Publications by authors named "Abdulhadi A AlAmodi"

37 Publications

Reactive oxygen species (ROS) in cancer pathogenesis and therapy: An update on the role of ROS in anticancer action of benzophenanthridine alkaloids.

Biomed Pharmacother 2021 Nov 15;143:112142. Epub 2021 Sep 15.

Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar; Laboratory Animal Research Center, Qatar University, Doha 2713, Qatar. Electronic address:

Reactive oxygen species play crucial role in biological homeostasis and pathogenesis of human diseases including cancer. In this line, now it has become evident that ROS level/concentration is a major factor in the growth, progression and stemness of cancer cells. Moreover, cancer cells maintain a delicate balance between ROS and antioxidants to promote pathogenesis and clinical challenges via targeting a battery of signaling pathways converging to cancer hallmarks. Recent findings also entail the therapeutic importance of ROS for the better clinical outcomes in cancer patients as they induce apoptosis and autophagy. Moreover, poor clinical outcomes associated with cancer therapies are the major challenge and use of natural products have been vital in attenuation of these challenges due to their multitargeting potential with less adverse effects. In fact, most available drugs are derived from natural resources, either directly or indirectly and available evidence show the clinical importance of natural products in the management of various diseases, including cancer. ROS play a critical role in the anticancer actions of natural products, particularly phytochemicals. Benzophenanthridine alkaloids of the benzyl isoquinoline family of alkaloids, such as sanguinarine, possess several pharmacological properties and are thus being studied for the treatment of different human diseases, including cancer. In this article, we review recent findings, on how benzophenanthridine alkaloid-induced ROS play a critical role in the attenuation of pathological changes and stemness features associated with human cancers. In addition, we highlight the role of ROS in benzophenanthridine alkaloid-mediated activation of the signaling pathway associated with cancer cell apoptosis and autophagy.
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http://dx.doi.org/10.1016/j.biopha.2021.112142DOI Listing
November 2021

Case study-based systematic review of literature on lymphoma-associated cardiac tamponade.

Contemp Oncol (Pozn) 2021 23;25(1):57-63. Epub 2021 Feb 23.

Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Jackson State University, Jackson, Mississippi, USA.

This study aimed to compile all the relevant studies of patients presenting with pericardial tamponade before or after diagnosis of lymphoma, describe the clinical presentations of patients with lymphoma and cardiac tamponade, and assess the difference in overall survival based on the timing of cardiac tamponade diagnosis. A comprehensive search strategy was conducted in the following databases: PubMed and Cochrane Library, using the following keywords: Lymphoma AND Cardiac Tamponade. The criteria for eligibility included cases with a confirmed diagnosis of lymphoma and cardiac tamponade, human studies, and publications in English language. The statistical analysis was performed using IBM Statistical Package for Social Sciences (SPSS) version 20. We included 48 research articles ( = 52 cases) with adequate reporting of measured outcomes. The median age of the patients was 52 (9-94) years. Only 6 patients were noted to have primary cardiac lymphoma, while the majority of cases were considered to have secondary cardiac lymphoma (88.5%). According to the data on the type of lymphoma reported through cytology and immunohistochemistry, 49 patients were diagnosed with non-Hodgkin lymphoma, and of these cases the most common subtype was large B-cell lymphoma (42.9%). Overall, the average duration of illness was 14 ± 23 days. A total of 13 patients had distant heart sounds, 12 cases were noted to be hypotensive, and 13 subjects were found to have increased jugular venous pressure. Our retrospective study demonstrated that most patients presented with pericardial tamponade after lymphoma diagnosis, and those were mostly secondary cardiac lymphoma of the non-Hodgkin type with large B-cell as the most common subtype. Dyspnoea, oedema, and constitutional symptoms were the most common presenting signs. The median overall survival of patients with lymphoma and cardiac tamponade is 4 months, with no significant difference in mortality in the presentation timing before and after the diagnosis of lymphoma.
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http://dx.doi.org/10.5114/wo.2021.103828DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063898PMC
February 2021

A systematic review of contemporary evidence on SARS-CoV-2 and HIV coinfection: What does it look like up to date?

Avicenna J Med 2020 Oct-Dec;10(4):189-197. Epub 2020 Oct 13.

School of Public Health, Jackson State University, Jackson, MS, USA.

Background: Preexisting alteration of the immune system by factors including older age, cardiovascular diseases, morbid obesity, diabetes, and chronic obstructive pulmonary disease (COPD) have detrimental effects on SARS-CoV-2 patients. Literature regarding SARS-CoV-2/human immunodeficiency virus (HIV) is still developing.

Materials And Methods: We reviewed the existing literature pertaining to SARS-CoV-2/HIV coinfection systematically. Research records' characteristics and patients' clinical data were collected.

Results: Seven research records were included, of which three were case series and four were case reports, reporting a total of 16 cases. There was one case of death, whereas (15/16) patients were discharged home. Majority of patients developed consistent clinical presentation of SARS-CoV-2. All patients had initial positive RT-PCR results, and four cases had HIV-related lymphopenia.

Conclusion: Although the current literature is still growing to increase our understanding of SARS-CoV-2/HIV coinfection, people living with HIV should adhere to the guidelines of healthy behavior and practice during this pandemic.
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http://dx.doi.org/10.4103/ajm.ajm_175_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791285PMC
October 2020

Recent developments in unraveling signaling mechanisms underlying drug resistance due to cancer stem-like cells.

Curr Opin Pharmacol 2020 10 6;54:130-141. Epub 2020 Nov 6.

Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha, Qatar; Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar; Department of Dermatology and Venereology, Rumailah Hospital, Hamad Medical Corporation, Doha 3050, Qatar. Electronic address:

Resistance in cancer cells to therapeutic measures is challenging and requires a rigorous delineation of the underlying mechanisms. Emerging findings reflect the characteristics of tumor cells to do the reprogramming of signaling machinery in order to overturn the therapeutic responses. Recent evidence shows that the tumor acquires drug resistance due to the presence of cancer stem cells (CSCs). Hence the understanding that how tumor cells reprogram their signaling mechanisms converging towards the stemness of CSCs is imperative for novel and effective therapy. This review outlines the current updates on how CSC-associated signaling pathways and its enhanced stemness trigger the development of drug resistance. Furthermore, we also discussed the strategies with a combinational approach that can simultaneously target both CSC-induced stemness and the resistance-related signaling pathways, which may provide an optimal outcome to overcome the problem of drug resistance in cancer therapy.
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http://dx.doi.org/10.1016/j.coph.2020.09.012DOI Listing
October 2020

The effect of hyoscine-N-butylbromide on pain perception during and after hysterosalpingography in infertile women: a systematic review and meta-analysis of randomised controlled trials.

Hum Fertil (Camb) 2020 Nov 3:1-8. Epub 2020 Nov 3.

Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.

This paper reports a systematic review and meta-analysis of the effectiveness of hyoscine-N-butylbromide (HBB) administration in hysterosalpingography (HSG). Four electronic databases were searched for randomised controlled trials (RCTs) that compared HBB versus placebo or no intervention in infertile women undergoing HSG. Pain during and after HSG and different adverse events including nausea, vomiting, and dizziness were evaluated. Three RCTs with 335 patients were included. The analysis showed HBB was significantly effective in reducing pain during and after HSG (MD = -0.76 mm, 95% CI [-1.35, -0.17],  = 0.01) and (MD = -0.81 mm, 95% CI [-1.07, -0.56],  < 0.001), respectively. There were no significant differences in adverse events between HBB and control groups. The methodological evidence quality was high as evaluated by GRADEpro. In conclusion, this review provides good evidence that prior administration of HBB is effective in reducing induced pain during and after HSG with tolerable side effects.
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http://dx.doi.org/10.1080/14647273.2020.1842915DOI Listing
November 2020

Efficacy and Safety of Intravenous Tramadol versus Intravenous Paracetamol for Relief of Acute Pain of Primary Dysmenorrhea: A Randomized Controlled Trial.

Gynecol Obstet Invest 2020 19;85(5):388-395. Epub 2020 Oct 19.

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Introduction: Many pharmaceutical, surgical, and complementary medical interventions are used for primary dysmenorrhea treatment. However, no consensus has been reached about the most effective intervention.

Objective: To compare the efficacy and safety of IV tramadol versus IV paracetamol in relieving acute pain of primary dysmenorrhea.

Methods: This randomized controlled trial was conducted in a tertiary referral hospital and included 100 patients between 18 and 35 years old diagnosed with primary dysmenorrhea. Patients received either 1-g paracetamol or 100-mg tramadol in 100-mL normal saline as an IV infusion over 10 min. Pain intensity was measured by using a visual analog scale at 15, 30, 60 min, and 2 h. We recorded drug side effects and requirements for rescue analgesics.

Results: Pain scores were significantly lower in the tramadol group compared with the paracetamol group at 15, 30, 60 min, and 2 h (p < 0.001). Fewer patients in the tramadol group needed rescue analgesics compared with the paracetamol group (p = 0.04). No significant differences were reported in side effects between both groups.

Conclusions: IV tramadol is superior to IV paracetamol in relieving acute pain of primary dysmenorrhea with a comparable side effect profile.
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http://dx.doi.org/10.1159/000510268DOI Listing
April 2021

Amlodipine Compared with Benidipine in the Management of Hypertension: A Systematic Review and Meta-Analysis.

High Blood Press Cardiovasc Prev 2020 Dec 1;27(6):527-537. Epub 2020 Oct 1.

Faculty of Medicine, Fayoum University, Mesalla Aboudy St., Fayoum, 63511, Egypt.

Introduction: Benidipine and amlodipine are two well-known drugs used in hypertensive patients with chronic kidney disease (CKD).

Aim: In this systematic review we aimed to compare benidipine and amlodipine in terms of efficacy in the management of hypertensive patients.

Methods: We searched PubMed, Cochrane CENTRAL, SCOPUS and Web of Science for relevant clinical trials and excluded observational studies. Quality appraisal was evaluated according to GRADE and we assessed the risk of bias using the Cochrane's risk of bias tool. We included the following outcomes: Systolic blood pressure, diastolic blood pressure, heart rate, estimated glomerular filtration rate (eGFR), and urinary albumin/creatinine ratio. Data were pooled as mean differences (MD) with relative 95% confidence intervals (CI).

Results: Eight studies were eligible for our meta-analysis. We found no significant difference between both drugs regarding systolic (MD = - 0.21 [- 1.48, 1.89], (P = 0.81) and diastolic (MD = 0.01[- 0.51, 0.53], (P = 0.97)) blood pressure measurements. The overall heart rate did not differ as well (MD = - 0.03 [- 1.63, 1.57], (P = 0.97)). We found that benidipine was statistically better than amlodipine in terms of eGFR (MD = 1.07 [0.43, 1.71], (P = 0.001)), and urinary albumin/creatinine ratio (MD = - 43.41 [- 53.53, - 33.29], (P < 0.00001)).

Conclusions: Finally we conclude that benidipine seems to show more positive and promising results in the management of hypertensive patients with chronic kidney disease.
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http://dx.doi.org/10.1007/s40292-020-00412-yDOI Listing
December 2020

Factors associated with strain among informal care providers of patients with traumatic brain injury in Malaysia.

J Family Med Prim Care 2020 Jun 30;9(6):2990-2994. Epub 2020 Jun 30.

