Faculty Publications (CoM)

Permanent URI for this collectionhttps://repository.mbru.ac.ae/handle/1/13

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Does fasting increase rates of trauma in Ramadan? A systematic review
(2024-09-15) Kellett, Catherine
Background: As part of their religious obligation, Muslims abstain from food and drink from dawn until dusk for a 30-day period during Ramadan. Fasting may affect daily functioning, such as increased risk of collision for drivers. A study of the impact of fasting during Ramadan on trauma incidence may allow for the creation of public health campaigns targeting this potential phenomenon. We aimed to determine whether trauma incidence increases during Ramadan, and to characterise the trauma occurring during Ramadan. Methods: Both published and unpublished literature, along with conference proceedings and reference lists from the selected studies, were searched up until the 1st of July 2023. A narrative synthesis was conducted, and the included studies were evaluated using appropriate tools based on their study design. Results: Seventeen studies (964,631 subjects) were included. There were methodological concerns pertaining to their low level of evidence and risk of bias. Of nine studies reporting on road traffic accidents (RTAs), six found a higher incidence during Ramadan. Road traffic accidents and occupational injuries (OIs) were more likely to occur near or at sunset (marking the end of the fast). Two studies presented conflicting evidence regarding the effect of fasting in Ramadan on sports-associated injuries. Current evidence suggests that falls and violence-related trauma do not occur more frequently during Ramadan, with insufficient evidence to determine the occurrence of other injury mechanisms. Conclusion: Individuals who fast may be at a higher risk of RTAs and OIs during Ramadan than outside this month. Due to the lack of studies performed in the Americas and Europe, it is unclear whether the findings are applicable to these regions. Current evidence is limited by lack of stratification according to time of trauma occurrence, and high risk of bias.
SpacerPlacer: ancestral reconstruction of CRISPR arrays reveals the evolutionary dynamics of spacer deletions
(2024-10-14) Alkhnbashi, Omer S
Bacteria employ CRISPR-Cas systems for defense by integrating invader-derived sequences, termed spacers, into the CRISPR array, which constitutes an immunity memory. While spacer deletions occur randomly across the array, newly acquired spacers are predominantly integrated at the leader end. Consequently, spacer arrays can be used to derive the chronology of spacer insertions. Reconstruction of ancestral spacer acquisitions and deletions could help unravel the coevolution of phages and bacteria, the evolutionary dynamics in microbiomes, or track pathogens. However, standard reconstruction methods produce misleading results by overlooking insertion order and joint deletions of spacers. Here, we present SpacerPlacer, a maximum likelihood-based ancestral reconstruction approach for CRISPR array evolution. We used SpacerPlacer to reconstruct and investigate ancestral deletion events of 4565 CRISPR arrays, revealing that spacer deletions occur 374 times more frequently than mutations and are regularly deleted jointly, with an average of 2.7 spacers. Surprisingly, we observed a decrease in the spacer deletion frequency towards both ends of the reconstructed arrays. While the resulting trailer-end conservation is commonly observed, a reduced deletion frequency is now also detectable towards the variable leader end. Finally, our results point to the hypothesis that frequent loss of recently acquired spacers may provide a selective advantage.
Drugs in focus: Botulinum toxin in the therapy of gastrointestinal disorders in children
(2024-12) Tzivinikos, Christos
What is Known: Botulinum toxin (BoNT) causes muscle relaxation by inhibiting acetylcholine release from presynaptic motor neurons at the neuromuscular junction. What is New: In children with achalasia, BoNT can be considered only in patients in whom rapid weight gain is important to improve surgical outcomes. BoNT has been suggested for treating cricopharyngeal achalasia and delayed gastric emptying. Anal achalasia and constipation after Hirschsprung disease corrective surgery are very promising indications for BoNT use. In selected children with resistant type of functional constipation and chronic anal fissure, BoNT is a viable option for treating.
Improving National and International Surveillance of Movement Behaviours in Childhood and Adolescence: An International Modified Delphi Study.
(2024-10-03) Loney, Tom
Background: The actions required to achieve higher-quality and harmonised global surveillance of child and adolescent movement behaviours (physical activity, sedentary behaviour including screen time, sleep) are unclear.
