Camel milk attenuates the biochemical and morphological features of diabetic nephropathy: inhibition of Smad1 and collagen type IV synthesis.

Diabetic nephropathy (DN) is a common microvascular complication of diabetes mellitus (DM) that worsens its morbidity and mortality. There is evidence that camel milk (CM) improves the glycemic control in DM but its effect on the renal complications especially the DN remains unclear. Thus the current study aimed to characterize the effects of CM treatment on streptozotocin (STZ)-induced DN. Using STZ-induced diabetes, we investigated the effect of CM treatment on kidney function, proteinuria, renal Smad1, collagen type IV (Col4), blood glucose, insulin resistance (IR), lipid peroxidation, the antioxidant superoxide dismutase (SOD), catalase (CAT) and glutathione (GSH). In addition renal morphology was also examined. The current results showed that rats with untreated diabetes exhibited marked hyperglycemia, IR, high serum urea and creatinine levels, excessive proteinuria, increased renal Smad1 and Col4, glomerular expansion, and extracellular matrix deposition. There was also increased lipid peroxidation products, decreased antioxidant enzyme activity and GSH levels. Camel milk treatment decreased blood glucose, IR, and lipid peroxidation. Superoxide dismutase and CAT expression, CAT activity, and GSH levels were increased. The renoprotective effects of CM were demonstrated by the decreased serum urea and creatinine, proteinuria, Smad1, Col4, and preserved normal tubulo-glomerular morphology. In conclusion, beside its hypoglycemic action, CM attenuates the early changes of DN, decreased renal Smad1 and Col4. This could be attributed to a primary action on the glomerular mesangial cells, or secondarily to the hypoglycemic and antioxidant effects of CM. The protective effects of CM against DN support its use as an adjuvant anti-diabetes therapy.

Distribution of clinical symptoms in carpal tunnel syndrome.

OBJECTIVE: To determine the distribution of clinical symptoms based on the gender and age of patients with Carpel Tunnel Syndrome (CTS). STUDY DESIGN: A cross-sectional observational study. PLACE AND DURATION OF STUDY: Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from April 2009 to June 2011. METHODOLOGY: Two hundred and twenty seven subjects with carpal tunnel syndrome symptom were recruited. CTS was diagnosed based on the clinical history and examination. For further confirmation of CTS symptoms, nerve conduction studies (NCS) were conducted. RESULTS: There were 67 (29.5%) males and 160 (70.5%) females with mean age of 47.79 ± 5.53 years. Distributions of symptoms were 34.3% at the level of whole three lateral fingers, 14.9% were at the level of hand and forearm, was common in males compared to females. However, 48.8% symptoms at the level of whole hand, and 11.3% at the tips of the three lateral fingers were common in females compared to males. Distribution of symptoms in the whole three lateral fingers (41.6%) were significantly higher (p = 0.0001) in patients who were more than 50 years of age and symptoms at the level of wrist region (12.7%) were significantly higher (p = 0.001) in patients with age group less than 50 years. CONCLUSION: The distribution of CTS symptoms at the level of whole of three lateral fingers, hand and forearm were higher in males compared to females, and symptoms at the lateral three tips of the fingers and whole hand were common in females compared to males. Furthermore, the symptoms in whole three lateral fingers were higher in patients with more than 50 years of age and at the level of wrist region were higher in patients with age less than 50 years.

Comparison of the impact of powerpoint and chalkboard in undergraduate medical teaching: an evidence based study.

OBJECTIVE: To compare the impact of the PowerPoint multimedia presentation and chalkboard in teaching by assessing the knowledge based on the marks obtained. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from December 2007 - June 2009. METHODOLOGY: Three-hundred male medical students were divided into three groups and a selected content-based lecture in physiology was delivered. For one group lecture was delivered using PowerPoint presentation, for second group using chalkboard and for third group the lecture was delivered by using both PowerPoint as well as chalkboard. Single-best Multiple Choice Questions [MCQs] paper was used for assessing the knowledge gained. The same exercise was repeated in another medical science school for the confirmation of validity and reliability of the results. RESULTS: Students who attended the class on both PowerPoint and chalkboard obtained significantly higher score in single best MCQ examination compared to those students who attended the same content based lecture on the PowerPoint or chalkboard alone (p = 0.05). CONCLUSION: The integrated (PowerPoint and chalkboard) method of teaching was found more suitable tool of teaching and learning than PowerPoint or chalkboard alone.

