Diabesity in the Arabian Gulf: Challenges and Opportunities

Diabesity [diabetes associated with obesity] is a major global and local public health concern, which has almost reached an epidemic order of magnitude in the countries of the Arabian Gulf and worldwide. We sought to review the lifestyle trends in this region and to highlight the challenges and opportunities that health care professionals face and attempt to address and correct them. In this regard, we aimed to review the regional data and widely held expert opinions in the Arabian Gulf and provide a thematic review of the size of the problem of diabesity and its risk factors, challenges, and opportunities. We also wished to delineate the barriers to health promotion, disease prevention, and identify social customs contributing to these challenges. Lastly, we wished to address specific problems with particular relevance to the region such as minimal exercise and unhealthy nutrition, concerns during pregnancy, the subject of childhood obesity, the impact of Ramadan fasting, and the expanding role of bariatric surgery. Finally, general recommendations for prevention, evidence-based, and culturally competent management strategies are presented to be considered at the levels of the individual, community, and policymakers

Mutation in the PCSK9 gene in Omani Arab subjects with autosomal dominant hypercholesterolemia and its effect on PCSK9 protein structure

Proprotein convertase subtilisin/kexin type [PCSK9] is a crucial protein in LDL cholesterol [LDL-C] metabolism by virtue of its pivotal role in the degradation of the LDL receptor. Mutations in the PCSK9 gene have previously been found to segregate with autosomal dominant familial hypercholesterolemia [ADFH]. In this study, DNA sequencing of the 12 exons of the PCSK9 gene has been performed for two patients with a clinical diagnosis of familial hypercholesterolemia where mutation in the LDL-receptor gene hasn't been excluded. One missense mutation was detected in the exon 9 PCSK9 gene in the two ADFH patients. The patients were found to be heterozygote for Ile474Val [SNP rs562556] Using an array of in silico tools, we have investigated the effect of the above mutation on different structural levels of the PCSK9 protein Although, the mutation has already been reported in the literature for other populations, to the best of our knowledge this is the first report of a mutation in the PCSK9 gene from the Arab population, including the Omani population

Clinical and epidemiological characteristics of pituitary tumors using a web-based pituitary tumor registry in Oman

From a recently instituted web-based pituitary tumour registry at Sultan Qaboos University Hospital, Oman, this study explores the results of comprehensive clinical evaluation, hormonal levels, radiological evidence of pituitary mass lesion using magnetic resonance [MRI] and the different treatment modalities. All patients who were diagnosed with pituitary mass tumours in our tertiary care endocrinology clinic between January 1998 and February 2006 were registered in the Oman pituitary tumour registry. Two physicians performed hospital chart review and data entry. A total of 160 entries were made into the pituitary tumour registry. The overall mean age of the cohort was 32 +/- 12 years [age range 8-73 years]. The majority of registrations were female [n=114; 71%]. There were 81 patients with non-functioning adenomas [50.6%], 59 with prolactinoma [36.9%] eight with acromegaly [5%], seven with craniopharyngioma [4.4%], four with Cushing's disease [2.5%] and one with sarcoidosis [0.6%]. Sub-group analyses were done only for the subjects with the 3 most prevalent pituitary tumours [non-functioning adenomas, prolactinomas, and acromegaly]. The most prevalent symptoms are amenorrhea-galactorrhea [n=55; 37%], headache [n=31; 21%] and fatigue [n=23; 16%]. The most common treatment modality was medical [n=58; 39%], followed by observation [n=56; 38%], surgery [n=31; 21%] and surgery plus medical [n=3; 2%]. None of the patients in this registry are recorded to have died. To our knowledge, this is the first pituitary tumour registry in the Arabian Gulf countries using a web-based programme. This tumour registry will enable us to characterize clinical and the epidemiological features of pituitary tumours in the Sultanate of Oman