A Cross-Sectional Analysis of Health Behavior in School-Aged Children: The Qassim Study.

Background Childhood obesity is a worldwide public health epidemic. Sedentary lifestyles and unhealthy dietary patterns increased the rates of overweight and obesity among children. This study aimed to (1) estimate healthy behaviors (including dietary patterns and physical activity) and (2) determine the prevalence of overweight and obesity among Saudi school-aged children in the Qassim region, Saudi Arabia. Methods A population-based cross-sectional study was conducted among Saudi schoolchildren aged between five and 16 years old. The study group consisted of 339 children including 237 males and 102 females. Data were collected using a questionnaire based on the Health Behavior in School-Aged Children (HBSC) survey. Body mass index (BMI) for age and gender was computed for each child using the AnthroPlus 2007 software (World Health Organization {WHO}, Geneva, Switzerland). Statistical Package for Social Sciences (SPSS) version 23.0 (IBM SPSS Statistics, Armonk, NY) was used for data analyses. Results The prevalence of overweight and obesity among Saudi children was 46 (13.6%) and 81 (23.9%), respectively. Males consumed more soft drinks and energy drinks, whereas females consumed more fruit juice. As children grew older, the consumption of unhealthy food and beverages increased. Males engaged in more daily physical activity compared to females. Conclusion Saudi schoolchildren (aged 5-16 years) demonstrated significant gender-specific variations in dietary patterns and levels of physical activity. A significant proportion of Saudi children were overweight or obese. The study highlighted the complex relationship between age, school class, gender, and health behaviors among Saudi school-aged children. Policymakers and parents could benefit from the understanding of such complex relationships to promote healthy behaviors among school-aged children.

Maternal early pregnancy serum level of 25-Hydroxyvitamin D and risk of gestational diabetes mellitus.

OBJECTIVE: To assess if early pregnancy (≤14 weeks of gestation) 25-hydroxyvitamin D (25(OH)D) level is associated with risk of gestational diabetes mellitus (GDM). METHODS: A nested case-control study (60 women in each arm) was conducted at Saad Abualila Hospital (Khartoum, Sudan) during the period of January to November 2017. Clinical and obstetrical data were gathered, 25(OH)D concentration was measured at the first prenatal visit, and a 75-g oral glucose tolerance test was performed at 24-28 weeks of gestation. RESULTS: Compared with women without GDM, in women with GDM, the median of the 25(OH)D level was significantly lower (7.3 [interquartile range 5.7-8.8] ng/mL versus 8.4 [interquartile range 6.6-11.9] ng/mL, P=0.001). All women in the study (with and without GDM) had vitamin D deficiency (25(OH)D<20 ng/mL). The results of the logistic regression showed that a low 25(OH)D level was the only factor associated with GDM (odds ratio [OR] 0.83, 95% confidence interval [CI] 0.73-0.95, P=0.010). Women with 25(OH)D less than 6.0 ng/mL were at a higher risk of GDM (OR 3.2, 95% CI 1.29-8.12, P=0.012). CONCLUSION: A low 25(OH)D level in early pregnancy was associated with increased risk of GDM. This finding might be useful in predicting GDM.

Serum level of 25-hydroxyvitamin D and obesity among early pregnant women.

AIM: To assess serum 25-hydroxyvitamin D 25(OH)D level in obese pregnant Sudanese women in early pregnancy. METHODS: A match case-control study was conducted in Saad Abualila Hospital (Khartoum, Sudan). The cases were obese (body mass index [BMI] ≥ 30.0 kg/m2 ) women. Controls were women with normal BMI (18.5-24.9 kg/m2 ) matched for age, parity and gestational age. The 25(OH)D level was measured using ELISA. RESULTS: There was no significant difference between the two groups in their age, parity or gestational age. There was no significant difference in the median (interquartile) level of the serum (25(OH)D between obese pregnant women and normal weight pregnant women (3.05 [11.100-15.937] ng/ml vs 13.05 [10.950-17.362] ng/ml, P = 0.237). There was no significant correlation between BMI and 25(OH)D level (r = -0.133, P = 0.149). CONCLUSION: There was no significant difference in the 25(OH)D level between the obese pregnant women and normal weight pregnant women in this study.