Department of Internal Medicine, Sebasticook Valley Hospital, 447 N Main St Pittsfield, ME 04967, USA.

Purpose: This study aims to investigate the level of strain and various influencing factors among informal care providers of traumatic brain injury (TBI) patients.

Methods: A cross-sectional study was conducted in a single center in Malaysia via recruiting care providers of patients with TBI. The modified caregiver strain index (MCSI) questionnaires were utilized to ascertain the level of strain. The demographic data of informal care providers were also obtained. Independent sample -test, analysis of variance (ANOVA), and a linear regression model were processed for data analysis.

Results: A total of 140 informal care providers were included in the study. More than half of informal care providers claimed to have strain (54.3%). Factors associated with increased strain include receiving tertiary education, being of Chinese background, and employed experience higher strain level. Informal care providers with characteristics such as being single, retired and provided care for 5 years experienced a lower level of strain.

Conclusion: Guidance on integrating the TBI knowledge into practice, assessing the care provider's level of strain regularly and providing supportive measures may aid in supporting informal care providers at risk.
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http://dx.doi.org/10.4103/jfmpc.jfmpc_247_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491810PMC
June 2020

High dose vs. low dose oxytocin for labor augmentation: a systematic review and meta-analysis of randomized controlled trials.

J Perinat Med 2021 Feb 21;49(2):178-190. Epub 2020 Sep 21.

Department of Obstetrics and Gynecology, Faculty of Medicine, Fayoum University, Fayoum, Egypt.

Objectives: To compare the safety and efficacy between high dose and low dose oxytocin administration for labor augmentation.

Methods: We searched for the available studies during March 2020 in PubMed, Cochrane Library, Scopus, and ISI Web of science. All randomized clinical trials (RCTs) that assessed safety and efficacy of high dose vs. low dose oxytocin for labor augmentation were considered. The extracted data were entered into RevMan software. Dichotomous and continuous data were pooled as odds ratio (OR) and mean difference (MD) respectively, with the corresponding 95% confidence intervals (CI). Our main outcomes were cesarean delivery rate, spontaneous vaginal delivery rate, uterine hyperstimulation and tachysystole, and labor duration from oxytocin infusion.

Results: Eight RCTs with 3,154 patients were included. High dose oxytocin did not reduce cesarean delivery rate compared to low dose oxytocin (OR=0.76, 95% CI [0.52, 1.10], p=0.15). After solving the reported heterogeneity, high dose oxytocin did not increase the rate of spontaneous vaginal deliveries vs. low dose oxytocin (OR=1.06, 95% CI [0.84, 1.32], p=0.64). Low dose oxytocin was linked to a significant decline in uterine hyperstimulation and tachysystole (p>0.001). A reduction in labor duration was found in high dose oxytocin group over low oxytocin regimen (MD=-1.02 h, 95% CI [-1.77, -0.27], p=0.008).

Conclusions: We found no advantages for high dose oxytocin over low dose oxytocin in labor augmentation except in reducing labor duration. Low dose oxytocin is safer as it decreases the incidence of uterine hyperstimulation and tachysystole. More trials are needed to confirm our findings.
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http://dx.doi.org/10.1515/jpm-2020-0042DOI Listing
February 2021

Quantitative and Qualitative Analysis of Medical Students' Research Output in Five Developing Countries.

Cureus 2020 May 8;12(5):e8026. Epub 2020 May 8.

Epidemiology and Public Health, School of Public Health, Jackson State University, Jackson, USA.

Objectives The purpose of this analysis was to investigate the quantity and quality of medical students' research output in Gulf Cooperation Council countries to aid in developing strategies to improve research output. Methods Abstracts presented by medical students in Gulf Cooperation Council countries were subject to analysis. Abstracts that propagated into full-length articles underwent further demographic analysis, in which data regarding the type of study, the field of study, country of origin, mode of presentation, and journal's impact factor were collected. A total of 798 abstracts were surveyed, with 19% (n=155) of the abstracts submitted by Gulf Cooperation Council countries progressing into full-length publications. The average impact factor for Gulf Cooperation Council country publications was found to be 1.85 ± 0.26 (standard error). Countries that recorded the highest conversion rates were, in descending order, Kingdom of Saudi Arabia, United Arab Emirates, Oman, Bahrain, and Kuwait. Moreover, basic biomedical and clinical research topics were more likely to be published in comparison with community-oriented and medical education-related topics. Conclusions Effective efforts to encourage more medical student research output in the Gulf Cooperation Council countries (with a focus on qualitative analysis) should be promoted in order to achieve publication rates comparable with those reported by developed countries.
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http://dx.doi.org/10.7759/cureus.8026DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7282381PMC
May 2020

Outpatient versus inpatient balloon catheter insertion for labor induction: A systematic review and meta-analysis of randomized controlled trials.

J Gynecol Obstet Hum Reprod 2020 Oct 31;49(8):101823. Epub 2020 May 31.

Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt. Electronic address:

Objective: To compare between outpatient and inpatient balloon catheter insertion for labor induction.

Methods: We searched in four different databases for the available trials during May 2020. We included randomized controlled trials (RCTs) that compared outpatient to inpatient balloon catheter for induction of labor. We extracted the available data from the included studies and pooled them in meta-analysis using RevMan software. The dichotomous data were pooled as risk ratio (RR) and the continuous data were pooled as mean difference (MD) with the corresponding 95% confidence intervals (CI).Our primary outcome was the rate of cesarean delivery. Our secondary outcomes were the length of hospital stay, Bishop score, and different adverse events including postpartum hemorrhage, Apgar score less than 7 at 5 minutes, and chorioamnionitis.

