Association of NOD2/CARD15, DLG5, OCTN1 and toll-like receptor 4 gene polymorphisms with inflammatory bowel disease: a university hospital experience

Background: Both genetic and environmental factors play major roles in the development of inflammatory bowel disease [IBD]. Recent studies have identified a number of genetic susceptibility loci for Crohn's disease [CD] and ulcerative colitis [UC]

Objectives: The present study aimed at examining the association of nine polymorphisms in four different genes with the development of CD and UC in a sample of Saudi patients with IBD

Materials and Methods: All gene polymorphisms were identified by polymerase chain reaction and by direct sequencing. Allele and genotype frequencies of polymorphisms of NOD2/CARD15 [R702W, G908R, L1007finsC], Toll-like receptor 4 [TLR4] [D299G, T399I], OCTN promoter [C1672, G207C] and DLG5 [G113A, C4136A] genes were determined in Saudi subjects with CD [51], UC [26] and in 75 normal controls

Results: Out of the nine polymorphisms studied in four loci, only two polymorphisms in two different loci were found to have increased in patients compared with the control subjects. The CT genotype of TLR4 T3991 was over represented in patients with CD or UC compared to that in controls [odds ratios [OR], 5.63:95% confident interval [CI], 1.19-26.69; P = 0.03]. In addition, the GA genotype of DLG5 G113A was over represented in patients with CD or UC compared with that in controls [OR, 4.72:95% CI 2.30-9.66; P = 0.0001]. However, there were no significant associations found between all other polymorphisms studied and the susceptibility of CD or UC found in the Saudi population

Conclusion: Our finding indicates that association of IBD with nine gene polymorphisms was only significant in two of these polymorphic variants

Glycoprotein B Genotyping in Congenital/perinatal Cytomegalovirus Infection in Symptomatic Infants.

Background: Molecular epidemiological studies on circulating strains of CMV in cogenital/perinatal infections have not been done earlier in this region. Objective: To study the glycoprotein B genotypes in babies with symptomatic congenital/perinatal CMV infection and to assess the possible influence of genotype on the outcome of the infection. Methods: Clinical samples (blood and urine) of symptomatic babies are sent to the Virology Department of NCDC, Delhi for the diagnosis of congenital infections. 375 clinical samples of infants (newborn - 6 months old) were included for the study. Serum samples were subjected to ELISA for detection of IgM antibodies against CMV. DNA isolation and amplification of CMV genomic DNA targeting gB gene fragment by nested PCR, was carried out in the samples. The amplified fragment including the cleavage site was subjected to RFLP using restriction enzymes Rsal and Hinf1. They were also verified by sequencing using Big Dye Terminator chemistry. Results: 75 samples out of 375 tested were confirmed positive for CMV infection by serology and PCR. Both RFLP and sequencing of gB gene fragment showed that gB 1, 2 and 3 genotypes were in circulation. gB 3 was the most prevalent genotype in symptomatic infants. Hepatosplenomegaly was the most common feature in gB-3 genotype of CMV. gB2 congenital CMV infection was more commonly associated with long term sequelae.

First organized screening mammography programme in Saudi Arabia: preliminary analysis of pilot round

The aim of this study was to analyse results of the pilot screening round for Al-Qassim Screening Mammography Programme and compare with international standards. Analysis was conducted in the central screening office in Prince Faisal Oncology Centre, which coordinates activities of various screening units. Data were collected during the period 1 January 2007 to 30 June 2008. Organizational and functional information was obtained from policy and procedure manuals of the programme. Out of 9812 eligible women, 1766 [18%] participated and data were available for 1628 [16.6%]. The median age of participants was 47 [standard deviation 8.12] years. The low uptake rate [18%] and a high recall rate [31.6%] characterized the pilot screening round. Biopsy rate was 1.5% and cancer detection rate was 0.24%. Many performance indicators in this pilot screening round were not available. Many of the available indicators did not meet international standards

Distribution of ABO and Rh D blood groups in the population of Poonch district, Azad Jammu and Kashmir

