Study protocol: a pragmatic, cluster-randomized controlled trial to evaluate the effect of implementation of the Truenat platform/MTB assays at primary health care clinics in Mozambique and Tanzania (TB-CAPT CORE)

BACKGROUND

In 2020, the WHO-approved Molbio Truenat platform and MTB assays to detect Mycobacterium tuberculosis complex (MTB) and resistance to rifampicin directly on sputum specimens. This primary health care center-based trial in Mozambique and Tanzania investigates the effect of Truenat platform/MTB assays (intervention arm) combined with rapid communication of results compared to standard of care on TB diagnosis and treatment initiation for microbiologically confirmed TB at 7 days from enrolment.

METHODS

The Tuberculosis Close the Gap, Increase Access, and Provide Adequate Therapy (TB-CAPT) CORE trial employs a pragmatic cluster randomized controlled design to evaluate the impact of a streamlined strategy for delivery of Truenat platform/MTB assays testing at primary health centers. Twenty-nine centers equipped with TB microscopy units were selected to participate in the trial. Among them, fifteen health centers were randomized to the intervention arm (which involves onsite molecular testing using Truenat platform/MTB assays, process process optimization to enable same-day TB diagnosis and treatment initiation, and feedback on Molbio platform performance) or the control arm (which follows routine care, including on-site sputum smear microscopy and the referral of sputum samples to off-site Xpert testing sites). The primary outcome of the study is the absolute number and proportion of participants with TB microbiological confirmation starting TB treatment within 7 days of their first visit. Secondary outcomes include time to bacteriological confirmation, health outcomes up to 60 days from first visit, as well as user preferences, direct cost, and productivity analyses.

ETHICS AND DISSEMINATION

TB-CAPT CORE trial has been approved by regulatory and ethical committees in Mozambique and Tanzania, as well as by each partner organization. Consent is informed and voluntary, and confidentiality of participants is maintained throughout. Study findings will be presented at scientific conferences and published in peer-reviewed international journals.

TRIAL REGISTRATION

US National Institutes of Health's ClinicalTrials.gov, NCT04568954. Registered 23 September 2020.

Economic valuation of selected ecosystem services in Islamabad Capital Territory (ICT), Pakistan

Abstract Payment for ecosystem services (PES) is a mechanism where a consumer is able and ready to pay for the protection of the precise ecosystem service and there must be a provider such as local societies receiving an economic resource, who in return, must have the ability to maintain that ecosystem service. Economic valuation provides basis for payment for ecosystem services. Therefore, objective of this study was to evaluate tourism and carbon stock services of the Islamabad Capital Territory (ICT), Pakistan. Two forest zones (Chirpine and Scrub) of Islamabad capital territory (ICT) were selected for estimation of carbon stock and their carbon credits and carbon worth, a questionnaire-based survey was conducted for tourism as a payment for ecosystem services. The method for carbon stock assessment was systematic sampling for Chirpine forest whereas random sampling was done for scrub forest. The size of sampling plot was 17.84 m radius, and a total of 93 plots (49 Scrub zone and 44 Chirpine zone) was taken in the study area. The carbon stock of both zones (Chirpine and Scrub zone) is 22556.75 ton/ha (Chirpine 20105.79, Scrub 2450.96) and total carbon dioxide sequestered by both zone is 82557.72 ton/ha (Chirpine 73587.2, Scrub 8970.52), total carbon credits of both zone is 302160.87 (Chirpine 269328.97, Scrub 32831.9) and the carbon worth of both Chirpine and scrub zone is 4532418.92 $ (Chirpine 4039937.09$, Scrub 492481.83$). Similarly, from tourism point of view, in Shakar Parian, 94% tourists were agreed for PES whereas 6% were disagreed for the PES (the 6% tourist were disagreed to contribute for PES, 40% were agreed for Rs.5 contribution and 54% for Rs.10.). moreover, in Lake view Park, 97% tourists were agreed and 3% are disagreed (In Lake View Park 5% tourists were disagreed for the PES contribution whereas 32% were agreed for Rs.5 and 63% were for Rs.10). In Damen e Koh, around 87% tourist were agreed and 13% were disagreed, (24% were agreed for the contribution of Rs.5 and 63% tourists were agreed for the contribution of Rs.10). In Marghazar Zoo, 93% tourists were agreed (22% were agreed for contribution of Rs.5 and 71% tourist were agreed for contribution of Rs.10) and 7% are disagreed for PES whereas 7% tourists were not agreed for contribution. PES may implement to compensate forest and parks manager to ensure better management of the forests and parks. Due to prime location and scenic beauty of the ICT, it has huge potential for implementation of PES mechanism for sustainable forest management and conservation. Therefore, it is recommended that Capital Development Authority (CDA) Islamabad should devise a plan for implementation of PES in forests and parks of ICT for its sustainable management of recreational and forest resources.

Prevalence of mutations in common tumour types in Northern England and comparable utility of national and international Trial Finders

PURPOSE

Tumour genomic profiling is of increasing importance in early phase trials to match patients to targeted therapeutics. Mutations vary by demographic group; however, regional differences are not characterised. This was investigated by comparing mutation prevalence for common cancers presenting to Newcastle Experimental Cancer Medicine Centre (ECMC) to The Cancer Genome Atlas (TCGA) and utility of trial matching modalities.

METHODS

Detailed clinicogenomic data were obtained for patients presenting September 2017-December 2020. Prevalence of mutations in lung, colorectal, breast and prostate cancer was compared to TCGA GDC Data Portal. Experimental Cancer (EC) Trial Finder utility in matching trials was compared to a Molecular Tumour Board (MTB) and commercial sequencing reports.

RESULTS

Of 311 patients with advanced cancer, this consisted of lung (n = 131, 42.1%), colorectal (n = 44, 14.1%), breast (n = 36, 11.6%) and prostate (n = 18, 5.6%). More than one mutation was identified in the majority (n = 260, 84%). Significant prevalence differences compared to TCGA were identified, including a high prevalence of EGFR in lung (P = 0.001); RB1 in breast (P = 0.0002); and multiple mutations in prostate cancer. EC Trial Finder demonstrated significantly different utility than sequencing reports in identifying trials (P = 0.007).

CONCLUSIONS

Regional differences in mutations may exist with advanced stage accounting for prevalence of specific mutations. A national Trial Finder shows utility in finding targeted trials whilst commercial sequencing reports may over-report 'actionable' mutations. Understanding local prevalence and trial availability could increase enrolment onto matched early phase trials.

