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DelFavero JJ, Jnah AJ, Newberry D. Glucose-6-Phosphate Dehydrogenase Deficiency and the Benefits of Early Screening. Neonatal Netw 2021; 39:270-282. [PMID: 32879043 DOI: 10.1891/0730-0832.39.5.270] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2020] [Indexed: 11/25/2022]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency, the most common enzymopathy worldwide, is an insufficient amount of the G6PD enzyme, which is vital to the protection of the erythrocyte. Deficient enzyme levels lead to oxidative damage, hemolysis, and resultant severe hyperbilirubinemia. If not promptly recognized and treated, G6PD deficiency can potentially lead to bilirubin-induced neurologic dysfunction, acute bilirubin encephalopathy, and kernicterus. Glucose-6-phosphate dehydrogenase deficiency is one of the three most common causes for pathologic hyperbilirubinemia. A change in migration patterns and intercultural marriages have created an increased incidence of G6PD deficiency in the United States. Currently, there is no universally mandated metabolic screening or clinical risk assessment tool for G6PD deficiency in the United States. Mandatory universal screening for G6PD deficiency, which includes surveillance and hospital-based risk assessment tools, can identify the at-risk infant and foster early identification, diagnosis, and treatment to eliminate neurotoxicity.
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Al-Jawaldeh A, Taktouk M, Doggui R, Abdollahi Z, Achakzai B, Aguenaou H, Al-Halaika M, Almamary S, Barham R, Coulibaly-Zerbo F, Ammari LE, Elati J, Nishtar NA, Omidvar N, Shams MQ, Qureshi AB, Nasreddine L. Are Countries of the Eastern Mediterranean Region on Track towards Meeting the World Health Assembly Target for Anemia? A Review of Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052449. [PMID: 33801513 PMCID: PMC7967583 DOI: 10.3390/ijerph18052449] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 02/19/2021] [Accepted: 02/21/2021] [Indexed: 11/16/2022]
Abstract
Anemia is a multifactorial condition, with a complex etiology that involves nutritional and non-nutritional factors. The misconception that iron deficiency is equivalent to anemia may mask the need to address other potential causative factors. This review paper aims to (1) assess the burden of anemia vs. iron deficiency anemia (IDA) amongst women of reproductive age (WRA), pregnant women (PW), and children under five years old (underfive children, U5C) in the Eastern Mediterranean region (EMR); (2) evaluate trends in anemia prevalence and whether countries are on track towards meeting the World Health Assembly (WHA) target for 2025; and (3) characterize anemia reduction efforts and provide a road map for future programs. A search of pertinent literature and databases was conducted. Anemia prevalence in the EMR ranged between 22.6% and 63% amongst PW, 27% and 69.6% amongst WRA, and 23.8% and 83.5% amongst U5C. Data showed that the EMR is not on course towards meeting the WHA target. The contribution of IDA to anemia was found to be less than half. Other potential contributors to anemia in the region were identified, including micronutrient deficiencies, parasitic infestations, and poor sanitation. A framework of action was proposed as a roadmap to meet the targets set by the WHA.
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Affiliation(s)
- Ayoub Al-Jawaldeh
- Regional Office for the Eastern Mediterranean (EMRO), World Health Organization (WHO), Cairo 7608, Egypt;
| | - Mandy Taktouk
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
| | - Radhouene Doggui
- Family Medicine Department, Université de Sherbrooke, Sherbrooke, QC J1K 2R1, Canada;
- Medical Research Department, Centre de Formation Médicale du Nouveau-Brunswick, Moncton, NB E1A 7R1, Canada
| | - Zahra Abdollahi
- General of Nutrition Department, Ministry of Health and Medical Education, Tehran 15655-415, Iran;
| | - Baseer Achakzai
- Nutrition/Regulations, Ministry of Health, Islamabad 56000, Pakistan;
| | - Hassan Aguenaou
- Joint Research Unit in Nutrition and Food, RDC-Nutrition AFRA/IAEA, Ibn Tofaïl University-CNESTEN, Rabat-Kénitra, Rabat-Kénitra 242, Morocco;
| | | | | | - Rawhieh Barham
- Nutrition Department, Ministry of Health, Amman 11118, Jordan;
| | | | - Laila El Ammari
- Nutrition Department, Ministry of Health, Rabat 335, Morocco;
| | - Jalila Elati
