Dietary Patterns of Females with Cholecystolithiasis: A Comprehensive Study from Central Region of Saudi Arabia

BACKGROUND: Cholecystolithiasis is a worldwide gastrointestinal disorder and dietary pattern is one of the major risk factors involved in formation of cholelithiasis. AIM: This study was undertaken to determine the dietary patterns of female patients with cholecystolithiasis in the central region of Saudi Arabia. METHODS: A total of 332 females respondents were included, among them 157 were cholecystolithiasis cases, whereas 175 were healthy female subjects. All respondents were from central region of Saudi Arabia. Data were collected from a self-administered questionnaire and dietary patterns of studied population samples were compared by Chi-square test using SPSS software. RESULTS: The data showed that the consumption of meat from beef, lamb or goat, butter, ghee, pizza, cereals, legumes, coffee, tea, kabsa rice, tomatoes, and eggs was found to be positively associated with the risk of cholelithiasis. Interestingly, the data also demonstrated that consumption of cakes, chocolates, cookies, ice cream, doughnuts, chicken, fish or other sea foods, French fries, and hot dogs showed no relation with the risk of cholelithiasis. CONCLUSIONS: This study provides a comprehensive description of the dietary patterns of females from central region of Saudi Arabia and their association with the risk of onset of cholelithiasis. Specifically, the majority of non-vegetarian food stuffs showed positive association with the risk of development of cholelithiasis. These findings strongly recommended that the Health Ministry of Saudi Arabia should initiate the specific intervention public health programs on the dietary pattern in relation with the risk of cholelithiasis

Investigating The Roles That G Protein-Coupled Receptor Kinase 2 Plays in Arterial Smooth Muscle Proliferation

Vascular smooth muscle cell (VSMC) proliferation plays a key role in the development of hypertensive vascular remodelling, a process strongly associated with increased circulating vasoconstrictor concentrations such as angiotensin-II (AngII), endothelin-1 (ET1) and uridine-5'-triphosphate (UTP), leading to continuous activation of their cognate Gαq-coupled/G protein-coupled receptors (GPCR). Furthermore, hypertension is associated with elevated G protein coupled receptor kinase 2 (GRK2) expression in arterial smooth muscle cells, which negatively regulates Gαq/GPCR signalling. Indeed, GRK2 has been shown to play a key role in cell growth and development of the cardiovascular system, and the regulation of cell cycle progression. Therefore this study aimed to investigate the potential roles that GRK2 plays in VSMC proliferation, and in particular on two signalling pathways that have been implicated in this process: mitogen activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) and phosphoinositide 3-kinase (PI3K)/Akt. Initial studies indicated that inhibition of MAPK/ERK and PI3K/Akt prevented VMSC growth stimulated by ET1 and AngII, while UTP did not stimulate proliferation. Similarly, GRK2 depletion or catalytic inhibition prevented ET1/AngII-stimulated VSMC proliferation. Furthermore, prolonged ET1 and AngII-stimulated ERK signalling was dependent on GRK2 expression and catalytic activity, whereas these treatments enhanced UTP-stimulated signals. Moreover, ET1-stimulated ERK signals were arrestin3-dependent, whilst AngII signals were arrestin2-dependent. Conversely, GRK2 expression but not its catalytic activity was essential to facilitate ET1 and AngII-stimulated PI3K/Akt signals, whereas UTP signals were unaffected. Interestingly, ET1/AngII-stimulated PI3K/Akt signalling was arrestin-independent. Similarly, ET1/AngII signalling to the Akt target GSK3 was ablated following GRK2 knockdown. Collectively, these data highlight two different molecular mechanisms underlying GRK2-mediated regulation of VSMC proliferation; with ERK-stimulated growth being dependent on GRK2 kinase activity and arrestin recruitment, and the other presumably utilizing GRK2 as a PI3K scaffold to facilitate efficient PI3K/Akt/GSK3 signalling. Thus, increased GRK2 expression in hypertension could be an underlying factor promoting long-term proliferative pathways and consequently, contribute to VSMC proliferation, vascular wall thickening, and hypertensive vascular remodelling.</div

Quality of Care and Quality of Life: Convergence or Divergence?

