The role of breastfeeding as a protective factor against the development of the immune-mediated diseases: A systematic review.

Introduction: Breast milk is rich in nutrients and immunological factors capable of protecting infants against various immunological diseases and disorders. The current systematic review has been framed with the objective of studying the role of breastfeeding as a protective factor against the development of immune-mediated diseases. Methods: The database and website searches were performed using PubMed, PubMed Central, Nature, Springer, Nature, Web of Science, and Elsevier. The studies were scrutinized based on the nature of participants and the nature of disease considered. The search was restricted to infants with immune-mediated diseases such as diabetes mellitus, allergic conditions, diarrhoea, and rheumatoid arthritis. Results: We have included 28 studies, out of which seven deal with diabetes mellitus, two rheumatoid arthritis, five studies about Celiac Disease, twelve studies about allergic/ asthma/wheezing conditions and one study on each of the following diseases: neonatal lupus erythematosus and colitis. Discussion: Based on our analysis, breastfeeding in association with the considered diseases was found to be positive. Breastfeeding is involved as protective factor against various diseases. The role of breastfeeding in the prevention of diabetes mellitus has been found to be significantly higher than for other diseases.

Prevalence of Food Allergy and Common Food Allergen Among Saudi Adults in Makkah Region, Saudi Arabia.

Introduction: The prevalence of food allergy (FA) in the Makkah region has received little attention, so we conducted this study to estimate the prevalence of FA in adults. Methods: This descriptive, cross-sectional, survey-based study was conducted online among 531 participants with or without a prior diagnosis of FA. The collected data related to socio-demographics (age and gender), whether the participant had been medically diagnosed with any food allergens, and assessing the prevalence of different food allergens. Results: Only 93 (17.5%) of the 531 people screened positive for FA; females (65.6%) predominated, with 37.6% aged 40-59. The type of food for allergy was: eggs (47%), seafood (44%), fruits (40%), nuts and legumes (37%), milk and dairy products (25%), vegetables (17%), sesame (11%), wheat (9%), soy (8%), 2% to chili peppers, and only 1% honey and chocolate. Conclusion: Both genders were allergic to eggs, followed by seafood, fruits, nuts, and legumes, and milk and dairy products, respectively.

Zinc Modulates the Priming of T Helper 1, T Helper 17, and T Regulatory Cells in Allogeneic and Autologous in vitro Models.

Introduction: Zinc is essential for the growth and differentiation of immune cells. Zinc insufficiency affects immune system function, thereby increasing infection susceptibility, autoimmunity, and allergies. Here, we aimed to determine the effects of zinc supplementation on T cell subpopulations, regulatory T (Tregs), T helper 1 (Th1), and T helper 17 (Th17) cells, in mixed lymphocyte cultures (MLC). Methods: Allogeneic immune reactions were imitative using mixed lymphocyte cultures, followed by incubation with zinc to further monitor their effects. Cells were analyzed by flow cytometry. Production of Interferon-gamma (IFNγ), Interleukin-17 A (IL17A), and IL10 were analyzed by enzyme-linked immunosorbent assay. Th1 cell-specific Tbet, Th17 cell-specific RORC2, and Tregs-specific Foxp3 expression levels were determined by quantitative real-time PCR. Results: Zinc supplementation at a physiological dose significantly increased CD4+ Foxp3+ Tregs and CD25+ Foxp3+ Tregs numbers and slightly decreased CD4+ RORC2+ and CD25+ RORC2+ Th17 cell numbers. A significant reduction in IFNγ production was observed in both restimulated T cells with autologous peripheral blood mononuclear cell (PBMC) and allogeneic PBMC compared to that in untreated T cells. Zinc significantly reduced IL17 expression, but the increase in IL10 expression was insignificant. In zinc-supplemented MLC, a non-significant decrease in Th1 or Th17 cell-specific transcription factors expression was observed, whereas there was a significant increase in Tregs-specific transcription factor expression. Conclusion: Zinc can stabilize Tregs participating in adverse immune reactions or in an in vitro transplantation model.

Beta vulgaris rubra L. (Beetroot) Peel Methanol Extract Reduces Oxidative Stress and Stimulates Cell Proliferation via Increasing VEGF Expression in H2O2 Induced Oxidative Stressed Human Umbilical Vein Endothelial Cells.

