University of Kalamoon

Autoimmune polyendocrinopathy syndrome type 1 (APS-1) is a rare autosomal recessive disorder caused by pathogenic variants in the AIRE gene and classically characterized by the triad of hypoparathyroidism, chronic mucocutaneous candidiasis, and adrenal insufficiency. Although hypoparathyroidism is often the earliest manifestation, isolated and prolonged monosymptomatic presentations remain uncommon and may delay recognition of the syndrome. We report the case of a child who was first presented at four years of age with severe hypocalcemia in the setting of acute gastroenteritis and was diagnosed with hypoparathyroidism. Apart from hypomagnesemia and hyperphosphatemia, extensive workup revealed no additional autoimmune or endocrine abnormalities. Genetic testing subsequently identified a homozygous likely pathogenic stop-loss AIRE gene mutation, confirming APS-1. Over a three-year follow-up period, the patient remained clinically stable with well-controlled hypoparathyroidism, except for hypocalcemic episodes during diarrheal illnesses, and persistently normal adrenal, thyroid, pancreatic, and celiac screening. The first additional disease feature emerged three years after the initial presentation, at the age of seven years, when a fungal nail infection consistent with mucocutaneous candidiasis was noted. This case highlights the marked phenotypic variability with delayed evolution of APS-1 and underscores that isolated hypoparathyroidism, even when severe, may precede other disease components by several years. Early genetic testing in children with apparently isolated hypoparathyroidism allows anticipatory guidance, structured surveillance, and timely recognition of evolving autoimmune manifestations.

Azithyromcin an antmicrobial medication, and belongs to a new class of azalide antimicrobials that belongs to the macrolide group of S50 protein inhibitors. Continuous monitoring of pharmaceutical products is vital because it is important for human health, Azithromycin recently more used effectively for treatment of lower and upper respiratory tract gram-negative and may gram-positive organisms in cases of resistance to anther antibiotics used for these diseases. A set of physicochemical and microbiological tests and quality control tests using the modified constitutional chromatography method to assessment Azithromycin tablets quality of various national Syrian brands and compared to reference international band (Azicip ®), the results of these tests showed that acceptable limit so can be used safely with suitable cost. The results of tests that used for evaluation; uniformity of weight, hardness, friability, and microbial assay. Their results ranged between ;651 mg to 902.5 mg, 14.91±0.42 to 19.58±0.43 (Kg/cm2), 0.02 to 0.5%, 94.18 to 98.32%, (mean ± S.D) respectively. All tablets disintegrated within 3.8 to 8 minutes with distilled water. The dissolution (%) in 0.1 N HCL and phosphate buffer solution pH = 6.0 at 37.0 ± 0.5 °C after 45 minutes was between 87% to 92% by using HPLC device. The results of assay were (99.4 %, 97.8 %, 98.6 %, 97.4 %) of A, B, C of local companies and D of reference company respectively, these results were acceptable according to USP Pharmacopeia limit. The validation of the analytical method was verified in which, the value of limit of detection (LOD) was 0.0933 µg/ml, the value of limit of quantification (LOQ) was 0.311 µg/ml, correlation coefficient R value was 0.9998 that indicated the linearity of applied method within the range of concentration (27.25- 132.14 %).

Cancer is one of the major diseases that threaten human life and causes death for many people worldwide. Some alkaloids derived from plants show promising potential for cancer treatment. Solanaceae family is of these plants that have promising alkaloid. In this study alkaloid production from Solanum elaeagnifolium callus cultures was investigated and their anticancer properties were evaluated. Optimal callus growth and alkaloid production were achieved in media enriched with a combination of BAP and 2,4-D at a ratio of 1.0:1.0 mg/L. LC-MS/MS analysis showed that β-Solamargine, tomatidenol, Solasonine, solanidine and solasodine are the most important alkaloids of Solanum elaeagnifolium. Moreover, the analysis revealed that β-Solamargine is the predominant alkaloid (78.7%) in callus extracts. The results of MTT assay, demonstrated that the most effective response were obtained from callus extracts medium containing a balanced concentration of BAP and 2,4-D, and it yielding an IC50 of 6.25 µl/ml. In contrast, lower efficacy was observed with IC50 values of 25 and 50 µl/ml, when callus medium were supplemented with NaCl and yeast extract, respectively. Gene expression analysis shows an increase in the Bax/Bcl-2 ratio following 24 h of the extracts treatment. Along with a down regulation of CDK1 gene expression in comparison to untreated MCF7 cells, the CDK1 levels were elevated. Alkaloids derived from S. elaeagnifolium may be a promising candidate for anticancer therapy; further investigation is needed in vivo.