We evaluated the distribution of ABO and Rhesus [Rh] D blood groups in the population of Poonch district in Azad Jammu and Kashmir. The blood group phenotypes were detected by the classic slide method. The ABO blood group system in the total sample showed the same trend of prevalence as for the general Indian subcontinent [B >/= O > A > AB]. The same trend was found among males, but among females the order of prevalence was different [O B > A > AB]. However, the allelic frequencies in both sexes were in the order of O > B > A. The Rh positive and negative distribution trend in both sexes was also similar

Malignant lymphoma in Al-Qassim, Saudi Arabia, reclassified according to the WHO classification

To determine the frequency of various types of malignant lymphoma [ML] in the Al-Qassim region of Kingdom of Saudi Arabia [KSA] according to recently introduced the WHO classification. For this retrospective analysis, material was available in 385 out of 519 cases diagnosed as ML from 1988-2007. Morphological assessment was followed by immunohistochemistry using a panel of antibodies. The study was conducted at Prince Faisal Oncology Centre [PFOC] of King Fahad Specialist Hospital [KFSH], Buraidah, Al-Qassim, KSA. Out of 385 cases reviewed, 251 [65.2%] had non-Hodgkin lymphoma [NHL] and 117 [30.4%] had Hodgkin lymphoma [HL]. Male preponderance [male to female ratio 1.6:1] and a wide age range was observed [6 months to 103 years]. B cell neoplasms were the most common NHL seen [81.6%] and diffuse large B cell lymphoma [DLBCL] was the most frequent type of NHL encountered [50.1%]. Indolent lymphomas like follicular lymphoma [FL] and small lymphocytic lymphoma [SLL] were rather uncommon [13.2%]. T cell lymphoma comprised 18.3% of the NHL. The most common type of HL was nodular sclerosis classical Hodgkin lymphoma [NSCHL] [68.3%]. In Al-Qassim region of KSA, NHL is the most common ML seen and DLBCL the most common type. Unlike other parts of KSA and Middle East, NSCHL is the most common type of HL encountered

Prevalence and predictors of smokeless tobacco use among high-school males in Karachi, Pakistan

A cross-sectional study was conducted in 3 towns in Karachi, Pakistan to investigate the prevalence of and factors associated with the use of smokeless tobacco among 772 high-school adolescent males. A structured questionnaire collected data on sociodemographic factors and history of cigarette and smokeless tobacco use. Prevalence of smokeless tobacco use [gutka, snuff, niswar] was 16.1% [95% CI: 13.5%-18.9%]. On multiple logistic regression analysis, the factors significantly related to smokeless tobacco use among the sample were: attending government school [adjusted odds ratio [OR] 6.3], smoking cigarettes [OR 3.2], not seeing anti-tobacco advertisements [OR 1.5], family history of tobacco use [OR 3.9], use of betel quid [OR 2.9] and use of areca nut [OR 3.2]

Electrocardiographic abnormalities among arsenic-exposed persons through groundwater in Bangladesh.

This study was carried out among arsenic-exposed and non-exposed people of Bangladesh to assess and compare their cardiac status based on electrocardiographic (ECG) findings. For the purpose of the study, participants were included in three groups: arsenic-exposed persons with arsenicosis (arsenicosis group), arsenic-exposed persons without arsenicosis (non-arsenicosis group), and persons not exposed to arsenic (non-exposed group). Each group included 50 respondents. In this study, no significant difference in heart rate, rhythm, axis, and pulse rate interval was detected among the arsenicosis, non-arsenicosis and non-exposed groups. A significant difference in corrected QT interval between the arsenicosis and the non-exposed group (p<0.05) was observed. On the contrary, no statistically significant difference in corrected QT interval between the non-arsenicosis and the non-exposed group was found. Abnormal QRS complex was found among 14%, 8%, and 2% of the arsenicosis, non-arsenicosis, and non-exposed groups respectively. ECG findings, indicative of left ventricular hypertrophy, ischaemic heart disease, and right bundle branch block, were high among the arsenicosis group. Overall, abnormal ECG findings were high (58%) among the respondents of the arsenicosis group and were highly significant (p<0.001). The findings revealed that there was a significant association between ECG abnormalities and arsenic exposure.

