Insulin gene flanking sequences in Saudi Arabians and Philipinos

We have studied the hypervariable sequence near the 5' end of the insulin gene in 148 Saudi Arabian and 94 Philipino blood donors. We found three major size classes of DNA restriction fragments: a small class 1 allele, a medium class 2 allele and a large class 3 allele. The allotype frequencies in the two populations are significantly different [p<0.0005]. The class 3 allele [large insertion] frequency is four times higher [95% fiducial limits 2.2-7.3] in Arabs [0.20 in Arabs and 0.05 in Philipinos]. No selection pressure was observed on the insulin locus since both the Arab and Philipino populations obey the Hardy-Weinberg equilibrium

Hyperlipidemia in diabetes mellitus: pathogenesis, diagnosis, and pharmacological therapy

Epidemiological studies have clearly shown that in diabetic patients there is a two to three times higher mortality resulting from myocardial infarction, stroke, and atherosclerosis of the legs than in the nondiabetic population. Although decreased glucose tolerance per se is associated with macroangiopathy, in recent years increasing attention has been focused on the role of pathogenesis of atherosclerosis in diabetic subjects. This report describes changes in lipid and lipoprotein concentration, the diagnostic evaluation, and the management of lipid disorders in diabetic subjects

Congenital adrenal hyperplasia: pregnancy in a bearded lady

A patient with congenital adrenal hyperplasia presented at the unusually late age of 26 years with gross hirsutism, virilization and primary amenorrhoea. Following bilateral adrenalectomy, adrenal replacement therapy and genital reconstruction she menstruated regularly. She remained markedly hirsute and bearded and recently gave birth to a normal girl

High-dose iodine 131 treatment of hyperthyroidism: experience at King Faisal Specialist Hospital and Research Centre

We have treated 186 Saudi patients [110 females, 76 males] with hyperthyroidism in the last 10 years. Case records of 100 patients were randomly selected for review. The female: male ratio was 1.4:1. The thyroid gland was diffusely enlarged in 46%, small, nodular, or gritty in 46%, and impalpable in 8%. Thyroid scanning revealed diffuse isotope uptake in 40% and patchy uptake in 60%. Ablative doses of 10 or 15 mC[i] of iodine 131 were given to 78 patients. The patients who become hypothyroid have been followed for a median of 18 months. Of these, 37% were hypothyroid at 3 months, 58% at 6 months, 36% at 9 months, and 68% at 12 months. The clinical presentation of hyperthyroidism appears to differ in Saudi Arabia compared with Western countries. The female: male ratio is significantly lower [P< 0.001], and classical Graves' disease less frequent. In large countries where follow-up may be difficult, ablative radioiodine treatment and subsequent thyroxine replacement have advantages over other treatment