Results: Eight RCTs with a total number of 740patients were included. The cesarean delivery rate was significantly reduced among outpatient balloon catheter compared to inpatient balloon catheter (RR = 0.63, 95% CI [0.46, 0.86], p = 0.004). Outpatient balloon catheter was associated with shorter hospital stay duration in comparison with inpatient group (MD= -0.38, 95% CI [-0.61, -0.14], p = 0.002). Outpatient group was linked to a more favorable increase in Bishop score (MD = 0.88, 95% CI [0.78, 0.98], p>0.001). There were no significant differences between both groups regarding different adverse events.

Conclusion: Outpatient balloon catheter priming is safe and effective in reducing cesarean delivery rates and shortening the length of hospital stay with a better Bishop score.
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http://dx.doi.org/10.1016/j.jogoh.2020.101823DOI Listing
October 2020

Medical therapy options for endometriosis related pain, which is better? A systematic review and network meta-analysis of randomized controlled trials.

J Gynecol Obstet Hum Reprod 2021 Jan 29;50(1):101798. Epub 2020 May 29.

Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Cairo, Egypt.

Our objective was to assess and rank different pharmacological interventions for relieving endometriosis-related pain. We conducted an online bibliographic search in different databases from their inception until March 2019. We included randomized controlled trials (RCTs) that assessed different medical therapies in the management of endometriosis-related pain. We applied this network meta-analysis (NMA) based on the frequentist approach using statistical package "netmeta" (version 1.0-1) in R software. Our main outcomes were the change in severity of pelvic pain, dysmenorrhea score, non-menstrual pelvic pain score, and dyspareunia score. Overall, 36 RCTs were included in this study (patients no. = 7942). Dienogest (0.94), combined hormonal contraceptives (CHCs) (0.782), and elagolix (0.38) were the highest-ranked interventions for reducing the severity of pelvic pain at three months, while at six months, gonadotropin-releasing hormone (GnRH) analogues (0.75), levonorgestrel-releasing intrauterine system (LNG-IUS) (0.73), and dienogest (0.65) were linked to more reduction in pelvic pain. The ranking p-score showed that GnRH analogues was the highest-ranked treatment for reducing dysmenorrhea at 3 months (1.00), while CHCs were the highest-ranked treatment at 6 months (0.97), followed by GnRH analogues (0.89). GnRH analogues (0.63) and elagolix (0.54) at three months while desogestrel (0.94) and CHCs (0.91) at six months were the highest-ranked treatment to reduce non-menstrual pelvic pain. GnRH analogues and elagolix were the highest-ranked pharmacologic therapies for reducing dyspareunia. In conclusion, CHCs, GnRH analogues, progesterone, and elagolix were the best approaches in reducing the pain of endometriosis.
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http://dx.doi.org/10.1016/j.jogoh.2020.101798DOI Listing
January 2021

Pulmonary Hypertension and Polycythemia Secondary to Pulmonary Alveolar Microlithiasis Treated with Sequential Bilateral Lung Transplant: A Case Study and Literature Review.

Am J Case Rep 2019 Jul 28;20:1114-1119. Epub 2019 Jul 28.

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

BACKGROUND Pulmonary alveolar microlithiasis is an autosomal recessive disease in which a mutation in the SLC34A2 gene that codes for a sodium phosphate type IIb transporter protein (expressed in human epithelial tissues and functions in the clearance of phosphate ions) leads to the formation of extensive pulmonary intra-alveolar microliths. The subsequent characteristic clinical features of dyspnea and hypoxia are a manifestation of these microliths. There have been fewer than 1000 cases of pulmonary alveolar microlithiasis reported worldwide, and there have been 19 reported lung-transplanted patients. CASE REPORT A 49-year-old Saudi male patient presented with longstanding history of easy fatigability and tiredness on exertion since he was 16 years old. Throughout his follow-up in different hospitals (1986-1989), tuberculosis and pulmonary fibrosis were suspected. The patient was lost to follow-up between 1989 and 2001. In 2002, he presented to the emergency room with coughing, shortness of breath on exertion, abdominal swelling, and pedal edema. An investigation with chest x-rays, CT scan, electrocardiogram, and an echocardiogram was conducted. After referral to a tertiary care center, the patient was diagnosed with pulmonary alveolar microlithiasis. He subsequently developed pulmonary hypertension and polycythemia and therefore received a bilateral lung transplant in 2016. Following the lung transplant, he developed a mild reperfusion injury and tonic-clonic seizures, requiring ICU admission. After a successful extubatation with stable vitals and good recovery, he was discharged home in stable condition with planned follow-up. CONCLUSIONS We report a case of pulmonary alveolar microlithiasis successfully treated with a bilateral lung transplant. Although pulmonary alveolar microlithiasis is a rare entity, healthcare providers should consider it in the differential diagnoses of parenchymal lung diseases and differentiate it from tuberculosis and pulmonary fibrosis.
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http://dx.doi.org/10.12659/AJCR.911045DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683309PMC
July 2019

Assessment of Consistency between Claims and References Referred to in Pharmaceutical Advertising Brochures in the Kingdom of Saudi Arabia.

Cureus 2019 Jan 17;11(1):e3907. Epub 2019 Jan 17.

Surgery, Alfaisal University College of Medicine, Riyadh, SAU.

