Faculty of Medicine and Surgery
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Item PI3K/AKT/mTOR Pathway in Breast Cancer Pathogenesis and Therapy: Insights into Phytochemical-Based Therapeutics(Nutrition and Cancer, 2025) Wali, Adil Farooq; Talath, Siajunisa; El Tanani, Mohamed; Rangraze, Imran Rashid; Babiker, Rasha; Shafi, Sadat; Bansal, RubyBreast cancer (BC) is listed as the most prevalent cancer form in women worldwide, with major subtypes classified by hormone receptor (HR) and HER2 status including, HR+/HER2– (~65–70%), HER2+ (~15–20%), Triple-Negative-HR–/HER2– (~10–15%) and rare sybtypes (<5%). Scientific evidence has revealed that PI3K/AKT/mTOR signaling cascade plays an important role in the development and progression of BC, contributing to key cellular processes including cell growth, proliferation, angiogenesis, and metastasis. Dysregulation of the components of this cascade including functional loss of Phosphatase and TENsin homolog (PTEN), PI3K hyperactivation, and gain-of-function of AKT, are frequently observed in BC subtypes, making it a promising target for therapeutic intervention. A myriad of studies have documented the potential of phytochemicals, including curcumin, chrysin, fisetin, genistein, resveratrol and lycopene as modulators of the PI3K/AKT/mTOR axis. These phytochemicals exhibit multifaceted mechanisms of action, including inhibition of key kinases, induction of apoptosis, suppression of angiogenesis, and reversal of resistance to chemotherapy. This review aims to provide a detailed overview about the role of PI3K/AKT/mTOR alteration in BC development and the current research on phytochemicals that modulate the PI3K/AKT/mTOR pathway in BC. We documented the molecular mechanisms through which these compounds exert their effects, their potential synergistic interactions with conventional therapies, and the challenges and prospects for their clinical application. The evidence presented underscores the promise of phytochemicals as novel, less toxic adjuncts to traditional BC therapies, warranting further exploration and development for clinical useItem Effect of Gum Arabic (Acacia Senegal) supplementation on visceral adiposity index (VAI) and blood pressure in patients with type 2 diabetes mellitus as indicators of cardiovascular disease (CVD): a randomized and placebo-controlled clinical trial(Lipids in Health and Disease, 2018) Babiker, Rasha; Elmusharaf, Khalifa; Keogh, Michael B.; Saeed, Amal M.Background: There is a strong association between cardiometabolic risk and adipose tissue dysfunction with great consequences on type 2 diabetic patients. Visceral Adiposity Index (VAI) is an indirect clinical marker of adipose tissue dysfunction. Gum Arabic (GA) is a safe dietary fiber, an exudate of Acacia Senegal. Gum Arabic had shown lipid lowering effect in both humans and animals. The aim of this trial was to determine the effect of GA supplementation on anthropometric obesity marker, Visceral Adiposity Index (VAI) and blood pressure in patients with type 2 diabetes mellitus. Methods: This randomized, double blinded, placebo controlled trial recruited a total of 91 type 2 diabetic patients (73 females, 18 males), age (mean ±SD) 50.09±9.3 years on hypoglycemic agents and were randomly assigned into two groups, either to consume 30 g of GA or 5 g of placebo daily for 3 months. Anthropometric obesity markers were measured and indices were calculated. Blood pressure was measured and high density lipoprotein (HDL) and triglycerides (TG) were determined in fasting blood samples at the start and end of the study period. Results: After intervention, Gum Arabic decreased BMI and VAI significantly (P < 0.05) in GA group by 2 and 23.7% respectively. Body adiposity index significantly decreased by 3.9% in GA group while there were no significant changes in waist circumference or waist-to-hip ratio (WHR). Systolic blood pressure significantly decreased by 7.6% in GA group and by 2.7% in placebo group from baseline with no significant changes in diastolic blood pressure in the two groups. Conclusion: Gum Arabic consumption at a dose of 30 g/d for 3 months may play an effective role in preventing weight gain and modulating adipose tissue dysfunction in type 2 diabetic patients, although no effect has been shown in