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   Table of Contents - Current issue
January-March 2020
Volume 12 | Issue 1
Page Nos. 1-75

Online since Thursday, March 26, 2020

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Ibnosina journal of medicine and biomedical sciences 2009–2019: Achievements, ambitions, and challenges p. 1
Elmahdi A Elkhammas, Salem A Beshyah
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Maternal and fetal outcomes in systemic lupus erythematosus p. 6
Rajaie A Namas, Bashir T Salih
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Nicotinamide adenine dinucleotide, the sirtuins, and the secret of a long health span p. 8
Nasr Anaizi
The sirtuins constitute a family of proteins with broad enzymatic activities that have an absolute requirement for nicotinamide adenine dinucleotide (NAD+) as a cosubstrate. Evidence has been mounting over the past 15 years or so that implicates the sirtuins in a vast array of critical cellular functions. In addition to transcription silencing and DNA repair, these functions include the regulation of ion channels, neuronal functions, cell growth, circadian rhythm, inflammatory response, mitochondrial biogenesis, insulin secretion, fat oxidation, and glucose metabolism. The sirtuins are critical for maintaining mitochondrial health, energy homeostasis, and redox balance. The sirtuins are widely believed to be behind the extension of lifespan brought about by calorie restriction and fasting. Changes in sirtuins activities have been linked to most age-related pathologies including cardiovascular disease, cancer, and Alzheimer's disease (AD). NAD+ is familiar to students of biological chemistry as an enzyme cofactor whose presence is essential for the progress of hundreds of vital biochemical reactions. This compound is present in virtually all living organisms. Simply put, without NAD+, life as we know it would not exist. The progress of these reactions requires the cleavage of NAD+, whose intracellular levels are known to decline steadily with age. This decline and its negative impact on the activities of these enzymes and on metabolism in general are implicated in the development of metabolic and age-linked diseases. Therefore, maintaining high intracellular NAD+ levels throughout life may not only extend the lifespan but is likely to extend the health span as well. In this paper I review how the intracellular pool of NAD+ is maintained and summarize the functions and regulation of sirtuins activities.
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A bibliometric analysis of the international medical literature on predatory publishing p. 23
Anas S Beshyah, Momna Basher, Salem A Beshyah
Introduction: Predatory journals threaten the quality, honesty, and credibility of published scholarly work. This study aimed to provide a quantitative overview of the issues of predatory publishing and journals in international literature. Materials and Methods: We searched the Scopus database for “predatory journalism and publishing” in the abstract, keywords, and title between 2012 and 2018. The Scopus tools were used online for calculations, and VOSviewer was used to construct the visualization maps. Documents were analyzed for bibliographic and citation characteristics such as publication years, languages, countries or regions, journals, articles, and authors. Results: Four hundred and eleven articles were retrieved; 31.3% were “open access;” 46.0% were original research articles. Medical journals were of varying impact. Authors from the USA and affiliated institutions were the most dominant. One author has a clearly evident dedication to the subject being the first to coin the term “predatory” journals. Visualization maps showed sparse associations between most prolific authors, journals, and institutions. Conclusions: This study is the first bibliometric analysis of the threat of predatory journalism to medical research. Increasing anxiety is evident with an uncoordinated strive to fight it. The study represents a starting point to identify and quantify the gaps in the field. It should help pinpoint possible directions and potential collaborations for future action.