Drug advertisement brochures (DABs) contain claims that are often supplemented by references in medical literature. Several studies have evaluated the DABs as they are commonly distributed by drug companies to practicing physicians. The objective of this study is to assess the consistency between the claims and references referred to in the DABs in Saudi Arabia. DABs were collected from medical practitioners in Riyadh, Saudi Arabia. Authors developed a protocol to be followed for quality assessment of the DABs. The vast majority of cited scientific papers were indexed in PubMed. Consequently, each reference was categorized as: justifiable, false, exaggerated or ambiguous. A total of 89 DABs were collected; 48 (53.9%) brochures were excluded from further analysis and the remaining 41 brochures (46.1%) contained 240 references with an approximate average of 5.9 references per DAB. A total of 201 cited papers were traced (83.8%). The majority of references (93.0%) supported the claims for which they were cited. However, 1.5%, 4.0% and 1.5% of claims were deemed inaccurate/false, exaggerated, and ambiguous, respectively. This study supports that the majority of the claims made in the DABs of pharmaceutical companies in Saudi Arabia were unreferenced. However, most of the evidence presented to substantiate claims made was considered true.
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http://dx.doi.org/10.7759/cureus.3907DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426555PMC
January 2019

A Case Report of Intrapulmonary Teratoma in the Right Upper Lung Zone in a 35-year-old Female Patient.

Cureus 2019 Jan 7;11(1):e3834. Epub 2019 Jan 7.

Surgery, Alfaisal University, Riyadh, SAU.

Teratomas are rare germ cell tumors usually found in the gonads. Extra-gonadal teratomas are especially rare, mostly occurring in the thorax. Only a few cases of intrathoracic teratomas have been reported in medical literature and most reported were located in the mediastinum. An additional intrathoracic location for teratoma occurrence is in the pulmonary system, most commonly in the upper lobe of the left lung. In this report, we describe a case of a 35-year-old woman diagnosed with an intrapulmonary mature teratoma found in the right upper lobe. A 35-year-old Saudi female presented with a chief complaint of a three-week history of dry cough. Chest X-ray revealed a right-sided para-pericardial mass in the anterior mediastinum and a significant decrease in the size of the right middle lobe opacity. Subsequently, a chest computed tomography (CT) was performed and revealed a cystic mass in the right lung, which required removal by surgical intervention. The surgery was performed via a thoracoscopic approach and the tumor was excised with no complications. Intrapulmonary teratomas (IPT) usually present with vague and non-specific symptoms such as cough, hemoptysis, and chest pain. It is a rare condition without diagnostic features detected preoperatively, save for trichoptysis which is reported in approximately 13% of the cases. We report a rare appearance of mature IPT in the right upper lung zone which is an unusual location.
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http://dx.doi.org/10.7759/cureus.3834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6411339PMC
January 2019

The Summer Enrichment Program: A Multidimensional Experiential Enriching Experience for Junior Medical Students.

Am J Med Sci 2018 08 16;356(2):185-186. Epub 2018 May 16.

College of Medicine Alfaisal University, Riyadh, Saudi Arabia.

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http://dx.doi.org/10.1016/j.amjms.2018.05.005DOI Listing
August 2018

Sterile Bronchopleural Fistula Following Surgical Removal of Primary Lung Leiomyoma Inducing Secondary Hypertrophic Osteoarthropathy.

Am J Case Rep 2018 Mar 9;19:267-271. Epub 2018 Mar 9.

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

BACKGROUND Leiomyomas are benign neoplasms of the smooth muscle. When found in the pulmonary system, a rare occurrence, leiomyomas can result in hypertrophic osteoarthropathy, or significant clubbing, associated with proliferation of long bone periosteum. Bronchopulmonary fistulas, or communications between the bronchial tree and pleural space, are an uncommon postoperative complication of pneumonectomies. Even more infrequent is the presence of a bronchopulmonary fistula that is determined to be sterile. CASE REPORT The patient presented in the current case report is a 40-year-old previously healthy woman who presented with a 5-year history of chronic cough, right-sided chest discomfort, and dyspnea associated with back pain, and lower leg pain. The CT scan performed on the patient revealed a mass originating from the right lower lobe. Activity at the site of the lesion, in the long bones of the upper and lower limbs, rib cage, and vertebral bones was demonstrated by a bone scan. A CT-guided biopsy was performed, and the pathology report confirmed the presence of a leiomyoma. Following a right-sided lobectomy, the resected tumor was sent for histopathology, with the results confirming the biopsy. The patient subsequently presented with a history of persistent cough associated with increased watery secretions. The CT scan revealed the presence of a bronchopleural fistula, after which the patient underwent surgical correction. All symptoms resolved, and the patient was discharged in stable condition. CONCLUSIONS Here, we report on a patient who presented with 3 rare clinical findings: pulmonary leiomyoma, hypertrophic osteoarthropathy, and sterile bronchopulmonary fistula.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865406PMC
http://dx.doi.org/10.12659/ajcr.908105DOI Listing
March 2018

Benign Pericardial Schwannoma: Case Report and Summary of Previously Reported Cases.

Am J Case Rep 2018 Jan 24;19:90-94. Epub 2018 Jan 24.

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

BACKGROUND Primary pericardial tumors have a prevalence of between 6.7% and 12.8% of all tumors arising in the cardiac region. Pericardial schwannoma is a rare entity. It arises from the cardiac plexus and vagus nerve innervating the heart. Most of the reported cases, have presented with benign behavior, however, in rare situations, they can undergo transformation to malignant behavior When comparing the prevalence of cardiac tumors to that of pericardial tumors, the latter is much lower in occurrence. A review of English literature identified six pericardial schwannoma cases. CASE REPORT We present a case of a 30-year-old male patient who presented to our center with the chief complaint of six months of gradually progressive left chest pain. His past medical history (PMH) was positive for panic attacks (for which he was taking beta-blockers), paroxysmal tachycardia, sweating, and irritability. A computed tomography chest scan was done; a differential diagnosis of paraganglioma was suggested. However, histopathological examination confirmed the pericardial mass was a schwannoma. The patient was surgically treated by thoracotomy to resect the lesion. CONCLUSIONS This case adds to the existing limited literature on pericardial schwannoma as the seventh reported case. Neurogenic cardiac tumors; our case marks the second case reported to occur in the subcarinal area near the left atrium.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5789752PMC
http://dx.doi.org/10.12659/ajcr.907408DOI Listing
January 2018

Malnutrition in Yemen: an invisible crisis.

