Vaccinations prevented severe clinical complications of COVID-19. It was considered a vital component of living endemically with COVID-19. The Pfizer-BioNTech vaccine is the first mRNA-based vaccination that enhances immunity. Resulting in various adverse effects that may emerge after vaccination. This systematic review was undertaken to assess the Pfizer-BioNTech vaccine side effects by reviewing the previous studies. A total of 107 PubMed and Google Scholar publications were screened for Pfizer-BioNTech COVID-19 vaccine side effects. Fourteen articles met the study inclusion criteria. The included searching terms were a combination of “Pfizer vaccine and Side effects,” “BioNTech vaccine and side effects,” and “BNT162b2 vaccine and side effects,” as well as all synonyms. The total number of participants in the 14 studies was 10,632 participants. Average of the most frequent side effects of 14 studies were injection site pain 77.34%, fatigue 43%, muscle pain 39.67%, local swelling 33.57%, headache 33.27%, joint pain 25.75%, chills 18.34%, fever 18%, itching 9.38%, lymph nodes swelling 7.86%, nausea 7.58%, dyspnea 7.86%,and diarrhea 6.36%. The average side effects after the first dose were 79% compared with 84% after the second dose. The average occurs side effects in females at 69.8% compared with males 30.2%. Our study reveals that side effects after the Pfizer-BioNTech vaccine are common, but they are usually mild and self-limited. Local reactions like pain at the injection site are the most common. Anaphylactic shock or severe reactions are rare. We hope that our results will reassure the public that the benefits of vaccination far exceed the dangers. Also, help reduce vaccine hesitancy among individuals worried about vaccine safety and possible adverse effects.

Methotrexate (MTX) is significantly more effective than and has a considerable advantage over placebo in patients with severe and persistent rheumatoid arthritis (RA). The drug is used to treat a variety of malignant disorders (leukemia and cancer of the lung, breast, and uterus) and ectopic pregnancy. As its side effects are outweighed by its effectiveness, MTX is a first-line antirheumatic drug in many countries. MTX is found in extracellular compartments, such as the synovium, as well as other organs, such as the kidney and liver. To improve treatment, increase adherence, and decrease mortality in MTX therapy, it is essential to reduce its toxicity and understand its side effects. Therefore, this comprehensive review was conducted to assist physicians and researchers in better understanding the toxicity of MTX and how to deal with this toxicity. MTX is eliminated via the kidneys, which are capable of excretion and reabsorption within the renal tubules. Although higher doses of MTX (known as high-dose MTX (HD-MTX), defined as doses of 500 mg/m 2 or greater) are often more beneficial, they can produce toxicity and side effects such as bone marrow suppression, pulmonary toxicity, nephrotoxicity, hematologic toxicity, and an increased risk of infections. Treatment of severe MTX toxicity has three main goals: clearance of MTX from the bloodstream, folinic acid therapy, and organ treatment. Leucovorin is highly beneficial in preventing myelosuppression, gastric toxicity, and neurotoxic effects after HD-MTX therapy. The preferred antidote for MTX poisoning is folinic acid. Glucarpidase has been licensed for the treatment of high plasma MTX levels of >1 μmol/L in patients with compromised renal function who have delayed MTX elimination. In patients with renal deficiency, a lower initial dose is considered with an estimated glomerular filtration rate (eGFR) between 30 and 59 mL/minute. These patients need to be monitored, and a more gradual dosage increase and a lower weekly maximum should be considered regarding their general health situation. MTX is contraindicated in patients with RA if the eGFR is <30 mL/minute.