The antioxidant capacity of polyphenols and flavonoids present in dietary agents aids in arresting the development of reactive oxygen species (ROS) and protecting endothelial smooth muscle cells from oxidative stress/induced necrosis. Beetroot (Beta vulgaris var. rubra L.; BVr) is a commonly consumed vegetable representing a rich source of antioxidants. Beetroot peel's bioactive compounds and their role in human umbilical vein endothelial cells (HUVECs) are still under-researched. In the present study, beetroot peel methanol extract (BPME) was prepared, and its effect on the bio-efficacy, nuclear integrity, mitochondrial membrane potential and vascular cell growth, and immunoregulation-related gene expression levels in HUVECs with induced oxidative stress were analysed. Gas chromatography-mass spectroscopy (GC-MS) results confirmed that BPME contains 5-hydroxymethylfurfural (32.6%), methyl pyruvate (15.13%), furfural (9.98%), and 2,3-dihydro-3,5-dihydroxy-6-methyl-4H-Pyran-4-one (12.4%). BPME extract effectively enhanced cell proliferation and was confirmed by MTT assay; the nuclear integrity was confirmed by propidium iodide (PI) staining assay; the mitochondrial membrane potential (Δψm) was confirmed by JC-1 staining assay. Annexin V assay confirmed that BPME-treated HUVECs showed 99% viable cells, but only 39.8% viability was shown in HUVECs treated with H2O2 alone. In addition, BPME treatment of HUVECs for 48 h reduced mRNA expression of lipid peroxide (LPO) and increased NOS-3, Nrf-2, GSK-3ß, GPX, endothelial nitric oxide synthase (eNOS) and vascular cell growth factor (VEGF) mRNA expression levels. We found that BPME treatment decreased proinflammatory (nuclear factor-κß (F-κß), tissue necrosis factor-α (TNF-α), toll-like receptor-4 (TLR-4), interleukin-1ß (IL-1ß)) and vascular inflammation (intracellular adhesion molecule (ICAM), vascular cell adhesion molecule (VCAM), EDN1, IL-1ß)-related mRNA expressions. In conclusion, beetroot peel treatment effectively increased vascular smooth cell growth factors and microtubule development, whereas it decreased vascular inflammatory regulators. BPME may be beneficial for vascular smooth cell regeneration, tissue repair and anti-ageing potential.

Prevalence and Perception Among Saudi Arabian Population About Resharing of Information on Social Media Regarding Natural Remedies as Protective Measures Against COVID-19.

INTRODUCTION: Ever since COVID-19 was declared as a global pandemic, there has been a prevalence of misinformation circulating online on social media platforms. In order to better tackle COVID-19 it is important to determine how the general population perceive the sharing of medical information on social media platforms. Based on this, the aim of the study is to analyse the perception of Saudi Arabian Health Care Workers' (HCWs) and Non-Health Care Workers' (NHCWs) regarding the sharing and resharing of medical information, whether true or false, on social media platforms regarding COVID-19. METHODS: To achieve the aim of this study, the general objective is to identify the most commonly used Social Media Platforms, determine the proportion of the Saudi Arabian population who have participated in recirculating information in those social media platforms, and to analyse their perception of medical information sharing in social media platforms. This study was conducted using a quantitative research methodology. The measurement tool used for this study was an online survey conducted using Google Survey. A 10-item questionnaire was adopted and translated to Arabic to conduct the survey. RESULTS: The total number of responses for the study were N=1249. The findings of the study indicate that Saudi Arabian general population understand the prevalence of unverified information, but are accepting of the practice of sharing information without evidence on social media platforms, with the belief that such information does not cause actual harm to the general public, but instead would be beneficial. WhatsApp was the most preferred social media platform for receiving and sharing information among participants, followed by Twitter and Snapchat. CONCLUSION: The findings of this study indicate that the Saudi Arabian population are more wary than the global general population regarding misinformation online on social media platforms regarding COVID-19.

Attitudes towards COVID-19-Related Medical Misinformation among Healthcare Workers and Non-Healthcare Workers in Saudi Arabia during the Pandemic: An Online Cross-Sectional Survey.

