Objectives: To investigate the potential efficacy of Nigella sativa (NS) oil supplementation on the outcomes of patients with mild Coronavirus Disease 2019 (COVID-19). Trial design: Prospective, two-arm, parallel-group, randomised (1:1 allocation ratio), open-label, controlled, exploratory phase II clinical trial of oral NS oil in patients with mild COVID-19. Participants: Inclusion Criteria: - Patients with mild COVID19 (defined as upper respiratory tract infection symptoms in the absence of clinical or radiological signs of pneumonia). - Adult (18 - 65 years old). - Written informed consent by the patient (or legally authorized representative) prior to initiation of any study procedures. - All patients should understand and agree to comply with planned study procedures. - Polymerase chain reaction (PCR)-confirmed infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) from throat swab. Exclusion Criteria: - Patients with pneumonia or severe illness requiring admission to intensive care unit. - Severe chronic kidney disease (i.e. estimated glomerular filtration rate [eGFR] < 30 mL/min) or end stage renal disease requiring dialysis - Severe chronic liver disease (Alanine transaminase [AlT] or Aspartate transaminase [AST] > 5 times the upper limit of normal). - Pregnancy or breast feeding. - Anticipated transfer within 72 hours to another hospital that is not a study site. - Allergy to the study medication The trial is currently conducted on patients recruited from King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Intervention and comparator: Intervention group: Nigella sativa oil (MARNYS® Cuminmar) 500 mg softgel capsules, one capsule orally twice daily for 10 days plus standard of care treatment (antipyretic, antitussive). Comparator group: standard of care treatment. Main outcomes: Proportion of patients who clinically recovered (defined as 3 days of no symptoms) within 14 days after randomisation. Randomisation: Patients will be randomly assigned to treatment or control groups in a 1:1 ratio using a computer-generated randomization scheme (Random permuted blocks of 10) developed using the web-based program: http://www.randomization.com . Blinding (masking): No blinding. Numbers to be randomised (sample size): Up to 200 eligible patients will be randomly assigned to either treatment or control groups. Trial Status: Protocol version 1, as of July 14, 2020. Recruitment was started on May 21, 2020. The intended completion date is December 31, 2020. Trial registration: ClinicalTrials.gov Identifier: NCT04401202. Date of trial registration: May 26, 2020. Full protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest of expediting dissemination of this material, the familiar formatting has been eliminated; this letter serves as a summary of the key elements of the full protocol.

The worldwide prevalence of asthma in children is variable. The different epidemiological definitions of asthma, the use of various methods of measurement, and the environmental variations between countries are responsible for such different prevalence rates. This study has been performed to identify the prevalence/risk factors of asthma in Saudi children/adolescents in Rabigh. A cross-sectional epidemiological survey has been conducted using the validated Arabic version of the “International Study of Asthma and Allergies in Childhood questionnaire”. Data on the sociodemographic characteristics of participants and risk factors of asthma have also been collected. Three hundred and forty-nine Children/adolescents with an age range of 5–18 years have been randomly selected for an interview from public places and houses in different regions of Rabigh City. The prevalence rates of physician-diagnosed asthma, any wheezing, and wheezing in the last 12 months among children/adolescents (mean age: 12.22 ± 4.14 years) have remarkably increased in association with the rapidly developing industrialization of Rabigh from previously recorded rates of 4.9%, 7.4%, and 6.4% in the only study that has previously been conducted in Rabigh in 1998 to 31.5%, 23.5%, and 14.9%, respectively. The univariate analysis has detected some significant risk factors for asthma. However, in younger aged children (5–9 years), allergic rhinitis, associated chronic illnesses, and viral respiratory infection-induced wheezing have remained significant risk factors of any wheezing. Drug allergy, exposure to dust, and viral respiratory infection-induced wheezing have persisted as significant risk factors for wheezing in the last 12 months. Eczema in the family, exposure to perfumes/incense, and viral respiratory infection-induced wheezing have remained as significant risk factors of physician-diagnosed asthma. The results of this survey should be useful in future targeted preventive plans/measures with special attention to improving air quality to limit the progressive increase in asthma prevalence in Rabigh, as well as in other similar industrial communities.