Effect of duration of exposure to cement dust on respiratory function of non-smoking cement mill workers.

This study aimed to determine the effect of long term exposure to cement dust on lung function in non-smoking cement mill workers. This is a cross-sectional study of respiratory functions. Spirometry was performed in 100 apparently healthy volunteers; 50 non-smoking cement mill workers and 50 non-smoking un-exposed subjects. Based on the duration of exposure, cement mill workers were divided into three groups, less than 5, 5-10 and greater than 10 years. All subjects were individually matched for age, height, weight, and socioeconomic status. Pulmonary function test was performed by using an electronic spirometer. Significant reduction was observed in the mean values of Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV(1)), Peak Expiratory Flow (PEF) and Maximal Voluntary Ventilation in cement mill workers who had been working in the cement industry for more than 10 years compared to their matched un-exposed group. Lung functions in cement mill workers were significantly impaired and results show a long term duration response effect of years of exposure to cement dust on lung functions.

Brainstem auditory evoked potentials and electrocochleographic findings in patients with idiopathic sudden sensorineural hearing loss.

OBJECTIVE: To determine the status of cochlea, auditory pathway and hearing threshold by recording brainstem auditory evoked potential (BAEP) and electrocochleography in patients with idiopathic sudden sensorineural hearing loss (ISSNHL). STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Department of Clinical Physiology at King Abdul Aziz University Hospital, Riyadh, Saudi Arabia, from May 2002 to November 2007. METHODOLOGY: Patients diagnosed with idiopathic sudden sensorineural hearing loss (ISSNHL) based on clinical features and pure tone audiometry were studied. Brainstem auditory evoked potential (BAEP) and electrocochleography (ECOG) was performed in them according to standard protocols for assessment of auditory pathway and hearing threshold. RESULTS: Out of 23 patients (14 males and 9 females) left ear was affected in 9 (39.1%) patients, right ear in 13 (56.5%) and both in 1 (4.3%). Absolute latency of wave I and wave V were significantly prolonged in affected ear compared to unaffected ears (p=0.0031), while interpeak I-V latency was significantly higher in affected ears versus unaffected ears (p=0.0544). Six patients (26.1%) had type II Diabetes mellitus, five cases (21.7%) had hypertension and 5 cases (21.7%) had dyslipidemia. ECOG revealed absence of summation potential (SP) and action potential (AP) response even at 95 dB in 17 out of 23 cases (73.9%). CONCLUSION: Patients with ISSNHL had significant abnormalities in BAEP and ECOG recordings showing predominantly cochlear involvement. Thus, these tests provide useful diagnostic information in patients with ISSNHL in addition to pure tone audiometry.

Hypospermatogenesis and spermatozoa maturation arrest in rats induced by mobile phone radiation.

OBJECTIVE: To determine the morphological changes induced by mobile phone radiation in the testis of Wistar albino rats. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia, from April 2007 to June 2008. METHODOLOGY: Forty male Wistar albino rats were divided in three groups. First group of eight served as the control. The second group [group B, n=16] was exposed to mobile phone radiation for 30 minutes/day and the third group [group C, n=16] was exposed to mobile phone radiation for 60 minutes/day for a total period of 3 months. Morphological changes in the testes induced by mobile phone radiations were observed under a light microscope. RESULTS: Exposure to mobile phone radiation for 60 minutes/day caused 18.75% hypospermatogenesis and 18.75% maturation arrest in the testis of albino rats compared to matched controls. However, no abnormal findings were observed in albino rats that were exposed to mobile phone radiation for 30 minutes/day for a total period of 3 months. CONCLUSION: Long-term exposure to mobile phone radiation can cause hypospermatogenesis and maturation arrest in the spermatozoa in the testis of Wistar albino rats.

Effect of cigarette smoking on fractional exhaled nitric oxide in Saudi medical college students.

