Abu Dhabi Falcon Hospital

Abstract Background The genetic architecture of Breast Cancer (BC) in Arab populations remains largely understudied, limiting the precision of current prevention and screening programs. The Emirati Genome Program (EGP), one of the world’s first nation-wide sequencing initiatives, offers an unprecedented opportunity to study inherited BC risk across an entire population. Methods We analyzed 436,780 EGP individuals, including 229,309 women, integrating whole-genome sequencing (WGS) with electronic health records (EHRs). We quantified the prevalence and penetrance of pathogenic and likely pathogenic (P/LP) variants across 13 NCCN-recommended BC genes, evaluated the performance of established polygenic risk scores (PRS), and reconstructed >48,000 pedigrees to measure familial aggregation. Results P/LP variants were identified in 0.84% of women, accounting for 5.2% of BC cases (mean age of 45.9±11.1 years). Highly penetrant BRCA1 c.4065_4068del (p.Asn1355fs) and BRCA2 c.2808_2811del (p.Ala938Profs) variants showed age-specific cumulative risks of 37.6% and 31% by age 60, respectively, and allele frequencies up to tenfold higher in the Emirati population than in global reference datasets. The European-derived PRS model (PGS000004) demonstrated strong performance, advancing 10-year BC risk onset by a decade for women in the top decile. Family-based PRS discriminated affected from unaffected individuals, revealing higher polygenic risk even within sister pairs. Conclusions Nation-scale genome sequencing reveals, for the first time, the comprehensive landscape of inherited BC susceptibility within a Middle Eastern population. The integration of monogenic, polygenic, and familial data establishes a national framework for genomic risk stratification, transforming population genomics into a foundation for precision prevention and early detection in the UAE and beyond.

The objective of this study was to assess the link between postpartum blood loss and placental elastography in multiparous pregnancies.In this prospective study, multiparous women who delivered at term between 2020 and 2024 were included. During the obstetric ultrasonography procedure, placental elastography was evaluated through the utilization of the shear wave elastography (SWE) technique. Elastographic measurements were performed at three distinct sites within the anteriorly positioned placentas via the abdominal route. The mean value of these three sites was subsequently calculated to derive the Z score. The difference (Δ) between prepartum and postpartum hemoglobin values was calculated, and cases with ΔHB below 2 g/dl were considered as the control group, and those with ΔHB above 2 g/dl were considered as the study group. Z scores were then compared between the two groups.A total of 109 cases was included in the study, 88 (80.7%) of which were assigned to the control group, and 21 (19.3%) to the study group. Maternal age (30.4±4.82 vs. 31.7±6.68) and BMI (28.7±3.96 vs. 28.1±4.77 kg/m2) were similar in both groups (p>0.05). A positive relationship was identified between ΔHB levels and Z score (r=0.521, p<0.001). The optimal cut-off value for the Z score was determined to be 5.64 kPa, exhibiting 76.2% sensitivity and 52.3% specificity (AUC: 0.709, p=0.003, 95% CI 0.586-0.833).The elastographic evaluation of the prepartum placenta has the potential to serve as a valuable tool in estimating postpartum hemoglobin decline.

Local wisdom-informed food technology innovation is increasingly attracting global scholarly attention as a viable strategy for addressing food security, sustainability, and public health challenges. This investigation examines prevailing research trajectories pertinent to applying traditional knowledge in food innovation through a bibliometric analysis framework. Following PRISMA 2020, we identified, screened, and included records under predefined criteria to ensure rigor and transparency. A total of 158 scholarly documents (coverage: 2014–2024; search conducted through 31 December 2024) were scrutinized utilizing the Scopus database. The articles selected pertained to local wisdom-informed food technology innovation and were published in English in peer-reviewed academic journals. The bibliometric analysis employed VOSviewer and Bibliometrix (R-package) to delineate publication trends, keyword prevalence, and international collaborative efforts within this domain. The analysis revealed a notable escalation in publication volume, with the United States, Italy, and India leading the output (19 documents each), followed by Indonesia (15), Canada (14), and China (13). Predominant themes encompassed “traditional knowledge,” “ethnobotany,” “food security,” and “nutrition.” Beyond mapping, we articulate a practical translation perspective for local-wisdom technologies, emphasizing documentation, standardization, validation, and scale-up, to bridge discovery and application. However, a discernible research gap persists concerning the integration and validation of advanced technologies (e.g. artificial intelligence, the Internet of Things, nanotechnology) and the commercialization and equitable governance (e.g. benefit-sharing, traceability) of local food innovations. Findings should be interpreted in light of Scopus-only and English-language inclusion, which may under-represent non-English local scholarship.