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Maternal and fetal outcomes in patients with systemic lupus erythematosus p. 33
Abdelnasir M Ahmed, Salem A Ibkhatra, Fathi M Elbraky, Khaled D Alsaeiti
Objectives: Lupus is associated with a considerable risk of fetal and maternal complications. The aim of this study was to assess the maternal and fetal outcomes in pregnant women with systemic lupus erythematosus (SLE) and likely predictors of adverse outcome in Benghazi, Libya. Patients and Methods: This was a retrospective review of the outcome of sixty pregnancies among 48 SLE patients attending the rheumatology clinics at Benghazi medical center, who were pregnant from January 2008 to December 2018. Each pregnancy was counted as a separate case. Results: The mean age to conceive was 30.6±6.1 years (19–42 years). Nineteen (31.7%) patients were primigravida, and the patients' age at SLE diagnosis was 25.2 ± 5.6 years. Forty-eight of the pregnancies (80%) were planned, ten patients have preexisting hypertension (HTN), most cases were in clinical remission before pregnancy (53 patients; 88%), only seven patients were identified as having active disease, four of them had lupus nephritis based on clinical features. Secondary antiphospholipid syndrome was diagnosed in four patients. Most pregnancies (50; 83%) resulted in live birth babies, 3 (5%) of them were preterm due to preeclampsia, six pregnancies (10%) ended in spontaneous abortion, and there were four intrauterine fetal deaths. More positive cases for aCl antibodies were affected than negative cases (P = 0.005). Five pregnancies complicated by preeclampsia, three of them have preexisting HTN, thirty patients (50%) underwent vaginal delivery, twenty patients (33%) underwent cesarean section due to different obstetric indications (previous cesareans and preeclampsia). Thirteen neonates (26%) were born with low birth weight, and two neonates (3%) required neonatal intensive care unit admission; no neonatal cases of lupus or congenital cardiac problems were reported. Postnatal SLE flare was reported among 16 patients (53%); preexisting HTN was strongly associated with preeclampsia, preterm labor, and postnatal SLE flares (P-values were 0.001, 0.003, and 0.004, respectively), whereas secondary Antiphospholipid antibody syndrome (APL) was associated with preeclampsia and abortion (P = 0.005 and 0.002). Conclusion: Preexisting HTN and secondary APL are associated with an increased risk of pregnancy complications. Characteristics and outcomes in our series are comparable to previously published international cohorts.
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Cryptococcal meningitis in Qatar: A hospital based study from 2005-2015 Highly accessed article p. 38
Fahmi Yousef Khan, Mohamed Abu Khattab, Mohamed Abu Qamar, Muna Al Maslamani, Hussam Al Soub, Anand Deshmukh
Introduction: Cryptococcal meningitis (CM) is an opportunistic and life-threatening infection, affecting mainly patients with AIDS. The aim of this study was to estimate the prevalence of CM and describe its clinical profile, laboratory parameters, and outcomes in patients with CM in Qatar. Patients and Methods: This retrospective study was conducted at Hamad General Hospital. This study includes all patients admitted to the hospital with CM from January 1, 2005, to December 31, 2015. Results: Eleven patients were included in the study, representing 0.01% of the total admissions and 1.1% of all reported meningitis cases during the study; their mean age was 38.5 ± 12 years. Seven patients (63.6%) were males, and most of them were Filipinos. The most frequent presenting symptom was a headache. Six patients (54.5%) were HIV seropositive, three (27.3%) had preexisting immunosuppressive disorders, and two patients (18.2%) had no risk factors. All the patients tested positive in the cerebrospinal fluid (CSF) India ink examination and had a positive CSF culture for Cryptococcus neoformans. All patients received amphotericin B or liposomal amphotericin B with or without 5-flucytosine as induction treatment. Ten patients received fluconazole as consolidation/maintenance therapy. Eight patients (72.7%) were cured at the end of the treatment period. Two patients (18.2%) left before treatment completion, while one patient (9%) died during admission. Conclusions: CM is rare in Qatar and affects both HIV-positive and HIV-negative expatriates. Clinical presentation is nonspecific and requires a high index of suspicion.
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A rare encounter in nonsuspecting circumstances: First congenital visceral leishmaniasis (kala-azar) in Libya p. 44
Amal Salem Elarabi, Zinab Ashour Saad, Walid K Saadawi, Nadia Milad Aldobea, Fauzi Abdalla Sagher
Congenital transmission of Leishmaniasis is very rare. It occurs through blood exchange from the mother to the child during pregnancy or delivery. We report the first confirmed congenital leishmaniasis in a 4-month-old Libyan boy with prolonged jaundice and hepatosplenomegaly. This was a congenital transmission from his mother who was asymptomatic and not known to have leishmaniasis, which was confirmed after the diagnosis of the infant. Despite treatment, the infant died. The diagnostic approach is illustrated by the case report. Poor obstetric history in the mother may be related to her own undiagnosed kala azar.
