This article has been retracted. Please see the Retraction Notice for more detail: https://doi.org/10.1186/s12889-024-18502-0.

The coronavirus disease (COVID-19) pandemic has profoundly impacted mental health worldwide, exacerbating anxiety and depression, and influencing adherence to public health measures. To measure the frequency and demographic determinants of anxiety, depression, and emotional contagion among Egyptians during the pandemic from May to August 2020. The study employed a cross-sectional web-based survey that specifically targeted 666 Egyptians from four different regions. A validated Arabic questionnaire was used to assess anxiety using the Generalized Anxiety Disorder-7 (GAD-7) scale, depression using the Patient Health Questionnaire-9 (PHQ-9), and emotional contagion using the Emotional Contagion Scale (ECS), along with demographic variables. Anxiety (GAD ≥ 5) was observed in 66.7

Colorectal cancer (CRC) remains a major cause of global morbidity and mortality, with rising incidence in younger adults. Growing evidence implicates modifiable lifestyle and environmental factors including diet, physical inactivity, obesity, smoking, alcohol consumption, and pollution exposure in shaping CRC risk. However, existing studies are often fragmented and geographically limited, leaving uncertainty regarding the broader effectiveness of preventive strategies. An integrative systematic review was conducted to synthesize evidence on lifestyle and environmental interventions for CRC prevention. Comprehensive research was conducted through PubMed and CINAHL in 2025 using predefined terms related to CRC, lifestyle behaviors, and environmental determinants. A total of 412 studies were screened, with 15 meeting inclusion criteria after full-text review and quality appraisal using the Newcastle–Ottawa Scale. Data were extracted on study design, population, intervention type, and outcomes, and synthesized thematically. The included studies encompassed 267,086 participants across diverse populations and designs, including case–control, quasi-experimental, pilot, and Mendelian randomization studies. Evidence consistently showed that adopting a healthy lifestyle characterized by fiber-rich diets, regular physical activity, smoking cessation, and limited alcohol intake significantly reduced CRC risk. Environmental interventions, such as reducing exposure to pollutants, improving food safety, and ensuring access to clean water, also demonstrated protective effects. Preventive programs integrating lifestyle and environmental strategies enhanced screening uptake, adherence to healthy behaviors, and long-term cost-effectiveness. Importantly, lifestyle modification was found to mitigate even genetically predisposed risks, underscoring its central role in prevention. This review highlights the pivotal role of lifestyle and environmental factors in reducing CRC risk. Comprehensive strategies that combine individual behavior change with policy-driven environmental improvements are essential to lowering CRC incidence and mortality. Future research should focus on culturally tailored, long-term, and scalable interventions to achieve sustainable and equitable cancer prevention worldwide.

Abstract Osteoporosis is a silent, progressive condition; however, it can be prevented and managed. The assessment of 10-year fracture risk can predict long-term osteoporotic fracture risk. This study was designed to examine osteoporotic fracture risk, its associated factors, and related knowledge among Egyptian adults aged 40+ from the 1st of April 2025 to the 1st of July 2025. This national survey included 2,242 participants over 40 years old from different regions in Egypt, using a questionnaire with five parts, including the OKAT questionnaire and the online FRAX tool, which was filled out by an interviewer. The mean age of participants was 50.6 years, ranging from 40 to 90 years, and the mean BMI was 29.9 (± 5.6) kg/m². 2% and 4.1% were at high risk for major and hip fractures, respectively. The risk of hip and major osteoporotic fractures was significantly associated with long-term cortisone use, smoking, how long someone has smoked, higher consumption of soft or energy drinks, as well as early menopause and using hormonal contraceptives among the women in the study. 58.7% had a poor knowledge level. The OKAT score showed a negative correlation with fracture risks, significant only for hip fracture (p = 0.007). A strong positive correlation was found between major and hip fracture risks. Most studied adult Egyptian participants had significant knowledge gaps and misconceptions, a high prevalence of risk factors, and inadequate preventive practices. Therefore, it is important to emphasize the necessity for targeted educational interventions and screening through reliable sources to reduce the future burden of osteoporosis.

