The Impact of the Covid-19 Pandemic on Patients with Obsessive Compulsive Disorder (OCD).

Objective: An intense desire to avoid contamination is one of the most common symptoms of Obsessive-Compulsive Disorder (OCD). In March 2020, when the COVID-19 outbreak was classified as a pandemic, authorities announced measures to control its spread, including hand washing, quarantine, social distancing and lockdowns. The disease spreads rapidly and has potentially serious complications, and adherence to the recommendations was strongly encouraged. These measures, both by their direct effect and as a consequence of their impact on care provision may trigger complications in patients with OCD. Method: An online survey was completed by 102 patients with a confirmed OCD diagnosis. The survey collected demographic data, medical and psychiatric history, and asked COVID-19 related questions, OCD-related questions, and included the Self-reported Yale-Brown Obsessive-Compulsive Symptom Checklist (Y-BOCS-II). Results: The results reveal that new OCD patterns started during the COVID-19 pandemic, including pathological doubt/checking (2.0%), a need for symmetry, order or precision (2.9%), religious pattern (2.9%), somatic/health pattern (4.9%), and a contamination/washing pattern (5.9%), which was the most reported among all patterns. The results also show an increase in overall severity of OCD (36.3%), and (27.5%) of participants also reported an increase in the overall severity of anxiety. Conclusions: The questionnaire completed by patients previously diagnosed with OCD revealed that during the COVID-19 pandemic there was an increase in the severity of symptoms, with the greatest effect being in individuals with contamination/ washing patterns.

Comparative biological activity of abamectin formulations on root-knot nematodes (Meloidogyne spp.) infecting cucumber plants: in vivo and in vitro.

The root-knot nematodes (Meloidogyne spp.) are considered one of the most destructive diseases in the world. In Egypt, farmers primarily rely on chemical nematicides, which have become costly to control. Currently, abamectin is a bio-based pesticide used as an alternative tool against Meloidogyne spp. on cucumber plants (Cucumis sativus L.). During the current research, four tested abamectin formulations were DIVA (1.8% EW), RIOMECTIN (5% ME), AGRIMEC GOLD (8.4% SC) and ZORO (3.6% EC) compared with two reference nematicides namely, CROP NEMA (5% CS) and TERVIGO (2% SC). The main results showed that, in vitro study elucidated that the most effective formulations of abamectin as a larvicidal were EW with LC50 value of 21.66 µg ml-1. However, in the egg hatching test, the formulations of abamectin SC (2%) and EW were the most effective in reducing egg hatching, with LC50 values of 12.83 and 13.57 µg ml-1. The calculated relative potency values showed diversity depending on the two referenced nematicides. On the other hand, in vivo study, the results indicated that, all tested formulations of abamectin recorded general mean reductions in root galls (23.05-75.23%), egg masses (14.46-65.63%). Moreover, the total population density declined by 39.24-87.08%. Furthermore, the influence of abamectin formulations, in the presence of root-knot nematodes, on the growth of cucumber plants parameters, such as root dry weight, root length, root radius, root surface area, shoot dry weight and shoot height, as well as the content of macro-elements (N, P and K) exhibited varying levels of response.

Implication of nanotechnology to reduce the environmental risks of waste associated with the COVID-19 pandemic.

The COVID-19 pandemic is the largest global public health outbreak in the 21st century so far. It has contributed to a significant increase in the generation of waste, particularly personal protective equipment and hazardous medical, as it can contribute to environmental pollution and expose individuals to various hazards. To minimize the risk of infection, the entire surrounding environment should be disinfected or neutralized regularly. Effective medical waste management can add value by reducing the spread of COVID-19 and increasing the recyclability of materials instead of sending them to landfill. Developing an antiviral coating for the surface of objects frequently used by the public could be a practical solution to prevent the spread of virus particles and the inactivation of virus transmission. Relying on an abundance of engineered materials identifiable by their useful physicochemical properties through versatile chemical functionalization, nanotechnology offers a number of approaches to address this emergency. Here, through a multidisciplinary perspective encompassing various fields such as virology, biology, medicine, engineering, chemistry, materials science, and computer science, we describe how nanotechnology-based strategies can support the fight against COVID-19 well as infectious diseases in general, including future pandemics. In this review, the design of the antiviral coating to combat the spread of COVID-19 was discussed, and technological attempts to minimize the coronavirus outbreak were highlighted.

