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Elkeraie AF, Al-Ghamdi S, Abu-Alfa AK, Alotaibi T, AlSaedi AJ, AlSuwaida A, Arici M, Ecder T, Ghnaimat M, Hafez MH, Hassan MH, Sqalli T. Impact of Sodium-Glucose Cotransporter-2 Inhibitors in the Management of Chronic Kidney Disease: A Middle East and Africa Perspective. Int J Nephrol Renovasc Dis 2024; 17:1-16. [PMID: 38196830 PMCID: PMC10771977 DOI: 10.2147/ijnrd.s430532] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 11/28/2023] [Indexed: 01/11/2024] Open
Abstract
Chronic kidney disease (CKD) is a major public health concern in the Middle East and Africa (MEA) region and a leading cause of death in patients with type 2 diabetes mellitus (T2DM) and hypertension. Early initiation of sodium-glucose cotransporter - 2 inhibitors (SGLT-2i) and proper sequencing with renin-angiotensin-aldosterone system inhibitors (RAASi) in these patients may result in better clinical outcomes due to their cardioprotective properties and complementary mechanisms of action. In this review, we present guideline-based consensus recommendations by experts from the MEA region, as practical algorithms for screening, early detection, nephrology referral, and treatment pathways for CKD management in patients with hypertension and diabetes mellitus. This study will help physicians take timely and appropriate actions to provide better care to patients with CKD or those at high risk of CKD.
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Affiliation(s)
- Ahmed Fathi Elkeraie
- Department of Internal Medicine and Nephrology, Alexandria University, Alexandria, Egypt
| | - Saeed Al-Ghamdi
- Department of Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ali K Abu-Alfa
- Department of Internal Medicine, Division of Nephrology and Hypertension, American University of Beirut, Beirut, Lebanon
| | - Torki Alotaibi
- Transplant Nephrology, Hamed Al-Essa Organ Transplant Center, Sabah Health Region, Kuwait City, Kuwait
| | - Ali Jasim AlSaedi
- Department of Nephrology, College of Medicine, University of Baghdad, Nephrology and Transplantation Center, Medical City Complex, Baghdad, Iraq
| | | | - Mustafa Arici
- Department of Nephrology, Faculty of Medicine, Hacettepe University, Altındağ, Ankara, Turkey
| | - Tevfik Ecder
- Department of Medicine, Istinye University; Division of Nephrology, Topkapı, Istanbul, Turkey
| | - Mohammad Ghnaimat
- Department of Nephrology, Specialty Hospital, Jaber Ibn Hayyan St. Shmeisani, Amman, Jordan
| | | | - Mohamed H Hassan
- Department of Medicine, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Tarik Sqalli
- Department of Nephrology, Moroccan Society of Nephrology, Casablanca, Morocco
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AlSahow A, AbdulShafy M, Al-Ghamdi S, AlJoburi H, AlMogbel O, Al-Rowaie F, Attallah N, Bader F, Hussein H, Hassan M, Taha K, Weir MR, Zannad F. Prevalence and management of hyperkalemia in chronic kidney disease and heart failure patients in the Gulf Cooperation Council (GCC). J Clin Hypertens (Greenwich) 2023; 25:251-258. [PMID: 36715554 PMCID: PMC9994174 DOI: 10.1111/jch.14633] [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] [Received: 08/21/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 01/31/2023]
Abstract
Hyperkalemia is a frequent complication in patients with chronic kidney disease (CKD) or heart failure (HF) and associated with neuromuscular manifestations, changes in the electrocardiogram, and increased risk of mortality. While data on the prevalence and management of hyperkalemia in the gulf region are scarce, risk factors such as preference for potassium-rich foods (e.g., dates and dried fruits/vegetables), periods of intense fasting (e.g., Ramadan), and diabetes (an ancestor of CKD and HF) are common. Therefore, a panel of nephrologists and cardiologists from countries of the Gulf Cooperation Council (GCC) convened to collate and review available data on the prevalence, regional drivers, and current practice in the management of hyperkalemia in the region. Eventually, this review provides consensus recommendations on a balanced utilization of dietary and pharmacological options including new potassium binders for achieving and sustainably maintaining desirable serum potassium levels in countries of the GCC region. Alignment with regional habits and practice was a key aspect to facilitate the uptake of the recommendations into physicians' practice and patients' lives.
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Affiliation(s)
| | | | - Saeed Al-Ghamdi
- Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | | | | | | | | | | | | | | | - Matthew R Weir
- University of Maryland School of Medicine, Baltimore, Maryland, USA
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3
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Al-Ghamdi S, Abu-Alfa A, Alotaibi T, AlSaaidi A, AlSuwaida A, Arici M, Ecder T, El Koraie AF, Ghnaimat M, Hafez MH, Hassan M, Sqalli T. Chronic Kidney Disease Management in the Middle East and Africa: Concerns, Challenges, and Novel Approaches. Int J Nephrol Renovasc Dis 2023; 16:103-112. [PMID: 37051319 PMCID: PMC10084934 DOI: 10.2147/ijnrd.s363133] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/22/2022] [Indexed: 04/14/2023] Open
Abstract
The burden of chronic kidney disease (CKD) and other comorbidities, such as hypertension and diabetes, which increase the risk of developing CKD, is on the rise in the Middle East and Africa. The Middle East and Africa CKD (MEA-CKD) steering committee, comprising eminent healthcare specialists from the Middle East and Africa, was formed to identify and propose steps to address the gaps in the management of CKD in these regions. The current article lists the MEA-CKD steering committee meeting outcomes and evaluates the available evidence supporting the role of novel therapeutic options for patients with CKD. The need of the hour is to address the gaps in awareness and screening, early diagnosis, along with referral and management of patients at risk. Measures to bring about appropriate changes in healthcare policies to ensure access to all benefit-proven protective therapies, including novel ones, at community levels are also vital for reducing the overall burden of CKD on the healthcare system as well as governing bodies, especially in developing countries of the Middle East and Africa.
