Antidiabetic and antioxidant activity of ethyl acetate extract fraction of Moringa oleifera leaves in streptozotocin-induced diabetes rats via inhibition of inflammatory mediators

Objective: To evaluate the antioxidant and antidiabetic mechanism(s) of ethyl acetate extract fraction of Moringa oleifera (M. oleifera) leaves on streptozotocin-induced diabetes in male Sprague-Dawley rats. Methods: A total of 24 adult male rats were segregated randomly into four groups (6 rats each group). Streptozotocin-induced diabetes rats were given (oral gavage) ethyl acetate extract fraction of M. oleifera (200 mg/kg b.w.) for 30 d. The rats of control and experimental groups were sacrificed after 24 hours of final dose of treatment, to extract blood and pancreatic tissue for biochemical and histopathological analysis. Results: The ethyl acetate extract fraction of M. oleifera significantly reversed (P<0.05) the manifestation of streptozotocin on the levels of serum glucose & insulin, lipid profile, hepatic damage markers (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase), malondialdehyde formation, antioxidants (glutathione, Vitamin C & Vitamin E), antioxidant enzymes (superoxide dismutase, glutathione S-transferase, glutathione peroxidase and catalase) and pro-inflammatory cytokines (IL-1 β , TNF- α & IL-6). Histopathological analysis of pancreatic tissues was in concurrence with the biochemical results. Conclusions: These findings support that M. oleifera leaves have potent therapeutic effect on diabetes mellitus via increasing antioxidant levels and inhibition of pro-inflammatory mediators.

Antidiabetic and antioxidant activity of ethyl acetate extract fraction of Moringa oleifera leaves in streptozotocin-induced diabetes rats via inhibition of inflammatory mediators

Objective: To evaluate the antioxidant and antidiabetic mechanism(s) of ethyl acetate extract fraction of Moringa oleifera (M. oleifera) leaves on streptozotocin-induced diabetes in male Sprague-Dawley rats. Methods: A total of 24 adult male rats were segregated randomly into four groups (6 rats each group). Streptozotocin-induced diabetes rats were given (oral gavage) ethyl acetate extract fraction of M. oleifera (200 mg/kg b.w.) for 30 d. The rats of control and experimental groups were sacrificed after 24 hours of final dose of treatment, to extract blood and pancreatic tissue for biochemical and histopathological analysis. Results: The ethyl acetate extract fraction of M. oleifera significantly reversed (P<0.05) the manifestation of streptozotocin on the levels of serum glucose & insulin, lipid profile, hepatic damage markers (alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase and lactate dehydrogenase),malondialdehyde formation, antioxidants (glutathione, Vitamin C & Vitamin E), antioxidant enzymes (superoxide dismutase, glutathione S-transferase, glutathione peroxidase and catalase) and pro-inflammatory cytokines (IL-1β, TNF-α& IL-6). Histopathological analysis of pancreatic tissues was in concurrence with the biochemical results. Conclusions: These findings support that M. oleifera leaves have potent therapeutic effect on diabetes mellitus via increasing antioxidant levels and inhibition of pro-inflammatory mediators.

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

Prevalence of Cryptosporidium-Associated Diarrhea in a High Altitude-Community of Saudi Arabia Detected by Conventional and Molecular Methods

Cryptosporidium diarrhea represents a relevant clinical problem in developing countries. In Al-Taif, a city of Saudi Arabia that lies at an altitude of an around 2 km above the sea level, Cryptosporidium infection seems to be undiagnosed in nearly all clinical laboratories. Furthermore, nothing was published regarding Cryptosporidium-associated diarrhea in this area. The objectives of this research were to (1) determine the Cryptosporidium prevalence among patients with diarrhea and (2) to estimate the performances of 3 different diagnostic methods. Total 180 diarrheal fecal samples, 1 sample per patient, were collected between January and August 2013. Samples were screened for Cryptosporidium with modified Zeihl Neelsen (ZN) microscopy, RIDA(R) Quick lateral flow (LF) immunotest, and a previously published PCR. The Cryptosporidium prevalence rate was 9.4% (17/180), 10% (18/180), and 11.6% (21/180) by microscopy, LF, and PCR test, respectively. Infection was significantly (P=0.004) predominant among children <5 years (22%) followed by children 5-9 years (11.1%). Although infection was higher in males than in females (16.2% males and 8.5% females), the difference was not statistically significant (P=0.11). Compared to PCR, the sensitivity of microscopy and the LF test were 80.9%, 85.7%, respectively. To conclude, high Cryptosporidium-associated diarrhea was found in this area especially in children < or =9 years. The PCR test showed the best performance followed by the LF test and ZN staining microscopy. The primary health care providers in Al-Taif need to be aware of and do testing for this protozoon, particularly for children seen with diarrhea.