First-Pass Effect in M1-Occlusion Stroke Patients Treated with Combined Stent-Retriever/Large-Bore Distal Aspiration Catheter Thrombectomy

INTRODUCTION

Combined stent-retriever/large-bore distal aspiration catheter (LB-DAC) thrombectomy was recently introduced to treat large-vessel occlusion; however, it is unclear whether larger inner diameters improve outcomes. We compared angiographic and clinical outcomes in patients with occlusions of the M1 segment of the middle cerebral artery treated with mechanical thrombectomy using extra-LB-DAC versus LB-DAC in combination with stent-retrievers.

METHODS

We analyzed consecutive patients with M1 occlusion included in the ROSSETTI registry treated with non-balloon guide catheter combined LB-DAC/stent-retriever thrombectomy between June 2019 and April 2022. We compared demographics, baseline clinical variables, procedural variables, angiographic outcomes, and clinical outcomes [National Institute of Health Stroke Scale score at 24 h (24h-NIHSS) and modified Rankin scale score at 3 months] between patients treated with extra-LB-DAC (Sofia Plus, MIVI Q6, Catalyst7; inner diameter, 0.068″-0.070″) versus LB-DAC (Sofia 5F, MIVI Q5, Catalyst 6; inner diameter, 0.055″-0.064″). Primary outcome was the first-pass effect (FPE) rate, defined as near-complete/complete reperfusion (mTICI 2c-3) after a single pass of the device.

RESULTS

We included 324 patients (extra-LB-DAC, 185, 57.1% patients). Demographics, clinical data, and clinical outcomes were similar between the two groups; however, there was a trend towards improvement in National Institute of Health Stroke Scale score at 24 h (24h-NIHSS) in the cohort treated with extra-LB-DAC 9 points (IQR 4;16 points) vs. 12 points (IQR 4;18 points, P = 0.083). Patients treated with extra-LB-DAC had higher FPE rate (47% vs. 30.9%; P = 0.003) and higher modified FPE (mTICI ≥ 2b after a single pass) rate (65.9% vs 46.8%; P = 0.001). The use of extra-LB-DAC was an independent factor in predicting FPE (odds ratio 1.982, 95% confidence interval 1.250-3.143, P = 0.004).

CONCLUSION

Our results suggest that in combined LB-DAC/stent-retriever thrombectomy, a larger aspiration catheter inner diameter is associated with higher rates of FPE and mFPE.

Pharmacogenetics of Anticancer Drugs: Clinical Response and Toxicity

Cancer is the most challenging disease for medical professionals to treat. The factors underlying the complicated situation include anticancer drug-associated toxicity, non-specific response, low therapeutic window, variable treatment outcomes, development of drug resistance, treatment complications, and cancer recurrence. The remarkable advancement in biomedical sciences and genetics, over the past few decades, however, is changing the dire situation. The discovery of gene polymorphism, gene expression, biomarkers, particular molecular targets and pathways, and drug-metabolizing enzymes have paved the way for the development and provision of targeted and individualized anticancer treatment. Pharmacogenetics is the study of genetic factors having the potential to affect clinical responses and pharmacokinetic and pharmacodynamic behaviors of drugs. This chapter emphasizes pharmacogenetics of anticancer drugs and its applications in improving treatment outcomes, selectivity, toxicity of the drugs, and discovering and developing personalized anticancer drugs and genetic methods for prediction of drug response and toxicity.

Assessing causality in the association between neurocognitive gains and fasting

Fasting is associated with improvements in cognitive function, and triggers weight loss in human and animal models. In recent years, the connection between fasting, brain health, and cognitive function has increasingly proven deserving of attention from researchers. The objective of this review work is to highlight evidence supporting a positive association between fasting and enhanced cognition. We looked at the following database sources "The Cochrane Library, PubMed, EMBASE, Web of Science and Google Scholar" for present review article. All the studies based on the key words "impact of fasting", or "cognitive function" or "brain stimulation". Much of this evidence demonstrates that fasting results in enhanced performance in cognitive tests of memory and visuospatial processing, which rely heavily on hippocampal function. The mechanisms responsible for the cognitive improvements associated with fasting are not fully understood, although current evidence suggests neuroplasticity plays an important role. Maintaining the health and the functionality of neurologically and cognitively impaired individuals can be extremely costly. Higher life expectancy and ageing populations globally is anticipated to increase the prevalence of many non-communicable, chronic, progressive conditions including neurological disorders.

Author Correction: Inhibitory potential of triazines and hydrazinyl thiazole substituted chromones against the HslVU protease/chaperone complex, a novel drug target

Correction to: European Review for Medical and Pharmacological Sciences 2022; 26 (22): 8567-8575. DOI: 10.26355/eurrev_202211_30392-PMID: 36459037-published online on November 30, 2022. After publication, the authors applied some corrections to the text: - Dr. U. Salar's affiliation has been corrected as follows: Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan. - The values in the row "Binding energy with HsIV (Kcal/mol)" Table I have been corrected as follows: from -8.4 into -9.0; from -8.6 into -9.2; from -8.0 into -8.5 from -8.3 into -8.7. There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/30392.

Correlations of milk and serum element concentrations with production and management traits in dairy cows

The present study investigated the potential consequences, positive or negative, that selection for favorable production-related traits may have on concentrations of vitamin B₁₂ and key chemical elements in dairy cow milk and serum and the possible impact on milk healthiness, and associated benefits, for the dairy product consumer. Milk and serum samples (950 and 755, respectively) were collected from Holstein-Friesian dairy cows (n = 479) on 19 occasions over a 59-mo period, generating 34,258 individual records, and analyzed for concentrations of key trace and quantity elements, heavy metals, and milk vitamin B₁₂. These data were then matched to economically important production data (milk, fat, and protein yield) and management data (dry matter intake, liveweight, and body condition score). Multivariate animal models, including full pedigree information, were used to analyze data and investigate relationships between traits of interest. Results highlighted negative genetic correlations between many quantity and trace elements in both milk and serum with production and management traits. Milk yield was strongly negatively correlated with the milk quantity elements Mg and Ca (genetic correlation between traits, r_a = -0.58 and -0.63, respectively) as well as the trace elements Mn, Fe, Ni, Cu, Zn, and Mo (r_a = -0.32, -0.58, -0.52, -0.40, -0.34, and -0.96, respectively); and in serum, Mg, Ca, Co, Fe, and Zn (r_a = -0.50, -0.36, -0.68, -0.54, and -0.90, respectively). Strong genetic correlations were noted between dry matter intake with V (r_a = 0.97), Fe (r_a = -0.69), Ni (r_a = -0.81), and Zn (r_a = -0.75), and in serum, strong negative genetic correlations were observed between dry matter intake with Ca and Se (r_a = -0.95 and -0.88, respectively). Body condition score was negatively correlated with serum P, Cu, Se, and Pb (r_a = -0.45, -0.35, -0.51, and -0.64, respectively) and positively correlated with Mn, Fe, and Zn (r_a = 0.40, 0.71, and 0.55, respectively). Our results suggest that breeding strategies aimed at improving economically important production-related traits would most likely result in a negative impact on levels of beneficial nutrients within milk for human consumption (such as Mg, Ca, Fe, Zn, and Se).

