Impact of Sickle Cell Anemia on children growth and clinical parameters in Al-Ahsa region of Saudi Arabia

Background: Sickle cell disease (SCD) is an autosomal recessive disease caused by a single gene mutation, leading to sickle-shaped red blood cells, causing many clinical complications. Resulting complications may affect the growth of the SCD patients that is a strong measure of severity of disease and helps in disease management strategies in any area.  Eastern province of Saudi Arabia has one of the highest SCD incidences. Nevertheless, no studies have been previously carried out of about clinical outcome of SCD in Al-Ahsa area of eastern province. Therefore, this study was conducted to find out the impact of SCD children at king Abdulaziz Hospital Al-Ahsa.Methods: All pediatric SCD patients were included in the study. Patient data was taken from hospital information system and analyzed using SPSS version 27.Results: A total of 53 patients were studied. The male to female ratio was 1.4:1 and mean age was 3.3 years (range: 1-9). Eighteen (34%) did not present with sickle cell crisis possibly due to ameliorating effects of high HbF and G6PD deficiency. Although growth parameters of SCD patients were not statistically different from international standards, there was significant difference between weight of SCD patients in recurrent sickle cell crisis group and non-crisis sickle cell (NC-SC) group at diagnosis and after clinical interventions (p= 0.04 and 0.03, respectively) that included hydroxyurea. The corrected reticulocyte (at diagnosis and after clinical intervention) and WBC counts were statistically significant between hydroxyurea and non-hydroxyurea groups (p-value < 0.05).Conclusions: Overall, one-third of SCD patients in Al-Ahsa region have mild disease and hydroxyurea can minimize the SCD severity through lowering corrected reticulocyte and WBC counts. Exact mechanisms of mild SCD and hydroxyurea in minimizing disease severity are needed to be elucidated.    Keywords: Salinity; Livelihood; Productivity; Farming experience; Farm size

Recent Advances in Genome-Editing Technology with CRISPR/Cas9 Variants and Stimuli-Responsive Targeting Approaches within Tumor Cells: A Future Perspective of Cancer Management

The innovative advances in transforming clustered regularly interspaced short palindromic repeats-associated protein 9 (CRISPR/Cas9) into different variants have taken the art of genome-editing specificity to new heights. Allosteric modulation of Cas9-targeting specificity by sgRNA sequence alterations and protospacer adjacent motif (PAM) modifications have been a good lesson to learn about specificity and activity scores in different Cas9 variants. Some of the high-fidelity Cas9 variants have been ranked as Sniper-Cas9, eSpCas9 (1.1), SpCas9-HF1, HypaCas9, xCas9, and evoCas9. However, the selection of an ideal Cas9 variant for a given target sequence remains a challenging task. A safe and efficient delivery system for the CRISPR/Cas9 complex at tumor target sites faces considerable challenges, and nanotechnology-based stimuli-responsive delivery approaches have significantly contributed to cancer management. Recent innovations in nanoformulation design, such as pH, glutathione (GSH), photo, thermal, and magnetic responsive systems, have modernized the art of CRISPR/Cas9 delivery approaches. These nanoformulations possess enhanced cellular internalization, endosomal membrane disruption/bypass, and controlled release. In this review, we aim to elaborate on different CRISPR/Cas9 variants and advances in stimuli-responsive nanoformulations for the specific delivery of this endonuclease system. Furthermore, the critical constraints of this endonuclease system on clinical translations towards the management of cancer and prospects are described

Healthcare Workers’ Worries and Monkeypox Vaccine Advocacy during the First Month of the WHO Monkeypox Alert: Cross-Sectional Survey in Saudi Arabia

Background: Monkeypox virus re-surged in May 2022 as a new potential global health threat, with outbreaks bursting in multiple countries across different continents. This study was conducted in Saudi Arabia during the first month following the WHO announcement of the Monkeypox outbreak, to assess healthcare workers (HCWs) perceptions of, worries concerning, and vaccine acceptance for, Monkeypox, in light of the resolving COVID-19 pandemic. Methods: A national cross-sectional survey was conducted between 27 May and 10 June 2022, in Saudi Arabia. Data were collected on: HCWs’ sociodemographic and job-related characteristics; COVID-19 infection status; and worries concerning Monkeypox, compared to COVID-19 and its sources; as well as their perceptions and awareness of, and advocacy for, supporting Monkeypox vaccination. Results: A total of 1130 HCWs completed the survey, of which 41.6% have already developed COVID-19. However, 56.5% were more concerned about COVID-19 compared to Monkeypox, while the rest were more worried about Monkeypox disease. The main cause for concern among 68.8% of the participants was the development of another worldwide pandemic, post-COVID-19, followed by their concern of either themselves or their families contracting the infection (49.6%). Most HCWs (60%) rated their level of self-awareness of Monkeypox disease as moderate to high. Males, and those who had previously developed COVID-19, were significantly less likely to worry about Monkeypox. The worry about Monkeypox developing into a pandemic, and the perception of Monkeypox being a severe disease, correlated significantly positively with the odds of high worry concerning the disease. The major predictors of participants’ advocacy for vaccination against Monkeypox disease were: those who had developed COVID-19 previously; and those who supported tighter infection control measures (than those currently used) to combat the disease. A total of 74.2% of the surveyed HCWs perceived that they needed to read more about Monkeypox disease. Conclusions: Approximately half of the HCWs in this study were more concerned about Monkeypox disease than COVID-19, particularly regarding its possible progression into a new pandemic, during the first month following the WHO’s Monkeypox international alert. In addition, the majority of participants were in favor of applying tighter infection prevention measures to combat the disease. The current study highlights areas requiring attention for healthcare administrators regarding HCWs’ perceptions and preparedness for Monkeypox, especially in the event of a local or international pandemic