Detection and evaluation of the presence of the BRAF V600E mutation in ameloblastomas in an Indian population

Introduction: Ameloblastoma is a benign epithelial odontogenic neoplasm that constitutes approximately 1% of all oral tumors and about 9 to 11% of all odontogenic tumors. They are slow-growing, locally invasive, and demonstrate a potential for metastasis and malignant transformation. The molecular pathogenesis of ameloblastoma is attributed to aberrant activity of the signal transduction pathways relating to developmental stages of odontogenesis including the mitogen-activated protein kinase (MAPK) pathway. The BRAF V600E mutation was identified as the most frequently mutated gene in this neoplasm. Studies have shown that use of BRAF inhibitors in patients diagnosed with ameloblastomas led to a significant reduction in tumor volume. Aims: To detect the expression of BRAF V600E mutation in ameloblastomas in an Indian population using immunohistochemistry. To compare the difference in the occurrence of the BRAF V600E mutation between mandibular and maxillary cases. Materials and Methods: Thirty-three formalin-fixed paraffin-embedded tissues of histopathologically proven cases of ameloblastoma were assessed for the BRAF V600E mutation by immunohistochemistry using the BRAF V600E monoclonal antibody. Patient data such as age, sex, anatomical site, recurrence were documented. Statistical Analysis: The statistical analysis was performed using the Pearson Chi-square test and Student's t-test. Results: The present study revealed a high expression of the BRAFV600E mutation in mandibular cases of ameloblastoma among Indians irrespective of the age, sex, site, recurrence or histological pattern. Conclusions: The identification of this driver mutation opens the possibility of an adjuvant therapeutic modality to reduce the significant facial disfigurement and morbidity following surgical management.

A Successful Feto-Maternal Outcome In Pregnancy With Wilsons Disease: An Extremely Rare Case Report With Review Of Literature

Wilson’s disease, also known as hepato-lenticular degeneration, is one of the very rare autosomal recessive disorder of copper metabolism.There is impaired liver metabolism of copper thereby causing decreased biliary excretion and deposition of ceruloplasmin levels mainly in the liver, corneas of eyes and brain. Untreated Wilson’s disease has been associated with menstrual irregularities, amenorrhoea, miscarriages and infertility. Hence proper chelationwith strict antenatal surveillance will lead to a successful feto-maternal outcome.

Study to Evaluate the Antioxidant and Hepatoprotective Activities of Roots Extracts of Doronicum hookeri in CCl4 Treated Rats.

Aims: To screen the hepatoprotective and antioxidant activity of ethanol (EDH) and aqueous (ADH) extracts of roots of Doronicum hookeri Hook. f.(Asteraceae). Study design: Animal study Place and Duration of Study: Department of Pharmacology, Biochemistry and Anatomy (Histology section), J N Medical College, AMU, Aligarh, India, between July 2010- July 2012. Methodology: The extracts were subjected to antioxidant tests (Total reducing power and Total phenolic content) and preliminary phytochemical screening. The rats were divided into 7 groups. The Control groups comprising of normal control (Saline 1ml/kg), negative control group (CCl4) and positive control group (Silymarin 50mg/kg). The Test drugs were given in a dose of 300mg/kg and 500 mg/kg for both EDH and ADH extract. Blood was collected for assaying biochemical parameters (AST, ALT, ALP, Total Bilirubin). The liver tissue was used for histopathological examination and in vivo antioxidant tests [Catalase (CAT), Glutathione Reductase (GSH) and Malonlydialdehyde (MDA)]. Results: The phytochemical study showed the presence of flavanoids, alkaloids, saponins, cardiac glycosides. EDH 500mg/kg showed a significant (p<0.01) increased in levels of AST, ALT and ALP as compared to negative while EDH 300 mg/kg (p<.05) and ADH group showed minimal activity. The GSH (p<0.001) and CAT (p<0.05) in EDH 500 mg/kg were significantly increased while MDA levels were decreased (P< 0.01) as compared negative control. The findings were confirmed histopathological examination. Conclusion: The ethanol extract of Doronicum hookeri showed dose dependent partial hepatoprotection against CCl4 toxicity.

Microbial colonization of Provox voice prosthesis in the Indian scenario.