Inhibitory potential of triazines and hydrazinyl thiazole substituted chromones against the HslVU protease/chaperone complex, a novel drug target

OBJECTIVE

Proteostasis is an important process occurring in all living cells and is highly indispensable for cell survival. The HslVU protease/chaperone complex's critical role in regulating proteostasis to maintain a healthy cellular proteome and its presence in pathogenic microbes made it an important drug target. This study aimed to identify small molecular inhibitors of the HslV protease.

MATERIALS AND METHODS

Herein, a library of small molecules belonging to the triazine and chromone families has been evaluated for their inhibitory potential against the E. coli HslV protease using both in silico and in vitro techniques.

RESULTS

Four compounds, i.e., SHS-II-123a, SHS-II-147a, US-IV-89, and US-IV-92, were identified as potential inhibitors of the HslV protease having IC50 values in the range of 0.1 to 0.32 µM. Additionally, these compounds' drug-likeness and ADMET profiles indicated their compatibility to be considered safer drug candidates.

CONCLUSIONS

To the best of our knowledge, this is the first report on small molecules having inhibitory effects on the HslVU complex. These identified compounds can be efficiently subjected to further investigations to develop novel and safer antimicrobial agents.

Study of the doubly charmed tetraquark [Formula: see text]

Quantum chromodynamics, the theory of the strong force, describes interactions of coloured quarks and gluons and the formation of hadronic matter. Conventional hadronic matter consists of baryons and mesons made of three quarks and quark-antiquark pairs, respectively. Particles with an alternative quark content are known as exotic states. Here a study is reported of an exotic narrow state in the D0D0π+ mass spectrum just below the D*+D0 mass threshold produced in proton-proton collisions collected with the LHCb detector at the Large Hadron Collider. The state is consistent with the ground isoscalar [Formula: see text] tetraquark with a quark content of [Formula: see text] and spin-parity quantum numbers JP = 1+. Study of the DD mass spectra disfavours interpretation of the resonance as the isovector state. The decay structure via intermediate off-shell D*+ mesons is consistent with the observed D0π+ mass distribution. To analyse the mass of the resonance and its coupling to the D*D system, a dedicated model is developed under the assumption of an isoscalar axial-vector [Formula: see text] state decaying to the D*D channel. Using this model, resonance parameters including the pole position, scattering length, effective range and compositeness are determined to reveal important information about the nature of the [Formula: see text] state. In addition, an unexpected dependence of the production rate on track multiplicity is observed.

Angular Analysis of D^{0}→π^{+}π^{-}μ^{+}μ^{-} and D^{0}→K^{+}K^{-}μ^{+}μ^{-} Decays and Search for CP Violation

The first full angular analysis and an updated measurement of the decay-rate CP asymmetry of the D^{0}→π^{+}π^{-}μ^{+}μ^{-} and D^{0}→K^{+}K^{-}μ^{+}μ^{-} decays are reported. The analysis uses proton-proton collision data collected with the LHCb detector at center-of-mass energies of 7, 8, and 13 TeV. The dataset corresponds to an integrated luminosity of 9  fb^{-1}. The full set of CP -averaged angular observables and their CP asymmetries are measured as a function of the dimuon invariant mass. The results are consistent with expectations from the standard model and with CP symmetry.

Tests of Lepton Universality Using B^{0}→K_{S}^{0}ℓ^{+}ℓ^{-} and B^{+}→K^{*+}ℓ^{+}ℓ^{-} Decays

Tests of lepton universality in B^{0}→K_{S}^{0}ℓ^{+}ℓ^{-} and B^{+}→K^{*+}ℓ^{+}ℓ^{-} decays where ℓ is either an electron or a muon are presented. The differential branching fractions of B^{0}→K_{S}^{0}e^{+}e^{-} and B^{+}→K^{*+}e^{+}e^{-} decays are measured in intervals of the dilepton invariant mass squared. The measurements are performed using proton-proton collision data recorded by the LHCb experiment, corresponding to an integrated luminosity of 9  fb^{-1} . The results are consistent with the standard model and previous tests of lepton universality in related decay modes. The first observation of B^{0}→K_{S}^{0}e^{+}e^{-} and B^{+}→K^{*+}e^{+}e^{-} decays is reported.

Observation of the Decay Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ}

The first observation of the semileptonic b-baryon decay Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ}, with a significance of 6.1σ, is reported using a data sample corresponding to 3  fb^{-1} of integrated luminosity, collected by the LHCb experiment at center-of-mass energies of 7 and 8 TeV at the LHC. The τ^{-} lepton is reconstructed in the hadronic decay to three charged pions. The ratio K=B(Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ})/B(Λ_{b}^{0}→Λ_{c}^{+}π^{-}π^{+}π^{-}) is measured to be 2.46±0.27±0.40, where the first uncertainty is statistical and the second systematic. The branching fraction B(Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ})=(1.50±0.16±0.25±0.23)% is obtained, where the third uncertainty is from the external branching fraction of the normalization channel Λ_{b}^{0}→Λ_{c}^{+}π^{-}π^{+}π^{-}. The ratio of semileptonic branching fractions R(Λ_{c}^{+})≡B(Λ_{b}^{0}→Λ_{c}^{+}τ^{-}ν[over ¯]_{τ})/B(Λ_{b}^{0}→Λ_{c}^{+}μ^{-}ν[over ¯]_{μ}) is derived to be 0.242±0.026±0.040±0.059, where the external branching fraction uncertainty from the channel Λ_{b}^{0}→Λ_{c}^{+}μ^{-}ν[over ¯]_{μ} contributes to the last term. This result is in agreement with the standard model prediction.