- SURVEN (Nutrition Surveillance and Epidemiology in Tunisia) Research Laboratory, INNTA (National Institute of Nutrition and Food Technology), Tunis 1007, Tunisia;
| | | | - Nasrin Omidvar
- Community Nutrition Department, National Nutrition and Food Technology Research Institute, Faculty of Nutrition Sciences and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran 19395-4741, Iran;
| | - Mohammad Qasem Shams
- Nutrition Department, World Health Organization (WHO), Kabul, Jalalabad Road Pul-e-Charkhi Kabul, Afghanistan;
| | | | - Lara Nasreddine
- Nutrition and Food Sciences Department, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11-0236, Lebanon;
- Correspondence: ; Tel.: +961-1-350000 (ext. 4547)
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Khan AM, Al-Sulaiti AM, Younes S, Yassin M, Zayed H. The spectrum of beta-thalassemia mutations in the 22 Arab countries: a systematic review. Expert Rev Hematol 2020; 14:109-122. [PMID: 33317346 DOI: 10.1080/17474086.2021.1860003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVES To investigate the mutational spectrum in the HBB gene in Arab patients with β-thal. METHODS Authors searched five databases (PubMed, Science Direct, Scopus, Web of Science, and Google Scholar) from the time of inception until March 2020. RESULTS The authors search strategy yielded 3,229 citations, of which 48 eligible studies captured. 105 mutations were captured, of these, 99 were shared between Arabs and other ethnic groups, six mutations were unique to Arabs (c.92 + 2 T > G, c.-240 G > A, c.150delC, c.420dupT, deletion of 192 bp spanning exon 1, intron 1, and the first two bases of exon 2 of HBB gene, and deletion of 9.6 kb, including exon 1 and intron 2 of HBB gene). The most common HBB gene mutations among Arabs were c.93-21 G > A, c.118 C > T, c.92 + 1 G > A, c.92 + 6 T > C, c.92 + 5 G > C, c.315 + 1 G > A, and c.27dupG. Consanguinity is high among Arab patients with β-thal. Migration into Arab countries led to allelic heterogeneity among Arab patients with β-thal. CONCLUSION Our findings present a platform for further genetic epidemiological studies for Arab patients with β-thal.
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Affiliation(s)
- Aisha Moeen Khan
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University , Doha, Qatar
| | - Asma Mohammed Al-Sulaiti
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University , Doha, Qatar
| | - Salma Younes
- Translational Research Institute, Women's Wellness and Research Center, Hamad Medical Corporation , Qatar
| | - Mohamed Yassin
- Department of Hematology and BMT, National Center for Cancer Care and Research, Hamad Medical Corporation , Doha, Qatar
| | - Hatem Zayed
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University , Doha, Qatar
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Abstract
OBJECTIVES The emergency department is considered the backbone of the medical service offered in any hospital. Yet, the data on the frequency of pediatric hematological presentation is scanty. Anemia occurs in 9% to 14% of pediatric emergency department (ED) patients. Glucose-6-phosphate dehydrogenase (G6PD) deficiency affects more than 400 million people worldwide. Unfortunately, we do not have screening program for G6PD deficiency in Egypt. The aim of this study is to assess the burden of hemolytic crisis among Egyptian children visiting ED. METHODS This is a prospective cross-sectional study among children presenting with acute hemolytic crisis in the ED of New Children Hospital, Cairo University from March to June 2016. Cases underwent full history taking, clinical examination, and laboratory tests based on clinical judgment of the resident. We categorized the presenting hemolytic anemias into 3 groups: G6PD deficiency, acute hemolysis in previously diagnosed patients with chronic hemolytic anemia, and acute undiagnosed hemolytic anemia. RESULTS Our study included 143 patients, 109 males (76.22%) and 34 females (23.76%), with a mean age 36 months (range, 3-188 months), who presented with hemolytic anemia in the ED. Seventy-six cases (53.1%) were diagnosed as G6PD deficiency, 36 (25.2%) were diagnosed as chronic hemolytic anemia, and 31 (21.7%) were diagnosed as undiagnosed acute hemolytic anemia. CONCLUSIONS Hemolytic anemia is very common presentation in ED. G6PD deficiency is the most common cause, representing 53.1% of the hemolytic anemia.
