Occurrence of Myopericarditis Following COVID-19 Vaccination Among Adults in the Eastern Region, Saudi Arabia: A Multicenter Study.

Background: Evidence supporting the possible causal association of myopericarditis with the coronavirus disease (COVID-19) vaccine has mainly come from case reports. Epidemiological evidence indicating an increased relative risk for myopericarditis after COVID-19 vaccination is lacking. Therefore, this study aimed to identify and assess all confirmed COVID-19 vaccine- related cases of myopericarditis presenting to major cardiac centers in the Eastern Region of Saudi Arabia, before and after the introduction of the COVID-19 vaccine. Methods: According to case definition, the hospital's information system database detected all confirmed cases at two main cardiac centers. Results: Of the 18 confirmed myocarditis and myopericarditis cases detected after the administration of COVID-19 vaccines, three were possibly related to COVID-19 immunization. The first case was of myopericarditis following a third dose of mRNA-1273. The second case was myocarditis, which occurred seven days after the first dose of AstraZeneca. The third case was myocarditis, which occurred 12 days after the third dose of BNT162b2. A cardiologist carefully evaluated the cases using recognized protocols and case definitions to demonstrate a direct relationship with vaccination consequences rather than coincidence. Conclusion: We found no difference in the occurrence of myocarditis and myopericarditis after the COVID-19 vaccine compared with the background rate during a similar period (P = 0.9783). The incidences of myocarditis and myopericarditis following immunization were low. The advantages of the COVID-19 vaccination outweigh the risk of myopericarditis.

Sternoclavicular Septic Arthritis and Surgical Intervention: A Case Report.

Management of septic arthritis is an area of controversy, especially in rare locations like the sternoclavicular joints. In this case report, we present a case of septic sternoclavicular joint, which was resistant to medical treatment and deteriorated during the treatment course. Although medical treatment has proven effective based on previous literature, some cases will still not benefit from it. In this case, our patient responded significantly to surgical treatment regarding upper limb function, faster infection eradication and rehabilitation, and shorter hospitalization and antibiotics duration.

The Association Between Physical Activity and Peripheral Neuropathy in Diabetic Patients: A Cross-Sectional Multicenter Study From Saudi Arabia.

Background Peripheral diabetic neuropathy (PDN) is a serious consequence of diabetes mellitus (DM) that can impair quality of life and result in physical disability. This study aimed to investigate the relationship between physical activity and the severity of PDN among a sample of Saudi diabetic patients in Medina city, Saudi Arabia. Methodology A total of 204 diabetic patients participated in this multicenter, cross-sectional study. A validated self-administered questionnaire was distributed electronically to patients on-site during follow-up. Physical activity and diabetic neuropathy (DN) were assessed using the validated International Physical Activity Questionnaire (IPAQ) and the validated Diabetic Neuropathy Score (DNS), respectively. Results The mean (SD) age of the participants was 56.9 (14.8) years. The majority of the participants reported low physical activity (65.7%). The prevalence of PDN was 37.2%. There was a significant correlation between the severity of DN and the duration of the disease (p = 0.047). Higher neuropathy score was noticed in those with hemoglobin A1C (HbA1c) level ≥7 compared to those with lower HBA1c (p = 0.045). Overweight and obese participants had higher scores compared to normal-weight participants (p = 0.041). The severity of neuropathy decreased significantly when the level of physical activity increased (p = 0.039). Conclusions There is a significant association between neuropathy and physical activity, body mass index, duration of diabetes mellitus, and HbA1c level.

Factors related to COVID-19 vaccine hesitancy in Saudi Arabia.