Serum inducible and endothelial nitric oxide synthase in coronary artery disease patients with Type 2 Diabetes mellitus

OBJECTIVE

Coronary artery disease (CAD) is a well-known cause of morbidity and mortality in type 2 diabetes mellitus (T2DM). The role of endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) in T2DM patients in relation to CAD is not well understood. We examined serum inducible and endothelial nitric oxide synthase activities in patients with T2DM in relation to the presence of coronary artery disease.

PATIENTS AND METHODS

The present study was conducted in the Department of Physiology, King Saud University, Riyadh, Saudi Arabia. Subjects were grouped into control (Group A, n=87), T2DM without CAD (Group B, n=70), and T2DM patients with CAD (Group C, n=49). The selection of T2DM subjects was according to the American Diabetes Association (ADA). Serum iNOS, eNOS, hsCRP, nitrates and nitrites along with lipid profile were compared between different groups. Spearman's correlation and ROC analysis were also performed.

RESULTS

Serum eNOS levels were significantly high in the control group (112.38±47.16 U/ml) than in DM without CAD (81.43±49.91 U/ml) and DM with CAD (84.80±43.32 U/ml, p<.001). Serum iNOS levels were significantly higher in DM with CAD (42.87±28.83 U/ml) compared to both control (22.08±11.77 U/ml) and DM without CAD (16.24±12.30 U/ml, p<.001). Additionally, the differences in nitrite and NO were not significant between the three groups (34.06±24.75, 33.02±21.50, 38.83±24.34 uM, p = .384), and (56.51±36.78, 49.89±28.83 vs. 55.77±30.34 uM, p=.416) respectively. ROC curve analysis revealed a sensitivity and specificity of 73.5% and 68.6% of iNOS level at a cutoff point of 21.1 U/ml to predict CAD in T2DM patients. The ROC analysis for iNOS, eNOS, and hs-CRP were .782 (p<.001), .574 (p=.170), and .726 (p<.001), respectively.

CONCLUSIONS

Patients with T2DM have significantly higher levels of serum iNOS and lower levels of eNOS. However, iNOS levels were significantly higher in T2DM patients with concomitant CAD. Moreover, iNOS activity positively correlated with glycemic control and hsCRP. Therefore, iNOS could be an emerging future marker for CAD in T2DM patients and its antagonists could be useful in the management of these patients.

Observation of Two New Excited Ξ_{b}^{0} States Decaying to Λ_{b}^{0}K^{-}π^{+}

Two narrow resonant states are observed in the Λ_{b}^{0}K^{-}π^{+} mass spectrum using a data sample of proton-proton collisions at a center-of-mass energy of 13 TeV, collected by the LHCb experiment and corresponding to an integrated luminosity of 6  fb^{-1}. The minimal quark content of the Λ_{b}^{0}K^{-}π^{+} system indicates that these are excited Ξ_{b}^{0} baryons. The masses of the Ξ_{b}(6327)^{0} and Ξ_{b}(6333)^{0} states are m[Ξ_{b}(6327)^{0}]=6327.28_{-0.21}^{+0.23}±0.12±0.24 and m[Ξ_{b}(6333)^{0}]=6332.69_{-0.18}^{+0.17}±0.03±0.22  MeV, respectively, with a mass splitting of Δm=5.41_{-0.27}^{+0.26}±0.12  MeV, where the uncertainties are statistical, systematic, and due to the Λ_{b}^{0} mass measurement. The measured natural widths of these states are consistent with zero, with upper limits of Γ[Ξ_{b}(6327)^{0}]<2.20(2.56) and Γ[Ξ_{b}(6333)^{0}]<1.60(1.92)  MeV at a 90% (95%) credibility level. The significance of the two-peak hypothesis is larger than nine (five) Gaussian standard deviations compared to the no-peak (one-peak) hypothesis. The masses, widths, and resonant structure of the new states are in good agreement with the expectations for a doublet of 1D Ξ_{b}^{0} resonances.

Assessment of particulate matter (PM) in ambient air of different settings and its associated health risk in Haripur city, Pakistan

Particulate matter (PM) is a major air pollutant causing serious health problems. The aim of the present study was to find out concentration of PM in ambient air and its associated health risk in Haripur city, Pakistan. Twenty-three samples were taken at various educational institutes, hospitals, recreational areas and industries in Haripur city. Concentration of PM2.5 (µg/m3) and PM10 (µg/m3) was measured with Youngteng YT-HPC 3000A portable PM counter. The results revealed that values of both PM2.5 and PM10 were above the permissible limits (35 µg/m3 for PM2.5 and 150 µg/m3 for PM10) set by Environmental Protection Agency Pakistan (Pak-EPA) in all the educational institutes, hospitals, recreational areas and industries investigated. Furthermore, significant (p<0.05) variation was found in the concentration of both PM2.5 and PM10 in all the educational institutes, hospitals, recreational areas, and industries studied. The concentration of PM2.5 was positively correlated with the concentration of PM10 in all the sampling sites. Therefore, from 1-14 scale standard of health index, the values of PM2.5 and PM10 exhibited that the ambient air quality of Haripur city Pakistan is under high risk. If the regulatory authorities such as Environmental Protection Agency, Health Department and Local Government monitor PM pollution in different settings of Haripur city, then a decrease can be possible in the pollution level. The remedies that can be taken to overcome the problem of ambient air pollution such as PM are plantation of trees at the sites where there are higher levels of air pollutants and use of masks on personal protection basis along with implementation of pollution control system in industries of Hattar Industrial Estate Haripur city, Pakistan.

259 Effect of Telegram Videos on Anatomy Education Among 2nd Year Medical Students, University of Khartoum, 2021

Aim

COVID-19 had major effect on the health and medical education. In order to oblige with the social distancing and quarantine, universities shifted to online learning. This study aimed to assess the effect of online education on anatomy DR (dissection room) teaching by the use of telegram software.

Method

This was a cross-sectional, prospective interventional study, which was carried out among 2nd year medical students in University of Khartoum. Students undertook initial tests on the heart and anterior abdominal wall modules. Telegram videos, prepared by the author, on the anatomy of the heart and the anterior abdominal wall were distributed to students. Students took a second test after watching the videos. A total number of 41 students attended heart sessions and 40 students attended the anterior abdominal wall sessions were included.

