Blood on the lab bench

Posted on 13 Sep 2017 by Pakinam Amer

Scientists in Qatar have taken research into organ development one more step into the future by expanding the potential for creating personalized blood and heart tissue in the lab.

The scientists, under the lead of Arash Rafii Tabrizi at Weill Cornell Medicine – Qatar, have postulated that endothelial cells, which line the walls of blood vessels, are a vehicle for organ development. “Different organs have different endothelial cells that express different and specific factors called angiocrine factors that lead to the development and function of the organ,” explains Tabrizi.

In order to test this, the scientists forced the expression of said transcription vectors in the lab. Twenty days later, the cells multiplied and differentiated into the building blocks of blood cells: hematopietic stem cells. These are the basis for cells such as red and white blood cells and platelets.

“If you have leukemia, for example, we would retrieve your endothelial cells and we could transform that into blood. It would be an unlimited personal source of blood for each individual,” says Tabrizi.

In addition to blood, the researchers paired endothelial cells with heart muscle cells to create more muscle cells, that beat together rhythmically, in a petri dish.

The scientists maintain, however, that it’s too early to make any sweeping assumptions about the reliability of results, not until the tests move into the animal and human trial phases.

Read more about what the scientists have termed a breakthrough discovery here.

Cholera in Yemen: Death by numbers

Posted on 15 Aug 2017 by Pakinam Amer

The World Health Organisation (WHO) has announced that the number of suspected cholera cases in war-battered Yemen this year hit the half a million mark.

According to the same report, released this week, around 2,000 people died since April’s outbreak. The international organisation says that the deadly waterborne disease infects an estimated 5,000 people per day, and is still spreading fast.

Yemen’s healthcare system was already acutely under-developed before the country was plunged into the current conflict, with barely enough doctors and hospital beds to meet national demand.

Now with the country’s ailing health infrastructure nearly destroyed, around 15 million people are unable to get basic healthcare, according to the new WHO report which deems Yemen’s cholera epidemic “the largest in the world”.

Compounding the problem is the country’s water shortages, which overall increased the risk of disease outbreak, especially in the countryside, and among children. Around 20 million Yemenis are struggling to get access to clean water. And diseases like diarrhoea, pneumonia, and malnutrition have become common as a result.

Yemen has already been water-stressed, with only 86 cubic metres of renewable water sources available per person per annum, according to the World Bank – far lower than the global average of 1,385 cubic metres per capita.

“Can you imagine a hospital without water? It is a desperate situation,” Marie Claire Feghali, spokesperson of the International Committee of the Red Cross (ICRC) in Yemen, had told Nature Middle East.

“To save lives in Yemen today we must support the health system, especially the health workers,” Tedros Adhanom Ghebreyesus, WHO Director-General, says. “The people of Yemen cannot bear it much longer.”

Prescription drugs overused and abused in the Mideast

Posted on 06 Jul 2017 by Pakinam Amer

It turns out that, in the Middle East, getting access to prescription medications for serious ailments, in the absence of supervision, can sometimes be as easy as picking up an over-the-counter medicine for a headache or the common cold, or so claims a new review published in Pharmacology Research & Perspectives.

In theory, the regulations separating access to either brand of medication is there. In practice, the review cites a “massive problem” of self-medication misuse in the region, particularly with prescription medication, one that eventually leads to greater health risks among patients, including drug dependency and addiction.

Drugs that are used recklessly or sometimes abused by Middle Eastern patients include codeine containing products, topical anesthetics, topical corticosteroids, antimalarial, and antibiotics. According to the review, which looked at 72 papers published on the subject between 1990 and 2015, self-medication medicine misuse cannot always be exactly quantified in the region but it seems widespread.

Some of the statistics that the review highlights are quite jarring.

For instance, 73.9% of the Sudanese population have reportedly used antibiotics or antimalarials without a prescription. Equally alarming trends have been observed in Syria, Yemen, Jordan, Tunisia, Egypt and the UAE, with drugs such as amoxicillin or ampicillin being dispensed freely. According to the review, most patients self-medicating on antibioitcs did not even follow through the full course of the medications and took them for less than three days.

