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Background Pulmonary eosinophilic syndromes (PES) are a heterogeneous group of respiratory disorders characterized by eosinophilic infiltration of lung tissues and/or elevated eosinophil counts in peripheral blood. Accurate diagnosis and understanding of PES are crucial for effective management, especially in underrepresented regions such as Saudi Arabia. Objectives To evaluate the clinical, radiological, and biomarker profiles of PES in a Saudi Arabian cohort and to identify factors associated with disease presentation and severity. Methods This retrospective case-control study included 95 patients diagnosed with PES at Mouwasat Hospital, Jubail, Eastern Province, Saudi Arabia, from January 2023 to January 2024. Clinical data, laboratory findings (including eosinophil counts, IgE, and FeNO levels), pulmonary function tests, and radiological imaging were analyzed. Statistical analysis was performed using SPSS, with descriptive and inferential methods to assess associations. Results The cohort had a mean age of 40.5 ± 12.9 years, with a majority being male (65.3%) and Saudi nationals (87%). Elevated eosinophil counts and FeNO levels were significantly associated with PES ( p  < 0.05). Patients exhibited characteristic radiological patterns such as ground-glass opacities and consolidations. Pulmonary function tests showed reduced FEV₁ and small airway impairment in cases versus controls ( p  = 0.027). The study observed strong correlations between eosinophilia, airway obstruction, and higher BMI. Smoking was associated with increased symptom severity. Conclusions The study underscores the distinct clinical, radiological, and biomarker features of PES in the included population. Integrating multi-modal assessments can improve diagnostic accuracy. These findings emphasize the importance of standardized pathways for PES diagnosis, especially in regions with potential underdiagnosis, and highlight the need for increased awareness among healthcare professionals.

Acinetobacter baumannii is a Gram-negative coccobacillus responsible for severe hospital-acquired infections, particularly in intensive care units (ICUs). The current study was designed to characterize the virulence traits of biofilm-forming carbapenem-resistant A. baumannii causing pneumonia in ICU patients using a Galleria mellonella model. Two hundred and thirty patients with hospital-acquired or ventilator-associated pneumonia were included in our study. Among the total isolates, A. baumannii was the most frequently isolated etiological agent in ICU patients with pneumonia (54/165, 32.7%). All A. baumannii isolates were subjected to antimicrobial susceptibility testing by the Kirby–Bauer disk diffusion method, while the minimum inhibitory concentrations of imipenem and colistin were estimated using the broth microdilution technique. The biofilm formation activity of the isolates was tested using the microtiter plate technique. Biofilm quantification showed that 61.1% (33/54) of the isolates were strong biofilm producers, while 27.7% (15/54) and 11.1% (6/54) showed moderate or weak biofilm production. By studying the prevalence of carbapenemases-encoding genes among isolates, blaOXA-23-like was positive in 88.9% of the isolates (48/54). The BlaNDM gene was found in 27.7% of the isolates (15/54 isolates). BlaOXA-23-like and blaNDM genes coexisted in 25.9% (14/54 isolates). Bap and blaPER-1 genes, the biofilm-associated genes, coexisted in 5.6% (3/54) of the isolates. For in vivo assessment of A. baumannii pathogenicity, a Galleria mellonella survival assay was used. G. mellonella survival was statistically different between moderate and poor biofilm producers (p < 0.0001). The killing effect of the strong biofilm-producing group was significantly higher than that of the moderate and poor biofilm producers (p < 0.0001 for each comparison). These findings highlight the role of biofilm formation as a powerful virulence factor for carbapenem-resistant A. baumannii that causes pneumonia in the ICU.

