Medical knowledge of ChatGPT in public health, infectious diseases, COVID-19 pandemic, and vaccines: multiple choice questions examination based performance.

Background: At the beginning of the year 2023, the Chatbot Generative Pre-Trained Transformer (ChatGPT) gained remarkable attention from the public. There is a great discussion about ChatGPT and its knowledge in medical sciences, however, literature is lacking to evaluate the ChatGPT knowledge level in public health. Therefore, this study investigates the knowledge of ChatGPT in public health, infectious diseases, the COVID-19 pandemic, and its vaccines. Methods: Multiple Choice Questions (MCQs) bank was established. The question's contents were reviewed and confirmed that the questions were appropriate to the contents. The MCQs were based on the case scenario, with four sub-stems, with a single correct answer. From the MCQs bank, 60 MCQs we selected, 30 MCQs were from public health, and infectious diseases topics, 17 MCQs were from the COVID-19 pandemic, and 13 MCQs were on COVID-19 vaccines. Each MCQ was manually entered, and tasks were given to determine the knowledge level of ChatGPT on MCQs. Results: Out of a total of 60 MCQs in public health, infectious diseases, the COVID-19 pandemic, and vaccines, ChatGPT attempted all the MCQs and obtained 17/30 (56.66%) marks in public health, infectious diseases, 15/17 (88.23%) in COVID-19, and 12/13 (92.30%) marks in COVID-19 vaccines MCQs, with an overall score of 44/60 (73.33%). The observed results of the correct answers in each section were significantly higher (p = 0.001). The ChatGPT obtained satisfactory grades in all three domains of public health, infectious diseases, and COVID-19 pandemic-allied examination. Conclusion: ChatGPT has satisfactory knowledge of public health, infectious diseases, the COVID-19 pandemic, and its vaccines. In future, ChatGPT may assist medical educators, academicians, and healthcare professionals in providing a better understanding of public health, infectious diseases, the COVID-19 pandemic, and vaccines.

Existential anxiety about artificial intelligence (AI)- is it the end of humanity era or a new chapter in the human revolution: questionnaire-based observational study.

Background: Existential anxiety can profoundly affect an individual, influencing their perceptions, behaviours, sense of well-being, academic performance, and decisions. Integrating artificial intelligence into society has elicited complex public reactions, marked by appreciation and concern, with its acceptance varying across demographics and influenced by factors such as age, gender, and prior AI experiences. This study aimed to investigate the existential anxiety about artificial intelligence (AI) in public in Saudi Arabia. Methods: The present questionnaire-based observational, analytical cross-sectional study with a structured, self-administered survey was conducted via Google Forms, using a scale to assess the existential anxiety levels induced by the recent development of AI. The study encompassed a diverse population with a sample size of 300 participants. Results: This study's findings revealed a high prevalence of existential anxieties related to the rapid advancements in AI. Key concerns included the fear of death (96% of participants), fate's unpredictability (86.3%), a sense of emptiness (79%), anxiety about meaninglessness (92.7%), guilt over potential AI-related catastrophes (87.7%), and fear of condemnation due to ethical dilemmas in AI (93%), highlighting widespread apprehensions about humanity's future in an AI-dominated era. Conclusion: The public has concerns including unpredictability, a sense of emptiness, anxiety, guilt over potential AI-related catastrophes, and fear of condemnation due to ethical dilemmas in AI, highlighting widespread apprehensions about humanity's future in an AI-dominated era. The results indicate that there is a need for a multidisciplinary strategy to address the existential anxieties in the AI era. The strategic approach must blend technological advancements with psychological, philosophical, and ethical insights, underscoring the significance of human values in an increasingly technology-driven world.

Climate Change and Diabetes Mellitus - Emerging Global Public Health Crisis: Observational Analysis.

Climate change is the most pressing challenge of the 21st century. It's immediate impacts on the environment are extreme weather conditions such as heatwaves, storms, rains, floods, sealevel rise, the disruption of crops, agricultural systems, water, vector-borne diseases, and ecosystems. The weather-related disasters disturbed the natural biological environment and dislocated millions of people from their homes. The extreme weather conditions caused the deaths of about two million people and $4.3 trillion in economic loss over the past half a century, and 90% of deaths were reported from developing countries. It has also been predicted that between 2030 and 2050, climate change is presumed to cause about 250,000 additional deaths per annum. The rapid rise in temperatures, frequencies of heat waves, wildfires, storms, and other weather extremes conditions could affect human health in many ways. The one-degree Celsius rise in outdoor temperature causes over 100,000 new cases of diabetes mellitus per annum. Climate change compromised body metabolism, vasodilation, sweating, insulin resistance and cause Type-2 diabetes mellitus and gestational diabetes Mellitus.