Prevalence of arsenicosis in terai, Nepal.

This paper summarizes the findings of surveys on arsenicosis cases conducted during 2001-2004 in terai, Nepal, by governmental and non-governmental organizations in their respective project areas and by some national and international institutes. Studies were conducted in six arsenic-contaminated districts of terai, namely Nawalparasi, Bara, Parsa, Rautahat, Rupandehi, and Kapilvastu. In these districts, arsenic contamination in tubewells varied from 2.1% to 25.7%. The prevalence of arsenicosis was, on average, 2.2% and varied from 0.7% in Kapilavastu district to 3.6% in Nawalparasi district. In the community-based study, the highest prevalence (18.6%) of arsenicosis was found in Patkhouli village of Nawalparasi, where 95.8% of tubewells were contaminated with arsenic. The prevalence of arsenicosis was higher in older age-groups (>50 years) of both the sexes. Males suffered more from arsenicosis than females (odds ratio: 2.50, 95% confidence interval 1.80-3.47). Skin manifestations, such as melanosis and keratosis, were the common symptoms of arsenicosis. Most patients were identified in the early or mild stage of the disease. They are expected to recover if further exposure to arsenic could be avoided by providing arsenic-safe drinking-water through intervention measures.

effects of reducing the exposure time of mitomycin C in glaucoma surgery

Topical application of mitomycin C has significantly increased the success rate of trabeculectomy. However the optimum exposure time of mitomycin C to the filtration site is not known. The purpose of this study was to determine whether adequate post-operative control of IOP and a lower incidence of post operative complications can be achieved by using mitomycin-C for a shorter period of time during trabeculectomy, performed in high risk glaucoma patients. Twenty eyes of patients of glaucoma, who were considered to be at high risk for failure because of their young age, previous ocular surgery like cataract extraction and trabeculectomy, inflammatory glaucoma, high myopia and prolonged anti-glaucoma medication, underwent trabeculectomy with topical application of 0.2 mg/ml concentration of mitomycin C for three minutes. They were case matched with a group of same number of eyes of high risk glaucoma patients who received same concentration of drug for 5 minutes. Twelve months after surg ery, the mean pre-operative IOP decreased from 29.9 mmHg to a post-operative level of 16.05 mmHg in 3 minutes group, with a success rate of 85%, and from 29.35 mmHg to 16.55 mmHg in 5 minutes group, with the same success rate of 85%. The incidence of complications was higher in 5 minutes group, when total number of complications was compared. [p value< 0.05] Ocular hypotony developed in 3 [15%] eyes in 5 minutes group, and none in 3 minutes group. No patient developed hypotony related maculopathy in either group. Other complications like hyphema, post-operative uveitis, and conjunctival wound leakage were managed conservatively. The present study supports the conclusion of previous studies that mitomycin C is highly effective drug when used in association with trabeculectomy, and when used in concentration of 0.2 mg/ml for three minutes is as effective in controlling post-operative IOP as is five minutes exposure time of the same concentration. Further, emphasizing that the shorter exposure of the drug is associated with lesser incidence of vision threatening complications

AgNOR stain in normal, cirrhotic and carcinomatous liver

In this era of tumor marker AgNOR stain has still retained the diagnostic yield in tumor pathology. This study was conducted to evaluate the role of AgNOR number and morphological features in cirrhotic and carcinomatous liver. A total of one hundred liver biopsy specimens were included, twenty cases were of hepatocellular carcinoma, sixty were those of cirrh0sis of the liver and twenty cases with normal histology as control. The mean AgNOR count, size and distribution were significantly of higher grade in hepatocellular carcinoma as compared to cirrhosis of liver

relationship of periodontal disease to cardiovascular diseases review of literature

