Fluctuation in the levels of immunoglobulin m and immunoglobulin g antibodies for cardiolipin and beta[2]-glycoprotein among healthy pregnant women

Antiphospholipid antibodies fluctuate during a healthy normal pregnancy. This study aimed to investigate the levels of both immunoglobulin M [IgM] and Immunoglobulin G [IgG] antibodies for cardiolipin and [beta[2]-glycoprotein [beta[2]GP] among healthy pregnant women. This study was conducted between May 2010 and December 2012. A total of 75 healthy Omani pregnant women with no history of autoimmune disease were investigated during their pregnancy and 90 days after delivery at the Armed Forces Hospital in Muscat, Oman. A control group of 75 healthy Omani non-pregnant women were also investigated as a comparison. Levels of IgM and IgG antibodies for both anti-cardiolipin antibodies [ACAs] and [beta[2]GP were measured using a standard enzyme-linked immunosorbent assay. The ACA IgM levels were significantly higher in the control group compared to the pregnant women [P <0.001]. No significant differences were observed in the ACA IgM levels between the control group and the pregnant women after delivery. In contrast, ACA IgG levels were significantly higher during pregnancy and after delivery compared with those of the healthy control group [P = 0.007 and 0.002, respectively]. The levels of beta[2]GP IgG were significantly higher during pregnancy than after delivery and in the control group [P = 0.001 and <0.001, respectively]. In this study, ACA IgG levels increased during healthy pregnancies and after normal deliveries whereas beta[2]GP IgG levels increased transiently during the pregnancies. Both phenomena were found to be significantly associated with a transient decline in the levels of IgM specific for these antigens. Therefore, the levels of these antibodies may be regulated during a healthy pregnancy

Spectrum of AIDS defining opportunistic infections in a series of 77 hospitalised HIV-infected Omani patients

Most of the morbidity and mortality in human immunodeficiency virus/acquired immune deficiency syndrome [HIV/AIDS] result from opportunistic infections [OIs]. Although the spectrum of OIs in HIV infected patients from developing countries has been reported, there is a paucity of data on the natural history, pattern of disease, and survival of hospitalised patients with HIV/AIDS, particularly in Arab countries. The aim of this study was to study retrospectively the spectrum and frequency of various OIs in a cohort of hospitalised HIV-infected Omani patients. Included in the study were 77 HIV-infected Omani patients admitted to a tertiary care teaching hospital in Muscat, Oman, between January 1999 and December 2008. They were diagnosed on their first admission and hence were not on highly active antiretroviral therapy [HAART] at presentation. The frequency of various clinical and laboratory findings and individual OIs were analysed. In total, 45 patients [58%] had one or more AIDS-defining OIs. Pneumocystis jiroveci pneumonia [PCP] was commonest [25%], followed by cryptococcal meningitis [22%], cytomegalovirus [CMV], retinitis [17%], disseminated tuberculosis [15%], and cerebral toxoplasmosis [12.5%]. Only one patient with Mycobacterium avium-intracellulare [MAI] was identified and one patient had disseminated visceral leishmaniasis. The majority of patients [77%] had CD4+ counts <200 cells/ micro L. Ten patients [22%] died during hospital stays, with five deaths [50%] being caused by disseminated CMV infection. A wide spectrum of OIs is seen in hospitalised HIV-infected patients in Oman. P. jiroveci pneumonia and cryptococcal meningitis were the commonest OIs, while disseminated CMV was the commonest cause of death. We hope these results will advance the knowledge of specialists treating HIV in Oman and the Gulf region

importance of HIV antenatal screening programs for pregnant women

To investigate retrospectively the prevalence of human immunodeficiency virus [HIV]-1 and among pregnant women during a 10-year period. The total number of pregnant women attending the Sultan Qaboos University Hospital [SQUH]. Muscat, Oman between January 1995 and December 2005 was 11553 women. Their age range was 16-45 years [average of 28.6 +/- 7.6 years]. The women were tested for HIV- 1 and 2 using the standard enzyme-linked immunosorbent assay [ELISA]. Positive samples were further tested by Western Blot. The data were statistically analyzed using the Statistical Package for Social Sciences Version 10.0. By ELISA testing, 21 women were positive for HIV-1 [prevalence rate: 0.2%] and 3 women were weakly positive for HIV-1 [24 women; 0.2% prevalence rate]. However, 15 women were confirmed HIV- 1 positive using the Western Blot method [prevalence rate: 0.13%] with an average of 1.5 positive women per year. None of the women were found positive for HIV-2. This relatively high prevalence of HIV-1 among pregnant women attending SQUH, highlights the need for screening all pregnant women attending different hospitals and antenatal clinics in Oman. This is essential for preventing the transmission of HIV-1 and 2 to the infants and to the community, and for the appropriate medical treatment and counseling of affected women

