Is the combination of domperidone and metoclopramide increasing the risk of developing serotonin syndrome?: a case report

Abdullah Nasser Aldosari,Abdullah Alzahrani,Mohammed Alghamdi,Abdulaziz Alzahrani,Abdulraheem Alghamdi 대한소아응급의학회 2024 대한소아응급의학회지 Vol.11 No.2

Metoclopramide and domperidone are dopamine antagonists that can cause an acute dystonic reaction. Metoclopramide is a rare but major contributor to serotonin syndrome, particularly when used with other serotonergic agents. Serotonin syndrome is a rare, potentially life-threatening adverse reaction characterized by a triad of altered mental status, autonomic dysfunction, and neuromuscular hyperactivity that typically results from exposure to serotonergic agents. Herein, we report a previously healthy 9-year-old girl who was brought to the emergency department with an alteration in the level of conscious and involuntary repetitive movements after approximately 24 hours of receiving a therapeutic dose of metoclopramide and domperidone. Physical examination showed tachycardia, hyperthermia, and a Glasgow Coma Scale score of 11, as well as mydriasis and hyperreflexia. In addition to resolving the symptoms after administering midazolam and diphenhydramine, the diagnosis of serotonin syndrome was made based on the classical symptoms and signs, which met the Hunter criteria. This case indicates the need for clinical awareness of the life-threatening syndrome and caution with medications having potential interactions with metoclopramide.

Antioxidant status and ultrastructural defects in the ovaries of red palm weevils (Rhynchophorus ferrugineus) intoxicated with spinosad

Abdelsalam Salaheldin,Alzahrani Abdullah M.,Elmenshawy Omar M.,Abdel‐Moneim Ashraf M. 한국곤충학회 2020 Entomological Research Vol.50 No.6

Red palm weevil, Rhynchophorus ferrugineus, destroys palms almost all over the world, especially in the Middle East, where dates are a strategic crop in arid places. In view of the urgent need to combat this destructive pest, effective pesticides with high environmental safety should be sought. Spinosad is a pesticide of bacterial origin that is presumed to have a high degree of environmental safety and is effective in combating a wide range of insect pests. In this study, the efficacy of spinosad was evaluated in females of R. ferrugineus. The lethal concentration for 50% of the treated females was calculated at 44.3 ppm. The effects of spinosad concentrations of 10, 50 and 200 ppm on the activity of catalase (CAT), glutathione S-transferase (GST) and superoxide dismutase (SOD) in the ovaries were assessed. In addition, the pathological effects of these concentrations were documented on the ultrastructure of the follicle cells and ooplasm. The results showed a significant increase in CAT activity only in response to treatment with 200 ppm. Treating the females with different spinosad concentrations resulted in varying intensity changes in cell organelles, where the most pronounced sign of programmed cell death was at the concentration 200 ppm. This study demonstrates the possibility of using spinosad as an insecticide against females of R. ferrugineus.

Predictive Value of IHC4 Score for Pathological Response to Neoadjuvant Chemotherapy in Hormone Receptor-Positive Breast Cancer

Elsamany, Shereef,Elmorsy, Soha,Alzahrani, Abdullah,Rasmy, Ayman,Abozeed, Waleed N,Mohammed, Amrallah A,Sherisher, Mohamed A,Abbas, Mohammed M,Mashhour, Miral Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.17

Purpose: This study aimed to explore the value of IHC4 in predicting pathological response after neoadjuvant chemotherapy in patients with hormonal receptor (HR)-positive breast cancer (BC). Materials and Methods: In this retrospective exploratory study, data for 68 HR-positive BC patients who received neoadjuvant chemotherapy were recorded. IHC4 scores were calculated based on estrogen receptors/progesterone receptors, Ki-67 and HER2 status. Logistic and ordinal regression analyses in addition to likelihood ratio test were used to explore associations of IHC4 scores and other clinico-pathological parameters with pathological complete response (pCR) and pathological stage. Results: Taking the 25th percentile as the cut-off, a lower IHC4 score was associated with an increased probability of pCR (low; 52.9% vs. High; 21.6%, OR=4.1, 95% CI=1.28-13.16, p=0.018) and a lower pathological stage (OR=3.9, 95% CI=1.34-11.33, p=0.012). When the IHC4 score was treated as a continuous variable, a lower score was again associated with an increased probability of pCR (OR=1.010, 95% CI=1.001-1.018, p=0.025) and lower pathological stage (OR=1.009, 95% CI=1.002-1.017, P=0.008). Lower clinical stage was associated with a better pCR rate that was of borderline significance (P=0.056). When clinical stage and IHC4 score were incorporated together in a logistic model, the likelihood ratio test gave a P-value of 0.004 after removal of the IHC4 score and 0.011 after removal of the stage, indicating a more significant predictive value of the IHC4 score for pCR. Conclusions: This study suggests that the IHC4 score can predict pathological response to neoadjuvant chemotherapy in HR-positive BC patients. This finding now needs to be validated in a larger cohort of patients.

