Serum Chemerin and Cardiovascular Risk Factors in Diabetic Subjects without Established Vascular Disease.

Aims: The current study aims to investigate serum chemerin as a potential cardiovascular marker in diabetic patients without established vascular diseases. Study Design: Case-Control study. Place and Duration of Study: The outpatients clinic, King Abdulaziz University Hospital in Jeddah, Saudi Arabia, between January 2013 and June 2014. Methodology: Ninety consecutive diabetic patients and 90 age- and sex-matched controls were recruited from King Abdulaziz University Hospital in Jeddah, Saudi Arabia. Demographic, anthropometric and biochemical variables were estimated. Results: Overall and central obesity were highly prevalent among both groups. Serum chemerin was correlated with glycated hemoglobin (r= -0.207, p<0.05) and with C reactive protein (CRP) (r= 0.171, p<0.05). Moreover, serum chemerin was correlated with prothrombin time (r = -0.278, p<0.05) in control subjects and with diastolic blood pressure (r = -0.233, p<0.05) in diabetic subjects. Conclusion: We concluded that only glycated hemoglobin was significantly and independently correlated with serum chemerin levels.

Prevalence of and predictive factors for nonalcoholic fatty liver disease in Sudanese individuals with type 2 diabetes: is metabolic syndrome the culprit?

Non-alcoholic fatty liver disease [NAFLD] is a common global chronic liver condition. The prevalence of NAFLD among individuals with type 2 diabetes is estimated to be as high as 75%. The aim of this study was to determine the prevalence of NAFLD among individuals with type 2 diabetes in Sudan. This was a cross-sectional hospital-based study, which was carried out at the Jabir Abu-Elizz diabetic centre in Khartoum; 167 outpatients with type 2 diabetes were enrolled. NAFLD was diagnosed based on ultrasound, following exclusion of significant alcohol intake and secondary causes of liver diseases. NAFLD was defined as hepatic steatosis in the absence of alcohol intake, medication, previous liver disease and negative results for the serological test for hepatitis B and C. Logistic regression analysis was used to determine independent risk factors for the development of NAFLD in individuals with type 2 diabetes. The number of female subjects was 89 [53.3%], and most subjects [145, 86.8%] were between the ages of 40 and 70 years. The overall prevalence of fatty liver among individuals with type 2 diabetes was found to be 50.3%. Age, duration of diabetes, hypertension and HbAlc levels appeared to have no impact on the prevalence of NAFLD. The possible predictors of NAFLD were overweight, obesity, central obesity, high triglyceride level and low high-density lipoprotein cholesterol [HDL-c] level. A higher prevalence of NAFLD was observed in individuals with three components of the metabolic syndrome. NAFLD was observed in half of the diabetic population, and its occurrence correlates positively with metabolic syndrome risk factors

Characteristics of developmental anomalies in the permanent dentition of jordanian orthodontic patients

To evaluate the frequency, distribution and gender differences of developmental permanent teeth anomalies with various malocclusions in a sample of Jordanian orthodontic patients. A total of 1.500 non-syndromic orthodontic patients [750 females and 750 males], attended the Dental Departments at King Hussein Medical Center and Prince Rashed Bin Al- Hassan Hospital between July 2008 and September 2011, were included. The study group comprised 180 orthodontic patients [96 females and 84 males], each with at least one developmental dental anomaly. Their ages ranged from 13 to 22 years, with a mean of 16.8 years [+/- 3.6]. Dental history, pretreatment records, intra oral radiographs, and orthopantomograms were used for the diagnosis of various dental anomalies. The following dental anomalies were identified, impacted teeth, transposition, transmigrant canines, ectopic eruption, peg-shaped lateral incisors, fusion, gemination, microdontia, macrodontia, oligodontia, hypodontia, hyperdontia, and amelogenesis imperfecta. The chi-square test was used to investigate the gender differences and the occurrence rate in various malocclusions. In 180 [12%] of 1500 orthodontic patients, at least one dental anomaly was detected. The most frequent dental anomaly was impacted teeth [3.07%]. Peg shaped maxillary lateral incisors were the most frequent anomalous teeth [1.27%]. A significant predominance of hypodontia in females and hyperdontia in males was detected. Impaction had a significantly lower frequency in Class II malocclusion. Except for impaction, there were no statistically significant associations between dental anomalies and orthodontic malocclusions. The characteristics of developmental dental anomalies in this sample of Jordanian orthodontic patients were comparable with the findings of most studies conducted in other countries

Assess the risk factors and knowledge on modification of lifestyle among patients who have experienced acute myocardial infarction in Taif.

