Immunological Factors Associated with Adult Asthma in the Aseer Region, Southwestern Saudi Arabia.

BACKGROUND: The prevalence of asthma is on the rise in Saudi Arabia. Data regarding the immunological profile of asthma in adults in the Aseer region, in southwestern Saudi Arabia, have not been well studied. OBJECTIVES: Our aim was to study the immunological factors associated with sensitization to asthma among adults in the Aseer region. METHODS: A cross-sectional study with a nested case control design in a 1:1 ratio was conducted on a sample of adults attending primary health care centers in the Aseer region. The study used a validated Arabic version of the International study of asthma and allergies in childhood (ISAAC) questionnaire. The presence of wheezing in the past 12 months was used as a proxy for bronchial asthma. Matched age and sex controls were selected. Both groups were tested for complete blood count (CBC), total and differential white blood cell (WBC) count including eosinophils, total immunoglobulin E (IgE) measurement, allergen-specific immunoglobulin E (IgE), and cytokine levels. RESULTS: The present study included 110 cases and 157 age- and sex-matched controls. Rye wheat was found to be a significant outdoor sensitizing agent ((odds ratio) OR = 5.23, 95% CI: 1.06-25.69). Indoors, house dust mites Dermatophagoides petronyssinus (OR = 2.04, 95% CI: 1.04-3.99) and Dermatophagoides farinae (OR = 2.50, 95% CI: 1.09-5.75) were significant. Higher total IgE (OR = 1.84, 95% CI: 1.10-3.06) and eosinophil levels (OR = 2.85, 95% CI: 1.14-7.15) were significantly associated with adult bronchial asthma in Aseer. On the other hand, the role of cytokines was not significant. CONCLUSIONS: In the present study, certain environmental agents were found to be important with regards to sensitization to bronchial asthma in adults. Knowledge about these sensitization agents should be disseminated to health providers and treating physicians in order to enhance preventive environmental control measures and asthma management. Asthma-treating physicians in the region should be alerted to the use of targeted biological therapies in selected asthmatics with difficult-to-control courses.

Catha edulis (khat) Induces Apoptosis in Madin-Darby Bovine Kidney Cell Line.

BACKGROUND: Khat (Catha edulis) is a controversial plant having a euphoretic effect, at the same time part of culture in many countries such as Africa and Arabian Peninsula. The presence of amphetamine-like substance, cathinone and cathine make this plant banned in many countries. Many neurological and other system related studies have been carried out in this plant, but the lack of toxicity studies are there especially the mechanism. OBJECTIVE: In this study, Madin-Darby Bovine Kidney cell line was used as an in vitro model to study the cell death mechanism. Crude extract of fresh Khat plant leaves were prepared and exposed to cells. MATERIALS AND METHODS: Trypan blue assay, phase-contrast microscopy, fluorescent microscopy, clonogenic assay, annexin-V assay, and hematoxylin and eosin (H and E) staining were employed to check the objectives. RESULTS: Reductions in cellular viability were observed at concentrations above 1.25 mg/ml while using Trypan blue assay. The results of the clonogenic assay had shown that the untreated control with the highest number of colonies (100% survival) and the 0.1562 concentration could not prevent the colony formation significantly. The high concentrations reduced the colony formation at concentration dependent manner 27.4% and 24.9%, for 0.625 mg/ml and 1.25 mg/ml concentrations, respectively. The acridine orange/ethidium bromide experiment had observed the cells were intact with round nucleus while the apoptosis features such as blebbing and nuclear chromatin condensation were clearly observed in treatment. The shrinkage of cells was clearly observed in H and E staining. CONCLUSION: In addition, annexin-V binding confirmed the presence of apoptosis significantly on Khat treatment. SUMMARY: Khat (Catha edulis) is a controversial plant having euphoretic effectReductions in cellular viability were observed at concentrations above 1.25 mg/ml while using Trypan blue assayThe high concentrations of khat extract had reduced the colony formation at concentration dependent mannerThe acridine orange/ethidium bromide experiment had observed the apoptosis features such as blebbing and nuclear chromatin in treatmentAnnexin-V binding confirmed the presence of apoptosis significantly on Khat treatment. Abbreviation used: PS: Phosphatidylserine (PS); MDBK: Madin-Darby Bovine Kidney; DMEM: Dulbecco's modified Eagle's medium; PI: propidium iodide; EB: ethidium bromide; PBS: Phosphate Buffer saline; FITC: fluorescein isothiocyante; TUNEL: Terminal deoxynucleotidyl transferase dUTP nick end labeling.