The aim of this study was to explore the impact of quality of care (QoC) on patients’ quality of life (QoL). In a cross-sectional study, two domains of QoC and the World Health Organization Quality of Life-Bref questionnaire were combined to collect data from 1,059 pre-discharge patients in four accredited hospitals (ACCHs) and four non-accredited hospitals (NACCHs) in Saudi Arabia. Health and well-being are often restricted to the characterization of sensory qualities in certain settings such as unrestricted access to healthcare, effective treatment, and social welfare. The patients admitted to tertiary health care facilities are generally able to present themselves with a holistic approach as to how they experience the impact of health policy. The statistical results indicated that patients reported a very limited correlation between QoC and QoL in both settings. The model established a positive, but ultimately weak and insignificant, association between QoC (access and effective treatment) and QoL ( r = 0.349, P = 0.000; r = 0.161, P = 0.000, respectively). Even though the two settings are theoretically different in terms of being able to conceptualize, adopt, and implement QoC, the outcomes from both settings demonstrated insignificant relationships with QoL as the results were quite similar. Though modern medicine has substantially improved QoL around the world, this paper proposes that health accreditation has a very limited impact on improving QoL. This paper raises awareness of this topic with multiple healthcare professionals who are interested in correlating QoC and QoL. Hopefully, it will stimulate further research from other professional groups that have new and different perspectives. Addressing a transitional health care system that is in the process of endorsing accreditation, investigating the experience of tertiary cases, and analyzing deviated data may limit the generalization of this study. Global interest in applying public health policy underlines the impact of such process on patients’ outcomes. As QoC accreditation does not automatically produce improved QoL outcomes, the proposed study encourages further investigation of the value of health accreditation on personal and social well-being

15. Sensitivity in visualizing vegetations in cardiac lead-induced endocarditis: A comparative study between transesophageal vs. transthoracic echocardiography

Despite advancement in sterile cardiac device implantation techniques, wound infections and/or bacteremia remain a significant problem. The presence of a vegetation in lead-induced endocarditis (LIE) is a critical factor that determines the management. Transthoracic (TTE) and Transesophageal (TEE) Echocardiography are two different cardiac modalities that are used for the detection of lead vegetation. However, it is not yet clear which of the two has the highest diagnostic accuracy. We aim to identify which of the two has the highest sensitivity. In addition, we aim to correlate the existence of a vegetation with blood and wound culture results. We conducted a chart review in 113 patients whom underwent lead extraction at Prince Sultan Cardiac Center in Saudi Arabia during the period of Jan, 2002 to Jul, 2015. Six patients underwent lead extraction twice, increasing the number to be a total of 119 cases. Out of the study cohort, we include 38 patients who had both TTE and TEE done prior to lead extraction. Data regarding TTE, TEE, as well as blood and wound cultures were collected from echocardiography and microbiology lab reports using a well-structured case report form.Of the study population, 21 patients (55.3%) had lead vegetations visualized either by TTE or TEE. Nineteen patients had vegetations detected by TEE, compared to 6 patients only when TTE was used. The sensitivity of TEE and TTE were 90.5% (CI: 69.6–98.8%) and 28.5% (95% CI: 11.3–52.1%), respectively. Blood and wound culture results showed that in the presence of a vegetation, blood cultures were positive in 55% of the cases (P=0.036) while only 44.4% of those with vegetations had a positive wound culture (P=0.347). TEE has higher sensitivity in detecting vegetations compared to TTE in LIE. The presence of a vegetation is more likely to be associated with a positive blood culture than a positive wound culture. Further studies ought to measure the accuracy of different modalities for capturing a vegetative lead. That is, measuring the additive value of blood and wound cultures to the overall cardiac imaging sensitivity, and to calculate the sensitivity of the combined techniques

Efficacy of patellar taping and electromyographic biofeedback training at various knee angles on quadriceps strength and functional performance in young adult male athletes with patellofemoral pain syndrome : a randomized controlled trial

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