Disorders of the Sclera

2022 ◽  
pp. 341-358
Keyword(s):  
Middle Eastern ◽  
Immunosuppressive Treatment ◽  
Disease Recurrence ◽  
Small Female ◽  
Chronic Inflammatory Response ◽  
Professional Advice ◽  
True Incidence ◽  
Before And After ◽  
Middle Eastern Population ◽  
Infectious Scleritis

Episcleritis and scleritis are the most common diseases among disorders of sclera. Episcleritis is a relatively common condition in the Middle Eastern population. The true incidence is difficult to determine, as episcleritis are self-limited conditions and patients generally do not seek professional advice. Scleritis is characterized by a chronic inflammatory response located in the sclera, which can spillover and involve adjacent ocular structures, mainly the cornea and the uvea. Scleritis can be seen at any age, but most commonly occurs in the fourth to sixth decades. It has a small female preponderance (1.6:1), and the condition is bilateral in 52% of cases. This chapter includes a severe infectious scleritis case with before and after treatment photos. The disease responded to antibiotic treatment, but later the patient presented with immune disease recurrence which responded to oral immunosuppressive treatment. Treatment photos are shown chronologically.

scholarly journals REPRODUCTIBILITY OF A METABOLITE RISK SCORE TO PREDICT CORONARY HEART DISEASE IN A MIDDLE EASTERN POPULATION

2021 ◽  
Vol 77 (18) ◽  
pp. 107
Author(s):  
Ayman El-Menyar ◽  
Ehsan Ullah ◽  
Khalid Kunji ◽  
Reem Elsousy ◽  
Amna Al-Nesf ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Risk Score ◽  
Middle Eastern ◽  
Eastern Population ◽  
Middle Eastern Population

scholarly journals P157 Potential benefit of intravenous immunoglobulin in connective tissue disease associated interstitial lung diseases

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Vasilis Kouranos ◽  
Lauren V Host ◽  
Corrado Campochiaro ◽  
Athol Wells ◽  
Christopher P Denton ◽  
...  
Keyword(s):  
Lung Function ◽  
Connective Tissue ◽  
Lung Diseases ◽  
Immunosuppressive Treatment ◽  
Interstitial Lung Diseases ◽  
Ivig Treatment ◽  
Before And After ◽  
Predicted Values ◽  
Relative Change ◽  
Median Change

Abstract Background/Aims  Intravenous immunoglobulin (IVIg) confers significant benefit in range of connective tissue diseases (CTD) including inflammatory myopathy (IM) of which interstitial lung diseases (ILD) are a major complication. This study aimed to assess the efficacy of IVIg on pulmonary involvement in refractory active CTD including systemic sclerosis (SSc). Methods  All patients with CTD-ILD confirmed on HRCT either with IM or SSc overlap myositis who did not achieve satisfactory clinical response to standard immunosuppressive agents and subsequently received regular IVIg infusions for IM were retrospectively identified. Serial lung function tests and immunosuppressive treatment regimen 9-12 months prior and 9-12 months after repeat courses of IVIg were recorded. Progressive ILD was considered when, despite immunosuppressive treatment, a relative FVC decline≥10% and/or relative DLco decline ≥15% were identified during the 9-12 months preceding IVIg treatment. The significance of median DLco and FVC percentage relative change to IVIg treatment was assessed by Wilcoxon signed-rank test. Results  22 patients (mean age 50.5±13.1 years old) with IM-ILD treated with IVIg were identified. ILD occurred in association with IM in 10 patients, overlap SSc myositis in another 11 patients, while one had mixed connective tissue disease with myositis. Lung function results were available for 19/22 (86%). Eight patients (42.1%) were found to have progressive ILD(four with IM and four with overlap SSc-myositis). The median change in FVC% predicted and DLco% predicted in the 9-12 months before and after IVIg treatment is presented in Table 1. There was a significant difference in the DLco% predicted rate of relative change before and after IVIg treatment (p = 0.035) for the overall cohort. However, no differences in lung function were observed in the rate of relative change between patients with IM and patients with SSc myositis overlap. Significant improvement in DLco% predicted values was identified in the subgroup analysis of patients with progressive ILD(p = 0.012). P157 Table 1:The median change in FVC and DLco% predicted values prior and after the IVIg treatmentPatients with myositis related ILD9-12 months before IVIg treatment (relative change)9-12 months after IVIg treatment (relative change)p-valueAll (n = 19)FVC % predicted-3.8 (-54.4 - 14.6)2.1 (-33 - 33.7)0.145DLco % predicted-9.2 (-60.7 - 9.2)-2.3 (-26 - 41.9)0.035PM/DM (n = 10)FVC % predicted-1.8 (-20.2 - 14.6)0.8 (-33 - 30.9)0.401DLco % predicted-9.6 (-60.7 - 9.2)-2.4 (-26 - 41.9)0.093SSc-PM/DM overlap (n = 11)FVC % predicted-6 (-54.4 - 10.6)3.4 (-19.9 - 33.7)0.139DLco % predicted-10.8 (-47.1 - 2.5)4.2 (-22.7 - 16.8)0.173Progressive ILD (n = 8)FVC % predicted-14.5 (-54.4 - 14.6)5.7 (-11.9 - 33.7)0.123DLco % predicted-25.3 (-60.6 - -14.1)12 (-2.3 - 41.9)0.012 Conclusion  IVIg may be an effective rescue therapy in the prevention of further lung function decline in refractory myositis and SSc overlap in particular in subgroups with progressive ILD. Future studies to determine its role in CTD-ILD are warranted. Disclosure  V. Kouranos: None. L.V. Host: None. C. Campochiaro: None. A. Wells: None. C.P. Denton: None. V.H. Ong: None. E. Renzoni: None.