Comparative study of serum 8-hydroxydeoxy-guanosine levels among healthy offspring of diabetic and non-diabetic parents.

OBJECTIVE: Parental diabetic status might inherit the likelihood of disease susceptibility. The risk of Type 2 diabetes mellitus is increased among individuals with diabetic parents. Moreover, oxidative stress is thought to be a risk factor in the onset and progression of diabetes. 8-hydroxydeoxy-guanosine (8-OHdG) is widely analyzed biomarker to assess the oxidative DNA damage. We aimed to investigate that serum 8-OHdG level among offspring of diabetic and non-diabetic parents. MATERIALS AND METHODS: A total of 84 volunteers participated in the study. Questionnaires were applied to record information including demographics, physical activity, smoking, and family history. Blood samples were collected, and laboratory investigations 8-OHdG levels, lipid, and glucose were analyzed using the standard technique. Finally, 24 samples were considered for further analysis. Student's t-test was applied for statistical analysis. RESULTS: Serum 8-OHdG levels were significantly (P < 0.05) high among healthy offspring of diabetic in comparison of healthy offspring of non-diabetic parents. While nonsignificant differences were found in their body mass index, glucose, and lipid level between the groups. CONCLUSION: There is possibility of a mild degree of oxidative DNA damage among offspring of diabetic due to family history. Such understanding is essential to avoid other modifiable risk factors related to lifestyle and dietary habit which could possibly control further oxidative stress, to delay the onset of diabetic especially among offspring of diabetic parents.

Outcome-based approach to medical education towards academic programmes accreditation: A review article.

The rapid change worldwide, as a consequence of advances in science and technology, necessitates the graduation of well-qualified graduates who have the appropriate knowledge and skills to fulfill specific work requirements. Hence, redesigning academic models by focusing on educational outcomes became the target and priority for universities around the world. In this systematic review we collected and retrieved literature using a selection of electronic databases. The objectives of this report is to: 1) provide an overview of the evolution of outcome-based education (OBE), (2) illustrate the philosophy and principle of OBE, (3) list the OBE advantages and benefits, (4) describe the assessment strategies used in OBE, and (5) discuss the role of teachers and students as key elements. In conclusion, there is growing interest by the Saudi government to provide student-centered education in their institutes of higher education to graduate students with the necessary knowledge and skill experiences. Moreover, OBE is considered a holistic approach which offers a powerful and appealing way of reforming and managing medical education for mastery in learning and to meet the prerequisites for local and international accreditation.

In Vivo Evaluation of Anti Diabetic, Hypolipidemic, Antioxidative Activities of Saudi Date Seed Extract on Streptozotocin Induced Diabetic Rats.

INTRODUCTION: Phoenix dactylifera (date palm) is major fruit of gulf region. In folk medicine; dates have been traditionally use. The date seed is used as hypoglycaemic, expectorant, tonic, aphrodisiac, antidiarrheic and mouth hygiene. AIM: This study intended to evaluate the anti-diabetic, hypolipidaemic and antioxidative activities of date seed extract in diabetes-induced rats. MATERIALS AND METHODS: Total of seven groups of rats, consisting of control rats and streptozotocin induced diabetic rats treated with aqueous seed extract in concentration of 100g/L in dosage of 10ml/day/rat. To evaluate the anti-diabetic property, glucose and weight was analysed weekly and at the end of eight week all rats were sacrificed. To evaluate the hypolipidaemic and antioxidative activities, serum cholesterol, triglyceride, malondialdehyde, superoxide dismutase, 8-hydroxy-2'-deoxyguanosine were estimated. Liver enzymes and kidney function tests were performed. Moreover to verify the glycaemic effect; glycated haemoglobin and serum insulin was performed. RESULTS: Aqueous seed extract in concentration of 100 gm/L in dosage of 10ml/day/rat brings a significant reduction of blood glucose levels in diabetic rats in comparison of control rats. There were significant differences in the investigated clinical chemistry and oxidative stress parameters between control and diabetic rats with both seed extract of Ajwa and Sukkari dates. CONCLUSION: Present study verifies the antidiabetic property, of aqueous seed extracts of two different varieties of dates namely Ajwa and Sukkari of Kingdom of Saudi on streptozotocin induced Diabetic rats. Prolong treatments with the extract restores the function of liver and kidney and balance the oxidative stress condition in diabetic treated rats.

