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Al Khubar, Saudi Arabia

Abu-Amero K.K.,King Saud University | Jaber M.,Gulf | Hellani A.,Saad Specialist Hospital | Bosley T.M.,King Saud University | Bosley T.M.,Cooper University Hospital
British Journal of Ophthalmology | Year: 2010

Aim: To obtain a whole genome-expression profile in Leber hereditary optic neuropathy (LHON), patients with the 11 778 mitochondrial DNA mutation. Methods; RNA was extracted from leucocytes and cDNA reverse-transcribed and hybridised to Affymetrix Gene Chips. A principal-component analysis and the rate monotonic algorithm were performed, and a further analysis applied to genes with a twofold expression difference and p<0.015 between patients and controls. Results: The gene-expression profile of patients with the 11 778 mtDNA mutation was significantly different from controls. The most commonly upregulated genes (n=137) were found to be related to the cellular transport (13.8%; 19/137) and transcription (12.4%; 17/137). Similarly, the most commonly downregulated genes (n=152) were also related to the cellular transport (17.8%; 27/152) and transcription (18.4%; 28/152). None of the 13 mitochondrial coded genes and no structural mitochondrial nuclear-encoded genes were differentially expressed. Interestingly, OPA1 gene was downregulated in all LHON patients, which could lead to fragmentation of the mitochondrial network, dissipation of the mitochondrial membrane potential and disorganisation of the cristae. Conclusions: The presence of the 11 778 mtDNA mutation resulted in a unique gene-expression profile compared with controls. Downregulation of OPA1 may contribute to the pathogenesis of LHON. Source


Aoun J.,American University of Beirut | Habib R.,American University of Beirut | Charaffeddine K.,American University of Beirut | Taraif S.,Saad Specialist Hospital | And 2 more authors.
PLoS Neglected Tropical Diseases | Year: 2014

Background:Caseating granulomas are often associated with a mycobacterial infection (TB) and are thought to be exceedingly rare in cutaneous leishmaniasis (CL). However, no large series has accurately documented the incidence of caseating granulomas in CL.Methods:A multiregional cohort consisting of 317 patients with CL [Syria (157), Pakistan (66), Lebanon (47), Saudi Arabia (43), Ethiopia (2) and Iran (2)] was reviewed. Clinical [age, sex, disease duration, lesion type and geographic and anatomic location] and microscopic data [presence of and type of granuloma, Ridley's parasitic index (PI) and pattern (RP)] were documented. Presence of microorganisms was evaluated using special stains (GMS, PAS, AFB and Gram) and polymerase chain reaction (PCR) for TB and CL. All cases included in this study were confirmed as CL by PCR followed by restriction fragment length polymorphism analysis for molecular speciation and were negative for other organisms by all other studies performed. Categorical and continuous factors were compared for granuloma types using Chi-square, t-test or Mann-Whitney test as aopriate.Results:Granulomas were identified in 195 (61.5%) cases of CL and these were divided to 49 caseating (25.2%), 9 surative (4.6%) and 137 tuberculoid without necrosis (70.2%). Caseating and tuberculoid granuloma groups were significantly different in terms of the geographical source, with more cases harboring caseating granulomas in Saudi Arabia (p<0.0001). Histologically, both groups were also different in the distribution of their RP (p<0.0001) with a doubling RP3 in caseating granulomas (31% vs. 15%) as osed to doubling of RP5 in tuberculoid granuloma group (38% vs. 19%). Time needed to achieve healing (RP5) was notably shorter in tuberculoid vs. caseating group (4.0 vs. 6.2 months). Parasitic Index, CL species and other considered variables did not differ for the granuloma type groups.Conclusion:In our multiregional large cohort, a notable 18.2% of all CL cases harbored caseating granulomas therefore; CL should be considered part of the differential diagnosis for cases with caseating granulomas in endemic regions, especially considering that the regions included in our cohort are also endemic for TB. Of note, cases of CL with caseating granulomas also showed a slower healing process, with no association with specific species, which may be due to worse host immune response in such cases or to a more aggressive leishmania strains. © 2014 Aoun et al. Source


Zeidan A.,Lebanese University | Mazoit J.X.,University Paris - Sud | Mazoit J.X.,Hopitaux universitaires Paris Sud | Ali Abdullah M.,Tanta University | And 3 more authors.
British Journal of Anaesthesia | Year: 2014

BackgroundParacetamol is widely used to treat postoperative pain and is well known for its morphine-sparing effect. Therefore, the effect of morphine-paracetamol combination can be synergistic, additive, or infra-additive. The primary aim of our study is to define the median effective analgesic doses (ED50s) of paracetamol, morphine, and the combination of both. Also, the nature of the interaction for postoperative pain after moderately painful surgery using an up-and-down method and isobolographic analysis was determined.MethodsNinety patients, undergoing moderately painful surgery, were included in one of the three groups. Determination of the median ED50s was performed by the Dixon and Mood up-and-down method. Initial doses were 1.5 g and 5 mg, with dose adjustment intervals of 0.5 g and 1 mg, in the paracetamol and morphine groups, respectively. The initial doses of paracetamol and morphine were 1.5 g and 3 mg, in the paracetamol-morphine combination group with dose adjustment intervals of 0.25 g for paracetamol and 0.5 mg for morphine. Analgesic efficacy was defined as a reduction to or <3 on a 0-10 numeric rating scale, 45 min after the beginning of drug administration. Isobolographic analysis was used to define the nature of their interaction.ResultsThe median ED50s of paracetamol and morphine were 2.1 g and 5 mg, respectively. The median ED50 of the combination was 1.3 g for paracetamol and 2.7 mg for morphine.ConclusionsOur study showed that the combination of the paracetamol and morphine produces an additive analgesic effect.Clinical trial registrationNCT01366313. © 2014 The Author. Source


Al-Dossary S.S.,Saad Specialist Hospital
Eastern Mediterranean health journal = La revue de santé de la Méditerranée orientale = al-Majallah al-ihhīyah li-sharq al-mutawassi | Year: 2010

Obesity among children is an increasing concern. This cross-sectional study in 2006 determined the prevalence and demographic characteristics of overweight and obesity in children in the Eastern province of Saudi Arabia. A total of 7056 children (aged 2-18 years) were selected from schools and the outpatient department of a hospital. The overall prevalence of overweight was 19.0% and of obesity was 23.3%. More than 50% of children between 14 and 18 years had weight above the 85th percentile. More males than females were obese by ages 14-18 years (35.6% versus 19.2%). Saudi and non-Saudi nationalities had the same distribution of body mass index. Interventions to encourage healthier lifestyles for children are needed at the national level. Source


Kanawati S.,Makassed General Hospital | Fawal H.,Makassed General Hospital | Maaliki H.,Saad Specialist Hospital | Naja Z.M.,Makassed General Hospital
Anaesthesia | Year: 2015

We report laparoscopic sleeve gastrectomy in five awake obese patients, completed under regional anaesthesia provided by paravertebral and superficial cervical plexus blockade. The technique was acceptable to patients, surgeons and anaesthetists. © 2015 The Association of Anaesthetists of Great Britain and Ireland. Source

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