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Abstract Impaired cognitive health is the leading cause of various disabilities and disorders. Air pollution has been dramatically increasing over the last few decades and has been identified as a potential risk factor for impaired cognitive health. This study investigates the effect of air pollutants, particulate matter (PM2.5, PM10), sulfur dioxide (SO2), and ground-level ozone, on global cognitive health. The data on environmental pollutants and cognitive health were recorded from PubMed, Web of Science, Scopus, and Google Scholar. Initially, 790 articles were identified after screening for duplicates and applying the inclusion and exclusion criteria, 21 studies were included, and data was synthesized to get a pooled result. The overall results revealed that increased exposure to PM2.5 was positively and significantly associated with cognitive decline (OR 1.49; 95% CI 1.11, 1.99; p = 0.01). The risk of cognitive impairment due to PM10 (OR 1.30; 95% CI 1.00–1.70, p = 0.05), and SO2 (OR 1.39; 95% CI 1.27–1.51; p

Abstract The vaccination against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an important public health strategy to prevent people from the pandemic. Vaccines are a game-changing tool, it is essential to understand the adverse events after COVID-19 vaccination. This study explored the adverse events of COVID-19 Vaccination Oxford–AstraZeneca, Pfizer-BioNTech, Moderna, Johnson and Johnson on Guillain–Barré Syndrome (GBS). In this study, initially 128 documents were identified from the databases, including Pub-Med, Web of Science-Clarivate Analytics, Scopus, and Google Scholar. The articles on COVID-19 vaccination and GBs were searched using the keywords “SARS-CoV-2, COVID-19, Vaccination, and Guillain Barré Syndrome, GBS”, finally, 16 documents were included in the analysis and synthesis. After administering 1,680,042,214 doses of COVID-19 vaccines, 6177 cases were identified with 10.5 cases per million vaccine doses. A significant positive risk was found between COVID-19 vaccine administration and GBS with a risk rate of RR 1.97 (95% CI 1.26–3.08, p = 0.01). The mRNA vaccines were associated with 2076 cases, and 1,237,638,401 vaccine doses were linked with 4.47 GBS events per million vaccine doses. The first dose of the m-RNA vaccine was associated with 8.83 events per million doses compared to the second dose with 02 events per million doses. The viral-vector vaccine doses 193,535,249 were linked to 1630 GBS cases with 11.01 cases per million doses. The incidence of GBS after the first dose was 17.43 compared to 1.47 cases per million in the second dose of the viral-vector vaccine. The adverse events of the Oxford–AstraZeneca vaccine were linked to 1339 cases of GBS following 167,786,902 vaccine doses, with 14.2 cases per million doses. The Oxford–AstraZeneca vaccine significantly increased the risk of GBS RR: 2.96 (95% CI 2.51–3.48, p = 0.01). For the Pfizer-BioNTech vaccine, there were 7.20 cases per million doses of the vaccine, and no significant association was identified between the Pfizer-BioNTech vaccine and GBS incidence RR: 0.99 (95% CI 0.75–1.32, p = 0.96). Moderna vaccine was related with 419 cases of GBS after administering 420,420,909 doses, with 2.26 cases per million doses. However, Johnson and Johnson's vaccination was linked to 235 GBS after 60,256,913 doses of the vaccine with 8.80 cases per million doses. A significant association was seen between the risk of GBS and Ad.26.COV2. S vaccine, RR: 2.47 (95% CI 1.30–4.69, p

Abstract Coronary artery disease is a leading cause of morbidity and mortality worldwide. It occurs due to a combination of genetics, lifestyle, and environmental factors. Premature coronary artery disease (PCAD) is a neglected clinical entity despite the rising number of cases worldwide. This study aimed to investigate the risk factors of premature coronary artery disease. In this study, we searched articles that had studied the risk factors of premature coronary artery diseases from January 2000 to July 2022 in Saudi Arabia in Web of Science, Pub Med, Scopus, Springer, and Wiley databases. The final analysis is based on seven articles. The smoking prevalence was 39%, diabetes mellitus 41%, hypertension 33%, overweight and obesity 18%, family history of coronary artery disease (CAD) 19%, dyslipidemia 37%, and the prevalence range of low-density lipoprotein cholesterol was 33.8–55.0%. The results revealed a mortality prevalence of 4% ranging from 2 to 8% which is similar to the prevalence in older patients which was 2–10%. Smoking, diabetes mellitus, hypertension, family history of CAD, dyslipidemia, and overweight/obesity are significantly and positively associated with premature coronary artery diseases. The health authorities should design and implement an intensive and effective prophylactic plan to minimize the subsequent impact of PCAD on the young population. In addition, early diagnosis of PCAD has great value in providing timely treatment, managing the patients, and minimizing the burden of the disease.

IntroductionThe rigorous nature of medical education, long and night shifts, and prevalent issues like stress, anxiety, and depression affect medical students’ mental well-being and medical professionalism. This study aims to explore the intricate relationships between mental well-being, medical professionalism, and coping strategies, among undergraduate medical students, utilizing structural equation modeling (SEM) to unravel these dynamics.MethodsConducted at Universiti Sains Malaysia, this cross-sectional study involved 234 medical students from the 1st, 3rd, and 5th years of the MBBS program. Data were collected via five validated survey instruments: DASS-9, TEQ, Dundee, Brief COPE, and CBI, through Google Forms. Participants were selected using purposive sampling. The surveys assessed mental well-being (burnout, anxiety, depression, stress), coping strategies, and medical professionalism attributes. Model fit was evaluated using established indices.ResultsFindings indicated that professional behavior reduces burnout and negatively impacts negative coping strategies (NCSs). Additionally, medical professionalism indirectly enhances empathy and positively influences CSs. Conversely, psychological distress increases NCSs and reduces empathy. Positive coping strategies (PCSs) enhance empathy levels, while MWB issues elevate NCSs.DiscussionThe study underscores the vital role of professional behavior in mitigating burnout and fostering positive coping mechanisms among medical students. Addressing MWB issues through targeted interventions can enhance empathy and professional behavior, ultimately improving the quality of patient care.

