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Vitamin D has many functions in the human body, and its deficiency is associated with skeletal and non-skeletal diseases. Vitamin D deficiency (blood level of 25 (OH) vitamin D < 20 ng/mL) has been reported worldwide, including Kingdom of Saudi Arabia (KSA). Its prevalence and associated factors vary according to KSA region. Therefore, this study aimed to explore the prevalence and risk factors of vitamin D deficiency in the Taif region of KSA. This retrospective study included patients who attended outpatient clinics at the Alameen General Hospital from 2019 to 2021. Demographic, clinical, and laboratory data were collected using a hospital software system. The study included 2153 patients and vitamin D deficiency was diagnosed in 900 (41.8%) of whom were diagnosed with vitamin D deficiency. It was more common in males (P=0.021), younger age (<0.001), and in patients without comorbidities. There was a positive correlation between 25 (OH) vitamin D levels and blood cholesterol, high-density lipoprotein, calcium, and vitamin B12 levels. In the binary logistic regression analysis, age was the most significant predictor (P<0.001), followed by the absence of thyroid disease (P=0.012) and asthma (P=0.030). Vitamin D deficiency is common in the Saudi population despite sunny weather in KSA. It is more prevalent among males, younger individuals, and those without comorbidities such as thyroid diseases and asthma.

This study aimed at assessing the dominance of risk practices associated with HCV endemicity in Egypt and detecting the behavioral development level concerning different aspects of HCV risk behaviors with respect to age and gender. The survey highlights the most cost-effective strategies that could accelerate HCV elimination in Egypt. A national household survey targeted 3780 individuals (age range: 10-85 years). The sample was a systematic probability proportionate to size from 6 governorates representing the six major subdivisions of Egypt. The indicators used for assessing the behavioral development level towards HCV included six domains: awareness (7 indicators), perceived risk (5 indicators), motivation with the intention to change (4 and 5 indicators for males and females respectively), trial, rejection or adoption (6 and 5 indicators for males and females respectively). The study revealed that along the continuum of behavior development, the percentage of the participants who acquired half of the scores was as follows: 73.1% aware, 69.8% developed perceived risk, 80.6% motivated with only 28.9% adopting the recommended behaviors, 32% rejected them, 2.3% were in the trial stage versus 35.8% who did not try any. Adolescents had significantly lower levels of development for almost all domains when compared to adults. Statistical higher significance was detected in favor of adults, employees, married, Lower Egypt governorates, and university-educated participants (p<0.001) regarding awareness, perceived risk, and motivation scores. More than half of the participants incorrectly believed that contaminated food, sharing food utilities, contaminated water, mosquitoes, and schistosomiasis would lead to HCV transmission. Egypt would be closer to HCV elimination when cost-effective strategies are directed not towards creating awareness, perceived risk or motivation to change- (at an acceptable level)- but towards motivating adopting risk-reduction behaviors for HCV, tackling misconceptions and reinforcement of social support.

Background Type 2 Diabetes mellitus (DM) is an affliction impacting the quality of life of millions of people worldwide. An approach used in the management of Type 2 DM involves the use of the carbohydrate-hydrolyzing enzyme inhibitor, acarbose. Although acarbose has long been the go-to drug in this key approach, it has become apparent that its side effects negatively impact patient adherence and subsequently, therapeutic outcomes. Similar to acarbose in its mechanism of action, bee propolis, a unique natural adhesive biomass consisting of biologically active metabolites, has been found to have antidiabetic potential through its inhibition of α-amylase. To minimize the need for ultimately novel agents while simultaneously aiming to decrease the side effects of acarbose and enhance its efficacy, combination drug therapy has become a promising pharmacotherapeutic strategy and a focal point of this study. Methods Computer-aided molecular docking and molecular dynamics (MD) simulations accompanied by in vitro testing were used to mine novel, pharmacologically active chemical entities from Egyptian propolis to combat Type 2 DM. Glide docking was utilized for a structure-based virtual screening of the largest in-house library of Egyptian propolis metabolites gathered from literature, in addition to GC–MS analysis of the propolis sample under investigation. Thereafter, combination analysis by means of fixed-ratio combinations of acarbose with propolis and the top chosen propolis-derived phytoligand was implemented. Results Aucubin, identified for the first time in propolis worldwide and kaempferol were the most promising virtual hits. Subsequent in vitro α-amylase inhibitory assay demonstrated the ability of these hits to significantly inhibit the enzyme in a dose-dependent manner with an IC 50 of 2.37 ± 0.02 mM and 4.84 ± 0.14 mM, respectively. The binary combination of acarbose with each of propolis and kaempferol displayed maximal synergy at lower effect levels. Molecular docking and MD simulations revealed a cooperative binding mode between kaempferol and acarbose within the active site. Conclusion The suggested strategy seems imperative to ensure a steady supply of new therapeutic entities sourced from Egyptian propolis to regress the development of DM. Further pharmacological in vivo investigations are required to confirm the potent antidiabetic potential of the studied combination.

