Bab Shar

Diffuse large B-cell lymphoma DLBCL is the most common and aggressive subtype of non-Hodgkin lymphoma, with rapid tumor growth and symptoms varying by tumor location. The disease is classified using advanced methods like immunohistochemistry and molecular testing to guide prognosis and personalized treatment. Despite standard immunochemotherapy curing 60-70% of patients, many experience treatment failure or relapse, and options after second-line therapies remain limited. This observational study examines treatment patterns, demographic, and clinical characteristics of DLBCL patients in the Middle East and Africa. It includes two patient groups those newly diagnosed and eligible for treatment, and those with relapsed or refractory DLBCL who have failed previous therapies. The study aims to explore access to novel therapies and understand real-world treatment approaches in these regions. Participants will be observed over 22 months, during which researchers will document treatment regimens, patient risk profiles, and access to new treatments. Data collection includes patient demographics, disease characteristics, and treatment outcomes. The study does not involve experimental treatments but gathers detailed information to inform future care strategies for DLBCL patients.

Obesity is a complex chronic disease affecting over 650 million adults worldwide and is linked to many health problems including metabolic, cardiovascular, and musculoskeletal conditions. Metabolic and Bariatric Surgery MBS is an effective long-term treatment for obesity, supporting sustained weight loss and remission of related diseases. However, MBS causes changes in digestion and nutrient absorption, leading to risks of vitamin imbalances, especially vitamin B6 deficiency or excess, which can cause nerve problems. This trial studies three specialized Elan bariatric supplements designed with a consistent, low dose of vitamin B6 400 micrograms daily tailored for patients undergoing one of three MBS types sleeve gastrectomy SG, Roux-en-Y gastric bypass RYGB, or one-anastomosis gastric bypass OAGB. Participants will receive the supplement matching their surgery type to compare vitamin B6 levels and overall micronutrient status. The study aims to identify risks of vitamin B6 toxicity or deficiency and assess supplement adherence and changes in body measurements. Participants will be monitored at 6 and 12 months after surgery with blood tests measuring vitamin B6 and other nutrients, body measurements, and adherence questionnaires. Researchers will evaluate the prevalence of vitamin B6 imbalance, related micronutrient deficiencies, and links between supplement use and clinical outcomes. The study lasts 12 months postoperatively, providing insights to improve vitamin supplementation safety after bariatric surgery.

Researchers are evaluating the long-term safety and effects of etavopivat, a new oral medicine being developed for inherited blood disorders such as sickle cell disease and thalassaemia. These conditions affect haemoglobin, the protein responsible for carrying oxygen in the blood. This phase 3 study involves participants who have already completed treatment in a prior etavopivat study and aims to understand how etavopivat performs over an extended period of up to 264 weeks, though the study may end earlier if the drug gains approval locally. Participants will receive oral doses of etavopivat, with different forms A, B, or C given based on their age and condition. Those aged 12 years and older will receive etavopivat A or C, while children under 12 years will receive etavopivat B. The study includes several groups covering various sickle cell disease and thalassaemia categories, including transfusion-dependent and non-transfusion-dependent cases. Treatment is continuous during the study period. Throughout the study, participants will undergo regular monitoring for side effects and treatment responses, including tracking treatment emergent adverse events, hospitalizations, vaso-occlusive crises, hemoglobin concentration changes, and blood transfusion needs. These assessments will help evaluate the drugs safety and efficacy across age groups and disease types. The study is open-label and non-randomized, with follow-up lasting up to about six years.

Researchers are evaluating treatments for stage III periodontitis, a serious gum disease that harms the tissues supporting teeth. The study aims to see if adding an active oxygen-releasing gel, with or without photodynamic therapy, improves outcomes beyond the standard scaling and root planing treatment. Photodynamic therapy uses light and a special dye to target harmful bacteria that cause gum inflammation. The trial randomly assigns 42 patients into three groups. One group receives scaling and root planing plus the oxygen-releasing gel applied to the gums for 3 minutes. The second group receives the same treatment plus photodynamic therapy using a diode laser and a photosensitizer dye. The third group receives only scaling and root planing using ultrasonic tools and curettes. These treatments are given in single sessions. Participants will have their gum health checked at the start, and then one and three months after treatment. Measurements include gingival index, bleeding on probing, pocket depth, and attachment level using periodontal probes. Researchers will also collect bacteria samples from gum pockets to measure specific harmful bacteria levels using quantitative PCR. The study runs until May 2026 and monitors changes over time to evaluate treatment effects.

Researchers are investigating whether an artificial intelligence AI-guided relaxation program can help reduce anxiety and improve coping skills in adults undergoing maintenance hemodialysis. This study focuses on patients with end-stage renal disease who often experience significant stress and discomfort during dialysis. The trial uses a randomized controlled design to compare patient well-being before and after using the AI intervention against standard care. Sixty adult patients will be randomly assigned to one of two groups an intervention group receiving AI-driven relaxation sessions during their dialysis treatments, and a control group receiving routine nursing care without AI. The AI program offers personalized relaxation techniques like deep breathing, progressive muscle relaxation, guided imagery, and mindfulness through a digital platform with headphones. These sessions last 20 to 30 minutes, occurring two to three times weekly over four to six weeks. Participants will be assessed before and after the intervention using standardized questionnaires measuring anxiety, depression, coping strategies, and perceived relaxation. The study also includes interviews with participants in the intervention group to explore their experiences with the AI technology. Data collection aligns with the 4-6 week treatment period, aiming to understand both quantitative changes and personal impacts. Safety and adherence are monitored throughout the study.

