The Importance of Preventive Medicine in Family Practice: A Review of Current Guidelines and Recommendations

Prevention is seen as a critical topic in family practice. Primordial prevention, primary prevention, secondary prevention, tertiary prevention, and quaternary prevention are all part of this strategy to disease prevention. To avoid the formation and development of risk factors, primary prevention focuses on addressing the fundamental causes and social determinants of disease. Primary prevention is the practice of preventing illnesses before they arise via the use of treatments such as immunizations and health education. Secondary prevention focuses on illness identification and intervention as early as possible to avoid disease development. Tertiary prevention addresses illness outcomes by restoring health and offering rehabilitation. Finally, quaternary prevention seeks to safeguard patients against needless medical treatments and the harm caused by over-medicating. Risks frequently rise in tandem with frailty and comorbidities. In contrast, advantages frequently drop as life expectancy increases. Preventive management strategies should consider the patient's viewpoint and be mutually agreed upon. Healthcare providers must prioritize the deployment of preventive care services, even when clinical treatments are required, in order to overcome preventive care hurdles. Healthcare practitioners may play a critical role in illness prevention and contribute to family well-being by investing in preventive care and executing these measures

Effectiveness of BNT162b2 and ChAdOx1 Vaccines against Symptomatic COVID-19 among Healthcare Workers in Kuwait: A Retrospective Cohort Study

Background: Estimating vaccine effectiveness (VE) against severe, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among healthcare workers (HCWs) is necessary to demonstrate protection from the disease. Between 24 December 2020 and 15 June 2021, we determined the factors associated with vaccine coverage and estimated VE against SARS-CoV-2 infection in HCWs at a secondary hospital in Kuwait. Methods: We extracted sociodemographic, occupational, SARS-CoV-2 infection, and vaccination data for eligible HCWs from the hospital records. Vaccine coverage percentages were cross-tabulated with the HCW factors. Cox regression was used to estimate hazard ratios in vaccinated versus unvaccinated. Results: 3246 HCWs were included in the analysis, of which 82.1% received at least one vaccine dose (50.4% only one dose of ChAdOx1, 3.3% only one dose of BNT162b2, and 28.3% two doses of BNT162b2). However, 17.9% of HCWs were unvaccinated. A significantly lower vaccination coverage was reported amongst female HCWs, younger age group (20–30 years), and administrative/executive staff. The adjusted VE of fully vaccinated HCWs was 94.5% (95% CI = 89.4–97.2%), while it was 75.4% (95% CI = 67.2–81.6%) and 91.4% (95% CI = 65.1–97.9%) in partially vaccinated for ChAdOx1 and BNT162b2, respectively. Conclusions: BNT162b2 and ChAdOx1 vaccines prevented most symptomatic infections in HCWs across age groups, nationalities, and occupations

Could vertigo be a post-COVID-19 sequela or presenting symptom?

Abstract Background It has been postulated that COVID-19 has a substantial neuro-otological impact such as vertigo or dizziness that is rarely evaluated. The purpose of this research is to study the occurrence of vertigo (whether as presenting symptom or a sequela) and its etiological characteristics in patients with covid 19 infection and close contact. It is a cross-sectional study (convenient sample) conducted on patients that had a previous history of covid 19 infection and another group of contact individuals who presented with the sensation of vertigo. All the included participants underwent full neurological and otological examination, nasopharyngeal swab PCR to confirm COVID-19 infection and video nystgmograghy (VNG). Results it was included 44 participants, where 7 (15.9%) of the participants were post-COVID-19 patients and 37 (84.1%) were close contacts of COVID patients. It was found that 6(85.7%) of post-COVID-19 patients had vestibular neuritis (VN), and 1(14.3%) patient had Benign Paroxysmal Positional Vertigo (BPPV). 9(23%) of those in close contact had positive PCR for COVID infection, 6(66.7%) of them had VN, and the other 3 (33.3%) had BPPV. Conclusion Vertigo could be a possible complication or a presenting symptom in patients with COVID patients that is mainly attributed to peripheral vestibular dysfunction

Monoclonal Antibody Treatment of RSV Bronchiolitis in Young Infants: A Randomized Trial.

BACKGROUND: Monoclonal antibody to respiratory syncytial virus (RSV; palivizumab) is recommend for prophylaxis of high-risk infants during bronchiolitis seasons but not for RSV bronchiolitis treatment. Our aim was to determine if palivizumab would be helpful in young infants with acute RSV bronchiolitis. METHODS: Eligible infants ≤3 months old presenting to the pediatric emergency service with RSV-positive bronchiolitis requiring inpatient admission underwent double-blind random assignment to single-dose intravenous palivizumab (15 mg/kg) or placebo. The primary efficacy outcome was the need for inpatient readmission in the 3 weeks after discharge. Secondary outcomes were time to readiness for hospital discharge, need for PICU on the initial admission, and need for revisit not requiring readmission for the same illness during 3-week follow-up. RESULTS: A total of 420 infants (median age 49 days) diagnosed with RSV bronchiolitis were randomly assigned; 417 received treatment, and 413 completed follow-up. Readmission during follow-up was needed for 23 (11%) patients on palivizumab and 19 (9.3%) patients in the placebo group (difference 1.8%; 95% confidence interval -4.4% to 7.7%; CONCLUSIONS: Intravenous palivizumab did not appear to help or harm young infants with acute RSV-positive bronchiolitis