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Affiliation(s)
- Saeed Al-Ghamdi
- Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom Saudi of Arabia
| | - Ali Abu-Alfa
- Department of Nephrology and Hypertension, American University of Beirut, Beirut, Lebanon
| | - Turki Alotaibi
- Department of Transplant Nephrology, Hamed Al-Essa Organ Transplant Center, Kuwait City, Kuwait
| | - Ali AlSaaidi
- Department of Nephrology, College of Medicine, University of Baghdad, Nephrology and Transplantation Center, Medical City Complex, Baghdad, Iraq
| | | | - Mustafa Arici
- Department of Nephrology, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Tevfik Ecder
- Department of Nephrology, Demiroglu Bilim University Faculty of Medicine, Istanbul, Turkey
| | - Ahmed F El Koraie
- Department of Internal Medicine and Nephrology, Alexandria Faculty of Medicine, Alexandria, Egypt
| | | | - Mohamed H Hafez
- Department of Nephrology and Medicine, Cairo University, Cairo, Egypt
| | - Mohamed Hassan
- Department of Medical Affairs, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
- Correspondence: Mohamed Hassan, Department of Medical Affairs, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates, Tel +971 508187944, Email
| | - Tarik Sqalli
- Department of Nephrology, Moroccan Society of Nephrology, Casablanca, Morocco
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Badahdah AA, Al-Ghamdi S, Banjar A, Elfirt E, Almarghlani A, Elfert A, Bahanan L. The association between salivary zinc levels and dysgeusia in COVID-19 patients. Eur Rev Med Pharmacol Sci 2022; 26:6885-6891. [PMID: 36196740 DOI: 10.26355/eurrev_202209_29793] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
OBJECTIVE Zinc insufficiency has been proposed to play a role in taste and smell impairment in Coronavirus disease 2019 (COVID-19) patients. Therefore, this study aimed at comparing salivary zinc levels in COVID-19 patients with and without dysgeusia. PATIENTS AND METHODS A total of 127 participants were recruited for this study. The patients were divided into three groups based on their COVID-19 test results and taste impairment. Groups I and II were COVID-19 positive with and without taste loss, respectively. Group III included the negative control participants. Salivary zinc levels were measured at baseline in all groups and three months after baseline in groups I and II. Wilcoxon signed-rank test was used to compare the zinc levels between baseline and three months after baseline within each group. Mann-Whitney U test was used to compare zinc levels between groups with different degrees of taste loss. RESULTS Salivary zinc levels were significantly lower in the COVID-19 positive group with taste loss compared to levels in the group without taste loss or the negative controls (p<0.005). Three months after baseline, salivary zinc levels were significantly elevated in both COVID-19 positive groups (p<0.001). CONCLUSIONS COVID-19 patients with dysgeusia had significantly lower levels of salivary zinc than positive and negative controls. Zinc levels were elevated after recovery, which may indicate that salivary zinc is directly associated with taste abnormalities and COVID-19 outcomes. This study showed that taste impairment is associated with lower salivary zinc levels in COVID-19 patients.
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Affiliation(s)
- A A Badahdah
- Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.
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Al-Homrany M, Saeed M, Ali F, Al-Ghamdi S, Mousa D, Alharbi A. The Effectiveness of Alternate-day Cinacalcet Therapy for Secondary Hyperparathyroidism in Noncompliant Hemodialysis Patients. Saudi J Kidney Dis Transpl 2022; 33:503-508. [PMID: 37929542 DOI: 10.4103/1319-2442.388184] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023] Open
Abstract
Chronic kidney disease (CKD) is defined as an abnormality of the kidney's structure or function that is present for more than 3 months. Secondary hyperparathyroidism is a consequence of CKD, which eventuates with a decrease in the glomerular filtration rate. This study aimed to evaluate the effectiveness of alternate-day cinacalcet in noncompliant dialysis patients compared with a daily dose. The effects on the levels of intact parathyroid hormone (iPTH), calcium, and phosphorus were measured, and the compliance of patients with our protocol was observed. We followed the patients' (n = 134) iPTH levels every 3 months and their serum calcium and phosphorous monthly for 6 months and compared the results with 6 months of data from patients receiving daily doses of cinacalcet. The patients' mean age was 49.54 ± 16.17 years, the mean duration of dialysis was 6.44 ± 5.10 years, and 37.3% had diabetic nephropathy. The mean dose of alternate-day cinacalcet was 61.92 ± 26.59 mg. The level of iPTH before and after the change was 924.63 ± 474.132 pg/mL and 787.87 ± 496.49 pg/mL, respectively (P = 0.001), and the mean serum calcium level before and after was 8.56 ± 1.91 mg/dL and 8.85 ± 1.25 mg/dL, respectively (P = 0.035). The level of serum phosphorous before and after the change was 4.81 ± 1.32 mg/dL and 5.08 ± 2.3 mg/dL, respectively (P = 0.204). Cinacalcet produced significant reductions in iPTH with intermittent (three times per week) doses and thus was more cost-effective and had better compliance.