Since the early 1980s, efforts to standardize ergonomic practices in laparoscopic surgeries have aimed to improve procedural efficiency and reduce complications, but clinical validation remains limited. In metabolic and bariatric surgeries (MBS), innovations in trocar site placements, driven by the popularity of laparoscopic sleeve gastrectomy (LSG), have advanced surgical techniques. However, practices often vary based on individual surgeon preferences rather than standardized evidence-based criteria. This study introduces the Port Site Placement and Outcomes for Surgical Obesity and Metabolic Surgeries (PSPOSO) checklist, aiming to standardize port placements and improve reporting consistency. A systematic review and meta-analysis of LSG studies were conducted following PRISMA guidelines. Data were extracted from 34 studies involving 7173 cases. Key variables included port configurations, manipulation angles, and outcomes such as operative time and excess weight loss percentage (EWL

Our objectives are to identify SP's global prevalence, the affected population's characteristics, and the SP's clinical picture.

Hypertension, the first global modifiable risk factor for cardiovascular disease (CVD) morbidity and mortality, is a consequential and remediable threat to the health of individuals and society. Therefore, we conducted this study to explore the role of calcium (Ca++), magnesium (Mg++), and vitamin D (Vit-D) supplementation as complementary therapies for hypertension, focusing on their effects on systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse rate. This systematic review and meta-analysis examined relevant 6509 articles in PubMed, Scopus, Web of Science, and Cochrane CENTRAL up to October 2024. The primary outcome was the difference in blood pressure measurements (systolic and diastolic) and the pulse rate. The extracted data were analyzed using Open Meta Analyst software. This systematic review and meta-analysis included 40 studies; of them, 24 studies were analyzed. Ca++ was associated with a significant drop in the DBP (MD: -2.04, 95

Proper feeding practices are essential for optimal infant growth and development, particularly during the first 2 years of life. Maternal knowledge regarding weaning plays a critical role in shaping these practices and in influencing infant health outcomes. This national study aimed to assess maternal knowledge about infant feeding and weaning practices among Saudi mothers with infants under 2 years old. Additionally, it examined the relationship between maternal knowledge and key infant health parameters and identified the maternal factors associated with better weaning knowledge. A cross‐sectional survey was conducted from January to March 2020 targeting 721 Saudi mothers of infants aged 4–18 months. Participants were recruited from primary healthcare centres across five regions of Saudi Arabia. Structured face‐to‐face interviews were used to collect data, and χ 2 tests and multinomial logistic regression were used to look for links between what mothers knew, how they weaned their infants, and signs of their infants' health. Most mothers (52.4%) were aged 25–35 years, and 72.4% had attained higher education. A statistically significant relationship was found between maternal weaning knowledge and age ( p = 0.010). Mothers with moderate to high weaning knowledge demonstrated better practices, including vitamin D supplementation, the gradual introduction of solid foods and adherence to hygiene practices. These mothers also had infants with healthier growth metrics, including normal head circumference and absence of anaemia. However, exclusive breastfeeding rates were notably low, underscoring the challenges in breastfeeding adherence. While maternal weaning knowledge in Saudi Arabia is generally high, the low prevalence of exclusive breastfeeding signals the need for targeted public health interventions. Educational programs and greater societal support for breastfeeding are recommended to enhance maternal practice and infant health.

