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Alshowair A, Altamimi S, Alruhaimi FA, Alshahrani S, Alsuwailem F, Alkhaldi M, Abdalla H, Alkhuraiji FH, Alaqeel MS, Almureef SS, Alhawasy S, Abdel-Azeem A. Cost-Savings Associated with Multi-Disciplinary Team Approach for Reducing Macrovascular and Microvascular Complications in Patients with Type 2 Diabetes: A Predictive Model. Clinicoecon Outcomes Res 2024; 16:211-223. [PMID: 38596283 PMCID: PMC11001564 DOI: 10.2147/ceor.s451739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 03/26/2024] [Indexed: 04/11/2024] Open
Abstract
Purpose This study aims to predict the expected cost savings associated with implementing a multidisciplinary team (MDT) approach to reduce macrovascular and microvascular complications among patients with type 2 diabetes mellitus (T2DM). Methods This economic evaluation study was conducted in Riyadh First Health Cluster, Saudi Arabia as a predictive model conceptualized by the authors based on models used in previous studies, particularly the CORE Diabetes Model. Our model was designed based on 1) the level of glycemic control among 24,755 T2DM patients served by MDTs; 2) the expected incidence of diabetes-related complications without intervention; 3) the predicted risk reduction of developing diabetes-related complications with MDTs. Costs of complications and cost savings were then calculated and expressed as mean incremental annual cost savings adjusted for a 1% reduction in HbA1c, and a 10 mmHg reduction in systolic blood pressure (SBP). Results Along with the expected reduction in all diabetes-related complications, the average incremental cost savings per diabetic patient is predicted to be ($38,878) with approximately ($11,108) in the year of complication onset and ($27,770) over the subsequent post-index 10-years. On adjustment of cost savings, the average incremental cost savings are predicted to be ($22,869) for each 1% reduction in HbA1c per diabetic patient and ($27,770) for every 10 mmHg reduction in SBP per diabetic patient. Conclusion MDT as a model of care is effective in glycemic control among T2DM patients with a predicted significant reduction of all diabetes-related complications and in turn, a predicted significant cost savings.
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Affiliation(s)
- Abdulmajeed Alshowair
- Community Health Excellence, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Saleh Altamimi
- Community Health Excellence, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Faisal A Alruhaimi
- Community Health Excellence, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Saad Alshahrani
- Academic and Training Affairs, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Fatima Alsuwailem
- Population Health Management and Research, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Mona Alkhaldi
- Health Administration Office, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Haiam Abdalla
- Model of Care, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | | | - Montaser Saad Alaqeel
- Financial Affairs, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | | | - Salman Alhawasy
- Reporting Department, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
| | - Amro Abdel-Azeem
- Population Health Management and Research, Riyadh First Health Cluster Ministry of Health, Riyadh, Saudi Arabia
- Department of Community, Environmental and Occupational Medicine, Faculty of Medicine Zagazig University, Zagazig, Egypt
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Nomier Y, Khuwaja G, Penakalapati SR, Alshahrani S, Rehman Z, Khawaji R, Alhazmi W, Mubarak A, Alam MF, Anwer T, Rashid H, Shaheen E, Alkashef K. Ethnopharmacological evaluation of Poppy seed oil in combination with Tramadol on behavioral paradigm and on dopamine, and cytokines levels. Eur Rev Med Pharmacol Sci 2023; 27:2077-2090. [PMID: 36930507 DOI: 10.26355/eurrev_202303_31579] [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: 03/18/2023]
Abstract
OBJECTIVE The present study was taken up to evaluate the combination of two drugs in the management of behavioral disorders such as locomotor activity, muscle relaxation, analgesic, and anxiolytic activity. MATERIALS AND METHODS In the methodology, Wistar rats weighing (150-180 g) were divided into six groups of 6 each (n=6). All the animals (groups II to VI) were subjected to stress and analyzed for anxiolytic activity using an elevated plus maze. The animals were treated for 28 days with poppy seed oil in lower and higher doses (1,000 and 2,000 mg/kg), tramadol in lower and higher doses (1.5 and 3 mg/kg) as individual groups, and one group with a combination of both drugs in lower doses. RESULTS The results depicted showed that the combined treatment had significantly (**p <0.001) improvised behavior deficits, extemporized, and diminished anxiety-like attitude in rats, and showed the analgesic property in a significant manner. The pro-inflammatory cytokines TNF-α and IL-1β were evaluated in the serum and were observed to be lessened the values of both in a significant manner with the co-administration of both the test drugs. The dopamine concentrations were also determined in the serum, which disclosed a decline (**p <0.001) significantly. CONCLUSIONS It was concluded from the results that a combined effect of drugs might be beneficial in the management of behavioral disorders and pain management.
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Affiliation(s)
- Y Nomier
- Department of Pharmacology and Toxicology, Pharmacy College, Jazan University, Saudi Arabia.
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Bashir S, Mir A, Altwaijri N, Uzair M, Khalil A, Albesher R, Khallaf R, Alshahrani S, Abualait T. Neuroeconomics of decision-making during COVID-19 pandemic. Heliyon 2023; 9:e13252. [PMID: 36744067 PMCID: PMC9882954 DOI: 10.1016/j.heliyon.2023.e13252] [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: 08/25/2022] [Revised: 12/27/2022] [Accepted: 01/23/2023] [Indexed: 01/29/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic reveals the decision-making challenges faced by communities, governments, and international organizations, globally. Policymakers are much concerned about protecting the population from the deadly virus while lacking reliable information on the virus and its spread mechanisms and the effectiveness of possible measures and their (direct and indirect) health and socioeconomic costs. This review aims to highlight the various balanced policy decision that would combine the best obtainable scientific evidence characteristically provided by expert opinions and modeling studies. This article's main goal is to summarize the main significant progress in the understanding of neuroeconomics of decision-making and discuss the anatomy of decision making in the light of COVID-19 pandemic.
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Affiliation(s)
- Shahid Bashir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia,Corresponding author
| | - Ali Mir
- Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Nouf Altwaijri
- College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammad Uzair
- Department of Biological Sciences, International Islamic University, Islamabad, Pakistan
| | - Amani Khalil
- Department of Mental Health, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Rania Albesher
- Department of Mental Health, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Roaa Khallaf
- Department of Neurology, Neuroscience Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Saad Alshahrani
- Department of Research Operation and Administration, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Turki Abualait
- College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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4
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Alshowair A, Altamimi S, Alshahrani S, Almubrick R, Ahmed S, Tolba A, Alkawai F, Alruhaimi F, Alsafwani E, AlSuwailem F, Abdalla H, Abdel-Azeem A. Effectiveness of Case Manager Led Multi-Disciplinary Team Approach on Glycemic Control Amongst T2DM Patients in Primary Care in Riyadh: A Retrospective Follow-Up Study. J Prim Care Community Health 2023; 14:21501319231204592. [PMID: 37902553 PMCID: PMC10617256 DOI: 10.1177/21501319231204592] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 08/16/2023] [Accepted: 09/13/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVES Our study aims to assess the effectiveness of implementing a case manager-led Multidisciplinary Team approach in the primary healthcare setting on improving glycemic control and reducing cardiovascular risks for T2DM patients over a 6-month period. METHODS This retrospective record-based follow-up study was carried out on 3060 uncontrolled T2DM patients in primary healthcare centers in Riyadh First Health Cluster over a period of 6 months. The patient records are investigated and analyzed, including demographic characteristics and measurements of Hemoglobin A1c (HbA1c), Low-Density Lipoprotein Cholesterol (LDL-C), total cholesterol, and BP levels at enrollment and after 6 months of Multi-Disciplinary Team follow-up. The changes in the study variables and their correlations to each other are tested using Statistical Package for the Social Sciences software. RESULTS At enrollment, our patients were characterized by poor glycemic control (HbAIC > 8%). Most of them have high body weight with a mean BMI of (31.2 ± 1.7), and nearly two-thirds are either hypertensive or have dyslipidemia (43.4% and 47.3% respectively). After 6 months of MDT follow-up, there is a significant improvement in glycemic control among 1971 patients (64.4%), with a reduction in the mean level of different outcomes relative to baseline HbA1c (-15%, P < .001), total cholesterol (-9.0%, P < .001), LDL-C (-11.0%, P < .001), systolic BP (-7.7%, P < .001), and diastolic BP (-10.5%, P < .001). The improved glycemic control showed a significant positive correlation with the number of MDT visits but negatively correlated with BMI and the number of comorbidities. In addition, the improvements in secondary outcomes were positively and significantly correlated with such improvements in glycemic control. CONCLUSION Case-manager-led MDT approach significantly improves glycemic control and significantly improves control over dyslipidemia and hypertension, reducing cardiovascular risks, and unfavorable events among such diabetic patients. We highly recommend developing more MDTs, training case managers, and rigorously evaluating the MDT approach.
