The global impact of SARS-CoV-2 variant BA.2.86: a comprehensive analysis with the latest developments and transmission trends - an epidemiological study.

OBJECTIVE: The variant BA.2.86 of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing concern globally. The virus contains a large number of mutations, and transmission trends are rapidly changing globally. This study investigates the global epidemiological and transmission trends of SARS-CoV-2 new variant BA.2.86 in various continents and countries. MATERIALS AND METHODS: The data were recorded using key terms, including SARS-CoV-2, Omicron, BA.2.86, epidemiology, occurrence, incidence, prevalence, and transmission trends. The data on SARS-CoV-2 variant BA.2.86 were searched by the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), the Global Initiative on Sharing All Influenza Data (GSIAD), PubMed, and Web of Science. Initially, 40 documents were identified, and finally, 8 documents were included for the data analysis and discussion. The analysis of findings on transmission trends was based on the data from August 14, 2023, to February 28, 2024. RESULTS: The SARS-CoV-2, novel variant BA.2.86, crossed the international borders of 6 continents and 89 countries and infected 19,532 people. In Europe, 32 countries are affected and involved 12,667 people (64.85%), North and South America 18 countries with 3,515 cases (17.99%), Asia 27 countries with 2,063 people (10.56%), Oceania 2 countries with 689 cases (3.52%), and Africa 10 countries with 598 (3.06%) cases. The BA.2.86 rapidly spread and mainly affected the people in the United Kingdom 3,228 (16.52%), Sweden 2,380 (12.18%), USA 1,929 (9.87%), Denmark 1,621 (8.29%), Canada 1,516 (7.67%), France 833 (4.26%), Japan 810 (4.14%), Netherlands 725 (3.71%), Germany 681 (3.48%), Spain 665 (3.40%), South Korea 556 (2.84%), and Australia 512 (2.62%). CONCLUSIONS: The SARS-CoV-2, novel variant BA.2.86, spread over six continents and 89 countries and affected 19,532 people worldwide. The disease is more prevalent in the United Kingdom, United States of America, and European countries. The detection of the disease in multiple continents and countries suggests some degree of transmissibility. Global health authorities need to rethink their policies and implement strict strategies to eradicate emerging variants and minimize the global disease burden.

Environmental pollutants PM2.5, PM10, carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) impair human cognitive functions.

OBJECTIVE: Environmental pollution is an emerging global public health problem across the world and causes serious threats to ecosystems, human health, and the planet. This study is designed to explore the impact of environmental pollution particulate matter PM2.5, PM10, carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), and ozone (O3) on cognitive functions in students from schools located in or away from air-polluted areas. SUBJECTS AND METHODS: In this study, two schools were selected: one was located near a traffic-polluted area (school #1), and the second was in an area away from the traffic-polluted area (school #2). In this study, a total of 300 students were recruited: 150 (75 male and 75 female) students from school #1 located in a traffic-polluted area, and 150 students (75 male and 75 female) from school #2 located away from a traffic polluted area. The overall average age of students was 13.53±1.20 years. The students were selected based on age, gender, health status, height, weight, BMI, ethnicity, and homogenous socio-economic and educational status. The pollutants PM2.5, PM10, CO, NO2, O3, and SO2 were recorded in the surrounding environment. The overall mean concentration of environmental pollutants in school #1 was 35.00±0.65 and in school #2 was 29.95±0.32. The levels of airborne particles were measured, and the cognitive functions were recorded using the Cambridge Neuropsychological Test Automated Battery (CANTAB). The students performed the cognitive functions tasks, including the attention switching task (AST), choice reaction time (CRT), and motor screening task (MOT). RESULTS: The results revealed that the AST-Mean 928.34±182.23 vs. 483.79±146.73 (p=0.001), AST-mean congruent 889.12±197.12 vs. 473.30±120.11 (p=0.001), AST-mean in-congruent 988.98±201.27  vs. 483.87±144.57 (p=0.001), CRT-Mean 721.36±251.72  vs. 418.17±89.71 (p=0.001), and MOT-Mean 995.07±394.37 vs. 526.03±57.83 (p=0.001) were significantly delayed among the students who studied in school located in the traffic polluted area compared to students who studied in school which was located away from the traffic-polluted area. CONCLUSIONS: Environmental pollution was significantly higher in motor vehicle-congested areas. Cognitive functions were impaired among the students who were studying in a school located in a polluted area. The results further revealed that the students studying in schools located in environmentally polluted areas have attention, thinking, and decision-making abilities related to cognitive function impairment.

Efficacy of Oxford-AstraZeneca (ChAdOx1 CoV-19) vaccine against Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) cases, hospital admissions, type of variants, and deaths.

