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Hypertension is one of the most common and complicated disorders associated with genetic and environmental risk factors. The angiotensin-converting enzyme (ACE) is important in the renin-angiotensin-system pathway. The gene expression of ACE has been investigated as a possible hypertension marker. This study investigates the association between polymorphisms within the ACE1 and ACE2 genes and hypertension susceptibility in a Jordanian population. The study comprised a total of 200 hypertensive patients and 180 healthy controls. A polymerase chain reaction (PCR) was performed to genotype the candidate polymorphism (rs4646994) of the ACE1gene. The Luminex DNA array technique was used for genotyping SNPs (rs4359, rs4344, rs4341, rs4343, and rs2106809) of the ACE1 and ACE2 genes. Our findings suggest no association between SNPs and hypertension regarding allelic and genotypic frequencies. However, rs4359 was significantly associated with diet (pP = 0.049), know HTN (P = 0.042), and number of years DM (P = 0.003). rs4341 was associated with diet (P = 0.032), peripheral vascular disease (P = 0.005), and chronic kidney disease (p = 0.049). While rs4343 was associated with diet (P = 0.031), diabetes mellitus (P = 0.032), and other medication (P = 0.025). Furthermore, the haplotypes of four SNPs of the ACE1 gene showed no significant association with HTN patients and healthy controls. Our findings indicate no association between the polymorphisms in the ACE gene and the risk of hypertension development in the Jordanian adult population.

Idiopathic palmoplantar hidradenitis (IPPH) is a disorder that mainly affects the palms and soles of children. Although many cases have been reported to occur after recreational swimming activities, whether IPPH is caused by intense physical activity or by Pseudomonas infection has yet to be proven. We report a case of a 3-year-old girl who presented with IPPH after swimming in a pool with evidence of P. aeruginosa contamination, further solidifying the association between Pseudomonas and IPPH.

Hypertension is one of the most common and complicated disorders associated with genetic and environmental risk factors. The angiotensin-converting enzyme (ACE) is important in the renin-angiotensin-system pathway. The gene expression of ACE has been investigated as a possible hypertension marker. This study investigates the association between polymorphisms within the ACE1 and ACE2 genes and hypertension susceptibility in a Jordanian population. The study comprised a total of 200 hypertensive patients and 180 healthy controls. A polymerase chain reaction (PCR) was performed to genotype the candidate polymorphism (rs4646994) of the ACE1gene. The Luminex DNA array technique was used for genotyping SNPs (rs4359, rs4344, rs4341, rs4343, and rs2106809) of the ACE1 and ACE2 genes. Our findings suggest no association between SNPs and hypertension regarding allelic and genotypic frequencies. However, rs4359 was significantly associated with diet (pP = 0.049), know HTN (P = 0.042), and number of years DM (P = 0.003). rs4341 was associated with diet (P = 0.032), peripheral vascular disease (P = 0.005), and chronic kidney disease (p = 0.049). While rs4343 was associated with diet (P = 0.031), diabetes mellitus (P = 0.032), and other medication (P = 0.025). Furthermore, the haplotypes of four SNPs of the ACE1 gene showed no significant association with HTN patients and healthy controls. Our findings indicate no association between the polymorphisms in the ACE gene and the risk of hypertension development in the Jordanian adult population. [ABSTRACT FROM AUTHOR]

Background: Obstructive Sleep Apnea (OSA) is a common respiratory disorder that causes intermittent upper airway collapse during sleep and can lead to various acute cardiovascular complications. Atrial Fibrillation (AF) is the most common sustained cardiac arrhythmia and is associated with an increased risk of cardiovascular hospitalization and all-cause mortality. Our study aimed to investigate the prevalence of individuals with AF and those considered at high risk for OSA. Methods: A cross-sectional study was conducted with a population comprising patients who had visited KAUH cardiology clinics between 2017– 2019; subjects were categorized into AF patients and general cardiology patients. Patients were surveyed for OSA using the Berlin Questionnaire to assess the degree of OSA symptoms and to classify patients into high- or low-risk groups based on their responses. Results: Of the 656 patients, 545 met our inclusion criteria, of whom 192 were diagnosed with AF. Comparable demographic characteristics were observed between the AF and non-AF groups, barring higher rates of obesity (p=0.001) and smoking (p=0.042) in the AF group. The prevalence of high-risk OSA was significantly higher in AF patients (68.2%) compared to non-AF patients (29.4%), with an adjusted odds ratio of 2.473 times (95% CI: 1.434 − 4.266, p=0.001) greater for AF. The age, gender, and BMI categories did not differ significantly between the two groups. Binary logistic regression revealed significant associations between OSA and risk factors such as asthma (OR=4.408, 95% CI: 2.634– 7.376, p=0.001). Conclusion: These results serve to display a statistically significant increase in high-risk OSA in existing AF patients, irrespective of the presence of conventional OSA risk factors; this could imply a more immediate and direct relationship between both diseases and calls to include routine screening for OSA in patients diagnosed, newly or otherwise, with AF. [ABSTRACT FROM AUTHOR]