INTRODUCTION: Tracheoesophageal speech using the voice prosthesis is considered to be the “gold standard” with success rates as high as 90%. Despite significant developments, majority eventually develop dysfunction due to microbial deterioration. We did a pilot study of 58 laryngectomy patients who developed prosthesis dysfunction. MATERIALS AND METHODS: A total of 58 laryngectomy patients who had their dysfunctional prosthesis removed were included in this study. Dysfunctional prostheses were removed and examined. Esophageal and tracheal flanges were examined separately. After obtaining pure fungal and bacterial cultures, the yeast strains were identified. Bacteria were identified with the light microscope and gram staining. We analyzed prosthesis lifespan and probable factors affecting it. RESULTS: Central leak was found in 43% cases while in 57% peri‑prosthetic leakage was the most common reason for prosthesis replacement. Microbial analysis revealed a combination of yeast and bacteria in approximately 55% culture samples. Out of these, almost 90% had the presence of single yeast species with bacteria. Pure fungal culture was identified in rest of the 45% cultures while none detected pure bacterial forms. Candida tropicalis was the solitary yeast in 81% while Candida albicans was seen in 10% as the solitary yeast. Bacterial isolates revealed Klebsiella pneumonia in 19%, Escherichia coli in 8% while Staphylococcus aureus was grown in 1% cultures. The consumption of curd (P = 0.036, 95% confidence intervals [CI]: 2.292‑64.285) to have a significant correlation of the mean prosthesis lifespan. Consumption of curd (P = 0.001, 95% CI: 0.564‑2.008) and history of prior radiotherapy (P = 0.015, 95% CI: 0.104‑0.909) had a significant bearing on the Provox prosthesis lifespan. CONCLUSIONS: Candida is the most common organism grown on voice prosthesis in Indian scenario. Consumption of curd and history of prior radiotherapy significantly affect Provox prosthesis lifespan.

Antioxidant and Hepatoprotective Activity of Ethanol Extract of Valeriana wallichii in CCl4 Treated Rats.

Aims: To screen the hepatoprotective and antioxidant activity of ethanol extract of roots of Valeriana wallichii DC (Valerianaceae)(VWE). Study Design: Animal study. Place and Duration of Study: Department of Pharmacology, Biochemistry and Anatomy (Histology section), J N Medical College, AMU, Aligarh, India, between July 2010-July 2012. Methodology: The VWE extract was subjected to in vitro antioxidant and phytochemical screening. For in vivo hepatoprotective studies albino rats of either sex were used. For the study, three control groups were taken comprising of the normal control (normal saline), negative control (CCl4) and positive control group (Silymarin 50mg/kg). The test group was given a dose of 300mg/kg and 500mg/kg of VWE extract. Biochemical parameters (Transaminase (AST, ALT), Alkaline Phosphatase (ALP), Total Bilirubin), histopathological examination and in vivo antioxidant tests [Catalase (CAT), Glutathione Reductase (GSH) and Malonlydialdehyde (MDA)] were performed. Results: The phytochemical study of VWE showed the presence flavonoids, terpenoids, tannins, alkaloids and cardiac glycosides. A dose dependent increase in the oxidative potential was observed in the extracts with total phenolic content 66.4GAE/g extract. VWE 500mg/kg and 300mg/kg showed a significant (p<0.001) increased in levels of AST, ALT and ALP as compared to negative control (percentage hepatoprotection=73% and 68% respectively). The GSH (p<0.001) and CAT in VWE 500mg/kg were significantly increased while MDA levels were decreased (P<0.001) as compared negative control. The findings were confirmed histopathological examination. Conclusion: The ethanol extract of Valeriana wallichii showed dose dependent partial hepatoprotection against CCl4induced toxicity.

Relationship of the Arabic version of the asthma control test with ventilatory function tests and levels of exhaled nitric oxide in adult asthmatics