OBJECTIVE: To see the levels of fractional exhaled nitric oxide (FENO) in young adult smokers and its relationship with duration and dose of smoking. METHODS: This study was conducted at the department of Physiology of College of Medicine and King Khalid University Hospital, Riyadh, Saudi Arabia from January 2009 to June 2009. A total of 60 medical students were initially recruited and 48 were finally selected for the study after fulfilling our selection criteria. FENO measurements were performed online according to the recent American Thoracic Society (ATS) guidelines and ventilatory functions were recorded. RESULTS: The difference in age, Body mass index (BMI), Systolic blood pressure (SBP) and Diastolic blood pressure (DBP) between the two groups was non significant. Lung function parameters included FEV1, FVC and FEV1/FVC ratio and the difference was non significant between the two groups. It was observed that FENO was significantly lower in smokers than non smokers (16.62 +/- 5.13 verses 24.35 +/- 6.17, p=0.0001). No relationship of FENO was observed with duration and dose of smoking. CONCLUSION: Young adult smokers exhibit lower levels of fractional exhaled nitric oxide compared to non smokers. This could be an early indicator of effects of smoking on lungs.

Health complaints among subjects involved in oil cleanup operations during oil spillage from a Greek tanker "Tasman Spirit".

BACKGROUND: Oil spillage in the sea water is a disaster for marine life and humans in the vicinity. The study aimed at investigating health complaints among subjects involved in oil cleanup operations during a spillage from a Greek oil tanker "Tasman Spirit". SUBJECTS AND METHODS: The project was conducted under the supervision of the Department of Physiology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. The study concerned the respiratory and general health complaints in 50 apparently healthy, non-smoking male workers exposed to crude oil during oil cleanup operations. The exposed group was matched with a similar number of male, non-smoking controls. The health complaints were evaluated based on a comprehensive interview. RESULTS: The subjects involved in oil cleanup operations had significantly higher rates of health complaints including cough (38%), runny nose (36%), eye irritation/redness (32%), sore throat (28%), headache (28%), nausea (24%) and general illness (18%), compared to their matched controls. CONCLUSION: Air pollution due to crude oil spillage into sea water may cause respiratory and general health complaints in workers involved in oil cleanup operations.

Effect of duration of exposure to polluted air environment on lung function in subjects exposed to crude oil spill into sea water.

BACKGROUND: Oil spill in sea water represents a huge environmental disaster for marine life and humans in the vicinity. The aim was to investigate the effect of duration of exposure to polluted air environment on lung function in subjects exposed to crude oil spill into sea water. MATERIAL AND METHODS: The present study was conducted under the supervision of Department of Physiology, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia, during the period July 2003 - December 2004. This was a comparative study of spirometry in 31 apparently healthy, non smoking, male workers, exposed to crude oil spill environment during the oil cleaning operation. The exposed group was matched with similar number of male, non smoking control subjects. Pulmonary function test was performed by using an electronic spirometer. RESULTS: Subjects exposed to polluted air for periods longer than 15 days showed a significant reduction in Forced Vital Capacity (FVC), Forced Expiratory Volume in First Second (FEV1), Forced Expiratory Flow in 25-25% (FEF25-75%) and Maximal Voluntary Ventilation (MVV). CONCLUSION: Air environment polluted due to crude oil spill into sea water caused impaired lung function and this impairment was associated with dose response effect of duration of exposure to air polluted by crude oil spill into sea water.

F-ratio, a surrogate marker of carpal tunnel syndrome.

OBJECTIVE: To explore the correlation of F-ratio and F-wave minimal latency (FWML) in carpal tunnel syndrome (CTS). METHODS: This retrospective study was conducted from January 2006 to January 2007 at the clinical physiology lab, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia. Motor and sensory nerve conduction studies, FMW latencies of median and ulnar nerves, and F-ratio were carried out in 54 CTS patients and 30 controls. RESULTS: Out of 54 CTS patients, there were 14 were males (26%), and 40 females (74%), CTS was bilateral in 32 (59%), and unilateral in 22 (41%) patients. Fifty-one patients (94.4%) had involvement of the right hand, 28 patients (51.8%) had dyslipidemia and 20 patients (37%) had hypertension. The FWML (ms) in the right median nerve was 25.46+/-2.2, and 25.79+/-1.7 in the right ulnar nerve in the control group (p=0.5224), while it was 29.1+/-3.35 in the right median nerve and 26.46+/-4.35 in the right ulnar nerve in patients with CTS (p=0.0008). A similar statistically significant increase in the median nerve latency was observed in the left hand. A statistically significant reduction in the F-ratio was found consistently in all patients with CTS in both the hands (p=0.0001). CONCLUSION: The present study reveals prolongation of FWML in the median nerve, and a statistically significant reduction of F-ratio in all CTS patients. A significant inverse correlation was found between FWML and F-ratio in CTS patients. Both FWML and F-ratio support the diagnosis of CTS.