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Affiliation(s)
| | - Saleh Altamimi
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Saad Alshahrani
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Rehab Almubrick
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Syed Ahmed
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Ali Tolba
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Fatimah Alkawai
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Faisal Alruhaimi
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Eman Alsafwani
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Fatima AlSuwailem
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Haiam Abdalla
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
| | - Amro Abdel-Azeem
- Riyadh First Health Cluster, Ministry of Health, Riyadh, Saudi Arabia
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
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5
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Moni SS, Sultan MH, Alshahrani S, Tripathi P, Assiri A, Alqahtani SS, Bakkari MA, Madkhali OA, Alam MF, Alqahtani AH, Tripathi R, Pancholi SS, Ashafaq M, Elmobark ME. Physical characterization and wound healing properties of Zamzam water. BRAZ J BIOL 2022; 82:e262815. [PMID: 35976285 DOI: 10.1590/1519-6984.262815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/23/2022] [Indexed: 01/06/2023] Open
Abstract
The objective of the study was to evaluate the quality of Zamzam water, holy water for Muslims and consumed for its medicinal value. The present study demonstrates the physicochemical characterization and wound healing property of Zamzam water. The physicochemical characterization of Zamzam water samples was analyzed for dissolved oxygen, pH, conductivity, total dissolved solids, redox potential, zeta potential, polydispersity index, and zeta size. The microbial quality of Zamzam water was also assessed by exposing water samples to open air. In this work, Zamzam water was also screened for the medicinal value through wound healing properties in Wistar rats. Zamzam water exhibited a unique physicochemical characterization with high levels of dissolved oxygen, zeta potential, polydispersity index, redox potential, total dissolved solids, and conductivity before exposure to open air. After open air exposure, Zamzam water resisted the growth of bacteria. The wound healing properties of Zamzam water in vivo showed a 96% of healing effect on 12th day observation. The wound healing was achieved by modulating pro-inflammatory cytokine such as interleukin -1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor -α (TNF-α). Followed by the level of apoptosis markers caspase-9 and caspase-3 were reduced. The present study proved that Zamzam water is a good-quality water and showed excellent wound healing property. Therefore, Zamzam water can be used for pharmaceutical formulations.
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Affiliation(s)
- S S Moni
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Kingdom of Saudi Arabia
| | - M H Sultan
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Kingdom of Saudi Arabia
| | - S Alshahrani
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Kingdom of Saudi Arabia
| | - P Tripathi
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Kingdom of Saudi Arabia
| | - A Assiri
- King Khalid University, College of Pharmacy, Department of Clinical Pharmacy, Abha, Kingdom of Saudi Arabia
| | - S S Alqahtani
- Jazan University, College of Pharmacy, Department of Pharmacy Practice, Jazan, Kingdom of Saudi Arabia.,Jazan University, College of Pharmacy, Pharmacy Practice Research Unit, Jazan, Kingdom of Saudi Arabia
| | - M A Bakkari
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Kingdom of Saudi Arabia
| | - O A Madkhali
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Kingdom of Saudi Arabia
| | - M F Alam
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Kingdom of Saudi Arabia
| | - A H Alqahtani
- Al- Dawaa Medical Services, Co Ltd, Riyadh, Kingdom of Saudi Arabia
| | - R Tripathi
- Jazan University, College of Pharmacy, Department of Pharmacy Practice, Jazan, Kingdom of Saudi Arabia
| | - S S Pancholi
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Kingdom of Saudi Arabia.,Ganpat University, S. K. Patel College of Pharmaceutical Education and Research, Mahesana, Gujarat, India
| | - M Ashafaq
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Kingdom of Saudi Arabia
| | - M E Elmobark
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Kingdom of Saudi Arabia
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6
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Alshahrani S. Women’s Perception and Attitude Towards Using Antidepressants During Pregnancy: A cross sectional study. Eur Psychiatry 2022. [PMCID: PMC9567852 DOI: 10.1192/j.eurpsy.2022.2203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Introduction Depression during pregnancy leads to deterioration of the mothers’ and the fetus’ health. Objectives To explore women’s perception and attitude towards using antidepressants during pregnancy and identify the factors that influence decision making regarding antidepressants use. Methods A cross-sectional survey of 991 subjects using convenient sampling. All study subjects (PNU affiliates; staff and students) were invited to fill out an electronic questionnaire, KAAUH staff and PNU female associates who were less than 18 years old were excluded. Answers were reported using 5-
point Likert scale. The responses were summed up to give a total score for each respondent. The cutoff point is 75%. Respondents who scored above or equal 75% of the total score was considered as positive perception or favorable attitude. Results The majority of women had negative perception and favorable attitude towards using antidepressants during pregnancy reaching 64%. While, women with positive perception and favorable attitude represented about 20% of the study subjects. The main factors influencing decision making were, education specialty (health, none-health) and subject history of diagnosis with any psychological disorder. Social stigma, religious believes and fear of addiction were reported by surveyors to be the reason influencing their perception and attitude about antidepressants use (P value <0.005). Conclusions This study reveals that although Saudi women reflect a negative perception towards using antidepressants during pregnancy, yet they have a favorable attitude once depression during pregnancy becomes an issue. Disclosure No significant relationships.
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7
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Alshahrani S, Korairi H, Sharifi A, Alqahtani M, Qahtani S, Ahamed K, Kaabi A, Alzahrani O, Abouelyazid A. Depression: a predictor of coronary heart disease in Saudi Arabia. CM 2022. [DOI: 10.18137/cardiometry.2022.22.147153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Aims and Objectives: This research study mainly deals to evaluate the effect of depression in coronary heart disease patients. Background: Depression is one of the common comorbidity among patients presented with acute coronary syndrome or those with major cardiovascular event. Depression has been independently associated or lead to acute cardiac events in patients. Method: The study was conducted from three months followed-up patients with recent diagnosed coronary heart disease and they getting treatment from cardiac centres “Armed Forces Hospitals. Depression was evaluated by using 17-item Hamilton Rating Scale and the cardiac outcome was assessed clinically by echo parameters and cardiac biomarkers such as C-reactive Protein. The data were analysis by SPSS version 23. Results: In this study 83 patients were part of this research. The patients had been picked up from range 18-65 year in which mostly patients were male (75%) than female (25%). Among 83 coronary heart disease patients 29.5% were suffering from depression while 19.5% were on severity. The deterioration factor was significantly influence by depression and smoking. Conclusion: Depression has a great impact on deterioration of the cardiac outcomes. It can serve as a predictive variable for future cardiological morbidity and mortality.
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8
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Moni SS, Tripathi P, Sultan MH, Alshahrani S, Alqahtani SS, Madkhali OA, Bakkari MA, Pancholi SS, Elmobark ME, Jabeen A, Sanobar S, Ashafaq M, Siddiqui MAH. Wound-healing and cytokine-modulating potential of medicinal oil formulation comprising leaf extract of Murraya koenigii and olive oil. BRAZ J BIOL 2022; 82:e256158. [PMID: 35384962 DOI: 10.1590/1519-6984.256158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 02/13/2022] [Indexed: 01/06/2023] Open
Abstract
The study investigated the wound healing effect of medicinal oil (MO) formulation prepared from Murraya koenigii leaves extract (methanolic) incorporated in olive oil. The MO was visually transparent, homogenous, smooth in texture, the viscosity grade was observed as 140 cP and easily spreadable. Pro-inflammatory cytokines IL-1β, IL-6, and TNF-α were significantly reduced to 82.3 ± 3.5, 156 ± 6.2, 137.3. ± 5.5 pg/ml, respectively after treatment with MO when compared to disease control animals that showed IL-1β, IL-6, and TNF-α levels of 170 ± 6, 265 ± 7, and 288.6 ± 11, pg/ml respectively. The level of pro-inflammatory cytokine in povidone iodine solution (PIS) group was 95.3 ± 3, 162 ± 6, 177.6 ± 8.9 pg/ml of IL-1β, IL-6, and TNF-α respectively. Interestingly, the wound-healing efficacy of MO was found better as compared to povidone iodine treated standard group and concluded that MO has excellent wound healing effect.
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Affiliation(s)
- S S Moni
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Saudi Arabia
| | - P Tripathi
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Saudi Arabia
| | - M H Sultan
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Saudi Arabia
| | - S Alshahrani
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Saudi Arabia
| | - S S Alqahtani
- Jazan University, College of Pharmacy, Clinical Pharmacy Department, Jazan, Saudi Arabia.,Jazan University,College of Pharmacy, Pharmacy Practice Research Unit, Jazan, Saudi Arabia
| | - O A Madkhali
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Saudi Arabia
| | - M A Bakkari
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Saudi Arabia
| | - S S Pancholi
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Saudi Arabia
| | - M E Elmobark
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Saudi Arabia
| | - A Jabeen
- Jazan University, College of Pharmacy, Department of Pharmaceutics, Jazan, Saudi Arabia
| | - S Sanobar
- Jazan University, College of Pharmacy, Department of Pharmacognosy, Jazan, Saudi Arabia
| | - M Ashafaq
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Saudi Arabia
| | - M A H Siddiqui
- Jazan University, College of Pharmacy, Department of Pharmacology and Toxicology, Jazan, Saudi Arabia
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9
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Bosaeed M, Alharbi A, Mahmoud E, Alrehily S, Bahlaq M, Gaifer Z, Alturkistani H, Alhagan K, Alshahrani S, Tolbah A, Musattat A, Alanazi M, Jaha R, Sultana K, Alqahtani H, Al Aamer K, Jaser S, Alsaedy A, Ahmad A, Abalkhail M, AlJohani S, Al Jeraisy M, Almaziad S, Albaalharith N, Alabdulkareem K, Alshowair A, Alharbi NK, Alrabiah F, Alshamrani M, Aldibasi O, Alaskar A. Efficacy of favipiravir in adults with mild COVID-19: a randomized, double-blind, multicenter, placebo-controlled trial clinical trial. Clin Microbiol Infect 2022; 28:602-608. [PMID: 35026375 PMCID: PMC8747778 DOI: 10.1016/j.cmi.2021.12.026] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 12/15/2022]
Abstract
Objective To evaluate whether favipiravir reduces the time to viral clearance as documented by negative RT-PCR results for severe acute respiratory syndrome coronavirus 2 in mild cases of coronavirus disease 2019 (COVID-19) compared to placebo. Methods In this randomized, double-blinded, multicentre, and placebo-controlled trial, adults with PCR-confirmed mild COVID-19 were recruited in an outpatient setting at seven medical facilities across Saudi Arabia. Participants were randomized in a 1:1 ratio to receive either favipiravir 1800 mg by mouth twice daily on day 1 followed by 800 mg twice daily (n = 112) or a matching placebo (n = 119) for a total of 5 to 7 days. The primary outcome was the effect of favipiravir on reducing the time to viral clearance (by PCR test) within 15 days of starting the treatment compared to the placebo group. The trial included the following secondary outcomes: symptom resolution, hospitalization, intensive care unit admissions, adverse events, and 28-day mortality. Results Two hundred thirty-one patients were randomized and began the study (median age, 37 years; interquartile range (IQR): 32–44 years; 155 [67%] male), and 112 (48.5%) were assigned to the treatment group and 119 (51.5%) into the placebo group. The data and safety monitoring board recommended stopping enrolment because of futility at the interim analysis. The median time to viral clearance was 10 days (IQR: 6–12 days) in the favipiravir group and 8 days (IQR: 6–12 days) in the placebo group, with a hazard ratio of 0.87 for the favipiravir group (95% CI 0.571–1.326; p = 0.51). The median time to clinical recovery was 7 days (IQR: 4–11 days) in the favipiravir group and 7 days (IQR: 5–10 days) in the placebo group. There was no difference between the two groups in the secondary outcome of hospital admission. There were no drug-related severe adverse events. Conclusion In this clinical trial, favipiravir therapy in mild COVID-19 patients did not reduce the time to viral clearance within 15 days of starting the treatment.