Association of Oral and Systemic diseases has gained importance because the high occurrence of oral diseases is an extremely common source of infection. Epidemiological Studies have presented periodontal diseases as a risk factor for development of cardiovascular diseases. A chronic oral infection such as periodontitis is a constant potential source of infection and has now been considered as a separate risk factor for cardiovascular diseases, cerebrovascular diseases, peripheral arterial disease and respiratory diseases as well as delivery of low-birth-weight infants. The possible pathways linking oral infections to systemic diseases are metastatic infections, bacterial endotoxins, and systemic vascular injury. People with a history of periodontal disease and/or tooth loss were found at higher risk for Peripheral arterial disease [PAD] as compared to those without periodontal disease and/or tooth loss. All studies on the relationship of periodontal diseases to cardiovascular diseases are inconclusive and most of the data is based on epidemiological studies

Nutritional status of pre-schooling children of different socio-econornic statuses as influence by various diseases

The study was carried out on 100 children [85 malnourished and 15 apparently healthy] of pre-schooling age [0-4 years]. The malnourished children were randomly selected from those admitted to Pediatrics wards of Allied and National Hospitals at Faisalabad [Punjab]. The test patients were divided into four age groups [up to 12, 13-23, 24-35 and 36-48 months], three socio-economic statuses, i.e. lower class [maximum earning of Rs. 5000 per month], middle class [Rs. 5000 - 15000 per month] and upper class [minimum earning of Rs. 15000 per month], sex and on the basis of area of living, i.e. industrial or non-industrial. Parameters of study included anthropometrics [BMI, mid-arm circumference and percent weight]. The obtained results revealed that diarrhoea, fever and malnutrition were the major complaints. Mid-arm circumference, percent of weight and body mass index were low in malnourished children. They were also low among malnourished children of 3rd degree. In each socio-economic status, age and sex groups, serum iron and copper were higher in malnourished children and in females than in males. Malnutrition was more prevalent in children of up to 12 months of age, in males, in children of low socio-economic status and of non-industrial area. Several types of milk were more frequently offered to males and breast-feeding was more often offered by uneducated and under-matriculate mothers

Study of blood pressure patterns versus serum lipid parameters in obese human subjects

A study was conducted to determine relationship of obesity with the blood pressure patterns and lipid parameters in preview of its unique local diet patterns. A total of 200 non-diabetic human subjects of either sex were included in the study. They were categorized on the basis of body mass index [BMI] as obese and non-obese. Each group was further divided into 2 subgroups; hypertensive and normotensive. Fasting lipid profile [total cholesterol, LDL-and HDL-Cholesterols and total triglycerides] in each group was determined to compare the levels among various groups. BMI was calculated from height and weight, while blood pressure was measured with a sphygmomanometer. Lipid profile was determined with Merck kits. Diet and related information was also collected from the patients directly. Means of all parameters, except LDL-C, were higher in females than males; among these BMI and HDL-C showed significant difference. There was a significant negative correlation of diastolic blood pressure with HDL-C in obese subjects; all the other parameters were non-significantly correlated. In the non-obese subjects, there was a significant positive correlation between systolic [SBP] and diastolic [DBP] blood pressures and LDL-C. All other parameters were found non-significantly correlated. The analysis of variance was done in four groups namely, obese non-hypertensives, obese hypertensives, non obese non-hypertensives and non obese hypertensives. BMI, SBP, DBP, LDL-C and total cholesterol had significantly different means in the above four groups, while HDL-C and total triglycerides were statistically non-significant [p>0.05] among four groups

Seroprevalance of Rubella antibodies among women of reproductive age: a study at Nishtar Hospital Multan

This study was conducted to determine the seroprevalance of rubella antibodies among women of reproductive age and to emphasize the importance of vaccinating this population. Serum specimen of 180 students of College of Nursing Nishtar Hospital Multan was screened with IMMULITE/IMMULITE 1000 Rubella Quantitative IgG assay at MINAR [Multan Institute of Nuclear medicine and Radiotherapy]. Out of 180 serum specimens screened 168 [93.33%] were seropositive. 9 [5%] were seronegative and 3 [1.6%] fell in the intermediate range. All subjects were unmarried, between 16 and 24 years of age and none had a previous history of rubella vaccination. However there was non specific history of fever and rash in 11 [6.1%] students. It is evident from this small age without acquiring natural immunity need to be immunized to prevent repeated pregnancy loss and birth of infants with congenital rubella syndrome [CRS]

