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Albgami MH, Alzahrani AS, Alghamdi AM, Alamri NS, Alghamdi AH, Alsuwat RA. Prevalence and Determinants Influencing the Use of Electronic Cigarette Smoking in Male Students of Taif University. Cureus 2023; 15:e40885. [PMID: 37492804 PMCID: PMC10364074 DOI: 10.7759/cureus.40885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND AND AIM Electronic cigarette (e-cigarette) smoking is a significant public health problem in Saudi Arabia, particularly among youth who use it as an alternative to traditional cigarettes. This study aimed to evaluate the prevalence and beliefs towards e-cigarette use among Taif University students in Saudi Arabia. METHODS A cross-sectional study was conducted among male Taif University students using a self-administered questionnaire. A sample of 319 students was selected through stratified sampling. The questionnaire included questions about socio-demographic characteristics, smoking history, awareness of e-cigarettes, prevalence of e-cigarette use, beliefs towards e-cigarettes, and reasons for e-cigarette use. RESULTS The study revealed a high prevalence of e-cigarette use among Taif University students, with 40.1% of participants having used e-cigarettes at least once during their lifetime and 43.7% believing that e-cigarettes are less dangerous than traditional cigarettes. Participants studying sciences had 0.76 times the odds of believing that e-cigarettes help smokers to quit compared to participants studying literature. Compared to smokers, ex-smokers had an OR of 34.1 (p<0.001) and non-smokers had an OR of 35.9 (p<0.001) for experimentation of e-cigarettes. Smokers who had friends that tried e-cigarettes had an OR of 6.6 (p<0.001) for trying e-cigarettes, compared to smokers who did not have such friends. CONCLUSION The study found that 40.1% of participants have used e-cigarettes at least once during their lifetime with a significant proportion of participants unaware of the potential health hazards of e-cigarettes, and many believed that e-cigarettes are less dangerous than traditional cigarettes. These findings emphasize the need for targeted educational interventions to address misconceptions and promote awareness among university students.
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Affiliation(s)
- Mhdee H Albgami
- Department of Preventive Medicine, Prince Mansour Military Hospital, Taif, SAU
| | - Ahmed S Alzahrani
- Department of Preventive Medicine, Armed Forces Hospital, Madina, SAU
| | - Anwar M Alghamdi
- Department of Home Health Care, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU
| | - Nawaf S Alamri
- Department of Aviation Medicine, Prince Sultan Military Hospital, Taif, SAU
| | - Ali H Alghamdi
- Department of Preventive Medicine, Prince Mansour Military Hospital, Taif, SAU
| | - Rami A Alsuwat
- Department of Aviation Medicine, Prince Sultan Military Hospital, Taif, SAU
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Alamri AS, Al-Otaibi FS, Alzahrani AO, Alharthi AS, Alfaran RM, Alzahrani AS. Lifestyle Assessment of Primary Healthcare Physicians in Taif, Saudi Arabia in the Year 2022. Cureus 2023; 15:e37323. [PMID: 37182051 PMCID: PMC10167881 DOI: 10.7759/cureus.37323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2023] [Indexed: 05/16/2023] Open
Abstract
Objective This study aims to evaluate primary healthcare physicians' lifestyles to promote their well-being and improve care quality for the general population. Methods This cross-sectional quantitative study was conducted on primary healthcare physicians in Taif, Kingdom of Saudi Arabia (KSA), using self-administered questionnaires. Results We included 206 participants aged 26-66. Most participants were 35 years old or younger (67%), male (62.1%), and residents (52.4%). Of all participants, 49.5% held a Bachelor's degree, 40.8% had completed their board certificate or Ph.D., and 69.9% had at least 10 years of experience. Of all participants, 16.5% and less than 9% reported having hypercholesterolemia and other comorbidities, respectively. More than 50% were physically inactive, 26.2% were moderately inactive, and 17.4% were moderately active or active individuals. Physical activity was significantly associated with job titles (p < 0.018). The qualification was associated with dietary score (p = 0.034), and 42.7% of participants were in need of diet change. About a quarter (25.2%) were smokers, and 92.3% of them smoked daily. Male participants were associated with a greater likelihood of smoking (p < 0.001). Overall, 41.7% were overweight, and 25.7% were obese. Increased BMI was associated with older age and male gender (p < 0.001 and p < 0.002, respectively), as well as the title of the physician and years of experience (p < 0.001 and p < 0.002, respectively). Conclusion Participants' unhealthy lifestyles indicate the need to establish measures to promote healthy lifestyles among physicians.