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Affiliation(s)
- Mohammad Bosaeed
- Department of Medicine, King Abdulaziz Medical City - Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
| | - Ahmad Alharbi
- Department of Medicine, King Abdulaziz Medical City - Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ebrahim Mahmoud
- Department of Medicine, King Abdulaziz Medical City - Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Sanaa Alrehily
- King Fahad Hospital - Almadinah, Ministry of Health, Saudi Arabia
| | - Mohannad Bahlaq
- Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Zied Gaifer
- Department of Medicine, Prince Mohammed Bin Abdul Aziz Hospital - Almadinah, Ministry of National Guard Health Affairs, Saudi Arabia
| | | | - Khaled Alhagan
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Saad Alshahrani
- Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Ali Tolbah
- Deputyship for Primary Health Care, Ministry of Health, Riyadh, Saudi Arabia
| | - Abrar Musattat
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Maha Alanazi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Raniah Jaha
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Khizra Sultana
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Hajar Alqahtani
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Kholoud Al Aamer
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Saud Jaser
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman Alsaedy
- Department of Medicine, King Abdulaziz Medical City - Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ayoub Ahmad
- Department of Medicine, King Abdulaziz Medical City - Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Mohammed Abalkhail
- Infection Prevention and Control Program, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Sameera AlJohani
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Pathology & Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia; College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Majed Al Jeraisy
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia; College of Pharmacy, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Sultan Almaziad
- Infection Prevention and Control Program, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Nahlah Albaalharith
- Department of Nursing, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | | | | | - Naif Khalaf Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Fahad Alrabiah
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Majid Alshamrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Infection Prevention and Control Program, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Omar Aldibasi
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ahmed Alaskar
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
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10
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Alrusayyis D, Aljubran H, Alshaibani A, Alsharhan S, AlSaied A, ALEnazi A, Alghamdi A, Alshahrani S, Salam A, Al Bar M. Patterns of Otorhinolaryngological Manifestations of Covid-19: A Longitudinal Questionnaire-Based Prospective Study in a Tertiary Hospital in Saudi Arabia. J Prim Care Community Health 2022; 13:21501319221084158. [PMID: 35311409 PMCID: PMC8941688 DOI: 10.1177/21501319221084158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: Many studied investigated the manifestations of COVID-19, yet few described
the pattern and severity of otolaryngological symptoms. We aim to describe
the picture of COVID-19-associated otorhinolaryngological manifestations and
recovery to explore individualized treatment, onward referral, and
complications prevention. Design: Prospective longitudinal questionnaire-based study. Setting: The online questionnaire was filled 3 times through a remote interview over a
period of 1 month from June 2020 to July 2020. Participants: Patients with confirmed COVID-19 by RT-PCR who were clinically stable. Main Outcome Measures: Date of diagnosis, sociodemographic data, and the presence of predictive
factors, such as nasal and paranasal disease, anosmia and dysgeusia.
Validated tools were used, such as Sino-nasal Outcome Test (SNOT-22), smell
test (medical academy screening tool), Voice Handicap Index (VHI), and
Reflux Symptoms Index (RSI). Result: The questionnaire was sent to 363 patients and the response rate was 70.80%
(n = 257). The mean age was 34.58 years (SD = 11.22) and the rate of male
participants was 60.7%. The most common otorhinolaryngological symptoms at
the time of enrollment was fever (48.6%), whilst the commonest severe
symptom was cough (57%). After 1 month, only 11 participants had persistent
severe symptoms, especially sleep and psychological symptoms (73%), and the
majority were female (63.6%). All of them had at least 1 comorbidity. There
was a significant difference between the mean age of participants with
severe symptoms (mean = 27.45, SD = 8.39) and without severe symptoms
(mean = 34.90, SD = 2.53, t(255) = 2.17,
P = .031). Conclusion: COVID-19 has a wide-ranged spectrum of presentations, with
otorhinolaryngological symptoms being the commonest and most serious.
Studying these symptoms is vital to advance management options.
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Affiliation(s)
| | | | | | - Salma Alsharhan
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | | | - Amal Alghamdi
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | | | - Abdul Salam
- King Fahad Specialist Hospital, Dammam, Saudi Arabia.,King Khalid Medical City (KKMC), Saudi Arabia
| | - Mohammed Al Bar
- Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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11
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Afzal A, Ansari Z, Alshahrani S, Raj AK, Saheer Kuruniyan M, Ahamed Saleel C, Nisar KS. Clustering of COVID-19 data for knowledge discovery using c-means and fuzzy c-means. Results Phys 2021; 29:104639. [PMID: 34513577 PMCID: PMC8424416 DOI: 10.1016/j.rinp.2021.104639] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 07/30/2021] [Accepted: 07/31/2021] [Indexed: 06/13/2023]
Abstract
In this work, the partitioning clustering of COVID-19 data using c-Means (cM) and Fuzy c-Means (Fc-M) algorithms is carried out. Based on the data available from January 2020 with respect to location, i.e., longitude and latitude of the globe, the confirmed daily cases, recoveries, and deaths are clustered. In the analysis, the maximum cluster size is treated as a variable and is varied from 5 to 50 in both algorithms to find out an optimum number. The performance and validity indices of the clusters formed are analyzed to assess the quality of clusters. The validity indices to understand all the COVID-19 clusters' quality are analysed based on the Zahid SC (Separation Compaction) index, Xie-Beni Index, Fukuyama-Sugeno Index, Validity function, PC (performance coefficient), and CE (entropy) indexes. The analysis results pointed out that five clusters were identified as a major centroid where the pandemic looks concentrated. Additionally, the observations revealed that mainly the pandemic is distributed easily at any global location, and there are several centroids of COVID-19, which primarily act as epicentres. However, the three main COVID-19 clusters identified are 1) cases with value <50,000, 2) cases with a value between 0.1 million to 2 million, and 3) cases above 2 million. These centroids are located in the US, Brazil, and India, where the rest of the small clusters of the pandemic look oriented. Furthermore, the Fc-M technique seems to provide a much better cluster than the c-M algorithm.
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Affiliation(s)
- Asif Afzal
- Department of Mechanical Engineering, P. A. College of Engineering (Affiliated to Visvesvaraya Technological University, Belagavi), Mangaluru, India
| | - Zahid Ansari
- Electrical Engineering Section, University Polytechnic, Aligarh Muslim University, Aligarh, India
| | - Saad Alshahrani
- Department of Mechanical Engineering, College of Engineering, King Khalid University, PO Box 394, Abha 61421, Kingdom of Saudi Arabia
| | - Arun K Raj
- Department of Mechanical Engineering, Indian Institute of Technology Bombay, Maharashtra 400076, India
| | - Mohamed Saheer Kuruniyan
- Department of Dental Technology, College of Applied Medical Science, King Khalid University, Asir-Abha, Kingdom of Saudi Arabia
| | - C Ahamed Saleel
- Department of Mechanical Engineering, College of Engineering, King Khalid University, PO Box 394, Abha 61421, Kingdom of Saudi Arabia
| | - Kottakkaran Sooppy Nisar
- Department of Mathematics, College of Arts and Sciences, Wadi Aldawaser, Prince Sattam bin Abdulaziz University, Saudi Arabia
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12
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Uddin I, Ullah I, Raja MAZ, Shoaib M, Islam S, Zobaer MS, Nisar KS, Saleel CA, Alshahrani S. The intelligent networks for double-diffusion and MHD analysis of thin film flow over a stretched surface. Sci Rep 2021; 11:19239. [PMID: 34584109 PMCID: PMC8478931 DOI: 10.1038/s41598-021-97458-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/18/2021] [Indexed: 11/10/2022] Open
Abstract
This study presents a novel application of soft-computing through intelligent, neural networks backpropagated by Levenberg-Marquardt scheme (NNs-BLMS) to solve the mathematical model of unsteady thin film flow of magnetized Maxwell fluid with thermo-diffusion effects and chemical reaction (TFFMFTDECR) over a horizontal rotating disk. The expression for thermophoretic velocity is accounted. Energy expression is deliberated with the addition of non-uniform heat source. The PDEs of mathematical model of TFFMFTDECR are transformed to ODEs by the application of similarity transformations. A dataset is generated through Adams method for the proposed NNs-BLMS in case of various scenarios of TFFMFTDECR model by variation of rotation parameter, magnetic parameter, space dependent heat sink/source parameter, temperature dependent heat sink/source parameter and chemical reaction controlling parameter. The designed computational solver NNs-BLMS is implemented by performing training, testing and validation for the solution of TFFMFTDECR system for different variants. Variation of various physical parameters are designed via plots and explain in details. It is depicted that thin film thickness increases for higher values of disk rotation parameter, while it diminishes for higher magnetic parameter. Furthermore, higher values of Dufour number and the corresponding diminishing values of Soret number causes enhancement in fluid temperature profile. Further the effectiveness of NNs-BLMS is validated by comparing the results of the proposed solver and the standard solution of TFFMFTDECR model through error analyses, histogram representations and regression analyses.
