Pub Date : 2023-01-30DOI: 10.2174/04666230130095723
Sepideh Parchami Ghazaee, V. Tumanov, N. Voloshyna, K. Marchenko-Tolsta, M. Hameed
Type 2 diabetes is a chronic health condition affecting hundreds of millions of people. Type 2 diabetes has traditionally been combated with a combination of lifestyle modification, insulin therapy and pharmacological agents, including sulfonylureas, biguanides, thiazolidinediones and alpha-glucosidase inhibitors. Type 2 diabetes is associated with an increased risk of cardiovascular disease and the development of diabetic kidney disease. Although sulfonylureas are low-cost drugs and widely prescribed, they have been shown in recent cardiovascular outcome trials to present a high risk of hypoglycemia, which in turn increases the risk of negative cardiovascular outcomes. Metformin, a biguanide that is the most commonly-prescribed antidiabetic agent worldwide, is contraindicated in patients with risk factors for lactic acidosis, including heart failure and chronic kidney disease. The last decade has seen significant advances in the development of novel antidiabetic agents shown to possess both reno- and cardioprotective qualities. This article aims to review the available literature and recent studies demonstrating the efficacy and safety of these agents individually, as well as exploring areas of future development in the field. The reporting of this review is based on the 2020 PRISMA statement. A literature search for all papers related to antidiabetic medication was conducted using reliable sources such PubMed and Google Scholar Databases, including a recent meta-analysis of renal and cardiovascular outcome trials. A critical analysis of clinical trials on type 2 diabetes and the two most severe comorbidities in cardiovascular and chronic kidney diseases may help cardiologists, urologists and diabetes specialists to adapt their therapeutic approaches to individual patients. Data related to antidiabetic effects of agents of natural origin accompanied by their Cardioprotective and renoprotective capacity testify benefits of these compounds as novel therapeutic agents.
{"title":"A Review of the Novel Antidiabetic Medications: Efficacy, Safety and Innovation","authors":"Sepideh Parchami Ghazaee, V. Tumanov, N. Voloshyna, K. Marchenko-Tolsta, M. Hameed","doi":"10.2174/04666230130095723","DOIUrl":"https://doi.org/10.2174/04666230130095723","url":null,"abstract":"\u0000\u0000Type 2 diabetes is a chronic health condition affecting hundreds of millions of people. Type 2 diabetes has traditionally been combated with a combination of lifestyle modification, insulin therapy and pharmacological agents, including sulfonylureas, biguanides, thiazolidinediones and alpha-glucosidase inhibitors. Type 2 diabetes is associated with an increased risk of cardiovascular disease and the development of diabetic kidney disease. Although sulfonylureas are low-cost drugs and widely prescribed, they have been shown in recent cardiovascular outcome trials to present a high risk of hypoglycemia, which in turn increases the risk of negative cardiovascular outcomes. Metformin, a biguanide that is the most commonly-prescribed antidiabetic agent worldwide, is contraindicated in patients with risk factors for lactic acidosis, including heart failure and chronic kidney disease.\u0000\u0000\u0000\u0000The last decade has seen significant advances in the development of novel antidiabetic agents shown to possess both reno- and cardioprotective qualities. This article aims to review the available literature and recent studies demonstrating the efficacy and safety of these agents individually, as well as exploring areas of future development in the field.\u0000\u0000\u0000\u0000The reporting of this review is based on the 2020 PRISMA statement. A literature search for all papers related to antidiabetic medication was conducted using reliable sources such PubMed and Google Scholar Databases, including a recent meta-analysis of renal and cardiovascular outcome trials.\u0000\u0000\u0000\u0000A critical analysis of clinical trials on type 2 diabetes and the two most severe comorbidities in cardiovascular and chronic kidney diseases may help cardiologists, urologists and diabetes specialists to adapt their therapeutic approaches to individual patients. Data related to antidiabetic effects of agents of natural origin accompanied by their Cardioprotective and renoprotective capacity testify benefits of these compounds as novel therapeutic agents.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121931965","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 : 2023-01-26DOI: 10.2174/04666230126094059
M. Al Izzi, AbdulRahim Al Suhaili, Ahmed El Serafi, A. Abogamal, Luay Tapponi, Zbiggy Brodzinski
{"title":"Launching the Emirates Osteoporosis Society (EOS) Guidelines 2022 in the United Arab Emirates","authors":"M. Al Izzi, AbdulRahim Al Suhaili, Ahmed El Serafi, A. Abogamal, Luay Tapponi, Zbiggy Brodzinski","doi":"10.2174/04666230126094059","DOIUrl":"https://doi.org/10.2174/04666230126094059","url":null,"abstract":"<jats:sec>\u0000<jats:title />\u0000<jats:p />\u0000</jats:sec>","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"129 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121274851","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}
Complete heart block (CHB) is the total absence of conduction from atria to ventricles with an escape rhythm most commonly arising from the AVN or His bundle. CHB in pregnancy is very rare, and most reported cases are due to congenital variety, where the pre-existing CHB from birth is either detected incidentally or presented with symptoms during pregnancy. Pregnancy is associated with various physiological changes, such as a pro-inflammatory, hypercoagulable state with possible oedema of the heart's conduction system, which may rarely give rise to CHB. There are no clear guidelines to manage CHB complicating pregnancy. An asymptomatic 27-year-old lady with G2P1L1, 39 weeks of gestation with breech presentation, was referred for delivery given the low maternal heart rate of 40 bpm. Per abdominal examination revealed a term size uterus with active contractions and a fetal heart rate of 140bpm. An ECG revealed a CHB with an escape rate of 40 bpm. Other routine investigations were normal, with negative serological evaluation for hepatitis B, C, and HIV. ANA and Anti-Ro ⁄ SSA antibodies. She underwent an emergency LSCS under spinal anaesthesia with a backup temporary pacemaker (TPM). She received a short course of empirical steroid therapy for three days as there were no obvious secondary causes for CHB, which reverted to sinus rhythm after 48 hours. CHB complicating pregnancy with or without symptoms may require definitive therapy in the form of permanent pacemaker implantation. However, the insertion of a TPM for managing pregnancy is controversial as opinion in the literature is divided. There are no reports of CHB occurring in pregnancy without congenital or other known acquired causes. In the reported case, the CHB reverted to sinus rhythm with a short course of IV steroid therapy without any subsequent need for a PPM implantation. Congenital CHB remains the most common cause of rarely seen CHB complicating pregnancy. Through the conduction system oedema and inflammation, physiological changes in gestation may rarely cause CHB during pregnancy. In the absence of congenital CHB and other demonstrable acquired causes, a short course of steroid therapy may reverse the CHB avoiding PPM implantation as shown in the reported case.