OBJECTIVE: The Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) epidemic has instigated enormous damage to the global healthcare system and economies. A large number of vaccines have been developed. However, confidence in any COVID-19 vaccine is essential for its sustainable success. The present study aimed to investigate the efficacy of the Oxford-AstraZeneca (ChAdOx1 CoV-19) vaccine against SARS-COV-2 cases, hospital admissions, type of variants and deaths. MATERIALS AND METHODS: This study recorded data using electronic platforms PubMed, Web of Science, World Health Organization, US-Food and Drug Authorities-FDA, Facts sheets, and Pharmaceutical Websites. Initially, 278 articles and reports were identified, and after revising the abstracts, 39 studies, clinical trials and organizations, reports were selected for a detailed analysis. RESULTS: The efficacy of the Oxford-AstraZeneca COVID-19 vaccine against symptomatic COVID-19 cases after the first dose was 60.59% (p=0.00001) and after the second dose was 66.84% (p=0.00001). The highest efficacy was against the Alpha variant 58.80% (p=0.00001) and the lowest efficacy was against the Beta variant 30.83% (p=0.00001). However, the overall efficacy against the SARS-CoV-2 variants after the first dose was 49.20%. The highest efficiency of SARS-CoV-2 variants after the second dose against the Beta (B.1.351) variant was 90.34% (p=0.00001), while the lowest efficacy was against the Omicron (B.1.1.529) variant 46.46% (p=0.00001), with overall efficacy against SARS-CoV-2-2 variants after the second dose 73.73%. The highest efficacy against emergency admission was 94.42% (p=0.00001), while the lowest efficacy was 86.57% (p=0.00001), with overall efficacy against ICU, hospital, and emergency admissions after the second dose was 87.74%. Furthermore, the efficacy of the Oxford-AstraZeneca vaccine against deaths after the second dose was 87.44% (p=0.00001). CONCLUSIONS: The efficacy of the Oxford-AstraZeneca COVID-19 vaccine against symptomatic COVID-19 cases, various variants, ICU, and emergency admissions, and against deaths was high. The present study results provide valuable insights for healthcare workers, policymakers, and researchers about the precise efficacy levels against symptomatic cases, hospitalization, and mortality across the diverse populations and age groups.

Omicron new variant BA.2.86 (Pirola): Epidemiological, biological, and clinical characteristics - a global data-based analysis.

OBJECTIVE: Since December 2019, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused a threatening situation worldwide. The new variant of SARS-CoV-2, BA.2.86, also known as Pirola, is an Omicron subvariant that causes great concern because it has been found to contain a large number of mutations. This study aims to investigate and identify the biological and clinical characteristics of this threatening new variant of SARS-CoV-2, which is BA.2.86. MATERIALS AND METHODS: This observational study was performed in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. The literature was searched using the key terms including "SARS-CoV-2, Omicron, BA.2.86, Pirola, epidemiology, clinical characteristics". The data on Omicron BA.2.86 were obtained from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), the Global Initiative on Sharing All Influenza Data (GSIAD), PubMed, Web of Science, regional ministries, research institutes, and international print media. Initially, 26 documents were identified and 10 documents were included for the data analysis. The information on the prevalence and the biological characteristics of the new variant of SARS-CoV-2, Omicron BA.2.86, was recorded and synthesized for analysis. RESULTS: The Omicron BA.2.86 has been identified in 23 countries with 264 confirmed cases as of September 28, 2023. The number and distribution of these cases encompass the United Kingdom 66 (25.0%), USA 34 (12.87%), Denmark 31 (11.74%), Sweden 25 (9.46%), South Africa 20 (7.57%), Spain 20 (7.57%), France 15 (5.68%), Portugal 7 (2.65%), Japan 6 (2.27%), Canada 5 (1.89%), Thailand 5 (1.89%), Israel 5 (1.89%), Greece 5 (1.89%), Germany 3 (1.13%), Belgium 3 (1.13%), Luxembourg 3 (1.13%), Netherlands 3 (1.13%), South Korea 3 (1.13%). However, one case in each country has been reported in Australia, Italy, Iceland, Switzerland, and China. The disease has been reported more frequently in females (71.0%) than males (29.0%). To date, no deaths have been reported. The novel variant has spread more swiftly than other variants of SARS-CoV-2 and has crossed many international borders. CONCLUSIONS: The new Omicron variant BA.2.86 has affected 264 people in 23 countries. The disease is more common in females than males and mainly affects old age people (over 60 years of age). However, no deaths have been reported. The variant is spreading swiftly and transmitted more rapidly. The clinical manifestations in patients with Omicron BA.2.86 variant are not well documented and may be similar to earlier strains of COVID-19 by presenting with mild infectious symptoms, including headache, body ache, cough, fever, generalized myalgia, and severe fatigue. The global health authorities must take preventive measures to stop the outbreak of this emerging variant across the globe to minimize the disease burden.

Author Correction: Impact of environmental pollutants Particulate Matter PM2.5, carbon monoxide, nitrogen dioxide and ozone on the incidence of Monkeypox cases in New York City.

Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (21): 8197-8203. DOI: 10.26355/eurrev_202211_30173-PMID: 36394769-published online on November 15, 2022. After publication, the authors applied a correction to the title: Impact of environmental pollutants Particulate Matter PM2.5, carbon monoxide, nitrogen dioxide and ozone on the incidence of Monkeypox cases There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/30173.

Lung functions pre- and post-endoscopic balloon dilation treatment among patients with subglottic stenosis.

OBJECTIVE: Subglottic stenosis (SGS) is an unusual clinical condition of mucosal wounding, compromising the extra-thoracic part of the tracheal airway below the vocal folds. The diagnosis of SGS is established with a detailed clinical examination and a direct endoscopic examination, and the role of spirometry is also often acknowledged. This study aimed to investigate the impact of SGS on lung functions before and after the balloon dilation procedure. PATIENTS AND METHODS: The respiratory functions were performed in the Department of Clinical Physiology and the Department of Otolaryngology College of Medicine, King Saud University, Riyadh, Saudi Arabia. In this study, 50 patients with SGS were referred from the Department of Otolaryngology, and lung functions before and after the balloon dilation procedure among patients with SGS were performed using an electronic spirometer. RESULTS: The results revealed that the mean values for lung function test parameters VC (p=0.01), FVC (p=0.01), FEV1 (p=0.004), FEV1/FVC Ratio (p=0.01), PEFR (p=0.01), FEF-25% (p=0.01), FEF-50% (p=0.01), and FEF-75%, (p=0.01) were significantly improved in both male and female patients with SGS on one month after the balloon dilation procedure. CONCLUSIONS: It is concluded that the lung function test parameters were increased after the balloon dilation procedure among patients with SGS. The findings showed the impact of SGS on lung function test parameters. Spirometry is a valuable test in patients with SGS and is an appropriate marker to reveal post-airway outcomes. Physicians must suggest lung function tests in patients with SGS before and after the balloon dilation procedure.

Public health in Global South: effect of environmental pollutant PM2.5 on the incidence and mortality of SARS-CoV-2 in Karachi, Lahore, and Islamabad.

OBJECTIVE: Environmental pollution has undoubtedly been established as a planetary, intergenerational, and existential threat to global human health and safety. Environmental pollution is adversely affecting the world, mainly the countries where human health is not a priority aspect, and this has been exacerbated due to the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and pandemic is known as "COVID pandemic". This study investigates the association of environmental pollutants, particulate matter (PM2.5), with SARS-CoV-2 daily cases and deaths in Karachi, Lahore, and Islamabad, Pakistan, presenting the perspectives from the Global South. MATERIALS AND METHODS: The day-to-day PM2.5 levels were recorded from the metrological website, Real-Time Air Quality Index-AQI. The corresponding data on the COVID cases and deaths in Karachi, Lahore, and Islamabad were obtained from August 1, 2020, to September 30, 2021, from the Health Ministry and National Command Operations Centre Pakistan. RESULTS: The mean values for PM2.5 in Karachi were 110.4±46.2; in Lahore 174.0±83.2; and in Islamabad 107.1±40.0. The COVID-19 mean daily cases in Karachi were 538.9±446.6; Lahore 398.3±403.1; and Islamabad 212.2±187.6; and mean daily deaths in Karachi were 9.2±8.3; Lahore 9.3±9.7; and Islamabad 1.8±1.8. The results further depicted that the SARS-CoV-2 cases were 2.86 times higher in Karachi and 1.4 times higher in Lahore than in Islamabad. Similarly, the SARS-CoV-2 deaths were 3.6 and 2.8 times higher in Karachi and Lahore, respectively, compared to Islamabad. CONCLUSIONS: The findings claim that cases and deaths augmented significantly along with PM2.5 levels. These empirical estimates demonstrate an association between PM2.5 and SARS-CoV-2 daily cases and deaths in the cities of the Global South. These findings can contribute to policy-making decisions about addressing air pollutants and climate concerns in developing countries and create an urgency to develop a strategy for minimizing environmental pollution. This study can also steer the actions needed to address the environmental problems in developing countries to improve public health and safety.

Impact of environmental pollutants Particulate Matter PM2.5, carbon monoxide, nitrogen dioxide and ozone on the incidence of Monkeypox cases. [corrected].