Many of the patients follow the advice of relatives, or have a drug prescribed to them by a doctor over the phone. As well, some pharmacists play a role. “People tended to select medication based mainly on advice received from community pharmacists,” says one of the studies cited.

One study said that the majority of the 200 pharmacies under scrutiny in Syria had sold antibiotics without prescription, and in Saudi Arabia, only a single pharmacy had refused to release the medication without a doctor’s prescription.

As well as stacking prescription medications for future use, Middle Eastern patients often used them inappropriately; it’s not uncommon for many to pop antibiotics to treat illnesses unrelated to bacterial infections, for instance, or with incorrect dosages for inappropriate period of time, according to the review.

Year in review: Under pressure

Posted on 31 Dec 2016 by Pakinam Amer

Conflict and wars have continued to bend the region out of shape in 2016, with health infrastructure in Syria and Yemen continuing to crumble and fall, and the exodus of people out of dangerous zones affecting neighboring populations. The following are some of the most critical situations borne out of the flow of people as a result of infighting in 2016.

Water

Besides the human cost of the war in Syria, the ecological and environmental impact has, no doubt, been huge. For example, earlier this month, researchers based in the US and Canada have shown how mass migrations are changing the country’s hydrological landscape.

The flight of Syrian refugees since 2013 has dramatically changed water-use patterns and led to an increased water flow into Jordan through the Yarmouk River. In the absence of direct measurement data from Syria, the scientists had turned to remote sensing techniques, combining spatial and statistical analyses of satellite imagery with water balance calculations to estimate the changes in irrigation patterns and reservoir usage in southwest Syria. While the end of a regional drought is partly responsible for the increased flow of the Yarmouk, the analysis showed that decreased water use in the Syrian part of the river basin accounts for roughly half of the 340% increase in transboundary flow.

In a way, the war in Syria carried some good for Jordan – at least in terms of water supply.

Health

War and migration had once led to outbreaks of infectious diseases, such as visceral leishmaniasis, across the region, originating from Sudan and South Sudan. And new research is warning that this could happen again. Visceral leishmaniasis is endemic in Sudan and South Sudan, where the climate allows sandflies to thrive, and poor health systems compound the problem.

Researchers from the US and Saudi Arabia have presented new evidence suggesting that conflict, and the chronic malnutrition and displacement that follow, interrupt the cycle of immunity and allow a disease like visceral leishmaniasis to flourish. Gloomily, the scientists say they expect another outbreak.

Not far off, in Aleppo, the scene of much violence and suffering, an outbreak of another form of leishmaniasis has taken place. The Aleppo boil, which is caused by a parasite in the bloodstream and transmitted through the bites of sandflies, has been reported to have infected hundreds of thousands across the Middle East, especially across refugee camps. The disease causes disfiguring lesions on the body and the numbers are bad, according to scientists.

Until recently, the disease was contained to areas around Aleppo and Damascus, but this changed with the continuous disruption of insecticide control, poor water and sanitation services in conflict zones.

Biosensor zeroes in on dangerous bacteria

Posted on 30 Dec 2016 by Pakinam Amer

Staphylococcus or Staph aureus is a type of infectious bacteria that commonly causes skin and respiratory infections in addition to food poisoning. In some cases, it can lead to life-threatening diseases such as pneumonia, and brain, bone or heart infections. As well, it’s a common hospital acquired infection.

Now, a team of scientists from Saudi Arabia and Jordan have developed a point-of-care diagnostic test as effective in food samples as it is in clinical samples to detect the bacteria. It’s cheap, instrument-free, and takes less than a minute, according to lead researcher Mohammed Zourob, professor of chemistry at Alfaisal University in Saudi Arabia.