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Adenovirus-associated intussusception in a child p. 49
Heidi Reinhard, Gary Rose, Vanessa Ladd, Samir B Kahwash
Intestinal intussusception is one of the most common causes of acute abdominal emergencies in children under 2 years of age. We herein describe a case of adenovirus associated small intestinal intussusception in a 5-month-old boy. A brief review on triggers of intussusception in children is provided. Thorough gross and microscopic inspections of resected intussusception specimens are recommended to diagnose subtle predisposing triggers such as viral infections.
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Unusually long survival of an adult patient with atypical teratoid/rhabdoid tumor of the sellar region: A follow-up report p. 53
Mussa Hussain Almalki, Abdullah Altwairgi, Yasser Orz
Atypical teratoid/rhabdoid tumor (AT/RT) is a rare and very aggressive central nervous system neoplasm that is most often seen in infants and young children. The prognosis remains poor, with a median survival time of <1 year. Here, we report a follow-up on a case of AT/RT that originated in the sellar and suprasellar region in a 42-year-old female patient with unusually long survival.
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“Diabetic holiday foot syndrome”: Home and away p. 57
Salem A Beshyah
Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide. It is the most common cause of hospitalization in diabetic patients and is the most frequent cause of nontraumatic amputations. Furthermore, diabetic foot disease can impair patients' quality of life and affect social participation and livelihood. People with diabetes have a higher risk of foot ulceration during holidays, especially those taken in hot countries for various causes. These causative factors may also coexist at home. In this clinical vignette, two case histories, several photographic illustrations, and a focused review of the relevant literature are presented with the view of alerting practicing clinicians to such encounters.
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The 8th Diabetes and Ramadan International Alliance Conference: January 23–24, 2020, Dubai, United Arab Emirates p. 62
Sami Kenz, Hussam Abusahmin, Akrem Elmalti, Salem A Beshyah
The 8th Ramadan and Diabetes International Alliance Annual Conference was held over 2 days on January 24th and 25th in Dubai, United Arab Emirates. The program included six sessions in total. The three states of the art lectures addressed (a) an overview of the current knowledge on insulin therapy during Ramadan, (b) journey of diabetes from EPIDIAR, to CREED and ending by DAR-MENA-T2DM, and (c) feasibility and management of fasting after bariatric surgery. Sessions on the 1st day considered four themes spanning from the impact of Ramadan on physical and mental well-being, efficacy and safety of newer antidiabetic medications during Ramadan, adherence to medications for diabetes and hypothyroidism, and the safety of Ramadan fasting in high-risk groups (cardiovascular and renal). The 2nd day started with a session on bridging the gap between physicians and religious scholars, including a live question and answer session “ask the imam.” The rest of the sessions covered management of type 1 diabetes during Ramadan, patients and doctors perceptions of fasting from various regions and finally a scientific session on nutrition and weight management during Ramadan. RaD activities seem to develop progressively in variety and quality of content and also far-reaching audiences and participants.
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On X-linked hypophosphatemia at the European society of pediatric endocrinology meeting, Vienna, Austria; september 19–21, 2019 p. 68
Hussain Alsaffar, Senthil Senniappan, Agnès Linglart
X-linked hypophosphatemia (XLH) is the most common form of inherited hypophosphatemic rickets. Phosphate wasting results in weak, soft and deformed bones, impaired growth, and affected mobility. It is mainly caused by a loss of function mutation in PHEX gene that leads to elevated fibroblast growth factor-23 which mediates the phosphate wasting. During the 58th annual meeting of the European Society of Pediatric Endocrinology (ESPE) held in Vienna between September 19, 2019 and 21, 2019, nearly 100 free communications and a dedicated symposium focused on XLH. The authors attended the conference and wished to share its highlights pertaining to XLH and burosumab therapy to extend the benefit to other professionals who did not attend.
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Syndromes with involvement of multiple cranial nerves: An overview p. 74
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
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