Human papillomavirus (HPV) is the most prevalent sexually transmitted infection among teenagers and young adults. HPV vaccination and screening are vital preventive measures to reduce the incidence of HPV-related complications, including cervical cancer. Given the rising global incidence of cervical cancer, understanding the factors influencing awareness and knowledge among young adults in Saudi Arabia is essential for developing effective prevention strategies. This study investigates the levels of awareness, knowledge, and vaccine acceptability regarding HPV and cervical cancer among college students in Saudi Arabia. A cross-sectional study was conducted between May and September 2023 among 442 students in Saudi Arabia using a structured questionnaire to assess their knowledge and awareness of HPV, HPV vaccination, and cervical cancer. Multivariate logistic regression analysis was employed to examine the associations between predictor and dependent variables. Among participants, 54.1% were aware of HPV, and 66.5% had heard of cervical cancer. However, only 17% correctly identified HPV16 and HPV18 as high-risk genotypes for cervical cancer. Awareness of the HPV vaccine was reported by 36.2% of participants, with just 10% having received the vaccine. Female students exhibited significantly higher knowledge levels than males (p = .018). The primary barrier to vaccination was identified as a lack of education and awareness (80.1%). The study highlights a significant gap in knowledge and awareness regarding HPV, its vaccine, and cervical cancer among college students in Saudi Arabia. Targeted educational programs and awareness campaigns are essential to enhance understanding and promote preventive practices, including vaccination and regular screening.

Objectives: Environmental pollution has been an emerging global public health problem worldwide. This study aimed to investigate the impact of air pollutants particulate matter PM2.5, PM10, Carbon Monoxide (CO), Nitrogen Dioxide (NO2), Sulfur Dioxide (SO2), and Ozone (O3) on lung functions. Methods: In this matched case-control, cross-sectional study, two schools were selected located in two different areas, school # 1 was located near a traffic-polluted area, and school # 2 was in an area away from the traffic-polluted area. Of a total of 300 students, 150 (75 boys and 75 girls) students from school # 1 and 150 students (75 boys and 75 girls) were from school # 2 located away from a traffic-polluted area. The mean age of students was 13.53 ± 1.20 years. The students in both schools were enrolled in the study on their voluntary involvement, and health status, matched by age, height, weight, gender, nationality, regional, socioeconomic, and cultural background, and the admission criteria of their schools. The environmental pollutants particulate matter “PM2.5, PM10, CO, NO2, SO2, and O3” were recorded. The level of air pollutants in school # 1 was 35.00 ± 0.65, significantly higher compared to school # 2 (29.95 ± 0.32). The pulmonary function test (PFT) parameters were performed on an electronic Spirometer. The parameters included “Forced Vital Capacity (FVC); Forced Expiratory Volume in the first second (FEV1); Forced Expiratory Ratio (FEV1/FVC %); Forced Expiratory Flow 25 % (FEF 25 %); Forced Expiratory Flow 50 % (FEF 50 %); Forced Expiratory Flow 75 % (FEF 75 %) and Peak Expiratory Flow Rate (PEFR) were recorded”. Results: The results revealed that the mean values for FEF-50 % (3.31 ± 1.18); FEF-75 % (1.66 ± 0.80) and PEFR (5.02 ± 1.79) were significantly decreased among students studying in school situated in a motor vehicle polluted area compared to those studying in school positioned away from the motor vehicle polluted area FEF-50 % (5.85 ± 6.21) (p = 0.001); and FEF-75 % (4.49 ± 6.87) (p = 0.001), and PEFR (8.14 ± 15.08) (p = 0.012). However, the groups had no significant difference between FVC, FEV1, FEV1/FVC Ratio (%), and FEF-25 %. The findings further demonstrated that the pattern of lung function impairment was peripheral airway lung involvement amongst the students in schools placed in environmentally contaminated areas. Conclusions: Environmental pollution significantly impaired lung function parameters FEF-50%, FEF-75% and PEFR, with peripheral airway lung involvement among students who studied in a school situated in motor vehicle-polluted areas. The results highlight the importance of the implementation of effective mitigation strategies and promoting sustainable and environmentally friendly transportation options to combat environmental pollution.

Background: Environmental pollution is a highly challenging global health concern, affecting the natural ecosystem and human health. The obesity risk is allied to diverse factors, including genetics, behaviour, food, and socio-cultural conditions, however, literature is lacking in exploring the effect of environmental pollution on obesity and the causal pathways are not fully understood. Therefore, this study aimed to investigate the effect of environmental pollutants particulate matter PM2.5 μm, PM10 μm, Nitrogen Dioxide (NO2), and ground level Ozone (O3) on obesity. Methods: This study recorded data on air pollutants and obesity using the electronic platforms Pub Med, Web of Science, Scopus, and Google Scholar. The keywords included for the literature search were based on a combination of two main aspects, which were used to represent exposure (air pollutants), and outcome (obesity). Initially, 324 articles and reports were identified, and after revising the abstracts and full articles, 12 studies were selected for a detailed analysis and discussion. The Odds Ratio (OR) and 95 % confidence intervals (CIs) were extracted to investigate the impact between air pollutants and obesity. The Cochrane chi-squared test (Chi2), fixed-effects design was used when I2 0.05; otherwise, a random-effects model was adopted. Results: Environmental pollutants, particulate matter PM2.5 (OR = 1.18; 95 % CI: 1.10–1.25p

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

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

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

Objectives: The major challenges of the current century are the rapid changes in the climate, weather conditions and the environment. Governments, individuals, and societies need to work together to tackle the challenges posed to the environment in recent times. The literature highlights the urgent need to act however, little is known about public perception and their responsibilities. This study aimed to explore the public perception of the role of individuals, societies, and states in managing environmental challenges. Methods: In this cross-section study, a well-established English language questionnaire was developed. A total of 1000 questionnaires were distributed, and the response rate was 852 (85.2%). Among 852 participants, 488 (57.28 %) were males and 364 (42.72%) were females. The survey encompassed students 681 (80%), teachers 85 (10%); government officials 34 (4%), shop owners, merchants 25 (3%), doctors and engineers 17 (2%) and housewives 10 (1%). The questionnaires were analyzed, frequencies and percentages were calculated, and a p-value less than 0.05 was considered significant. Results: The results revealed that 621 (72.8%) of the individuals suggested that states adopt sustainable environmental policies; 639 (75%) of the respondents were in favor that individuals personally playing a role in tackling climate change; 699 (82%) agreed that there should be a bottom-up approach while dealing with the environmental problems. Moreover, 605 (71%) believed that the young generation is more inclined than the previous generation for global climate action, 542 (63.61 %) were in favor that civil society galvanized to enshrine environmental protection in the state constitution, and 554 (65%) suggested that national and international efforts cannot make a difference until and unless individuals don’t play a role in reducing the environmental pollution. The majority of the respondents were in favor of adopting the constructive approach to managing environmental challenges. Conclusions: These days the environmental issues have become a grave concern. This role cannot be performed only by the states, but the role of societies and individuals is also of utmost importance. A large number of people suggested a bottom-up approach required to deal while managing environmental challenges. The importance of individual, societal and collective efforts are essential in managing environmental challenges.