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Al Sarraj Y, Nair SC, Al Siraj A, AlShayeb M. Characteristics of salivary gland tumours in the United Arab Emirates. Ecancermedicalscience 2015; 9:583. [PMID: 26557881 PMCID: PMC4631580 DOI: 10.3332/ecancer.2015.583] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2015] [Indexed: 01/12/2023] Open
Abstract
Salivary gland tumours (SGT) are relatively rare cancers characterised by striking morphological diversity and wide variation in the global distribution of SGT incidence. Given the proximity to the head and neck structures, management of SGT has been clinically difficult. To the best of our knowledge, there are no epidemiological studies on SGT from the United Arab Emirates (UAE) or the Gulf Cooperation Council Countries (GCC). Patient charts (N = 314) and associated pathological records were systematically reviewed between the years 1998–2014. Predominance of benign (74%) compared with malignant (26%) SGT was observed. Among the 83 malignant SGT identified, frequency was higher in males (61%) than in females (39%) and peak occurrence was in the fifth decade of life. Mucoepidermoid carcinoma was the most common type of tumour (35%) followed by adenoid cystic carcinoma (18.1%) and acinar cell carcinoma (10.8%). A similar pattern of tumour distribution was seen in patients from GCC, Asian, and Middle East countries. This is the first report to address the distribution of salivary gland tumours in a multiethnic, multicultural population of the Gulf. The results suggest that the development of an SGT registry will help clinicians and researchers to better understand, manage, and treat this rare disease.
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Affiliation(s)
- Yasir Al Sarraj
- Ajman University of Science and Technology, Department of Oral and Maxillofacial Surgery, Post Box 346, United Arab Emirates
| | - Satish Chandrasekhar Nair
- Tawam Hospital- Johns Hopkins Medicine International Affiliate, Department of Academic Affairs-Medical Research, Post Box 15258, Al Ain, United Arab Emirates
| | - Ammar Al Siraj
- Mawi Medical Centre, Post Box 55510, Dubai, United Arab Emirates
| | - Maher AlShayeb
- Ajman University of Science and Technology, Department of Oral and Maxillofacial Surgery, Post Box 346, United Arab Emirates
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Puig A, Dighe AS. Case records of the Massachusetts General Hospital. Case 20-2013. A 29-year-old man with anemia and jaundice. N Engl J Med 2013; 368:2502-9. [PMID: 23802518 DOI: 10.1056/nejmcpc1302333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Alberto Puig
- Department of Medicine, Massachusetts General Hospital, Boston, USA
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Nair SC, Ibrahim H, Celentano DD. Clinical trials in the Middle East and North Africa (MENA) Region: grandstanding or grandeur? Contemp Clin Trials 2013; 36:704-10. [PMID: 23712082 DOI: 10.1016/j.cct.2013.05.009] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/09/2013] [Accepted: 05/17/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Nearly 31% of the world's clinical trials are conducted outside the US and 25% of the new drug applications include data from international sites. The high population growth, demand for medication, increased prevalence of life-style related and rare genetic diseases in the MENA countries should be associated with a consequent scale-up of clinical trials in these countries. However, the region sponsors under 1% of global clinical trials. METHODS Determinants including the regulatory environment, patient protection, physician-preparedness, types of diseases, costs of trials and pace of subject recruitment, were analyzed to identify critical factors that influence barriers to the conduct clinical trials in MENA. RESULTS Strategic planning by the CRO can help overcome challenges related to regulatory and oversight requirements. Barriers related to trial quality and subject protection can be mitigated by risk-based monitoring. Growing healthcare infrastructure and communication technologies provide clear advantages for subject recruitment. Low operating costs combined with the increase in pharmaceutical sales provide incentives for the future conduct of clinical trials. LIMITATIONS Although the opportunities and challenges cited are common to the MENA region, further studies are needed to assess other potential contributing variables for the conduct of clinical trials specific to each MENA country. CONCLUSION Challenges in drug importation and site oversight can be overcome with systematic interventions. Social media network and community awareness programs can assist reductions in barriers in obtaining effective informed consents. Increasing pharmaceutical sales, population growth, high prevalence of genetic and life-style related diseases and reduced clinical trial development costs offer expanding opportunities for future clinical trials in MENA.
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Affiliation(s)
- Satish Chandrasekhar Nair
- Department of Academic Affairs, Medical Affairs, Tawam Hospital, Post Box 15258, Al Ain United Arab Emirates.