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Affiliation(s)
| | | | - Furqan Ali
- Diaverum Renal Care, Riyadh, Saudi Arabia
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6
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Khoshhal S, Al-Harbi K, Al-Mozainy I, Al-Ghamdi S, Aselan A, Allugmani M, Salem S, El-Agamy D, Abo-Haded H. Assessment of quality of life among parents of children with congenital heart disease using WHOQOL-BREF: a cross-sectional study from Northwest Saudi Arabia. Health Qual Life Outcomes 2019; 17:183. [PMID: 31842888 PMCID: PMC6915919 DOI: 10.1186/s12955-019-1249-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [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: 01/23/2019] [Accepted: 11/22/2019] [Indexed: 11/10/2022] Open
Abstract
Background and aims Health-related quality of life (HRQOL) has garnered increasing interest especially for health care providers and researchers. The study aims to evaluate the HRQOL in parents of congenital heart disease (CHD) children, and to clarify the effect of the disease severity on the outcome of the HRQOL perception. Also, to analyze the internal consistency of the Arabic version of the World Health Organization (WHO) QOL-BREEF tool in order to determine whether the tool had good validity for the target population. Methods A cross-sectional study. The HRQOL perception was evaluated using WHOQOL-BREF questionnaire, and the internal consistency of the tool was tested using Cronbach’s alpha (α-C), Results The study sample consisted of 200 individuals, 120 parents of CHD children, compared to 80 parents of children with minor illnesses (mean age of participating parents = 35.1 ± 9.8 years). While evaluating the HRQOL, the group of parents of children with minor illnesses had higher scores than the total group of parents of CHD children in all domains, indicating a better HRQOL. Class-IV subgroup of parents of CHD children showed the most significant lower total score of domains between all classes (44.47 ± 12, p < 0.001). With respect to the internal consistency of the WHOQOL-BREF, estimation of α-C values were 0.84 points for the group of parents of CHD children, and 0.87 for the group of parents of children with minor illnesses. Conclusions This short-term study emphasized that, HRQOL scores among parents of CHD children are compromised, and the severity of their children illness significantly affect the total score of domains in their HRQOL perception. Furthermore, the tool showed to be practical and efficient to evaluate the QOL of parents of CHD children in our population in future researches.
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Affiliation(s)
- Saad Khoshhal
- Pediatric Cardiology Team, Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Khaled Al-Harbi
- Pediatric Cardiology Team, Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Ibrahim Al-Mozainy
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Saeed Al-Ghamdi
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Adnan Aselan
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Mohammad Allugmani
- Pediatric Cardiology Unit, Department of Pediatrics, Maternity and Children Hospital (MCH), Al-Madinah Al-Munawarah, Saudi Arabia
| | - Sherif Salem
- Pediatric Cardiology Department, Madinah Cardiac Center (MCC), Al-Madinah Al-Munawarah, Saudi Arabia.,Department of Pediatrics, Faculty of Medicine, Menoufiya University, Menoufiya, Egypt
| | - Dina El-Agamy
- Department of Pharmacology, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Hany Abo-Haded
- Pediatric Cardiology Team, Department of Pediatrics, Faculty of Medicine, Taibah University, Al-Madinah Al-Munawarah, Saudi Arabia. .,Pediatric Cardiology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, 35516, Egypt.
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AlSahow A, Muenz D, Al-Ghonaim M, Al Salmi I, Hassan M, Al Aradi A, Hamad A, Al-Ghamdi S, Shaheen F, Alyousef A, Bieber B, Robinson B, Pisoni R. FP530KT/V ACHIEVEMENT AND SURVIVAL IN HEMODIALYSIS PATIENTS IN THE GULF COOPERATION COUNCIL (GCC) COUNTRIES: INTERNATIONAL RESULTS FROM DOPPS 5 & 6 (2012-2018). Nephrol Dial Transplant 2019. [DOI: 10.1093/ndt/gfz106.fp530] [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] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Daniel Muenz
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
| | | | | | | | | | | | | | | | | | - Brian Bieber
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
| | - Bruce Robinson
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
| | - Ronald Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, United States of America
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Prasad SC, Laus M, Al-Ghamdi S, Vashishth A, Piazza P, Sanna M. Update in the classification and the role of intra-arterial stenting in the management of carotid body paragangliomas. Head Neck 2019; 41:1379-1386. [PMID: 30771228 DOI: 10.1002/hed.25567] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 06/02/2018] [Accepted: 11/21/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To review the Shamblin classification of carotid body paragangliomas (CBPs) and the role of intra-arterial stenting in their surgical management. METHODS Retrospective case series of 20 patients with 28 CBPs that were surgically resected at our center. Intra-arterial stenting was performed in Shamblin II and II classes. RESULTS The mean follow-up was 47.8 months. Five (17.9%) tumors were Shamblin class I, 15 (53.6%) were class II, and 8 (28.6%) were class III. Thirteen (68.4%) CBPs were associated with other paragangliomas. The internal carotid artery (ICA) was stented preoperatively in eight (28.6%) cases and occluded in four (14.3%) cases. The tumor extended to the jugular foramen in six cases (21.4%). Intraoperatively, there was an ICA injury in one case of Shamblin II CBP in the present era. CONCLUSIONS The proposed classification enables the clinician to plan the management of the ICA and the right approach. Stenting of the ICA gives a chance for complete tumor removal with arterial preservation.
