Prevalence and risk factors of gestational diabetes mellitus among pregnant patients visiting National Guard primary health care centers in Saudi Arabia.

OBJECTIVES: To measure the prevalence of gestational diabetes mellitus (GDM) and its risk factors in Saudi Arabia, in comparison with developed and developing countries worldwide.  Methods: We enrolled pregnant women aged 15-45 years who visited 3 National Guard-Health Affairs' primary health care centers in Jeddah, Saudi Arabia between January 2017 and December 2017. We used stratified samples and computer-generated random numbers to collect data. This data includes demographics, obstetric history, blood pressure, non-fasting 1-hour glucose challenge test (GCT), 3-hour oral glucose tolerance test (OGTT), hemoglobin level, rubella immunization status, hepatitis B surface antigen status, urinalysis results, and labor, and delivery notes. We categorized the patients into 2 groups, GDM and non-GDM, based on GCT and OGTT. Results: We enrolled 347 women in the study (mean age, 28.8±6 years; range, 18-45 years). On GCT, 36.6% of women showed abnormal values and 6.9% exhibited diagnostic values. Oral glucose tolerance test indicated impairment in 18.7% of patients and a diagnostic finding in 15% of patients. Women diagnosed with GDM tended to be older and have greater body mass index (BMI) values. Conclusion: The prevalence of GDM in Saudi Arabia is high compared to other countries. Advanced maternal age and higher BMI values were associated with increased prevalence of GDM. Thus, early prevention and management of GDM is vital to minimize the risks to both the mother and fetus.

How well can signs and symptoms predict AMI in the Malaysian population?

The aim of the study was to use data from an electronic medical record system (EMR) to look for factors that would help us diagnose acute myocardial infarction (AMI) with the ultimate aim of using these factors in a decision support system for chest pain. We extracted 887 records from the electronic medical record system (EMR) in Selayang Hospital, Malaysia. We cleaned the data, extracted 69 possible variables and performed univariate and multivariate analysis. From the univariate analysis we find that 22 variables are significantly associated with a diagnosis of AMI. However, multiple logistic regression reveals that only 9 of these 22 variables are significantly related to a diagnosis of AMI. Race (Indian), male sex, sudden onset of persistent crushing pain, associated sweating and a history of diabetes mellitus are significant predictors of AMI. Pain that is relieved by other means and history of heart disease on treatment are important predictors of a diagnosis other than AMI. The degree of accuracy is high at 80.5%. There are 13 factors that are significant in the univariate analysis but are not among the nine significant factors in the multivariate analysis. These are location of pain, associated palpitations, nausea and vomiting; pain relieved by rest, pain aggravated by posture, cough, inspiration and exertion; age more than 40, being a smoker and abnormal chest wall and face examination. We believe that these findings can have important applications in the design of an intelligent decision support system for use in medical care as the predictive capability can be further refined with the use of intelligent computational techniques.

The organization of ribosomal RNA processing correlates with the distribution of nucleolar snRNAs.

We have analyzed the organization of pre-rRNA processing by confocal microscopy in pea root cell nucleoli using a variety of probes for fluorescence in situ hybridization and immunofluorescence. Our results show that transcript processing within the nucleolus is spatially highly organized. Probes to the 5' external transcribed spacer (ETS) and first internal transcribed spacer (ITS1) showed that the excision of the ETS occurred in a sub-region of the dense fibrillar component (DFC), whereas the excision of ITS1 occurred in the surrounding region, broadly corresponding to the granular component. In situ labelling with probes to the snoRNAs U3 and U14, and immunofluorescence labelling with antibodies to fibrillarin and SSB1 showed a high degree of coincidence with the ETS pattern, confirming that ETS cleavage and 18 S rRNA production occur in the DFC. ETS, U14, fibrillarin and SSB1 showed a fine substructure within the DFC comprising closely packed small foci, whereas U3 appeared more diffuse throughout the DFC. A third snoRNA, 7-2/MRP, was localised to the region surrounding the ETS, in agreement with its suggested role in ITS1 cleavage. All three snoRNAs were also frequently observed in numerous small foci in the nucleolar vacuoles, but none was detectable in coiled bodies. Antibodies to fibrillarin and SSB1 labelled coiled bodies strongly, though neither protein was detected in the nucleolar vacuoles. During mitosis, all the components analyzed, including pre-rRNA, were dispersed through the cell at metaphase, then became concentrated around the periphery of all the chromosomes at anaphase, before being localized to the developing nucleoli at late telophase. Pre-rRNA (ETS and ITS1 probes), U3 and U14 were also concentrated into small bodies, presumed to be pre-nucleolar bodies at anaphase.