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Affiliation(s)
- Abdullah S Alamri
- Department of Preventive Medicine, Prince Mansour Military Hospital, Taif, SAU
| | - Fawaz S Al-Otaibi
- Department of Family Medicine, Alhada Armed Forces Hospital, Taif, SAU
| | - Ali O Alzahrani
- Department of Family Medicine, Alhada Armed Forces Hospital, Taif, SAU
| | | | - Raed M Alfaran
- Department of Family Medicine, Prince Mansour Military Hospital, Taif, SAU
| | - Ahmed S Alzahrani
- Department of Preventive Medicine, Prince Mansour Military Hospital, Taif, SAU
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Alsanie WF, Alamri AS, Alyami H, Alhomrani M, Shakya S, Habeeballah H, Alkhatabi HA, Felimban RI, Alzahrani AS, Alhabeeb AA, Raafat BM, Refat MS, Gaber A. Increasing the Efficacy of Seproxetine as an Antidepressant Using Charge-Transfer Complexes. Molecules 2022; 27:molecules27103290. [PMID: 35630766 PMCID: PMC9147639 DOI: 10.3390/molecules27103290] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/18/2022] [Accepted: 05/19/2022] [Indexed: 01/25/2023] Open
Abstract
The charge transfer interactions between the seproxetine (SRX) donor and π-electron acceptors [picric acid (PA), dinitrobenzene (DNB), p-nitrobenzoic acid (p-NBA), 2,6-dichloroquinone-4-chloroimide (DCQ), 2,6-dibromoquinone-4-chloroimide (DBQ), and 7,7′,8,8′-tetracyanoquinodi methane (TCNQ)] were studied in a liquid medium, and the solid form was isolated and characterized. The spectrophotometric analysis confirmed that the charge–transfer interactions between the electrons of the donor and acceptors were 1:1 (SRX: π-acceptor). To study the comparative interactions between SRX and the other π-electron acceptors, molecular docking calculations were performed between SRX and the charge transfer (CT) complexes against three receptors (serotonin, dopamine, and TrkB kinase receptor). According to molecular docking, the CT complex [(SRX)(TCNQ)] binds with all three receptors more efficiently than SRX alone, and [(SRX)(TCNQ)]-dopamine (CTcD) has the highest binding energy value. The results of AutoDock Vina revealed that the molecular dynamics simulation of the 100 ns run revealed that both the SRX-dopamine and CTcD complexes had a stable conformation; however, the CTcD complex was more stable. The optimized structure of the CT complexes was obtained using density functional theory (B-3LYP/6-311G++) and was compared.
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Affiliation(s)
- Walaa F. Alsanie
- Department of Clinical Laboratories Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia; (W.F.A.); (A.S.A.); (M.A.)
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia;
| | - Abdulhakeem S. Alamri
- Department of Clinical Laboratories Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia; (W.F.A.); (A.S.A.); (M.A.)
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia;
| | - Hussain Alyami
- College of Medicine, Taif University, Taif 21944, Saudi Arabia;
| | - Majid Alhomrani
- Department of Clinical Laboratories Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia; (W.F.A.); (A.S.A.); (M.A.)
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia;
| | - Sonam Shakya
- Department of Chemistry, Faculty of Science, Aligarh Muslim University, Aligarh 202002, India;
| | - Hamza Habeeballah
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences in Rabigh, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
| | - Heba A. Alkhatabi
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (H.A.A.); (R.I.F.)
- Center of Excellence in Genomic Medicine Research (CEGMR), King Abdulaziz University, Jeddah 21589, Saudi Arabia
- King Fahd Medical Research Centre, Hematology Research Unit, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Raed I. Felimban
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (H.A.A.); (R.I.F.)
- Center of Innovation in Personalized Medicine (CIPM), 3D Bioprinting Unit, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ahmed S. Alzahrani
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia;
| | | | - Bassem M. Raafat
- Department of Radiological Sciences, College of Applied Medical Sciences, Taif University, Taif 21944, Saudi Arabia;
| | - Moamen S. Refat
- Department of Chemistry, College of Science, Taif University, Taif 21944, Saudi Arabia
- Correspondence: (M.S.R.); (A.G.)
| | - Ahmed Gaber
- Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif 21944, Saudi Arabia;
- Department of Biology, College of Science, Taif University, Taif 21944, Saudi Arabia
- Correspondence: (M.S.R.); (A.G.)
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Alshehri FM, Ahmed SA, Ullah S, Ghazal H, Nawaz S, Alzahrani AS. The Patterns of Acquired Upper and Lower Extremity Amputation at a Tertiary Centre in Saudi Arabia. Cureus 2022; 14:e24026. [PMID: 35463563 PMCID: PMC8996339 DOI: 10.7759/cureus.24026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2022] [Indexed: 11/05/2022] Open
Abstract
Introduction: Upper and lower extremity amputations are associated with variable degrees of physical disability. In Saudi Arabia, disability still represents a major challenge for healthcare systems. There are insufficient data to describe the incidence and prevalence of impairment and disability. This study attempts to identify the patterns of limb amputations at a tertiary centre. Methods: A retrospective chart review of the data of patients who received integrated tertiary healthcare in an amputation rehabilitation program (ARP) from 2013 to 2018 at King Fahad Medical City, Riyadh, Saudi Arabia was conducted. Data were collected using the demographic data and clinical history of amputees. Results: A total of 412 patients were included in the study. Transtibial amputation (70%) and partial hand amputation (48%) were the most common levels for lower and upper limb amputations, respectively. There was a significantly higher rate of lower limb amputations secondary to vascular causes than that of upper limb amputations, which were more related to traumatic causes. Most patients, 213 (52%), were enrolled in an amputation rehabilitation program over a year after their amputation. Conclusion: Vascular amputation is the most common cause of amputation. Most patients entered the rehabilitation program over a year after amputation. National guidelines for the prevention and management of the risk factors for vascular amputations should be developed.
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Affiliation(s)
- Fayez M Alshehri
- Department of Physical Medicine and Rehabilitation, Rehabilitation Hospital, King Fahad Medical City, Riyadh, SAU
| | - Salwa A Ahmed
- Department of Physical Medicine and Rehabilitation, Rehabilitation Hospital, King Fahad Medical City, Riyadh, SAU
| | - Sami Ullah
- Department of Physical Medicine and Rehabilitation, Rehabilitation Hospital, King Fahad Medical City, Riyadh, SAU
| | - Haitham Ghazal
- Department of Physical Therapy, Rehabilitation Hospital, King Fahad Medical City, Riyadh, SAU
| | - Shah Nawaz
- Department of Rehabilitation Technology, Rehabilitation Hospital, King Fahad Medical City, Riyadh, SAU
| | - Ahmed S Alzahrani
- Department of Physical Medicine and Rehabilitation, Rehabilitation Hospital, King Fahad Medical City, Riyadh, SAU
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Alharbi HY, Alharthi SS, Alzahrani AS, Dakhel MKA, Alawaji ZH. Increased psychological distress after the lifting of COVID-19 lockdown in the Saudi population: a cross-sectional study. Middle East Curr Psychiatry 2022. [PMCID: PMC8721643 DOI: 10.1186/s43045-021-00167-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Abstract
Background
Amid the ongoing COVID-19 pandemic and its global health and socioeconomic aftereffects, the enduring state of crisis is increasingly impacting the coping capacity of the populations. In this study, we aimed to characterize the levels of psychological distress after the lifting of COVID-19 lockdown.
Results
The Impact of Event Scale (IES-R) and Depression, Anxiety, and Stress Scales-21 items (DASS-21) were used to screen for post-traumatic stress syndrome (PTSD), depression, anxiety, and stress. The prevalence of PTSD was 41.6% and was associated with severe or extremely severe stress (27.8%), anxiety (31.4%), and depression (39.0%). All disorders were strongly correlated with one another. The risk of developing PTSD was independently associated with residence in high COVID-19 prevalence region (OR = 2.25, p = 0.004), poor (OR = 3.98, p = 0.002), or moderate (OR = 1.63, p = 0.048) self-assessed overall physical health, psychiatric comorbidity (OR = 1.87, p = 0.036), number of COVID-19-like symptoms (OR = 1.94, p = 0.039), and severe COVID-19 morbidity in the acquaintances (OR = 1.54, p = 0.026). Four theories were proposed to explain these high figures, with a discussion of their practical implications.
Conclusions
The lifting of lockdown measures was associated with a substantial increase in psychological distress among the Saudi population, referring to figures reported during the lockdown. This may indicate a decline in the overall population’s coping capacity with the enduring crisis.
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Al-Eyadhy A, Temsah MH, Hasan GM, Almazyad M, Alhaboob AA, Alabdulhafid M, Alsohime F, Alzahrani AS, Alammari AM, Abunohaiah FS, Alfawzan NF, Alghamdi SS. Causes, timing, and modes of death in a tertiary pediatric intensive care unit: Five years' experience. Saudi Med J 2021; 42:1186-1194. [PMID: 34732550 PMCID: PMC9149741 DOI: 10.15537/smj.2021.42.11.20210508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 09/28/2021] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To identify the causes, modes, and timing of death in a tertiary pediatric intensive care unit (PICU). METHODS This is a retrospective data analysis of patients older than 48 hours and younger than 15 years who died in the PICU over a 5-year period from January 2012 until December 2016 at a tertiary hospital in Riyadh, Saudi Arabia. RESULTS There were 101 deaths out of 2295 admissions, representing average crude mortality rate of 4.4%. Sepsis was the most common cause of death in 31 patients (30.7%), followed by lower respiratory tract infections in 19 (18.8%), and cardiac diseases in 12 (11.9%). Failed cardiopulmonary resuscitation was the most common mode of death in 51 patients (50.5%), followed by withholding life-sustaining treatment in 43 (42.6%), and brain death in 7 (6.9%). Although more deaths occurred during after hours (n=70; 69.3%), there was no significant correlation between mode of death and working hours vs. after hours (p>0.05). Among the cohort, 63 patients (62.4%) had an infection-attributed mortality, of which 43 (68.3%) were bacterial, 14 (22.2%) were viral, and 10 (15.9%) were fungal. CONCLUSION Infections remain a significant cause of death in the PICU. Further improvement of prevention programs and early therapy of severe infections could lower pediatric mortality. This report highlights the need for enhancing palliative care programs. The low rate of brain death diagnoses warrants further investigation.
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Affiliation(s)
- Ayman Al-Eyadhy
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
- Address correspondence and reprint request to: Dr. Ayman A. Al-Eyadhy, Pediatric Intensive Care Unit, Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: https://orcid.org/0000-0002-6051-9125
| | - Mohamad-Hani Temsah
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Gamal M. Hasan
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Mohammed Almazyad
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Ali A. Alhaboob
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Majed Alabdulhafid
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Fahad Alsohime
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Ahmed S. Alzahrani
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Abdullah M. Alammari
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Faisal S. Abunohaiah
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Nawaf F. Alfawzan
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
| | - Suhail S. Alghamdi
- From the College of Medicine (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime, Alzahrani, Alammari, Abunohaiah, Alfawzan, Alghamdi), King Saud University; from the Department of Pediatric (Al-Eyadhy, Temsah, Almazyad, Alhaboob, Alabdulhafid, Alsohime), Pediatric Intensive Care Unit, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Faculty of Medicine, Assiut University, Assiut, Egypt, and from the Department of Pediatrics (Hasan), Pediatric Intensive Care Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates.
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7
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Sedick Q, Elyamany G, Hawsawi H, Alotaibi S, Alabbas F, Almohammadi M, Alahmari HA, Aljasem H, Ferrer AG, Alzahrani AS, AlMoshary M, Alsuhaibani O. Diagnostic accuracy of reticulocyte parameters on the sysmex XN 1000 for discriminating iron deficiency anaemia and thalassaemia in Saudi Arabia. Am J Blood Res 2021; 11:172-179. [PMID: 34079632 PMCID: PMC8165718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/22/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Iron deficient erythropoiesis and Thalassaemia are both associated with microcytic erythropoiesis albeit from different pathological mechanisms. Given the high prevalence of Hemoglobinopathies in the Mediterranean region, discriminating these two conditions is important. Several algorithms using conventional red cell indices have been developed to facilitate diagnosis, however, their diagnostic accuracy is low. The new generation haematology analyzers enabled the use of more innovative parameters such as reticulocyte parameters. We aimed to evaluate the diagnostic performance of the reticulocyte parameters on the Sysmex XN 1000 to distinguish between IDA and Thalassemia in our population. METHODS We performed a retrospective analysis of blood samples sent to our laboratory for haemoglobin electrophoresis screening. We categorized our cohort into Thalassemia and Iron Deficient patients based on known diagnostic criteria. We analyzed the reticulocyte parameters using receiver operator curve analysis (ROC) and determined the cut off value for each parameter. RESULTS Reticulocyte parameters most accurate for discriminating IDA from Thalassemia patients was: RET, RET-HE and IRF. The RET-HE had the best statistical significance for IDA patients with AUC = 0.69 for cut off 22.25. The RET-HE for dual positive patients was more accurate with AUC = 0.78 for cut off 21.25. The IRF had the best statistical significance for Alpha Thalassemia with AUC = 0.66 for cut off value 18. CONCLUSION An IRF cut off below 15.5 and RET-HE cut off below 22.25 was the most accurate variable in predicting IDA with a sensitivity of 59.4% and 68.3%.
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Affiliation(s)
- Qanita Sedick
- Central Military Laboratory and Blood Bank, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Ghaleb Elyamany
- Central Military Laboratory and Blood Bank, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Huda Hawsawi
- Central Military Laboratory and Blood Bank, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Sultan Alotaibi
- Department of Adult Hematology, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Fahad Alabbas
- Department of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Mohammed Almohammadi
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, Pathology and Laboratory Medicine, King Abdulaziz Medical CityJeddah, Saudi Arabia
| | - Hassan A Alahmari
- Department of Pediatric Hematology/Oncology, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Hassan Aljasem
- Department of Adult Hematology, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Arnel G Ferrer
- Central Military Laboratory and Blood Bank, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - Ahmed S Alzahrani
- Central Military Laboratory and Blood Bank, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
| | - May AlMoshary
- Basic Science Department, College of Medicine, Princess Nourah Bint Abdulrahman UniversityRiyadh, Kingdom of Saudi Arabia
| | - Omar Alsuhaibani
- Central Military Laboratory and Blood Bank, Prince Sultan Military Medical CityRiyadh, Kingdom of Saudi Arabia
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Alharthi SS, Altalhi HH, Alzahrani AS. Validation and psychometric evaluation of the Arabic version of the prejudice towards people with mental illness (PPMI) scale. Arch Pharma Pract 2021. [DOI: 10.51847/zxuozeqibu] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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AlQahtani AH, Alzahrani AS, Alzahrani SH, Alqahtani SM, AlOtaibi AF, Khan AA. Levels of Practice and Determinants of Diabetes Self-Care in Primary Health Care in Jeddah City, Saudi Arabia. Cureus 2020; 12:e8816. [PMID: 32742831 PMCID: PMC7384715 DOI: 10.7759/cureus.8816] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/25/2020] [Indexed: 01/12/2023] Open
Abstract
Objective To assess the level and determinants of practice in diabetes self-management at primary health care centers (PHCCs) and to analyze the association of self-management with the level of glycemic control. Method A cross-sectional study was conducted among patients with type 1 and type 2 diabetes, aged ≥ 17 years, and being followed at PHCCs in Jeddah, Saudi Arabia, from December 1, 2019, to December 30, 2019. A multistage cluster sampling technique was used to select 350 participants from five PHCCs. The level of practice in self-management was assessed using the Arabic version of the Summary of Diabetes Self-care Activities (SDSCA) questionnaire. The tool was administered as a face-to-face interview, followed by the collection of sociodemographic and relevant clinical data. In addition, blood was collected to measure fasting blood glucose (FBG) and HbA1c levels. The association of the overall SDSCA score with diabetes control was analyzed using linear regression and the receiver operator characteristics (ROC) curve. Multivariate binary logistic regression was carried out to analyze independent factors of inadequate practice. Result The overall mean (SD) SDSCA score was 3.13 (1.13)/7. Of the five dimensions of self-care, medication adherence yielded the highest score (mean=5.39 days per week), followed by diet (2.83) and blood glucose monitoring (2.78), while footcare had the lowest level of practice (2.26). The SDSCA score showed a negative correlation with the level of HbA1c, with a correlation coefficient r-squared =0.530 and regression coefficient B=-0.648 (p <0.001). ROC curve analysis showed that optimal glycemic control was associated with SDSCA score cutoff ≥3.5 with 82.0% sensitivity and 77.0% specificity, and the model showed that 38.0% of participants had adequate practice in self-management. Inadequate practice in diabetes self-management was independently associated with age >50 years (OR=2.00 [95%CI=1.02, 3.89]), rental accommodation (OR=0.42 [95%CI=0.23, 0.76]), independent job (OR=3.98 [95%CI=1.66, 9.57]), and longer duration of diabetes (≥8 years) (OR=4.25 [95%CI=1.82, 9.92]). Conclusion There are low levels of diabetes self-management among patients being followed at Jeddah PHCCs. This is associated with suboptimal glycemic control among the majority of the patients, indicating the importance of self-management to improve diabetes control. Patient health literacy and education for self-management should be considered the standard of care for diabetic patients in all PHCCs, with specific attention to subcategories of patients with the lowest levels of practice in self-management such as those with a longer duration of diabetes and the elderly.
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Affiliation(s)
- Ali H AlQahtani
- Public Health Administration, Ministry of Health, Jeddah, SAU
| | | | | | - Saleh M Alqahtani
- Family Medicine, Ministry of Health, Jeddah East Hospital, Jeddah, SAU
| | | | - Adeel Ahmed Khan
- Epidemiology and Public Health, Ministry of Health, Saudi Board of Preventive Medicine, Mecca, SAU
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10
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Affiliation(s)
- Mohamed A. Mabrok
- Department of Mathematics and Physics, School of Engineering, Australian College of Kuwait, Kuwait
| | - Hassan K. Mohamed
- Department of Mathematics and Physics, School of Engineering, Australian College of Kuwait, Kuwait
| | - Abdel-Haleem Abdel-Aty
- Department of Physics, College of Sciences, University of Bisha, Bisha, Saudi Arabia
- Department of Physics, Faculty of Science, Al-Azhar University, Assiut, Egypt
| | - Ahmed S. Alzahrani
- Department of Computer Science, Faculty of Computing and Information Technology, King Abdulaziz University, Jeddah, Saudi Arabia
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11
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Alzahrani AS. Gingival Crevicular Fluid Release Profile of Vascular Endothelial Cell Growth Factor and Platelet-Derived Growth Factors-BB Following Minimally Invasive Flap Reflection during Treatment of Intrabony Defects: A Randomized Clinical Trial. J Int Acad Periodontol 2017; 20:3-11. [PMID: 31473715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVES As a primary objective, we examined the gingival crevicular fluid (GCF) levels of the endogenously released platelet-derived growth factor (PDGF-BB) and vascular endothelial growth factor (VEGF) following the use of minimally invasive surgical flap reflection (MIS) and compared them with those in traditional open flap debridement (OFD). The secondary objective was to determine if any correlation exists between the expression of growth factors (GF), indicated by their levels, and associated clinical outcomes. MATERIALS AND METHODS Twenty-eight non-smoking individuals with severe chronic periodontitis were recruited in this prospective, randomized and single-blinded trial. Each person presented one interproximal defect that was randomly assigned to either the experimental MIS group (14 sites) or the open flap debridement (OFD) control group (14 sites). Plaque index, gingival index, probing depth (PD), clinical attachment level (CAL) and the intra-bony depth of the defect (IBD) were measured at baseline for the patient's enrollment. Gingival crevicular fluid (GCF) samples were collected on days 1, 3, 7, 14, 21 and 30 after therapy. Clinical follow-ups were scheduled at 6 and 9 months following the therapy. RESULTS In both groups, the highest levels of VEGF and PDGF-BB concentrations were found in the GCF during the period from 1 to 14 days. During the early stages of healing (1, 3, 7 and 14 days), the mean VEGF and PDGF-BB levels at sites treated with MIS were significantly higher than those at the OFD-treated sites. Growth factor levels decreased sharply in the samples obtained at days 21 and 30 in both groups, with non-significant differences between the patient and control groups. MIS-treated sites reported significantly more PD reduction and attachment gain 9 months following therapy. No significant difference in intrabony defect reduction was reported between the patient and control groups. CONCLUSIONS Within the limits of the present study, we can surmise that MIS treatment of periodontal defects is associated with initially higher GCF levels of the studied growth factors. These increased GF levels are well correlated with the improved soft-tissue parameters of the periodontal defects.
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Affiliation(s)
- Ahmed S Alzahrani
- Division of Periodontics, College of Dentistry, Umm Al-Qura University, Mecca, Saudi Arabia.
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12
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Abstract
Diabetes mellitus (DM) is considered one of the major chronic diseases in the world. Long-term hyperglycemia considerably affects the body tissues, and consequently, can lead to morbidity and mortality. Moreover, many oral complications have been observed with DM but little consideration in relation to the placement of dental implants has been investigated. Dental research has analyzed the relation of dental implants and bone osseointegration in diabetic patients. Theoretically, an impaired immune system and delayed wound healing of these patients might decrease the success rate of implant placement; however, with noticeable advances in evidence-based dentistry and statistically significant results, successful implant treatment could be achieved significantly in well-controlled diabetic patients.
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Affiliation(s)
- Ahmed S Alzahrani
- Division of Periodontology, Department of Basic and Clinical Oral Sciences, Faculty of Dentistry, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia. E-mail.
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13
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Alzahrani AS, Bissada NF, Jurevic RJ, Narendran S, Nouneh IE, Al-Zahrani MS. Reduced systemic inflammatory mediators after treatment of chronic gingivitis. Saudi Med J 2013; 34:415-419. [PMID: 23552596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE To assess the changes in the level of C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-alpha) in gingival crevicular fluid (GCF) after treatment of chronic gingivitis in systemically healthy individuals. METHODS This is a clinical trial conducted at Case Western Reserve University, Cleveland, Ohio, United States of America from February to December 2011. A total of 41 systemically healthy subjects were assigned to 2 groups according to the severity of gingival inflammation. Group I consisted of 18 subjects who had mild gingival inflammation; and group II consisted of 23 with more severe gingival inflammation. Periodontal assessment consisted of gingival index (GI), probing depths (PD), and GCF volume. Four to six weeks after prophylaxis and oral hygiene instruction, the same measurements were repeated. The level of CRP and TNF-alpha in the GCF was determined using enzyme-linked immunosorbent assays. RESULTS A statistically significant reduction in the mean CRP and TNF-alpha levels after the treatment was found in the severe, but not in the mild gingivitis group. Both groups showed a statistically significant reduction in GI, PD, and periotron readings after the treatment. CONCLUSION Treatment of severe chronic gingivitis reduces the levels of CRP and TNF-alpha in GCF of otherwise systemically healthy individuals, which could have an impact on preventing or controlling future or existing systemic disease conditions.
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Affiliation(s)
- Ahmed S Alzahrani
- Department of Periodontics, Case Western Reserve University, Cleveland, Ohio 44106, USA
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Shi Y, Zou M, Baitei EY, Alzahrani AS, Parhar RS, Al-Makhalafi Z, Al-Mohanna FA. Cannabinoid 2 receptor induction by IL-12 and its potential as a therapeutic target for the treatment of anaplastic thyroid carcinoma. Cancer Gene Ther 2007; 15:101-7. [PMID: 18197164 DOI: 10.1038/sj.cgt.7701101] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Anaplastic thyroid carcinoma is the most aggressive type of thyroid malignancies. Previously, we demonstrated that tumorigenicity of anaplastic thyroid carcinoma cell line ARO was significantly reduced following interleukin (IL)-12 gene transfer. We suspected that tumor target structure in ARO/IL-12 cells might be changed and such a change may make them more susceptible to be killed through mechanisms apart from natural killer-dependent pathway. To identify genes involved, we examined gene expression profile of ARO and ARO/IL-12 by microarray analysis of 3757 genes. The most highly expressed gene was cannabinoid receptor 2 (CB2), which was expressed eightfold higher in ARO/IL-12 cells than ARO cells. CB2 agonist JWH133 and mixed CB1/CB2 agonist WIN-55,212-2 could induce significantly higher rate of apoptosis in ARO/IL-12 than ARO cells. Similar results were obtained when ARO cells were transfected with CB2 transgene (ARO/CB2). A considerable regression of thyroid tumors generated by inoculation of ARO/CB2 cells was observed in nude mice following local administration of JWH133. We also demonstrated significant increase in the induction of apoptosis in ARO/IL12 and ARO/CB2 cells following incubation with 15 nM paclitaxel, indicating that tumor cells were sensitized to chemotherapy. These data suggest that CB2 overexpression may contribute to the regression of human anaplastic thyroid tumor in nude mice following IL-12 gene transfer. Given that cannabinoids have shown antitumor effects in many types of cancer models, CB2 may be a viable therapeutic target for the treatment of anaplastic thyroid carcinoma.
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Affiliation(s)
- Y Shi
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
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15
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Abu-Amero KK, Alzahrani AS, Zou M, Shi Y. Association of mitochondrial DNA transversion mutations with familial medullary thyroid carcinoma/multiple endocrine neoplasia type 2 syndrome. Oncogene 2006; 25:677-84. [PMID: 16205644 DOI: 10.1038/sj.onc.1209094] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Medullary thyroid carcinoma (MTC) is a malignant tumour of the calcitonin-secreting parafollicular C cells of the thyroid, and occurs sporadically or as a component of the multiple endocrine neoplasia (MEN) type 2/familial medullary thyroid carcinoma (FMTC) syndromes. In the present study, we investigated the frequency of mtDNA mutations in 26 MTC tumour specimens (13 sporadic and 13 familial MTC) and their matched normal tissues by sequencing the entire coding regions of mitochondrial genome. Nonsynonymous mutations were detected in 20 MTC samples (76.9%): nine out of 13 sporadic MTC (69.2%) and 11 out of 13 (84.6%) familial MTC/MEN2. Both transition and transversion types of mutations were found in the samples. Interestingly, 76.2% (16/21) of transversion mutations were found in FMTC/MEN2 patients, whereas 66.7% (12/18) of transition mutations were in sporadic MTC. Synonymous mutations were found in 12 MTC samples. In total, we identified 27 transversion mutations (21 nonsynonymous and six synonymous) in MTC. Of them, 22 (81.5%) were from FMTC/MEN2, and five (18.5%) were from sporadic MTC. The association of transversion mutation with familial MTC/MEN2 was statistically significant (P = 0.0015, binomial test). Majority of the mutations were involved in the genes located in the complex I of the mitochondrial genome, and were often resulting in a change of a moderately or highly conserved amino acid of their corresponding protein. Mitochondrial respiratory function was also compromised in a TT cell line, which carries mtDNA mutation at nt 4917 and 11,720, and in peripheral lymphocytes of MTC patients with mtDNA mutations. These data suggest that mtDNA mutation may be involved in MTC tumourigenesis and progression. Given that mtDNA mutation spectra are different between sporadic and familial MTC, different mechanisms of oxidative DNA damage may occur in the disease process.
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Affiliation(s)
- K K Abu-Amero
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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16
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Alzahrani AS, Mohamed G, Al Shammary A, Aldasouqi S, Abdal Salam S, Shoukri M. Long-term course and predictive factors of elevated serum thyroglobulin and negative diagnostic radioiodine whole body scan in differentiated thyroid cancer. J Endocrinol Invest 2005; 28:540-6. [PMID: 16117196 DOI: 10.1007/bf03347243] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED Following the initial management, some patients with differentiated thyroid cancer (DTC) develop a state of high thyroglobulin (Tg) and negative diagnostic radioactive iodine (RAI) whole body scan (DxWBS). The predisposing factors and outcome of this condition are unclear. In this study, our objectives were to determine the predictive factors for the development of high Tg and negative DxWBS (Tg+/scan-) and to study the long-term course of the disease in patients with this condition. METHODS We, retrospectively, reviewed the medical records of a cohort of 105 non-selected DTC patients (26 males and 79 females; median age 37.7 yr, range 7-72). None of these patients had positive Tg antibodies or distant metastases. All Tg levels were obtained off thyroid hormone therapy. At the first follow-up visit after RAI ablation (13 +/- 7.6 months), patients were classified into those with low Tg (<2 ng/ml off L-T4) and negative DxWBS (control group) and those with high Tg ( > or = 22 ng/ ml off L-T4) and negative DxWBS (Tg+/scan- group). Using univariate and multivariate logistic regression analyses, we evaluated a number of parameters (see results) for their association with the development of Tg+/scan-. In addition, the long-term course of the disease in Tg+/scan- group was analyzed. RESULTS In univariate analysis, the following factors were found to be significantly associated with Tg+/scan-: perithyroidal tumor extension (p=0.025), soft tissue invasion (p=0.001), cervical lymph node metastases (p=0.014) and Tg level before RAI ablation (p=0.015). In multivariate analysis, only soft tissue invasion remained significantly associated with Tg+/scan- [p 0.001, odds ratio, 15.6 (95% Cl, 2.96-82.06)]. Age, sex, duration of goiter before surgery, pressure symptoms, tumor size, tumor multifocality, lymph nodedissection at initial surgery, tumor-node-metastasis (TNM) stage, and RAI ablative dose were not associated with Tg+/ scan-. In 53 patients with Tg+/scan-, 42 cases were followed without any therapeutic intervention; over a median follow-up of 71.6 months (range, 13-144.7), 31 cases had a spontaneous remission and 11 cases continued to have a persistent disease (Tg > or = 2 ng/ml, negative DxWBS, and no palpable disease or distant metastases); Tg declined from 9.32 +/- 9.91 ng/ml at first visit after RAI ablation to 1.59 +/- 5.39 ng/ml at last visit (p<0.0001). In the other 11 cases of Tg+/scan- group, one or more therapeutic interventions (RAI, surgery, or external radiotherapy) were undertaken. Over a median follow-up of 98.4 months (range, 6-147), Tg decreased from 110.2 +/- 147.5 to 23.5 +/- 41.2 ng/ml (p 0.026); 4 cases achieved remission, 5 cases continued to have persistent disease, and 2 cases had progression of their disease, which led to their death. CONCLUSION Soft tissue invasion on original surgery strongly predicts the development of Tg+/scan- in DTC patients. The long-term course of the disease is mostly favorable especially when the Tg level is only modestly elevated.
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Affiliation(s)
- A S Alzahrani
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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Alzahrani AS, Raef H, Sultan A, Al Sobhi S, Ingemansson S, Ahmed M, Al Mahfouz A. Impact of cervical lymph node dissection on serum TG and the course of disease in TG-positive, radioactive iodine whole body scan-negative recurrent/persistent papillary thyroid cancer. J Endocrinol Invest 2002; 25:526-31. [PMID: 12109624 DOI: 10.1007/bf03345495] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the management of papillary thyroid cancer (PTC), surgery is indicated for locoregional recurrent/persistent disease. In this study, we examined the effect of such surgery on serum TG and the course of the disease in 21 patients with PTC (mean age 38.5 yr), who after the initial surgery and radioactive iodine (RAI) ablation developed high TG (>10 ng/ml) and negative 123I whole body scan (DxWBS). All patients had neck persistent/recurrent PTC that was confirmed by ultrasound-guided fine needle aspiration. Prior to neck re-exploration, radiological studies (chest X-rays, CT scan of the chest, and fluoro-18-deoxyglucose positron emission tomography [FDG-PET]) showed no evidence of distant metastases. TG autoantibodies were negative in 19 patients. Second surgery consisted of unilateral (13 patients) or bilateral (8 patients) modified neck dissection. The mean+/-SE TG prior to neck re-exploration was 184.8+/-79.0 ng/ml and declined after surgery to 127.5+/-59.0 ng/ml (p=0.25). The corresponding TSH values were 150.6+/-23.0 and 143.4+/-20.0 mU/l, respectively (p=0.34). After a mean follow-up of 20.7+/-3 months, TG increased to 168+/-68.0 ng/ml. This increase, however, was NS (p=0.67). The corresponding TSH values were 143.4+/-20.0 and 132.0+/-22.0 mU/l (p=0.27). Following second surgery, only 4 patients achieved remission, the other 17 patients received one or more of the following therapies; RAI (10 patients), third surgery (5 patients), and/or external radiation (7 patients). Thirteen patients continued to have persistent disease and 4 patients showed progressive course of their disease (distant metastases or grossly palpable neck disease). In conclusion, second surgery for recurrent/persistent PTC leads to remission in only a minority of cases but the course of the disease tends to be stable in most cases.
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Affiliation(s)
- A S Alzahrani
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia.
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Alzahrani AS, Bakheet S, Al Mandil M, Al-Hajjaj A, Almahfouz A, Al Haj A. 123I isotope as a diagnostic agent in the follow-up of patients with differentiated thyroid cancer: comparison with post 131I therapy whole body scanning. J Clin Endocrinol Metab 2001; 86:5294-300. [PMID: 11701695 DOI: 10.1210/jcem.86.11.8030] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Radioactive iodine (131I) plays a major role in the diagnosis and management of differentiated thyroid cancer (DTC); however, data on the use of the 123I isotope in DTC are limited. We compared 238 diagnostic whole body scans performed 24 h after oral ingestion of 185-555 MBq 123I with their corresponding 131I posttherapy whole body scans obtained 4-5 d after 131I therapy. We studied scans in 3 clinical situations: with the first 131I therapy, with the second 131I therapy, and in cases of elevated Tg and negative diagnostic scan. One hundred and seventy-seven pairs were obtained with the first 131I therapy and showed complete concordance between pretreatment and posttreatment scans in 166 pairs (concordance rate, 93.8%). Six other posttreatment scans showed more foci in the thyroid bed than the pretreatment scans, but no evidence of uptake in new areas. Only 5 posttreatment scans showed foci in new locations: 3 in cervical lymph nodes (CLN), 1 in the lung, and 1 new bone metastasis in a patient with known skeletal metastases. With the second 131I therapy, 34 pairs were obtained and showed complete concordance in 28 pairs (concordance rate, 82.4%). Five discordant pairs showed additional foci in areas that were already positive on pretreatment scans. Only 1 posttreatment scan showed a new bone metastasis in a different site from the bone metastases that were seen on its corresponding pretreatment scan. Of 27 pairs of scans in patients with elevated Tg and negative pretreatment scans, 15 posttreatment scans remained negative, 6 posttreatment scans showed an uptake in the thyroid bed, and 3 other posttreatment scans showed lung uptake in patients whose computed tomography scans of the chest showed only bronchiectasis (in 2 patients) and lung scarring (in the third patient) without evidence of lung metastases. Three posttreatment scans showed definite uptake (in thyroid bed, thyroid bed and lung, and CLN) compared with their corresponding pretreatment scans, which were initially reported negative but were retrospectively thought to have had faint uptake. In 56 pretreatment scans, the 123I diagnostic activity was 185 MBq, and the results showed complete concordance in 54 pairs. Two posttreatment scans showed additional uptake: 1 in the bone and 1 in CLN. These data suggest that pretreatment scanning using 123I is highly comparable to 131I posttreatment scanning and that 123I is an excellent diagnostic agent in DTC.
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Affiliation(s)
- A S Alzahrani
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia.
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