Human papillomavirus is the most common viral sexually transmitted infection worldwide and affects individuals of all ages and both sexes. It is also the most preventable cause of cervical cancer. The World Health Organization’s Cervical Cancer Elimination Strategy (2030 targets) aims for 90% of girls to receive the Human papillomavirus vaccine by age 15, 70% of women to be screened by ages 35–45, and 90% of cervical-cancer cases to be appropriately treated. To determine cervical-cancer–related risk factors and knowledge levels, and to assess Human papillomavirus -related knowledge and attitudes toward vaccination. The survey also examined general adult vaccination behaviors—including measles, influenza, coronavirus, respiratory syncytial virus, and shingles vaccines—among adults. A cross-sectional study was conducted among 1,174 randomly selected adults from Egypt, Syria, Jordan, and Yemen between March and May 2025, using a validated Arabic self-administered questionnaire. Most participants were female (635, 54.2%), university-educated or higher (699, 59.6%), and living in urban areas (796, 67.9%). Regarding risk factors, 489 (41.7%) were smokers, 94 (8.0%) reported genital laser hair removal, 84 (7.2%) had oral or other herpes lesions, and 81 (6.9%) had a family history of reproductive-system cancer. Overall, 626 (53.4%) had poor Human papillomavirus knowledge and 779 (66.5%) had poor cervical-cancer knowledge. Only 60 (9.5%) had ever undergone cervical-cancer screening, and 23 (2.0%) had received at least one Human papillomavirus -vaccine dose. Reported adverse events included allergic reactions (13, 6.8%) and dizziness or fainting (13, 56.5%). Approximately 578 (49.3%) were unaware of the Human papillomavirus vaccine, while 976 (83.3%) had not received—and did not intend to receive—the vaccine, citing lack of information, perceived low risk, adherence to preventive measures, or vaccine unavailability. Most participants demonstrated poor overall knowledge of Human papillomavirus and cervical cancer. Several demographic determinants significantly influenced knowledge and attitudes toward vaccination. Comprehensive health-education initiatives are urgently needed to enhance awareness and progress toward the World Health Organization 2030 elimination targets.

Introduction:The effects of COVID-19 extend beyond acute illness, with many survivors experiencing persistent symptoms. This study aimed to determine the frequency and contributing factors of cognitive impairment and other neurological symptoms in COVID-19 survivors four weeks after diagnosis, compared with healthy controls during the pandemic's fourth wave. Methods:A multicenter case-control study was conducted involving 176 COVID-19 survivors, diagnosed four weeks prior, and 92 healthy controls from Algeria, Egypt, and Libya. Data were collected through interviews using a structured, validated questionnaire administered by a trained physician. Results:Post-COVID-19 survivors exhibited significant cognitive deficits, chronic fatigue, and sensory impairments (including loss of appetite, taste, smell, and hearing). Cognitive impairment (Montreal Cognitive Assessment [MoCA] score <26) was observed in 57 participants (32.3%), with those affected being older (44.6 ± 16.9 years, P < 0.001) and consuming more junk food (8.6 ± 3.3 servings, P = 0.04). Cognitive disorders were more frequent among females (83.3%), smokers (57.9%), highly educated individuals (76.5%), and married participants (63.7%). Discussion:The study revealed a substantial burden of cognitive and sensory impairments in post-COVID-19 patients, supporting global observations and emphasizing the need for early screening and lifestyle interventions. The reliance on self-reported data and a case-control design limit causal inference. Conclusion:Post-COVID-19 survivors showed significant cognitive deficits, fatigue, and sensory impairments. Cognitive impairment was present in 32.3%, with higher prevalence in females, smokers, highly educated individuals, and married participants.

Late-onset Pompe Disease (LOPD) is a subtype of Pompe Disease (PD) that manifests any time after infancy. This review explores the efficacy, safety and limitations of various therapeutic options for LOPD, including enzyme replacement therapy (ERT), substrate reduction therapy (SRT), pharmacological chaperone therapy (PCT), supplementary therapies, and gene therapy from inception to February 2025, and compares them where possible. Emphasis is given to therapeutic selection and the potential for switching between approved ERT formulations based on the recently updated Triple-S (Start, Switch, Stop) consensus recommendations. A literature search was done on PubMed, ScienceDirect, and Embase utilizing MESH terms, keywords, and Boolean operators. It included all English-language studies relevant to our topic from inception to February 2025. Among the ERT, alglucosidase alfa significantly improves the 6-min walk test (6MWT) and forced vital capacity (FVC