Perceptions about the Implementation and Education of Telemedicine among University Students in Riyadh, Saudi Arabia.

Objectives: This study evaluated and compared the perceptions, awareness, and experiences of telemedicine among university students in Riyadh. Methods: In this cross-sectional study, a questionnaire was distributed electronically to undergraduate university students in Riyadh. The study was conducted from September 2021 to March 2022. Five-point Likert scale data were reported as percent agreement, while open-text comments were reported as recurring themes. Besides, the perceptions of medical students were compared with students from other disciplines. Results: Of 564 participants, 209 (37%) were medical students. Most respondents agreed that telemedicine could save patients' time (77.7%) and improve access to healthcare (73.4%). The agreement was low for the statements that doctors would effectively evaluate the clinical features (39.2%) and that patients would effectively communicate their illnesses (44.3%). The agreement of medical students compared to students from other disciplines was even lower for these statements (25% vs. 47%; p<0.001) and (37% vs. 48%; p=0.03), respectively. Most medical students reported that they never learned about telemedicine (65%) and its tools (69%). Lack of awareness, training of healthcare workers and perceived lower quality of healthcare emerged as the most relevant factors for the limited acceptance of telemedicine. Conclusions: Most participants perceived that telemedicine could save patients' time and improve access to healthcare. The low agreement, especially of medical students, for the ability of physicians to evaluate clinical features and of patients to communicate illnesses effectively possibly represented suboptimal education of telemedicine in medical curricula. Thus, incorporating telemedicine into medical curricula and improving public awareness might expedite telemedicine implementation.

The Scientific Knowledge of Bard and ChatGPT in Endocrinology, Diabetes, and Diabetes Technology: Multiple-Choice Questions Examination-Based Performance.

BACKGROUND: The present study aimed to investigate the knowledge level of Bard and ChatGPT in the areas of endocrinology, diabetes, and diabetes technology through a multiple-choice question (MCQ) examination format. METHODS: Initially, a 100-MCQ bank was established based on MCQs in endocrinology, diabetes, and diabetes technology. The MCQs were created from physiology, medical textbooks, and academic examination pools in the areas of endocrinology, diabetes, and diabetes technology and academic examination pools. The study team members analyzed the MCQ contents to ensure that they were related to the endocrinology, diabetes, and diabetes technology. The number of MCQs from endocrinology was 50, and that from diabetes and science technology was also 50. The knowledge level of Google's Bard and ChatGPT was assessed with an MCQ-based examination. RESULTS: In the endocrinology examination section, ChatGPT obtained 29 marks (correct responses) of 50 (58%), and Bard obtained a similar score of 29 of 50 (58%). However, in the diabetes technology examination section, ChatGPT obtained 23 marks of 50 (46%), and Bard obtained 20 marks of 50 (40%). Overall, in the entire three-part examination, ChatGPT obtained 52 marks of 100 (52%), and Bard obtained 49 marks of 100 (49%). ChatGPT obtained slightly more marks than Bard. However, both ChatGPT and Bard did not achieve satisfactory scores in endocrinology or diabetes/technology of at least 60%. CONCLUSIONS: The overall MCQ-based performance of ChatGPT was slightly better than that of Google's Bard. However, both ChatGPT and Bard did not achieve appropriate scores in endocrinology and diabetes/diabetes technology. The study indicates that Bard and ChatGPT have the potential to facilitate medical students and faculty in academic medical education settings, but both artificial intelligence tools need more updated information in the fields of endocrinology, diabetes, and diabetes technology.

Implications of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infected Hospitalised Patients with Co-Infections and Clinical Outcomes.

