The Journal of Middle East and North Africa Sciences

5

Authors: Warren T. Blume; Mashael Al. Khateeb; Salah Baz

Objective: To demonstrate that the semiology of human bilateral tonic motor seizures evolves intra-ictally and that their full description should comprise this evolution. Method: We scrutinized sequential tonic phenomena of bilateral motor seizures as recorded by video-EEG telemetry among 15 adult patients investigated because of intractable epilepsy. Seizures were divided into sequential stages, each defined as a tonic motor posture maintained for at least three seconds. As posture reflects joint involvement and its principally flexor or extension contour, results are expressed by joints as opposed to patients. Only the first seizure of each patient meeting all criteria are included. All four limbs had to be involved for three consecutive stages for inclusion. Two authors (SB, WB) each independently assessed ictal evolution, rare discordances (rare werer esolved by mutual review. Results: The tonic motor component of each of 15 seizures evolved intra-ictally. More joints were involved in seizure stages two and three than in stage one, except cephalic version, which occurred principally in, stage one. Involvement of joints became more bilaterally symmetrical as seizures evolved. Joint flexion evolved to extension far more commonly than conversely. Significance: Our data suggest that any study describing tonic motor semiology must indicate at what point in seizure evolution the observations were made. Its findings will sharpen ictal history taking: lay persons’ observations may better reflect ictal evolution if sequence is emphasized. We interpret these findings as reflecting increasing reticulospinal tract involvement as the seizure proceeds.

8-17

Authors: Iana Malasevskaia; Ahmed Ali Al-Awadhi; Fatima Ali Raza

Background: Perianal fistula is a highly exhausting and difficult‐to‐treat condition and might negatively impact patients' quality of life. Recently, the application of mesenchymal stem cells has shown notable encouraging results in treating perianal fistula. Previous studies have shown that adult stem cells isolated from adipose tissue imply a subset of pluripotent mesodermal stem cells with a potential differentiation in myogenic, audiogenic, and chondrogenic types of cells. Additionally, human adipose-derived stem cells being multipotent cells, are capable of self-renewal and differentiation and have become apparent as crucial regulators of an immune response. It is well known that mesenchymal stem cells exist in almost all tissues and probably reduce inflammation through their intrinsic immunomodulatory properties; however, the exact mechanism of action in treating perianal fistula still under development. Aim: The present review aims to analyze the published scientific literature on adipose-derived MSCs in treating perianal fistula and clinical outcomes. Method: A literature search in PMC, PubMed, Google, and Google Scholar was carried out using the following keywords: "perianal fistula," “stem cells and perianal fistula” "adipose derived stem cells in perianal fistula," "mechanism of action of adipose derived stem cells" Study selection was in the language (English only), model (humans only), open accesses, and all types of studies were included as long as they were relevant to our study.

20-23

Authors: Safwaan Zamakda Allison

Since the independence of Morocco from France in 1956, the area known as Western Sahara has been in dispute between several parties including Morocco, Spain [who previously administered it], Algeria, Mauritania, and the Saharawi Arab Republic. In recent years, Spain and Mauritania have relinquished claims. Recent political maneuvers by Morocco, the USA, Jordan and other states have given rise to the proposition that a Paradigmal shift is taking place, and that Moroccan sovereignty over the entire region is becoming the norm and accepted by the international community. The issue of sovereignty has been a highly contentious issue since the Green March in 1975, but recent developments indicate that this is likely to no longer be the case in the near future.