Impact of phosphate solubilizing bacteria on wheat (Triticum aestivum ) in the presence of pesticides / Impacto das bactérias solubilizantes de fosfato no trigo (Triticum aestivum ) na presença de pesticidas

Abstract Three phosphate solubilizing bacteria were isolated and identified by 16S rRNA sequencing as Pseudomonas putida, Pseudomonas sp and Pseudomonas fulva . The strains were subjected to plant biochemical testing and all the PGPR attributes were checked in the presence of pesticides (chlorpyrifos and pyriproxyfen). The phosphate solubilizing index of strain Ros2 was highest in NBRIP medium i.e 2.23 mm. All the strains showed acidic pH (ranges from 2.5-5) on both medium i.e PVK and NBRIP. Strain Ros2 was highly positive for ammonia production as well as siderophore production while strain Rad2 was positive for HCN production. The results obtained by the strains Rad1, Rad2 and Ros2 for auxin production were 33.1, 30.67 and 15.38 µg ml-1, respectively. Strain Rad1 showed 16% increase in percentage germination in comparison to control in the presence of pesticide stress. Most promising results for chlorophyll content estimation were obtained in the presence of carotenoids upto 6 mgg-1 without stress by both strains Rad1 and Rad2. Study suggests that especially strain Ros2 can enhance plant growth parameters in the pesticide stress.

Resumo Três bactérias solubilizantes de fosfato foram isoladas e identificadas por seqüenciamento de rRNA 16S como Pseudomonas putida, Pseudomonas sp e Pseudomonas fulva. As estirpes foram submetidas a testes bioquímicos de plantas e todos os atributos PGPR foram verificados na presença de pesticidas (clorpirifos e piriproxifeno). O índice de solubilização de fosfato da estirpe Ros2 foi mais elevado no meio NBRIP, isto é, 2,23 mm. Todas as estirpes apresentaram um pH ácido (varia de 2,5-5) em ambos os meios, isto é PVK e NBRIP. A estirpe Ros2 foi altamente positiva para a produção de amoníaco, bem como a produção de sideróforos enquanto a estirpe Rad2 foi positiva para a produção de HCN. Os resultados obtidos pelas estirpes Rad1, Rad2 e Ros2 para a produção de auxina foram 33,1, 30,67 e 15,38 μg ml-1 , respectivamente. A deformação Rad1 mostrou aumento de 16% na germinação percentual em comparação com o controlo na presença de stress de pesticida. Os resultados mais promissores para a estimativa do teor de clorofila foram obtidos na presença de carotenóides até 6 mgg-1 sem estresse por ambas as cepas Rad1 e Rad2. Estudo sugere que especialmente a estirpe Ros2 pode melhorar parâmetros de crescimento de plantas no estresse de pesticidas.

A case of intramural coronary amyloidosis associated with hemodialysis

Dialysis-related amyloidosis predominantly occurs in osteo-articular structures and dialysis-related amyloid (DRA) substances also deposit in extra-articular tissues. Clinical manifestations of DRA include odynophagia, gastrointestinal hemorrhage, intestinal obstruction, kidney stones, myocardial dysfunction, and subcutaneous tumors. The pathological characteristics of DRA in the heart of hemodialysis patients have rarely been reported. We report the case of a 73-year-old female with a history of cerebral palsy and end-stage renal disease status post two failed renal transplants who had been on hemodialysis for 30 years. The patient was admitted with the working diagnosis of pneumonia. An echocardiography showed markedly reduced biventricular function manifested by low blood pressure with systolic in the 70s and elevated pulmonary artery pressure of 45 mmHg, which did not respond to therapy. Following her demise, the autopsy revealed bilateral pulmonary edema and pleural effusions. There was cardiac amyloid deposition exclusively in the coronary arteries but not in the perimyocytic interstitium. Amyloids were also found in pulmonary and intrarenal arteries and the colon wall. Previous case reports showed that beta 2-microglobulin amyloid deposits in various visceral organs but less frequently in the atrial and/or the ventricular myocardium. In the present case, amyloids in the heart were present in the intramural coronary arteries causing myocardial ischemia and infarction, which was the immediate cause of death.