To determine the relationship between the asthma control test [ACT] score using the Arabic version, fractional exhaled nitric oxide [FENO], and lung functions, and to derive the cutoff points for the ACT score with the American Thoracic Society recommended FENO standard levels of inflammation control. We recruited 59 adult asthmatics out of which 53 subjects completed the study between July 2011 and June 2012 at King Saud University, Riyadh, Saudi Arabia. The FENO levels were measured by NIOX MINO[R] [Aerocrine AB, Solna, Sweden], and ventilatory functions were recorded by standard techniques. The FENO values were significantly higher in patients with an ACT score <20 [65.5 +/- 35.4] compared with those patients with an ACT score >/= 20 [27.4 +/- 10.5, p<0.001]. Among the well-controlled group based on the ACT score criteria, 6 [25%] cases had high FENO levels, while among the poorly controlled group, 23 [79.3%] cases had high FENO levels [odds ratio: 11.5; p<0.0001; confidence interval: 3.16-41.72]. There was a significant negative correlation between FENO and ACT score [r=-0.581, p<0.0001]. At the international cutoff point of 20, the sensitivity was 95.2, and the specificity was 68.8. The receiver operating curve [ROC] showed that maximum sensitivity and specificity were observed at an ACT score cut off point of 19 [sensitivity: 90.5, and specificity: 81.2]. The FENO levels correlate negatively with ACT scores however, the relationship between FENO and lung function is not significant. A significant relationship between ACT score and FENO levels indicate that there is an ongoing inflammatory state in patients with poor asthma control

Serum resistin levels in patients with type 2 Diabetes Mellitus and its relationship with body composition

To assess the relationships of resistin concentrations with body mass index [BMI], body fat mass, lean body mass, and body protein mass in patients with type 2 diabetes mellitus [DM]. This cross-sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia from April 2008 to March 2011. A total of 229 subjects were selected for the study. Body composition was assessed by bioelectrical impedance analyzer. Parameters recorded included BMI, waist hip ratio [WHR], total body water, fat, protein, and lean body masses. Blood samples were analyzed for glucose, glycosylated hemoglobin [HbA1c], and resistin levels. We found that BMI, WHR, fasting blood glucose, HbA1c, and resistin levels were significantly higher in diabetics compared to non-diabetic healthy individuals. Fat mass was significantly higher in diabetic patients compared with controls, while the difference for muscle mass and lean body mass was non-significant. A significant positive correlation was observed between plasma levels of resistin and fat mass in patients with DM [r=0.2824, p=0.0030]. Type 2 DM patients have significantly higher resistin levels that are positively correlated with body fat mass supporting the evidence that resistin plays an important role in the pathogenesis of obesity and insulin resistance.

Kearns-Sayre syndrome: an unusual ophthalmic presentation

Kearns-Sayre syndrome [KSS] belongs to the group of neuromuscular disorders known as mitochondrial encephalomyopathies. It has characteristic syndromal features, which include: chronic progressive external ophthalmoplegia, bilateral atypical pigmentary retinopathy, and cardiac conduction abnormalities. So far, only a single case has been reported where a patient with KSS had a normal retina. Herein, we report this extremely rare variant of KSS, which not only presented later than the normal age of presentation, but also had minimal pigmentary retinopathy

Perceived Stress Scale Psychometric Validation for Malaysian Diabetic Patients.

Aims: The purpose of this study was to provide factorial analytic findings, construct validation and normative data for the Malaysian diabetic patients. Gender difference was also examined with racial response to PSS-10. Study design: Population base cross sectional survey. Place and Duration of Study: Penang between Nov 2009 and March 2010. Methodology: Cluster random sampling technique was employed for the selection participants in the community. A total of 1924 diabetic patients with age ≥ 18 (mean age = 39.51) were approached; 992 of them were female and 932 of them were male. People rated how often they had experienced these feelings in the last week on a five-point Likert scale from 0 = never to 4 = very often. The scale was translated into Malay language independently by two psychological counselors who had at least a master’s degree and bilingual efficiency. The LISREL 8.30 program was used to assenting factor analysis. Chisquare (χ 2)/df (degree of freedom) ratio, GFI (goodness of fit index), AGFI (adjusted goodness of fit index) and root mean square error of approximation (RMSEA) were used to evaluate the fit of the model (two-factor). Results: Barlett’s test of sphericity was 1603.417 (p<0.001) and Kaiser-Meyer-Olkin measure of the sampling adequacy was 0.83. Varimax rotation was conducted with these two identified factors. Factor A integrated items 1, 2, 3, 6, 9 and 10, labeled as ‘Perceived Avoidance’ while Factor B containing items 4, 5, 7, 8 and labeled as ‘Perceived Controllable’. Item variance showed 45.73 per cent of accountability with Factor A and 13.43 per cent with Factor B. Mandatory factor analysis for the two-factor of Malaysian version of PSS yielded: GFIs: χ 2 (39) = 127.846, p<0.001, χ 2/df= 4.1; GFI = 0.97; AGFI = 0.96; RMSEA = 0.06 and CFI = 0.99. Conclusion: PSS-10 is a reliable tool for assessing the stress measures among diabetic living of the society. High stress level is identified among the females as compared to male diabetic patients. Overall the whole cohort has high perceived stress level.

