Type 2 diabetes associated variants of KCNQ1 strongly confer the risk of cardiovascular disease among the Saudi Arabian population.

Genome-wide association studies have identified several loci associated with an increased risk for cardiovascular disease (CVD) and type 2 diabetes (T2D). Polymorphisms within the KCNQ1 (potassium voltage-gated channel, KQT-like subfamily, member 1) gene are consistently associated with T2D in a number of populations. The current study was undertaken to evaluate the association of 3 polymorphisms of KCNQ1 (rs2237892, rs151290 and rs2237895) with T2D and/or CVD. Patients diagnosed with either T2D (320 patients), CVD (250 patients) or both (60 patients) and 516 healthy controls were genotyped by TaqMan assay run on a real time PCR thermocycler. A statistically significant association was found for SNPs rs151290 (OR = 1.76; 95%CI = 1.02-3.05; p = 0.0435) and rs2237895 (OR = 2.49; 95%CI = 1.72-3.61; p < 0.0001) with CVD. SNP rs151290 (OR = 7.43; 95%CI = 1.00-55.22; p = 0.0499) showed a strong association in patients with both T2D and CVD. None of the SNPs showed any significant association with T2D. Haploview analysis showed that the ACC (rs151290, rs2237892 and rs2237895) haplotype is the most significant risk allele combination for CVD, while CCA is the most significant risk haplotype for co-morbidity with T2D. KCNQ1 polymorphism at SNPs rs151290 and rs2237895 is strongly associated with CVD in this population, but presented no association with T2D.

Dietary assessment of type 2 diabetic patients using healthful plant-based diet score in the Eastern Province of Saudi Arabia.

BACKGROUND: Diabetes mellitus is a chronic disease characterized by a wide range of metabolic problems. The current study sought to assess nutritional habits of Saudi patients with type 2 diabetes (T2D) and to propose recommendations to improve these patients' dietary habits and delay possible disease complications. METHODS: Over a period of three years, (2017-2019) 577 patients with T2D attending the outpatient's diabetic clinics at King Fahd Hospital of the University, Al Khobar, Saudi Arabia were invited to participate in this study. Data of dietary intake were collected by trained nurses using a pretested structured validated semi quantitative food frequency questionnaire. The dietary data were collected using 7-day dietary recall questionnaire. A modified score system that associates dietary habits with glycemic control and lipid profile was used. RESULTS: Overall, a high healthful plant-based diet score was associated with a significant (P = 0.018) reduction in triglycerides (TG) level (mean difference - 3.78%; 95% CI, -0.65% to -6.81%) and a statistically non-significant (P = 0.06) increase in high density lipoprotein (HDL) levels (mean difference 1.87%; 95% CI -0.06-3.84%) in T2D patients from the Eastern Province of Saudi Arabia. Additionally, in our patient group, the prevalence of coronary artery disease, stroke, peripheral artery disease, and chronic kidney disease in T2D patients was 11.3%, 6.2%, 3.3%, and 8.4%, respectively and were higher when compared to the prevalence in the general population. CONCLUSION: The present study showed that adherence to a healthful plant-based diet, when compared to high glycemic index diet, is associated with a favorable outcome in glycemic control and lipid profile in T2D patients. Prior assessment of total diet quality may be beneficial when giving nutritional advice to T2D patients with the possibility of improving glycemic control and lipid profile.

The Effects of Various Teaching Methods on Chest X-ray Interpretation Skills Among Medical Students and Interns: A Systematic Review.

Chest X-ray (CXR) is a common tool used in medical practice. Medical students and interns should acquire knowledge of CXR interpretation, as it is an essential diagnostic tool for a large spectrum of diseases. This systematic review aimed to compare the effect of different intervention techniques on the competency of medical students and interns to demonstrate the level of confidence and competence in interpreting common presentations of CXRs. The population, intervention, comparison, and outcomes (PICO) framework was used to formulate the review question. All related articles in five databases (PubMed, Web of Science, Scopus, Medline, and Embase) were retrieved and the search was completed in March 2023 with no limiters on date and time. The number of relevant studies was 469. A multi-level approach through the Rayyan platform was used for the screening and exclusion processes. Eleven articles were included in the systematic review consisting of eight randomized controlled trials, one quasi-experimental study, one cross-sectional study, and one interventional cohort. Results showed significant effects of teaching methods utilizing deductive or inductive approach, clinical history, patient care comfort survey, and SAFMEDS (Say-All-Fast-Minute-Every-Day-Shuffled). Contrarily, no significant effect was shown by flipped classroom models and mixed and blocked practice, peer-assisted learning vs. expert-assisted learning, and Chester, an artificial intelligence tool. This review identified beneficial approaches that may enhance the learning outcomes of interpreting CXRs for medical students and interns, highlighting the remarkable impact of SAFMEDS on medical students' ability to identify CXR findings as well as the availability and practicality of online and e-learning resources for students.