The objective of this web-based study is to analyze the attributes of bariatric surgery cases ensuing health implications. Additionally, the study seeks to delve into the factors influencing post-bariatric psychological evaluations and the impact of various bariatric surgeries on weight loss and psycho-social assessment scores for patients who had undergone bariatric surgeries within a specific bariatric surgery center in Egypt between January 2017 and January 2024. An analytical cross-sectional study recruited 411 adults who had undergone different bariatric procedures by the same surgical team. We collected the data using a validated self-administered questionnaire that included the Body Image Scale (BIS), the Rosenberg Self-Esteem Scale (RSES), the quality-of-life score (QOLS), and the modified General Patient Satisfaction Score after Bariatric Surgeries (GSABS). The most commonly performed bariatric surgery was sleeve gastrectomy (SG), accounting for 82.7

This study aimed to systematically identify the key characteristics of retracted articles in pediatric literature and explore the patterns and reasons of pediatric retraction from 1995 to 2024. We searched PubMed and Retraction Watch databases to identify all retracted publications in the field of pediatrics. After the screening process, data were extracted into Excel. Statistical analysis was conducted using Jamovi and Excel. A correlation matrix was used for the important retraction-related factors. After screening, 590 unique retracted pediatric articles were included, with most of them, 572 (96.9

Infant health is profoundly influenced by socioeconomic factors, parental lifestyle, and prenatal care. Understanding the critical role of all these factors can guide targeted public health interventions to reduce infant morbidity and mortality. To investigate the impact or association of various maternal and paternal factors, including periconceptional care, pregnancy-related health conditions, antenatal care, smoking, radiation, nutrition, SARS-CoV-2 infection, and COVID-19 vaccination, on infant health in Egypt, Palestine, Yemen, and Jordan. A cross-sectional study was conducted among 445 mothers from August 2024 to October 2024 using a pretested and well-structured questionnaire. A well-trained physician conducted a face-to-face interview to collect data. Statistical analysis was performed to identify significant associations. The mean ±SD maternal age was 27.72 ± 6.4 years, and the paternal age was 32.35 ± 7.25 years. Most mothers were Palestinian (34.8

Background Achondroplasia, the most common form of dwarfism, poses significant medical and psychosocial challenges. Vosoritide, a new C-type natriuretic peptide analog, has shown promise in treating achondroplasia by helping bones grow. Therefore, we conducted this study to examine the effect of different vosoritide doses on height from baseline (z-score), annualized growth velocity (AGV), the upper-to-lower body segment ratio (ULBR), and side effects. changes in growth velocity and the frequency of adverse effects. Methods This systematic review and dose-related meta-analyses follow the PRISMA guidelines, which meticulously screen and extract randomized controlled trials (RCTs) from four databases until April 2024 involving 220 patients. We used pairwise meta-analyses and assessed quality using the Cochrane Risk of Bias Tool. Results Higher Vosoritide doses (15 µg/kg or 15–30 µg/kg) showed significantly greater improvements in height z-scores compared to lower doses (2.5 µg/kg or 7.5 µg/kg) or placebo. We observed similar trends for AGV. The 15 µg/kg dose displayed a significantly greater increase compared to both 2.5 µg/kg and 7.5 µg/kg. Interestingly, no significant difference was found between the 15 µg/kg and 30 µg/kg groups, suggesting a possible plateau effect at higher doses. Importantly, both the 15 µg/kg and 15–30 µg/kg groups demonstrated statistically significant improvements in growth velocity compared to placebo. While most comparisons showed no significant changes in ULBR, one study reported a small increase in ULBR with the 15 µg/kg dose compared to the 2.5 µg/kg dose. Adverse effects were mild to moderate across all studies, with no severe effects reported. Conclusion Vosoritide improves achondroplasia growth in a dose-dependent manner. Higher doses (15 µg/kg or 15–30 µg/kg) significantly increased height and growth velocity compared to lower doses or placebo. All adverse effects were mild to moderate. However, the impact on the ULBR and adverse effects require further investigation.