Results

The pre-test mean score for the heart and abdomen modules were 4.56 ± 2.335 and 6.15 ± 2.94, respectively. The post-tests means were 9.98 ± 2.877 and 8.95 ± 3.14, respectively. 90% and 75% of the students were satisfied with these videos, respectively.

Conclusions

This study revealed that Telegram videos as a method of online teaching had a positive effect on the students' performance, which was evidenced by the significant improvement in student's scores after watching the videos. Additionally, most of the students were satisfied with the videos and give positive feedback.

Study of Z Bosons Produced in Association with Charm in the Forward Region

Events containing a Z boson and a charm jet are studied for the first time in the forward region of proton-proton collisions. The data sample used corresponds to an integrated luminosity of 6  fb^{-1} collected at a center-of-mass energy of 13 TeV with the LHCb detector. In events with a Z boson and a jet, the fraction of charm jets is determined in intervals of Z-boson rapidity in the range 2.0<y(Z)<4.5. A sizable enhancement is observed in the forwardmost y(Z) interval, which could be indicative of a valencelike intrinsic-charm component in the proton wave function.

Evidence for a New Structure in the J/ψp and J/ψp[over ¯] Systems in B_{s}^{0}→J/ψpp[over ¯] Decays

An amplitude analysis of flavor-untagged B_{s}^{0}→J/ψpp[over ¯] decays is performed using a sample of 797±31 decays reconstructed with the LHCb detector. The data, collected in proton-proton collisions between 2011 and 2018, correspond to an integrated luminosity of 9  fb^{-1}. Evidence for a new structure in the J/ψp and J/ψp[over ¯] systems with a mass of 4337_{-4}^{+7} _{-2}^{+2}  MeV and a width of 29_{-12}^{+26} _{-14}^{+14}  MeV is found, where the first uncertainty is statistical and the second systematic, with a significance in the range of 3.1 to 3.7σ, depending on the assigned J^{P} hypothesis.

Impact of COVID-19 pandemic on psychological wellbeing of Oncology clinicians in the Middle East and North Africa (MENA) region

OBJECTIVE

The reorganization of cancer services and the increased work burden on health care providers during the COVID-19 pandemic are likely to be associated with significant negative psychological impact. The aim of this study is to evaluate the impact of COVID-19 pandemic on the psychological well-being of oncology clinicians in the Middle East and North Africa (MENA) region.

MATERIALS AND METHODS

We randomly invited 1500 oncology clinicians including medical oncologists, clinical oncologists, radiation oncologists and surgical oncologists from 17 countries in the MENA region to complete a web-based survey to determine the level of psychological stress during the COVID-19 pandemic from October 2020 to January 2021. The questionnaire was based on the Perceived Stress Scale (PSS), Generalized Anxiety Disorders Scale (GAD-7) and WHO Well-being Index (WHO-5). The data was analyzed using SPSS version 21 and the difference between groups was measured by t-test and ANOVA.

RESULTS

Overall, 520 (35%) clinicians including 368 (71%) males and 152 (29%) females participated in the survey with 247 (47%) participants between the ages of 36 to 45 years. Average score of 29.6 for males and 30.2 on PSS-10, indicative of high-perceived stress in both the genders. Compared to males, females had significantly higher anxiety levels on GAD-7 scale (p=.04), but this difference in stress level and well-being was not observed on PSS-10 (p=.134) and WHO -5 well-being index (p=.709). Clinicians of age 25-35 years had significantly higher anxiety levels on GAD-7 scale (p=.004) and higher stress on PSS (p=.000) as compared to other age groups. Age over 55 years was associated with lower levels of anxiety and stress on GAD-7 and PSS. Oncology clinicians working in public sector experienced significantly lower stress as compared to private sector on PSS scale (p=.041).

CONCLUSIONS

Anxiety and stress levels among oncology clinicians have significantly increased in COVID-19 pandemic in the MENA region. Females and young clinicians had higher anxiety and stress, while oncology clinicians over the age of 55 years and working in the public sector reported less stress and anxiety. The general wellbeing of clinicians was well preserved even in a highly stressful and anxious situation.

Environmental sustainability assessment of wooden furniture produced in Pakistan

Life cycle assessment was carried out for a conventional wooden furniture set produced in Mardan division of the Khyber Pakhtunkhwa province of Pakistan during 2018-19. Primary data regarding inputs and outputs were collected through questionnaire surveys from 100 conventional wooden furniture set manufacturers, 50 in district Mardan and 50 in district Swabi. In the present study, cradle-to-gate life cycle assessment approach was applied for a functional unit of one conventional wooden furniture set. Production weighted average data were modelled in the environmental impacts modelling software i.e., SimaPro v.8.5. The results showed that textile used in sofa set, wood preservative for polishing and preventing insects attack and petrol used in generator had the highest contribution to all the environmental impact categories evaluated. Total cumulative energy demand for wooden furniture set manufactured was 30,005 MJ with most of the energy acquired from non-renewable fossil fuel resources.

Will weather stem the spread of the COVID-19 in Pakistan?

The pandemic of COVID-19 started spreading more exponentially across Pakistan since the end of February 2020. Numerous models and factors have been used to estimate predictions of the prevalence and severity of COVID-19 infections around the globe. While many factors play a role in the spread of COVID-19, climate and weather conditions are considered key elements in the transmission of COVID-19. Many researchers believe that recent increases in COVID-19 cases correlate strongly with local temperatures and factors (such as humidity, weather conditions, etc.) related to it. In this manuscript we test the hypothesis that SARS-CoV-2 spread is temperature-dependent by using the available data derived from Pakistan. The present review focuses on the relationship between temperature and COVID-19, examining the virus's viability and infectivity under various conditions. Our findings indicate that the trough and crest of the COVID-19 wave observed in 2020 are likely to repeat in the summer and winter of 2021, respectively. In Pakistan, temperatures, and humidity significantly affect the COVID-19 transmission and incidence. Like other types of beta-coronaviruses (ß-CoVs), the spread of COVID-19 may depend upon a great deal on temperature.

Physical exercise and cortical thickness in healthy controls: a pilot study

OBJECTIVE

Physical exercise has showed potential in improving brain function and increase in cortical size. This study aims to assess the cortical changes that are associated with physical exercise.

SUBJECTS AND METHODS

We investigated 45 subjects; 25 of them involved in exercise group and 20 in non-exercise group. The exercise group underwent 6 months of intervention consisting of 40 minutes (min) of aerobic exercise and 20 minutes of anaerobic exercise. Magnetic resonance imaging (MRI) scans were acquired from both groups to measure the thickness of the cortex and was assessed with FreeSurfer software.