Evaluating the Usability and Effectiveness of Madrasati Platforms as a Learning Management System in Saudi Arabia for Public Education

Alkinani, Edrees A.,Alzahrani, Abdullah I.A. International Journal of Computer ScienceNetwork S 2021 International journal of computer science and netw Vol.21 No.6

Ministries of Education are integrating different Learning Management Systems (LMS) to enhance teaching and learning during the lockdown to avoid academic loss. The key factor for delivering a high-quality education through LMS platforms is teachers' acceptance and adoption of the platform. Madrasati platform (which means My school) was introduced by Saudi Arabian Ministry of education as the formal teaching and learning for distance education for public education levels. This study aims to examine the effectiveness, usability and adoption of "Madrasati" platform from teachers' perspectives in Saudi Arabia. "SUS, CSUQ" tests were used to test the usability of the new platform. Using quantitative research design, data were collected using questionnaire. 200 teachers were selected randomly answered the survey. Data was analysed descriptively and inferentially using SPSS (25). The results obtained indicate that the teachers are highly satisfied using Madrasati platform and technically it is well designed. Also, Madrasati has positive effect on teaching quality. Moreover, Madrasati has high usability in teaching. One of the key findings were that the quality of the information content in Madrasati has a strong effect on teachers' perception of the Madrasati usefulness that led to a positive attitude towards Madrasati. These findings would be useful to the ministry of education and institutions trying to integrate technology in their teaching and learning processes. Thus, this paper contributes towards more effective utilisation of the extensive functionalities that Madrasati have to offer, which will contribute toward the development of pedagogy in Saudi Arabia.

Biochemical and ultrastructural changes in the ovaries of red palm weevil, Rhynchophorus ferrugineus (Coleoptera: Curculionidae) following acute imidacloprid poisoning

Salaheldin A. Abdelsalam,Abdullah M. Alzahrani,Omar M. Elmenshawy,Azza Sedky,Ashraf M. Abdel-Moneim 한국응용곤충학회 2020 Journal of Asia-Pacific Entomology Vol.23 No.3

This study aims to inspect the effects of Imidacloprid (IMI) acute toxicity in the ovaries of the red palm weevil (Rhynchophorus ferrugineus). The LC50 of IMI was determined to be 15.7 ppm. We assessed the biochemical changes resulting from treatment with four IMI concentrations (10, 15, 20 and 30 ppm). IMI reduced acetylcholine esterase activity in a dose-dependent manner. Glutathione (GSH) content decreased with increasing concentration of IMI; however, GSH was not affected and accompanied by an increase in catalase activity with the highest concentration of IMI. Lipid peroxidation increased steadily as IMI concentration increased. Based on the ultrastructural analyses of the follicle cells and the ooplasm of developing oocytes, acute IMI toxicity produced damaged yolk bodies, pale nuclei, and shrinking microvilli. Fractionation of rough endoplasmic reticulum, deformed mitochondria, and autophagic bodies were also observed. In conclusion, these ovarian pathobiochemical changes could be used as biomarkers of acute IMI exposure.

Clinico-Pathological Patterns and Survival Outcome of Colorectal Cancer in Young Patients: Western Saudi Arabia Experience

Elsamany, Shereef Ahmed,Alzahrani, Abdullah Saeed,Mohamed, Mervat Mahrous,Elmorsy, Soha Ali,Zekri, Jamal Eddin,Al-Shehri, Ahmed Saleh,Haggag, Rasha Mostafa,Alnagar, Ahmed Abdel-Reheem,El Taani, Hani A Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.13

