Background: GLP-1 receptor agonists (GLP-1 RAs) have been shown to improve glycemic control and insulin sensitivity and reduce body weight in obese patients with type 2 diabetes mellitus (T2D). This trial sought to evaluate the therapeutic effect of oral and subcutaneous semaglutide in NAFLD and its sequelae in obesity and/or T2D. Methods: In an open-labelled intervention study, the sample was 180 patients classified into three parallel groups (1:1:1): group I received oral semaglutide, group II patients received injectable semaglutide, and group III received pioglitazone and/or vitamin E. Patients were evaluated at 6 and 12 months. Results: There was a substantial improvement in lipid profile, liver enzymes, and body mass index, especially in group II. As for HDL, only group II showed a consistent increase at both 6 months (51 ± 4.62 mg/dL) and 12 months (50.08 ± 2.45 mg/dL) compared with baseline (45.6 ± 6.37 mg/dL) (p-value < 0.001). Despite the non-significant difference in NAFLD fibrosis score (NFS) (p-value = 0.45 and 0.63), group II had significantly lower scores of the fibrosis-4 score (FIB-4), liver stiffness measurement (LSM), and controlled attenuation parameter (CAP) at 6 and 12 months (p-value < 0.001). Conclusions: Semaglutide improves lipid profile, liver steatosis, and fibrosis parameters and reduces the BMI in T2D and obese patients with NAFLD.

Background: The integration of AI into healthcare influences healthcare providers’ knowledge, attitudes, and workplace flourishing, grounded in key theoretical frameworks. Social cognitive theory suggests AI-enhanced programs may shape knowledge acquisition and decision-making. The Theory of Planned Behavior helps explain how perceptions of AI affect professional attitudes. Meanwhile, workplace flourishing aligns with positive organizational psychology, emphasizing autonomy and engagement factors potentially impacted by AI adoption. We aimed to examine the impact of artificial intelligence enhancement programs on the knowledge, attitudes, and workplace flourishing of healthcare providers.Methods: The present study was a quasi-experimental study conducted on healthcare providers at Zagazig University Hospital. The data was gathered using a self-administered three-domain tool, including an artificial intelligence knowledge domain, general attitudes toward artificial intelligence domain, and a workplace flourishing domain.Results: Regarding the artificial intelligence technologies knowledge, attitude, and flourishing at work scales, post-intervention scores of all domains showed a statistically significant increase compared to pre-intervention, with a percent increase in knowledge score, attitude, and flourishing at work score were 123.14, 74.28, and 10.63%, respectively. Post-intervention attitude score was significantly positively correlated with knowledge score (p = 0.001). In addition, age and years of experience were negatively correlated with changes in knowledge and attitude.Conclusion: Artificial intelligence training is essential for enhancing healthcare providers’ knowledge and alleviating their concerns regarding its integration into healthcare.Clinical trial registration: Identifier PACTR202403647083094; https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=27347

The emergence of mucormycosis as a life-threatening fungal infection after the coronavirus disease of 2019 (COVID-19) is a major concern and challenge, but there is limited information on the risk factors for mortality in patients. We conducted a prospective cohort study from May 2021 to April 2022 to determine the in-hospital outcomes of post-COVID-19 mucormycosis during the intensive care unit (ICU) stay. The sample of the study was collected as consecutive sampling using all accessible patients in the study period. The Statistical Package for Social Sciences (SPSS), version 25 (IBM, Chicago, Illinois, USA) was used for statistical analysis. Among 150 patients with post-COVID-19 mucormycosis, the majority had a primary sinus infection (86.0 %), while 11.3 % had both sinus and ocular infections, and 2.7 % had sinus and cutaneous infections. Around 21 % (n = 31) of patients deceased after staying in the ICU for a median (range) of 45.0 (10.0-145.0) days. The majority of the patients who deceased had pneumonia patches on computed tomography (CT) (90.3 %) while none of the patients who were discharged had pneumonia patches (p < 0.001). The deceased group had higher rates of pulmonary embolism (93.5 %) compared to the surviving groups (21.8 %). In a multivariate Cox regression analysis, the risk of death was higher in older patients above 60 years old (hazard ratio (95 %CI): 6.7 (1.73-15.81)), increase among patient with history of steroid administration (hazard ratio (95 %CI): 5.70 (1.23-10.91)), who had facial cutaneous infection with mucormycosis (hazard ratio (95 %CI): 8.76 (1.78-25.18)), patients with uncontrolled diabetes (hazard ratio (95 %CI): 10.76 (1.78, 65.18)), and total leukocytic count (TLC>10 ×103 mcL) (hazard ratio (95 %CI): 10.03 (3.29-30.61)). Identifying high-risk patients especially old diabetic patients with corticosteroid administration and detecting their deterioration quickly is crucial in reducing post-COVID-19 mucormycosis mortality rates, and these factors must be considered when developing treatment and quarantine strategies.

