Polymorophisms in MTHF and ACE genes and the association with hypertension among Saudi population from Qassim region

Three clinically important mutations; Two of the methyl-tetrahydrofolate reductase [MTHFR] gene namely C677T, A1298C, and insertion/deletion [I/D] polymorphism of the angiotensin converting enzyme [ACE] gene are reported to be associated with various pathological conditions. This study is planned in order to evaluate the association of genetic polymorphisms related to these genes with hypertension. These polymorphisms can be utilized as biomarkers for susceptibility and severity of the disorder with a potential impact on diagnosis and management. Participants included 117 cases [78 males and 39 females] with an age mean +/- SD of 50.93 +/- 15.43 years. They were hospitalized for hypertensive complications including cardiac affection [64.9%] and renal dysfunction [17.9%] or strokes [20%]. For comparison, 169, age and sex matched; with an age mean +/- SD of 47.65 +/- 11.15 normal healthy unrelated subjects [78 males and 91 females] were taken from the same locality as controls. For all participants, DNA was extracted followed by real-time PCR amplifications for characterization of genotypes and alleles related to MTHFR C677T, A1298C and ACE I/D gene polymorphisms. Compared to controls, cases showed significantly higher frequency of the heterozygous genotypes of MTHFR AC [52.1% vs. 36.5%, p<0.05] and ACE ID [96.5% vs. 43.5%, p<0.0001]. Cases showed also significantly higher MTHFR 1298 mutant C allele carriage rate with nonsignificant higher carriage rate for the MTHFR 677 mutant T allele and ACE mutant D allele. It was also noted that 74% of cases carried at least one of the 3 studied mutant forms. Comparing case-subgroups in terms of being either positive or negative for diabetes, cardiac, renal or cerebral complications and obesity showed non-significant difference related to the studied genotypes and alleles. This work shows that genetic polymorphisms related to the methyltetrahydrofolate reductase [MTHFR] and angiotensin converting enzyme [ACE] genes are associated probably with other environmental factors as that imposed by smoking and obesity. With the risk of hypertension among Saudi subjects from Qassim region

Generic drug prescribing in central Saudi Arabia: perceptions and attitudes of physicians

Physicians play a key role in generic drug prescribing, but their behavior is affected by many determinants. We examined physician practices and attitudes and other factors influencing the prescription of generic drugs. A self-administered questionnaire was used to collect information from a random sample of physiccians from different settings in central Saudi Arabia. Data were analyzed to describe all variables and test any significant difference between groups of physicians. The study included 772 physicians from different affiliations. The majority of physicians [n=741, 96%] reported that they knew enough about the therapeutic value of generic drugs. The majority [75%] reported that they knew the price differences, and this knowledge helped 72% of them to switch to generic prescription medication. Most physicians [79%] support generic substitution, but they indicated that there are certain cliniccal situations where they prefer to use brand name drugs. Physicians reported receiving visits and samples more frequently from representatives of brand name companies. Physicians did not report a significant difference in pressure from patients to prescribe either generic or brand drugs. Most physicians had a positive attitude towards the government role in assuring the quality of local drug products [80%] and in enforcing physicians to prescribe generic drugs [85%]. Physicians face competing forces to prescribe either brand name or generic drugs. The majority support generic drug substitution. There are multiple factors that support prescription of generic drugs