Hana Fakhoury

Year-round vitamin D deficiency among Saudi female out-patients.

OBJECTIVE The aim of the present study was to investigate vitamin D status among female out-patients in Saudi Arabia during the summer and winter seasons. DESIGN Data were retrospectively collected using medical record abstraction. SETTING A multidisciplinary hospital in Riyadh between January and December 2009. SUBJECTS Saudi females (age ≥19 years; n 1556) attending out-patient clinics for various complaints comprised the studied population. The population was subdivided into two groups depending on the date of their visit where blood samples were collected: summer (n 659) and winter groups (n 897). The summer group was further subdivided into premenopausal (age 19-49 years; n 425) and postmenopausal subgroups (age ≥50 years; n 234). Similarly, the winter group was subdivided into premenopausal (n 543) and postmenopausal subgroups (n 354). Serum levels of 25-hydroxyvitamin D (25(OH)D) were measured using HPLC. RESULTS The prevalence of vitamin D deficiency (25(OH)D <50 nmol/l) was high in both premenopausal and postmenopausal groups (80 % and 68 %, respectively) during the summer, as well as during the winter (85 % and 76 %, respectively). CONCLUSIONS A high prevalence of vitamin D deficiency among Saudi female out-patients was observed throughout the year despite the routine supplementation with 10-20 μg vitamin D3 for postmenopausal women. Clinicians should seriously consider determining the vitamin D status of Saudi females routinely and prescribing them proper supplementation.

Is the Saudi public aware of Middle East respiratory syndrome

Summary To limit the spread of Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia, the Ministry of Health tried to raise public awareness using different public campaigns. We aimed to measure public awareness of MERS in Saudi Arabia. A cross-sectional study was conducted between May and June 2014 using a newly designed Arabic questionnaire that was distributed and completed online. We analyzed the response of 1149 respondents across Saudi Arabia. We found that 97% of the participants were aware of MERS. In addition, 72% realized that coughing and sneezing could spread the infection. Furthermore, 83% thought that some patients with MERS could be cured. Moreover, 62% knew that no vaccine can prevent the disease. However, only 36% realized that taking antibiotics will not stop the infection, and only 41% recognized that no medication has yet been manufactured to treat it. Regarding protection measures, 74% used hand sanitizers, 43% avoided crowded places, and 11% wore masks in public places. Moreover, only 47% knew that bats and camels are the primary source of the virus. As anticipated, this level of awareness varied between the different categories of the studied population. Female, married, older, and more educated participants were significantly more knowledgeable about the disease. Public awareness of MERS is generally sufficient. However, some false beliefs about treatment were fairly common. In addition, almost half of the population remains unaware that bats and camels are the most likely sources of the virus.

Vitamin D levels and breast cancer characteristics: Findings in patients from Saudi Arabia

Inverse relationship between vitamin D status and risk of breast cancer has been previously reported in the literature. We conducted this study to determine the association between vitamin D levels and breast cancer characteristics in patients from Saudi Arabia. Newly diagnosed breast cancer patients (N=406) were recruited. Serum levels of 25-hydroxyvitamin D [25 (OH) D] were measured at baseline. A significantly higher percentage of patients with triple negative status (18%) had 25 (OH) D levels ≤25nmol/L, compared to only 8% with 25 (OH) D levels >25nmol/L (p=0.009). Patients with 25 (OH) D levels ≤25nmol/L were 2.54 times more likely to present with triple negative status compared to those with 25 (OH) D levels >25nmol/L (p=0.02). Our findings suggest an association between low 25 (OH) D levels and increased risk of triple negative breast cancer.

Association of MMP3-1171(5A>6A) polymorphism with lung cancer in Lebanon.

Matrix metalloproteinases (MMPs) are a family of enzymes that degrade extracellular matrix components and are involved in the development and progression of cancer. Lung cancer is the most commonly diagnosed cancer in Lebanon. This study was undertaken to investigate the association between -1171(5A>6A) polymorphism in the promoter of MMP3 gene and the susceptibility to lung cancer in a Lebanese population. The MMP3 polymorphism was investigated in 41 lung cancer patients and 51 unrelated healthy controls using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. We found a significant association between MMP3-1171 5A allele and lung cancer (Odds ratio [OR]=2.7, 95% [CI]=1.3-5.3; Fishers p-value=0.005). This study may form an additional evidence for the association of MMP3 enzyme and genetic susceptibility to lung cancer.