Laparoscopic Sleeve Gastrectomy for Morbid Obesity: UAE Tertiary Care Hospital Initial Experience.

Aim: To study efficacy of Laparoscopic Sleeve Gastrectomy (LSG) for morbid obesity as a measure of weight reduction over a period of one year from May 2011 – 2012. Materials and Methods: Morbidly obese patients (n=109) referred from clinics with primary problem of obesity and consequent co-morbidities underwent the procedure LSG during a period of one year. The data included; demographics, weight of patients/BMI, Comorbid conditions, preoperative work up, indications for surgery, length of hospital stay, duration of surgery, postoperative complication and reduction of weight at 3 weeks, 3, 6 and 12 months. Results: Out of 109 patients, 94 (86%) are below 40 years of age, reflecting high prevalence of obesity in the younger population in UAE. As per gender, 67 (61.5%) are female and 42 (38.5%) male. Preoperatively, mean weight is 121±16 kg; 68 (62.4%) patients have BMI 40-50 kg/m2 and 41 (37.6%) of 35-40 kg/m2, 12 (11%) patients are diabetics (DM), 9 (8.3%) hypertensive (HTN), 12 (11%) have symptoms of Gastritis, 3 (2.8%) have shown Clo test +ve., 7 (6.4%) complaining Knee Joint pain, 3 (2.8%) with Backache, 2 (1.8%) patients are diagnosed cases of gastroesophageal reflux disease (GERD), though 58 (53.2%) have no comorbidities. Among those 107 (98.2%) patients are referred to dietitian. All patients underwent laparoscopic sleeve gastrectomy (LSG). Postoperatively, 104 (95.4%) patients were without any complication. 1 (0.9%) patient has bleeding while 4 (3.7%) has minor issues (nausea, vomiting) and there was no leak in this group of patients. On follow up, there was a significant weight loss and improvement of comorbidities: At 3 weeks post op, the mean weight was 113±16 kg, at 3 months 103±13 kg, at 6 months 92±12 kg and at 1 year 82±10 kg. Complete resolution of Diabetes Mellitus (DM) observed in 7 (58.33%) out of 12 patients and improvement in 5 (41.55%). Complete resolution of hypertension (HTN) in 5 (55.55) and improvement in 4 (44.44). Gastritis completely resolved in 10 (83.33) and improved in 2 (16.66). The patients who had knee joint pain and backache, all improved. Conclusion: LSG has clearly proven its efficacy for morbid obesity in term of weight reduction and consequent co-morbidities. It’s gaining popular in community being an acceptable and safe procedure.

control-matched comparison of flap off and flap on laser-assisted subepithelial keratectomy [LASEK] for the treatment of myopia and myopic astigmatism

Purpose: To compare the visual and refractive outcomes of flap off and flap on, Laser Assisted Subepithelial Keratectomy [LASEK] for low to moderate myopia

Methods: A prospective non-randomized control-matched study was conducted in which 53 patients underwent LASEK for the treatment of low to moderate myopia and myopic astigmatism. Right eye of each patient had the flap removed [flap off] while in the left eye the flap was recapped [flap on]. Equal number [N = 53] of flap on was matched with flap off having preoperative manifest refraction spherical equivalent within +/- 0.75 Diopters [D]. Primary outcome variables included uncorrected visual acuity [UCVA], best spectacle-corrected visual acuity [BSCVA] and manifest refraction

Results: Preoperatively, the mean spherical equivalent [SE] was -3.59 +/- 1.46 D for flap off and -3.67 +/- 1.51 D for flap on [p = 0.779]. The mean preoperative sphere was -3.32 +/- 1.58 D for flap off group and -3.36 +/- 1.61 D for flap on group [p = 0.338] whereas, the mean preoperative cylinder was -0.55 +/- 0.70 D and -0.63 +/- 0.68 D for flap removal and flap preservation groups respectively [p = 0.576]. Postoperatively, the mean LogMAR UCVA was -0.035 +/- 0.079 for flap off and -0.043 +/- 0.085 for flap on. The percentages of eyes that had UCVA of 20/40 or better were 98.1% for flap off group and 100% for flap on group [p = 0.317]. Mean postoperative SE was 0.00 +/- 0.19 D for flap off group and -0.03 +/- 0.43 D for flap on group. In flap removal group, 100% eyes were within +/- 0.50 D of the intended correction while in flap preservation group, 92.5% and 100% eyes were within +/- 0.50 D and +/- 1.00 D of the intended correction, respectively. Mean postoperative LogMAR BSCVA was -0.013 +/- 0.044 for flap removal group and -0.016 +/- 0.049 for flap preservation group [p = 0.727]