Background: The unprecedented global spread of coronavirus disease 2019 (COVID-19) has imposed huge challenges on the healthcare facilities, and impacted every aspect of life. This has led to the development of several vaccines against COVID-19 within one year. This study aimed to assess the attitudes and the side effects among Arab communities after receiving a COVID-19 vaccine and use of machine learning (ML) tools to predict post-vaccination side effects based on predisposing factors. Methods: An online-based multinational survey was carried out via social media platforms from 14 June to 31 August 2021, targeting individuals who received at least one dose of a COVID-19 vaccine from 22 Arab countries. Descriptive statistics, correlation, and chi-square tests were used to analyze the data. Moreover, extensive ML tools were utilized to predict 30 post vaccination adverse effects and their severity based on 15 predisposing factors. The importance of distinct predisposing factors in predicting particular side effects was determined using global feature importance employing gradient boost as AutoML. Results: A total of 10,064 participants from 19 Arab countries were included in this study. Around 56% were female and 59% were aged from 20 to 39 years old. A high rate of vaccine hesitancy (51%) was reported among participants. Almost 88% of the participants were vaccinated with one of three COVID-19 vaccines, including Pfizer-BioNTech (52.8%), AstraZeneca (20.7%), and Sinopharm (14.2%). About 72% of participants experienced post-vaccination side effects. This study reports statistically significant associations (p < 0.01) between various predisposing factors and post-vaccinations side effects. In terms of predicting post-vaccination side effects, gradient boost, random forest, and XGBoost outperformed other ML methods. The most important predisposing factors for predicting certain side effects (i.e., tiredness, fever, headache, injection site pain and swelling, myalgia, and sleepiness and laziness) were revealed to be the number of doses, gender, type of vaccine, age, and hesitancy to receive a COVID-19 vaccine. Conclusions: The reported side effects following COVID-19 vaccination among Arab populations are usually non-life-threatening; flu-like symptoms and injection site pain. Certain predisposing factors have greater weight and importance as input data in predicting post-vaccination side effects. Based on the most significant input data, ML can also be used to predict these side effects; people with certain predicted side effects may require additional medical attention, or possibly hospitalization.

Purpose: In low- and middle-income countries like Nigeria, women present with advanced breast cancer at an earlier age. Given the limited resources, development of screening programs that parallel resource capabilities of low- and middle-income countries is imperative. The objective of this study was to evaluate the perceptions, practices, and barriers regarding clinical breast examination (CBE) screening in a low-income community in Nigeria. Materials and Methods: A cross-sectional survey of women age 40 years or older in Ife, Nigeria, using multistaged sampling was performed. Information on sociodemographics, knowledge of breast cancer, screening practices, and willingness to participate in CBE screening was obtained using an interviewer-administered questionnaire. Results: A total of 1,169 women whose ages ranged from 40 to 86 years (mean age, 47.7 years; standard deviation, 8.79 years) were interviewed. The majority of women (94%) knew about breast cancer, whereas 27.5% knew someone who had had breast cancer, the majority of whom (64.5%) had died of the disease. Of the 36% of women who had breast screening recommended to them, only 19.7% had an actual CBE. Of these, only 6% had it in the last year. The majority of women (65.4%) were willing to have regular CBEs and did not care about the sex of the examiner in most instances. Lack of perceived need was the reason cited by women unwilling to participate. Conclusion: The majority of women were aware of breast cancer and knew it as a fatal disease. With the relatively encouraging number of those willing to be examined, a carefully designed CBE program coupled with advocacy to correct uneducated beliefs seems promising.