waist-to-hip ratioItem Unraveling the tumor microenvironment: Insights into cancer metastasis and therapeutic strategies(Cancer Letters, 2024) El-Tanani, Mohamed; Rabbani , Syed Arman; Babiker, Rasha; Rangraze, Imran; Kapre, Sumedha; Palakurthi, Sushesh Srivastsa; Alnuqaydan, Abdullah M.; Aljabali, Alaa A.; Rizzo, Manfredi; El-Tanani, Yahia; Tambuwala, Murtaza M.This comprehensive review delves into the pivotal role of the tumor microenvironment (TME) in cancer metastasis and therapeutic response, offering fresh insights into the intricate interplay between cancer cells and their surrounding milieu. The TME, a dynamic ecosystem comprising diverse cellular and acellular elements, not only fosters tumor progression but also profoundly affects the efficacy of conventional and emerging cancer therapies. Through nuanced exploration, this review illuminates the multifaceted nature of the TME, elucidating its capacity to engender drug resistance via mechanisms such as hypoxia, immune evasion, and the establishment of physical barriers to drug delivery. Moreover, it investigates innovative therapeutic approaches aimed at targeting the TME, including stromal reprogramming, immune microenvironment modulation, extracellular matrix (ECM)-targeting agents, and personalized medicine strategies, highlighting their po tential to augment treatment outcomes. Furthermore, this review critically evaluates the challenges posed by the complexity and heterogeneity of the TME, which contribute to variable therapeutic responses and potentially unintended consequences. This underscores the need to identify robust biomarkers and advance predictive models to anticipate treatment outcomes, as well as advocate for combination therapies that address multiple facets of the TME. Finally, the review emphasizes the necessity of an interdisciplinary approach and the integration of cutting-edge technologies to unravel the intricacies of the TME, thereby facilitating the development of more effective, adaptable, and personalized cancer treatments. By providing critical insights into the current state of TME research and its implications for the future of oncology, this review highlights the dynamic and evolving landscape of this field.Item Neurological Manifestation among Patients with Visceral Leishmaniasis at the Tropical Teaching Hospital – Khartoum(Zagazig University Medical Journal, 2023) Ebrahim, Ahmed Alameleman Edris; Saeed, Mohammed Khalfallah; Nail, Abdelsalam; Abdelmalik, Rawan Iz Eldin Mohamed; Mohammed, Eltayeb Abdalla; Ahmed, Sali Elhaj; Ahmed, Ahmed Abdelaziz; Babiker, Rasha; Ali, Ibrahim ABackground: Leishmaniasis is an endemic disease in Sudan that caused by Leishmania spp. Several studies suggest neurological manifestations in visceral leishmaniasis, such as burning sensation, and weakness. This study was aimed to assess the frequency of the neurological manifestations in Visceral Leishmaniasis. Methods: This is a descriptive, prospective cohort study, was conducted in The Tropical Teaching Hospital – Khartoum for one-year duration. A pretested questionnaire contained the study variables were conducted, nerve conduction Study (NCS) and laboratory tests were done. SPSS v 26.0 was used to analyze the data. Results: Forty four percent of total patients (22/50) were symptomatic.Peripheral neuropathy was elicited in 60% (30/50), Numbness has been the most common feature 56.6% (17/30), and Weakness 26.6% (8/30) all were Axonal damage. Sensorimotor neuropathy was exhibited in 70% (21/30), pure motor neuropathy in 26.7% (8/30). Polyneuropathy was encountered in 46.6% (14/30), poly-radiculopathy in 20% (6/30) along with 23.3% (7/30) as mononeuropathy. Conclusions: peripheral neuropathy was developed in patients with visceral leishmaniasis, frequent occurrence of subclinical neurological manifestations is higher than reported.Item Comparative Efficacy of Immune Checkpoint Inhibitors and Therapeutic Vaccines in Solid Tumors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials(Vaccines, 2025) Babiker, Rasha; Wali, Adil Farooq; El-Tanani, Mohamed; Rabbani, Syed Arman; Rangraze, Imran; Satyam, Shakta Mani; Patni, Mohamed Anas; El-Tanani, YahiaBackground: Immune checkpoint inhibitors (ICIs) and therapeutic vaccines have emerged as promising immunotherapeutic strategies for