Patient: Male, 27-year-oldFinal Diagnosis: Pancreatic duct leak • pancreatic fistulaSymptoms: Abdominal painClinical Procedure: ThermoablationSpecialty: Gastroenterology and Hepatology • Radiology • SurgeryObjective: Unusual or unexpected effect of treatmentBackgroundPancreatic fistulas are serious complications following abdominal trauma which are often overlooked and may lead to hemorrhage, sepsis, and abscess formation. Early diagnosis is critical, yet options are limited when the anatomy gets distorted secondary to a high impact collision. In the setting of trauma, delayed or missed ductal injuries can perpetuate collections and septic physiology despite drainage. Although commonly treated with endoscopic retrograde cholangiopancreatography (ERCP) or conservative measures, a complex case of pancreatic fistula seen in our clinic saw mainstream treatments continuously fail. This report describes the case of a 27-year-old man with chronic post-traumatic pancreatic fistula successfully managed with percutaneous microwave ablation.Case ReportA 27-year-old man sustained blunt abdominal trauma in a road traffic collision and developed a chronic pancreatic fistula. Despite multiple surgeries, conservative management with octreotide, total parenteral nutrition, and several unsuccessful attempts at ERCP, the fistula persisted, leading to recurrent sepsis and multi-organ failure. As a last resort, computed tomography (CT)-guided percutaneous microwave ablation of the pancreatic neck was performed. Multidisciplinary consensus favored targeted thermal occlusion to achieve source control while avoiding another high-risk laparotomy. The procedure resolved the fistula within 4 weeks. Drain output fell and the patient stabilized without further organ support.ConclusionsThis case demonstrates a novel use of percutaneous microwave ablation to treat a chronic traumatic pancreatic fistula, highlighting microwave ablation as a potential therapeutic option when conventional treatments fail. Also highlighted is the importance of early consideration of pancreatic fistula in cases of abdominal trauma.

Introduction Antidysrhythmic medications are commonly prescribed, but there is little information on the incidence of adverse effects following an inadvertent extra dose of these medications. This poses a challenge to poison centers when trying to decide which patients need to be sent to a healthcare facility for monitoring. Methods A retrospective data review of cases reported to a regional poison center between January 1, 2012 and December 31, 2022 was performed. Cases were included if the exposure was a double dose or less of the patient’s own antidysrhythmic medication, the exposure was unintentional or a result of therapeutic error, and the antidysrhythmic(s) belonged to Vaughan Williams Class I or III. Cases were included even if other medications were included in the therapeutic error. Descriptive data were collected on cases meeting the inclusion criteria. Results One hundred and sixty-two exposures were included. Of these, only 49 were monitored in a healthcare facility for which coded outcomes were available. Of these, the majority had no or minor effects (83.7%). Two of the exposures developed hypotension, but both also involved either a beta-adrenoceptor blocking drug or a calcium-channel blocker. Of the 25 cases that only included an antidysrhythmic, adverse effects were even less common, with 92.0% having no or only minor effects. Discussion In this small cohort, adverse events were uncommon with inadvertent extra dose antidysrhythmic exposures. However, serious outcomes have been reported in other studies. It appears adverse events are less common if the extra dose exposure does not involve other cardioactive medications. Conclusions Extra-dose exposures of some antidysrhythmics belonging to Vaughan Williams Class I or III were generally well tolerated, but more data are needed to determine whether certain patients can be safely monitored at home. For example, only three cases involved Class IA drugs. Based on our findings, patients who reportedly ingest an extra dose of an antidysrhythmic plus another cardioactive medication should be evaluated at a healthcare facility.