A group of nanoparticles (NPs); ZnO, CuO, MgO, and Se were eco-friendly biosynthesized using gamma irradiated culture filtrate of Bacillus cereus. The impact of obtained NPs on growth and lipid accumulation of Chlorella vulgaris was evaluated. NPs were characterized by UV–Vis., FTIR, XRD, and TEM. After irradiation, an increase in NPs reduction and/or yield was observed and confirmed by UV. NPs demonstrated spherical morphology with crystal size; 12–105 nm indicated by XRD and TEM images. FTIR analysis of the bacterial filtrate suggested the presence of biomolecules which may act as reducing and stabilizing agents. Low concentrations of obtained NPs enhanced the biomass and lipid production of C. vulgaris with 50 mg/L of ZnONPs demonstrating the highest potential to enhance both of them. Saturated and polyunsaturated fatty acids contents of C. vulgaris increased by ~ 16% and ~ 59% respectively, while unsaturated FA content decreased by ~ 20% compared to control. In conclusion, this study highlights the efficiency of B. cereus filtrate on biosynthesis of different NPs. Moreover, coupling of biosynthesized NPs with gamma irradiation represents a potential strategy to increase NPs yield. Irradiated biosynthesized NPs could be used to enhance the production of microalgal biomass and lipids as a promising feedstock for several applications.

Background In 2012, the WHO described the quality of health care as the route to equity and dignity for women and children. Aim of the work To provide community based support and empowerment to women in childbearing period to seek optimal prenatal, natal and postnatal healthcare. Achieving this is anticipated to decrease maternal morbidity and mortality in Egypt. Subjects and methods An interventional study was conducted among women in childbearing period in the poorest two governorates of Upper Egypt. The study passed through three stages over three and a half years; pre-interventional assessment of awareness ( n  = 1000), educational interventions targeting the health providers and all women in childbearing period in their communities ( n  = 20,494), and post-intervention evaluation of change in awareness of their rights for prenatal, natal and postnatal care (no = 1150). Results The studied indicators relating to receiving care in pregnancy, labor, and puerperium have changed dramatically as a result of the study interventions. Results of the study showed that before interventions, the surveyed women had inaccurate knowledge regarding most of the items related to their rights. The percentages of women aware of their right to have pregnancy card increased and those who possessed a pregnancy card were doubled with a significant percent change of more than 25%. Some indicators showed more than 75% improvement, including; percent of surveyed women who knew that it’s their right to follow up their pregnancy and to deliver with a specialized doctor, a trained nurse or at an equipped health facility, and those who knew their right to have at least two home preparations necessary for safe delivery at home. Conclusion and recommendations More work is needed in order to achieve the targeted reduction of maternal mortality. This could be achieved by ensuring accessible and high quality care provided by the governmental health facilities together with increasing the awareness of women regarding their rights in receiving such care.

Objective In epilepsy, early diagnosis, accurate determination of epilepsy type, proper selection of antiseizure medication, and monitoring are all essential. However, despite recent therapeutic advances and conceptual reconsiderations in the classification and management of epilepsy, serious gaps are still encountered in day‐to‐day practice in Egypt as well as several other resource‐limited countries. Premature mortality, poor quality of life, socio‐economic burden, cognitive problems, poor treatment outcomes, and comorbidities are major challenges that require urgent actions to be implemented at all levels. In recognition of this, a group of Egyptian epilepsy experts met through a series of consecutive meetings to specify the main concepts concerning the diagnosis and management of epilepsy, with the ultimate goal of establishing a nationwide Egyptian consensus. Methods The consensus was developed through a modified Delphi methodology. A thorough review of the most recent relevant literature and international guidelines was performed to evaluate their applicability to the Egyptian situation. Afterward, several remote and live rounds were scheduled to reach a final agreement for all listed statements. Results Of 278 statements reviewed in the first round, 256 achieved ≥80% agreement. Live discussion and refinement of the 22 statements that did not reach consensus during the first round took place, followed by final live voting then consensus was achieved for all remaining statements. Significance With the implementation of these unified recommendations, we believe this will bring about substantial improvements in both the quality of care and treatment outcomes for persons with epilepsy in Egypt. Plain Language Summary This work represents the efforts of a group of medical experts to reach an agreement on the best medical practice related to people with epilepsy based on previously published recommendations while taking into consideration applicable options in resource‐limited countries. The publication of this document is expected to minimize many malpractice issues and pave the way for better healthcare services on both individual and governmental levels.

