Olfactory Dysfunction following COVID-19 and the Potential Benefits of Olfactory Training.

COVID-19 is associated with a common symptom of olfactory dysfunction, which may persist even after the infection is resolved. Olfactory training (OT) has emerged as the most effective intervention for post-viral olfactory dysfunction. OT involves daily exposure of the olfactory system to various odors. The current study aims to explore olfactory dysfunction following COVID-19 and the potential benefits of olfactory training. METHODS: This is a cross-sectional study conducted among adults aged 18-60 living in Alahssa, Saudi Arabia. An online questionnaire containing an informed consent form and a survey to collect demographic data, vaccination status, level of loss of smell and taste, and the level of awareness about olfactory training (OT) was distributed among all participants who agreed to participate in this study. RESULTS: The study included 524 participants and presented their baseline characteristics, including age, gender, COVID-19 infection status, and complaints. Most patients were female (66.0%), and 46.2% had previously been infected with COVID-19. About 54.8% of participants reported chemosensory dysfunction, while 286 had olfactory dysfunction. Of those, 29.8% had anosmia, 16.8% had hyposmia, and 8.0% had parosmia. Results suggest that being fully or partially vaccinated may offer some protection against olfactory dysfunction compared to being unvaccinated. Adherence to olfactory training was associated with improvement in the sense of smell. CONCLUSIONS: The study highlights the importance of awareness and adherence to olfactory training, which may improve the sense of smell in individuals with chemosensory dysfunction. The findings of this study can inform public health policies and interventions aimed at reducing the burden of olfactory dysfunction associated with COVID-19 vaccination.

Comparison of clinical features and surgical outcomes between hypopnea- and apnea-predominant obstructive sleep apnea.

OBJECTIVES: This study is aimed to investigate the differences in the clinical features and surgical outcomes between hypopnea- and apnea-predominant obstructive sleep apnea (OSA). DESIGN: Cohort study. SETTING: Single tertiary care centre. PARTICIPANTS: This study included 190 patients with OSA who underwent multilevel upper airway surgery between September 2012 and September 2021. The patients were divided into two groups according to the proportion of each respiratory event: hypopnea-predominant (n = 102) and apnea-predominant (n = 88). MAIN OUTCOME MEASURES: The primary outcome measure was the percentage improvement in the apnea-hypopnea index (AHI) from baseline AHI after surgery. RESULTS: The apnea-predominant group included more male patients and had higher AHI, respiratory disturbance index (RDI) and oxygen desaturation index (ODI) than the hypopnea-predominant group. Both groups showed significant improvements in AHI, apnea index, RDI, supine AHI, REM AHI, non-REM AHI, ODI, lowest O2 saturation and Epworth Sleepiness Scale scores following the surgery. Notably, hypopnea index increased after surgery in the apnea-predominant OSA group. Although the improvement in the absolute value of AHI by surgery was significantly greater in the apnea-predominant group than in the hypopnea-predominant group, the two groups showed no significant difference in the percentage improvement in AHI from baseline AHI. CONCLUSION: Patients with apnea-predominant OSA had more severe disease than those with hypopnea-predominant OSA; however, surgical outcomes, as evaluated by percentage AHI improvement, were comparable between the two groups. In addition, multilevel upper airway surgery may induce the transition from apnea to hypopnea in patients with apnea-predominant OSA.

Cichoriin, a Biocoumarin, Mitigates Oxidative Stress and Associated Adverse Dysfunctions on High-Fat Diet-Induced Obesity in Rats.

