Prof. Ahmed Kamal Dyab
Assiut University, Egypt.

Short Biosketch

ISBN 978-81-974582-4-8 (Print)
ISBN 978-81-974582-8-6 (eBook)
DOI: https://doi.org/10.9734/bpi/mria/v7

This book covers key areas of medical research and its applications. The contributions by the authors include alzheimer's disease, parkinson’s disease, amyloid-\(\beta\)42 protein accumulation, neurodegenerative diseases, autoimmune antibodies, insulin autoimmune syndrome, hirata disease, endocrinal disease, robotic hysterectomy, abdominal hysterectomy, histopathology, adhesiolysis, medical writing, artificial intelligence, patient education, post abortive uterine-colon necrosis, clostridium perfringens infection, erythrophagocytosis, multiple organ failure, platelet activating factor, splenic abscess, peritonitis, hemolysins, klebsiella pneumoniae, neural tube defects, NTD-affected pregnancies, twin pregnancy, congenital abnormalities, mandibular second molar, orthopantomography, panoramic radiography, periodontal tissue health, hemovigilance, quality system management, statistical process control, vein-to-vein lifeline, transfusion medicine, cinderella position, quality adjusted life years, essential medicines, patient blood management, lung cancer, anorexia, non-small-cell lung cancer, mesothelioma, transthoracic evacuation, dendrimers of doxorubicin, attention deficit and hyperactive disorder, neurodevelopmental disorder, sensory integration disorders, Wisconsin cards sorting test, social life ability, human cord blood-derived stem cells, hematopoietic stem cells, mesenchymal stem cells, gal-9-mediated mechanism, peripheral blood mononuclear cells, stem cell educator therapy, systemic lupus erythematosus, carbohydrate recognition domains. This book contains various materials suitable for students, researchers, and academicians in the fields of medical research and its applications.


The present study focuses on Alzheimer's disease (AD) and Parkinson’s disease (PD), since they vastly affect millions of people in the world, and occur when nerve cells lose functional ability and/or die over time. AD and PD, the likelihood of developing the issues rises dramatically with age. Degenerative nerve illnesses impact speech, breathing, mobility, balance, and heart function in the body. Neurodegenerative diseases can be categorized according to their molecular causes, such as aberrant protein aggregation, cell death, or loss of function of the implicated cell. Alzheimer's disease (AD) is linked to tau, and amyloid-\(\beta\)42 protein accumulation, and Parkinson's disease (PD) is connected with \(\alpha\)-synuclein aggregation.

The cause of disease may be genetic, and may also be sporadic. Alcoholism, pesticides, a tumor, or a stroke are sometimes noticed in the disease background. Sometimes the cause remains totally unknown. Neurodegeneration, to date, cannot be cured.

Further, some types of NDD could also be fatal.

Unfortunately, there is no cure at present for them except for some palliative measures to give some comfort to the victims. Increasing our knowledge of the cause(s) of neurodegenerative disorders may aid in the development of novel treatment and preventative strategies. These days, all neurodegenerative diseases can be better understood because of high-throughput technologies like RNA sequencing, network biology, and Omics data. Considering the importance of managing protein aggregates during aging and in neurodegenerative diseases, a detailed understanding of how those aggregates is formed and transferred. New research in the area of brain mechanisms may open a new avenue for disease prevention and treatment.

Insulin Autoimmune Syndrome: A Case Report

Adel Ekladious

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 20-28

Insulin Autoimmune syndrome is a very rare endocrinal disease characterized by repeated hypoglycemia in the presence of elevated serum insulin and positive insulin autoantibodies, in the absence of administration of exogenous insulin, commonly patients with insulin autoimmune syndrome will be harboring other autoimmune diseases that could be active clinically or inactive and only diagnosed by positive serological markers.

In this chapter, we will discuss two clinical cases followed by discussions and my personal clinical approach in the absence of guidelines.

