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Lubna Al Asoom,1 Maha A Alassaf,2 Najd S AlSulaiman,3 Dhuha N Boumarah,4 Aldana M Almubireek,2 Gaeda K Alkaltham,2 Hussain A Alhawaj,5 Taleb Alkhamis,5 Nazish Rafique,1 Ahmed Alsunni,1 Rabia Latif,1 Seham Alsaif,1 Dana Almohazey,6 Sayed AbdulAzeez,7 J Francis Borgio7 1Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 2King Fahd hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Internal Medicine, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Department of Surgery, King Fahd Hospital of the University, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 5Animal House, Environmental Health Department, Institute for Research and Medical Consultation, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 6Department of Stem Cell Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 7Department of Genetic Research, Institute for Research and Medical Consultations (IRMC), Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaCorrespondence: Lubna Al Asoom, Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, P.O Box 2004, Dammam, 31541, Saudi Arabia, Tel +966505846344, Email lasoom@iau.edu.saBackground: Obesity is a global pandemic that is associated with high morbidity and mortality. Natural herbs are commonly used for weight reduction and appetite suppression. Therefore, we aim to investigate the role and mechanism of Nigella sativa (NS) and ginger on weight reduction and appetite regulation.Methods: This experimental study was performed at Imam Abdulrahman Bin Faisal University. Twenty-five female rats were distributed into 5 groups: NS (oral 1000mg/kg), Ginger (500 mg/kg), NS-ginger (both interventions), a positive control (intraperitoneal 50 μg/kg Liraglutide), and a negative control. Each intervention was given for 9 weeks. Food intake and body weight were assessed weekly. Serum lipid profile and peptides involved in appetite control (cholecystokinin (CCK), glucagon-like peptide 1(GLP-1), gastric inhibitory polypeptide (GIP), ghrelin, peptide YY, and orexin) were assayed at the end of the experiment.Results: None of the interventions showed a statistically significant difference regarding food consumption or weight gain (p > 0.05). However, the three interventions significantly reduced total cholesterol (TC), NS and NS-ginger significantly increased HDL, NS increased ghrelin and ginger increased orexin.Conclusion: The present dose and duration of NS, ginger, or in combination did not demonstrate a significant change in body weight or food consumption in comparison to the negative or positive controls. However, NS or ginger has improved the lipid profile by reducing TC and increasing HDL. In addition, NS or ginger can influence some of the peptides involved in appetite regulation such as the increase in ghrelin induced by NS and the reduction of orexin induced by ginger. We believe that these latter effects are novel and might indicate a promising effect of these natural products on appetite regulation.Keywords: Nigella sativa, ginger, body weight, appetite, Liraglutide

Almost half a century ago, organ transplantation was introduced to Arabian Gulf countries. The criteria for diagnosing brain death among these countries is relatively similar, in which the main area of discrepancy is the number of physicians required to diagnose and their required specialties. Regarding the organs and tissues allowed for transplantation, they must possess an intrinsic regenerative ability if they are harvested from a living donor to avoid jeopardizing their health. To donate, Arabian Gulf countries follow an opt-in consent system, requiring the donor's informed consent before organ procurement. Live donors can be related or unrelated to the recipient, although the latter is subjected to variable restrictions among Arabian Gulf countries and prohibition in one of them. This is due to its implication in commercial trade. Furthermore, the Gulf Health Council was established to coordinate different health initiatives and programs between Gulf states, including organ transplantation, in an attempt to improve the health sector of all of its member states. Although organ trafficking is illegal in all Arabian Gulf countries, their penalty systems vary from barring physicians, subjecting them to fines or even imprisonment. As for the attitudes of people towards organ transplantation, the willingness to donate varies among these countries. The rate of organ transplantation remains low. This article aims to cover the history of organ transplantation, brain death diagnosis protocols, organ donation enrollment policies and conditions, as well as the issue of organ trafficking in Arabian Gulf countries., (© 2021. Springer Science+Business Media, LLC, part of Springer Nature.)

BACKGROUND Metastatic mixed adeno-neuroendocrine carcinoma (MANEC) is a rare malignancy. It is characterized by the presence of both neuroendocrine and epithelial components, each of which constitute at least 30% of the lesion to establish the diagnosis. CASE REPORT A 48-year-old man presented with a 1-month history of right upper-quadrant pain and unintentional weight loss of 18 kg. He was also complaining of constipation and fatigue for 6 days. The initial diagnosis from a referring hospital was colon cancer with liver metastasis based on a computed tomography (CT) scan of the chest, abdomen and pelvis. After re-evaluation at our hospital, the scan revealed multiple peritoneal deposits in addition to the previously reported findings. A colonoscopy and biopsy were performed, after which the histopathological examination demonstrated a mixed poorly differentiated large cell neuroendocrine carcinoma and adenocarcinoma. Based on the imaging and histopathology reports, he was diagnosed with a poorly differentiated MANEC of the colon with liver metastasis and multiple peritoneal deposits. His lesions were deemed unresectable, and he was referred to the oncology department for palliative care. There he received a total of 9 cycles of cisplatin and etoposide for 8 months. His CT scan showed a regression of the primary tumor indicating a good response to chemotherapy. The patient is still following up with his medical oncologist. CONCLUSIONS Although it is rare, MANEC is a complex neoplasm that requires a high index of suspicion to diagnose due to its nonspecific presentation. It is confirmed through histopathology and immunohistochemistry of the tumor biopsy. Imaging is performed for staging, with most patients presenting at advanced stages with metastases. The only curative option is complete surgical resection of both the primary and metastatic lesion. Many cases, however, are regarded as unresectable and are referred for palliative treatment.