Targeting PAR2-mediated inflammation in osteoarthritis: a comprehensive in vitro evaluation of oleocanthal's potential as a functional food intervention for chondrocyte protection and anti-inflammatory effects.
(2024-10-01) Patnaik, Rajashree; Varghese, Riah; Jannati, Shirin; Naidoo, Nerissa; Banerjee, Yajnavalka
Background: Osteoarthritis (OA) is a prevalent degenerative joint disease characterized by chronic inflammation and progressive cartilage degradation, ultimately leading to joint dysfunction and disability. Oleocanthal (OC), a bioactive phenolic compound derived from extra virgin olive oil, has garnered significant attention due to its potent anti-inflammatory properties, which are comparable to those of non-steroidal anti-inflammatory drugs (NSAIDs). This study pioneers the investigation into the effects of OC on the Protease-Activated Receptor-2 (PAR-2) mediated inflammatory pathway in OA, aiming to validate its efficacy as a functional food-based therapeutic intervention.
Triglyceride-glucose index (TyG) as a novel biomarker in the era of cardiometabolic medicine.
(2025-01-01) Rizzo, Manfredi
In the period of increasing prevalence of metabolic disorders such as obesity and diabetes, healthcare professionals are facing significant challenges. Therefore, an accurate global assessment of insulin resistance is of utmost importance. Current medical research is focused on identifying an easily accessible and reproducible gold-standard surrogate marker for insulin resistance. Ideally, such a marker would enable healthcare providers to predict the risk of type 2 diabetes and cardiovascular diseases. The triglyceride-glucose index (TyG) is a promising marker for preventive cardiology and cardiometabolic medicine. This narrative review article aims to provide a comprehensive evaluation of the credibility of TyG as a surrogate marker of insulin resistance among patients at different stages across the cardiometabolic continuum. This assessment fully complies with evidence-based medicine and offers valuable insight into the clinical utility of TyG.
Genomic insights from a deeply phenotyped highly consanguineous neurodevelopmental disorders cohort.
(2024-09-26) Mohamed, Nesrin; Satsangi, Dharana; Hanif, Shehzad; Tambi, Richa; Nassir, Nasna; Uddin, Mohammed
Purpose: The genetic underpinning of neurodevelopmental disorders (NDDs) in diverse ethnic populations, especially those with high rates of consanguinity, remains largely unexplored. Here, we aim to elucidate genomic insight from 576 well-phenotyped and highly consanguineous (16%) NDD cohort.
Pathogenic mechanisms, diagnostic, and therapeutic potential of microvesicles in diabetes and its complications.
(2024-11) Giordo, Roberta
Extracellular vesicles (EVs), particularly microvesicles (MVs), have gained significant attention for their role as mediators of intercellular communication in both physiological and pathological contexts, including diabetes mellitus (DM) and its complications. This review provides a comprehensive analysis of the emerging roles of MVs in the pathogenesis of diabetes and associated complications such as nephropathy, retinopathy, cardiomyopathy, and neuropathy. MVs, through their cargo of proteins, lipids, mRNAs, and miRNAs, regulate critical processes like inflammation, oxidative stress, immune responses, and tissue remodeling, all of which contribute to the progression of diabetes and its complications. We examine the molecular mechanisms underlying MVs' involvement in these pathological processes and discuss their potential as biomarkers and therapeutic tools, particularly for drug delivery. Despite promising evidence, challenges remain in isolating and characterizing MVs, understanding their molecular mechanisms, and validating them for clinical use. Advanced techniques such as single-cell RNA sequencing and proteomics are required to gain deeper insights. Improved isolation and purification methods are essential for translating MVs into clinical applications, with potential to develop novel diagnostic and therapeutic strategies to improve patient outcomes in diabetes.
Non-coding RNAs in meningitis: Key regulators of immune response and inflammation.