Reticulocyte Hemoglobin as a Screening Test for Iron Deficiency Anemia: A New Cut-Off.

INTRODUCTION: Latent iron deficiency (LID), in which iron stores in the body are depleted without incidental anemia, poses a key diagnostic challenge. Reticulocyte hemoglobin content (Ret-Hb) is directly correlated with the functionally available iron for heme synthesis in erythroblasts. Consequently, Ret-Hb has been proposed as an efficient iron status marker. AIM: To assess the importance of Ret-Hb in detecting latent iron deficiency as well as its use in screening for iron deficiency anemia. MATERIALS AND METHODS: A study involving 108 individuals was conducted at Najran University Hospital, 64 of whom had iron deficiency anemia (IDA) and 44 of whom had normal hemoglobin levels. All patients were subjected to complete blood count (CBC), reticulocyte percentage, Ret-Hb, serum iron, total iron binding capacity (TIBC), and serum ferritin measurements. RESULTS: A significant decrease in Ret-Hb level was observed in IDA patients compared to non-anemic individuals, with a cut-off value of 21.2 pg (a value below which indicates IDA). CONCLUSION: The measurement of Ret-Hb, in addition to CBC parameters and indices, provides an accessible predictive marker for both iron deficiency (ID) and IDA. Lowering the Ret-Hb cut-off could better allow for its use as a screening parameter for IDA.

Impact of Action Video Gaming Behavior on Attention, Anxiety, and Sleep Among University Students.

BACKGROUND: Recently, there has been an increase in the prevalence of action video gaming among adolescents and young adults. This has made video gaming a topic of interest for behavioral and higher brain cognitive function researchers. The present study investigated the impact and consequences of action video gaming on human behavior-specifically, attention, anxiety levels, and sleep patterns. OBJECTIVE: The study aimed to investigate the potential associations between action video gaming and attention, anxiety, and sleep. METHODS: Recruited participants (N = 97) were asked to independently complete an online questionnaire consisting of 4 sections: demographic data, gaming behavior, 8-item Epworth Sleepiness Scale, and 7-item Generalized Anxiety Disorders Scale. Participants were further divided into 2 groups (expert and non-expert video gamers) based on the number of hours they spent on action video games. After completing the questionnaires, the patients attended an on-site session, where they completed a validated psychological online battery test that assessed their sustained attention. RESULTS: The mean age of the participants was 21 years. There was a significant difference in attention between expert and non-expert video gamers; when exposed to stimuli, expert gamers displayed significantly shorter reaction times than the non-expert gamers (p < 0.05). Both groups showed a non-significant decrease in attention span throughout time. The data demonstrated no statistically significant difference in anxiety levels or daytime sleepiness between expert and non-expert video gamers, and minimal to mild anxiety levels were reported in most expert and non-expert gamers. CONCLUSION: Expert video gamers were significantly more attentive compared to non-expert gamers, and most participants showed low levels of generalized anxiety. Accordingly, expanding our knowledge on the effects of action video games on attention span is important for creatively using games in the field of education, especially for those who suffer from attention deficit hyperactivity disorders.

Eleven Cases of Hb J-Paris-I [HBA2: c.38C>A (or HBA1)]: A Stable α Chain Variant Elutes in the P3 Window on High-Performance Liquid Chromatography.

Hb J-Paris-I [HBA2: c.38C>A (or HBA1)] is a stable fast-moving hemoglobin (Hb) that elutes in the P3 window on high performance liquid chromatography (HPLC). The mutation can happen on either the α1- or α2-globin gene. Codon 12 changes from GCC to GAC to replace the alanine amino acid with aspartic acid. This change is external with no clinical significance. The elution in the P3 wave on HPLC can interfere with the glycated Hb assay by HPLC. In this study, data of 11 cases of Hb J-Paris-I were thoroughly presented. The majority of the cases were of Indian ethnicity. The mean value of Hb J-Paris-I on HPLC was 26.7 ± 2.0%. The retention time (RT) was 1.75 ± 0.03 min. The isoelectric focusing (IEF) mean value was -5.6 (range -6.1 to -4.9). Hb A2 was consistently reduced to 1.8 ± 0.3%. A fraction of 0.8% corresponding to the Hb A2-J-Paris-I (α2J-Paris-Iδ2) is likely to be concealed within the A0 peak of Hb A on HPLC. Interestingly, two cases were associated with two different polymorphisms [HBA2: c.-24C>G or Cap +14 (C>G) and HBA2: c.*136A>G polymorphism] without apparent effect on the variant expression.