The clinical severity of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection may rise because of acquiring a co-infection during the hospital stay of the patients. The rate of hospital co-infection alongside COVID-19 infection remains low. However, the mortality rates and intensive care unit (ICU) admission remains ambiguous. The present study investigates the implications of COVID-19 hospitalised infected patients with co-infection and the clinical outcomes. In this study, 142 patients were included. The eligible patients who tested positive for COVID-19 infection were hospitalised for more than two days. Each patient's characteristics and laboratory results were collected, such as who was admitted to the intensive care unit and who was discharged or expired. The results revealed that out of the 142 hospitalised patients, 25 (17.6%) were co-infection positive, and 12 identified types of co-infection: two Gram-positive bacterial infections, one fungal infection and nine Gram-negative bacterial infections. In addition, 33 (23.2%) were ICU admitted, 21 were co-infection negative and 12 were co-infection positive. Among the 12 ICU admitted with co-infection, 33.4% were discharged. The death rate and ICU admission had a p-value < 0.05, indicating statistical significance for co-infected patients compared to non-co-infected patients. It was concluded that co-infection remains very low within hospitalised COVID-19-infected patients but can have severe outcomes with increased ICU admission and increased mortality rates. Thus, implementing infection preventive measures to minimize the spread of hospital-acquired infections among COVID-19 hospitalised patients.

ChatGPT Knowledge Evaluation in Basic and Clinical Medical Sciences: Multiple Choice Question Examination-Based Performance.

The Chatbot Generative Pre-Trained Transformer (ChatGPT) has garnered great attention from the public, academicians and science communities. It responds with appropriate and articulate answers and explanations across various disciplines. For the use of ChatGPT in education, research and healthcare, different perspectives exist with some level of ambiguity around its acceptability and ideal uses. However, the literature is acutely lacking in establishing a link to assess the intellectual levels of ChatGPT in the medical sciences. Therefore, the present study aimed to investigate the knowledge level of ChatGPT in medical education both in basic and clinical medical sciences, multiple-choice question (MCQs) examination-based performance and its impact on the medical examination system. In this study, initially, a subject-wise question bank was established with a pool of multiple-choice questions (MCQs) from various medical textbooks and university examination pools. The research team members carefully reviewed the MCQ contents and ensured that the MCQs were relevant to the subject's contents. Each question was scenario-based with four sub-stems and had a single correct answer. In this study, 100 MCQs in various disciplines, including basic medical sciences (50 MCQs) and clinical medical sciences (50 MCQs), were randomly selected from the MCQ bank. The MCQs were manually entered one by one, and a fresh ChatGPT session was started for each entry to avoid memory retention bias. The task was given to ChatGPT to assess the response and knowledge level of ChatGPT. The first response obtained was taken as the final response. Based on a pre-determined answer key, scoring was made on a scale of 0 to 1, with zero representing incorrect and one representing the correct answer. The results revealed that out of 100 MCQs in various disciplines of basic and clinical medical sciences, ChatGPT attempted all the MCQs and obtained 37/50 (74%) marks in basic medical sciences and 35/50 (70%) marks in clinical medical sciences, with an overall score of 72/100 (72%) in both basic and clinical medical sciences. It is concluded that ChatGPT obtained a satisfactory score in both basic and clinical medical sciences subjects and demonstrated a degree of understanding and explanation. This study's findings suggest that ChatGPT may be able to assist medical students and faculty in medical education settings since it has potential as an innovation in the framework of medical sciences and education.

Brain drain of healthcare professionals from Pakistan from 1971 to 2022: Evidence-based analysis.

Since the creation of Pakistan in August 1947, political instability has been a persistent issue in the country, causing a migration of highly qualified, skilled people, and healthcare professionals. From 1971 to 2022 the total number of highly qualified and skilled people including healthcare professionals who migrated from the country is 60,19,888. Among them, 251677 (4.18%), were highly qualified, 455097 (7.55%) were highly skilled, and 5313114 (88.27%) were skilled professionals. Moreover, 50110 (0.83%) were healthcare professionals including doctors 31418 (62.69%), nurses 12853 (25.64%), and pharmacists 5839 (11.65%). The unsustainable political environment, lack of advanced technology-based institutes, poor healthcare infrastructure, low job opportunities and salary benefits in Pakistan caused the brain drain of highly qualified people including healthcare professionals. It adversely affected the academic institutes, the healthcare system, socio-economic growth, research productivity, and the development of the nation. The government of Pakistan must establish sustainable policies to minimize the brain drain of highly qualified people, and healthcare professionals, and recuperate the prosperity of their academic institutes and healthcare system for better healthcare services, and the advancement and sustainable development of the nation.