Omega is a polyunsaturated fatty acid (PUFA) that has an essential impact on cognitive performance at all stages of life. Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and alpha-linolenic acid (ALA) are essential for brain functions. DHA, the dominant omega-3 in the brain, impacts neurotransmitters and functions of the brain. This systematic review aimed to assess the effects of omega-3 on brain functions. We searched for articles from 2010 to 2022 in PubMed, electronic databases: discover, academic search complete (EBSCO), and Cochrane. To increase search efficiency, search terms include database-specific indexed phrases and keywords. Search terms included "omega three," "DHA," "fish oil," "eicosapentaenoic acid," "EPA," "docosahexaenoic acid," "omega-3," "cognition," "brain," "mental health," and "PUFAs". We conducted a review of only randomized clinical trials (RCTs) that were published in English. We evaluated the quality of the studies using the Cochrane Collaboration bias assessment tool. Our search strategy yielded 174 articles, out of which 33 full-text articles were reviewed and nine articles were selected for data abstraction. The overall number of individuals in all nine studies was 1319. Of the participants, 591 (44.81%) were men, and 728 (55.19%) were women. Participants who received omega-3 were 700 (65.06%) compared to 376 (34.94%) who received a placebo, and their mean age was 45. Ingestion of omega-3 fatty acids increases learning, memory, cognitive well-being, and blood flow in the brain. Omega-3 treatments are advantageous, welltolerated, and risk-free. Lonelier people, the elderly, and those who eat fewer healthy foods containing omega-3 may benefit from an omega-3 supplement. We suggest that natural omega-3 consumption through the diet should be promoted.

Varicose veins (VV) in the lower limbs are the most prevalent vascular condition in humans. They can cause significant signs and symptoms and, in extreme cases, death. This study aims to investigate the prevalence and identify the risk factors for varicose veins among nurses working in multiple departments at Jazan King Fahd Central Hospital and Prince Muhammad bin Nasser Hospital. A cross-sectional study was conducted by sending a questionnaire to female and male nurses in these hospitals. This study included 482 nurses, 415 (86.1%) of whom were female and 67 (13.9%) male. The prevalence of varicose veins among the nurses of both hospitals was 76 (15.8%), compared with 406 (84.2%) not diagnosed with varicose veins. The prevalence of varicose veins was 67 (88.2%) in female nurses, compared with 9 (11.8%) in male nurses. The risk factors associated with varicose veins were ethnicity ( p = 0.007), carrying heavy items ( p = 0.001), lack of exercise ( p = 0.031), family history ( p = 0.001), use of hormonal therapy ( p = 0.001), use of contraceptive pills ( p = 0.0035), type of delivery ( p = 0.002), number of children ( p = 0.004), and hours sitting per shift ( p = 0.002). The comorbidities associated with varicose veins were deep vein thrombosis ( p = 0.001), hypertension ( p = 0.002), chronic constipation ( p = 0.006), diabetes ( p = 0.001), kidney disease ( p = 0.001), rheumatoid arthritis ( p = 0.001), coronary artery disease, and severe occupational injury to the lower extremities ( p = 0.001). Nurses are responsible for most of the health system's services. Increasing the number of nursing workers for patient care, encouraging physical exercise, and lowering the pension age appear to be required to avoid the occurrence and development of varicose veins among nurses.

Background and aim: Bullying is one of the most significant problems that has emerged across the world. It has negative effects on physical, psychological, and social health, especially among adolescents. No previous studies have been conducted in the Jazan region of Saudi Arabia to investigate the association between bullying and health-related quality of life (HRQOL). The study aimed to estimate the prevalence of bullying and its association with HRQOL among adolescents in Jazan.Methods: A cross-sectional study was conducted among 461 adolescents in the Jazan region, Saudi Arabia. They were selected from nine schools by a convenient type of sampling, using snowball technique. HRQOL was tested using the Arabic version of KIDSCREEN-27. Data were collected using a web survey and analyzed by the Statistical Package for Social Sciences (SPSS) version 24 (Armonk, NY: IBM Corp.).Results: The study revealed that 35.3% of all participants were labeled as victims. Victimization was more common among boys (17.78%) than girls (17.57%) (P = 0.001). Most of the victims were bullied verbally (75.6%), and most of them were bullied by friends (57.67%). Regarding sex differences, cyberbullying was more prevalent among girls (18.04%) than among boys (9.82%) (P = 0.01). Bullying was more common in elementary schools (39.5%) than in others. Associations were found between bullying and all aspects of HRQOL that were evaluated (P<0.0001).Conclusions: Bullying prevalence is high among adolescents of the Jazan region and is associated with a poorer quality of life. This requires more attention from families and sectors of education, health, and social services.