Introduction Paragonimiasis, a parasitic infection caused by Paragonimus westermani , is a rare but important differential diagnosis in patients presenting with cavitating lung lesions, especially those from endemic regions. Extrapulmonary involvement is uncommon and can pose significant diagnostic challenges. Patient information A 41-year-old Filipino man, working as a driver, came to the emergency department with a 4-week history of shortness of breath, productive cough with yellowish sputum, fever, and body aches. He had a known history of poorly controlled type 2 diabetes for 4 years and was a heavy smoker. Clinical findings On examination, the patient appeared unwell with signs of hypoxemia and fever. Diagnostic assessment Initial investigation for multiple caviraty lesion were done like sputum for AFB. Given his background and travel history from an endemic area, parasitic infection was considered. A wet mount examination of fresh sputum revealed P. westermani ova, confirming the diagnosis. MRI scans of the brain and abdomen were unremarkable, but pelvic MRI revealed a scrotal abscess. The patient underwent surgical drainage of the abscess along with a left inguinal orchidectomy. Interestingly, Paragonimus ova were found in the abscess fluid, but no bacteria were cultured. Histopathology of the excised tissue showed intense inflammation involving the epididymis, spermatic cord, and surrounding tissues, with atrophic changes in the testicle—though no ova were seen in the histological samples. Therapeutic intervention He was started on praziquantel, the standard antiparasitic treatment, and recovered well following surgery. Follow-up and outcomes The patient showed noticeable clinical improvement after treatment. Conclusion This case underscores the importance of considering parasitic infections like P. westermani in patients with cavitary lung disease, particularly when typical causes are excluded. It also illustrates that extrapulmonary manifestations, though rare, can occur and may require surgical intervention. A high index of suspicion, especially in patients from endemic areas, can lead to timely diagnosis and effective management. This is the first case report of pulmonary paragonimiasis in Jubail and complicated by scrotal abscess worldwide.

Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has a high incidence of spread. On January 30, 2020, the World Health Organization proclaimed a public health emergency of worldwide concern. More than 6.9 million deaths and more than 768 million confirmed cases had been reported worldwide as of June 18, 2023. This study included 51 patients and 50 age- and sex-matched healthy subjects. The present study aimed to identify the expression levels of lncRNA CASC2 and miRNA-21-5p (also known as miRNA-21) in COVID-19 patients and their relation to the clinicopathological characteristics of the disease. The expression levels of noncoding RNAs were measured by RT-PCR technique. Results detected that CASC2 was significantly downregulated while miRNA-21-5p was significantly upregulated in COVID-19 patients compared to healthy subjects. A significant negative correlation was found between CASC2 and miRNA-21-5p. ROC curve analysis used to distinguish COVID-19 patients from controls. MiRNA-21-p serum expression level had a significant positive association with temperature and PO2 ( p  = 0.04 for each). These findings indicate that CASC2 and miRNA-21-p might be used as potential diagnostic and therapeutic biomarkers in COVID-19.

Background Tropical pulmonary eosinophilia (TPE) is an uncommon but important manifestation of lymphatic filarial infection, caused primarily by Wuchereria bancrofti , Brugia malayi , and Brugia timori . This syndrome results from a hypersensitivity reaction to microfilariae. While lymphatic filariasis is rare in Saudi Arabia, isolated cases have been observed among expatriate Asian workers. With increasing global migration, clinicians in non-endemic regions should consider TPE in patients with compatible clinical and exposure histories. Objectives This study aims to raise awareness among healthcare providers in Saudi Arabia regarding TPE as a treatable infectious disease among immigrants from endemic regions of India. It also seeks to recommend the incorporation of TPE considerations into asthma diagnosis guidelines for Indian patients from endemic areas, and to propose a diagnostic roadmap for the syndrome. Methods A retrospective chart review was conducted at the Chest Clinic of Al Mouwasat Hospital in Jubail, Eastern Province, Saudi Arabia. Medical records from January 2023 to January 2024 were examined for patients presenting with asthma-like symptoms and laboratory or radiological findings consistent with TPE. Only data from existing records were included; no prospective data collection was performed. Results Eight patients met all six diagnostic criteria for TPE: a relevant history of exposure, marked eosinophilia, elevated immunoglobulin E (IgE), positive filarial-specific antibodies, negative blood films for microfilariae, and a favorable response to diethylcarbamazine therapy. Two additional patients satisfied five of the six diagnostic criteria and also responded well to diethylcarbamazine. Conclusion TPE should be considered in the differential diagnosis for expatriates from endemic regions presenting with suggestive clinical and laboratory features in Saudi Arabia. Increasing clinical awareness and applying structured diagnostic protocols may improve detection and treatment outcomes for this rare but treatable disease.