Objectives: To assess the amount of vaccine hesitancy and its determinants in relation to various demographic, social, and personal characteristics among the Saudi population. Study design: Cross-sectional study. Methods: we utilized a structured questionnaire on a five point-Likert scale that included immunization process awareness, perception towards immunization and factors leading to vaccine refusal. Results: The study included 5965 participants characterized according to various demographical factors. The participant's knowledge, perception, and the factors affecting the decision of taking the vaccine were calculated. About 40.7% had enough information about COVID-19 vaccines and were willing to take it. The participant's perception towards COVID-19 vaccines is proportional to their knowledge and varied with the personal characteristics. Factors influencing vaccine use varied also with personal characteristics. Intent to be vaccinated was higher among older age groups, advanced education, retirees, and higher income persons (P < 0.001). Moreover, the influence of heterogeneity in personal perception towards COVID-19 vaccines has been discussed. Vaccine barriers scores were significantly higher among lower educational and income levels (P = 0.004). The leader's influence on vaccine decision was high (p < 0.001). The side effects of COVID-19 vaccine is the most important barrier to vaccine acceptance. Knowledge and perception score were consistently and significantly higher among the group who received their information from official websites, followed by those who had used both websites and social media (p < 0.001). Conclusion: Additional approaches will be needed to effectively meet the needs of the hesitant population, particularly the safety and efficacy concerns, the speed of vaccine development, and the distrust in government and health organizations.

Community practice of using face masks for the prevention of COVID-19 in Saudi Arabia.

Community face masking is possibly of great value in reducing COVID-19 transmission, especially when universally adopted with high compliance. The aim of this study is to investigate the knowledge, common misconceptions, barriers, and the compliance of the community with the use of face masks for the prevention of COVID-19. A validated questionnaire was administered to the participants through a web link by using various social media. The collected data were statistically analyzed for significant differences according to demographic variables. The average knowledge of face masks and their role in preventing COVID-19 transmission was 95.64%, with no differences among most of the demographical factors. Older groups and females demonstrated a better attitude towards wearing face masks than other groups did (p<0.001). Another significant difference in the participant's attitude was noticed between the various educational levels, employment, and nationality (p<0.001). Of the total respondents, 88.2% encouraged wearing face masks. Misconceptions about wearing face masks were very low. The frequency of wearing face masks at public places, workplaces, or social gatherings was 87.2%, 80.5%, and 47.5% respectively. There was a significant variation in the compliance with wearing face masks between the various groups based on age, gender, nationality, and employment status (p<0.001). The inconvenience in wearing face masks was reported by 36.3%. Face irritation and ear pain were reported by 70.2% and 43.5%, respectively. The inconvenience of wearing face masks with eyeglasses was reported by 44.3% of those wearing eyeglasses. In general, the study demonstrated a good attitude among participants towards wearing face masks. Although the respondents in the study were aware of the benefits of wearing face masks, the barriers may have decreased their desire to do so. These barriers include difficulty in breathing, discomfort, face irritation, and ear pain.

Sustainable development and its role in containing crises: Corona virus pandemic crisis (COVID-19) in China as a model.

Sustainable development has become an indispensable thing in our current world, as it constitutes a strong support factor for the process of facing crises if they are present properly, and if their aims that were approved by the United Nations are achieved, countries will rise to an advanced level as in China that has turned from a third world country to a major country after its success in achieving sustainable development, which made it able and ready to face crises such as the COVID-19 pandemic, which has received international and global attention, whether from the United Nations or other countries, organizations and companies interested and donors to reduce the pandemic because of its great dangers In all dimensions, the fact that the virus has troubles that exacerbate the situation in the event that no necessary measures are taken immediately, and indeed the virus has shifted from a local health crisis in Wuhan, China to a global economic, social and environmental crisis that transcends geographical boundaries, but China is linked to the developmental policies and environmental and social policies were able to face the pandemic, and to overcome it and overcome it quickly, as it has real sustainable development.

The Impact of Aerobic Exercise on Female Bone Health Indicators.

INTRODUCTION: Females usually suffer from bone health problems, particularly with aging. Aerobic exercise has been shown to have health benefits for females. AIM: The main objective of this study was to investigate the impact of aerobic exercise on female bone health by measuring serum trace elements and bone metabolism markers. METHODS: Prospective interventional study was conducted at rehabilitation clinics in Royal Medical Services, Jordan. A total of 65 female participants were included. Participants were assigned into three groups: control group (N = 20), osteopenic group (N = 22), and osteoporotic group (N = 23). A standard aerobic exercise protocol was followed for 12 weeks. Endurance exercise protocol involved three sessions weekly for 60 minutes each. At basal level and after the experiment, the following parameters were assessed: body mass index (BMI), bone-specific alkaline phosphatase (BAP), T-score, bone mineral density (BMD), and calcium. The analysis of data was carried out using SPSS version 21. The difference in means was computed based on t-test. Significance was considered at p < 0.05. RESULTS: Aerobic training exercise improved the levels of all parameters in all groups for both sexes significantly, including BMI, BAP, T-score, BMD, and calcium (p < 0.05). CONCLUSION: Aerobic training exercise improves bone health and restores the hemostasis of bone tissue by restoring bone biomarkers, including BAP and calcium.

