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    Internet Addiction and its Relationship with Attachment Styles Among Tunisian Medical Students

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    Internet addiction is a growing addictive behavior and a major public health problem worldwide. Several psychological factors can contribute to the problematic use of the Internet. This study aimed to determine the prevalence of Internet Addiction (IA) in a sample of university students and to examine the relationship between IA, self-esteem, and attachment styles.The present study was a cross-sectional study, involving 135 students from the Faculty of Medicine of Monastir. The participants completed a questionnaire, which contained the socio-demographic data, the reasons for Internet use, the Young Cyberaddiction scale to seek IA, the Relationships-style-questionnaire-RSQ to assess attachment style, and the Rosenberg Self-Esteem Scale (RSES).The mean age of the students was 21.5 ± 1.9 years old. They were 112 (83%) females. The prevalence of Internet addiction was 23.7%. The average connection time was 3.5 ± 1.8 hours/day. The most frequent online activities were chat (online discussion, forums ...) in 94.8% of cases followed by download activities (78.5%), scientific research (75.6%), online games (23.7%), and online shopping (13.3%). IA was associated with school failure, alcohol use, online gaming, and low self-esteem. The majority of the participants (84.4%) in this study reported an insecure attachment style. Logistic regression analysis showed a strong association between IA and fearful attachment style.IA was frequent among students. Fearful attachment style was found to be a risk factor for IA. This study highlights the impact of relationships between child and their caregivers on the development of addiction

    Male in Early Adolescence Presenting with Guillain-Barré Syndrome Following BECOV2D Vaccine

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    COVID vaccination has been associated with serious disorders including thrombosis with thrombocytopenia syndrome (TTS), Guillain-Barré syndrome (GBS), and myocarditis. GBS has been reported in adults following COVID-19 infection and rarely following the COVID-19 vaccination. Post COVID vaccination GBS has been associated with prominent and early facial diplegia and quadriplegia. Extension of the COVID vaccination program to the pediatric age group of 5 to 17 years has exposed this population to the adverse effects of the vaccination. Only a few case reports of post-vaccination GBS have been reported in the pediatric age group without any data on the true prevalence. We report a case of a male in his early adolescence with GBS presenting as facial diplegia and rapid quadriplegia following the BECOV2D, (Corbevax) vaccination. Our case is the first case of GBS reported following BECOV2D, (Corbevax) vaccination and highlights the presentation with prominent and early diplegia, which is similar to the presentation in adults

    The Effect of Zinc Oxide, Copper, and Silver Nanoparticles Synthesized by the Green Method for Controlling Strawberry Gray Mold Fungus, B. Cinerea Pers

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    Gray mold disease, caused by the fungus Botrytis cinerea, causes heavy losses in strawberries. The use of chemical fungicides due to the dangers for humans and the environment has caused attention to reduce their consumption and use biological methods. In this research, the effects of zinc oxide, copper, and silver nanoparticles have been synthesized from an aqueous extract of cloves, and the probiotic bacteria Lactobacillus casei by the green method was investigated on the gray mold disease of strawberries. The results showed that concentrations of 10% of zinc oxide nanoparticles synthesized from aqueous extract of cloves can completely control this pathogen on the culture medium and the fruit. Zinc and silver nanoparticles produced by Lactobacillus casei prevented 93.7% and 81% of fungal growth in the culture medium, respectively. Other treatments did not show a good inhibitory effect on the fungus. All treatments were able to prevent 100% to 50% of fungal growth after 96 hours on strawberries. The investigation of the storage characteristics showed the positive effect of the examined nanoparticles on reducing the rate of change of the physicochemical characteristics of the strawberry fruit tissue. Apparent decay was significantly reduced and samples treated with nanoparticles scored higher in sensory evaluation compared to control. Also, investigating the toxicity of nanoparticles in this experiment on the HepG2 cell line showed that Compared to the control, copper and zinc nanoparticles did not have significant toxicity on cells, but silver nanoparticles led to 25% cell death. This research provides promising results in the field of using nanoparticles for pre-harvest and post-harvest control of plant diseases

    latrogenic Pneumothorax Caused by Thoracic Puncture Secondary to Anti-aging Medicine

