Quality of Type 2 Diabetes Management in the States of The Co-Operation Council for the Arab States of the Gulf: A Systematic Review

Type 2 diabetes mellitus is a growing, worldwide public health concern. Recent growth has been particularly dramatic in the states of The Co-operation Council for the Arab States of the Gulf (GCC), and these and other developing economies are at particular risk. We aimed to systematically review the quality of control of type 2 diabetes in the GCC, and the nature and efficacy of interventions. We identified 27 published studies for review. Studies were identified by systematic database searches. Medline and Embase were searched separately (via Dialog and Ovid, respectively; 1950 to July 2010 (Medline), and 1947 to July 2010 (Embase)) on 15/07/2009. The search was updated on 08/07/2010. Terms such as diabetes mellitus, non-insulin-dependent, hyperglycemia, hypertension, hyperlipidemia and Gulf States were used. Our search also included scanning reference lists, contacting experts and hand-searching key journals. Studies were judged against pre-determined inclusion/exclusion criteria, and where suitable for inclusion, data extraction/quality assessment was achieved using a specifically-designed tool. All studies wherein glycaemic-, blood pressure- and/or lipid- control were investigated (clinical and/or process outcomes) were eligible for inclusion. No limitations on publication type, publication status, study design or language of publication were imposed. We found the extent of control to be sub-optimal and relatively poor. Assessment of the efficacy of interventions was difficult due to lack of data, but suggestive that more widespread and controlled trial of secondary prevention strategies may have beneficial outcomes. We found no record of audited implementation of primary preventative strategies and anticipate that controlled trial of such strategies would also be useful

Chemoattractant Receptor Homologous to the T Helper 2 Cell (CRTH2) Is Not Expressed in Human Amniocytes and Myocytes

BACKGROUND: 15-deoxy-Δ 12,14- Prostaglandin J2 (15dPGJ2) inhibits Nuclear factor kappa B (NF-κB) in human myocytes and amniocytes and delays inflammation induced preterm labour in the mouse. 15dPGJ2 is a ligand for the Chemoattractant Receptor Homologous to the T helper 2 cell (CRTH2), a G protein-coupled receptor, present on a subset of T helper 2 (Th2) cells, eosinophils and basophils. It is the second receptor for Prostaglandin D2, whose activation leads to chemotaxis and the production of Th2-type interleukins. The cellular distribution of CRTH2 in non-immune cells has not been extensively researched, and its identification at the protein level has been limited by the lack of specific antibodies. In this study we explored the possibility that CRTH2 plays a role in 15dPGJ2-mediated inhibition of NF-κB and would therefore represent a novel small molecule therapeutic target for the prevention of inflammation induced preterm labour. METHODS: The effect of a small molecule CRTH2 agonist on NF-κB activity in human cultured amniocytes and myocytes was assessed by detection of p65 and phospho-p65 by immunoblot. Endogenous CRTH2 expression in amniocytes, myocytes and peripheral blood mononuclear cells (PBMCs) was examined by PCR, western analysis and flow cytometry, with amniocytes and myocytes transfected with CRTH2 acting as a positive control in flow cytometry studies. RESULTS: The CRTH2 agonist had no effect on NF-κB activity in amniocytes and myocytes. Although CRTH2 mRNA was detected in amniocytes and myocytes, CRTH2 was not detectable at the protein level, as demonstrated by western analysis and flow cytometry. 15dPGJ2 inhibited phospho-65 in PBMC'S, however the CRTH2 antagonist was not able to attenuate this effect. In conclusion, CRTH2 is not expressed on human amniocytes or myocytes and plays no role in the mechanism of 15dPGJ2-mediated inhibition of NF-κB

An exploration into the impact of exposure to community violence and hope on children's perceptions of well-being: a South African perspective

The study aims to explore the relationship between exposure to community violence, hope, and well-being. More specifically, the study aims to ascertain whether hope is a stronger predictor of well-being than exposure to violence. Stratified random sampling was used to select a sample of 566 adolescents aged 14–17 years, from both high violence and low violence areas in Cape Town, South Africa. A questionnaire consisting of Snyder’s Children’s Hope Scale, the Recent Exposure to Violence Scale and the KIDSCREEN-52 was used. Data analysis techniques included descriptive statistics, correlations, and multiple regression. A positive, significant relationship was found between children’s hope and their well-being. Although exposure to community violence was found to be significantly correlated with wellbeing, the relationship was negligible.While exposure to community violence and hope were found to be significant predictors of well-being, hope emerged as a stronger predictor of child well-being than exposure to community violence.Department of HE and Training approved lis

Validation of the children’s hope scale amongst a sample of adolescents in the Western Cape Region of South Africa

