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Breast cancer is the most common malignancy affecting women, manifesting as a heterogeneous disease with diverse molecular characteristics and clinical presentations. Recent studies have elucidated the role of epigenetic modifications in the pathogenesis of breast cancer, including drug resistance and efflux characteristics, offering potential new diagnostic and prognostic markers, treatment efficacy predictors, and therapeutic agents. Key modifications include DNA cytosine methylation and the covalent modification of histone proteins. Unlike genetic mutations, reprogramming the epigenetic landscape of the cancer epigenome is a promising targeted therapy for the treatment and reversal of drug resistance. Epidrugs, which target DNA methylation and histone modifications, can provide novel options for the treatment of breast cancer by reversing the acquired resistance to treatment. Currently, the most promising approach involves combination therapies consisting of epidrugs with immune checkpoint inhibitors. This review examines the aberrant epigenetic regulation of breast cancer initiation and progression, focusing on modifications related to estrogen signaling, drug resistance, cancer progression, and the epithelial–mesenchymal transition (EMT). It examines existing epigenetic drugs for treating breast cancer, including agents that modify DNA, inhibitors of histone acetyltransferases, histone deacetylases, histone methyltransferases, and histone demethyltransferases. It also delves into ongoing studies on combining epidrugs with other therapies and addresses the upcoming obstacles in this field.

Salmonellosis continues to be a global public health priority in which humans, livestock, and the contaminated environment interact with food to create complex interactions. Here, a new non-autonomous model is proposed to capture seasonal dynamics of Salmonella typhimurium transmission with key compartments that include humans, cattle, and bacteria in environmental and food sources. The model explores how bacterial growth, shedding, and ingestion rates, along with contamination pathways, determine disease dynamics. Some analytical derivations of the basic reproduction number (R0) and threshold conditions for disease persistence or extinction are derived by using the spectral radius of a linear operator associated with the monodromy matrix. Parameter estimation for the model was accomplished with the aid of Latin hypercube sampling and least squares methods on Salmonella outbreak data from Saudi Arabia ranging from 2018 to 2021. The model was able to conduct an analysis based on the estimated 0.606 value of R0, and this meant that the model was able to fit reasonably well for both the cumulative and the new individual case data, which in turn, suggests the disease is curable. Predictions indicate a gradual decline in the number of new cases, with stabilization anticipated at approximately 40,000 cumulative cases. Further simulations examined the dynamics of disease extinction and persistence based on R0. When R0 is less than 1, the disease-free equilibrium is stable, resulting in the extinction of the disease. Conversely, when R0 exceeds 1, the disease persists, exhibiting endemic characteristics with recurrent outbreaks. Sensitivity analysis identified several parameters as having a significant impact on the model’s outcomes, specifically mortality and infection rates, along with decay rates. These findings highlight the critical importance of precise parameter estimation in understanding and controlling the transmission dynamics of Salmonella. Sensitivity indices and contour plots were employed to assess the impact of various parameters on the basic reproduction number and provide insights into the factors most influencing disease transmission.

We present a nonautonomous compartmental model that incorporates vaccination and accounts for the seasonal transmission of typhoid fever. The dynamics of the system are governed by the basic reproductive number R0. This demonstrates the global stability of the disease-free solution if R0<1. On the contrary, if R0>1, the disease persists and positive periodic solutions exist. Numerical simulations validate our theoretical findings. To accurately fit typhoid fever data in Taiwan from 2008 to 2023, we use the model and estimate its parameters using Latin hypercube sampling and least squares techniques. A sensitivity analysis reveals the significant influence of parameters such as infection rates on the reproduction number. Increasing vaccination coverage, despite challenges in developing countries, reduces typhoid cases. Accessible and highly effective vaccines play a critical role in suppressing the epidemic, outweighing concerns about the efficacy of the vaccine. Investigating possible parameter changes in Taiwan highlights the importance of monitoring and managing transmission rates to prevent recurring annual epidemics.

Mathematical models play a crucial role in predicting disease dynamics and estimating key quantities. Non-autonomous models offer the advantage of capturing temporal variations and changes in the system. In this study, we analyzed the transmission of typhoid fever in a population using a compartmental model that accounted for dynamic changes occurring periodically in the environment. First, we determined the basic reproduction number, R0, for the periodic model and derived the time-average reproduction rate, [R0], for the non-autonomous model as well as the basic reproduction number, R0A, for the autonomous model. We conducted an analysis to examine the global stability of the disease-free solution and endemic periodic solutions. Our findings demonstrated that when R0<1, the disease-free solution was globally asymptotically stable, indicating the extinction of typhoid fever. Conversely, when R0>1, the disease became endemic in the population, confirming the existence of positive periodic solutions. We also presented numerical simulations that supported these theoretical results. Furthermore, we conducted a sensitivity analysis of R0A, [R0] and the infected compartments, aiming to assess the impact of model parameters on these quantities. Our results showed that the human-to-human infection rate has a significant impact on the reproduction number, while the environment-to-human infection rate and the bacteria excretion rate affect long-cycle infections. Moreover, we examined the effects of parameter modifications and how they impact the implementing of efficient control strategies to combat TyF. Although our model is limited by the lack of precise parameter values, the qualitative results remain consistent even with alternative parameter settings.