Antidiabetic and Antioxidant Impacts of Desert Date (Balanites aegyptiaca) and Parsley (Petroselinum sativum) Aqueous Extracts: Lessons from Experimental Rats.

Medicinal plants are effective in controlling plasma glucose level with minimal side effects and are commonly used in developing countries as an alternative therapy for the treatment of type 1 diabetes mellitus. The aim of this study is to evaluate the potential antidiabetic and antioxidant impacts of Balanites aegyptiaca and Petroselinum sativum extracts on streptozotocin-induced diabetic and normal rats. The influences of these extracts on body weight, plasma glucose, insulin, total antioxidant capacity (TAC), malondialdehyde (MDA) levels, and liver-pyruvate kinase (L-PK) levels were assessed. Furthermore, the weight and histomorphological changes of the pancreas were studied in the different experimental groups. The herbal preparations significantly reduced the mean plasma glucose and MDA levels and significantly increased the mean plasma insulin, L-PK, and TAC levels in the treated diabetic groups compared to the diabetic control group. An obvious increase in the weight of the pancreas and the size of the islets of Langerhans and improvement in the histoarchitecture were evident in the treated groups compared to untreated ones. In conclusion, the present study provides a scientific evidence for the traditional use of these extracts as antidiabetic and antioxidant agents in type 1 diabetes mellitus.

Progress toward malaria elimination in Jazan Province, Kingdom of Saudi Arabia: 2000-2014.

BACKGROUND: The draft Global Technical Strategy for malaria aims to eliminate malaria from at least 10 countries by 2020. Yemen and Saudi Arabia remain the last two countries on the Arabian Peninsula yet to achieve elimination. Over the last 50 years, systematic efforts to control malaria in the Kingdom of Saudi Arabia has successfully reduced malaria cases to a point where malaria is now constrained largely to Jazan Province, the most south-western area along the Red Sea. The progress toward elimination in this province is reviewed between 2000 and 2014. METHODS: Data were obtained from the Ministry of Health case-reporting systems, activity reports, unpublished consultants reports, and relevant scientific published papers. Sub-provincial population data were obtained the national household censuses undertaken in 2004 and 2010. Rainfall data were obtained from the Meteorological Department in Jazan. RESULTS: Between 2000 and 2014 there were 5522 locally acquired cases of malaria and 9936 cases of imported malaria. A significant reduction in locally acquired malaria cases was observed from 2000 to 2014, resulting in an average annual incidence (2010-2014) of 0.3 cases per 10,000 population. Conversely imported cases, since 2000, remain consistent and higher than locally acquired cases, averaging between 250 and 830 cases per year. The incidence of locally acquired cases is heterogeneous across the Province, with only a few health districts contributing the majority of the cases. The overall decline in malaria case incidence can be attributed to coincidental expansion of control efforts and periods of exceptionally low rainfall. CONCLUSIONS: Jazan province is poised to achieve malaria elimination. There is a need to change from a policy of passive case detection to reactively and proactively detecting infectious reservoirs that require new approaches to surveillance. These should be combined with advanced epidemiological tools to improve the definitions of epidemiological receptive and hotspot malaria risk mapping. The single largest threat currently remains the risks posed by imported infections from Yemen.

Prevalence of Khat chewing in college and secondary (high) school students of Jazan region, Saudi Arabia.