(2024-11) Alfaresi, Mubarak
Non-coding RNAs (ncRNAs) contain circular RNAs (circRNAs), long non-coding RNAs (lncRNAs), and micro-ribonucleic acids (miRNAs). These RNAs receive good functionality in modulation of gene expressions & cellular roles. Recent research is shedding light on their pivotal roles in the pathophysiology of inflammatory meningitis, such as viral, fungal, or bacterial infections. This review addresses the intricate roles of non-coding RNAs (ncRNAs) that transcribe code-independent mRNA and other biological elements that control inflammation and immunological events extant during meningitis. ncRNAs, acting on a myriad of immune cell development, cytokine production, pathogen recognition, and so forth, finely orchestrate the host's immune response. Although lncRNAs and circRNAs are associated with gene networks regulating immune responses, miRNAs can precisely modulate the expression of pro- and anti-inflammatory cytokines. Moreover, ncRNAs have unique expression patterns in disease states and are stable in bio-fluids; therefore, they can serve as specific molecular biomarkers for meningitis concerning the diagnosis and prognosis. It might also be helpful to target ncRNAs as a therapeutic strategy to impact immune regulation and inflammation. Here, we review the current knowledge of how ncRNAs function in meningitis and discuss adopted approaches and perspectives and their implications for therapeutic strategies.
Monitoring the liver as a part of the cardio-renal-metabolic continuum - What is cooking and burning with non-invasive tests and treatment options?
(2024-12) Rizzo, Manfredi
The implications of steatotic liver dysfunction in the cardio-renal-metabolic continuum have been progressively recognized. The performance of non-invasive tests (NIT) for drug introduction and intervention monitoring remains an unmet clinical need. A call for debate and the rationale for NITs to be further improved for applications in clinical practice.
Utilization of tissue-free minimal residual disease testing in colorectal cancer patients from Asia and Middle East.
(2024) Dawood, Shaheenah
Introduction: The presence of minimal residual disease (MRD) after curative-intent surgery for early-stage cancers is associated with disease recurrence. Circulating tumour deoxyribonucleic acid (ctDNA) has emerged as a promising biomarker for MRD assessment in patients with colorectal cancer (CRC) who have undergone surgery or completed adjuvant therapy. MRD tests are already available for use in clinics; however, treatment decisions following MRD results obtained in routine practice are infrequently described.
Combinational regenerative inductive effect of bio-adhesive hybrid hydrogels conjugated with hiPSC-derived myofibers and its derived EVs for volumetric muscle regeneration
(Elsevier BV, 2025-01) Nasr, Mahmoud Lotfi
In regenerative medicine, extracellular vesicles (EVs) possess the potential to repair injured cells by delivering modulatory factors. However, the therapeutic effect of EVs in large-scale tissue defects, which are subject to prolonged timelines for tissue architecture and functional restoration, remains poorly understood. In this study, we introduce EVs and cell-tethering hybrid hydrogels composed of tyramine-conjugated gelatin (GelTA) that can be in-situ crosslinked with EVs derived from human induced pluripotent stem cell-derived myofibers (hiPSC-myofibers) and hiPSC-muscle precursor cells. This hybrid hydrogel sustains the release of EVs and provides a beneficial nano-topography and mechanical properties for creating a favorable extracellular matrix. Secreted EVs from the hiPSC-myofibers contain specific microRNAs, potentially improving myogenesis and angiogenesis. Herein, we demonstrate increased myogenic markers and fusion/differentiation indexes through the combinatory effects of EVs and integrin-mediated adhesions in the 3D matrix. Furthermore, we observe a unique impact of EVs, which aid in maintaining the viability and phenotype of myofibers under harsh environments. The hybrid hydrogel in-situ crosslinked with hiPSCs and EVs is facilely used to fabricate large-scale muscle constructs by the stacking of micro-patterned hydrogel domains. Later, we confirmed a combinational effect, whereby muscle tissue regeneration and functional restoration were improved, via an in vivo murine volumetric muscle loss model.
Empowering patients: how accurate and readable are large language models in renal cancer education.
(2024) Hasan, Mudhar N
Background: The incorporation of Artificial Intelligence (AI) into healthcare sector has fundamentally transformed patient care paradigms, particularly through the creation of patient education materials (PEMs) tailored to individual needs. This Study aims to assess the precision and readability AI-generated information on kidney cancer using ChatGPT 4.0, Gemini AI, and Perplexity AI., comparing these outputs to PEMs provided by the American Urological Association (AUA) and the European Association of Urology (EAU). The objective is to guide physicians in directing patients to accurate and understandable resources.
Post-Meningitic Syndrome: Pathophysiology and Consequences of Streptococcal Infections on the Central Nervous System.
