Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Association of vitamin D receptor gene polymorphisms with type 2 diabetes mellitus in Taif population: a case-control study / Associação de polimorfismos do gene do receptor de vitamina D com diabetes mellitus tipo 2 na população Taif: um estudo de caso-controle

Abstract Several reasons may underlie the dramatic increase in type2 diabetes mellitus. One of these reasons is the genetic basis and variations. Vitamin D receptor polymorphisms are associated with different diseases such as rheumatoid arthritis and diabetes. The aim of this study is to investigate the possible association of two identified mutations ApaI (rs7975232) and TaqI (rs731236). Eighty-nine healthy individuals and Fifty-six Type 2 Diabetic (T2D) patients were investigated using RFLP technique for genotyping and haplotyping as well. The distribution of Apal genotypes was not statistically significant among the control (P=0.65) as well as for diabetic patients (P=0.58). For Taql allele frequencies of T allele was 0.61 where of G allele was 0.39. The frequency distribution of Taql genotypes was not statistically significant among the control (P=0.26) as well as diabetic patients (P=0.17). Relative risk of the allele T of Apa1 gene is 1.28 and the odds ratio of the same allele is 1.53, while both estimates were < 1.0 of the allele G. Similarly, with the Taq1 gene the relative risk and the odds ratio values for the allele T are 1.09 and 1.27 respectively and both estimates of the allele C were 0.86 for the relative risk and 0.79 for the odds ratio. The pairwise linkage disequilibrium between the two SNPs Taq1/apa1 was statistically significant in control group (D = 0.218, D' = 0.925 and P value < 0.001) and similar data in diabetic groups (D = 0.2, D' = 0.875 and P value < 0.001). These data suggest that the T allele of both genes Apa1 and Taq1 is associated with the increased risk of type 2 diabetes. We think that we need a larger number of volunteers to reach a more accurate conclusion.

Resumo Várias razões podem estar subjacentes ao aumento dramático da diabetes mellitus tipo 2. Um desses motivos é a base genética e variações. Os polimorfismos do receptor da vitamina D estão associados a diferentes doenças, como artrite reumatoide e diabetes. O objetivo deste estudo é investigar a possível associação de duas mutações identificadas ApaI (rs7975232) e TaqI (rs731236). Oitenta e nove indivíduos saudáveis ​​e 56 pacientes com diabetes tipo 2 (T2D) foram investigados usando a técnica RFLP para genotipagem e haplotipagem também. A distribuição dos genótipos Apal não foi estatisticamente significativa entre o controle (P = 0,65), bem como para os pacientes diabéticos (P = 0,58). Para as frequências do alelo Taql, o alelo T foi de 0,61, onde o alelo G foi de 0,39. A distribuição de frequência dos genótipos Taql não foi estatisticamente significativa entre o controle (P = 0,26), bem como os pacientes diabéticos (P = 0,17). O risco relativo do alelo T do gene Apa1 é 1,28 e a razão de chances do mesmo alelo é 1,53, enquanto ambas as estimativas foram < 1,0 do alelo G. Da mesma forma, com o gene Taq1, os valores de risco relativo e razão de chances para o alelo T são 1,09 e 1,27, respectivamente, e ambas as estimativas do alelo C foram de 0,86 para o risco relativo e 0,79 para o odds ratio. O desequilíbrio de ligação par a par entre os dois SNPs Taq1 / apa1 foi estatisticamente significativo no grupo de controle (D = 0,218, D' = 0,925 e valor P < 0,001) e dados semelhantes em grupos diabéticos (D = 0,2, D' = 0,875 e valor P < 0,001). Esses dados sugerem que o alelo T de ambos os genes Apa1 e Taq1 está associado ao aumento do risco de diabetes tipo 2. Achamos que precisamos de um número maior de voluntários para chegar a uma conclusão mais precisa.