Hospital-Acquired Infections Caused by Carbapenem-Resistant Enterobacteriaceae: An Observational Study.

Worldwide, hospital-acquired infections (HAIs) are continuously rising within healthcare settings, leading to high mortality and morbidity rates. Many hospitals have reported the spread of carbapenemases globally, specifically within the E. coli and K. pneumoniae species. This study was aimed at analyzing the state of hospital-acquired, carbapenem-resistant E. coli and K. pneumoniae in the United Kingdom between 2009 and 2021. Moreover, the study analyzed the most efficacious approaches to patient management for controlling the carbapenem-resistant Enterobacteriaceae (CRE) spread. Initially, 1094 articles were identified as relevant for screening, and among them, 49 papers were eligible for full-text screening, with a total of 14 articles meeting the inclusion criteria. The information was recorded from published articles through PubMed, the Web of Science, Scopus, Science Direct, and the Cochrane library and was used to search for hospital-acquired carbapenem-resistant E. coli and K pneumoniae in the UK between 2009 and 2021, in order to evaluate the spread of CRE in hospitals. The total number of carbapenem-resistant E. coli was 1083 and this was 2053 for carbapenem-resistant K. pneumoniae in more than 63 UK hospitals. KPC was the dominant carbapenemase produced by K. pneumoniae. The results showed that the treatment options considered depended on the type of carbapenemase produced; K. pneumoniae showed more resistance to a treatment options, i.e., Colistin, than the other carbapenemase. The current state of the UK is at minimal risk for a CRE outbreak; however, appropriate treatment and infection control measures are highly required to prevent this CRE spread at the regional and global levels. The present study findings have an important message for physicians, healthcare workers, and policymakers about hospital-acquired carbapenem-resistant E. coli and K. pneumoniae spread and approaches to patient management.

Impact of traveling on transmission trends of human monkeypox disease: worldwide data based observational analysis.

Background: Human monkeypox is an emerging viral zoonotic disease caused by a monkeypox virus (MPXV). This year since early May 2022, the virus swiftly spread involved 94 countries, and 41,358 people, and has developed a highly challenging and threatening situation worldwide. This study aimed to investigate the impact of traveling on the transmission of human monkeypox disease and comprehend the link between monkeypox exported cases in the context of the global outbreak. Methods: In this study, we identified data from two leading health organizations, the World Health Organization (WHO), and the Centers for Disease Control Prevention (CDC), as well as 40 documents that were identified through the search engines Web of Science, Pub-Med, Medline, EMBASE, Scopus, and Google Scholar using the keywords "monkeypox," "human monkeypox," "imported"', "exportation" "travelers," and "prevalence." Finally, two international organizations WHO, and CDC, and out of 40 documents, 10 (25.0%) were included in the analysis, and the remaining 30 (75.0%) documents were excluded. The studies originated from the United Kingdom, the United States of America, Singapore, Israel, the Republic of Korea, Taiwan, and India. The data on transmission trends and human monkeypox was recorded and analyzed. Results: The epidemiological data for exported monkeypox cases were analyzed jointly for understanding the transmission trends of exportations and the geographic context of the monkeypox outbreak. Ten people had a travel history, six had a travel history from Nigeria to the United Kingdom (2), Nigeria to the United States of America (2), Nigeria to Singapore (1) and Nigeria to Israel (1). Moreover, from Germany to Taiwan (1), Germany to the Republic of Korea (1) and the United Arab Emirates to India (2). Among these 10 people, all travelers were male (100%), with age ranges of 20-38 years, seven people (70%) developed clinical symptoms before the start of travel, three people (30%) developed symptoms 2-6 days after the travel, and one person (10%) developed clinical symptoms in the flight during the journey. Conclusion: The study findings conclude that traveling can cause the spread of human monkeypox disease in various countries. The findings support the hypothesis that virus sources can travel and spread the disease from person to person and from region to region. The international health authorities must implement global preventive policies to control the burden of the disease both at regional and international levels.

Prevalence of Chemosensitive Neurological Disorders of Smell and Taste and Association with Blood Groups in SARS-CoV-2 Patients: Cross-Sectional Study.