solid tumors. However, their comparative efficacy in improving overall survival (OS) remains unclear. This systematic review and meta-analysis aimed to evaluate the efficacy of ICIs and therapeutic vaccines in improving OS in patients with solid tumors. Methods: A comprehensive search was con ducted across PubMed, Cochrane Library, Embase, and Clinical Trials.gov for randomized controlled trials (RCTs) published between 1 January 2010 and 31 December 2024. Studies comparing ICIs or therapeutic vaccines against control treatments (placebo, standard of care, or active comparators) in adults with solid tumors were included. The primary out come was OS, and data were pooled using RevMan (web). Risk of bias was assessed using the Cochrane Risk of Bias tool. Results: Thirteen RCTs involving 10,991 participants were included. A total of 5722 of them were treated with therapeutic vaccines or checkpoint inhibitors. Therapeutic vaccines demonstrated insignificant improvement in OS, with a pooled mean difference of 1.89 months (95% CI: −0.54–4.31; P = 0.13), although with homo geneity (I2 = 0%). ICIs showed a statistically significant OS benefit, with a pooled mean difference of 1.32 months (95% CI: 0.62–2.02; P = 0.0002) and low heterogeneity (I2 = 12%). Conclusions: Therapeutic vaccines provide a larger but less consistent benefit, whereas ICIs offer modest but more consistent survival advantage. These findings support the need for personalized immunotherapy approaches as well as further research to identify predictive biomarkers and optimize treatment strategies by acquiring deep insights into the TMEdynamic and behaviors.Item Metformin: A Dual-Role Player in Cancer Treatment and Prevention: A Comprehensive Systematic Review and Meta-Analysis(Medicina, 2025) Rangraze, Imran; Wali, Adil Farooq; El-Tanani , Mohamed; Patni , Mohamed Anas; Rabbani, Syed Arman; Babiker, Rasha; Satyam, Shakta Mani; El-Tanani, Yahia; Rizzo, ManfrediBackground and Objectives: Metformin is said to reduce the incidences and deaths resulting from cancer in patients suffering from type 2 diabetes mellitus, but the results have been inconsistent. Perform a systematic review and meta-analysis concentrating on the different outcomes of several cancers while taking into account the impact of metformin use. Materials and Methods: As of 15 October 2024, the literature for Medline, Embase, and WebofScience was systematically searched. ROBINS-I and the RoB 2 tool were used for assessing the risk of bias in observational studies and randomized controlled trials (RCTs), respectively. The strength of the evidence with respect to the GRADE criteria was checked. Random effects meta-analyses were conducted alongside sensitivity analyses, subgroup analyses, and meta-regressions. By utilizing funnel plots as well as Egger’s test and trim-and-fill analysis, publication bias was evaluated. Results: In total, 65 studies were included in the final analyses: Metformin intake was linked to a lower risk of cancer (RR 0.72; 95% CI: 0.64–0.81, I2 = 45%). Significant reductions were observed in breast cancer (RR 0.68; 95% CI: 0.55–0.83) and colorectal cancers (RR 0.62; 95% CI: 0.51–0.76). Evidence certainty fluctuated from moderate to low, though analyses confirmed the results. Plofs funded the publication bias, but adjustment in trim-and-fill did not change the outcome significantly. Conclusions: Metformin intake seems to lower the chances of developing several types of cancers, especially breast and colorectal cancers, but the observational designs hinder determining the causal factors for observational studies. There is a need for large RCTsItem Unveiling the perceptions of medical and allied health students towards cadaveric dissection and virtual resources in anatomy education: a cross sectional study(BMC Medical Education, 2025) Elbeshbeishy, Rana; Salama, Rasha; Goud, BK Manjunatha; Babiker, Rasha; Jhancy, Malay; Hamed, Nour; Oraby, Farah; Merghani, TarigBackground Cadaveric dissection has long been a cornerstone of anatomy education, offering unparalleled hands-on experience that fosters both intellectual and emotional growth in medical students. It plays a crucial role in shaping professional identity while enhancing anatomical understanding. However, the emergence of digital platforms, including