Post-surgical complications of symphyseal block graft with and without soft tissue grafting

To determine whether soft tissue augmentation prior to block grafting will minimize post-block grafting soft tissue complications. This longitudinal controlled pilot study was conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from October 2010 to January 2013. Fourteen sites requiring block grafting were divided into 2 groups: Group A - 7 sites in 6 patients were subjected to monocortical block graft [control]; and Group B - 7 sites in 6 patients were subjected to soft tissue graft through new tunnel technique, followed by monocortical block graft [test]. In Group A, 2 patients had wound dehiscence and graft exposure. The first that had an exposure of 3x4 mm resulted in 45% resorption of the graft. The second had an exposure of 4x5 mm followed by infection, which resulted in 75% resorption of the graft. In the other 5 cases, sites healed with no complications and minimal resorption [0-15%]. In Group B - there were generalized 1-2 mm increases in the thickness of soft tissue following soft tissue graft. Recipient sites healed with no complications or infection following block grafting. Block graft resorption ranged from 0-15%. More complications were seen in those patients who did not receive soft tissue augmentation, thus demonstrating the importance of soft tissue preparation prior to block grafting, especially in patients having thin soft tissue

practical approach to discerning between atrial lead displacement and reversal in dual chamber pacemakers

We describe a 12-lead electrocardiogram image of a pacemaker malfunction due to atrial lead displacement. Facilitating the understanding of pacemaker timing cycles could explain the underlying mechanisms in this instance. This review utilizes the feature of the ventricular safety pacing interval to discern between atrial lead displacement and reversal

Effect of periodontal treatment on serum C-reactive protein level in obese and normal-weight women affected with chronic periodontitis

To investigate the effect of conventional periodontal therapy on serum C-reactive protein [CRP] level and periodontal status in obese and normal-weight chronic periodontitis patients. This is a controlled clinical trial conducted at the King Abdulaziz University Faculty of Dentistry, Jeddah, Kingdom of Saudi Arabia between December 2009 and March 2011. A total of 40 women affected with moderate to severe chronic periodontitis were selected [20 obese [test group] and 20 normal-weight [control]]. Smokers, pregnant women, and subjects with any systemic disease were excluded. Serum CRP level and periodontal parameters, including clinical attachment level, probing depth, bleeding on probing and plaque scores were assessed at baseline, and 2 months after non-surgical periodontal treatment. Periodontal therapy was effective in reducing gingival inflammation, as well as serum CRP level in the total sample and within each group. The pretreatment mean level of serum CRP was 0.78 [ +/- 0.51] and post- treatment was 0.55 [ +/- 0.41] mg/l in the total sample [p=0.001]. A tendency was observed toward a better systemic response to treatment in normalweight compared to obese women, however, it was not statistically significant [the mean changes in CRP levels after therapy were 0.28 [ +/- 0.43] and 0.19 [ +/- 0.32] mg/l]. Periodontal treatment is effective in reducing systemic inflammation as measured by serum CRP level, and obesity does not have a major negative impact on response to periodontal therapy

Awareness of healthcare workers regarding preventive measures of communicable diseases among Hajj pilgrims at the entry point in Western Saudi Arabia

To determine the level of knowledge of healthcare workers [HCWs] towards preventive measures for communicable diseases among pilgrims, and to highlight the difficulties faced by HCWs in implementing preventive measures at entry point. A cross-sectional study was conducted at King Abdulaziz International Airport Hajj Terminals in Jeddah, Kingdom of Saudi Arabia during Hajj season from October to November 2009 including 325 healthcare workers [HCWs]. Data were collected using a self-administered questionnaire. Difficulties reported by HCWs were refusal of vaccine, or chemoprophylaxis by some pilgrims, language barriers, and difficulties in organizing pilgrims. The different items related to meningococcal meningitis were answered correctly by most HCWs except for preventive measures applied to infants and children. Less than one half were aware of the period of validity for Yellow Fever vaccine certificate and measures to be taken for unvaccinated pilgrims. Only 32.9% were aware of preventive measures that should be applied against influenza A [H1N1]. Physicians, those reading guidelines, and those with high experience a showed significantly better level of knowledge than other categories. The HCWs have difficulties in some preventive measures, especially among non-physicians, those with less years of experience, and those who did not read the written guidelines, which highlighted the importance of training courses before Hajj season

NKH477 inhibits proliferation and induces apoptosis in a panel of cancer cell lines