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

Objectives: The Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) infection is a highly challenging problem in the world. The impact of weather conditions on the spread of SARS-CoV-2 has been hypothesized, but the level of understanding remains lacking. This study investigates the impact of seasonal variations on SARS-CoV-2 incidence and mortality in the Southern and Northern hemispheres. Methods: We enlisted all the countries from both hemispheres and then randomly selected 20 countries, 10 countries from each hemisphere. After that, we recorded the SARS-CoV-2 daily cases and deaths in these selected countries from the Worldometer for the period of two years from December 31, 2019, to December 31, 2021. Results: During the study period, in 10 selected countries of the Northern hemisphere, the number of SARS-CoV-2 cases was 18381.6 ± 419.7 and deaths 300.4 ± 6.4. However, the number of cases in the southern hemisphere is 6282.9 ± 205.8, and mortality was 210.0 ± 7.7. In the Northern hemisphere, the number of SARS-CoV-2 cases (p = 0.001) and deaths (p = 0.001) significantly increased compared to the southern hemisphere. The maximum number of cases and deaths occurred during the winter (18806.4 ± 785.3) and autumn (17034.1 ± 538.4) periods in both the hemisphere compared to spring and summer. Similarly, the number of deaths increased in winter (391.0 ± 13.4, p = 0.001) and autumn (308.6 ± 11.6) compared to spring and summer in both hemispheres. Conclusions: The highest occurrence of SARS-CoV-2 cases and deaths was found during the winter and autumn seasons, while the lowest was found in the spring and summer during the study period of two years. The health officials inform the public about the seasonal occurrence of the SARS-CoV-2 outbreak and take priority preventive measures to minimize the disease burden.

Objectives: The rapid growth in population, urbanization, and industrialization reduces the natural green space environment and increases air pollution on the planet. The green space environment minimizes air pollutants, and swift climate changes and provides fresh and clean air. This study investigates the prevalence of diabetes mellitus in environmentally highly green and less green countries in Europe. Subjects and methods: Based on the Environmental Performance Index (EPI) score, which rates a country’s environment, 43 European countries with 760 million people were selected. The EPI score was recorded from the USA's Environmental Performance Index (EPI) website. 60% of the EPI score is based on seven categories related to ecosystem vitality: biodiversity and habitat, ecosystem, fisheries, climate change, pollution emissions, agriculture, and water resources. 40% of the score is based on four categories related to environmental health: air quality, sanitation and drinking water, heavy metals, and waste management system. The prevalence of diabetes mellitus in all 43 European countries was obtained from the International Diabetes Federation (IDF). The European countries' populations were obtained from the World Bank. We divided the countries into three groups based on each country's EPI score. The 11 countries with an EPI score of more than 75 were classified as highly green space, 24 countries with an EPI score of 50–75 were classified as moderately green space, and 8 countries with an EPI score of less than 50 were classified as less green space environment countries in Europe. Results: The mean prevalence of diabetes mellitus for highly green space environment countries was 7.49 ± 1.53%; moderately green space countries were 8.98 ± 2.38%, and for less green space environment countries was 9.79 ± 3.05%. In countries with less green space (i.e., environment, EPI scores less than 50), the prevalence of DM was significantly higher than in green space countries with EPI scores of more than 75 (p = 0.041). The results revealed a negative correlation between the green space environment (EPI Score) and the prevalence of diabetes mellitus. Conclusions: The prevalence of diabetes mellitus is significantly reduced in environmentally high green space countries than in low green space countries in Europe. This means that countries with environmentally sustainable environment policies have less diabetes. It is suggested to establish strategies to keep the living environment green and clean to minimize air pollution and fight against diabetes mellitus.

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

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

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

Objectives: Sandstorms are natural climate calamities causing severe weather changes and health problems. The sandstorm allied issues are of significant apprehension worldwide, mainly in the present pandemic. This study aims to examine the “sandstorm impact on environmental pollution particulate matter (PM2.5), carbon monoxide (CO), ozone (O3), and daily new cases and deaths due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)” in Kuwait. Methods: The two incidences of sandstorms occurred in Kuwait, dated 13 March 2021 and 13 June 2021. The data on “PM2.5, CO, NO2, and O3, and SARS-CoV-2 cases and deaths” were documented three weeks before and after both incidences of the sandstorm. For the first incidence, the data was recorded from 18 February to 12 March 2021; and from 13 March to 2 April 2021. However, for the second incidence of sandstorms, data were documented from 23 May to 12 June 2021; and from 13 June to 3 July 2021. The daily “PM2.5, CO, NO2, and O3 levels” were recorded from “Air Quality Index-AQI, metrological web, and data on COVID-19 daily cases and deaths were recorded from the World Health Organization”. Results: After the first and second sandstorm incidence, the air contaminants PM2.5 was increased by 26.62%, CO 22.08%, and O3 increased 18.10% compared to before the sandstorm. SARS-CoV-2 cases were markedly amplified by (21.25%), and deaths were increased by (61.32%) after the sandstorm. Conclusions: Sandstorm events increase air pollutants PM2.5, CO, and O3 levels, and these pollutants increase the SARS-COV-2 daily cases and deaths in Kuwait. The findings have a meaningful memorandum to healthcare representatives to advise the public about the health hazards of the sandstorm and its linkage with SARS-CoV-2 cases and deaths.

