Delivery of inhibitory signalling via co-crosslinking of FcεRI and FcγRIIB with engineered micro-surfaces as a new therapeutic concept

Mast cell and basophil mediators play a major role in the development of immunoglobulin E (IgE)-dependent allergic disorders. One of these mediators is histamine, which is released by activation of inflammatory cells through cross-linking of the high affinity IgE receptor (FcεRI). The current immunotherapies are accompanied by major drawbacks, such as an increase the risk of anaphylaxis and systemic reaction, difficulties in allergen extract standardisation of allergen-specific immunotherapy (SIT), and a small but worrying increase in the incidence of cancer with omalizumab. It is known that co-aggregation of immunoglobulin G (IgG) low-affinity receptor (FcγRIIB) with FceεRI can lead to inhibition of mast cell degranulation, thus inhibiting production of pharmacological mediators. The potential underlying this principle has been highlighted by many approaches published in the literature. In this study, we designed a novel immunotherapy vector that takes advantage of the most recent advances in drug delivery systems using microparticles. This micro-carrier will carry the Fc parts of both IgG and IgE in defined stoichiometric ratios to be directed towards the allergic inflammatory cells (mast cells and basophils). Fcγ receptors have different binding affinities for IgG1, either with high affinity in the case of FcγRI, or low as with FcγRIIB. We engineered mutant IgG-Fc fragments with increased binding affinity for FcγRIIB. These recombinant Fc-genes were successfully transfected, expressed and purified from the cell supernatant of a high yield HEK293- 6E cell line mammalian expression system. To obtain a site-specific conjugation between the recombinant Fc proteins and microparticles, a novel 15 amino acid peptide tag known as Avi-Tag was used. Both particle size and Fc density have an effect on the level of the immune response. On the reporter cell lines derived from the parental RBL-2H3 cell lines (RS-ATL8 and NFAT-DsRed), a 0.5μm particle coated with IgE Fc significantly affected the activation response compared to other particles sizes (1,2 and 6 μm). Cell activation was also affected by the density of IgE Fc, and a lower dilution ratio of added IgE Fc to particles (1:50) showed the highest activation value. Unexpectedly, the preliminary data for the release of histamine from purified human peripheral blood basophils treated with different Fc-particle conjugate formulations did not show any effect for the suggested therapy

Addressing medication errors in an adult oncology department in Saudi Arabia: A qualitative study

Objective: There is a wide range of strategies that could help in minimizing medication errors during healthcare delivery. We undertook a qualitative study to identify recommended solutions to minimize medication errors in an adult oncology department in Saudi Arabia from the perspectives of healthcare professionals. Methods: This was a qualitative study conducted in an adult oncology department in Saudi Arabia. After obtaining the required ethical approvals and written consents from the participants, seven focus group discussions were carried out for data collection. A stratified purposive sampling strategy was used to recruit medical doctors, pharmacists, and nurses. NVivo Pro version 11 was used for data analyses. Inductive content analysis was adopted in the coding of collected data. Result: Our study showed that improving organizational support, staff education, and communication could help in minimizing medication errors in the adult oncology department. Conclusion: The adoption of multiple strategies is required to improve the safety of the medication process in the adult oncology department. We argue that the availability of supportive leadership should be prioritized as it plays a crucial role in determining the effectiveness and efficiency of both staff education and communication

Does dental students' attendance in classroom lectures depend on the mode of attendance tracking?

Purpose: The necessity to attend classroom lectures is a disputable topic among dental schools globally. Since there is an ongoing debate on different aspects of this problem in literature, the purpose of this study was to compare students’ attitudes toward classroom attendance and investigate if stricter attendance tracking methods could lead to better classroom attendance at two dental schools utilising different modes of tracking students’ attendance. Method: This was an observational, cross-sectional survey distributed among dental students enrolled at King Abdul-Aziz University (KAU) and King Saud University (KSU) in Saudi Arabia. The survey included questions on demographics, average travel time, student's attitudes toward classroom lectures and common reasons for absenteeism. Collected data were analysed and summarised as frequencies and percentages and then compared using the Chi-square test for statistical significance. Findings: The study involved 678 participants from KAU and 475 participants from KSU. In general, there was a significant difference in students’ attendance between both schools in which 26.8% of KAU dental students skipped 5 or more lectures/month compared to 11.5% of students at KSU. Among the factors affecting classroom lecture attendance, commuting time was a major one reported by students (44.8% of students at KSU and 51.4% at KAU needed 30-60 min to reach their schools). The availability of lectures through online resources and the necessity to study for exams were additional factors reported by students of both schools. Implications for research and practices: Based on the current data, the school’s method to track students’ attendance may have a role in the pattern of classroom absenteeism

