Pub Date : 2023-08-31DOI: 10.2174/0250688205666230831143856
Marcelo A. F. Ribeiro Junior, G. Tebar, Rafael de Lima Silva, Thiago Gaspar, Vitor Hernandes Lopes, Vinicius Vertematti de Castro, Jose Mauro da Silva Rodrigues
Chylothorax corresponds to the incidence of chyle in the pleural space; it was described for the first time in 1633. Its most common cause is associated with iatrogenic injuries to the thoracic duct; 80% of them take place during surgeries, such as pneumonectomy or esophagectomy. A case of an unusual cervical stab wound complication in a 23-year-old man who presented a late large volume chylothorax has been presented and discussed in this paper, as well as its management. The presented case demonstrates a rare complication after a cervical stab wound. The management of chylothorax can involve non-operative management, non-operative intervention, or operative management depending on the symptoms and duration. Usually, surgical interventions are required after two weeks of clinical treatment. The differential diagnosis in a post-trauma acute onset ventilatory manifestation is mandatory to rule out pulmonary embolism. Traumatic chylothorax is a rare event; however, its morbidity and mortality rates can be catastrophic when it is not diagnosed early and when the treatment is not established based on a proper flowchart. Thus, dietary and drug-based clinical measures, interventional radiology, videothoracoscopy, and thoracotomy for thoracic duct ligation are valid therapeutic options for the proper management of these cases.
{"title":"Traumatic Chylothorax due to Cervical Stab Wound: A Case Report","authors":"Marcelo A. F. Ribeiro Junior, G. Tebar, Rafael de Lima Silva, Thiago Gaspar, Vitor Hernandes Lopes, Vinicius Vertematti de Castro, Jose Mauro da Silva Rodrigues","doi":"10.2174/0250688205666230831143856","DOIUrl":"https://doi.org/10.2174/0250688205666230831143856","url":null,"abstract":"\u0000\u0000Chylothorax corresponds to the incidence of chyle in the pleural space; it was described for the first time in 1633. Its most common cause is associated with iatrogenic injuries to the thoracic duct; 80% of them take place during surgeries, such as pneumonectomy or esophagectomy.\u0000\u0000\u0000\u0000A case of an unusual cervical stab wound complication in a 23-year-old man who presented a late large volume chylothorax has been presented and discussed in this paper, as well as its management.\u0000\u0000\u0000\u0000The presented case demonstrates a rare complication after a cervical stab wound. The management of chylothorax can involve non-operative management, non-operative intervention, or operative management depending on the symptoms and duration. Usually, surgical interventions are required after two weeks of clinical treatment. The differential diagnosis in a post-trauma acute onset ventilatory manifestation is mandatory to rule out pulmonary embolism.\u0000\u0000\u0000\u0000Traumatic chylothorax is a rare event; however, its morbidity and mortality rates can be catastrophic when it is not diagnosed early and when the treatment is not established based on a proper flowchart. Thus, dietary and drug-based clinical measures, interventional radiology, videothoracoscopy, and thoracotomy for thoracic duct ligation are valid therapeutic options for the proper management of these cases.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"117 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126713904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-22DOI: 10.2174/0250688205666230822113350
Yahya Kiwan, Abdulla Shehab, Asim Ahmed Elnour, O. Shehab
Regenerative therapies to rejuvenate the heart have a significant appeal for researchers. Preliminary findings from pre-clinical studies suggest that bone marrow cells may have reparative and regenerative effects on heart muscles, creating a ripe area for research. Many generations of stem cells used in pre-clinical and early clinical studies have shown promising but variable results. The current review article discusses the dilemmas in applying stem cell therapy to cardiovascular diseases and possible strategies to make it feasible. The field of regenerative therapies continued to progress with second-generation cells, third-generation cells, combination cell therapy, and the use of cell products alone. Research showed promising positive results in multiple randomized phases 1, 2, and 3 clinical trials in addition to numerous meta-analyses. The gaps in knowledge included stem-cell sources, their delivery routes, dosing, types of cells, and the indicated cardiac conditions. The results from the latest randomized clinical trials, namely the Dream-HF, showed improved left ventricle function, symptoms, and overall survival. Studied patient populations include post-myocardial infarction (MI), ischemic/non-ischemic cardiomyopathy, intractable/microvascular angina, and cardiac surgery for congenital and valvular heart disease. The phase 3 DREAM-HF trial did not meet the primary heart failure endpoint of reducing hospital admission. Still, it showed a clinically significant reduction in major adverse cardiovascular events (MACE), including recurrent MI and stroke, by 60%. A 60% reduction in cardiovascular mortality and a 79% reduction in cardiovascular mortality in patients with evidence of inflammation (high CRP). The latter finding suggests a more anti-inflammatory effect. This effect was much higher than that observed in the PARADIGM-HF trial, which showed a 20% relative risk reduction in cardiovascular mortality. By combining the results of the DREAM-HF trial with MSC-HF, ixCELL-DCM, CONCERT-HF, and REGENERATE-DCM, the potential for clinical applications of cell therapy is promising. There is a promising role for cell therapy in the management of cardiovascular diseases. Results of trials in the setting of heart failure are more encouraging in both ischemic and non-ischemic cardiomyopathy. This is in contrast with acute myocardial infarction, where the results have been variable. Amongst all the various cell types tested MSCs show the most significant promise for treating HF.