RESULTS

Exercise group demonstrated significantly increased cortical thickness in the left pericalcarine area, left superior parietal area, right rostral middle frontal and right lateral occipital gyrus compared to non-exercise group.

CONCLUSIONS

Regular and continuous physical exercise can enhance brain structures. The current findings have important implications for understanding the effect of physical activity or fitness programs on the brains of healthy individuals and of patients with a range of conditions.

Sodium voltage-gated channel alpha subunit 9 mutation in epilepsy

In humans, gene mutations in voltage-gated sodium channels can cause a range of epileptic symptoms, including genetic (generalized) epilepsy with febrile seizures plus (GEFS+) and Dravet syndrome (DS). The SCN9A is a member of the SCN9 gene family that encodes sodium transporter proteins. In the current case report, we delineate a 12-year-old patient who was referred to a pediatric neurology clinic for infantile-onset generalized epileptic seizures and progressive neurodevelopmental delay. Novel heterozygous mutations c.4702A>C (p.Asn1568His) in the SCN9A gene, and c.65G>A (p.Arg22Gln) in the MLC1 gene were detected using targeted next-generation gene sequencing. The replacement of Histidine (His) with Asparagine (Asn) at position 1568 in the topological domain of SCN9A channel protein provides new insights into the impaired excitation and inactivation patterns of sodium channels. The case report adds this new patient with genetic link of SCN9A variants with progressive myoclonic epilepsy and cognitive difficulties.

Forest yield prediction under different climate change scenarios using data intelligent models in Pakistan

This study aimed to develop and evaluate data driven models for prediction of forest yield under different climate change scenarios in the Gallies forest division of district Abbottabad, Pakistan. The Random Forest (RF) and Kernel Ridge Regression (KRR) models were developed and evaluated using yield data of two species (Blue pine and Silver fir) as an objective variable and climate data (temperature, humidity, rainfall and wind speed) as predictive variables. Prediction accuracy of both the models were assessed by means of root mean squared error (RMSE), mean absolute error (MAE), correlation coefficient (r), relative root mean squared error (RRMSE), Legates-McCabe's (LM), Willmott's index (WI) and Nash-Sutcliffe (NSE) metrics. Overall, the RF model outperformed the KRR model due to its higher accuracy in forecasting of forest yield. The study strongly recommends that RF model should be applied in other regions of the country for prediction of forest growth and yield, which may help in the management and future planning of forest productivity in Pakistan.

Use of multi-strain probiotics in linseed meal based diet for Labeo rohita fingerlings

Unavailability of probiotics in fish digestive system fingerlings is unable to digest and absorb their food properly. The current research was conducted to investigate the influence of probiotics added Linseed meal based (LMB) diet on hematology and carcass composition of Labeo rohita juveniles. Hematological parameters are essential diagnostics used to estimate the health status of fish. The usage of probiotics for fish health improvement is becoming common due to the higher demand for environment-friendly culture system in water. Linseed meal was used as a test ingredient to prepare six experimental test diets by adding probiotics (0, 1, 2, 3, 4 and 5 g/kg) and 1% indigestible chromic oxide for seventy days. According to their live wet weight, five percent feed was given to fingerlings twice a day. Fish blood and carcass samples (Whole body) were taken for hematological and carcass analysis at the end of the experiment. The highest carcass composition (crude protein; 18.72%, crude fat; 8.80% and gross energy; 2.31 kcal/g) was observed in fish fed with test diet II supplemented with probiotics (2 g/kg). Moreover, maximum RBCs number (2.62× 106mm-3), WBCs (7.84×103mm-3), PCV (24.61), platelets (63.85) and hemoglobin (7.87) had also been reported in the fish fingerlings fed on 2 g/kg of probiotics supplemented diet. Results indicated that probiotics supplementation has a critical role in improvement of fingerlings' body composition and hematological indices. Present findings showed that probiotics supplementation at 2 g/kg level in linseed by-product-based diet was very useful for enhancing the overall performance of L. rohita fingerlings.

Incidence and determinants of catastrophic health expenditures and impoverishment in Pakistan

OBJECTIVES

Out-of-pocket (OOP) payment is a major health financing mechanisms across developing nations such as Pakistan. Private health expenditures are estimated to be 64.4%, of which 89% are OOP made by the households (National Health Accounts, 2015-16). These high health care expenditures cause households to face financial burden resulting in poverty. This study aims to estimate the incidence and determinants of catastrophic health expenditures and impoverishment for Pakistan.

STUDY DESIGN

Household-based cross-section study.

METHODS

We used the data from the Household Integrated Economic Survey (2015-16 and 2018-19), carried out by the Pakistan Bureau of Statistics. The well known methodology developed by Wagstaff and Doorslaer was used in this study for estimating the incidence and impoverishment effect of catastrophic health spending.

RESULTS

It is found that at 10% threshold (out of total consumption expenditures), catastrophic health payments are incurred by 4.51% and 13.15% of households for 2015-16 and 2018-19, respectively. Moreover, following the 40% threshold (out of non-food expenditures), this incidence is 0.45% and 4.57%. Poverty headcount was 23.28% and 18.43% gross of health payments in both the considered years, respectively, whereas it turns out to be 24.68% and 22.02% net of healthcare payments for the respective years, representing an increase in poverty headcounts of 1.4% and 3.59%.

CONCLUSION

OOP health payments exert pressure on household's capacity to pay and push them into poverty. This article recommends that the burden of OOP expenditures borne by households should be reduced to prevent them from falling into poverty by initiating some strategies (health financing policy reforms in terms of financial protection) with political support.

Altered default mode network activity and cortical thickness as vulnerability indicators for SCZ: a preliminary resting state MRI study

OBJECTIVE

Alterations in brain function in patients with schizophrenia (SCZ) and other neuropsychiatric disorders are evident not only during specific cognitive challenges, but also from functional MRI data obtained during a resting state. Patients with chronic SCZ have shown deficits in default mood network (DMN) and gray matter volume in resting-state functional magnetic resonance imaging (rs-fMRI). However, cortical thickness and surface area in first-episode schizophrenic patients have rarely been investigated.