virtual reality (VR), augmented reality (AR), and 3D modeling, presents new opportunities to transform anatomy education. Objectives This study explores the perceptions of medical and health sciences students at Ras Al Khaimah Medical and Health Sciences University (RAKMHSU) regarding the integration of digital tools alongside traditional cadaveric dissection. By comparing attitudes toward these approaches, the study aims to identify strategies like using 3D models, animations, and interactive apps to familiarize students with anatomical structures before entering the dissection lab for harmonizing traditional and digital learning methods to optimize anatomy education. Methods This cross-sectional study was conducted over seven months using an anonymous, structured 20-item questionnaire administered to 454 students from various health disciplines at Ras Al Khaimah Medical and Health Sciences University. A convenience sampling method was used. The questionnaire assessed sociodemographic data, attitudes toward cadaveric dissection, its significance in practical learning, comparisons with digital resources, and its role in professional development. Institutional approval was obtained, and informed written consent was secured from all participants before the study commenced. Results Medical students expressed significantly stronger support for cadaveric dissection compared to allied health students, particularly regarding emotional engagement (p < 0.05), perceived educational value (p < 0.001), and comfort with handling cadavers (p < 0.001). While both groups acknowledged the benefits of digital resources, medical students reported greater improvements in visualization, confidence, and interactive learning (p < 0.01). Conclusion Cadaveric dissection remains an essential pillar of anatomy education, offering irreplaceable benefits in anatomical comprehension and psychomotor skill development. This study highlights its role in fostering professional attributes while demonstrating that digital platforms serve as valuable complementary tools. Rather than replacing cadaveric dissection, these digital innovations enhance learning by creating a synergistic educational environment.Item Development and application of a learning enjoyment scale for pedagogical activities [version 2; peer review: 2 approved](F1000Research, 2024) Merghani, Tarig; Babiker, Rasha; Alawad, Azza O.The impact of learning enjoyment on motivation, enthusiasm, and overall learning experiences is significant. Previous studies, lacking an unbiased tool for measuring enjoyment and confronting various influencing factors, produced conflicting results regarding enjoyment levels in different instructional methods. Hence, we developed a learning enjoyment scale for evaluating both active and passive educational activities. We applied the developed scale to 112 first-year medical and dental students to assess their enjoyment during didactic physiology lectures and explored possible associated factors. Within this data note, we present students’ responses to the developed LES. The LES encompasses six dimensions: knowledge, comprehension, application, analysis, concentration, and enjoyment. Students provided ratings for each dimension on a five-point Likert scale, spanning from 1 (strongly disagree) to 5 (strongly agree). The cumulative scores across the six dimensions range from a minimum of 6 to a maximum of 30. These total scores can be categorized as excellent (> 24), acceptable (18-24), or low (< 18). The second section of the dataset examines specific factors influencing overall enjoyment, such as teacher proficiency, topic difficulty, active student participation, objectives fulfillment, low stress levels, and self perceived acquisition of skills. In addition to objective measurement of students’ enjoyment level, the LES can be utilized for quantitative cross-comparisons between different teaching activities. By employing this dataset, we will undertake an analysis to determine the internal consistency of the Learning Enjoyment Scale (LES), with the anticipation that the outcomes will be published in another venueItem IMMUNOMETABOLIC CORRELATIONS OF AUTOANTIBODIES IN LATENT AUTOIMMUNE DIABETES IN ADULTS PATIENTS (LADA): A CROSS-SECTIONAL STUDY(GEORGIAN MEDICAL NEWS, 