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused a highly challenging and threatening situation worldwide. SARS-CoV-2 patients develop various clinical symptoms. The olfactory and taste dysfunctions are potential neurological manifestations among SARS-CoV-2 patients; however, their relationship with blood groups has rarely been investigated. This study aimed to investigate the prevalence of chemosensitive neurological disorders of smell and taste and their association with blood groups in SARS-CoV-2 patients. The present cross-sectional study was performed in the Department of Pathology, and Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. A well-structured, self-administered questionnaire was designed and distributed through social media platforms. A total of 922 Saudi and non-Saudi adults aged 18 years or older participated in the study. Out of 922 participants, the number of people who had anosmia was 309 (33.5%), 211 (22.9%) had hyposmia, and 45 (4.8%) had dysosmia. Moreover, 180 (19.52%) had ageusia, 47 (5.1%) and 293 (31.8%) had hypogeusia and dysgeusia, respectively. Among all the participants, 565 (61.27%) had smell-related disorders and 520 (56.39%) participants had taste-related clinical symptoms. The occurrence of anosmia and ageusia was relatively high among females compared to males (p = 0.024). The prevalence of smell-related disorders was 25.0% (230) and taste-related disorders was 23.21% (214) among the study participants with blood group O compared to all other blood group (A, B, and AB) participants who have smell allied disorders 30.69% (283), and taste allied disorders 27.98% (258). The prevalence of chemosensitive neurological disorders involving impaired smell and taste was higher in SARS-CoV-2 patients. These clinical symptoms were common among the participants with blood group type O compared to all other ABO blood group types. The role of certain demographic characteristics was consistent throughout multiple studies, notably with female gender and young adults.

The Risk Factors for Acute Cerebrovascular Accident (Stroke) in Patients with Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2).

Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) patients may experience an acute ischemic stroke; however, risk factors, in-hospital deaths, and outcomes have not been thoroughly investigated. This study investigates the risk factors, comorbidities, and outcomes in patients with SARS-VoV-2 infection and acute ischemic stroke compared to patients without these conditions. The present retrospective study was conducted in the King Abdullah International Medical Research Centre (KAIMRC), Ministry of National Guard, Health Affairs, Riyadh, Saudi Arabia, during the period from April 2020 to February 2022. This study investigates the risk variables among the individuals who were diagnosed with either SARS-CoV-2 with stroke or patients with stroke alone. A total of 42,688 COVID-19 patients were registered, 187 cases of strokes were listed in COVID-19 patients, however, 5395 cases with stroke without SARS-CoV-2 infection. The results revealed that factors including age, hypertension, deep vein thrombosis, and ischemic heart disease are associated with an increased risk of ischemic stroke. The results also displayed an elevated frequency of in-hospital deaths in COVID-19 patients with acute ischemic stroke. The results also showed that SARS-CoV-2 together predicts the probability of stroke and death in the study sample. The study findings conclude that ischemic strokes were infrequent in patients with SARS-CoV-2 and usually occur in the presence of other risk factors. The risk factors of ischemic strokes in patients with SARS-CoV-2 are old age, male gender, hypertension, hyperlipidaemia, DVT, ischemic heart disease, and diabetes mellitus. Furthermore, the results showed a higher frequency of in-hospital deaths in COVID-19 patients with stroke compared to COVID-19 patients without stroke.

Comparison of Biological, Pharmacological Characteristics, Indications, Contraindications, Efficacy, and Adverse Effects of Inactivated Whole-Virus COVID-19 Vaccines Sinopharm, CoronaVac, and Covaxin: An Observational Study.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an emerging viral zoonotic illness that has developed a distinctive and threatening situation globally. Worldwide, many vaccines were introduced to fight against the COVID-19 pandemic. The present study aims to compare the bio-pharmacological characteristics, indications, contraindications, efficacy, and adverse effects of inactivated whole-virus COVID-19 vaccines, Sinopharm, CoronaVac, and Covaxin. Initially, 262 documents and 6 international organizations were selected. Finally, 41 articles, fact sheets, and international organizations were included. The data were recorded from the World Health Organization (WHO), Food and Drug Administration (FDA) USA, Web of Science, PubMed, EMBASE, and Scopus. The results demonstrated that these three inactivated whole-virus COVID-19 vaccines, Sinopharm, CoronaVac, and Covaxin, received emergency approval from the FDA/WHO, and all three of these vaccines are beneficial for the prevention of the COVID-19 pandemic. The Sinopharm vaccine has been recommended during pregnancy and for people of all age groups, and the CoronaVac and Covaxin vaccines are recommended for people over 18 years of age and older. These three vaccines have recommended intramuscular doses of 0.5 mL each, with a 3-4 week interval. These three vaccines can be stored in a refrigerator at +2 to +8 °C. The common adverse effects of these vaccines are pain at the injection site, redness, fatigue, headache, myalgias, general lethargy, body ache, arthralgia, nausea, chills, fever, and dizziness. The overall mean efficiency for the prevention of the COVID-19 disease is 73.78% for Sinopharm, 70.96% for CoronaVac, and 61.80% for Covaxin. In conclusion, all three inactivated whole-virus COVID-19 vaccines, Sinopharm, CoronaVac, and Covaxin, are beneficial for the prevention of the COVID-19 pandemic. However, evidence suggests that the overall impact of Sinopharm is slightly better than that of CoronaVac and Covaxin.