The Ideological Dimensionality in the Middle Eastern and North African Constitutions: A New Era in the Evolution of Islamic Constitutionalism

2020 ◽  
pp. 147892992091294
Author(s):  
Berna Öney
Keyword(s):  
Middle Eastern ◽  
Political Regime ◽  
North African ◽  
New Era ◽  
Regime Changes ◽  
Political Debates ◽  
Before And After ◽  
Popular Movements ◽  
Ideological Dimension

The popular movements in 2011 led to many regime changes that resulted in amended or new constitutions in the Middle East and North Africa region. The constitutional debates concentrated mainly on the functions of the constitutions in authoritarian regimes, constitution-making processes, and the role of Islam during and after the uprisings. However, no research has analyzed the ideological dimensionality of the Middle Eastern and North African constitutions. By analyzing 19 newly enacted, drafted, and amended constitutions before and after the popular movements in the region, this article shows that the single ideological dimension in the constitutions can be defined by the openness of a state for liberal and modern values. This ideological dimension encompasses all the regional political debates on the political regime dynamics, the inclusion of rights and liberties, and the role of Islam. Besides offering an alternative typology for the constitutions in the region, this article also provides evidence for the beginning of the fourth phase of Islamic constitutionalism that merges the ideas of rule of law, which originates from democratic notions, and Islamic norms.

scholarly journals TERT promoter mutations in thyroid cancer: a report from a Middle Eastern population

2015 ◽  
Vol 22 (6) ◽  
pp. 901-908 ◽  
Author(s):  
Ebtesam Qasem ◽  
Avaniyapuram Kannan Murugan ◽  
Hindi Al-Hindi ◽  
Mingzhao Xing ◽  
Mai Almohanna ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Middle East ◽  
Direct Sequencing ◽  
Tumour Size ◽  
Middle Eastern ◽  
Middle Eastern Population ◽  
Thyroid Adenomas ◽  
Cell Variant ◽  
Hürthle Cell Thyroid Cancer ◽  
Promoter Mutations

Telomerase reverse transcriptase (TERT) promoter mutations C228T and C250T have recently been described in follicular cell-derived thyroid cancer (TC) in patients from North America and Europe. In this study, we explored whether these findings could be replicated in patients from a different ethnic group. We screened 17 benign thyroid adenomas and 265 TC samples from patients in the Middle East for these mutations by PCR and direct sequencing using DNA isolated from paraffin-embedded tumor tissues. None of the 17 benign adenomas harbored TERT promoter mutations. Of 265 TC, 34 (12.8%) harbored TERT promoter mutations, including 10/153 (6.5%) conventional papillary TC (CPTC), 8/57 (14.0%) follicular variant PTC, 9/30 (30%) tall cell variant PTC, 1/3 (30%) Hurthle cell thyroid cancer (HTC), 1/5 (20%) follicular TC, and 5/13 (38.5%) poorly differentiated TC. C250T mutation was present in only 6/265 (2.3%) cases, while C228T mutation was present in a total of 28/265 (10.6%) cases. These two mutations were mutually exclusive. TERT promoter mutations were significantly more common in older (≥45 years) than younger patients and were associated with larger tumour size, vascular invasion, higher TNM stage (stage III and IV), BRAFV600E mutation and persistent/recurrent disease at 6–12 months after initial treatment and at the last follow up. These associations were stronger in non-CPTC. Thus, this study on a large cohort of TC patients from Middle East demonstrates that TERT promoter mutations are relatively common, especially in the non-CPTC, and are associated with more aggressive histopathological features, BRAFV600E mutation, and disease persistence/recurrence than the WT TERT.

scholarly journals Validation of the Framingham hypertension risk score in a middle eastern population: Tehran lipid and glucose study (TLGS)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatemeh Koohi ◽  
Ewout W. Steyerberg ◽  
Leila Cheraghi ◽  
Alireza Abdshah ◽  
Fereidoun Azizi ◽  
...  
Keyword(s):  
Simple Model ◽  
Risk Score ◽  
Screening Tool ◽  
Middle Eastern ◽  
Predictive Ability ◽  
Eastern Population ◽  
Hypertension Risk ◽  
Graphical Comparison ◽  
Middle Eastern Population

