Qatar Foundation Annual Research Forum Volume 2013 Issue 1

Plants and fruits are an essential component of the universe. Human beings have used those as medicine from the very beginning of time. There are many plants with medicinal applications that have been mentioned in the holy book of Muslims, the Quran. The objective of this research is the identification of medicinal plants enumerated in the Quran and exploring their traditional uses and phytotherapeutical benefits. At least 52 plant species have been identified in Qu'ranic Botanical Garden Qatar. In the present work, we have chosen three species native to the Qatar flora and also cited in the Holy Quran and Hadith. A search for any documentation or publication of their traditional uses and therapeutically benefits was carried out using the scientific literature and internet websites for well referenced publications. Results were systematically arranged by alphabetic order of botanical names followed by English name, Arabic name, family, parts used and medicinal uses.

Xenopus oocytes are naturally arrested at prophase of meiosis I for sustained periods of time before resuming meiosis in a process called maturation that prepares the egg for fertilization. GPRx is a G-Protein coupled Receptor (GPCR) expressed in Xenopus oocytes that sustains its meiotic arrest by increasing intracellular levels of cAMP via GaSß? proteins. Progesterone (PG) is the widely used hormone to release Xenopus oocytes meiotic arrest by reducing cAMP levels via its non-classical membrane PG receptor. However and to date the exact mechanism by which PG decreases cAMP levels and releases the meiotic arrest is still unclear. In this study we aimed to determine if PG treatment can promote GPRx desensitization and endocytosis leading to Xenopus oocyte maturation. As previously shown, overexpression of GPRx-GFP in Xenopus oocyte completely blocks PG-induced maturation. We defined GPRx subcellular distribution (~80% at the cell membrane), confirmed its presence in early endosomes and showed that its membrane localization is crucial for its meiotic arrest. Although early data showed a dip in cAMP levels within 15 sec after PG treatment, we found that no less than 30 minutes treatment with PG was needed to fully induce oocyte maturation compared to overnight treatment with PG, and was accompanied with a dip in cAMP levels and a significant shift of endogenous and overexpressed GPRx-GFP distribution from the membrane toward the inside of the oocyte. PG may induce GPRx endocytosis by phosphorylating the Serines/Threonine (S-TSS) domain at GPRx C-terminal end, since mutating these residues in the S-TSS motif completely blocked the effectiveness of PG in inducing GPRx endocytosis. Moreover, dose response experiments using GPRx wt or GPRx S-TSS mutant showed that PG induce maturation more efficiently in the presence of low intermediate concentration of GPRx wt in comparison to GPRx S-TSS mutant. Our data argue that PG releases Xenopus meiotic arrest by inducing GPRx desensitization and endocytosis.

Road traffic injuries are recognized as the leading killer in Qatar, causing 1 in 8 deaths. ten percent of all victims are children, under the age of 18. Evidence is needed to inform the formulation of preventive programs to make the children of Qatar safer on the roads. A retrospective analysis was done on trauma registry data of the Trauma Section, Department of Surgery, Hamad General Hospital. All patients, under 18 years, who presented with road related injuries from 1 January 2010 to 31 December 2012 were included. There were 443 patients who made up 9.1 % of all trauma patients. 83.3% were male and motor vehicle crashes [MVC] made up 54.4%, Pedestrians [PED] 25.5%, ATV's 13.5%, Motorcyclists [MCC] 5% and Bicyclists [BIKE] 1.6% of all patients seen. Adolescents, ages 15-18, made up 56,4% of MVC victims. Toddlers, ages 1-4, made up 40.7% of PED victims. Older children, ages 10-14, made up 57.6% of all ATV and 61.9% of all BIKE victims. Targeted programs should be implemented to address the greatest risk for road trauma in each age-group.Implementing best evidence through school-based educational programs should be considered.

