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Abstract Background This research aims to investigate the relationship between the Big Five personality traits and their impact on academic burnout and satisfaction within the context of pursuing a medical career, particularly focusing on medical students in the University of Jordan. This investigation aims to enhance the overall well-being and success of medical students, ultimately enhancing the quality of medical services provided by future physicians. Methodology This is a cross-sectional study conducted in the University of Jordan between January-June of 2024. A self-administered online survey was filled by 436 medical students from the first to sixth academic year. Participants completed a questionnaire that assessed personality traits using the Big Five Inventory (BFI), academic burnout by Copenhagen burnout inventory-student version (CBI-S), as well as students’ satisfaction using one question with a scale from 1 to 5. For data analysis, R statistical software version 4.3.2 was used. Results Individuals with high levels of neuroticism exhibited higher levels of burnout (β = 0.429, SE = 0.048, t = 8.849, p

Abstract Background Multiple myeloma (MM) is a malignant disorder characterized by monoclonal differentiated plasma cells. While it is more commonly diagnosed in elderly individuals, it can also affect younger populations, though with a lower incidence. Case presentation Here, we present the case of a 32-year-old woman diagnosed with IgA lambda MM. She presented with fatigue, nausea, acute kidney injury (AKI) with a rapid increase in creatinine, and anemia. A kidney biopsy was done to rule out a rapidly progressive glomerular disease and a diagnosis was thus reached. A genetic workup revealed t(14;16) translocation and an extra copy of TP53. The patient received aggressive intravenous steroids and intravenous fluid resuscitation, resulting in an improvement in renal function. Treatment with daratumumab in combination with bortezomib, thalidomide, and dexamethasone was initiated and well tolerated. Despite the generally poor prognosis of IgA MM, our case emphasizes the importance of considering MM in young patients with unexplained kidney injury. Conclusion Early recognition and prompt intervention are essential in managing MM patients, especially in those with high-risk cytogenetic abnormalities. This case serves as a reminder for clinicians to maintain a high index of suspicion for MM, even in younger populations, when presented with unexplained kidney injury.

Abstract The palladium anchored to BisPyP@bilayer-SiO2@NMP organic–inorganic hybrid was employed as an effective and recyclable organometallic catalyst in Suzuki and Stille C–C coupling reactions. The structure of this magnetic nanocatalyst was determined using various techniques such as SEM, TEM, FT-IR, EDS, ICP-OES, VSM, N2 adsorption–desorption isotherms, XRD, and TGA. In both of the mentioned coupling paths, the yields of the products were very favorable and ranged from 90 to 98%. Also, they had significant features compared to previous reports, such as very short reaction time (5–15 and 7–20 min respectively in the Suzuki and Stille reactions), easy work-up, broad substrate scope, ease of separation of the catalyst using a magnet, suitable reproducibility of the catalyst in 6 runs, heterogeneous nature of the catalyst and not washing it during consecutive runs with confirmation of hot filtration and ICP-OES methods.

Abstract Background War results in widespread destruction of a country’s infrastructure, healthcare facilities, and educational institutions. This study aims to assess the attacks on medical schools amidst the ongoing conflict in Sudan. Methods A descriptive cross-sectional study was conducted across 58 medical schools located in the states of Khartoum, Darfur, and Kordofan. Data on attacks between April 15, 2023, and July 15th 2023, were collected using online data collection form. Results All medical schools in conflict areas were included in the study. More than half (58.6%) of these medical schools were attacked. Private schools, constituting the majority of the study sample, were the most frequently attacked (70.6%). Of these, 52.9% were located in Khartoum city. More than one form of attack was reported in 64.7% of the affected schools. Looting occurred in 73.5% of the attacked faculties, while 67.6% of them were converted into military bases. Despite these challenges, 60.3% of the schools in the conflict zone managed to restore the educational process through online learning and collaboration with other institutions. Conclusion During a three-month period of warfare, most medical schools within conflict zones were attacked. This emphasizes the vulnerability of medical education institutions during war and highlights the urgent need of the Ministry of Higher Education interventions to provide leadership, support, and oversight for the educational process in medical schools across the country.