Patient-reported adverse drug reactions and drug-drug interactions: a cross-sectional study on malaysian HIV/AIDS patients

This study aimed to explore the adverse drug reactions [ADRs] reported by patients and to identify drug-drug interactions [DDIs] among human immunodeficiency virus/acquired immunodeficiency syndrome [HIV/AIDS] patients. This cross-sectional study was conducted at the Medication Therapy Adherence Clinic, Hospital Sungai Buloh, an HIV/AIDS referral centre. The patients were randomly selected and were encouraged to describe ADRs caused specifically by any of the prescribed antiretroviral drugs [ARDs]. Sociodemographic characteristics were recorded from the patients' medical records. In addition data on antiretroviral treatment [ART], DDIs and other conventional medication were also documented. A total of 325 randomly selected HIV/AIDS patients with a mean age of 22.94 years participated in the study. The most frequently prescribed ARDs were lamivudine [64.6%], zidovudine [40.6%] and efavirenz [42.5%]. Commonly reported ADRs were fatigue [54.8%], allergic reactions [41.5%], weight loss [41.5%], dry mouth [35.1%] and memory loss [35.1%]. Female [87.8%], non-complementary and alternative medicine [CAM] users [87.3%] and participants below 50 years old [81.1%] were identified as having a higher prevalence of ADRs compared to males [79.6%], CAM users [78.7%] and participants aged 50 years or more [77.5%]. Patient age was found to be significantly associated [p = 0.048] with the ADRs. In addition, a total of 44 cases of DDIs belonging to category D were also found in this study. This study enabled us to identify the most common ADRs and DDIs associated with the use of ART. Safe and effective treatment depends on the healthcare providers' knowledge of the same

Stimuli-sensitive hydrogels: A novel ophthalmic drug delivery system.

Background: Stimuli-sensitive hydrogels are three-dimensional, hydrophilic, polymeric networks capable of imbibing large amounts of water or biological fluids on stimulation, such as pH, temperature and ionic change. Aim: To develop hydrogels that are sensitive to stimuli, i.e. pH, in the cul-de-sac of the eye for providing a prolonged effect and increased bioavailability with reduction in frequency of administration. Materials and Methods: Hydrogels were formulated by using timolol maleate as the model drug, polyacrylic acid as the gelling agents, hydroxyl ethyl cellulose as the viscolizer and sodium chloride as the isotonic agent. Stirring of ingredients in pH 4 phosphate buffer at high speed was carried out. The dynamic dialysis technique was used for drug release studies. In vivo study for reduction in intraocular pressure was carried out by using albino rabbits. Statistical Analysis: Drug release studies data were used for statistical analysis in first-order plots, Higuchi plots and Peppas exponential plots. Student t-test was performed for in vivo study. Results: Viscosity of the hydrogel increases from 3.84 cps to 9.54 cps due to change in pH 4 to pH 7.4. The slope value of the Peppas equation was found to be 0.3081, 0.3743 and 0.2964. Up to 80% of drug was released in an 8 h drug release study. Sterile hydrogels with no ocular irritation were obtained. Conclusions: Hydrogels show increase in viscosity due to change in pH. Hydrogels were therapeutically effacious, stable, non-irritant and showed Fickian diffusion. In vivo results clearly show a prolonged reduction in intraocular pressure, which was helpful for reduction in the frequency of administration.

