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

Ross operation in children and young adults: the Alder Hey case series

BACKGROUND: The ideal prosthesis for aortic valve replacement in children and young adults has not been found yet. In recent years there has been a renewed interest in the replacement of aortic valve with the pulmonary autograft owing to its advantages of lack of anticoagulation, potential for growth and excellent haemodynamic performance. The purpose of this study was to review our institutional experience at Alder Hey hospital with the Ross procedure in children and young adults. METHODS: From November 1996 to September 2003, 38 patients (mean age, 13.1 ± 5.7 years) underwent the Ross procedure for various aortic valve diseases using the root replacement technique. Clinical and echocardiographic follow-up was performed early (within 30 days), 3 to 6 months, and yearly after surgery. Medical records of all patients were reviewed retrospectively. RESULTS: There was 1 perioperative death. The patients were followed-up for a median interval of 36 months and up to 7 years. One patient died 3 years after surgery secondary to ventricular arrhythmia with overall mortality of 5.3%. Actuarial survival at 7 years was 94 ± 2.5% and there was 100% freedom from reoperation for autograft valve dysfunction or any other cause. Balloon dilatation was required in 2 patients for pulmonary homograft stenosis. The haemodynamics at the latest follow-up were also similar to those at the time of discharge after surgery. There was no progression in the degree of aortic regurgitation for 11 patients with trivial and 3 with mild regurgitation. CONCLUSION: Our experience demonstrates that Ross operation is an attractive option for aortic valve replacement in children and young adults. Not only can the operation be accomplished with a low operative risk but the valve function stays normal over a long period of time with minimal alteration in lifestyle and no need for repeated operations to replace the valve as a result of somatic growth of the children

WNT signalling in prostate cancer

Genome sequencing and gene expression analyses of prostate tumours have highlighted the potential importance of genetic and epigenetic changes observed in WNT signalling pathway components in prostate tumours-particularly in the development of castration-resistant prostate cancer. WNT signalling is also important in the prostate tumour microenvironment, in which WNT proteins secreted by the tumour stroma promote resistance to therapy, and in prostate cancer stem or progenitor cells, in which WNT-β-catenin signals promote self-renewal or expansion. Preclinical studies have demonstrated the potential of inhibitors that target WNT receptor complexes at the cell membrane or that block the interaction of β-catenin with lymphoid enhancer-binding factor 1 and the androgen receptor, in preventing prostate cancer progression. Some WNT signalling inhibitors are in phase I trials, but they have yet to be tested in patients with prostate cancer

Consanguinity and reproductive health among Arabs

Consanguineous marriages have been practiced since the early existence of modern humans. Until now consanguinity is widely practiced in several global communities with variable rates depending on religion, culture, and geography. Arab populations have a long tradition of consanguinity due to socio-cultural factors. Many Arab countries display some of the highest rates of consanguineous marriages in the world, and specifically first cousin marriages which may reach 25-30% of all marriages. In some countries like Qatar, Yemen, and UAE, consanguinity rates are increasing in the current generation. Research among Arabs and worldwide has indicated that consanguinity could have an effect on some reproductive health parameters such as postnatal mortality and rates of congenital malformations. The association of consanguinity with other reproductive health parameters, such as fertility and fetal wastage, is controversial. The main impact of consanguinity, however, is an increase in the rate of homozygotes for autosomal recessive genetic disorders. Worldwide, known dominant disorders are more numerous than known recessive disorders. However, data on genetic disorders in Arab populations as extracted from the Catalogue of Transmission Genetics in Arabs (CTGA) database indicate a relative abundance of recessive disorders in the region that is clearly associated with the practice of consanguinity

Effect Of Field Environmental Exposure Conditions On The Properties Of Hardened Concrete

The effects of harsh field environmental exposure conditions on compressive, tensile and flexural strengths and durability aspects of concrete such as chloride penetration, sulphate attack and carbonation were investigated for a period of 240 days. The environmental variables studied were control laboratory condition at Qatar University, chloride and sulphate rich ground field condition (Zone A) located 10 Km from Doha City, and below the water table field condition (Zone B) exist at the same selected site. The results indicate that concrete specimens kept at ground field condition (Zone A) exhibit lower compressive, tensile and flexural strength values than both the control laboratory and the below water table field conditions. The loss in strength has been attributed to the cessation of hydration due to drying of the concrete. The strength values of control laboratory condition and below water table field condition (Zone B) were marginally comparable in spite of the considerable difference of chloride, sulphate and carbonation values

Genomics into Healthcare: The 5th Pan Arab Human Genetics Conference and 2013 Golden Helix Symposium

The joint 5th Pan Arab Human Genetics conference and 2013 Golden Helix Symposium, "Genomics into Healthcare" was coorganized by the Center for Arab Genomic Studies (http://www.cags.org.ae) in collaboration with the Golden Helix Foundation (http://www.goldenhelix.org) in Dubai, United Arab Emirates from 17 to 19 November, 2013. The meeting was attended by over 900 participants, doctors and biomedical students from over 50 countries and was organized into a series of nine themed sessions that covered cancer genomics and epigenetics, genomic and epigenetic studies, genomics of blood and metabolic disorders, cytogenetic diagnosis and molecular profiling, next-generation sequencing, consanguinity and hereditary diseases, clinical genomics, clinical applications of pharmacogenomics, and genomics in public health. © 2014 WILEY PERIODICALS, INC

The Effect of Hyperoxia During Cardiopulmonary Bypass on Blood Cell Rheology and Postoperative Morbidity Associated with Cardiac Surgery

In a prospective randomized open study, 48 patients underwent coronary bypass operation using cardiopulmonary bypass (CPB), with the same type of membrane oxygenator. Twenty-fout,IJatients were oxygenated during CPB by high PO2 level between 190 and 300 mmHg (H-POz) and in the remaining patients the PO2 was maintained low between 75 and 112 mmHg (L-PO2.) The groups were comparable regarding age, sex, perfusion time, aortic occlusion time and preoperative blood cell rheological status. The effect of possible oxygen toxicity was assessed by monitoring blood cell rheology and analyzing the postoperative complications. Blood cell rheology was studied using standard microfiltration methods and samples were taken regularly during CPB. There was a significant reduction in blood cell rheology in both groups during CPB in a time-dependent manner. The L-PO2 group had significantly better rheology than the H-PO2 group, which was first noted at 60 min for red cells (p<0.01). Following operation, the time spent on the respirator was significantly lower in the L-PO2 compared to the H-PO2 (5.3 h ± 1.8 h vs. 7.2 h ± 2.5 h, p<0.0l). There was significantly more bleeding in the H-PO2 group (p<0.05) and the use of blood products was significantly raised (p<0.0l). The total number of complications requiring treatment (arrhythmias, myocardial infarction, cardiovascular accidents and respiratory insufficiency) showed a significantly higher frequency in the H-PO2 (16/24 vs. 6 /24; p<0.01) compared to the L-PO2• There were three cases of mild renalfailure in the HPO2 group which was managed with conservative treatment. A significantly higher liver enzymes (p<0.01) and creatinine levels (p<0.05) were seen in the H-PO2 group. This study suggests that the use of high PO2 levels during CPB might lead to increased morbidity postoperatively and should be avoided