Comparison of fentanyl, clonidine and tropisetron effect on agitation after sevoflurane anaesthesia in children

One hundered ASA physical status I and II children aged 3-6 years were included in this study. After inhalation induction with sevoflurane, patients were randomly assigned to receive either saline [group I, n=25], fentanyl 1 mic/kg IV [group II, n=25] or clondine 3 mic/kg IV [group III, n=25] tropisetron [0.1mg/kg] 10 minutes before discontinuation of anesthetics. There was no significant difference [p>0.05] between the four groups regarding time to eye opening, modified Aldrete recovery scores and post operative complication. The time of first postoperative analgesic dose was significantly shorter in group I compared with other three groups. The incidence of agitation was significantly higher in group I compared with other three groups, the incidence of agitation was 60% in Group I, 30% in Group II, 20% in Group Ill and 25% in Group IV. The dose of fentanyl 1 mic/kg iv or clonidine 3 mic/kg iv or tropisetron [0.1mg/kg]iv that is administered 10 minutes before the termination of anesthesia reduces the postoperative agitation in children with no adverse effects. There was no significant difference [p>0.05] between the four groups regarding age, weight, duration of surgery and discontinuation of anesthetics

effect of intraoperative use of esmolol and nicardipine on splanchnic perfusion in functional endoscopic sinus surgery

There are many techniques for reduction of mean arterial blood pressure [MAP] and heart rate [HR] during anesthesia. We designed this prospective, randomized, double-blinded study to test the effect of this technique for maintaining hemodynamic stability during general anesthesia and their influences on splanchnic perfusion. Sixty healthy consenting patients undergoing functional endoscopic sinus surgery [FESS] were randomly assigned to 1 of 3 treatment groups: Group I [control n = 20] received normal saline 5 mL and 1 mL, followed by a saline infusion at a rate of 0.005 mL kg[-1] min[1]; Group 2 [n = 20] received esmolol 50 mg and saline 1.mL, followed by an esmolol infusion 5 micro g kg[-1] min[-1]; and Group 3 [n = 20] received esmolol 50 mg and nicardipine 1 mg, followed by an esmolol infusion 5 micro g kg[-1] min[-1]. The study drugs were administered after the induction of anesthesia with fentanyl 1.5 micro g/kg, and propofol 2 mg/kg IV. Tracheal intubation was facilitated with vecuronium 0.12 mg/kg IV. Anesthesia was initially maintained with sevoflurane 2% end-tidal and N[2]O 50% In oxygen in all 3 groups. After induction of anesthesia a gastric tonometer [TRIP] NGS Catheter and a radial catheter were inserted. Baseline values of gastric intramucosal pH [pHi] were determined before induction of hypotension. The [pHi] values were calculated every 30 min until hypotension was discontinued .The CO2 -gap [i.e., the difference between arterial and gastric Pco2] was registered. Arterial blood lactate levels also were measured. During surgery, the mean arterial blood pressure [MAP] was maintained within +/- 15% of the baseline value by varying the study drug infusion rate and the inspired concentration of sevoflurane. In addition to MAP and heart-rate values, were recorded throughout the perioperative period. Recovery times and postoperative side effects were assessed. None of the [pHi] values calculated was less than 7.35 in the three studied groups. Arterial blood lactate levels did not increase in any of the patients. Compared with the control group, adjunctive use of esmolol and nicardipine attenuated the increase in heart rate [in Group 2] and MAP [in Group 3]. after tracheal intubation. Furthermore, the use of an esmolol infusion as an adjunct to sevoflurane to control the acute autonomic responses during the maintenance period significantly decreased emergence times [4 +/- 2 versus 7 +/- 4 min], decreased the need for postoperative opioid analgesics [35% versus 60%], and reduced the time before discharge [209 +/- 89 versus 269 +/- 100 min]. We conclude that the adjunctive use of esmolol alone or in combination with nicardipine during the induction of anesthesia reduced the hemodynamic response to tracheal intubation. It did not compromise splanchnic tissue oxygen balance in healthy patients nor increased blood lactate. Furthermore, use of an esmolol infusion as an adjuvant to sevoflurane- N[2] O anesthesia for controlling the acute hemodynamic responses during the maintenance period improved the recovery profile after functional endoscopic sinus surgery

Elevation of liver enzymes after laparoscopic cholecystectomy versus open cholecystectomy

