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Post-operative adhesions develop in most abdominal and pelvic surgeries and cause pain, bowel obstruction, infertility, and reoperation. Current measures such as Seprafilm® and NSAIDs provide only partial protection and may cause adverse effects. This review evaluates natural products and biomaterial platforms as potential strategies for adhesion prevention. A structured literature search was performed in PubMed, Scopus, and Google Scholar. Peer-reviewed English-language in vitro, animal, and clinical studies, as well as relevant reviews and meta-analyses, were considered. Studies focusing on natural products and biomaterial-based delivery systems for post-surgical adhesion prevention were screened for mechanistic relevance and translational value, with emphasis on publications from 2015 to 2025. Curcumin, resveratrol, epigallocatechin-3-gallate, bromelain, and vitamin E demonstrated antioxidant, anti-inflammatory, and anti-fibrotic actions that interfere with TGF-β, ROS, cytokines, and extracellular matrix deposition. Hydrogels, bioresorbable films, and nanosystems enhanced local release and added barrier effects. Preclinical data are promising, but clinical evidence is scarce, and issues of bioavailability, safety, and standardisation remain. Natural products combined with biomaterial platforms represent a promising strategy for adhesion prevention, but robust clinical trials are needed to confirm safety and efficacy. Post-surgical adhesions are common complications after abdominal and pelvic surgeries and can cause pain, infertility, and bowel obstruction. This review discusses how natural compounds such as curcumin, resveratrol, bromelain, green tea extracts, and vitamin E may help prevent adhesion formation through anti-inflammatory and antioxidant effects. The article also highlights advanced biomaterial systems, including hydrogels and nanoparticles, that can improve delivery of these compounds. While early research is promising, more clinical studies are needed to confirm their safety and effectiveness in humans.
Abstract Background Emerging infectious diseases (EIDs), including Ebola, Lassa fever, cholera, coronavirus disease 2019 (COVID-19), Marburg virus disease, and mpox, continue to pose major global health threats, with sub-Saharan Africa experiencing a disproportionate share of morbidity and mortality. Effective epidemiological surveillance is important for early detection, rapid response, and outbreak preparedness; however, surveillance performance across the region remains inconsistent. Approach This perspective article presents a narrative synthesis of peer-reviewed literature, policy documents, and regional surveillance reports to examine the current epidemiological surveillance landscape in sub-Saharan Africa. The analysis is organized around key domains influencing surveillance effectiveness, with selected regional and country-level experiences used to illustrate broader systemic patterns. Key themes identified Although notable progress has been made through facility- and event-based surveillance systems, the adoption of digital health tools (including mobile health applications, geographic information systems, and genomic surveillance), and strengthening of regional coordination mechanisms, such as the Africa Centers for Disease Control and Prevention and the Integrated Disease Surveillance and Response framework, substantial gaps remain. These include persistent underreporting, limited diagnostic and laboratory capacity, inequitable surveillance coverage among rural, nomadic, displaced, and conflict-affected populations, reliance on externally funded vertical programs, and the constraining effects of sociopolitical instability. Lessons from polio eradication initiatives and responses to Ebola, COVID-19, and cholera suggest the importance of community engagement, trust building, interoperable data systems, genomic data sharing, and integration of water, sanitation, and hygiene interventions. Conclusions Strengthening epidemiological surveillance in sub-Saharan Africa likely requires sustained regional collaboration, context-appropriate digital innovation, investment in workforce capacity, integration of One Health approaches, and more sustainable domestic and pooled financing mechanisms. More resilient and equitable surveillance systems are essential for improving outbreak preparedness in the region and reinforcing global health security against transboundary and epidemic threats.
