Dubai Medical Journal

An Evaluation of Antibacterial, Antioxidant, and Biocompatibility (Hemocompatibility) Nature of Green Synthesized ZnONPs: An In-vitro Approach

Mathiyazhagan Narayanan — 2025-03-24

Introduction: Zinc oxide nanoparticles (ZnONPs) derived from plant extracts are garnering attention in medical applications due to their unique properties and eco-friendly synthesis, which enhance antimicrobial, antioxidant, anti-inflammatory, and anticancer effects. This research investigated the antibacterial and biocompatibility properties of previously characterized ZnONPs against bacterial pathogens, with biocompatibility evaluated through a hemocompatibility study using human blood samples.

Methods: The bactericidal efficacy of phyto-synthesized ZnONPs was evaluated using the standard agar well-diffusion method against bacterial pathogens including E. coli, P. aeruginosa, S. aureus, K. pneumoniae, and S. flexneri. Moreover, their antioxidant capacity was evaluated using various nonenzymatic in-vitro assays, including ABTS, DPPH, TRP, and TAC assays.

Results: The antibacterial efficacy of presynthesized and characterized ZnONPs showed dosage-dependent bactericidal activity against bacterial pathogens including Pseudomonas aeruginosa, Streptococcus pneumoniae, Staphylococcus aureus, Escherichia coli, and Klebsiella pneumoniae. At a concentration of 800 μg mL⁻¹, the ZnONPs exhibited significant free radicals scavenging and reducing capabilities as demonstrated by DPPH, TAC, TRP, and ABTS assays. Moreover, the ZnONPs demonstrated excellent biocompatibility, as evidenced by hemocompatibility assay.

Discussion: Phytochemicals derived from plants, including alkaloids, flavonoids, and tannins, stabilize nanoparticles, thereby enhancing their antibacterial effectiveness against Grampositive and Gram-negative bacteria. Green synthesized ZnONPs demonstrate reduced toxicity to human cells, notable antimicrobial effectiveness, strong antioxidant characteristics, and low cytotoxicity, making them beneficial for anti-aging therapies, wound healing, drug delivery, and tissue engineering.

Conclusion: Green-synthesized ZnONPs demonstrate significant dose-dependent antibacterial efficacy against pathogenic bacteria such as P. aeruginosa, S. pneumoniae, S. aureus, E. coli, and K. pneumonia. The antioxidant test results demonstrated a significant dosedependent capacity of DPPH, TAC, TRP, and ABTS to eliminate free radicals. The antibacterial and antioxidant properties of ZnONPs exhibited notable biological compatibility.

Evaluating the Impact of Adding Lee Silverman Voice Treatment BIG into Routine Physiotherapy on Both Motor and Nonmotor Functions in Individuals with Parkinson’s Disease

Zahra Sadaghiani — 2025-03-24

Introduction: Parkinson’s Disease (PD) is a disorder that causes both motor and nonmotor symptoms. While PD typically appears in older adults, it can also affect individuals in the later stages of middle age. Traditional drug therapies have side effects and diminishing returns. Exercise, particularly high-intensity programs like Lee Silverman Voice Treatment BIG (LSVT BIG), can enhance motor skills and overall quality of life by recalibrating the sensory system.

Method: This research included 40 individuals with PD, who were separated into a control group (standard physiotherapy) and an intervention group (physiotherapy + LSVT-BIG). Participants were from a local hospital, aged between 35 and 70, with stable medication and Montreal Cognitive Assessment (MoCA) scores > 20. Exclusions included active exercise programs and severe mental disorders. Participants were evaluated by an LSVT BIG-certified physical therapist and completed surveys on medical history and current issues. Tests included Timed Up & Go (TUG), TUG manual, and TUG cognitive. Both groups received 16 one-hour exercise sessions over 4 weeks. Statistical analyses included Kolmogorov-Smirnov for normality, independent t-test for baseline values, paired-sample t-test for within-group comparisons, and ANCOVA for post-test differences.

Results: Demographic and clinical attributes were consistently and normally distributed across groups (p > 0.05). Both groups demonstrated notable improvements across all outcomes (p < 0.05); however, the experimental group had a notably greater improvement in TUG cognitive scores in comparison to the control group (p < 0.05). No side effects occurred.

Discussion: TUG cognitive and manual tests highlighted LSVT-BIG’s effectiveness in enhancing dual-task performance.

Conclusion: Improvements in various TUG scores for individuals with PD indicate enhanced mobility and dual-task performance, which are crucial for daily activities and overall quality of life for individuals with PD.