{"title":"Reversible complete Heart block in a Pregnant Woman responding to Steroids: A rare Case Report","authors":"Manjappa Mahadevappa, Soumya Patil, Rishi Tripathi, Virupaksha Ajjammanavar, Prashanth Kulkarni","doi":"10.2174/04666230124110901","DOIUrl":"https://doi.org/10.2174/04666230124110901","url":null,"abstract":"\u0000\u0000Complete heart block (CHB) is the total absence of conduction from atria to ventricles with an escape rhythm most commonly arising from the AVN or His bundle. CHB in pregnancy is very rare, and most reported cases are due to congenital variety, where the pre-existing CHB from birth is either detected incidentally or presented with symptoms during pregnancy. Pregnancy is associated with various physiological changes, such as a pro-inflammatory, hypercoagulable state with possible oedema of the heart's conduction system, which may rarely give rise to CHB. There are no clear guidelines to manage CHB complicating pregnancy.\u0000\u0000\u0000\u0000An asymptomatic 27-year-old lady with G2P1L1, 39 weeks of gestation with breech presentation, was referred for delivery given the low maternal heart rate of 40 bpm. Per abdominal examination revealed a term size uterus with active contractions and a fetal heart rate of 140bpm. An ECG revealed a CHB with an escape rate of 40 bpm. Other routine investigations were normal, with negative serological evaluation for hepatitis B, C, and HIV. ANA and Anti-Ro ⁄ SSA antibodies. She underwent an emergency LSCS under spinal anaesthesia with a backup temporary pacemaker (TPM). She received a short course of empirical steroid therapy for three days as there were no obvious secondary causes for CHB, which reverted to sinus rhythm after 48 hours.\u0000\u0000\u0000\u0000CHB complicating pregnancy with or without symptoms may require definitive therapy in the form of permanent pacemaker implantation. However, the insertion of a TPM for managing pregnancy is controversial as opinion in the literature is divided. There are no reports of CHB occurring in pregnancy without congenital or other known acquired causes. In the reported case, the CHB reverted to sinus rhythm with a short course of IV steroid therapy without any subsequent need for a PPM implantation.\u0000\u0000\u0000\u0000Congenital CHB remains the most common cause of rarely seen CHB complicating pregnancy. Through the conduction system oedema and inflammation, physiological changes in gestation may rarely cause CHB during pregnancy. In the absence of congenital CHB and other demonstrable acquired causes, a short course of steroid therapy may reverse the CHB avoiding PPM implantation as shown in the reported case.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"96 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134351456","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 : 2023-01-12DOI: 10.2174/04666230112162945
N. Shah, Naser Jamil, G. Abdalla, Khalifa Omar Muhammed, Haitham Al Hashimi, F. Baslaib
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic due to ‘coronavirus disease 2019’ (COVID-19) that has led to millions of deaths. This may have resulted in a change in the rate of admissions for other potentially life-threatening conditions such as acute coronary syndromes (ACS). Therefore, we investigated the incidence of ACS admissions during the current pandemic and compared it to a similar period the year before. This was a retrospective analysis of all patients admitted to a tertiary cardiology centre with ACS between February 2019 and the end of April 2019 (pre-COVID) that was compared with admissions between the same three months in 2020 (post-COVID). The main outcomes of interest were to evaluate any potential reduction of ACS admissions during the pandemic or change in mortality. In addition, we evaluated the rate of patients proceeding to coronary angiography (CAG). During the post-COVID period, only 200 patients were admitted with ACS as compared to 331 patients during the pre-COVID period (39.6% reduction; 95% confidence interval (CI): 34% - 44%; p<0.01). A reduction in the percentage of patients proceeding to CAG was also noted (253 patients during the pre-COVID period compared to only 134 patients in the post-COVID period (76.4% vs 67.0%; p = 0.02)) but no associated reduction of primary percutaneous coronary intervention was noted. No increase in in-hospital mortality was noted between the pre-COVID and post-COVID groups (1.5% vs 1% respectively; p = 0.62). There was a significant reduction in admissions for ACS in the post-COVID period compared to a similar period prior. There was also a reduction in the overall invasive management of ACS, with less CAG performed but no associated reduction in the rate of PPCI. The in-hospital mortality rate was similar in the two groups.