Maternal mortality: a 10-year study at Nishtar-Hospital Multan

To analyse causes of maternal deaths and to identify preventable causes leading to this tragedy in our setup. An analytical, hospital-based study. Department of Obstetric and Gynaecology, Nishter Hospital Multan from June-August 2005. During the study period retrospective data was collected for period of 10 year from January 1995 to December 2004. This data was analyzed in order to determine the Maternal Mortality Rate [MMR], causes of death and characteristics of the mothers who died including her age, parity and whether they were booked or unbooked. A total numbers of 30031 deliveries took place during the study period and there were 178 maternal deaths with maternal mortality rate of 593/100,000 LB [live births]. 7[3.9%] patients were below the age of 20, 74[41.5%] were in the age group of 21-30 and 82[46%] in 31-40 years age range. 15[8.42%] were above the age of 40. Most of them [69%] were grand multiparas [Parity >5]. The major causative factors were haemorrhage 63[35.4%], eclampsia 41[23.03%], sepsis 25[14.04%], anaemia 18[10.1%], hepatic encephalopathy 14[7.9%], abortion 11[6.2%]. Majority of the patients were unbooked and presented in the hospital very late. A high proportion of potentially preventable maternal deaths indicate the need for improvements in education for both patient and health care provider. The provision of skilled care and timely management of complications can lower maternal mortality in our setup

Risk behaviours associated with urethritis and genital ulcer disease in prison inmates, Sindh, Pakistan

We evaluated the epidemiological differences with respect to demographics, drug use and sexual behaviours associated with lifetime risk of urethritis, genital ulcer disease [GUD] and urethritis and GUD together among 3395 male prisoners in Sindh. Factors associated with urethritis and GUD alone were sex with multiple females, sex with men, and ethnicity. Additional factors associated with urethritis alone were sex with prostitutes, sex with partners having multiple partners and sex with partners believed to be injecting drugs. Behaviours associated with lifetime risk for urethritis and GUD together were sex with multiple females, sex with prostitutes, sex with men, sex with partners believed to be injecting drugs and ethnicity. These relationships were consistently stronger compared to urethritis or GUD alone

Breast cancer risk in relation to dietary fat along with some other nutrients

To study association of dietary intake of food groups in breast cancer patients and normal subjects. The study was conducted on 148 breast cancer patients and 149 control subjects, randomly selected and distributed among six age groups and three socio-economic statuses.The subjects were selected from Shaukat Khanum Memorial Cancer Hospital, Lahore, during April to August, 2000. Intakes of various nutrients were assessed from information on past 5-8 years by food frequency questionnaire and food composition tables. The data showed that percentage of breast cancer patients was low below the age group of 25 [0.67%] and above the age group of 65 [10.13%]. It was significantly higher between the age groups of 55-65 [16.9%] and 25-33 [14.2%]. Most of the breast cancer cases were observed between the ages of 35-45 [26.4%] and 45-55 [31.7%] years. Breast cancer patients showed higher percentage in low [43.9%] and middle [39.9%] socio-economic statuses than the high socio-economic status. Results also revealed that dietary energy [kcal/day] was significantly higher in the age groups of 25-35 [1280] and above 65 [1207] of control subjects than breast cancer patients in which the values were 1262 and 1192 kcal/day, respectively. Differences in the intake of dietary proteins and fats among various age groups of breast cancer patients and controls were non-significant. However, intake of carbohydrate [g/day] was significantly more above the age group of 65 in controls [196.83] as compared to breast cancer patients [185.85]. While, all other age groups showed non-significant differences. The percentage of intake of butter [40.54%] and fried foods were found to be higher in breast cancer patients than controls [20.3%]. Positive correlation was observed between dietary fats and carbohydrate [g/day] in all age groups of breast cancer patients and controls except above 65 years of age group in controls which showed negative correlation between these nutrients. Fats [g/day] and protein also showed positive correlation in all age groups of breast cancer patients and controls. The intakes of nutrients [fats, proteins, carbohydrates] have not been found to contribute to the risk of breast cancer together with family history, breast feeding, contraceptives and menstrual abnormalities