Browsing by Author "Al-Muhanna, Fahd"

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Effect of granulocyte-macrophage colony-stimulating factor on chemotherapy-induced oral mucositis in non-neutropenic cancer patients
(1998) Ibrahim, Ezzeldin; Al-Mulhim, Fatma; Al-Muhanna, Fahd; Al-Amri, Ali
Objective: The study was designed to assess prospectively the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) in the management of chemotherapy-induced oral mucositis in non-neutropenic cancer patients. Material and Methods: In a prospective open study, adult cancer patients with chemotherapy-induced, neutropenia-independent oral mucositis were treated with GM-CSF (Schering Plough Corporation, Kenilworth, NJ) prepared as mouthwash solution (5 to 10 μgm /ml). GM-CSF was administered within 24 hours of occurrence of oral mucositis at a frequency of 4 to 6 times daily. Systemic GM-CSF was not permissible. Oral mucositis was graded according to the modified Radiation Therapy Oncology Group criteria. Results: Forty-nine patients were recruited but nine were subsequently excluded as they experienced neutropenia during GM-CSF therapy. The remaining 40 patients were all evaluable. Most patients had either Grade 3 or 4 gross (71%) or functional (70%) mucositis. The mean ± SEM gross oral mucositis scores for all 40 patients combined decreased from 3.3 ± 0.11 at baseline to 2.1 ± 0.12 (p<0.0001) after 2 days, 0.95 ± 0.11 (p<0.0001) after 5 days and 0.23 ± 0.07 (p <0.0001) after 10 days of therapy. Likewise, the mean ± SEM functional oral mucositis scores decreased from 3.03 ± 0.13 at baseline to 1.58 ± 0.13 (p<0.0001) after 2 days, 0.68 ± 0.11 (p<0.0001) after 5 days, and 0.15 ± 0.06 (p<0.0001) after 10 days of therapy. The duration of severe oral mucositis was also shortened as Grade 0 or 1 (gross mucositis grading score) was evident in 12 (30%), 29 (73%), and 40 (100%) patients by the 2 nd , 5 th and 10 th day of therapy, respectively. Similarly, Grade 0 or 1 (functional mucositis grading score) reported in 19 (48%), 31 (78%), and 40 (100%) patients by the 2 nd , 5 th and 10 th day of therapy, respectively. The use of GM-CSF mouthwash was not associated with any apparent ill effect. Conclusion: GM-CSF mouthwash as used in this study has a significant recuperative efficacy on the severity, morbidity, and duration of chemotherapy-induced oral mucositis. A large randomized, placebo-controlled study is warranted to ascertain that benefit and determine the optimal dosage and schedule.
The future of academic medical centers in Saudi Arabia: Difficulties encountered in a teaching hospital
(1999) Al-Muhanna, Fahd
Objective: The objective of this study was to define and analyze the major difficulties experienced and documented in a university teaching hospital. Methodology: The academic medical center (AMC) reviewed was the King Fahd Hospital of the University (KFHU), Al-Khobar, Eastern Saudi Arabia. Data sources included student registration figures, budget allocation and the hospital annual reports. The retrospective analysis was restricted to difficulties encountered. Results: While numbers of medical students increased, staff positions remained static. There was remarkable budgetary deficiency over 9 years; especially for pharmacy, equipment's and supplies. The number of patients' visit markedly increased. The difficulties encountered were 237 in 70 sections of KFHU. Other problems included recruitment difficulties and the triple role for the faculty; teaching, researching and service. Conclusion: The role of leadership is emphasized to provide answers for the problems; to manage AMC's more efficiently; to find ways of providing medical care more cost-effectively and to generate more funds.
Transport Characteristics of patients on automated peritoneal dialysis may not affect their lipid profile
(2013) Al-Hwiesh, Abdullah; Al-Amri, Ali; Al-Dhafery, Bander; Al-Muhanna, Fahd; Abdul-Rahman, IbrahiemAloadh, Nadia
End-stage renal disease patients undergoing peritoneal dialysis usually have significant hyperlipidemia. The peritoneal membrane permeability and residual renal function (RRF) may affect lipid profile in these patients. Objective: To study the correlation of lipid profile with peritoneal membrane transport characteristic and RRF as well as cancer antigen (CA)-125 in patients on automated peritoneal dialysis (APD). Materials and Methods: The present study is a retrospective analysis of forty end-stage renal disease patients on APD. Lipid profile (total cholesterol, serum triglyceride, low-density lipoprotein and high-density lipoprotein), serum albumin and CA-125 were correlated with various peritoneal membrane transporters, assessed by peritoneal equilibration test (PET). Lipid profile was also correlated with residual renal function and KT/V. Results: The study included 21 female and 19 male patients on APD. The duration of peritoneal dialysis was 18-70 months. There was no significant difference in lipid profile at baseline and at one year in patients with different peritoneal transporter status. There was no correlation between lipid profile and residual renal function as well as CA-125. Conclusion: The findings suggest that there is no relation of lipid profile with peritoneal membrane transporter status and residual renal function in patients maintained on automated peritoneal dialysis.
β 2 adrenergic receptor gene polymorphisms in normal and in patients with myocardial infarction in the eastern province of Saudi Arabia
(2013) Al-Rubaish, Abdullah; Al-Shehri, Abdullah; Al-Ali, Abdullah; Al-Ali, Amein; Al-Nafaie, Awatif; Larbi, Emmanuel; Al-Muhanna, Fahd; Asselberg, Folkert; Al-Faraidy, KhalidShakil, Mohammed
Single nucleotide polymorphisms (SNPs) of the ?₂ -adrenergic receptor (?₂ -AR) gene have been implicated in the pathogenesis of cardiovascular diseases. This study evaluated two ?₂ -AR SNPs in association with myocardial infarction (MI), namely arginine-glycine (G16R) substitution at codon 16 and glutamine-glutamic (Q27E) substitution at condon 27. bjectives: Therefore, our main objective was to determine the association of these two SNPs among patients with MI with and without type 2 diabetes (T2D). Materials and Methods: Blood samples were collected from 201 MI patients with and without diabetes and from 115 controls and the ?₂ -AR gene polymorphisms at codon 16 and codon 27 were assessed by restriction fragment length polymorphism. The ?² test was used to compare differences between groups. Results: The SNPs did not deviate significantly from Hardy-Weinberg equilibrium in the control population. The allele and genotype frequencies of the ?₂ -AR gene polymorphism at codon 16 (G16R) was significantly different between MI cases and controls (?² = 10.495, P < 0.05 and ?² = 8.849, P < 0.05, respectively). No significant difference in genotype and allele frequencies at codon 27 was shown between these two groups (?² = 2.661, P ? 0.05 and ?² = 1.587, P ? 0.05, respectively). When the MI patients with and without T2D were pooled together, genotype distribution was different between cases and controls at codon 16 (?² = 4.631, P = 0.099) and codon 27 (?² = 7.247, P = 0.027). However, no significant differences were found in allele frequencies for codon 16 and codon 27 between the two groups (?² = 0.628, P = 0.428; ?² = 0.33, P = 0.565, respectively). Conclusion: Our findings indicate a moderate association of the ?₂ -AR G16R gene polymorphism with MI suggesting that this gene plays a universal role in the development of MI across ethnicities. However, there was no association of ?₂ -AR G16R gene polymorphism with diabetic patients with MI.