Faculty Publications (CoM)

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Alterations in blood pressure dependent activation of leg muscles during standing following bed rest mimic those observed with ageing
(Frontiers Media SA, 2025-04-29) Goswami, Nandu
Introduction Baroreflex-mediated activation of lower leg muscles (i.e., muscle-pump baroreflex) has been suggested to play a significant role in blood pressure regulation during standing. Compromised muscle-pump baroreflex because of ageing or prolonged inactivity could contribute to orthostatic hypotension. Understanding the contribution of individual lower leg muscles to blood pressure regulation could lead to the development of muscle-specific strategies to prevent orthostatic hypotension associated with muscle-pump baroreflex dysfunctions. Methods In this study, individual muscle (tibialis anterior (TA), lateral soleus (SOL), medial gastrocnemius (MG), and lateral gastrocnemius (LG)) responses to blood pressure changes upon a supine-to-stand orthostatic challenge were examined in young adult male participants (35 ± 2 years) before and after 60 days of 6° head-down tilt bed rest (HDBR). By analyzing the interactions between systolic blood pressure (SBP) and heartbeat-by-heartbeat electromyogram impulse (EMGimp) during standing, the interactions between SBP and EMGimp including muscle-pump baroreflex were characterized by fraction time active (FTA) and response gain from wavelet transform coherence analysis and the causality values using convergent cross mapping method for individual leg muscles. Since inactivity and ageing are common causes of orthostatic intolerance, the HDBR results were compared with those from young and older individuals in a previously published study to investigate the similarities in their effects on muscle-pump baroreflex. Results During standing, FTA reduced for all muscles except MG following HDBR and was lower in older compared to younger participants. Muscle-pump baroreflex causality (SBP→EMGimp) reduced for all muscles following HDBR and was lower for LG and SOL muscles in older compared to younger adults. The mechanical muscle-pump causality (SBP→EMGimp) was not affected by HDBR or by age. Increased TA muscle-pump baroreflex gain post-HDBR may point to a compensatory mechanism for decreased active control. Conclusions Our results showed striking similarities in the alteration of muscle-pump baroreflex induced via ageing and HDBR, suggesting strong commonalities between ageing and long-term inactivity in terms of the adverse effects on baroreflex mediated control of lower leg muscle activities in response to orthostatic challenge.
Targeting PAR-2-driven inflammatory pathways in colorectal cancer: mechanistic insights from atorvastatin and rosuvastatin treatment in cell line models
(AME Publishing Company, 2025-03) Patnaik, Rajashree; Varghese, Riah Lee; Khan, Sara; Huda, Bintul; Bhurka, Farida; Amiri, Layla; Banerjee, Yajnavalka
Background: Colorectal cancer (CRC) is a growing health concern globally and in regions such as the United Arab Emirates, where risk factors like obesity and hyperlipidaemia are prevalent. Chronic inflammation, driven by pathways involving protease-activated receptor 2 (PAR-2), plays a pivotal role in CRC progression, creating a tumour-promoting microenvironment. The overexpression of PAR-2 has been associated with increased tumour aggressiveness and drug resistance. While previous studies have focused on broad inflammatory modulation, this study explores the selective targeting of PAR-2 by atorvastatin (ATV) and rosuvastatin (RSV), highlighting their specificity by assessing minimal impact on PAR-1 expression, which serves as a control. Methods: HT-29 and Caco-2 CRC cell lines were employed to investigate the anti-inflammatory effects of ATV and RSV. Inflammation was induced with lipopolysaccharide (LPS), followed by treatment with varying concentrations of ATV and RSV. Western blotting and real-time polymerase chain reaction for quantification (qPCR) were performed to quantify PAR-2 and TNF-α at both the protein and mRNA levels. Enzyme linked immunosorbent assay (ELISA) was used to measure the secretion of TNF-α. Calcium signalling, which plays a crucial role in inflammation, was analysed using Fluo-4 AM dye, with fluorescence imaging capturing the effects of statin treatment on intracellular calcium influx. Results: LPS treatment significantly upregulated PAR-2 and TNF-α expression in both cell lines, validating the inflammatory model. Co-treatment with ATV or RSV reduced PAR-2 and TNF-α expression in a dose-dependent manner. The higher concentrations of ATV (50 µg/mL) and RSV (20 µg/mL) produced the most significant reduction in these inflammatory markers at both the protein and mRNA levels. Importantly, the treatment did not substantially alter PAR-1 expression, underlining the specificity of ATV and RSV in modulating PAR-2-mediated pathways. Additionally, statin treatment attenuated LPS-induced calcium influx, with fluorescence intensity decreasing markedly at higher concentrations of both statins. Conclusions: This study provides novel insights into the selective targeting of PAR-2 by ATV and RSV, distinguishing their effects from PAR-1. The reduction in PAR-2 expression and TNF-α secretion, along with the suppression of calcium signalling, underscores the potential of these statins as targeted antiinflammatory agents in CRC. The findings highlight the therapeutic value of ATV and RSV in modulating inflammation through PAR-2-specific pathways, which may contribute to reduced cancer progression. These results pave the way for further preclinical and clinical evaluations to explore statins as adjunctive therapies in the management of CRC.