Abstract Background The Framingham hypertension risk score is a well-known and simple model for predicting hypertension in adults. In the current study, we aimed to assess the predictive ability of this model in a Middle Eastern population. Methods We studied 5423 participants, aged 20–69 years, without hypertension, who participated in two consecutive examination cycles of the Tehran Lipid and Glucose Study (TLGS). We assessed discrimination based on Harrell’s concordance statistic (c-index) and calibration (graphical comparison of predicted vs. observed). We evaluated the original, recalibrated (for intercept and slope), and revised (for beta coefficients) models. Results Over the 3-year follow-up period, 319 participants developed hypertension. The Framingham hypertension risk score performed well in discriminating between individuals who developed hypertension and those who did not (c-index = 0.81, 95% CI: 0.79–0.83). Initially, there was a systematic underestimation of the original risk score (events predicted), which was readily corrected by a simple model revision. Conclusions The revised Framingham hypertension risk score can be used as a screening tool in public health and clinical practice to facilitate the targeting of preventive interventions in high-risk Middle Eastern people.

scholarly journals Molecular Characterization of Prostate Cancer in Middle Eastern Population Highlights Differences with Western Populations with Prognostic Implication

2019 ◽  
Author(s):  
Ramy A. Abdelsalam ◽  
Ibrahim Khalifeh ◽  
Alan Box ◽  
Maria Kalantarian ◽  
Sunita Ghosh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Middle Eastern ◽  
Genomic Alteration ◽  
Published Data ◽  
Lower Grade ◽  
Eastern Population ◽  
Western Population ◽  
Pten Loss ◽  
Middle Eastern Population ◽  
Grade Groups

Abstract Background To investigate the incidence and prognostication of ERG, PTEN and SPINK1 protein expressions in prostate cancer cohort of Middle Eastern descent in comparison to published data from Western populationMethods Immunohistochemistry for ERG, PTEN and SPINK1 was performed in cohort of localized PCa (n=340). Data correlated to pathological and clinical outcomes and compared to Western populations.Results ERG expression and PTEN loss noted in 123/288 (42.7%) and 91/297 (30.6%) of patients, respectively. SPINK1 expression assessed in subset of cases, noted in 6/150 (4%) of patients. Only ERG expression was associated with grade groups, being more common in lower grade groups (1-3 vs 4-5; p=0.04). In contrast to Western population, PTEN loss foci were more likely to be ERG negative, observed in 81% of tumor foci and patients with PTEN neg/ERG pos were more likely to exhibit biochemical recurrence (OR 2.831; 95% CI: 1.10-726, p=0.03). This association remained significant in multivariate analysis (OR 2.68; 95% CI: 0.98-7.33, p=0.05), after adjusting for GG, path stage and surgical margin.Conclusion This study documents significant differences in key molecular events in PCa in Middle Eastern population compared to Western populations that could explain differences in PCa incidence, progression and prognostication. ERG, PTEN and SPINK1 genomic alteration occur less frequently and the enrichment of ERG for PTEN loss is not observed. Additionally, patients with combined PTEN loss/ERG positive are at highest rate for BCR vs North American Caucasian population where PTEN loss alone seems to be associated with the worst clinical outcome. The data presented here further support differences in clonal evolution between Middle Eastern and Western population in relation to PCa and add further insight to understanding PCa molecular pathways.

The More Ethnic the Face, the More Important the Race: A Closer Look at Colorism and Employment Opportunities among Middle Eastern Women

2020 ◽  
pp. 016059762093288
Author(s):  
Ahzin Bahraini
Keyword(s):  
United States ◽  
Middle Eastern ◽  
The United States ◽  
Political Climate ◽  
Structured Interviews ◽  
Middle Eastern Women ◽  
Middle Eastern Population ◽  
The Face ◽  
Study Participants ◽  
Middle Easterners

Colorism is the intra- and interracial discrimination an individual experiences based on one’s phenotype. Current research focused on colorism among black Americans has found that “dark-skinned blacks have lower levels of education, income, and job status” in the United States. As bias against Middle Easterners rises in the United States, current research regarding this population is scarce. In the context of today’s political climate, the term Muslim has become a misnomer to refer to the Middle Eastern population, with the term Islamophobia specifically referring to Middle Easterners regardless of their religion rather than individuals from regions of the world who practice Islam. Participants ordered job applicants in terms of who they would hire, followed by interviews. Through 16 semi-structured interviews, this project identifies what participants believe are phenotypically Middle Eastern and Muslim facial features. Throughout the study, participants preferred to hire lighter Middle Eastern women.

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