Novel Marine Compounds: Anticancer or Genotoxic?

In the past several decades, marine organisms have generously gifted to the pharmaceutical industries numerous naturally bioactive compounds with antiviral, antibacterial, antimalarial, anti-inflammatory, antioxidant, and anticancer potentials. But till date only few anticancer drugs (cytarabine, vidarabine) have been commercially developed from marine compounds while several others are currently in different clinical trials. Majority of these compounds were tested in the tumor xenograft models, however, lack of anticancer potential data in the chemical- and/or oncogene-induced pre-initiation animal carcinogenesis models might have cost some of the marine anticancer compounds an early exit from the clinical trials. This review critically discusses importance of preclinical evaluation, failure of human clinical trials with certain potential anticancer agents, the screening tests used, and choice of biomarkers

The need for hospital-based neonatal palliative care programs in Saudi Arabia

The terms palliative care, supportive care, and comfort care are used to describe individualized care that can provide a dying person the best quality of life until the end. The term "end-of-life care" is also used in a general sense to refer to all aspects of care of a patient with a potentially fatal condition. While the concept of palliative care is not new, it has only recently been applied to the neonatal population. To the best of our knowledge, none of the neonatal intensive care units (NICUs) in Saudi Arabia have adopted a neonatal program for palliative care. We believe the main reason is lack of knowledge of such programs and the fear of being accused of being heartless and cruel by providing comfort care for dying babies. Comfort care begins with the diagnosis of a life-threatening/terminal condition, and continues throughout the course of illness regardless of the outcome. In this perspective, our aim is to introduce these programs for caregivers in the NICUs in Saudi Arabia. For this purpose, we have reviewed the current recommendations in establishing neonatal palliative care programs and discussed some of the social and religious aspects pertaining to this issue

Management of twin reversed arterial perfusion sequence: one center's experience

BACKGROUND: Twin reversed arterial perfusion (TRAP) sequence is a rare condition that affects primarily monozygotic monochorionic twin pregnancies in which a normal twin acts as a pump (donor) for an acardiac recipient (perfuse) twin. OBJECTIVE: We report our experience over the last 13 years at a tertiary health care center. DESIGN: Descriptive, retrospective case series SETTING: Tertiary health care center PATIENTS AND METHODS: All TRAP cases managed between the years 2009 and 2022 at our Fetal Diagnosis and Therapy Center were included. Data recorded included demographic and clinical information which was used to generate descriptive data. Patients were managed by a multidisciplinary team with variable interventions. MAIN OUTCOME MEASURE: Survival of normal twin SAMPLE SIZE: Eight RESULTS: Eight pregnant women with TRAP syndrome were managed at our center during that period. One was monozygotic monochorionic and the others were monochorionic diamniotic. Median maternal age at presentation was 27 years and median gestational age at diagnosis was 23 weeks. All were diagnosed with ultrasound (US) imaging. Three were managed with bipolar ligation of the cord of the acardiac twin under general anesthesia, one US-guided (single port) and 2 fetoscopic (2 ports) with a median operative time of 39 minutes. The last five cases were managed with US-guided radiofrequency ablation (RFA) under local anesthesia, one needed 2 sessions, 1 week apart. The median duration of the RFA procedure was 23 minutes. There were no complications and all had viable normal babies born at a median of 32 weeks of gestation (6 C-section, 2 spontaneous membrane rupture). CONCLUSIONS: Acardiac twin cord ligation and RFA are feasible and safe options with excellent outcome for TRAP syndrome. RFA may be preferable owing to its less invasiveness under local anesthesia. LIMITATIONS: None, given the rarity of the disease and the study design. CONFLICT OF INTEREST: None

Differential modulation of benzo[a]pyrene-derived DNA adducts in MCF-7 cells by marine compounds.