Utilization of Low‐Dose Phentermine for Weight Loss Prior to Metabolic and Bariatric Surgery: A Prospective, Randomized, and Placebo‐Controlled Trial
(Wiley, 2025-01-17) Rivas, Homero
ABSTRACT Introduction: Studies examining preoperative weight loss using pharmacotherapy in metabolic and bariatric patients are limited. The objective was to investigate if patients taking a low‐dose formulation of phentermine had improved weight loss. Methods: This study was a randomized, placebo‐controlled trial including patients undergoing laparoscopic Roux‐en‐Y gastric bypass and sleeve gastrectomy. Anthropometric and serological data were collected during the initial consult visit and again during two follow‐up visits. Lomaira is a low‐dose formulation of phentermine. Patients took 8‐mg tablets three times a day for 14 weeks. The primary outcome of this study was weight loss, which was measured as percentage total weight loss (%TWL) and change in body mass index (BMI). Results: Among 53 participants randomized, 45 (85%) completed the trial. Participants were predominantly female (91%); the mean age was 41 years (SD = 11); and the mean initial BMI was 48.4 kg/m2 (SD = 8.2 kg/m2). Average weight loss was 6.2 kg (SD = 6) in the treatment group versus 1.1 kg (SD = 4.54) in the placebo group (p = 0.001). Average % TWL was greater in treatment Group 4.7 ± 4.3 versus placebo Group 1.1 ± 3.6, p = 0.001. Multivariate regression analysis demonstrated that preoperative medication use was significantly associated with greater %TWL (p = 0.004). There was no difference in OR time or post‐operative complications between the groups. Conclusions: Low‐dose phentermine is efficacious and safe for preoperative weight loss in patients undergoing metabolic and bariatric surgery.
Pharmacy workforce: a systematic review of key drivers of pharmacists’ satisfaction and retention
(Informa UK Limited, 2025-02-28) Sallam, Mohammed
Background: Pharmacy workforces are central to healthcare systems, yet the profession faces challenges in job satisfaction and retention due to evolving roles, workload pressures, and other issues. Understanding workforce stability is crucial for optimising pharmacy services. Objective: This systematic review aimed to identify and analyze the critical factors impacting pharmacy staff job satisfaction and retention, providing actionable insights to improve workforce stability and long-term engagement in the profession. Methods: A comprehensive search was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), covering broad academic databases including EMBASE, Web of Science, PubMed, International Pharmaceutical Abstracts, and the supplementary use of Google Scholar for studies published between 2019 and 2024. The quality of the included articles was evaluated, revealing a generally low to moderate risk of bias. Results: The review synthesised findings from 81 studies and extracted ten relevant themes. Countries including the United States, Saudi Arabia, Nigeria, Pakistan, and Southeast Asia countries contributed most frequently, highlighting regional research diversity. Key factors influencing job satisfaction included burnout, stress, and workload (24%); work conditions and roles (22%); professional development (14%); earnings and benefits (10%); and leadership support (9%). Conclusion: With a global perspective that travels across 36 countries in five continents, this study is the latest in-depth analysis of factors influencing job satisfaction in the pharmacy workforce. This review emphasises the need for policy reforms and further research on workplace conditions in different locations. It provides insights for policymakers and healthcare leaders to enhance the pharmacy workforce's strategic support and engagement initiatives.