The association between serum ferritin and bilirubin with glycemic control among patients with type 2 diabetes mellitus.

Previous evidence has shown an association between serum ferritin and bilirubin levels in the development of type 2 diabetes mellitus (T2DM) and glycemic control. However, the evidence is scarce in Saudi Arabia. In this study, we aimed to evaluate the association between serum ferritin and bilirubin levels with glycemic control in patients with T2DM. This was a cross-sectional study that involved 153 patients with T2DM recruited from outpatient diabetes clinics. Participants were categorized into two groups: well-controlled and uncontrolled T2DM, based on their glycemic status. We focused on comparing the iron profile and bilirubin levels between these two groups and examining the influence of antidiabetic medications on these parameters. A total of 153 patients with T2DM were included (58.2% women and 41.8% men). In both univariate and multivariate analyses, ferritin levels did not have a statistically significant association with glycemic control. However, patients with well-controlled T2DM had a significantly higher median level of total bilirubin and direct bilirubin than those with uncontrolled T2DM. Only direct bilirubin showed a statistically significant association with FBG less than 130 mg/dl and HbA1c level less than 7.0%. Ferritin level was not associated with glycemic control in patients with T2DM. On the other hand, direct bilirubin level was an independent predictor of better glycemic control. Monitoring direct bilirubin levels could aid in predicting glycemic control in T2DM and could be a potential target for developing antidiabetic medications.

The Impact of Vitamin D Level on the Severity and Outcome of Hospitalized Patients with COVID-19 Disease.

PURPOSE: The world is experiencing a life-altering and extraordinary situation in response to the COVID-19 pandemic. There are limited data and controversies regarding the relationship between vitamin D (Vit D) status and COVID-19 disease. Thus, this study was designed to investigate the association between Vit D levels and the severity or outcomes of COVID-19 disease. METHODS: A cross-sectional observational study was conducted in the Eastern province of Saudi Arabia from January to August 2021. All the admitted patients who were diagnosed with COVID-19 infection were distributed into three groups depending on their Vit D levels: normal, insufficiency, and deficiency. For the three groups, demographic data, and laboratory investigations as well as data regarding the severity of COVID-19 were collected and analysed. RESULTS: A total of 203 diagnosed cases of COVID-19 were included in this study. The Vit D level was normal (>30) in 31 (15.3%) cases, insufficient in 45 (22.2%) cases and deficient in 127 (62.6%) cases. Among the included cases, 58 (28.6%) were critical cases, 109 (53.7%) were severe and 36 (17.7%) had a mild-moderate COVID-19 infection. The most prevalent comorbidity of patients was diabetes mellitus 117 (57.6%), followed by hypertension 70 (34.5%), cardiac disease 24 (11.8%), chronic kidney disease 19 (9.4%) and chronic respiratory disease in 17 (8.4%) cases. Importantly, the current study did not detect any significant association between Vit D status and COVID-19 severity (p-value=0.371) or outcomes (hospital stay, intensive care units admission, ventilation, and mortality rate) (p-value > 0.05), even after adjusting the statistical model for the confounders. CONCLUSION: In hospital settings, Vit D levels are not associated with the severity or outcomes of COVID-19 disease. Further, well-designed studies are required to determine whether Vit D status provides protective effects against worse COVID-19 outcomes.

The impact of obesity on hospitalized patients with COVID-19 infection in the Eastern Province of Saudi Arabia.

This study aimed to assess the association of obesity with the severity and outcome of COVID-19 infection. A retrospective observational study was performed from March to September 2020 in Saudi Arabia. Baseline and laboratory data were collected from the inpatient health record system. The cohort was divided into three groups based on body mass index. Following this, the severity and outcome of COVID-19 disease were analyzed between the three groups. Of the 502 COVID-19 cases included, 244 (48.5%) were obese. Obesity was significantly associated with severe (53.5%) or critical (28%) COVID-19 infection (P<0.001) and a higher need for ICU admission (35.8%, P=0.034). Multivariate analysis showed that overweight/obesity was an independent risk factor of severe (P<0.001) as well as critical COVID-19 infection (P=0.026, respectively) and a predictor of a higher risk of ICU admission (P=0.012). Class I obesity was associated with severe-critical COVID-19 disease (33.6%, P=0.042) compared to other obesity classes. Obesity is an independent risk factor for severe-critical COVID-19 infection and a higher risk of ICU admission. Clinicians should give special attention to such populations and prioritize vaccination programs to improve outcomes.