The Stress Burden and Positive Coping Among the United Arab Emirates Population During Crisis: A Cross-sectional Study from the Pandemic Era

Yousef M. Aljawarneh — 2025-03-24

Introduction: The pandemic crisis created a psychosocial and public health crisis that affected the lives of millions globally. This cross-sectional study aims to examine the stress burden during the pandemic crisis and positive coping among the general population in the United Arab Emirates (UAE). Methods: This study employed a crosssectional design to examine the stress burden of the pandemic crisis and positive coping among the general population in the UAE. The study questionnaires were sent to potential participants as an online survey. A total of 465 UAE residents were enrolled between October and December 2021. The stress burden and positive coping were measured using the Coronavirus Disease of 2019 Pandemic Mental Health Questionnaire (CoPaQ).

Results: Regarding stress burdens related to the pandemic crisis, only 20.9% (n = 97) of the participants reported no stress burden, while most of the participants had mild to moderate stress burden (124 (26.7%) and 188 (40.4%), respectively). In contrast, 56 participants (12.0%) had severe stress burden related to the pandemic crisis. Positive coping with daytime structure was reported as 102 participants (21.9%) reported highly effective coping, 123 participants (26.5%) reported moderately effective coping, 137 participants (29.5%) reported slightly effective coping, and 103 participants (22.2%) reported ineffective coping. Positive coping with inner resources was reported where most of the participants reported either highly or moderately effective coping (110 (23.7%) and 155 (33.3%), respectively), while only 62 participants (13.3%) reported ineffective coping. Being symptomatic quarantined was significantly associated with positive coping categories of daytime structure but not inner resources, while being infected was significantly associated with both positive coping categories of daytime structure and inner resources. Stress burden was significantly associated with demographic variables (marital status, gender, and age) pandemic-specific variables (quarantined, infected, and symptomatic), and psychological variables (pre-existing conditions and undergoing psychotherapy).

Conclusion: The pandemic crisis has significantly affected the stress burden of the UAE population. The individual differences identified in this study underscore the importance of anticipating the impact of future crises and implementing personalized interventions that address the needs of vulnerable groups.

Empowering Patient Self-care in Plantar Hyperkeratotic/Palmoplantar Keratodermas Eczema: A Case Report

B. Parveen — 2025-03-24

Introduction: Palmoplantar keratodermas (PPKs) include a range of inherited or acquired skin disorders characterized by thickening of the skin on the soles. Hyperkeratotic dermatitis on the hands and feet is a chronic, challenging-to-treat condition that often results in pain, reduced mobility, and impaired functionality.

Case Report: This study describes a 42-year-old man with idiopathic PPK and no prior dermatological history. He initially presented with recurrent eczema on his left foot, which gradually spread to both feet, particularly affecting the lateral borders. Despite the negative results for fungal and patch tests, as well as a biopsy, his hyperkeratosis and peeling skin have persisted for 5 years.

Conclusion: Because plantar hyperkeratotic eczema is a chronic condition, effective management requires a combination of patient selfcare and medical treatment. Standard therapies, including antifungal, antibiotic, and steroid creams, keratolytic agents, acitretin tablets, and regular wound care, were insufficient in this case, with the patient experiencing recurrent symptoms that impacted his quality of life. A collaborative self-care approach is essential, focusing on minimizing adverse effects such as scarring, skin peeling, and hemorrhaging while considering personal and environmental factors contributing to the condition.

Advanced Carcinoma Endometrium in a Reproductive Age Group Woman: A Magnetic Resonance Imaging Diagnosis

Fatma Mohamed Al Wahaibi — 2025-03-24

Introduction: Endometrial adenocarcinoma, usually seen in postmenopausal women, can also occur in younger patients and is often associated with polycystic ovarian syndrome (PCOS) and obesity.

Case Report: We report a case of a 33-year-old nulligravida woman with a 14-year history of subfertility, who presented with abdominal pain and a large abdominopelvic mass. While initial computed tomography (CT) imaging suggested ovarian malignancy, magnetic resonance imaging (MRI) revealed significant myometrial invasion, pointing to endometrial carcinoma. An endometrial biopsy confirmed grade 1 endometrioid adenocarcinoma, later staged as grade 2 stage 3 with positive pelvic lymph nodes after surgery.

Discussion: Though clinical examination was suggestive of ovarian tumors, imaging helped in the diagnosis of endometrial cancer and further management.

Conclusion: This case highlights the critical role of MRI in diagnosing endometrial carcinoma in younger women with atypical symptoms and underscores the importance of awareness among healthcare providers to suspect and appropriately investigate endometrial cancer in this population.