Conclusions: The differences in the visual and refractive results between flap preservation and flap removal groups were not clinically significant. Both procedures seemed safe and effective for the treatment of myopia and myopic astigmatism

Evaluation of knowledge of Health Care Professionals on warfarin interactions with drug and herbal medicines

Objectives: To evaluate health care professionals' knowledge on warfarin interactions with drugs and herbs

Methods: A self-administered questionnaire was developed to assess health care professionals' knowledge on warfarin interactions with drug and herb. Respondents were asked to classify 15 drugs that may effect on warfarin action as "enhance", "inhibit ", "no effect". The study sample involved health care professionals [physicians, pharmacists and nurses] from king Salman hospital, Saudi Arabia

Results: About 92.2% of health care professionals identified warfarin interactions with aspirin, 4.4% for warfarin and fluoxetine .Warfarin and cardiac agents [atenolol] was correctly identified by 11.1% of respondents. In warfarin -herb interactions section, the majority of respondents [66.7%] identified the interaction between green tea and warfarin. Approximately one-third of respondents [n=33] correctly classified warfarin interactions with cardamom. No significant difference was found between the health care professionals [p=0.49] for warfarin-drug interactions knowledge score and p= 0.52 for warfarin- herb interactions knowledge score

Conclusion: This study suggests that health care professionals' knowledge of warfarin- drug-herb interactions was inadequate. Therefore, health care professionals should receive more education programs about drugdrug/ herb interactions to provide appropriate patient counseling and optimal therapeutic outcomes

Gulf implantable cardioverter-defibrillator registry: rationale, methodology, and implementation

Background: The implantable cardioverter-defibrillator [ICD] is effective in the prevention of sudden cardiac death in high-risk patients. Little is known about ICD use in the Arabian Gulf. We designed a study to describe the characteristics and outcomes of patients receiving ICDs in the Arab Gulf region

Methods: Gulf ICD is a prospective, multi-center, multinational, and observational study. All adult patients 18 years or older, receiving a de novo ICD implant and willing to sign a consent form will be eligible. Data on baseline characteristics, ICD indication, procedure and programing, in-hospital, and 1-year outcomes will be collected. Target enrollment is 1500 patients, which will provide adequate precision across a wide range of expected event rates

Results: Fifteen centers in six countries are enrolling patients [Saudi Arabia, United Arab Emirates, Kuwait, Oman, Bahrain, and Qatar]. Two-thirds of the centers have dedicated electrophysiology laboratories, and in almost all centers ICDs are implanted exclusively by electrophysiologists. Nearly three-quarters of the centers reported annual ICD implant volumes of

Conclusions: Gulf ICD is the first prospective, observational, multi-center, and multinational study of the characteristics and, the outcomes of patients receiving ICDs in the Arab Gulf region. The study will provide valuable insights into the utilization of and outcomes related to ICD therapy in the Gulf region

Factors associated with public awareness of the crown health program in the Al-Jouf region