Abstract This study compared effects of diminazene aceturate (berenil), commonly used to treat domestic animals infected with Trypanosoma evansi, with the hemolymph of Sarcophaga argyostoma larva. The hemolymph may be acting as a possible natural alternative to berenil, based on immunomodulation mediated inflammatory response. Inflammatory mediators and histopathological changes in liver, kidney, and spleen of albino mice experimentally infected with T. evansi were studied. Mice were divided into five groups: G1, uninfected, untreated (negative control); G2, T. evansi infected (positive control); G3, infected and treated with berenil; G4, infected and treated with hemolymph; G5, infected and treated with hemolymph 3 days before infection (prophylactic group). Animals in (G4) and (G5) exhibited a significant overall reduction in serum levels of IFN-γ. However, the reduction in TNF-α and IL-6 levels was more limited compared to (G2) and (G3). Notably, an elevation in IL-10 levels was observed compared to animals in other groups. Furthermore, the groups treated with hemolymph demonstrated an alleviation of T. evansi infection in contrast to the other groups. This study highlights that the administration of Sarcophaga argyostoma larval hemolymph at a dosage of 0.5 ml/kg significantly inhibited T. evansi organisms in vivo, showcasing a pronounced trypanocidal effect.

Abstract Introduction Severe congenital ptosis poses a complex challenge for oculoplastic surgeons, requiring meticulous surgical intervention to restore eyelid function and improve aesthetic outcomes mainly by using frontalis sling approach. A crucial issue in frontalis sling surgeries is the sustainability of effect. Purpose This retrospective study reports the outcomes of two surgical techniques for treating severe congenital ptosis in the paediatric age group: Silicon rods ptosis sling and a novel technique involving the use of Silicon rods with green braided polyester (Ethibond) sutures to secure the rods in place “sling for the sling”. Methods The medical records of children who underwent frontalis suspension were reviewed in a retrospective fashion. We identified two groups; the first group (20 patients: 35 eyelids) had the traditional frontalis suspension surgery using silicone suspension set, the second group (14 patients: 25 eyelids) was operated using the new “sling for sling” technique. We used the postoperative marginal reflex distance-1 (MRD-1) as the primary outcome measure while the frequency of both wound related complications and recurrence were considered as secondary outcome measures. Post operative data were collected and compared after 1 month, 6 months, 12 months, and 18 months. Results Preliminary results indicate promising outcomes for both techniques, with significant improvement in eyelid elevation observed in both groups. However, the novel technique using Silicon rods with Ethibond sutures demonstrated enhanced sustainability, leading to a more durable outcome with significantly less recurrence. Conclusion This study highlights the potential benefits of the novel technique in treating severe congenital ptosis and introduces an innovative approach to Silicone rods fixation to achieve a long-term corrective effect.

Background: Strong familial bonds are crucial to building resilience among youth exposed to traumatic events in socially adverse environments. Exploring parental experiences in the aftermath of adolescents’ traumatic exposure in these settings would help tailor early interventions.Objective: We qualitatively explored experiences and perceived needs among parents of teenagers aged 11–16 years who were exposed in the last three months to a potentially traumatic event in Beirut, Lebanon.Method: We purposively sampled 28 parents of 24 adolescents meeting the inclusion criteria. Semi-structured interviews were conducted, and thematic analysis was applied combined with a grounded theory approach.Results: The most frequent traumatic event was direct exposure to the violent clashes that happened in Beirut on 14 October 2021. Parents identified that the recent event exacerbated pre-existing mental health difficulties caused by cumulative stress. They were reminded of their own war experiences and tended to reject the ‘sick role’ associated with trauma. A majority of participants viewed resilience as a fixed trait characteristic of the Lebanese and avoided communication with their children about traumatic memories, while a significant minority criticised resilience as a myth that added pressure on them and had more open communication about trauma. Parenting styles oscillated between controlling behaviours, warmth, and avoidance, which impacted the family dynamic. Despite adversity, most parents tried to cope through social connectedness, humour, and living day by day.Conclusions: Our findings hold implications for contextual adaptations of early posttraumatic interventions aimed at strengthening family support, such as addressing parental mental health; increasing awareness among first-line responders on parents’ potential representations of trauma and resilience; addressing the issue of controlling parenting; and including a component in psychoeducation on traumatic stress that validates the impact of daily stressors on mental health while avoiding direct labelling. Further research is needed to validate the impact of these domains.