BACKGROUND: Khat is widely consumed among the youth of Jazan region of Saudi Arabia. However, its prevalence is not well documented. OBJECTIVE: This study was conducted to assess the prevalence and associated risk factors of khat chewing among college and secondary school students in Jazan region. METHODS: The study was conducted in May 2006 in the colleges and secondary schools in Jazan region. A sample of 10,000 students aged between 15 and 25 years was randomly selected. Students in each year of study were selected by systematic random sampling technique. Self-administered questionnaire was used for data collection. RESULTS: The overall prevalence of khat chewing in all the studied population was 21.4% (colleges 15.2% versus schools 21.5%). There were 3.8% female khat chewers and 37.70% male Khat chewers. Significant differences were found between khat chewers according to age, gender and residence (p < 0.05). The prevalence was different in different colleges and in different provinces of Jazan region. CONCLUSION: The prevalence of Khat chewing seems to be high among male students and not remarkable among female students. The use of Khat is significantly associated with age, gender, residence and school and college education (p < 0.05) among students of Jazan region. Strong measures need to be taken for greater awareness among school and college students to reduce its prevalence.

Health and socio-economic hazards associated with khat consumption.

The consumption of the stimulant leaf Khat (Catha edulis Forsk) is widespread in several countries of East Africa and the Arabian Peninsula. The leaf comes from a small evergreen shrub that can grow to the size of a tree. Young buds and tender leaves are chewed to attain a state of euphoria and stimulation. Khat leaves contain cathinones, an active brain stimulant that is similar in structure and pharmacological activity to amphetamines. Like amphetamines, Khat ingestion in low doses results in decreased appetite, euphoria, increased intellectual efficiency, and hyperalertness.High doses and chronic use of Khat can cause more serious adverse neurological, psychiatric, cardiovascular, dental, gastrointestinal and genitourinary effects. Besides damaging health, Khat has adverse socio-economic consequences effects on many other aspects of life including the loss of thousands of acres of arable land and billions of hours of work.The purpose of this review is to describe briefly the adverse consequences of habitual chewing of Khat on health, and help educate the general public. The study is based on literature review that includes internet search and journals.

Prevalence of Helicobacter pylori infection among patients with dyspepsia in South-Western Saudi Arabia.

OBJECTIVE: Helicobacter pylori (H. pylori) infection is a major cause of various upper gastrointestinal (UGI) disorders. The aim of this study was to determine the prevalence of H. pylori among patients with dyspepsia. METHODS: A prospective study was carried out in the Gastroenterology Division, King Fahd Central Hospital, Gizan, Kingdom of Saudi Arabia from January 1995 to December 1998. Four hundred and eighty-eight patients with dyspepsia were consecutively examined using the UGI endoscopy during a 4-year period. Data analyzed included demographic details, clinical indications for the examination, endoscopic findings and results of the histopathologic assessment for H. pylori. RESULTS: Overall, H. pylori were detected in 268 (54.9%) of the gastric biopsies from 488 patients (322 males and 166 females, aged 13-90 years). Helicobacter pylori infection was present in 140 (60.1%) of 253 patients with chronic gastritis diagnosed by endoscopy and in 49 (62.8%) of 78 patients with duodenal ulcers (DU). The rate in DU patients was significantly higher than the rate (43.6%) in patients with normal endoscopic findings (odds ratio [OR]=2.18, 95% confidence interval [CI] 1.02-4.70; p=0.04]. Of 455 biopsies with histologic gastritis, 268 (OR=58.9%, 95% CI 54.2-63.4) were positive for H. pylori and all specimens (n=33) with no histological evidence of gastritis were negative. CONCLUSION: The well-described association of H. pylori with DU and non-ulcer dyspepsia was confirmed by our study. However, the rate of H. pylori in our patients was at the lower end of the range (50-80%), which was previously reported among largely urban populations in Saudi Arabia suggests differences in the prevalence of H. pylori-infections between urbanized and rural populations. Helicobacter pylori negative peptic ulcer disease remains an important entity that may be associated with the use of non-steroidal anti inflammatory drugs and in our environment, the habitual chewing of qat leaves (catha edulis).

A case of neuropsychiatric lupus with myelopathy successfully treated with corticosteroids.

This report describes a 16-year old female patient who presented with acute paresis in both lower limbs, acute urinary retention, blurred vision and arthritis. The patient was diagnosed as having systemic lupus erythematosus with myelitis and bilateral abducent nerves palsy. The administration of steroids resulted in marked improvement in her neurological symptoms.