The anti-proliferative effects of cAMP in cancer cells may be regulated by the adenylyl-cyclase-V isoform. As Colforsin Daropate [NKH477] is more selective for this isoform, we hypothesized that this water soluble compound may promise utility as an oral anti-tumour agent. Using separate cancer cell lines [MCF7, HT29, A431, WiDr, RKO, A375, H630, Du145, SW480 and SW620], we studied the effects of NKH477 on cell proliferation, cell viability and apoptosis. NKH477 induced >70% inhibition of proliferation in all cancer cell lines tested. NKH477 induced a dose-dependent apoptosis causing G1 arrest and priming cells to die. NKH477 treatment on the tested cell lines inhibited proliferation and induced apoptosis. Thus, NKH477 shows early promise as an oral anti-cancer agent

Effect of stress on pain perception in young women

To determine the effect of physical and mental stressors on pressure pain threshold [PPT], and pressure pain tolerance [PTOL] values, and to compare these different types of stressors on its ability to affect PPT and PTOL values in young women. We also correlated body mass index [BMI] with PPT and PTOL in young women. This was a self-controlled study carried out on 79 second-year female medical students in the Department of Physiology, King Faisal University, Dammam, Saudi Arabia during the year 2007. The students were assessed before, and after they were subjected to a mental [exam], and 2 physical stressors. Measurements of PPT and PTOL were carried out using a pressure algometer. The 2 physical stressors used were: cold water immersion and isometric exercise [ISO EX] with a dynamometer. Students' body mass indices were measured in addition to the measurement of blood pressure and heart rate for each student before, and after exposure to the stressors. All 3 stressors significantly increased the PPT values [p=0.000]. The PTOL was also significantly increased immediately after exposure to the physical stressors [p=0.000], while for the mental stressor, the PTOL readings were not significantly increased. Among the 3 types of stressors, the cold water immersion was the most effective in increasing PPT and PTOL. Moreover, a significant [p=0.009] negative correlation was demonstrated between the BMI and PTOL readings. Various types of physical and mental stressors significantly increased PPT and PTOL readings in young female adults, in addition to the significant findings that students with higher body mass indices tolerated pain less

Burkholderia gladioli associated abscess in a type 1 diabetic patient

Burkholderia gladioli, a bacterial pathogen, causes a variety of infectious ailments in immunocompromised individuals. We present a case report of foreign body associated Burkholderia gladioli related abscess in an immunocompetent type 1 diabetic patient. Relevant medical literature is reviewed to understand this unusual mode of presentation of this bacterium in our patient

Current concepts in alveolar bone augmentation: a critical appraisal

Augmentation of the alveolar bone is widely used in implant treatment to create predictable function and esthetics in areas with inadequate bone volume. This can be achieved by various techniques including hard tissue onlays, bone grafts, membrane techniques, bone distraction and bone expansion. The objective of this article is to discuss recent observations of the various bone grafts and bone substitutes, guided bone regeneration, combination techniques, as well as ridge preservation techniques. Despite the increase in the number of procedures that require bone grafts, there has not been a single ideal bone graft substitute. An attempt is made to review the existing bone grafts, and the developments in tissue engineering that may bring biologic alternatives to enhance the functional capabilities of the bone graft substitutes

impact of periodontal infections on systemic diseases. An update for medical practitioners

Oral health status is an integral component of a general health and well-being of an individual. Knowledge about the link between periodontal disease and systemic diseases are growing rapidly. Increasing evidence is available from many investigators to indicate periodontitis as a risk factor for cardiovascular diseases, diabetes mellitus, low birth weight infants and pulmonary diseases. Both epidemiologists and researchers in oral microbiology have contributed significantly to the new paradigm of periodontal disease. Although additional studies are needed to determine the mechanisms by which such associations exist; available research clearly demonstrates that oral diseases and conditions are not only markers for underlying health problems, but also important determinants influencing the development and management of adverse chronic health conditions. Physicians and dentists should be aware of this link and provide treatment that will greatly benefit the patients. A review of the relationship between periodontal infections and its possible impact on systemic diseases is discussed

Serosurvey of measles, mumps and rubella antibodies in Saudi children

A serosurvey study to evaluate the proportion of children with antibodies against diseases targeted by the Expanded Program of Immunization in the Kingdom of Saudi Arabia. Using multistage sampling techniques, we collected samples and sent them for laboratory assay from the following age groups; 100 samples at 6 months, 12 months, 18 months, 6 years, 13 years, and 17 years. We conducted the study from September 2001 to February 2002. We assayed sera for measles, rubella, and mumps antibodies in the measles-mumps-rubella reference laboratory in Germany, using enzyme immunoassay and plaque neutralization [PN] as a backup test for equivocal and negative samples. We only carried out a backup test for measles samples. The age group of 6 months had the highest proportion with negative measles antibodies. After adding the backup test [PN], the proportions of children with protective measles antibody were; 64% at 6 months, 87% at 12 months, 91% at 18 months, 75% at 6 years, 96% at 13 years, and 98% at 17 years. Rubella antibody positivity rates [>7 IU] were 28% at 6 months, 49% at 12 months, 97% at 18 months, 98% at 6 years, and 100% at 13 years. While positivity rates in mumps were 14% at 6 months, 29% at 12 months, 59% at 18 months, 64% at 6 years, and 75% at 13 years. The unexpected low proportion of children with protective level at 6 years, despite being vaccinated with 2 measle doses is an important phenomenon. This reflects the interference between the first and the second measles dose. The Ministry of Health decided to conduct a catch up campaign targeting 1st through 3rd grade primary schools, who did not catch the mass campaign conducted in 2000. Also, this supports the decision taken by the ministry to change the measles immunization schedule to MMR at 12 months and a second dose at 6 years of age