Due to the disease's rarity, Hirata disease is frequently misdiagnosed, which exposes patients to needless testing and surgery. Hirata disease is an insulin autoimmune disease marked by non-exogenous hyperinsulinemic postprandial hypoglycemia caused by elevated insulin autoimmune antibodies (IAS), without exogenous insulin and without pathological abnormalities of pancreatic islets cells.

The disease is uncommon in non-Asian populations, among the Caucasian population, most of the cases are due to drug exposure, autoimmune diseases or hematological malignancies, sometimes Hirata disease can be triggered by viral infection.

In this manuscript, we presented a case of autoimmune insulin hypoglycemia, the patient was subjected to a few unnecessary investigations before reaching the correct diagnosis, we reviewed the recent literature about autoimmunity of endogenous insulin hypoglycemia, we also will suggest the best practice based on our experience given that there are no guidelines to follow due to the rarity of the disease. Autoimmune insulin syndrome and insulin syndrome type B should be in the differential diagnosis of hyperinsulinemia hypoglycemia, and should be ruled out before proceeding with any expensive investigations or surgery.

Understanding the Suppression of B-Cell Activation by Human Cord Blood-Derived Stem Cells (CB-SCs) through the Galectin-9-Dependent Mechanism

Wei Hu, Xiang Song, Haibo Yu, Sophia Fan, Andrew Shi, Jingyu Sun, Hongjun Wang, Laura Zhao, Yong Zhao

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 29-52

Human cord blood-derived stem cells (CB-SCs) display a unique phenotype, with both embryonic and hematopoietic markers that distinguish them from other known types of stem cells, including hematopoietic stem cells (HSCs) and mesenchymal stem cells (MSCs). It was demonstrated that the direct immune modulation of CB-SCs on the activated B cells via the Gal-9-mediated mechanism leads to the marked suppression of B-cell proliferation and phenotypic changes. The Stem Cell Educator therapy was developed among multiple clinical trials based on the immune modulations of multipotent cord blood-derived stem cells (CB-SCs) on different compartments of immune cells, such as T cells and monocytes/macrophages, in type 1 diabetes and other autoimmune diseases. However, the effects of CB-SCs on the B cells remained unclear. To better understand the molecular mechanisms underlying the immune education of CB-SCs, we explored the modulations of CB-SCs on human B cells. CB-SCs were isolated from human cord blood units and confirmed by flow cytometry with different markers for their purity. B cells were purified by using anti-CD19 immunomagnetic beads from human peripheral blood mononuclear cells (PBMCs). Next, the activated B cells were treated in the presence or absence of coculture with CB-SCs for 7 days before undergoing flow cytometry analysis of phenotypic changes with different markers. Reverse transcription-polymerase chain reaction (RT-PCR) was utilized to evaluate the levels of galectin expressions on CB-SCs with or without treatment of activated B cells in order to find the key galectin that was contributing to the B-cell modulation. Flow cytometry demonstrated that the proliferation of activated B cells was markedly suppressed in the presence of CB-SCs, leading to the downregulation of immunoglobulin production from the activated B cells. Phenotypic analysis revealed that treatment with CB-SCs increased the percentage of IgD+CD27- naive B cells, but decreased the percentage of IgD-CD27+ switched B cells. The transwell assay showed that the immune suppression of CB-SCs on B cells was dependent on the galectin-9 molecule, as confirmed by the blocking experiment with the anti-galectin-9 monoclonal antibody. Mechanistic studies demonstrated that both calcium levels of cytoplasm and mitochondria were downregulated after the treatment with CB-SCs, causing the decline in mitochondrial membrane potential in the activated B cells. Western blot exhibited that the levels of phosphorylated Akt and Erk1/2 signaling proteins in the activated B cells were also markedly reduced in the presence of CB-SCs. CB-SCs displayed multiple immune modulations on B cells through the galectin-9-mediated mechanism and calcium flux/Akt/Erk1/2 signaling pathways. The data advance our current understanding of the molecular mechanisms underlying Stem Cell Educator therapy to treat autoimmune diseases in clinics.