Eight Cases of Hb Winnipeg [HBA2: c.226G>T (or HBA1)]: A Detailed Study.

Hb Winnipeg [α75(EF4)Asp→Tyr (α2); HBA2: c.226G>T (or HBA1)] is a stable α-globin chain variant described in a few articles. The majority of reported cases in older articles were clustered in Canada. It can occur on both α1- and α2-globin genes and in different populations. In this study, eight cases of Hb Winnipeg were characterized by DNA sequencing during a wide-spectrum study of suspected α-globin gene variants collected in the United Kingdom. All cases detected peaked in the S window between 4.4 and 4.54 min. on high performance liquid chromatography (HPLC). The isoelectric focusing (IEF) averaged at 6.21 below Hb A. All the mutations were detected on the α1-globin gene except in one case. The ethnic origin of the majority of the patients was Canadian. Only one case was associated with the common polymorphism HBA2: c.-24C>G (or HBA1) [Cap +14 (C>G)] on both α-globin genes without any apparent effect on the variant expression. All cases were detected in a heterozygous state. Hb Winnipeg expression was consistently lower than the theoretical value for α chain variants, ranging between 11.8 and 15.8% of total hemoglobin (Hb). This study gave more details about Hb Winnipeg that may help in presumptive diagnosis, especially in routine laboratories.

Twelve Cases of Hb Manitoba [α102(G9)Ser→Arg]: the Fluctuation in the Variant Expression.

Hb Manitoba [α102(G9)Ser→Arg] is a rare α chain variant with diverse ethnic origins. It is mildly unstable with an expression of around 10.0-14.2% in the heterozygous state in most literature. In this study, 12 cases of Hb Manitoba [11 cases carried Hb Manitoba II (HBA1: c.309C>A) and one case carried Hb Manitoba IV (HBA1: c.307A>C)] were detected during a wide-spectrum study of α chain variants in the UK. Fluctuation in variant expression from 6.9 to 15.2% of total Hb on high performance liquid chromatography (HPLC) would pose a diagnostic dilemma in routine laboratories. Focusing on the variant expression, the median of Hb Manitoba was around 11.5% of total Hb in three cases, apparently with normal hemoglobin (Hb), and normal red blood cell (RBC) indices. Two cases showed a higher expression (13.9 and 15.2%) and five cases showed a lower expression (6.9-9.9%). The common α-thalassemia (α-thal) -α3.7 (rightward) deletion coexisted with one case of increased Hb Manitoba expression. Iron (or other nutrient) deficiency was likely the cause of decreased Hb Manitoba percentage in this study. The α73(EF2)Val→Val (α2) (HBA2: c.222G>T) polymorphism is published for the first time and coexisted with two cases. The Cap +14 (C>G) (HBA2: c.-24C>G) polymorphism coexisted with another case in a heterozygous state. In conclusion, the fluctuation in variant expression can cause a diagnostic dilemma, especially in routine laboratories. Screening for the common -α3.7 deletion and iron deficiency is recommended when an α chain variant is suspected.

Fifteen Cases of Hb J-Meerut: The Rare Association with Hb E and/or HBA1: c.-24C>G (or HBA2) Variants.