Background and ObjectivesOff-campus online learning methods abruptly increased and gained popularity during the COVID-19 pandemic. Previous studies have highlighted the limitations of online learning mode; however, further studies on the experiences of medical students are needed. This study aimed to investigate the preclinical medical students and faculty members' experiences with online education and learning.Subjects and MethodsIn this cross-sectional study, data were collected using convenience sampling. Two hundred nine students and 13 faculty members who participated in the online courses offered during the spring semester of 2019–2020 completed an online questionnaire. A 30-item questionnaire for the students and a 25-item questionnaire for the faculty were used in this cross-sectional study.ResultsOverall, 30% of the student sample was satisfied; importantly, high-achieving students (GPA > 3.5) were less satisfied (25 vs. 32%; p = 0.006). Satisfaction was also low (35%) for student-faculty interaction opportunities. About half of the student sample agreed that small-group interactive sessions would improve learning (53%). The most favored course format was the blended mode (43%), followed by traditional (40%) and online modes (17%). Six out of 13 (46%) faculty members were satisfied with their online experiences. Most of them found virtual teaching applications convenient (77%). Conversely, few faculty members agreed to interact effectively (54%), while 69% favored a blended format.ConclusionsThe level of satisfaction in fully online courses offered during the COVID-19 pandemic remained low, especially among high-achieving students. Both students and faculty favored the blended format for future purposes. Small group active-learning strategies and web-based interactive tools may facilitate engagement and student-faculty interactions.

Objective: Date palm is a significant crop mainly of hot regions and used as a traditional remedy for various ailments. Ajwa is a well-known functional food with an abundance of phytochemicals that possess different beneficial and medicinal properties. The study's objective was to calculate the impact of Ajwa consumption in a daily routine on lipid profile and HDL in the general population. Methods: Randomized clinical trial was conducted for six weeks on participants, including both genders, with HDL levels below 40 mg/dl. The intervention group was advised to take Ajwa (70 gm) on an empty stomach in the morning for five days a week for six consecutive weeks with their routine diet and physical activity. The control group was advised not to make any changes in their diet and everyday life. Body weight, BMI, blood glucose, and lipid levels were recorded before and after the trial to evaluate the effect of Ajwa on these markers. Result: The Ajwa intervention group showed a significant effect for total cholesterol, triglycerides, LDL, and HDL (p = 0.001), representing that the Ajwa group showed more alterations than the control group. However, no significant interaction effect was identified for body weight, BMI, and blood glucose level for both Ajwa and the control group. Conclusion: The study findings recommend that intake of Ajwa is well tolerated, and its inclusion in diet and routine life provides cardioprotection by improving the lipid profile and raising the sub-optimal HDL levels.

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

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

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

Abstract Background This study aimed to assess the impact of 15 days before, 15 days during, and 15 days after the lockdown on the trends in the prevalence and mortality in 27 countries during COVID-19 pandemic. Methods Twenty-seven countries were randomly selected from the different continents. The information on the trends in the prevalence and mortality due to COVID-19 pandemic in 27 countries was obtained from World Health Organization and lockdown data were obtained from concerned countries and their ministries. The impact of lockdown for 15 days before, 15 days during, and 15 days after the lockdown on the prevalence and mortality due to the COVID-19 pandemic in 27 countries was analyzed. Results The findings showed that 15 days after the lockdown there was a trend toward a decline, but no significant decline in the mean prevalence and mean mortality rate due to the COVID-19 pandemic compared to 15 days before, and 15 days during the lockdown in 27 countries. The mean growth factor for number of cases was 1.18 and for mortality rate was 1.16. Conclusions The findings indicate that 15 days after the lockdown, daily cases of COVID-19 and the growth factor of the disease showed a declined trend, but there was no significant decline in the prevalence and mortality.

Objectives: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, also known as COVID-19 pandemic has caused an alarming situation worldwide. Since the first detection, in December 2019, there have been no effective drug therapy options for treating the SARS-CoV-2 pandemic. However, healthcare professionals are using chloroquine, hydroxychloroquine, remdesivir, convalescent plasma and some other options of treatments. This study aims to compare the biological, molecular, pharmacological, and clinical characteristics of these three treatment modalities for SARS-COV-2 infections, Chloroquine and Hydroxychloroquine, Convalescent Plasma, and Remdesivir. Methods: A search was conducted in the “Institute of Science Information (ISI)-Web of Science, PubMed, EMBASE, ClinicalTrials.gov, Cochrane Library databases, Scopus, and Google Scholar” for peer reviewed, published studies and clinical trials through July 30, 2020. The search was based on keywords “COVID-19” SARS-COV-2, chloroquine, hydroxychloroquine, convalescent plasma, remdesivir and treatment modalities. Results: As of July 30, 2020, a total of 36,640 relevant documents were published. From them 672 peer reviewed, published articles, and clinical trials were screened. We selected 17 relevant published original articles and clinical trials: 05 for chloroquine and/or hydroxychloroquine with total sample size (n = 220), 05 for Remdesivir (n = 1,781), and 07 for Convalescent Plasma therapy (n = 398), with a combined total sample size (n = 2,399). Based on the available data, convalescent plasma therapy showed clinical advantages in SARS-COV-2 patients. Conclusions: All three treatment modalities have both favorable and unfavorable characteristics, but none showed clear evidence of benefit for early outpatient disease or prophylaxis. Based on the current available data, convalescent plasma therapy appears to show clinical advantages for inpatient use. In the future, ongoing large sample size randomized controlled clinical trials may further clarify the comparative efficacy and safety of these three treatment classes, to conclusively determine whom to treat with which drug and when to treat them.

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The novel coronavirus (Covid-19) infection outbreak has posed a major threat to the international health system and economy. This study is aimed at investigating the biological and epidemiological trends in the prevalence and mortality due to outbreaks of novel coronavirus (COVID-19) infections. The data on the global outbreak of COVID-19, were obtained from World Health Organization (WHO), Worldometer, Centers for Disease Control and Prevention (CDC), and research institutes. The information was also recorded from research documents published in global scientific journals indexed in Pub Med and Institute of Scientific Information (ISI) Web of Science on the trends in the prevalence and mortality due to COVID-19 infection outbreaks. The results show rising trends in the transmission, prevalence and mortality rate due to coronavirus COVID-19. During the period of December 29, 2019 through March 31, 2020, it has infected 750,890 people worldwide, resulting in 36,405 deaths with a mortality rate of 4.84%. The infections were more frequent among male gender over 60 years of age. The mean growth rate index for total number of cases from January 23 to March 31, 2020 was 1.20 and growth rate index for mortality rate was 1.12. There was a positive association between the prevalence and mortality rate (R2 = 0.996). The novel coronavirus COVID-19 is highly contagious and has affected a large number of people worldwide. It is still spreading with mutable prevalence and mortality outbreak trends. The global health officials have taken priority measures to prevent further outbreaks of this emerging pathogen across the globe. However, the rising number of cases and mortality risk estimates are demonstrating that enhanced public health mediations, good hygienic conditions, social distancing, and movement limitations may control the COVID-19 epidemics.