(2024-10-15) Kaddoura, Rachid; Abdalbari, Karim; Badla, Beshr Abdulaziz; Hijleh, Amin Abu; Hanifa, Mohamed; AlAshkar, Masa; Asbaita, Mohamed; Othman, Deema; Faraji, Hanan; AlBakri, Orjwan; Tahlak, Sara; Hijleh, Amir Abu; Kabbani, Raneem; Resen, Murtadha; Du Plessis, Stefan S; Omolaoye, Temidayo S
Streptococcus species represent a significant global cause of meningitis, leading to brain damage through bacterial virulence factors and the host inflammatory response. Upon entering the central nervous system (CNS), excessive inflammation leads to various neurological and psychological complications. This review explores the pathophysiological mechanisms and associated outcomes of streptococcal meningitis, particularly its short- and long-term neurological sequelae. Neurological symptoms, such as cognitive impairment, motor deficits, and sensory loss, are shown to vary in severity, with children being particularly susceptible to lasting complications. Among survivors, hearing loss, cognitive decline, and cranial nerve palsies emerge as the most frequently reported complications. The findings highlight the need for timely intervention, including neurorehabilitation strategies that focus on optimizing recovery and mitigating long-term disabilities. Future recommendations emphasize improving early diagnosis, expanding vaccine access, and personalizing rehabilitation protocols to enhance patient outcomes. As a novel contribution, this review proposes the term "post-meningitic syndrome" to showcase the broad spectrum of CNS complications that persist following streptococcal meningitis, providing a framework for a future clinical and research focus.
Beyond the filter: Impact of popularity on the mental health of social media influencers.
(2024) Azayem, Ala'a K; Jeyaseelan, Lakshmanan; Kair, Hawk M; Sultan, Meshal A
Objective: This study examines the emotional state and interpersonal relationships of social media influencers, focusing on the psychological effects of their popularity and engagement. Despite increased awareness of mental health issues, influencers remain underrepresented in research. Barriers such as low mental health literacy, stigma, access issues, and the pressure to maintain virtual personas highlight the need for this investigation. This research addresses these gaps by systematically examining the impact of social media on influencers' mental health.
Exploring the impact of stimulant medications on weight in children with attention deficit hyperactivity disorder in Dubai, United Arab Emirates.
(2024) Al Eid, Faten; Albanna, Ammar; Joseph, Jessie; Talo, Sami; Jeyaseelan, Lakshmanan; Sultan, Meshal A
Objective: Attention deficit hyperactivity disorder (ADHD), prevalent in 5% of children worldwide, impacts academic performance and often coexists with psychiatric disorders. Psychostimulant medications are primary treatments for ADHD, enhancing dopamine to reduce symptoms. However, dopamine increase may cause appetite loss. This pioneering study in the United Arab Emirates (UAE) explores psychostimulant effects on weight in children diagnosed with ADHD, aiming to uncover unique regional characteristics and contributing factors to weight changes.
Abortive and Prophylactic Therapies to Treat Migraine in Pregnancy: A Review
(2024-10) Ibrahim, Mohammed O
Migraine is a common issue during pregnancy, often affected by hormonal changes. More than half of the women affected by migraine experience improvement in or remission of migraine symptoms, particularly during the second and third trimesters, with those having menstrual migraines or migraines without aura benefiting the most. However, a small percentage of women may see a worsening of their migraines, especially those with migraine with aura, and some may even develop migraines for the first time during pregnancy, often in the first trimester. Postpartum, many women experience a recurrence of migraines, likely due to the drop in estradiol and endorphin levels. A literature search was performed in PubMed for articles published from 2013 through 2023, and 80 out of 362 publications were included. When it comes to managing pregnant women with migraine, non-pharmacological treatments are preferred, including lifestyle modifications and avoiding known triggers. When medication is necessary, acetaminophen is the first-line treatment, with nonsteroidal anti-inflammatory drugs and triptans regarded as secondary options, though trimester-specific risks limit their use. Preventive treatments, if required, may include low doses of β-blockers or amitriptyline but should be used cautiously. This article aims to provide a concise overview of the existing research on the acute and prophylactic use of medications to treat migraines in pregnant and lactating women. Furthermore, it presents recommendations for healthcare professionals managing pregnant females presenting with migraine in clinical settings.