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    Introduction: Pneumothorax is defined as air in the pleural cavity, the iatrogenic cause happens after invasive procedures as thoracic needle aspiration, central line placement, pacemaker placement, etc. Nevertheless, it is possible to be found in non-medical procedures, such as alternative medicine, more specifically acupuncture. There are medications used against aging that FDA has warned to be used only in its first objective, an example is procaine hydrochloride.Case: A 63 y/o female, Mexico City resident, with anxiety, came to a follow-up appointment for an aging cohort, where CT, PFT, and laboratories are made for pulmonary healthy subjects to investigate normal lung aging and how other environmental factors can affect the lungs; at physical examination, we did not find any pleuropulmonary syndrome, but in the CT a left Iatrogenic pneumothorax was found; we re-asked for antecedents and she described that 15 days before the date she had 2 punctures in the middle clavicular line to apply procaine hydrochloride as an anti-aging treatment.Discussion: There is diverse evidence of adverse effects associated with acupuncture, and even if pneumothorax has a small percentage of incidence, in some cases it can be severe and can even cause fatalities.Conclusion: The pneumothorax in this case was iatrogenic due to the thoracic puncture for an anti-aging treatment, with a total resolution with conservative treatment, however we as health professionals have the responsibility to inform our patients that initiatives of administration ways can cause important complications

    Knowledge, Attitude, and Practices of Parents toward (Infant & Child) Oral Health in Family Medicine Center at PSMMC, Riyadh

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    Background: Early childhood caries may develop as soon as teeth erupt. Promoting oral health care programs is very important and helps to reduce dental caries in young children. The aim of this study was to assess the infant/child oral health (IOH) related knowledge, attitudes, and practices (KAP) of parents in Riyadh, Saudi Arabia. Materials and Methods: A cross-sectional descriptive study was conducted among 327 parents. Visiting the family medicine center at prince sultan military medical city, Riyadh Saudi Arabia. A 39-item questionnaire covering socio-demographic characteristics and questions pertaining to KAP regarding OH care will be used to collect the data. Descriptive statistics, Student’s t-test, one-way analysis of variance, and Scheffe’s test will use for the statistical analysis (p ≤ 0.05). Results: The result showed that the majority of the parents had good knowledge regarding OH, knowledge of cleaning (92.4.%), and knowledge of the amount of sugar (88.1.%). the parent’s age group (30 to 39) years (n =147) reported the highest mean (knowledge, attitudes, and practice) scores among all other age groups with a knowledge mean score of (6.80 ± 1.73), an attitude mean score of (8.86 ± 1.37), and a practice mean score of (5.14 ± 1.86).  Female parents showed significantly higher mean knowledge, attitude, and practice scores than male parents. In addition, the middle-income level parents’ group (n = 295) reported higher knowledge mean score compared to the low-income parents’ group (n = 15) with a mean difference of d = 1.15, p = .041.  Conclusion: Parents’ knowledge about maintaining oral and dental health care for infants/children was inadequate. Essentially, medical professionals are the initial ones to interact with expecting and new moms. Therefore, need to raise parents’ awareness about oral and dental health for infants/children, through the development and implementation of long-term education and promotions programs

    Preventing Coronary Occlusion in an Elderly Severe Aortic Stenosis Patient with Critically Low Coronary Heights – A Case Report

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    Background: Transcatheter Aortic Valve Replacement (TAVR) is an established treatment for severe, symptomatic Aortic Stenosis (AS). However, the presence of low coronary heights confers a high risk for coronary obstruction during or after TAVR. Case: In this case report, we present our experience with transfemoral-TAVR in an elderly, high-risk (STS score – 12.08%) female severe AS patient with low coronary heights (right: 7.4 mm, left: 8.7 mm). She had lower annulus area (287 mm2) and moderately low valve area (0.7 cm2) as well. Her mean and peak pressure gradients (PGs) were 38 mmHg and 61 mmHg, respectively. Upon the Heart Team’s evaluation, TAVR was recommended and a 20 mm Balloon Expandable (BE) Myval Transcatheter Heart Valve (THV) was selected. No peri-procedural or post-procedural complications were reported and the post-procedural hemodynamics, namely the mean and peak PGs improved to 16 mmHg and 30 mmHg after TAVR, respectively. The patient was discharged in a stable condition after four days of hospital stay.Conclusion: We report the successful implantation of a small-sized BE Myval THV (20 mm) in a patient with low coronary heights. Life-threatening complications including paravalvular leak, coronary obstruction, or annular rupture were well averted; hence, we ascertain that the Myval THV is a suitable device for treating severe AS in difficult anatomies. However, the viability of the novel valve needs to be reaffirmed in larger studies..&nbsp

    Decline in human sperm parameters: How to stop?