Introduction The ultrasound (US) of the chest is useful in the diagnosis of different parenchymal, pleural, and chest wall diseases. The US is preferred because no radiation is used (safe during pregnancy), is not expensive, is easy portability, provides real-time imaging, and has the ability to make a dynamic imaging. Aim This study aimed for the correlation between B-lines and spirometry, arterial blood gases, 6-minute walk test (6MWT), and pulmonary artery systolic pressure (PASP) in patients with diffuse parenchymal lung disease (DPLD). Design A prospective study was conducted. Setting The study was conducted at Fayoum University Hospital in Egypt between January 2017 and June 2017. Patients and methods This study was done on 60 patients with DPLD. They were subjected to a full medical history, a detailed clinical examination, high-resolution computed tomography, echocardiography, arterial blood gases analysis, spirometry, 6MWT, and chest US. Results The studied group showed female predominance, with 54 (90%) patients. They had a wide range of age from 20 to 75 years, and their mean age was 47.5±13.6 years. Most of them were involved in breeding birds, exposed to biomass, and nonsmokers. The studied patients had bilateral B-lines. The number of B-lines was positively correlated with PaO 2 , 6MWT, forced vital capacity, and PASP and negatively correlated with high-resolution computed tomography affection, whereas the distance between B-lines was inversely correlated with each of PaO 2 , numbers of B-line, 6MWT, forced vital capacity, and PASP. Most of patients had irregular and thickened pleura (71.6%), and abolished lung sliding was seen in 51.6%. Conclusion Chest US may be used in the evaluation of DPLD. Multiple B-lines with thickened and irregular pleural line are suggestive of DPLD.

Background Shisha smoking is a common practice among the population in Arabic countries. Shisha smoking has a negative effect on lung function; it is probably one of the causes for chronic obstructive pulmonary disease (COPD). Objective Detection of COPD among Shisha Smokers in the Fayoum Governorate. Design Prospective study. Setting Fayoum University Hospital in Egypt between 2016 and 2017. Patients and methods Of the 300 participants, 200 were shisha smokers for more than 20 years or their age above 40 years and 100 of them were nonsmoker volunteers. History of smoking was taken from the patients with recording of the COPD assessment score and then general and local examination was done followed by flow volume loop and finally by a chest radiography (posteroanterior view). Statistical analysis: case–control study Coding of the data was done and then entered with SPSS (statistical package for the social sciences) version number 24. After that data was summarized using mean, SD, median, minimum and maximum in the quantitative data with using frequency (count) and relative frequency (percentage) for categorization of data. Results Out of the 300 male patients included in this study 51% has obstructive airway disease and 19% had restrictive airway disease. The mean age was 56.20±10.98 years. Number of hagars smoked by the COPD patients were 10.82±9.88 hagars per day with a duration of smoking of 24.87±12.36 years. Conclusion Shisha smoking increases the risk of COPD and this risk increases with the increase in the duration of smoking and number of hagar smoked was the conclusion of the study.

Background Tuberculosis (TB) is one of the causes of health problem in millions of people annually, and in 2015, it was one of the top 10 reasons of doom worldwide, ranking above HIV/AIDS as one of the important causes of death owing to an intended disease. A negative smear result in pulmonary TB is believed to be a widespread clinical problem, so early detection of smear-negative pulmonary tuberculosis (SNPTB) is important for TB control and restriction of number of deaths, and it is tricky in these patients. Aims To detect TB in SNPTB in Fayoum Chest Hospital Design This was a retrospective study. Setting Fayoum Chest Hospital and Fayoum University Hospital in Egypt were used for conducting the study between 2015 and 2017. Patients and methods Fifty patients suspected to have pulmonary TB and had negative sputum smear results were included in the study. For each patient, full history was taken, and clinical body checkup was done. Then, plain posteroanterior chest radiograph was done. Tuberculin test, direct sputum examination, and other diagnostic methods used for detection such as GeneXpert, bronchoscopy, bronchoalveolar lavage (BAL), transbronchial lung biopsy, Löwenstein–Jensen culture, QuantiFERON, or even open lung biopsy were recorded. Statistical analysis Coding of the data was done then entered with SPSS (Statistical Package for the Social Sciences) version number 18 windows 7 after that data were summarized using mean, standard deviation, median, minimum and maximum in the quantitative data with using frequency (count) & relative frequency (percentage) for categorization of data. Results It was found that 42% of patients were diagnosed by GeneXpert and 46% were diagnosed by BAL during bronchoscopy, whereas 68% of patients had positive ‘Löwenstein–Jensen culture’ result. Conclusion The GeneXpert MTB/RIF assay is an important test for quick diagnosis of acid-fast bacilli SNPTB. Flexible fiberoptic bronchoscopy is a beneficial tool in the diagnosis of pulmonary TB in patients whose sputum smear is negative. Clinical implications are as follows: in patients with SNPTB, microbiological samples should be obtained (through sputum, BAL, or induced sputum), and then radiological investigation should be performed. Thereafter, antituberculous treatment should be started following the diagnosis, with follow-up of the case. Rapid detection and proper treatment of pulmonary TB, even in smear negative patients, can eliminate spread of the infection to others and may decrease the severity of the disease.