This update and revision of the international guideline for urticaria was developed in accordance with the methods recommended by Cochrane and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group. It is an initiative of the Global Allergy and Asthma Excellence Network (GA(2)LEN) and its Urticaria and Angioedema Centers of Reference and Excellence (UCAREs and ACAREs), with the participation of 210 delegates from 107 national and international societies, from 59 countries. The consensus conference was held on December 6th, 2024. This guideline was acknowledged and accepted by the European Union of Medical Specialists (UEMS). Urticaria is a frequent, mast cell-driven disease, defined by a rapid appearance of wheals, angioedema, or both. The lifetime prevalence of acute urticaria is estimated to be approximately 20%. Chronic urticaria, categorized as either chronic spontaneous urticaria or chronic inducible urticaria, is disabling, impairs quality of life, and affects performance at work and school, however, novel therapies are available. This updated version of the international guideline for urticaria covers the definition and classification of urticaria and outlines expert-guided and evidence-based diagnostic and therapeutic approaches for the different subtypes of urticaria.
BACKGROUND:Head-to-head randomised trials or real-world studies comparing the safety and efficacy of natalizumab and anti-CD20 monoclonal antibodies are limited. This study aimed to compare the effectiveness and safety of natalizumab versus ocrelizumab/rituximab in a real-world cohort of relapsing-remitting multiple sclerosis (RRMS) patients using data from the Middle East and North Africa Committee for the Treatment and Research in Multiple Sclerosis (MENACTRIMS) registry. METHODS:This registry-based, retrospective, multicentre study was carried out in seven Middle Eastern countries by analysing data from the MENACTRIMS registry. All adults RRMS patients treated with natalizumab, rituximab or ocrelizumab and maintained on treatment for at least 12 months were included. Patients were matched using propensity scores. Primary outcomes were annualised relapse rate (ARR), confirmed disability progression and improvement and MRI activity. RESULTS:A total of 1954 patients met the inclusion criteria, with 1277 receiving anti-CD20 therapy (768 on rituximab and 509 on ocrelizumab) and 677 natalizumab. Natalizumab significantly reduced ARR compared with anti-CD20 therapies (0.062 vs 0.092, p=0.001). Confirmed disability progression rates, MRI outcomes and no evidence of disease activity (NEDA-3) were similar between the two groups. However, natalizumab demonstrated higher rates of disability improvement compared with anti-CD20 therapies (9.3% vs 5.5%, p=0.03). Adverse events were more frequent in the anti-CD20 group (36.4% vs 27.5% for natalizumab, p=0.001). CONCLUSION:In this large, real-world cohort, natalizumab was associated with lower ARR, greater likelihood of disability improvement, lesser adverse events, but lower persistence compared with anti-CD20 therapies. These findings provide valuable insights into the comparative efficacy and safety of these RRMS therapies, aiding clinicians in personalised treatment decisions.
BackgroundCritical pertussis continues to cause significant morbidity and mortality in infants necessitating pediatric intensive care. Despite advances in supportive care, knowledge gaps persist. This study aimed to examine institutional capacity, physician knowledge, and practice variability in managing critical pertussis among pediatric intensive care units (PICUs) across the Gulf Cooperation Council (GCC) countries.MethodsA cross-sectional internet-based survey was distributed to PICU physicians across the six GCC countries between December 1, 2024, and January 31, 2025. Demographic information, clinical experience, diagnostic resources, and therapeutic approaches were collected. A multivariable generalized linear regression (Gamma) model identified factors associated with pertussis knowledge scores.ResultsAmong 185 respondents, almost 70% of participants were male, 62.7% were specialists or consultants, and around half (47%) were certified pediatric intensivists. Access to mechanical ventilation was almost universal (98.4%), yet extracorporeal membrane oxygenation was available in only 24.3% of centers. Polymerase chain reaction-based diagnosis was widely available, but more than one-third (36.2%) of participants reported a test turn-around-time of at least two days. A majority (66%) of physicians used exchange transfusion for hyperleukocytosis, but white blood cell thresholds varied widely. Institutional protocols were lacking in over 40% of centers. The average pertussis knowledge score was 9.52 out of 13 questions (SD ±1.72). Physician's clinical experience showed a strong and graded association with pertussis knowledge.ConclusionsThis study highlights the heterogeneity in pertussis management practices across the GCC PICUs, compounded by variability in resources and different institutional guidelines. Findings highlight the urgent need for standardized protocols to harmonize pertussis care.
