Articles

Introduction: Busulfan (Bu)-based regimens are crucial for myeloablative conditioning in pediatric allogeneic stem cell transplantation. Despite its efficacy, Intravenous Bu has a narrow therapeutic index and variable pharmacodynamics especially in children, heightening the risk of adverse events. This study explores Bu dosing and related organ toxicities in pediatric patients at a tertiary center in Saudi Arabia.Methodology: This retrospective study at King Fahad Specialist Hospital in Dammam (KFSH-D), Saudi Arabia, included pediatric patients (≤16 years) treated with intravenous Bu before bone marrow transplantation from 2010 to 2022. Pharmacokinetic dose adjustments were based on AUC targets of 900-1350 µMol-min. Descriptive measures included mean, Standard Deviation (SD), median, minimum-maximum values, counts, and percentages. Statistical analyses used Kruskal-Wallis, Chi-square, and Fisher’s exact tests. Ethical approval was obtained from KFSH-D.Results: We identified 44 pediatric patients who underwent Bu prior to HSCT. Mean age was 4.95 ± 2.49 years, with a female majority (56.8%). Primary diseases included Beta Thalassemia (34.09%), Neuroblastoma (29.55%) among others. There was no significant difference in the cohort’s demographic and clinical features of the cohort. Nonetheless, higher infections were found in the Low-AUC group (66.7%) compared to the Target-AUC (40.0%) and Higher-AUC groups (0.0%) (p = 0.015).Conclusion: This study emphasizes the need for therapeutic drug monitoring and individualized Bu dosing in pediatric HSCT to minimize toxicity and improve outcomes. Larger multicenter studies are recommended to refine dosing strategies and enhance the safety and efficacy of Bu-based regimens.

Ventricular Septal Defect, also known as VSD is a rare and life-threatening complication associated with MI. Therefore, it should be immediately diagnosed and treated. Transcatheter closure of the ventricular septal defect is a new alternative treatment approach compared to surgery. In this case, we presented a patient with post-infarct basal ventricular septal defect whose ventricular septal defect was closed using an atrial septal defect closure device. The ability to successfully close such a large defect via catheter is promising for the treatment of patients with VSD.

Introduction: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) was first reported in 2003. In 2014, it was revealed that not only bisphosphonates but also other antiresorptive and antiangiogenic drugs can cause osteonecrosis (Medication-related osteonecrosis of the jaw: MRONJ). The aim of this study is to compare awareness and knowledge about BRONJ and MRONJ among specialists/trainers (ST), general dental practitioners (GDP); and dentists who graduated before and after the year 2014. Materials and methods: A survey regarding demographic information and knowledge about BRONJ and MRONJ was prepared and delivered to dentists via social media.Results: A total of 422 dentists participated in our study. It was observed that the awareness and knowledge about BRONJ and MRONJ were statistically higher in ST and in dentists who graduated in 2014 or later. In addition, when their specialties were compared to each other, it was seen that the awareness and knowledge of Oral and Maxillofacial Radiologists (OMR) and Oral and Maxillofacial Surgeons (OMS) were higher than others.Discussion: According to the results of this study, it was seen that the awareness and knowledge of the ST group were higher than GDP, maybe because they may encounter these cases more. In addition, dentists who graduated in 2014 or later had higher awareness, maybe because MRONJ was coined and entered the dentistry education curriculum in 2014. Awareness and knowledge of OMR and OMS were found higher may be because they encounter these patients more frequently. Planning educational strategies for all dentists, especially GDP and dentists who graduated before 2014 is very important for post-graduate dentistry education.

Porcine Epidemic Diarrhea Virus (PEDV) can infect pigs of any age, but the disease severity varies significantly, particularly affecting neonatal piglets due to their immature immune system. Various vaccination strategies have been questioned for their efficacy, especially since outbreaks have occurred even on vaccinated farms. Recent suggestions indicate that exposure to the virus may enhance the effectiveness of inactivated vaccines, highlighting the potential benefits of using attenuated viruses to generate immunity in sows without prior exposure. This study aimed to evaluate the humoral and cytokine responses in pregnant sows and their piglets after inoculation of affected piglet intestinal contents and a virus isolated. We measured immune parameters such as IL-12, IL-22, IgG, and IgA, as well as neutralizing antibodies in serum, colostrum, and milk. Notably, higher titers of neutralizing antibodies were found in sows immunized with the viral inoculum, while IL-12 and IL-22 levels showed no significant differences. Additionally, we assessed productive parameters like total piglets born, weaning mortality, average birth weight, and stillborn rates. The results indicated that sows treated with affected piglet intestinal contents had higher mortality (48.31%) and stillborn rates (20.96%) compared to those receiving the isolated virus (30.02% and 10.44%, respectively). These findings suggest that using an isolated virus can offer a safe, long-lasting, and specific immune response, underscoring the importance of thorough analysis of both systemic and mucosal immune responses against PEDV.