Lifestyle factors such as dietary habits, perceived weight, sleep, and physical activity worsened during the COVID-19 pandemic. Through this study, we aimed to understand the impact of COVID-19 on these lifestyle factors in Bahrain. A cross-sectional study was conducted among 1005 adult Bahrainis. Data were collected online using a structured and validated questionnaire for the assessment of eating habits, physical activity, and lifestyle during the COVID-19 pandemic. Participants were snowballed through those who agreed to answer the online questionnaire. There was a higher consumption of fast food, and a higher dependence on takeaways during the COVID-19 pandemic. About 63.5% of the participants consumed >4 meals per day, compared to 36.5% before the COVID-19. About 30% reported consumption of sugar sweetened beverages from two to three times a day. Weight loss was predominantly observed in persons exercising 1–3 times a week. The consumption of sugar-sweetened beverages was also high, with about 19% reporting drinking sweet beverages once every day, 10.6% from two to three times a day, and 40.4% from one to four times a week. A higher proportion of the participants reported poor sleep quality during the pandemic (31.2%) compared to before (12.2%), and 39.7% of the participants reported feeling lazy. Screen time use also doubled during the pandemic, with participants spending more than five hours per day on screens for entertainment, which went from 22.4% before to 51.9% during the pandemic. The lifestyle and dietary habits changed drastically for our study participants during the pandemic. The increased reliance on processed fast food instead of healthier options is a challenge to be tackled in any future pandemic situation. Future research needs to focus on strategies to promote healthier lifestyle modifications during situations such as the COVID-19 pandemic.

Giant bladder stones, defined as stones weighing over 100 g and/or measuring more than 4 cm in diameter, are relatively uncommon compared to other types of urinary tract stones. This patient, an 85-year-old male with an unknown medical history, initially presented with urinary incontinence and hematuria. Radiological findings revealed a large prostate, a forgotten left renal double-J (DJ) stent for more than 20 years with an encrusted bladder stone, and additional calculi in the lower pole of the left kidney. The patient underwent laser cystolithotripsy, but due to the complexity of the case, a second procedure was scheduled. Following the second procedure, the patient experienced a generalized tonic-clonic seizure and subsequent loss of consciousness, which was attributed to hyponatremia. The patient received appropriate management to correct hyponatremia and antiepileptic medication to control the seizure. The patient's condition eventually improved and he was discharged home with prescribed medications and follow-up appointments. This case emphasizes the potential complications of giant bladder stones and a forgotten DJ stent in an 85-year-old male patient as a rare consequence following such a rare presentation.

BackgroundEczema herpeticum, also known as Kaposi varicelliform eruption, is a potentially life-threatening disseminated cutaneous viral infection. In the majority of cases, this condition develops as a complication in patients with atopic dermatitis. However, it may arise in a wide spectrum of pre-existing skin conditions, including psoriasis, seborrheic dermatitis, contact dermatitis, cutaneous T cell lymphoma, pemphigus vulgaris, and others.Case presentationWe present the case of a 2-year-old boy who was brought to the emergency department because of a high-grade fever and rash. The fever started 2 days before his presentation, and its maximum measurement was 39.6°C. The following day, the patient developed numerous painful, pruritic vesiculopustular eruptions, and oozing involving the lips, rendering the patient unable to tolerate oral feeding. The patient was seen by the dermatology team who diagnosed the child as having eczema herpeticum. The patient was commenced on antiviral and empirical antibiotic therapy in the form of intravenous acyclovir and cephalexin along with topical fusidic acid and panthenol. The patient showed clinical improvement with resolution of the fever and partial involution of the rash 2 days following the administration of the antimicrobial therapy.ConclusionEczema herpeticum is a rare clinical entity that can result in significant morbidity. The case highlights the importance of considering the diagnosis of eczema herpeticum in the appropriate clinical settings, even in patients who were not known to have any prior skin disorder.

Health systems are experiencing health crises and pandemics that weaken their ability to provide health care to communities and patients. Nursing is the first line of defense in health care, and therefore plays a critical role in responding to crises and pandemics and ensuring the continuity of health care. This review explores the multifaceted roles of nurses during crises and pandemics, including education, surveillance, vaccination management, and post-pandemic recovery. It highlights barriers faced by nurses, such as time constraints, scarce resources, communication challenges, and inadequate technology integration. Furthermore, the review explores strategies to enhance nursing capacity, such as prioritizing the distribution of personal protective equipment, enhancing syndromic surveillance, investing in technology, and expanding home care. Addressing these challenges and implementing forward-looking strategies enhances the role of nurses in crisis and pandemic management, ensuring preparedness for future crises.

Introduction: The variety in the nature of these occupational hazards necessitates a multidisciplinary approach to effectively mitigate them. The aim of this systematic review is to explore multidisciplinary approaches to reduce occupational injuries among different health professions.Methods: Initially, the search strategy was developed to identify interventional studies that provided insights into the effectiveness of various strategies. The search was conducted across several electronic databases to ensure a thorough coverage of the literature. These included PubMed, Scopus, Web of Science, and the Cochrane Library. These databases were chosen for their extensive coverage of medical and health sciences literature. Only interventional studies that specifically addressed occupational injuries among healthcare professionals were included.Results: The systematic review conclusively demonstrates that multidisciplinary interventions are effective in reducing occupational injuries among healthcare professionals. The analysis Of seven key studies revealed that ergonomic training combined with assistive devices, comprehensive injury prevention programs, and the implementation of safety-engineered devices significantly reduce injury rates, with risk reductions ranging from 25% to 50%. Specifically, ergonomic adjustments were found to be more effective than physical exercises in addressing musculoskeletal disorders. Additionally, the use of ceiling lifts was preferred over mobile lifts for injury prevention among nursing staff.Conclusions: Ihese findings highlight the necessity of tailored, profession-specific interventions in healthcare settings to effectively mitigate the risk Of occupational injuries. The integration Of technological, educational, and ergonomic solutions emerges as a pivotal strategy to enhance workplace safety and reduce the physical burden on healthcare workers.