Review Article
Decoding the Genetic Basis of Alzheimer's Disease: A Comprehensive Review of Key Causal and Risk Genes, Pathological Mechanisms, Convergent Pathways, and Emerging Therapeutic Targets
Sumithira George , Sharan Kumar, Sivakumar Subramaniyan, Venkatesh Aditiyaa Narayanaa, Priya Palanisamy, Aravinth Murugesan, Sivanandhan Rajendiran
Middle East Research Journal of Medical Sciences; 267-281.
https://doi.org/10.36348/merjms.2026.v06i04.002
Abstract: Alzheimer's disease (AD) is the leading cause of dementia worldwide, accounting for approximately 60–70% of all dementia cases. It is a progressive neurodegenerative disorder that results in memory loss, cognitive decline and functional impairment, and affects over 55 million individuals worldwide. The number of affected individuals is projected to reach 139 million by 2050, posing a substantial public health and socioeconomic burden. Pathologically, AD is defined by extracellular deposits of amyloid-β (Aβ) plaques and intracellular accumulation of hyperphosphorylated tau in the form of neurofibrillary tangles (NFTs). There is growing evidence that the pathogenesis of AD is multifactorial, involving genetic, molecular, and environmental factors. This review aims to give a comprehensive overview of the major genes and molecular pathways involved in the pathogenesis of AD, as well as recent advances in genome-wide association studies (GWAS) and emerging therapeutic strategies. The mutations in amyloid precursor protein (APP), presenilin 1 (PSEN1), presenilin 2 (PSEN2), and β-site amyloid precursor protein cleaving enzyme 1 (BACE1) are associated with early-onset familial AD, while late-onset AD is linked to several susceptibility genes identified by GWAS. The molecular mechanisms underlying AD pathogenesis and progression are discussed with respect to major AD-associated genes, such as microtubule-associated protein tau (MAPT), apolipoprotein E (APOE), triggering receptor expressed on myeloid cells 2 (TREM2), sortilin-related receptor 1 (SORL1), bridging integrator 1 (BIN1), phosphatidylinositol-binding clathrin assembly protein (PICALM), Clusterin (CLU), ATP-binding cassette subfamily A member 7 (ABCA7), complement receptor 1 (CR1), acetylcholinesterase (AChE), nuclear factor erythroid 2-related factor 2 (NRF2), and tumor necrosis factor (TNF). Current therapeutic strategies, including anti-amyloid immunotherapy, AChE inhibitors, tau-directed therapies, and emerging gene-targeted approaches, are also discussed. In addition, progress in multi-omics technologies, disease models using induced pluripotent stem cells (iPSC), gene editing with CRISPR-Cas9, and artificial intelligence (AI) analysis are likely to speed up the implementation of precision medicine for early diagnosis, risk prediction, and treatment of Alzheimer's disease.
Research Article
Molecular Epidemiology and Antifungal Resistance of Candida Species in Iraq: A Review of Available Evidence and a Critical Analysis of the Genomic Gap
Hussein R. Mahmood
Middle East Research Journal of Medical Sciences; 282-286.
https://doi.org/10.36348/merjms.2026.v06i04.003
Candida species have become increasingly resistant to antifungals, particularly azoles. Studies in Iraq are fragmented and limited, relying almost entirely on single-center studies despite the growing body of evidence on molecular epidemiology of these species. This study reviews the published literature regarding the distribution of Candida species, antifungal resistance patterns, and molecular and genomic characteristics, in addition to identifying key research gaps preventing the development of a comprehensive molecular epidemiological map at the national level. I searched scientific databases (PubMed and PMC repositories, as well as indexed Iraqi and regional journals) systematically. reports lacking systematic documentation were excluded. The most common strain in Iraqi clinical samples is C.albicans, followed by C.glabrata and C.tropicalis, to varying degrees, depending on geographical region and sample type. As of now, most molecular characterizations are based ITS sequencing, without extending to whole-genome techniques or identifying specific resistance genes (such as ERG11 and FKS1/2). No officially documented cases of Candida auris in Iraq. Iraqi literature reveals a clear genomic gap. Multicenter national surveillance studies, genetic analyses of resistance mechanisms, and an effective surveillance system for C.auris are lacking in the country. As an essential step to understand this increasingly important pathogen's true epidemiological dynamics, the review recommends the establishment of a national surveillance network for invasive fungal infections.