Obesity is a widespread health concern affecting over a billion people globally and increasing the risk of serious conditions like type 2 diabetes, heart disease, and cancer. Research shows that the chronic low-level inflammation linked to obesity plays a key role in developing obesity-related cancers, including gastric cancer. This inflammation results from changes in fat tissue that attract immune cells like macrophages and mast cells, which create a pro-inflammatory environment by releasing various signaling molecules. This observational study examines changes in the stomach lining of obese patients, especially focusing on mast cells, macrophages, and the density of small blood vessels. It uses tissue samples collected from adults undergoing bariatric surgery called laparoscopic sleeve gastrectomy, as well as from lean patients having biopsies for other gastric conditions. Researchers analyze these tissues using immunohistochemistry and morphometric techniques to assess immune cell infiltration and blood vessel formation, which may help understand early cancer development linked to obesity. Participants will undergo preoperative evaluations including blood tests and assessments by a team of specialists before surgery or biopsy. The study measures immune cell presence and vessel density in the gastric tissue samples as primary outcomes. Researchers aim to clarify the immunopathological changes in the gastric mucosa before any overt cancer appears. The studys duration and follow-up details are based on the timing of tissue collection and evaluations, with no long-term treatment interventions involved.

Researchers are evaluating new diagnostic methods for asthma and chronic obstructive pulmonary disease COPD that can be used in primary care settings. Traditional spirometry relies on patients ability to perform forceful breathing maneuvers, which can be challenging and limit accurate diagnosis. This observational study aims to assess how well oscillometry and fractional exhaled nitric oxide FeNO testing work compared to specialist diagnosis, across six countries in the Middle East, Africa, Asia, and Latin America, to improve early and reliable detection of asthma and COPD. Primary care physicians will be trained to use oscillometry and FeNO testing following international guidelines and will use devices like the Ambulatory Lung Diagnosis System. Patients suspected of having asthma or COPD will be assessed through history, symptom questionnaires, and these tests. If specialist evaluation is not possible on the same day, it will occur within three days. No follow-up visits are planned. The study compares diagnosis accuracy and feasibility between primary care and specialist settings. Participants will provide consent and complete symptom questionnaires, followed by primary care assessments including oscillometry and FeNO testing. Researchers will measure the accuracy of primary care diagnoses against specialist diagnoses using statistical methods and observe agreement, sensitivity, and specificity within one to three days. The study does not require further follow-up, aiming to inform integration of these diagnostic tools into routine primary care for better asthma and COPD identification.

Researchers are evaluating changes in the labial bone plate after immediate implant placement in Type II extraction sockets using two different xenograft materials along with a de-epithelialized free gingival graft in the esthetic zone. This randomized clinical trial aims to compare the effects of these grafting materials on bone preservation and implant success. The study addresses concerns about bone changes following tooth extraction and immediate implant placement, focusing on maintaining bone and soft tissue structure in the front upper jaw area. Participants will undergo immediate implant placement after tooth extraction in the esthetic zone. They will be randomly assigned to one of two groups receiving defect grafting with either Medpark S1 xenograft or bio-Oss xenograft. Both groups will also receive a de-epithelialized free gingival graft during the procedure. The interventions involve placing the implant and grafting material in the extraction socket to support bone and tissue preservation. During the study, clinical evaluations and standardized radiographic assessments using CBCT scans will be conducted to measure changes in labial bone plate thickness and peri-implant bone stability. Implant success will be monitored over a follow-up period of six months. Researchers will assess outcomes such as bone thickness changes and peri-implant mucosal levels, ensuring participants compliance and safety throughout the trial.

Researchers are evaluating two ways of delivering autologous nanofat grafts to treat post-burn and traumatic atrophic scars. The study compares injections of nanofat grafts with microneedling combined with nanofat grafts to see which method better improves scar appearance. This interventional trial is sponsored by Alexandria University and focuses on adults with scars lasting more than six months. Participants will have two scars with similar properties treated differently one scar or part of a large scar will receive nanofat graft injections, while the other scar or part will be treated with microneedling combined with nanofat grafts. Both treatments involve procedures using the patients own nanofat tissue. The study is non-randomized and does not use masking. During the study, researchers will assess changes in the scars using the Patient and Observer Scar Assessment Scale POSAS six months after treatment. Participants must be adults aged 18 to 60 years with scars older than six months and not currently receiving other scar treatments. The study excludes certain types of scars and participants with specific medical conditions. The total follow-up period for outcomes is six months after the procedures.

This research aims to evaluate treatments for children aged 5 to 7 years who have deep cavities in their second primary molars that need vital pulp therapy. The study compares two materials, MTA and bioceramic putty, used for pulpotomy, followed by full coverage of the teeth with either stainless steel crowns or 3D printed resin crowns. The trial is a randomized controlled clinical study sponsored by Alexandria University. During treatment, caries will be removed from the affected molars reaching the pulp, and pulpotomy will be performed by controlling bleeding. The pulp chamber will be covered with either MTA or bioceramic putty. Resin-modified glass ionomer will then be placed, and the tooth will be prepared for a full crown. Participants will receive either stainless steel crowns or digitally designed 3D printed resin crowns created using advanced scanning and printing technology. Participants will be monitored at 1 week, 6 months, and 12 months after treatment to assess clinical and radiographic success of the pulpotomy. Crowns will be evaluated at 6 and 12 months using a standardized dental service scale. Both parental and child satisfaction regarding the appearance, color, size, durability, and overall outcome will be measured immediately and at follow-up visits. The study will track these outcomes throughout the planned observation period ending in 2027.