Emergence of livestock-associated MRSA in the Egyptian Nile Delta that carry the exfoliative toxin gene etA: a case for enhanced surveillance
(2025-07-05) Senok, Abiola
Background: Staphylococcus aureus is a common opportunistic pathogen. Methicillin-resistant strains, MRSA, carry SCCmec elements that include beta-lactam resistance genes mecA/mecC. One globally common lineage, Clonal Complex (CC) 15 failed to evolve MRSA until, in 2016, CC15-MRSA were described from Saudi Arabia that carried a SCCmec V element also comprising the fusidic acid resistance gene, fusC. Henceforth, this strain has spread across Gulf states and Egypt infecting or colonizing both, humans and livestock. Methods: DNA-microarray-based typing was performed on 134 MRSA isolates collected from livestock and farmers in the Nile Delta region of Egypt in 2022. Isolates with conspicuous toxin gene carriage were sequenced applying Oxford Nanopore Technology. Results: Twenty-eight out of 134 isolates were assigned to CC15-MRSA-[V+fusC]. Thus, this strain was the second most common MRSA strain, behind CC88-MRSA-[IV+fusC]. Twenty out of those 28 isolates harboured the gene etA, encoding exfoliative toxin A associated with staphylococcal scalded skin syndrome. Sequencing confirmed the presence of etA on a sufB-integrating prophage. Based on gene content and on electron microscopic morphology after mitomycin C induction, it was assigned to the genus Phietavirus. In addition to SCCmec-borne genes mecA, fusC and aacA-aphD (encoding beta-lactam, fusidic acid and gentamicin/tobramycin resistance), isolates also harboured aadD, lnu(A), tet(K) (for tobramycin, lincosamide and tetracycline resistance) as well as beta-lactamase and cadmium resistance operons on a plasmid. They showed a conspicuous recombination affecting the hsdS/M operon associated with the set/ssl-locus (νSaα). This, and the identity of the composite SCCmec-[V+fusC] element, suggest descent from the etA-negative strain previously observed in Gulf states and Egypt.: Conclusion We describe a novel variant of a CC15 livestock-associated MRSA strain from Egypt. Because of the presence of etA, it might be of increased virulence to humans, especially to new-borns who might also be exposed to contaminated milk. Hence, we urgently recommend surveillance of SSSS/Ritter´s disease in Egypt or in people with relevant travel history.
Content validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in low-, middle-, and high-income countries across 6 continents
(2025-07-05) Baghestani, Ameneh
Background: Investigators from low-, middle-, and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ). The GAC-PAQ is designed to assess physical activity (PA) across all key domains (i.e., school, chores, work/volunteering, transport, free time, outdoor time). It aims to address multiple gaps in global PA surveillance (e.g., omission of important PA domains, insufficient cultural adaptation, underrepresentation of rural areas in questionnaire validation studies). The purpose of this study was to assess the content validity of the GAC-PAQ among PA experts, 8- to 17-year-olds, and one of their parents/ guardians, and to discuss changes made to the questionnaire based on participants’ feedback. Methods: Sixty-two experts in PA measurement and/or surveillance from 24 countries completed an online survey that included both closed- and open-ended questions about the content validity of the GAC-PAQ. The proportion of experts who agreed or strongly agreed with the items was calculated. Child-parent/guardian dyads from 15 countries (n = 250; 10 40 per country) participated in a structured cognitive interview to assess the clarity of the questions and response options, and they were encouraged to provide suggestions to improve clarity and facilitate completion of the questionnaire. Participating countries are: Aotearoa New Zealand, Brazil, Canada, China, Colombia, Czech Republic, India, Malawi, Mexico, Nepal, Nigeria, Spain, Sweden, Thailand, and the United Arab Emirates. Interviews were conducted in 13 different languages and structured by PA domain. Generic images were included to help participants in answering questions about PA intensity. Results: Expert agreement with the items for each domain exceeded 75%, and their qualitative feedback was used to revise the questionnaire before cognitive interviews. In general, participants found the questionnaire to be comprehensive. Adolescents (12 17 years) found it easier than children (8 11 years) to answer the questions. Several children struggled to answer questions about the duration and intensity of activities and/or concepts related to travel modes, active trips, and organized activities. Many parents/guardians were unsure about the frequency, duration, and intensity of their children’s or adolescents’ PA at school and/or recommended using more culturally relevant and appropriate images. Some participants misunderstood the concept of activities that “make you stronger” (intended to assess resistance activities) and/or struggled to differentiate between work, volunteering, and chores. Conclusion: Participants’ feedback was used to develop a revised, simplified, and culturally adapted GAC-PAQ, which will be pilot-tested in all 15 countries in an App that will include country-specific images and narration in local languages. Further research is needed to assess the reliability and validity of the revised GAC-PAQ.