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    A large systematic review and meta-regression analysis found that sperm counts all over the world appeared to be declining rather than stabilizing. The decline in male sperm counts does not necessarily translate to a decline in male fertility. The cause of declining sperm counts remains unknown; however, several potential causative factors have been identified: 1. Chronic diseases: diabetes mellitus, hypertension; hyperlipidemia, hyperuricemia and skin Diseases & metabolic syndrome. 2. Environmental factors: bisphenol a; phthalates; heavy metals and heat. 3. Lifestyle: obesity, diet, tobacco, alcohol, marijuana, stress, reduced sleep & sedentary life. Addressing these causes is required to stop or decrease male fertility decline. Action to improve semen quality such as prevention & treatment of chronic disease, decreasing unhealthy lifestyle behaviors such as smoking, poor diet, or lack of physical activity & eliminating toxic environmental chemicals

    Treatment protocol with alternative iron drugs in patients with an allergic reaction during iron replacement therapy

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    In our study, we aimed to show that alternative iron salts containing different additives are safe to use in patients who have type 1 hypersensitivity reactions to iron drugs and need iron replacement therapy.Materials and methods: Between January 2022 and June 2022, patients who had previously developed type 1 hypersensitivity reactions with iron preparations and needed iron replacement were included in the study. The study was designed retrospectively. Skin tests were first performed on patients to demonstrate a type 1 hypersensitivity reaction. If skin tests were negative and there was no history of life-threatening anaphylaxis, oral provocation tests were continued. If the absence of variability in symptoms and perimeter values, the drug allergy test was considered negative. Results: Twenty-two patients were included in the study. Twenty-one of the patients were female and one was male. Iron deficiency anemia was found in nine patients, and low iron stores in thirteen patients without anemia were found. Type 1 hypersensitivity reaction developed with Iron 3 Carboxymaltose in 7 patients, Iron 2 Sulfate in 5 patients, Iron 2 Glycine in 4 patients, Iron 3 Hydroxy Polymaltose in 4 patients, Iron 2 Fumarate in 1 patient and Iron 3 Hydroxide Sucrose in 1 patient. Allergy tests with all alternative iron drugs containing additional additives were negative.Conclusion: If patients with allergic reactions cannot be referred to allergy clinics, we think that oral iron salts with different additives can be used after the first dose is given in the hospital under general anaphylaxis precautions. We show that oral iron salts containing different additives can be safely used

    Mammographic correlation with molecular subtypes of breast carcinoma

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    Aim: To determine the correlation between mammographic features of breast cancer with molecular subtypes and to calculate the predictive value of these features. Materials and method: This is a retrospective study of breast cancer patients presenting between January 2017 and December 2021, who underwent mammography of the breast followed by true cut biopsy and immunohistochemical staining of the tissue sample. Breast carcinoma patients without preoperative mammograms, those unable to undergo histopathological and IHC examinations and h/o prior cancer treatment were excluded. On mammography, size, shape, margins, density, the presence or absence of suspicious calcifications and associated features were noted. Results: Irregular-shaped tumors with spiculated margins were likely to be luminal A/B subtypes of breast cancer. Tumors with a round or oval shape with circumscribed margins were highly suggestive of Triple negative breast cancer. Tumors with suspicious calcifications were likely to be HER2 enriched. Conclusion: Mammographic features such as irregular or round shape, circumscribed or noncircumscribed margins and suspicious calcifications are strongly correlated in predicting the molecular subtypes of breast cancer and thus may further expand the role of conventional breast imaging

    SARS-CoV-2 infection does not affect ovarian reserve in women undergoing assisted reproduction

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    Information regarding the effects of the novel coronavirus on human reproduction is currently limited. The objective of our work was to assess whether, in women who have passed the disease, there was a variation in the ovarian reserve through the determination of AMH levels. During May-June 2020, women performing an Assisted Reproductive treatment and who had a positive IgG for SARS-CoV-2 were included in the study; this group of women had a previous AMH determination of no more than 6 months. Women were stratified into two groups, according to their previous AMH levels: low responders (AMH<1 ng/ml) or normal-high responders (AMH ≥ 1 ng/ml) Statistical analyses were performed using the Statistical Package for Social Sciences 19.0 (IBM Corporation, Armonk, NY, USA). A total of 46 patients were included in the study; 16 women were diagnosed as having low ovarian reserve (AMH < 1 ng/ml), with an average age of 38.6 years, whereas 30 were classified as having normal ovarian reserve (AMH ≥ 1 ng/ml), with an average age of 34.7 years. Generally, the data show no variation in AMH levels before and after SARS-CoV-2 infection (1.73 ng/ml vs. 1.61 ng/ml, respectively). However, when we analyzed these differences according to the study groups, the results were consistent with the patient's ovarian status. It is possible to conclude that the fact of having passed the disease does not affect the ovarian reserve status but the degree of the variation of AMH levels depending on the patient was a low or high responder

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