Venous Thromboembolism (VTE) is a major public health concern, affecting approximately 900,000 people annually in the United States. In rare cases, a Patent Foramen Ovale (PFO) may allow a venous thrombus to cross into the arterial circulation, causing a paradoxical embolism. This case report presents a 46-year-old male who developed left renal artery stenosis after a paradoxical embolism, likely triggered by a prolonged flight and binge alcohol consumption. The patient was found to have a moderate-sized PFO and renal infarction, confirmed by imaging studies. Despite initial anticoagulation therapy and a planned stenting procedure, intraoperative findings revealed only mild stenosis, leading to cancellation of the stent placement. The patient ultimately underwent PFO closure with an Amplatzer Talisman device. This case underscores the diagnostic challenges in managing paradoxical embolism and the need for individualized treatment, particularly concerning anticoagulation duration, the decision for PFO closure, and post-procedural antithrombotic therapy. Further research is required to establish optimal management strategies for cryptogenic embolic events.

Water deficit is a fundamental factor in public health and economic growth. Water supply and population growth are directly linked to water demand. The physio-chemistry and microbiology analysis of water is utmost significance in dietary requirements. Drinking water has the main concern especially it affects food security. This study includes a number of representative sites where 24 water samples (from wells, reservoirs and tap water) were analysed. These sites are located in the western villages of Baalbeck, the main city of the Bekaa Plain in Lebanon where the analysed water is used mainly for domestic needs and for irrigation. This study  investigates the physiochemical and microbiological properties. Among the selected sites, Hawsh Barada site shows a strong contamination by nitrate. At the Nabi Rashaded (tap), Beit Shema and Bednayel (borehole and tap), contamination above the norm by zinc ion was noted. From a microbiological point of view, Hawsh barada, Nabi-Rashadeh, Hawsh-bay, and Beit shema are markedly polluted and do not meet the standard for drinking water. Hence, water quality in Hawsh barada, Nabi-Rashadeh, Hawsh-bay, Beit shema and Bednayel are not suitable for drinking, and this must be informed to decision makers who can act implementing environmental controls for health protection in the studied region.

Background: The impact of COVID-19 and long-term COVID-19 on gastrointestinal neoplasms remains underexplored. The current review investigates the potential link between these conditions and the role of gut microbiota in mediating oncogenic processes. Dysbiosis, characterized by alterations in gut microbial composition, may exacerbate inflammation and immune dysregulation, contributing to cancer development.Methods: A comprehensive literature review was conducted using databases including PubMed, Scopus, Embase, SciELO, and Web of Science. Inclusion criteria encompassed studies published between 2020 and 2024 that explored the intersection of COVID-19, long-term COVID-19, and gastrointestinal cancers. The articles were critically appraised for quality and relevance, and data were synthesized to elucidate common mechanisms and outcomes.Results: The review identifies several mechanisms by which gut microbiota may influence cancer risk in COVID-19 patients. Persistent inflammation, oxidative stress, and immune dysfunction observed in Long COVID were associated with dysbiosis. Specific microbial metabolites, such as secondary bile and short-chain fatty acids, were implicated in promoting tumorigenesis. Comparative analysis of studies suggests that SARS-CoV-2-induced dysbiosis may heighten susceptibility to gastrointestinal cancers, particularly in patients with prolonged post-infection symptoms.Conclusion: The findings underscore the need for further research to clarify the role of gut microbiota in cancer development among COVID-19 patients. These mechanisms could inform preventative strategies and therapeutic interventions, particularly for those experiencing COVID. The review highlights gaps in current knowledge and advocates for longitudinal studies to assess the long-term effects of COVID-19 on gastrointestinal health.