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Affiliation(s)
| | - Melissa Laus
- Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Italy.,Department of ENT-Head & Neck Surgery, University of Chieti, Chieti, Italy
| | - Saeed Al-Ghamdi
- Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Italy
| | - Ashish Vashishth
- Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Italy
| | - Paolo Piazza
- Department of Neuroradiology, University-Hospital of Parma, Parma, Italy
| | - Mario Sanna
- Department of Otology & Skull Base Surgery, Gruppo Otologico, Piacenza, Italy
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Salama SM, Ibrahim IAA, Shahzad N, Al-Ghamdi S, Ayoub N, AlRashdi AS, Abdulla MA, Salehen N, Bilgen M. Hepatoprotectivity of Panduratin A against liver damage: In vivo demonstration with a rat model of cirrhosis induced by thioacetamide. APMIS 2018; 126:710-721. [PMID: 30058214 DOI: 10.1111/apm.12878] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 08/04/2017] [Accepted: 06/22/2018] [Indexed: 12/16/2022]
Abstract
This experiment evaluated Panduratin A (PA), a chalcone isolated from Boesenbergia rotunda rhizomes, for its hepatoprotectivity. Rats were subjected to liver damage induced by intra-peritoneal injection of thioacetamide (TAA). PA was tested first for its acute toxicity and then administered by oral gavage at doses 5, 10, and 50 mg/kg to rats. At the end of the 8th week, livers from all rats were excised and evaluated ex vivo. Measurements included alkaline phosphatase (AP), alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transferase (GGT), serum platelet-derived growth factor (PDGF) and transforming growth factor (TGF-β1), and hepatic metalloproteinase enzyme (MMP-2) and its inhibitor extracellular matrix protein (TIMP-1). Oxidative stress was measured by liver malondialdehyde (MDA) and nitrotyrosine levels, urinary 8-hydroxy 2- deoxyguanosine (8-OH-dG), and hepatic antioxidant enzyme activities. The immunohistochemistry of TGF-β1 was additionally performed. PA revealed safe dose of 250 mg/kg on experimental rats and positive effect on the liver. The results suggested reduced hepatic stellate cells (HSCs) activity as verified from the attenuation of serum PDGF and TGF-β1, hepatic MMP-2 and TIMP-1, and oxidative stress. The extensive data altogether conclude that PA treatment could protect the liver from the progression of cirrhosis through a possible mechanism inhibiting HSCs activity.
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Affiliation(s)
- Suzy M Salama
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ibrahim Abdel Aziz Ibrahim
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Naiyer Shahzad
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Saeed Al-Ghamdi
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Nahla Ayoub
- Department of Pharmacology and Toxicology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ahmed Salim AlRashdi
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mahmood Ameen Abdulla
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nur'Ain Salehen
- Department of Biomedical Science, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Mehmet Bilgen
- Biophysics Department, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
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Al-Ghamdi S. Prevalence, knowledge & attitudes toward herbal use during pregnancy, labor and after delivery. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw174.018] [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] [Indexed: 11/14/2022] Open
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Al Sayed N, Al Waili K, Alawadi F, Al-Ghamdi S, Al Mahmeed W, Al-Nouri F, Al Rukhaimi M, Al-Rasadi K, Awan Z, Farghaly M, Hassanein M, Sabbour H, Zubaid M, Barter P. Consensus clinical recommendations for the management of plasma lipid disorders in the Middle East. Int J Cardiol 2016; 225:268-283. [PMID: 27741487 DOI: 10.1016/j.ijcard.2016.09.081] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/22/2016] [Accepted: 09/23/2016] [Indexed: 12/22/2022]
Abstract
BACKGROUND Plasma lipid disorders are key risk factors for the development of atherosclerotic cardiovascular disease (ASCVD) and are prevalent in the Middle East, with rates increasing in recent decades. Despite this, no region-specific guidelines for managing plasma lipids exist and there is a lack of use of guidelines developed in other regions. METHODS A multidisciplinary panel of regional experts was convened to develop consensus clinical recommendations for the management of plasma lipids in the Middle East. The panel considered existing international guidelines and regional clinical experience to develop recommendations. RESULTS The panel's recommendations include plasma lipid screening, ASCVD risk calculation and treatment considerations. The panel recommend that plasma lipid levels should be measured in all at-risk patients and at regular intervals in all adults from the age of 20years. A scoring system should be used to calculate ASCVD risk that includes known lipid and non-lipid risk factors. Primary treatment targets include low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol. Lifestyle modifications should be first-line treatment for all patients; the first-line pharmacological treatment targeting plasma lipids in patients at moderate-to-high risk of ASCVD is statin therapy, with a number of adjunctive or second-line agents available. Guidance is also provided on the management of underlying conditions and special populations; of particular pertinence in the region are familial hypercholesterolaemia, diabetes and metabolic dyslipidaemia. CONCLUSIONS These consensus clinical recommendations provide practicing clinicians with comprehensive, region-specific guidance to improve the detection and management of plasma lipid disorders in patients in the Middle East.
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Affiliation(s)
- Nasreen Al Sayed
- Gulf Diabetes Specialist Center, P.O. Box 21686, Manama, Bahrain.
| | - Khalid Al Waili
- Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Al-Khod, P.O. Box 38, postal code 123, Muscat, Oman.
| | - Fatheya Alawadi
- Endocrine Department, Dubai Hospital, Dubai Health Authority, Dubai, United Arab Emirates.
| | - Saeed Al-Ghamdi
- Department of Medicine, King Abdulaziz University Hospital, P.O. Box 80215, Jeddah 21589, Saudi Arabia.
| | - Wael Al Mahmeed
- Heart and Vascular Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates.
| | - Fahad Al-Nouri
- Cardiovascular Prevention Unit, Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
| | - Mona Al Rukhaimi
- Dubai Medical College, P.O. Box 22331, Dubai, United Arab Emirates.
| | - Khalid Al-Rasadi
- Department of Biochemistry, Sultan Qaboos University Hospital, Al-Khod, P.O. Box 38, postal code 123, Muscat, Oman.
| | - Zuhier Awan
- King Abdulaziz University, Jeddah 22254, Saudi Arabia.
| | | | | | - Hani Sabbour
- Shaikh Khalifa Medical City, Cardiac Sciences Institute, Abu Dhabi, United Arab Emirates.
| | - Mohammad Zubaid
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait.
| | - Philip Barter
- School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.