PATIENTS AND METHODS

In the present study, we applied independent component analysis (ICA) to a series of rs-fMRIs of 15 SCZ patients and 15 matched healthy controls. The data were analyzed using MELODIC of FMRIB's Software Library (FSL version 5.9; www.fmrib.ox.ac.uk/fsl) to identify large-scale patterns of temporal signal-intensity coherence.

RESULTS

Patients with SCZ showed significantly higher functional connectivity in the DMN, auditory network, and cerebellum network (p=0.049, p=0.05, and p=0.007, respectively) than matched healthy controls. The patients also exhibited significantly less cortical thickness, primarily in the bilateral prefrontal and parietal cortex, and higher thickness in the bilateral anterior temporal lobes, left medial orbitofrontal cortex, and left cuneus than the matched healthy controls.

CONCLUSIONS

These results indicate that significantly abnormal DMN connectivity and cortical thickness contribute to local functional pathology in patients with SCZ.

Prescribing practices at a secondary healthcare setting of Islamabad, Pakistan: a descriptive cross-sectional study

Objectives

Irrational drug utilization is one of the key factors behind therapeutic failure, the emergence of antibiotic resistance, and a high incidence of adverse effects worldwide. This study was designed to assess drug use patterns, based on World Health Organization (WHO)/INRUD core drug use indicators and some additional parameters, in the secondary healthcare hospital of Islamabad, Pakistan.

Methods

The outpatient department (OPD) of the healthcare facility was randomly visited from December 2019 to March 2020 to prospectively collect data from the prescriptions and conduct patient interviews. A total of 2290 prescriptions were included in this study. The data analysis was done through SPSS software v23.0.

Key findings

The average number of drugs prescribed per encounter was 3.37. Polypharmacy was positively correlated with the age of the patients. Only 4.8% of the drugs were prescribed by generic name. There was frequent (41.5%) use of antibodies. However, the proportion of injectable drugs (12.3%) was within the optimum limit. Essential components of a prescription notably diagnosis, dosage form, method of administration, and duration of therapy were frequently missing. 87% of the prescribed drugs were from the National Essential Medicines List. 80% of the total prescribed drugs were available in the hospital pharmacy. Only 30% of the patients had correct dosage information, while only 20% of the drugs were correctly labelled.

Conclusion

This study suggests frequent non-compliant prescribing practices including polypharmacy, use of a brand name, antibiotics overuse, compromised legibility and completeness of prescription and inadequate patient counselling and drug labelling, in the secondary healthcare hospital of Islamabad, Pakistan.

Healthcare workers' knowledge and attitudes towards COVID-19 in Saudi Arabia

OBJECTIVE

The world is facing a devastating challenge in the COVID-19 (coronavirus disease 19) outbreak.  Healthcare workers (HCWs) provide the first line of defense against any disease outbreak. Thus, the present study is designed to assess HCWs' attitudes towards, knowledge of, and awareness of COVID-19.

MATERIALS AND METHODS

A cross-sectional observational study was conducted using an online survey on social media; the participants were 597 adults. The study was conducted from March to April 2020. The questionnaire was randomly administered on Arabic-language social media applications; the 26-item survey assessed knowledge levels, attitudes, and practices.

RESULTS

The analysis includes 597 complete responses from HCWs; participants included physicians, nurses, medical students, and pharmacists. Most participants were females aged 18 to 25 years. Most participants agreed that the virus can spread via direct and indirect contact. Most participants indicated that they wash their hands; avoid touching their eyes, nose, or mouth; and avoid crowded places to protect themselves against infection. Most indicated that a bat was the original source of the virus. Most participating HCWs indicated that the symptoms of COVID-19 include fever, cough, and shortness of breath. Most of the participants also indicated that there is no specific treatment for patients infected with COVID-19.

CONCLUSIONS

The findings of this work can support the design of effective measures to prevent and control COVID-19 infections during the pandemic. The results also highlight where improvement is needed to HCWs' knowledge of and attitudes towards COVID-19; the findings also highlight the best healthcare practices regarding this illness.

Antiurolithic effects of medicinal plants: results of in vivo studies in rat models of calcium oxalate nephrolithiasis-a systematic review

Urolithiasis is one of the oldest diseases affecting humans, while plants are one of our oldest companions providing food, shelter, and medicine. In spite of substantial progress in understanding the pathophysiological mechanisms, treatment options are still limited, often expensive for common people in most parts of the world. As a result, there is a great interest in herbal remedies for the treatment of urinary stone disease as an alternative or adjunct therapy. Numerous in vivo and in vitro studies have been carried out to understand the efficacy of herbs in reducing stone formation. We adopted PRISMA guidelines and systematically reviewed PubMed/Medline for the literature, reporting results of various herbal products on in vivo models of nephrolithiasis/urolithiasis. The Medical Subject Heading Terms (Mesh term) "Urolithiasis" was used with Boolean operator "AND" and other related Mesh Unique terms to search all the available records (July 2019). A total of 163 original articles on in vivo experiments were retrieved from PubMed indexed with the (MeshTerm) "Urolithiasis" AND "Complementary Therapies/Alternative Medicine, "Urolithiasis" AND "Plant Extracts" and "Urolithiasis" AND "Traditional Medicine". Most of the studies used ethylene glycol (EG) to induce hyperoxaluria and nephrolithiasis in rats. A variety of extraction methods including aqueous, alcoholic, hydro-alcoholic of various plant parts ranging from root bark to fruits and seeds, or a combination thereof, were utilized. All the investigations did not study all aspects of nephrolithiasis making it difficult to compare the efficacy of various treatments. Changes in the lithogenic factors and a reduction in calcium oxalate (CaOx) crystal deposition in the kidneys were, however, considered favorable outcomes of the various treatments. Less than 10% of the studies examined antioxidant and diuretic activities of the herbal treatments and concluded that their antiurolithic activities were a result of antioxidant, anti-inflammatory, and/or diuretic effects of the treatments.

Relationship of asthma control test scores with pulmonary function tests, quality of life and adiposity in asthmatic children

OBJECTIVE

This study aimed at assessing asthma control test (ACT score), quality of life (QOL), and pulmonary functions in asthmatic children, and to see the correlations between ACT score, QOL, and pulmonary functions.

PATIENTS AND METHODS

This cross-sectional study was conducted at the departments of pediatrics and physiology, College of Medicine, King Saud University Medical City (KSUMC), Riyadh, Saudi Arabia. A total of 109 (53 asthmatics and 56 controls) children (aged 6 to 13 years) of both genders were studied. All subjects underwent clinical evaluation, 36-Item Short Form Survey (SF-36) for QOL, Spirometry, and cognitive assessment through mini mental state examination (MMSE).

