Publications by authors named "Sumaiah J Alarfaj"

5 Publications

  • Page 1 of 1

The AMPK modulator metformin as adjunct to methotrexate in patients with rheumatoid arthritis: A proof-of-concept, randomized, double-blind, placebo-controlled trial.

Int Immunopharmacol 2021 Jun 24;95:107575. Epub 2021 Mar 24.

Department of Biochemistry, Faculty of Pharmacy, Menoufia University, Egypt.

Background: Metformin (MET) may exert anti-rheumatic effects and reduce cartilage degradation through its immunomodulatory and anti-inflammatory actions.

Methods: This was a double-blind placebo-controlled study, 120 adult patients with active rheumatoid arthritis (RA) were randomized to receive MET (1000 mg) or placebo daily with methotrexate (MTX, 7.5 mg/week) for 12 weeks. American College of Rheumatology (ACR)20, ACR50, and ACR70 response rates, Disease Activity Score in 28 joints (DAS-28), and drug safety were the efficacy endpoints. Serum levels of TNF-α, IL-1β, IL-6, IL-10, IL-17A, NF-κB, TGG-β1, MDA together with gene expression of AMPK and IGF-IR were assessed before and after the therapy.

Results: A total of 80.8% of the patients in the MET group, compared with 54.7% in placebo group, met the criteria of ACR20 response after 12 weeks (P = 0.001). Statistically significant enhancements in the DAS28-3 (CRP) were observed after 4 and 8 weeks for the MET group compared with placebo and were sustained after 12 weeks. MET group showed statistically significant increase in percentage of patients achieving DAS remission after 12 weeks (P = 0.015). Significant improvements in ACR50, ACR70, Health Assessment Questionnaire Disability Index (HAQ-DI), and DAS28-3 (CRP) were also reported. MET was well-tolerated, and no serious adverse effects were reported in both groups. Furthermore, the MET group was superior in improving the measured parameters compared to the placebo.

Conclusions: MET improved the anti-rheumatic effect of MTX; suggesting it to be a beneficial adjuvant in patients with RA. Trial registration ID: NCT04068246.
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June 2021

Therapeutic effect of rocket seeds (Eruca sativa L.) against hydroxyapatite nanoparticles injection induced cardiac toxicity in rats.

Pak J Pharm Sci 2020 Jul;33(4(Supplementary)):1839-1845

Pharmaceutical Sciences Department, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia/Department of Biochemistry, Faculty of Pharmacy, Al Azhar University, Cairo, Egypt.

Hydroxyapatite is bio-ceramic materials with a calcium to phosphorus proportion like to that of normal bone and teeth. The current study meant to examine the cardiac toxicity by hydroxyapatite nanoparticles (HAP NPs) and the protective effect of the rocket seeds in treatments. An aggregate of 40 male Wistar rodents were partitioned into 4 equal groups [Gp1, control; Gp2, rocket seeds extract (RS); Gp3, HAP NPs; Gp4, HAP NPs+RS]. Current results exhibit that; HAP NPs induce a significant increase in myoglobin, LDH (lactate dehydrogenase), CK-MB (creatinine kinase) and CK (creatinine kinase) levels, cardiac thiobarbituric acid-reactive substances (TBARS), injury and P53 expressions. In contrast; a significant reduction in cardiac catalase, reduced glutathione (GSH) and superoxide dismutase (SOD) as compared to control group. Post treatment of rat with HAP NPs and rocket seeds extract (HAP NPs+RS) improved the cardiac functions and structure. Rocket seeds extract may offer advantages against the harmful effects of hydroxyapatite nanoparticles.
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July 2020

Pain perception assessment using the short-form McGill pain questionnaire after cardiac surgery.

Saudi J Anaesth 2020 Jul-Sep;14(3):343-348. Epub 2020 May 30.

Department of Adult Cardiac Surgery, Prince Sultan Cardiac Centre, Riyadh, KSA.

Background: Pain management remains an integral part of patient care after cardiac surgery, and it required proper pain assessment. The aim of the study was to assess pain perception using validated Arabic version of the short-form McGill Pain Questionnaire (SF-MPQ) and to identify analgesics prescribing patterns post cardiac surgery.