Impact of MERS-CoV and SARS-CoV-2 Viral Infection on Immunoglobulin-IgG Cross-Reactivity.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has posed a considerable threat to public health and global economies. SARS-CoV-2 has largely affected a vast world population and was declared a COVID-19 pandemic outbreak, with a substantial surge of SARS-CoV-2 infection affecting all aspects of the virus' natural course of infection and immunity. The cross-reactivity between the different coronaviruses is still a knowledge gap in the understanding of the SARS-CoV-2 virus. This study aimed to investigate the impact of MERS-CoV and SARS-CoV-2 viral infections on immunoglobulin-IgG cross-reactivity. Our retrospective cohort study hypothesized the possible reactivation of immunity in individuals with a history of infection to Middle East Respiratory Syndrome coronavirus (MERS-CoV) when infected with SARS-CoV-2. The total number of participants included was 34; among them, 22 (64.7%) were males, and 12 (35.29%) were females. The mean age of the participants was 40.3 ± 12.9 years. This study compared immunoglobulin (IgG) levels against SARS-CoV-2 and MERS-CoV across various groups with various histories of infection. The results showed that a reactive borderline IgG against both MERS-CoV and SARS-CoV-2 in participants with past infection to both viruses was 40% compared with 37.5% among those with past infection with MERS-CoV alone. Our study results establish that individuals infected with both SARS-CoV-2 and MERS-CoV showed higher MERS-CoV IgG levels compared with those of individuals infected previously with MERS-CoV alone and compared with those of individuals in the control. The results further highlight cross-adaptive immunity between MERS-CoV and SARS-CoV. Our study concludes that individuals with previous infections with both MERS-CoV and SARS-CoV-2 showed significantly higher MERS-CoV IgG levels compared with those of individuals infected only with MERS-CoV and compared with those of individuals in the control, suggesting cross-adaptive immunity between MERS-CoV and SARS-CoV.

Adverse Effects of Pfizer (BioNTech), Oxford-AstraZeneca (ChAdOx1 CoV-19), and Moderna COVID-19 Vaccines among the Adult Population in Saudi Arabia: A Cross-Sectional Study.

The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) outbreak has caused massive damage to the global healthcare system and economy. To compete with the SARS-COV-2 pandemic, several vaccines have been proposed to immunize the population. The present study aimed to investigate the adverse effects following the three doses of COVID-19 vaccination, Pfizer (BioNTech), (Oxford-AstraZeneca (ChAdOx1 CoV-19), and Moderna among the adult population in the Eastern province of Saudi Arabia. In this study, the total number of participants were 426, among them 277 (65%) were females and 149 (35%) were males. An online survey using Google forms in the English language and translated into the Arabic language was used to record the information. The questionnaire was distributed to participants who received either Pfizer-BioNTech, Oxford-AstraZeneca or Moderna vaccines. The general characteristics of participants were obtained, alongside an evaluation of the vaccination's adverse effects. The results revealed that Pfizer-BioNTech COVID-19 vaccines caused significantly less adverse effects than Oxford-AstraZeneca (ChAdOx1) and Moderna (p < 0.001), and females experienced more adverse effects after vaccination compared to males. Injection site pain was the most common adverse event among the participants (60.6%), followed by fatigue, headache, and pain (43.9%), muscle and joint pain (32.4%), increased body temperature and shivering (24.2%). In addition, the group of individuals under the age of sixty was more likely to experience side effects than the participants with other age groups. All three vaccines, Pfizer-BioNTech, Oxford-AstraZeneca (ChAdOx1 CoV-19) and Moderna, cause post-vaccinal adverse effects; however, Moderna and Oxford-AstraZeneca (ChAdOx1) causes adverse effects more frequently than the Pfizer-BioNTech.

