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Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterized by an exaggerated response of the immune system (a hypersensitivity response) to the fungus . -associated pericarditis leading to pericardial tamponade is rare. In our case, we presented a case of a 22-year-old female asthmatic patient with no other medical conditions who presented to the emergency department (ED) complaining of severe chest tightness and shortness of breath. Echocardiography revealed significant pleural and pericardial effusion consistent with cardiac tamponade. Both pleural and pericardial fluids were hemorrhagic. Four months later, she presented to the ED with chief complaints of shortness of breath and a cough lasting two days. She was admitted as a case of asthma exacerbation. In the following months, when the patient visited the pulmonology outpatient clinic, the doctors recommended for specific IgE test. Allergen-specific IgE testing was positive for to confirm the presence of ABPA. As we rolled out other causes of cardiac tamponade, we link the development of cardiac tamponade secondary to an underlying infection. We report this case with the aim of improving clinical knowledge regarding probable causes of cardiac tamponade in patients with asthma, which may facilitate the establishment of early diagnosis and treatment protocols.

Background and objectives Chronic obstructive pulmonary disease (COPD) is a prevalent respiratory condition, often complicated by frequent exacerbations and increased mortality risk. COPD patients also had a higher risk for developing diabetes mellites. Recently, the studies showed promising utility of HbA1C in identifying patients at heightened risk of critical illnesses. This study evaluated the diagnostic and prognostic value of glycated hemoglobin (HbA1c) in predicting COPD exacerbation and short-term mortality. Methods A prospective cohort study involved 184 COPD patients. Patients were categorized as either stable or experiencing an acute exacerbation. Demographic and laboratory data, including HbA1c levels, were collected. Results HbA1c levels were significantly elevated in COPD patients experiencing exacerbations. Factors influencing HbA1c levels included lower oxygen saturation upon admission, use of home oxygen, lymphocyte count, CRP levels, diabetes, and ischemic heart disease (IHD). HbA1c emerged as a strong predictor of both COPD exacerbation and short-term mortality. In the unadjusted model, HbA1c was associated with an increased risk of exacerbation (OR = 1.59, p  = 0.001) and remained significant after adjusting for other variables (OR = 2.25, p  = 0.03). Similarly, HbA1c was a significant predictor of mortality in both the unadjusted (OR = 1.44, p  = 0.001) and adjusted models (OR = 1.66, p  = 0.001). Notably, the use of home oxygen was associated with a lower risk of both exacerbation and mortality. Other risk factors for exacerbation included lower oxygen saturation, male sex, IHD, and a history of previous exacerbations. The mortality rate was significantly higher in patients who had experienced recent exacerbations. Conclusion Elevated HbA1c levels were consistently associated with a higher risk of adverse outcomes, even after adjusting for other significant factors. This highlights the importance of routine HbA1c monitoring in COPD management, particularly in patients with a history of exacerbations or comorbid conditions like diabetes and ischemic heart disease. Additionally, the protective effect of home oxygen therapy against exacerbations and mortality suggests it should be considered as a key component in the management strategy for high-risk COPD patients.

Background: Social media (SM) use has become an integral aspect of daily life. Overutilization of SM can adversely impact an individual’s physical and emotional well-being, especially that of students. This study evaluated the potential impact of SM addiction on anxiety and academic performance among university students. Methods: A cross-sectional study was conducted among medical ad non-medical students at Qassim University during September 2022–April 2023 after obtaining the Ethics Committee’s permission. Raosoft was used for calculating the sample size, and participants were selected through convenience sampling. Both descriptive and inferential statistics were used to analyze and interpret the results, using SPSS version 25. Results: A total of 269 students participated in the study. The majority of them were male (52%), with a mean age of 22.28. The main purpose of SM usage was entertainment, followed by communication. More than 30% of them were using SM for 4–6 h per day, accessing SM 1–10 times in a day, with more than half of them feeling that they had SM addiction and that it was affecting their daily activities and sleep. The majority of them agreed that SM can be used for group discussion (78.1% vs. 71.6%) and knowledge sharing (93.7% vs. 90%). However, a statistically significant difference was observed about anxiety level between the two groups. A negative correlation was found between cumulative grade point average (CGPA) and anxiety level. Conclusion: The findings suggest that SM has both positive and negative effects on academic performance and social anxiety. Continuous education and motivation about wise use of SM is warranted among students by parents, university authorities, and policymakers.