Reference ranges for lymphocyte subsets in healthy adult male Omanis

To determine the reference ranges of lymphocyte subsets in serologically HIV-seronegative healthy male adults in Oman. A cohort, of 118 healthy male blood donors ranging in age from 18-51 years, was included in the study. The average age was 25 years. Blood samples collected into tubes containing ethylene-diamine-tetra acetic acid were investigated for lymphocyte subsets using flow cytometer. This study was conducted in the Immunology Laboratory of the Sultan Qaboos University, College of Medicine and Health Sciences, Muscat, Oman during the year 2006. For the 118 males investigated, the mean percentage and absolute values of the lymphocyte subsets were as follows: CD3: 68.53 +/- 7.5%, 1701 +/- 489 cells/microliter; CD4: 40.4 +/- 6.5%, 1006 +/- 319 cells/microliter; CD8: 25.8 +/- 5.9%, 638 +/- 225 cells/microliter; CD19: 13.7 +/- 4.7%, 349 +/- 158 cells/microliter, and CD56: 12.2 +/- 6.7%, 308 +/- 204 cells/microliter. The ratio of CD4/CD8 was 1.6. Immunophenotyping has been used to establish reference values of lymphocyte subsets in normal healthy adult males in Oman. The Omani male reference values obtained in this study show wide variations compared with kits values previously used as a reference

Mechanism of host resistance against HIV infection and progression to AIDS

Since the discovery in the early eighties of the Human Immunodeficiency Virus [HIV] that causes acquired immunodeficiency syndrome [AIDS], there have been reports of people who were completely resistant to infection with HIV and others who progressed at slower rates to AIDS. The present article summarises the mechanisms involved in resistance against HIV infection and progression to AIDS. The paper will specifically focus on the role of immunological mechanisms, genetics, ethnicity and cultural practices such as male circumcision in mitigating infection. The current understanding on host natural resistance against HIV infection and progression to AIDS would potentially contribute to better prevention strategies, delayed onset of AIDS in people living with HIV, the identification of more efficient types of therapy for AIDS patients and, possibly, appropriate vaccines against HIV/AIDS. This area of research has important implications for patient care through controlling factors that contribute to AIDS progression

Reference ranges for serum immunoglobulin A, G and M in the adult population from the South of Oman

Data on the normal levels of serum immunoglobulins in the south of Oman is lacking. This region of Oman is unique in its climate and environment compared to all other regions of Oman and the Gulf countries. We have conducted this study to determine the reference levels of serum immunoglobulin G, M and A in an adult healthy group of individuals from the south of Oman. Serum samples were collected from 489 healthy Omani individuals, 389 males and 100 females, from the southern area of Oman [Dhofar]. The age range of the males and females were 18 to 54 and 19 to 48 years, with an average of 30 and 24 years, respectively. Serum lgG, IgM and IgA levels were measured using a rate nephelometer. The mean serum levels of lgG, IgM and IgA were 12.88 g/L, 1.01 g/L and 2.64g/L, respectively. The lower and upper limits for the normal serum levels of IgG, IgM and IgA were determined as 8.52-17.45g/L; 0.374-2.05g/L and 1.23-4.77g/L, respectively. No significant difference in the mean serum levels was observed between the two sexes for lgG. However, IgM and IgA levels were significantly higher in the female group [P<0.001]. Young individuals with age below 20 years have significantly low levels of IgA [P<0.01] as compared to those above this age. The normal levels of the serum immunoglobulin G, M, and A were established for this Omani group. Our results confirmed the significant difference in IgM concentration between adult male and female individuals, with females having higher levels than males. Further, the results showed the occurrence of low levels IgA in young Dhofari individuals [

Rheumatoid arthritis cytokines and hypoxia. What is the link?

