Delayed diagnosis of systemic lupus erythematosus due to lack of competency skills in musculoskeletal examination

Deficiencies in musculoskeletal (MSK) examination skills among internal medicine residents can cause serious outcomes. We report a case of systemic lupus erythematosus with active arthritis where the diagnosis was delayed for 7 days after hospital admission due to the lack of basic skills in MSK examination.     

Resveratrol as an effective adjuvant therapy in the management of rheumatoid arthritis: a clinical study

Resveratrol (RSV), a naturally occurring polyphenol, has been found to have potent antioxidant, anti-inflammatory, and anticancer effects. Recently, RSV was reported as a new potential agent to suppress inflammation of collagen-induced arthritis in a mouse model. Nevertheless, the clinical benefits of RSV in the management of rheumatoid arthritis (RA) were not studied. This randomized controlled clinical trial aims to shed some light on the therapeutic benefits of RSV in the treatment of RA in patients with different stages of the disease activity. In this randomized controlled clinical trial, 100 RA patients (68 female, 32 male) were enrolled randomly and divided into two groups, each of 50 patients: an RSV-treated group that received a daily RSV capsule of 1 g with the conventional treatment for 3 months and a control group that just received the regular treatment. The clinical and biochemical markers of RA in both groups were assessed. It was found that the clinical markers (i.e., the 28-joint count for swelling and tenderness) and the disease activity score assessment for 28 joints were significantly lowered in the RSV-treated group. Moreover, serum levels of certain biochemical markers (i.e., C-reactive protein, erythrocyte sedimentation rate, undercarboxylated osteocalcin, matrix metalloproteinase-3, tumor necrosis factor alpha, and interleukin-6) were also significantly decreased in RSV-treated patients. The current study suggests the addition of RSV as an adjuvant to the conventional antirheumatic drugs.     

Sporadic creutzfeldt jacob disease

We report a 65-year-old lady who presented with rapidly progressive dementia and was found to have Creutzfeldt-Jacob disease (CJD). On reviewing the literature, there have been only 3 case reports of CJD from Saudi Arabia. Our aim is to report this rare disease and to include it in the differential diagnosis of rapidly progressive dementia in our practice.     

Prevalence of bleeding symptoms among young adults in Saudi Arabia,a national survey

Prevalence of bleeding disorders vary due to several factors including geographical location. Mild bleeding disorders can lead to iron deficiency, morbidity, and in severe cases mortality. Quantification of haemorrhagic symptoms is a key component in management of bleeding disorders and a challenging task for clinicians.An abridged version of MCMDM-1vWD questionnaire with validated Arabic translation was used to quantify bleeding disorders in adult students (n = 1138) in 4 different regions of Kingdom of Saudi Arabia. Statistical analysis was performed to indicate gender disparity and prevalence.74.5% of respondents answered at least 1 question with affirmation, with 32.3% affected in Riyadh showing the highest prevalence and 14.03% affected in Dammam showing the least prevalence (P-value < .001). Gender-wise, higher prevalence of bleeding disorders in females 54.9% than in males 45.1% was observed (P-value .01). Epistaxis prevalence was significantly higher in males 30.7% vs 23.2% in females (P-value .0004), while cutaneous symptoms were reported significantly more by female participants 29.7% vs 12.3% in males (P-value < .001). Menorrhagia was reported by 28% of females, with heavy bleeding experienced by 57.6% female participants for <7 days while in 42.4% of females for >7 days.The current study signifies the ethnic distribution and gender disparity of mild bleeding disorders, and highlights the need for national surveillance system in order to improve management of patients with bleeding disorders.     

Factors influencing public participation in biobanking

A diversity of public participation in biobanking is a highlight for the success of biobanks. It was previously reported that only two-thirds of Jordanians expressed interest in biobanking. To promote public involvement in a biobank, it is imperative to determine the aspects that influence the decision-making to participate. On the basis of a national survey involving 3196 respondents, the influence of 13 biobanking factors was assessed, including returning research results, privacy, freedom of choice, uncertainties about research, monetary and health considerations, and personal belief. Perception toward each factor was also correlated with willingness to participate in a biobank. A considerable number of respondents indicated returning research results as influential in their decision to become biobank donors. Interestingly, whereas the positive perception of availability of general results (39%) correlated with willingness to donate for biobanking, the negative view of unavailability of individualized results (47%) did not correlate with unwillingness. Religious permission of sample donation for research had the strongest positive influence (61%) and the highest correlation to participate among positively perceived factors. Unspecified research was highly indicated as a negative factor (45%), but did not correlate with unwillingness to become a biobank donor, whereas allowed withdrawal had a positive effect (31%) and correlation to contribute to biobanking. The negative perception of accessing medical information (9.5%) and re-contact (8.5%) had the strongest correlation with unwillingness to donate to a biobank. These results may provide an insight into how to formulate strategies to promote public participation in biomedical research and biobanking.     