Hb J-Meerut [HBA2: c.362C>A (or HBA1)] is a rare, stable, nonpathogenic α-globin gene variant that peaks in the area between the P3 and A0 windows on high performance liquid chromatography (HPLC). Few cases from different ethnic origins have been published but the majority were Asian Indians. Coinheritance with other hemoglobin (Hb) variants are rarer and can change the Hb J-Meerut phenotype making a diagnostic dilemma. In this study, we have reported 15 cases of Hb J-Meerut, discovered during a wide spectrum study of α-globin chain variants in the UK. The diagnosis was confirmed by forward and reverse DNA sequencing of the α1- and α2-globin genes. The average of the Hb J-Meerut expression was 20.9% of total Hb and characterized by a retention time (RT) of 1.9 min. (on average) on HPLC. The median of isoelectric focusing (IEF) was 5.6 mm above Hb A. Among the 15 cases studied, one case coinherited the Hb E (HBB: c.79G>A) mutation in heterozygosity and another case was associated with the Cap +14 (C>G) [HBA1: c.-24C>G (or HBA2)] variant. We noticed that the coinheritance of the Hb E mutation reduced the Hb J-Meerut expression with the formation of a hybrid peak missed on the HPLC chromatograph. We also noticed an increased expression of Hb J-Meerut in the case showing the coinheritance of the HBA2: c.-24C>G (or HBA1) variant.

A Wide Spectrum Study of α-Globin Chain Variants: Cases from the UK.

Over many years, cases of suspected α-globin chain variants were collected from different parts of the UK. The suspicion was based on the clinical picture, high performance liquid chromatography (HPLC) variant percentage, retention time (RT) and isoelectric focusing (IEF). DNA sequencing and the restriction enzyme EaeI were used for definitive diagnosis. One hundred and forty-eight variants were confirmed on one or both of the two α-globin genes (HBA2, HBA1). These cases were identified as 46 different α-globin chain variants. The most common variants were Hb J-Meerut [HBA2: c.362C>A (or HBA1)] (10.1%) and Hb Q-India (HBA1: c.193G>C) (8.1%), followed by Hb J-Paris-I [HBA2: c.38C>A (or HBA1)] and Hb Manitoba II (HBA1: c.309C>A) (7.4% for each). Other α variants were detected at lower frequencies. Two novel alleles were also detected: Hb Walsgrave [α116(GH4)Glu→Val (HBA2: c.350A>T)] and Hb Coombe Park [α127(H10)Lys→Glu (HBA2: c.382A>G)]. The majority of the ethnic origin was Indian. The positive predictive value for α variant identification by HPLC-RT analysis was 65.9%, 41.9% by IEF, and using both RT and IEF, the value was 72.1%. The number of variants was higher in HBA1 than in HBA2 genes and in exons 1 and 2 than in exon 3. There was no clustering of mutations in consecutive codons. This study, the characterization of a wide spectrum of α-globin chain variants, can facilitate the presumptive diagnosis of these variants prior to screening by a panel of amplification refractory mutation system-polymerase chain reaction (ARMS-PCR), and a definitive diagnosis by DNA sequencing.

Ten Years of Routine α- and ß-Globin Gene Sequencing in UK Hemoglobinopathy Referrals Reveals 60 Novel Mutations.