Patient risk factors and outcomes of vasospasm following aneurysmal subarachnoid hemorrhage: A propensity-score matched analysis
(2025-07-09) Sharif, Ahmad
Background: Vasospasm is a serious complication following subarachnoid hemorrhage (SAH) secondary to an aneurysm rupture. It has been associated with poor clinical outcomes and higher healthcare costs; however, the studies have been limited to relatively small institutional samples. We aimed to identify patient risk factors and outcomes associated with vasospasm following an aneurysmal SAH and develop a predictive model for the risk of vasospasm.
The Hawthorne effect on wearable technology: A systematic review
(2025-08) Kellett, Catherine
Introduction: The use of wearable technology has increased over time. Wearable technology can be used to track, measure, and document physical activity, and to assess performance in healthcare. The Hawthorne effect may play an important role in wearable technology, such that awareness of being monitored can influence the behavioural outcomes of interest. The aim of this systematic review was to ascertain the acknowledgement and management of the Hawthorne effect in studies pertaining to wearable technology.
The role of simulation in oncology nursing: A systematic review
(2025-07-07) Jalal, Ayesha
Aim(s): This study aims to evaluate the impact of simulation-based learning on improving clinical skills, decision-making, confidence and critical thinking among nurses in the oncology setting compared with traditional teaching methods.
Incidence and outcome of biliary atresia in the United Arab Emirates: A multicenter national study
(2025-07-01) Almheiri, Mira; Qazi, Abid; Tzivinikos, Christos
Background: While extensive research provides valuable insights into biliary atresia (BA) globally, there remain gaps in region-specific data, such as West Asia. We aim to evaluate the incidence and survival of patients with BA in the United Arab Emirates.
Clinical insights on the complications of TPM use during pregnancy-enabling expectant mothers to make informed choices for their health and the future of their offspring
(2025-07-24) Maideen, Naina Mohamed Pakkir
Background: Topiramate (TPM) is a new-generation, broad-spectrum anti-seizure drug with a unique structure compared to other anti-epileptic medications. It is widely used for epilepsy treatment, migraine prevention, and weight management in overweight or obese individuals. Additionally, it has off-label applications in conditions such as alcohol use disorder, binge eating disorder, and neuropathic pain. TPM exerts its therapeutic effects through multiple mechanisms, including the inhibition of voltage-gated ion channels and the enhancement of GABAergic neurotransmission.
Evaluating Gulf Cooperation Council Trauma Care Infrastructure: A Scoping Review of Key Components and Gaps.
(2025-07-29) Alabboudi, Yousif Habib
Background: Trauma systems are multifaceted frameworks that optimize patient care and outcomes. The development of trauma systems has been a regional priority in the Gulf Cooperation Council (GCC), yet implementation varies across countries. These variations contribute to measurable differences in system performance and patient outcomes. A systematic mapping of these disparities can guide efforts to harmonize standards and enhance trauma-care delivery throughout the region.