{"title":"A retrospective single centre analysis of the incidence of hospital admission for Acute Coronary Syndrome during the COVID-19 pandemic.","authors":"N. Shah, Naser Jamil, G. Abdalla, Khalifa Omar Muhammed, Haitham Al Hashimi, F. Baslaib","doi":"10.2174/04666230112162945","DOIUrl":"https://doi.org/10.2174/04666230112162945","url":null,"abstract":"\u0000\u0000The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a pandemic due to ‘coronavirus disease 2019’ (COVID-19) that has led to millions of deaths. This may have resulted in a change in the rate of admissions for other potentially life-threatening conditions such as acute coronary syndromes (ACS). Therefore, we investigated the incidence of ACS admissions during the current pandemic and compared it to a similar period the year before.\u0000\u0000\u0000\u0000This was a retrospective analysis of all patients admitted to a tertiary cardiology centre with ACS between February 2019 and the end of April 2019 (pre-COVID) that was compared with admissions between the same three months in 2020 (post-COVID). The main outcomes of interest were to evaluate any potential reduction of ACS admissions during the pandemic or change in mortality. In addition, we evaluated the rate of patients proceeding to coronary angiography (CAG).\u0000\u0000\u0000\u0000During the post-COVID period, only 200 patients were admitted with ACS as compared to 331 patients during the pre-COVID period (39.6% reduction; 95% confidence interval (CI): 34% - 44%; p<0.01). A reduction in the percentage of patients proceeding to CAG was also noted (253 patients during the pre-COVID period compared to only 134 patients in the post-COVID period (76.4% vs 67.0%; p = 0.02)) but no associated reduction of primary percutaneous coronary intervention was noted. No increase in in-hospital mortality was noted between the pre-COVID and post-COVID groups (1.5% vs 1% respectively; p = 0.62).\u0000\u0000\u0000\u0000There was a significant reduction in admissions for ACS in the post-COVID period compared to a similar period prior. There was also a reduction in the overall invasive management of ACS, with less CAG performed but no associated reduction in the rate of PPCI. The in-hospital mortality rate was similar in the two groups.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125905786","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 : 2023-01-05DOI: 10.2174/04666230105120905
T. El-Azzabi
Duchenne muscular dystrophy (DMD) is a rare neuromuscular disease that causes muscle weakness with respiratory and cardiac complications. International DMD standard of care guidelines exist, but their implementation and DMD treatment access in the Middle East have historically been challenging. This report highlights sub-optimal management of DMD in the Middle East together with recommendations for best practices, and the first reported use of ataluren, a mutation-specific treatment for nonsense mutation DMD (nmDMD), in this region. The management of two patients in the United Arab Emirates diagnosed with nonsense mutation DMD is described. Under multidisciplinary care, both patients were treated with corticosteroids as per international DMD standard of care guidelines. Although both patients presented with typical DMD signs/symptoms, one received a genetic diagnosis and treatment relatively late owing to low awareness of the early signs and symptoms of DMD among physicians in the region; delayed genetic diagnosis of DMD hinders early initiation of mutation-specific treatments such as ataluren. Moreover, this patient demonstrated low adherence to the treatment plan, potentially resulting from low DMD awareness and poor understanding of the-risk-benefit of corticosteroids in the patient’s family. In contrast, the other patient was genetically diagnosed early at 25 months, was administered ataluren whilst ambulatory, and demonstrated high adherence to the management plan. Limited expertise in performing motor function assessments and complications with medical insurance for ataluren in the region created additional obstacles in the management of both patients. The contrasting experiences of these patients highlight the high variability of diagnosis and management of DMD in the Middle East. There is a need in the region to boost disease education for both public and professional communities, establish local DMD networks and guidelines, and improve access to treatments to improve the quality of care that patients with DMD receive.