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Abstract
AIM: The prevalence of obstructive sleep apnea (OSA) in end-stage renal disease (ESRD) patients was reported to be 10-fold that in the general population. OSA can worsen the clinical symptoms and cardiovascular complications of ESRD. We aimed to investigate the prevalence of symptoms and risk of OSA among Saudi patients with ESRD. SETTINGS AND DESIGN: This multi-center, cross-sectional study was conducted in Jeddah, Saudi Arabia, between June 2012 and September 2013. METHODS: The prevalence of OSA was assessed using the Berlin questionnaire. The presence of daytime sleepiness was evaluated using the Epworth sleepiness scale. Data were also collected on the medical history, clinical, and laboratory findings of participants. RESULTS: In all, 355 patients (61% male) were enrolled (mean age: 45.5 ± 15.4 years). The overall prevalence of high-risk of OSA was 44.2% (males, 47.3%; females, 44.8%; P = 0.65). The prevalence of excessive daytime sleepiness (EDS) was 74%. Controlling for age, gender and body mass index, multivariate analysis revealed that hypertension and hepatitis C infection were the only comorbidities significantly associated with OSA (odds ratio [OR]: 3.827 and 0.559; confidence interval [CI]: 2.120-6.906 and 0.324-0.964; P < 0.0001 and 0.036, respectively). OSA was also strongly associated with EDS (OR: 3.054; CI: 1.676-5.565; P < 0.0001). CONCLUSIONS: In Saudi Arabia, the risk of OSA is more common in ESRD patients than in the general population. OSA is strongly associated with EDS. Interestingly, a significant negative correlation between OSA and hepatitis C infection was noted, which warrants further investigation.
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Affiliation(s)
- Siraj Omar Wali
- Sleep Medicine and Research Center, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Abeer Alkhouli
- Department of Statistics, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohannad Howladar
- Sleep Medicine and Research Center, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Ibrahim Ahmad
- Sleep Medicine and Research Center, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Saad Alshohaib
- Renal Unit, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Saeed Al-Ghamdi
- Renal Unit, Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia
| | - Ayman Krayem
- Sleep Disorders Center, Department of Medicine, King Abdulaziz Medical City, Jeddah, Saudi Arabia
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Mail N, Albarakati Y, Ahmad Khan M, Saeedi F, Safadi N, Al-Ghamdi S, Saoudi A. The impacts of dental filling materials on RapidArc treatment planning and dose delivery: challenges and solution. Med Phys 2014; 40:081714. [PMID: 23927311 DOI: 10.1118/1.4816307] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The presence of high-density material in the oral cavity creates dose perturbation in both downstream and upstream directions at the surfaces of dental filling materials (DFM). In this study, the authors have investigated the effect of DFM on head and neck RapidArc treatment plans and delivery. Solutions are proposed to address (1) the issue of downstream dose perturbation, which might cause target under dosage, and (2) to reduce the upstream dose from DFM which may be the primary source of mucositis. In addition, an investigation of the clinical role of a custom-made plastic dental mold∕gutter (PDM) in sparing the oral mucosa and tongue reaction is outlined. METHODS The influence of the dental filling artifacts on dose distribution was investigated using a geometrically well-defined head and neck intensity modulated radiation therapy (IMRT) verification phantom (PTW, Freiberg, Germany) with DFM inserts called amalgam, which contained 50% mercury, 25% silver, 14% tin, 8% copper, and 3% other trace metals. Three RapidArc plans were generated in the Varian Eclipse System to treat the oral cavity using the same computer tomography (CT) dataset, including (1) a raw CT image, (2) a streaking artifacts region, which was replaced with a mask of 10 HU, and (3) a 2 cm-thick 6000 HU virtual filter [a volume created in treatment planning system to compensate for beam attenuation, where the thickness of this virtual filter is based on the measured percent depth dose (PDD) data and Eclipse calculation]. The dose delivery for the three plans was verified using Gafchromic-EBT2 film measurements. The custom-made PDM technique to reduce backscatter dose was clinically tested on four head and neck cancer patients (T3, N1, M0) with DFM, two patients with PDM and the other two patients without PDM. The thickness calculation of the PDM toward the mucosa and tongue was purely based on the measured upstream dose. Patients' with oral mucosal reaction was clinically examined initially and weekly during the course of radiotherapy. RESULTS For a RapidArc treatment technique, the backscatter dose from the DFM insert was measured to be 9.25±2.17 in the IMRT-verification-phantom. The measured backscatter upstream dose from DFM for a single-field was 22% higher than without the DFM, whereas the downstream dose was lower by 14%. The values of homogeneity index for the plans with and without the application of mask were 0.09 and 0.14, respectively. The calculated mean treatment planning volume (PTV) dose differed from the delivered dose by 13% and was reduced to 2% when using the mask and virtual filter together. A grade 3 mucosa reaction was observed in the control group after 22-24 fractions (44-48 Gy). In contrast, no grade 3 mucositis was observed in the patients wearing the PDM after 25-26 fractions (50-52 Gy). CONCLUSIONS The backscatter from the DFM for a single, parallel-opposed fields, and RapidArc treatment technique was found significant. The application of mask in replacing streaking artifacts can be useful in improving dose homogeneity in the PTV. The use of a virtual filter around the teeth during the planning phase reduces the target underdosage issue in the phantom. Furthermore, a reduction in mucositis is observed in the head and neck patients with the use of PDM.