ABSTRACTBackground: Parents have a significant role in supporting children who have been exposed to traumatic events. Little is known about parental experiences and needs in the wake of traumatic exposure, which could help in designing tailored early interventions.Objective: This qualitative study explored experiences, perceived needs, and factors impacting those needs being met, in parents of adolescents aged 11–16 years who had been exposed in the past 3 months to a potentially traumatic event, in the city of Montpellier, France.Method: We purposively sampled 34 parents of 25 adolescents aged 11–16 years meeting the inclusion criteria and used semi-structured in-depth interviews. Thematic analysis was applied using a multistage recursive coding process.Results: Parents lacked trauma-informed explanations to make sense of their child’s reduced functioning. They experienced stigma attached to the victim label and were reluctant to seek help. School avoidance and lack of collaboration with schools were major obstacles experienced by parents. Parents trying to navigate conflicting needs fell into two distinct categories. Those who experienced distressing levels of shame and guilt tended to avoid discussing the traumatic event with their child, pressuring them to resume life as it was before, despite this perpetuating conflictual interactions. Others adapted by revisiting their beliefs that life should go on as it was before and by trying to come up with new functional routines, which improved their relationship with their child and helped them to restore a sense of agency and hope, but at the cost of questioning their parental role.Conclusions: Key domains of parental experiences could provide potential early intervention targets, such as psychoeducation on traumatic stress, representations about recovery and the victim status, parent–child communication, and involvement of schools and primary caregivers. Further research is needed to validate the impact of these domains in early post-traumatic interventions.

Abstract Background and goal The pandemic of the twenty-first century is diabetes. Both type 2 diabetes mellitus and obesity pose severe problems for public health. Despite significant improvements in diagnosing and managing both conditions, diabetes mellitus remains poorly controlled, and diabetic complications are more common than ever. Internists have discovered over the past 20 years that obese people with type 2 diabetes who have gastric bypass surgery to shed weight have improved glycemic control. Thus, interventional diabetology has a growing significance in patients’ ability to reverse type 2 diabetes mellitus. We want to evaluate the impact of gastric bypass on blood sugar regulation and look for potential causes. Patients and methods Between 2018 and 2020, a prospective interventional study was carried out. Ninety patients in total were enrolled in the trial. The two patient groups (A and B) contained 45 obese T2DM patients with a body mass index (BMI) of over 35 kg/m2. Group B received its antidiabetic medications, either oral hypoglycemic or insulin, while Group A underwent gastric bypass surgery. Each patient underwent a comprehensive history review and clinical assessment. Both groups had their HA1c and blood sugar levels measured; group A had their insulin, GLP-1, and HOMA-IR (Homeostasis Model Assessment for Insulin Resistance) levels calculated at time O and one year later. Results The demographic differences between the two study groups were negligible. After a one-year follow-up, group A had significantly lower anthropometric measurement data for BMI and waist circumference (cm), lipid profile data for triglycerides, total cholesterol, and LDL levels, and systolic and diastolic blood pressure. Fasting plasma glucose and HbA1c, two metrics of glucose metabolism, significantly decreased in group A. Regarding indicators of glucose metabolism, there was a drop in fasting insulin level and HOMA-IR and an increase in GLP1 level in the gastric bypass group. Conclusion As a result of improving all indicators, gastric bypass is an effective treatment for patients with uncontrolled T2DM. Future research that is confirmed is needed.

Abstract Background Diabetes vascular complications are classified as either macrovascular (cardiovascular disease) or microvascular (nephropathy). These complications considerably raise the risk of morbidity and death. Irisin is a myokine that has been linked to metabolic disorders and cardiovascular disease. The purpose of this study was to look at the relationship between irisin and vascular complications among type 2 diabetic (T2DM) individuals. In this case–control study, the patients were put into four groups based on the occurrence of a diabetic cardiovascular complications and the presence of diabetic nephropathy into group 1: twenty T2DM cases without complications, group 2: twenty T2DM cases with diabetic nephropathy, group 3: twenty T2DM cases with cardiovascular complications, and group 4: thirty controls. History was taken, and clinical examination was done. Laboratory investigations (fasting blood glucose, 2-h postprandial blood glucose, HbA1C, cholesterol, triglycerides, HDL-C and LDL-C, serum urea and creatinine, albumin/creatinine ratio, eGFR, serum irisin) were analyzed. Results Serum level of irisin was significantly lower in T2DM patients than in control. Also, irisin level was significantly lower in diabetic cases with vascular complications versus those without complications. Irisin level had a negative correlation to BMI and lipid profile in diabetic cases and had a positive correlation to eGFR in diabetic patients with cardiovascular complications. Conclusions Irisin level was significantly lower in T2DM patients than control and in diabetic patients with vascular complications than patients without complications. So, irisin may have a role as a marker of vascular complications in T2DM.