Lancet 2017 01 21;389(10064):31-32. Epub 2016 Dec 21.

Alfaisal University College of Medicine, Riyadh 11533, Saudi Arabia.

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http://dx.doi.org/10.1016/S0140-6736(16)32592-2DOI Listing
January 2017

Assessment of first-year medical students' perceptions of teaching and learning through team-based learning sessions.

Adv Physiol Educ 2016 Dec;40(4):536-542

Department of Medical Education, Alfaisal University College of Medicine, Riyadh, Kingdom of Saudi Arabia

Team-based learning (TBL) is an emerging teaching and learning strategy being employed in medical schools. The College of Medicine at Alfaisal University has adopted a TBL approach as an instructional method for first-year medical students. The aim of the present study was to describe the TBL method employed at Alfaisal University College of Medicine and to assess first-year medical students' perceptions of this learning modality for the anatomy- and physiology-based blocks/courses in organ systems form of curriculum. A five-point Likert scale questionnaire was structured based on Kirkpatrick's theory and assessed three major domains: reaction, learning, and behavior. Confirmatory factor analysis (CFA) and Cronbach's α-coefficient tests were used to assess the validity and reliability of the construct, respectively. CFA showed an adequate validity of the survey and Cronbach's α revealed an acceptable internal uniformity (0.69). A total of 185 respondents rated reaction, learning, and behavior toward introduction of TBL as 3.53 ± 1.01, 3.59 ± 1.12, and 3.57 ± 1.12, respectively. Excellent students rated TBL highly in all major domains compared with borderline students (reaction, behavior, and learning domains with P values of <0.049, <0.035, and <0.031, respectively). Students who had prior teamwork experience rated TBL higher in terms of their learning experience compared with those who were rarely involved in team work. This study demonstrated that Alfaisal University first-year medical students perceived TBL positively as a teaching and learning strategy for functional anatomy, and prior involvement in teamwork and academic performance correlates with higher ratings of TBL.
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http://dx.doi.org/10.1152/advan.00001.2016DOI Listing
December 2016

Biliverdin Reductase A Attenuates Hepatic Steatosis by Inhibition of Glycogen Synthase Kinase (GSK) 3β Phosphorylation of Serine 73 of Peroxisome Proliferator-activated Receptor (PPAR) α.

J Biol Chem 2016 Nov 10;291(48):25179-25191. Epub 2016 Oct 10.

From the Department of Physiology & Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson, Mississippi 39216,

Non-alcoholic fatty liver disease is the most rapidly growing form of liver disease and if left untreated can result in non-alcoholic steatohepatitis, ultimately resulting in liver cirrhosis and failure. Biliverdin reductase A (BVRA) is a multifunctioning protein primarily responsible for the reduction of biliverdin to bilirubin. Also, BVRA functions as a kinase and transcription factor, regulating several cellular functions. We report here that liver BVRA protects against hepatic steatosis by inhibiting glycogen synthase kinase 3β (GSK3β) by enhancing serine 9 phosphorylation, which inhibits its activity. We show that GSK3β phosphorylates serine 73 (Ser(P)) of the peroxisome proliferator-activated receptor α (PPARα), which in turn increased ubiquitination and protein turnover, as well as decreased activity. Interestingly, liver-specific BVRA KO mice had increased GSK3β activity and Ser(P) of PPARα, which resulted in decreased PPARα protein and activity. Furthermore, the liver-specific BVRA KO mice exhibited increased plasma glucose and insulin levels and decreased glycogen storage, which may be due to the manifestation of hepatic steatosis observed in the mice. These findings reveal a novel BVRA-GSKβ-PPARα axis that regulates hepatic lipid metabolism and may provide unique targets for the treatment of non-alcoholic fatty liver disease.
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http://dx.doi.org/10.1074/jbc.M116.731703DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5122784PMC
November 2016

Does bilirubin prevent hepatic steatosis through activation of the PPARα nuclear receptor?

Med Hypotheses 2016 Oct 31;95:54-57. Epub 2016 Aug 31.

Department of Physiology & Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, 2500 North State St, Jackson, MS 39216, USA. Electronic address:

Several large population studies have demonstrated a negative correlation between serum bilirubin levels and the development of obesity, hepatic steatosis, and cardiovascular disease. Despite the strong correlative data demonstrating the protective role of bilirubin, the mechanism by which bilirubin can protect against these pathologies remains unknown. Bilirubin has long been known as a powerful antioxidant and also has anti-inflammatory actions, each of which may contribute to the protection afforded by increased levels. We have recently described a novel function of bilirubin as a ligand for the peroxisome proliferator-activated receptor-alpha (PPARα), which we show specifically binds to the nuclear receptor. Bilirubin may function as a selective PPAR modulator (SPPARM) to control lipid accumulation and blood glucose. However, it is not known to what degree bilirubin activation of PPARα is responsible for the protection afforded to reduce hepatic steatosis. We hypothesize that bilirubin, acting as a novel SPPARM, increases hepatic fatty acid metabolism through a PPARα-dependent mechanism which reduces hepatic lipid accumulation and protects against hepatic steatosis and non-alcoholic fatty liver disease (NAFLD).
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http://dx.doi.org/10.1016/j.mehy.2016.08.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5433619PMC
October 2016

Interferon gamma-induced apoptosis of head and neck squamous cell carcinoma is connected to indoleamine-2,3-dioxygenase via mitochondrial and ER stress-associated pathways.

Cell Div 2016 2;11:11. Epub 2016 Aug 2.