Role of GeneXpert in extrapulmonary tuberculosis

Background Tuberculosis (TB) commonly affects the lung (pulmonary TB). Extrapulmonary TB (EPTB) can involve many systems. Diagnosis is often difficult. EPTB may be misdiagnosed with many other inflammatory, granulomatous, and neoplastic disorders. GeneXpert mycobacterium tuberculosis /rifampicin is a valuable test in diagnosis of pulmonary TB. There is limited research about its diagnostic role in EPTB. Patients and methods The aim of this study was to assess the diagnostic value of GeneXpert in EPTB. Samples from EPTB cases were sent for standard mycobacterial culture and GeneXpert assay. The sensitivity and specificity of GeneXpert were calculated. Results A total of 100 patients were included. Overall, 61 cases were definitely diagnosed as EPTB, whereas 39 cases were negative according to culture. GeneXpert was positive in 40 cases, which represent 65.6% of EPTB cases, and negative in 21 (34.4%) cases. Sensitivity and specificity of GeneXpert was 65.6 and 97.4%, respectively. The positive predictive value and negative predictive value were 97.4 and 64.4%, respectively. Conclusion GeneXpert is a rapid, valuable tool in diagnosis of patients with EPTB. It is a highly specific test with fair sensitivity. A multicenter study with larger sample size is needed to evaluate the diagnostic role of GeneXpert in different sites of EPTB

Green Biosynthesis of Silver Nanoparticles Using <i>Annona glabra</i> and <i>Annona squamosa</i> Extracts with Antimicrobial, Anticancer, Apoptosis Potentials, Assisted by In Silico Modeling, and Metabolic Profiling

Annona glabra L. (AngTE) and Annona squamosa L. (AnsTE) fruits have been widely used in cancer treatment. Accordingly, their extracts were used to synthesize silver nanoparticles via a biogenic route (Ang-AgNPs) and (Ans-AgNPs), respectively. Chemical profiling was established using UPLC-QTOF-MS/MS. All species were tested for anticancer activity against human cervical cancer cells (HeLa), prostate adenocarcinoma metastatic (PC3), and ovary adenocarcinoma (SKOV3) using sulphorhodamine B assay. Apoptosis was determined using Annexin flow cytometry along with cell cycle analysis and supported by a molecular docking. The antibacterial and synergistic effect when combined with gentamicin were evaluated. A total of 114 compounds were tentatively identified, mainly acetogenins and ent-kaurane diterpenes. AnsTE and Ans-AgNPs had the most potent cytotoxicity on HeLa and SKOV3 cells, inducing a significant apoptotic effect against all tumor cells. The AnsTE and Ans-AgNPs significantly arrested PC3, SKOV3, and HeLa cells in the S phase. The nanoparticles demonstrated greater antibacterial and antifungal activities, as well as a synergistic effect with gentamicin against P. aeruginosa and E. coli. Finally, a molecular docking was attempted to investigate the binding mode of the identified compounds in Bcl-2 proteins’ receptor, implying that the fruits and their nanoparticles are excellent candidates for treating skin infections in patients with ovarian or prostatic cancer

Two Red Sea Sponge Extracts (<i>Negombata magnifica</i> and <i>Callyspongia siphonella</i>) Induced Anticancer and Antimicrobial Activity

Bioactive compounds extracted from marine organisms showed several biological activities. The present study is an extension of our earlier studies where we assessed the antiproliferative and pro-apoptotic activities of ethanol, methylene chloride, ethyl acetate, acetone, and chloroform crude extracts of sponges: Negombata magnifica (NmE) and Callyspongia siphonella (CsE) against cancer cells. Herein, we are extending our previous findings on both sponge species depending on an alternative methanol extraction method with more advanced molecular biochemical insights as additional proof for anticancer and antimicrobial activity of N. magnifica and C. siphonella. Therefore, sponge specimens were collected during winter 2020 from the Dahab region at the Gulf of Aqaba. Each sponge was macerated with methanol to obtain the crude extracts; NmE and CsE. GC–MS analysis presented a total of 117 chemical compounds; 37 bioactive, 11 represented previously as constituents for a natural organism, and 69 had no biological activities. NmE dose-dependently inhibited the growth of HepG2, MCF-7, and Caco-2 carcinoma cell lines compared to CsE, which unfortunately has no antiproliferative activity against the same cancer cells. NmE was found to induce G0/G1 cell cycle arrest in HepG2 cells with its inhibition for CDK6, Cyclins D1, and E1 in HepG2, MCF-7, and Caco-2 cells. NmE also activated ROS production in HepG2 cells and induced apoptosis in HepG2, MCF-7, and Caco-2 cells via an increase in pro-apoptotic protein Bax, caspase-3, and cleavage PARP, and a decrease in anti-apoptotic protein BCL2. Unlike its anticancer potential, CsE exhibited clear superior results as an antimicrobial agent with a wider range against six microbial strains, whereas NmE showed a positive antibacterial activity against only two strains