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Affiliation(s)
- Iftikhar Uddin
- Department of Mathematics, Abdul Wali Khan University Mardan (KP), Mardan, 23200, Pakistan
| | - Ikram Ullah
- Department of Sciences and Humanities, National University of Computer and Emerging Sciences Peshawar Campus, KP, Peshawar, 25000, Pakistan
| | - Muhammad Asif Zahoor Raja
- Future Technology Research Center, National Yunlin University of Science and Technology, 123 University Road, Section 3, Douliou, Yunlin, 64002, Taiwan, R.O.C..
| | - Muhammad Shoaib
- Department of Mathematics, COMSATS University Islamabad, Attock Campus, Attock, 43600, Pakistan
| | - Saeed Islam
- Department of Mathematics, Abdul Wali Khan University Mardan (KP), Mardan, 23200, Pakistan
| | - M S Zobaer
- McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - K S Nisar
- Department of Mathematics, College of Arts and Sciences, Prince Sattam Bin Abdulaziz University, Wadi Aldawaser, 11991, Saudi Arabia
| | - C Ahamed Saleel
- Department of Mechanical Engineering, College of Engineering, King Khalid University, Asir-Abha, 61421, Saudi Arabia
| | - Saad Alshahrani
- Department of Mechanical Engineering, College of Engineering, King Khalid University, Asir-Abha, 61421, Saudi Arabia
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13
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Kallannavar V, Kattimani S, Soudagar MEM, Mujtaba MA, Alshahrani S, Imran M. Neural Network-Based Prediction Model to Investigate the Influence of Temperature and Moisture on Vibration Characteristics of Skew Laminated Composite Sandwich Plates. Materials (Basel) 2021; 14:ma14123170. [PMID: 34207585 PMCID: PMC8227106 DOI: 10.3390/ma14123170] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/27/2021] [Accepted: 05/29/2021] [Indexed: 11/25/2022]
Abstract
The present study deals with the development of a prediction model to investigate the impact of temperature and moisture on the vibration response of a skew laminated composite sandwich (LCS) plate using the artificial neural network (ANN) technique. Firstly, a finite element model is generated to incorporate the hygro-elastic and thermo-elastic characteristics of the LCS plate using first-order shear deformation theory (FSDT). Graphite-epoxy composite laminates are used as the face sheets, and DYAD606 viscoelastic material is used as the core material. Non-linear strain-displacement relations are used to generate the initial stiffness matrix in order to represent the stiffness generated from the uniformly varying temperature and moisture concentrations. The mechanical stiffness matrix is derived using linear strain-displacement associations. Then the results obtained from the numerical model are used to train the ANN. About 11,520 data points were collected from the numerical analysis and were used to train the network using the Levenberg–Marquardt algorithm. The developed ANN model is used to study the influence of various process parameters on the frequency response of the system, and the outcomes are compared with the results obtained from the numerical model. Several numerical examples are presented and conferred to comprehend the influence of temperature and moisture on the LCS plates.
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Affiliation(s)
- Vinayak Kallannavar
- Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal 575025, India;
- Correspondence: (V.K.); (S.A.)
| | - Subhaschandra Kattimani
- Department of Mechanical Engineering, National Institute of Technology Karnataka, Surathkal 575025, India;
| | - Manzoore Elahi M. Soudagar
- Department of Mechanical Engineering, Glocal University, Delhi-Yamunotri Marg, Uttar Pradesh 247121, India;
| | - M. A. Mujtaba
- Department of Mechanical Engineering, Faculty of Engineering, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Saad Alshahrani
- Department of Mechanical Engineering, King Khalid University, Guraiger, Abha 62529, Saudi Arabia
- Correspondence: (V.K.); (S.A.)
| | - Muhammad Imran
- Department of Mechanical, Biomedical and Design Engineering, College of Engineering and Physical Sciences, Aston University, Birmingham B4 7ET, UK;
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14
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Ansari MJ, Alshetaili A, Aldayel IA, Alablan FM, Alsulays B, Alshahrani S, Alalaiwe A, Ansari MN, Ur Rehman N, Shakeel F. Formulation, characterization, in vitro and in vivo evaluations of self-nanoemulsifying drug delivery system of luteolin. Journal of Taibah University for Science 2020. [DOI: 10.1080/16583655.2020.1812269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Mohammad Javed Ansari
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Abdullah Alshetaili
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ibrahim Abdulaziz Aldayel
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Faisal Mohammed Alablan
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Bader Alsulays
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Saad Alshahrani
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ahmad Alalaiwe
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Mohd Nazam Ansari
- Department of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Najeeb Ur Rehman
- Department of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Faiyaz Shakeel
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
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15
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Anwer MK, Ahmed MM, Aldawsari MF, Alshahrani S, Fatima F, Ansari MN, Rehman NU, Al-Shdefat RI. Eluxadoline Loaded Solid Lipid Nanoparticles for Improved Colon Targeting in Rat Model of Ulcerative Colitis. Pharmaceuticals (Basel) 2020; 13:ph13090255. [PMID: 32961713 PMCID: PMC7559404 DOI: 10.3390/ph13090255] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 08/29/2020] [Revised: 09/16/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
The aim of the current study was to evaluate the therapeutics potential of eluxadoline (ELX) loaded solid lipid nanoparticles (SLNs) in ulcerative colitis. ELX loaded SLNs were prepared using three different lipids according to the solvent emulsification technique. The optimization of prepared SLNs (F1-F3) were carried out based on size, PDI, zeta potential, percent drug entrapment (%EE), and loading (%DL). The lipid (stearic acid) based SLNs (F2) was optimized with particle size (266.0 ± 6.4 nm), PDI (0.217 ± 0.04), zeta potential (31.2 ± 5.19 mV), EE (65.0 ± 4.8%), and DL (4.60 ± 0.8%). The optimized SLNs (F2) was further evaluated by DSC, FTIR, SEM, in vitro release, and stability studies, which confirmed the successful encapsulation of ELX in SLNs. The efficacy of optimized SLNs (F2) in comparison to the pure ELX drug was assessed in acetic acid induced colitis rat models. It was observed that the delivery of ELX by SLNs alleviated the induced acetic acid colitis significantly. Thus, ELX loaded SLNs delivery to the colon has a significant potential to be developed for the treatment of ulcerative colitis.
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Affiliation(s)
- Md. Khalid Anwer
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (M.M.A.); (M.F.A.); (S.A.); (F.F.)
- Correspondence:
| | - Mohammed Muqtader Ahmed
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (M.M.A.); (M.F.A.); (S.A.); (F.F.)
| | - Mohammed F. Aldawsari
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (M.M.A.); (M.F.A.); (S.A.); (F.F.)
| | - Saad Alshahrani
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (M.M.A.); (M.F.A.); (S.A.); (F.F.)
| | - Farhat Fatima
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (M.M.A.); (M.F.A.); (S.A.); (F.F.)
| | - Mohd Nazam Ansari
- Department of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (M.N.A.); (N.U.R.)
| | - Najeeb Ur Rehman
- Department of Pharmacology and Toxicology, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj 11942, Saudi Arabia; (M.N.A.); (N.U.R.)