OBJECTIVE: The human monkeypox disease (MPXD), is an emerging zoonotic disease caused by the monkeypox virus. The rapid spread of human monkeypox cases has developed an alarming situation worldwide. This study evaluated the impact of day-to-day air pollutants, particulate matter PM2.5, Carbon monoxide (CO), Nitrogen dioxide (NO2), and Ozone (O3) on the daily incidence of monkeypox cases in New York City, United States of America. MATERIALS AND METHODS: The daily data on air pollutants and monkeypox cases were recorded from May 1, 2022, to August 16, 2022. The everyday concentrations of "PM2.5, CO, NO2, and O3 were recorded from the metrological website "Real-Time Air Quality Index-AQI" and human monkeypox cases were documented from the official website of "NVC Health". The mean values along with correlations were performed to investigate the impact of environmental pollutants on the occurrence of monkeypox cases in New York, city USA. RESULTS: The mean value for the concentration of CO in the air was 25.61 ppm, NO2 38.16 ppm, O3 9.46 µg/m3 and PM2.5 was 1.82 ppm. The air pollutants, CO, and NO2 have a positive association (p=0.001) with daily monkeypox cases in New York, USA. The correlation analysis showed significant relationships between CO and NO2 and the number of monkeypox cases (r=0.298, p<0.002), (r=0.513, p<0.001), respectively. The linear regression analysis also showed that CO has a positive impact on monkeypox cases (ß=0.298, p<0.001). With one unit increase in the CO levels in the air, the number of monkeypox cases increased by 0.298 units, and adjusted R-square shows a 0.08 or 8% variation in the number of monkeypox cases due to an increase in CO in the environment. Moreover, NO2 has a significant positive impact on monkeypox cases (ß=0.513, p<0.001), with a one-unit increase in NO2 concentration in the air, the monkeypox cases increased by 0.513. The adjusted R-square shows that NO2 causes a 25.7% variation in the increase in monkeypox cases. However, Ozone (ß=0.018. p>0.05) and PM2.5 (ß=-0.122, p>0.05) does not have a significant correlation with monkeypox cases in the city of New York. CONCLUSIONS: Environmental pollutants NO2 and CO have a positive relationship with the number of daily monkeypox cases in New York City, USA. The air pollutants which have a high concentration in the environment have a strong relationship with the occurrence of monkeypox cases. Environmental pollution may be a risk factor for the increasing occurrence of monkeypox cases. Health officials must take priority preventive measures to curtail environmental pollution to combat the monkeypox disease.

Millimeter-wave breast cancer imaging by means of a dual-step approach combining radar and tomographic techniques: preliminary results.

Breast cancer is one of the most diagnosed forms of cancer among women worldwide. However, the survival rate is very high when the tumor is diagnosed early. The search for diagnostic techniques increasingly able to detect lesions of the order of a few millimeters and to overcome the limitations of current diagnostic techniques (e.g., the X-ray mammography, currently used as standard for screening campaigns) is always active. Among the main emerging techniques, microwave and millimeter-wave imaging systems have been proposed, using either radar or tomographic approaches. In this paper, a novel dual-step millimeter-wave imaging which combines the advantages of tomographic and radar approaches is proposed. The goal of this work is to reconstruct the dielectric profile of suspicious regions by exploiting the morphological information from the radar maps as a priori information within quantitative tomographic techniques. Promising preliminary dielectric reconstruction results against simulated data are shown in both single- and dual-target scenarios, in which high-density healthy and tumor tissues are present. The reconstruction results were compared to the dielectric characteristics of human breast exvivo tissues used in the simulated models. The proposed dual-step approach allows to distinguish the nature of the targets also in the most challenging case represented by the co-presence of high-density healthy tissues and a malignant lesion, thus paving the way for a deeper investigation of this approach in experimental scenarios. Clinical Relevance-The proposed dual-step approach in the millimeter-wave regime allows to improve the reliability of the diagnostic technique, increasing its specificity.

Human monkeypox outbreak: global prevalence and biological, epidemiological and clinical characteristics - observational analysis between 1970-2022.

OBJECTIVE: The human monkeypox infection has become the prevalent orthopoxviral disease in humans, and has developed challenging and threatening situations worldwide. This study is aimed at exploring the global epidemiological, biological and clinical characteristics of monkeypox from 1970 to July 1, 2022. MATERIALS AND METHODS: Information about the monkeypox outbreak and its epidemiological and biological characteristics was obtained from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC) reports, Pub-Med, and Web of Science. Initially, these two leading international health organizations, and 10 documents were identified; after reviewing, we included WHO and CDC, and six documents in the analysis. RESULTS: Worldwide, from 1970 to July 1, 2022, the total number of confirmed and suspected cases of human monkeypox disease in endemic and non-endemic nations was 46,915. In endemic regions, the number of confirmed cases has been 2,805 and suspected cases have been 38,327, with a total number of 41,132. However, from May 7, 2022, to July 1, 2022, 5,783 monkeypox cases have been found in 52 non-endemic nations in Europe, the UK, the USA, Australia and the Middle East. The majority of cases have been found in the United Kingdom (1,235), Germany (1,054), Spain (800), France (498), United States (459), Portugal (402), Netherlands (288), Canada (287), Italy (192), Belgium (117), Switzerland (91), Israel (42), Ireland (39), Austria (37), Sweden (28), Brazil (21), and Denmark (20). The clinical presentation of monkeypox disease is mild symptoms, including headache, lymphadenopathy, body aches, severe weakness, and acute onset of fever above 38.5°C. A skin rash initiates as macules or papules, progresses to pustules and vesicles, ulcers, and ultimately transitions to crusted scabs. In a short period of about two months, the monkeypox cases swiftly spread in 52 non-endemic countries with an increased percentage worldwide. CONCLUSIONS: The geographic pattern of monkeypox disease spread is rapidly shifting from endemic to non-endemic regions. It now involves not only Africa but also Europe, the USA, the UK, Australia and the Middle East. The clinical characteristics of monkeypox infection are mostly mild symptoms, including headache, lymphadenopathy, body aches, severe weakness, and acute onset of fever above 38.5 degrees Centigrade. A skin rash originates as macules or papules, progresses to pustules and vesicles, ulcers, and eventually to crusted scabs. The regional and international health establishments must take priority preventive procedures to break the outbreaks of monkeypox disease across the globe. The physicians, healthcare workers, patients, and public education is of utmost importance to eradicate the disease.