Background. The growing amount of monkeypox cases in non-endemic regions raises concerns in societies as a potential pandemic. This study highlights the prevalence and epidemiological trends of a human monkeypox outbreak in various regions in Europe. Methods. This cross-sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. The data about the monkeypox outbreak in European countries were recorded by the World Health Organization (WHO), and Centers for Disease Control and Prevention (CDC) reports. The period prevalence-based data were recorded from Jan 1, 2022, to July 7, 2022, and analyzed, and epidemiological trends were established in different European regions and countries. Results. In Europe, the human monkeypox rapidly spread in all the four subregions and involved 30 European countries, infecting 6077 people. The rising number of monkeypox cases is identified in Western Europe, 2599 (42.76%); Southern Europe, 1932 (31.79%); Northern Europe, 1487 (24.46%); and Eastern Europe, 59 (0.97%). In Western Europe, significant cases are found in Germany (1304), France (604), the Netherlands (352), Belgium (168), and Switzerland (131). In Northern Europe, it is found in the United Kingdom (1351), Ireland (44), Sweden (28), and Denmark (26); in Southern Europe, it is found in Spain (1256), Portugal (415), and Italy (233). However, a smaller number of cases are found in Eastern European states, Hungary (22), Poland (13), and Romania (12). The results further revealed that the number of monkeypox cases per million people in Northern Europe was 14.40%; Southern Europe, 13.49%; Western Europe, 13.26%; and Eastern Europe, 0.70%. The highest monkeypox cases per million population are found in Portugal, 40.70; Gibraltar, 29.68; Spain, 26.86; the United Kingdom, 19.90; Malta, 18.12; the Netherlands, 20.54; Germany, 15.56; Switzerland, 15.14; Belgium, 14.50; France, 9.27; and Ireland, 8.90. Conclusions. In a short period, the monkeypox cases swiftly spread in 30 non-endemic European countries and involved all four European regions. The healthcare authorities must take timely decisions to control the outbreak of human monkeypox disease, as the world cannot afford the global burden of human monkeypox outbreak as another potential pandemic.

Objectives: The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has developed a challenging situation worldwide. In India, the SARS-CoV-2 cases and deaths have markedly increased. This study aims to evaluate the impact of environmental pollutants “particulate matter (PM 2.5 μm), carbon monoxide (CO), Ozone (O3), and Nitrogen Dioxide (NO2) on daily cases and deaths due to SARS-CoV-2 infection” in Delhi, Mumbai, and Kolkata, India. Methods: The day-to-day air pollutants PM2.5, CO, O3, and NO2 were recorded from the metrological web “Real-time Air Quality Index (AQI).” SARS-COV-2 everyday cases and deaths were obtained from the “Coronavirus outbreak in India Web”. The PM 2.5, CO, O3, NO2, and daily cases, deaths were documented for more than one year, from March 2, 2020, to March 15, 2021. Results: Environmental pollutants CO, O3, and NO2, were positively related to SARS-COV-2 cases and deaths. The findings further described that for each one-unit increase in CO, O3, and NO2 levels, the number of cases was significantly augmented by 0.77%, 0.45%, and 4.33%. Conclusions: Environmental pollution is a risk factor to SARS-CoV-2 daily cases and deaths. The regional and international authorities must implement the policies to reduce air pollution and the COVID-19 pandemic. The findings can inform health policymakers' verdicts about battling the COVID-19 pandemic in India and globally by minimizing environmental pollution.

Face masks (FM) play a role in limiting the spread of viral infections; despite this, their role is influenced by the population's adherence to wearing the FM. However, the impact on the effectiveness of the FM is variable in various communities. This study aimed to investigate the knowledge, attitude, and practices toward FM use during COVID-19 in Saudi Arabia. This observational “cross-sectional questionnaire-based study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia.” The data was collected using an online questionnaire survey from September 8–21, 2021, during the COVID-19 pandemic. The questionnaire was distributed via social media platforms to assess knowledge, attitude, and practices using single choice questions and a five-point Likert scale. Among 1,356, respondents' the rate was 678 (50%), 207 (30.5%) were males and 471 (69.5%) females. Among the participants, Saudi citizens were (649; 95.7%), with University education (502; 74%) and were mostly (368; 54.3%) between 16 and 24 years of age. The participants (384; 56.6%, p < 0.001) had good knowledge about face masks, and more than half of the respondents, 531 (78.3%) (p < 0.001), showed a positive attitude. Most of the respondents (477, 70.2%) believed that everyone could use the face mask to minimize the spread of the disease; however (111; 16.4%) reported that they would not wear a face mask if the government did not recommend wearing it in public places during the COVID-19 pandemic. Saudi citizens have above-average knowledge and optimistic attitudes toward using face masks during the COVID-19 pandemic. The community is convinced about the face masks and believes that face masks play a predominant role in limiting the spread of SARS-CoV-2.

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

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

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

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

The human monkeypox disease is caused by the monkeypox virus (MPXV), which is a zoonotic disease. In the year 2022, the prevalence of monkeypox cases swiftly increased worldwide and the disease has now been declared a global public health emergency. The present study aimed to assess the public’s perceptions and knowledge of and attitudes toward monkeypox in Riyadh, Saudi Arabia. This questionnaire-based cross-sectional study was conducted from 15 May to 15 July 2022. The participants’ perceptions, knowledge, and attitudes were collected via a 28-item-based questionnaire survey. The survey was based on 1020 participants (554 (54.3%) were females, and 466 (45.7%) were males). The results reveal that out of 1020 participants, 799 (78.3%) respondents believed that monkeypox disease has developed into a pandemic situation, and 798 (78.2%) suggested that the disease is most common in Western and Central Africa. Further analysis shows that 692 (67.8%) respondents agreed that monkeypox cases are increasing worldwide, 798 (21.8%) believed that monkeypox is commonly transmitted through direct contact, and 545 (53.4%) of respondents reported that it is easily transmitted from human to human. Moreover, 693 (67.9%) participants mentioned that monkeypox disease is spreading more widely as people travel from one country to another, while 807 (79.1%) participants were aware that smallpox and monkeypox have similar clinical features. Furthermore, the majority of participants (p = 0.033) agreed that health officials should start a vaccination campaign to combat monkeypox. Regarding preventive measures and vaccination campaigns, 641 (62.8%) participants suggested that health officials should take public preventive measures and 446 (43.7%) recommended that health officials start vaccination campaigns against monkeypox. The knowledge of human monkeypox among the general population in Riyadh, Saudi Arabia was satisfactory for all ages, genders, levels of education, and economic groups. Moreover, the majority of participants proposed adopting preventive measures and starting a vaccination campaign to combat monkeypox disease. The knowledge of monkeypox in the public domain is a key factor to improve the public‘s capacity to minimize the disease burden and fight against viral infectious diseases at regional and global levels.