Research Article
Prevalence and Forms of Domestic Violence among Pregnant Women Attending Antenatal Clinics in Ilorin West Local Government, Kwara State, Nigeria
Ijaiya, Zainab Bimpe, Sowunmi, Christiana Olanrewaju, Olofin-Samuel, Mary Ayodeji, Aderibigbe, Olusegun, Kadir, Aminat Titi, Afolayan, Ishaq Ajibola, Olowoyo, Kikelomo S.
Middle East Research Journal of Medical Sciences; 287-293.
https://doi.org/10.36348/merjms.2026.v06i04.004
Abstract: Domestic violence (DV) during pregnancy constitutes a serious public health challenge with profound consequences for maternal and foetal health. Despite growing global attention to intimate partner violence (IPV), subnational prevalence data in Nigeria remain sparse. This study sought to determine the prevalence and forms of domestic violence among pregnant women attending antenatal clinics in Ilorin West Local Government Area (LGA), Kwara State, Nigeria. A descriptive cross-sectional design was employed. A total of 384 pregnant women were recruited using multistage sampling from seven primary health care facilities. Data were collected using a validated, structured questionnaire that assessed three domains of DV: psychological, physical, and sexual violence. Descriptive statistics were computed using IBM SPSS Statistics Version 25. Ethical approval was obtained, and informed consent was secured from all participants. The overall prevalence of domestic violence was 33.3%, indicating that one in every three pregnant women experienced at least one form of abuse. Psychological violence was the most prevalent form (37%), manifesting principally as verbal insults, humiliation, intimidation, and threats. Physical violence was recorded in 25% of respondents, with slapping, pushing, and hitting being the most common acts. Sexual violence was the least reported at 5.7%, though this likely reflects underreporting attributable to cultural taboos surrounding marital rape and sexual coercion. Domestic violence is prevalent among pregnant women in Ilorin West LGA, with psychological abuse being the predominant form. These findings underscore the necessity for routine DV screening during antenatal care, trauma-informed health services, and targeted community sensitisation programmes. Institutionalising DV screening protocols within maternal health systems is recommended as a priority intervention.
Research Article
Probiotic Lactobacillus Strains Alter Gut Microbiome Composition under Antibiotic Exposure Conditions
Lina Abdulkadhim Oudah
Middle East Research Journal of Medical Sciences; 294-301.
https://doi.org/10.36348/merjms.2026.v06i04.005
Abstract: Lactobacillus strains have been documented to be effective in shaping composition and restoring gut microbiome dysbiosis in antibiotic-treated or post-antibiotic mice; nonetheless, it has rarely been studied for individual Lact probiotics from feces. Antibiotic therapy is an effective therapeutic arsenal against pathogenic microorganisms; on the other hand, they frequently alter the intestinal microbial ecosystem mainly through a reduction of representative micro-organisms, leading to functional imbalance and increased susceptibility to opportunistic infections. But in this respect, the Lactobacillus species have emerged as beneficial gut protecting and restorative probiotics. Probiotic Treatment Reversed a Number of Different Antibiotic-Induced Dysbiosis Different antibiotics induce dysbiosis by distinct pathway with varying effects on gut microbial diversity and community recovery. In particular, Lactobacillus species enhanced the diversity of commensal microbes and suppressed opportunistic pathogens. These effects appear to be mediated by several mechanisms, such as competitive exclusion, production of antimicrobial compounds and modulation of host immunity. Also, probiotic delivery maintained key metabolic functions of the gut microbiota (notably short chain fatty acid production which is clinically reduced after antibiotic treatment). Temporal analyses revealed that early administration of Lactobacillus strains strikingly increased microbiome recovery relative to untreated controls and indicated the potency of these seemingly innocuous probiotic treatments. Conclusion: This study highlights that directed probiotic intervention is a promising adjunct to antibiotics preserving the intestinal microbiota landscape while accelerating recovery and mitigating adverse effects induced by prior antibiotic exposure. Together these observations create a stronger justification for the clinical use of Lactobacilli-based probiotic approaches for ncontrolling microbiome resilience before and after antibiotic therapy.
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