Impact of the residential green space environment on the prevalence and mortality of Type 2 diabetes mellitus.

OBJECTIVE: The residential green space environment plays a significant role in the progression of social, neuropsychological, behavioral, and public health. Green spaces are considered one of the most important components of healthy life events. This study investigated the impact of the green space environment on the prevalence and mortality of type 2 diabetes mellitus. MATERIALS AND METHODS: In this study, 110 research articles were initially identified through search engines (Web of Science, Pub-Med, Medline, EMBASE, Scopus) using the keywords "green space, environment, prevalence, mortality, diabetes mellitus." Finally, out of 110, 16 (14.54%) original research publications were included in the analysis, and the remaining 94 (85.45%) articles were excluded. The sample size of these 16 studies was 4,615,359. These studies originated from China (4), Canada (3), the United States of America (2), Australia (2), and one study each from the United Kingdom, Hong Kong, Korea, Belgium, and Bangladesh. The data on prevalence and diabetes mellitus were recorded and analyzed. RESULTS: Worldwide total of 16 studies met the selection criteria. The results showed that a high green space environment was significantly associated with a decreased prevalence of diabetes mellitus (13 studies; OR=0.875, 95% CI=0.859-0.891; p<0.001; I2=61.0%) and mortality (3 studies; HR=0.917, 95% CI=0.904-0.930; p<0.001; I2=75.4%). The findings support the hypothesis that a green space environment significantly reduces the prevalence and mortality of diabetes mellitus. CONCLUSIONS: The residential green space environment significantly decreases the prevalence and mortality of type 2 diabetes mellitus. It is suggested to establish strategies to keep residential areas and living environment green and clean to minimize air pollution and fight diabetes mellitus.

Effect of ambient air pollutants PM2.5 and PM10 on COVID-19 incidence and mortality: observational study.

OBJECTIVE: Environmental pollution is a leading global challenge affecting weather conditions and causing severe environmental, social, and public health problems. This study explores the impact of ambient air pollutants, particular matter (PM), PM2.5 and PM10 on morbidity and mortality of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) globally. MATERIALS AND METHODS: In this study, initially 492 research articles were identified through seven search engines containing Web of Science, Medline, PubMed, EMBASE, Scopus, WHO COVID-19 literature, and Ovid databases by consuming keywords "Environmental pollution, Ambient air pollutants, particulate matter, PM2.5, PM10, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and COVID-19 pandemic". Finally, 26 original research publications were included for the analysis, and the remaining were excluded. These studies were originated from the United States of America (9), China (5), Italy (3), India (1), worldwide (1), and one study each from England, Spain, Canada, Saudi Arabia, Singapore, Japan, and Iran. RESULTS: The analysis based on a worldwide dataset assembled the information from the global literature from December 2019 to September 30, 2021. The assessment for the various regions to a global extent was based on air pollutants and COVID-19 cases and deaths. Twenty- six studies met the selection criteria representing almost all over the world. Based on the synthesis of scientific studies, it was identified that PM2.5 and PM10 are associated with 15.08%, 11.44 increased COVID-19 cases, and 9.26% and 0.75% COVID-19 deaths, respectively. CONCLUSIONS: The evidence indicates that PM2.5 and PM10 can affect COVID-19 epidemiology in various geographical regions. The findings established an association and a possible causal link between increasing ambient air pollutants, particulate matter PM2.5 and PM10 with increased incidence and mortality of COVID-19. The global health authorities must take strict preventive measures to minimize air pollution and combat such challenging and threatening COVID-19 pandemic globally.

Effect of Pfizer/BioNTech and Oxford/AstraZeneca vaccines against COVID-19 morbidity and mortality in real-world settings at countrywide vaccination campaign in Saudi Arabia.

