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Background: Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widespread, treatable sexually transmitted infections (STIs) of global significance, affecting millions annually. Left untreated, they pose significant risks, including pelvic inflammatory disease (PID), infertility, and complications during pregnancy. The U.S. Centers for Disease Control recommends annual chlamydial screening for sexually active women to address these risks. Responding to this global challenge, the World Health Organization (WHO) has formulated a global health sector strategy on sexually transmitted infections, outlining priority actions to strengthen STI responses in countries. However, STI epidemiological studies encounter challenges in developing nations like Egypt due to socio-cultural factors, poverty, and limited diagnostic facilities. In Egypt, STI diagnosis primarily relies on clinical presentations, lacking structured screening programs for CT and NG. This study's main objective is to estimate the prevalence of Chlamydial and gonorrheal infections, advocating for supportive STI strategies in Egypt. Additionally, the study aims to provide a foundation for national prevalence estimates of CT and NG infections., Methods: A cross-sectional study encompassed five antenatal clinics in different regions of Egypt. A total of 1040 pregnant women attending these clinics were consecutively sampled. Data collection involved structured questionnaires, and urine samples were subjected to the GeneXpert CT/NG qualitative real-time PCR test., Results: The prevalence of CT infections was 0.29% (95% CI, 0.10-0.86%), with no detected NG infections. The three CT-positive cases were distributed across different recruitment centers, with no statistically significant differences observed between infected and non-infected participants. Notably, 40.3% of recruited women reported gynecological symptoms, primarily discharge. Additionally, 9.6% had undergone previous testing for sexually transmitted infections, with 8.2% receiving positive results., Conclusions: This study provides valuable data on the prevalence of CT and NG infections among pregnant women attending ANC clinics in Egypt. The findings underscore the importance of ongoing surveillance, routine screening, and targeted interventions to ensure the reproductive health and well-being of pregnant women and their infants. Further research is warranted to explore the broader implications of STIs in different populations and to inform evidence-based guidelines for screening and management in diverse settings., Trial Registration: IRB no.: 17,400,017; WHO ERC Protocol Id. A66005., (© 2024. The Author(s).)

Objectives: Social media facilitate the interaction between individuals without regard to the distances between the users. Everybody who has access to internet can suffer from social media addiction. During COVID-19 pandemic there was an increase in social media usage among all population types and especially the university students, which would negatively affect their mental health. Therefore, this study aims at assessing social media addiction and depression among pharmacy students by using questionnaires specifically designed for this purpose., Methods: A cross-sectional study with convenience sampling was conducted from the start of November to the end of December 2021 among undergraduate pharmacy students in Mosul city, Iraq. An online questionnaire was adopted; it consisted of three parts, the first was for collecting socio-demographic and social media usage information, Social Media Addiction Questionnaire (SMAQ) was used in the second part to assess social media addiction of the participants, and the third part was comprised of the Patient Health Questionnaire (PHQ-9) to assess depression among students., Results: Six hundred-three students completed the questionnaire and constituted the final study sample. Instagram was the most used social media program among the students. About 38 % of the students were at risk of becoming addicted on social media, with only 8.4 % of them being minimally or not depressed. Additionally, positive significant correlation was observed between social media addiction and depression. Using social media for more than 4 h and poor academic performance were found to be predictors for social media addiction and depression., Conclusions: Addiction to social media and depression are prevalent among pharmacy students in Iraq and the two are related to each other., (© 2024 Walter de Gruyter GmbH, Berlin/Boston.)

Introduction: Anticoagulation treatment is routinely underused in patients with atrial fibrillation (AF), particularly in settings with limited resources. The current study is aimed at evaluating the appropriateness of oral anticoagulation treatment among AF patients at the Yekatit 12 Hospital Medical College (Y12HMC), Addis Ababa, Ethiopia., Methods: Institutional-based retrospective cross-sectional study conducted in Y12HMC from November 2019 to March 2020. During the study period, 256 patients' medical records were found; 231 of them met the eligibility criteria and were included in the study. The data were analyzed using SPSS version 25, descriptive statistics were used to summarize the data, and binary logistic regression was performed to identify predictors of inappropriate anticoagulation management., Results: The majority of study participants were males (55.8%), and over half of them (57.6%) had a nonvalvular type of AF. The majority of patients (61.9%) were receiving anticoagulant treatment, and of them, warfarin was prescribed to most of the study subjects (71.3%). Nearly half (47.6%) of the study participants had inappropriate anticoagulation treatment; among these, the majority of them (69.1%) were from a valvular type of AF. Patients with a valvular type of AF and having the diagnosis of congestive heart disease as comorbidity showed a statistically significant association towards inappropriate anticoagulation management., Conclusion: According to the study, a significant portion of AF patients received inappropriate anticoagulant treatment, which may play a significant role for the increased risk of stroke in these groups of patients. All of the inappropriate cases were due to failure to start anticoagulant treatment., Competing Interests: The authors have not declared any conflict of interest., (Copyright © 2023 Abdella Birhan Yabeyu et al.)

