Prevalence of chronic obstructive pulmonary disease in Saudi Arabia

To assess the prevalence of epidemiologically defined chronic obstructive pulmonary disease [COPD] in Saudi Arabia. This cross-sectional, observational, population-based survey of COPD was conducted between June 2010 and December 2011 across the country of Saudi Arabia. A total of 56,000 randomly selected telephone numbers were called, which identified 10,001 eligible subjects; of whom 9,779 agreed to participate. A screening questionnaire included 6 questions related to cigarette consumption and water-pipe use was administered to each participant. Subjects with positive screening results were invited to provide input for a detailed COPD questionnaire. The adjusted proportion of subjects who reported a current, or past smoking history was 27.9%. Gender specific smoking rates adjusted by age were 38.7% [95% confidence interval [CI]: 37.5-39.9%] in men, and 7.4% [95% CI: 6.5-8.3%] in women. The epidemiological definition of symptomatic COPD was met by a total of 249 subjects. The age and gender-adjusted prevalence of COPD was 2.4% [95% CI: 2.1-2.7%]. Overall, COPD was more frequently documented [p<0.0001] in men [3.5% [95% CI: 3-4%]] than in women [1% [95% CI: 0.7-1.3%]]. The prevalence of epidemiologically defined COPD in the general population of Saudi Arabia is 2.4%, which is lower than that reported in industrialized countries

Comparison of adults with insulin resistance (IR) in latent autoimmune diabetes versus IR in glutamic acid decarboxylase antibody-negative diabetes

<p><b>INTRODUCTION</b>Insulin resistance in latent autoimmune diabetes in adults (LADA) patients is controversial. The aim of this study was to evaluate insulin resistance and its related factors (metabolic syndrome parameters) among subjects with LADA and glutamic acid decarboxylase antibodies (GADA) negative diabetes, as well as the impact of these factors on insulin resistance.</p><p><b>MATERIALS AND METHODS</b>GADA levels were investigated in 1140 diabetic patients aged between 30 and 70 years. Insulin resistance and metabolic syndrome parameters were assessed in LADA and GAD-negative diabetic patients by general linear model. In addition, the impact of metabolic syndrome factors on insulin resistance was assessed in LADA and glutamic acid decarboxylase (GAD)-negative diabetic patients.</p><p><b>RESULTS</b>LADA was diagnosed in 33 subjects from 1140 Malaysian diabetic patients (prevalence = 2.9%). The results showed that LADA patients had higher insulin resistance and high density lipoprotein cholesterol (HDLc) (P = 0.003 and 0.00017 respectively) and lower body mass index (BMI) (P = 0.007) compared to GAD-negative diabetic patients. The HDLc was associated with decreased insulin resistance in LADA patients (P = 0.041), whereas HbA1c, triacylglycerides (TG) and waist were associated with increased insulin resistance in GAD-negative diabetic patients (P = 3.6×10⁻¹², 1.01×10⁻⁵ and 0.004 respectively). HbA1c was highly associated with decreasing β-cell function in both LADA (P = 0.009) and GAD-negative diabetic subjects (P = 2.2×10⁻²⁸).</p><p><b>CONCLUSION</b>Insulin resistance is significantly higher in LADA than GAD-negative diabetic Malaysian subjects.</p>

Array comparative genomic hybridization screening in IVF significantly reduces number of embryos available for cryopreservation / 대한생식의학회지

OBJECTIVE: During IVF, non-transferred embryos are usually selected for cryopreservation on the basis of morphological criteria. This investigation evaluated an application for array comparative genomic hybridization (aCGH) in assessment of surplus embryos prior to cryopreservation. METHODS: First-time IVF patients undergoing elective single embryo transfer and having at least one extra non-transferred embryo suitable for cryopreservation were offered enrollment in the study. Patients were randomized into two groups: Patients in group A (n=55) had embryos assessed first by morphology and then by aCGH, performed on cells obtained from trophectoderm biopsy on post-fertilization day 5. Only euploid embryos were designated for cryopreservation. Patients in group B (n=48) had embryos assessed by morphology alone, with only good morphology embryos considered suitable for cryopreservation. RESULTS: Among biopsied embryos in group A (n=425), euploidy was confirmed in 226 (53.1%). After fresh single embryo transfer, 64 (28.3%) surplus euploid embryos were cryopreserved for 51 patients (92.7%). In group B, 389 good morphology blastocysts were identified and a single top quality blastocyst was selected for fresh transfer. All group B patients (48/48) had at least one blastocyst remaining for cryopreservation. A total of 157 (40.4%) blastocysts were frozen in this group, a significantly larger proportion than was cryopreserved in group A (p=0.017, by chi-squared analysis). CONCLUSION: While aCGH and subsequent frozen embryo transfer are currently used to screen embryos, this is the first investigation to quantify the impact of aCGH specifically on embryo cryopreservation. Incorporation of aCGH screening significantly reduced the total number of cryopreserved blastocysts compared to when suitability for freezing was determined by morphology only. IVF patients should be counseled that the benefits of aCGH screening will likely come at the cost of sharply limiting the number of surplus embryos available for cryopreservation.