Squint Among Adult Population in Hail City, Saudi Arabia

Background: Strabismus, also known as crossed eyes, is a condition in which the eyes do not properly align with each other when looking at an object. If present during a large part of childhood, it may result in amblyopia. If onset is during adulthood, it is more likely to result in double vision. Objective: The aim of the study was to estimate the prevalence of squint, types and treatment characteristics in the studied adults in Hail city, Saudi Arabia. Methods: A cross-sectional study conducted in Hail city, Saudi Arabia. The study included 294 participants; 95 male and 199 female adults aged >20 years. The study period was from 1 January to 30 April 2018. Data collected by personal interview using a pre-designed questionnaire, which distributed among the participants to be self-reported. Results: The prevalence of squint among the studied population was 9.9%. it was more common in females than males. Squint was right sided in 24.1% of the cases, left sided in 51.7% and in both eyes in 24.1% of the studied cases. About half (44.8%) of cases had inward squint (esotropia) and 10.3% outward squint (exsotropia), 24.1% of the cases had Intermittent squint and 6.9% had permanent squint. Most (55.2%) of squint cases use glasses and 34.5% of cases squint affected their visual acuity. In 6.9%, squint causes psychological troubles. As regards treatment, 20.7% received medical treatment and 17.2% received surgical treatment but 62.1% do not seek medical care. Only 10.3% of cases completely cured and 13.8% had recurrence. There was insignificant relation with age, sex, education, squint in parents, chronic diseases, consanguinity or hereditary diseases (P>0.05). Conclusion: in this study, the prevalence of squint in the adult participants in Hail city, Saudi Arabia was 9.9% but 62.1% do not seek medical care. After treatment, only 10.3% of cases completely cured and 13.8% had recurrence. Health education of the public about importance of early treatment is highly recommended. Keywords: Squint; strabismus; adult population; prevalence; types; Hail; Saudi Arabia

Public satisfaction with COVID-19 vaccination program in Saudi Arabia

The challenges posed by the ongoing COVID-19 pandemic have required the introduction of new care delivery models and procedures. For the foreseeable future, vaccine administration will be a key part of the patient experience journey. It is important therefore to understand and evaluate experiences of individuals taking the vaccination, an area which requires considerable attention. To address this, the COVID-19 Vaccination Satisfaction survey was developed and administered at several healthcare facilities across Saudi Arabia. Between January 2021 and end of December 2021, a total of 1,699,177 completed surveys were collected. The survey results suggest high satisfaction among participants taking the vaccine; however, satisfaction with information and communication about the vaccine was relatively low. Results from this survey are updated daily and provide unique insights into the key strengths of the vaccination process, as well as aspects within the process that require improvement. Experience Framework This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this lens

Inverse Correlation between Stress and Adaptive Coping in Medical Students

BACKGROUND: Medical students in their academic years are generally under stress but very few studies revealed the relationship between the stress and how the students manage to adapt these stressful conditions. AIM: The aim of the study was to investigate the levels of stress and their adaptive coping in the 1st 3 years medical students and also to determine the factors associated with adaptive coping strategies. METHODS: This is a descriptive cross-sectional study conducted on 441 medical students of Qassim University from September-October 2019. First 3 years medical students were randomly selected and their stress levels or adaptive coping strategies were determined by general health questionnaire (GHQ-12) and strategies coping mechanisms (SCM), respectively. The 5-points Likert scale was used for scoring and the data obtained were further validated by DASS and Brief COPE scales. RESULTS: Out of 441 medical students, 39.2% agreed to participate. The data showed that the level of stress among students was highest during their 1st year academic blocks, followed by 2nd and 3rd year students. Interesting, the adaptive coping among them was found highest during the academic blocks of 3rd year students, followed by the 2nd and 1st year students. Importantly, female students showed better adaptation against stress. Students living with their parents avoided stress in better ways as compared to those who were living alone. CONCLUSION: This is the first study that shows an inverse correlation between the stress and adaptive coping in medical students of Qassim University. The data concluded that adaptation of stress in the 3rd-year students was the highest followed by 2nd and 1st year medical students. Moreover, female students adapted well against stress and students living alone showed worse adaptation of stress

Sickle cell disease and systematic lupus erythematous association in a 14-year-old adolescent female

SCD develops when haemoglobin (HbS) is produced in the body as a result of a mutation occurring in haemoglobin beta chain. SLE is defined as a rare, chronic autoimmune multi-organ manifestation. SCD and SLE rarely coincide in literature due to the limited number of cases and the overlapping of symptoms of both diseases. Majority affecting child bearing age, with a mean of 23-year-old. Articular manifestations like joint pain are common in both diseases. We report a case of female adolescent with sickle cell disease associated with systemic lupus erythematous

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

Overview on Juvenile Primary Fibromyalgia Syndrome

JPFS (juvenile primary fibromyalgia syndrome) is a musculoskeletal pain illness that affects children and adolescents. The intricacy of the clinical picture in JPFS has not been adequately characterized in the literature. JFMS symptoms are sometimes difficult to compare to adult fibromyalgia syndrome since many of them are "medically unexplained" and frequently overlap with other medical disorders.  The etiology of the illness is multifaceted, with impaired central pain processing being a significant contributor. Musculoskeletal pain that is severe and pervasive is the defining symptom. Other signs and symptoms include headaches, stiffness, subjective joint swelling, sleep and mood disorders, and headaches. Multiple sensitive spots might be found during a physical examination. The diagnosis has certain criteria and is clinical. Early detection and treatment are crucial. The gold standard of care combines a variety of modalities, but most significantly, exercise and cognitive behavioral therapy. The outlook varies, and symptoms might last well into adulthood. Discussing the epidemiology, etiology, pathophysiology, clinical symptoms, diagnosis, and management of JPFS is the goal of the review