{"title":"A review of stem cell therapy in ischemic heart disease, where are we now?","authors":"Yahya Kiwan, Abdulla Shehab, Asim Ahmed Elnour, O. Shehab","doi":"10.2174/0250688205666230822113350","DOIUrl":"https://doi.org/10.2174/0250688205666230822113350","url":null,"abstract":"\u0000\u0000Regenerative therapies to rejuvenate the heart have a significant appeal for researchers. Preliminary findings from pre-clinical studies suggest that bone marrow cells may have reparative and regenerative effects on heart muscles, creating a ripe area for research. Many generations of stem cells used in pre-clinical and early clinical studies have shown promising but variable results.\u0000\u0000\u0000\u0000The current review article discusses the dilemmas in applying stem cell therapy to cardiovascular diseases and possible strategies to make it feasible.\u0000\u0000\u0000\u0000The field of regenerative therapies continued to progress with second-generation cells, third-generation cells, combination cell therapy, and the use of cell products alone. Research showed promising positive results in multiple randomized phases 1, 2, and 3 clinical trials in addition to numerous meta-analyses. The gaps in knowledge included stem-cell sources, their delivery routes, dosing, types of cells, and the indicated cardiac conditions.\u0000\u0000\u0000\u0000The results from the latest randomized clinical trials, namely the Dream-HF, showed improved left ventricle function, symptoms, and overall survival. Studied patient populations include post-myocardial infarction (MI), ischemic/non-ischemic cardiomyopathy, intractable/microvascular angina, and cardiac surgery for congenital and valvular heart disease. The phase 3 DREAM-HF trial did not meet the primary heart failure endpoint of reducing hospital admission. Still, it showed a clinically significant reduction in major adverse cardiovascular events (MACE), including recurrent MI and stroke, by 60%. A 60% reduction in cardiovascular mortality and a 79% reduction in cardiovascular mortality in patients with evidence of inflammation (high CRP). The latter finding suggests a more anti-inflammatory effect. This effect was much higher than that observed in the PARADIGM-HF trial, which showed a 20% relative risk reduction in cardiovascular mortality. By combining the results of the DREAM-HF trial with MSC-HF, ixCELL-DCM, CONCERT-HF, and REGENERATE-DCM, the potential for clinical applications of cell therapy is promising.\u0000\u0000\u0000\u0000There is a promising role for cell therapy in the management of cardiovascular diseases. Results of trials in the setting of heart failure are more encouraging in both ischemic and non-ischemic cardiomyopathy. This is in contrast with acute myocardial infarction, where the results have been variable. Amongst all the various cell types tested MSCs show the most significant promise for treating HF.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"23 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132738234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-18DOI: 10.2174/0250688205666230818113555
Suha Alshuaibat, Karina Soubra, Deena Alhashmi, Fathumo Mohamed, Sarah Moqbel, S. Almarzooqi, Z. Alloub, S. Willis, Ammar Albanna
This qualitative study explored parental perceptions of autism spectrum disorder (ASD) services in the United Arab Emirates (UAE). Forty-one parents of children with ASD participated in five focus groups to explore their experiences with ASD services in the UAE. These moderated focus groups were recorded, transcribed, coded, and analyzed using thematic analysis. The following primary themes and subthemes were identified: (a) lack of awareness and support, (b) challenges in accessibility and affordability, (c) inconsistent quality of therapeutic services, and (d) Lack of educational inclusion and support. Findings of this study support the need for creating a comprehensive system of care for ASD that is coordinated, is person centered, and promotes continuity of care that improves the outcomes for those “navigating” the often-fragmented system of ASD in the UAE.