A community-based intervention, the Crown Health Project [CHP], was developed by the Ministry of Health. It was implemented on a small-scale in Al-Jouf Region in Northern Kingdom of Saudi Arabia to assess its feasibility and effectiveness so that it can be scaled up. This study primarily aimed at investigating factors associated with the awareness of CHP in order to improve subsequent campaigns for the program in Al-Jouf and other regions. A secondary aim was to assess possible changes of public awareness during intensification of the awareness campaign between October 2011 and May 2012. A pre- and post-questionnaire cross-sectional approach was undertaken, and the intervention was an awareness campaign. Variables collected included demographic characteristics [e.g., age, gender, education, occupation, urban/rural residence] and CHP awareness [its existence, sources of knowledge about CHP, its goals and objectives, its target diseases, location of activities, participation in such activities]. Logistic regression was used to analyze the awareness of the program according to participant characteristics, with a time of the survey as a variable. Awareness of the program was found to be 11 times higher among postsurvey respondents than presurvey respondents. Respondents of the second survey were better at correctly identifying "health education" as the main goal of the CHP [odds ratio [OR], 4.1; 95% confidence interval [CI], 3.1-5.5], "noncommunicable diseases" as the main diseases targeted [OR, 4.8; 95% CI, 3.6-6.4] and "attention to health" as the purpose [OR, 6.0; 95% CI, 4.0-8.9]. The different activities of the CHP were successful in dramatically increasing awareness of the CHP program in Al-Jouf

Knowledge and attitude of healthcare professionals toward medication pregnancy category systems in Saudi hospitals

To assess the knowledge and attitudes of healthcare professionals [HCPs] toward systems used in describing the safety of medications use during pregnancy. A cross-sectional self-administered survey was conducted in 4 tertiary hospitals in Riyadh, Saudi Arabia between March and May 2012. The targeted HCPs were physicians and pharmacists. The survey was validated and contained 4 main sections. Descriptive statistics were used to report responses to the survey's questions. A total of 393 HCPs responded to the survey, with a response rate of 97%. Half of the respondents were physicians. Of the participants, 60% were males. Most respondents [66%] stated that they have prescribed/dispensed a drug that may cause teratogenicity. Moreover, 87% of the respondents [48% pharmacists and 39% physicians] were aware of the Food and Drug Administration [FDA] pregnancy category, and most [72%] found it helpful. Only 11% of the participants strongly agree to use the European Medicine Agency [EMA] system for pregnancy category system as their main reference. In general, HCPs in Saudi Arabian hospitals have good knowledge of and attitudes toward pregnancy category systems, with more familiarity with the FDA system. The FDA system is preferred over the EMA system

Correlation between hepatitis B surface antigen titers and HBV DNA levels

To assess the correlation between serum HBsAg titers and hepatitis B virus [HBV] DNA levels in patients with hepatitis B envelop antigen-negative [HBeAg -ve] HBV genotype-D [HBV/D] infection. A total of 106 treatment- na‹ve, HBeAg -ve HBV/D patients were included; 78 in the inactive carrier [IC] state and 28 in the active hepatitis [AH] stage. HBV DNA load and HBsAg titers were tested using TaqMan real-time polymerase chain reaction [PCR] and automated chemiluminescent microparticle immunoassay, respectively. The median [range] log10 HbsAg titer was significantly lower in the IC group compared with AH group, 3.09 [-1 to -4.4] versus 3.68 [-0.77 to 5.09] IU/mL, respectively; P < 0.001. The suggested cutoff value of HBsAg titer to differentiate between the two groups was 3.79 log10 IU/mL. In addition, there was a significant positive correlation between HBsAg and HBV DNA levels in the whole cohort, AH, and IC groups [r = 0.6, P < 0.0001; r = 0.591, P = 0.001; and r = 0.243, P = 0.032, respectively]. Serum HBsAg titers may correlate with HBV DNA in treatment-na‹ve HBeAg -ve HBV/D patients, and supports the use of HBsAg levels in clinical practice as a predictor of serum HBV DNA levels.

Clinical spectrum of hereditary spastic paraplegia in children: a study of 74 cases

The aim of the study was to explore the spectrum of hereditary spastic paraplegia [HSP] in children in Oman. This retrospective study was carried out between January 1994 and August 2011 on children with delayed development, gait disorders and motor handicaps, with signs of symmetrical pyramidal tract involvement. A detailed perinatal and family history, including the age of onset of symptoms, was recorded. The children were labelled as having either the pure or complicated form of HSP based on the established diagnostic criteria. In families with more than one affected child, parents and all other siblings were also examined. Within the study, 74 children from 31 families were diagnosed with HSP. Parental consanguinity was seen in 91% of cases, with 44 children [59.4%] experiencing onset of the disease under one year of age. Complicated HSP was the most common type, seen in 81.1%. Speech involvement, mental retardation, and epilepsy were the most common associated abnormalities. Nonspecific white matter changes and corpus callosum abnormalities were noted in 24.3% of cases on magnetic resonance imaging. The study described clinical features of 74 children with HSP. Autosomal recessive complicated HSP was seen in 81.1% of cases