Indole-3-carbinol (I3C), a hydrolysis product of indole-3-methylglucosinolate, is toxic to herbivorous insects and pathogens. In mammals, I3C is extensively studied for its properties in cancer prevention and treatment. Produced in Brassicaceae, I3C reversibly inhibits root elongation in a concentration-dependent manner. This inhibition is partially explained by the antagonistic action of I3C on auxin signaling through TIR1. To further elucidate the mode of action of I3C in plants, we have employed a forward-genetic amiRNA screen that circumvents functional redundancy. We identified and characterized two amiRNA lines with impaired I3C response. The first line, ICT2, targets the phosphatidylinositol 4-phosphate 5-kinase family (PIP5K), exhibiting tolerance to I3C, while the second line, ICS1, targets the Wall-Associated Kinases (WAK1–3) family, showing susceptibility to I3C. Both lines maintain I3C-induced antagonism of auxin signaling, indicating that their phenotypes are due to auxin-independent mechanisms. Transcript profiling experiments reveal that both lines are transcriptionally primed to respond to I3C treatment. Physiological, metabolomic, and transcriptomic analysis reveal that these kinases mediate numerous developmental processes and are involved in abiotic and biotic stress responses.

IntroductionGastrointestinal bleeding (GI) is a prevalent condition among pediatric patients, with a reported incidence of 6.4%, often severe enough to require admission to the pediatric intensive care unit (PICU). There are multiple therapies utilized in the management of GI bleeding in pediatrics, among which continuous intravenous (IV) infusion of omeprazole is used off-label without standard pediatric dosing recommendations. Reviewing the current literature reveals a lack of studies assessing the efficacy, safety, and appropriate dosing regimen of continuous omeprazole infusion in children with GI bleeding. This study aimed to evaluate the efficacy and safety of continuous IV omeprazole infusion in comparison to other therapeutic modalities in children.MethodsThis study is a single-center, retrospective chart review of children admitted to the PICU at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. The treatment group included pediatric patients with GI bleeding and receiving omeprazole IV continuous infusion over ≥24 h while the control group included pediatric patients with GI bleeding managed using other therapies. Primary outcomes were the efficacy of omeprazole continuous infusion in stopping GI bleeding, and PICU length of stay (LOS). Secondary outcomes included instances of rebleeding post- therapy discontinuation, transfusion requirements, and the safety of omeprazole continuous infusion.ResultsThe study included 81 critically ill pediatric patients, 22 of whom received continuous infusion omeprazole while 59 received other therapies. The results indicated that patients in the control group had a significantly shorter PICU LOS (8 vs. 18.5 days, p

Metallic components in boating industry are being replaced with carbon fiber composites due to their light weight, excellent mechanical properties, and corrosion resistance. However, the carbon fiber cost has obstructed the substitution. Hybridization is suggested to merge carbon and glass fibers in cost-effective composites while maintaining the desired engineering properties. This study experimentally examines the impact of hybridization and seawater aging on the mechanical properties of glass and carbon fibers hybrid composites. A range of composites ([C]6, [CGC]s, [C]3[G]3, [GCG]s, and [G]6) are fabricated and aged in simulated seawater solution before their tensile, flexural, impact, and hardness properties are examined. The results revealed degradation in properties due to the ageing, the degree of degradation is influenced by the s hybridization configuration. The [G]6 sample shows the highest tensile strength reduction of 30% compared to 20% for the [C]6. The remaining samples exhibit reduction percentages falling between these two extremes. A similar behavior is observed in the flexural test, though the extremes values are smaller, 10.2%, and 12.5%. The impact and hardness tests showed an inverse relationship between the glass fiber content and impact strength degradation due to aging, while they exhibited a linear correlation for hardness degradation due to ageing.

Introduction: In the first trimester, almost one in five identified pregnancies end in spontaneous miscarriage, and another 22% result in induced abortion. After a spontaneous and/or induced abortion, there may be retained products of conception (POC). Because of its relatively poor efficacy and the unpredictability of the time interval until spontaneous evacuation, expectant treatment is not often chosen by healthcare professionals. In view of these facts, the current study's objective was to weigh the effectiveness of MVA and oral misoprostol 600 mg in managing incomplete abortion. Materials and Procedures: The investigation was conducted at the tertiary care center in India. The survey was conducted for one year. Subjects were selected from those attending the department for either spontaneous or induced abortions. A total of 230 women were randomly assigned to receive the interventions of a single dose of oral misoprostol 600 mcg or MVA. They were equally distributed to two groups and observed for the various parameters of success, signs and symptoms, satisfaction, and complications. The obtained values were compared statistically for the significance at