Prepubertal to adolescent lupus: Age-related variations in clinical, laboratory, and outcome profiles
(2025-09) Jaber, Samar; Abdulwali, Sameeha
Background: Childhood-onset systemic lupus erythematosus (cSLE) is a heterogeneous autoimmune disease with age-related variations. Older children often exhibit higher disease activity, whereas early-onset cSLE is associated with worse outcomes. However, most existing studies are retrospective and based on single-nation cohorts, yiedling inconsistent findings.ObjectiveTo investigate age-related variations in cSLE subgroups, namely prepubertal, peripubertal, and adolescent-onset cases. Methods: This systematic review, registered in PROSPERO and conducted in accordance with PRISMA guidelines, searched PubMed, the Cochrane Library, and Web of Science for English-language studies pubslished between January 2000- February 2025. Eligible studies examined age-related variations in cSLE diagnosed before 18 years of age. Data were categorized into prepubertal, peri-pubertal, and adolescent-onset groups. Exclusion criteria included case reports, comments, editorials, viewpoint articles, conference abstracts, and incomplete studies. Four reviewers independently screened the articles, with discrepancies resolved by a fifth reviewer. Study quality was assessed using the NHLBI criteria. Results: Of 16,313 studies screened, 13 met the inclusion criteria, comprising a total of 3920 cSLE cases. Among these, 464 (11.8%) were prepubertal, 1943 (49.6%) peripubertal, and 1513 (38.6%) adolescent-onset. The mean age at diagnosis was 5.8 ± 2.3, 9.4 ± 2.5, and 13.9 ± 1.1 years, respectively. The female-to-male ratio was highest in the adolescent-onset group ( = .002). Clinical manifestations showed no significant age-related differences; however, musculoskeletal involvement increased with age, while neuropsychiatric symptoms and fever decreased. Lymphopenia was more frequent in the adolescent-onset group (60% vs 25.6%, = .016). Although disease activity and damage did not differ significantly across age groups, mortality was signficantly higher in the prepubertal group (16.5%) compared to the adolescent-onset group (2.9%) ( = .014). Conclusion: This review underscores both similarities and differences in cSLE across age groups. Prepubertal onset was associated with higher mortality, emphasizing the need for timely diagnosis and early intervention in this subgroup.
Methicillin-Sensitive Staphylococcus aureus Bacteremia With Multiple Lung Abscesses: A Case Without an Apparent Source of Septic Emboli
(2025-07) Prakash, Amog
Staphylococcus aureus is a Gram-positive bacterium implicated in several infections. While the methicillin resistant strains are usually a greater cause for concern, it is imperative to recognize that methicillin sensitive Staphylococcus aureus (MSSA) is capable of causing a wide variety of complications as well. When disseminated MSSA is encountered, workup usually reveals a source for the septic emboli, be it infective endocarditis or septic thrombophlebitis. Here, we present a young gentleman who presented with a facial wound that grew MSSA, who, despite adequate source control, developed disseminated MSSA bacteremia with multiple lung abscesses. Most notably, there were no findings or septic thrombophlebitis, and both transthoracic echocardiogram (TTE) and transesophageal echocardiogram (TEE) revealed no cardiac vegetation.
Demographic associations with attitudes to psychiatry amongst medical and psychology students in the United Arab Emirates: a multi-institution cross-sectional study.
(2025-06-02) Khan, Nusrat
Background: Despite recent improvements in the visibility of mental health, the prevalence of stigma remains high. Exploring the attitudes toward psychiatry among students can provide insight into the future. Currently, there is limited available data about the attitudes toward psychiatry among university students in the United Arab Emirates (UAE). This study aimed to explore the attitudes toward psychiatry among medical and psychology students in the UAE. The country's diverse population allowed us to explore the possibility of cultural and geographical differences in the participants' stated views toward psychiatry.
Molecular signatures of xenograft colorectal cancer in mice treated with topotecan: A mass spectrometry-based study.
