Genetic studies of metabolic syndrome in Arab populations: A systematic review and meta-analysis

Background: The metabolic syndrome (MetS) is prevalent in Arabian populations. Several small-scale studies have been performed to investigate the genetic basis of MetS. This systematic review and meta-analysis aimed to examine whether candidate gene polymorphisms are associated with MetS susceptibility among ethnic groups of the Arabian world and to suggest possible directions for future research regarding genetic markers and MetS. Methods: A search was conducted for peer-reviewed articles that examined the genetic association of MetS in Arabian populations in the following databases: Medline, Embase, Scopus, Direct Science, Web of Science, ProQuest, and Google Scholar until March 31, 2021. Articles were eligible if they were case-control studies, which investigated MetS as a dichotomous outcome (MetS vs no MetS). To assess the quality of the studies, the Q-Genie tool (Quality of Genetic Association Studies) was used. A non-central chi2 (random-effect) distribution was used to determine the heterogeneity (H) of Q and I (Galassi et al., The American journal of medicine, 2006, 119, 812–819) statistics. Results: Our search strategy identified 36 studies that met our inclusion criteria. In most cases, studies were excluded due to a lack of statistical information such as odds ratios, confidence intervals, and p-values. According to the Q-Genie tool, 12 studies scored poorly (a score of ≤ 35), 13 studies scored moderately ( \u3e 35 and ≤ 45), and 12 studies had good quality ( \u3e 45 or higher). The most frequently studied genes were FTO and VDR (both included in four studies). Three SNPs indicated increased risk for MetS after calculating the pooled odds ratios: FTO-rs9939609 (odds ratio 1.49, 95% CI: 0.96–2.32); LEP-rs7799039 (odds ratio 1.85, 95% CI: 1.37–2.5); and SERPINA12-rs2236242 (odds ratio 1.65, 95% CI: 1.21–2.24). Meta-analysis studies showed no significant heterogeneity. Conclusion: There were many sources of heterogeneity in the study settings. Most of the studies had low to moderate quality because of sample size and power issues, not considering all potential sources of bias, and not providing details about genotyping methods and results. As most studies were small-scale, aimed to replicate findings from other populations, we did not find any unique genetic association between MetS and Arabian populations

CLINICAL PROFILE OF PATIENTS WITH SEPTICEMIA

OBJECTIVE: To evaluate the clinical profile of patients with septicemia. PATIENTS AND METHODS: This cross sectional case series study of six months was conducted at tertiary care teaching hospital Hyderabad. The admitted patients of age ≥18 years, either gender diagnosed as sepsis were recruited. The diagnosis of sepsis was made by the detail clinical history and examination and relevant investigations. The clinical parameters include fever, hypothermia or hyperthermia, tachycardia, tachypnea, leucocytosis or leucopenia, acute altered mental status, thrombocytopenia, hypotension. The etiological diagnosis requires isolation of pathogen from the blood or local site of infection. The Gram staining and culture of the specimen from the site of infection for microbial study was taken. Other relevant laboratory investigations depending upon the requirement were advised accordingly. RESULTS: During six months study period total fifty individuals with sepsis were recruited and studied for detecting the focus of infection. The mean age ±SD for whole population was 55.83±8.95 with male gender predominance 37 (74%). The male gender was predominant 37 (74%), Common co-morbidities observed were diabetes 7(14%), hypertension 5(10%) and chronic liver disease 3(6%). The common source of infection detected were respiratory infection 10(20%), urinary tract infection 8(16%) and wound infection 06(12%). Forty two (84%) patients were recovered while eight (16%) were expired. CONCLUSION: Respiratory and urinary tract infection and wound infections were the most common source of sepsis. KEYWORDS: Septicemia, Infections, Sepsi

Serial population-based serosurveys for COVID-19 in two neighbourhoods of Karachi, Pakistan

Objective: To determine population-based estimates of coronavirus disease 2019 (COVID-19) in a densely populated urban community of Karachi, Pakistan. Methods: Three cross-sectional surveys were conducted in April, June and August 2020 in low- and high-transmission neighbourhoods. Participants were selected at random to provide blood for Elecsys immunoassay for detection of anti-severe acute respiratory syndrome coronavirus-2 antibodies. A Bayesian regression model was used to estimate seroprevalence after adjusting for the demographic characteristics of each district. Results: In total, 3005 participants from 623 households were enrolled in this study. In Phase 2, adjusted seroprevalence was estimated as 8.7% [95% confidence interval (CI) 5.1-13.1] and 15.1% (95% CI 9.4-21.7) in low- and high-transmission areas, respectively, compared with 0.2% (95% CI 0-0.7) and 0.4% (95% CI 0-1.3) in Phase 1. In Phase 3, it was 12.8% (95% CI 8.3-17.7) and 21.5% (95% CI 15.6-28) in low- and high-transmission areas, respectively. The conditional risk of infection was 0.31 (95% CI 0.16-0.47) and 0.41 (95% CI 0.28-0.52) in low- and high-transmission neighbourhoods, respectively, in Phase 2. Similar trends were observed in Phase 3. Only 5.4% of participants who tested positive for COVID-19 were symptomatic. The infection fatality rate was 1.66%, 0.37% and 0.26% in Phases 1, 2 and 3, respectively. Conclusion: Continuing rounds of seroprevalence studies will help to improve understanding of secular trends and the extent of infection during the course of the pandemic. &nbsp;</p

Community-based seroprevalence of SARS CoV-2 in an urban district of Karachi, Pakistan

