Bab Shar

Obesity is a complex and chronic disease affecting over 650 million adults worldwide, linked to many health problems including metabolic, cardiovascular, and musculoskeletal diseases. Metabolic and Bariatric Surgery (MBS) is currently the most effective long-term treatment for obesity, helping patients lose significant weight and improve related health conditions. However, MBS changes the digestive system in ways that disrupt nutrient absorption, raising risks of deficiencies or excessive vitamin intake, particularly vitamin B6 imbalance, which can cause nerve problems similar to other serious conditions. This study focuses on evaluating vitamin B6 levels after MBS and the impact of specialized supplementation. The trial compares three tailored Elan bariatric supplements—Believe, Compass, and Supreme—each designed for a specific type of MBS: sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and one-anastomosis gastric bypass (OAGB). Each supplement contains a standardized, conservative dose of vitamin B6 (400 micrograms daily), about 29% of the adult recommended daily allowance, allowing direct comparison of vitamin B6 status across different surgery types. These procedure-specific supplements address unique nutritional needs while maintaining consistent vitamin B6 dosing. Participants will be followed for 12 months after surgery with assessments at 6 and 12 months to monitor vitamin B6 levels and detect hypervitaminosis. The study will also evaluate overall micronutrient status, weight and body measurements, and how well participants follow the supplement regimen. The goal is to provide safer, procedure-specific vitamin supplementation guidelines for patients after metabolic and bariatric surgery.

Researchers are evaluating the long-term safety and effectiveness of etavopivat, a new oral medicine being developed to treat inherited blood disorders such as sickle cell disease and thalassemia. These disorders affect hemoglobin, the protein responsible for carrying oxygen in the body. This phase 3 study aims to monitor how well etavopivat works and its safety profile over an extended period. Participants will receive one of three forms of etavopivat (A, B, or C) as oral doses. The study is open-label and multicenter, involving adults, adolescents, and children who have previously completed treatment in an etavopivat parent study and continue to benefit clinically. The treatment period can last up to 264 weeks but may end earlier if etavopivat is approved in the participant's country. During the study, researchers will track the number of treatment-emergent adverse events and adverse reactions for each participant by indication and age group from baseline through the end of the study, which can last up to 316 weeks. Participants' safety and response to long-term treatment will be closely monitored throughout this period.

This research evaluates new ways to detect and manage Early Childhood Caries (ECC) using tele-detection methods combined with referral pathways. It aims to see how effective these methods are, both with and without removing user fees, in controlling ECC in children under 6 years old with only primary teeth. The study is a randomized factorial trial called the TRACE Study. The study uses two main caries detection devices: a specialized intraoral camera with fluorescence and color amplification modes to capture detailed videos and photos of a child's mouth, and a smartphone camera system that takes clear images of the upper and lower jaws. These images are transferred to an electronic platform. Children will be referred for dental care either through a conventional referral process without financial incentives or through a referral pathway where user fees and transportation costs are covered to encourage preventive dental visits. Participants and their guardians will be involved in screenings using these devices, and the study will track the percentage of teeth receiving care over 12 months. Care plans, treatment costs, and attendance at dental visits will be monitored. The study focuses on children younger than 6 years with only primary teeth, and results will help determine how tele-detection and referral methods can improve early childhood dental care.

Stage III periodontitis is a serious gum disease that damages the tissues supporting teeth. Researchers are evaluating whether adding an active oxygen-releasing gel, with or without photodynamic therapy, to standard scaling and root planing treatment can improve outcomes in patients with this condition. The oxygen-releasing gel releases oxygen to help reduce harmful bacteria, while photodynamic therapy uses a special dye and light to target bacteria and enhance gum health. In this randomized clinical trial, 42 patients with stage III periodontitis will be divided into three groups. One group will receive scaling and root planing plus the oxygen-releasing gel. A second group will get scaling and root planing plus the gel and photodynamic therapy using a diode laser. The third group will receive only scaling and root planing with ultrasonic and manual instruments. The oxygen gel is applied topically for 3 minutes, and photodynamic therapy involves a specific laser light treatment of the periodontal pockets. Participants will be evaluated at the start of the study and after one and three months. Researchers will measure gum health using the Modified Gingival Index, bleeding on probing, clinical attachment level, and probing pocket depth. They will also collect microbiological samples from periodontal pockets to assess bacteria levels related to periodontal disease. These assessments will help determine if the additional treatments improve gum health compared to standard care.

This research aims to evaluate whether an Artificial Intelligence (AI)-guided relaxation program can reduce anxiety and improve coping strategies in adult patients receiving maintenance hemodialysis, who often experience significant psychological stress and physical discomfort. The study uses a randomized controlled trial design comparing patient well-being before and after the AI-guided intervention during dialysis sessions. Researchers will measure anxiety, depression, coping skills, and relaxation levels, and also explore participants' experiences with the AI technology through interviews. Sixty adult patients will be randomly assigned to either an intervention group or a control group with 30 participants each. The intervention group will use an AI-driven relaxation platform that delivers personalized relaxation guidance and prompts lasting 20 to 30 minutes, two to three times per week during their dialysis sessions via a tablet or mobile device with headphones. The control group will receive standard nursing care during dialysis without the AI intervention. Data collection will occur at baseline and immediately after completing the 4 to 6 week intervention period. Participants will be assessed using standardized scales for anxiety and other psychological measures before and after the intervention. Researchers will also conduct semi-structured interviews with those in the intervention group to understand how they engaged with the AI program and how it affected their stress management. The study carefully monitors safety and collects data on changes in generalized anxiety levels throughout the trial.