Despite several marine anticancer compounds to be DNA-interactive, causing from reductive DNA cleavage to DNA adduct formation, not much attention has been given to the DNA adduct as early biomarker in the screening and development of marine anticancer drugs. Most of these compounds have been tested in vitro by high-throughput cost-effective screening assays for their anticancer potential. In the present study, chemically diverse marine compounds were screened using benzo[a]pyrene (BP)-derived DNA adduct formation in MCF-7 cells. Briefly, MCF-7 cells were incubated with the marine compounds, namely manzamine A, sarcophine, aaptamine, verongiaquinol, curcuphenol, and curcudiol (10, 50 and 100 μM) for 24 h followed by treatment with BP (0.5 μM). After 24 h re-incubation, cellular DNA was isolated and analyzed for BP-derived DNA adducts by 32P-postlabeling technique. Interestingly, at 50 μM dose, only manzamine A, a probable antitumor compound, increased the BP-DNA adducts by 3-folds while curcuphenol and curcudiol lowered the BP-DNA adduction by up to 50%. Other compounds insignificantly modulated the BP-DNA adduction. At 10 μM, all the marine compounds were ineffective except aaptamine, which induced BP-DNA adduction by 2-fold. Further at 100 μM dose, all the compounds except manzamine A and verongiaquinol increased the BP-DNA adducts by up to 500%. In addition, verongiaquinol (50 μM) substantially down-regulated the levels of p53, p21, and p16, while manzamine A (50 μM), significantly inhibited the expression of p53. Aaptamine (50 μM) induced the p53 expression by 40%, however, other compounds were ineffective. All other marine compounds resulted in a differential response related to p21 and p16 expression

Design of two-dimensional recursive filters using genetic algorithms (vol 50, pg 634, 2003)

Physico-chemical and microbial analyses of four commercial fresh date cultivars (Sukari, Barhi, Khalas and Rothana) grown in Saudi Arabia were evaluated. Colorimetric assay indicated that Sukari had the highest total sugar content of 13.21g/100gFW while the lowest was in Rothana with 7.96g/100gFW. Total phenolic content (TPC) ranged from 76.74 to 122.20mgGAE/100gFW in Barhi and Rothana respectively, whereas antioxidant activity was highest in Sukari (105.99μgGAE/gFW) and lowest in Khalas (90.81μgGAE/gFW). The dominant fungal genera were Aspergillus sp., Rhizopus sp., Penicillium sp. and Sarocladium sp., occurring at 37, 18, 13 and 12% respectively. The highest fungal occurrence was in Barhi (30%) followed by Sukari (29%), Khalas (26%) and Rothana (15%). The TPC had a negative correlation with fungal occurrence whilst the total sugars had a positive correlation

Machine learning decision tree algorithm role for predicting mortality in critically ill adult COVID-19 patients admitted to the ICU

Background: Coronavirus disease-19 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is currently a major cause of intensive care unit (ICU) admissions globally. The role of machine learning in the ICU is evolving but currently limited to diagnostic and prognostic values. A decision tree (DT) algorithm is a simple and intuitive machine learning method that provides sequential nonlinear analysis of variables. It is simple and might be a valuable tool for bedside physicians during COVID-19 to predict ICU outcomes and help in critical decision-making like end-of-life decisions and bed allocation in the event of limited ICU bed capacities. Herein, we utilized a machine learning DT algorithm to describe the association of a predefined set of variables and 28-day ICU outcome in adult COVID-19 patients admitted to the ICU. We highlight the value of utilizing a machine learning DT algorithm in the ICU at the time of a COVID-19 pandemic. Methods: This was a prospective and multicenter cohort study involving 14 hospitals in Saudi Arabia. We included critically ill COVID-19 patients admitted to the ICU between March 1, 2020, and October 31, 2020. The predictors of 28-day ICU mortality were identified using two predictive models: conventional logistic regression and DT analyses. Results: There were 1468 critically ill COVID-19 patients included in the study. The 28-day ICU mortality was 540 (36.8 %), and the 90-day mortality was 600 (40.9 %). The DT algorithm identified five variables that were integrated into the algorithm to predict 28-day ICU outcomes: need for intubation, need for vasopressors, age, gender, and PaO2/FiO2 ratio. Conclusion: DT is a simple tool that might be utilized in the ICU to identify critically ill COVID-19 patients who are at high risk of 28-day ICU mortality. However, further studies and external validation are still required