Laparoscopic cholecystectomy [LC] has been accepted as an alternative to laparotomy, and has become the standard treatment of benign gall bladder diseases. However, it has been noticed that following LC, the serum level of certain liver enzymes rises markedly, in patients who had preoperatively normal liver enzyme value. We measured serum values of hepatic alcohol dehydrogenase [AD] and glutathione S-transferase [GST] alanine aminotransferase [ALT] and aspertase aminotransferase [AST], in 80 patients who underwent open cholecystectomy or laparoscopic cholecystectomy, they were divided randomly into two groups. Group 1[40 patients] underwent laparoscopic cholecystectomy [LC]. Group 11[40 patients] underwent open cholecystectomy [OC]. To assess the liver function, serum liver enzymes of AD, GST, ALT, and AST were measured before operations and at 1, 3, 7, and 10 days postoperative. Pre operative AD, GST, ALT, and AST were insignificantly different between the two groups. Twenty four hours after the procedure. AD, GST, ALT and AST increased significantly in the LC group [AD 8.1 +/- 2.2 U/L, GST 82.2 +/- 19.1 U/L, ALT 87.1 +/- 24.2 U/L, and AST 95.1 +/- 7.7 U/L but in [OC] group these enzymes were [AD 4.8 +/- 1.9 U/L, GST 35.3 +/- 3.9 U/L, ALT 27.8 +/- 11.9 U/L, and AST 5.3 +/- 0.9 U/L]. A further increase in serum AD, GST, ALT and AST value in LC group at the 3 [rd] day after the operation [AD 9.3 +/- 1.5 U/L, GST 103.5 +/- 21.6 U/L, ALT 99.3 +/- 19.4 U/L, and AST 120.9 +/- 10.4 U/L] but in [OC] group these enzymes were [AD 5.6 +/- 3.4 U/L, GST 47.9 +/- 1.4 U/L, ALT 38.6 +/- 3.4 U/L, and AST 17.9 +/- 1.4 U/L]. Slow return to normality occurred 7-10 days after the procedure in the LC group. Alterations in hepatic function occur after LC and appear to be clinically insignificant. These alterations in hepatic function return to normal levels within ten days. CO2 pneumoperitoneum seems to be the main reason for these changes but other factors may also contribute

Intrathecal neostigmine versus intrathecal morphine, their combination for postoperative analgesia in patients undergoing herniorrhaphy

We designed this study to evaluate the postoperative analgesic efficacy and safety of intrathecal [IT] neostigmine, intrathecal [IT] morphine, and their combination in patients undergoing herniorrhaphy under spinal anesthesia. Eighty adult patients were randomly divided into four groups to receive isotonic sodium chloride solution 0.5 ml, neostigmine 100ug, morphine 0.3 mg or the combination of IT neostigmine 50 ug and morphine 0.15 mg with IT 0.5 0/0 hyperbaric bupivacaine 15 mg. There were no significant differences among the four groups with regard to spinal anesthesia, age, heart rate, or mean arterial blood pressure. Postoperative analegisa was provided by IM diclofenac. Compared with the saline group, the time to first use of analgesic was significantly longer in neostigmine group [p= 0.02], with lower 24 h analgesic consumption [p=0.001]. Nausea and vomiting were the most common side effects of IT neostigmine 60 0/0. Analgesic effectiveness was similar between the neostigmine and morphine groups. Compared with the neostigmine group, the combination group had significantly longer analgesic effects [P=0.02] with less incidence of nausea and vomiting [p=0.04]. Compared with the morphine group, the combination group tended to have prolonged times to first use of analgesic [p=0.02] with lower incidence of pruritus [p=0.03]. the combination of IT neostigmine 50 ug and IT morphine 0.15 mg produce longer postoperative analgesia with fewer side effects than IT neostigmine 100ug or IT morphine 0.3 mg alone. Intrathecal [IT] neostigmine 100ug produced postoperative analgesia for herniorraphy similar to [IT] morphine 0.3mg, but with high incidence of nausea and vomiting, morphine group had high incidence of pruritus. Thus, combination of both has higher analgesic effects with lower side effects than single drug alone