Background: Patient education programme for cardiac patients is an essential part of quality medical care today. For the diagnosis and therapeutic regimen to be beneficial, patients must be informed about their own health and motivated to share the responsibility. Aims & Objective: This study was conducted to evaluate the risk factors for myocardial infarction in Taif region, Saudi Arabia kingdom and establish a modification in the life style to decrease the incidence of cardiac diseases. Material and Methods: A hospital based cross-sectional study was conducted at governmental hospital at Taif. Thirty nine subjects admitted to Emergency department during the study period with their first episode of Acute Myocardial Infarction participated in this study. Results: A structured questionnaire was used to collect data. They were 31 (79.5%) males and 8 (20.5%) females, the majority of patients (46.2%) under the scope of this study was above the age of 50 years, 87.2% of them was married and 12.8% was divorced. the main risk factors that affect the patients in Taif region, KSA were the presence of hypertension (59%) , diabetes (35.9%), consuming a highly deep fried food (76.9%) , lack of regular exercise (89.7%) and nervous mode (79.5%). the mean knowledge score of patients recruited in this study was either low (51%) or medium score (29%), and little percentage was either high (14%) or very high (6%) knowledge score. Conclusion: It is recommended to encourage health care providers especially nurses and physicians to teach their patients about disease process, risk factors, and preventive measures during providing either medical or nursing care.

Near fatal fall complicated by penetrating neck injury with uneventful outcome: a case report.

Fall from height is commonly associated with long bones fractures or neurological compromised outcome. On the other hand, penetrating neck injury is linked to life threatening complications especially when the injury involves major blood vessels, spinal cord, cervical spines and aerodigestive tracts. However, in some rare circumstances, a patient may suffer both the eventful fall from height complicated with penetrating neck injury. We report a patient who presented with a wooden stick passing through the lateral side of his neck after an episode of fall. He survived without any residual complications.

Management of obesity and outcomes of hepatitis C treatment

Obesity is a modifiable risk factor for nonresponse to chronic hepatitis C [CHC] treatment. We examined whether weight loss during pegylated interferon [IFN] plus Ribavirin therapy is associated with improved response. Rapid virological response, early virological response, end of treatment response, and sustained virological response [SVR] were compared among patients with or without weight loss [>/= 0.5 body mass index [BMI]] during therapy for hepatitis C virus. Among 324, who provided consent, 280 were treatment-naive patients and 200 started pegylated-IFN/Ribavirin therapy and were included in the study. Median pretreatment BMI was 28.8 +/- 5.7 [19.9-48.9] with 42.6% overweight and 31.6% obese [BMI 25-30 and >/= 30, respectively]. Hepatitis C virus genotype 1 was the prevalent genotype among the candidates of this study, affecting 99 cases of 136 [72.7%], whereas genotypes 2/3 affected 37 cases [27.3%]. For genotype 1, weight loss at 1 and 3 months was associated with higher SVR rates [59.5 vs. 36.8% at 1 month and 55.2 vs. 34.1% at 3 months, respectively, P values=0.02 and 0.03, respectively]. Hepatic fibrosis, elevation of high-density lipoprotein, and decline of homeostasis model of assessment-insulin resistance at 6-months follow-up were proven to be independent predictors for SVR. Weight loss during the first 6 months of IFN therapy was associated with improved SVR in patients with CHC genotype 1 rather than genotypes 2/3. Molecular changes associated with weight loss during CHC and its relation with treatment response need to be prospectively examined

Effects of metronidazole, tinidazole, captopril and valsartan on taste and serum levels of zinc and magnesium

To study the effect of metronidazole, tinidazole, captopril and valsartan on the levels of zinc and magnesium in the serum of rabbits and humans and the histology of taste buds in rabbits. We conducted this study in the College of Medicine and Teaching Hospital, Basrah, Iraq from April 2005 to September 2006. It was in 2 parts: a clinical observational study of 54 patients treated with one of these drugs. The second part involved oral administration of metronidazole [45mg/kg], tinidazole [40mg/kg], captopril [3mg/kg] or valsartan [3mg/kg] or normal saline to 42 rabbits randomly. Serum zinc and magnesium were measured, and histological sections of tongues were examined for taste buds. In rabbits, oral metronidazole [13.6%] or tinidazole [7%] resulted in a significant reduction in serum zinc. Reductions in captopril [6.7%] and valsartan [4.2%] were smaller and insignificant. Body weight increased by 15.5gm [1391 +/- 225.3 gm to 1407 +/- 223.2 gm] in the control group, a lesser increase of approximately 8 gm, was found in the metronidazole group [1452 +/- 222.6 gm to 1460 +/- 221.9 gm]. Rabbit tongues showed moderate degeneration of taste buds caused by tinidazole, severe degeneration of captopril and minimal changes of valsartan. In humans, the drugs did not result in significant changes in serum zinc or magnesium. Approximately 73.3% of patients in the metronidazole group and 11.1% in the valsartan group had taste changes. It is concluded that metronidazole and tinidazole, but not captopril or valsartan resulted in a significant reduction of zinc level in rabbit, but not in human. Captopril and not valsartan caused severe degeneration in taste buds. Serum zinc level seems not to be related to taste buds changes