Introduction:Down syndrome (DS) affects 1 in 787 live births, linked to congenital anomalies and intellectual impairment. Colorectal Crohn’s disease is prevalent in DS patients, presenting with fatigue, abdominal pain, and strictures, often treated with surgery, immunomodulators, and biotherapy for management.Case presentation:The patient presented with symptoms of abdominal pain, cramping, and significant bowel sounds, along with weight loss and a decreased appetite. Histopathological examination and upper endoscopy were used to diagnose the condition, and a gluten-free dietary treatment was implemented.Clinical discussion:Crohn’s disease can be diagnosed by several methods, including histopathology, and its treatment can involve various approaches, including dietary management. There is a connection with genetic diseases, and it is not necessary for all symptoms and signs of the disease to appear, as they often vary.Conclusion:DS with Crohn’s disease is considered a very rare condition, especially in low-income countries and at a young age. It should be taken into account when differentiating diagnoses in autoimmune and intestinal diseases.

Abstract Superior mesenteric artery syndrome is a rare condition that causes duodenal obstruction due to compression by the superior mesenteric artery and the aorta. It can be related to congenital or acquired factors that reduce the aortomesenteric angle and distance. The clinical presentation is nonspecific and often mimics other causes of upper gastrointestinal obstruction. The diagnosis requires a high index of suspicion and a correlation of clinical symptoms with radiographic findings. We report a case of a 17-year-old female patient who presented with chronic abdominal pain, vomiting, and weight loss. She was diagnosed with superior mesenteric artery syndrome based on an abdominal computed tomography scan that showed a reduced aortomesenteric angle of 30° and a reduced aortomesenteric distance of 7 mm. She was treated conservatively with anticoagulation therapy, dietary modification, and physical activity. She reported symptom improvement and weight gain after 2 weeks of treatment. This case illustrates the challenges and pitfalls in diagnosing superior mesenteric artery syndrome.

Abstract Background Artificial intelligence (AI) enables computers to process data and solve problems via algorithms, with China at the forefront of medical AI applications like diagnostics. Medical students increasingly rely on AI tools (e.g., ChatGPT) for education, and ML advances predictive research. Methods A cross-sectional study assessed AI readiness among 799 medical students from all universities in the West Bank, Palestine, that have a Faculty of Medicine, using the validated MAIRS-MS scale (22 items across 4 domains). Data collection combined electronic and paper questionnaires, ensuring high participation and reliability (α = 0.87). Results Most participants were from Hebron University (66%) and represented all academic years. The majority (83%) were aware of AI in medicine, and 73% had prior experience with AI tools. The median total readiness score was 73 (IQR: 66–84), with highest scores in ability (median: 27) and cognition (median: 26), and lower scores in vision and ethics (both median: 10). Males, older students, high-GPA achievers, and those from higher-income backgrounds had significantly higher readiness scores (p < 0.001). Prior AI experience and awareness were also strongly associated with increased readiness. No significant differences were observed across universities or academic years. Conclusion Palestinian medical students demonstrate moderate to high readiness for AI integration in medicine, particularly in technical and cognitive domains. However, notable gaps remain in ethical understanding and visionary thinking. Addressing these gaps requires national curricular reform focused on ethics, regulation, and strategic AI applications. Equitable access to AI education across socioeconomic and gender lines is essential to prepare future physicians for a digitally enhanced healthcare landscape.