Serosurvey of hepatitis B surface antigen in pregnant Saudi women

In 1990, Saudi Arabia began vaccinating all children at school entry against hepatitis B. We evaluated hepatitis B surface antigen [HBsAg] prevalence rate among pregnant Saudi women 12 years later in 5 regions of the country. Using multistage sampling, 2664 pregnant Saudi women were recruited. Blood samples were tested for HBsAg; positive samples were also tested for hepatitis Be antigen [HBeAg]. In all 2.44% were positive for HBsAg and 4 [0.15%] were also positive for HBeAg. HBsAg prevalence was highest in Gizan [4.2%] and lowest in Tabuk [1.4%]. Positivity for women < or = 20 years of age was 0.5% compared with 2.6% for older women [P = 0.049]. The overall HBsAg prevalence rate was lower than previously reported

Screening of pregnant Saudi women for hepatitis B surface antigen

The high prevalence of hepatitis B surface antigen [HBsAg] and hepatitis B e antigen [HBeAg] in pregnant women is considered the most important factor contributing to the higher carrier rate of HBsAg in some populations, including Saudi Arabia. Universal hepatitis B vaccination in infancy was implemented in Saudi Arabia in 1990 to avoid early acquisition of infection. At the same time, another program was launched to vaccinate all school children at school entry as a second target group. The aim of this study was to evaluate the HBsAg prevalence rate in Saudi pregnant women 12 years after launching the program and to assess regional variation, if any. In a cross-sectional study, 2664 pregnant Saudi women were recruited from the five main regions in Saudi Arabia. Blood samples were tested for HBsAg. Positive samples were tested also for HBeAg. Of 2664 pregnant Saudi women, 65 were positive for HBsAg [2.46%, 95% CI=2.11%- 2.69%]. Four were positive for HBeAg [0.15%]. The HBsAg prevalence rate was higher in Gizan [4.2%] and lower in Tabuk [1.4%] [P=0.035]. Only one case was positive for HBsAg in women under the age of 20 years [1/186], a 0.5% positivity rate in this age group compared with 2.6% in the older age group [P=0.049 for the one-sided test]. A history of surgical procedures was associated with a higher [3%], but not significantly higher rate of HBsAg positivity. No significant association was found between HBsAg positivity and a history of dental procedures or blood transfusion.Although the HBsAg prevalence rate among Saudi pregnant women was lower than previously published data, the full impact of the hepatitis B vaccination program in infancy and childhood will take more years to decrease the prevalence rate in pregnant women. The MOH should continue to give the first dose of hepatitis B vaccine at birth to prevent early acquisition, but in the meantime a regional policy can be adopted to deal with the high prevalence rate of HBsAg among pregnant Saudi women

Pattern of skin cancer in southwestern Saudi Arabia

Skin cancer is a common malignant neoplasm in the Kingdom of Saudi Arabia [KSA] and it is the most common malignant neoplasm in Al-Baha area. This study was performed to determine the pattern of skin cancers seen at King Fahad Hospital, Al-Baha, KSA. Histologically diagnosed skin cancers, seen between 1990 and 2003, were reviewed and analyzed according to age, gender, race and site of distribution. Of a total of 193 patients, there were 79 [41%] cases of basal cell carcinoma [BCC], 56 [29%] cases of squamous cell carcinoma [SCC] and 34 [18%] cases of Kaposi's sarcoma. Malignant melanomas represent 4.1% of the cases. The male to female ratio for all cancer was 1.6:1. The peak age distribution was in the 70-80-year group. The most common site involved in BCC was the head and neck [90%] and in Kaposi's sarcoma were the lower limbs [59%]. Acral distribution of malignant melanoma was seen in 62% cases. The most common skin cancers seen are BCC and SCC followed by Kaposi's sarcoma. The site of distribution of BCC and SCC in our study is similar to studies in Caucasians. The site of distribution of BCC in sun exposed area supports the role of the ultraviolet light in the pathogenesis of such tumor. In contrast to the western countries, melanoma is a rare skin neoplasm in KSA