Cancer therapeutics have developed and improved overtime. Currently, the most common oncology therapeutics are chemotherapy and radiation therapy. These cancer therapies predominantly follow a 'one-size-fits-all' strategy. They attach general features common to all cancers, although the dose size and frequency are typically customized from one patient to another. Two popular forms of cancer therapeutics are chemo and radiation. These forms use different approaches. Chemotherapy attacks fast-dividing cells in the patient body. Since chemotherapy does not distinguish between good and bad cells, it can induce side effects. Side effects include hair loss, bone marrow problems, and digestive system problems. Chemotherapy kills hair follicles, blood cells in bone marrow, and intestinal cells in digestive system. High doses are required for chemotherapy to be effective. Moreover, not all types of cancer respond well to chemotherapy. Cancer cells are "smart" in the sense that they can eventually "learn" and detect chemotherapy and "adapt/protect" themselves, rendering chemotherapy impotent. Radiation therapy attempts to avoid chemotherapy shortfalls by damaging cancer cell DNA in the targeted body part. Radiation offers two main advantages over chemotherapy: (1) the former is targeted, so it does not damage other body parts, and (2) it is more effective because the DNA of the cancer cells are damaged beyond repair leaving no chance for adaptation. Radiation effectively causes the tumor to shrink and die. However, good cells can still be affected by radiation, and side effects can still occur, e.g. fatigue, memory loss, skin irritation, scar tissue, and chronic bowel effects. More recently, newer cancer therapies (known as targeted therapies) attack specific features or mutations found in individual cancers in an attempt to kill fast-dividing cells without killing normal healthy cells. A targeted therapy attacks specific mutated proteins or DNA known as biomarkers, found in individual types of cancer. Targeted therapy works only on the targeted biomarkers. Only patients with the correct DNA mutation (biomarker) can benefit from targeted therapies. Targeted therapies have some advantages over chemo and radiation therapies. They operate in a wider "effective treatment window" and cause fewer side effects (joint and muscle pain, fatigue, skin lesions, diarrhea, and nausea) compared to either chemo or radiation. The paper offers a historic perspective of the evolution of the personalized cancer treatment approach, it enablers, current research issues and its future promise.

Introduction: Stomach cancer is one of the leading causes of death. The two main existing screening tests are the non-invasive carbon urea breath test (not reliable enough) and the classical gastric endoscopy (costly and uncomfortable) which is preferred by clinicians. However, patients are reluctant to do it and this increases the chance to detect stomach cancer after the early stage of development. To overcome these limitations, an efficient "patient oriented" and clinically efficient approach to stomach cancer detection is highly relevant. The most famous autonomous capsule is probably PillCam, the first commercialized and FDA approved capsule endoscope. It is equipped with a video camera but has no navigation abilities. Its two main limitations compared to the classical endoscopes are the lack of control and the impossibility to perform a biopsy. In this abstract, a new approach for early stomach cancer detection is proposed: a tethered capsule endoscope containing embedded visual sensing (Seibel et al., 2008, IEEE Transactions on Biomedical Engineering), chemical sensing (Arnecke et al., 2009, Analytical Chemistry) and offering navigation abilities. Preliminary design: The tethered capsule endoscope comes as an interesting alternative. Being tethered, there is no need to embed the energy source and electronics required for navigation and sensing. This enables a great simplification of the embedded material and thus a cost reduction of the capsule itself. This also allows a drastic size reduction and ensures a great sense of comfort during the whole procedure. Moreover, using a chemical sensor embedded in the capsule design gives the possibility to perform an improved in situ version of the carbon urea breath test. The navigation system is based on the actuation of the last portion of the tether. It can bend in all direction up to 180° thus allowing orienting the sensors toward every desired portion of the stomach (Figure 1). The capsule contains a wire pulling system. Controlling in opposite pairs the pull and release of the wires allows producing bending motions of the tether active portion. The wire pulling system uses two miniature piezoelectric linear motors coupled with two extension springs. One nylon wire is attached to each linear motor and each opposite wire is attached to an extension spring (Figure 2). The actual prototype for navigation along with micro optochemical sensor set is currently under fabrication. This work was made possible by the support of an NPRP grant from the Qatar National Research Fund (NPRP4-049-2-021). The statements made herein are solely the responsibility of the authors.

Objective: To analyze demographic and socio-economic determinants of neonatal mortality Introduction: Evidence suggests that it is challenging to reduce the infant and under-five mortality without specific focus on neonatal mortality, given that about 43% of under-five deaths and 60% of infant deaths are attributed to neonatal mortality. Hence, key to achieving MDG-4 is the reduction of the global total of 3.82 million neonatal deaths per year, especially the 3 million who pass away in the first week of life (early neonatal period). Socio-economic and demographic variables are generally viewed as important determinants to a range of health outcomes, including neonatal mortality. The current study collected and analyzed the socio-demographic determinants of Qatar's Neonatal Mortality during 2011 about which little is known in the published literature. Methods: A Prospective National Epidemiologic Study was carried out to assess the association between fourteen demographic and socioeconomic variables and neonatal mortality. Data was collected from the 2011 National cohort of 20,583 live births and 102 neonatal deaths and entered in Qatar National Perinatal Registry (Q-Peri-Reg). One fetal variable (gender), three maternal variables (level of education, occupation, age), three paternal variables (level of education, occupation, age), and seven household (family) variables (nationality, consanguinity, family income, house ownership, type of housing, family type, domestic help) were analyzed in a univariate regression model. Results: Less than secondary level of maternal education was associated with two-fold increase in neonatal mortality (OR 2.08, 95% CI 1.23-3.53, p=0.009). The association between the rest of the thirteen variables and neonatal mortality was non-significant. Conclusions: Higher level of maternal education, as compared to lower level of maternal education, is significantly associated with reduced neonatal mortality. Keywords: neonatal mortality, demographic, socio-economic variables, maternal, paternal, household, family