OBJECTIVE: Vaccinations are highly essential to control infectious diseases and epidemics. Presently, the entire world faces a challenging crisis of "Severe Acute Respiratory Diseases Coronavirus 2 (SARS-CoV-2), also known as the COVID-19 pandemic". The impact of vaccines at national levels to reduce the SARS-CoV-2 cases and deaths are unclear, and people have concerns about the effectiveness of vaccines in real-world settings. This study's objective was to examine the effect of the "Pfizer/BioNTech and Oxford/AstraZeneca" vaccines to prevent SARS-CoV-2 cases and deaths in Saudi Arabia. MATERIALS AND METHODS: In this retrospective cohort study, we collected data on SARS-CoV-2 cases and deaths from the date of the first case of SARS-CoV-2 in Saudi Arabia March 2, 2020, to the date of launching the vaccination campaign on December 14, 2020; and from December 15, 2020, to September 8, 2021. We recorded the World Health Organization data and Ministry of Health of Saudi Arabia to evaluate the impact of the "Pfizer/BioNTech, (BNT162b2 mRNA) and Oxford/AstraZeneca (AZD1222)" vaccine against SARS-CoV-2 cases and deaths before and after the vaccination campaign in Saudi Arabia. RESULTS: Saudi Arabia launched the "Pfizer/BioNTech and Oxford/AstraZeneca" vaccination campaign against SARS-CoV-2 on December 14, 2020. In Saudi Arabia, before the vaccination campaign from March 2, 2020, to December 14, 2020, the mean daily SARS-CoV-2 cases were 1235.60, daily deaths were 22.70, that significantly reduced (p=0.0001) compared to the period after the vaccination campaign from December 15, 2020, to September 8, 2021, in which the daily cases fell to 692.08, and daily deaths fell to 9.48 (p=0.0001). CONCLUSIONS: In Saudi Arabia, Pfizer/BioNTech and Oxford/AstraZeneca vaccinations significantly reduced the number of SARS-CoV-2 cases and deaths after the vaccination compared to the period before the vaccination campaign at country levels. The study findings demonstrate that vaccination and adherence to nonpharmaceutical intervention can better control the COVID-19 pandemic.

Impact of Glycated Hemoglobin (HbA1c) on cognitive functions in Type 2 diabetic patients.

OBJECTIVE: Diabetes mellitus is a highly challenging worldwide epidemic affecting the health of millions of people. This study investigates the impact of glycated hemoglobin (HbA1c) and duration of diabetes on cognitive functions in type 2 diabetic patients and evaluates whether high HbA1c or duration is more harmful to impair cognitive functions. PATIENTS AND METHODS: In this study, 202 participants, 101 patients with type 2 diabetes mellitus (T2DM), and 101 age, gender, height, and weight-matched controlled subjects were enlisted. The HbA1c was determined using a clover analyzer, and cognitive functions were evaluated using "Cambridge Neuropsychological Test Automated Battery (CANTAB). RESULTS: The results revealed that AST Mean correct latency, AST Mean correct latency (congruent), AST Mean correct latency (incongruent), CRT Mean correct latency, MOT Mean latency, SWM Between errors, SWM Strategy, PRM Percent correct responses were meaningly delayed in the diabetic group as compared to the control group (p < 0.0001). CONCLUSIONS: High HbA1c or uncontrolled DM and duration of diabetes cause cognitive function impairment. Moreover, the cognitive functions declined were significantly linked with the duration of the disease and high HbA1c. While treating diabetic patients, physicians must monitor the HbA1c level as reasonable glycemic control is vital to curtail the complications of DM, including cognitive function impairment.

COVID-19 vaccines: comparison of biological, pharmacological characteristics and adverse effects of Pfizer/BioNTech and Moderna Vaccines.

