23. Does the maximum allowable contrast dose (MACD) predict the risk of contrast induced nephropathy (CIN) in patients with chronic kidney disease (CKD)

BackgroundCIN is associated with high in-hospital mortality. Some studies recommend the utilization of the MACD formula to guide safe contrast dosing, however the evidence supporting use of this measure is limited.ObjectiveThe purpose of this study was to determine if MACD is helpful in predicting the risk of CIN in patients with CKD.Methods8670 patients who underwent coronary angiography in our center with or without Percutaneous Coronary Intervention (PCI) (2008–2013) were included. Patients with CKD (n=144) were selected. Patients in shock, on intra aortic balloon pump, on prophylactic hemofiltration or on dialysis were excluded.Creatinine was measured 48–72h post procedure. T-test, Chi-Square and multiple regression were used to compare those patients who developed CIN and those who did not develop CIN. CIN was defined as an increase in serum creatinine by ⩾25% or 0.5mg/dL from baseline within 48–72h after contrast exposure.ResultsCIN occurred in 28 patients (19.4%). Only 8 (5.6%) of the 144 patients exceeded MACD and 2 of these patients developed CIN. The use of biplane angiography explains the lower contrast dose. For this reason the impact of exceeding MACD could not be evaluated. Primary PCI was associated with CIN (p=0.012; OR 5.1)).ConclusionOverall it is best to limit contrast dose to the extent possible as this is a known risk factor, however MACD is not a useful variable in a risk model for predicting CIN in our population. Primary PCI was the only predictor of CIN in our population

Sequencing, Analysis, and Annotation of Expressed Sequence Tags for Camelus dromedarius

Despite its economical, cultural, and biological importance, there has not been a large scale sequencing project to date for Camelus dromedarius. With the goal of sequencing complete DNA of the organism, we first established and sequenced camel EST libraries, generating 70,272 reads. Following trimming, chimera check, repeat masking, cluster and assembly, we obtained 23,602 putative gene sequences, out of which over 4,500 potentially novel or fast evolving gene sequences do not carry any homology to other available genomes. Functional annotation of sequences with similarities in nucleotide and protein databases has been obtained using Gene Ontology classification. Comparison to available full length cDNA sequences and Open Reading Frame (ORF) analysis of camel sequences that exhibit homology to known genes show more than 80% of the contigs with an ORF>300 bp and ~40% hits extending to the start codons of full length cDNAs suggesting successful characterization of camel genes. Similarity analyses are done separately for different organisms including human, mouse, bovine, and rat. Accompanying web portal, CAGBASE (http://camel.kacst.edu.sa/), hosts a relational database containing annotated EST sequences and analysis tools with possibility to add sequences from public domain. We anticipate our results to provide a home base for genomic studies of camel and other comparative studies enabling a starting point for whole genome sequencing of the organism

Sequencing, Analysis, and Annotation of Expressed Sequence Tags for \u3ci\u3eCamelus dromedarius\u3c/i\u3e

Despite its economical, cultural, and biological importance, there has not been a large scale sequencing project to date for Camelus dromedarius. With the goal of sequencing complete DNA of the organism, we first established and sequenced camel EST libraries, generating 70,272 reads. Following trimming, chimera check, repeat masking, cluster and assembly, we obtained 23,602 putative gene sequences, out of which over 4,500 potentially novel or fast evolving gene sequences do not carry any homology to other available genomes. Functional annotation of sequences with similarities in nucleotide and protein databases has been obtained using Gene Ontology classification. Comparison to available full length cDNA sequences and Open Reading Frame (ORF) analysis of camel sequences that exhibit homology to known genes show more than 80% of the contigs with an ORF\u3e300 bp and ~40% hits extending to the start codons of full length cDNAs suggesting successful characterization of camel genes. Similarity analyses are done separately for different organisms including human, mouse, bovine, and rat. Accompanying web portal, CAGBASE (http://camel.kacst.edu.sa/), hosts a relational database containing annotated EST sequences and analysis tools with possibility to add sequences from public domain. We anticipate our results to provide a home base for genomic studies of camel and other comparative studies enabling a starting point for whole genome sequencing of the organism

Head and Neck Surgery: A Differential Diagnosis in Otolaryngology

Introduction: In otolaryngology of the head and neck surgery; differential diagnosis is a practical and comprehensive guide that is organized uniquely by signs and symptoms instead of by diseases. Aim: This study will describe the keys to diagnostic evaluation and differential diagnosis of presenting symptoms for problems affecting each otolaryngology organ system.Methods: Each symptom opens with the patient’s presentation followed by an easily accessible list of potential diagnoses and supplementary data on the features of the different diseases to help correctly identify the problem. And identify features labeled by signs and symptoms, not by disease, and then enable quick clinical reference In-depth coverage of the diagnostic and treatment evaluation of all ENT disorders.