Rheumatoid arthritis [RA] is a chronic systemic inflammatory disorder that affects approximately 1% of the population, in a female to male ratio of 3:1. The disease can occur at any age, but it is most common among those aged 40-70 years. Despite many years of study, the etiology of RA is still undefined. However, with increased understanding of the immune system the pathogenesis of RA has become clearer. A large bulk of data suggests that T lymphocytes and macrophages play a critical role in the initiation and perpetuation of synovial inflammation. Recently, the cytokine profile of T helper cells has been associated with the disease, the cytokine repertoire of inflamed synovia is categorized as that of T helper 1 response. Moreover, in RA elevated levels of pro-inflammatory or inflammatory cytokines such as Tumor Necrosis Factor - alpha [TNF-alpha] and Interleukin -1 beta [IL-1beta] have been detected. Hypoxia up-regulates TNF-alpha and IL-1beta; therefore, considerable research interest has been focused on the biological consequences of the hypoxic nature of the rheumatoid synovium. Hypoxia might underlie the functional polarization of the T cells and cytokine production, and thus may contribute to the progression and persistence of the disease. In this short review, we discuss our current knowledge of the link between cytokines and RA and the role of hypoxia in the pathogenesis of the disease

In-vitro antimicrobial activity of Lawsonia inermis Linn. A pilot study on the Omani henna

To investigate the antimicrobial activity of henna's fresh and dry leaves and seeds obtained from Oman. This study was carried out at the College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman during the period January-June, 2004. Crude extracts of fresh and dry leaves and seeds were investigated for their antimicrobial activity against 3 standard bacterial strains namely: Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa. Eleven different bacterial strains were obtained from patients attending the Sultan Qaboos University Hospital, Muscat, Sultanate of Oman. In addition, one Candida albicans [C. albicans] species was used for testing the antifungal activity of the Omani henna sample. All fresh and dry leaves and seeds of the Omani henna demonstrated antibacterial activity against all 3 standard strains and the 11 patients' isolated strains. Henna dry leaves demonstrated the best in-vitro antimicrobial activity and in particular against Shigella sonnei. However, henna fresh and dry seeds failed to show any activity against C. albicans. Omani henna does possess, in-vitro antibacterial activity against a wide spectrum of bacterial strains and C. albicans

Anticardiolipin and antinuclear antibodies in the adult healthy Omani individuals

To investigate the prevalence and normal versus abnormal levels of anticardiolipin antibodies [aCL] in a healthy adult population of Omanis and whether a correlation exists between aCL and antinuclear antibodies [ANA] in this Omani population. A total of 521 healthy Omani individuals [333 males and 188 females], aged between 17-54-years were investigated for the presence and quantities of anticardiolipin antibodies [immunoglobulin G [IgG]] and IgM isotypes using a conventional enzyme linked immunosorbent assay. Antinuclear antibodies were detected, in this group, using standard indirect immunofluorescence techniques. This study was conducted during the period 2002 through to 2003 at the Immunology Laboratories, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Sultanate of Oman. The prevalence of aCL in the healthy Omani population was estimated to be 2.5% for IgG and 3.1% for IgM. The cut off points for IgG and IgM were determined for the whole population as 22.5 IgG phospholipid [GPL] units and 15.7 IgM phospholipid [MPL] units, using the mean plus 5 standard deviations. Using these cut off values, aCL were not detected in the majority of individuals [97%] and in the remaining 3%, the levels were not very high. There was no significant difference between the levels of aCL in either the male or female groups and no significant correlation for the presence of aCL with the age in this studied population. Antinuclear antibodies were detected in 76/521 [14.6%] of the population studied, with some individuals [0.8%] showing titers of 1:640, but there was no association with aCL. Although, ANA is present in this healthy Omani population at high frequency and in some individuals at high levels, high levels of aCL do not occur and their presence may be an indicator of autoimmune mediated pathology

Awareness of hepatitis B virus among undergraduate medical and non-medical students

To investigate the awareness of Omani medical and non-medical students of hepatitis-B virus [HBV] infection. A structured questionnaire of 31 different statements concerning basic knowledge of HBV, its modes of transmission, diagnosis, risk behaviors, prevention, treatment, beliefs as well as attitudes towards patients with HBV infection were distributed to 280 students [154 females and 126 males]. Of these 138 were pre-clinical medical students and 142 were non-medical students. The study was conducted at Sultan Qaboos University, Muscat, Sultanate of Oman during the period of 2001 to 2003. The majority of the students [75%] were aware that HBV is a common cause of hepatitis and 50.7% of them think that HBV infection is preventable. Availability of vaccine is a fact appreciated more by medical [65.2%] than by non-medical [35.2%] students [p<0.05]. Approximately 70% of the cohort believed that screening blood for HBV renders blood safe for transfusion. Hepatitis B virus infected student or colleague in the same classroom or working place was accepted by 58% of medical and 46.5% of non-medical students. However, the majority of students [63.2%] hesitate to take care of a HBV infected patient. The majority of students showed some knowledge regarding HBV transmission, risk behaviors and prevention. However, there are still misconceptions regarding the attitudes, which reflect a false perception of the disease among students. This calls for well-structured health education programs stressing on such misconceptions