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Affiliation(s)
- Noor Mail
- Princess Norah Oncology Center, National Guard Health Affairs, Jeddah 21423, Saudi Arabia.
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Al-Ghamdi S, Moreira J, de Lasa H. Kinetic Modeling of Propane Oxidative Dehydrogenation over VOx/γ-Al2O3 Catalysts in the Chemical Reactor Engineering Center Riser Reactor Simulator. Ind Eng Chem Res 2014. [DOI: 10.1021/ie404064j] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- S. Al-Ghamdi
- Chemical
Reactor Engineering Centre, University of Western Ontario, London, Ontario, Canada
- Research & Development Center, Saudi Aramco Oil Company, Dhahran, Saudi Arabia
| | - J. Moreira
- Chemical
Reactor Engineering Centre, University of Western Ontario, London, Ontario, Canada
| | - H. de Lasa
- Chemical
Reactor Engineering Centre, University of Western Ontario, London, Ontario, Canada
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Gomaa W, Bahlas S, Habhab W, Mushtaq M, Al-Ghamdi S, Al-Maghrabi J. Clinicopathological characteristics of lupus nephritis in Western region of Saudi Arabia: An experience from two tertiary medical centres. J Microsc Ultrastruct 2014. [DOI: 10.1016/j.jmau.2014.02.001] [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] [Indexed: 10/25/2022] Open
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16
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Al-Aama J, Al-Ghamdi S, Bdier A, AlQarawi A, Jiman O, Al-Aama N, Al-Aata J, Wilde A, Bhuiyan Z. Genotype-phenotype analysis of Jervell and Lange-Nielsen syndrome in six families from Saudi Arabia. Clin Genet 2013; 87:74-9. [DOI: 10.1111/cge.12330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Revised: 11/28/2013] [Accepted: 12/02/2013] [Indexed: 11/29/2022]
Affiliation(s)
- J.Y. Al-Aama
- Department of Genetic Medicine; King Abdulaziz University Hospital; Jeddah Saudi Arabia
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
| | - S. Al-Ghamdi
- Department of Pediatric Cardiology; Prince Sultan Cardiac Center; Riyadh Saudi Arabia
| | - A.Y. Bdier
- Department of Genetic Medicine; King Abdulaziz University Hospital; Jeddah Saudi Arabia
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
| | - A. AlQarawi
- Department of Genetic Medicine; King Abdulaziz University Hospital; Jeddah Saudi Arabia
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
| | - O.A. Jiman
- Department of Genetic Medicine; King Abdulaziz University Hospital; Jeddah Saudi Arabia
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
| | - N. Al-Aama
- Department of Cardiology; King Abdulaziz University Hospital; Jeddah Saudi Arabia
| | - J. Al-Aata
- Department of Cardiology; King Abdulaziz University Hospital; Jeddah Saudi Arabia
| | - A.A.M. Wilde
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
- Department of Cardiology, Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
| | - Z.A. Bhuiyan
- Laboratoire de Génétique Moléculaire, Service de Génétique Médicale; CHUV; Lausanne Switzerland
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Al-Aama J, Al-Ghamdi S, Bdier A, Wilde A, Bhuiyan ZA. De novomutation in theKCNQ1gene causal to Jervell and Lange-Nielsen syndrome. Clin Genet 2013; 86:492-5. [DOI: 10.1111/cge.12300] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 10/02/2013] [Accepted: 10/09/2013] [Indexed: 11/27/2022]
Affiliation(s)
- J.Y. Al-Aama
- Department of Genetic Medicine; King Abdulaziz University Hospital; Jeddah Saudi Arabia
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
| | - S. Al-Ghamdi
- Department of Pediatric Cardiology; Prince Sultan Cardiac Center; Riyadh Saudi Arabia
| | - A.Y. Bdier
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
| | - A.A.M. Wilde
- Princess Al Jawhara Albrahim Center of Excellence in Research of Hereditary Disorders; King Abdulaziz University; Jeddah Saudi Arabia
- Department of Cardiology, Academic Medical Center; University of Amsterdam; Amsterdam the Netherlands
| | - Zahurul A. Bhuiyan
- Laboratoire de Génétique Moléculaire, Service de Génétique Médicale; CHUV; Lausanne Switzerland
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Khan M, Safadi N, Al-Ghamdi S, Mail N, Saoudi A. EP-1207 BENEFIT OF SYSTEMATIC RAPIDARC RE-PLANNING AND ADAPTIVE TREATMENT OF NASOPHARYNGEAL CANCER. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)71540-2] [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] [Indexed: 10/28/2022]
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Mail N, AlBarakati Y, Khan M, Saeedi F, Safadi N, Al-Ghamdi S, Shabra A, Saoudi A. OC-0229 EFFECT OF DENTAL FILLING ON HEAD AND NECK RAPIDARC TREATMENT: CLINICAL CHALLENGES AND SOLUTION. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70568-6] [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] [Indexed: 11/25/2022]
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20
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Elsheikh H, Ibrahim E, Al-Ghamdi S, Al-Malki T, Elhadd T. Metabolic efficacy of PHS-E 2(Glucoherb), a chinese antidiabetic herbal health product, in Streptozotocin-induced diabetic wistar rats. Saudi J Health Sci 2012. [DOI: 10.4103/2278-0521.94978] [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] [Indexed: 11/04/2022] Open
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Al Ahmed B, Khawandanah E, Al Safadi N, Al-Ghamdi S, Saoudi A. 186 oral ASSESSMENT OF HEAD AND NECK IMMOBILIZATION DEVICE FOR ACCURATE RAPIDARC(r) TREATMENT DELIVERY. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)70308-5] [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] [Indexed: 10/18/2022]
