Exploring the Impact of Personalized Nutritional Approaches on Metabolism and Immunity: A Systematic Review of Various Nutrients and Dietary Patterns.

The systematic review investigates the impact of different nutrients and dietary patterns on metabolism and immunity to answer the research question: "Can personalized nutritional approaches boost immunity?" The importance of diet in supporting the immune system has come to light in today's environment, where a strong immune system is crucial for protection against infectious illnesses, as highlighted by the COVID-19 pandemic. This systematic review adhered to the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020. Four databases were screened for relevant data published in 2022-2023: PubMed, PubMed Central (PMC), MEDLINE, and Cochrane Library. Inclusion and exclusion criteria were utilized, and 13 papers were finalized after screening and employing the quality appraisal tool Cochrane Bias assessment for randomized controlled trials (RCT). Personalized nutrition can strengthen immunity and enhance overall health by adjusting dietary recommendations and following a person's genetic makeup, lifestyle, and health state. An adequate supply of vitamins, minerals, proteins, and fatty acids as well as an optimum caloric intake are essential for immune health, and individual requirements can vary significantly due to genetic factors, lifestyle choices, and underlying health conditions. Personalized nutrition considers these factors, enabling tailored dietary recommendations to address specific nutrient needs and optimize nutrient intake, leading to better health outcomes. The review concludes that personalized nutrition is more effective than a one-size-fits-all approach in boosting immunity, and its potential impact on health and immune function is highly important.

The Role of Proton Pump Inhibitors in the Realm of Idiopathic Pulmonary Fibrosis and its Associated Comorbidities: A Systematic Review.

As the global incidence of idiopathic pulmonary fibrosis (IPF) is on the rise, there is a need for better diagnostic criteria, better treatment options, early and appropriate diagnosis, adequate care, and a multidisciplinary approach to the management of patients. This systematic review explores the role of proton pump inhibitors (PPIs) in IPF and answers the question, "Does proton pump inhibitor improve only the prognosis of gastroesophageal associated idiopathic pulmonary fibrosis or for other types of idiopathic pulmonary fibrosis too?" We used PubMed (PMC) and Google Scholar for data collection for this systematic review and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting this review. After in-depth literature screening and quality appraisal, 12 articles were selected for this systematic review. On the one hand, the efficacy of PPI therapy is supported by research such as the CAPACITY and ASCEND trials, a pilot randomized control trial (RCT) investigating the role of omeprazole in IPF and a bidirectional two-sample Mendelian randomization (MR) study, respectively. On the other hand, a systematic review and meta-analysis on antacid and antireflux surgery in IPF negate these results and show no statistical significance. Questions regarding the efficacy of PPI therapy must be dealt with in an adequately powered multicenter and double-blinded randomized control trial. The anti-inflammatory properties of antacids can serve as the cornerstone for future trials. In the following systematic review, antacid, antireflux therapy, omeprazole, and proton pump therapy are synonymous with stomach acid suppression therapy.

Comparison of Low-Dose Interleukin 2 Therapy in Conjunction With Standard Therapy in Patients With Systemic Lupus Erythematosus vs Rheumatoid Arthritis: A Systematic Review.

This systematic review aims to compare the efficacy and safety of a novel immunotherapy with low-dose interleukin 2 (IL2) across two of the most prevalent autoimmune diseases i.e. systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Contemporary therapeutic practices have not been able to achieve complete remission from these autoimmune disorders. In contrast, low-dose IL2 has shown promise in achieving this therapeutic goal via inducing self-tolerance in patients with autoimmune diseases; however, due to variable irregularities among autoimmune processes of variable diseases, the benefit of low-dose IL2 could not be determined among different autoimmune diseases. Therefore, we conducted a study to compare low-dose IL2 therapy effects on SLE and RA. We systematically screened four databases: PubMed, Medical Literature Analysis and Retrieval System Online (MEDLINE), PubMed Central (PMC), and Google Scholar. Inclusion and exclusion criteria were implemented. Quality appraisal of studies chosen for the review was done using the Cochrane Risk-of-Bias (RoB) assessment tool for randomized controlled trials, and the Newcastle-Ottawa Scale (NOS) and JBI critical appraisal tool for non-randomized clinical trials. Information was gathered from seven articles: three randomized controlled trials and four non-randomized clinical trials. Our review concluded that low-dose IL2 therapy in conjunction with respective standard therapies for SLE and RA has a higher efficacy and safety profile as compared to standard therapy alone and the therapeutic effects were comparable in both SLE and RA patients treated with low-dose IL2; however, this novel intervention does not seem to have a significant corrective effect on the biomarkers of RA as it does for SLE biomarkers.