Chronic epididymo-orchitis and scrotal ulcers.

Extrapulmonary tuberculosis (TB) still presents a diagnostic and therapeutic challenge. Genitourinary TB constitutes about 20% of the extrapulmonary cases in regions where TB is endemic. Tuberculous infection of epididymis and testis is difficult to differentiate clinically from pyogenic infection, tumour or infarction. High-resolution sonography is currently the best readily available technique for imaging the scrotum and its contents, and accurate differentiation is important for proper diagnosis and treatment. The authors are presenting a unique case of chronic epididymo-orchitis with scrotal ulcers.

Scoping a perforated bleeding peptic ulcer: learning points.

Peptic ulcer perforation and haemorrhage is not unusual as a complication of peptic ulcer disease. In the older patientspresentation can be dramatic and atypical. The authors are presenting a case of duodenal ulcer perforation and haemorrhage which was misdiagnosed as a gastric malignancy and thus failure to have Helicobacter pylori eradication, recurrence with complication and hesitancy in surgical intervention due to initial label of malignancy.

Massive haematemesis due to strangulated gangrenous gastric herniation as the delayed presentation of post-traumatic diaphragmatic rupture.

Diaphragmatic injuries are quite uncommon and often result from either blunt or penetrating trauma. Diaphragmatic ruptures are usually associated with abdominal trauma; however, it can occur in isolation. Acute traumatic rupture of the diaphragm may go unnoticed and there is often a delay between the injury and the diagnosis. Patients present with non-specific symptoms and may complain of chest pain, abdominal pain, dyspnoea, tachypnoea and cough, heartburn and symptoms of gastro-oesophageal reflux. Respiratory distress and faeco-pneumothorax have been reported. We present an interesting case of traumatic diaphragmatic hernia presenting 5 years after a road traffic accident as acute abdomen and massive haematemesis due to strangulated gangrenous gastric hernia.

Identification of a novel Pseudomonas syringae Psy61 effector with virulence and avirulence functions by a HrpL-dependent promoter-trap assay.

The hrp pathogenicity island of Pseudomonas syringae encodes a type III secretion system (TTSS) that translocates effectors into plant cells. Most genes encoding effectors are dispersed in the P. syringae genome. Regardless of location, all are regulated coordinately by the alternative sigma factor HrpL. An HrpL-dependent promoter-trap assay was developed to screen genomic libraries of P. syringae strains for promoters whose activity in Escherichia coli is dependent on an inducible hrpL construct. Twenty-two HrpL-dependent promoter fragments were isolated from P. syringae Psy61 that included promoters for known HrpL-dependent genes. One fragment also was isolated that shared no similarity with known genes but retained a near consensus HrpL-dependent promoter. The sequence of the region revealed a 375-amino acid open reading frame encoding a 40.5-kDa product that was designated HopPsyL. HopPsyL was structurally similar to other secreted effectors and carried a putative chloroplast-targeting signal and two predicted transmembrane domains. HopPsyL':'AvrRpt2 fusions were translocated into host cells via the P. syringae pv. tomato DC3000 hrp TTSS. A hopPsyL::kan mutant of Psy61 exhibited strongly reduced virulence in Phaseolus vulgaris cv. Kentucky Wonder, but did not appear to act as a defense response suppressor. The ectopically expressed gene reduced the virulence of Pseudomonas syringae DC3000 transformants in Arabidopsis thaliana Col-0. The gene was shown to be conserved in 6 of 10 P. syringae pv. syringae strains but was not detected in 35 strains of other pathovars. HopPsyL appears to be a novel TTSS-dependent effector that functions as a host-species-specific virulence factor in Psy61.