Hepatitis C genotype 4: genotypic diversity, epidemiological profile, and clinical relevance of subtypes in Saudi Arabia

Hepatitis C virus genotypes 4 [HCV-4] is the most prevalent genotype in Saudi Arabia, although it's various subtypes, mode and route of transmission remains unknown. The aim of this study was to analyze [i] the variability of the HCV-4 subtypes, the route and source of HCV transmission and [ii] the influence of HCV-4 subtypes on their therapeutic response. Sixty-four HCV-4 patients were analyzed retrospectively for the prevalence of various sub-genotypes and the possible mode of transmission, and it was correlated with their treatment response to pegylated interferon [PEG-IFN] alpha-2a and ribavirin therapy. Positive history of blood or blood products transfusion was noted in 22 patients [34%], hemodialysis in 10 patients [15.6%], surgery in 7 patients [11%], and unknown etiology in 25 patients [39%]. Prevalence of HCV-4 subtypes was 4a = 48.4% [31/64], 4d = 39% [25/64], 4n = 6.25% [4/64], and remaining combined [4m, 4l, 4r, 4o] 6.25% [4/64]. No significant correlation between subtypes and the source of transmission was recognized [P = 0.62]. Sustained virological response in all HCV-4 patients was 64% [41/64], while in each subtypes separately it was 4a 77.4% [24/31], 4d 52% [13/25], and combined [4n, 4m, 4l, 4r, 4o] 62.5% [5/8] [P = 0.046]. No obvious cause for the mode of HCV transmission was noted in majority of the patients. No significant correlation was observed between HCV-4 subtypes and the source of HCV infection. 4a and 4d subtypes were the most common in Saudi Arabia, and patients infected with 4a subtype responded significantly better to combination therapy than to 4d subtype

Use of alternative medicine by Saudi liver disease patients attending a tertiary care center: prevalence and attitudes

Complementary alternative medicine [CAM] covers many types of treatments and procedures that are usually not included in conventional medicine and are used in addition to physician-prescribed drugs to "complement" treatment. Although liver disease is prevalent in Saudi Arabia, not much is known about CAM use among Saudi liver disease patients. Thus, this study aimed to assess the prevalence of CAM use in these patients and their attitudes toward it. Patients were recruited randomly from a tertiary care hepatology clinic at King Khalid University Hospital [KKUH], Riyadh, Saudi Arabia from February 4 to March 20, 2012. A four-page questionnaire was used to interview patients. Of all the 232 participants surveyed, 55.6% have used or are using CAM to treat their liver disease with 45.0% of CAM users stating that they believe it has a positive effect on their treatment. Honey was the most used CAM treatment among the participants [39.0%]. Herb use was represented by 31.8% of all users, while 13.5% used bloodletting as a treatment. Cautery was the least used CAM method [3.4%]. Nearly 76.6% of CAM users were satisfied with using alternative treatments to help control their disease. Nearly 69.4% of users and nonusers stated that they believe CAM treatments to have numerous beneficial effects. Nearly 60.5% of CAM users stated that their physician had no knowledge of their CAM use. Of the factors included in linear multivariate regression analysis [including: Age, gender, and family CAM use, among other socioeconomic factors] only family CAM use was considered a significant independent factor affecting participants CAM use [Beta 0.582, 95% CI: 0.372-0.754, P 0.0001]. More than half of the patients have reported CAM use. Overall, more than two-thirds of the entire sample believed that CAM treatments have numerous health benefits

Epidemiology of viral hepatitis in Saudi Arabia: are we off the hook?