We review and report here the genotypes and phenotypes of 60 novel thalassemia and abnormal hemoglobin (Hb) mutations discovered following the adoption of routine DNA sequencing of both α- and ß-globin genes for all UK hemoglobinopathy samples referred for molecular investigation. This screening strategy over the last 10 years has revealed a total of 11 new ß chain variants, 15 α chain variants, 19 ß-thalassemia (ß-thal) mutations and 15 α(+)-thalassemia (α(+)-thal) mutations. The large number of new thalassemia alleles confirms the wide racial heterogeneity of mutations in the UK immigrant population. Eleven of the new variants ran with Hb A on high performance liquid chromatography (HPLC), demonstrating the value of routine sequencing of both α- and ß-globin genes for all hemoglobinopathy investigations. The new ß chain variants are: Hb Bury [ß22(B4)Glu → Asp (HBB: c.69A > T)], Hb Fulwood [ß35(C1)Tyr → His (HBB: c.106T > C)], Hb Little Venice [ß42(CD1)Phe → Cys (HBB: c.128T > G)], Hb Cork [ß57(E1)Asn → Ser (HBB: c.173A > G), Hb Basingstoke [ß118(GH1)Phe → Ser (HBB: c.356T > C)], Hb Howden [ß20(B2)Val → Ala (HBB: c.62T > C)], Hb Wilton [ß41(C7)Phe → Leu (HBB: c.126C > A)], Hb Belsize Park [ß120(GH3)Lys → Asn (HBB: c.363A > T)], Hb Hampstead Heath [ß2(NA2)His → Gln;ß26(B8)Glu → Lys (HBB: c.[6C > G;79G > A])], Hb Grantham [ß85(F1)Phe → Cys (HBB: c.257T > G)] and Hb Calgary [ß64(E8)Gly → Val (HBB: c.194G > T). The new α chain variants are: Hb Edinburgh [α70(E19)Val → Gly (HBA2: c.212T > G)], Hb Walsgrave [α116(GH4)Glu → Val (HBA2: c.350A > T)], Hb Wexham [α117(GH5) and 118(H1) insertion Ser (HBA1: c.354-355insTCA)], Hb Coombe Park [α127(H10)Lys → Glu (HBA2: c.382A > G)], Hb Oxford [α17(A15)Val → Asp (HBA2: c.53T > A)], Hb Bridlington [α32(B13)Met → Thr (HBA1: c.98T > C), Hb Wolverhampton [α81(F2)Ser → Tyr (HBA2: c.9245C > A)], Hb Little Waltham [α13(A11)Ala → Asp (HBA2: c.41C > A)], Hb Derby [α61(E10)Lys → Arg (HBA1: c.185A > G)], Hb Uttoxter [α74(EF3)Tyr → Asp (HBA2: c.223G > T)], Hb Harehills [α124(H7)Ser → Cys (HBA1: c.374C > G)], Hb Hekinan II [α27(B8)Glu → Asp (HBA1: c.84G > T)], Hb Manitoba IV [α102(G9)Ser → Arg (HBA1: c.307A > C), Hb Witham [α139(HC1)Lys → Arg (HBA2: c.419A > G) and Hb Farnborough [α9(A7)Asn → Asp (HBA1: c.28A > G). In addition, 10 more paralogous α-globin chain variants have been discovered. The novel ß-thal alleles are: HBB: c.-138C > G, HBB: c.-121C > T, HBB: c.-80T > G, HBB: c.18_19delTG, HBB: c.219_220insT, HBB: c.315 + 2_315 + 13delTGAGTCTATGGG, HBB: c.316-70C > G, HBB: c.345_346insTGTGCTG, HBB: c.354delC, HBB: c.376-381delCCAGTG, HBB: c.393T > A, HBB: c.394_395insA, HBB: c.375_376insA, HBB: c.*+95_*+107delTGGATTCTinsC, HBB: c.* + 111_*+112delAA, HBB: c.*+112A > T, HBB: c.394C > T, HBB: c.271delG and HBB: c.316-3C > T. The novel α (+ )-thal alleles are: HBA1: c.95+1G > C, HBA1: c.315C > G [Hb Donnington, α104(G11)Cys → Trp], HBA1: c.327delC, HBA1: c.333_345del, HBA1: c.*+96G > A, HBA2: c.2T > G, HBA2: c.112delC, HBA2: c.143delA, HBA2: c.143_146delACCT, HBA2: c.156_157insG, HBA2: c.220_223delGTGG, HBA2: c.305T > C [Hb Bishopstown, α101(G8)Leu → His], HBA2: c.169_170delAA, HBA2: c.1A > T and HBA2: c.-3delA.

A study of δ-globin gene mutations in the UK population: identification of three novel variants and development of a novel DNA test for Hb A'2.

We report here the spectrum of δ-globin gene mutations found in the UK population. Nine different δ chain variants and two δ-thalassemia (δ-thal) mutations were characterized in a study of 127 alleles in patients with either a low Hb A2 value or a split Hb A2 peak on high performance liquid chromatography (HPLC). The most common δ chain variant was Hb [Formula: see text] (or Hb B2) [δ16(A13)Gly → Arg; HBD: c.49G > C] (77.0%), followed by Hb A2-Yialousa [δ27(B9)Ala → Ser; HBD: c.82G > T] (12.0%), Hb A2-Babinga [δ136(H14)Gly → Asp; HBD: c.410G > A] (3.0%), Hb A2-Troodos [δ116(G18)Arg → Cys; HBD: c.349C > T] (1.0%), Hb A2-Coburg [δ116(G18)Arg → His; HBD: c.350G > A] (2.0%) and Hb A2-Indonesia [δ69(E13)Gly → Arg; HBD: c.208G > C] (1.0%). Three novel variants were identified: Hb A2-Calderdale [codon 2 (CAT > AAT), His → Asn; HBD: c.7C > A], Hb A2-Walsgrave [codon 52 (GAT > CAT), Asp → His; HBD: c.157G > C] and Hb A2-St. George's [codon 81 (CTC > TTC), Leu → Phe; HBD: c.244C > T]. In addition, two known δ-thal mutations were observed: -68 (C > T); HBD: c.-118C > T and codon 4 (ACT > ATT); HBD: c.14C > T. Amplification refractory mutation system (ARMS) primers were developed to provide a simple molecular diagnostic test for the most common variant, Hb [Formula: see text]. Three of the variants had a characteristic HPLC retention time that can be used for a presumptive diagnosis.

