Molecular surveillance of Plasmodium Falciparum chloroquine resistance transporter variant T76 in Jazan area, Kingdom of Saudi Arabia

The development of chloroquine as an antimalarial drug and the subsequent evolution of drug resistant Plasmodium strains had major impacts on global public health in the 20th century. In P. falciparum, the cause of the most lethal human malaria, chloroquine resistance is linked to multiple mutations in PfCRT, a protein that likely functions as a transporter in the parasite's digestive vacuole membrane. Rapid diagnostic assays for PfCRT mutations are already employed as surveillance tools for drug resistance. However, several reports have been published demonstrating cases with CO resistance. Sporadic cases have been reported as well as one large scale study demonstrated 12.4% resistance. However, all these reports were based on treatment failure [in vivo]. rather than in vitro or molecular bases. Evidence suggests a crucial role for a point mutation in the P. falciparum chloroquine resistance transporter [pfcrt] gene on chromosome 7 in conferring CQ resistance. The mutation in the K76 codon in 3 cases out of 60 [5%] using ApoI restriction enzyme was detected. Although the percentage of drug resistance was not quite disturbing, but represented the possible establishment of chloroquine-resistant P. falciparum in Saudi Arabia, or the beginning of resistant strains by labors coming from abroad. Cross-border importation of resistant strains from neighboring countries must be considered. In vivo tests must be conducted parallel with the molecular markers to estimate more precisely the actual prevalence of resistance. Validation of molecular markers is urgently required and needs strong collaborative partnerships between subregional and regional networks

Transobturator tape [TOT] for treatment of female stress incontinence: early experience

Objective: Evaluation of the transobturator tape [TOT], the newest tension-free technique for the treatment of female stress urinary incontinence [SUI] and its early results with 6 months follow up

Patients and Methods: This study was conducted at King Saud Hospital, Saudi Arabia, between September 2002 and March 2004. Fourteen cases with pure SUI were treated with Uratape, a low- elasticity polypropylene tape, according to the technique described by Delorme[1, 2]. Preoperative assessment included full history, urogynecological examination, cough stress test, Q-tip test, cystogram and urodynamic studies. Perioperative cystoscopy was also done

Results: No intraoperative complications were recorded. Postoperative complications included transient incisional pain in 2 [14.3%], transient voiding difficulty in 5 [35.7%] and urgency and frequency withmild pyuria in 3 cases [21.4%]. Mild groin ecchymosis was seen in 5 cases [35.7%]. Vaginal wound infection and wound dehiscence with subsequent tape removal occurred in one case only [7.1%] Twelve cases [85.7%] achieved full continence and one patient [7.1%] had minimal leak with extreme stress but was fully satisfied

Conclusion: From the promising results of our early experience we conclude that the TOT procedure is a simple, safe, fast and minimally invasive technique for the treatment of SUI in women with few minor complications and a high success rate. Further studies on a larger number of patients will however be needed to confirm these results

Clinico-pathological studies in the male goats subjected to experimental retention of urine and rupture of the urinary bladder, both before and after treatment

Experimental uretheral obstruction was done on 30 male goats. Serum biochemical analysis declared that there was an increase in the blood urea nitrogen ion or ruptured bladder. These values regained their normality within a week after operation. Serum sodium and chloride showed slight increase during uretheral obstruction and slight decrease after ruptured bladder. Serum calcium and magnesium showed no significant changes all over the period of the experiment