Transfusion medicine has come a long way, largely in the shadow of other fields of science and medical practice, virtually a Cinderella position.

Its comprehensiveness (vein-to-vein) provides a unique scenery and environment to bridge with the many supportive scientific disciplines. Most of these are beta or exact sciences, but over the past decades increasingly ‘soft sciences’ like sociology and environmental psychology, and the group of applied exact sciences (gamma sciences) have been discovered like pharmaco-economy and bridged enriching the field and profession. Today there is a growing interest in the application of ICT and artificial intelligence.

Lost in Development: Unveiling the Complexity of Fatal Neural Tube Abnormalities - A Preventable Tragedy

Alemayehu Shiferaw Lema, Jemila Salih Suleyman, Amanuel Oljira Raga, Suresh Kumar Rajamani Sekar

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 62-74

Neural tube defects (NTDs) are serious birth defects that affect the central nervous system. They occur due to a disruption in the normal development of the nervous system during embryogenesis. Although largely preventable, they are the second most common type of human congenital abnormality and pose a significant threat to global morbidity, disability, mortality, and financial expenses. According to estimates from 2015, approximately 260,100 newborns around the world are born annually with NTDs, excluding early spontaneous fetal losses. Additionally, there were an estimated 117,100 NTD-affected pregnancies that ended in stillbirth or elective terminations of pregnancy for fetal anomalies. Of the NTD-affected live births, approximately 117,900 resulted in under five deaths. The disability-adjusted life years from NTDs exceed 8.6 million.

NTDs have both environmental and genetic causes. Folic acid supplementation during the periconceptional period is a well-known primary prevention method, but its implementation lags behind the knowledge about prevention. However, NTDs have been neglected and have recently become the subject of limited research. Furthermore, surveillance efforts for NTDs continue to be insufficient, with high prevalence rates persisting worldwide. Robust surveillance data are essential for the prevention and monitoring of NTDs. This chapter provides an updated discussion on the epidemiology, embryology, risk factors, diagnosis, associated defects, management, surveillance, and prevention strategies of NTDs, with a particular emphasis on lethal NTDs. Furthermore, to illustrate the clinical presentation of lethal NTDs, this chapter includes case presentations of different types of lethal NTDs with typical associated defects in singleton and multiple pregnancies that resulted in stillbirth.

Diagnostic Dilemma of Post-abortive Patient with Extensive Uterine and Colonic Necrosis Secondary to Clostridium Perfringens: Case Report at Saint Francis Referral Hospital Ifakara Tanzania

Theresia. A. Karuhanga, Rashidi Mayoka, Fassil Tekie, Tariq S. Muhamed, Yeremia N. Elia, Isabella Masenga, Madoshi Philbert, Sadikiel Kaale

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 75-84

Post abortive Uterine-colon necrosis secondary to Clostridium perfringens infection is extremely rare of unknown incidence. The most reported cases include abdominal or uterine perforation due to C. perfringes forming visceral necrosis. It is associated with significant morbidity and mortality. The pathogen produces Lecithinase C which is a phospholipase C and it is believed to be involved in the pathologic effects of C. perfringens. Below we present the post incomplete abortion who presented with acute abdominal conditions of which surgical intervention was performed in addition to broad-spectrum antibiotics. Intra-operatively, there was extensive uterine and colonic necrosis and the patient survived but remained with permanent complications of total hysterectomy and lack of colon.

An Overview on Hemovigilance - Fact and Fiction

Cees Th. Smit Sibinga

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 85-93

Performance of the blood system – blood supply and consumption or clinical use in general, follows the 5 key elements of Quality System Management:

  1. Organization, (infra-)Structure and Leadership (governance);
  2. Standards, References and Guidelines (technical and quality);
  3. Documentation (quality pyramid with its 4 levels – 2 managerial and 2 operational);
  4. Education (teaching and training, maintaining competency, and developing stewardship);
  5. Assessment - monitoring and evaluation (M&E), statistical process control (SPC), hemovigilance.