Prevalence of attention deficit hyperactivity symptoms in female schoolchildren in Saudi Arabia.

BACKGROUND AND OBJECTIVES: Attention deficit hyperactivity disorder (ADHD) is the most commonly seen developmental disorder, with significant impacts on the child's social, psychological, and scholastic functioning. The aim of this study was to determine the prevalence and sociodemographic correlates of ADHD in female primary schoolchildren. DESIGN AND SETTING: A cross-sectional study conducted in Al-Khobar Town, Eastern Saudi Arabia. METHODS: A random sample of six primary schools for girls was chosen, from which samples of 1009 students were selected by systematic random sampling, with ages ranging between 6 and 15 years (mean and standard deviation, 9.2 [1.9]). All subjects were screened for different types of ADHD using the Attention Deficit Disorders Evaluation Scale. RESULTS: The overall prevalence of ADHD was 3.5%. The prevalence of children with ADHD/inattentive type was 2.1% and the prevalence of children with ADHD/hyperactive-impulsive type was 5.6%. This rate decreased significantly with increase in age. The prevalence was higher in government school students, among Saudi citizens, later born siblings, higher number of siblings, and lower parental education. CONCLUSIONS: It was concluded that the prevalence of ADHD in female primary schoolchildren is comparable with what has been reported in other studies. Some demographic factors should be taken into consideration when interpreting this result. Implications and recommendations to the concerned authorities are outlined to improve the health and educational care services to help these children.

Reliability and confirmatory factor analysis of the arabic version of the University of Rhode Island Change Assessment (URICA).

AIM: To develop an Arabic version of the University of Rhode Island Change Assessment (URICA), and to examine its internal reliability and factor structure. METHODS: Participants were 175 substance abuse/dependent male patients recruited from Al-Amal Hospital of Substance Abuse in Dammam, Saudi Arabia. The URICA was administered to all subjects by two experienced psychologists working at the detoxification and rehabilitation units. RESULTS: All subscales showed good internal reliability and factorial validity. Coefficient alphas for each of the four scales of the URICA (precontemplation, contemplation, action and maintenance) revealed that each scale has adequate and acceptable internal consistency (ranging between 0.76 and 0.89). The correlation coefficients between all subscales confirmed the expected prediction in that scores for adjacent stages of changes showed significantly higher correlations than the scale scores for nonadjacent stages. Confirmatory factor analysis revealed an adequate to reasonable fit to the intended subscales and replicated the four-factor model of the original work. CONCLUSION: The Arabic version of the URICA has shown encouraging psychometric properties, supporting the validity and reliability of the four factors of the scale. The implications of these findings, and recommendation for future research, are described.

Preliminary Arabic normative data of neuropsychological tests: the verbal and design fluency.

OBJECTIVES: The objective of the present study was to provide preliminary norms for three fluency tests in Arabic language: the verbal fluency (phonemic and semantic) and design fluency tests. METHODS: Three Arabic letters have been chosen for the phonemic fluency task, in accordance with the letter selection procedure described in the development of the standard test. Animal fluency was chosen for the semantic fluency, and the Five-Point test for the design fluency test. PARTICIPANTS: An Arabic speaking sample of 215 healthy participants (125 male, 90 female), with age ranging from 18-59 years and with different educational levels, were selected for this study. RESULTS: Age and education significantly influenced performance in the verbal phonemic and semantic tasks, but not in the design fluency test. No gender effect was found in any of the three tasks. The education effects were linear, while age effects appeared to be curvilinear. CONCLUSION: This pattern is congruent with that reported in the western literature. The implications of these results in relation to the development of Arabic norms were discussed. It was concluded that these tests could be used in an Arabic-speaking population with due considerations to the effects of age and education.