BackgroundPulmonary arterial hypertension (PAH) is a progressive, fatal cardiopulmonary disorder characterized by elevated pulmonary vascular resistance leading to right heart failure. Current treatment utilizes pathway-specific vasodilators, including numerous prostacyclin therapies with diverse delivery methods. Despite available options, head-to-head studies comparing these treatments remain scarce.AimThis network meta-analysis seeks to systematically evaluate all prostacyclin-based PAH therapies to guide clinical decision-making regarding treatment selection.MethodsWe implemented a frequentist approach to network meta-analysis (NWM). For continuous outcomes, we calculated pooled mean differences (MD), whereas risk ratios (RR) were determined for binary endpoints. All estimates incorporated 95% confidence intervals. Results achieving p-values below 0.05 were considered statistically significant.ResultsOur NWM comprising 32 studies (N = 7,819) revealed significant mortality reduction with treprostinil versus placebo (RR 0.66, 95%CI 0.49–0.90), while epoprostenol transitioned demonstrated superior survival benefit (P-score 0.78). For functional capacity, epoprostenol exhibited the greatest 6-Minute Walking Distance (6MWD) improvement (46.84 m, 95%CI 21.90–71.78; P-score 0.90) versus placebo. Hemodynamically, epoprostenol achieved optimal Pulmonary Arterial Pressure (PAP) reduction (−6.29 mmHg, 95%CI -6.99 to −5.59; P-score 0.95), while iloprost demonstrated superior Pulmonary Vascular Resistance (PVR) improvement (−342.09, 95%CI -410.30 to −273.87; P-score 1.00). Epoprostenol ranked highest for Right Atrial Pressure (RAP) reduction (−2.41 mmHg, 95%CI -2.65 to −2.18) and cardiac index improvement (0.56, 95%CI 0.49–0.63). Regarding clinical worsening, selexipag showed potential superiority (RR 0.62, 95%CI 0.51–0.74; P-score 0.95) compared to treprostinil (P-score 0.55).ConclusionOur NMA demonstrates that prostacyclin pathway therapies offer benefits in PAH management. While epoprostenol exhibits superior improvements in hemodynamics and functional capacity, treprostinil reduces mortality by 34%, and selexipag excels in preventing clinical worsening and hospitalizations.

Cardiac imaging is vital for diagnosing coronary artery disease (CAD), with coronary computed tomography angiography (CCTA) being commonly used to evaluate coronary vessels for stenosis, calcification, and atherosclerosis. However, CCTA images often suffer from artifacts like beam hardening, scatter, and noise, degrading image quality and obscuring anatomical details, leading to diagnostic uncertainty. Conventional post-processing techniques, such as filtered back projection and iterative reconstruction, have limited effectiveness in correcting these artifacts, posing challenges in CCTA, where precise visualization of coronary arteries is crucial. Artifacts can blur vessel boundaries, obscure calcified plaques, and misrepresent stenosis severity, potentially leading to misdiagnosis and suboptimal clinical decisions. Recent advancements in computational imaging, particularly deep learning algorithms, offer clinical benefits for artifact reduction in CCTA. Deep learning models, such as convolutional neural networks (CNNs), outperform traditional methods by effectively de-noising and correcting artifacts through learning complex patterns from large datasets. These models adapt to the non-linear, heterogeneous nature of artifacts, enhancing image clarity and diagnostic reliability. Improved image quality in CCTA enables better visualization of coronary arteries, aiding in accurate assessment of stenosis and calcification. This review highlights deep learning approaches for artifact correction in CCTA, emphasizing their potential to improve CAD diagnosis.

IntroductionInformation regarding the impact of topical antibiotics with or without corticosteroids on the microbiota of the horses’ eyes is limited. This study aimed to describe the bacterial ocular surface microbiota in healthy horses and evaluate the effect of topical antibiotics or antibiotic-corticosteroid medication on the ocular surface microbiota.MethodsThis was a prospective, randomized, longitudinal, blinded study in which one eye of 12 horses was treated 3 times daily for 7 days with neomycin, polymyxin B and bacitracin ophthalmic ointment (n = 6) or neomycin, polymyxin B and dexamethasone ophthalmic ointment (n = 6). The contralateral eyes operated as untreated controls. The inferior conjunctival fornix of both eyes was sampled at baseline before antibiotic administration (day 0), on days 3, 7, 9, 14, and 30. The ocular surface microbiota was characterized by amplifying the V4 region of the 16S ribosomal RNA gene.ResultsAlpha- (richness and diversity) and beta-diversity (weighted and unweighted UniFrac distances) measurements of the ocular surface microbiota varied similarly after treatments starting on day 1, returning to baseline measurements by day 30. At baseline, the main phyla detected in the ocular microbiota was Proteobacteria, representing 75% relative abundance, followed by Firmicutes and Bacteroidetes. After treatments, Proteobacteria declined in all groups, and Firmicutes and Bacteroidete’s relative abundance increased, returning to baseline levels on day 30. The main genera detected on the ocular surface on day 0 were Suttonella, Nicoletella, Pasteurella, and members of the family Moraxellaceae. After treatment, the relative abundance of this bacteria declined in all groups, returning to baseline levels on day 30, although some alterations were still present.DiscussionHere we show that topical antibiotics administered with or without corticosteroids induce changes in the ocular surface of horses’ eyes, and the microbiota appears to return to baseline approximately three weeks after treatment discontinuation.