RESULTS

QOL showed significantly lower scores in asthmatic compared to non-asthmatic children. The higher social functioning [SF] (p=0.0012) and less role limitation due to physical health [RLPH] (non-asthmatic patients had had higher physical functioning [PF] (p=0.0001), less energy/fatigue [EF] (p=0.0008=0.0068). On the opposite side, no significant difference was found regarding role limitations due to emotional problems [RLEP] (p=0.0644) and Emotional well-being [EW] (p=0.0758) between the two groups. A significant positive correlation was seen between QOL items and ACT score in PF (r=.535, p<0.01), less RLPH (r=.593, p<0.01), less FE (r=.379, p<0.01), higher EW (r=.310, p<0.05), and higher SF (r=.495, p<0.01). No significant correlation was found between body mass index (BMI) and lung functions in children with asthma. Interestingly, a positive correlation was found in asthmatic children between BMI and MMSE scores (r=.298, p=0.030).

CONCLUSIONS

Our study concluded that QOL in asthmatic patients was significantly lower than healthy subjects in terms of patient's physical functioning and social life. However, the emotional aspects of QOL were not significantly affected in asthmatic children.

Perspective of Covid-19 pandemic in South Asian countries

COVID-19 is rapidly spreading throughout the world since December 2019. It has hit South Asian countries with faded impact, which can be attributed to (a) availability of kits, (b) number of people tested for COVID-19, (c) immunity, (d) environmental conditions and (e) vaccination.

Hydroethanolic leaf extract of Parthenium hysterophorus attenuates blood glucose in alloxan induced diabetic mice

The Parthenium hysterophorus (P. hysterophorus) is used to treat diabetes mellitus in local medicinal system of Pakistan but very limited scientifically proved information is available in this context. The objective of this work was to evaluate the antioxidant and antidiabetic activity of P. hysterophorus leaf extract. The extraction was made with freeze drying assisted ultrasonication using 40%, 60% and 80% ethanol as solvent. The total phenolic and flavonoid contents were calculated. Antioxidant activity was determined by 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay and α-glucosidase inhibitory assay was also performed. The in vivo hypoglycemic potential of leaf extract was determined in alloxan monohydrate induced diabetic mice. The 60% ethanolic extract exhibited comparatively higher phenolic and flavonoid contents with values of 105.44±2.55 mg GAE/g D.E and 41.50±2.25 mg RE/g D.E, respectively. The 60% extract also possessed lowest IC50 value of 87.55 μg/mL and 98.22 μg/mL for DPPH radical scavenging and α-glucosidase inhibition, respectively. The same extract substantially reduced the blood glucose level in alloxan induced diabetic mice and results were quite comparable with standard drug metformin. The extract dose of 450 mg/kg reduced the blood glucose level of diabetic mice from 268.05 mg/dL 137.88 mg/dL at the end of 28 days treatment. The findings confirmed the ethnopharmacological use of P. hysterophorus to treat and manage diabetes mellitus type 2. The experimental outcomes may be employed as pharmacological leads to treat diabetes mellitus and to develop functional foods with hypoglycemic attributes.

Antioxidant, iron chelating, lipase inhibition activities and metabolite’s prediction of hyrdoethanolic leaf extract of Conocarpus erectus

The current study was conducted to evaluate the antioxidant, Fe-chelating and lipase inhibition activities of hydroethanolic leaf extracts of Conocarpus erectus. The proton magnetic resonance spectroscopy (1H-NMR) was used to identify the major types of primary and secondary metabolites in extract. The 60% ethanolic extract was found to be the most effective fraction regarding antioxidant, Fe chelating and lipase inhibitory properties. The 60% ethanolic leaf extract exhibited total antioxidant power of 223.0±3.27 mg ASE/g PE, β-carotene bleaching inhibition of 81.39±2.11%, Fe-chelating of 68.21±1.17% and pancreatic lipase inhibition of 50.60±1.47%, respectively. The 1H-NMR -based prediction of metabolites provided the information for presence of polyphenolic secondary metabolites and organic acids which might be responsible for the biological activities of extract. These findings of this work may be extended for metabolite characterization, in vivo trials and toxicity determination to get benefits for functional food development with antioxidative and antiobesity attributes.

TMS as tool to investigate the effect of pharmacological medications on cortical plasticity

The application of medications with a well-defined mode of action on a neurotransmitter or neuromodulator of the central nervous system (CNS) can be utilized to test the pharmaco-physiological properties of transcranial magnetic stimulation (TMS) on cortical excitability and plasticity. Similarly, a physiologically well-defined TMS measure of cortical excitability may be exploited to study a particular drug's effect at the level of the cerebrum. In this review, we aim to assess the impact of calcium channel blockers, Selective Serotonin Reuptake Inhibitors (SSRIs), and GABAergic agents on cortical excitability and plasticity while concurrently investigating how TMS can enhance this understanding. We will begin by reviewing the basics of neuroplasticity, as explored in animal experimentation, and relate this to our knowledge about neuroplasticity induced in humans by TMS techniques. We will then discuss pharmacological modulation of plasticity in humans. Finally, we will review abnormalities of plasticity inherent to certain neuropsychiatric diseases and discuss how the combination of TMS with pharmacological intervention can augment our knowledge of the pathophysiology of these diseases and guide purposeful treatment.

The future of transcranial magnetic stimulation in neuroscience and neurology in the Middle East

OBJECTIVE

Transcranial magnetic stimulation (TMS) is a noninvasive technique for brain stimulation often used as a diagnostic and therapeutic therapy in neuroscience and psychiatry for different diseases including epilepsy, stroke, multiple sclerosis, and treatment-resistant major depressive disorders, such as autism and schizophrenia.

MATERIALS AND METHODS

Recent studies have shown the enhanced benefits of using TMS for its potential to provoke changes in the physiological processing of the human brain.

RESULTS

In the current review article, emphasis will be placed on both the applications of TMS as well as the different types of TMS used to benefit subjects with epilepsy, stroke, and multiple sclerosis. Furthermore, we aim at discussing the potential of using TMS for the treatment of neurological diseases.

CONCLUSIONS

By paying special consideration to a Middle Eastern context, we aimed at illustrating the possibilities that TMS could bring for clinicians and patients in this nationally prioritized research field.