Study of the association between −403G/A and −28C/G RANTES gene polymorphisms and asthma in Lebanon

CONTEXT: Asthma is a complex inflammatory condition often associated with bronchial hyper reactivity and atopy. Genetic and environmental factors are implicated in the etiopathogenesis of asthma. Regulated upon Activation Normal T- cell Expressed and Secreted (RANTES) is a CC chemokine responsible for the recruitment of inflammatory cells, suggesting a possible role for this chemokine in asthma. Both -403A and -28G alleles of the RANTES promoter region were found to be associated with asthma/atopy in some but not all studies. AIM: The purpose of this study was to investigate the genetic influence of -403A and -28G alleles of the RANTES promoter region on the development of asthma in Lebanon. SETTINGS AND DESIGN: This case control study was conducted at Makassed Hospital, Beirut on 40 asthmatic patients and 38 healthy controls. METHODS: RANTES gene polymorphisms -403G/A and -28C/G alleles were genotyped using PCR-RFLP. RESULTS: No significant differences in allele or genotype frequencies for the RANTES gene polymorphisms between asthmatic patients and controls were found. The difference of the -403 GA genotype frequency between patients and controls was not statisti-cally significant; (OR=0.8, 95% CI=0.2-2.3, P=0.8). Similarly, the difference of the A-allele frequencies between patients and con-trols was not significant (OR=0.824, CI=0.3–2.2, P=0.7). CONCLUSIONS: Our data show that RANTES gene promoter polymorphisms are not associated with asthma susceptibility in the Lebanese population.

MMP1-1607(1G>2G) polymorphism and the risk of lung cancer in Lebanon

CONTEXT: Matrix metalloproteinases (MMPs) are a family of enzymes that degrade various components of the extracellular matrix and are involved in the development and progression of cancer. Lung cancer is the most commonly diagnosed cancer in Lebanon. MMP1 is responsible for degrading stromal collagens, which enhance the ability of neoplastic cells to cross basal membrane of both the endothelium and the vascular endothelium. A recent meta-analysis has suggested that the MMP1-1607 2G allele may be associated with an increased risk for certain types of cancers. AIM: This study was undertaken to investigate the association between guanine insertion polymorphism in the MMP1 promoter and the susceptibility to lung cancer in the Lebanese population. SETTINGS AND DESIGN: This case-control study was conducted on 41 patients with lung cancer and 51 age-matched healthy controls, recruited from different regions of Lebanon. METHODS: Cases were histologically confirmed lung cancer patients obtained from different hospitals in Lebanon. Controls were healthy unrelated individuals with no history of cancer or genetic diseases. All subjects were genotyped for MMP1 -1607(1G>2G) polymorphism using polymerase chain reaction-restriction fragment length polymorphism method (PCR-RFLP). RESULTS: No statistically significant differences were found when genotype and allele distribution of MMP1 -1607(1G>2G) polymorphism were compared between patients with lung cancer and controls [P= 0.6 by chi-squared test on a 3×2 contingency table; allelic P=0.61, OR (95% CI) = 1.18 (0.60-2.31)]. CONCLUSION: Our data shows that MMP1 promoter polymorphism is not associated with lung cancer susceptibility in the Lebanese population.

Age and BMI Adjusted Comparison of Reproductive Hormones in PCOS.