2025) Elebaid, Asia; Khalid, Mosab; Saeed, Abdelwahab A.; Higazi, Hassan; Abdalhabib, Ezeldine K; Babiker, Rasha; Yousif, Tagwa Yousif Elsayed; Mahagoub, Maha; Osman, Hussam Ali; Gaffer, Amged; Fadl Elmula, Tarig Mohamed; Ismail, May K.; Rakhmatbayevna, Karimova Feruza; Yusupov, Shukhrat Abdurasulovich; Babker, Asaad; Ismail, Marwan; Alfeel, AymanBackground: As a form of diabetes mellitus, latent autoimmune diabetes in adults (LADA) shares the features of both type 1 diabetes mellitus and type 2 diabetes mellitus, which can result in misdiagnosis at the early stage of insulin independence. However, we have limited knowledge about the relations between immunological, anthropometric and clinical parameters in LADA, mainly in Sudanese subjects. Objective: We aimed to assess the prevalence of LADA in patients with T2DM and to investigate associations between autoantibodies, C-peptide, anthropometry, and clinical characteristics. Methods: A cross-sectional comparative study was conducted from April 2020 to January 2024 in Osman Degna Hospital and Ahmed Hassan Diabetic Center. A total of 250 patients with type 2 diabetes were included in the study: 150 on insulin treatment several years after diagnosis (study group) and 100 patients not using insulin (control group). Structured interviews were used to obtain demographic, clinical and lifestyle information. C-peptide, GADA, and IA-2A autoantibodies in serum were detected by the MAGLUMI-800 chemiluminescence immunoassay. Results: The prevalence of LADA was 10.7%. The mean C-peptide level was significantly lower in patients with LADA as compared to non-LADA patients (0.50±0.18 vs. p0.7, p<0.001], whilst C-peptide levels negatively correlated with GADA concentrations [r=-0.65, p<0.001]. Inverted correlations were found for autoantibody titers and BMI, waist, weight (p<0.01), showing a link of autoimmune activity with leaner phenotypes and less preserved β cell function. Conclusion: LADA is under recognized with (10.7%), GADA as a significant early marker. Its close associations with C-peptide and anthropometric indices underline its autoimmune-metabolic profile.Item Advancements in non-invasive biomarkers for detection and monitoring of breast cancer recurrence(SCIENCE PROGRESS, 2025) El-Tanani, Yahia; El-Tanani, Mohamed; Rabbani, Syed Arman; Babiker, Rasha; Satyam, Shakta ManiBreast cancer recurrence remains a major cause of mortality, with up to 30% of early stage patients relapsing as incurable metastatic disease. Conventional surveillance with imaging and serum markers (CA15–3, CEA) lacks the sensitivity and specificity to detect minimal residual disease. This narrative review examines non-invasive biomarkers such as circulating tumor DNA (ctDNA), circulating tumor cells (CTCs) and exosomes and the technologies enhancing their performance. Droplet digital PCR and next-generation sequencing detect ctDNA at allele frequencies below 0.1%, identifying molecular relapse a median of 10–12 months before radiologic progression. Microfluidic and affinity-based platforms isolate CTCs with over 75% sensitivity in metastatic settings. Nanoengineered sensors and standardized workflows improve exosome isolation, revealing miRNA and protein signatures predictive of recurrence. Proteomic and metabolomic profiling iden tify dysregulated metabolic pathways and protein networks, offering functional insights that complement molecular assays. Integrative multi-omics approaches merge genomic, transcriptomic, proteomic and metabolomic data; machine-learning frameworks detect subtle patterns and correlations, enabling dynamic, personalized surveillance. By detect ing molecular and functional biomarkers early, clinicians can tailor therapy, monitor treatment response and intervene promptly. Challenges include low analyte abundance, assay variability, high costs and lack of standardized protocols, limiting clinical adoption. Prospective validation in large cohorts is critical. We highlight ongoing clinical trials such as ctDNA-guided adjuvant therapy and CTC-driven stratification studies that aim to establish clinical utility. Non-invasive biomarker platforms could shift breast cancer fol low-up from reactive detection to proactive intervention, ultimately improving survival and quality of life through personalized, real-time monitoring.