Objective: This study aimed to investigate the bibliometric analysis, progress and prospects of the journal of King Saud University-Science (JKSU-Science) in global sciences. Material and methods: In this study, we recorded the number of research documents, number of citations, citations per document, impact factor and Hirsch index (h-Index) of JKSU-Science from January 2016 to December 2020. The main source of information was Clarivate Analytics Web of Science, Elsevier Science Direct and SCI-mago/Scopus. Results: The JKSU-Science contributed 910 articles, 3373 citations, 3.75 citations per document, with an impact factor of 3.819 and Hirsch (h-index) of 20. The journal provides an opportunity for the global science community to contribute their research work and promote research at global levels. Conclusions: The performance of JKSU-Science in global sciences has markedly increased during the period 2016–2020. The global contribution, research publications, impact factor, citations, and h-Index are continuously on a mounting path. The journal is playing a pivotal role in enhancing the research culture and country research ranking both at regional as well as international levels.

Objectives: Childhood obesity contributes to the risk of numerous health problems and has become a major global health concern. This study aimed to establish the association between obesity and cognitive function among healthy school adolescents. Methods: This study was carried out by taking school adolescents (n = 400) from June 2016 to December 2017. The mean age of the participants was 13.93 ± 0.81 years. The students were divided into group A (obese, n = 223) and B (non-obese, n = 177). Cognitive functions were recorded as per study tool of the Cambridge Neuropsychological Test Automated Battery (CANTAB). Results: Severely obese students showed a significant delay in cognitive functions as compared to students with normal BMI. Attention Switching Task (AST)-Latency among students with normal BMI was 647.88 ± 137.59 compared to the students with high BMI (685.08 ± 115.92, p = 0.05), AST-Incongruent was 680.78 ± 142.07 versus 726.76 ± 122.31 (p = 0.02), AST-Percent correct trials was 84.31 ± 10.45 versus 78.09 ± 14.87 (p = 0.001), and Intra-Extra Dimensional Set Shift (IED) Total errors among students with normal BMI was 33.93 ± 21.53 compared to the students with high BMI (42.86 ± 37.27, p = 0.03). Conclusion: Cognitive functions including AST-Latency, AST-Incongruent, AST-Percent correct trials, and IED Total errors were significantly weakened in markedly obese students. Significant impairments in their cognitive functions, especially attention, retention, intelligence, and cognitive flexibility, were observed. The findings of this study emphasize the need to involve school adolescents in physical activities to reduce body weight in order to have cognitive functions within normal range and also to minimize obesity-associated complications.

Objectives: COVID-19 pandemic raised several queries on the relationship between the environment pollution and occurrence of new cases and deaths. This study aims to explore the effect of environmental pollution, particulate matter (PM 2.5 μm), carbon monoxide (CO) and Ozone (O3) on daily cases and daily deaths due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in a largest metropolitan city London, United Kingdom. Methods: For this study, we selected London, one of the highly populated capitals, and markedly affected due to COVID-19 pandemic. The data on the SARS-CoV-2 daily new cases and deaths were recorded from UK-gov Web ''Coronavirus COVId-19 in the UK, 2020''. The daily environmental pollutants PM 2.5 μm, CO and O3 were recorded from the metrological web ''(London Air Pollution, Air Quality Index- AQI, 2020)''. The daily cases, deaths, PM 2.5 μm, CO and O3 were documented from the date of the occurrence of the first case of SARS-CoV-2 in London, February 24 to November 2, 2020. Results: The SARS-CoV-2 cases and deaths were positively related with environmental pollutants, PM2.5, O3 and CO levels. Additionally, with 1 µm increase in PM2.5 the number of cases and deaths significantly increased by 1.1% and 2.3% respectively. A 1 unit increase in CO level significantly increased the number of cases and deaths by 21.3% and 21.8% respectively. A similar trend was observed in O3, with 1-unit increase, the number of cases and deaths were significantly increased respectively by 0.8% and 4.4%. Conclusions: Environmental pollutants, PM2.5, CO and O3 have a positive association with an increased number of SARS-CoV-2 daily cases and daily deaths in London, UK. Environmental pollution management authorities must implement necessary policies and assist in planning to minimize the environmental pollution and COVID-19 pandemic.

Background: Sub-optimal HDL is a prognostic marker of cardiovascular disease. South Asia has a high prevalence of sub-optimal HDL compared to other parts of the world. Intermittent fasting (IF) is a type of energy restriction which may improve serum HDL and other lipids thereby reducing the risk of cardiovascular diseases.Objective: The aim of the study was to evaluate the effect of IF on lipid profile and HDL-cholesterol in a sample of South Asian adults.Methods: A 6-week quasi-experimental (non-randomized) clinical trial was conducted on participants with low HDL (< 40 mg/dl for men and < 50 mg/dl for women). Participants of the control group were recommended not to change their diet. The intervention group was recommended to fast for ~12 h during day time, three times per week for 6 weeks. Pulse rate, blood pressure, body weight, waist circumference, serum lipid profile, and blood glucose levels were measured at baseline and after 6 weeks.Result: A total of 40 participants were enrolled in the study (N = 20 in each group), while 35 (20 control and 15 intervention) completed the trial and were included in data analysis of the study. Body measurements, including body weight, BMI and waist circumference, showed significant interaction effects (p's < 0.001), indicating that there were larger reductions in the IF group than in the control group. Significant interaction effects were also observed for total (p = 0.033), HDL (p = 0.0001), and LDL cholesterol (p = 0.010) with larger improvements in the IF group.Conclusion: This study suggests that intermittent fasting may protect cardiovascular health by improving the lipid profile and raising the sub-optimal HDL. Intermittent fasting may be adopted as a lifestyle intervention for the prevention, management and treatment of cardiovascular disorders.Clinical Trial Registration: NCT03805776, registered on January 16, 2019, https://clinicaltrials.gov/ct2/show/NCT03805776

