Asthma diagnosis and treatment - 1012. The efficacy of budesonide in the treatmetn of acute asthma in children: a double-blind, randomized, controlled trial.

Background Current evidence suggests that inhaled glucocorticoids (IGC) have a more profound topical none genomic effect on bronchial airways as compared to systemic glucocorticoids. The value of adding IGC to current therapy of acute asthma is not well established. Methods We conducted a double-blind, randomized, two-arm, parallel groups, controlled clinical trial to compare the addition of budesonide 1500 mcg or placebo (normal saline) to standard acute asthma treatment (albuterol and ipratropium bromide) administered in 3 divided mixed doses within 1 hour in the emergency department (ED). Children 2-12 years of age with moderate or severe acute asthma, scoring 8-15/15 on a well-validated scoring system were included. Both groups received a single dose of prednisone 2 mg/kg/day (max. 60 mg) at the beginning of therapy. The primary outcome was admission rate within 2-4 hours from starting therapy. Results A total of 723 children were enrolled in the study over 17 months duration, of whom 139 were allowed to re-enroll and be randomized to constitute 906 randomization assignments (458 on the treatment group and 448 on the control group); with baseline mean + SD asthma score of 10.63 + 1.73; age 5.52 + 2.76 years; 35% girls; 30.8% (16.5%) with baseline severe asthma score of ≥12 (≥ 13). Statistical Analysis plan allowed for the potential dependency in response due to reenrollments of a subset of children, using Generalized Linear Mixed Modeling (GLMM) techniques. Baseline demographic and clinical characteristics were not significantly different between the two randomized groups. Seventy-five out of 458 (16.4%) of the treatment group vs. 82/448 (18.3%) of the control group were admitted, (OR 0.85, CI: 0.59-1.23, p-value=0.39). Among the severe asthmatics with baseline score ≥13, treatment vs. placebo group, GLMM adjusted admission rate was 30% vs. 47%, indicating a 17% difference in admission rate in favor of the treatment group (adjusted OR of 0.49, CI: 0.25-0.95; p-value= 0.035) that indicated a 51% reduction in the risk of admission for the treatment vs. control group. Conclusions Children with baseline severe asthma score ≥13 who were treated with budesonide had a significant reduction in their admission rate

Applications of Soft Sets in -Algebras

In 1999, Molodtsov introduced the concept of soft set theory as a general mathematical tool for dealing with uncertainty and vagueness. In this paper, we apply the concept of soft sets to K-algebras and investigate some properties of Abelian soft K-algebras. We also introduce the concept of soft intersection K-algebras and investigate some of their properties

Analysis of SNPs of MC4R , GNB3 and FTO gene polymorphism in obese Saudi subjects

Background: The goal of this study was to analyze the association between the FTO rs17817449 (G>T), G protein beta3 subunit (GNB3) C825T and Melanocortin 4 receptor (MC4R) A822G single nucleotide  olymorphism (SNP) with obesity in Saudi subjects.Methods: The subjects were divided into 2 groups according to BMI: Obese (BMI> 29.9) and non- obese control (BMI<24.9). Genotyping of the target genes were determined by polymerase chain reaction (PCR) followed by restriction fragment length polymorphism analysis (RFLP).Results: We demonstrated the association of the FTO genotype TT with increased weight, BMI and leptin levels in both males and females. However, there was no association of genotype TT with fasting blood glucose, triglycerides and cholesterol levels. Regarding GNB3 rs5443 polymorphism, the likelihood of obesity was linked to the TT genotype which was also associated with increased leptin levels. On the other hand, the SNP of MC4R A822G did not exhibit any significant association with obesity among studied subjects and showed only the presence of homozygous AA genotype.Conclusion: The polymorphism of FTO gene rs17817449 and GNB3 gene rs5443 (C825T) may be a genetic determinant of obesity in Saudi population whereas impact of MC4R Asn274Ser change could not be detected.Keywords: Obesity, FTO gene-polymorphism

Aberrant right subclavian artery in a cadaver: a case report of an aortic arch anomaly

In early embryogenesis, aortic anomalies occur as a consequence of disorders in the development of the primitive aortic arches system. Aberrant right subclavian artery, also known as arteria lusoria, is one of the important congenital anomalies of the aortic arch, in which the right subclavian artery arises from the arch of aorta instead of the brachiocephalic trunk. During routine dissection of a female cadaver, we observed retro-oesophageal aberrant right subclavian artery arising as the fourth branch from the aortic arch. In this case, the brachiocephalic trunk was absent. Early detection of aortic arch anomalies through diagnostic interventions is helpful to avoid complications during surgical procedures