The researcher and his colleagues tested the biosensor in food and clinical isolates from a hospital but instead of targeting bacterial cells, as traditional sensors would, they targeted poteases enzymes released by the cells or expressed on the cells’ surface. The former’s sensitivity is too poor to detect infectious dozes of most bacteria, according to Zourob, unlike the latter method, invented by Zourob et al.

The probe itself is made up of a specific peptide sequence, cleaved by Staph aureus proteases, and sandwiched between magnetic nanobeads and gold surface on top of a paper support.

Another perk to the test, according to its developer, is that it does not require special training to use, so it can be easily administered by food inspectors and hospital nurses.

Zourob and his colleagues say they are now establishing a spin off in order to commercialize this new technology.

This injectable biomaterial can control bleeding

Posted on 30 Nov 2016 by Pakinam Amer

The biomaterial can maintain its shape upon injection, only becoming liquid after a force is applied. {credit}Ali Khademhosseini, Brigham and Women’s Hospital{/credit}

Scientists swap metallic coils, classically used to treat aneurysms and uncontrolled hemorrhaging, with a a hydrogel that can hold its shape within a blood vessel to prevent bleeding.

The agent, tagged a shear-thinning biomaterial, is similar to toothpaste in consistency and is made up of both gelatin and nanoparticles. The research by a team of scientists led by Ali Khademhosseini, from Brigham and Women’s Hospital and the department of physics, King Abdulaziz University, Saudi Arabia, developed the agent to overcome the limitations of the coils. In 47% of patients on blood thinning medications or in those who cannot form blood clots, dangerous break-through bleeding, with rebleeding, occurs when the coils are inserted into their blood vessels.

The new biomaterial doesn’t rely on the formation of blood clots to obstruct the vessel and halt bleeding. It can also withstand high pressure, and naturally degrades over time. It was tested on porcine models, whose blood vessels have similar dimensions to human’s. And the scientists plan to test it on humans next.

“This work is an example of how bioengineering can help address the challenges that clinicians and patients face,” says Khademhosseini of the research, published this month in Science Translational Medicine. “Our work thus far has been in the lab, but we are on a translational path to bring this new biomaterial for embolization to the clinic to improve patient care.”

Diagnosing diseases using a simple blood test

Posted on 31 Oct 2016 by Pakinam Amer

Researchers from Qatar have developed biomarkers for plasma volume and red cell mass, which are used to monitor numerous disease states, such as heart failure, kidney disease or sepsis. The markers provide an applicable method to measure absolute plasma or red cell volumes, via a simple blood test, in a clinical set-up.

In their initial investigation, the scientists observed 33 healthy males over a period of six months. They collected monthly blood samples and concurrently estimated vascular volume.

They then analysed the individual variations of 45 common chemistry markers, such as total protein, cholesterol, calcium, transferrin, and albumin. These observed variations were then matched to the observed plasma volume variability. “We identified two panels of biomarkers, composed of 8 and 15 chemistry variables, which explained approximately 67% of plasma volume variance,” says corresponding author Louisa M. Lobigs, from Aspetar Sports Medicine Hospital, Doha, Qatar.

The scientist explains that, currently, vascular volumes are estimated in hospitals by calculating the change in concentration-based blood markers, such as hemoglobin concentration or hematocrit. This common approach produces relative values and assumes uniform mixing of the blood constituent (often not the case in the critically ill); it is also dependent on factors like the patient’s hydration levels, posture, their fluid intake. Alternatively, absolute vascular volumes can be estimated with radio-active tracers, but it’s a cumbersome and time-consuming approach, according to Lobigs.

The new method measures absolute volumes, and requires only a simple blood test.

“This is extremely promising news for improved volume management in the clinic,” she says. Validation of the model’s stability will be required before it can be streamlined among hospital patients.

Beating cancer with smarter use of radiation?

Posted on 28 Sep 2016 by Pakinam Amer

This is a guest post by Nature Middle East writer Hebah Salama.

Cancers infect different tissues, and so they manifest differently, in various types, and require different treatments or sometimes a combination of treatments. Throw in variability among patients as a factor, and it’s even more complicated. It’s the reason why numerous studies are carried out every year to try and gauge the most effective therapy for different cancer types.

