COVID-19 clinical presentations: the modern mimic of other conditions

The coronavirus pandemic (COVID-19) has placed enormous challenges on the health sector. Diagnosis is one of these challenges, where a clinical presentation may suggest a disease other than COVID-19. In this review we describe many presentations unrelated to the respiratory system. The ACE2 receptor is present in a wide variety of body tissues and it appears that this may be a link with the clinical pathology. To find these data we searched the major academic research engines, Google Scholar, and Pubmed, as well as the most recent case reports and original research published in specialized journals. An awareness of these uncommon presentations helps health workers to recognize and treat the disease early and appropriately. Keywords: COVID-19, coronavirus, pandemic, ACE2, unusual symptoms, revie

THE RELATIONSHIP BETWEEN OBESITY AND DIETARY INTAKE OF OBESE AND PRE-OBESE FEMALE STUDENTS – AJA CAMPUS HAIL UNIVERSITY

Globally obesity has reached to epidemic proportions, and the people of the Gulf countries have also affected, especially high income, oilproducing countries. Recent data clearly indicate a high prevalence of adult obesity particularly in women in the Kingdom. This paper aims to identify the relationship between obesity and dietary intake of obese and pre-obese female students in Hail University–KSA. Descriptive analytical approach was used in this paper. BMI was calculated and related to dietary intake using food frequency questionnaire. Results shows prevalence of obesity grades was n(%); 43(43%) obesity grade I, 17(17%) obesity grade II, and 8(8%) were grade III obesity. Thirty one subjects were pre-obese and only one subject was overweight. Basic food groups consumption as stated in frequency per week revealed that: female students consumed more servings (>6 times/ week ) of fruits; vegetables; and dairy products, alternatives, sweets and candies, eggs, legumes, rice macaroni and other starch foods, non-alcoholic beverages. Whereas they consumed less servings (≤Once/ week) of breads, fruit juices, carbonated drinks and potato. The majority of the subjects 65% ate chicken with rice (Kabsa) as staple food, whereas 4% ate other starchy food. High consumption of energy dense foods might be responsible for increased deposition of calories in the form adipose tissue. Conclusion: It is crucial to enumerate awareness programs to modify dietary behavior and eating habits of female students and Hail community with respect to food intake. This will be effective in the treatment of obesity, especially in Saudi Arabia

Perakaunan dan pelaporan kewangan Islam bagi Institusi Baitulmal, Zakat dan Wakaf Di Malaysia Fasa 4 (Zon 3)

Di Malaysia, pentadbiran institusi Baitulmal, Zakat dan Wakaf (selepas ini dinyatakan sebagai institusi BZW) dilaksanakan oleh Majlis Agama Islam Negeri (MAIN), selaras dengan peruntukan undang-undang Perlembagaan Malaysia. Secara amnya institusi BZW ditadbir menggunakan dasar sektor awam, namun institusi ini mempunyai perbezaan atau keunikan dalam pentadbirannya berbanding dengan agensi sektor awam yang lain, iaitu institusi ini berlandaskan Islam. Mutakhir ini peranan dan perkembangan institusi BZW dalam membangunkan ekonomi dan harta umat Islam semakin ketara dan meningkat. Aktiviti berkaitan zakat semakin meluas dan pembangunan hartanah baitulmal dan wakaf lebih dinamik. Selaras dengan perkembangan ini, suatu piawaian perakaunan dan pelaporan kewangan khusus bagi institusi BZW yang berlandaskan Islam perlu diwujudkan bagi membantu institusi BZW dalam melaksanakan tanggungjawabnya. Ini bagi membolehkan setiap kegiatan dan perkhidmatan yang dilakukan oleh institusi tersebut dapat dilaporkan dengan telus sepertimana tuntutan Syariah. Amalan perakaunan yang seragam dan mematuhi keperluan Syariah diharapkan dapat membantu semua pemegang taruh mendapat maklumatmaklumat yang diperlukan berkaitan dengan aktiviti institusi BZW. Amalan dan kaedah perakaunan semasa yang sedikit berbeza di antara institusi BZW di negeri yang berbeza memberi kesan kepada ketelusan maklumat dan akauntabiliti institusi berkenaan. Kajian Fasa 1, 2 dan 3 mendapati ketiadaan piawaian khusus bagi perakaunan dan pelaporan BZW sebagai punca ketidakseragaman amalan dan kaedah perakaunan semasa. Sehubungan dengan itu, pembangunan piawaian adalah dituntut bagi memastikan agar perbezaan pelaporan dan perakaunan tidak terlalu ketara. Dalam konteks BZW, harus diingat bahawa memang terdapat perbezaan yang berpunca dari beberapa sebab seperti kelainan transaksi, perbezaan keputusan majlis fatwa negeri dan juga amalan tradisi yang telah diwarisi sejak sekian lama. Perbezaan ini perlu diraikan kerana kemungkinan terdapat kekangan tertentu yang tidak boleh atau agak sukar untuk dilaksanakan secara serta merta. Menyedari perkara ini, terdapat keperluan untuk menyeimbangi antara keperluan penyeragaman dan meraikan perbezaan. Oleh itu, usaha untuk membangunkan garis panduan yang boleh dijadikan rujukan buat institusi BZW menjadi satu keperluan