Biopsychosocial Impact of Multiple Sclerosis in Omani Patients: A Multicenter Comparative Study.
(2024-10-22) Jeyaseelan, Lakshmanan
Multiple sclerosis (MS) is a chronic neurological disorder characterized by various clinical presentations and manifestations that include biopsychosocial impediments. This study has three interrelated goals relevant to biopsychosocial functioning: (i) compare reasoning ability, neuropsychological functioning, affective range, and quality of life (QoL) between people with multiple sclerosis (PwMS) and healthy controls; (ii) explore gender differences in reasoning ability and neuropsychological functioning, affective symptoms, and QoL among PwMS; and (iii) examine the relationship between QoL and cognitive performance in PwMS, focusing on those with inadequate vs. adequate QoL. : This multicenter study was carried out among clinically stable PwMS (no relapse in the last two months) at follow-up in two tertiary care units in urban Oman. Healthy controls, matched for age and sex, were also recruited as a comparison group. Data were collected using cognitive batteries sensitive to current reasoning ability and conventional neuropsychological batteries designed to measure verbal learning, visual-spatial ability, and processing speed. The affective range (anxiety and depressive symptoms) and quality of life (QoL) were also evaluated. : The PwMS group scored lower on current reasoning ability, verbal learning, visual-spatial ability, and processing speed compared to the control group. The incidence of anxiety was higher in the PwMS group, but there were no statistically significant differences in depressive symptoms. No significant differences were found in cognitive variables between the two sexes, except in visual-spatial ability, where women outperformed men. PwMS with low QoL scored lower on attention and concentration indices than those with adequate QoL. According to QoL, no significant differences were observed in reasoning, verbal learning, or visual-spatial ability. : The present sentinel study suggests that the Omani cohort with MS tends to have lower indices of current reasoning ability, visual and spatial memory, and cognitive speed compared to control subjects. Gender differences are minimal, except for visual-spatial abilities, where women outperform men. Quality of life significantly affects cognitive functioning. In general, the biopsychosocial impediment appears to be significant, indicating the need for comprehensive evaluation and care in the management of MS.
Successful Treatment of a Rare Complication of Varicella Pneumonitis in an Immunocompromised 11-Year-Old Child Using Pooled Intravenous Immunoglobulin
(Springer Science and Business Media LLC, 2024-10-16) Saeed, Ahsan A
Varicella-zoster virus, or herpes zoster virus, is a human alphaherpesvirus. It causes varicella (chicken pox) and herpes zoster (shingles). Though a relatively common and benign childhood illness, it can lead to severe disseminated infections in immunocompromised patients. Varicella pneumonitis is a common complication of varicella found in adults but is rare in children. As such, we present a rare case of an 11-year-old immunosuppressed male on methotrexate who developed a disseminated varicella infection resulting in pneumonia. Methotrexate is not known to cause immunosuppression, as compared to infliximab, which is similarly indicated for rheumatoid autoimmune conditions. He was treated with high-dose acyclovir and pooled intravenous immunoglobulin (IVIG). Due to the efficacy of high-dose acyclovir in immunocompromised patients with varicella-zoster and modern preparations of IVIG containing high titers of zoster immunoglobulins, the treatment allowed the patient to recover fully.
Retinal blood vessel diameter changes with 60-day head-down bedrest are unaffected by antioxidant nutritional cocktail.
(2024-11-15) Goswami, Nandu
Long-term human spaceflight can lead to cardiovascular deconditioning, but little is known about how weightlessness affects microcirculation. In this study, we examined how the retinal microvessels and cerebrovascular regulation of 19 healthy male participants responded to long-term head-down bedrest (HDBR), an earth-based analog for weightlessness. In addition, we examined whether an anti-inflammatory/antioxidant cocktail could prevent the vascular changes caused by HDBR. In all study participants, we found a decrease in retinal arteriolar diameter by HDBR day 8 and an increase in retinal venular diameter by HDBR day 16. Concurrently, blood pressure at the level of the middle cerebral artery and the cerebrovascular resistance index were higher during HDBR, while cerebral blood flow velocity was lower. None of these changes were reversed in participants receiving the anti-inflammatory/antioxidant cocktail, indicating that this cocktail was insufficient to restore the microvascular and cerebral blood flow changes induced by HDBR.

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