Background: The prognosis of young colorectal cancer (CRC) patients has been addressed by several studies but with contradictory results. The aim of the present study was to evaluate the clinico-pathological features of young Saudi patients with CRC in addition to displaying their survival outcome. Materials and Methods: In this retrospective study, young CRC patients (${\leq}40$ years) diagnosed between 2007 and 2011 from 4 centres in western Saudi Arabia, were included. Clinico-pathological features, tumor markers, dates of disease relapse and death were collected. Survival parameters were compared with those of older Saudi patients, reported in previous studies. Results: One hundred and sixteen young patients with CRC were identified (32.2% rectal, 67.8% colon). Some 44% were metastatic while 32.7% had stage III at diagnosis. Patients with grade 3 tumors made up 29.4% of the total while 49.5% had positive lymphovascular invasion (LVI), 56% had a lymph node (LN) ratio ${\geq}0.2$ and 40.2% were K-ras mutant. Median disease-free survival (DFS) and overall survival (OS) in non-metastatic cases were 22.8 and 49.6 months respectively with better median DFS in K-ras wild compared to mutant patients (28.5 vs 20.9 months, p=0.005). In metastatic cases, median OS was 19.5 months. These survival outcomes are inferior compared to those of older Saudi patients reported in prior studies. Conclusions: Young CRC patients present more commonly with advanced stage and a high incidence of adverse prognostic factors such as LVI and high LN ratio. Young CRC patients seem to have worse survival compared to older Saudi patients.

Thyroid Transcription Factor-1 Expression in Advanced Non-Small Cell Lung Cancer: Impact on Survival Outcome

Elsamany, Shereef Ahmed,Al-Fayea, Turki M,Alzahrani, Abdullah Said,Abozeed, Waleed Nabeel,Darwish, Waseem,Farooq, Mian Usman,Almadani, Ahmed Salahuddin,Bukhari, Esraa Ahmed Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.7

Background: The prognostic role of thyroid transcription factor-1 (TTF-1) expression in lung cancer has been assessed but with inconsistent results. The present study aimed to evaluate the prognostic value of TTF1 expression in advanced non-squamous non-small cell lung cancer (NSCLC). Materials and Methods: In this retrospective study, patients with stage IIIB-IV non-squamous NSCLC were enrolled. Progression free survival (PFS) and overall survival (OS) were assessed according to TTF1 expression status, age categories (${\leq}60$ vs >60 years), gender, performance status (PS) (0-2 vs 3-4), type of 1st line chemotherapy (pemetrexed containing vs others) and EGFR status. Results: A total of 120 patients were included. In univariate analysis, PFS was improved in patients with PS 0-2 (7.0 vs 2.0 months, p=0.002) and those who received pemetrexed-containing chemotherapy (9.2 vs 5.8 months, p=0.004). OS was improved in female patients (23.0 vs 8.7 months, p<0.0001), PS 0-2 (14.4 vs 2.0 months, p<0.0001), those with pemetrexed-containing chemotherapy (17.0 vs 11.0 months, p=0.019), TTF1-positive (12.8 vs 5.8 months, p=0.011) and EGFR- mutant patients (23.0 vs 11.7 months, p=0.006). In multivariate analysis, male gender (HR=2.34, p=0.025) and non-pemetrexed containing therapy (HR=2.24, p=0.022) were independent predictors of worse PFS. Wild EGFR status (HR=2.49, p=0.015) and male gender (HR=2.78, p=0.008) were predictors of worse OS. Conclusions: Pemetrexed-containing therapy significantly improved PFS while OS was improved in EGFR mutant patients. Female patients had better PFS and OS. TTF1 expression was not a prognostic marker in advanced non-squamous NSCLC.

Swertiamarin ameliorates inflammation and oxidative damage in autoimmune encephalomyelitis mouse model

Ibrahim Hairul-Islam Mohamed,Ahmed Emad A.,Alzahrani Abdullah M.,Sayed Abdullah A.,Hanieh Hamza 한국응용생명화학회 2022 Applied Biological Chemistry (Appl Biol Chem) Vol.65 No.2

Multiple sclerosis (MS) is a degenerative autoimmune disease attacks the myelin sheath of the central nervous system (CNS) neurons causing different disabilities. According to recent evidence, the main bioactive component in Enicostema axillare , the Swrtiamarin (SM) has been found to exert anti-inflammatory and antioxidant activities against several diseases. However, SM activities in treatment of autoimmune diseases remain to be explored. Herein, we used a murine model of MS, to show that SM treatment ameliorates the severity of experimental autoimmune encephalomyelitis (EAE). This occurs through reducing the levels of pro-inflammatory cytokines and infiltration of CD4+CD45+ cells into CNS. That was associated with a reduction in the expression of STAT3 and NFkB in CD4+ T cells under Th17 and LPS-stimulated macrophages. Furthermore, in silico studies revealed that SM interacts with NF-E2-related factor 2 (NRF2), and therefore, suppressed oxidative stress by inducing formation NRF2-antioxidant response element (ARE) complex. We found that SM is an agonist of NRF2 complex regulating the total CD4 population and antioxidant markers in EAE mice. Molecular docking analysis showed a stable and higher binding affinity between SM and NRF2. Results revealed that SM treatment increased the complex formation between ARE and NRF2 where immunoprecipitation methods showed a higher binding affinity of ARE to NRF2 in SM treated animals. Complex formation triggered ARE cascade of antioxidant gene clusters and reduces the MS pathological alterations in EAE mice model. Current data proposed SM as an effective biomolecule in treatment of MS and controlling neuronal damage through inhibiting oxidative stress markers and targeting NRF2.

