Combining immune checkpoint inhibitors, specifically nivolumab (anti-PD-1) and ipilimumab (anti-CTLA-4), holds substantial promise in revolutionizing cancer treatment. This review explores the transformative impact of these combinations, emphasizing their potential for enhancing therapeutic outcomes across various cancers. Immune checkpoint proteins, such as PD1 and CTLA4, play a pivotal role in modulating immune responses. Blocking these checkpoints unleashes anticancer activity, and the synergy observed when combining multiple checkpoint inhibitors underscores their potential for enhanced efficacy. Nivolumab and ipilimumab harness the host’s immune system to target cancer cells, presenting a powerful approach to prevent tumor development. Despite their efficacy, immune checkpoint inhibitors are accompanied by a distinct set of adverse effects, particularly immune-related adverse effects affecting various organs. Understanding these challenges is crucial for optimizing treatment strategies and ensuring patient well-being. Ongoing clinical trials are actively exploring the combination of checkpoint inhibitory therapies, aiming to decipher their synergistic effects and efficacy against diverse cancer types. This review discusses the mechanisms, adverse effects, and various clinical trials involving nivolumab and ipilimumab across different cancers, emphasizing their transformative impact on cancer treatment.

Background: Previous studies have reported involvement of Toxoplasma gondii (T. gondii) infections in the pathogenesis of some autoimmune diseases, such as polymyositis, rheumatoid arthritis, autoimmune thyroiditis, and Crohn’s disease. However, data on the association between T. gondii infections and Type 1 diabetes mellitus (T1DM) are still controversial. Therefore, in the present study, we aimed to investigate the pancreatic pathological changes in mouse models with acute and chronic toxoplasmosis and their association with T1DM. Materials and Methods: Three groups (10 mice each) of male Swiss Albino mice were used. One group of mice was left uninfected, whereas the second and third groups were infected with the acute virulent T. gondii RH strain and the chronic less virulent Me49 T. gondii strain, respectively. T. gondii-induced pancreatic pathological changes were evaluated by histopathological examination of pancreatic tissues. Moreover, the expression of insulin, levels of caspase-3, and the pancreatic infiltration of CD8⁺ T cells were evaluated using immunohistochemical staining. Results: Pancreatic tissues of T. gondii-infected animals showed significant pathological alterations and variable degrees of insulitis. Mice with acute toxoplasmosis exhibited marked enlargement and reduced numbers of islets of Langerhans. However, mice with chronic toxoplasmosis showed considerable reduction in size and number of islets of Langerhans. Moreover, insulin staining revealed significant reduction in β cell numbers, whereas caspase-3 staining showed induced apoptosis in islets of Langerhans of acute toxoplasmosis and chronic toxoplasmosis mice compared to uninfected mice. We detected infiltration of CD8⁺ T cells only in islets of Langerhans of mice with chronic toxoplasmosis. Conclusions: Acute and chronic toxoplasmosis mice displayed marked pancreatic pathological changes with reduced numbers of islets of Langerhans and insulin-producing-β cells. Since damage of β cells of islets of Langerhans is associated with the development of T1DM, our findings may support a link between T. gondii infections and the development of T1DM.

Background: The Hajj pilgrimage is one of the largest annual mass gatherings in the world, and it presents unique healthcare issues due to the vast number and diversity of participants. Optimizing the delivery and planning of health services requires an understanding of prevalent diseases and healthcare usage patterns. The aim of the study was to examine the patterns of disease burden and healthcare utilization among 2024 Hajj pilgrims. Methods: This study used a retrospective, descriptive cross‑sectional design. Data from 37,758 adult patient records in the outpatient clinics (OPCs) of the primary healthcare centers (PHCs) and hospitals located at the holy sites (Mena, Arafat, and Muzdalifah) during Hajj 2024 were analyzed. Data covered demographics, nationality, diagnoses, discharge outcomes, and healthcare utilization in holy sites. Patterns and associations were assessed using descriptive statistics and chi‑square testing (p < 0.05). Results: Most pilgrims were men (65.5%), and older than 60 years of age (26.4%). They came from more than 100 different countries. The most frequent diagnosis (44.6%) was upper respiratory tract infections (URTIs), which was followed by dermatitis (6.3%), gastrointestinal disorders (7.4%), headaches (7.8%), and musculoskeletal problems (7.3%). Geographically, disease prevalence varied: URTIs were most common in Mena (46.3%), dermatitis peaked in Muzdalifah (14.8%), and heat exhaustion was most common in Arafat (9.4%). Primary care use peaked in Mena (14,500 visits), mirroring pilgrim mobility. Conclusion: The results emphasize the necessity for flexible, data‑driven resource allocation by highlighting the dynamic and site‑specific character of healthcare demands during the Hajj. To improve health outcomes in upcoming Hajj seasons, it is imperative to enhance infection control, heat illness prevention, and culturally competent care, in addition to tailored interventions for older pilgrims and those with chronic illnesses.

Food contains several microorganisms that may cause illnesses and food poisoning in humans. Small numbers of microorganism contamination could result in rapid spoilage of food. The Centres for Disease Control and Prevention (CDC), USA estimates that 76 million people are affected by foodborne illnesses each year in the USA. Salmonella infections alone account for one billion dollars yearly in direct and indirect medical costs and more than 5,000 deaths. In Sudan, diarrhoeal disease was reported as the second major disease during the years from 2003 to 2007 (Annual health statistical report of the Federal Ministry of Health, Sudan). We aimed to develop a rapid molecular procedure for the detection of Escherichia coli, Shigella dysentery, and salmonella Typhiin food so as to minimize the public health hazard of food contamination. We used the Multiplex PCR method as rapid methods were tested for identification of Enterobacteriaceae species Escherichia coli as an indicator organism for food contamination and two strains of Enterobacteriaceae that causes food borne illness (namely Shigella dysentery and salmonella Typhi). The Multiplex PCR was performed to detect E. coli using Mdh primer pair, Salmonella Typhi using IpaB primer pair, and Shigella dysentery using IpaH1 primer pair. The sensitivity to detect E. coli, Salmonella Typhi, and Shigella dysentery in contaminated food in the concentration of the infective and the over infective doses were 100%, 96.3%, and 88.9% respectively for the three bacteria strains. There was no significant difference in the detection of the bacteria after incubation for 8 hours, 24 hours, or even without incubation period. There were no differences in the result of the samples that were contaminated artificially in laboratory and those obtained from the market. The Multiplex PCR method for identification of E. coli, Salmonella Typhi and Shigella dysentery was developed as a model for detection and risk assessment of the three bacteria in one program, and it is suitable for routine analysis.

This study aims to evaluate the knowledge, attitudes, and practices (KAP) concerning antibiotics and antimicrobial resistance (AMR) among medical students, a crucial group in fighting the global menace of AMR. Utilizing a cross-sectional design, an electronic questionnaire was administered to explore diverse facets of antibiotics and AMR. Conducted from January to April 2023, the survey collected 340 responses that were subsequently analyzed through statistical software. The results revealed sig