The Impact of Vaccination Against SARS-CoV-2 Virus on the Outcome of COVID-19 Disease.

Background: Coronavirus disease 2019 (COVID-19) is a rapidly spreading infection that is on the rise. New variants are continuously appearing with variable degrees of lethality and infectivity. The extensive work since the start of the pandemic has led to the evolution of COVID-19 vaccines with varying mechanisms. We aim to determine real-world data by looking at the different clinical outcomes associated with COVID-19 vaccination, focusing on the rate of hospitalization, severity, and mortality. Methodology: A retrospective observational study included 624 patients with COVID-19 infection who were hospitalized at King Fahad Hospital of the University and King Fahad Military Medical City between April and July 2021. The cohort was divided into 3 groups: unvaccinated, partially vaccinated (PV), and fully vaccinated (FV). The severity and outcome of COVID-19 disease were compared among the three groups. Among the vaccinated group, we studied the effect of vaccine type on the severity and outcome of COVID-19 disease. Results: We found that 70.4% of patients with COVID-19 disease who required hospitalization were unvaccinated. Un-vaccination was a significant predictor of critical COVID-19 disease (OR 2.31; P <0.001), whereas full vaccination was associated with significantly milder disease severity (OR 0.36; P 0.01). Moreover, un-vaccination status was an independent predictor of longer hospitalization (OR 3.0; P <0.001), a higher requirement for ICU admission (OR 4.7; P <0.001), mechanical ventilation (OR 3.6; P <0.001), and death (OR 4.8; P <0.001), whereas the FV group had a lower risk of ICU admission (OR 0.49; P 0.045). Unvaccinated patients with comorbidities had worse severity and outcome of COVID-19 infection (P<0.05). Both vaccine types (Pfizer and AstraZeneca) had similar protective effects against the worst outcomes of COVID-19 disease. Conclusion: COVID-19 vaccination has been shown to be effective in reducing hospitalization, the severity of COVID-19 infection, and improving outcomes, especially in high-risk group patients. COVID-19 vaccination programs should continue to improve the outcome of such a disease.

Beneficial effects of adding magnesium to desalinated drinking water on metabolic and insulin resistance parameters among patients with type 2 diabetes mellitus: a randomized controlled clinical trial.

There is evidence that increasing the consumption of water containing magnesium can improve glucose metabolism and insulin resistance in patients with type 2 diabetes mellitus (T2DM). This trial was undertaken with the objective of evaluating the effect of adding different concentrations of magnesium chloride to the desalinated drinking water on the glycemic, metabolic, and insulin resistance parameters among patients with T2DM. A randomized cross-sectional controlled clinical trial was conducted to evaluate the effects of adding magnesium chloride supplement to desalinated drinking water consumed by patients with T2DM on the glycemic and metabolic parameters and indicators of insulin sensitivity. The total number of patients with T2DM who successfully completed the trial is 102. Patients were randomly allocated into three groups: the first group received bottled water without added magnesium (0 mg/L) (Group A, n = 37); the second group received bottled water with a low level of magnesium (20 mg/L) (Group B, n = 33); and the third group received drinking water with a high level of magnesium (50 mg/L) (Group C, n = 32). The daily consumption of elemental magnesium for a period of 3 months resulted in significant improvement in HbA1C (8.0 vs 8.2%, p = 0.04), insulin level (7.5 vs 9.9 µIU/mL, p = 0.03), and homeostasis model assessment-estimated insulin resistance (HOMA.IR) (2.5 vs 2.9, p = 0.002) in group C. However, there was no significant improvement in fasting blood glucose (FBS) level or lipid profile. The results of this study suggest that oral magnesium supplementation at the given dose of 50 mg/L daily added to drinking water could improve long-term glycemic control indicators and reduce insulin resistance in patients with T2DM.

The Impact of Diabetes Mellitus and Hyperglycemia on the Severity and Outcome of Patients with COVID-19 Disease: A Single-Center Experience.