Abstract Background Middle East respiratory syndrome coronavirus (MERS-CoV) was identified in humans in 2012. Since then, 2605 cases and 937 associated deaths have been reported globally. Camels are the natural host for MERS-CoV and camel to human transmission has been documented. The relationship between MERS-CoV shedding and presence of neutralizing antibodies in camels is critical to inform surveillance and control, including future deployment of camel vaccines. However, it remains poorly understood. The longitudinal study conducted in a closed camel herd in Egypt between December 2019 and March 2020 helped to characterize the kinetics of MERS-CoV neutralizing antibodies and its relation with viral shedding. Results During the 100-day longitudinal study, 27 out of 54 camels (50%) consistently tested negative for presence of antibodies against MERS-CoV, 19 (35.2%) tested positive and 8 (14.8%) had both, positive and negative test results. Fourteen events that could be interpreted as serological indication of probable infection (two seroconversions and twelve instances of positive camels more than doubling their optical density ratio (OD ratio) in consecutive samples) were identified. Observed times between the identified events provided strong evidence (p = 0.002) against the null hypothesis that they occurred with constant rate during the study, as opposed to clustering at certain points in time. A generalized additive model showed that optical density ratio (OD ratio) is positively associated with being an adult and varies across individual camels and days, peaking at around days 20 and 90 of the study. Despite serological indication of probable virus circulation and intense repeated sampling, none of the tested nasal swab samples were positive for MERS-CoV RNA, suggesting that, if the identified serological responses are the result of virus circulation, the virus may be present in nasal tissue of infected camels during a very narrow time window. Conclusions Longitudinal testing of a closed camel herd with past history of MERS-CoV infection is compatible with the virus continuing to circulate in the herd despite lack of contact with other camels. It is likely that episodes of MERS-CoV infection in camels can take place with minimal presence of the virus in their nasal tissues, which has important implications for future surveillance and control of MERS-CoV in camel herds and prevention of its zoonotic transmission.

Abstract Background and aims Nutritional status is essential for the maintenance of the immune system, with malnutrition suppressing immunity. The aims of the current study were to assess the immune status of a group of Jordanian adults and to evaluate the association between vitamin C, vitamin D, and zinc consumption and the Immune Status during the COVID-19 pandemic. Methods A total of 615 adults Jordanian participants were enrolled in this study, an online- based cross sectional survey was used as a tool for this study. Data was collected by distributing the questionnaire form link through social media platforms. The association between ISQ score and the supplement intake pattern (daily, weekly, monthly and rarely) was assessed using multinomial logistic regression analysis, described as Odds ratio and 95% CI. Results Data have indicated that the majority of the participants did not take Vitamin D supplements during the pandemic (46.3%). Also, there was a significant association between the frequency of Vitamin D supplement intake and ISQ (r = 12.777; P

Purpose: Healthcare practitioners in Saudi Arabia sometimes experience workplace bullying (WPB). However, more research on this issue must be carried out in the country. This study aimed to investigate the prevalence of WPB and how individual factors among nurses contribute to different experiences of WPB in clinical settings. Methods: This cross-sectional quantitative study occurred among registered nurses in Riyadh, Saudi Arabia. A self-administered questionnaire was used, and nurses filled it out via a Google survey that included sociodemographic details such as age, gender, education, and the WBS to gauge the prevalence of workplace bullying in hospital settings. Results: Of 416 nurses, 58.7% were aged between 31 and 40, and 76.9% were women. The prevalence of WPB was found to be 54.8%. WPB was higher among middle-aged nurses, men, charge/managerial nurses, nurses with higher education, those with 3 to 6 years of experience, and those working in specialty units. Conclusions: More than half of the nurses had experienced WPB at some point. Middle-aged nurses, especially men with higher education and more experience in specialty units, were the most common victims of WPB compared to other registered nurses.

Pseudomonas jordanii strain G34 is a moderately halophilic endophytic bacterium isolated from the root tissue of durum wheat plants growing in the saline environment of the Jordan Valley’s Ghor Sweimeh region. Microscopic and biochemical analyses of P. jordanii strain G34 revealed that it is a Gram-negative, non-motile rod. It also exhibits capsule formation, catalase and oxidase positive reactions, indole positivity, citrate utilization, and non-glucose fermenting capability. Pseudomonas jordanii strain G34 showed growth-promoting effects on durum wheat seedlings grown under severe salinity stress conditions up to a 200 mM NaCl concentration. The draft genome of P. jordanii strain G34 comprises 5,142,528 base pairs (bp) and possesses a G + C content of 64.0%. It contains 57 RNA coding genes and is predicted to encode a total of 4675 protein-coding genes. Putative genes linked to various aspects of the bacterial endophyte lifestyle were identified including ion transport, motility, secretion, adhesion, delivery systems, and plant cell wall modification. Performing a comprehensive phylogenomic analysis identified P. jordanii as a new species, with its closest relative being P. argentinensis LMG 22563, sharing only around 40.2% digital DNA-DNA hybridization identity. Pseudomonas jordanii strain G34 holds great potential for future use as a biofertilizer in saline environments.