Lipoprotein [a] is a feature of the presence, diffuseness, and severity of coronary artery disease in Saudi population

To study lipoprotein[a] [Lp[a]] levels in Saudi patients with angiographically defined coronary artery disease and to see its relationship with its severity and diffuseness. This cross sectional study was carried out at King Khalid University Hospital, Riyadh, Saudi Arabia in 2006-2007. One hundred and forty-seven individuals with coronary artery disease [CAD] and 49 healthy individuals matched for age and body mass index were studied. Among CAD patients, 133 underwent angiography. Blood samples were analyzed for total cholesterol [TC], triglycerides [TG], low density lipoprotein [LDL] and high density lipoprotein [HDL] and Lp[a]. Coronary artery disease patients had higher Lp[a] levels than controls [25.78 +/- 25.09mg/dl versus 14.57 +/- 11.81 mg/dl, p=0.0030]. Patients without stenosis [10.97 +/- 8.06mg/dl] and one vessel involvement [19.67 +/- 17.33mg/dl] had significantly lower levels of Lp[a] compared to double [31.88 +/- 32.17mg/dl] and triple [29.70 +/- 28.12mg/dl] vessel disease. Lipoprotein[a] levels correlated significantly with coronary vessel score [r = 0.234, p = 0.033] and Gensini score [r = 0.256, p = 0.02]. Smoking [odds ratio [OR]: 1.86; 95% confidence interval [CI]: 1.020-2.510; p=0.04], TG levels [OR: 2.04; 95% CI: 1.251-4.932; p = 0.03] and Lp[a] levels [OR: 1.56; 95% CI: 1.033-3.687; p = 0.025] significantly predicted CAD severity. High risk levels of Lp[a] >/= 30 mg/dL were present in 66.7% of CAD patients. Lipoprotein[a] levels are significantly higher in Saudi patients with CAD compared to healthy individuals, and are associated with more severe and diffuse blockage of the coronary vessels

Reference range values of fractional exhaled nitric oxide in healthy Arab adult males

To determine the reference values of the fraction of exhaled nitric oxide [FENO] among healthy, non-smoking male adults and its correlation with age, height, weight, and body mass index [BMI]. This cross-sectional study was conducted at the Departments of Physiology and Medicine, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, from September 2007 to August 2008 on healthy non-atopic, non-smoking male Saudi subjects. The FENO was measured online using the single-breath technique according to recent guidelines of the American Thoracic Society [ATS]. We studied 121 subjects with a mean age of 31.00 +/- 12.24 years, BMI of 27.23 +/- 6.64, and FEV1/FVC 85% [81-92%]. The FENO ranged between 7.66 parts per billion [ppb] and 46.6 ppb [mean 22.79 +/- 8.13], with >84% of subjects recording levels <30 ppb and >95% with levels <40 ppb. The FENO negatively correlated with body weight [r=0.3888, p=0.001] and BMI [r=0.238, p=0.009]. No correlation was observed between FENO, FEV1/FVC ratio, age, and height. The reference values of FENO for non-smoking, non-atopic male Saudi adults fall between 7.66 and 46.6 ppb [mean 22.79 +/- 8.13], similar to other populations. The FENO negatively correlates with body weight and BMI

Exhaled nitric oxide in stable chronic obstructive pulmonary disease

The objective of the study was to test the hypothesis that fraction of exhaled nitric oxide [FENO] is elevated in nonsmoking subjects with stable chronic obstructive pulmonary disease [COPD] and compare it with the results in patients with asthma and a control population. Cross-sectional study. Pulmonology Clinic at a University Hospital. Twenty five control subjects, 25 steroid naive asthmatics and 14 COPD patients were studied. All the patients were nonsmokers and stable at the time of the study. All subjects completed a questionnaire and underwent spirometry. Exhaled nitric oxide was measured online by chemiluminescence, using single-breath technique. All the study subjects were males. Subjects with stable COPD had significantly higher values of FENO than controls [56.54 +/- 28.01 vs 22.00 +/- 6.69; P =0.0001] but lower than the subjects with asthma [56.54 +/- 28.01 vs 84.78 +/- 39.32 P = 0.0285].The FENO values in COPD subjects were inversely related to the FEV[1]/FVC ratio. There was a significant overlap between the FENO values in COPD and the control subjects. There is a significant elevation in FENO in patients with stable COPD, but the elevation is less than in asthmatic subjects. Its value in clinical practice may be limited by the significant overlap with control subjects