Comprehensive Analysis of Six Biomarkers Expression in Early-stage Breast Cancer: A Cross-sectional Study

Hamid K. Al-Tameemi — 2025-03-24

Introduction: Breast cancer is a heterogeneous disease with variable molecular profiles. This study aims to evaluate the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), phosphatidylinositol-4,5- bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), interleukin-8 (IL-8), and antigen Kiel 67 (Ki-67) in early-stage breast cancer and their associations with clinicopathological features.

Methods: Tissue samples from 93 early diagnosed breast cancer patients, attending Al- Andalus Hospital in Baghdad, Iraq, from February 2022 to April 2023, were analyzed using immunohistochemistry. Expression patterns of the six biomarkers (ER, PR, HER2, PIK3CA, IL-8, and Ki-67) were correlated with tumor grade, histological type, tumor size, and lymph node involvement. Statistical analyses included chi-square and Fisher’s exact tests as well as various correlation coefficients (Pearson, Spearman, and phi).

Results: ER and PR positivity were inversely associated with tumor grade, while HER2, PIK3CA, and Ki-67 showed positive correlations. In addition, invasive ductal carcinomas mainly expressed ER+/PR+ profiles, while invasive lobular carcinomas showed higher rates of HER2 positivity compared to ductal carcinomas. Furthermore, increasing tumor size and higher degrees of lymph node involvement were positively correlated with increased expression of HER2, PIK3CA, and Ki-67. Moreover, a strong positive correlation was observed between IL-8 and Ki-67 expressions.

Discussion: The study reported distinct molecular profiles associated with various clinicopathological features. In particular, well-differentiated tumors predominantly displayed hormone receptor-positive subtypes, while poorly differentiated tumors showed more aggressive molecular profiles. The findings confirm the complex relationship between some biomarkers and tumor characteristics.

Conclusion: The current study’s analysis gives information about the molecular shape of early-stage breast cancer. The reported associations between biomarker expression and clinicopathological features may add to improved prognostic assessment and treatment strategies for breast cancer patients.

The Assessment of Students’ Perception Regarding the Learning Experience in the Virtual Pharmacology Laboratory

Bandar T. Alenezi — 2025-03-24

Objective: The current study was conducted to evaluate students’ feedback on the virtual pharmacology classes among the second-year students in Faculty of Medicine, Northern Border University, Saudi Arabia.

Materials and Methods: The study was conducted through distribution of a structured self-administered questionnaire of three sections covering satisfaction of participants regarding the virtual pharmacology classes, their effect on students’ performance, and the attitude of students toward the virtual classes.

Results: A total of 152 responses were enrolled in the study. The number of female and male participants were 78 (51.3%) and 74 (48.7%), respectively. The overall answers of the respondents were satisfactory for the different sections with an overall average score of 3.4 (ranging from 3.3 to 3.47). Paired t-test revealed a statistically significant difference between male and female responses (p<0.0001). Male participants showed higher levels of satisfaction in all questions with an average response of 3.7 while the female participants showed an average satisfaction level of 3.1. Male participants were significantly more satisfied about convenience aspect of the practical classes (p=0.0052) with clearer results (p=0.0094), time saving (p=0.045), and better class organization (p=0.033). Also, male participants reported significantly higher satisfaction levels regarding the effect of virtual classes on their topic understanding (p=0.025), exam grades (p=0.0007), and improvement of thinking abilities (p=0.0058). Also, both questions of attitude showed that male participants significantly had a better attitude toward virtual classes.

Conclusion: The current data revealed satisfactory levels of satisfaction among students attending virtual pharmacology classes with their belief that these classes improved achievement of learning outcomes and a positive attitude toward having more virtual classes.

Assessment of Beep Test Performance and Cardiorespiratory Endurance in Young Footballers: A Cross-sectional Study in the UAE

Shahwar Fatima Ansari — 2025-03-24

Aim: The study aims to examine the Beep test performance and the cardiorespiratory endurance among young footballers in the United Arab Emirates while also analyzing the correlations of lower limb muscle strength (quadriceps, hamstrings, and calf muscle) with the Beep test performance.

Methods: In this cross-sectional study, 78 participants were selected according to the inclusion criteria, and demographic data was collected. Preparatory tests such as heart rate (HR), blood pressure (BP), and lower limb strength measurements were recorded. Parameters such as peak expiratory flow rate (PEFR), forced expiratory volume in 1 second (FEV1), and forced vital capacity (FVC) were measured using MIR SPIRODOC. The data was collected in two stages, before and after conducting the Beep test.