The accurate prediction of rare hemoglobin variants using a combination of high performance liquid chromatography, retention time and isoelectric focusing electrophoresis position.

OBJECTIVE: To investigate the predictive accuracy of using a combination of the high pressure liquid chromatography (HPLC) retention time and the relative isoelectric focusing (IEF) position to diagnose rare hemoglobin variants. METHODS: A selected group of 40 patients with a rare beta-chain variant were assigned a presumed diagnosis following HPLC and IEF screening and then the variant identified in each case by DNA analysis. The study was conducted at the National Hemoglobinopathy Reference Laboratory, Oxford, United Kingdom, from August 2008 to October 2008. RESULTS: Thirteen out of 14 different variants were predicted accurately in 39 (97.5%) cases, compared to only one each for HPLC and IEF when used individually. A novel amplification refractory mutation system-polymerase chain reaction test was developed for Hb J-Baltimore and used successfully, to provide a simple, rapid, and inexpensive diagnosis. CONCLUSION: The use of both HPLC retention time and isoelectric focusing position provides an accurate presumed diagnosis of a rare hemoglobin variant in the majority of cases. Amplification refractory mutation system-polymerase chain reaction test can provide a simple, rapid and inexpensive molecular diagnostic method for rare beta-chain variants.

Incidence of haemoglobinopathies in various populations - the impact of immigration.

OBJECTIVES: The aim of this study was to update the incidence data of beta thalassaemia mutations in various populations and compare it to the spectrum of mutations in the United Kingdom (UK) population in order to determine the impact of immigration. DESIGN AND METHODS: Published data for the beta-thalassaemia mutation spectrum and allele frequencies for 60 other countries was updated and collated into regional tables. The beta-thalassaemia mutations in the UK population have been characterised in 1712 unrelated carriers referred for antenatal screening. Similarly, the alpha-thalassaemia mutations in the UK population have been characterised in 2500 possible alpha-thalassaemia carriers. RESULTS: A total of 68 different beta-thalassaemia mutations were identified in couples requiring screening for antenatal diagnosis in the UK population. Of these mutations, 59 were found in immigrants to the UK, from all major ethnic groups with a high incidence of haemoglobinopathies. A total of 40 different alpha-thalassaemia mutations were characterised in the UK population. Ten deletion mutations were identified, including all the Southeast Asian and Mediterranean alpha(0)-thalassaemia mutations. In addition, 30 non-deletion alpha(+)-thalassaemia mutations were discovered, accounting for 46% of the worldwide known non-deletion mutations. CONCLUSIONS: The impact of immigration has resulted in the UK population having a higher number of beta-thalassaemia mutations and alpha-thalassaemia mutations than any of the 60 other countries with a published spectrum of mutations, including both endemic countries and the non-endemic countries of Northern Europe. The racial heterogeneity of the immigrant population in a non-endemic country significantly increases the spectrum of haemoglobinopathy mutations and their combinations found in individuals, making the provision of a molecular diagnostic prenatal diagnosis service more challenging.

Initial linguistic and psychometric validation of the Arabic version of Nepean Dyspepsia Index.