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Blair J, Hodge W, Al-Ghamdi S, Balabanian R, Lowcock B, Pan YI, Sherif H, AlMahmoud T, Fergusson D, Slomovic A. Comparison of antibiotic-only and antibiotic-steroid combination treatment in corneal ulcer patients: double-blinded randomized clinical trial. Can J Ophthalmol 2011; 46:40-5. [PMID: 21283156 DOI: 10.3129/i10-054] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE To determine the benefit of early addition of corticosteroids to antibiotics in the treatment of corneal ulcers. DESIGN Randomized clinical trial. PARTICIPANTS Thirty eyes of 30 patients, over the age of 12 years, with bacterial corneal ulcer confirmed by culture. METHODS Patients were randomized before enrollment; 15 were treated with gatifloxacin (Zymar) and a masked placebo and the other 15 were treated with gatifloxacin and masked dexamethasone 0.1% (Maxidex). Primary outcome was residual ulcer size at 10 weeks based on digital photographs. Secondary outcomes included residual ulcer area by clinician estimate, visual acuity, VF-14 score, and time to healing. RESULTS All subjects (n = 30) demonstrated a reduction in ulcer size over the study period. There was no significant difference between the 2 groups in terms of the primary outcome. There was a significant difference between the 2 groups in 1 of the secondary outcomes. The mean residual ulcer size compared with the baseline by clinician estimate (slit-lamp) was -0.789 mm2 for the antibiotic-only group and -4.206 mm2 for the antibiotic-steroid group (p = 0.05). Among the other secondary outcomes there were no significant differences between the 2 groups. CONCLUSIONS No benefit was demonstrated in our primary outcome for using steroids in combination with antibiotic therapy in treatment of corneal ulcers. This study suggests that the early addition of steroids to the antibiotic treatment of corneal ulcers does not seem to be harmful when employed in a closely monitored clinical setting.
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Affiliation(s)
- Jason Blair
- Department of Ophthalmology, University of Ottawa, Ottawa, Ont
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Khawajah AQ, Al-Maghrabi J, Kanaan HD, Al-Ghamdi S. IgA nephropathy: a clinicopathologic study from two centers in Saudi Arabia. Saudi J Kidney Dis Transpl 2010; 21:269-275. [PMID: 20228512] [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: 05/28/2023] Open
Abstract
A total of 42 patients, who were diagnosed to have primary Immunoglobulin A nephropathy (IgAN) at the King Abdul Aziz University Hospital and King Faisal Hospital, Jeddah over the last seven years, were studied. The objective was to analyze their clinical and pathological features and to classify them according to Hass Classification by using light, immunofluorescence and electron microscopy. Majority of the study cases were males in the second, third and fourth decades of life. Hematuria was the most common clinical complaint followed by proteinuria. There were varying degrees of mesangial proliferation. Majority of the cases presented with class-2 followed by class-3. Immunofluorescence demonstrated diffuse granular deposition of IgA in the glomerular mesangium in majority of the cases. Ultrastructural analysis showed electron dense deposits within the matrix of the mesangium and paramesangium in majority of the cases. Sub-endothelial deposits and mesangial interposition were demonstrated in few cases. Extensive effacement with fusion of the visceral epithelial foot processes was detected in only few patients while focal effacement was demonstrated in many cases. Irregularities of the glomerular basement membrane were seen in some cases. We conclude that IgA nephropathy is an immune-complex glomerular disease, which occurs at all ages and with higher frequency in males and presents mostly with hematuria and proteinuria. Public health awareness is seriously needed to perform the investigations at an early stage.
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Abstract
BACKGROUND Strabismus surgery involving open exploration of the posterior orbit is difficult. Exploration is sometimes avoided by considering alternative procedures (transposition and weakening other muscles). Although the use of endoscopic sinus surgery (ESS) to retrieve medial rectus (MR) muscles lost in the posterior orbit has been described, the use of an endoscopic approach to the posterior orbit in elective strabismus surgery has never been reported. METHODS A patient with thyroid orbitopathy had severe bilateral restrictive strabismus with bilateral esohypotropia, rendering him functionally blind. The MR was inaccessible via the anterior approach. We describe a transnasal endoscopic approach to the posterior orbit where the MR was identified, sectioned, and reattached to the globe. We also describe two other patients who had endoscopic posterior orbit exploration after ESS-related MR injury. RESULTS In patient 1, repositioning of the medial rectus muscles facilitated follow-up conventional strabismus surgery and dramatically improved ocular alignment. In patient 2, the medial rectus muscle was severely disrupted. A temporary traction suture was placed endoscapically. Follow-up transposition strabimus resulted in satisfactory alignment. In patient 3, endoscopic exploration and freeing of adhesions was done in anticipation of follow-up strabismus surgery. CONCLUSION These cases illustrate the expanding frontiers of ESS. The endoscopic approach to the posterior orbit allows enhanced posterior orbit access in elective strabismus surgery and posttraumatic exploration of the MR.
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Affiliation(s)
- Michael Flanders
- Department of Ophthalmology, McGill University Health Center, Centre Hospitalier de l'Université de Montreal, Montreal, Canada.