{"title":"Parental Perceptions of Autism Spectrum Disorder (ASD) Services in the UAE","authors":"Suha Alshuaibat, Karina Soubra, Deena Alhashmi, Fathumo Mohamed, Sarah Moqbel, S. Almarzooqi, Z. Alloub, S. Willis, Ammar Albanna","doi":"10.2174/0250688205666230818113555","DOIUrl":"https://doi.org/10.2174/0250688205666230818113555","url":null,"abstract":"\u0000\u0000This qualitative study explored parental perceptions of autism spectrum disorder (ASD) services in the United Arab Emirates (UAE).\u0000\u0000\u0000\u0000Forty-one parents of children with ASD participated in five focus groups to explore their experiences with ASD services in the UAE. These moderated focus groups were recorded, transcribed, coded, and analyzed using thematic analysis.\u0000\u0000\u0000\u0000The following primary themes and subthemes were identified: (a) lack of awareness and support, (b) challenges in accessibility and affordability, (c) inconsistent quality of therapeutic services, and (d) Lack of educational inclusion and support.\u0000\u0000\u0000\u0000Findings of this study support the need for creating a comprehensive system of care for ASD that is coordinated, is person centered, and promotes continuity of care that improves the outcomes for those “navigating” the often-fragmented system of ASD in the UAE.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116422894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-08DOI: 10.2174/0250688204666230808150829
Z. Tolou_Ghamari
A recently published article confirmed that in 2019, around 523 million people suffered from cardiovascular disease (including 18.6 million deaths) worldwide. Losartan, a drug, was patented 35 years ago and approved for medical use in the United States in 1995 (28 years ago). As an effective treatment for hypertension, losartan blocks the interaction of angiotensin II with its receptor by inhibiting the renin-angiotensin system. This article aims to review the available literature and recent studies demonstrating the efficacy, safety, mechanism of action and drug-drug interactions of losartan in cardiovascular disease. This is a focused literature review with the keywords relevant to the terms performed in PubMed, Scopus and Web of Science through May 28, 2023, according to the PRISMA guidelines. Based on the PICO standard format, fifty-two relevant in-depth consequent guide approaches and evidence-based choices were selected associated with a knowledgeable collection of current, high-quality manuscripts. After oral administration, time to reach maximum concentration is about 1-2 hours. With a 78% binding to protein, it has a bioavailability of 25-35%. Losartan is not removed by hemodialysis. For the full effect to occur, it may take up to 6 weeks. The drug is mainly prescribed for patients with high blood pressure, diabetic nephropathy, hypertension and left ventricular hypertrophy. The publication reported higher drug exposures and adverse reactions in women than men with antihypertensive medications. Losartan could improve changes in gut microbiota that might be associated with hypertension. In the high-risk group of renal transplant recipients with arterial hypertension, research reported well-controlled blood pressure with losartan monotherapy. In addition to the major losartan interactions with captopril, enalapril, lisinopril, and lithium, there are moderate interactions with aspirin, pregabalin, alprazolam, amitriptyline, baclofen, betamethasone, buspirone. Muscle cramps, respiratory infection, cough, hyperkalemia, anemia and stuffy nose are the main reported side effects. As polypharmacy could hide pharmacokinetics interaction due to cytochrome P450, therefore, the combination of losartan with drugs such as phenobarbital, rifampin or fluconazole needs vigilant attention regarding therapeutic drug monitoring.
最近发表的一篇文章证实，2019年，全球约有5.23亿人患有心血管疾病(包括1860万人死亡)。氯沙坦是一种药物，35年前获得专利，1995年(28年前)在美国获准用于医疗用途。氯沙坦通过抑制肾素-血管紧张素系统阻断血管紧张素II与其受体的相互作用，是治疗高血压的有效药物。本文旨在综述氯沙坦治疗心血管疾病的有效性、安全性、作用机制和药物-药物相互作用的现有文献和最新研究。根据PRISMA指南，这是一篇重点文献综述，其中的关键词与PubMed、Scopus和Web of Science中截止到2023年5月28日的相关术语相关。基于PICO标准格式，选择了52个相关的深入后续指导方法和基于证据的选择，并与当前高质量手稿的知识集合相关联。口服后，达到最大浓度的时间约为1-2小时。与蛋白质的结合率为78%，生物利用度为25-35%。氯沙坦不能通过血液透析去除。要达到完全效果，可能需要长达6周的时间。该药主要用于高血压、糖尿病肾病、高血压、左室肥厚患者。该出版物报道了服用降压药的女性比男性有更高的药物暴露和不良反应。氯沙坦可以改善可能与高血压有关的肠道微生物群的变化。在动脉性高血压肾移植受者的高危人群中，研究报告氯沙坦单药治疗血压控制良好。氯沙坦除了与卡托普利、依那普利、赖诺普利和锂的主要相互作用外，还与阿司匹林、普瑞巴林、阿普唑仑、阿米替林、巴氯芬、倍他米松、丁螺环酮有中度相互作用。肌肉痉挛、呼吸道感染、咳嗽、高钾血症、贫血和鼻塞是报道的主要副作用。多药联用可隐藏细胞色素P450引起的药代动力学相互作用，因此氯沙坦与苯巴比妥、利福平、氟康唑等药物联用治疗药物监测需引起高度重视。
{"title":"Losartan: A Pharmacotherapy in Cardiovascular Disease","authors":"Z. Tolou_Ghamari","doi":"10.2174/0250688204666230808150829","DOIUrl":"https://doi.org/10.2174/0250688204666230808150829","url":null,"abstract":"\u0000\u0000A recently published article confirmed that in 2019, around 523 million people suffered from cardiovascular disease (including 18.6 million deaths) worldwide. Losartan, a drug, was patented 35 years ago and approved for medical use in the United States in 1995 (28 years ago). As an effective treatment for hypertension, losartan blocks the interaction of angiotensin II with its receptor by inhibiting the renin-angiotensin system.\u0000\u0000\u0000\u0000This article aims to review the available literature and recent studies demonstrating the efficacy, safety, mechanism of action and drug-drug interactions of losartan in cardiovascular disease.\u0000\u0000\u0000\u0000This is a focused literature review with the keywords relevant to the terms performed in PubMed, Scopus and Web of Science through May 28, 2023, according to the PRISMA guidelines. Based on the PICO standard format, fifty-two relevant in-depth consequent guide approaches and evidence-based choices were selected associated with a knowledgeable collection of current, high-quality manuscripts.