Since the SARS-CoV-2 virus caused a global pandemic, the amount of misinformation in various media outlets has been on the rise. This has caused confusion among both healthcare workers and the general population about what the proper precautions against COVID-19 are. This study investigated attitudes towards misinformation related to protective measures that can be taken against COVID-19. The study was conducted in Saudi Arabia using an online survey questionnaire during the first three months of lockdown responding to the pandemic. The sample size of the study was N = 1294, of which 275 were healthcare workers and 974 were non-healthcare workers. The findings indicate that the Saudi Arabian population has a "Neutral" attitude towards COVID-19-related misinformation, meaning that, overall, they neither agree nor disagree with the most common COVID-19-related misinformation. Both healthcare workers and non-healthcare workers displayed a "Neutral" attitude towards herbal remedies for COVID-19. The level of agreement regarding the SARS-CoV-2 virus remaining in the throat for two days and the BCG vaccine protecting against COVID-19 was low. The findings of this research imply that knowledge dissemination is severely lacking in Saudi Arabia and that the Ministry of Health in Saudi Arabia should sincerely consider educating healthcare workers better about verified and true information regarding COVID-19. Conclusion: Future research should include larger sample sizes for each of the healthcare specialties surveyed in this study and analyse their attitudes towards COVID-19 misinformation.

The Impact of Media on Public Health Awareness Concerning the Use of Natural Remedies Against the COVID-19 Outbreak in Saudi Arabia.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has caused major health system problems and has fueled the emergence of various misinformation regarding preventive measures. The current study was conducted to evaluate the effect of media on raising the level of health awareness of Saudi Arabian populations regarding the medical misinformation about the use of natural remedies against COVID-19. METHODS: This descriptive cross-sectional study was conducted anonymously in the Kingdom of Saudi Arabia between May 1st and June 30, 2020. The sample size was calculated using version-3.0 of OpenEpi. An 11-item questionnaire was designed to assess the effect of media on raising the level of health awareness of the population regarding the medical misinformation about the use of natural remedies during this pandemic. RESULTS: Among 1300 participants, nearly half (55.4%) reported having watched the Saudi Ministry of Health's (MOH) broadcasted awareness videos. Social media (78.9%) was the main media platform on which they accessed these videos, followed by television (14.9%), and the Internet (6.2%). The MOH's awareness videos had a positive effect on 69.5% of participants, who reported a change in their attitudes toward natural remedies and discontinuing the use of them as preventive medicine. The most discontinued natural remedies after watching the awareness videos were gargling with salt water (32.1%), followed by myrrh (17.6%), and garlic (12.9%). Positive effects were greater among participants with a low than high education level. CONCLUSION: The findings of the current study indicate that the Saudi MOH's usage of social media channels has had a positive effect on the level of public health awareness concerning the reliability of natural remedies used during the pandemic. However, more research is needed to validate how social media networks can be used in a cross-cultural context to enhance health awareness and adaptation to healthy behaviors.

Relationship between high CRP and cytokines in Saudi old people with dental caries in alkharj Region, Saudi Arabia.

OBJECTIVE: Dental caries is one of the most common problems of the oral cavity which is frequently observed in older people. The aim of this study is to evaluate serum C-reactive proteins (CRP) levels and to identify the correlation between dental caries and CRP levels. METHODOLOGY: The study included 12 aged patients with an average age of 65-years; the patients were diagnosed with dental caries and did not have clinical history of heart diseases, rheumatoid arthritis or any other infection. The control group consisted of 10 healthy donors with an average age of 60-years. The CRP level of positive samples was measured by using CRP Enzyme-linked immunosorbent assay-ELISA Kit. RESULTS: The currents study showed that only 5 out of 12 patients were CRP positive. CONCLUSIONS: Because of study limitations, it is early to conclude of close relationship between serum CRP and dental caries from the findings of this study; however, this study will give a clearer picture to understand the relationship between serum CRP, inflammatory cytokines and dental caries.

Prevalence of using herbs and natural products as a protective measure during the COVID-19 pandemic among the Saudi population: an online cross-sectional survey.