Comparative Study of 5'-Nucleotidase Test in Various Liver Diseases.

INTRODUCTION: The liver regulates many important metabolic functions. The 5'-nucleotidase activity is increased in obstructive jaundice, parenchymal liver disease, and hepatic metastases. AIM: This study was conducted to assess the serum levels of 5'-nucleotidase on patients with viral hepatitis, alcoholic liver diseases and liver cirrhosis, moreover to make comparison to assess the degree of biliary involvement. MATERIALS AND METHODS: A total of 60 male subjects (15 healthy controls and 45 case subjects) were enrolled, aged between 30 -50 years, each case group consisted of 15 male age-matched patients suffering with viral hepatitis, alcoholic liver disease (more than 10 years.) and liver cirrhosis. Serum 5'-nucleotidase was analyzed as per the standard laboratory procedure. RESULTS: The 5'-nucleotidase levels were significantly raised in viral hepatitis, alcoholic liver disease and cirrhosis patients. The levels being 35.2±8.43, 29.87±3.94, and 24.07± 4.33 respectively as compared to healthy control (11±3.42) U/L. CONCLUSION: Serum 5'-nucleotidase levels showed elevations in mean value of three fold in viral hepatitis, 2.5 folds elevation in alcoholic liver disease and two fold in cirrhosis as compared of healthy control subjects.

Association between serum carcinoembryonic antigen level and oxidative stress parameters among diabetic females.

UNLABELLED: In this study we intended to determine serum level of the carcinoembryonic antigen (CEA) and to find out the correlation with oxidative stress parameters among diabetic female in comparison to control subjects. METHODS: A total of 120 Saudi (type 2 diabetic "T2DM", n = 60 and healthy non-diabetic, n = 60) nonsmokers females were enrolled in this study. Body mass index (BMI) was estimated using weight and height; CEA, superoxide dismutase (SOD), 8-hydroxy-deoxyguanosine (8-OHDG), malondialdehyde (MDA) were performed using enzyme-linked immunosorbent assay (ELISA) kits. Blood glucose was estimated by GOD/POD method and, glycated haemoglobin (HbA1c) by immunoturbidimetric method. RESULTS: The student's t-test showed significant differences between the diabetics and controls in CEA, blood glucose, age, oxidative stress markers. Moreover, Pearson's correlation coefficient (r) indicated significant correlations between CEA and age, BMI, blood glucose, HbA1, and MDA. No significant correlation was found between CEA and 8-OHdG, SOD. CONCLUSIONS: In this study we confirmed that CEA influence with components of type 2 diabetes and glycemic control. We found correlation between Lipid peroxidation and CEA among diabetic female in comparison to control subjects.

Dyslipidemia and reduced total antioxidant status in young adult Saudis with prediabetes.

AIMS: Lifestyle related noncommunicable health conditions are having an increasingly negative impact on the health. This study aimed to assess the lipid profile, total antioxidant capacity, and the lifestyle predictors of conversion to prediabetes in young Saudis with prediabetes. MATERIALS AND METHODS: One hundred and twenty-one young Saudis with fasting plasma glucose (<125 mg/dl) enrolled in this study who further categorized into normal glucose tolerance "NGT" group (n=86) and prediabetes group (IFG; n=08/IGT; n=27) based on American Association criteria. Venous blood samples were collected at fasting and 2h postprandial from participants. Chemistry parameters and total antioxidant status (TAS) were assayed by standard procedures. Questionnaires were applied to collect information including demographic characteristics, physical activity, and family history to diabetes. Statistical analysis was performed using SPSS version 17. RESULTS: Compared to NGT subjects, the prediabetics characterized by marked obesity (p=.027), visceral obesity (p=.002), dyslipidemia, significantly increased HbA1c (p=.003), reduced TAS (p<.001), more sedentary lifestyle (p=.010). Positive correlations were documented between FPG, 2-h plasma glucose and HbA1c, BMI, WC, TC, LDL cholesterol, TG while negative correlations with HDL cholesterol, TAS. CONCLUSION: The current study reported that prediabetes condition (in young adult Saudis) was associated with dyslipidemia, reduced total antioxidant status, obesity, central obesity, and physical inactivity compared to those with normoglycemia. Lifestyle modifications (through weight loss, regular physical activity, and healthy diet) should be encouraged especially among young Saudis to prevent the progression to type 2 diabetes and its complications from prediabetes state.