Now, researchers from Sudan and Lebanon specializing in medical physics and biochemistry have collaborated together on one such study. Their research deals with cancer cases in children, specifically analyzing the effect of different single radiation doses of X-rays on Rhabdomyosarcoma (RMS) – a malignant tumor involving skeletal muscle tissue.

Radiation, one of the most commonly used methods of cancer treatment, is known to cause damage in both healthy and cancerous tissue. It’s what sparked the known risk-benefit-ratio debate on whether the benefits from radiation therapy outweigh the harms. Scientists often discuss the different methods in which radiation can be used while keeping its side-effects to a minimum. As well, new technologies that provide high accuracy in dose delivery have been invented for this purpose; sparing healthy cells.

In this study, the scientists treated cultured RMS cells in vitro (outside of the human body) with therapeutic X-rays. The cells have shown to be resistant to radiation. Additionally, and depending on the radiation dosages, many of the treated cells have repaired from the X-rays’ radiation damage.

The scientists use this study to demonstrate that efforts put into studying tumors’ and healthy tissues’ biological responses to radiation based on tumor type should be stepped up. The more accurate the data provided about these types of responses, the better the outcome of patient treatment is.

“The advancement in technology should be met with more scientific research,” says Alexander Fadul lead researcher.

He adds that more patient oriented studies are certainly needed to determine the different parameters of radiation.

Calgary Depression Scale for Schizophrenia, in Arabic

Posted on 26 Sep 2016 by Pakinam Amer

Scientists from Qatar and the United States have managed to validate an Arabic version of the Calgary Depression Scale for Schizophrenia (CDSS) among patients with schizophrenia.

Schizophrenics commonly show both depressive and negative symptoms that can affect the prognosis and course of their treatment. Negative symptoms are disabling symptoms that have a major impact on the quality of life of patients, more so than positive symptoms, which are thought patterns and behaviors that patients acquire after they become ill.

Tests such as CDSS are designed to distinguish between depression, and negative symptoms that are distinctive of schizophrenia.

These tests are not diagnostic per se, “but they are mainly there to asses the severity of psychotic symptoms in schizophrenia and the possible associated depressive symptoms (using CDSS),” explains Hassen Al-Amin, professor of psychiatry at Weill Cornell Medicine-Qatar and corresponding author of the study that validated the psychiatric test.

“They are significant because they can help us know how sick these patients are and also to monitor how they are responding to treatment with time,” he says.

These types of tests have been used worldwide and their validity is established.

In order to make them work for Arab populations, experts and researchers had to translate the material thoroughly and decide the appropriate cultural equivalents in Arabic. “We then test the Arabic versions with Arab patients with schizophrenia and compare them with those obtained internationally to make sure that we have a valid scale that is culturally acceptable also,” says Al-Amin.

Can garlic-derived creams cure cutaneous leishmanisis?

Posted on 28 Aug 2016 by Pakinam Amer

A few months after a flesh-eating disease has resurfaced in the Middle East, a research team from Saudi Arabia and Egypt has released a new study which claims that allicin, a sulfur compound found in garlic, can hold the key to a cure.

Leishmaniasis is a protozoal parasitic disease spread by the bite of certain types of sandflies. From cutaneous lesions to fatal visceral infections, the parasite is vicious, but now these scientists are saying that the compound that is derived from the oldest medicinal plant and a cream based on it can heal cutaneous leishmaniasis in mice.

The study published in PLOS One says that at a concentration of 50 micromoles of allicin put a stopper on the growth of Leishmania parasites. Topical application of allicin cream have successfully reduced lesion sizes.

The scientists studied the toxic effects of allicin on the liver and kidney, but they discovered no significant differences in their biochemical analysis between the control and treated groups.

The potential cure’s promise lies in the fact that it overcomes the disease’s drug resistance, according to the study.

House of Wisdom

a blog from Nature Middle East

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