Environmental Pollutants PM2.5, PM10, Nitrogen Dioxide (NO2), and Ozone (O3) Association with the Incidence of Monkeypox Cases in European Countries.

Background: Monkeypox, also known as monkeypox disease, is caused by the monkeypox virus (MPXV), which is a zoonotic infection. The swift spread of human monkeypox cases has caused an alarming situation worldwide. This novel study aimed to investigate the association of particulate matter air pollutants PM2.5, PM10, Nitrogen dioxide (NO2), and Ozone (O3) on the incidence of monkeypox cases from May 1, 2022, to July 15, 2022. Methods: The data on air pollutants PM2.5, PM10, NO2, and O3 and monkeypox cases were recorded from the date of occurrence of the first case of monkeypox in the United Kingdom, Spain, France, Germany, Italy, the Netherlands, Switzerland, and Portugal from May 1, 2022, to July 15, 2022. The daily concentrations of PM2.5, PM10, NO2, and O3 were recorded from the metrological website "Air Quality Index-AQI," and daily human monkeypox cases were recorded from the official website of "Our World in Data." The mean values along with simple, multiple, and Spearman Rho correlations were performed to investigate the relationship and strength of association between the concentrations of air pollutants and cases of monkeypox. Results: The environmental pollutants PM2.5, PM10, NO2, and O3 were positively associated with monkeypox cases in the United Kingdom, Spain, France, Germany, Italy, the Netherlands, Switzerland, and Portugal. The analysis further revealed that for each 10-unit increase in PM2.5, PM10, and NO2, levels, the number of monkeypox cases was significantly augmented by 29.6%, 9.7%, 13%, and 80.6%, respectively. Conclusions: Environmental pollutants PM2.5, PM10, NO2, and O3 have been positively linked to the number of daily monkeypox cases in European countries. Environmental pollution is a risk factor for the increasing incidence of monkeypox daily cases. The regional and international authorities must implement policies to curtail air pollution to combat the cases of monkeypox in European countries and worldwide.

Adverse Effects of Sinopharm COVID-19 Vaccine among Vaccinated Medical Students and Health Care Workers.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease caused a highly problematic situation worldwide. Various vaccines were launched to combat the COVID-19 pandemic. This study aims to investigate the adverse effects of first and second doses of the Sinopharm vaccine among vaccinated medical and dental students and healthcare workers. A well-established questionnaire was distributed online, and 414 medical and dental students and healthcare workers (HCW) comprising 355 females (85.7%) and 59 males (14.3%) participated; all were vaccinated with two doses of Sinopharm. The most common side effect was pain at the injection site after dose one in 253 respondents (61.3%) and after dose two in 161 respondents (38.9%). Other symptoms included general lethargy in 168 (40.6%), myalgia/body pain in 99 (23.9%), low-grade fever in 93 (22.4%), and headache in 87 (21%) respondents. Common side effects reported after the second dose of the vaccine following pain at the injection site included general lethargy in 21.3% (88), headache in 10.4% (43), myalgia/body pain in 9.9% (41), and low-grade fever in 6.1% (25) of the respondents. In conclusion, common adverse effects of the Sinopharm vaccine were pain at the injection site, general lethargy, myalgia, body pain, low-grade fever, and headache. These adverse effects were mild in intensity for both doses but slightly more frequent and severe for the first dose than the second dose.

Comparison of Biological, Pharmacological Characteristics, Indications, Contraindications and Adverse Effects of JYNNEOS and ACAM2000 Monkeypox Vaccines.