Background:Choriocarcinoma (CC), a rare and aggressive form of cancer, is composed of cytotrophoblasts and syncytiotrophoblasts. It is present in two subtypes: gestational choriocarcinoma (GCC) and non-gestational choriocarcinoma (NGCC). Recognizing the disparities between GCC and NGCC is essential for the precise staging, prognosis, and determination of the primary treatment strategy.Objective:This study aimed to differentiate clinical outcomes, treatment responses, and prognostic factors between GCC and NGCC and to introduce innovative tools for personalized treatment strategies.Design:A retrospective cohort study with Survival Analysis and Nomogram Development.Methods:We analyzed data from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database and identified female patients diagnosed with GCC and NGCC between 2000 and 2020. The clinicopathological features of each group were compared using the chi-square test. Kaplan-Meier curves, log-rank tests, and Cox proportional hazard regression were used to assess overall survival and cancer-specific survival and to determine risk factors. The 5-year survival predicting nomogram was constructed, evaluated, and validated.Results:The study included 919 patients with 719 CC and 200 patients with NGCC. The NGCC group was characterized by older age, a higher proportion of married individuals, more advanced disease stages, larger tumor sizes, and a higher frequency of surgical interventions than the GCC group. NGCC was associated with worse survival rates than GCC patients.Conclusions:This study highlights the critical role of chemotherapy in improving the survival of patients with NGCC, in contrast to its limited effect on GCC. The negative prognosis associated with radiotherapy underscores the urgent need for further investigation to optimize its use. In addition, the introduction of the first web-based survival prediction tool and predictive nomogram marked a significant advancement in personalized treatment strategies, enabling improved clinical outcomes by tailoring therapy to individual patients.

Langerhans cell histiocytosis (LCH) is a rare disorder characterized by the proliferation of Langerhans cells that affects multiple organs. It presents variably in children, complicating diagnosis and treatment strategies. Understanding its genetic and clinical characteristics is crucial for its effective management. We report the case of a 13-year-old male with multisystem LCH involving the temporal bone, parotid gland, and lymph nodes, who presented with auricular pain and swelling. Despite the initial non-specific treatment, advanced imaging and biopsy confirmed the diagnosis. The patient underwent a treatment regimen according to the LCH4 protocol, which included Prednisolone and Vinblastine, and showed significant improvement. This case highlights the necessity of a multidisciplinary approach for diagnosing and managing LCH and illustrates the potential of genetic research and targeted therapies to improve outcomes. Future studies should explore the genetic basis of LCH and the potential links between immunization and disease onset, aiming to refine treatment protocols and enhance patient prognosis.

Vildagliptin is a dipeptidyl peptidase-4 inhibitor used to treat diabetes mellitus. Quality control of pharmaceutical products is an essential operation because it affects on the human health. Evaluation if Vildagliptin local Syrian brand comparing with the reference drug Galvus® (Novartis Pharma). Many physical and chemical quality control tests were applied to Vildagliptin tablets including weight variation, friability, hardness tests in addition to disintegration, dissolution and drug content using modified constitutional chromatography method. The results of physical and chemical tests showed that the tablets within acceptable limits, which allows the use of the tablets of local companies safely. The tests of weight variation, friability, hardness testes were between 182.51±7 to 234.78mg, 0.03 to 0.27% and 7.02±0.43kg/cm2 to 8.49±0.57kg/cm2 respectively. All tablet disintegrated within 2.02 min to 7.06 min in distilled water. The drug release (%) in 0.01 HCL and phosphate-buffered saline (PBS) (pH 6.8) after 40 min were between 95.52% to 98.57%. Result assay using HPLC showed that drug content (%) range between 93.29% to 97.24%. The result validation of the analytical method was verified, as the value of the coefficient of determination R was equal to 0.997, which indicates the linearity of this method within the range of concentrations (60-120)%, limit of detection (LOD) is 1.135µg\ml