Prevalence of Chronic Kidney Diseases in Patients with Diabetes Mellitus in the Middle East: A Systematic Review and Meta-Analysis

Aims. The prevalence of CKD in patients with diabetes mellitus in the Middle East region is unknown. Therefore, we aimed to understand the pooled prevalence of CKD in patients with diabetes mellitus in the Middle East region. Methods. PubMed, Embase, and Cochrane databases were searched for relevant studies up to October 2020. The search strategy was conducted using both keywords and MeSH terms. Randomised controlled trials (RCTs) and observational studies that included patients from all age groups and any study design that reported on the prevalence of CKD in patients with diabetes mellitus were included. The pooled estimate for the prevalence of CKD in patients with diabetes was calculated using random-effect models with 95% confidence intervals (CIs). Results. A total of 489 citations were identified, of which only nine studies matched our inclusion criteria and were included in the meta-analysis. All of the studies used an observational study design covering a total of 59,395 patients with type 2 diabetes mellitus. The pooled estimate of the prevalence of CKD in patients with diabetes mellitus was 28.96% (95% CI: 19.80–38.11). Conclusions. A high prevalence of CKD in patients with diabetes mellitus in the Middle East region was found. Further epidemiological studies are warranted in this area to have a better estimate of the prevalence of CKD among DM in the Middle East region

Hospital admission trends due to respiratory diseases in England and Wales between 1999 and 2019: an ecologic study

BACKGROUND: Identifying trends of hospital admissions for respiratory diseases is crucial for public health and research to guide future clinical improvements for better outcomes. This study aims to define the trends of respiratory disease-related hospital admissions (RRHA) in England and Wales between 1999 and 2019. METHODS: An ecological study was conducted using hospital admission data taken from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Hospital admissions data for respiratory diseases were extracted for the period between April 1999 and March 2019. The trend in hospital admissions was assessed using a Poisson model. RESULTS: Hospital admission rate increased by 104.7% [from 1535.05 (95% CI 1531.71–1538.38) in 1999 to 3142.83 (95% CI 3138.39–3147.26) in 2019 per 100,000 persons, trend test, p < 0.01]. The most common causes were influenza and pneumonia, chronic lower respiratory diseases, other acute lower respiratory infections, which accounted for 26.6%, 26.4%, and 14.9%, respectively. The age group 75 years and above accounted for 34.1% of the total number of hospital admissions. Males contributed to 50.5% of the total number of hospital admissions. Hospital admission rate in females increased by 119.8% [from 1442.18 (95% CI 1437.66–1446.70) in 1999 to 3169.38 (95% CI 3163.11–3175.64) in 2019 per 100,000 persons, trend test, p < 0.001]. Hospital admission rate increased by 92.9% in males [from 1633.25 (95% CI 1628.32–1638.17) in 1999 to 3149.78 (95% CI 3143.46–3156.09) in 2019 per 100,000 persons, trend test, p < 0.001]. CONCLUSION: During the study period, hospital admissions rate due to respiratory diseases increased sharply. The rates of hospital admissions were higher among males for the vast majority of respiratory diseases. Further observational studies are warranted to identify risk factors for these hospital admissions and to offer relevant interventions to mitigate the risk

Hospital Admissions Due to Ischemic Heart Diseases and Prescriptions of Cardiovascular Diseases Medications in England and Wales in the Past Two Decades

Objectives: The aim of this study was to explore the trend of ischemic heart disease (IHD) admission and the prescriptions of IHD medications in England and Wales. Methods: A secular trends study was conducted during the period of 1999 to 2019. We extracted hospital admission data for patients from all age groups from the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. Prescriptions of IHD medications were extracted from the Prescription Cost Analysis database from 2004 to 2019. The chi-squared test was used to assess the difference between the admission rates and the difference between IHD medication prescription rates. The trends in IHD-related hospital admission and IHD-related medication prescription were assessed using a Poisson model. The correlation between hospital admissions for IHD and its IHD medication-related prescriptions was assessed using the Pearson correlation coefficient. Results: Our study detected a significant increase in the rate of cardiovascular disease (CVD) medication prescriptions in England and Wales, representing a rise in the CVD medications prescription rate of 41.8% (from 539,334.95 (95% CI = 539,286.30–539,383.59) in 2004 to 764,584.55 (95% CI = 764,545.55–764,623.56) in 2019 prescriptions per 100,000 persons), with a mean increase of 2.8% per year during the past 15 years. This increase was connected with a reduction in the IHD hospital admission rate by 15.4% (from 838.50 (95% CI = 836.05–840.94) in 2004 to 709.78 (95% CI = 707.65–711.92) in 2019 per 100,000 persons, trend test, p < 0.01), with a mean decrease of 1.02% per year during the past 15 years and by 5% (from 747.43 (95% CI = 745.09–749.77) in 1999 to 709.78 (95% CI = 707.65–711.92) in 2019 per 100,000 persons, trend test, p < 0.01) with a mean decrease of 0.25% per year during the past two decades in England and Wales. Conclusion: The rate of hospitalisation due to IHD has decreased in England and Wales during the past two decades. Hospitalisation due to IHD was strongly and negatively correlated with the increase in the rates of dispensing of IHD-related medications. Other factors contributing to this decline could be the increase in controlling IHD risk factors during the past few years. Future studies exploring other risk factors that are associated with IHD hospitalisation are warranted