# Background Antibody-based serological tests which target households and communities can estimate the true extent of infection in a population. It minimizes the biases of facility-based selective testing and generates scientific data on disease transmission through household asymptomatic cases. The objective of this study was to determine the seroprevalence and trend of SARS-CoV-2 in a densely populated urban community of Karachi. # Methods Three serial cross-sectional surveys were conducted in November 2020, February 2021, and December 2021 in Karachi's District East. Households were selected to provide serum samples for Elecsys® immunoassay for the detection of SARS-CoV-2 antibodies. All household members were eligible to participate regardless of age and infection status. Bayesian regression was used to adjust for assay performance and estimate seroprevalence. # Results We enrolled 1506 participants from 501 households. In November 2020, adjusted seroprevalence was estimated as 24.0% (95% confidence interval, CI=18.0-31.0), compared to 53.9% (95% CI=45.5-63.2) in February. In December 2021, it increased to 84.9% (95% CI=78.5-92.3). The conditional risk of infection was 41% (95% CI=29.9-51.6), 56.7% (95% CI=50.4--62.6) and 77.8% (95% CI=73.0-81.7) in surveys 4, 5, and 6 respectively. Only 18.7% of participants who had reactive antibodies for COVID-19 were symptomatic. # Conclusions An increase in seroprevalence estimates in Karachi's District East was observed over time. Community-based seroprevalence studies help to estimate the true proportion of the population that has been infected and predicts the spread of the disease in similar settings

Genomics and Epigenomics of Gestational Diabetes Mellitus: Understanding the Molecular Pathways of the Disease Pathogenesis

One of the most common complications during pregnancy is gestational diabetes mellitus (GDM), hyperglycemia that occurs for the first time during pregnancy. The condition is multifactorial, caused by an interaction between genetic, epigenetic, and environmental factors. However, the underlying mechanisms responsible for its pathogenesis remain elusive. Moreover, in contrast to several common metabolic disorders, molecular research in GDM is lagging. It is important to recognize that GDM is still commonly diagnosed during the second trimester of pregnancy using the oral glucose tolerance test (OGGT), at a time when both a fetal and maternal pathophysiology is already present, demonstrating the increased blood glucose levels associated with exacerbated insulin resistance. Therefore, early detection of metabolic changes and associated epigenetic and genetic factors that can lead to an improved prediction of adverse pregnancy outcomes and future cardio-metabolic pathologies in GDM women and their children is imperative. Several genomic and epigenetic approaches have been used to identify the genes, genetic variants, metabolic pathways, and epigenetic modifications involved in GDM to determine its etiology. In this article, we explore these factors as well as how their functional effects may contribute to immediate and future pathologies in women with GDM and their offspring from birth to adulthood. We also discuss how these approaches contribute to the changes in different molecular pathways that contribute to the GDM pathogenesis, with a special focus on the development of insulin resistance

Genomics and Epigenomics of Gestational Diabetes Mellitus: Understanding the Molecular Pathways of the Disease Pathogenesis

One of the most common complications during pregnancy is gestational diabetes mellitus (GDM), hyperglycemia that occurs for the first time during pregnancy. The condition is multifactorial, caused by an interaction between genetic, epigenetic, and environmental factors. However, the underlying mechanisms responsible for its pathogenesis remain elusive. Moreover, in contrast to several common metabolic disorders, molecular research in GDM is lagging. It is important to recognize that GDM is still commonly diagnosed during the second trimester of pregnancy using the oral glucose tolerance test (OGGT), at a time when both a fetal and maternal pathophysiology is already present, demonstrating the increased blood glucose levels associated with exacerbated insulin resistance. Therefore, early detection of metabolic changes and associated epigenetic and genetic factors that can lead to an improved prediction of adverse pregnancy outcomes and future cardio-metabolic pathologies in GDM women and their children is imperative. Several genomic and epigenetic approaches have been used to identify the genes, genetic variants, metabolic pathways, and epigenetic modifications involved in GDM to determine its etiology. In this article, we explore these factors as well as how their functional effects may contribute to immediate and future pathologies in women with GDM and their offspring from birth to adulthood. We also discuss how these approaches contribute to the changes in different molecular pathways that contribute to the GDM pathogenesis, with a special focus on the development of insulin resistance

Secondary attack rates and determinants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) household transmission in Pakistan: A case-ascertained prospective, longitudinal study

Background: Households are considered ideal settings for studying the transmission dynamics of an infectious disease. Methods: A prospective study was conducted, based on the World Health Organization FFX protocol from October 2020 to January,2021. Household contacts of laboratory-confirmed index cases were followed up for their symptomatic history, nasal swabs for RT-PCR,and blood samples for anti-SARS CoV-2 antibodies were collected at enrollment and days 7, 14 and 28. We estimated secondary attack rate (SAR), effective household case cluster size and determinants of secondary infection among susceptible household contacts using multivariable logistic regression. Results: We enrolled 77 index cases and their 543 contacts. Out of these, 252 contacts were susceptible at the time of enrollment. There were 77 household clusters, out of which, transmission took place in 20 (25.9%) giving rise to 34 cases. The acquired secondary attack rate (SAR) was 14.0% (95% CI 9.0–18.0). The effective household case cluster size was 0.46 (95%CI 0.33,0.56). Reported symptoms of nausea and vomiting (aOR, 7.9; 95% CI, 1.4–45.5) and fatigue (aOR, 9.3; 95% CI, 3.8–22.7) were associated with SARS-CoV-2 transmission. Conclusions: We observed a low SARS-CoV-2 secondary attack rate in the backdrop of high seroprevalence and asymptomatic transmission among households in Karachi, Pakistan