{"title":"Duchenne Muscular Dystrophy Management and Treatment Access Challenges: Case Report","authors":"T. El-Azzabi","doi":"10.2174/04666230105120905","DOIUrl":"https://doi.org/10.2174/04666230105120905","url":null,"abstract":"\u0000\u0000Duchenne muscular dystrophy (DMD) is a rare neuromuscular disease that causes muscle weakness with respiratory and cardiac complications. International DMD standard of care guidelines exist, but their implementation and DMD treatment access in the Middle East have historically been challenging. This report highlights sub-optimal management of DMD in the Middle East together with recommendations for best practices, and the first reported use of ataluren, a mutation-specific treatment for nonsense mutation DMD (nmDMD), in this region.\u0000\u0000\u0000\u0000The management of two patients in the United Arab Emirates diagnosed with nonsense mutation DMD is described. Under multidisciplinary care, both patients were treated with corticosteroids as per international DMD standard of care guidelines. Although both patients presented with typical DMD signs/symptoms, one received a genetic diagnosis and treatment relatively late owing to low awareness of the early signs and symptoms of DMD among physicians in the region; delayed genetic diagnosis of DMD hinders early initiation of mutation-specific treatments such as ataluren. Moreover, this patient demonstrated low adherence to the treatment plan, potentially resulting from low DMD awareness and poor understanding of the-risk-benefit of corticosteroids in the patient’s family. In contrast, the other patient was genetically diagnosed early at 25 months, was administered ataluren whilst ambulatory, and demonstrated high adherence to the management plan. Limited expertise in performing motor function assessments and complications with medical insurance for ataluren in the region created additional obstacles in the management of both patients.\u0000\u0000\u0000\u0000The contrasting experiences of these patients highlight the high variability of diagnosis and management of DMD in the Middle East. There is a need in the region to boost disease education for both public and professional communities, establish local DMD networks and guidelines, and improve access to treatments to improve the quality of care that patients with DMD receive.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129246028","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 : 2022-12-29DOI: 10.2174/04666221229092808
O. Abdallah, Nour Isleem, Rania Abu-Kuhail, Sali El Hoseny, Y. Eltorki, Noriya Al Khuzaei
This study was conducted to explore the trends of prescribing pharmacological medications used in ADHD and identify the reasons of discontinuations of such medications. Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. The consequences of ADHD could seriously impact the patient’s lives and thus parental training, behavioral therapies, and pharmacological interventions are main therapeutic options applied. This study was conducted to explore the trends of prescribing pharmacological medications used in ADHD at CAMHS as a primary outcome measure. In addition to identifying the reasons of discontinuations of such medications (in terms of effectiveness, safety, and other reasons). The study also aimed to identify the incidence of psychotropic polypharmacy in such group and the incidence of co-existing diseases. Lastly, it aimed at investigating the adherence to the required monitoring parameters in this patient’s group. A Retrospective chart review for patients diagnosed with (ADHD) at Child and Adolescents’ Mental Health Services (CAMHS) in Qatar from Jan 2019 – Dec 2019 was conducted. Patients less than 18 years old, diagnosed with ADHD as per the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and who are on pharmacological treatment for ADHD were suitable to be included. Patients who are not on anti-ADHD medications were excluded from the study. Ninety-two patients were eligible to be included in the study. Autism Spectrum Disorder (ASD) were found to be the most coexisting condition in addition to ADHD in 16.3%. Methylphenidate was the most prescribed medication (68.5%) followed by Atomoxetine (30.4%). None of the participants were found on Modafinil, Guanfacine, Bupropion, or Benzodiazepines and none of them exceeded the maximum licensed dose of either Methylphenidate or Atomoxetine. Half (50%) of the sample on Atomoxetine discontinued treatment compared to 14.2% in methylphenidate group. The clinical practice of prescribing pharmacological options in ADHD was thoroughly in alignment with international guidelines. Long term use of these psychotropics in this particular group of patients on their neurobiological, behavioral and physical health should be studied further. None
{"title":"Pharmacological Treatment of Children and Adolescents Diagnosed with Attention-deficit/hyperactivity Disorder at Mental Health Services in Qatar: A Retrospective Study","authors":"O. Abdallah, Nour Isleem, Rania Abu-Kuhail, Sali El Hoseny, Y. Eltorki, Noriya Al Khuzaei","doi":"10.2174/04666221229092808","DOIUrl":"https://doi.org/10.2174/04666221229092808","url":null,"abstract":"\u0000\u0000This study was conducted to explore the trends of prescribing pharmacological medications used in ADHD and identify the reasons of discontinuations of such medications.\u0000\u0000\u0000\u0000Attention-deficit/hyperactivity disorder (ADHD) is one of the most common mental disorders affecting children. The consequences of ADHD could seriously impact the patient’s lives and thus parental training, behavioral therapies, and pharmacological interventions are main therapeutic options applied.