PROPOLIS AND BEE VENOM IN DIABETIC WOUNDS; A POTENTIAL APPROACH THAT WARRANTS CLINICAL INVESTIGATION

Background: Wound healing in diabetes mellitus is a complex multi-stage process that requires the proper function of multiple systems. The mechanisms of impaired wound healing of diabetic wounds are still poorly understood. Therefore, various interventions are being used for wound management without great success. Bee products have various properties that make them an important addition to the diabetic wound management. Methods: This review summarized previous and recently published papers of the effects of two bee products, propolis and bee venom, on the wound healing. The main results were obtained from preclinical experimentation. Results: Diabetes mellitus compromises immune system, increases infections, impairs wound healing, and affects cells and factors involved in the wound healing. There is an increasing interest in natural products in modern medicine as part of disease management. Bee products are natural substances that others and we have explored some of their biological activities and applications in the treatment of various diseases. Some of these products are bee venom and propolis. These products have analgesic, antioxidant, antimicrobial, and anti-inflammatory properties. In addition, both propolis and bee venom contain considerable amounts of antioxidants that have a great role in accelerating wound healing. Conclusion: There is sound rationality and scientific data for using propolis and bee venom in diabetic wound healing. We believe that topical application of propolis in addition to bee venom might have a place in repairing damaged tissues and accelerating the healing of diabetic wounds

First data on chigger mites (Acariformes: Trombiculidae) of Saudi Arabia, with a description of four new species

A collection of chigger mites from three species of rodents in the ꞌAsir Region of Saudi Arabia resulted in the finding of 19 species. Four new species are described: Schoutedenichia asirensis sp. nov., Schoutedenichia saudi sp. nov., Microtrombicula microscuta sp. nov., and Microtrombicula muhaylensis sp. nov. Fifteen species – Gahrliepia lawrencei Jadin and Vercammen-Grandjean, 1952, Schoengastiella wansoni Wolfs and Vercammen-Grandjean, Walchia parvula Schluger, Ascoschoengastia browni Taufflieb, Mouchet and Courtois, Helenicula lukshumiae Nadchatram and Traub, Schoutedenichia thracica Kolebinova, Schoutedenichia zarudnyi Kudryashova, Ericotrombidium caucasicum (Schluger), Ericotrombidium galliardi (Vercammen-Grandjean and Taufflieb), Ericotrombidium kazeruni (Kudryashova), Microtrombicula centropi (Vercammen-Grandjean), Microtrombicula hoogstraali (Radford), Microtrombicula hyracis (Vercammen-Grandjean), Microtrombicula traubi (Muljarskaja and Verdieva), and Pentidionis agamae (André) – are for the first time recorded in Saudi Arabia and on new host species. Six of them are for the first time recorded outside their type localities and five were only known previously from the African continent.</jats:p

A systematic review and meta-analysis of heart rate variability in COPD

Background: Chronic obstructive pulmonary disease (COPD) is associated with disruption in autonomic nervous control of the heart rhythm. We present here quantitative evidence of the reduction in HRV measures as well as the challenges to clinical application of HRV in COPD clinics. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we search in June 2022 Medline and Embase databases for studies reporting HRV in COPD patients using relevant medical subject headings (MeSH) terms. The quality of included studies was assessed using the modified version of the Newcastle–Ottawa Scale (NOS). Descriptive data were extracted, while standardized mean difference was computed for changes in HRV due to COPD. Leave-one-out sensitivity test was performed to assess exaggerated effect size and funnel plots to assess publication bias. Results: The databases search yielded 512 studies, of which we included 27 that met the inclusion criteria. The majority of the studies (73%) had a low risk of bias and included a total of 839 COPD patients. Although there were high between-studies heterogeneity, HRV time and frequency domains were significantly reduced in COPD patients compared with controls. Sensitivity test showed no exaggerated effect sizes and the funnel plot showed general low publication bias. Conclusion: COPD is associated with autonomic nervous dysfunction as measured by HRV. Both sympathetic and parasympathetic cardiac modulation were decreased, but there is still a predominance of sympathetic activity. There is high variability in the HRV measurement methodology, which affects clinical applicability