Objective To determine the safety of a combination of Magnesium Sulphate and Therapeutic Hypothermia in the management of term and near term newborns with moderate to severe Hypoxic Ischemic Encephalopathy Introduction The neuroprotective research in Hypoxic Ischemic Encephalopthay (HIE) is currently testing Hypothermia plus therapies. The Mag Cool Study aims to test the safety and efficacy of Therapeutic Hypothermia plus Magnesium Sulphate. The current poster presents the preliminary safety results which were presented in the First DSMB meeting of the Trial. Methods Study design: Multicenter, Prospective, Randomized, double blind, placebo controlled trial. Study Duration: June 2012 to December 2013. Funding: HMC Internal Research Grants Competition Qatar (Grant # GC 1028A). IRB Approval: Approved by the IRB of all participating centers. Randomization: Babies were randomized, using a web based randomization system provided by Sealed envelopes Inc. London UK, to Arm A (Magnesium Sulphate 250mg/k/dose for three doses at 24 hours interval or Arm B (an equivalent volume of normal saline as placebo) to be administered as soon as possible after birth; preferably within six hours of birth. Method: Term and near term babies (≥35 completed weeks of gestation) with evidence of moderate to severe Hypoxic Ischemic encephalopathy using Inclusion and Exclusion criteria. All babies were provided standard intensive care plus hypothermia therapy as soon after birth as possible, using either a total body cooling machine or head cooling machine to maintain a rectal temperature of 33.50 C for a period of 72 hours followed by an eight hours period of gradual rewarming to normal body temperature and another 16 hours of observation (total duration 96 hours). Safety outcome measures: Death or severe adverse events during the 96 hours of treatment Analysis SPSS Version 20 was used. Univariate analysis using cross tabulations of Intervention (MgSO4) and Control arms with outcome measures was done. Chi-square test and Fischer Exact test was used. A p-value of <0.05 was taken as significant. Results A total of 34 patients were enrolled in the safety study from 26 May 2012 till 31st April 2013. There were 18 patients in Arm A and 16 in Arm B. Therapeutic hypothermia was successfully maintained between 33.5 and 34.50 C as per standard protocol in all patients except one in which hypothermia was terminated at 62 hours of age due to persistent sinus bradycardia. All 34 patients received intensive care including endotracheal intubation and ventilation Conclusion The combined use of therapeutic hypothermia and MgSO4 appears to be safe particularly with respect to maintaining blood pressure and coagulopathy. Long term survival and neurodevelopmental outcomes remain to be evaluated. Participating Centers and Patients Contributed: Hamad Medical Corporation Qatar, Zekai Tahir Burak Hospital Turkey, Al Rayyan Hospital Riyadh KSA, Mansoura University Children's Hospital Egypt, University Malaya Medical Center Kuala Lumpur Malaysia, Tawam Hospital UAE

INTRODUCTION: CBIA is a small group discussion which emphasizes on the active role of participants in looking for information. CBIA has been proven effective to improve tuberculosis patient's adherence to treatment program, pharmacy assistant's skills in hypertension drug information service, and skills in early detection of Brest cancer. Therefore, CBIA was developed adapting the original CBIA, enriched with key messages in healthy life-style for diabetic patients as CBIA-DM. OBJECTIVE: This study was aimed to assess the impact of CBIA-DM on diabetic patients' quality of life. METHODS: Time series, pre and post quasi-experimental design. Three groups were involved in the study: CBIA-DM, DM-club and normal-care group. Data were collected in preintervention,immediately, one, three and 6 months post intervention using WHOQOL-bref questionnaires Bahasa version. Categorizing scores in good (>mean + SD), fair (between mean + SD and mean − SD), and poor (