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Marar T. Amelioration of glucose induced hemolysis of human erythrocytes by vitamin E. Chem Biol Interact 2011; 193:149-53. [PMID: 21736874 DOI: 10.1016/j.cbi.2011.06.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 06/14/2011] [Accepted: 06/16/2011] [Indexed: 01/16/2023]
Abstract
Cells under aerobic condition are always threatened with the insult of reactive oxygen species, which are efficiently taken care of by the highly powerful antioxidant systems of the cell. The erythrocytes (RBCs) are constantly exposed to oxygen and oxidative stress but their metabolic activity is capable of reversing the injury under normal conditions. In vitro hemolysis of RBCs induced by 5, 10 and 20mM glucose was used as a model to study the free radical induced damage of biological membranes in hyperglycemic conditions and the protection rendered by vitamin E on the same. RBCs are susceptible to oxidative damage, peroxidation of the membrane lipids, release of hemoglobin (hemolysis) and alteration in activity of antioxidant enzymes catalase and superoxide dismutase. The glucose induced oxidative stress and the protective effect of vitamin E on cellular membrane of human RBCs manifested as inhibition of membrane peroxidation and protein oxidation and restoration of activities of superoxide dismutase and catalase, was investigated. Thiobarbituric acid reactive substances are generated from decomposition of lipid peroxides and their determination gives a reliable estimate of the amount of lipid peroxides present in the membrane. Vitamin E at 18 μg/ml (normal serum level) strongly enhanced the RBC resistance to oxidative lysis leading to only 50-55% hemolysis in 24h, whereas RBCs treated with 10 and 20mM glucose without vitamin E leads to 70-80% hemolysis in 24h. Levels of enzymic antioxidants catalase, superoxide dismutase and nonenzymic antioxidants glutathione showed restoration to normal levels in presence of vitamin E. The study shows that vitamin E can protect the erythrocyte membrane exposed to hyperglycemic conditions and so a superior antioxidant status of a diabetic patient may be helpful in retarding the progressive tissue damage seen in chronic diabetic patients.
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Affiliation(s)
- Thankamani Marar
- Patil University, Department of Biotechnology and Bioinformatics, Navi Mumbai, Maharashtra, India.
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Bouchlaka C, Abdelhak S, Amouri A, Ben Abid H, Hadiji S, Frikha M, Ben Othman T, Amri F, Ayadi H, Hachicha M, Rebaï A, Saad A, Dellagi K. Fanconi anemia in Tunisia: high prevalence of group A and identification of new FANCA mutations. J Hum Genet 2003; 48:352-61. [PMID: 12827451 DOI: 10.1007/s10038-003-0037-z] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2003] [Accepted: 04/19/2003] [Indexed: 10/26/2022]
Abstract
Fanconi anemia (FA) is a rare autosomal recessive disease characterized by progressive pancytopenia, congenital malformations, and predisposition to acute myeloid leukemia. Fanconi anemia is genetically heterogeneous, with at least eight distinct complementation groups of FA (A, B, C, D1, D2, E, F, and G) having been defined by somatic cell fusion studies. Six genes (FANCA, FANCC, FANCD2, FANCE, FANCG, and FANCF) have been cloned. Mutations of the seventh Fanconi anemia gene, BRCA2, have been shown to lead to FAD1 and probably FAB groups. In order to characterize the molecular defects underlying FA in Tunisia, 39 families were genotyped with microsatellite markers linked to known FA gene. Haplotype analysis and homozygosity mapping assigned 43 patients belonging to 34 families to the FAA group, whereas one family was probably not linked to the FANCA gene or to any known FA genes. For patients belonging to the FAA group, screening for mutations revealed four novel mutations: two small homozygous deletions 1693delT and 1751-1754del, which occurred in exon 17 and exon 19, respectively, and two transitions, viz., 513G-->A in exon 5 and A-->G at position 166 (IVS24+166A-->G) of intron 24. Two new polymorphisms were also identified in intron 24 (IVS24-5G/A and IVS24-6C/G).
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Affiliation(s)
- Chiraz Bouchlaka
- Laboratoire d'Immunologie, Vaccinologie et Génétique Moléculaire, Institut Pasteur de Tunis, BP 74, 13 Place Pasteur, 1002 Tunis Belvédère, Tunisia
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Derossi SS, Raghavendra S. Anemia. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2003; 95:131-41. [PMID: 12582350 DOI: 10.1067/moe.2003.13] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Scott S Derossi
- University of Pennsylvania School of Dental Medicine, Pennsylvania, USA
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