Introduction: To date, the world has experienced four waves of the Coronavirus disease- 19 (COVID-19) pandemic. Patients infected during the era of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant were the subject of this study. The objectives were to describe their clinical manifestations, explain their laboratory and radiological findings, conclude factors contributing to clinical outcomes, and evaluate treatment protocols. Methodology: Relevant data were collected retrospectively from records of patients admitted to six referral centers in four countries. Data included sociodemographic patterns, symptoms, associated comorbidities, physical examination, laboratory and radiologic findings, treatment received, and patient outcomes. Results: Data analysis identified symptomatology and variables related to acquisition and infection outcome. The most prevalent symptoms were cough (81.5%), body aches (74.1%), and fever (71.6%). Independent risk factors for mortality were age, vomiting, epigastric pain, diabetes, obesity, oxygen saturation less than 90%, leukocytosis, neutrophilia, lymphopenia, thrombocytopenia, elevated creatinine, high glucose level, lung ground glass opacities with consolidation, affection of four lobes and bilateralism. Neither d-dimer nor lactate dehydrogenase nor ferritin foretells death possibility. The efficacy of the medications used was convenient. Conclusions: Assessing the clinical features of different COVID-19 waves, identifying predictors of outcomes, and concluding the efficacy of treatment protocols provide insight into patients’ responses and viral behaviors, which help in the proper diagnosis and treatment of subsequent surges.

Metabolic syndrome doubles the risk of developing cardiovascular diseases and type II diabetes mellitus. Intermittent Islamic fasting is an effective health strategy associated with various benefits. to compare effect of intermittent Islamic fasting with lifestyle modification versus lifestyle modification only on weight management, blood pressure, blood glucose and lipid profile among a group of metabolic syndrome patients. A Randomized control trial was conducted on (54 patients) with metabolic syndrome, their ages range from (30–45 years) attending the clinical nutrition outpatient clinic in the Zagazig University hospital from 1st of August (2023) to the end of February (2024). Intervention group (27 patients) followed Islamic fasting with lifestyle modification (Islamic fasting means: fasting two days per week (Monday and Thursday) with fasting (13, 14, 15) middle of lunar months) and control group (27 patients) followed lifestyle modification only. There is statistically non-significant difference between groups regarding healthy lifestyle score, clinical or laboratory parameters. There is statistically significant difference between the studied groups regarding percent of change in weight (p-value < 0.001), waist circumference (P-value < 0.001), systolic ( p-value = 0.042), diastolic blood pressure (P < 0.001), Fasting blood glucose (p-vale < 0.001), triglycerides (p-value < 0.001), HDL(p-value < 0.001) and total cholesterol (p-value = 0.023) with better improvement in intervention group, although no significant difference between them regrading lifestyle before or after intervention but both groups showed significant improvement after intervention. Intermittent Islamic fasting (ISF) demonstrated a statistically significant enhancement in weight regulation, systolic blood pressure, triglyceride levels, total cholesterol, and HDL concentrations when compared to lifestyle modification alone. Retrospectively registered on ClinicalTrials.gov, registered at 22/1/ 2025, Identifier NCT06805526. The online version contains supplementary material available at 10.1186/s12889-025-23493-7.

Background: Microscopic colitis (MC) is a recognized cause of chronic diarrhea and is often underestimated when a colonoscopy appears normal. This study aims to accurately diagnose chronic diarrhea through histopathological examination of colonoscopic mucosal biopsies and assess the prevalence of microscopic colitis and the diagnostic value of biomarkers. Methods: A hospital-based cohort study was conducted on 116 patients with chronic diarrhea. Colonoscopies and colonic mucosal biopsies were performed and analyzed, along with various tests including fecal calprotectin (FC) level, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), stool analysis, routine laboratory tests, and clinical data related to nocturnal diarrhea, abdominal pain, and unexplained weight loss. Results: In the study group, 32.8% had MC, with 25.9% having lymphocytic colitis (LC) and 6.9% having collagenous colitis (CC). Patients with MC had significantly higher FC, ESR, and CRP levels than those without colitis (p < 0.001). Factors associated with MC included nocturnal diarrhea (OR = 4.26; 95% CI [1.64–11.08]; p-value = 0.003) and abdominal pain (OR = 4.62; 95% CI [1.85–11.54]; p-value = 0.001). ESR at a cutoff >14 mm/h and FC at a cutoff >64 mcg/g showed excellent validity in diagnosing MC with area under the curve (AUC) values of 0.94 and 0.97, respectively. Conclusions: Microscopic colitis, particularly LC-type, is not an uncommon cause of chronic diarrhea, especially when accompanied by symptoms such as abdominal pain and nocturnal diarrhea, warranting further investigation, including inflammatory markers and colonic biopsy. Inflammatory markers can be useful in diagnosing MC with proper values and approaches; however, further studies are needed.