SARS-CoV-2 susceptibility and COVID-19 disease severity are associated with genetic variants affecting gene expression in a variety of tissues

Variability in SARS-CoV-2 susceptibility and COVID-19 disease severity between individuals is partly due to genetic factors. Here, we identify 4 genomic loci with suggestive associations for SARS-CoV-2 susceptibility and 19 for COVID-19 disease severity. Four of these 23 loci likely have an ethnicity-specific component. Genome-wide association study (GWAS) signals in 11 loci colocalize with expression quantitative trait loci (eQTLs) associated with the expression of 20 genes in 62 tissues/cell types (range: 1:43 tissues/gene), including lung, brain, heart, muscle, and skin as well as the digestive system and immune system. We perform genetic fine mapping to compute 99% credible SNP sets, which identify 10 GWAS loci that have eight or fewer SNPs in the credible set, including three loci with one single likely causal SNP. Our study suggests that the diverse symptoms and disease severity of COVID-19 observed between individuals is associated with variants across the genome, affecting gene expression levels in a wide variety of tissue types

A first update on mapping the human genetic architecture of COVID-19

peer reviewe

Parental Attitudes and Beliefs toward Attention Deficit Hyperactivity Disorder in Prince Sultan Military Medical City, Riyadh City

The present study was designed to investigate attitudes and beliefs among parents of patients with attention deficit hyperactivity disorder (ADHD), with regard to symptoms, causes, prognosis, and management. The study was of a cross-sectional descriptive design including 283 parents of patients with ADHD (preschool, primary school, and adolescent). It was conducted at child and adolescent outpatient clinics in Prince Sultan Military Medical City, Riyadh to assess parents’ knowledge, attitudes, treatments, and beliefs regarding ADHD. Among 283 parents, 59.8% believed that diet could improve ADHD symptoms. Approximately 75% of parents believed that ADHD is a form of misbehavior rather than a neurodevelopmental disorder, whereas 55.6% believed that ADHD is a genetic disease. In total, 89% of parents wanted to treat their children by receiving specialist advice and recommendations. A significant and nonsignificant correlation between gender and preschool and primary school was recorded, respectively. However, a positive correlation was recorded between age and caregiver’s education in adolescents. Since parents’ attitudes and perceptions were poor overall, the mismanagement of ADHD was noticed. Furthermore, government-level media campaigns should be implemented to enhance parents’ knowledge and debunk myths in order to improve ADHD management

Inferior vena caval filters: 5 years of experience in a tertiary care center

<b>Background and Objectives</b> : Interruption of the Inferior Vena Cava (IVC) is recommended in certain cases to prevent Pulmonary Embolism (PE). Reported data on the efficacy and rate of complications vary considerably. <b> Patients and Methods</b> : We conducted a retrospective analysis of patients who had a temporary or permanent IVC filter inserted at our institution during the past 5 years. <b> Results</b> : Seventy-seven of 225 patients (34&#x0025;) with Venous Thrombosis (VT) had an IVC filter inserted. Deep vein thrombosis and PE were the most common causes for anticoagulation. Bleeding was the reason for IVC filter insertion in 48 (62&#x0025;). The only complication found was the breaking of a temporary filter during removal related to the procedure. However, 3 patients (out of 10) had a recurrence of VT after prolonged discontinuation of anticoagulation. <b>Conclusions</b> : Our criteria for indication of IVC filter insertion are in line with current standard of care. The immediate and delayed complications caused by IVC filter insertion was low. Active bleeding was the most common indication for filter insertion, whereas inherited thrombophilia was relatively common

Risk Factors for Ischaemic Stroke in an Omani Community: A case-control study

Objectives: Stroke is recognised as the third most common cause of mortality and it has an increasing incidence in developing countries. Recognition and control of risk factors are of prime importance in the prevention of stroke. This study aimed to examine the characteristics of ischaemic stroke (IS) patients in Oman and quantify its various risk factors using a case-control model. Methods: This case-control study was conducted from January 2012 to March 2013 at Sultan Qaboos University Hospital and Royal Hospital, Muscat. Adult Omani patients with IS who were admitted to either hospital were compared to age- and gender-matched controls. Demographic factors and frequency of various conventional risk factors were documented. Univariate and stepwise multivariate logistic regression analyses were performed to evaluate the risk factors associated with IS. Results: A total of 255 patients and age-and gender-matched controls were included in this study. The mean age was 62.2 ± 13.2 years and 63.14% were male. Most cases (89.02%) were above 45 years of age. Cardio-embolism (31.76%) was the commonest mechanism of IS. Stepwise multiple logistic regression model revealed that family history of stroke was the strongest independent risk factor, followed by hypertension and high-density lipoprotein levels (odds ratio: 10.10, 5.17 and 3.34, respectively; P &lt;0.01 each). Conclusion: Cardio-embolism was the predominant mechanism of IS in this study. Family history of stroke, hypertension and reduced high-density lipoprotein were the leading independent risk factors. Strong emphasis on screening for risk factors, control of hypertension and lifestyle modification for those with a family history of stroke would be expected to emerge as the major stroke-preventive measures in Oman. Keywords: Ischemic Stroke; Risk Factors; Case-Control Study; Oman