Methods: This is a prospective study conducted in an adult cardiac critical care unit of a tertiary cardiac center from September 2018 to March 2019. The study enrolled 74 patients who underwent cardiac surgical procedures through a median sternotomy.

Results: The mean age of our patients was 57 ± 11 years and 47 (63.5%) were males. Patients described post-cardiac surgery pain as heavy ( = 37; 50%) and tiring-exhausting ( = 49; 66%), mainly at the site of incision ( = 20; 27%). Pain intensity at day 1 according to pain rating index (PRI) and numerical rating scale (NRS) was 7 (25, 75 percentiles: 2.8-15) and 6 (3-8), respectively. There was a significant change in pain intensity score between 2 days of assessment (PRI: 7 [2.8-15] vs 5 [2-11] = 0.010; NRS: 6 (3-8) vs 5 (2-8), = 0.021]). The most common analgesics prescribed were paracetamol (39%) and a combination of tramadol and paracetamol (33.8%).

Conclusion: Pain decreased the second day after cardiac surgery compared to day 1. Paracetamol was the most prescribed analgesic; however, there was an underutilization which might be affected by insufficient pain reporting. Future improvement could focus on multimodal pain management and proper communication of pain experience.
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May 2020

Statin Use and the Point Prevalence of Antibiotics in Ambulatory Patients with Diabetes in the National Health and Nutrition Examination Survey (NHANES) 2003-2012.

Antibiotics (Basel) 2019 May 27;8(2). Epub 2019 May 27.

Gilead Sciences, Foster City, CA 94404, USA.

In patients with diabetes, the risk of infections is increased, hypothesized to be due to alterations in the immune system, among other changes. The pleotropic effects of statins have been investigated to assess their role in reducing the risk of infection and infection-related outcomes with varying results. The aim of this study is to determine if the use of statins is associated with a decrease in the point prevalence of oral antibiotic use in ambulatory patients with diabetes. Using data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2012, all adult patients diagnosed with diabetes were analyzed. Patients were grouped into those who were prescribed statins and those who were not. Oral antibiotic use between the two groups was compared. Data were standardized to national estimates. A total of 3240 patients with diabetes were identified, with 1575 statin users and 1665 non-statin users. After controlling for baseline socio-demographic and clinical variables, the overall point prevalence of oral antibiotic use in diabetes population was 3.5% with no difference between statin users and non-statin users (2.9% vs. 4%, = 0.116). Based on the results of this study, the use of statins in patients with diabetes was not associated with a reduction in the point prevalence of antibiotic use.
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May 2019

Comparison of drug administration logistics between prothrombin complex concentrates and plasma in the emergency department.

Am J Emerg Med 2018 12 24;36(12):2182-2186. Epub 2018 Mar 24.

Department of Pharmacy Services, Banner - University Medical Center Tucson, 1501 N Campbell Ave, Tucson, AZ 85724, USA. Electronic address:

Background: Prothrombin complex concentrate (PCC) is used as an alternative to fresh frozen plasma (FFP) for emergency bleeding. The primary objective of this study was to compare the time from order to start of administration between 3-factor PCC (PCC3), 4-factor (PCC4), and FFP in the emergency department (ED). The secondary objective was to evaluate the effect of an ED pharmacist on time to administration of PCCs.

Methods: This was a single center three-arm retrospective cohort study. Adult patients in the ED with bleeding were included. The primary outcome measure was the time from order to administration, which was compared between PCC3, PCC4, and FFP. The time from order to administration was also compared when the ED pharmacist was involved versus not involved in the care of patients receiving PCC.

Results: There were 90 patients included in the study cohort (30 in each group). The median age was 69years (IQR 57-82years), and 57% (n=52) were male. The median time from order to administration was 36min (IQR 20-58min) for PCC3, 34min (IQR 18-48min) for PCC4, and 92min (IQR 63-133) for FFP (PCC3 versus PCC4, p=0.429; PCC3 versus FFP, p<0.001; PCC4 versus FFP, p<0.001). The median time from order to administration was significantly decreased when the ED pharmacist was involved (24min [IQR 15-35min] versus 42min [IQR 32-59min], p<0.001).

Conclusions: Time from order to administration is faster with PCC than FFP. ED pharmacist involvement decreases the time from order to administration of PCC.
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December 2018