Effects of the Rome IV Criteria to Functional Dyspepsia Symptoms in Saudi Arabia: Epidemiology and Clinical Practice

( Georgios Zacharakis ),( Sameer Al-ghamdi ),( Jamaan Alzahrani ),( Abdulaziz Almasoud ),( Omar Arahmane ),( Abdullah Alshehri ),( Moaz Hassan Alharbi ),( Manal Mahmood Alsalmi ),( Sultan Bander Aloti 대한소화기학회 2020 대한소화기학회지 Vol.76 No.6

Background/Aims: Limited data is available in Saudi Arabia (SA) regarding the prevalence of functional dyspepsia (FD) symptoms and its subtypes, as defined by the ROME IV criteria. This study evaluated the burden of self-reported FD symptoms in the adult general population of SA and the current clinical practices. Methods: A web-based national cross-sectional health survey of the general population of SA was conducted using the Rome IV Diagnostic Questionnaire for Functional Gastrointestinal Disorders in Adults with additional questions on the presence of symptoms compatible with functional heartburn (FH) and irritable bowel syndrome (IBS). The quality of life and somatization questionnaires were also included. Results: Overall, 3,114 adults completed the questionnaire, but 303 (9.7%) were excluded due to inconsistent responses. Of the 2,811 consistent responders, 532 (18.3%) fulfilled the Rome IV criteria for FD symptoms. These were distributed into the FD subtypes as follows: 208 (7.4%) had postprandial distress syndrome, 228 (8.1%) had epigastric pain syndrome, and 96 (3.4%) had the overlapping variant. IBS-like symptoms were reported in 232 (44%) and FH in 102 (19%) 19% (102) of the subjects with functional dyspepsia. H. pylori-associated dyspepsia was reported by 25% (87/348). High somatization, lower quality of life scores, younger age, and female sex were associated more with the FD symptoms participants than those without. Approximately 1/5 respondents used over-the-counter medications to relieve the FD symptoms. Conclusions: In this population-based survey, FD affected almost 1/5 of the responding adult population in SA, which was less than previously reported. (Korean J Gastroenterol 2020;76:304-313)

Diagnostic approach and use of CTPA in patients with suspected pulmonary embolism in an emergency department in Saudi Arabia

Feras Almarshad,Ali Alaklabi,Abdulrahman Al Raizah,Yousof AlZahrani,Somaya Awad Aljohani,Rawaby Khalid AlShammari,Al-zahraa Saleh Al-mahlawi,Abdulaziz Abdullah Alahmary,Mosaad Almegren,Dushad Ram 대한혈액학회 2023 Blood Research Vol.58 No.1

Background In patients with suspected pulmonary embolism (PE), the literature suggests the overuse of computerized tomography pulmonary angiography (CTPA) and underuse of clinical decision rules before imaging request. This study determined the potential for avoidable CTPA using the modified Wells score (mWS) and D-dimer assay in patients with suspected PE. Methods This hospital-based retrospective study analyzed the clinical data of 661 consecutive patients with suspected PE who underwent CTPA in the emergency department of a tertiary hospital for the use of a clinical prediction rule (mWS) and D-dimer assay. The score was calculated retrospectively from the available data in the files of patients who did not have a documented clinical prediction rule. Overuse (avoidable) CTPA was defined as D-dimer negativity and PE unlikely for this study. Results Of 661 patients’ data examined, clinical prediction rules were documented in 15 (2.3%). In total, 422 patients (63.8%) had required information on modified Wells criteria and D-dimer assays and were included for further analysis. PE on CTPA was present in 22 (5.21%) of PE unlikely (mWS ≤4) and 1 (0.24%) of D-dimer negative patients. Thirty patients (7.11%) met the avoidable CTPA (DD negative+PE unlikely) criteria, and it was significantly associated with dyspnea. The value of sensitivity of avoidable CTPA was 100%, whereas the positive predictive value was 90.3%. Conclusion Underutilization of clinical prediction rules before prescribing CTPA is common in emergency departments. Therefore, a mandatory policy should be implemented regarding the evaluation of avoidable CTPA imaging to reduce CTPA overuse.