Frequency and levels of autoantibodies in healthy adult Omanis

A previous pilot study showed a high frequency of anti-smooth muscle autoantibody in Omani blood donors and pregnant women. We conducted this larger-scale study to investigate the frequency and significance of several autoantibodies in healthy individuals from different regions of Oman. Sera obtained from 1537 healthy Omanis [1153 males and 384 females], ranging in age from 18 to 57 years, were tested for the presence of ten different autoantibodies using indirect immunofluorescence, haemagglutination and latex agglutination techniques. Low levels of autoantibodies were detected in 33.5%, whereas a few individuals [1.8%] showed high autoantibody titres. Anti-smooth muscle autoantibodies [ASMA] were the most prevalent [11%]. Anti-nuclear autoantibodies [ANA] were the second most prevalent [7.6%]. Anti-thyroid microsomal autoantibodies [ATMA] and anti-thyroglobulin autoantibodies [ATA] were present in 6.5% and 4.4% of individuals, respectively. The other autoantibodies were detected much less frequently: anti-parietal cells autoantibodies [APCA] were found in 1.6%, anti-brush border antibodies [ABBA] in 1.3%, anti-reticulin autoantibodies [ARA] in 1%, antimitochondrial antibodies [AMA] in 0.8%, antiglomerular basement membrane antibodies [AGBMA] in 0.7% and rheumatoid factor [RF] in 0.4%. The data indicate that autoantibodies are present in healthy Omani individuals, and therefore caution should be taken when interpreting laboratory results of patients suspected of having autoimmune disease

How does HIV-1 infect a susceptible human cell? Current thinking

To insure its survival, the human immunodeficiency virus [HIV], the causative agent of acquired immunodeficiency syndrome [AIDS], utilises more than one gate to enter a target cell. This strategy makes it more difficult for the immune system to defeat the virus. This has also made it difficult for scientists working in the HIV research to understand how exactly HIV infects a susceptible human cell. Such understanding will no doubt open many gates for scientists to vanquish the virus by designing agents that can block HIV entry into target cells, thus rendering the virus vulnerable to immune destruction. This will also help in understanding the replication of the virus and the pathogenesis of the disease. The present article briefly describes the past and current thinking of how HIV-1 infects a susceptible human cell, and the dilemma scientists are facing when studying the infectivity of this virus and applying current knowledge to design agents that can block HIVs entering target cells. In the context of our own experience with HIV infectivity in vitro, the present article will also address the behaviour of different HIV isolates, both laboratory-adopted and clinical [primary] isolates in culture and the difficulties in performing HIV infectivity testing. Moreover, our experience of peripheral blood mononuclear cells- [PBMCs] susceptibility to HIVs infection in vitro is discussed

Occurence of autoantibodies in healthy Omani individuals

To investigate the occurence of various autoantibodies in the Omani population. Sera from 392 healthy Omani individuals comprising 183 pregnant women and 209 blood donors [183 men and 26 women] were investigated. Autoantibodies were detected using immunofl uorescence, haemagglutination and latex agglutination techniques. Low levels of autoantibodies were detected in approximately 50% of the subjects; very few subjects showed high autoantibody titres. Anti smooth muscle autoantibodies [ASMA] were the most prevalent, and were detected in 31.6% of the individuals. Anti thyroid microsomal autoantibodies [ATMA] and anti thyro globulin autoantibodies [ATA] were present in 5.9% and 4.9% of indivi duals respect ively. The other autoantibodies were detected much less frequently, viz. anti nuclear auto antibodies [ANA] in 1.5%, anti parietal cells autoantibodies [APCA] in 1.8%, antireticulin autoantibodies patterns [ARAP] in 3.0% and rheumatoid factor [RF] in 1.0% of the subjects. The data indicate that autoantibodies do exist in healthy Omani individuals and the results of clinical tests for these autoantibodies must be interpreted with caution