Metabolic dysfunctions linked to obesity carry the risk of co-morbidities such as diabetes, hepatorenal, and cardiovascular diseases. Coumarins are believed to display several biological effects on diverse adverse health conditions. This study was conducted to uncover the impact of cichoriin on high-fat diet (HFD)-induced obese rats. Methods: Obesity was induced in twenty rats by exposure to an HFD for six weeks. The rats were randomly divided into five groups; group I comprised five healthy rats and was considered the control one. On the other hand, the HFD-induced rats were divided into the following (five per each group): group II (the HFD group), groups III (cichoriin 50 mg/kg) and IV (cichoriin 100 mg/kg) as the treatment groups, and group V received atorvastatin (10 mg/kg) (as a standard). Triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), alanine transaminase (ALT), aspartate transaminase (AST), creatine kinase MB (CK-MB), urea, creatinine, the hepatic and renal malondialdehyde (MDA) as well as reduced glutathione (GSH) levels were assessed. Histopathological analysis of the heart, kidney, and liver tissues was investigated. mRNA and protein expressions of the peroxisome proliferator-activated receptor gamma (PPAR-γ) were estimated. Results: The administration of cichoriin alleviated HFD-induced metabolic dysfunctions and improved the histopathological characteristics of the heart, kidney, and liver. Additionally, the treatment improved the lipid profile and hepatic and renal functions, as well as the oxidative balance state. Cichoriin demonstrated an upregulation of the mRNA and protein expressions of PPAR-γ. Taken together, these findings are the first report on the beneficial role of cichoriin in alleviating adverse metabolic effects in HFD-induced obesity and adapting it into an innovative obesity management strategy.

Mechanistic Insights into the Ameliorative Effect of Cichoriin on Diabetic Rats-Assisted with an In Silico Approach.

Type 2 diabetes mellitus is considered to be a substantial socioeconomic burden worldwide on both patients and governments. Coumarins are biomolecules with a diversity of biological activities. The current investigation aimed to explore the ameliorative effects of cichoriin, which is a type of coumarin, on high-fat diet/streptozotocin (HFD/STZ)-induced diabetic rats. METHODS: Rats were allocated into five groups. Group I was considered as the control group, while the other groups were HFD/STZ-induced diabetic rats. Group II was assigned as the diabetic control. Groups III and IV were treated with cichoriin (50 or 100 mg/kg, respectively). Group V received glibenclamide (5 mg/kg) (as a positive control). The blood glucose (BG), serum insulin, triglycerides (TG), total cholesterol (TC), total antioxidant capacity (TAC), catalase, hepatic superoxide dismutase (SOD) and content of malondialdehyde (MDA) were assessed. Histopathological and immunohistochemistry analysis of pancreatic tissue were performed. mRNA and protein expressions of GLUT4, AMPK, and PI3K were estimated. RESULTS: Cichoriin treatment ameliorated HFD/STZ-induced diabetic conditions and mitigated the histopathological characteristics of the pancreas, as well as increasing pancreatic insulin expression. This decreased the levels of BG, TG, TC, and MDA and improved the TAC, catalase and SOD contents. Cichoriin demonstrated upregulation of mRNA and protein expressions of GLUT4, AMPK, and PI3K. The in silico binding of cichoriin with GLUT4, AMPK, and PI3K supported the possible current activities. CONCLUSION: Collectively, this work highlighted the potential role of cichoriin in mitigating HFD/STZ-induced diabetic conditions and showed it to be a valuable product.

Brassica oleracea L. var. botrytis Leaf Extract Alleviates Gentamicin-Induced Hepatorenal Injury in Rats-Possible Modulation of IL-1ß and NF-κB Activity Assisted with Computational Approach.