Aim: To confirm the hypothesis of the presence of a possible endometriosis inducing factor(s) (EIF) in the blood of women with endometriosis. Patients and Methods: Forty infertile women were studied. The study group compromised of fifteen women of each three different degrees of endometriosis and fifteen women without endometriosis as a control group. Stem cells are characterized by being spindle shaped and proliferate in appropriate culture indefinitely. The women sera were co-cultured with mesenchymal stem cells (MSCs) which were followed up weekly to look for morphological changes and to detect Annexin 1 marker and ß-actin gene by reverse transcriptase polymerase chain reaction. Results: MSCs cultured with sera of cases with, mild, moderate and severe endometriosis, showed morphological changes to be columnar and cuboidal shaped cells -resembling endometrial cells and glands- by the 4th week in 60%, 60% & 100% respectively. These cells were detected from as early as the first week in women with moderate and severe types (20% for each group). The percentage of the change into endometrial like cells increased among the three groups where it was 30±25.8%, 45±29.9% and 75±37.9% respectively. Moreover, increasing number of endometrial like cells are detected weekly, the more severe the disease is. None of the cultures of serum of the control group had made such changes all over the study. Furthermore, with more differentiation there was a considerable decrease in number of stem cells. These differentiated cells expressed the Annexin-1 marker. Conclusion: It was evident that serum of women with endometriosis posses a factor(s) that enables the MSCs to be transformed into endometrial like cells and glands in vitro. This finding supports a new theory for the etiology of endometriosis. This observation may have a tremendous effect on the therapeutic implications of this debilitating condition.Introduction: Endometriosis is a common condition that results from the presence of endometrial glands and stroma outside the uterus. The exact incidence of endometriosis is uncertain because the disease process exists in several stages, from microscopic lesions to macroscopic disease, some of which are not apparent during evaluation. Although, the current prevalence of endometriosis is estimated to be up to 10%1, endometriosis is found in 40–60% of women with pelvic pain2 and in 20–30% of women suffering from infertility3. Moreover, women with more advanced disease have a higher rate of infertility4. Endometriosis can be found in different sites, however, it has been estimated that endometriosis is predominately found in ovaries (44%), Pouch of Douglas (38%) and vesico-uterine space (34%), uterosacral ligaments and surrounding pelvic peritoneum (22%)5. Additional sites include laparotomy 6, and episiotomy scars7, Appendix8, cervix9, pleura10, abdominal wall11-12, lungs13, nose14and rarely the brain15. The consequences of endometriosis include pelvic pain, dysparunia, pelvic adhesions and infertility16.Endometriosis is a disease of theories, where the metaplasia theory suggests that under diverse influences, coelomic tissue could be transformed into endometrium17. Unfortunately, no direct evidence showing the formation of endometrial stroma has been reported at the end of the metaplastic process. Moreover, according to this theory, ectopic endometrium develops in situ from local tissues, including germinal epithelium of the ovary and remnants of the Müllerian and Wolffian ducts. In a broader context, this theory also implies that peritoneal endometriosis results from in situ metaplasia of totipotent mesothelial serosal cells18. The fact that endometriosis mostly occurs when endometrium is present, and that males are spared from this disease, weakens the power of the concept of metaplasia to explain endometriosis. Another theory proposes that the physiological phenomenon of endometrial reflux in the fallopian tubes during menstruation may, in certain conditions, overcome local defense mechanisms, implant, and proliferate19. However, the occurrence of endometriosis in sites very remote from pelvic organs directed the research towards other theories such as genetic background20, embryonic rest theory21 and stem cell dysfunction22.Stem cells are primitive cells which are known for their capacity to self renew as well as to differentiate into one or more mature cell types23. A growing body of evidence has implicated stem cells as possible endometrial progenitors. In one study, bone marrow-derived stem cells have been identified in the endometrium of women who were bone marrow transplant recipients; these cells appear histologically indistinguishable from