The current scientific community is facing a daunting challenge to unravel reliable natural compounds with realistic potential to treat neurological disorders such as Alzheimer’s disease (AD). The reported compounds/drugs mostly synthetic deemed the reliability and therapeutic potential largely due to their complexity and off-target issues. The natural products from nutraceutical compounds emerge as viable preventive therapeutics to fill the huge gap in treating neurological disorders. Considering that Alzheimer’s disease is a multifactorial disease, natural compounds offer the advantage of a multitarget approach, tagging different molecular sites in the human brain, as compared with the single-target activity of most of the drugs so far used to treat Alzheimer’s disease. A wide range of plant extracts and phytochemicals reported to possess the therapeutic potential to Alzheimer’s disease includes curcumin, resveratrol, epigallocatechin-3-gallate, morin, delphinidins, quercetin, luteolin, oleocanthal, and other phytochemicals such as huperzine A, limonoids, and azaphilones. Reported targets of these natural compounds include inhibition of acetylcholinesterase, amyloid senile plaques, oxidation products, inflammatory pathways, specific brain receptors, etc. We tenaciously aimed to review the in-depth potential of natural products and their therapeutic applications against Alzheimer’s disease, with a special focus on a diversity of medicinal plants and phytocompounds and their mechanism of action against Alzheimer’s disease pathologies. We strongly believe that the medicinal plants and phytoconstituents alone or in combination with other compounds would be effective treatments against Alzheimer’s disease with lesser side effects as compared to currently available treatments.

Saudi Arabian population has amongst the highest prevalence of obesity globally. Apart from nutritional measures, physical activity is considered a major modifiable risk factor for the prevention of obesity and its consequences. An insight into the physical activity and awareness parameters of healthcare professionals and those in the making can provide an insight into how prepared we are to deal with the epidemic of non-communicable diseases. The aim of this study is to find out about the degree of physical activity undertaken by the medical students, faculty and staff at the College of Medicine, King Khalid University, as well as their awareness regarding physical activity guidelines. This study surveyed 300 adult participants - medical students, faculty and staff - in the College of Medicine, King Khalid University. An international validated questionnaire was used to assess the physical activity profile of participants as well as BMI parameters. Moreover, awareness and knowledge of the recommended physical activity guidelines for adults were also assessed. The study participants comprised around 83% students, 9% faculty members, and 7% staff members. Around 55% of the participants were male, while the rest were female. More than 65% of participants across all categories reported low levels of physical activity, with only about 4.5% of participants across various age groups reporting high levels of physical activity. There was no significant difference by gender across the group (P value = 0.227). Only 17% of the study participants were knowledgeable of the recommended physical activity guidelines for adults. We found a low level of physical activity as well as inadequate awareness about the physical activity guidelines amongst our study participants. This study reiterates the urgent need for well-researched and well-funded health promoting interventions to promote physical activity, especially in the context of health professions' education.