| | - Ramadan I. Al-Shdefat
- Department of Pharmaceutical Sciences, Faculty of Pharmacy, Jadara University, Irbid 21110, Jordan;
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16
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Alshahrani S, Baabbad F, Bahobail M, Hawsawi A, Jastania E, Bamousa S, Shobair A, Zaidi SF. Survival Time in Treatment Modalities of Gastric Carcinoma at King Khalid Hospital- Jeddah Saudi Arabia: a Retrospective Cohort Study. Mater Sociomed 2020; 32:271-276. [PMID: 33628129 PMCID: PMC7879444 DOI: 10.5455/msm.2020.32.271-276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Indexed: 11/09/2022] Open
Abstract
Background: Gastric cancer (GC) is the fifth most common cancer worldwide and is responsible for 10% of annual cancer deaths. Gastric cancer treatment requires a multimodality approach involving surgery, adjuvant chemotherapy (AC), and neoadjuvant chemotherapy (NAC) for locally advanced tumors. Surgical removal of the tumor is the most common and effective curative approach with a more promising survival rate. Objectives: Due to the scarcity of studies in the kingdom of Saudi Arabia, this study aims to provide an epidemiological background on the subject and compare multiple treatments and their survival outcomes in a tertiary hospital in the western region. Methods: After obtaining the IB approval, data was collected from medical files of all histologically confirmed GC patients (101) between the years 2000-2015. In this study, patients’ demographics, tumor characteristics, treatment types, and patients’ vital status (deceased or alive) were collected. Survival analysis between treatment modalities subgroups was carried out using the Kaplan-Meier test and Cox regression model. Results: Out of 101 patients with GC, 65.35% were males with a mean age of 64.9±19 years and 61.71±17.83 years for female patients. Most patients had a stage IV tumor 47 (74.6%). The adjuvant chemotherapy group had a median survival time of 140 months (95% CI 33.72-246.29), while the neoadjuvant chemotherapy was 69 months. Patients who only underwent surgery had a median survival time of 28 months (95% CI 0-56.14), whereas patients who received no intervention had a median survival time of 8 months (95% CI 1.47-14.53) (log-rank = 0.002). The median overall survival time for all patients was 28 months (95%CI 0-77.68) with an overall five-year survival rate of 19.6%. Cox regression model revealed that treatment type and tumor stage were significant predictors of survival with p values of 0.001 and 0.009, respectively. Conclusion: Adjuvant, neoadjuvant, and palliative chemotherapy constitute the paramount treatment modalities of GC with adjuvant treatment having the highest survival time. However, these modalities necessitate further understanding as to whether other factors play a role in the selection of one treatment with the preferable outcome.
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Affiliation(s)
- Saad Alshahrani
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Faisal Baabbad
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Majed Bahobail
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Alaa Hawsawi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Essam Jastania
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
| | - Saeed Bamousa
- Princess Norah Oncology Center at King Khalid Hospital, Jeddah 22384, Saudi Arabia
| | - Ammar Shobair
- Gastroenterology and Hepatology Department at King Khalid Hospital, Jeddah 22384, Saudi Arabia
| | - Syed Faisal Zaidi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Jeddah 22384, Saudi Arabia
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17
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Alshahrani S, Hablas A, Chamberlain RM, Meza J, Remmenga S, Seifeldin IA, Ramadan M, Soliman AS. Changing Incidence of Uterine Cancer in Rural Egypt: Possible Impact of Nutritional and Epidemiologic Transitions. J Glob Oncol 2019; 5:1-7. [PMID: 31365301 PMCID: PMC6690630 DOI: 10.1200/jgo.18.00255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Uterine cancer is a top-ranking women's cancer worldwide, with wide incidence variations across countries and by rural and urban areas. Hormonal exposures and access to health care vary between rural and urban areas, globally. Egypt has an overall low incidence of uterine cancer but variable rural and urban lifestyles. Are there changes in the incidence of uterine cancer in rural and urban areas in middle-income countries such as Egypt? No previous studies have addressed this question from a well-characterized and validated population-based cancer registry resource in middle-income countries. The aim of this study was to explore the differences in clinical and demographic characteristics of uterine cancer over the period of 1999 to 2010 in rural and urban Gharbiah province, Egypt. METHODS Data were abstracted for all 660 patients with uterine cancer included in the Gharbiah Population-based Cancer Registry. Clinical variables included tumor location, histopathologic diagnosis, stage, grade, and treatment. Demographic variables included age, rural or urban residence, parity, and occupation. Crude and age-adjusted incidence rates (IRs) and rate ratios by rural or urban residence were calculated. RESULTS No significant differences were observed in most clinical and demographic characteristics between rural and urban patients. The age standardized IR (ASR) was 2.5 times higher in urban than in rural areas (6.9 and 2.8 per 100,000 in urban and rural areas, respectively). The rate ratio showed that the IR in urban areas was 2.46 times the rate in rural areas. CONCLUSION This study showed that the disease IR in rural areas has increased in the past decade but is still low compared with the incidence in urban areas in Egypt, which did not show a significant increase in incidence. Nutritional transitions, obesity, and epidemiologic and lifestyle changes toward Westernization may have led to IRs increasing more in rural than in urban areas in Egypt. This pattern of increasing incidence in Egypt, which used to have a low incidence of uterine cancer, may appear in other middle-income countries that experience emerging nutritional and epidemiologic transitions. The rate of uterine cancer in urban areas in Gharbiah is almost similar to the corresponding rates globally. However, the rate in rural areas in this population has increased over the past decade but is still lower than the corresponding global rates. Future studies should examine the etiologic factors related to increasing rates in rural areas and quantify the improvement in rural case finding.
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Affiliation(s)
| | - Ahmed Hablas
- Gharbiah Cancer Society and Gharbiah Population-based Cancer Registry, Tanta, Egypt
| | - Robert M Chamberlain
- City University of New York Medical School, New York, NY.,University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jane Meza
- University of Nebraska Medical Center, Omaha, NE
| | | | - Ibrahim A Seifeldin
- Gharbiah Cancer Society and Gharbiah Population-based Cancer Registry, Tanta, Egypt
| | - Mohamed Ramadan
- Gharbiah Cancer Society and Gharbiah Population-based Cancer Registry, Tanta, Egypt
| | - Amr S Soliman
- City University of New York Medical School, New York, NY
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18
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Alalaiwe A, Carpinone P, Alshahrani S, Alsulays B, Ansari M, Anwer M, Alshehri S, Alshetaili A. Influence of chitosan coating on the oral bioavailability of gold nanoparticles in rats. Saudi Pharm J 2018; 27:171-175. [PMID: 30766426 PMCID: PMC6362168 DOI: 10.1016/j.jsps.2018.09.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 06/25/2018] [Accepted: 09/20/2018] [Indexed: 11/19/2022] Open
Abstract
Gold nanoparticles are one of the most extensively investigated metallic nanoparticles for several applications. It is less toxic than other metallic nanolattices. The exceptional electrical and thermal conductivity of gold make it possible to be administered as non-invasive radiofrequency irradiation therapy that produces sufficient heat to kill tumor cells. Nanoparticles are generally administered intravenously instead of orally due to negligible oral absorption and cellular uptake. This study evaluated the oral bioavailability of gold nanoparticles coated with chitosan (C-AuNPs), a natural mucoadhesive polymer. We employed traditional method of evaluating bioavailability that involve estimation of maximum concentrations and area under the curve of 3 nm chitosan coated gold nanoparticles (C-AuNPs) in the rat plasma following intravenous and oral administrations (0.8 mg and 8 mg/kg body weight respectively). The oral bioavailability of C-AuNPs was found to be 2.46% (approximately 25 folds higher than polyethylene glycol (PEG) coated gold nanoparticles, reported earlier). These findings suggest that chitosan coating could be better than PEG coating for the enhancement of oral bioavailability of nanoparticles.
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Key Words
- AUCINF, area under curve extrapolated till infinite time
- AUCcall, area under curve calculated till last quantifiable time point
- AUCiv, Area Under the Plasma Concentration-Time Curve of intravenous administration
- AUCpo, Area Under the Plasma Concentration-Time Curve of oral administration
- Area under curve
- Bioavailability
- C-AuNPs, gold nanoparticles coated with chitosan
- CL, clearance
- Chitosan
- Chitosan coated gold nano-particles (C-AuNP)
- Cmax, maximum concentration of gold nanoparticles in blood
- F_AUCINF, bioavailability calculated from Area Under the Plasma Concentration-Time Profile from Time 0 to Infinity
- Gold nanoparticles (AuNP)
- Rat plasma
- T ½, biological half-life (time required to eliminate half amount of drug from body)
- Vd, volume of distribution
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Affiliation(s)
- Ahmed Alalaiwe
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
- Corresponding author.
| | - Paul Carpinone
- Particle Engineering Research Center, University of Florida, United States
| | - Saad Alshahrani
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Bader Alsulays
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mohammed Ansari
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Mohammed Anwer
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah Alshetaili
- Department of Pharmaceutics, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Alkharj, Saudi Arabia
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Abstract
Purpose
The purpose of this paper is to develop a comprehensive conceptual model for the impact of hospital-supplier integration on the overall performance of healthcare organisations. It also investigates the moderating role of lean practices between hospital-supplier integration and hospital performance.
Design/methodology/approach
Data were collected from 498 public and private hospitals in Saudi Arabia using a survey. Structural equation modelling was used for data analysis.
Findings
The results indicate that hospital-supplier integration has a positive impact on the hospital performance. These effects are even more notable when adopting lean practices in the hospitals.
Research limitations/implications
The data were collected from one developing country, namely Saudi Arabia. Thus, the findings may be relevant to the Saudi context but not those of other developing countries. Second, the data were collected from the hospitals’ end but not from the suppliers, so the latter’s perspectives on the themes covered here are not known. Future research may investigate the validity of the model in various developing countries whose healthcare systems have different characteristics, and the relationships between hospitals and their suppliers may follow different governance models.
Practical implications
The developed model and results will help hospitals in the Saudi health system to make better decisions on managing their logistics and supply partners.
Originality/value
This study extends the current research by developing a model that highlights the impact of hospital-supplier integration on the overall performance of healthcare organisations and tests this model to confirm its validity. To the authors’ knowledge, this study would be one of the first that uses both lean thinking and relational view of competitive advantage theory combined to examine the moderating role of lean practices on the inter-organisational relationships in Saudi Arabia.