\u0000\u0000\u0000\u0000This study was conducted to explore the trends of prescribing pharmacological medications used in ADHD at CAMHS as a primary outcome measure. In addition to identifying the reasons of discontinuations of such medications (in terms of effectiveness, safety, and other reasons). The study also aimed to identify the incidence of psychotropic polypharmacy in such group and the incidence of co-existing diseases. Lastly, it aimed at investigating the adherence to the required monitoring parameters in this patient’s group.\u0000\u0000\u0000\u0000A Retrospective chart review for patients diagnosed with (ADHD) at Child and Adolescents’ Mental Health Services (CAMHS) in Qatar from Jan 2019 – Dec 2019 was conducted. Patients less than 18 years old, diagnosed with ADHD as per the Diagnostic and Statistical Manual of Mental Disorders (DSM–5) and who are on pharmacological treatment for ADHD were suitable to be included. Patients who are not on anti-ADHD medications were excluded from the study.\u0000\u0000\u0000\u0000Ninety-two patients were eligible to be included in the study. Autism Spectrum Disorder (ASD) were found to be the most coexisting condition in addition to ADHD in 16.3%. Methylphenidate was the most prescribed medication (68.5%) followed by Atomoxetine (30.4%). None of the participants were found on Modafinil, Guanfacine, Bupropion, or Benzodiazepines and none of them exceeded the maximum licensed dose of either Methylphenidate or Atomoxetine. Half (50%) of the sample on Atomoxetine discontinued treatment compared to 14.2% in methylphenidate group.\u0000\u0000\u0000\u0000The clinical practice of prescribing pharmacological options in ADHD was thoroughly in alignment with international guidelines. Long term use of these psychotropics in this particular group of patients on their neurobiological, behavioral and physical health should be studied further.\u0000\u0000\u0000\u0000None\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114586610","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 : 2022-12-23DOI: 10.2174/04666221223090640
Noopur R. Kedia, M. Kejariwal, M. Jhancy
With improved technology and better access to health care, the number of pregnant women with heart diseases is increasing. Due to various physiological changes in pregnancy, women with heart diseases are at increased risk of both maternal and fetal complications. Thus, pregnancy with heart disease is considered a high-risk pregnancy. In the near future, the burden on the healthcare system will increase and we will be required to answer various questions about the different outcomes possible and their management. If women are made aware of the various risks associated with their pregnancies, they can make informed life choices. This can only be achieved if more objective data is offered to her.[1] In this article, we review the available data on the observed perinatal outcomes in mothers with heart disease, their management, and what lacunas need to be filled, so as to be able to provide better care. Relevant articles were referred and data was summed. We concluded that in the majority of studies, the odds for adverse neonatal outcomes like preterm birth, low birth weight, stillbirth, low Apgar score and admissions to neonatal intensive care unit were higher among pregnant women with heart disease as compared to women with no heart disease.
{"title":"Perinatal outcome in pregnant women with heart disease","authors":"Noopur R. Kedia, M. Kejariwal, M. Jhancy","doi":"10.2174/04666221223090640","DOIUrl":"https://doi.org/10.2174/04666221223090640","url":null,"abstract":"\u0000\u0000With improved technology and better access to health care, the number of pregnant women with heart diseases is increasing. Due to various physiological changes in pregnancy, women with heart diseases are at increased risk of both maternal and fetal complications. Thus, pregnancy with heart disease is considered a high-risk pregnancy. In the near future, the burden on the healthcare system will increase and we will be required to answer various questions about the different outcomes possible and their management. If women are made aware of the various risks associated with their pregnancies, they can make informed life choices. This can only be achieved if more objective data is offered to her.[1] In this article, we review the available data on the observed perinatal outcomes in mothers with heart disease, their management, and what lacunas need to be filled, so as to be able to provide better care. Relevant articles were referred and data was summed. We concluded that in the majority of studies, the odds for adverse neonatal outcomes like preterm birth, low birth weight, stillbirth, low Apgar score and admissions to neonatal intensive care unit were higher among pregnant women with heart disease as compared to women with no heart disease.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"5 4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131937982","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 : 2022-12-05DOI: 10.2174/04666221205091500
Ramya Rathan, Rihab Sayed Sufiyan, Lin Jawish, Sarah Ait Tayeb, Aisha Bachir, Miral Nagy F Salama
Although pain is common for everyone, it is a subjective sensation influenced by different variables. One factor that influences pain threshold and perception is body mass index (BMI). This study investigates the connection between BMI and pain by assessing the pressure pain threshold and tolerance on the median and ulnar nerves in the palms. Although pain is common for everyone, it is a subjective sensation influenced by different variables. One factor that influences pain threshold and perception is body mass index (BMI). This study investigates the connection between BMI and pain by assessing the pressure pain threshold and tolerance on the median and ulnar nerves in the palms. The PPT and PT of 120 participants were measured with a digital pressure algometer (FPIX50; Wagner Instruments). Measurement sessions consisted of consecutive PPT and PT readings on the thenar and hypothenar eminence of the dominant and non-dominant