BACKGROUND: Recently, crop byproducts are considered a hot topic and can be converted into beneficial products. Cauliflower is well-known for its protective effects against oxidative stress-induced damage. The current study aimed to investigate the chemical profile and the ameliorative effects of cauliflower leaf extract (CL) on gentamicin-induced renal and hepatic injuries in rats. METHODS: Cauliflower leaf was extracted with methanol to give the total methanol extract (TME) followed by the determination of total phenolic contents (TPC). Rats were divided into five groups; Group I was assigned as the control group, while the other groups were injected with gentamicin for ten days. Group II was given distilled water. Rats in groups III and IV were treated with oral CL (200 mg/kg and 400 mg/kg, respectively). Group V received L-cysteine (as a positive control). The functions of the kidneys and liver; oxidative stress and morphological and apoptotic changes of renal and hepatic tissues were assessed. RESULTS: The TME was subjected to chromatographic techniques to yield ferulic acid, vanillic acid, p-coumaric acid and quercetin. TPC was 72.31 mg GAE/g of dried extract. CL treatment dose-dependently ameliorated gentamicin-induced impaired kidney and liver functions and improved the histopathological appearance of both organs. It also reduced gentamicin-induced oxidative stress. CL demonstrated downregulation of mRNA and protein expressions of IL-1ß and NF-κB compared to nontreated rats. In silico interaction of the isolated compounds with amino acid residues of IL-1ß and NF-κB might explain the current findings. CONCLUSION: Taken together, this study raises the waste-to-wealth potential of cauliflower to mitigate gentamicin-induced hepatorenal injury and convert the waste agromaterials into valuable products.

Voice Disorders Among Teachers in Al-Ahsa, Eastern Region, KSA: Vocal Complaints, Treatment-Seeking Behaviors, and Knowledge of Vocal Care.

BACKGROUND: Voice disorders are a serious and common complaint among teachers, yet there are no published studies on these conditions in the context of Al-Ahsa city in the eastern region of the Kingdom of Saudi Arabia. This study analyzed the vocal complaints of Saudi teachers, investigated their treatment-seeking behaviors, and assessed their knowledge of vocal care. METHODS: A cross-sectional online survey was randomly distributed to 604 Saudi teachers from December 2021 to March 2022. The data included sociodemographic characteristics, academic statuses, vocal symptoms and their effects, and attitudes toward voice problems. Statistical analysis was done using the Statistical Package for the Social Sciences (v. 23). Categorical variables were expressed as frequencies and percentages. A chi-square test was conducted to verify the association between the categorical variables. RESULTS: Of the participants, 62.1% were female. 65.4% reported having voice-related problems, with the most frequently reported symptoms being hoarseness (68.35%), throat dryness (60.76%), and sore throat (56.46%). Out of the participants who reported voice problems, 32.15% stated being affected by absenteeism from school. Only a minority of teachers sought medical help (5.1%) or received information about the vocal care (29.5%). The factors that were found to be significantly associated with voice complaints include female gender, positive family history of vocal disorders, speaking in a loud voice, being non-smoker, and having the high number of classes per week (P < 0.05). CONCLUSION: Voice-related complaints were highly prevalent among Saudi teachers for multiple factors, most of which were manageable. This study strongly recommends the vocal educational programs to be implemented during student teacher training.

Indications and complications for surgical management of thyroid diseases: A single center experience.

Background: Thyroid disorders are one of the most common endocrine disorders. Thyroid disorders are highly prevalent in the Saudi population. There are many approaches to treat thyroid disorders, varying from conservative to surgical, depending on the severity of each condition. There are many indications for surgical management of thyroid diseases, including carcinoma, hyperthyroidism, and local compression symptoms. Materials and methods: This is a retrospective study included subjects operated upon for a thyroid disorder over 6 years period in the eastern province of Saudi Arabia. Results: The clinical manifestations and postoperative characteristics of the patients are given in Table 2. It can be observed that the most dominant clinical presentation was neck mass (76.4%), while the most common indication of surgery was the suspicion of cancer (54.5%). Furthermore, the most common histopathology was papillary thyroid cancer (41.8%), whereas the most common complication after the surgery was hypocalcemia (9.1%). Likewise, total thyroidectomy was the most commonly sought surgical intervention (70.9%). Additionally, Bethesda class III constitutes 35.1%, while Bethesda class II constitutes 29.7%. Conclusion: Suspicion of cancer was the most prominent indication for surgical intervention. The most prevalent postoperative complications were hypocalcemia. Furthermore, papillary thyroid carcinoma was the most common histological findings, which raises several questions since it contrasts with previous studies done in Saudi Arabia. We believe that the number of thyroid procedures in our region is underreported, and more research is needed to validate this.