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Alshahrani S, Aldossari K, Al-Zahrani J, Gabr AH, Henkel R, Ahmad G. Interpretation of semen analysis using WHO 1999 and WHO 2010 reference values: Abnormal becoming normal. Andrologia 2017; 50. [DOI: 10.1111/and.12838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/28/2017] [Indexed: 01/21/2023] Open
Affiliation(s)
- S. Alshahrani
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
| | - K. Aldossari
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
| | - J. Al-Zahrani
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
| | - A. H. Gabr
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
- Faculty of Medicine; Minia University; Minya Egypt
| | - R. Henkel
- Department of Medical Bioscience; University of the Western Cape; Bellville South Africa
| | - G. Ahmad
- College of Medicine; Prince Sattam Bin Abdulaziz University; Al Kharj Saudi Arabia
- Department of Physiology; University of Health Sciences; Lahore Pakistan
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Ahmed AF, Maarouf A, Shalaby E, Alshahrani S, El-Feky M, Khaled S, Daoud A, Soliman A, Desoky E, El-Helaly H. Semi-Rigid Ureteroscopy for Proximal Ureteral Stones: Does Adjunctive Tamsulosin Therapy Increase the Chance of Success? Urol Int 2016; 98:411-417. [PMID: 27871076 DOI: 10.1159/000452926] [Citation(s) in RCA: 13] [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: 10/03/2016] [Accepted: 10/27/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To assess the efficacy of adjunctive tamsulosin therapy in improving the success rate of laser-assisted semi-rigid ureteroscopy (URS) for removing proximal ureteral stones. PATIENTS AND METHODS This prospective study included 165 patients with proximal ureteral stones ≥10 mm. The patients were randomly assigned to a tamsulosin group (Group I, n = 81) receiving tamsulosin 0.4 mg daily for 1 week pre-URS and a control group (Group II, n = 84) without tamsulosin therapy. Treatment consisted of URS using a semi-rigid ureteroscope (7.5 Fr), followed by intracorporeal holmium: YAG laser lithotripsy. The patients were followed up regularly for 8 weeks after URS. RESULTS The operative time was 43.4 and 49.6 min in Groups I and II, respectively (p < 0.001). Scope to stone access rate was 93.8 and 82.1% in patients of Groups I and II, respectively (p = 0.022). The stone-free rate was significantly higher in Group I compared to Group II (74/81; 91.4% vs. 67/84; 79.8%; p = 0.035). The complication rate was significantly lower in Group I compared to Group II (17.3 vs. 38.1%, p = 0.003). Only minor complications were encountered and were managed conservatively. CONCLUSIONS Tamsulosin therapy prior to semi-rigid URS improved ureteroscopic access to proximal ureteral stones, thus leading to an increased success rate and low morbidity.
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Alshahrani S, Ahmed AF, Gabr AH, Al Ansari A, El-feky M, Elbadry MS. Phosphodiesterase type 5 inhibitors: Irrational use in Saudi Arabia. Arab J Urol 2016; 14:94-100. [PMID: 27489735 PMCID: PMC4963165 DOI: 10.1016/j.aju.2016.03.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [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: 01/12/2016] [Revised: 03/12/2016] [Accepted: 03/16/2016] [Indexed: 01/08/2023] Open
Abstract
Objective To identify the criteria of phosphodiesterase type 5 inhibitor (PDE5i) users and to analyse the knowledge, attitude, and practices of PDE5i use amongst Saudi men. Subjects and methods A web-based, cross-sectional survey was conducted in Saudi Arabia between January and April 2015. Sexually active adult men were interviewed using a website questionnaire designed by the authors. Descriptive statistics were used to analyse the data. Results In all, 1008 men participated in the survey with 378 (37.5%) reporting use of PDE5i. Of those using PDE5i, 144 (38.1%) reported erectile dysfunction and 234 (61.9%) reported normal erection (recreational users). We found several demographic features, including high education level, health field occupation, high income, smoking, and increased frequency of sexual intercourse amongst the PDE5i users. Most of the PDE5i users (92.3%) had knowledge about PDE5i and 84.1% of them bought it without medical prescription. The most commonly used PDE5i was tadalafil (46.1%) and most of the users (79.9%) reported improvement in their sexual activity after PDE5i usage. Amongst the recreational users, the main reasons for PDE5i usage were curiosity (38.5%) and improving self-confidence (25.6%). Of them, 69.2% reported benefits from PDE5i usage, mainly in the form of enhancement of erection (36.7%) and increasing erection duration (31.2%). Conclusion PDE5i use appears to be frequent in Saudi Arabia. Most of the users had knowledge about PDE5i and claimed to get benefits from it, even if used as a recreational drug.
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Affiliation(s)
- Saad Alshahrani
- Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia
| | - Abul-Fotouh Ahmed
- Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
- Corresponding author at: Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, P.O. Box 173, Al-kharj 11942, Saudi Arabia. Tel.: +966 15886100; fax: +966 15886101.Department of UrologyCollege of MedicinePrince Sattam Bin Abdulaziz UniversityP.O. Box 173Al-kharj11942Saudi Arabia
| | - Ahmed H. Gabr
- Department of Urology, College of Medicine, Prince Sattam Bin Abdulaziz University, Saudi Arabia
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
| | - Ahmed Al Ansari
- Bahrain Defence Force Hospital, Department of Surgery, Arabian Gulf University, Bahrain
| | - Mohamed El-feky
- Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed S. Elbadry
- Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
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Alshahrani S, Ahmed AF, Gabr AH, Abalhassan M, Ahmad G. The impact of body mass index on semen parameters in infertile men. Andrologia 2016; 48:1125-1129. [PMID: 26847036 DOI: 10.1111/and.12549] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2015] [Indexed: 11/27/2022] Open
Abstract
This hospital-based, prospective study was conducted to evaluate the relationship between body mass index (BMI) and various semen parameters in infertile men. A total of 439 men presented for infertility evaluation were assessed by basic infertility evaluation measures including semen analysis and BMI calculation. The main outcome measure was the relationship between BMI groups [BMI: 18.5-24.9 kg/m2 (normal weight), 25-29.9 kg/m2 (overweight) and ≥30 kg/m2 (obese)] and different semen parameters [volume, concentration, motility and morphology]. The mean BMI was 29.67 ± 5.89. Most of patients (82.91%) were overweight or obese. The 3 BMI groups were comparable in semen parameters (P > 0.05). BMI had a negative correlation with various semen parameters. However, this correlation was significant only with sperm concentration (P = 0.035). We concluded that sperm concentration was the only semen parameter which showed significant reduction with higher BMI in infertile men.
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Affiliation(s)
- S Alshahrani
- Department of Urology, Faculty of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - A-F Ahmed
- Department of Urology, Faculty of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia.,Department of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - A H Gabr
- Department of Urology, Faculty of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia.,Department of Urology, Faculty of Medicine, Minia University, Minia, Egypt
| | - M Abalhassan
- Department of Urology, Faculty of Medicine, Prince Sattam bin Abdulaziz University, Alkharj, Saudi Arabia
| | - G Ahmad
- University of Health Sciences, Lahore, Pakistan
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Almetrek M, Alqahtani M, Alsamghan A, Alqahtani H, Alshahrani M, Alshahrani S, Alshahrani F. Sleep quality among male medical students in King Khalid University. J Neurol Sci 2015. [DOI: 10.1016/j.jns.2015.08.598] [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: 10/22/2022]
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Agarwal A, Mulgund A, Alshahrani S, Assidi M, Abuzenadah AM, Sharma R, Sabanegh E. Reactive oxygen species and sperm DNA damage in infertile men presenting with low level leukocytospermia. Reprod Biol Endocrinol 2014; 12:126. [PMID: 25527074 PMCID: PMC4292986 DOI: 10.1186/1477-7827-12-126] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Accepted: 12/14/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Leukocytes contribute directly and indirectly to reactive oxygen species (ROS) production. Although leukocytospermia is defined as the presence of ≥ 1 × 106 white blood cells/mL (WBC/mL) in a semen sample, the presence of less than 1×10(6) WBC/mL (low-level leukocytospermia) can still produce a detectable amount of ROS, impairing sperm function and lowering the chances of pregnancy. Our objective was to assess the effect of low-level leukocytospermia on semen quality, ROS levels, and DNA damage in infertile men. METHODS Semen samples were examined from 472 patients and divided into 3 groups: no seminal leukocytes; group 2, men with low-level leukoctyospermia (0.1-1.0 × 106 WBC/mL); and group 3, frank leukocytospermia, (>1.0 × 106. WBC/mL). Semen analysis, leukoctyospermia, reactive oxygen species and DNA fragmentation was tested. RESULTS Conventional semen parameters between the 3 groups were similar. Group 2 patients had significantly higher levels of ROS and sperm DNA fragmentation (1839.65 ± 2173.57RLU/s; DNA damage: 26.47 ± 19.64%) compared with group 1 (ROS: 1101.09 ± 5557.54 RLU/s; DNA damage: 19.89 ± 17.31%) (ROS: p=0.002; DNA damage: p=0.047). There was no significant difference in ROS levels between groups 2 and 3. CONCLUSIONS Patients presenting with low-level leukocytospermia have seminal oxidative stress. Although these patients are not categorized as leukocytospermic by current World Health Organization (WHO) guidelines, these men may benefit by treatment with antibiotics, testing for bacterial cultures, or antioxidant supplements to reduce ROS-induced sperm DNA fragmentation and improve their chances of fertility. The WHO guidelines for leukocytospermia may need to be revised accordingly.