Biomarkers of the pathogenesis of metabolic syndrome

To investigate the association between oxidant/anti-oxidant balance [MDA and paraoxonase] with the degree of severity of metabolic syndrome [MS] that was measured by the pro/anti-inflammatory markers [TNF-alpha and adiponectin] and other clinical and biochemical criteria to find biomarkers identifying patients at risk for cardiovascular disease [CVD]. The study included eighty patients [20 obese diabetics, 20 non-obese diabetics. 20 obese non-diabetics and 20 controls]. Serum levels of adiponectin and TNF-allpha, were analyzed by ELIZA. MDA and paraoxonase activity [PON] were determined by colorimetric method in all patients with or without MS. The international Diabetes Federation [IDF] proposal identified a greater percentage of MS. The highest prevalence was found in females. Serum levels of adiponectin and paraoxonase activity were significantly decreased but serum levels of TNF-alpha and MDA were significantly increased in MS subjects. There was an inverse correlation between number of features of metabolic syndrome [BMI, waist circumference, fasting plasma glucose, fasting insulin, insulin resistance, blood pressure, TGs and LDL] and protective markers [serum adiponectin and paraxonase levels]. Positive correlation existed with serum TNF-alpha and MDA levels. Metabolic syndrome patients had a higher accumulate [from 3/25 to 9/25 to 13/25]. Triglycerides and TG/HDL-C ratio were significantly positively correlated with TNF-alpha and negatively correlated with adiponectin. Hypoadiponectemia and decreased paraoxonase are associated with higher degree of metabolic alterations of MS. These could be contributing factors to the increased incidence and severity of CVD. These markers levels were significantly changed before accumulation of metabolic criteria indicating their role in production of metabolic syndrome

Oxidant/antioxidant status and endothelial dysfunction in obese and hypertensive models of insulin resistance

[1] To investigate the oxidant-antioxidant status and nitric oxide [NO] production in essential hypertensive patients and comparing them to obese normotensive and obese hypertensive patients [2] To compare the NO, antioxidant and oxidants in insulin resistant [IR] patients [fasting glucose insulin ratio [F-G/l ratio] <4.5] versus insulin sensitive [IS] ones [F-G/l ratio > 4.5]. Design: A case control study. Patients: Fifty two patients ranging from 30-55 years of age, and classified into: Essential hypertensive, non obese patients [group II]; normotensive obese subjects [group III]; and hypertensive obese patients [group IV]. They were further subdivided according to the F.G/I ratio into IR and IS groups. Sixteen age and sex matched healthy subjects [group I] were chosen as controls. Setting: Internal Medicine and Biochemistry Depts., Cairo Medical Hospital. Serum malondialdehyde [MDA] [as a marker for lipid peroxidation], total plasma nitrites and nitrates [Nox] [as an index for NO production], erythrocytic reduced glutathione [GSH], glutathione peroxidase]. [GSH-PX], superoxide dismutase [SOD], and blood vitamin C were estimated by specific colourimetric assays. Plasma selenium was estimated by atomic absorption spectrophotometry. A significant increase mean levels of MDA and reduction in Nox, GSH, vitamin C and, SOD was detected in all patients' groups. Significant reduction in GSH-PX was detected only in the obese groups III and IV. Significant increase in MDA and decrease in Nox, vitamin C and GSH were detected in IR versus IS patients. Simple correlation [r] showed positive relations between MDA and each of MABP, BMI and WHR. Negative correlation was detected between each of Nox, GSH and vitamin C, and each of mean arterial blood pressure [MABP], body mass index [BMI] and waist hip ratio [WHR]. The correlations were higher with WHR than BMI. The F.G/I ratio was negatively correlated with MDA and positively correlated with Nox, GSH and vitamin C. By multiple regression analysis, the WHR was an independent variable concerning F G-I ratio and MABP Activation of lipid peroxidation processes and depression of some antioxidants [especially vitamin C and GSH] proceed more or less in parallel with declining NO bioavailability, the severity of hypertension, extent of obesity, distribution of body fat and degree of IR. The body fat distribution appears to be a more important associate to hypertension and IR than total body fat

Study of thromboxane A2 in dysfunctional uterine bleeding

Thromboxane A2 [TXA2] level was determined in 25 cases with dysfunctional uterine bleeding [DUB] and in 10 cases with normal menstrual blood loss as control group. The patients were not taking anti prostaglandins or hormonal therapy during the last three months, the mean level of TXA2 in cases with DUB was 9.92 pg/0.1 ml plasma +/- 6.587, while in the control group the mean level of TXA2 was 26.7 pg/0.1 ml plasma at 9.03. The difference between the two groups was significant [P <0.001]. Thromboxane A2 being a potent vasconstrictor and a potent platelet aggregator is important in the control of bleeding from the uterus and its decrease level could be one of the etiological factors in the pathogenesis of DUB