Background: Candida albicans ( C. albicans ) is a major cause of vulvovaginal candidiasis (VVC), a condition that is commonly treated with azole agents. Biofilm formation and aspartyl proteinase production are important virulence factors that could be linked to azole resistance in C. albicans impeding therapy., Aim: To find out the association of both factors with azole resistance among C. albicans isolated from VVC cases in Egyptian nonpregnant women of childbearing age., Patients and Methods: In a cross-sectional study, C. albicans was isolated from nonpregnant females diagnosed clinically as having VVC during a 1-year study period. Susceptibility to azole agents was tested using the disc diffusion method. Biofilm formation and aspartyl proteinase production were assessed phenotypically. Additionally, two biofilm-related genes ( ALS1 and HWP1 ) and three proteinase genes ( SAP2, SAP4 , and SAP6 ) were screened for using polymerase chain reaction (PCR)., Results: Among 204 C. albicans isolates, azole resistance ratios were as follows: voriconazole (30.4%), itraconazole (17.6%), fluconazole (11.3%) and econazole (6.4%). Biofilm-producing capacity was detected in 63.2% of isolates, and 63.2% were proteinase producers. The frequencies of ALS1 and HWP1 were 69.6% and 74.5%, respectively, while SAP2, SAP4 , and SAP6 were 69.2%, 88.7%, and 64.7%, respectively. Biofilm formation was significantly associated with azole resistance (P < 0.001 for each tested azole agent) as was proteinase production (P < 0.001 for fluconazole, voriconazole, and econazole resistance and P = 0.047 for itraconazole)., Conclusion: Among nonpregnant Egyptian women of childbearing age, azole resistance in C. albicans causing VVC is significantly associated with biofilm formation and proteinase production. The development of new therapeutic agents that can target these factors is warranted., Competing Interests: None of the authors have any conflicts of interest to declare for this work., (© 2023 Gerges et al.)

BACKGROUND Primary retroperitoneal choriocarcinoma is a rare form of extragonadal germ cell tumor that is highly aggressive and responds poorly to chemoradiation. Extragonadal choriocarcinomas are notoriously challenging to diagnose, and have often progressed to advanced disease by the time of diagnosis. The survival rate for extragonadal choriocarcinoma is approximately 30%, which is much lower than that of extragonadal non-seminomatous germ cell tumors (GCT) in general. CASE REPORT A 24-year-old man with no significant past medical history presented with left-sided, pleuritic chest pain and back pain radiating down his left leg, of 1-year duration. Computed tomography (CT) of the chest revealed multiple bilateral pulmonary nodules and a CT of the abdomen and pelvis showed a large heterogeneous soft tissue mass measuring 9.3×8×10.5 cm. A CT-guided core needle biopsy of a lung nodule was performed and the findings were consistent with the diagnosis of metastatic choriocarcinoma. Magnetic resonance imaging (MRI) of the brain was negative for metastatic disease. Tumor markers were significant for a markedly elevated beta human chorionic gonadotropin (B-hCG) of 104 712 mIU/mL. He was diagnosed with a stage IIIC germ cell tumor, further classified as a primary retroperitoneal choriocarcinoma with lung metastasis, and was started on urgent inpatient chemotherapy. CONCLUSIONS Due to the poor outcomes associated with extragonadal choriocarcinoma, it is important to promptly and correctly identify this malignancy in order to initiate treatment in a timely manner. The following case report explores the histopathologic characterization of this malignancy and describes the clinical course and outcomes from treatment for this patient.

Objective: To study the incidence, causes, and outcome of major ocular complications in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT)., Design: Retrospective, noncomparative, observational clinical study., Participants: The study included a total of 620 patients who underwent allogeneic HSCT in the period from 1997 to 2007 at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Intervention: Allogeneic HSCT., Main Outcome Measures: Patients with ocular complications were referred to the ophthalmology division for complete ophthalmologic examination, including visual acuity, tonometry, Schirmer test, biomicroscopy, and dilated ophthalmoscopy. Laboratory investigations were performed whenever indicated. The incidence and causes of major ocular complications after allogeneic HSCT were determined. Visual acuity at 1 year after allogeneic HSCT was recorded., Results: Major ocular complications occurred in 80 (13%) of 620 patients who underwent allogeneic HSCT. There were 36 male patients (45%) and 44 female patients (55%) with a mean age of 29 years and an age range of 9 to 65 years. Prophylaxis for graft-versus-host disease (GVHD) consisted of cyclosporine and methotrexate in 69 patients, and cyclosporine, methotrexate and corticosteroids, or mycophenolate mofetil in 11 patients. The most frequently encountered ocular complications were chronic GVHD, dry eye syndrome without GVHD, corneal ulcers, cataract, glaucoma, cytomegalovirus retinitis, fungal endophthalmitis, and acquisition of allergic conjunctivitis from atopic donors. There was no correlation between the pattern of ocular complications and the transplanted stem cell source. Best-corrected visual acuity (BCVA) at 1 year after transplantation was less than 20/200 in 13 patients (16%), less than 20/50 in 17 patients (21%), and better than 20/50 in 50 patients (63%)., Conclusions: Ocular complications are common in patients undergoing allogeneic HSCT. Early recognition and prompt treatment are important., Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

It has been suggested that a drug which selectively inhibits platelet thromboxane synthesis, sparing vascular synthesis of prostacyclin, would be more effective as an anti-thrombotic agent. We studied the effect of an aqueous extract of garlic on the production of thromboxane and prostacyclin by rabbit whole blood and aorta in vitro and ex vivo. A dose-dependent inhibition of thromboxane production was observed during blood clotting. Synthesis of prostacyclin was not affected by any concentration of garlic extract used in the experiment. A slight but insignificant reduction in the vascular synthesis of prostacyclin was observed at the highest concentration of garlic used in in vitro experiments. The synthesis of thromboxane by aorta was completely suppressed at all the concentrations of garlic tested. A similar pattern of results was observed after intraperitoneal administration of garlic (1 ml/kg) for one week on the enzymatic synthesis of thromboxane and prostacyclin of these tissues ex-vivo. Aortic synthesis of prostacyclin was significantly increased in the garlic treated rabbits compared to the controls. The data obtained from these rabbit experiments suggested that it may be possible to achieve a selective suppression of thromboxane formation by platelets with sparing of vascular synthesis of prostacyclin by garlic treatment.