Cardiovascular diseases (CVD) are the leading causes of death worldwide. Dyslipidemia is a cardiometabolic risk factor of CVD, yet it can be modifiable. Walnuts have been suggested as a dietary intervention to improve the lipid profile. Therefore, we reviewed the literature to assess the evidence linking walnut intake to the improvement of blood lipids, including total cholesterol (TC), low-density lipoprotein (LDL-C) cholesterol, high-density lipoprotein (HDL-C) cholesterol, and triglycerides (TG). PubMed and Embase databases were searched from 2010 up to March 2022. We limited our search to randomized controlled trials conducted on humans and published in English during the specified period. Cochrane’s risk of bias tool for interventional studies was used. A random-effects model was used for the meta-analysis, and weighted mean differences were obtained (WMD) Thirteen trials from the U.S., Europe, and Asia were included. Walnut intake was associated with significant reductions in TC (WMD: −8.58 mg/dL), LDL-C (WMD: −5.68 mg/dL), and TG (WMD: −10.94 mg/dL). Walnut consumption was not associated with HDL-C. Subgroup analysis showed that overweight/obese and those with comorbidities had more lipid improvement. A longer trial duration did result in further improvements. However, our results may be prone to bias due to extraneous confounding factors. Additionally, levels of heterogeneity were considerable for some outcomes of interest. Results from this meta-analysis provide evidence for the health benefits of walnuts on blood lipids. Walnuts possibly reduce the risk of CVD; thus, they can be successfully added to a dietary pattern to enhance health benefits.

Introduction: Patients receiving rituximab (RTX) may be at increased risk for severe Coronavirus infections and worse outcomes compared with the general population. Because of the conflicting results concerning the effect of RTX on the clinical course and outcomes of COVID-19 infection, we aimed to share our experience with 35 patients infected with COVID-19 while treated with RTX for a variety of clinical indications. Methods: This was a single-centre retrospective cohort study that included 35 patients. All patients aged ≥ 14 years who were treated with RTX for various conditions and were found to have COVID-19 infection were included. Patients with poor outcomes or patients with suspected COVID-19 infection were excluded. Results: The patients’ mean age was 42.8 ± 16.3 years with an average BMI of 29.9 ± 11.4 kg/m². Over half (51.4%, n = 18) of the patients received RTX at a dose of 375 mg/m2 with a median frequency of 4 doses. More than a third (37.1%, n = 13) of the patients had hypogammaglobulinemia and 25.7% had low CD19. Over a third (42.9%, n= 15) of the patients required hospitalization and almost a third (25.7%, n = 9) required treatment in the intensive care unit. There was a statistically significant association between intensive care unit admission and age, steroid use, and low CD19. The mortality rate was 25.7%, and it was significantly higher in elderly, diabetics, corticosteroid users, patients who were hospitalized, treated in the intensive care unit, and had low immunoglobin or CD19. Conclusion: Treatment with RTX seems to be a potential risk factor for unfavorable outcomes in COVID-19 patients. RTX should be used with caution or avoided unless the benefit clearly outweighs the risk.

Background: Effective notifiable disease surveillance depends on healthcare providers’ ability to identify and report cases. Evidence on factors associated with surveillance performance remains limited in high-risk regions such as Jazan, Saudi Arabia. Objective: This study examined factors associated with healthcare providers’ notification and case management skills, prevention and training competencies, and perceptions toward the Notifiable Disease Surveillance System (NDSS). Methods: A cross-sectional analytical study was conducted among 420 healthcare providers working in government hospitals and primary healthcare centers in Jazan. Data were collected using an adapted self-administered questionnaire. Composite scores were analyzed using t-tests, ANOVA, and linear regression. Results: Higher NDSS-related scores were associated with professional category, HESN+ training, epidemiology or surveillance training, and years of experience. In multivariable analyses, HESN+ training, formal epidemiology or surveillance training, professional category, and experience remained associated with notification and prevention-related outcomes. Notification and case management skills were also associated with more favorable NDSS perceptions. Conclusions: NDSS-related competencies and perceptions were associated mainly with training exposure, professional role, and experience. Strengthening HESN+ training and integrating surveillance education into workforce development programs may support disease reporting and surveillance capacity in Jazan.

Background: Health care workers working in Covid-19 vacciantion centers due to their exponential demand experience burnout and stress. Burnout, a psychological syndrome is characterized by emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (PA). It can adversely affect professional and personal well being of an individual. Aim of this study was to check prevalence of burnout among health care workers, to identify personal and work-related factors, and to compare the risk factors associated with the different dimensions of burnout (EE, DP, and PA). Methods: This cross-sectional study was carried out among 180 employees of various COVID-19 vaccination centers. Three dimensions of burnout (EE, DP, and PA) were evaluated usinge Maslach Burnout Inventory (MBI), and association between burnout and other factors were assessed using logistic regression analysis with 95% confidence intervals (CI). Results: Prevalence rate of burnout among health care workers was 73.3%. Emotional exhaustion being the highest dimension (38.4%) followed by Depersonalization (30.8%) and personal accomplishment (33.1%). Young employees (<30 years) had significantly higher prevalence of burnout compared to old employees (82.4% vs. 52.4%, p = 0.033). Additionally, employees working more than 8 hours/day (OR = 9.98, p = 0.032) and employess with less than 6 hours of sleep/night (OR = 0.39, p = 0.042) had more likely to experience burnout. Conclusion: There was an increase prevalence rate of burnout observedamong employees at COVID-19 vaccination centers. There was a significant association between personal and work-related factors such as age, working hours, and sleep patterns. Addressing these factors, particularly by promoting better work-life balance and mental health support, is essential to mitigate burnout and improve employee well-being.