One of the most prevalent human infections is Helicobacter pylori ( H. pylori ), which affects more than half of the global population. Although H. pylori infections are widespread, only a minority of individuals develop severe gastroduodenal disorders. The global resistance of H. pylori to antibiotics has reached concerning levels, significantly impacting the effectiveness of treatment. Consequently, the development of vaccines targeting virulence factors may present a viable alternative for the treatment and prevention of H. pylori infections. This review aims to provide a comprehensive overview of the current understanding of H. pylori infection, with a particular focus on its virulence factors, pathophysiology, and vaccination strategies. This review discusses various virulence factors associated with H. pylori , such as cytotoxin-associated gene A ( cagA ), vacuolating cytotoxin gene ( vacA ), outer membrane proteins ( OMPs ), neutrophil-activated protein ( NAP ), urease ( ure ), and catalase. The development of vaccines based on these virulence characteristics is essential for controlling infection and ensuring long-lasting protection. Various vaccination strategies and formulations have been tested in animal models; however, their effectiveness and reproducibility in humans remain uncertain. Different types of vaccines, including vector-based vaccines, inactivated whole cells, genetically modified protein-based subunits, and multiepitope nucleic acid (DNA) vaccines, have been explored. While some vaccines have demonstrated promising results in murine models, only a limited number have been successfully tested in humans. This article provides a thorough evaluation of recent research on H. pylori virulence genes and vaccination methods, offering valuable insights for future strategies to address this global health challenge.

Dyslipidemia is a prevalent condition with significant morbidity and mortality across the world, including in the Arabian Gulf. The present study aimed to describe the characteristics of patients receiving evolocumab in clinical practice. ZERBINI was a multi-country, observational, retrospective/prospective study of subjects receiving evolocumab as part of routine clinical management of their hyperlipidemia. This regional publication reports on adult participants from Saudi Arabia and Kuwait who have had ≥1 dose of evolocumab before enrollment and ≤6 months' prior exposure to evolocumab. Patient characteristics and treatment persistence data were collected in addition to baseline and follow-up data up to 12 months post-evolocumab initiation. Overall, 225 patients were included from two sites, Saudi Arabia (N = 155) and Kuwait (N = 70). Mean age was comparable across sites and most patients had baseline coronary artery disease and/or hypertension. Baseline LDL-C levels (mean ± SD 3.6 ± 1.4 mmol/L in Saudi Arabia, 3.1 ± 1.4 mmol/L in Kuwait) were reduced by approximately 57%-62% in the first 6 months after evolocumab initiation (1.5 ± 1.2 mmol/L in Saudi Arabia [n = 63], 1.2 ± 0.8 mmol/L in Kuwait [n = 28]). This decrease was maintained over the 12-month follow-up period. Most patients achieved ACC 2018 LDL-C goals (<1.8 mmol/L; 74.6% in Saudi Arabia, 93.1% in Kuwait) and ESC 2019 LDL-C goals (<1.4 mmol/L; 66.7% in Saudi Arabia, 75.9% in Kuwait) in the first 6 months after evolocumab initiation. Medication persistence with evolocumab was high (up to 90.7%). Evolocumab had a favorable safety profile and no treatment-emergent adverse events were observed at either site. Evolocumab is an effective lipid-lowering treatment in local populations. LDL-C goal achievement is increased when evolocumab is added to background lipid-lowering therapy with high tolerability and persistence. Long-term follow-up and large-scale data are needed to further support these observations.

BackgroundHead-to-head randomised trials or real-world studies comparing the safety and efficacy of natalizumab and anti-CD20 monoclonal antibodies are limited. This study aimed to compare the effectiveness and safety of natalizumab versus ocrelizumab/rituximab in a real-world cohort of relapsing-remitting multiple sclerosis (RRMS) patients using data from the Middle East and North Africa Committee for the Treatment and Research in Multiple Sclerosis (MENACTRIMS) registry.MethodsThis registry-based, retrospective, multicentre study was carried out in seven Middle Eastern countries by analysing data from the MENACTRIMS registry. All adults RRMS patients treated with natalizumab, rituximab or ocrelizumab and maintained on treatment for at least 12 months were included. Patients were matched using propensity scores. Primary outcomes were annualised relapse rate (ARR), confirmed disability progression and improvement and MRI activity.ResultsA total of 1954 patients met the inclusion criteria, with 1277 receiving anti-CD20 therapy (768 on rituximab and 509 on ocrelizumab) and 677 natalizumab. Natalizumab significantly reduced ARR compared with anti-CD20 therapies (0.062 vs 0.092, p=0.001). Confirmed disability progression rates, MRI outcomes and no evidence of disease activity (NEDA-3) were similar between the two groups. However, natalizumab demonstrated higher rates of disability improvement compared with anti-CD20 therapies (9.3% vs 5.5%, p=0.03). Adverse events were more frequent in the anti-CD20 group (36.4% vs 27.5% for natalizumab, p=0.001).ConclusionIn this large, real-world cohort, natalizumab was associated with lower ARR, greater likelihood of disability improvement, lesser adverse events, but lower persistence compared with anti-CD20 therapies. These findings provide valuable insights into the comparative efficacy and safety of these RRMS therapies, aiding clinicians in personalised treatment decisions.