OBJECTIVE: The "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" disease has caused a worldwide challenging and threatening pandemic (COVID-19), with huge health and economic losses. The US Food and Drug Administration, (FDA) has granted emergency use authorization for treatment with the Pfizer/BioNTech and Moderna COVID-19 vaccines. Many people have a history of a significant allergic reaction to a specific food, medicine, or vaccine; hence, people all over the world have great concerns about these two authorized vaccines. This article compares the pharmacology, indications, contraindications, and adverse effects of the Pfizer/BioNTech and Moderna vaccines. MATERIALS AND METHODS: The required documents and information were collected from the relevant databases, including Web of Science (Clarivate Analytics), PubMed, EMBASE, World Health Organization (WHO), Food and Drug Authorities (FDA) USA, Local Ministries, Health Institutes, and Google Scholar. The key terms used were: Coronavirus, SARS-COV-2, COVID-19 pandemic, vaccines, Pfizer/BioNTech vaccine, Moderna vaccine, pharmacology, benefits, allergic responses, indications, contraindications, and adverse effects. The descriptive information was recorded, and we eventually included 12 documents including research articles, clinical trials, and websites to record the required information. RESULTS: Based on the currently available literature, both vaccines are beneficial to provide immunity against SARS-CoV-2 infection. Pfizer/BioNTech Vaccine has been recommended to people 16 years of age and older, with a dose of 30 µg (0.3 m) at a cost of $19.50. It provides immunogenicity for at least 119 days after the first vaccination and is 95% effective in preventing the SARS-COV-2 infection. However, Moderna Vaccine has been recommended to people 18 years of age and older, with a dose of 50 µg (0.5 mL) at a cost of $32-37. It provides immunogenicity for at least 119 days after the first vaccination and is 94.5% effective in preventing the SARS-CoV-2 infection. However, some associated allergic symptoms have been reported for both vaccines. The COVID-19 vaccines can cause mild adverse effects after the first or second doses, including pain, redness or swelling at the site of vaccine shot, fever, fatigue, headache, muscle pain, nausea, vomiting, itching, chills, and joint pain, and can also rarely cause anaphylactic shock. The occurrence of adverse effects is reported to be lower in the Pfizer/BioNTech vaccine compared to the Moderna vaccine; however, the Moderna vaccine compared to the Pfizer vaccine is easier to transport and store because it is less temperature sensitive. CONCLUSIONS: The FDA has granted emergency use authorization for the Pfizer/BioNTech and Moderna COVID-19 vaccines. These vaccines can protect recipients from a SARS-CoV- 2 infection by formation of antibodies and provide immunity against a SARS-CoV-2 infection. Both vaccines can cause various adverse effects, but these reactions are reported to be less frequent in the Pfizer/BioNTech vaccine compared to the Moderna COVID-19 vaccine; however, the Moderna vaccine compared to the Pfizer vaccine is easier to transport and store because it is less temperature sensitive.

Automated detection of diabetic retinopathy using machine learning classifiers.

OBJECTIVE: Diabetic Retinopathy (DR) is a highly threatening microvascular complication of diabetes mellitus. Diabetic patients must be screened annually for DR; however, it is practically not viable due to the high volume of patients, lack of resources, economic burden, and cost of the screening procedure. The use of machine learning (ML) classifiers in medical science is an emerging frontier and can help in assisted diagnosis. The few available proposed models perform best when used in similar population cohorts and their external validation has been questioned. Therefore, the purpose of our research is to classify the DR using different ML methods on Saudi diabetic data, propose the best method based on accuracy and identify the most discriminative interpretable features using the socio-demographic and clinical information. PATIENTS AND METHODS: This cross-sectional study was conducted among 327 diabetic patients in Almajmaah, Saudi Arabia. Socio-demographic and clinical data were collected using a systematic random sampling technique. For DR classification, ML algorithm including, linear discriminant analysis, support vector machine, K nearest neighbor, random forest and its variate ranger random forest classifiers were used through cross-validation resampling procedure. RESULTS: In classifying DR, ranger random forest outperforms the other methods by accurately classifying 86% of the DR patients on the test data. HbA1c (p<0.001) and duration of diabetes (p<0.001) were the most influential risk factor that best discriminated the DR patients. Other influential risk factors were the body mass index (p<0.001), age-onset (p<0.001), age (p<0.001), systolic blood pressure (p<0.05), and the use of medication (p<0.05) that significantly discriminated the DR patients. CONCLUSIONS: Based on the present study findings, integrating ophthalmology and ML can transform diagnosing the disease pattern that can help generate a compelling clinical effect. ML can be used as an added tool for clinical decision-making and must not be the sole substitute for a clinician. We will work to examine the classification performance of multi-class data using more sophisticated ML methods.

Magnetic Resonance Imaging (MRI) and neurological manifestations in SARS-CoV-2 patients.

OBJECTIVE: The "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" disease caused a challenging and threating pandemic (COVID-19) worldwide with a great loss to life and the global economy. SARS-CoV-2 mainly involves the respiratory system, however, with Magnetic Resonance Imaging (MRI), neurological and special senses clinical manifestations have been reported rarely. The present study aims to investigate the MRI findings, clinical manifestations of neurological and special senses involvement in SARS-CoV-2 patients. MATERIALS AND METHODS: In this study, 284 articles from the databases "Pub-Med, Web of Science-Clarivate Analytics, Embase and Google Scholar" were identified. The keywords, coronavirus, SARS-CoV-2, COVID-19 pandemic, MRI, brain, special senses, neurological involvement were entered into the search engines and the concerned documents were selected and reviewed. The descriptive information was recorded from the particular studies; finally, we included 48 publications. RESULTS: The common neurological manifestations in SARS-CoV-2 patients were headache, impaired consciousness, acute cerebrovascular disease, ataxia, tremors, meningitis, encephalitis, cerebral bleeding, subarachnoid hemorrhage, frontal lobe, temporal lobe and intracerebral hematoma, hemiparesis and seizures. However, common special senses manifestations in SARS-CoV-2 patients were olfactory, auditory and gustatory disorders including red eyes, painless monocular visual disturbance, anosmia, ageusia, dysgeusia, dysosmia and hypoacusis. Moreover, the MRI findings identified in SARS-CoV-2 patients were isolated oval-shaped lesion in the corpus callosum, bilateral basal ganglia hemorrhage, ischemic lesions involving the corpus callosum, basal ganglia, cerebellum and vasogenic edema extending to the cerebral peduncles, pons and ventricles. CONCLUSIONS: The neurologic manifestations of SARS-CoV-2 patients are highly variable. The SARS-COV-2 exerts its damaging effects on the nervous system and special senses by developing determinant numerous neurological and special senses' clinical manifestations. Physicians with the help of MRI must rule out the neurological and special senses manifestations among SARS-CoV-2 patients.