Lung function in subjects exposed to crude oil spill into sea water.

A Greek oil-tanker ran aground, resulting in a huge oil spill along the costal areas of Karachi, Pakistan. The purpose of this study was to assess the lung function and follow up change after one year in subjects exposed to crude oil spill in sea water. It was a cross sectional study with follow up in 20 apparently healthy, non-smoking, male workers, who were exposed to a crude oil spill environment during oil cleaning operation. The exposed group was matched with 31 apparently healthy male control subjects. Pulmonary function test was performed using an electronic Spirometer. Subjects exposed to polluted air have significant reduction in forced vital capacity (FVC), forced expiratory volume in first second (FEV(1)), forced expiratory flow (FEF(25-75%)) and maximum voluntary ventilation (MVV) compared to their matched controls. This impairment was reversible and lung functions parameters were improved when the subjects were withdrawn from the polluted air environment.

Effect of duration of disease on ventilatory function in an ethnic Saudi group of diabetic patients.

BACKGROUND: Diabetes mellitus is a leading cause of illness and death across the world and is responsible for a growing proportion of global health care expenditures. The present study was designed to observe the effect of diabetes mellitus on lung function in patients with diabetes belonging to a specific ethnic group, namely Saudis. METHOD: In this study, a group of 47 apparently healthy volunteer male Saudi patients with diabetes was randomly selected. Their ages ranged from 20 to 70 years. The patients were matched with another group of 50 healthy male control subjects in terms of age, height, weight, ethnicity, and socioeconomic status. Both groups met exclusion criteria as per standard. Spirometry was performed with an electronic spirometer (Schiller AT-2 Plus, Switzerland), and results were compared by a Student's t test. RESULTS: Subjects with diabetes showed a significant reduction in forced vital capacity (FVC) and forced expiratory volume in the first second (FEV(1)) relative to their matched controls. However, there were no significant differences in the forced expiratory ratio (FEV(1)/FVC%) and the middle half of the FVC (FEF(25-75%)) between the groups. We observed a significantly negative correlation between duration of disease and pulmonary function, as measured by FEV(1) (r = 0.258, p = 0.04), FVC (r = 0.282, p = 0.28), and the middle half of the FVC (FEF(25-75%)) (r = 0.321, p = 0.014). CONCLUSIONS: Pulmonary function in a specific ethnic group of patients with diabetes was impaired as evidenced by a decrease in FVC and FEV(1) compared to pulmonary function in matched controls. Stratification of results by years of disease revealed a significant correlation between duration of disease and a decline in pulmonary function.

Dose response effect of cement dust on respiratory muscles competence in cement mill workers.

Electromyography (EMG) of respiratory muscles is a reliable method of assessing the ventilatory muscle function, but still its use has not been fully utilized to determine the occupational and environmental hazards on respiratory muscles. Therefore, EMG of intercostal muscles was performed to determine the dose response effect of cement dust on respiratory muscles competence. Matched cross-sectional study of EMG in 50 non-smoking cement mill workers with an age range of 20 - 60 years, who worked without the benefit of cement dust control ventilation or respiratory protective devices. EMG was performed by using surface electrodes and chart recorder. Significant reduction was observed in number of peaks (p < 0.0005), maximum peak amplitude (p < 0.0005), peak-to-peak amplitude (p < 0.0005) and duration of response (p < 0.0005) in cement mill workers compared to their matched control. Cement dust impairs the intercostal muscle competence and stratification of results shows a dose-effect of years of exposure in cement mill.

Hazards of X-ray radiation on the quantitative and phagocytic functions of polymorphonuclear neutrophils in X-ray technicians.