Acute bacterial meningitis (ABM) is an emerging disease with high morbidity and mortality. It is a globally serious disease and is considered endemic in Egypt, affecting all age groups and being common in low-standard and overcrowded areas. Early and appropriate antimicrobial therapy is crucial for suspected bacterial meningitis, even before the causative pathogen is identified. This is because definitive laboratory confirmation can take several days and may not always be successful. Those who do recover, especially if there was delayed appropriate intervention, can have permanent disabilities, such as brain damage, hearing loss, and learning disabilities. Rapid intervention in such cases is mandatory, which is not easy in countries with limited income due to weak capabilities and resources. Therefore, we are in dire need of making an Egyptian consensus that suits our country as a low-resource one, in order to facilitate and speed up the process of managing such cases. This consensus-based paper is under the supervision of the Egyptian Society of Fever comprising clinicians, microbiologists, epidemiologists, and public health representatives. They convened to assess the current situation and develop a new consensus on the management of ABM, taking into consideration the human and health potential of Egypt. All the experts who participated in writing and directing this conference belong to different Egyptian universities, and their main clinical interest was infectious diseases. Others work in fever hospitals that are affiliated with the Ministry of Health. They collaborated on the statements` writing, reviewing, and voting to reach the final version. Each statement was voted as strongly, moderately, or weekly recommended. Each statement should have a predefined score of 80% agreement to be accepted and reported in this consensus. Conclusion This Egyptian consensus model offers a feasible and context-specific approach to managing ABM, aiming to improve outcomes and reduce disparities in resource-limited settings.

During the early stages of the pandemic, computed tomography (CT) of the chest, along with serological and clinical data, was frequently utilized in diagnosing COVID-19, particularly in regions facing challenges such as shortages of PCR kits. In these circumstances, CT scans played a crucial role in diagnosing COVID-19 and guiding patient management. The COVID-19 Reporting and Data System (CO-RADS) was established as a standardized reporting system for cases of COVID-19 pneumonia. Its implementation necessitates a high level of agreement among observers to prevent any potential confusion. This study aimed to assess the inter-observer agreement between physicians from different specialties with variable levels of experience in their CO-RADS scoring of CT chests for confirmed COVID-19 patients, and to assess the feasibility of applying this reporting system to those having little experience with it. All chest CT images of patients with positive RT-PCR tests for COVID-19 were retrospectively reviewed by seven observers. The observers were divided into three groups according to their type of specialty (three radiologists, three house officers, and one pulmonologist). The observers assessed each image and categorized the patients into five CO-RADS groups. A total of 630 participants were included in this study. The inter-observer agreement was almost perfect among the radiologists, substantial among a pulmonologist and the house officers, and moderate-to-substantial among the radiologists, the pulmonologist, and the house officers. There was substantial to almost perfect inter-observer agreement when reporting using the CO-RADS among observers with different experience levels. Although the inter-observer variability among the radiologists was high, it decreased compared to the pulmonologist and house officers. Radiologists, house officers, and pulmonologists applying the CO-RADS can accurately and promptly identify typical CT imaging features of lung involvement in COVID-19.

Since the announcement of COVID-19 as a pandemic infection, several studies have been performed to discuss the clinical picture, laboratory finding, and imaging features of this disease. The aim of this study is to demarcate the imaging features of novel coronavirus infected pneumonia (NCIP) in different age groups and outline the relation between radiological aspect, including CT severity, and clinical aspect, including age, oxygen saturation, and fatal outcome. We implemented a prospective observational study enrolled 299 laboratory-confirmed COVID-19 patients (169 males and 130 females; age range = 2-91 years; mean age = 38.4 ± 17.2). All patients were submitted to chest CT with multi-planar reconstruction. The imaging features of NCIP in different age groups were described. The relations between CT severity and age, oxygen saturation, and fatal outcome were evaluated. The most predominant CT features were bilateral (75.4%), posterior (66.3%), pleural-based (93.5%), lower lobe involvement (89.8%), and ground-glass opacity (94.7%). ROC curve analysis revealed that the optimal cutoff age that was highly exposed to moderate and severe stages of NCIP was 38 years old (AUC = 0.77, p < 0.001). NCIP was noted in 42.6% below 40-year-old age group compared to 84% above 40-year-old age group. The CT severity was significantly related to age and fatal outcome (p < 0.001). Anterior, centrilobular, hilar, apical, and middle lobe involvements had a significant relation to below 90% oxygen saturation. A significant negative correlation was found between CT severity and oxygen saturation (r = - 0.49, p < 0.001). Crazy-paving pattern, anterior aspect, hilar, centrilobular involvement, and moderate and severe stages had a statistically significant relation to higher mortality. The current study confirmed the value of CT as a prognostic predictor in NCIP through demonstration of the strong relation between CT severity and age, oxygen saturation, and the fatal outcome. In the era of COVID-19 pandemic, this study is considered to be an extension to other studies discussing chest CT features of COVID-19 in different age groups with demarcation of the relation of chest CT severity to different pattern and distribution of NCIP, age, oxygen saturation, and mortality rate.

Introduction: Iron deficiency is a serious condition occurring when the human body’s total iron is less than the normal amount (three-four g). This study aimed to find the prevalence of iron deficiency anemia (IDA) and its association with cognitive abilities among female students. A cross-sectional study was carried out on 198 female students recruited using convenience sampling from Imam Abdulrahman Bin Faisal University. Materials & methods: A food frequency questionnaire and cognitive abilities tests were used to collect the required information. Results: The results showed that the prevalence of IDA was 27.4%. The cognitive abilities parameters of immediate memory, working memory, speed of attention, and accuracy of attention for 50.0% of the students were 24, 16, 194, and three, respectively. Conclusions: No significant association between IDA and cognitive abilities was noted. Therefore, more studies are needed to explore the association between iron-supplemented diet and cognitive function.