A new Schiff base (H2L) generated from sulfamethazine (SMT), as well as its novel micro- and nanocomplexes with Ni(II) and Cd(II) metal ions, have been synthesized. The proposed structures of all isolated solid compounds were identified with physicochemical, spectral, and thermal techniques. Molar conductance studies confirmed that the metal complexes are not electrolytic. The molecular geometry located at the central metal ion was found to be square planar for the NiL2 and tetrahedral for the CdL2 complexes. The kinetic and thermal parameters were obtained using the Coats and Redfern approach. Coriandrum sativum (CS) in ethanol was used to create the eco-friendly Ni and Cd nanocomplexes. The size of the obtained nanoparticles was examined using PXRD and TEM, and found to be in the sub-nano range (3.07–4.61 nm). Furthermore, the TEM micrograph demonstrated a uniform and homogeneous surface morphology. The chemistry of the prepared nanocomplexes was studied using TGA and TEM techniques. The effect of temperature on the prepared nanocomplexes’ size revealed a decrease in size by heating. Furthermore, the nanocomplexes’ antimicrobial and anticancer properties were evaluated. The outcomes demonstrated that the nanocomplexes exhibited better antimicrobial properties. Moreover, the antitumor results showed that after heating, the Ni nanocomplex exhibited a substantial antitumor activity (IC50 = 1.280 g/mL), which was higher than the activity of cis-platin (IC50 = 1.714 g/mL). Finally, molecular-docking studies were performed to understand the evaluated compounds’ ability to bind to methionine adenosyl-transferases (PDB ID: 5A19) in liver cancer and COVID-19 main protease (PDB ID: 6lu7) cell-proteins. The findings reveal that [NiL2]·1.5H2O2 has a higher binding energy of −37.5 kcal/mol with (PDB ID: 5A19) cell protein.

New multi-featured adsorbent beads were fabricated through impregnation of sulfonated graphene (SGO) oxide into cellulose acetate (CA) beads for fast adsorption of cationic methylene blue (MB) dye. The formulated SGO@CA composite beads were thoroughly characterized by several tools including FTIR, TGA, SEM, XRD, XPS and zeta potential. The optimal levels of the most significant identified variables affecting the adsorption process were sequential determined by the response surface methodology (RSM) using Plackett–Burman and Box–Behnken designs. The gained results denoted that the surface of SGO@CA beads displayed the higher negative charges (− 42.2 mV) compared to − 35.7 and − 38.7 mV for pristine CA and SGO, respectively. In addition, the floated SGO@CA beads demonstrated excellent floating property, fast adsorption and easy separation. The adsorption performance was accomplished rapidly, since the adsorption equilibrium was closely gotten within 30 min. Furthermore, the adsorption capacity was greatly improved with increasing SGO content from 10 to 30%. The obtained data were followed the pseudo-second order kinetic model and agreed with Langmuir adsorption isotherm model with a maximum adsorption capacity reached 234.74 mg g −1 . The thermodynamic studies designated the spontaneity and endothermic nature of MB dye adsorption. Besides, the floated beads exposed acceptable adsorption characteristics for six successive reuse cycles, in addition to their better adsorption selectivity towards MB dye compared to cationic crystal violet and anionic Congo red dyes. These findings assume that the formulated SGO@CA floated beads could be used effectively as highly efficient, easy separable and reusable adsorbents for the fast removal of toxic cationic dyes.