Hemovigilance, as a quality gatekeeping surveillance tool, is an integral part of the assessment element, based on continuous M&E of what has been done, and whether that matches standards of performance, quality and technical. Statistical process control (SPC), Six Sigma and Safety-I and Safety-II are recommended to trace development, where the track and tracing (T&T) is based on waterproof documentation. Hence, as a matter of fact hemovigilance is an integral part of the blood transfusion chain, a gate keeping tool to sustain overall quality, based on meticulous documentation to secure an optimal track and trace-back of data.

Medical writing is a significant link between science and communication. It plays a vital role amid complex medical information and diverse audiences. As the healthcare landscape evolves, so does the practice of medical writing. This article explores the current trends shaping the field of medical writing, from advancements in technology such as the adoption of AI and ML algorithms to changes in regulatory standards of the agencies, such as the FDA in the United States and the EMA in Europe as well as the evolving role of patient-centered communication. By navigating these trends, medical writers can effectively communicate critical information, drive informed decision-making, and ultimately improve healthcare outcomes.

The ruptured splenic abscess is usually uncommon but associated with significant life-threatening. Concurrence of ruptured splenic abscess and severe anemia may lead to death if not treated effectively, especially in limited health care. We present the 43-year-old who presented with generalized peritonitis due to a ruptured spleen. Also, she had severe anemia with hb of 4.3 g/dl. The cause of anemia was not immediately identified. However, tests for bacterial sensitivity revealed Klebsiella pneumoniae which was resistant to Ceftriaxone, Amoxiclav, Ceftizine and Cotrimoxazole but sensitive to Meropenem, Ciprofloxacin and Vancomycin. After the result, the treatment shifted to Meropenem1 Gm tds for 5/7. After seven days in the ward, the patient fully recovered and she was discharged in good condition.

Influence of Surgical Experience in Performing the Abdominal Hysterectomy and Improving the Linear Curve of Skills

Kamil Fram, Farah Fram, Rand Fram, Eman Sadaqa, Mahmoud Eid, Zaid Sunna, Rana Haddad

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 112-126

Objectives: This study aimed to highlight the influence of surgical experience in performing the abdominal hysterectomy and improving the linear curve of skills.

Background: Hysterectomy is the most frequently conducted major gynecological surgical procedure. Several approaches to hysterectomy are available to surgeons. It may be performed by an abdominal incision (total abdominal hysterectomy [TAH]) or by less invasive approaches, including vaginal hysterectomy (VH), total laparoscopic hysterectomy (TLH), laparoscopic-assisted vaginal hysterectomy (LAVH), or robotic hysterectomy (RH).

Materials and Methods: This retrospective study was conducted on 245 women who underwent hysterectomy at Jordan University Hospital, Amman, Jordan, from January 2017 to 2019. The gravidity, parity, age, body mass index, the cause and type of the hysterectomy, duration of surgery, need for blood transfusion, estimated blood loss, time of hospital stay, intraoperative and postoperative complications, and the histopathology results were extracted from records of the participants and analyzed.

Results: This study showed that the leading cause of hysterectomy in participants was abnormal vaginal bleeding. The most common type of hysterectomy was a simple abdominal hysterectomy with a mean operation time of 1 hour 12 minutes. In total, 25.6% of women received packaged red blood cells, the main cause of which was preoperative anemia (17.5%). These results reflect an improvement in the linear curve of learning surgical skills. Increasing the learning curve in teaching hospitals will help patients and be implemented for benign or malignant situations, particularly with the stability of the medical team. Interestingly, the effect of the acquired skills grew by practice and proved to be preferential over previous years.

Conclusions: Our findings demonstrated how performing abdominal hysterectomy improved surgical technique expressively, resulting in shorter operating times than when using a traditional technique, lower overall surgical costs, and fewer surgical threads needed for each procedure. Numerous clinical metrics, such as mean operative time, complication rates, and other outcome variables, can be used to evaluate surgical expertise. These outcomes were directly caused by the medical team's perseverance and the development of surgical abilities.