Lipoprotein (a) and atherogenic indices in Sudanese patients with type 2 diabetes.

BACKGROUND & AIMS: Type 2 diabetes is associated with significant cardiac morbidity and mortality with a more than threefold increased risk of coronary artery disease (CAD). We aimed to assess the serum concentrations of lipoprotein (a) and lipid profile indexes as predictors for CAD in Sudanese type 2 diabetics compared to healthy subjects. MATERIALS & METHODS: This case-control study was conducted at Jabir Abu-Aliz Specialized Center, Khartoum State, Sudan. After overnight fasting, 4 ml blood samples were collected in plain vials through venous puncture from each subject. Lipid profile parameters were estimated by standard laboratory procedures. Serum lipoprotein (a) was measured by immunoturbidimetric method. Statistical analyses were performed using SPSS software (version 17). RESULTS: Compared to healthy controls, type 2 diabetics showed significantly higher serum lipids and lipoprotein fractions. The mean values of lipoprotein (a), TC: HDL-C (5.55±.8 vs. 3.89±.6) and LDL-C: HDL-C (3.80±0.7 vs. 2.32±0.5) were significantly increased in patients. Lipoprotein (a) was significantly correlated with TG (p=.025), HDL-C (inversely, p<.001), VLDL-C (p= .025), and TC: HDL-C ratio (p= 016). Moreover, LDL-C: HDL-C ratio and TC were the most common risk factors distributed among the study patients (80% and 71.4% respectively). CONCLUSION: Diabetic patients characterized by higher ratios of TC: HDL -C and LDL: HDL and Lipoprotein (a) compared to healthy controls. The evaluation of these lipid indices in diabetics, beside the routine lipid profile analysis, may be a crucial helpful step in the prevention of coronary artery disease since these atherogenic factors can be reduced by lifestyle modifications.

Dyslipidemia and lipid peroxidation of Saudi type 2 diabetics with proliferative retinopathy.

OBJECTIVES: To assess lipid profile and lipid peroxidation in type 2 diabetics with proliferative retinopathy (PDR), and investigate the association between these biochemical parameters and PDR. METHODS: This study was conducted between June 2011 and February 2012 in the Research Laboratory, College of Applied Medical Sciences, Qassim University, Qasssim, Kingdom of Saudi Arabia. The study included 54 patients with type 2 diabetes (21 with PDR and 33 controls) and 30 healthy subjects. The biochemical parameters were measured using standard laboratory procedures. RESULTS: Patients with PDR characterized by significantly (p<0.05) increased levels of serum cholesterol, triglyceride, low density lipoprotein (LDL-C), plasma malondialdehyde; decreased levels of serum high density lipoprotein (HDL-C) and apolipoprotein A1 (Apo A1); positive correlation of malondialdehyde with triglyceride, but negative with HDL-C, Apo A1. In logistic regression, malondialdehyde, LDL-C, and Apo A1 were not associated with PDR. However, triglyceride (OR = 1.745; p=0.000), total cholesterol (OR = 0.079; p=0.000), and HDL-C (OR = 10.676; p=0.000) were independent risk factors for developing PDR. CONCLUSION: Dyslipidemia and lipid peroxidation may play a role in pathogenesis of diabetic retinopathy. Patients with PDR displayed marked lipid abnormalities and increased lipid peroxidation. The control of lipid alterations through glycemic control and/or lipid lowering medication is required for type 2 diabetics at least to postpone or prevent loss of vision from retinopathy.