F-ratio, a surrogate marker of carpal tunnel syndrome

To explore the correlation of F-ratio and F-wave minimal latency [FWML] in carpal tunnel syndrome [CTS]. This retrospective study was conducted from January 2006 to January 2007 at the clinical physiology lab, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia. Motor and sensory nerve conduction studies, FMW latencies of median and ulnar nerves, and F-ratio were carried out in 54 CTS patients and 30 controls. Out of 54 CTS patients, there were 14 were males [26%], and 40 females [74%], CTS was bilateral in 32 [59%], and unilateral in 22 [41%] patients. Fifty-one patients [94.4%] had involvement of the right hand, 28 patients [51.8%] had dyslipidemia and 20 patients [37%] had hypertension. The FWML [ms] in the right median nerve was 25.46 +/- 2.2, and 25.79 +/- 1.7 in the right ulnar nerve in the control group [p = 0.5224], while it was 29.1 +/- 3.35 in the right median nerve and 26.46 +/- 4.35 in the right ulnar nerve in patients with CTS [p = 0.0008]. A similar statistically significant increase in the median nerve latency was observed in the left hand. A statistically significant reduction in the F-ratio was found consistently in all patients with CTS in both the hands [p = 0.0001]. The present study reveals prolongation of FWML in the median nerve, and a statistically significant reduction of F-ratio in all CTS patients. A significant inverse correlation was found between FWML and F-ratio in CTS patients. Both FWML and F-ratio support the diagnosis of CTS

Exhaled nitric oxide: An emerging marker of inflammation in respiratory diseases

Fractional exhaled nitric oxide [FENO] is a recently introduced non invasive marker to measure inflammation and oxidative stress in the lung. The numerous roles of NO in respiratory pathophysiology have been extensively reviewed. There is contradictory evidence regarding the exact function of NO in lung diseases. In pathological states, the enzyme inducible NO synthase generates extraordinarily high concentrations of NO when the body faces an inflammatory response by attracting macrophages that generate NO and hence NO participate in host defense against specific organisms. Fractional exhaled nitric oxide measurements have been useful in asthma, chronic obstructive pulmonary disease, cystic fibrosis, and bronchiectasis. The technique used to measure FENO is well standardized, requires the same amount of time that spirometry takes, and is feasible to be performed in young children. Measuring FENO has added another dimension to the determination of adverse respiratory effects because it allows detection of inflammatory responses in the absence of functional impairments. This review provides an insight into measurement methods, physiological factors affecting FENO, interpretation of results and diseases related to changes in FENO levels. This will help physicians in diagnosing and monitoring their treatments for different respiratory diseases

Assessment of lipid profile in Saudi type 2 diabetic and non-diabetic periodontal patients

To study the extent of periodontal disease in diabetic and non-diabetic periodontitis patients, and to investigate the relationship of dyslipidemia and periodontal disease, in diabetic and non-diabetic periodontitis patients. This is a cross-sectional study at the Department of Preventive Dental Sciences College of Dentistry and Department of Physiology College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from February 2003 to June 2004. A total of 90 patients was recruited, and divided into 3 equal groups of 30 subjects, with age and gender matched, and divided as follows: group 1 healthy group: periodontally and systemically healthy subjects, group 2 periodontitis group: chronic periodontitis patients with no systemic disease, group 3 diabetic group: chronic periodontitis patients with type 2 diabetes mellitus. Plaque index, bleeding on probing, probing pocket depth PPD, and clinical attachment level CAL were measured at the time of initial examination. The glycated hemoglobin, total cholesterol, low density lipoprotein LDL, triglyceride, high density lipoprotein were also measured. Periodontal parameters PPD and CAL were of significantly higher value in the diabetic patients, when compared to the periodontitis patients p<0.05. The total cholesterol, LDL, and triglyceride were also found to be significantly higher among the periodontitis patients than the healthy subjects p<0.05. This study indicated that type 2 diabetic patients had a higher risk to develop advanced periodontal disease than the non-diabetic subjects. It also highlighted the association of dyslipidemia in periodontitis patients

Gene expression profiling in women with breast cancer in a Saudi population

To generate consensus gene expression profiles of invasive breast tumors from a small cohort of Saudi females, and to explore the possibility that they may be broadly conserved between Caucasian and Middle Eastern populations. This study was performed at King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia, from January 2005 to January 2007. Gene expression profiles were generated from 38 invasive breast tumors, and 8 tumor adjacent tissues [TATs] using BD Atlas cDNA expression arrays containing 1176 genes. Results were confirmed by reverse transcriptase polymerase chain reaction, and analyzed by 2-dimensional unsupervised hierarchical clustering. The analysis identified 48 differentially expressed genes in tumors from which 25 are already reported by various western studies. Forty-three of these genes were also differentially expressed in TATs. The same data set has been able to distinguish between tumors and the TATs, interestingly by using only 4 of the differentially expressed genes. Moreover, we were able to group the patients according to prognosis to an extent by hierarchical clustering. Our results indicate that expression profiles between Saudi females with breast cancer and the Caucasian population are conserved to some extent, and can be used to classify patients according to prognostic groups. We also suggest 3 differentially-expressed genes [IGHG3, CDK6, and RPS9] in tumors may have a novel role in breast cancer. In addition, the role of TATs is much more essential in breast cancer, and needs to be explored thoroughly