Lung Cancer: Exploring Symptoms, Types and Novel Drug Delivery Systems for Treatment

Vitthal Chopade, Pradnya Waman, Shivani Morkhade, Hemant Bhoi

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 127-143

Lung cancer reveals itself in a variety of ways, but it is still one of the most common and fatal cancers in the world. This review article discusses the many categories, symptoms, and conventional treatment options for lung cancer in great depth. Lung cancer comes in many histological variants, like non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC), each with distinct characteristics and treatment modalities. Significant efforts have been made recently to create innovative medication delivery methods that will maximize therapeutic benefits while reducing adverse outcomes from lung cancer treatment. These cutting-edge strategies include polymer-based carriers, liposomal formulations, and nanoparticle-based drug delivery techniques. These innovative drug delivery systems have the potential to enhance treatment outcomes and quality of life for patients by accurately delivering therapeutic drugs to the tumor site and reducing interactions with healthy tissues. Recent developments regarding the administration of medications for the treatment of lung cancer are highlighted in this review, assessing the effectiveness and safety of innovative formulations.

Attention Deficit and Hyperactive Disorder (ADHD) is a common chronic neurodevelopmental disorder in childhood, whose onset cause and mechanism are not yet clear. This article compiles and analyzes a total of 67 relevant pieces of literature from the past 20 years with the keywords "children", "attention deficit hyperactivity disorder", and "sensory integration training" through CNKI and Pubmed. The search results show that sensory integration training has a good effect on improving the neurobiochemistry, executive function, sensory integration ability, daily behavior, intelligence, and social adaptation ability of children with ADHD; the combination of sensory integration training and drug therapy has a better effect than sensory integration training or drug therapy alone, and sensory integration training can improve the effectiveness of other non-drug treatments. This article provides researchers with a theoretical basis for ADHD and suggestions for frontline teachers and parents to correctly understand and intervene in children with ADHD.

Comparing Changes in Bone Level Distal to the Mandibular Second Molar (MSM) in Patients with an Extracted IMTM Versus Non-extracted IMTM Using OPG

Hassan Assiri Ahmed, Jose López-López, Sonia Egido-Moreno, Xavier Roselló Llabrés, Mohammed Hameed, Albert Estrugo-Devesa

Medical Research and Its Applications Vol. 7, 18 June 2024, Page 156-182

Aim: The present study compared the changes in bone level distal to the mandibular second molar (MSM) in patients with an extracted IMTM versus non-extracted IMTM using OPG.

Background: The most common impacted tooth is the mandibular third molar, which can be detected using orthopantomography (OPG) and may have detrimental effects, including bone loss, on the neighboring mandibular second molar (MSM).

Methods: In this retrospective case-control study, 160 orthopantomograms (OPGs) of 80 patients who attended Dental Hospital of the University of Barcelona (HOUB) were randomly selected. Participants were stratified into a study group and a control group.

Results: Males and females show bone gain in the study group and bone loss in the control group. However, the difference in bone-level change was not statistically significant regarding gender in the study group. Within the study group, participants of 29–39 years show significant (p-value = 0.042) bone gain after extraction compared to other age groups. However, the control group shows bone loss in all age groups. our study solely focused on the radiographic findings without considering clinical parameters, such as those obtained via clinical probing. Thus, further studies correlating findings based on OPGs with three-dimensional imaging, such as cone-beam computed tomography and clinical probing, and the use of a larger sample size are required to validate the findings of the current study.

Conclusions: Bone improvements distal to the MSM were observed after the extraction of an IMTM compared to when an IMTM was not extracted. The findings of this study suggest that considering the routine use, affordability, and convenience of OPG, this method may be beneficial for visualizing a patient’s bone status after the extraction of an impacted molar.