OBJECTIVE: To report the initial evaluation of the linguistic and psychometric validation of the Nepean Dyspepsia Index (NDI), as part of the ongoing research of quality of life among dyspeptic patients. METHODS: The Arabic version of the NDI was administered to 158 subjects (54 with non-ulcer dyspeptic [NUD]), 50 with gastro-esophageal reflux disease (GERD) and 54 with no history of gastroenteritis disease), with a mean age of 46.6 and SD 10.7. All subjects answered the Arabic versions of the General Health Questionnaire (GHQ), the Self-Report Questionnaire (SRQ), and the Short Form-12 Quality of Life (QOL) scale. We administered the final translation of the NDI by consensus. The study was conducted in King Fahad Hospital of the University, Al-Khobar, Saudi Arabia, between December 2002 and January 2004. RESULTS: The NDI has shown adequate internal consistency. Cronbach Alpha coefficient ranged between 0.88 to 0.93, and Split-half correlation reliability ranged between 0.82 and 0.94. Correlations between NDI subscales and total scores were high and significant. Adequate Face and content validity was demonstrated by consultation with gastroenterologists and clinical psychologists. Convergent validity was shown in the moderate and significant correlation of the NDI subscales and global index with the indices of the SF-12. Divergent validity was shown in that subscales of the NDI revealed low correlation with scales which measure other dimensions; thus, both QOL subscales and symptom checklist have discriminated patients from non-patients groups (p > 0.01). The factorial structure of the NDI was also examined, and it revealed 4 factors, which is similarly the same with other studies. CONCLUSION: The initial validation of the Arabic version of the NDI has shown that this scale has adequate psychometric and linguistic property and can represent a good addition to health outcome measures in dyspepsia research. Further validation studies are recommended.

The impact of functional dyspepsia on health-related quality of life in Saudi patients.

OBJECTIVE: The purpose of this study was to evaluate the impact of non-ulcer dyspepsia (NUD) on health-related quality of life (HRQOL), which was assessed using the Nepean Dyspepsia Index, the Short Form-12 quality of life (QOL) scale, the general health questionnaire (GHQ-30) and the self-reporting questionnaire (SRQ-20). MATERIALS AND METHODS: Validated Arabic versions of the four scales were administered to 158 subjects (54 with NUD, 50 with gastroesophageal reflux disease [GERD] and 54 with no history of gastrointestinal [GI] disease), with a mean age of 46.6 years and SD 10.7. RESULTS: Subjects with NUD showed the poorest scores in all indices of general QOL and HRQOL. The differences between the NUD patients and the health control in all HRQOL indices were statistically significant (P < 0.05 to P < 0.001). Comparison between NUD and GERD patients showed significant differences only in the indices of psychological health related QOL ( P < 0.05) but not in the indices of other components of QOL, including physical health components. The study also showed that the women scored lower than men in HRQOL indices, particularly those of psychological and mental health components (P < 0.05 to P < 0.001). Finally, it was found that severity of symptoms is associated with the degree of impairments in HRQOL - (r = 0.69) was significant at (P < 0.001). CONCLUSION: Results of our study showed that HRQOL was significantly impaired in the NUD group. Psychological and mental health related quality of life was particularly impaired in this group compared to both normal patients and patients with similar GI disease. This magnitude of effects on HRQOL was also found to be associated with the severity of symptoms. The implications of these findings for the management of NUD are discussed.

The effects of birth interval on intellectual development of Saudi school children in Eastern Saudi Arabia.

OBJECTIVE: The primary aim of this study was to investigate the effect of birth intervals on some aspects of intellectual ability of Saudi primary school boys. METHODS: This is a cross-sectional study of Saudi school children comparing their intellectual ability (general intelligence) in relation to the length of the birth interval before and after the birth of the index child. The study area comprised 3 townships in the eastern province; Khobar, Thogba and Dhahran. The study was conducted in 2000/2001 and the study population comprised Saudi primary school boys aged 9-10 years from a middle class background. A 2 stage random sampling technique was adopted. Data were collected using student data sheet, a family questionnaire and the Standard Progressive Raven Matrices Test of intellectual ability, standardized for use in Saudi Arabia. Data were analyzed using SPSS software. RESULTS: More than 90% of children born after a birth interval greater than 35 months were classified as average and above according to the Raven Matrices Test, compared to 79% of children born after a birth interval of less than 19 months (p<0.03). Analysis of variance showed that test scores increased consistently as the succeeding birth interval increased. Multivariate analysis showed the most import predicting variables in the Raven Matrices Test to be family income and height. CONCLUSION: Longer birth intervals were shown to be associated with higher general intelligence levels in the 9-10 year olds. These results confirm those obtained in a previous study in Singapore conducted more than 2 decades ago. Our results have also shown that the succeeding birth interval is more significant than the preceding interval in relation to perceptive ability of children. The findings enable us to advise parents that by observing a birth interval between 2-3 years would make their children grow and do better at school.