Omicron SARS-CoV-2 new variant: global prevalence and biological and clinical characteristics.

OBJECTIVE: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has created a challenging and threatening situation worldwide. The SARS-CoV-2 embodies diverse epidemiological trends, alongside emerging and reemerging pathogenic characteristics, which have raised great public health concerns. This study aims to investigate the global prevalence, biological and clinical characteristics of Omicron, a new variant of SARS-CoV-2 that is causing concern and fear internationally. MATERIALS AND METHODS: The data on the outbreak of the new variant "Omicron" was obtained from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), European Centre for Disease Prevention and Control (ECDC), research institutes, and global international print media. We recorded information on the prevalence, the biological and clinical characteristics of the Omicron Variant of SARS-CoV-2 from November 24 to December 9, 2021. RESULTS: Worldwide, the new variant of SARS-CoV-2, Omicron, has been identified in 57 countries with 2152 confirmed cases reported on December 9, 2021, ever since the emergence of the first case of this variant dated November 24, 2021. The number of confirmed Omicron variant cases has significantly increased globally. The novel variant is spreading swiftly and has crossed many borders all around the world. This new variant has been observed to be transmitted far more rapidly than other variants of SARS-CoV-2. CONCLUSIONS: The new variant of SARS-CoV-2 has novel epidemiological and biological characteristics, making it more contagious than other variants of SARS-CoV-2. It has affected 2152 people in 57 countries in a short period of two weeks. However, the fatality rate of the SARS-CoV-2 Omicron variant has not yet been reported. The major clinical manifestations in this new variant are those of a "mild infection", including headache, body ache, muscles ache, cough, fever, generalized myalgia, and severe fatigue. It is infecting younger and middle-aged people more than previous variants. Worldwide health establishments should take immediate preventive measures to stop outbreaks of this emerging and reemerging pathogenic variant across the globe to minimize the disease burden on humanity.

Impact of weather conditions on incidence and mortality of COVID-19 pandemic in Africa.

OBJECTIVE: The weather-related conditions change the ecosystem and pose a threat to social, economic and environmental development. It creates unprecedented or unanticipated human health problems in various places or times of the year. Africa is the world's second largest and most populous continent and has relatively changeable weather conditions. The present study aims to investigate the impact of weather conditions, heat and humidity on the incidence and mortality of COVID-19 pandemic in various regions of Africa. MATERIALS AND METHODS: In this study, 16 highly populated countries from North, South, East, West, and Central African regions were selected. The data on COVID-19 pandemic including daily new cases and new deaths were recorded from World Health Organization. The daily temperature and humidity figures were obtained from the weather web "Time and Date". The daily cases, deaths, temperature and humidity were recorded from the date of appearance of first case of "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)" in the African region, from Feb 14 to August 2, 2020. RESULTS: In African countries, the daily basis mean temperature from Feb 14, 2020 to August 2, 2020 was 26.16±0.12°C, and humidity was 57.41±0.38%. The overall results revealed a significant inverse correlation between humidity and the number of cases (r= -0.192, p<0.001) and deaths (r= -0.213, p<0.001). Similarly, a significant inverse correlation was found between temperature and the number of cases (r= -0.25, p<0.001) and deaths (r=-0.18, p<0.001). Furthermore, the regression results showed that with 1% increase in humidity the number of cases and deaths was significantly reduced by 3.6% and 3.7% respectively. Congruently, with 1°C increase in temperature, the number of cases and deaths was also significantly reduced by 15.1% and 10.5%, respectively. CONCLUSIONS: Increase in relative humidity and temperature was associated with a decrease in the number of daily cases and deaths due to COVID-19 pandemic in various African countries. The study findings on weather events and COVID-19 pandemic have an impact at African regional levels to project the incidence and mortality trends with regional weather events which will enhance public health readiness and assist in planning to fight against this pandemic.