\u0000\u0000\u0000\u0000After oral administration, time to reach maximum concentration is about 1-2 hours. With a 78% binding to protein, it has a bioavailability of 25-35%. Losartan is not removed by hemodialysis. For the full effect to occur, it may take up to 6 weeks. The drug is mainly prescribed for patients with high blood pressure, diabetic nephropathy, hypertension and left ventricular hypertrophy. The publication reported higher drug exposures and adverse reactions in women than men with antihypertensive medications. Losartan could improve changes in gut microbiota that might be associated with hypertension. In the high-risk group of renal transplant recipients with arterial hypertension, research reported well-controlled blood pressure with losartan monotherapy.\u0000\u0000\u0000\u0000In addition to the major losartan interactions with captopril, enalapril, lisinopril, and lithium, there are moderate interactions with aspirin, pregabalin, alprazolam, amitriptyline, baclofen, betamethasone, buspirone. Muscle cramps, respiratory infection, cough, hyperkalemia, anemia and stuffy nose are the main reported side effects. As polypharmacy could hide pharmacokinetics interaction due to cytochrome P450, therefore, the combination of losartan with drugs such as phenobarbital, rifampin or fluconazole needs vigilant attention regarding therapeutic drug monitoring.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115576231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-03DOI: 10.2174/0250688204666230803115254
Musab Egaimi, Byoung-Kwon Kim, Jihye Chang
Echinococcosis is a zoonotic infection that is characterised clinically by the development of hydatid cysts in different organs, mainly the liver and lungs. Cardiac involvement is rare but can lead to serious and fatal complications. We report a rare challenging case of multiple, extensive cardiac and pulmonary Echinococcal cysts that were treated by successful single-stage surgical resection via median sternotomy without additional thoracic incisions. This article highlights the rare presentation of multiple, extensive cardiac and pulmonary Echinococcal cysts and how to overcome diagnostic challenges in the era of modern diagnostic imaging. Surgical removal remains the mainstay treatment, and a single-stage surgical approach is feasible in capable centres. Perioperative chemotherapy with Albendazole and the intraoperative use of scolicidal agents improved immediate surgical outcomes, although long-term effects could not be established in this case due to loss of follow-up.
{"title":"Multiple, Extensive Cardiac and Pulmonary Hydatid Cysts Managed by a Single-stage Surgical Removal: A Case Report","authors":"Musab Egaimi, Byoung-Kwon Kim, Jihye Chang","doi":"10.2174/0250688204666230803115254","DOIUrl":"https://doi.org/10.2174/0250688204666230803115254","url":null,"abstract":"\u0000\u0000Echinococcosis is a zoonotic infection that is characterised clinically by the development of hydatid cysts in different organs, mainly the liver and lungs. Cardiac involvement is rare but can lead to serious and fatal complications.\u0000\u0000\u0000\u0000We report a rare challenging case of multiple, extensive cardiac and pulmonary Echinococcal cysts that were treated by successful single-stage surgical resection via median sternotomy without additional thoracic incisions.\u0000\u0000\u0000\u0000This article highlights the rare presentation of multiple, extensive cardiac and pulmonary Echinococcal cysts and how to overcome diagnostic challenges in the era of modern diagnostic imaging. Surgical removal remains the mainstay treatment, and a single-stage surgical approach is feasible in capable centres. Perioperative chemotherapy with Albendazole and the intraoperative use of scolicidal agents improved immediate surgical outcomes, although long-term effects could not be established in this case due to loss of follow-up.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125965128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-20DOI: 10.2174/04666230317110616
M. Sultan, Tamim Alghamdi, Maya Helou, L. Jeyaseelan
Attention-deficit/ hyperactivity disorder (ADHD) is a neurodevelopmental disorder that starts during childhood. It is commonly associated with elevated levels of parenting stress. This study aimed to examine parents’ stress levels, potential contributing factors, as well as changes associated with the COVID-19 pandemic. This study was based on a cross-sectional design. The target population was parents of children with ADHD aged 6-18 years who were evaluated in a tertiary care hospital in Dubai, United Arab Emirates (UAE) from January 2018 to August 2021. Participants completed a survey, which gathered information on the child’s personal characteristics and medical history as well as the parents’ and family characteristics. Additionally, the parents stress level was evaluated using the English and Arabic-translated versions of the Perceived Stress Scale (PSS). Parents of 103 children diagnosed with ADHD participated in this study. Most children were males (74.8%), and their mean age was 10.0 ± 3.4 years. Most children had ADHD as a primary diagnosis (87.4%), with ADHD subtypes being mainly combined presentation (60.2%), followed by a predominately inattentive presentation (35.9%). Psychiatric morbidity was present in 87.4% of the children, mainly learning disorders (41.7%), conduct disorder (34%), or autism spectrum disorder (24.3%). On the other hand, physical disorders were present in 68.9% of the children. Parents’ perceived stress levels differed significantly according to their children’s ADHD subtypes (p=0.002), with the highest stress levels among parents of children with predominately hyperactive/impulsive ADHD. PSS scores were moderate in 62.1% of the sample and high in 32% of the sample. Significant associations with elevated PSS scores was found in the presence of comorbid tic disorders (p<0.001) as well as in comorbid autism spectrum disorder (p=0.029). The most frequently reported items on the PSS were: being upset because of something that happened unexpectedly; feeling nervous and stressed; being angered because of things that were