Effect of the aqueous extract of matricaria chamomilla on stress-ethanol induced acute gastric ulceration in rabbits

The anti-ulcer effect of the aqueous extract of Matricaria chamomilla flowers [chamomile extract, CE] had been tested on stress- ethanol induced gastric ulceration in rabbits. The first part of the study was to induce acute gastric ulceration by stress or stress ethanol combinations. Stress alone teas unable to produce gastric ulcerations while ulcer was induced in the group of rabbits exposed to stress in the presence of ethanol [5ml / kg] with a mean value of ulcer index of 108.3mm +/- 29 [n=8]. Histopathological examination was done to confirm the effect of stress-ethanol combination on gastric mucosa. The second part of the study was performed to investigate the pharmacological effect of various concentrations of the aqueous extract of chamomile [1%, 4% and 8%] on gastric ulceration. The extract was given 15 minutes before ethanol administration. The results have shown a significant anti ulcer effect of chamomile extract with mean values of ulcer index of 76. 4mm +/- 14.2 [P< 0.01]; 11mm +/- 14.2 [P<0.005] and 53mm +/- 27.9 [P<0.01] for the concentrations 1%, 4% and 8% respectively as compared to the control value of 133.25 mm +/- 46.2 [n=8]. It is concluded that the extract of Matricaria chamomilla flowers has anti ulcer effect

Prenatal diagnosis of beta-thalassemia in the West Bank and Gaza

This study focuses on the genetic aspect of beta-thalassemia among 88 at risk couples from the West Bank and Gaza, and the attitude of these couples toward prenatal diagnosis and its outcome as a preventive method. We tested 130 prenatal samples for beta-thalassemia during the period from January 1999 to July 2005. We performed prenatal diagnosis in these cases using the amplification refractory mutation system, as well as beta-globin gene sequencing as a conformational method. We drew a chorionic villus sample [CVS] for 1st trimester pregnant women and amniotic fluid [AF] for those in the 2nd trimester depending on the stage the pregnant woman contacted our lab. The DNA analysis of 130 prenatal samples revealed 25 [19.2%] cases of beta-thalassemia major and 67 [51.5%] cases of beta-thalassemia carriers, while the remaining 38 [29.2%] were normal. The 25 affected fetuses were aborted according to the wishes of the parents. In the tested 88 couples, 14 mutations of beta-thalassemia were identified. These mutations and their frequencies were: IVSI-110 [22.2%], IVSI-6 [13.6%], Cd37 [12%], IVSI-I [9.7%], IVSII-1 [6.2%], Cd39 [9%], Cd6 [sickle cell mutation] [8.5%], Cd5 [8%], Cd8/9 [2.8%], Cd106/107 [2.8%], -30 promoter [1.1%], -88 promoter [1.1%], IVSI [-1] [2.3%] and IVSI-5 [0.6%]. We found that in 77.3% of the couples, both the mother and the father carry the same type of mutation while 22.7% of them carry different mutations. We found 77.9% consanguinity among the couples. We found very good acceptability for prenatal diagnosis in beta-thalassemia afflicted families. All couples with affected fetuses opted for abortion. The spectrum of mutations in the tested couples revealed several similarities to neighboring countries with -88 promoter mutation reported for the first time in our region

Small round cell tumours of childhood a histopathological study

A retrospective study of 132 solid small round cell tumours of childhood were reviewed from the files of histopathology department of Saddam Medical City Teaching Hospital. Non-Hodgkin's lymphoma was the most frequent tumour, together with Hodgkin's disease, they comprised 47% of the total cases. These tumours were followed by neuroblastoma [18%], nephroblstoma [16%], Ewing's sarcoma [8%] and rhabdomyosarcoma [7%]. Despite differences in their light micro-scopical appearances, age, sex, and anatomical locations, 4.5% of these tumours were unclassifiable. Means to reduce the occurrence of the latter category is discussed

Awareness of hypertension in Basrah City: first announcement which needs action

Present study is the first announcement of the prevalence of hypertension among Basrah population and it estimates for the first time the percentage of awareness among the hypertensives to their high blood pressure. The distribution of hypertension was determined by age, Sex and body weight. In addition, risk factors such as smoking and family history were also evaluated. The WHO recommended diagnostic criteria were followed so that hypertension is defined as blood pressure measured greater than or equal to 140/90 mm Hg at the age of 20's and 160/95 mm Hg at the age of 50's or self-reported taking antihypertensive medication. Hypertension in turn was classified into mild, moderate and severe categories. The prevalence of hypertension among the total subjects [750] studied was found to be 32% and it is higher in males than in females [37% vs 27% respectively]. Blood pressure was increased with age and body weight in both males and females. Only 19% of the hypertensives were aware of their high blood pressure and the percentage of awareness correlated positively with age and severity of hypertension and it was higher in females [31%] than in males [12%]. However, only 5% of the aware hypertensives were on regular antihypertensive medications. This study estimates the size of the problem in Basrah which can provide a data base for a further epidemiological studies of hypertension in Basrah