Child abuse is a global problem. Shaken baby syndrome (SBS) is a result of child abuse, with shaking being the most common form of maltreatment, causing mortality or severe brain damage in infants. A lack of awareness of SBS among current and future healthcare professionals can have serious consequences. To date, no studies have been conducted in Saudi Arabia to examine student nurses’ awareness of SBS, so we sought to assess this issue in an academic institution in Riyadh, Saudi Arabia. For this questionnaire-based study, we employed a cross-sectional, descriptive design. The target population was nursing students from every year of study in the institution’s five-year undergraduate nursing programme, who received an online questionnaire during the 2022–2023 academic year. The data were analysed using descriptive and inferential statistical analysis. Of the 293 respondents, 100.0% confirmed that they were not aware of SBS through their nursing curricula, and 62.1% reported not being made aware of SBS at all during their academic journey. The majority of participants were unaware of the negative consequences of shaking a baby. Most were not aware that shaking a baby vigorously can cause permanent blindness (73.4%), postural impairments (56.7%), sleep disorders (61.1%), or convulsions (60.1%). The results of our study revealed a statistically significant relationship between nursing students’ awareness of SBS and both their year of study and marital status. Those at higher academic levels and those who were married were more aware of SBS. To improve nursing students’ knowledge of SBS and help them to better inform the public of this syndrome, particularly parents, child maltreatment topics should be added to nursing curricula in Saudi Arabia, and their importance should be emphasised. This will help reduce the prevalence and burden of SBS nationally.

IntroductionResearch from around the world shows important differences in the impact of the COVID-19 pandemic and lockdowns on mental health. This study examined the extent of mental health challenges (depressive and anxiety symptoms and daily life difficulties) and their associations with pandemic- and response-related factors during the first lockdown in Lebanon, which happened amid a severe economic crisis and socio-political turmoil.MethodsData come from a cross-sectional internet-based survey (May-June 2020). Association of depressive (Patient Health Questionnaire (PHQ-9)) and anxiety symptoms (Generalized Anxiety Disorder (GAD-7)) with outbreak-related worries and knowledge, information sources, and confidence and satisfaction in response measures were estimated using logistic regression adjusted for sociodemographic and socioeconomic indicators.ResultsAmong 510 participants (mean age 36.1±11.3; 69.4% women), 32.3% had elevated depressive and 27.3% had elevated anxiety symptoms; younger age, unemployment, loss of employment, and lower income were related to more mental health symptoms. Most prevalent daily life challenges were feelings of uncertainty (74.5%) and financial (52.2%) and emotional (42.2%) difficulties; these and all other daily life difficulties (work-related, caregiving, and online learning) were significantly higher among participants with higher depressive and anxiety symptoms. Higher outbreak-related worries were associated with higher depressive (OR = 1.36, 95% CI = 1.20,1.53) and anxiety symptoms (OR = 1.47, 95% CI = 1.30,1.67). Higher pandemic-related knowledge, reliance on and trust in local health agencies and professionals' information, and satisfaction and confidence regarding governmental and health institutions' response were all related to lower mental health symptoms.ConclusionResults show that mental health burden in Lebanon during the first lockdown (when the COVID-19 outbreak was still minimal) is among the highest reported worldwide and highlight elevated emotional and financial tolls and widespread impact on daily life. In this high-burden and multiple-challenges context, results suggest an important role for the healthcare body, knowledge, and trust in the institutions managing the response.

Background: Pulmonary fibrosis is a progressive lung disorder that occurs by lung injury and scarring of the lung tissue. This injury makes the lung thickened and stiff causing difficulty to breathe. Corticosteroid resistance pulmonary fibrosis is a major health problem. Bleomycin is an anti-cancer agent, it induces pulmonary fibrosis resistance to corticosteroid therapy, this study aimed to determine the effectiveness of nintedanib (NIN) a tyrosine kinase inhibitor on corticosteroid resistance pulmonary fibrosis induced by bleomycin in mice. Methods: Sixty albino male adult mice were used in this study. The mice were divided into five groups (n=12) at random. control group, the BLM group received a single dose of bleomycin (BLM); 2U/kg by endotracheal instillation, the BLM+MP group received bleomycin and methylprednisolone (MP) 10mg/kg/day by gastric gavage, BLM+NIN group received BLM and NIN, 60mg/kg/day by gastric gavage and the combined treatment group received BLM, NIN, and MP. All groups were sacrificed after the last dose of treatment on day 7 (acute stage) and day 28 (chronic stage). The lung tissues were obtained for biochemical analysis, gene expression, and histopathological examination at the end of the experiment. Results: After 7 days of treatments, BLM+NIN and BLM + NIN + MP groups showed a significant (P