hand. In addition, the PPT and PT were compared between BMI, thenar and hypothenar, dominant and non-dominant hand, and sexes. The results have shown that the PPT and PT increased with BMI. However, only three out of the eight readings were significant (p = <0.05). When comparing the thenar and hypothenar, the results revealed significantly higher PPT and PT levels in the hypothenar (p = < 0.001). The results comparing the PPT and PT between the dominant and non-dominant hand revealed a significantly higher PPT in the non-dominant hand reflected across the thenar and hypothenar (t= -6.197, p= <0.01) (t= -2.550, p= 0.012), respectively. In addition, males had higher PPT and PT values (p = <0.05). The results suggest that individuals with higher BMI can tolerate more pain. They also indicate that the hypothenar eminence could withstand higher pain levels than the thenar eminence. In addition, our assessment also revealed a higher pain threshold observed in participants' non-dominant hands, but the same could not be deduced for the pressure pain tolerance. Furthermore, the results have shown that males could tolerate more pain than females. The results have shown that the PPT and PT increased with BMI. However, only three out of the eight readings were significant (p = <0.05). When comparing the thenar and hypothenar, the results revealed significantly higher PPT and PT levels in the hypothenar (p = < 0.001). The results comparing the PPT and PT between the dominant and non-dominant hand revealed a significantly higher PPT in the non-dominant hand reflected across the thenar and hypothenar (t= -6.197, p= <0.01) (t= -2.550, p= 0.012), respectively. In addition, males had a higher PPT and PT values (p = <0.05). One of the current study''s limitations is that all examiners involved in this project were females, which might have influenced some of the participants'' readings. Therefore, it would be best that the examiner would be of the same sex of the participant. Similarly, we selected a relatively narrow age
{"title":"A Cross-Sectional Study to Associate BMI With Pressure Pain Threshold and Pain Tolerance Among Healthy Young Individuals","authors":"Ramya Rathan, Rihab Sayed Sufiyan, Lin Jawish, Sarah Ait Tayeb, Aisha Bachir, Miral Nagy F Salama","doi":"10.2174/04666221205091500","DOIUrl":"https://doi.org/10.2174/04666221205091500","url":null,"abstract":"\u0000\u0000Although pain is common for everyone, it is a subjective sensation influenced by different variables. One factor that influences pain threshold and perception is body mass index (BMI). This study investigates the connection between BMI and pain by assessing the pressure pain threshold and tolerance on the median and ulnar nerves in the palms.\u0000\u0000\u0000\u0000Although pain is common for everyone, it is a subjective sensation influenced by different variables. One factor that influences pain threshold and perception is body mass index (BMI). This study investigates the connection between BMI and pain by assessing the pressure pain threshold and tolerance on the median and ulnar nerves in the palms.\u0000\u0000\u0000\u0000The PPT and PT of 120 participants were measured with a digital pressure algometer (FPIX50; Wagner Instruments). Measurement sessions consisted of consecutive PPT and PT readings on the thenar and hypothenar eminence of the dominant and non-dominant hand. In addition, the PPT and PT were compared between BMI, thenar and hypothenar, dominant and non-dominant hand, and sexes.\u0000\u0000\u0000\u0000The results have shown that the PPT and PT increased with BMI. However, only three out of the eight readings were significant (p = <0.05). When comparing the thenar and hypothenar, the results revealed significantly higher PPT and PT levels in the hypothenar (p = < 0.001). The results comparing the PPT and PT between the dominant and non-dominant hand revealed a significantly higher PPT in the non-dominant hand reflected across the thenar and hypothenar (t= -6.197, p= <0.01) (t= -2.550, p= 0.012), respectively. In addition, males had higher PPT and PT values (p = <0.05).\u0000\u0000\u0000\u0000The results suggest that individuals with higher BMI can tolerate more pain. They also indicate that the hypothenar eminence could withstand higher pain levels than the thenar eminence. In addition, our assessment also revealed a higher pain threshold observed in participants' non-dominant hands, but the same could not be deduced for the pressure pain tolerance. Furthermore, the results have shown that males could tolerate more pain than females.\u0000\u0000\u0000\u0000The results have shown that the PPT and PT increased with BMI. However, only three out of the eight readings were significant (p = <0.05). When comparing the thenar and hypothenar, the results revealed significantly higher PPT and PT levels in the hypothenar (p = < 0.001). The results comparing the PPT and PT between the dominant and non-dominant hand revealed a significantly higher PPT in the non-dominant hand reflected across the thenar and hypothenar (t= -6.197, p= <0.01) (t= -2.550, p= 0.012), respectively. In addition, males had a higher PPT and PT values (p = <0.05).\u0000\u0000\u0000\u0000One of the current study''s limitations is that all examiners involved in this project were females, which might have influenced some of the participants'' readings. Therefore, it would be best that the examiner would be of the same sex of the participant. Similarly, we selected a relatively narrow age ","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"272 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122949070","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 : 2022-11-28DOI: 10.2174/04666221128110145
Basheer Abdullah Marzoog