outside of your control; feeling unable to control important things in life; and feeling that difficulties were piling up so high that could not be overcome. Various changes were reported during the COVID-19 pandemic, which included a significant decrease in social activities (31.1%), time spent with friends (26.2%), conflicts between the child and siblings (18.5%), and conflicts between parents (25.3%). Furthermore, a significant increase was reported in children’s average screen time (28.2%), the quality of the child’s relationship with parents (19.4%), and the overall stresses faced by the family (16.5%). ADHD is commonly associated with high levels of parental stress. Factors associated with an increased level of stress include ADHD predominantly hyperactive/ impulsive subtype as well as comorbidity with tic disorders or autism spectrum disorder. Furthermore, the COVID-19 pandemic had a ma
{"title":"Stress Level of Parents of Children Diagnosed with Attention-deficit/\u0000Hyperactivity Disorder (ADHD) in Dubai, United Arab Emirates","authors":"M. Sultan, Tamim Alghamdi, Maya Helou, L. Jeyaseelan","doi":"10.2174/04666230317110616","DOIUrl":"https://doi.org/10.2174/04666230317110616","url":null,"abstract":"\u0000\u0000Attention-deficit/ hyperactivity disorder (ADHD) is a neurodevelopmental disorder that starts during childhood. It is commonly associated with elevated levels of parenting stress. This study aimed to examine parents’ stress levels, potential contributing factors, as well as changes associated with the COVID-19 pandemic.\u0000\u0000\u0000\u0000This study was based on a cross-sectional design. The target population was parents of children with ADHD aged 6-18 years who were evaluated in a tertiary care hospital in Dubai, United Arab Emirates (UAE) from January 2018 to August 2021. Participants completed a survey, which gathered information on the child’s personal characteristics and medical history as well as the parents’ and family characteristics. Additionally, the parents stress level was evaluated using the English and Arabic-translated versions of the Perceived Stress Scale (PSS).\u0000\u0000\u0000\u0000Parents of 103 children diagnosed with ADHD participated in this study. Most children were males (74.8%), and their mean age was 10.0 ± 3.4\u0000years. Most children had ADHD as a primary diagnosis (87.4%), with ADHD subtypes being mainly combined presentation (60.2%), followed by\u0000a predominately inattentive presentation (35.9%). Psychiatric morbidity was present in 87.4% of the children, mainly learning disorders (41.7%),\u0000conduct disorder (34%), or autism spectrum disorder (24.3%). On the other hand, physical disorders were present in 68.9% of the children.\u0000Parents’ perceived stress levels differed significantly according to their children’s ADHD subtypes (p=0.002), with the highest stress levels among\u0000parents of children with predominately hyperactive/impulsive ADHD. PSS scores were moderate in 62.1% of the sample and high in 32% of the\u0000sample. Significant associations with elevated PSS scores was found in the presence of comorbid tic disorders (p<0.001) as well as in comorbid\u0000autism spectrum disorder (p=0.029). The most frequently reported items on the PSS were: being upset because of something that happened\u0000unexpectedly; feeling nervous and stressed; being angered because of things that were outside of your control; feeling unable to control important\u0000things in life; and feeling that difficulties were piling up so high that could not be overcome. Various changes were reported during the COVID-19\u0000pandemic, which included a significant decrease in social activities (31.1%), time spent with friends (26.2%), conflicts between the child and\u0000siblings (18.5%), and conflicts between parents (25.3%). Furthermore, a significant increase was reported in children’s average screen time\u0000(28.2%), the quality of the child’s relationship with parents (19.4%), and the overall stresses faced by the family (16.5%).\u0000\u0000\u0000\u0000ADHD is commonly associated with high levels of parental stress. Factors associated with an increased level of stress include ADHD predominantly hyperactive/ impulsive subtype as well as comorbidity with tic disorders or autism spectrum disorder. Furthermore, the COVID-19 pandemic had a ma","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131532960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-20DOI: 10.2174/04666230317104250
Fatima A. Al Dhaheri, Ahmed A. Al Hammadi, R. Boni, Amina A. Randhawa, E. Nsutebu, M. Mooty, M. Al Seiari, S. Holt, A. Al Obaidli
The lifesaving practice of organ donation and transplantation has been deeply impacted by the COVID-19 pandemic. Up until January 2022, donors were screened out of the donor pool in the UAE if they tested positive for SARS-COV-2. We report a case of a COVID-19 infected donor whose organs were transplanted to 3 uninfected recipients (2 kidneys, 1 liver). A national guideline was created to permit a change in practice after the engagement and endorsement of relevant stakeholders. Recipients were informed of Donor’s COVID status and consented. The Donor was a 35-year-old previously healthy male who was hospitalized due to a spontaneous intracerebral bleed of unclear etiology and met brain death criteria. SARS-COV-2 PCR testing was obtained on admission and remained persistently positive beyond day 14 of admission. The donor was otherwise afebrile and had normal inflammatory markers with no evidence of an infectious pulmonary process on CT scan. The donor did not receive any COVID therapies. The donor had received 3 doses of the Sinopharm vaccine, the last dose being 3 months prior to admission. Organ retrieval occurred on day 24 of COVID-19 PCR positivity to three uninfected recipients in two different transplant centers in the UAE. Transplanting solid organs from non-lung COVID positive donors can effectively maintain an expanded donor pool during the pandemic.