The vaccination campaign against COVID-19 is an essential public health strategy to reach herd immunity, eradicate diseases, and prevent a pandemic. This study aimed to investigate the acceptance rate of the COVID-19 vaccine among people in Riyadh, Saudi Arabia. This cross-sectional study was conducted in the Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia. Out of the 922 participants involved, 294 (31.9%) were male and 628 (68.1%) were female, with a mean age of 30–49 years. A bilingual, self-administered, computer-based questionnaire was designed and distributed through social media platforms. In total, 900 participants (97.6%) showed a high acceptance rate of the vaccine. The vaccine acceptance rate was higher among people aged 60 years and above than in other age groups (p = 0.008) and single individuals compared to other groups (p = 0.003). The results reveal a relatively high acceptance level of the COVID-19 vaccine among study participants. Importantly, regression analysis results show that female gender and elderly participants are more likely to accept the COVID-19 vaccine than their counterparts. Moreover, the main factor that influenced the participants’ perception of the COVID-19 vaccine was the proper timely scientific recommendations.

Objective Hajj is an important component of Islam. This study aimed to determine the effect of wearing a cotton towel or plain cotton ihram on the onset of respiratory symptoms and fractional exhaled nitric oxide (FeNO) levels in Hajj pilgrims. Methods One hundred male nonsmoking subjects (age: 20–60 years) without a previous clinical history of respiratory illnesses were included. Fifty subjects were dressed in a cotton towel ihram and 50 wore a plain cotton ihram (control group). Respiratory symptoms and FeNO levels were recorded on the day before leaving for Hajj, when ihrams were removed, and when the pilgrims had returned home. Results Pilgrims who wore cotton towel ihrams showed significantly higher rates of respiratory symptoms, including being generally ill, coughing, a sore throat, and a runny nose, than those who wore plain ihrams. FeNO levels also tended to be higher in pilgrims who wore a cotton towel ihram compared with those with a plain cotton ihram during and after Hajj. Conclusions Hajj pilgrims who wear cotton towel ihrams may have a risk of respiratory symptoms, including a cough, sore throat, and runny nose. Therefore, a plain cotton ihram is advisable while performing Hajj to minimize respiratory illness.

Vaccinating children against COVID-19 is an essential public health strategy in order to reach herd immunity and prevent illness among children and adults. Parents are facing tremendous stress in relation to the COVID-19 pandemic and the effectiveness of the COVID-19 vaccination program for children. In this study, we aimed to investigate parents’ perceptions and acceptance of the COVID-19 vaccine for their children in Saudi Arabia. A well-designed, pre-validated, Google questionnaire was distributed to parents through social media websites. The selection of the participants was based on the simple random sample technique. The study sample size was 1304 participants, with 342 males (26.2%), and 962 females (73.8%). The personal information, perception about COVID-19, and their children’s vaccination status were obtained. Among the participants, 602 (46.1%) were willing to get the COVID-19 vaccination for their children, whereas 382 (29.3%) were hesitant to inoculate their children for COVID-19 and 320 (24.4%) were unsure. Age (p = 0.004), gender (p = 0.001), occupation (0.004), income (p = 0.030), and vaccination status (p = 0.001) had an influence on the parents’ acceptance of COVID-19 vaccination of their children. On the other hand, education level, number of children, and having been previously infected with COVID-19 had no statistically significant effect on the parent acceptance. The correlation of parents’ knowledge about COVID-19 and their agreement to the vaccination of their children was statistically significant, along with gender (males were more knowledgeable, with p < 0.001), occupation, income (higher income showed a statistical difference, with p < 0.001), and vaccination status (p < 0.001). There was a decrease in parents’ acceptance toward the COVID-19 children vaccine in Saudi Arabia, which requires more attention and focus from health providers to eliminate fear and anxiety among the parents through additional educational programs and events to decrease the resistance toward the vaccination of children. More emphasis is required to increase the awareness of parents and convey the importance of the vaccine for children. In addition, more studies are needed to ensure the vaccine’s safety.

Scientific paper writing for science journals is highly adroit, competitive, and laborious process. Scientific writing has a constant design, which is confounding for apprentice science writers. The huge amount of impediments is associated with scientific writing which may be reduced by applying some practices and guidelines. The basic structure of scientific articles mainly comprises of the title, abstract, keywords, introduction, methods, results, discussion, conclusion, acknowledgments, and references. The pathophysiological aspects which minimize the chances of publication of an academic paper are rarely discussed in the literature. Early career of physicians and researchers is not well acquainted with the components of scientific paper. This study established an approach to understand the basic characteristics of pathophysiology of scientific writing.

Methods section is the easiest part of the scientific paper and you can start writing it down even when the research is unfinished. It has to be written in the past tense because you have already written the proposal and either you have started or have conducted the study. The basic elements of the methods section are study design, setting and subjects, data collection, data analysis, and ethical approval.

Objective: FTY720, an immunomodulator derived from sphingosine-1-phosphate, has recently demonstrated its immunomodulatory, anti-inflammatory, anti-oxidant, anti-apoptotic and anti-inflammatory properties. Furthermore, FTY720 might be a key pharmacological target for preconditioning. In this preclinical model, we have investigated the effects of FTY720 on myocardium during reperfusion in an experimental model of cardioplegic arrest (CPA) and cardiopulmonary bypass.Methods: 30 Sprague–Dawley rats (300–350 g) were randomized into two groups: Group-A, treated with FTY720 1 mg/kg via intravenous cannulation, and Group-B, as control. After 15 min of treatment, rats underwent CPA for 30 min followed by initiation of extracorporeal life support for 2 h. Support weaning was done, and blood and myocardial tissues were collected for analysis. Hemodynamic parameters, inflammatory mediators, nitro-oxidative stress, neutrophil infiltration, immunoblotting analysis, and immunohistochemical staining were analyzed and compared between groups.Results: FTY720 treatment activated the Akt/Erk1/2 signaling pathways, reduced the level of inflammatory mediators, activated antiapoptotic proteins, and inhibited proapoptotic proteins, leading to reduced nitro-oxidative stress and cardiomyocyte apoptosis. Moreover, significant preservation of high-energy phosphates were observed in the FTY720-treated group. This resulted in improved recovery of left ventricular systolic and diastolic functions.Conclusion: The cardioprotective mechanism in CPA is associated with activation of prosurvival cell signaling pathways that prevents myocardial damage. FTY720 preserves high-energy phosphates attenuates myocardial inflammation and oxidative stress, and improves cardiac function.