A growing body of research has provided evidence for the cognitive-motivational construct of hope as a psychological strength, particularly for adolescents confronted with ensuing adverse conditions. Given the dearth of research on hope in South Africa, the aim of the current study was to validate Snyder’s Children’s Hope Scale within this context. A cross sectional survey design was used to collect data from a sample of 1022 adolescents between the ages of 13 and 16 (449 males and 573 females) attending high schools within the Western Cape geographical region of South Africa. The sample was selected using a two-stage stratified random sampling protocol, with socio-economic status (low, medium and high) as the defining variable. Data were collected using Snyder’s (1997) Children’s Hope Scale which was adapted to the South African context and translated into Afrikaans. Confirmatory factor analysis was used to analyse the data. The results indicate good fit indices for the overall model with two error co-variances (x2 =35.692; df=7; p=0.00; CFI=0.984; RMSEA=0.063; SRMR=0.023). Multi-group analysis with constrained factor loadings and intercepts show good fit across socio-economic status groups which indicate that these groups can be compared by correlations, regressions and means. The overall findings suggest that the Children’s Hope Scale is an appropriate measure for use in the South African context

ICAR: endoscopic skull‐base surgery

n/

Lipoprotein Lipase mRNA expression in different tissues of farm animals

Lipoprotein lipase (LPL) controls triacylglycerol partitioning betweenadipose tissues and muscles, so it is important enzyme for fattening ofanimals .The present work was planned to clarify the use ofpolymerase chain reaction (PCR) for detection of LPL mRNAexpression in different tissues representing internal organs of maleFriesian cows. The obtained results revealed that, LPL mRNA wasexpressed in all tested tissues, and the highest expression wasencountered in testis (1.03). The expression in heart, liver, kidney,adrenal gland, spleen were 0.92, 0.77, 0.76, 0.73, and 0.70respectively .The lowest expression was found in adipose tissue (0.64)It could be concluded from the present study that, expression of LPLmRNA differs according to the type of tissue. The highest expressionwas found in testis which may confirm the role of LPL in the processof spermatogenesis

Effect of zinc supplementation on body mass index and serum levels of zinc and leptin in pediatric hemodialysis patients

Ahmed Nabih El-Shazly,1 Soha Abd El-Hady Ibrahim,1 Ghada Mohamed El-Mashad,2 Jehan H Sabry,3 Nashwa Said Sherbini11Department of Pediatrics, Faculty of Medicine, Benha University, Banha, 2Department of Pediatrics, Faculty of Medicine, Menoufia University, Shibin Al Kawm, 3Department of Clinical and Chemical Pathology, Faculty of Medicine, Benha University, Banha, Egypt Introduction: Zinc is an essential trace element for human nutrition, and its deficiency is associated with anorexia, poor food efficiency, growth retardation, and impaired neurological and immune systems. The zinc-deficiency rate is particularly high in many disease states, such as with end-stage renal disease patients undertaking hemodialysis. The aim of this study was to determine the effect of zinc supplementation on body mass index (BMI) and serum levels of zinc and leptin in pediatric hemodialysis patients. Patients and methods: This was a prospective clinical trial study in which 60 hemodialysis patients were randomly divided into two groups: group I received 50–100 mg zinc sulfate (equivalent to 11–22 mg elemental zinc) according to age, sex, and nutritional status of the child; and group II received placebo (cornstarch) twice daily for 90 days. Anthropometric measurements were taken, and serum zinc and leptin levels were determined by colorimetric test with 5-Br-3'-phosphoadenosine-5'-phosphosulfate and enzyme-linked immunosorbent assay, respectively, at days 0 and 90 of the study. Results: Zinc supplementation resulted in a significant increase in mean serum zinc level and BMI. Serum leptin decreased significantly after supplementation in children under hemodialysis. A significant negative correlation was observed between serum zinc and leptin levels as a result of zinc supplementation. Conclusion: There was an increase in serum zinc level and BMI and decreased serum leptin after zinc supplementation in children under hemodialysis. Keywords: serum zinc, serum leptin, hemodialysis, body weigh

Visual Hallucinations following Coronary Artery Bypass Grafting: A Prospective Study

Background and Objectives: After major heart surgery, some patients report visual hallucinations that cannot be attributed to psychosis or delirium. This study aimed to investigate the hallucination incidence in patients after coronary artery bypass grafting with (on-pump) and without (off-pump) extracorporeal circulation. Materials and Methods: A total of 184 consecutive patients listed for elective on- or off-pump coronary artery bypass grafting were prospectively enrolled into the study. Preoperative baseline investigations 24–48 h before surgery (t0) and postoperative follow-up 24–48 h (t1) and 5–6 days (t2) after surgery included cognitive testing and a clinical visual acuity test (Landolt rings). Patients reporting visual hallucinations were interviewed using a structured survey to record the type, timing, duration, and frequency of their hallucinations. All the patients received a neurological examination and cranial magnetic resonance imaging if indicated. Results: Of the patients in the sample, 155 patients underwent on-pump bypass surgery, and 29 patients received off-pump surgery. Of these, 25 patients in the on-pump group, but none in the off-pump group, reported transient visual hallucinations (p = 0.020), which could not be attributed to stroke, delirium, psychosis, migraine, or severely impaired vision. Significant correlations were observed for the occurrence of visual hallucinations and the amount of nicotine consumption and aortic clamp/extracorporeal circulation time. Conclusions: Transient visual hallucinations occur in a noticeable proportion of patients after on-pump heart surgery. Knowledge of the phenomenon’s benignity is important for patients to prevent anxiety and uncertainty and for treating physicians to avoid unnecessary medication and drug-induced delirium