{"title":"Solid Organ Transplantation from SARS-CoV-2–infected Donor to Uninfected\u0000Recipients: First in the United Arab Emirates and the Neighboring Region","authors":"Fatima A. Al Dhaheri, Ahmed A. Al Hammadi, R. Boni, Amina A. Randhawa, E. Nsutebu, M. Mooty, M. Al Seiari, S. Holt, A. Al Obaidli","doi":"10.2174/04666230317104250","DOIUrl":"https://doi.org/10.2174/04666230317104250","url":null,"abstract":"\u0000\u0000The lifesaving practice of organ donation and transplantation has been deeply impacted by the COVID-19 pandemic. Up until January 2022, donors were screened out of the donor pool in the UAE if they tested positive for SARS-COV-2.\u0000\u0000\u0000\u0000We report a case of a COVID-19 infected donor whose organs were transplanted to 3 uninfected recipients (2 kidneys, 1 liver). A national guideline was created to permit a change in practice after the engagement and endorsement of relevant stakeholders. Recipients were informed of Donor’s COVID status and consented.\u0000\u0000\u0000\u0000The Donor was a 35-year-old previously healthy male who was hospitalized due to a spontaneous intracerebral bleed of unclear etiology and met brain death criteria. SARS-COV-2 PCR testing was obtained on admission and remained persistently positive beyond day 14 of admission. The donor was otherwise afebrile and had normal inflammatory markers with no evidence of an infectious pulmonary process on CT scan. The donor did not receive any COVID therapies. The donor had received 3 doses of the Sinopharm vaccine, the last dose being 3 months prior to admission. Organ retrieval occurred on day 24 of COVID-19 PCR positivity to three uninfected recipients in two different transplant centers in the UAE.\u0000\u0000\u0000\u0000Transplanting solid organs from non-lung COVID positive donors can effectively maintain an expanded donor pool during the pandemic.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124061984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.2174/0250688204666230718142031
Naina Mohamed Pakkir Maideen, Ibrahim Ramadan Barakat, Abdurazak Hassan Jumale
Domperidone is an antiemetic and prokinetic agent that is widely used to treat nausea and vomiting, gastroparesis, and as a galactagogue. This review article focuses on QT prolongation, torsades de pointes, severe ventricular arrhythmia, and sudden cardiac death associated with the use of domperidone or domperidone-containing products. The online databases, such as Medline/Pubmed/PMC, Google Scholar, Science Direct, Ebsco, Scopus, Web of Science, Embase, and reference lists, were searched using keywords like Domperidone, Cardiotoxicity, QT prolongation, Cardiac arrhythmia, Torsades de pointes, Ventricular arrhythmia, and Sudden Cardiac Death, to identify published articles relevant to domperidone-associated cardiotoxicity. Domperidone has been linked to an increased risk of QT prolongation, torsades de pointes, severe ventricular arrhythmia, and sudden cardiac death, according to a number of epidemiological studies and meta-analyses. Domperidone can only be used to treat nausea and vomiting in patients between the ages of 12 and 60, and a maximum daily dose of 30 mg has been set by a number of regulatory bodies. The risk of severe ventricular arrhythmia and sudden cardiac death caused by domperidone should be made clear to clinicians along with the recommendations from regulatory bodies to avoid any potential complications.