Background: The coronavirus disease 2019 (COVID-19) pandemic has gravely affected the world in various ways. COVID-19 is a major health crisis, with long-term physical and mental health consequences. Many women reported menstrual irregularities during and after the pandemic. The study aimed to assess the effects of COVID-19 on menstrual cycles in females of reproductive age in the Jazan region.Methodology: A descriptive cross-sectional research design was utilized to conduct the study in Jazan, Saudi Arabia. A structured questionnaire was used to collect data from 346 women aged 18-44 years who had normal menstrual cycles for more than a year before the outbreak and had a history of COVID-19 infection.Result: The questionnaire was completed by 346 women. Only 144 (41.6%) of the study's respondents were aged 25-34 years. Of the respondents, 283 (81.8%) were university students, and 219 (63.3%) were married. The majority of women (337, 97.4%) were vaccinated against COVID-19. A total of 301 (87.0%) were healthy. Before being infected with COVID-19, 19.70% of the responders had irregular periods, which increased to 59.50% during infection and 33.20% after getting better. There was a relationship between the regularity of menstrual periods during COVID-19 infection and the duration of menstrual periods after COVID-19 (p = 0.035); the frequency of menstrual periods before (p = 0.001), during (p = 0.009), and after (p = 0.001) COVID-19; menstrual period regularity before (p = 0.001) and after (p = 0.001) COVID-19 infection; and pain severity level during (p = 0.001) and after (p = 0.004) COVID-19 infection. Regarding the perception of the impact of COVID-19 on menstrual changes, there was an association between COVID-19 infection and variation in days during two consecutive menstrual cycles (p = 0.001), changes in the duration of menstrual cycles (p = 0.022), delayed or absent menstruation (p = 0.019), and menstruation stopping (p = 0.023). Conclusion:The research demonstrated the COVID-19 pandemic is an international health problem that affects women, leading to changes in regularity, duration, frequency, and severity of pain. These changes may have a long-term impact on women's reproductive health.

Fluvoxamine (FLV) is a well-tolerated, widely accessible antidepressant of the selective serotonin reuptake inhibitor (SSRI) category. It was formerly used to reduce anxiety, obsessive-compulsive disorder, panic attacks, and depression. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enclosed ribonucleic acid (RNA) virus with a positive-sense RNA genome that belongs to the Coronaviridae family. Infection with SARS-CoV-2 causes clinical deterioration, increased hospitalization, morbidity, and death. As a result, the purpose of this research was to review FLV and its use in the treatment of SARS-CoV-2. FLV is a potent sigma-1 receptor (S1R) agonist that modulates inflammation by reducing mast cell downregulation, cytokine production, platelet aggregation, interfering with endolysosomal viral transport, and delaying clinical deterioration. FLV treatment reduced the requirement for hospitalization in high-risk outpatients with early identified coronavirus disease 2019 (COVID-19), defined by detention in a COVID-19 emergency department or transfer to a tertiary hospital. In addition, FLV may reduce mortality and risk of hospital admission or death in patients with SARS-CoV-2. The most common adverse effect is nausea; other gastrointestinal symptoms, neurologic consequences, and suicidal thoughts may also occur. There is no evidence that FLV can treat children with SARS-CoV-2. Although FLV is not expected to increase the frequency of congenital abnormalities during pregnancy, this risk must be balanced with the potential benefit. More research is required to determine the effectiveness, dose, and mechanisms of action of FLV; however, FLV appears to offer significant promise as a safe and widely accessible drug that can be repurposed to reduce substantial morbidity and mortality due to SARS-CoV-2.

Monkeypox (MPX) belongs to the genus Orthopoxvirus (OPV), family Poxviridae, and sub-family Chordopoxvirinae. Human monkeypox (HMPX) is a viral zoonotic illness caused by the monkeypox virus (MPXV). Several non-endemic countries have confirmed MPX cases across the globe. Therefore, consider an outbreak to be a global health emergency. MPXV transmits from animals to humans via infected animals, and there is currently human-to-human transmission, notably among guys who have sexual relations with males. Healthcare interventions are required to stop outbreaks. These include strict isolation and care for MPX patients while they are still contagious or until the skin lesions dry out and crust over. JYNNEOS was approved as a vaccine for the prevention of MPXV. Tecovirimat is licensed to treat severe MPX or risk developing a serious disease. We should encourage international cooperation to conduct clinical trials investigating the effectiveness and safety of MPXV vaccines and antiviral medications. Precautions must be taken at the global level to prevent an MPXV outbreak.