Potential repurposed SARS-CoV-2 (COVID-19) infection drugs

The global outbreak of COVID-19 viral infection is associated with the absence of specific drug(s) for fighting this viral infection. About 10 million people are already infected, about 500 000 deaths all over the world to date. Great efforts have been made to find solutions for this viral infection, either vaccines, monoclonal antibodies, or small molecule drugs; this can stop the spread of infection to avoid the expected human, economic and social catastrophe associated with this infection. In the literature and during clinical trials in hospitals, several FDA approved drugs for different diseases have the potential to treat or reduce the severity of COVID-19. Repurposing of these drugs as potential agents to treat COVID-19 reduces the time and cost to find effective COVID-19 agents. This review article summarizes the present situation of transmission, pathogenesis and statistics of COVID-19 in the world. Moreover, it includes chemistry, mechanism of action at the molecular level of the possible drug molecules which are liable for redirection as potential COVID-19 therapeutic agents. This includes polymerase inhibitors, protease inhibitors, malaria drugs, lipid lowering statins, rheumatoid arthritis drugs and some miscellaneous agents. We offer research data and knowledge about the chemistry and biology of potential COVID-19 drugs for the research community in this field.

The global outbreak of COVID-19 viral infection is associated with the absence of specific drug(s) for fighting this viral infection.     

Various α-Thalassemia Genotype Combinations of the Saudi-Type Polyadenylation Signal Mutation (αT-Saudiα) in the Population of Bahrain: An Update of Genotype-Phenotype Analyses

Abstract

The Saudi-type polyadenylation (polyA) signal mutation on the α2-globin gene, HBA2: c.*94A?>?G; AATAAA>AATAAG; α^T-Saudiα, is one of the major α-thalassemia (α-thal) determinants in the population of Bahrain. We determined five different genotype combinations involving this mutation in Bahrain. Here, we report these various genotypes involving the Saudi-type polyA signal mutation and their relevant phenotype presentations. A total of 32 patients were diagnosed with the genotype of α^T-Saudiα/α^T-Saudiα. These homozygous patients presented with a typical form of Hb H disease and severe anemia with a mean hemoglobin (Hb) level of 8.5?±?0.7?g/dL. Second, we diagnosed 29 patients carrying the genotype of α^T-Saudiα/α^HpHα, and they presented with a less severe form of Hb H disease and a mean Hb level of 9.9?±?0.9?g/dL. Third, we found two genotype combinations of the polyA signal mutation with either the rightward (–α^3.7) (n?=?46) or leftward (–α^4.2) (n?=?22) deletions. These patients presented with an α-thal trait phenotype or a mild form of Hb H disease with a mean Hb level of 10.8?±?1.0?g/dL for the –α^3.7/α^T-Saudiα, and 10.4?±?1.4?g/dL for the –α^4.2/α^T-Saudiα genotypes. We also found 39 patients with the simple heterozygous state of the polyA signal mutation, who presented with a mild form of α-thal trait and a mean Hb level of 12.1?±?1.7?g/dL. Finally, data from 48 patients carrying the normal α genotype (αα/αα) are presented with a mean Hb level of 12.9?±?1.7?g/dL. These data could pave the way for accurate genetic counseling and sound clinical management based on precise molecular diagnosis of α-thal.     

Chitosan Edible Films Enhanced with Pomegranate Peel Extract: Study on Physical,Biological, Thermal,and Barrier Properties

In the present study, pomegranate peel extract was used as a reinforcing agent in developing chitosan-based edible film. Different concentrations (0.2 g/mL, 0.4 g/mL, 0.6 g/mL, 0.8 g/mL, and 1.0 g/mL) of pomegranate peel extract were incorporated in chitosan-based edible film. A neat chitosan film was used as a control. This work covers the effect of pomegranate peel extract on the physical, biological, mechanical, thermal, and barrier properties of enriched chitosan-based edible film. The results showed that the thickness (0.142–0.159 mm), tensile strength (32.45–35.23 MPa), moisture (11.23–15.28%), opacity (0.039–0.061%), water (1.32–1.60 g·mm/m²), gas barrier properties (93.81–103.45 meq/kg), phenolic content (5.75–32.41 mg/g), and antioxidant activity (23.13–76.54%) of the films increased with increasing volume fraction of pomegranate peel extract. A higher concentration of incorporated pomegranate peel extracts significantly (p < 0.05) reduced the thermal stability of the film, along with its transparency, solubility, swelling, and color. This work revealed that the incorporation of a higher portion of pomegranate peel extract in chitosan film holds significant (p < 0.05) potential for the increase in biological activities of such films in terms of antioxidant and antimicrobial behavior. The properties of pomegranate peel extract-enriched chitosan films could be an excellent cure for free radicals, whereas they could also inhibit the growth of the foodborne pathogens during the processing and preservation of the food. Further studies are needed for the application of pomegranate peel extract-enriched edible films on food products such as fruits and vegetables in order to extend their storage life and improve the quality and safety of preserved food products.