Purpose of the study:  To evaluate the performance of Best Practice Recommendation (BPR) compliance in reporting abdominal aortic aneurysm findings on imaging, comparing the results before and after its deployment.Methods: Best Practice Recommendations for AAA were deployed in 2020 at a large radiology practice site. Reports between January 2018 through October 2022 were reviewed, representing studies read prior to and subsequent to the implementation of the reporting standards. Cases of abdominal aortic aneurysms ≥ 2.6 cm were counted by year. Adherence to the BPR for each year was calculated as [total number of confirmed cases of ≥ 2.6 cm AAAs with compliant reports] * 100 / [the total number of confirmed ≥ 2.6 cm AAAs]. A secondary analysis was performed to determine whether there was a statistically significant difference in the proportion of BPR-compliant reports for AAA cases before (from 2018 to 2019) and after (from 2020 to 2022) BPR deployment using a chi-square test. Results: From January 2018 to December 2022, there were 8,693 reports referencing AAA. After excluding cases of suspected AAA (N = 2,131), confirmed AAAs with indeterminate sizes (N = 103), and confirmed AAAs with sizes < 2.6 cm (N = 85), the number of AAA cases ≥ 2.6 cm in size was 6,374. Concordance with the BPR standards for the remaining cases with sizes ≥ 2.6 cm were 1.6% and 4.1% in 2018 and 2019, respectively. Post-implementation of BPRs, there was a substantial improvement in guideline adherence to 32.1%, 84.3%, and 83.6% in 2020, 2021, and 2022, respectively. In general, the proportion of BPR-compliant reports of AAA cases in the pre-deployment (3.6%) period statistically differs (p - value < 0.0001) from those in the post-deployment period (73.9%)Conclusion: Adherence to reporting standards increased after the BPR deployment in 2020. The inclusion of management recommendations in the radiology report when AAA is identified is a simple and cost-effective way of improving outcomes for patients with AAAs through appropriate follow-up treatment.

The presence of heavy metals (HMs) on Earth is essential to all forms of life. These metals are essential for plant and animal development but can have numerous negative effects on the living environment. In this review, we looked at where HMs come from, why they are harmful, and how they affect plants. Articles indexed in Google Scholar, PubMed, Research Gate, Science Direct, and a few books on heavy metals were consulted for this study. Heavy metals are essential for plant development and growth. According to this analysis, the hazardous effects of HMs are on the rise all throughout the globe, and this trend may be attributed mostly to human activity. Because of its impact on agricultural productivity and environmental changes, soil pollution caused by HMs is among the most crucial elements. Plants have evolved very sophisticated defense systems to deal with these environmental challenges. The threat that HM stress poses to plants has attracted a lot of attention worldwide because it could stunt agriculture’s long-term expansion. In spite of their importance for plants, this study found that HMs pose a significant threat to plant life. The novelty of this review lies in its detailed examination of both the beneficial and detrimental roles of HMs, providing a balanced perspective often overlooked in current literature. The significance of this work is underscored by its potential to inform sustainable agricultural practices and environmental management strategies, as it highlights the delicate balance required to harness the benefits of HMs while mitigating their risks. Despite their necessity for plant development, this review underscores the significant risks HMs pose to plant health and ecosystems.Less than 10 cases have been reported in the literature of the association of germline BRCA1 and Squamous cell Carcinoma – the esophagus. The article focuses on the probable pathogenesis of BRCA1 mutation with non-classic malignancies and the response of Poly adenosine diphosphate ribose polymerase inhibitors (PARP) inhibitors in such a scenario. We report an unusual manifestation of the BRCA1 gene with second primary oesophageal squamous cell cancer occurring five years later to triple-negative breast cancer.

Spin-depending internal magnetic interactions in oxygen are crucial for the chemistry and photobiology of this molecule. Photosynthesis, respiration, and many other life-supporting oxygen reactions are governed by enzymes that use fine magnetic forces to overcome the spin-forbidden character of all aerobic metabolism. Life on Earth occurs on the border between combustion and oxidative phosphorylation, and this balance is largely dependent on reactive oxygen species. ROS can cause apoptosis or cell necrosis, and ROS also controls homeostasis through numerous signaling functions. Until recently, biochemists had not paid attention to internal magnetic interactions that influence the chemical activity of such ROS as superoxide ion, singlet oxygen, peroxynitrite, and many others. The role of superoxide dismutase, the oldest enzyme on the Earth, which provides superoxide concentration control, stresses the importance of the O2-• species as the precursor of many other ROS. Spin-orbit coupling in O2-• and O2 species are the main internal magnetic interactions that could influence cancer growth and be connected with cancer therapy.