Effect of soluble insulin administered rectally in rabbits

Soluble insulin [10U/Kg] was given rectally to eight rabbits. Blood glucose level was found to be reduced one hour after insulin administration and the maximum reduction occurred after two hours. The blood glucose level started to recover to normal level after three hours. It is recommended that the rectal route of insulin administration should be further evaluated for its potential use especially in diabetic ketoacidosis and in the maintenance therapy of insulin dependent diabetics

Serum lipids in diabetes mellitus

Levels of fasting plasma glucose, haemoglobin A1, serum total lipids, serum triglycerides and serum cholesterol of the Libyan noninsulin dependent diabetic patients attending the outpatient clinic of the diabetes hospital, Tripoli, Libyd were determined. The respective mean values were 219 +/- 4.9 mg.dl-1, 9 +/- 0.26%, 912 +/- 23.8 mg.dl-1, 157.9 +/- 6.0 mg.dl-1 and 186 +/- 3.5 mg.dl-1 respectively. The mean body mass index was 27.6 +/- 0.45 kg.m-2. 37.5% of the male patients and 72% of the female patients were obese. Obesity as well as the levels of serum total lipids, triglycerides and cholesterol are higher in the females as compared with their male counterparts. Statistically significant correlations were present between fasting plasma glucose concentrations or body mass index and serum levels of total lipids or triglycerides or cholesterol. These correlations suggest the relationship between diabetes and lipid metabolism

Serum antiepileptic drugs monitoring

A total of 25 patients with grand mal epilepsy were included in the present study. Blood samples collected and assayed for phenytoin and carbamazepine by modified HPLC method. The total number of samples assayed for phenytoin were 14 samples and for carbamazepine 16 samples [6 samples contain both drugs]. In phenylion 4 patients show subtherapeutic level and one patient showed toxic level. For carbamazepine 3 patients have subtherapeutic level and 3 patients had toxic level. The dose range for both drugs were in the lower recommended limit, and 52% of the patients were on multiple drug therapy. It is concluded that treatment with phenytion and carbamazepine should be started with monotherapy accompanied by serum level monitoring and the dose gradually increased until we reach the upper therapeutic range, if no response is obtained another drug can be added

Iris colour, skin colour and mydriatic response

Mydriatic response to one drop of 2% homatropine applied locally into the eye was measured in subjects with different iris and skin colours. Maximum mydraisis was detected in subjects with green colour iris [7.9mm], followed by brown [6.9mm] and black [5.9mm] irides respectively. Subjects with white skin showed maximum mydriatic response [7.8mm], followed by dark [6.8mm] and black [5.2mm] skin. The majority of our local population has a dark complexion with heavily pigmented iris, therefore doses of mydriatic drugs should be adjusted according to the response. Further studies with topically applied drugs into the eye is recommebded, as well as the interaction between different drugs applied to the eye simultaneously

Acute poisoning in adults: a 4-year retrospective study of patients admitted to Basrah Al-Jumhorit Hospital

During the period of January 1983 to December 1986, there were 190 adult admissions to medical wards at Basrah AI-Jumhori Hospital as a result of acute poisoning [0.73% of total medical admission]. The overall male to female ratio was 1: 1.92 and about two thirds of patients were less than 20 years of age. Admissions were more common in the summer months and in 70% of poisoning cases, medicinal preparations were involved. Benzodiazepines were the main agents [22%], followed by analgesics [17.4%], while gases [5.8%] and organo-phosphorus compounds [4.7%] were the main non-medicine offenders [10.5%]. Patients who have ingested more than one substance accounted for 15. Poisoning was accidental in only 10.5%. High percentage of patients [42%] were given forced diuresis as a treatment and 18.4% had psychiatric assessment prior to discharge. The majority of patients were discharged in less than three days with an inpatient mortality mounting to 1.6%

study on sandflies in a focus of infantile kala azar in Iraq during 1978

Over 4.00 sandflies were collected throughout the season in 1978. The aim of this study was to incriminate the vector species. It also shows how preliminary studies of possible vector species could be made. Collection was made by different methods from an infantile kala azar focus in the centre of Iraq. All sandflies were identified, 75% of them were dissected in search of promastigotes but none were found