Considering that no food or supplement has been authorised to prevent COVID-19, individuals continue to search for and consume specific herbs, foods and commercial supplements for this purpose. This study aimed to estimate the prevalence of using such alternatives, determine their usage reasons and evaluate their potential side effects. An online cross-sectional survey of 1,054 participants was conducted from 1 May to 31 July 2020 and focused on respondents' chronic disease histories, socio-demographic characteristics and frequency and trends of using these products. Descriptive and univariate analyses were performed to determine prevalence and associations between various products used and respondents' socio-demographic data. Relationships were tested using Pearson's chi-square test or an exact probability test. The use of herbs and natural products merely because of the COVID-19 pandemic was significantly increased (p=0.036) among Saudi populations. The products included honey (84%), black seeds (63%), lemon (54%) and ginger (41%). Furthermore, the distribution of using herbs and natural products was not linked with any socio-demographic factors other than age. Among the population, 69.30% were aware that herbs can improve their immunity but will not protect them from COVID-19. Finally, the current study highlights the undesirable side effects associated with using herbs and natural products in patients with chronic disease and recommends future research to assess the undesirable effects of using herbs in patients with diabetes with a control group.

Comparison Between Healthcare Professionals and the General Population on Parameters Related to Natural Remedies Used During the COVID-19 Pandemic.

INTRODUCTION: Herbal medicine is commonly used for symptom relief and treatment because of its availability and lack of prescription regulation. However, the use of herbs is associated with adverse effects, drug interaction, and sometimes life-threatening complications. During the coronavirus disease (COVID-19) pandemic, herbs were used when modern medicine failed to treat or immunize people against the virus in its early course. Although trials are still ongoing, herbal medicine was recommended for COVID-19 in Eastern countries based on expert consensus. METHODS: A descriptive web-based anonymous survey was created and distributed online all-over Saudi Arabia to gather information on commonly used herbs, knowledge, and attitude towards them among general population (GP) and health care workers (HCWs). RESULTS: Although the use of natural products was high among the GP, both groups used similar herbs, reflecting cultural traditions and beliefs. However, the GP had better knowledge about and attitudes toward the use of herbal medicine than HCWs did. CONCLUSION: Mental exhaustion during the COVID-19 pandemic and a lack of research-based evidence might influence HCWs' trust in and knowledge about herbal medicine. Therefore, research and educational courses on herbal medicine for all medical practitioners are needed for proper patient counseling to reduce risk and ensure patient safety.

Learning Environment Quality for Medical Students at Umm Al-Qura University: A Comprehensive Study on Stressors, Sources, and Solutions After Introduction of a New Bachelor of Medicine and Bachelor of Surgery (MBBS) Curriculum.

OBJECTIVE: Due to introduction of a new curriculum and the related stressors that medical students might encounter, we aimed to assess the quality of the students' learning environment across academic years at Umm Al-Qura University (UQU), by evaluating stress levels, their sources, and impacts on students, to help improve the quality of learning environment and protect students from personal and academic burnout. METHODS: We conducted a descriptive cross-sectional study in August and September of 2020 on 572 students enrolled in the new Bachelor of Medicine and Bachelor of Surgery (MBBS) curriculum at UQU. All statistical analyses were performed using SPSS software and two-tailed tests. RESULTS: In total, 46.5% of participants encountered severe stress levels during their studies at UQU. In term of stressor sources, the highest prevalence of severe stress was found among students who lacked learning resources (68.8%), followed by those who complained of ambiguity in teaching, learning, and assessment strategies (64.1%). Self-study strategy issues (58.4%) and difficulty in reading textbooks (58.2%) also ranked high. Anxiety was often reported by the students as an impact of stress (62.9%), followed by mood swings (60%). Severe stress levels showed a statistically significant relationship to gender, being highest among females (P = 0.001). For a solution to manage the stress, 79% of the students suggested a supportive learning environment and identification of students' struggles at early stages. CONCLUSION: Almost half the medical students were severely stressed after the new curriculum was introduced. Therefore, professors and universities should look out for potential stressors and help students overcome them. Universities can also help by offering counseling services to students, improving the student tutoring system, providing appropriate learning environment and resources, and including stress management courses as a part of the overall curriculum.