Breaking It Down: A Systematic Review Unravelling the Impact of Attention Deficit Hyperactivity Disorder and Methylphenidate on Childhood Fractures.

Limb fractures are a common cause of pediatric hospital admissions and surgeries, with a significant prevalence in the United Kingdom across all injury categories. Among psychiatric conditions in children, attention deficit hyperactivity disorder (ADHD) stands out as frequently associated with fractures, particularly those involving extremities. ADHD, with diagnoses prevalent among a significant proportion of school-age children and adolescents, has witnessed a growing global incidence. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist for our systematic literature search, using various databases and specific search terms related to ADHD and fractures. We considered articles from 2018 to 2023, focusing on English language papers with free full-text access. Our selection process used the PRISMA flowchart. We began with 1,890 articles and, after deduplication, title screening, abstract assessment, and quality evaluation included nine research papers in our review. Our primary focus was on examining fracture-related outcomes in individuals with ADHD compared to those without, considering medication status. These studies encompassed various designs, with a focus on the ADHD-fracture relationship and methylphenidate's (MPH) impact. Our study confirms that ADHD increases fracture risk and suggests that MPH may help mitigate this risk. Early ADHD detection is vital for nonpharmacological interventions. Orthopedic surgeons should proactively identify ADHD, while healthcare professionals should offer injury prevention guidance, particularly for at-risk groups.

Effectiveness of Probiotic Use in Alleviating Symptoms of Irritable Bowel Syndrome: A Systematic Review.

Irritable bowel syndrome (IBS) is a common functional gastrointestinal (GI) condition, and changes in the gut microbiota's composition contribute to the development of symptoms. Although the precise mechanisms of probiotic use in the human body are not fully understood, probiotic supplements are believed to reduce symptoms, such as abdominal pain, by regulating neurotransmitters and receptors associated with pain modulation in IBS patients compared to placebo by altering the gut flora. This systematic review aimed to assess the most current randomized controlled trials (RCTs) on how probiotic supplementation affects the symptoms in people with IBS. The effects of probiotic supplements on IBS symptoms were studied in RCTs published between January 2018 and June 2023. After a search through PubMed and Google Scholar using the keywords probiotics, gut microbiota, irritable bowel syndrome, and IBS; eight articles matched the inclusion criteria and were reviewed. Four trials used a multistrain probiotic, whereas the remaining four trials examined the effects of a monostrain supplement. All eight trials came to the same conclusion: Probiotic treatment may significantly reduce symptoms.

Knowledge, preventive behavior and risk perception regarding COVID-19: a self-reported study on college students.

INTRODUCTION: There are a limited number of studies on the issues associated with the knowledge and self-practice preventive measures for COVID-19 among medical students. We aimed to determine the extent of knowledge, self-reported preventive behavior, and risk perception of the COVID-19 outbreak among college students in Libya. METHODS: A cross-sectional study was conducted from April 20 to April 30, 2020. The participants were students of medical and non-medical subjects from Libyan educational institutes. Data on participants' characteristics, knowledge, preventive behavior, and risk perception were collected. RESULTS: Approximately 3669 participants completed the questionnaire, of which 2547 (69.4) were medical students and 1122 (30.6%) were non-medical students. The mean knowledge score on COVID-19 was 8.62 (SD: 1.26, range: 0-12), corresponding to 71.8% correct answers. A significant difference was observed between medical and non-medical students in terms of knowledge (p < 0.001). Overall, the knowledge score of the students differed significantly with respect to age, current year of study, and financial source (p < 0.05). The mean score of preventive behavioral measures toward COVID-19 (out of 8) was 7.42 (SD: 0.95, range: 0-8), and the overall preventive measure score was estimated to be approximately 7.42/8*100, which corresponds to 92.7% for both medical and non-medical students. CONCLUSION: Notably, college students were observed to have substantial knowledge, preventive behavior, and a positive attitude toward COVID-19. Government programs should aim to educate individuals from other sectors of the society to ensure the proper dissemination of knowledge on preventive safety measures, as this will help restrict and control the pandemic.