Some 400 million people worldwide are currently infected with the hepatitis B virus [HBV], and the infection is common in the Middle East. Another 170 million people around the globe presently live with chronic hepatitis C virus [HCV] infection. Both HBV and HCV represent a worldwide epidemic. Despite significant decline in the prevalence of HBV and HCV infection in Saudi Arabia, these viral diseases cause significant morbidity and mortality, and impose a great burden on the country's healthcare system. On the other hand, Saudi epidemiology studies have shown that the hepatitis A virus seroprevalence in the country has reduced considerably over the past two decades. The progress in mapping the epidemiological pattern of viral hepatitis in Saudi Arabia has not only aided our understanding of the disease, but has also exposed the small but relevant gaps in our identification of the intricate details concerning the disease's clinical expression. In this review, we aim to document the timeline of viral hepatitis epidemiology in Saudi Arabia, while summarizing the relevant published literature on the subject

Efficacy, predictability, and safety of laser-assisted subepithelial keratectomy for the treatment of myopia and myopic astigmatism

The purpose was to report the refractive and visual outcomes of laser-assisted subepithelial keratectomy [LASEK] for the treatment of myopia. A retrospective, noncomparative consecutive case series of 173 of 91 patients who had undergone LASEK is presented. Primary outcome variables included uncorrected visual acuity [UCVA], best spectacle-corrected visual acuity [BSCVA], manifest refraction, epithelialization time, pain, haze, and complications. Preoperatively, the mean spherical equivalent [SE] was -3.71 +/- 1.63 D [range, -0.875 D to 8.25 D], and the mean LogMAR BSCVA was -0.0374 +/- 0.0767 D [range, -0.47 D to 0.00 D]. On the final visit, the mean SE was -0.05 +/- 0.335 D [range, -1.63 D to 1.00 D], the mean LogMAR UCVA was 0.04674 +/- 0.0771 D [range, -0.3010 D to 0.1249 D] and the mean LogMAR BSCVA was -0.0164 +/- 0.0497 [range -0.3010 to 0.124]. All eyes achieved vision of 20/40 or better, and 83.2% of the eyes achieved a vision of 20/25 or better. One 64 [94.94%] and all the eyes were within +/- 0.50 D and +/- 1.00 D of the attempted correction respectively. Complete epithelialization occurred in 4.70 +/- 2.09 days [range, 2-10 days]. At the final visit, 79.7% of eyes had a clear cornea. Grade 1 haze developed in 17.34% of the eyes, grade 2 haze developed in 2.89% of eyes developed; no eyes developed grade 3 or 4 haze. LASEK is a safe, effective, and predictable method for the treatment of myopia and myopic astigmatism

Saudi gelines for the diagnosis and management of hepatocellular carcinoma: technical review and practice guidelines created and endorsed by the saudi association for the study of liver diseases and transplantation and the Saudi oncology society

Recognizing the significant prevalence of hepatocellular carcinoma [HCC] in Saudi Arabia, and the difficulties often faced in early and accurate diagnoses, evidence-based management, and the need for appropriate referral of HCC patients, the Saudi Association for the study of liver diseases and transplantation [SASLT] formed a multi-disciplinary task force to evaluate and update the previously published guidelines by the Saudi Gastroenterology Association. These guidelines were later reviewed, adopted and endorsed by the Saudi Oncology Society [SOS] as its official HCC guidelines as well. The committee assigned to revise the Saudi HCC guidelines was composed of hepatologists, oncologists, liver surgeons, transplant surgeons, and interventional radiologists. Two members of the task force served as guidelines editors. A wide based search on all published reports on all aspects of the epidemiology, natural history, risk factors, diagnosis, and management of HCC was performed. All available literature was critically examined and available evidence was then classified according to its strength. The whole document and the recommendations were then discussed in details by members and consensus was obtained. All recommendations in these guidelines were based on the best available evidence, but were tailored to the patients treated in Saudi Arabia. We hope that these guidelines will improve HCC patient care and enhance the multidisciplinary care needed for these patients