Background: Despite the use of multimodal therapy to treat high-risk neuroblastoma, the prognosis of this patient population remains poor. The addition of dinutuximab-beta to standard maintenance therapy after autologous peripheral blood stem cell transplantation (auto-PBSCT) has been found to improve survival rates. We present treatment outcome of high-risk neuroblastoma (HR NBL) before and after the introduction of dinutuximab-beta in comprehensive large cancer centers in Saudi Arabia. Materials and Methods: This is a multicenter retrospective chart review of all patients aged 1–14 years diagnosed with HR-NBL who received multimodal therapy including dinutuximab-beta during maintenance phase after auto-PBSCT compared with patients who did not receive between 2015 and 2020. Supportive therapy was administered to manage dinutuximab-beta-associated adverse events. Results: The treatment outcome was evaluated for 32 patients (21 received dinutuximab-beta and 11 patients did not receive it). Among 21 patients who received dinutuximab-beta, 12 (57.1%) patients received all planned five cycles of dinutuximab-beta (cumulative 100% of the dose) and 9 (42.9%) patients received less than 5 cycles of dinutuximab-beta maintenance mainly secondary to toxicities, which is reported in 11.1%, and progressive disease during dinutuximab-beta therapy, which is reported in 88.9%. The 5-year mean and median survival were 67.3 and 99 months, respectively, while the overall survival (OS) rate was approximately 57%. The mean and median disease-free survival (DFS) were 36.3 and 20 months, respectively, while the DFS rate was approximately 22%. There was nonsignificant difference in OS and DFS between patients who received dinutuximab-beta and patients who did not receive it (P values 0.970 and 0.113). From all examined factors, there were no statistically significant differences between patients who received dinutuximab-beta and patients who did not receive it with the baseline characteristics, except for relapse status with P = 0.013, time from PBSCT to relapse with P = 0.023, and mortality with P=0.049. Dinutuximab-beta maintenance treatment was generally well tolerated with proper use of supportive therapy, with the most prevalent toxicities being nonhematological in nature and being reported in 52%. Conclusion: There is a noticeable improvement and reduction in disease progression-free survival with manageable adverse events in patients who received dinutuximab-beta maintenance therapy, but the overall survival rate remains unchanged.

Abstract Background Since the onset of the coronavirus (COVID-19) pandemic crisis, the supplement market has consistently grown. Therefore, we conducted this survey during the fourth wave of the COVID-19 pandemic to study the frequency and context of dietary supplement (DS) consumption (vitamins and mineral intake) and explore the consumer’s pharmaceutical buying behaviour; and (3) to study its determinants as regards the demographics, Fatigue Severity Scale (FSS), and healthy eating pyramids. Methods We conducted a cross-sectional web-based survey on 1333 Arabic adults aged 18 years or more residing in six Arabic-speaking countries in May 2022, using a validated self-administrated questionnaire. The survey-involved questions about sociodemographic characteristics, physical activity, FSS, healthy eating pyramid, DS consumption, and consumers’ pharmaceutical purchasing behaviour. Results Most participants were aged 20 to less than 35 years, and 64.6% used dietary supplements. There was a statistically significant difference between supplement users and nonusers as regards consumers’ pharmaceutical buying behaviour in terms of advertising quality, safety rules, pharmaceutical forms, and packet quality. Arabic adults consumed the following dietary supplements: 63.5% vitamin C, 60.1% vitamin D, 47.1% iron, and 44.4% zinc. Authorised products (76.0%), natural contents (75.0%), and safety rules (68%), were the most common factors influencing Arabic consumers’ pharmaceutical purchasing behavior. Multi-logistic regression analysis showed that being female, having a history of COVID-19, having a positive attitude about the benefits, and being recommended for supplement use were predictors of dietary supplement use. Conclusion The dietary consumption of supplements is prevalent, mainly including vitamin C, vitamin D, iron, zinc, vitamin B, and magnesium. In addition, Arabic adults are poorly adherent to healthy eating pyramids. Given the ongoing COVID-19 pandemic, Arabic health authorities should prioritize this issue to minimize the potential for misusing dietary supplements.