Prognostic Value of Leptin Gene Polymorphisms in Type 2 Diabetes Mellitus Patients in Egypt.

Aim: The work wasto study polymorphisms in the LEP gene in type 2 diabetics in Minia, Egypt and determined the relationship between the leptin and c-peptide levels in different genotypes and insulin resistance in obese patients. The study also has evaluated the role of leptin gene polymorphism in prediction of diabetes mellitus prognosis and its prevention. Study Design: Investigative. Place and Duration of Study: Samples were analyzed at Biochemistry Department, Faculty of Medicine- Minia University, Egypt, between August 2012 and April 2014. Methodology: This study was performed in 80 patients with type 2 diabetes mellitus (54 men and 26 women) and 15 normal controls (12 men and 3 women). In our thesis we measured HbAc, fasting blood glucose, leptin hormone and c-peptide. DNA extracted and the human leptin gene (for product 242 bp) was amplified by PCR, Restriction analysis of the PCR products was performed with restriction enzyme HhaI and genotyped at the restriction site located -2549 bp from the transcription initiation site of leptin gene. Presence of allele (C at -2549 bp) and absence of allele (A at the same position) were identified through the GCGC sequence. Results: Our study showed C-2549 A variant is associated with the fasting leptin levels, the results which are in agreement with previous studies. The polymorphism in leptin gene has an effect on the level of plasma leptin in different genotypes, and individuals with AA genotype have the lower plasma levels of leptin and also c-peptide than AC and CC variants. Conclusion: Our study reveals that both diabetic patients and their non-diabetic relatives have different basal leptin and c-peptide specific to different leptin genotypes. This suggests that the association between leptin and insulin in members of diabetic families may be controlled by inheritance.

probability distribution of attendance to hospital emergency units for school students in Alexandria

The present work is a retrospective study designed to examine the assumption that emergency arrivals at the Sporting Students' Hospital in Alexandria follow a Poisson distribution. Data about all arrivals at the emergency room [ER] for the year, 2000 [43076 arrivals] was extracted from the records of the emergency department and classified by age, sex, school, reason for visit, date and time of visit. Data analysis revealed that 12.9% of the total arrivals indicated hospital admission either to the inpatient units [12.5%] or the ICU [0.4%]. Goodness of fit test showed that admissions to the ICU fit the Poisson distribution but those admitted to the inpatient units did not follow the assumed distribution. However the latter group did not fit exactly the normal distribution which indicated that deviance from the Poisson is due to the large mean non-elective admissions [14.74% per day]. Hence the Poisson assumption is not excluded as the inpatient emergency admissions are still randomly distributed and independent. Univariate and multivariate Poisson regression of the daily emergency admissions gave another clue to the goodness of fit of emergency admissions to the Poisson process. Regression analysis showed significantly higher log[e] number of emergency admissions among the age group 12 or more, male students, medical conditions in contrast to injuries, governmental schools, and at 04:00-11:59 pm in contrast to midnight to 07:59 am. Results of the present study indicated the random nature of demand for emergency admission which affects use of bed stock. A prospective study of these admissions on daily basis is needed

use of locked nails in the treatment of humeral shaft: Delayed union and nonunion

To assess the results and clinical outcome of delayed union and nonunion humeral shaft treatment using locked medullary nails. The Russel and Taylor humeral locking nail was used to treat 21 patients with humeral shaft fractures at Al Razi hospital, Kuwait, from 1997 to 2001. Of these, 8 had delayed union and 13 nonunion. Also, 13 had previous operative treatment, while 8 had nonoperative treatment, Antegrade nailing was done in all cases, and all nails were fixed statically. Autogenous iliac bone grafts were used in 17 cases. Of the 21 cases of fractures, 19 were united. Only 2 cases had persistent nonunion. Eighteen cases had satisfactory shoulder function, and 3 lost shoulder abduction between 40 and 65 degrees. Our data showed that humeral locked nails can achieve satisfactory clinical results in treating humeral shaft delayed unions and nonunions

Posterior reduction, transpedicular screw fixation and fusion in the treatment of adult spondylolisthesis

To assess the results and clinical outcome of treating adult spondylolisthesis by posterior transpedicular screw fixation and spinal fusion. Thirty two cases of various degrees of spondylolisthesis including isthmic degenerative and iatrogenic types were treated at Al Razi Orthopedic Hospital in Kuwait between 1998 and 2001 by posterior reduction and pedicular screw fixation with posterior or posterolateral spinal fusion. Two spinal systems were used in this study, SOCON-SRI from Aesculap and USS from Synthes. The mean follow up period was 21.8 months. In thirty cases [93.8 percent], solid fusion was obtained with mean correction of percentage of slippage from 44 percent to 18 percent. Twenty seven patients [84.4 percent] had satisfactory functional recovery. Transpedicular screw fixation with posterior fusion offers a reliable and satisfactory treatment option of adult spondylolisthesis with high rate of successful fusion and functional recovery

Malignant recurrent schwannoma of the chest wall without multiple neurofibromatosis

A case of malignant recurrent schwannoma of the chest wall unassociated with multiple neurofibromatosis is presented. This is the first case to be reported from the King Abdulaziz University Hospital in Jeddah. The clinical, macroscopic and microscopic features of this unique malignant and recurrent chest wall tumour in a young man are discussed

Extrapulmonary tuberculosis

Tuberculosis is still one of the most prevalent communicable diseases in the developing countries. There is no evidence that such incidence is decreasing [Medical Research Council 1979]. The lungs are the commonest site of primary infection, but extrapulmonary sites may become infected either primarily or secondarily to pulmonary disease. The aim of this paper is to focus attention on the prevalence of extrapulmonary tuberculosis among people in the Kingdom of Saudi Arabia

Crohn's disease in Saudi Arabians

We describe two cases of Crohn's disease, which we believe are the first to be reported from Saudi Arabia