Public Attitudes Towards Lung Cancer Screening in Saudi Arabia: A Cross-Sectional Study

Mohammad S Dairi, Basem Bahakeem Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi ArabiaCorrespondence: Mohammad S Dairi, Department of Medicine, College of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia, Tel +966555501560, Email [email protected]: Lung cancer is one of the leading causes of death worldwide, and it is ranked as the first cause of death in more than 100 countries around the world. The aim of this study was to explore the knowledge and attitude of the general population in Saudi Arabia toward lung cancer screening.Methods: A cross-sectional study employing an online survey was conducted between November 2021 and February 2022 in Saudi Arabia. This study utilized a previously developed questionnaire instrument. Logistic regression was used to identify predictors of positive attitude toward lung cancer screening.Results: A total of 473 participants were involved in this study. The majority of the study participants (74.6%) reported that they are current smokers. Almost 31.5% of the study participants reported that if lung cancer is detected early, the person’s chance of surviving is poor to very poor. The majority of the study participants reported that they would be willing to do tests to diagnose lung cancer if you were invited by the Ministry of Health or their doctor. Males, participants aged (24– 34 years), and current smokers were more likely to have positive attitude towards lung cancer screening (p ≤ 0.05). On the other hand, patients aged 46 years and over and those with higher education had less positive attitude towards lung cancer screening (p ≤ 0.05).Conclusion: This is the first study to look into the general public’s attitudes toward lung cancer screening in Saudi Arabia. According to our findings, the majority of people believe that early detection of lung cancer can lead to improved results and have a favourable attitude toward lung cancer screening if it is indicated. Thus, incorporating lung cancer screening into the local guidelines in at-risk population is highly recommended and considering the launch of nation-wide lung cancer screening program is advised.Keywords: cancer, lung, screening, smoker

A peptide ligase and the ribosome cooperate to synthesize the peptide pheganomycin

Peptide antibiotics are typically biosynthesized by one of two distinct machineries in a ribosome-dependent or ribosome-independent manner. Pheganomycin (PGM (1)) and related analogs consist of the nonproteinogenic amino acid (S)-2-(3,5-dihydroxy-4-hydroxymethyl)phenyl-2-guanidinoacetic acid (2) and a proteinogenic core peptide, making their origin uncertain. We report the identification of the biosynthetic gene cluster from Streptomyces cirratus responsible for PGM production. Unexpectedly, the cluster contains a gene encoding multiple precursor peptides along with several genes plausibly encoding enzymes for the synthesis of amino acid 2. We identified PGM1, which has an ATP-grasp domain, as potentially capable of linking the precursor peptides with 2, and validate this hypothesis using deletion mutants and in vitro reconstitution. We document PGM1's substrate permissivity, which could be rationalized by a large binding pocket as confirmed via structural and mutagenesis experiments. This is to our knowledge the first example of cooperative peptide synthesis achieved by ribosomes and peptide ligases using a peptide nucleophile

De Novo Truncating Variants in ASXL2 Are Associated with a Unique and Recognizable Clinical Phenotype

The ASXL genes (ASXL1, ASXL2, and ASXL3) participate in body patterning during embryogenesis and encode proteins involved in epigenetic regulation and assembly of transcription factors to specific genomic loci. Germline de novo truncating variants in ASXL1 and ASXL3 have been respectively implicated in causing Bohring-Opitz and Bainbridge-Ropers syndromes, which result in overlapping features of severe intellectual disability and dysmorphic features. ASXL2 has not yet been associated with a human Mendelian disorder. In this study, we performed whole-exome sequencing in six unrelated probands with developmental delay, macrocephaly, and dysmorphic features. All six had de novo truncating variants in ASXL2. A careful review enabled the recognition of a specific phenotype consisting of macrocephaly, prominent eyes, arched eyebrows, hypertelorism, a glabellar nevus flammeus, neonatal feeding difficulties, hypotonia, and developmental disabilities. Although overlapping features with Bohring-Opitz and Bainbridge-Ropers syndromes exist, features that distinguish the ASXL2-associated condition from ASXL1- and ASXL3-related disorders are macrocephaly, absence of growth retardation, and more variability in the degree of intellectual disabilities. We were also able to demonstrate with mRNA studies that these variants are likely to exert a dominant-negative effect, given that both alleles are expressed in blood and the mutated ASXL2 transcripts escape nonsense-mediated decay. In conclusion, de novo truncating variants in ASXL2 underlie a neurodevelopmental syndrome with a clinically recognizable phenotype. This report expands the germline disorders that are linked to the ASXL genes