endogenous endometrial cells and express markers of glandular and stromal differentiation24. The examination of a sexually dimorphic organ such as the uterus demonstrates the ability of male bone marrow, which cannot harbor circulating endometrial cells, to generate endometrium de novo and proves their mesenchymal stem cell origin. In addition, finding Y chromosome bearing endometrial cells demonstrates the potential to recapitulate embryonic developmental pathways that were never activated in males22.The aim of this study was to confirm the hypothesis of the presence of a possible endometriosis inducing factor(s) (EIF) in the blood of women with endometriosis that transforms allogenic stem cells into endometrial like cells.Study Design: This was prospective case control experimental study that acquired the approval of Bioethical Committee of the National Research Center under number 09-079. Setting: The study was carried out in collaboration between the Obstetrics and Gynecology Department, Cairo University; Unit of Biochemistry and Molecular Biology, Medical Biochemistry Department, Cairo University; Reproductive Health Research Department, National Research Centre; and Biomedical Technology Department, National Research Center. Patients and Methods: The study included thirty infertile women undergoing diagnostic laparoscopy for infertility work out. Fifteen cases served as a control group where the diagnostic laparoscopy showed no endometriotic implants. The other fifteen cases had endometriosis of variable degrees based on the modified American Fertility Society (mAFS) classification25. The study group was subdivided into 3 sub-groups of 5 women each, with mild, moderate and severe endometriosis. No women had history of immunological diseases or received any type of hormonal therapy in last six months before the diagnostic laparoscopy procedure. Venous blood samples were obtained and left to clot at 37°C, centrifuged and serum was separated and kept in sterile tubes at -20°C till later use.Stem cell preparation: Human umbilical cord blood (UCB) was collected from mothers delivering at full term. Informed consent was obtained from all mothers in accordance with the Ethical Committee of National Research Centre guidelines, Research Ethical Committee of Kasr El-Aini teaching hospital and Islamic conference guidelines on stem cell research. In each sample, UCB was harvested in sterile tubes containing 100 mM EDTA as anticoagulant at 22°C and the low-density mononuclear cells were isolated using Ficoll-Plaque Plus (Amersham Biosciences, Sweden). Then, the cells were co-cultured in growth medium (Dulbecco’s Modified Eagle medium-low glucose) with the addition of 10% fetal bovine serum with 2 mmol/l L-glutamine and 0.3% penicillin-streptomycin (Gibco- BRL, USA). Co-cultures were incubated at 37°C and 5% CO2 concentration. The mesenchymal stem cells (MSCs) derived from UCB were propagated and characterized. Follow-up: Ten µL serum samples from the different subgroups were added to the stem cell culture medium at 37°C26 and followed up weekly for 4 weeks for possible differentiation of stem cells into endometrial like cells. Thereafter, Annexin-1 gene expression in the cells was carried out using RT-PCR. PCR detection of Annexin-1 gene expression: Total RNA was extracted from co-cultured cells using RNeasy Purification kit (Qiagen, Valencia, CA), and then 1 μg RNA was reverse transcribed with AMV reverse transcriptase for 30 min at 42 °C in the presence of oligo-dT primer. PCR amplification was performed using the following primer; forward 5’ GCAGGCCTGGTTTATTGAAA-3’, and reverse primer 5’-GCTGTGCATTGTTTCGCTTA-3’. For PCR reaction, 4 µl cDNA was added to 30.5 µ l water, 4 µl 25 mM MgCl2,1 µ l dNTPs (10 mM) , 5 µl 10× PCR buffer, 0.5 µ l (2.5 U) Taq polymerase and 2.5 µl of each primer containing 10 pmol. The amplification profile was, denaturation at 95 °C for 30 s, annealing at 55°C for 30 s, and elongation at 72 °C for 1 min; for 35 cycles with final extension for 10 min at 72 °C. To exclude the possibility of contaminating genomic DNA, PCRs were also run without RT. The PCR product was separated by electrophoresis using 1% agarose gel. The presence of RNA in all tissues was assessed by analysis of the “house-keeping” gene -actin according to Chun-yan L, et al 27. The β- Actin gene expression was carried out to the sera of the control and study groups to confirm the integrity of RNA.Results: There was no statistical significant difference between the two groups as regards the mean age (29.2 ± 4.5 vs. 31.7 ±3.8; P=0.2), duration of infertility (3 ± 0.8 vs. 2.5 ± 0.6; P=0.1) or their hormonal profile levels as FSH, LH and Progesterone (Table 1).