants with different BMIs (P=0.001). The prevalence of smoking was significantly higher in obese and overweighted participants (35.1% and 31.3%, respectively) compared with 28.4% in normal-weighted participants. CONCLUSION: The prevalence of smoking and obesity in this study was significantly higher than reported in different studies. Moreover, we found a significant relationship between smoking and obesity; however, further investigation should be conducted to determine the cause of this relationship.

Unmasking May-Thurner Syndrome: A Case Report of Massive Deep Vein Thrombosis.

Deep venous thrombosis is a significant medical condition that results in life-threatening complications such as pulmonary embolism. Various factors can contribute to the formation of deep venous thrombosis, including prolonged immobility, surgery, and specific health conditions. May-Thurner syndrome is an underrecognized cause of deep venous thrombosis due to the compression of the left common iliac vein by the right common iliac artery. It poses diagnostic challenges due to its varied clinical presentations. This report discusses a 42-year-old female with no notable medical history who presented with acute onset of left leg swelling, pain, and discoloration. Despite the absence of common risk factors for deep venous thrombosis, investigations revealed a massive left-sided deep venous thrombosis. Additional imaging studies revealed the diagnosis of May-Thurner syndrome, manifesting as significant compression of the left common iliac vein. The patient underwent anticoagulation therapy, catheter-directed thrombolysis, and stent placement, resulting in symptomatic improvement and no recurrence over a six-month follow-up period. This case underscores the necessity of considering anatomical variations like May-Thurner syndrome in patients with unexplained deep venous thrombosis, particularly without typical risk factors. It highlights the importance of a comprehensive diagnostic approach, including advanced imaging techniques, to uncover underlying causes of deep venous thrombosis.

Knowledge and Preparedness of Physicians in Relation to Anaphylaxis at Primary Healthcare Centers in Al-Qassim, Saudi Arabia.

Background Anaphylaxis is a significant, often fatal, systemic allergic reaction with a rapid start that may affect the respiratory and/or circulatory systems; for patients to survive, emergency management must be done properly. When anaphylaxis is confirmed or highly suspected, epinephrine should be injected intramuscularly. This study aimed to assess the preparedness of primary healthcare physicians for anaphylaxis in terms of recognition and management of this condition in Al-Qassim, Saudi Arabia. Methods This cross-sectional study was carried out among primary healthcare physicians in the Qassim region of Saudi Arabia. A self-administered questionnaire was distributed among the targeted physicians. The questionnaire comprised sociodemographic characteristics, general awareness and management of anaphylaxis, and a 10-item questionnaire to assess physicians' knowledge of anaphylaxis. Results Out of 121 primary healthcare physicians, 61.2% were male, and 47.9% were aged between 25 and 35 years. Nearly all physicians (97.5%) believed that anaphylaxis is a life-threatening situation. The overall mean knowledge score was 4.74 out of 10 points. Nearly half (48.8%) were categorized as having poor knowledge levels, 43% as moderate, and only 8.3% as having good knowledge. Being specialists/consultants and being trained in managing anaphylaxis were the factors associated with increased knowledge. Conclusion The knowledge of primary care physicians regarding anaphylaxis was deficient. However, increased knowledge of anaphylaxis was seen more frequently among consultants or specialists who attended training for managing anaphylaxis cases. A multi-center study involving a bigger sample size is needed to establish physicians' knowledge of anaphylaxis.

Pediatric Acute Mastoiditis in Saudi Arabia: Demographic Insights, Clinical Profiles, and Prognostic Factors.

Acute mastoiditis, a complication of otitis media, poses significant challenges in diagnosis and treatment, particularly in pediatric populations. This study aims to comprehensively evaluate the demographic characteristics, clinical features, and prognostic factors associated with acute mastoiditis in pediatric patients in Saudi Arabia. Analysis of a multicenter dataset was conducted to assess demographic variables, symptomatology, disease course, and predictors of acute mastoiditis in pediatric patients. Significant associations were found between demographic variables (age group, gender, nationality) and acute mastoiditis risk. Symptomatology analysis revealed consistent frequencies of otalgia across age groups and genders. Disease course analysis highlighted a mean duration from symptom onset to diagnosis of 14.11 days, with frequent complications like mastoid abscess and meningitis. Predictor identification identified symptoms (otalgia, fever, otorrhea), duration of illness, and complications as significant predictors of disease severity. These findings contribute valuable insights into the epidemiology and clinical management of acute mastoiditis, informing targeted interventions to improve patient outcomes.

A Comprehensive Evaluation of AI-Assisted Diagnostic Tools in ENT Medicine: Insights and Perspectives from Healthcare Professionals.