Psychological Impact of the Civil War and COVID-19 on Libyan Medical Students: A Cross-Sectional Study.

OBJECTIVE: We aim to determine the psychological status of medical students during the COVID-19 outbreak and civil war in Libya. METHODS: A cross-sectional study was conducted among medical students from 15 medical schools between April 20 and May 1, 2020. The demographic characteristics, generalized anxiety disorder 7-item (GAD-7) scale, and patient health questionnaire (PHQ-9) results were collected. RESULTS: Of the 3,500 students, 2,430 completed the survey. The mean (± SD) score of anxiety symptoms determined by the GAD-7 was 7.2 (5.1). A total of 268 (11%) students had a GAD-7 score of ≥15, which is indicative of moderate to severe anxiety. A total of 1,568 (64.5%) students showed different degrees of anxiety: mild, 910 (37.5%); moderate, 390 (16%); and severe, 268 (11%). Anxiety was significantly associated with living status and internal displacement (P < 0.05). The mean (+ SD) score of depressive symptoms determined by the PHQ-9 was 9.7 (6.3). A total of 525 (21.6%) students had a PHQ-9 score of ≥15, which is indicative of moderate to severe depression. A total of 1,896 (88%) students were diagnosed with mild (PHQ ≥ 5) depression. Suicidal ideation was present in 552 patients (22.7%). Depression was only statistically associated with the year of study (P = 0.009). CONCLUSION: These data highlight that medical students in Libya are at risk for depression, especially under the current stressful environment of the civil war and the COVID-19 outbreak.

Psychological status of healthcare workers during the civil war and COVID-19 pandemic: A cross-sectional study.

OBJECTIVE: Healthcare workers, particularly those working in departments that provide care for patients with coronavirus disease 2019 (COVID-19), are at a higher risk of this contagious disease than those who work in other departments. The aim of this study was to assess the psychological status of healthcare workers during the COVID-19 outbreak, which has compounded Libya's existing civil war-related problems. METHODS: A multi-center cross-sectional survey on depressive symptoms, anxiety symptoms, and abuse was conducted. The Hospital Anxiety and Depression Scale (HADS) was used to measure the prevalence of anxiety and depressive symptoms among healthcare workers. RESULTS: The data of 745 eligible healthcare workers from 15 hospitals were analyzed. Depressive and anxiety symptoms were compared to the basic characteristics of the participants to determine the association. A total of 420 (56.3%) participants had depressive symptoms, while 348 (46.7%) had anxiety symptoms. Age, residency status, department, stigmatization, and living in a conflict zone were significantly associated with depressive symptoms. Age, department, years of experience, working hours per week, internal displacement, stigmatization, living in a conflict zone, and verbal abuse were significantly associated with anxiety symptoms. CONCLUSION: Our study presents important findings regarding depressive, anxiety symptoms, and abuse among physicians providing care during the COVID-19 outbreak and civil war in Libya. It also demonstrates several factors that can be associated with depressive and anxiety symptoms in this population.

Assessment of Healthcare Workers' Levels of Preparedness and Awareness Regarding COVID-19 Infection in Low-Resource Settings.

COVID-19, caused by the SARS-CoV-2 virus, is spreading rapidly worldwide, with devastating consequences for patients, healthcare workers, health systems, and economies. As it reaches low- and middle-income countries, the pandemic puts healthcare workers at high risk and challenges the abilities of healthcare systems to respond to the crisis. This study measured levels of knowledge and preparedness regarding COVID-19 among physicians and nurses. A cross-sectional survey was conducted among healthcare workers in Libya between February 26 and March 10, 2020. We obtained 1,572 valid responses of a possible 2,000 (78.6%) participants from 21 hospitals, of which 65.1% were from physicians and 34.9% from nurses. The majority of participants (70%) used social media as a source of information. A total of 47.3% of doctors and 54.7% of nurses received adequate training on how to effectively use personal protective equipment. Low confidence in managing suspected COVID-19 patients was reported by 83.8% of participants. Furthermore, 43.2% of healthcare workers were aware of proper hand hygiene techniques. Less than 7% of participants received training on how to manage COVID-19 cases, whereas 20.6% of doctors and 26.3% of nurses felt that they were personally prepared for the outbreak. Awareness and preparedness for the pandemic were low among frontline workers during the study. Therefore, an effective educational training program should be implemented to ensure maintenance of appropriate practices during the COVID-19 pandemic.