Background and Aim: Due to climatic changes, arthropod-borne viruses have become a global health concern. In Egypt, West Nile virus (WNV) was initially detected in humans in 1950 and then in 1951, 1954, 1968, and 1989. Although WNV infection has been recorded in numerous Middle Eastern countries, its prevalence among the equine population in Egypt is unknown. This study aimed to investigate the current situation of vector-borne WNV in Egypt, estimate its seroprevalence, and assess the associated risk factors. Materials and Methods: We screened 1100 sera samples and nasal swabs from the same equids, 156 mosquito pools, and 336 oropharyngeal and cloacal swabs from migratory birds for WNV. The sera were investigated for the presence of immunoglobulin G (IgG) and immunoglobulin M (IgM) against WNV-prE. Real-time reverse transcription-polymerase chain reaction was used to detect WNV RNA in the nasal swab samples, mosquito pools, and migratory birds’ oropharyngeal and cloacal swabs. Results: The seroprevalence showed positive IgG in sera samples collected from different districts. The data showed that horses were 1.65-fold more susceptible than donkeys, with male being 1.45 times more susceptible than females. Moreover, the tested equids samples were divided into three groups based on their age: 10 years. The 5–10- year group was 1.1 and 1.61 times more vulnerable to infection than the 10 year groups. All the sera samples were negative for IgM. The nasal swabs from equids, oropharyngeal and cloacal swabs from migratory birds, and mosquito samples tested negative for WNV by molecular detection. Conclusion: Based on the obtained data, we recommend that effective control programs should be implemented to enable epidemiological investigations and understand the current situation of WNV in Egypt.

Abstract Objective To evaluate the epidemiologic profile of microbial keratitis in Alexandria- Egypt, with special emphasis on risk factors, visual outcome and microbiological results. Methods This retrospective study reviewed files of patients treated for microbial keratitis during a period of 5 years at Alexandria Ophthalmology Hospital Cornea Clinic, Alexandria- Egypt, between February 2017 and June 2022. The patients were evaluated for the risk factors e.g., trauma, eyelid disorders, co-morbidities, and contact lens use. They were also evaluated for their clinical picture, the identified microorganisms, visual outcomes, and complications. Non-microbial keratitis and incomplete files were excluded from the study. Results A total of 284 patients were diagnosed as microbial keratitis in our study. Viral keratitis was the most common cause of microbial keratitis (n = 118 (41.55%)), followed by bacterial keratitis (n = 77 (27.11%)), mixed keratitis (n = 51 (17.96%)), acanthamoeba keratitis (n = 22 (7.75%)) and the least cause was fungal keratitis (n = 16 (5.63%)). Trauma was the most common risk factor for microbial keratitis (29.2%). Fungal keratitis had a statistically significant association with trauma (p

ICT1 is an Arabidopsis thaliana line that overexpresses the gene encoding the S30 ribosomal subunit, leading to tolerance to exogenous indole-3-carbinol. Indole-3-carbinol (I3C) is a protective chemical formed as a breakdown of I3M in cruciferous vegetables. The overexpression of S30 in ICT1 results in transcriptional changes that prime the plant for the I3C, or biotic insult. Emerging evidence suggests that ribosomal proteins play important extra-ribosomal roles in various biochemical and developmental processes, such as transcription and stress resistance. In an attempt to elucidate the mechanism leading to I3C and stress resistance in ICT1, and using a multi-pronged approach employing transcriptomics, metabolomics, phenomics, and physiological studies, we show that overexpression of S30 leads to specific transcriptional alterations, which lead to both changes in metabolites connected to biotic and oxidative stress tolerance and, surprisingly, to photomorphogenesis.