The rising prevalence of diabetes mellitus (DM) is a serious global health concern. The world is experiencing type 2 diabetes epidemics and prevalence differs by gender, regions, and level of socioeconomic development. Type 2 diabetes mellitus (T2DM) in men increased at a faster rate and numbers are continuing to rise in some regions of the world. This study aimed to estimate the prevalence of T2DM among men in the Middle East countries. Seventy-four research articles were identified through search engines including Web of Science, Medline, PubMed, EMBASE, Scopus, and Ovid databases by using keywords “epidemiology,” “prevalence,” “diabetes mellitus,” and individual names of the Middle East states. Finally, 17 studies were included for the assessment of prevalence of T2DM among men in the Middle East. In the Middle East, high prevalence of T2DM among men was identified in Bahrain (33.60%), Saudi Arabia (29.10%), United Arab Emirates (UAE; 25.83%), and Kuwait (25.40%), whereas low prevalence was reported in Iran (9.90%) and Yemen (9.80%). The random pooled prevalence in the Gulf Cooperation Council (GCC) states was (24.0%) compared to non-GCC states (16.0%), and in both GCC and non-GCC countries combined, it was 19%. The prevalence was significantly associated with the gross domestic product of these states ( p = .0005). Despite different socioeconomic and cultural settings in the Middle East, the rising T2DM prevalence among men was identified in Bahrain, Saudi Arabia, UAE, and Kuwait. These states must incorporate future diabetes defensive strategies targeting the Middle East population to minimize the burden of DM from the region.

Electronic cigarettes (e-cigarettes) are rapidly becoming an alternative form of nicotine consumption worldwide and a disruptive element in the global health diplomacy. This study aimed to investigate the impact of e-cigarettes on lung function and fractional exhaled nitric oxide (FeNO) among young healthy male adults. Sixty apparently healthy male volunteers were recruited and divided into two groups. Group 1 (e-cigarette-exposed group) consisted of 30 males who were daily e-cigarette users (age 27.07 ± 6.00 [mean ± SD ] years). Group 2 (control group) consisted of 30 males who were not e-cigarette users (age 25.90 ± 7.72 [mean ± SD ] years). Both groups were neither current nor former traditional tobacco users. Age, ethnicity, height, weight, and socioeconomic status were considered using a matched design to investigate the impact of e-cigarette use on lung function and FeNO. The lung function test parameters that were found to be significantly decreased in e-cigarette users compared to their control group were forced expiratory volume in the first second (FEV 1 ), forced expiratory ratio (FEV 1 /FVC), forced expiratory flow—25% (FEF 25% ), forced expiratory flow—50% (FEF 50% ), forced expiratory flow—75% (FEF 75% ), forced expiratory flow—25%–75% (FEF 25%–75% ), and forced expiratory flow—75%–85% (FEF 75%–85% ). FeNO was also decreased in e-cigarette users, but it did not reach the level of significance. The use of e-cigarettes significantly impaired various lung function parameters and the pattern of impairment exhibited a peripheral obstructive airway involvement. These findings have a general message for the global health community on the potential harm of e-cigarettes on lung function.

The use of mobile phones has remarkably increased and become a basic need of daily life. Increasing subscriptions of mobile phones boost the installation of mobile phone base station towers (MPBSTs) in crowded commercial and residential areas including near school buildings. This study investigated the impact of exposure to radiofrequency electromagnetic field (RF-EMF) radiation generated by MPBSTs on cognitive functions. Two hundred and seventeen volunteer male students aged between 13 and 16 registered from two different intermediate schools: 124 students were from School 1 and 93 students were from School 2. The MPBSTs were located within 200 m from the school buildings. In School 1, RF-EMF was 2.010 µW/cm 2 with a frequency of 925 MHz and in School 2, RF-EMF was 10.021 µW/cm 2 with a frequency of 925 MHz. Students were exposed to EMFR for 6 hr a day, 5 days a week for a total period of 2 years. The Narda Safety Test Solution device SRM-3006 was used to measure RF-EMF in both schools, and cognitive functions tasks were measured by the Cambridge Neuropsychological Test Automated Battery (CANTAB). Significant impairment in Motor Screening Task (MOT; p = .03) and Spatial Working Memory (SWM) task ( p = .04) was identified among the group of students who were exposed to high RF-EMF produced by MPBSTs. High exposure to RF-EMF produced by MPBSTs was associated with delayed fine and gross motor skills, spatial working memory, and attention in school adolescents compared to students who were exposed to low RF-EMF.

Abstract Background Medical professionalism is an essential aspect of medical education and practice worldwide and it must be adopted according to different social and cultural contexts. We examined the current congruence and variance in the perception of professionalism in undergraduate medical students and faculty members in one medical school in Saudi Arabia. Methods The target population was first year to final year medical students of College of Medicine, King Saud University. Out of a total of 1431 students at College of Medicine 750 students (52 %) participated in the study. Fifty faculty members from clinical and non-clinical departments of the College of Medicine were randomly selected for this study and all participated in the study. The respondents recorded their responses through the Bristol online survey system, using a bilingual (English and Arabic) version of the Dundee Polyprofessionalism Inventory I: Academic integrity, which has 34 items. Results There are 17 lapses (50 % of the total) in professional behaviour where none of the faculty recommend the ignore sanction while students recommended a variable ignore sanction in a range of 6–29 % for different behaviours. Students and faculty recommended similar sanctions for 5 lapses (14.7 % of the total) in professional behaviours. Furthermore, there is statistically significant two level difference between the sanctions approved by faculty and students in the recommended sanctions for 12 lapses (35 % of the total (p