Aldo-keto reductase and sorbitol dehydrogenase enzymes in Egyptian diabetic patients with and without proliferative diabetic retinopathy.

BACKGROUND: Activation of the polyol pathway due to increased aldo-keto reductase (AKR) activity has been implicated in the development of diabetic complications, including proliferative diabetic retinopathy (PDR); however, the relationship between hyperglycaemia-induced activation of the polyol pathway in the retina and PDR is still uncertain. METHODS: This study was conducted on 73 individuals, who were categorised into three groups: healthy individuals as normal control (15 age-matched subjects), diabetic patients treated with oral hypoglycaemic drugs (OHD, 34 patients), six of whom (17.7 per cent) were diagnosed with PDR and the rest were diagnosed with non-proliferative diabetic retinopathy (NPDR) and diabetic patients treated with insulin (INS, 24 patients), 12 of whom (50 per cent) were diagnosed with PDR and the rest had NPDR. RESULTS: The AKR level in diabetic subjects showed a significant increase compared with the normal controls. Interestingly, AKR levels were significantly increased in the INS compared with the OHD group. Also the AKR level was significantly increased in the patients with proliferative compared with the non-proliferative retinopathy in both the insulin and oral diabetic groups. The sorbitol dehydrogenase (SDH) level in diabetic patients showed a significant decrease compared with the normal control level. Interestingly, the SDH level was significantly decreased in the INS compared with the OHD group. Also, the SDH level was significantly decreased in patients with proliferative compared with non-proliferative retinopathy in both INS and OHD groups. The HbA(1c) level in both INS and OHD subjects showed a significant increase compared with normal controls. In addition, the triglyceride level in insulin proliferative retinopathy showed a significant increase compared with other groups. CONCLUSIONS: The AKR level was significantly increased in patients with proliferative compared with non-proliferative retinopathy in both insulin and oral diabetic groups. The SDH level was significantly decreased in patients with proliferative compared with non-proliferative retinopathy in both insulin and oral diabetic groups. Both AKR and SDH could be used as indicators for diabetic control.

Inflammatory markers and haptoglobin polymorphism in Saudi with non-insulin-dependent diabetes mellitus.

OBJECTIVES: Haptoglobin (Hp) polymorphism associated with clinical evolution of several inflammatory diseases and considered as a predictive factor for development of diabetes complications. We designed the present study to investigate the frequency distribution of Hp phenotypes among Saudi with non-insulin-dependent diabetes mellitus compared to healthy nondiabetic subjects. Moreover, we explored the possibility of relationship between serum levels of inflammatory markers (namely, high-sensitive C-reactive proteins "hs-CRP", interleukin (IL)-6, and Hp) and Hp phenotypes. METHODS: In the present case-control study, we enrolled 60 type 2 diabetic patients as the study group and 60 healthy subjects as the control group. We assayed serum levels of Hp and hs-CRP by immunoturbidimetric method; while IL-6 was measured by ELISA. Native polyacrylamide gel electrophoresis was used for determination of Hp phenotypes. RESULTS: In type 2 diabetics, serum concentrations of IL-6, hs-CRP, and Hp were significantly elevated and correlated to body mass index. Moreover, there was a significant correlation between plasma glucose level and Hp (r = 0.577, p = 0.000), IL-6 (r = 0.448, p = 0.000), and hs-CRP (r = 0.380, p = 0.001). In addition, data demonstrated a positive correlation between HbA1c and Hp (r = 0.521, p = 0.000), IL-6 (r = 0.420, p = 0.001), and hs-CRP (r = 0.353, p = 0.008). Hp 2-1 phenotype predominated among subjects in both study and control groups. No significant association between Hp phenotypes with any of the investigated inflammatory markers was documented. CONCLUSION: Inflammation may represent the link between type 2 diabetes and obesity. Hp 2-1 was the predominant phenotype among Saudi type 2 diabetics as well as healthy subjects. In addition to Hp; other possible genetic polymorphisms like CRP may have its effect on diabetes through different mechanisms.