Department of Pathology, University of Mississippi Medical Center, Jackson, MS 39216 USA ; Clinic of Operative Dentistry, Periodontology and Preventive Dentistry, Saarland University, Kirrberger Str. 100, 66421 Homburg/Saar, Germany ; Institut National de la Santé et de la Recherche Médicale, University of Strasbourg, 67000 Strasbourg, France ; Cancer Institute, University of Mississippi Medical Center, Jackson, MS 39216 USA.

Background: Tumor response to immunotherapy is the consequence of a concerted crosstalk between cytokines and effector cells. Interferon gamma (IFNγ) is one of the common cytokines coordinating tumor immune response and the associated biological consequences. Although the role of IFNγ in the modulation of tumor immunity has been widely documented, the mechanisms regulating IFNγ-induced cell death, during the course of immune therapy, is not described in detail.

Results: IFNγ triggered apoptosis of CLS-354 and RPMI 2650 cells, enhanced the protein expression and activation of indoleamine 2,3-dioxygenase (IDO), and suppressed the basal expression of heme oxygenase-1(HO-1). Interestingly, IFNγ induced the loss of mitochondrial membrane potential (Δψm) and increased accumulation of reactive oxygen species (ROS). The cytokine also induced the activation of Janus kinase (JAK)/Signal Transducer and Activator of Transcription (STAT)1, apoptosis signal-regulating kinase 1 (ASK1), p38, c-jun-N-terminal kinase (JNK) and NF-κB pathways and the transcription factors STAT1, interferon regulatory factor 1 (IRF1), AP-1, ATF-2, NF-κB and p53, and expression of Noxa protein. Furthermore, IFNγ was found to trigger endoplasmic reticulum (ER) stress as evidenced by the cleavage of caspase-4 and activation of protein kinase RNA-like endoplasmic reticulum kinase (PERK) and inositol-requiring-1α (IRE1α) pathways. Using specific inhibitors, we identified a potential role for IDO as apoptotic mediator in the regulation of IFNγ-induced apoptosis of head and neck squamous cell carcinoma (HNSCC) cells via Noxa-mediated mitochondrial dysregulation and ER stress.

Conclusion: In addition to the elucidation of the role of IDO in the modulation of apoptosis, our study provides new insights into the molecular mechanisms of IFNγ-induced apoptosis of HNSCC cells during the course of immune therapy.
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http://dx.doi.org/10.1186/s13008-016-0023-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969639PMC
August 2016

Cancer stem cell as therapeutic target for melanoma treatment.

Histol Histopathol 2016 Dec 15;31(12):1291-301. Epub 2016 Jun 15.

Department of Pathology, University of Mississippi Medical Center, Jackson, USA.

Human malignant melanoma is a highly aggressive skin tumor that is characterized by its extraordinary heterogeneity, propensity for dissemination to distant organs and resistance to cytotoxic agents. Although chemo- and immune-based therapies have been evaluated in clinical trials, most of these therapeutics do not show significant benefit for patients with advanced disease. Treatment failure in melanoma patients is attributed mainly to the development of tumor heterogeneity resulting from the formation of genetically divergent subpopulations. These subpopulations are composed of cancer stem-like cells (CSCs) as a small fraction and non-cancer stem cells that form the majority of the tumor mass. In recent years, CSCs gained more attention and suggested as valuable experimental model system for tumor study. In melanoma, intratumoral heterogeneity, progression and drug resistance result from the unique characteristics of melanoma stem cells (MSCs). These MSCs are characterized by their distinct protein signature and tumor growth-driving pathways, whose activation is mediated by driver mutation-dependent signal. The molecular features of MSCs are either in a causal or consequential relationship to melanoma progression, drug resistance and relapse. Here, we review the current scientific evidence that supports CSC hypothesis and the validity of MSCs-dependent pathways and their key molecules as potential therapeutic target for melanoma treatment.
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http://dx.doi.org/10.14670/HH-11-791DOI Listing
December 2016

Chronic treatment with a carbon monoxide releasing molecule reverses dietary induced obesity in mice.

Adipocyte 2016 Jan-Mar;5(1):1-10. Epub 2015 Aug 7.

Department of Physiology & Biophysics; Center for Excellence in Cardiovascular-Renal Research; University of Mississippi Medical Center ; Jackson, MS USA.

Chronic, low level treatment with a carbon monoxide releasing molecule (CO-RM), CORM-A1, has been shown to prevent the development of obesity in response to a high fat diet. The objective of this study was to test the hypothesis that chronic, low level treatment with this CO-RM can reverse established obesity via a mechanism independent of food intake. Dietary induced obese mice were treated with CORM-A1, the inactive compound iCORM-A1, or saline every 48 hours for 30 weeks while maintained on a high fat (60%) diet. Chronic treatment with CORM-A1 resulted in a 33% decrease from initial body weight over the 30 week treatment period while treatment with iCORM and saline were associated with 18 and 25% gain in initial body weight over the same time frame. Chronic treatment with CORM-A1 did not affect food intake or activity but resulted in a significant increase in metabolism. CORM-A1 treatment also resulted in lower fasting blood glucose, improvement in insulin sensitivity and decreased heptatic steatosis. Chronic treatment with CO releasing molecules can reverse dietary induced obesity and normalize insulin resistance independent of changes in food intake or activity. These findings are likely though a mechanism which increases metabolism.
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http://dx.doi.org/10.1080/21623945.2015.1038443DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4836479PMC
May 2016

Dual-degree MBBS-PhD programs in Saudi Arabia: A call for implementation.

Med Teach 2016 ;38 Suppl 1:S9-S11

a Alfaisal University , Saudi Arabia.