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Abdelmoneim I, Khan MY, Daffalla A, Al-Ghamdi S, Al-Gamal M. Knowledge and attitudes towards AIDS among Saudi and non-Saudi bus drivers. East Mediterr Health J 2002; 8:716-24. [PMID: 15568448] [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] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We explored the AIDS knowledge and attitudes of long-distance (non-Saudi) and in-city (Saudi) bus drivers in Saudi Arabia. The 69 non-Saudi drivers tended to score higher on knowledge than the 40 Saudi drivers although there were several gaps in their knowledge. As regards attitude, more Saudis knew that chastity could protect against AIDS and both groups tended to think that they were not the kind of people to get AIDS. Intensive health education and follow up is highly recommended for this sector of workers.
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Affiliation(s)
- I Abdelmoneim
- Department of Family and Community Medicine, College of Medicine and Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Abstract
The incidence of nosocomial infection and prevalence of antibiotic misuse were studied in a 174-bed community hospital in Saudi Arabia over a six-month period. Of 2445 patients admitted, 8.5% developed nosocomial infection, the rates were highest for nursery (35.8%), intensive care (19.8%), gynaecological (16.2%) and surgical (11.7%) patients. Urinary tract (31.3%), wound (27.1%) and blood (14.9%) infections accounted for more than 70% of the infections. Staphylococcus aureus (23%) and Pseudomonas aeruginosa (11%), caused more than 90% of the infections. The majority of the bacterial pathogens (79%) were multi-drug resistant. Over 80% of patients were administered prophylactic and/or therapeutic antibiotics, with 53% receiving multiple antibiotics; 72% of the antibiotics were judged to be misused. Both prophylaxis and treatment were mostly misguided and clinically unwarranted. Host- and hospital-associated infection risk factors were identified. The minimum government cost estimates for the nosocomial infections and misused antibiotics were US $273 180 and $565 603, respectively. The findings emphasize the need for effective measures to reduce both the high infection rates and widespread antibiotic misusage in the hospital. Such measures should include institution of an effective infection control committee and a hospital antibiotic policy.
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Affiliation(s)
- S Al-Ghamdi
- Departments of Clinical Microbiology and Parasitology, King Khalid University, Abha, Saudi Arabia
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Ghalib HW, Al-Ghamdi S, Akood M, Haridi AEA, Ageel AAM, Abdalla RE. Therapeutic efficacy of chloroquine against uncomplicated, Plasmodium falciparummalaria in south-western Saudi Arabia. Annals of Tropical Medicine & Parasitology 2001. [DOI: 10.1080/00034983.2001.11813696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ghalib HW, Al-Ghamdi S, Akood M, Haridi AE, Ageel AA, Abdalla RE. Therapeutic efficacy of chloroquine against uncomplicated, Plasmodium falciparum malaria in south-western Saudi Arabia. Ann Trop Med Parasitol 2001; 95:773-9. [PMID: 11784431 DOI: 10.1080/0003498012011127] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The results of annual random screening indicated that Plasmodium falciparum strains showing chloroquine (CQ) resistance in vitro became increasingly common in the Jazan region of south-western Saudi Arabia between 1986 and 1998 (chi(2) for trend = 50.027; P < 0.001). This worrying trend and the emergence of a micro-epidemic in 1997-1998 prompted an assessment of the therapeutic efficacy of CQ against uncomplicated, P. falciparum malaria in the area. The in-vivo testing of sensitivity to CQ was carried out in 291 clinically manifest, microscopically positive cases of P. falciparum malaria. Most of these patients (88%) were successfully treated with a single standard regimen of CQ therapy. The other 36 patients (12%) showed early treatment failure or a poor response to the CQ, although all of these were then successfully treated with a single standard dose of sulfadoxine-pyrimethamine (Fansidar), as a replacement therapy. Those unsuccessfully treated with CQ were generally younger (t = 2.625; P = 0.01) and tended to have higher body temperatures (t = -2.62; P = 0.012) and higher levels of parasitaemia at initial presentation (P > 0.000) than those who responded well to the drug. Although CQ remains a reasonably effective drug for the treatment of malaria in the Jazan region, and therefore will be kept as the first-line drug for the foreseeable future, failure of CQ efficacy must be carefully monitored in the area.
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Affiliation(s)
- H W Ghalib
- Department of Clinical Microbiology & Parasitology, College of Medicine, King Khalid University, P.O. Box 641 Abha, Saudi Arabia.
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Affiliation(s)
- S Al-Ghamdi
- Department of Surgery (Otolaryngology), College of Medicine, King Saud University-Abha Branch, Abha, Saudi Arabia
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Shamim A, Al-Ghamdi S, Kameswaran M, Shenoy AK, Thomas R, Okafor BC. Is fine needle aspiration of the tonsil superior to a surface swab for isolating its core flora in recurrent tonsillitis? Ann Saudi Med 1996; 16:50-2. [PMID: 17372407 DOI: 10.5144/0256-4947.1996.50] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This prospective study was designed to explore the possible role of fine needle aspiration of recurrently inflamed tonsils in determining their core flora. Seventy-seven patients undergoing tosillectomy for recurrent tonsillitis were included. Colonies grown from fine needle aspirate and surface swab were compared with tonsillar core culture obtained after tosillectomy. The pathogens isolated by fine needle aspiration culture were not greatly different from surface swab results in comparison to core isolates. The results of fine needle aspirate do not appear to confer any advantage over surface swab in representing core flora. These findings would seem to indicate no clinical use for fine needle aspiration in the management of recurrent tonsillitis.
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Affiliation(s)
- A Shamim
- Departments of Otolaryngology and Microbiology, Asir Central Hospital and College of Medicine, King Saud University, Abha, Saudi Arabia
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