Objective and Background: Polycystic ovary syndrome (PCOS) is a complex condition and has been described in women who have polycystic ovaries as the underlying cause of hirsutism and chronic anovulation. Studies on PCOS in the Saudi population are very few. The aim of this study was to investigate the reproductive hormones levels in patients with PCOS. Effect of age and body mass index (BMI) on the hormonal findings was eliminated through a multivariate analysis. Materials and Methods: A comparative study was conducted on Saudi subjects attending the outpatient clinic of National Guard Hospital in Riyadh. A total of 62 cases with PCOS and 40 healthy Saudi women were included in this study. Physical evaluation and laboratory investigations were carried out. Blood luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2), dehydroepiandrosterone sulfate (DHEA-SO4), sex hormone-binding globulin (SHBG), total testosterone, prolactin, and progesterone were determined. To adjust for the potentially confounding effect of age and BMI, we carried out multivariate linear regression analyses for the association between each of the reproductive hormones and PCOS. Results: Serum levels of FSH, SHBG, and progesterone were significantly lower in PCOS compared to controls (respective P values 0.001, 0.001, and 0.002), while LH/FSH and testosterone levels were higher in PCOS cases than in controls (P = 0.008 and 0.003, respectively). When multivariate linear regression analyses were carried out, LH/FSH and total testosterone were positively correlated with the disease [95% confidence interval (CI) = 0.02–0.35 and 0.02–0.17, respectively], whereas FSH, SHBG, and progesterone were negatively correlated with the disease (95% CI = –0.06 to 0.001, –0.01 to 0.001, and –0.17 to –0.03, respectively), independent of age and BMI. Conclusion: Our study suggests that regardless of the age and weight factors, Saudi patients with PCOS have higher levels of LH/FSH and total testosterone; but have lower levels of FSH, SHBG, and progesterone compared to controls.

Re-emerging Middle East respiratory syndrome coronavirus: The hibernating bat hypothesis

218 Annals of Thoracic Medicine Vol 10, Issue 3, July-September 2015 obtained by using a lower maximum standardized uptake value (SUVmax) cut-off and considering the normal lung, and not the mediastinum (as in)[3], as background region for the visual assessment. This is useful especially for TCs, which commonly show low FDG uptake. Applying a SUVmax cut-off of 1.5 to the radiometabolic findings reported in,[3] we found only one “false negative” case (SUVmax = 1.2 in a TC) and overall detection rate would stand at 95.5%.

What encourages Saudis to quit smoking

Context: Despite the noticeable increase in public awareness among Saudis, Saudi Arabia is still ranked as the fourth largest tobacco importer in the world. A very limited number of studies have studied ex-smokers in the Saudi population. Aims: In this study, we aimed to analyse the socio-demographic characteristics of ex-smokers in an attempt to determine who is most likely to quit smoking among Saudis. Settings and Design: This study is an extension to a previous cross-sectional study, which was conducted in Saudi Arabia during the period between April and May 2013. Subjects and Methods: A new questionnaire was developed and manually distributed electronically through different popular Twitter accounts. The questionnaire was written in Arabic and included information about socio-economic factors and smoking history. Results: The results of 2057 questionnaires showed that 808 (39%) were current smokers, 460 (22%) were ex-smokers while the remaining 808 (39 %) never smoked. The majority of ex-smokers (57%) decided to quit because of religious and social reasons. In addition, health reasons were the drive for 40% of the quitters while only 2.7% of the quitters made the decision because of financial reasons. In the multivariate analysis for reasons to stop smoking, we found that quitting was not influenced by gender, income or age at the onset of smoking. Conclusions: We have looked at smoking cessation from a broader perspective, analysing different categories of the Saudi population. Social, religious and health reasons must be emphasised by counsellors assisting Saudi smokers to quit.

P067 : TWO NOVEL ALLELES HLA-A∗02:433 AND HLA-A∗02:434 IDENTIFIED IN SAUDI BONE MARROW DONORS USING SEQUENCE-BASED TYPING

In this report, we present two novel HLA-A alleles: HLA-A ∗ 02:433 and HLA-A ∗ 02:434. These alleles were identified by sequence-based typing method (SBT), in two donors for the Saudi Bone Marrow Donor Registry (SBMDR). Allele A ∗ 02:433 is identical to A ∗ 02:05:01G except for a G to A substitution at nucleotide position 449 in exon 2. This substitution results in glycine to serine substitution at position 83. Whereas, allele A ∗ 02:434 is identical to A ∗ 02:01:01G except for a C to A substitution at nucleotide position 245 in exon 2, which results in phenylalanine to threonine substitution at position 15. The generation of both alleles appears to be the result of nucleotide point mutation involving 02:01:01 and 02:05:01.