Background: Hirsutism is the excessive body or facial terminal (coarse) hair growth in females in a male-like pattern, carries a worldwide prevalence of 5%–20%, and requires careful evaluation and long-term management. Purpose: The study aims to critically appraise public and private institutions' practices in managing hirsutism, compared against international standards. The purpose of this study was to assess how frequently patients receive counseling to address the causes of hirsutism and to determine if disease severity, screening, and outpatient management vary between public and private clinics in Saudi Arabia. Methods: Patients were recruited from gynecology, endocrine, dermatology, and women's skin care clinics in public (n = 119) and private outpatient clinics (n = 238). Sociodemographics, body mass index (BMI), menstrual cycle rhythm, hirsutism site and scores, associated acne and/or alopecia, family history, and treatment modality received were queried. This study had two groups: Group 1 (n = 119) patients who were seen at public outpatient clinics and Group 2 (n = 238) patients who were seen at private outpatient clinics. Results: The median age was 27 years (range 18–45) and median BMI was 25 kg/m2 (range 16–44). The total mean hirsutism score was 9.3 ± 3.8. The severity of hirsutism was categorized into three groups: mild cases were recorded in 224 women (62.7%), moderate cases were recorded in 94 women (26.3%), and severe cases were recorded in 39 women (10.9%). There was no significant correlation between total mean hirsutism scores, age and BMI, P = 0.5 and P = 0.2, respectively. Approximately one-third of women were seen and investigated by physicians either at public or private clinics and about 70% of women were seen and treated by nonphysician skin care specialist without prior medical investigations in either public or private outpatient departments (OPDs). Conclusion: Assessment and management of hirsutism are similar in the public and private setting. Most patients presented to private rather than public OPDs and were not appropriately investigated for hirsutism. Weight reduction can be beneficial for the management of hirsutism for those with raised BMI and advice should be given accordingly in the OPD setting.

Background: Immune thrombocytopenia purpura (ITP) is one of the most common autoimmune diseases in children characterized by a decreased number of circulating platelets combined with impaired platelet production. There is limited literature data on the prevalence and treatment modalities, and outcome of ITP in children from Lebanon. Methods: We retrospectively reviewed the demographic and clinical data of 59 patients aged 0–18 years diagnosed with ITP between January 2007 and April 2016 in different hospitals in Beirut and the south of Lebanon. Results: ITP patients represented 2.5% of the total number of children admitted to these hospitals during this period. Among the ITP children, 55.93% were male and 44.07% were female. The greatest number of ITP children were in the 1–4 year group, followed by the 5–9 year group. As for the clinical course of the disease, 40.68% of the ITP children presented acute ITP, whereas 59.32% presented chronic ITP. Among the different therapeutic approaches adopted to treat these ITP children, intravenous immunoglobulin was the most commonly used, followed by steroids, a combination of these both agents, cyclosporine, and splenectomy. Interestingly, these therapeutic modalities induced a statistically significant increase in the patients’ platelet count. In addition, the clinical course of ITP was not significantly associated with each of the age group, the platelet count at diagnosis, and gender of patients. Conclusion:This study showed the prevalence of ITP among children from Lebanon, where more than half of ITP children presented a chronic disease. Further studies are needed to evaluate additional predictors of chronic ITP among children from Lebanon and help medical providers make informed decisions about treating childhood ITP. Doi: 10.28991/SciMedJ-2022-04-04-02 Full Text: PDF

Abstract Background Optical coherence tomography (OCT) angiography (OCTA) provides a quantitative assessment of the microcirculation of the retina and choroid. It may precede the retinal nerve layer (RNFL) and optic disc head defects. Retinal nerve fiber layer defects and reduced central corneal thickness (CCT) are important parameters in the assessment of a glaucoma suspect patients. The aim of this study is to investigate any possible relationship between the reduced central corneal thickness and the radial peripapillary capillary (RPC) density defect in glaucoma suspect. Methods In this cross sectional study, 92 eyes were incorporated. Peripapillary OCT angiography (4.5 mm) and Anterior segment OCT for corneal pachymetry were done. C/D Ratio, thickness of nerve fiber layer, the blood flow indices and central corneal thickness also were evaluated. Results In eyes of glaucoma suspect patients; a significant positive correlation between CCT and total RPC density was detected (r = 0.38, P

AIM: To report the surgical outcomes of correcting large angle intermittent exotropia in adult patients by bilateral lateral rectus muscle recession with intraoperative use of botulinum toxin and to compare the results with those of bilateral lateral rectus muscle recession and unilateral medial rectus resection. METHODS: The medical records of patients who underwent surgical correction of large angle intermittent exotropia [exotropia >50 prism dioptre (PD)] were retrospectively reviewed. Two groups of patients were identified; Group I (21 patients) had bilateral lateral recti recession augmented with intraoperative botulinum toxin A (BTA) injection into the recessed muscles and group II (30 patients) were treated by bilateral lateral recti recession with unilateral medial rectus muscle resection. Preoperative data were extracted for age, gender, refraction, type of exotropia, angle of stereopsis and angle of deviation. The main outcome measures were the postoperative angle of deviation and stereoacuity angle by Titmus test measured at the end of one year of postoperative follow up. RESULTS: By the end of the first postoperative year, 10 patients in group I (47.6%) and 20 patients in group II (66.7%) achieved esotropia/esophoria