多潘立酮是一种止吐和促动剂，广泛用于治疗恶心和呕吐，胃轻瘫，并作为催乳剂。这篇综述文章的重点是与多潘立酮或含多潘立酮产品的使用相关的QT延长、点扭转、严重室性心律失常和心源性猝死。在线数据库，如Medline/Pubmed/PMC, Google Scholar, Science Direct, Ebsco, Scopus, Web of Science, Embase和参考文献列表，使用关键词如多潘立酮，心脏毒性，QT延长，心律失常，Torsades de pointes，室性心律失常和心源性猝死等进行搜索，以确定与多潘立酮相关的心脏毒性相关的已发表文章。根据一些流行病学研究和荟萃分析，多潘立酮与QT间期延长、点扭转、严重室性心律失常和心源性猝死的风险增加有关。多潘立酮只能用于治疗12岁至60岁患者的恶心和呕吐，一些监管机构规定的最大日剂量为30毫克。多潘立酮引起的严重室性心律失常和心源性猝死的风险应向临床医生明确，同时应遵循监管机构的建议，以避免任何潜在的并发症。
{"title":"Domperidone-associated Ventricular Arrhythmia and Sudden Cardiac Death: A Descriptive Literature Review","authors":"Naina Mohamed Pakkir Maideen, Ibrahim Ramadan Barakat, Abdurazak Hassan Jumale","doi":"10.2174/0250688204666230718142031","DOIUrl":"https://doi.org/10.2174/0250688204666230718142031","url":null,"abstract":"\u0000\u0000Domperidone is an antiemetic and prokinetic agent that is widely used to treat nausea and vomiting, gastroparesis, and as a galactagogue.\u0000\u0000\u0000\u0000This review article focuses on QT prolongation, torsades de pointes, severe ventricular arrhythmia, and sudden cardiac death associated with the use of domperidone or domperidone-containing products.\u0000\u0000\u0000\u0000The online databases, such as Medline/Pubmed/PMC, Google Scholar, Science Direct, Ebsco, Scopus, Web of Science, Embase, and reference lists, were searched using keywords like Domperidone, Cardiotoxicity, QT prolongation, Cardiac arrhythmia, Torsades de pointes, Ventricular arrhythmia, and Sudden Cardiac Death, to identify published articles relevant to domperidone-associated cardiotoxicity.\u0000\u0000\u0000\u0000Domperidone has been linked to an increased risk of QT prolongation, torsades de pointes, severe ventricular arrhythmia, and sudden cardiac death, according to a number of epidemiological studies and meta-analyses.\u0000\u0000\u0000\u0000Domperidone can only be used to treat nausea and vomiting in patients between the ages of 12 and 60, and a maximum daily dose of 30 mg has been set by a number of regulatory bodies. The risk of severe ventricular arrhythmia and sudden cardiac death caused by domperidone should be made clear to clinicians along with the recommendations from regulatory bodies to avoid any potential complications.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125447537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-18DOI: 10.2174/0250688204666230718142018
Fatema Albafta, Taghrid Elgergawi
Estimate the proportion and outcomes of blood transfusion in iron deficiency anemia in a specialist maternal hospital in Dubai, United Arab Emirates (UAE). In a cross-sectional study, data were collected from 177 pregnant inpatients and delivered outpatients with haemoglobin less than 12g/dL at the hospital in Dubai (UAE) between the 1st of February 2018 to 31st of January 2019. Sociodemographic factors were age, parity (number of birth to a live neonate or gestational age more than 24 weeks), and ethnicity. The outcome variable is blood transfusion. Different variables such as age, parity, nationality, gestational age at diagnosis, most severe haemoglobin reading, serum ferritin, haemoglobin electrophoresis, treatment, gestational age at delivery, mode of delivery, postpartum haemorrhage, neonatal birthweight, neonatal haemoglobin were tested using frequencies and means (standard deviation), chi-square and sample T-test was used. One hundred and seventy-seven ladies had anemia, and one hundred and twenty-two (68%) had iron deficiency anemia (ferritin<30ng/dL). 52.5% (N=93) had moderate to severe anemia, and only 7.3% (N=13) received a blood transfusion. Anaemia was mostly diagnosed in the first trimester (40.7%; N=72) and second trimester (38.4%; N=68). 11 (6.2%) ladies had hemoglobinopathies such as beta-thalassemia, 138 (78%) ladies didn’t have hemoglobin electrophoresis reading. 37.9% (N=67) of vaginally delivered ladies and 4.5% (N=8) of cesarean section-delivered ladies had a postpartum hemorrhage. The majority of anemic antenatal and postnatal were Emiratis (74.6%; N=132), and a greater number fell in the middle age group between 30-39 (58.2%; N=103). The larger part had normal neonatal birthweight (76.8%; N=136) and only had a low neonatal birthweight (18.1%; N=32). 105 (59.3%) of neonates had abnormal hemoglobin readings. This is the first study in the UAE that assess both maternal and fetal outcome due to iron deficiency anemia in pregnant ladies. The prevalence of blood transfusion increased as iron deficiency anaemia was more severe. We endorse health practitioners to regularly measure serum haemoglobin, to treat anaemia early in pregnancy to avoid the need for blood transfusion.