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Affiliation(s)
- Ashok Agarwal
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195 USA
- Center of Excellence in Genomic Medicine Research, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Aditi Mulgund
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195 USA
| | - Saad Alshahrani
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195 USA
- Salman Bin Abdul Aziz University, College of Medicine, Al Kharj, Jeddah, Saudi Arabia
| | - Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King AbdulAziz University, Jeddah, Saudi Arabia
- KACST Technology Innovation Center in Personalized Medicine, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Adel M Abuzenadah
- Center of Excellence in Genomic Medicine Research, King AbdulAziz University, Jeddah, Saudi Arabia
- KACST Technology Innovation Center in Personalized Medicine, King AbdulAziz University, Jeddah, Saudi Arabia
| | - Rakesh Sharma
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195 USA
| | - Edmund Sabanegh
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH 44195 USA
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Ahmed AF, Gabr AH, Emara AA, Ali M, Abdel-Aziz AS, Alshahrani S. Factors predicting the spontaneous passage of a ureteric calculus of ⩽10 mm. Arab J Urol 2014; 13:84-90. [PMID: 26413326 PMCID: PMC4561928 DOI: 10.1016/j.aju.2014.11.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/26/2014] [Accepted: 11/12/2014] [Indexed: 12/01/2022] Open
Abstract
Objective To evaluate the outcome of the expectant management of ureteric stones and to determine the factors predictive of the spontaneous passage of stones. Patients and methods We retrospectively reviewed the medical records of patients who had ureteric stones of ⩽10 mm and who were treated conservatively at our institutions during the period 2008–2013. The stone-passage rate and time, and different clinical, laboratory and radiological variables, were analysed. Results In all, 163 patients with ureteric stones were enrolled in the study, of whom 127 (77.9%) passed their stones spontaneously, with a mean (SD) passage time of 24.0 (8.09) days. The cumulative stone-passage rate was 1.6%, 15%, 41.7%, 72.4%, 89.8% and 98.4% at 7, 14, 21, 28, 35 and 42 days from the first presentation, respectively. Patients with a high pain-scale score, stones of ⩽5 mm, a lower ureteric stone, a high white blood cell count and those with absent computed tomography (CT) findings of perinephric fat stranding (PFS) and tissue-rim sign (TRS) had a higher likelihood of spontaneous stone passage. Patients with stones of ⩽5 mm, stones in the lower ureter and those with no PFS had a shorter spontaneous passage time. In a multivariate analysis the absence of PFS and TRS were the only significant predictors for spontaneous stone passage (P < 0.001 and 0.002, respectively). Conclusions The spontaneous ureteric stone-passage rate and time varies with different factors. The absence of CT findings of PFS and TRS are significant predictors for stone passage, and should be considered when choosing the expectant management.
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Affiliation(s)
- Abul-Fotouh Ahmed
- Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, Salman Bin Abdul-Aziz University, Al-kharj, Saudi Arabia
| | - Ahmed H Gabr
- Department of Urology, Salman Bin Abdul-Aziz University, Al-kharj, Saudi Arabia ; Department of Urology, Minia University, Minia, Egypt
| | - Abdel-Aziz Emara
- Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, Ghodran Hospital, Baljurashi, Saudi Arabia
| | - Mahmoud Ali
- Department of Urology, Al-Azhar University, Cairo, Egypt ; Department of Urology, King Khalid Hospital, Tabouk, Saudi Arabia
| | - Al-Sayed Abdel-Aziz
- Department of Urology, Al-Azhar University, Damietta, Egypt ; Department of Urology, Al-Rafie Hospital, Makkah, Saudi Arabia
| | - Saad Alshahrani
- Department of Urology, Salman Bin Abdul-Aziz University, Al-kharj, Saudi Arabia
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Alshahrani S, Baccaglini L. Psychological Screening Test Results for Stress, Depression, and Anxiety are Variably Associated With Clinical Severity of Recurrent Aphthous Stomatitis and Oral Lichen Planus. J Evid Based Dent Pract 2014; 14:206-8. [DOI: 10.1016/j.jebdp.2014.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Alshahrani S, Agarwal A, Assidi M, Abuzenadah AM, Durairajanayagam D, Ayaz A, Sharma R, Sabanegh E. Infertile men older than 40 years are at higher risk of sperm DNA damage. Reprod Biol Endocrinol 2014; 12:103. [PMID: 25410314 PMCID: PMC4258051 DOI: 10.1186/1477-7827-12-103] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 11/05/2014] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The effect of paternal age on semen quality is controversial. In this retrospective study, the aim was to investigate the effects of advancing age on sperm parameters including reactive oxygen species (ROS), total antioxidant capacity (TAC) and sperm DNA damage in infertile men. We also examined whether paternal age >40 y is associated with higher risk of sperm DNA damage. METHODS A total of 472 infertile men presenting for infertility were divided into 4 age groups: group A: patients ≤ 30 y; group B: patients 31- 40 y, group C: ≤ 40 y and group D: patients >40 y. The following tests were performed - semen analysis according to WHO 2010 criteria, seminal ROS by chemiluminescence, TAC by colorimetric assay and sperm DNA damage by TUNEL assay - and the results were compared amongst the 4 age groups. RESULTS There was no statistical difference in conventional semen parameters, TAC and ROS with advancing paternal age as well as between different age groups. However, a significant negative association was noted between sperm DNA damage and advancing paternal age. Men >40 y showed higher levels of sperm DNA damage (24.4 ± 18.5%) compared to younger men (<30 y; 16.7 ± 11.2%; p <0.05). CONCLUSIONS Infertile men over the age of 40 y have a greater percentage of sperm DNA fragmentation compared to infertile men aged 40 y and below. Advanced paternal age (>40 y) may increase the risk of sperm DNA damage in infertile men.
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Affiliation(s)
- Saad Alshahrani
- Glickman Urological and Kidney Institute, Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH USA
- College of Medicine, Salman Bin Abdulaziz University, Alkharj, Saudi Arabia
| | - Ashok Agarwal
- Glickman Urological and Kidney Institute, Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH USA
| | - Mourad Assidi
- College of Medicine, Salman Bin Abdulaziz University, Jeddah, Saudi Arabia
- Center of Excellence in Genomic Medicine Research, King AbdulAziz University, Jeddah, Saudi Arabia
- KACST Technology Innovation Center in Personalized Medicine at King AbdulAziz University, Jeddah, Saudi Arabia
| | - Adel M Abuzenadah
- College of Medicine, Salman Bin Abdulaziz University, Jeddah, Saudi Arabia
- Center of Excellence in Genomic Medicine Research, King AbdulAziz University, Jeddah, Saudi Arabia
- KACST Technology Innovation Center in Personalized Medicine at King AbdulAziz University, Jeddah, Saudi Arabia
| | - Damayanthi Durairajanayagam
- Glickman Urological and Kidney Institute, Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH USA
- MARA University of Technology, Selangor Darul Ehsan, Malaysia
| | - Ahmet Ayaz
- Glickman Urological and Kidney Institute, Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH USA
| | - Rakesh Sharma
- Glickman Urological and Kidney Institute, Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH USA
| | - Edmund Sabanegh
- Glickman Urological and Kidney Institute, Center for Reproductive Medicine, Cleveland Clinic, Cleveland, OH USA
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Agarwal A, Sharma RK, Sharma R, Assidi M, Abuzenadah AM, Alshahrani S, Durairajanayagam D, Sabanegh E. Characterizing semen parameters and their association with reactive oxygen species in infertile men. Reprod Biol Endocrinol 2014; 12:33. [PMID: 24885775 PMCID: PMC4047553 DOI: 10.1186/1477-7827-12-33] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 04/26/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND A routine semen analysis is a first step in the laboratory evaluation of the infertile male. In addition, other tests such as measurement of reactive oxygen species can provide additional information regarding the etiology of male infertility. The objective of this study was to investigate the association of semen parameters with reactive oxygen species (ROS) in two groups: healthy donors of unproven and proven fertility and infertile men. In addition, we sought to establish an ROS cutoff value in seminal plasma at which a patient may be predicted to be infertile. METHODS Seminal ejaculates from 318 infertile patients and 56 donors, including those with proven fertility were examined for semen parameters and ROS levels. Correlations were determined between traditional semen parameters and levels of ROS among the study participants. ROS levels were measured using chemiluminescence assay. Receiver operating characteristic curves were obtained to calculate a cutoff value for these tests. RESULTS Proven Donors (n = 28) and Proven Donors within the past 2 years (n = 16) showed significantly better semen parameters than All Patients group (n = 318). Significantly lower ROS levels were seen in the two Proven Donor groups compared with All Patients. The cutoff value of ROS in Proven Donors was determined to be 91.9 RLU/s with a specificity of 68.8% and a sensitivity of 93.8%. CONCLUSIONS Infertile men, irrespective of their clinical diagnoses, have reduced semen parameters and elevated ROS levels compared to proven fertile men who have established a pregnancy recently or in the past. Reactive oxygen species are negatively correlated with traditional semen parameters such as concentration, motility and morphology. Measuring ROS levels in the seminal ejaculates provides clinically-relevant information to clinicians.