Cardiovascular disease (CVD) is increasing dramatically in young people and is the leading cause of death worldwide. This study aimed to evaluate differences in the adaptive and compensatory mechanisms of the cardiovascular system (CVS) in young men and women to determine the most significant risk factors and assess the stability of the non-invasive method used in the early detection of CVD risk factors in young people. Currently, early assessment of CVD risk factor is possible only through invasive methods such as the Framingham risk score and the SCORE chart. Therefore, the development of a more flexible and non-invasive method is crucial in large populations. Currently, early evaluation of CVD risk factors is possible only through invasive methods, such as the Framingham risk score and the SCORE chart. Therefore, the development of a more flexible and non-invasive method is crucial in large populations. A cohort cross-sectional investigation examined 173 volunteers, divided into two groups according to gender (n1 female=83, n2 male=90), and their heart rate, blood pressure (SBP/DBP), height, weight, and waist and hip circumference were non-invasively measured. Then, the potential adaptation value (R.M. Baevsky et al., 1987), Martinet test (MT), body mass index (BMI), and waist/hip ratio were calculated. Moreover, we collected information on lifestyle risk factors, including tobacco smoking, alcohol consumption, factors related to unhealthy diet, lack of physical activity, sleep deprivation, and anxiety, through special in-person interviews using paper/online questionnaires. The T-test and the x2 tests were applied for statistical analysis. Impaired/pathological cardiovascular adaptation was observed in 11.54% of the female group and in 46.07% of the male group. In the female group, cardiovascular recovery abnormalities were observed in the SBP, DBP, HR MT in 20.59%, 16.18%, 44.12%, respectively. Whereas in the male group, 32.50%, 21.25% and 36.25%, respectively. Despite gender, these deviations were accompanied by the prevalence of sympathetic influences in the regulation of CVS functions in 72.73% in the first group and by 69.66 % in the second group. BMI was violated in 47.19% of males and in 29.49% of the females. The used test shows result identical to that in the invasive methods of assessment of CVD risk factors. Impaired/pathological cardiovascular adaptation was observed in 11.54% of the female group and 46.07% of the male group. In the female group, cardiovascular recovery abnormalities were observed in the SBP, DBP, and HR MT in 20.59%, 16.18%, and 44.12%, respectively, whereas in the male group, 32.50%, 21.25% and 36.25%, respectively. Despite gender, these deviations were accompanied by the prevalence of sympathetic influences in the regulation of CVS functions in 72.73% of the first group and 69.66 % of the second group. BMI was violated in 47.19% of males and 29.49% of females. The test results were identical
心血管疾病(CVD)在年轻人中急剧增加，是世界范围内死亡的主要原因。本研究旨在评估年轻男性和女性心血管系统(CVS)适应性和代偿机制的差异，以确定最重要的危险因素，并评估用于年轻人心血管疾病危险因素早期检测的无创方法的稳定性。目前，CVD危险因素的早期评估只能通过Framingham风险评分和score表等侵入性方法进行。因此，开发一种更灵活和非侵入性的方法对大规模人群至关重要。目前，CVD危险因素的早期评估只能通过侵入性方法，如Framingham风险评分和score表。因此，开发一种更灵活和非侵入性的方法对大规模人群至关重要。一项队列横断面调查调查了173名志愿者，根据性别分为两组(n1名女性=83名，n2名男性=90名)，并测量了他们的心率、血压(收缩压/舒张压)、身高、体重、腰围和臀围。然后计算潜在适应值(R.M. Baevsky et al.， 1987)、Martinet检验(MT)、体重指数(BMI)和腰臀比。此外，我们收集了生活方式风险因素的信息，包括吸烟、饮酒、与不健康饮食有关的因素、缺乏体育活动、睡眠剥夺和焦虑，通过特殊的面对面访谈，使用纸质/在线问卷。采用t检验和x2检验进行统计分析。11.54%的女性和46.07%的男性存在心血管适应性受损/病理性。在女性组中，收缩压、舒张压、HR MT的心血管恢复异常分别为20.59%、16.18%、44.12%。而男性组分别为32.50%、21.25%和36.25%。尽管存在性别差异，但在CVS功能的调节中，交感神经的影响在第一组中占72.73%，在第二组中占69.66%。47.19%的男性BMI超标，29.49%的女性BMI超标。试验结果与有创性心血管疾病危险因素评估方法一致。11.54%的女性和46.07%的男性存在心血管适应性受损/病理性。在女性组中，收缩压、舒张压和HR MT的心血管恢复异常分别为20.59%、16.18%和44.12%，而在男性组中，分别为32.50%、21.25%和36.25%。尽管存在性别差异，但在第一组的72.73%和第二组的69.66%中，这些偏差都伴随着交感神经影响对CVS功能的调节。47.19%的男性和29.49%的女性BMI指数不达标。试验结果与有创性方法评价心血管疾病危险因素的结果一致。年轻女性心血管适应机制的异常不太明显。性别相关的风险因素有很高的产量，如肥胖、体育活动不足和高血压，这些在男性中更为明显。测试的可用性需要对更大的样本进行进一步的调查。
{"title":"Adaptive and Compensatory Mechanisms of the Cardiovascular System and Disease Risk Factors in young males and females","authors":"Basheer Abdullah Marzoog","doi":"10.2174/04666221128110145","DOIUrl":"https://doi.org/10.2174/04666221128110145","url":null,"abstract":"\u0000\u0000Cardiovascular disease (CVD) is increasing dramatically in young people and is the leading cause of death worldwide.\u0000\u0000\u0000\u0000This study aimed to evaluate differences in the adaptive and compensatory mechanisms of the cardiovascular system (CVS) in young men and women to determine the most significant risk factors and assess the stability of the non-invasive method used in the early detection of CVD risk factors in young people.\u0000\u0000\u0000\u0000Currently, early assessment of CVD risk factor is possible only through invasive methods such as the Framingham risk score and the SCORE chart. Therefore, the development of a more flexible and non-invasive method is crucial in large populations.\u0000\u0000\u0000\u0000Currently, early evaluation of CVD risk factors is possible only through invasive methods, such as the Framingham risk score and the SCORE chart. Therefore, the development of a more flexible and non-invasive method is crucial in large populations.\u0000\u0000\u0000\u0000A cohort cross-sectional investigation examined 173 volunteers, divided into two groups according to gender (n1 female=83, n2 male=90), and their heart rate, blood pressure (SBP/DBP), height, weight, and waist and hip circumference were non-invasively measured. Then, the potential adaptation value (R.M. Baevsky et al., 1987), Martinet test (MT), body mass index (BMI), and waist/hip ratio were calculated. Moreover, we collected information on lifestyle risk factors, including tobacco smoking, alcohol consumption, factors related to unhealthy diet, lack of physical activity, sleep deprivation, and anxiety, through special in-person interviews using paper/online questionnaires. The T-test and the x2 tests were applied for statistical analysis.