This cross-sectional study aims to evaluate the immune system status and hematological disturbances among individuals who abuse amphetamines and cannabis. Substance abuse, particularly of amphetamines and cannabis, has been associated with various adverse effects on the body, including potential impacts on the immune system and hematological parameters. However, limited research has been conducted to comprehensively assess these effects in a cross-sectional design. Additionally, fungal infections are on the rise internationally, and immune-compromised people are particularly susceptible. The study will recruit a sample of amphetamine and cannabis abusers (n = 50) at the Eradah Hospital in the Qassim Region of Buraydah and assess their sociodemographic and biochemical variables, including blood indices and differential WBC indices, liver, and kidney profiles. Additionally, 50 sputum samples in total were cultured for testing for fungus infections. To obtain the descriptive statistics, the data was imported into Microsoft Excel and subjected to statistical analysis using SPSS 22.0. Amphetamine and cannabis abuser's sociodemographic variables analysis observed that the majority (52%) were aged 18–30, with 56% in secondary school. Unemployment was a significant issue, and most had no other health issues. The majority (50%) had 5–10 years of abuse, while 32% had less than 5 years, and only 18% had been drug abusers for more than 10 years. There were significant changes ( p  < 0.001) in all different leukocyte blood cells, including neutrophils, lymphocytes, monocytes, eosinophils, and basophils. Furthermore, a microscopic examination of blood films from individuals who misuse the combination of the medications \"amphetamine and cannabis\" reveals hazardous alterations in Neutrophils. Out of 50, 35 sputum samples showed positive growth on Sabouraud dextrose agar (SDA) with chloramphenicol antibiotic, indicating a unicellular fungal growth. The present study explores the immune system and hematological disturbances linked to amphetamine and cannabis abuse, providing insights into health risks and targeted interventions. The findings complement previous research on drug users' hematological abnormalities, particularly in white blood cells. Routine hematological tests help identify alterations in homeostatic conditions, improving patient knowledge and preventing major issues. Further research is needed on multi-drug abuse prevention, early detection, and intervention. The cross-sectional design allows for a snapshot of the immune system and hematological status among abusers, laying the groundwork for future longitudinal studies. Key Words: Drug Effect, Immunity, Epidemiology, Oxidative Stress, Inflammation.

Advances in information technology have included the development of smart wearable healthcare (SWH) devices that have potential benefits for consumer health. The adoption of SWH devices is limited, however, compared with other established digital technologies. This study examines the determinants of consumers’ adoption of SWH devices. A conceptual model is proposed that incorporates health (health beliefs and health information accuracy), and technology (compatibility and functional congruence) attributes into the technology acceptance model framework. The proposed model was tested in two steps. Structural equation modelling (SEM) was performed with 473 usable responses to test the hypothesized relationships. The artificial neural network (ANN) approach was then applied to validate the outcomes of Step 1. The SEM analysis indicates that all the hypothesized relationships are supported. The ANN analysis further validates the outcomes of the SEM. The findings of this study and the dual-stage SEM-ANN methodology will have a strong impact on the existing literature regarding SWH devices.