Obesity is a widespread health issue affecting over one billion people globally and increasing the risk of conditions such as type 2 diabetes, cardiovascular diseases, and cancer. This research focuses on the chronic low-grade inflammation linked to obesity, particularly how it may contribute to the early development of gastric cancer by affecting immune cells like macrophages and mast cells in the stomach lining. The study aims to better understand the changes in these immune cells and blood vessel density in obese patients before cancer develops. The study compares two groups: obese patients undergoing bariatric surgery called laparoscopic sleeve gastrectomy, and lean control patients undergoing endoscopic biopsy for benign or malignant gastric conditions. Researchers assess the presence of adipose tissue macrophages, mast cells positive for tryptase, and microvascular density by examining stomach tissue samples using immunohistochemistry and detailed microscopic analysis. Participants will have tissue samples collected during their respective procedures, which are then analyzed to identify highly stained areas indicating immune cell infiltration and blood vessel formation. Researchers will evaluate these markers to understand the early events in gastric cancer development linked to obesity. The study includes careful preoperative evaluations and excludes participants with other conditions or treatments that might affect immune responses. This research may provide new insights into how obesity-related inflammation influences stomach tissue changes.

Researchers are evaluating the accuracy and feasibility of using oscillometry and fractional exhaled nitric oxide (FeNO) testing as diagnostic tools for asthma and chronic obstructive pulmonary disease (COPD) in primary care settings. The study addresses limitations of traditional spirometry, such as the need for forceful breathing maneuvers and specialized equipment, which can hinder timely diagnosis. This cross-sectional, observational study is conducted across six countries in the Middle East, Africa, Asia, and Latin America, comparing primary care diagnosis with specialist assessments. Primary care physicians will be trained to perform oscillometry and FeNO testing using standardized protocols and devices like the Ambulatory Lung Diagnosis System, following Global Initiative for Asthma (GINA) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Eligible patients with suspected asthma or COPD will undergo symptom questionnaires and these diagnostic tests during a single visit. If specialist evaluation cannot be completed the same day, it will occur within three days. No follow-up visits are planned. Participants will provide informed consent and complete history and symptom questionnaires. Researchers will assess diagnostic accuracy by comparing primary care test results with specialist diagnoses, measuring agreement, sensitivity, and specificity over 1 to 3 days. The study aims to inform the potential integration of oscillometry and FeNO testing into routine primary care to improve early, reliable diagnosis of asthma and COPD, without requiring extended follow-up.

Researchers are studying changes in the labial bone plate following immediate implant placement in Type II extraction sockets located in the esthetic zone. This randomized clinical trial compares two different xenograft materials combined with a de-epithelialized free gingival graft to evaluate their effects on bone preservation and implant success. The goal is to provide evidence about which xenograft material better maintains bone and soft tissue shape after tooth extraction and immediate implant placement. Participants needing tooth extraction and immediate implant placement will be randomly assigned to one of two groups. Each group will receive immediate implant placement with gap grafting using either the Medpark S1 xenograft or the bio-Oss xenograft. Both procedures are designed to support the implant and surrounding tissues in the esthetic zone. The study focuses on Type II extraction sockets where preserving bone thickness is especially challenging. During the study, clinical assessments and standardized radiographic scans using CBCT will be performed to measure changes in labial bone plate thickness and peri-implant bone stability. Researchers will evaluate implant success and dimensional bone changes over a defined follow-up period, with the primary outcome being labial bone plate thickness change six months after implant placement. Patient compliance and health will be closely monitored to ensure safety and data integrity throughout the trial.

Researchers are evaluating the effectiveness of two different methods of delivering autologous nanofat grafts to improve post-burn and traumatic atrophic scars. The study compares direct injection of nanofat grafts to delivery using microneedling. This research focuses on managing scars that have been present for more than six months in adults aged 18 to 60 years. Participants will receive either an injection of nanofat grafts or microneedling combined with nanofat graft delivery. Both procedures involve applying the participant's own processed fat cells to the scarred area. The study does not involve any other treatments during the participation period. The study groups are designed to assess which method better improves the appearance and condition of atrophic scars caused by burns or trauma. During the study, participants' scars will be evaluated using the Patient and Observer Scar Assessment Scale (POSAS) six months after treatment. Researchers will monitor changes in the scars to measure treatment outcomes. Participants should not have received any scar treatments within three months prior to enrollment. The total study period includes initial treatment and follow-up assessments to track scar improvement and safety.

Researchers are evaluating different methods of blocking blood flow through the uterine arteries during laparoscopic myomectomy to see how these techniques affect blood loss and ovarian health in women with uterine fibroids. This controlled, randomized trial is conducted at two gynecological centers in Alexandria, Egypt, and focuses on women planning laparoscopic myomectomy who meet specific eligibility criteria. The main goal is to compare intraoperative blood loss and changes in hemoglobin levels after surgery, along with the impact on ovarian reserve and surgery time. Participants will be randomly assigned to one of four groups: temporary clipping of both uterine arteries, temporary occlusion using a shoelace suture technique, permanent occlusion using bipolar coagulation, or no occlusion (control group). Each procedure is performed before or during the laparoscopic myomectomy. The temporary occlusion methods involve removing clips or sutures after the myomectomy, while the permanent method coagulates the arteries before surgery. During the study, participants will undergo laparoscopic myomectomy with their assigned artery occlusion technique or no occlusion. Researchers will measure blood loss during surgery and check hemoglobin levels 24 hours afterward. They will also monitor ovarian reserve and record the time needed to perform the artery occlusion. Safety and surgical outcomes will be observed throughout the trial.