Human monkeypox is an emerging viral zoonotic disease, that has caused highly distinctive, challenging and threatening problems worldwide. The US Food and Drug Administration (FDA) has given interim authorization for the JYNNEOS and ACAM2000 vaccines for the outbreak of monkeypox 2022. The present study aims to highlight the globally derived evidence about the biological and pharmacological features, indications, contraindications and adverse effects of JYNNEOS and ACAM2000 vaccines. Initially, 82 documents were selected and, finally, 14 fact sheets, documents and international organizations were included. The data were recorded from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), Food and Drug Administration (FDA) USA, ISI-Web of Science, PubMed, EMBASE and Scopus. The data revealed that the JYNNEOS vaccine has been recommended to children, adults, females during pregnancy and people of all age groups with a dose of 0.5 mL, and the complete vaccination cost per person is about USD 115. It provides immunogenicity, and the mean titer of neutralizing antibodies was 153.5. However, the ACAM2000 vaccine is contraindicated in infants and pregnant females, and recommended to people over 18 years of age and older, with a single dose of 0.0025 mL, and a cost of about USD 139. ACAM2000 provides immunogenicity, and the mean titer of neutralizing antibodies was 79.3. The JYNNEOS vaccine has mild adverse effects including pain, redness, swelling or itching at the site of the vaccine shot, fever, fatigue, headache, nausea and muscle pain. However, the ACAM2000 vaccine can cause pain, redness, edema, headache, fever, fatigue, muscle pain, body ache, nausea, vomiting, diarrhea, shortness of breath and increased risk of myopericarditis and cardiomyopathy. The evidence supports the view that both vaccines are beneficial, but the overall impact of JYNNEOS is better than that of ACAM2000.

Human Monkeypox: Old virus with new Epidemiological and Transmission Trends.

Human monkeypox is an emerging zoonotic disease caused by a monkeypox virus. The monkeypox virus history originated in 1958 after the occurrence of a pox-like illness in monkeys. In September 1970, the first case of human monkeypox was identified in the Democratic Republic of Congo, Africa. This year, from January 01, to September 30, 2022, the virus swiftly spread from endemic to non-endemic counties, involving 106 states, infecting 68,017 people; 689 cases from 07 endemic African countries and 67,328 cases in 99 non-endemic countries in Europe, America, Asia and Oceania continents. The disease caused 27 deaths in 13 countries worldwide. The human monkeypox disease significantly affects the population in South, North and Central America 34767 (51.11%), Europe 32047 (47.11%), Africa 707 (1.03%), Asia 351 (0.51%), and Australia and Oceania continent 145 (0.21%). The occurrence of the disease is high in males with age ranges of 21-55 years. The common clinical features in monkeypox patients are skin rashes (95%), fever (72%), malaise (69%), chills (67%), pruritis (64%), headache (64%), enlarged lymph nodes (63%) myalgia (60%) and nausea and vomiting (20%). The transmission trends of the disease are rapidly changing; the virus is not limited to close contact with humans. It can spread through body fluids, respiratory droplets, and sexual contact. The disease can transmit during travelling, contact with soiled materials, infected cloths, bed linen, objects, air pollutants, and in various workplace environments. The monkeypox virus has adopted multiple transmission routes, and swiftly spreading and developing challenging and threatening situations worldwide.

Incense Burning Indoor Pollution: Impact on the prevalence of prediabetes and Type-2 Diabetes Mellitus.

Objectives: Incense burning is a well-known practice in Asian and Middle Eastern cultures for ceremonial and religious purposes. The excessive use of incense burning has become a critical environmental health concern. The incense sellers are more exposed to incense allied air pollution. This study examines the association between prediabetes and type 2 diabetes mellitus (T2DM) in incense sellers. Methods: This cross-sectional prevalence study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia" during the period July 2019 to January 2020. After medical history and examinations had been performed, a total of 265 non-smoking volunteers male incense sellers were selected. American Diabetes Association (ADA) criteria were followed, people with "HbA1c less than 5.7% were considered normal; HbA1c 5.7%-6.4% were pre-diabetics, and HbA1c > 6.4% were considered people with diabetes". In shops, the incense sellers were exposed to incense-related pollution for 8 hours daily, seven days a week. The mean age for the participants was 25±5.5 years, and body mass index was 19±2.8 (kg/m)2. Results: In incense sellers, the pre-diabetic was 125 (47.2%), and diabetes was 75 (28.3%). However, 65 (24.5 %) incense sellers were without prediabetes and diabetes. There was an increase in HbA1c levels with increasing working exposure to incense shops. Conclusions: The prevalence of pre-diabetic and type-2 diabetes was increased in incense sellers. The prevalence of pre-diabetic and type-2 diabetes was further increased with the increasing working duration of incense sellers. The study findings call for safe practice and avoiding indoor burning incense. It is suggested that well-ventilated areas with proper masks for the workers may reduce the incense-related pollution effects.