Over exposure to X-ray radiation is detrimental to the living cells and may lead to development of life-threatening diseases. It is intuitive to postulate that a low level exposure may lead to functional abnormalities in human immune cells. Therefore, the objective of the present study was to study the effects of X-ray radiation on the total leukocyte count (TLC) and phagocytic activity of Polymorphonuclear neutrophils (PMN). A group of 42 apparently healthy X-ray technicians were recruited with age ranging from 25-50 years. They were matched with another group of 42 control healthy volunteer subjects in terms of age, sex and ethnic variation. The mean exposure level of X-ray radiation in X-ray technicians was 72.4 mrem per calendar quarter and 289.6 mrem per year. TLC was performed by using a Beckman Coulter counter and phagocytic activity of whole blood and PMN was determined by measuring chemiluminescence (CL) response with a chemiluminescence luminometer. The mean value of CL response was significantly decreased (p<0.0005) in X-ray technicians, even though they had low levels of exposure, compared to their controls. However, no significant difference was observed in TLC between the two groups at this low level of exposure. Exposure to X-ray radiation decreases the physiological functions of PMN as measured by decreasing chemiluminescence response even at low levels of exposure.

Lung function in type 2 Saudi diabetic patients.

OBJECTIVE: To study the effects of type 2 diabetes mellitus on lung function and to determine its severity in relation to duration of disease. METHODS: We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002 - 2004. A group of 32 apparently healthy volunteer male type 2 diabetic patients were randomly selected with an age range from 24-73 years. We matched the diabetic patients with another group of 40 control healthy male subjects in terms of age, height, weight, and socioeconomic status. Both groups met with exclusion criteria as per standard. Spirometry was performed on an Electronic Spirometer (Schiller AT-2 Plus, Switzerland) and results were compared using the 2-tailed student t-test. RESULTS: Diabetic patients showed a significant reduction in the forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) relative to their matched controls. However, there were no significant difference in the forced expiratory ratio (FEV1/FVC%) and middle half of the FVC (FEF 25-75%) between the groups. CONCLUSION: Lung function in type 2 diabetic patients is impaired by a decrease in FVC, FEV1 and PEF, as compared to their matched controls. Stratification of results by years of disease showed a dose-response effect on lung function.

Assessment of respiratory muscles endurance in diabetic patients.

OBJECTIVE: Respiratory muscle endurance is of interest in pulmonary, critical care and many other areas of medicine. The maximal voluntary ventilation (MVV) test is an objective dynamic method for measuring the working capacity of respiratory muscles. Therefore, we designed the present study to determine the effect imposed by diabetes mellitus on respiratory muscle endurance in Saudi diabetic patients. METHODS: We conducted this study in the Department of Physiology, College of Medicine, King Khalid University Hospital and Diabetic Centre, King Abdul-Aziz University Hospital, Riyadh, Saudi Arabia during the year 2002-2004. In this study, we recruited 39 male diabetic patients and equal number of control subjects and all participants were non-smokers with age range of 23-71 years. The subjects were matched for age, height and weight. We determined the respiratory muscles endurance by a direct MVV test during inspiratory and expiratory phases of respiration by using a MP-100 student Bio Pac system and compared the results using a paired t-test. RESULTS: In inspiratory and expiratory phases of respiration, diabetic patients showed a significant reduction in the mean values of direct MVV test (p<0.001) relative to their matched controls. CONCLUSION: We conclude that in diabetic patients the respiratory muscles endurance is impaired by a decreased in MVV values. This decline in MVV further showed that the diabetic patients have a reduced inhaled and exhaled volumes during consecutive breaths.

Lung function among non-smoking wheat flour mill workers.

OBJECTIVES: Flour dust occurs across the range of food industries; its exposure may induce acute or chronic respiratory ailments. The objective of the study was to assess the effects of flour dust on the lung function. MATERIALS AND METHODS: The lung function was studied in forty-six male flour mill workers and a similar number of male control subjects; all participants were non-smokers with the age range from 18 to 65 years. The subjects were matched for age, height, weight and socioeconomic status. The pulmonary function test was performed by using an electronic spirometer (Compact Vitalograph, UK) and results were compared by a paired t-test. RESULTS: Significant reduction in the overall mean values of FVC, FEV1, PEF, and MW were observed in wheat flour mill workers relative to their matched controls. CONCLUSIONS: Based on the results of the present study, we conclude that the flour mill workers in Pakistan, like grain workers elsewhere, are at an increased risk of developing occupationally related pulmonary function impairments. The results suggest that there is an urgent need to improve dust control measures and the health status of flour mill workers.