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Affiliation(s)
- Ashok Agarwal
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio 44106, USA
| | - Rakesh K Sharma
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio 44106, USA
| | - Reecha Sharma
- Health Services Department, Saint Joseph University, 5600 City Avenue, Philadelphia, PA 19131, USA
| | - Mourad Assidi
- Center of Excellence in Genomic Medicine Research, King AbdulAziz University, Jeddah, Saudi Arabia
- KACST Technology Innovation Center in Personalized Medicine at King AbdulAziz University, Jeddah, Saudi Arabia
| | - Adel M Abuzenadah
- Center of Excellence in Genomic Medicine Research, King AbdulAziz University, Jeddah, Saudi Arabia
- KACST Technology Innovation Center in Personalized Medicine at King AbdulAziz University, Jeddah, Saudi Arabia
| | - Saad Alshahrani
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio 44106, USA
- Department of Surgery, Salman Bin Abdulaziz University, College of Medicine, Alkharj, Saudi Arabia
| | - Damayanthi Durairajanayagam
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio 44106, USA
- MARA University of Technology, Sungai Buloh Campus, Jalan Hospital, 47000 Sungai Buloh, Selangor Darul Ehsan, Malaysia
| | - Edmund Sabanegh
- Center for Reproductive Medicine, Cleveland Clinic, Cleveland, Ohio 44106, USA
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Alshahrani S, Agarwal A, Assidi M, Abuzenadah AM, Durairajanayagam D, Ayaz A, Sharma R. Impact of World Health Organization (WHO) new standards on the referral pattern of infertile men for assisted reproduction. BMC Genomics 2014. [PMCID: PMC4075603 DOI: 10.1186/1471-2164-15-s2-p31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Alshahrani S, Agarwal A, Assidi M, Abuzenadah AM, Durairajanayagam D, Ayaz A, Sharma R, Sabanegh E. Effect of advancing paternal age on semen parameters and seminal oxidative stress markers in infertile men. BMC Genomics 2014. [PMCID: PMC4075617 DOI: 10.1186/1471-2164-15-s2-p42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Alshahrani S, McGill J, Agarwal A. Prostatitis and male infertility. J Reprod Immunol 2013; 100:30-6. [DOI: 10.1016/j.jri.2013.05.004] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 05/06/2013] [Accepted: 05/09/2013] [Indexed: 12/17/2022]
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Carchenilla MSC, Agudo D, Rubio S, Becerra D, Bronet F, Garcia-Velasco JA, Pacheco A, Lardone M, Piottante A, Parada-Bustamante A, Argandona F, Florez M, Espinoza A, Ebensperger M, Castro A, Cohen-Bacrie M, Belloc S, Dalleac A, Amar E, Izard V, Hazout A, Cohen-Bacrie P, de Mouzon J, Muzzonigro F, Crivello AM, Stanghellini I, Bernardini L, Ferraretti AP, Magli C, Gianaroli L, Martin PS, Duvison MH, Silva MD, Gosalvez J, Martin FS, Pomante A, Muzzonigro F, Colombo F, Mattioli M, Barboni B, Ferraretti AP, Magli MC, Gianaroli L, Hacifazlioglu O, Findikli N, Goktolga U, Bahceci M, Jakab A, Mokanszki A, Varga A, Benyo M, Kassai Z, Olah E, Molnar Z, Gundogan GI, Bozkurt HH, Irez T, Domingo A, Anarte C, Presilla N, Calvo I, Aguirre O, Oroquieta A, Agirregoikoa JA, De Pablo JL, Barrenetxea G, Moragues I, Medrano ML, Montoya A, Ramos B, Torres MJG, Aizpurua J, Ibala SR, Ghedir H, Mehri A, Zidi I, Brahem S, Mehdi M, Ajina M, Saad A, Medrano ML, Moragues I, Gomez-Torres MJ, Montoya A, Aizpurua J, Cavaco JE, Rato L, Alves MG, Dias TR, Lopes G, Socorro S, Oliveira PF, Lobascio AM, Minasi MG, Greco E, Bungum M, Bungum A, Silver N, Zahiri M, Movahedin M, Mowla SJ, Noruzinia M, Huleihel M, Abarbanel Y, Haber EP, Azab M, Lan D, Lunenfeld E, Smith MJ, Neri QV, Harvey L, Rosenwaks Z, Palermo GD, Alhalabi M, Samawi S, Droubi H, Khalaf M, Taha A, Khatib R, Bednarowska-flisiak A, Wcislo M, Liss J, Swider A, Szczyglinska J, Grzymkowska M, Bruszczynska A, Glowacka J, Kitowska-Marszalkowska K, Krapchev M, Mirecka A, Wisniewska K, Lukaszuk K, Natali I, Tamburrino L, Cambi M, Marchiani S, Noci I, Maggi M, Forti G, Baldi E, Muratori M, Ferraretto X, Pasquet B, Damond F, Matheron S, Epelboin S, Yahi S, Demailly P, Rougier N, Yazbeck C, Delaroche L, Longuet P, Llabador M, Estellat C, Patrat C, Wcislo M, Liss J, Swider A, Szczyglinska J, Grzymkowska M, Bruszczynska A, Glowacka J, Krapchev M, Mirecka A, Kitowska-Marszalkowska K, Wisniewska K, Lukaszuk K, Askarijahromi M, Movahedin M, Amanlu M, Mowla SJ, Mazaheri Z, Christensen P, Sills ES, Fischer R, Naether OGJ, Walsh D, Rudolf K, Coull G, Baukloh V, Labouriau R, Birck A, Parisi F, Parrilla B, Oneta M, Savasi V, Veleva L, Milachich T, Bochev I, Antonova I, Shterev A, Vlaisavljevic V, Breznik BP, Kovacic B, Serrano M, Gonzalvo MC, Clavero A, Fernandez MF, Mozas J, Martinez L, Fontes J, Carrillo S, Lopez-Regalado ML, Lopez-Leria B, Orozco I, Mantilla A, Castilla JA, Mskhalaya G, Zakharova E, Zaletova V, Kasatonova E, Melnik Y, Efremov E, Breznik BP, Kovacic B, Vlaisavljevic V, Schiewe MC, Verheyen G, Tournaye H, Phletincx I, Sims CA, Rothman C, Borges E, Setti AS, Braga DPAF, Vingris L, Iaconelli A, Dupont C, Faure C, Sermondade N, Gautier B, Herbemont C, Aknin I, Klein JP, Cedrin-Durnerin I, Wolf JP, Czernichow S, Levy R, Rondanino C, Chauffour C, Ouchchane L, Artonne C, Janny L, Lobaccaro JM, Volle DH, Brugnon F, Colacurci N, Piomboni P, Ruvolo G, Lombardo F, Verde EL, De Leo V, Lispi M, Papaleo E, De Palo R, Gandini L, Longobardi S, Yokota Y, Yokota M, Yokota H, Araki Y, Araki Y, Alshahrani S, Durairajanayagam D, Sharma R, Sabanegh E, Agarwal A, Hattori H, Nakajo Y, Ikeno T, Sato Y, Kyoya T, Kyono K, Li B, Li JB, Xiao XF, Ma YF, Wang J, Liang XX, Zhao HX, Jiang F, Yao YQ, Wang XH, Roan NR, Liu H, Muller J, Avila-Herrera A, Pollard KS, Lishko P, Kirchhoff F, Munch J, Witkowska HE, Greene WC, Mangiarini A, Paffoni A, Restelli L, Guarneri C, Somigliana E, Ragni G, Anarte C, Domingo A, Calvo I, Presilla N, Aguirre O, Bou R, Aleman M, Guardiola F, Agirregoikoa JA, De Pablo JL, Barrenetxea G, Camargo C, Oliveira JBA, Petersen CG, Mauri AL, Massaro FC, Nicoletti A, Nascimento AM, Vagnini LD, Martins AMVC, Cavagna M, Baruffi RLR, Franco JG. Andrology. Hum Reprod 2013. [DOI: 10.1093/humrep/det206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Madbouly K, Alshahrani S, Al-Omair T, Matrafi HA, Mansi M. Efficacy of local subcutaneous anesthesia versus intramuscular opioid sedation in extracorporeal shockwave lithotripsy: a randomized study. J Endourol 2011; 25:845-9. [PMID: 21417936 DOI: 10.1089/end.2010.0427] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To evaluate the analgesic efficacy of local subcutaneous (SC) anesthesia compared with intramuscular (IM) opioid sedation during extracorporeal shockwave lithotripsy (SWL) in a randomized study. PATIENTS AND METHODS After informed consent was obtained, 125 patients with urolithiasis who were scheduled for SWL were included in the study. The patients in each treatment session were randomized to receive either IM meperidine (group A) or SC infiltration of 10 mL 2% lidocaine and 10 mL 0.5% bupivacaine at the area of shockwave entry (group B). Degree of pain was rated by the patient using a five-point visual analogue scale (VAS). RESULTS The study included 88 (70.4%) men and 37 (29.6%) women with a mean age of 47.6 ± 12.5 years and a mean body mass index (BMI) of 28.16 ± 4.67 kg/m2. Of the patients, 89, 26, and 10 received a single, two, or more than two treatment sessions, respectively (176 sessions). Maximum stone length was 10.68 ± 5.12 mm. Pretreatment stent placement was performed in 17 (13.6%) patients (28 sessions). Group A comprised 89 treatment sessions while 87 were involved in group B. Both groups were similar. Supplemental intrvenous sedation was needed in two (2.5%) and four (4.6%) sessions in groups A and B, respectively. VAS was not different between both groups (P = 0.063). Patients with pretreatment stent placement had significantly lower VAS score compared with patients without stents (P = 0.012). Sex and BMI had no impact on the VAS score. CONCLUSIONS Local SC anesthesia alone is effective for analgesic purposes during extracorporeal SWL. Sex, age, and BMI have no relation to analgesia requirement.
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Affiliation(s)
- Khaled Madbouly
- Department of Surgery, Division of Urology, King Fahad National Guard Hospital, King Abdul-Aziz Medical City, Riyadh, Saudi Arabia.
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