(2025-06) Soares, Nelson C
Background: Colorectal cancer (CRC) is one of the most common cancers worldwide, yet it continues to have a low survival rate, largely due to the lack of effective treatments. Metabolomics offers new insight into disease diagnosis and biomarkers discovery. The aim of the study is to identify serum biomarkers in a CRC xenograft mouse model treated with topotecan using advanced metabolomics techniques to enhance our understanding and management of the disease.
Genetic landscape of primary ovarian insufficiency in Bangladeshi women through whole exome sequencing.
(2025-08-15) Nassir, Nasna; Uddin, Mohammed
Background: Primary Ovarian Insufficiency (POI), a significant cause of female infertility, involves premature ovarian dysfunction before the age of 40 and is influenced by genetic predispositions, autoimmune disorders, environmental factors, and metabolic changes. In this study, we employed Whole Exome Sequencing (WES) to explore genetic variations linked to POI in Bangladeshi women.
Feasibility of transpedicular screw placement through the posterior arch of C1: A CT study in the Emirati population
(Elsevier BV, 2025-06) Prithishkumar, Ivan James; Suresh, Dineshwary; Naidoo, Nerissa; AlSharhan, Rashid; Lakshmanan, Jeyaseelan
Background: Instrumentation of the lateral mass of first cervical vertebra (C1) is required in atlantoaxial instability. C1 bears a complicated relationship with adjacent neurovascular structures such as the vertebral artery and cervical spinal cord, which are at risk of injury in a misplaced screw. The objective of this study was to look at the feasibility of transpedicular screw placement into the C1 lateral mass with entry through the posterior arch. Methods: Computed tomography images of the cervical spine in 160 adults (>18 years) who are natives of the United Arab Emirates (UAE) (M = 80; F = 80) were reviewed. Morphometric parameters relevant to pedicle screw fixation via the posterior arch were studied. Results: Mean intraosseous distance from screw entry point in the posterior arch to the anterior cortex of lateral mass following a straight course without any inclination was 28.0 mm in males and 29.0 mm in females, allowing a safe distance of 3.2 mm from the foramen transversarium laterally and 9.0 mm from the vertebral canal medially. A medial inclination of 18◦ in males and 14◦ in females allows for increased bone purchase. Mean height of the pedicle at its junction with lateral mass was 5.6 mm in both sexes. However, the mean height of the posterior arch at the vertebral artery groove was 3.3 ± 0.4 mm in males and 3.1 ± 0.4 mm in females. Conclusion: We recommend placement of 3.5/4.0 mm screws using the notching technique, of length 28–30 mm with a slight medial angulation of 15◦ for increased bone purchase and greater stability of fixation.
Appendicitis Perforated by Endometriosis in a 50-Year-Old Woman: A Case Report
(Springer Science and Business Media LLC, 2025-06-09) Jayakumar, Joanna E
People often experience pain in the lower right side of the abdomen due to appendicitis, which is a frequent issue for both men and women. Every year, numerous appendectomies are performed in the United States. Another condition that affects many women is endometriosis, where tissue similar to the uterine lining appears in other parts of the body, such as the ovaries, fallopian tubes, or abdominal area. In rare situations, it might even be found in the chest. We report a case of a 50-year-old woman presenting with acute right lower quadrant pain, diagnosed with complicated appendicitis. Laparoscopic appendectomy was performed, and histopathology revealed appendiceal endometriosis at the site of perforation. Appendiceal endometriosis remains a rare and often unsuspected cause of appendicitis, posing diagnostic and surgical challenges.
Methicillin-resistant in Saudi Arabia: genomic evidence of recent clonal expansion and plasmid-driven resistance dissemination.
(2025) Senok, Abiola
Objectives: Staphylococcus aureus is a leading cause of hospital-acquired infections worldwide. Over recent decades, methicillin-resistant (MRSA), which is resistant to multiple antimicrobials, has emerged as a significant pathogenic strain in both hospital and community settings. The rapid emergence and dissemination of MRSA clones are driven by a dynamic and evolving population, spreading swiftly across regions on epidemiological time scales. Despite the vast geographical expanse and diverse demographics of the Kingdom of Saudi Arabia and the broader West Asia region, the population diversity of MRSA in hospitals in these areas remains underexplored.

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