Results: The mean age and body mass index (BMI) of the participants were 13.71 years and 19.18 kg/m². The variables like heart rate, systolic blood pressure, FEV1, FVC, and PEFR for pre- and post-Beep test performance showed statistical significance (p<0.05). The correlation coefficients for quadriceps, hamstrings, and calf muscle strength with Beep test performance were found to be r=0.87, r=0.79, and r=0.31, respectively, indicating a strong correlation for quadriceps and hamstrings and a weak correlation for calf muscles.

Conclusion: The study found a direct correlation of quadriceps and hamstrings with Beep test performance, and the pre-and post-Beep test values of various cardiorespiratory parameters such as HR, systolic blood pressure (SBP), FEV1, FVC, and PEFR showed significance, highlighting the physiological demands of the test.

Public-focused Pharmacovigilance Mobile Software: Comparison and Evaluation

Mariam Saeed Al-Attar — 2025-03-24

Introduction: Medications can lead to severe health complications including adverse drug reactions, a major cause of mortality globally. Pharmacovigilance plays a critical role in identifying, evaluating, and mitigating these risks. While mobile medical apps present new opportunities for enhancing medication safety, there is a recognized need for better pharmacovigilance support within these applications. This study assesses the role of medical applications in pharmacovigilance and drug safety with the goal of enhancing these applications and bridging the gap between their current offerings and patient needs.

Methods: This mixed-methods study developed a pharmacovigilance concept specifically for public-use mobile applications, identifying six key aspects related to patient needs. These aspects guided the creation of an investigation form which was then used to evaluate nine selected apps.

Discussion: The findings showed a high degree of similarity among the apps, with significant gaps between their features and the actual needs of users. Most apps were limited to providing medication reminders, with only a few offerings information on safety alerts or drug interaction verification. The study recommends addressing these gaps and enhancing the capabilities of drug vigilance applications by providing comprehensive and credible information services tailored to patient needs, thus improving the effectiveness of health applications in drug vigilance.

Conclusion: Mobile applications have the potential to significantly improve pharmacovigilance and medication safety. However, existing apps have notable gaps. Collaboration between developers and healthcare professionals is essential to improve these apps and prioritize pharmacovigilance in all health-related mobile applications.

Spontaneous Spinal Epidural Hemorrhage Following Intravenous Thrombolysis: A Systematic Review of Case Reports

Atef F. Hulliel — 2025-03-24

Background: Spontaneous spinal epidural hematoma (SSEDH) is a rare condition typically occurring in adults aged between 40 and 50 years. The condition can eventually evolve into neurological deficits that result in motor and sensory loss. Tissue plasminogen activators are Food and Drug Administration-approved drugs for various vascular thrombotic diseases including myocardial infarction and acute ischemic stroke. This review seeks to examine the available literature regarding the SSEDH following thrombolytic therapy.

Method: A total of 21 papers underwent screening for eligibility criteria and subsequent evaluation led to the extraction and qualitative synthesis of data from 12 selected papers. The gathered information encompassed patients’ demographic details, primary diagnoses, types of thrombolytic therapy administered, neurological presentations, treatment modalities employed, and ultimate outcomes.

Results: This analysis delves into 13 cases of SSEDH following intravenous thrombolysis, encompassing patients aged 39 to 75 years across diverse global regions. The study revealed that eight out of 13 cases were male and nine were above 50 years old. Neurological symptoms, diagnosed via MRI or CT, manifested within 30 minutes to 48 hours post-therapy, with 76.92% occurring within the initial 24 hours. Bleeding occurrences were notably frequent across the combined cervical and upper thoracic spinal regions (cervico-thoracic), similar to their frequency in the isolated lumbar area (23.08% each). Myocardial infarction (MI) accounted for 69.2% of thrombolytic administrations.

Conclusion: Spontaneous spinal epidural hematoma is a rare but serious complication that can occur following thrombolytic therapy with tissue plasminogen activators (tPA). Our review of 12 case reports reveals that SSEDH, although infrequent, often develops within 48 hours of treatment, particularly in patients over 50. The potential link between tPA and SSEDH emphasizes the need for careful monitoring and early imaging. Further research through prospective, multicenter studies is crucial to clarify this association and enhance patient care, highlighting the importance of vigilance in managing thrombolytic therapy

Acknowledgement to Reviewers 2024

DMJ Editorial Board — 2025-03-24

This is an annual reviewer acknowledgement by the journal's editorial board to thank and acknowledge the journal reviewers for their time and efforts.