One barrier to interpreting past studies of cognition and Major Depressive Disorder (MDD) has been the failure in many studies to adequately dissociate the effects of MDD from the potential cognitive side effects of Selective Serotonin Reuptake Inhibitors (SSRI) use. To better understand how remediation of depressive symptoms affects cognitive function in MDD, we evaluated three groups of subjects: medication-naïve patients with MDD, medicated patients with MDD receiving the SSRI paroxetine and healthy control subjects. All were administered a category-learning task that allows for dissociation between learning from positive feedback (reward) versus learning from negative feedback (punishment). Healthy subjects learned significantly better from positive feedback than medication-naïve and medicated MDD groups, whose learning accuracy did not differ significantly. In contrast, medicated patients with MDD learned significantly less from negative feedback than medication-naïve patients with MDD and healthy subjects, whose learning accuracy was comparable. A comparison of subject's relative sensitivity to positive versus negative feedback showed that both the medicated MDD and healthy control groups conform to Kahneman and Tversky's (1979) Prospect Theory, which expects losses (negative feedback) to loom psychologically slightly larger than gains (positive feedback). However, medicated MDD and HC profiles are not similar, which indicates that the state of medicated MDD is not 'normal' when compared to HC, but rather balanced with less learning from both positive and negative feedback. On the other hand, medication-naïve patients with MDD violate Prospect Theory by having significantly exaggerated learning from negative feedback. This suggests that SSRI antidepressants impair learning from negative feedback, while having negligible effect on learning from positive feedback. Further, we examined the influence of the 3' variable number of tandem repeats (VNTR) polymorphism in the dopamine transporter gene (DAT1) on learning from positive and negative feedback in medicated patients with MDD. We grouped medicated MDD according to DAT1 VNTR genotype into 9-repeat carriers and 10-repeat homozygotes. Carriers of the 9-repeat allele, who presumably express less DAT1 and thus exhibit higher levels of dopamine, were more efficient in learning from positive feedback, whereas there was no difference between polymorphism carriers in learning from negative feedback. Overall, these findings shed light on the importance of dissociating the cognitive consequences of MDD from those of SSRI treatment, and from cognitive evaluation of MDD subjects in a medication-naïve state before the administration of antidepressants. Further, incorporating genetic profiles can guide future research to correlate the mood-elevating effects and the cognitive balance between reward- and punishment-based learning related to SSRIs.

Background: The Arabic coffee is commonly used in Qatar and the Gulf region as a traditional drink. It is prepared by boiling roasted coffee in water after being milled. Coffee contains more than 1,000 compounds that are mostly produced during the roasting process (Parliament and Stahl, 2005).However, lipids and caffeine remain virtually unchanged, while sugars and proteins decrease significantly. In general, there is a difference in coffee consumption between Gulf and Western countries in that it is unfiltered drink. One study has shown that Arabic coffee significantly increased the low density lipoprotein (LDL) level of plasma in rats. This increase might be due to the direct consumption of infiltrated Arabic coffee as several studies showed that filtration in Drip-filtered coffee is important in holding the Chlorogenic acids Kahweol, and Cafestol "coffee Diterpenes" which in turn increase the total cholesterol (TC) and LDL. The Aim: The aim of the study is to evaluate the lipid profile in the four main types of beans used in the market: Yemeni, Indian, Brazilian, and American coffee in the form of green and roasted beans using the LC/QQQ (Liquid chromatography triple quadrupole) and HRAM MS and MS/MS techniques. Research Methods: Lipids extraction was performed using Dionex ASE-350 (accelerated solvent extraction at high pressure and temperature) instrument for all coffee beans after grinding. The LC/QQQ was an Agilent 6490 using AJS-ESI ion source was used to analyze lipids in coffee extracts while HRAM MS experiment were performed on a Thermo Q-Exactive at a mass resolution of 70,000. The column used was ZORBAX Eclipse XDB-C18 1.8µX2.1X100mm (Agilent) and with Acetonitrile (0.1% Formic Acid) and Isopropanol (10mM Ammonium acetate) as the mobile phase. Results & Conclusion: Using this method TAGs profile was analyzed in all coffee types and the most abundant were: LPS, LPP. Vastly different composition of TAGs was derived using MS/MS. The percentage of lipids was the highest in Roasted Brazilian beans with 9.24%, while the lowest was in Roasted Indian beans with 1.48%. The lipid profiles are comprehensively described and differences among the specimens discussed. These results imply that intake of Arabic coffee can subject the consumer to unforeseen levels of lipids in their dietary intake.