Toxoplasma gondii, an obligate intracellular and opportunistic parasite, is one of the most widely spread infections all over the globe, affecting about 30% of the world population [1]. Unlike many other parasitic disorders, its distribution is not merely restricted to developing countries, but it also afflicts developed nations such as France, which is known for having a high incidence of toxoplasmosis [2]. The wide range of this infection is attributed to the multiplicity of its modes of infection. Besides, being a zoonosis, T. gondii oocysts shed by the feline definitive host can be acquired by the mammalian intermediate host through the ingestion of contaminated food and water. Also, improperly cooked meat containing tissue cysts constitute a potential source of infection. Additional modes of infection include organ transplantation, blood transfusion and congenital transmission from mother to fetus [3]. The clinical range includes acute toxoplasmosis presenting with a variety of nonspecific symptoms such as sore throat and lymphadenitis, opportunistic

Background The burden of post-coronavirus disease (COVID)-19 symptoms has been increasing and is of great concern in patients with pre-existing chronic medical conditions.This study aimed to delineate the post-COVID-19 neuropsychiatric symptoms among migraine patients compared to the non-migraine control group. Methods Two groups, each of 204 COVID-19 survivors, were enrolled in the study after 3 months of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, one group fulfilling the episodic migraine criteria and the other serving as a matching control group. Subjects were evaluated through an in-person interview for post-COVID-19 neuropsychiatric symptoms, including detailed headache patterns and severity, using the visual analogue scale. Results The Frequency of headache during the acute phase of COVID-19 was more frequent in migraine patients (OR = 1.60, 95%CI = 1.04–2.45, P-value = 0.031). The reported significant post-COVID-19 neuropsychiatric symptoms in migraine patients compared to controls were fatigue (OR = 1.662, 95%CI = 1.064–2.596, P-value = 0.025), anosmia/hyposmia (OR = 2.06, 95%CI = 1.164- 3.645, P-value = 0.012), cacosmia (OR = 2.663, 95%CI = 1.145–6.195, P-value = 0.019), depression (OR = 2.259, 95%CI = 1.284- 3.975, P-value = 0.004), anxiety (OR = 3.267, 95%CI = 1.747- 6.108, P-value ≤ 0.001), insomnia (OR = 2.203, 95%CI = 1.298- 3.739, P-value = 0.003), and headache (OR = 3.148, 95%CI = 1.616–6.136, P-value =  ≤ 0.001).While there was no statistically significant difference between migraine patients and controls regarding the post-COVID-19 functional status score (P-value = 0.102). The pattern of post-COVID-19 headache was reported as chronic headache transformation in 17.6% of the migraine group, with the median intensity rate being 5.5 and IQR (3–7). In the control group, 14% experienced chronic headache attributed to systemic viral infection with a median intensity rate of 2 and IQR (2–5), while 12% experienced a new daily persistent headache with a median intensity of 5 and IQR (1–6). Conclusion The study highlighted the importance of follow-up migraine patients upon recovery from COVID-19 infection, being more vulnerable to post-COVID-19 symptoms.

The potential long-term neuropsychiatric effects of COVID-19 are of global concern. This study aimed to determine the prevalence and predictors of neuropsychiatric post-acute sequelae of COVID-19 among Egyptian COVID-19 survivors and to study the impact of full vaccination before COVID-19 infection on the occurrence and severity of these manifestations. Three months after getting COVID-19 infection, 1638 COVID-19 survivors were screened by phone for possible neuropsychiatric sequelae. Subjects suspected to suffer from these sequelae were invited to a face-to-face interview for objective evaluation. They were requested to rate the severity of their symptoms using visual analogue scales (VAS). The mean age of participants was 38.28 ± 13 years. Only 18.6% were fully vaccinated before COVID-19 infection. Neuropsychiatric post-acute sequelae of COVID-19 were documented in 598 (36.5%) subjects, fatigue was the most frequent one (24.6%), followed by insomnia (16.4%), depression (15.3%), and anxiety (14.4%). Moderate and severe COVID-19 infection and non-vaccination increased the odds of developing post-COVID-19 neuropsychiatric manifestations by 2 times (OR 1.95, 95% CI = 1.415–2.683), 3.86 times (OR 3.86, 95% CI = 2.358–6.329), and 1.67 times (OR 1.67, 95% CI = 1.253–2.216), respectively. Fully vaccinated subjects before COVID-19 infection ( n = 304) had significantly lesser severity of post-COVID-19 fatigue, ageusia/hypogeusia, dizziness, tinnitus, and insomnia ( P value = 0.001, 0.008, < 0.001, 0.025, and 0.005, respectively) than non-vaccinated subjects. This report declared neuropsychiatric sequelae in 36.5% of Egyptian COVID-19 survivors, fatigue being the most prevalent. The effectiveness of COVID-19 vaccines in reducing the severity of some post-COVID-19 neuropsychiatric manifestations may improve general vaccine acceptance.

Background: Data regarding prevalence, characteristics, and factors associated with caffeine-withdrawal headache are lacking. This work aimed to study the prevalence of caffeine-withdrawal headache among caffeine consumers during Ramadan's first day and describe its characteristics and associated factors. Methods:This analytical cross-sectional study targeted 755 caffeine consumers eligible to fast on the first day of Ramadan. Two methodological approaches were followed: an online open survey and a face-to-face interview. Using an adjusted form of food frequency questionnaire, eligible participants were requested to report their intake of caffeine-containing products during the last week of Shaaban month, the month preceding Ramadan. Results:The prevalence of caffeine-withdrawal headache on the first day of Ramadan was 419 (55.5%), with 95% confidence interval (CI; 51.9-59.0%). The headache in the majority of the participants was throbbing in character (249/419, 59.4%), diffuse (146/419, 34.8%), and moderate in intensity (227/419, 54.2%). Participants who developed caffeine-withdrawal headache had significantly higher body mass index (27.2 ± 5.1 vs. 26.3 ± 5 [mean ± standard deviation], p-value = 0.012), daily caffeine intake, mg (316 [185.2-537.8] vs. 144.4 [60.0-312.4] [median interquartile range (IQR)], p-value < 0.001), and caffeine intake mg/kg body weight (4.7 [2.6-7.2] vs. 1.9 [0.8-4.4] [median (IQR)], p-value < 0.001) than participants who did not develop it. Mild, moderate, and severe caffeine use disorder were found to have adjusted associations with developing caffeine-withdrawal headache. They increased the odds of headache by 5.3 (95% CI = 3.40-8.3), 10.2 (95% CI = 5.9-17.5), and 15.5 (95% CI = 9.0-26.8) times, respectively. The optimal cut-off value of daily caffeine intake/Kg body weight was determined at 1.97 mg/kg with an area under the curve of 0.722 and sensitivity and specificity of 85.1% and 50.2%, respectively. Conclusion:Daily caffeine intake/kg body weight and caffeine use disorder are significantly associated with a caffeine-withdrawal headache.