Engaging medical students in scholarly research activities and producing clinically competent and research-oriented medical workforces are essential demands, particularly in developing countries. Dual-degree MD-PhD programs offer simultaneous rigorous education in medicine and research, and train its graduates (physician-scientists) to successfully catalyze translational research evolutions. Literature fundamentally identifies dual-degree MD-PhD programs as the single most important, well-established, popular and influential programs toward commencing physician-scientist professions. While the physician-scientist population is alarmingly vanishing in the West with ongoing efforts to reverse this undesired trend, such population is largely nonexisting, unfortunately to start with, in Saudi Arabia. This is simply because no single dual-degree MBBS-PhD program is yet established in Saudi Arabia. Herein, we call on the Saudi Higher Education bodies to implement dual-degree MBBS-PhD programs with anticipated generation of competent physician-scientists in Saudi Arabia. To the best of our knowledge, this is the first ever report to call for such innovative implementation.
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http://dx.doi.org/10.3109/0142159X.2016.1142509DOI Listing
January 2017

Tackling preventable diseases in Yemen.

Lancet 2015 Dec;386(10010):2251-2

College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia.

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http://dx.doi.org/10.1016/S0140-6736(15)01101-0DOI Listing
December 2015

The interplay between academic performance and quality of life among preclinical students.

BMC Med Educ 2015 Oct 31;15:193. Epub 2015 Oct 31.

Alfaisal University, Riyadh, Saudi Arabia.

Background: The high academic performance of medical students greatly influences their professional competence in long term career. Meanwhile, medical students greatly demand procuring a good quality of life that can help them sustain their medical career. This study examines validity and reliability of the tool among preclinical students and testifies the influence of their scholastic performance along with gender and academic year on their quality of life.

Methods: A cross sectional study was conducted by distributing World Health Organization Quality of Life, WHOQOL-BREF, survey among medical students of year one to three at Alfaisal University. For validity, item discriminate validity(IDV) and confirmatory factor analysis were measured and for reliability, Cronbach's α test and internal item consistency(IIC) were examined. The association of GPA, gender and academic year with all major domains was drawn using Pearson's correlation, independent samples t-test and one-way ANOVA, respectively.

Results: A total of 335 preclinical students have responded to this questionnaire. The construct has demonstrated an adequate validity and good reliability. The high academic performance of students positively correlated with physical (r = 0.23, p < 0.001), psychological health (r = 0.29, p < 0.001), social relations (r = 0.11, p = 0.03) and environment (r = 0.23, p < 0.001). Male student scored higher than female peers in physical and psychological health.

Discussion: This study has identified a direct relationship between the academic performance of preclinical students and their quality of life.

Conclusion: The WHOQOL-BREF is a valid and reliable tool among preclinical students and the positive direction of high academic performance with greater QOL suggests that academic achievers procure higher satisfaction and poor achievers need a special attention for the improvement of their quality of life.
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http://dx.doi.org/10.1186/s12909-015-0476-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4628381PMC
October 2015

Comparative analysis of quantity and quality of biomedical publications in Gulf Cooperation Council countries from 2011-2013.

Saudi Med J 2015 Sep;36(9):1103-9

Department of Pharmacology, College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia. E-mail.

Objectives:   To compare the research productivity of different Gulf Cooperation Council (GCC) countries in the field of biomedical sciences from 2011-2013. 

Methods: This is a retrospective study conducted in the College of Medicine, Alfaisal University, Riyadh, Saudi Arabia. Data on the biomedical publications originating from GCC countries published between January 2011 to December 2013 was searched via MEDLINE using PubMed. The total number of publications emanating from each country was normalized with the country's population. The mean impact factor (IF) of all the publications in a year was calculated for comparative analysis. 

Results: A total of 11,000 publications were retrieved via MEDLINE using PubMed, out of which, 9222 were selected for analysis. A successive increase in the number of publications by every country was observed. The most striking increase in the number of publications was from Saudi Arabia. However, after normalization with population, the performance of Oman, Qatar, and Kuwait looks far better than Saudi Arabia in terms of research productivity. Data on mean IF showed that the overall mean IF of all GCC countries has remained largely unchanged except Oman. Although Oman had a comparatively low mean IF value in 2011, they recorded a tremendous improvement in successive years. 

Conclusion: All GCC countries underwent an increase in quantitative research productivity over the last 3 years. However, no increase in quality of research publications was noted based on the proxy reports of mean journal IF.
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http://dx.doi.org/10.15537/smj.2015.9.12369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613636PMC
September 2015

Research-oriented series: a portal into the culture of biomedical research for junior medical students at Alfaisal University in Saudi Arabia.

Adv Physiol Educ 2015 Mar;39(1):32-8

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

Student contributions to research have been shown to effectively reflect on their communication and critical thinking skills. Short-term research courses offer opportunities for medical students to advance their research experience in subsequent high-demanding long-term research opportunities. The purpose of the present study was to describe the development, implementation, and evaluation of a research-oriented series (ROS) on undergraduate students at Alfaisal University in Saudi Arabia. The ROS was designed to comprise eight sessions. Each session addressed core principles and the practice of research concepts and was based on theoretical morning sessions supplemented by afternoon practical sessions delivered by experienced senior medical students and faculty members. Students were assessed comprehensively by the end of the ROS. The series was conducted twice, and 35 students were involved each time. A total of 70 enrolled students (35 men and 35 women) with grade point averages of >3.5 and <3.5 were asked to fill out an anonymous, online, self-administered questionnaire assessing their perception of knowledge, skills, and confidence after attending the ROS and evaluating their senior peers. Ninety percent of the medical students responded to the online survey and rated the ROS highly in improving their research knowledge, skills, and confidence. Male students reported significant gains compared with their female peers (P<0.05). Grade point averages did not play a role in student gains after attending the ROS. Qualitative responses were in support of three recurring themes favoring the unique learning environment in the ROS. In conclusion, the ROS offers a short-term systematic approach to fundamental steps and concepts of biomedical research.
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http://dx.doi.org/10.1152/advan.00148.2013DOI Listing
March 2015
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