\u0000\u0000\u0000\u0000Impaired/pathological cardiovascular adaptation was observed in 11.54% of the female group and in 46.07% of the male group. In the female group, cardiovascular recovery abnormalities were observed in the SBP, DBP, HR MT in 20.59%, 16.18%, 44.12%, respectively. Whereas in the male group, 32.50%, 21.25% and 36.25%, respectively. Despite gender, these deviations were accompanied by the prevalence of sympathetic influences in the regulation of CVS functions in 72.73% in the first group and by 69.66 % in the second group. BMI was violated in 47.19% of males and in 29.49% of the females. The used test shows result identical to that in the invasive methods of assessment of CVD risk factors.\u0000\u0000\u0000\u0000Impaired/pathological cardiovascular adaptation was observed in 11.54% of the female group and 46.07% of the male group. In the female group, cardiovascular recovery abnormalities were observed in the SBP, DBP, and HR MT in 20.59%, 16.18%, and 44.12%, respectively, whereas in the male group, 32.50%, 21.25% and 36.25%, respectively. Despite gender, these deviations were accompanied by the prevalence of sympathetic influences in the regulation of CVS functions in 72.73% of the first group and 69.66 % of the second group. BMI was violated in 47.19% of males and 29.49% of females. The test results were identical ","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132811468","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 : 2022-11-22DOI: 10.2174/04666221122085900
A. Hossain, Noor Yaser Asaad, Maram Walid Ballan, Heba Yead Abdel-Latif Shalabi
The gut microbiome (microorganisms present in our gut) has emerged as an important determinative factor in a variety of diseases and health conditions. One new area in which the role of the gut microbiome is of intense interest is its role in various neurological manifestations, including insomnia, the most common sleep disorder. In this mini-review, we aim to highlight the latest research developments concerning the association between the gut microbiome and insomnia and summarize gut-brain interaction for a better understanding of the role of microbiota in insomnia. Our search results included publications written in English from the year 2010 up to the year 2022. We used Pubmed, Google Scholar, and ScienceDirect to search for original articles pertaining to the relationship between the gut microbiome and insomnia using the following search terms: "Gut-brain Axis and Insomnia," "Brain and Gut Microbiome," " Gut-brain Homeostasis”, and "Circadian Rhythm and Gut Microbiome". Relevant articles from the reference list were reviewed in order to collect additional information. Studies have shown that the microbiome-gut-brain axis is thus associated with the development of insomnia. The gut microbiome can have an important role in the development of insomnia. On the other hand, insomnia can also modulate the gut microbiome. However, scientific work in this field is limited as relevant scientific research is at the initial state. Bacteria present in the gut send signals to the brain via the vagus nerve by stimulating the afferent neurons of the enteric nervous system and influencing sleep quality and stress reactivity of the hypothalamic-pituitary-adrenal axis. The gut microbiome also communicates with the nervous system via the neuroendocrine pathway through various metabolic products. Insomnia also influences the structure and function of the gut microbiome.
{"title":"Gut microbiome and insomnia: A mini review","authors":"A. Hossain, Noor Yaser Asaad, Maram Walid Ballan, Heba Yead Abdel-Latif Shalabi","doi":"10.2174/04666221122085900","DOIUrl":"https://doi.org/10.2174/04666221122085900","url":null,"abstract":"\u0000\u0000The gut microbiome (microorganisms present in our gut) has emerged as an important determinative factor in a variety of diseases and health conditions. One new area in which the role of the gut microbiome is of intense interest is its role in various neurological manifestations, including insomnia, the most common sleep disorder. In this mini-review, we aim to highlight the latest research developments concerning the association between the gut microbiome and insomnia and summarize gut-brain interaction for a better understanding of the role of microbiota in insomnia.\u0000\u0000\u0000\u0000Our search results included publications written in English from the year 2010 up to the year 2022. We used Pubmed, Google Scholar, and ScienceDirect to search for original articles pertaining to the relationship between the gut microbiome and insomnia using the following search terms: \"Gut-brain Axis and Insomnia,\" \"Brain and Gut Microbiome,\" \" Gut-brain Homeostasis”, and \"Circadian Rhythm and Gut Microbiome\". Relevant articles from the reference list were reviewed in order to collect additional information.\u0000\u0000\u0000\u0000Studies have shown that the microbiome-gut-brain axis is thus associated with the development of insomnia. The gut microbiome can have an important role in the development of insomnia. On the other hand, insomnia can also modulate the gut microbiome. However, scientific work in this field is limited as relevant scientific research is at the initial state.\u0000\u0000\u0000\u0000Bacteria present in the gut send signals to the brain via the vagus nerve by stimulating the afferent neurons of the enteric nervous system and influencing sleep quality and stress reactivity of the hypothalamic-pituitary-adrenal axis. The gut microbiome also communicates with the nervous system via the neuroendocrine pathway through various metabolic products. Insomnia also influences the structure and function of the gut microbiome.\u0000","PeriodicalId":110816,"journal":{"name":"New Emirates Medical Journal","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128073293","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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