{"title":"Blood transfusion for iron deficiency Anaemia in antenatal and postnatal in maternal specialist hospital, 2018-2019: An analytical cross-sectional study","authors":"Fatema Albafta, Taghrid Elgergawi","doi":"10.2174/0250688204666230718142018","DOIUrl":"https://doi.org/10.2174/0250688204666230718142018","url":null,"abstract":"\u0000\u0000Estimate the proportion and outcomes of blood transfusion in iron deficiency anemia in a specialist maternal hospital in Dubai, United Arab Emirates (UAE).\u0000\u0000\u0000\u0000In a cross-sectional study, data were collected from 177 pregnant inpatients and delivered outpatients with haemoglobin less than 12g/dL at the hospital in Dubai (UAE) between the 1st of February 2018 to 31st of January 2019. Sociodemographic factors were age, parity (number of birth to a live neonate or gestational age more than 24 weeks), and ethnicity. The outcome variable is blood transfusion. Different variables such as age, parity, nationality, gestational age at diagnosis, most severe haemoglobin reading, serum ferritin, haemoglobin electrophoresis, treatment, gestational age at delivery, mode of delivery, postpartum haemorrhage, neonatal birthweight, neonatal haemoglobin were tested using frequencies and means (standard deviation), chi-square and sample T-test was used.\u0000\u0000\u0000\u0000One hundred and seventy-seven ladies had anemia, and one hundred and twenty-two (68%) had iron deficiency anemia (ferritin<30ng/dL). 52.5% (N=93) had moderate to severe anemia, and only 7.3% (N=13) received a blood transfusion. Anaemia was mostly diagnosed in the first trimester (40.7%; N=72) and second trimester (38.4%; N=68). 11 (6.2%) ladies had hemoglobinopathies such as beta-thalassemia, 138 (78%) ladies didn’t have hemoglobin electrophoresis reading. 37.9% (N=67) of vaginally delivered ladies and 4.5% (N=8) of cesarean section-delivered ladies had a postpartum hemorrhage. The majority of anemic antenatal and postnatal were Emiratis (74.6%; N=132), and a greater number fell in the middle age group between 30-39 (58.2%; N=103). The larger part had normal neonatal birthweight (76.8%; N=136) and only had a low neonatal birthweight (18.1%; N=32). 105 (59.3%) of neonates had abnormal hemoglobin readings.\u0000\u0000\u0000\u0000This is the first study in the UAE that assess both maternal and fetal outcome due to iron deficiency anemia in pregnant ladies. The prevalence of blood transfusion increased as iron deficiency anaemia was more severe. We endorse health practitioners to regularly measure serum haemoglobin, to treat anaemia early in pregnancy to avoid the need for blood transfusion.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123193412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-14DOI: 10.2174/0250688204666230714110857
Basheer Abdullah Marzoog
Autophagy regulates endothelial cell homeostasis. Autophagy is a catabolic process involving degradation of intracellular components. Dysregulation of autophagy induces endothelial cell dysfunction. Endothelial cell dysfunction is a multifactorial pathophysiological change that occurs at the cellular and subcellular levels. Lipophagy and mitophagy are hallmarks of the pathogenesis of endothelial cell dysfunction. The regulation of the autophagy mechanism involved amino acids, growth factors, hormones, myo-inositol-1,4,5-triphosphate, calpain, calcium, bcl-2, reactive oxygen species, BNIP3, DRAM, p19ARF, FADD and TRAIL. Down-regulation of autophagy reduces endothelial cell resistance to stressful conditions such as shear stress, deprivation of oxidative stress, nutrients deprivation, and hypoxemia. Autophagy optimizes endothelial cell function, increases longevity, slows senescence, and prevents endothelial cell transdifferentiation. Pathophysiologically, autophagy is inhibited in endothelial cells due to mTORC1 repression release. Also, AMPK expression repression downregulates autophagy and subsequently endothelial dysfunction. The paper provides state of art on the current advances in the autophagy role in endothelial cell dysfunction.
{"title":"Autophagy behavior in Endothelial Cell Dysfunction","authors":"Basheer Abdullah Marzoog","doi":"10.2174/0250688204666230714110857","DOIUrl":"https://doi.org/10.2174/0250688204666230714110857","url":null,"abstract":"\u0000\u0000Autophagy regulates endothelial cell homeostasis. Autophagy is a catabolic process involving degradation of intracellular components. Dysregulation of autophagy induces endothelial cell dysfunction. Endothelial cell dysfunction is a multifactorial pathophysiological change that occurs at the cellular and subcellular levels. Lipophagy and mitophagy are hallmarks of the pathogenesis of endothelial cell dysfunction. The regulation of the autophagy mechanism involved amino acids, growth factors, hormones, myo-inositol-1,4,5-triphosphate, calpain, calcium, bcl-2, reactive oxygen species, BNIP3, DRAM, p19ARF, FADD and TRAIL. Down-regulation of autophagy reduces endothelial cell resistance to stressful conditions such as shear stress, deprivation of oxidative stress, nutrients deprivation, and hypoxemia. Autophagy optimizes endothelial cell function, increases longevity, slows senescence, and prevents endothelial cell transdifferentiation. Pathophysiologically, autophagy is inhibited in endothelial cells due to mTORC1 repression release. Also, AMPK expression repression downregulates autophagy and subsequently endothelial dysfunction. The paper provides state of art on the current advances in the autophagy role in endothelial cell dysfunction.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115063973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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