Effect of Aromatase Inhibitor Letrozole on the Placenta of Adult Albino Rats: A Histopathological, Immunohistochemical, and Biochemical Study

Background: Letrozole, an aromatase inhibitor, has recently been introduced as the preferred treatment option for ectopic pregnancy. To date, no study has investigated the effect of letrozole alone on placental tissue. The present study aimed to evaluate the effect of different doses of letrozole on the placenta of rats and to clarify the underlying mechanism. Methods: Sixty pregnant female rats were equally divided into three groups, namely the control group (GI), low-dose (0.5 mg/Kg/day) letrozole group (GII), which is equivalent to the human daily dose (HED) of 5 mg, and high-dose (1 mg/Kg/day) letrozole group (GIII), equivalent to the HED of 10 mg. Letrozole was administered by oral gavage daily from day 6 to 16 of gestation. Data were analyzed using a one-way analysis of variance followed by Tukey’s post hoc test and Chi square test. P<0.05 was considered statistically significant.Results: Compared to the GI and GII groups, high-dose letrozole significantly increased embryonic mortality with a high post-implantation loss rate (P<0.001) and significantly reduced the number of viable fetuses (P<0.001) and placental weight (P<0.001) of pregnant rats. Moreover, it significantly reduced placental estrogen receptor (ER) and progesterone receptor (PR) (P<0.001) and the expression of vascular endothelial growth factor (P<0.001), while increasing the apoptotic index of cleaved caspase-3 (P<0.001).Conclusion: Letrozole inhibited the expression of ER and PR in rat placenta. It interrupted stimulatory vascular signals causing significant apoptosis and placental vascular dysfunction. Letrozole in an equivalent human daily dose of 10 mg caused a high post-implantation loss rate without imposing severe side effects

Association between solar insolation and a history of suicide attempts in bipolar I disorder

In many international studies, rates of completed suicide and suicide attempts have a seasonal pattern that peaks in spring or summer. This exploratory study investigated the association between solar insolation and a history of suicide attempt in patients with bipolar I disorder. Solar insolation is the amount of electromagnetic energy from the Sun striking a surface area on Earth. Data were collected previously from 5536 patients with bipolar I disorder at 50 collection sites in 32 countries at a wide range of latitudes in both hemispheres. Suicide related data were available for 3365 patients from 310 onset locations in 51 countries. 1047 (31.1%) had a history of suicide attempt. There was a significant inverse association between a history of suicide attempt and the ratio of mean winter solar insolation/mean summer solar insolation. This ratio is smallest near the poles where the winter insolation is very small compared to the summer insolation. This ratio is largest near the equator where there is relatively little variation in the insolation over the year. Other variables in the model that were positively associated with suicide attempt were being female, a history of alcohol or substance abuse, and being in a younger birth cohort. Living in a country with a state-sponsored religion decreased the association. (All estimated coefficients p <0.01). In summary, living in locations with large changes in solar insolation between winter and summer may be associated with increased suicide attempts in patients with bipolar disorder. Further investigation of the impacts of solar insolation on the course of bipolar disorder is needed.Peer reviewe

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly