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Awuah WA, Tan JK, Shkodina AD, Ferreira T, Adebusoye FT, Mazzoleni A, Wellington J, David L, Chilcott E, Huang H, Abdul-Rahman T, Shet V, Atallah O, Kalmanovich J, Jiffry R, Madhu DE, Sikora K, Kmyta O, Delva MY. Hereditary spastic paraplegia: Novel insights into the pathogenesis and management. SAGE Open Med 2023; 12:20503121231221941. [PMID: 38162912 PMCID: PMC10757446 DOI: 10.1177/20503121231221941] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Hereditary spastic paraplegia is a genetically heterogeneous neurodegenerative disorder characterised primarily by muscle stiffness in the lower limbs. Neurodegenerative disorders are conditions that result from cellular and metabolic abnormalities, many of which have strong genetic ties. While ageing is a known contributor to these changes, certain neurodegenerative disorders can manifest early in life, progressively affecting a person's quality of life. Hereditary spastic paraplegia is one such condition that can appear in individuals of any age. In hereditary spastic paraplegia, a distinctive feature is the degeneration of long nerve fibres in the corticospinal tract of the lower limbs. This degeneration is linked to various cellular and metabolic processes, including mitochondrial dysfunction, remodelling of the endoplasmic reticulum membrane, autophagy, abnormal myelination processes and alterations in lipid metabolism. Additionally, hereditary spastic paraplegia affects processes like endosome membrane trafficking, oxidative stress and mitochondrial DNA polymorphisms. Disease-causing genetic loci and associated genes influence the progression and severity of hereditary spastic paraplegia, potentially affecting various cellular and metabolic functions. Although hereditary spastic paraplegia does not reduce a person's lifespan, it significantly impairs their quality of life as they age, particularly with more severe symptoms. Regrettably, there are currently no treatments available to halt or reverse the pathological progression of hereditary spastic paraplegia. This review aims to explore the metabolic mechanisms underlying the pathophysiology of hereditary spastic paraplegia, emphasising the interactions of various genes identified in recent network studies. By comprehending these associations, targeted molecular therapies that address these biochemical processes can be developed to enhance treatment strategies for hereditary spastic paraplegia and guide clinical practice effectively.
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Affiliation(s)
| | | | - Anastasiia D Shkodina
- Department of Neurological Diseases, Poltava State Medical University, Poltava, Ukraine
| | - Tomas Ferreira
- Department of Clinical Neurosciences, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | | | - Adele Mazzoleni
- Barts and the London School of Medicine and Dentistry, London, UK
| | - Jack Wellington
- Cardiff University School of Medicine, Cardiff University, Wales, UK
| | - Lian David
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Ellie Chilcott
- Cardiff University School of Medicine, Cardiff University, Wales, UK
| | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Vallabh Shet
- Faculty of Medicine, Bangalore Medical College and Research Institute, Karnataka, India
| | - Oday Atallah
- Department of Neurosurgery, Hannover Medical School, Hannover, Germany
| | | | - Riaz Jiffry
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | | | - Mykhailo Yu Delva
- Department of Neurological Diseases, Poltava State Medical University, Poltava, Ukraine
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Salam A, Wireko AA, Jiffry R, Ng JC, Patel H, Zahid MJ, Mehta A, Huang H, Abdul-Rahman T, Isik A. The impact of natural disasters on healthcare and surgical services in low- and middle-income countries. Ann Med Surg (Lond) 2023; 85:3774-3777. [PMID: 37554857 PMCID: PMC10406090 DOI: 10.1097/ms9.0000000000001041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 06/29/2023] [Indexed: 08/10/2023] Open
Affiliation(s)
- Abdus Salam
- Department of Surgery, Khyber Teaching Hospital
| | | | - Riaz Jiffry
- Faculty of Medicine and Health Sciences, University of Putra Malaysia, Serdang, Malaysia
| | - Jyi C. Ng
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Heli Patel
- Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Florida, USA
| | - Muhammad J. Zahid
- Department of Surgery, Hayatabad Medical Complex, Peshawar, Pakistan
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | | | - Arda Isik
- Department of General Surgery, Istanbul Medeniyet University, Istanbul, Turkey
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Akhtar SE, Shakil S, Farooqui SK, Khedro T, Alzufairi AL, Niaz MA, Syed S, Jiffry R, Alsubai AK, Almesri A, Ismail H, Khan KA, Al-Hindawi A, Ali HK, Falodun T, Tabassi A, Tabassi A, Almas T. Safety and efficacy of pimecrolimus versus vehicle for the treatment of atopic dermatitis in adults and paediatric population: a systematic review and meta-analysis. Ann Med Surg (Lond) 2023; 85:3563-3573. [PMID: 37427183 PMCID: PMC10328566 DOI: 10.1097/ms9.0000000000000844] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 05/03/2023] [Indexed: 07/11/2023] Open
Abstract
Atopic dermatitis remains a widespread problem affecting various populations globally. While numerous treatment options have been employed, pimecrolimus remains a potent and viable option. Recently, there has been increasing interest in comparing the safety and efficacy of pimecrolimus with its vehicle. Methods The authors conducted a comprehensive search of several databases, including PubMed, COCHRANE, MEDLINE, and Cochrane Central, from inception to May 2022, using a wide search strategy with Boolean operators. The authors also employed backward snowballing to identify any studies missed in the initial search. The authors included randomized controlled trials in our meta-analysis and extracted data from the identified studies. The authors used Review Manager (RevMan) Version 5.4 to analyze the data, selecting a random-effects model due to observed differences in study populations and settings. The authors considered a P-value of 0.05 or lower to be statistically significant. Results The authors initially identified 211 studies, of which 13 randomized controlled trials involving 4180 participants were selected for analysis. Our pooled analysis revealed that pimecrolimus 1% was more effective at reducing the severity of atopic dermatitis than its vehicles. However, no significant difference was observed in adverse effects between pimecrolimus and vehicle, except for pyrexia, nasopharyngitis, and headache, which were increased with pimecrolimus. Conclusion Our meta-analysis showed that pimecrolimus 1% is more effective than vehicle, although the safety profile remains inconclusive. Pimecrolimus reduced the Investigator's Global Assessment score, Eczema Area and Severity Index score, and severity of pruritus when compared to its vehicle, indicating a higher efficacy profile. This is one of the first meta-analyses to assess the efficacy and safety profile of pimecrolimus 1% against a vehicle and may assist physicians in making informed decisions.
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Affiliation(s)
| | | | | | - Tarek Khedro
- RCSI University of Medicine and Health Sciences, Dublin 2
| | | | | | - Saifullah Syed
- RCSI University of Medicine and Health Sciences, Dublin 2
| | - Riaz Jiffry
- RCSI University of Medicine and Health Sciences, Dublin 2
| | | | | | | | | | | | - Hussein K. Ali
- RCSI University of Medicine and Health Sciences, Dublin 2
| | | | - Aysa Tabassi
- RCSI University of Medicine and Health Sciences, Dublin 2
| | - Aylin Tabassi
- RCSI University of Medicine and Health Sciences, Dublin 2
| | - Talal Almas
- RCSI University of Medicine and Health Sciences, Dublin 2
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Kundu M, Ng JC, Awuah WA, Huang H, Yarlagadda R, Mehta A, Nansubuga EP, Jiffry R, Abdul-Rahman T, Ou Yong BM, Sikora V, Isik A. NeuroVerse: neurosurgery in the era of Metaverse and other technological breakthroughs. Postgrad Med J 2023; 99:240-243. [PMID: 36892407 DOI: 10.1093/postmj/qgad002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/18/2022] [Indexed: 03/10/2023]
Abstract
The tremendous evolution in modern technology has led to a paradigm shift in neurosurgery. The latest advancements such as augmented reality, virtual reality, and mobile applications have been incorporated into neurosurgical practice. NeuroVerse, representing the application of the metaverse in neurosurgery, brings enormous potential to neurology and neurosurgery. Implementation of NeuroVerse could potentially elevate neurosurgical and interventional procedures, enhance medical visits and patient care, and reshape neurosurgical training. However, it is also vital to consider the challenges that may be associated with its implementation, such as privacy issues, cybersecurity breaches, ethical concerns, and widening of existing healthcare inequalities. NeuroVerse adds phenomenal dimensions to the neurosurgical environment for patients, doctors, and trainees, and represents an incomparable advancement in the delivery of medicine. Therefore, more research is needed to encourage widespread use of the metaverse in healthcare, particularly focusing on the areas of morality and credibility. Although the metaverse is expected to expand rapidly during and after the COVID-19 pandemic, it remains to be seen whether it represents an emerging technology that will revolutionize our society and healthcare or simply an immature condition of the future.
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Affiliation(s)
- Mrinmoy Kundu
- Faculty of Medicine, Institute of Medical Sciences and SUM Hospital, Bhubaneswar 751003, India
| | - Jyi Cheng Ng
- Faculty of Medicine and Health Sciences, University of Putra Malaysia, Serdang 43400, Malaysia
| | | | - Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 10250, Ireland
| | - Rohan Yarlagadda
- School of Osteopathic Medicine, Rowan University, Stratford, NJ 08807, United States
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen 4026, Hungary
| | | | - Riaz Jiffry
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin 10250, Ireland
| | | | - Brian M Ou Yong
- School of Medicine, College of Medical & Veterinary Life Sciences, University of Glasgow, Glasgow G116QQ, United Kingdom
| | | | - Arda Isik
- Department of General Surgery, Istanbul Medeniyet University, Istanbul 34100, Turkey
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Almas T, Alsufyani R, Jiffry R, Subai AKA, Almesri A, Ali SA, Baqal O, Malik J, Ahmed T, Rana MN. Estimated Glomerular Filtration Rate (eGFR) Slope Assessment as a Surrogate End-point in Cardiovascular trials: Implications, Impediments, and Future Directions. Curr Probl Cardiol 2023; 48:101508. [PMID: 36402218 DOI: 10.1016/j.cpcardiol.2022.101508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/11/2022] [Indexed: 11/18/2022]
Affiliation(s)
- Talal Almas
- Royal College of Surgeons in Ireland, Dublin, Ireland.
| | | | - Riaz Jiffry
- Royal College of Surgeons in Ireland, Dublin, Ireland
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Wireko AA, Patel H, Mehta A, Jiffry R, Adebusoye FT, Miteu GD. Pediatric brain tumors in low- and middle-income countries: available evidence on recent advancements in management, challenges, and recommendations – editorial. Int J Surg 2023; 109:235-238. [PMID: 37093068 PMCID: PMC10389311 DOI: 10.1097/js9.0000000000000226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/06/2023] [Indexed: 04/08/2023]
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