Background: The role of immunoglobulin G (IgG) responses to food as potential triggering factors in allergic disorders continues to be debatable, and is not endorsed by most allergy societies. Objective: To explore the prevalence of specific IgG immune responses to common foods in pediatric allergic disorders and any potential relationship between them. Methods: A retrospective study was conducted on children and adolescents diagnosed with allergic disorders at the Ekthar Clinic in Jeddah City. Food-specific IgG (FS-IgG) antibody test results were collected from their medical records. Results: Seventy-five children with a mean age of 8.5 years (SD = 5.3) were included. The overall allergic diagnosis determined atopic dermatitis as the most common (57.3%, 43 participants), followed by food allergy and allergic rhinitis (each 40%, 30 participants), and bronchial asthma (29.3%, 22 participants). Food-specific IgG levels were elevated in all participants. The foods with the highest levels of FS-IgG were dairy products (88%: cow’s milk [86.6%], sour milk [81.3%], sheep’s milk [74.7%], cheese [72%], and goat’s milk [70.7%]), followed by gluten-containing products (81.3%: wheat [70.7%], gluten [69.3%], and spelt [66.6%]), and eggs (66.6%). Significant correlations (P < 0.05) were found between atopic dermatitis and several foods; chronic urticaria and chicken and lamb; asthma and ocean perch; allergic rhinitis and rennet cheese; and allergic conjunctivitis and potato, pollock, and lamb. Conclusion: Among pediatric allergic disorders, dairy, gluten, and eggs were the most detected foods in FS-IgG tests, with some notable correlations with other foods. FS-IgG testing may help identify potential triggers in refractory allergic disorders.

There are limited data about neurological manifestations in pediatric COVID-19 patients from all over the world, including Saudi Arabia. This study was performed to identify characteristics of pediatric COVID-19 cases with neurologic involvement hospitalized at King Abdulaziz University Hospital (KAUH), Saudi Arabia. This retrospective cross-sectional study included hospitalized patients aged 0–19 years with confirmed SARS-CoV-2 from April 2020 to February 2022. The required data were retrieved from patients’ medical records. Ninety-four cases were included. The median ages of the studied group, those with neurological manifestations, and those without neurologic manifestations, were 6.5, 11.0, and 5.0 years, respectively. Neurological manifestations occurred in 29 COVID-19 patients (30.9%) with headache and decreased consciousness being the most common recorded manifestations in 8.5% and 6.4% of patients, respectively. Specific neurological manifestations were rare, as only two infants developed encephalopathy with fatal outcome. Most patients with and without neurological manifestations survived. Neuroimaging abnormalities were detected in 8 cases with neurological manifestations. Neurological manifestations were common in 31% of hospitalized pediatric COVID-19 cases. However, most of the neurological manifestations were mild and nonspecific, with headache being the most common one. Specific neurological manifestations were rare; however, pediatric COVID-19 patients, particularly young infants, were at risk of developing severe encephalopathy with fatal outcome.

Although all health organizations recommend exclusive breastfeeding (EBF), few neonates meet these recommended goals. The early intake of cow milk formulas (CMFs) has been linked to several childhood illnesses, including atopic diseases. Therefore, this study aimed to evaluate the prevalence of early exposure to CMFs in the nursery of a tertiary care hospital in Jeddah, Kingdom of Saudi Arabia. A retrospective review was conducted on the medical records of feeding practices of neonates born in King Abdulaziz University Hospital (KAUH) at Jeddah, Kingdom of Saudi Arabia. Two months from each year (May and December) were selected over the last five years. Approval from the ethical research committee at KAUH was obtained. Eight hundred and ninety-four different neonate files were reviewed. Four hundred and eighty-seven (54.5%) were males. Out of the total of 894, 838 (93.7%) newborns experienced an early introduction to CMFs, 797 (89.1%) received mixed CMF and breast milk, 41 (4.6%) received CMF only, and 56 (6.3%) received exclusive breastfeeding (EBF). Surprisingly, EBF has declined over time, from 39% in May 2016 to 1% in December 2020. The prevalence of early exposure to CMF was very high in newborns at KAUH nursery, and this prevalence was trending upwards. Extensive teaching programs on EBF and allergy prevention for mothers and related health care providers are highly recommended

Background: Non‐priority legume ( NPL ) allergies are increasing, creating significant concerns due to the widespread use of these foods. This study aims to evaluate the natural history of NPL allergy in children and identify predictive factors associated with their resolution. Methods: A retrospective review of medical records of pediatric patients (Age 5–15 Years) from the Pediatric Allergy Department at Evelina London Children's Hospital (from July 2023 to June 2024) who had an IgE ‐mediated allergy to any NPLs (lentils, chickpeas, peas, and beans). Children with a suggestive history of NPL allergy with a positive skin prick test ( SPT ) ≥8 Mm, specific immunoglobulin E ( sIgE ) ≥ 15 kUA /L and/or positive oral food challenge were included. Results: Two hundred and three children were included; the median age was 10 years (62.6% male), and median duration of follow‐up was 7 years. 6.3% of all children with food allergies were allergic to NPLs, with lentils being most common. Kaplan–Meier analysis showed varying resolution rates by age: 2.2% for lentils, 4.9% for chickpeas, 8.3% for peas, and 13% for beans by age 5. By age 10, these rates increased to 11.3%, 8.8%, 20.1%, and 24.5%, respectively, and by age 15, they increased to 21% for lentils, 19.3% for chickpeas, 23.5% for peas, and 32.9% for beans. Children who had low SPT and sIgE results were more likely to outgrow their legume allergy. Conclusion: NPL allergy represents a significant disease burden and the rate of resolution by age 15 years was 20%–32.9%, similar to legumes such as peanut.