Monkeypox (MPOX) is an emerging zoonotic disease caused by monkeypox virus (MPXV), an orthopoxvirus closely related to smallpox. Initially confined to endemic regions in Central and West Africa, MPOX has recently gained global significance with outbreaks reported across multiple continents. MPXV is maintained in animal reservoirs but is increasingly transmitted from person to person, facilitated by close contact, respiratory droplets, and, in some cases, sexual transmission. Clinically, MPOX presents with fever, lymphadenopathy, and a characteristic vesiculopustular rash, though atypical manifestations have been observed in recent outbreaks, complicating diagnosis. Laboratory confirmation relies on molecular testing, while differential diagnosis must consider varicella, herpes, and other vesicular illnesses. Therapeutic options remain limited; supportive care is the cornerstone of management, but antivirals such as tecovirimat and brincidofovir, as well as smallpox vaccines, have shown efficacy in mitigating disease severity and preventing infection. The unprecedented global outbreak has underscored the importance of surveillance, rapid diagnostics, and coordinated public health responses to contain transmission. This review provides an overview of epidemiology, virology, clinical manifestations, modes of transmission, available diagnostics, and prophylactic and therapeutic strategies against MPOX. We also discuss the role of animal reservoirs, viral evolution, and human-to-human transmission in shaping the dynamics of recent MPOX outbreaks. By summarizing the latest evidence, this review aims to inform clinicians, researchers, and policymakers about key aspects of MPOX biology, clinical management, and prevention, while identifying gaps that warrant future investigation for the control of this and potentially other emerging zoonotic-related pathogens with an impact on human health.

Background: The clinical presentations of coronavirus disease 2019 (COVID-19) exhibit significant variation, ranging from asymptomatic cases to mortality resulting from severe pneumonia. Host genetics can partially explain this variation. Objective: This study evaluated possible associations between severity and outcome of COVID-19 and single nucleotide polymorphism (SNP) rs2285666 in the ACE2 gene and SNP rs2070788 in the TMPRSS2 gene. Methods: The study included a sample of 100 consecutive adult patients admitted to the COVID-19 Isolation and Intensive Care Units of the Zagazig University Hospitals, Zagazig, Egypt from July 2021 to November 2021. For rs2285666, polymerase chain reaction-restriction fragment length polymorphism was carried out. For rs2070788, real-time polymerase chain reaction was performed. Results: For rs2285666, the GA genotype was the most frequent among female patients (39% [16/41]) and the A genotype was more prevalent among male patients (54.2% [32/59]). For rs2070788, the AA genotype was the most frequent among all patients (46% [46/100]). No rs2285666 or rs2070788 genotypes or allele frequencies had significant associations with either severity or outcomes of patients. Conclusion: This study found no significant associations of COVID-19 severity or outcomes of patients with genotypes or allele frequencies of the rs2285666 SNP in the ACE2 gene or the rs2070788 SNP of the TMPRSS2 gene. The search for other genetic associations with COVID-19 infection is still required. What this study adds: The study reveals that host genetics explain the variation observed in the disease. Specific genetic variants can confer either increased susceptibility or resistance to the disease.

Background and study aim: Biliary strictures (BS), especially when associated with undetected masses on magnetic resonance imaging (MRI) or computed tomography (CT), present diagnostic challenges. Termed indeterminate biliary strictures (IBS), these cases necessitate accurate differentiation between benign and malignant causes. Endoscopic ultrasonography (EUS) is an advanced imaging modality with diagnostic and interventional capabilities that can help in better identification of IBS. This study aims to evaluate the accuracy of EUS in identifying the underlying causes of indeterminate biliary strictures (IBS). Patients and Methods: The study included 36 patients with distal common bile duct strictures and undetected masses on CT or MRI. EUS was employed to differentiate between benign and malignant strictures, and the final diagnosis was confirmed through histological examination. Results: EUS demonstrated a sensitivity of 90% and specificity of 71.4% in accurately identifying DBS without a tumor. After six months of follow-up, EUS maintained sensitivity and specificity rates of 87% and 100%, respectively. Malignant strictures were associated with significant weight loss and elevated levels of aspartate aminotransferase (AST), alanine transaminase (ALT), direct bilirubin, cancer antigen 19-9 (CA 19-9), and carcinoembryonic antigen (CEA). Conclusion: In summary, EUS emerged as a dependable diagnostic tool for patients with DBS and undetected masses on cross-sectional imaging, revealing small irregular hypoechogenic masses disrupting duodenal and bile duct layers, potentially indicative of malignancy.