The integration of Artificial Intelligence (AI) into healthcare has the potential to revolutionize medical diagnostics, particularly in specialized fields such as Ear, Nose, and Throat (ENT) medicine. However, the successful adoption of AI-assisted diagnostic tools in ENT practice depends on the understanding of various factors; these include influences on their effectiveness and acceptance among healthcare professionals. This cross-sectional study aimed to assess the usability and integration of AI tools in ENT practice, determine the clinical impact and accuracy of AI-assisted diagnostics in ENT, measure the trust and confidence of ENT professionals in AI tools, gauge the overall satisfaction and outlook on the future of AI in ENT diagnostics, and identify challenges, limitations, and areas for improvement in AI-assisted ENT diagnostics. A structured online questionnaire was distributed to 600 certified ENT professionals with at least one year of experience in the field. The questionnaire assessed participants' familiarity with AI tools, usability, clinical impact, trust, satisfaction, and identified challenges. A total of 458 respondents completed the questionnaire, resulting in a response rate of 91.7%. The majority of respondents reported familiarity with AI tools (60.7%) and perceived them as generally usable and clinically impactful. However, challenges such as integration with existing systems, user-friendliness, accuracy, and cost were identified. Trust and satisfaction levels varied among participants, with concerns regarding data privacy and support. Geographic and practice setting differences influenced perceptions and experiences. The study highlights the diverse perceptions and experiences of ENT professionals regarding AI-assisted diagnostics. While there is general enthusiasm for these tools, challenges related to integration, usability, trust, and cost need to be addressed for their widespread adoption. These findings provide valuable insights for developers, policymakers, and healthcare providers aiming to enhance the role of AI in ENT practice.

Investigating foliar application of bulk and nanoparticles titanium dioxide on fennel productivity to mitigate the negative effects of saline irrigation water.

BACKGROUND: Fennel essential oils are fragrance compounds used in food and pharmaceutical sectors. One of the major impediments to expansion of fennel farming in Egypt's reclamation areas is saline water. Titanium dioxide (TiO2) or TiO2 nano particles (TiO2NP) can be utilized to boost the yield of aromatic plants cultivated under saline irrigation water. Saline water, particularly which contains sodium chloride can harm fennel plant; consequently, it was predicted that fennel production would fail in Egypt's reclaimed area, where the primary source of irrigation is groundwater consisting sodium chloride. This study sought to help fennel respond to sodium chloride by applying Ti forms to their leaves in order to reduce the detrimental effects of sodium chloride on them for expanding their production in the newly reclamation areas as a natural source of essential oil. Ti forms were applied as foliar application at 0, 0.1, 0.2 TiO2, 0.1 TiO2NP, and 0.2 TiO2NP, mM under irrigation with fresh water (0.4 dS m-1), or saline water (51.3 mM or 4.7 dS m-1). RESULTS: Plants exposed to 0.1 mM TiO2NP under fresh water resulted in the maximum values of morphological characters, estragole, oxygenated monoterpenes and photosynthetic pigments; while those subjected to 0.1 mM TiO2NP under saline water gave the greatest values of essential oil, proline, antioxidant enzymes and phenols. The greatest amounts of soluble sugars were recorded with 0.2 mM TiO2NP irrigated with saline water. Plants subjected to 0 mM TiO2 under saline water produced the greatest values of flavonoids, hydrogen peroxide and malondialdehyde. CONCLUSION: To mitigate the negative effects of salty irrigation water on fennel plant production, TiO2NP application is suggested as a potential strategy.

COVID-19 Vaccine Hesitancy: Umbrella Review of Systematic Reviews and Meta-Analysis.

BACKGROUND: The unprecedented emergence of the COVID-19 pandemic necessitated the development and global distribution of vaccines, making the understanding of global vaccine acceptance and hesitancy crucial to overcoming barriers to vaccination and achieving widespread immunization. OBJECTIVE: This umbrella review synthesizes findings from systematic reviews and meta-analyses to provide insights into global perceptions on COVID-19 vaccine acceptance and hesitancy across diverse populations and regions. METHODS: We conducted a literature search across major databases to identify systematic reviews and meta-analysis that reported COVID-19 vaccine acceptance and hesitancy. The AMSTAR-2 (A Measurement Tool to Assess Systematic Reviews) criteria were used to assess the methodological quality of included systematic reviews. Meta-analysis was performed using STATA 17 with a random effect model. The data synthesis is presented in a table format and via a narrative. RESULTS: Our inclusion criteria were met by 78 meta-analyses published between 2021 and 2023. Our analysis revealed a moderate vaccine acceptance rate of 63% (95% CI 0.60%-0.67%) in the general population, with significant heterogeneity (I2 = 97.59%). Higher acceptance rates were observed among health care workers and individuals with chronic diseases, at 64% (95% CI 0.57%-0.71%) and 69% (95% CI 0.61%-0.76%), respectively. However, lower acceptance was noted among pregnant women, at 48% (95% CI 0.42%-0.53%), and parents consenting for their children, at 61.29% (95% CI 0.56%-0.67%). The pooled vaccine hesitancy rate was 32% (95% CI 0.25%-0.39%) in the general population. The quality assessment revealed 19 high-quality, 38 moderate-quality, 15 low-quality, and 6 critically low-quality meta-analyses. CONCLUSIONS: This review revealed the presence of vaccine hesitancy globally, emphasizing the necessity for population-specific, culturally sensitive interventions and clear, credible information dissemination to foster vaccine acceptance. The observed disparities accentuate the need for continuous research to understand evolving vaccine perceptions and to address the unique concerns and needs of diverse populations, thereby aiding in the formulation of effective and inclusive vaccination strategies. TRIAL REGISTRATION: PROSPERO CRD42023468363; https://tinyurl.com/2p9kv9cr.