Comparative recognition by human IgG antibodies of recombinant proteins representing three asexual erythrocytic stage vaccine candidates of Plasmodium vivax

In previous immuno-epidemiological studies of the naturally acquired antibody responses to merozoite surface protein-1 (MSP-1) of Plasmodium vivax, we had evidence that the responses to distinct erythrocytic stage antigens could be differentially regulated. The present study was designed to compare the antibody response to three asexual erythrocytic stage antigens vaccine candidates of P. vivax. Recombinant proteins representing the 19 kDa C-terminal region of MSP-1(PvMSP19), apical membrane antigen n-1 ectodomain (PvAMA-1), and the region II of duffy binding protein (PvDBP-RII) were compared in their ability to bind to IgG antibodies of serum samples collected from 220 individuals from the state of Pará, in the North of Brazil. During patent infection with P. vivax, the frequency of individuals with IgG antibodies to PvMSP1(19), PvAMA-1, and PvDBP-RII were 95, 72.7, and 44.5 percent respectively. Although the frequency of responders to PvDBP-RII was lower, this frequency increased in individuals following multiple malarial infections. Individually, the specific antibody levels did not decline significantly nine months after treatment, except to PvMSP1(19). Our results further confirm a complex regulation of the immune response to distinct blood stage antigens. The reason for that is presently unknown but it may contribute to the high risk of re-infection in individuals living in the endemic areas.

Comparison of lipid profiles and lipoprotein [a] levels in patients with type 2 diabetes mellitus during oral hypogrlycemic or insulin therapy

The aim of this study is to compare lipid and lipoprotein [a] profiles in patients with type 2 diabetes mellitus [DM] on insulin and oral hypoglycemic therapy. The study took place in the Department of Physiology, Army Medical College, Rawalpindi, Pakistan, during 2002. Ninety-seven type 2 DM patients participated in the study. We divided the patients according to the type of treatment into sulphonylurea [n=40], sulphonylurea plus metformin [n=33] and insulin [n=24] therapy groups as well as 40 healthy subjects served as controls. Fasting blood samples were analyzed for lipoprotein [a] [Lp [a]], total cholesterol [TC], triglycerides [TG], low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], glucose, glycosylated hemoglobin [HbA1c] and insulin. Different groups of diabetic patients showed elevated fasting blood glucose [FPG] levels [p<0.0001 for all], HbA1c [p<0.0001 for all] compared with controls. Meanwhile, fasting insulin levels were elevated only in insulin treated group compared with oral hypoglycemic treated groups and controls [p<0.0001 for all]. Patients on sulphonylurea and on sulphonylurea plus metformin groups showed significantly elevated TC [p<0.001, p<0.0001], TG [p<0.001, p<0.01], LDL-C [p<0.01, p<0.001] and LDL-C/HDL-C [p<0.0001, p<0.0001] compared with controls. Insulin therapy group showed significantly decreased TC, TG, LDL-C, LDL-C/HDL-C levels compared with sulphonylurea and sulphonylurea plus metformin treated groups, however, no significant difference was noted in the levels of above mentioned parameters and controls. Meanwhile, HDL-C levels were significantly lower in all diabetic groups compared with controls and were higher in insulin treated group compared with sulphonylurea plus metformin therapy group [p<0.05]. Lipoprotein [a] levels were significantly higher in different diabetic groups compared with controls. While there was a non-significant difference in Lp [a] levels between different diabetic groups. Patients with type 2 DM who are being treated on insulin have a better lipid profile [TC, HDL-C, LDL-C, TG] compared with those patients on oral hypoglycemic agents. Meanwhile, Lp [a] levels were raised in all diabetic patients and seem not to be affected either by insulin or by oral hypoglycemic treatment