Effect of interferon treatment on hearing of patients with chronic hepatitis C

Some reports in the literature have linked interferon therapy for the treatment of hepatitis C [HCV] with hearing loss. The aim of this study has been to examine the effects of interferon therapy on hearing of patients treated for HCV. Patients were recruited according to preset inclusion criteria from two centers. All patients received standard dose pegylated interferon [PEG-IFN alpha-2b or alpha-2a] plus ribavirin [RBV]. All patients had pure-tone audiometry [PTA], tympanogram and distortion-product otoacoustic emission [DPOAE] before treatment, three months after initiation of treatment, and three months after completion of treatment. Twenty one patients were prospectively recruited. The mean age was 45.7 years. The male to female ratio was 1.1:1. The mean PTA was 15.9 +/- 5.3 before treatment, 17.4 +/- 6.1 during treatment and 16.5 +/- 5.1 after treatment. The differences between pre and mid, pre and post, as well as mid and post were not significantly different [P>0.05] in all audiological assessments. Our results indicate that PEG-IFN/RBV therapy does not have any impact on the hearing thresholds of patients with HCV

Sarcoidosis in the eastern region of Saudi Arabia

To review a general hospital's experience with sarcoidosis and the clinical pattern of the disease among Saudis. A retrospective file review was carried out on all patients with a proven diagnosis of sarcoidosis in a general hospital in Eastern Saudi Arabia over a period of 11 years [1998-2008]. Sixty-nine patients, of whom 33 cases were included in the analyses, were diagnosed to have sarcoidosis during the study period. There were 18 females and 15 males. The mean age was 44.5 years [SD 17]. The most common presentations were cough [48%], dyspnea [21%], joint pain [18%], splenomegaly [12%], hepatomegaly [9%], and lymphadenopathy [5%]. The biochemical analysis showed elevated calcium levels in 6% and elevated angiotensin converting enzyme [ACE] in 14 [46.7%]. The tuberculin skin test was negative in all tested patients [n = 29] except one patient. The patients were classified using the modified Scadding classification system. None of the patients was in stage 0, 39.4% were in stage 1, 45% were in stage 2 and 15% were in stage 3.. The diagnosis in all patients was proven histologically. The outcome was favorable in most patients [85%], and in 6% of the patients, the course was chronic and progressive, although 66% received active treatment. Sarcoidosis does occur in native Saudis. The clinical presentation of these patients was similar to the western pattern of disease with some differences such as relative lack of cardiac, eye, parotid, and central nervous system involvement. The rarity of cardiac and central nervous system involvement was comparable with other Middle Eastern studies. Sarcoidosis, though rare in our community, should still be considered in the differential diagnosis of patients with the typical presentation after excluding tuberculosis

study on the effect of Myrtus communis and Olibanum on Giardia lamblia infection in Egypt

Giardia lamblia is one of the most common protozoal infections in humans. Although metronidazole [MTZ] is the drug of choice for treatment of giardiasis, yet its chemical composition poses major threats. The search for new alternative therapeutic approaches for this parasitic disease in replacement of MTZ. The effect of Myrtus Communis [MC; called Aas plant in Arabic] and Olibanum [OL; called Leban in Arabic] on G. lamblia were studied. Extracts of MC [methyl alcohol, petroleum ether, chloroform, ethyl acetate and aqueous extracts] amid ethanol extract of OL were used. In vitro culture of G. lamblia trophozoites on TYI-S-33 medium was done, followed by inoculation of the plants' extracts in three different concentrations. This was evaluated by trophiozoite multiplication, adherence assay and electron microscopic study. The in viva effect was evaluated by histopathological study of the duodenum of experimentally infected mice after treatment by each herb. All plant extracts affected G. lamblia trophozoites in a manner dependent on concentration and time of exposure. In low concentration, both herbs significantly decreased the in vitro adherence of tropliozoites when compared to infection control group, while there was no statistical difference when compared to MTZ control group. Extensive ultrastructural changes of Giardia trophozoites were evident after 48 hours exposure to each medical herb. Histopathological examination of duodenum of G. lamblia infected mice showed epithelial microvillus abnormalities, which improved after administration of MC and OL extracts. Results confirm the antiparasitic effect of MC and OL on G. lamblia as an alternative to MTZ, to overcome its resistance and hazards