Prevalence and Variation of Medical Comorbidities in Oral Surgery Patients: A Retrospective Study at Jazan University.

BACKGROUND An aged population is susceptible to chronic diseases, which impacts oral surgery treatment procedures. This retrospective study aimed to evaluate the incidence of medical comorbidities in 640 oral surgery patients treated at the College of Dentistry, Jazan University. MATERIAL AND METHODS This single-center observational study investigated medical records of outpatients who visited Jazan University Dental College Hospital in a 1-year period (2018-2019). Patients’ clinical and radiographic archives were screened to obtain relevant data. Categorical and continuous variables were expressed in terms of frequency and mean values, respectively. Differences in variables were statistically analyzed using the chi-square goodness of fit and proportional test, with a probability value P≤0.05 considered significant. RESULTS Analysis of 640 patient records included records of 300 men and 340 women who underwent oral surgery, of whom 176 patients (27.5%), including 97 men and 79 women, had medical comorbidities. The most common comorbidities were endocrine disease (7.03%), cardiovascular disease (6.71%), respiratory disease (4.53%), and hematological disorders (3.43%). Individual diseases that showed higher prevalence were diabetes mellitus (4.68%), hypertension (3.43%), bronchial asthma (2.65%), and anemia (1.4%). Differences by sex were observed in many individual disorders. CONCLUSIONS Outpatients in oral surgery clinics presented a significant variance in the incidence of medical comorbidities, among which diabetes and hypertension were most common. A proper case history is the best preventive measure that helps a surgeon avert medical emergencies and post-surgical complications.

Dietary nano-Selenium supplementation improves growth performance, nutrient digestibility and hematology in Cirrhinus mrigala fingerlings.

The following investigation was carried out to determine the effects of Selenium nanoparticles (Se NPs) on the growth rates, nutrient digestibility, and hematology of Cirrhinus mrigala fingerlings fed sunflower meal as basal diet. The experiment included seven test diets with varying Se levels (0, 0.5, 1, 1.5, 2, 2.5, and 3 mg/kg) based on Se NPs supplementation. Chromic oxide, an inert maker, was also added. Fingerlings were fed at a rate of 5% of their body weight. The test meal of 1 mg/kg Se NPs resulted in the highest weight gain (12.31 g) and the lowest feed conversion ratio (1.58). Best hematological indices (RBCs 2.84 106 mm-3, WBCs 7.79 103 mm-3, PLT 66, Hb 8.5 g/100 ml, PCV 25% and MCV 190 fl) and maximum nutrient absorption (crude protein 72%, ether extract 73% and gross energy 67%) were also observed in the case of 1 mg/kg supplementation of Se NPs. Hematology studies indicated that when fish were fed 0.5 mg/kg Se NPs, their levels began to rise. Maximum results were achieved with feed containing 1 mg/kg of Se NPs, but when the concentration increased above 1 mg/kg, the values began to decline. Instead, nutrient digestibility began to increase when the concentration of Se NPs increased to 1 mg/kg and abruptly started to decline with a further increase in Se NPs. The results demonstrated that a sunflower meal-based diet supplemented with Se NPs (1 mg/kg) increased the growth performance, nutritional digestibility, and hematology of C. mrigala fingerlings.

A loss-of-function AGTR1 variant in a critically-ill infant with renal tubular dysgenesis: case presentation and literature review.

BACKGROUND: Renal tubular dysgenesis (RTD) is a severe disorder with poor prognosis significantly impacting the proximal tubules of the kidney while maintaining an anatomically normal gross structure. The genetic origin of RTD, involving variants in the ACE, REN, AGT, and AGTR1 genes, affects various enzymes or receptors within the Renin angiotensin system (RAS). This condition manifests prenatally with oligohydramninos and postnatally with persistent anuria, severe refractory hypotension, and defects in skull ossification. CASE PRESENTATION: In this report, we describe a case of a female patient who, despite receiving multi vasopressor treatment, experienced persistent hypotension, ultimately resulting in early death at five days of age. While there was a history of parental consanguinity, no reported family history of renal disease existed. Blood samples from the parents and the remaining DNA sample of the patient underwent Whole Genome Sequencing (WGS). The genetic analysis revealed a rare homozygous loss of function variant (NM_000685.5; c.415C > T; p.Arg139*) in the Angiotensin II Receptor Type 1 (AGTR1) gene. CONCLUSION: This case highlights the consequence of loss-of-function variants in AGTR1 gene leading to RTD, which is characterized by high mortality rate at birth or during the neonatal period. Furthermore, we provide a comprehensive review of previously reported variants in the AGTR1 gene, which is the least encountered genetic cause of RTD, along with their associated clinical features.