PURPOSE: Diabetes mellitus (DM) has been reported to be associated with a  worse outcome of COVID-19 infection. The evidence is scarce in the Middle East and Saudi Arabia. We aimed to evaluate the impact of diabetes mellitus and hyperglycemia in non-diabetic individuals on the severity and outcome of COVID-19 infection. METHODS: This is a retrospective observational study, which included patients with confirmed COVID-19 infection [RT-PCR positive for SARS-CoV2] who were admitted to King Fahd Hospital of the University-Khobar-Eastern Province-Saudi Arabia from March to September 2020. Baseline demographic data, laboratory investigations, and markers of the severity of COVID-19 were analyzed. The collected data were categorized according to the Saudi Arabian Ministry of Health COVID-19 infection severity criteria. Patients were divided into three groups as follows: patients in Group 1 had pre-existing DM, patients in Group 2 did not have DM but were documented to have hyperglycemia at presentation, and patients in Group 3 were neither diabetics nor hyperglycemics at presentation and served as the control group. The severity and outcome of the control group were compared with the other two groups. The effect of risk factors on the severity and outcome of COVID-19 infection was studied in the DM group. RESULTS: A total of 414 patients were included (70.5% males and 29.5% females). The mean age (SD) of patients was 52.3 (±15.5) years. Compared to the control group, pre-existing DM was found to be significantly associated with severe (OR 3.61), critical disease (OR 4.32), intensive care unit (ICU) admission (OR 2.0), and death (OR 2.0) from COVID-19 infection. Hyperglycemia without known DM was also found to be associated with critical COVID-19 pneumonia (P 0.001), and had longer duration of hospitalization (P 0.014), higher ICU admission, mechanical ventilation, and death from COVID-19 infection (P < 0.0001). CONCLUSION: Diabetes mellitus and hyperglycemia at presentation, even in the absence of pre-existing DM, are independent risk factors for disease severity and worse outcome of COVID-19 infection. These patients should be identified and managed accordingly. The COVID-19 vaccination program should also target those populations to improve their outcomes.

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis in 2 sisters.

Familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) is a rare autosomal recessive tubular disorder characterized by excessive renal magnesium and calcium wasting, eventually, progressing to renal failure. It has been recently attributed to a mutation in the Claudin 16 (CLDN 16) gene of the Paracellin-1 (PCLN-1) tight junction protein. Herein, we report 2 sisters with FHHNC. Both sisters presented at an early stage with hypomagnesemia and hypocalcemia. The first patient was initially mislabeled and treated as a case of hypoparathyroidism, while the second patient was diagnosed retrospectively after the diagnosis of her sister. The 2 patients developed end stage renal disease.

25-Hydoxyvitamin D levels among healthy Saudi Arabian women.

OBJECTIVE: To assess the serum level of 25 hydroxyvitamin D 25OHD among healthy Saudi Arabian women living in the eastern province. METHODS: A cross-sectional randomized study was conducted between February 1st 2008 and May 31st 2008 at the King Fahd University Hospital, Al-Khobar, Kingdom of Saudi Arabia in 200 Saudi women between 25-35 years group 1 and women of > or =50 years group 2. Clinical examination, laboratory tests, a complete blood picture, serum calcium, phosphorous, alkaline phosphatase, parathormone, and the serum levels of 25OHD levels were carried out. Data on lifestyle, dietary, and demographic questionnaires were collected. Vitamin D was defined as deficient with serum level <50 nmol/L, insufficient between 52-72 nmol/L, and normal as 75nmol/L. RESULTS: In group 1, 70% of women had normal 25OHD, and in women of group 2, 45% had normal levels of 25OHD. Alkaline phosphatase and parathormone levels were significantly higher in women with low vitamin D levels. Sun exposure and consumption of dairy products were minimal. CONCLUSION: Vitamin D deficiency among healthy young Saudi women of 25-35 years was 30% and 55% in women of > or =50 years. This study indicates that hypovitaminosis D is common in young and postmenopausal women. Efforts are require to augment and encouraged women for adequate exposure to sunlight and increased intake of fortified vitamin D products to maintain skeletal health.

Influence of androgens on bone mass in young women with sickle cell anemia.

OBJECTIVE: To evaluate the relationship between the gender hormonal levels and bone mineral density in premenopausal women suffering with sickle cell disease. METHODS: A cross-sectional study including consecutive female adult patients with sickle cell anemia attending the outpatient hematology/orthopaedic clinics, or admitted to King Fahd University Hospital, Al-Khobar, Saudi Arabia, between August 2006 and June 2007. Patient's age was documented, and body mass index was calculated. Blood was drawn for complete blood picture, biochemistry, and hormonal profile including total estradiol E2 and total testosterone Te. Bone mineral density BMD was measured for all patients using dual energy x-ray absorptiometry scan at the hip and lumbar spine. RESULTS: We analyzed the data of 51 patients with an average age of 26+/-3.1 years. Patients were divided into 2 groups group A and group B. Group A had normal BMD and group B with low BMD. Thirty-one (60.8%) were in group A and 20 (39.2%) were in group B. The E2 level was not statistically different between the 2 groups, while Te level was significantly lower in women with low BMD 38+/-11.8 versus 22.3+/-11.7 ng/dl, p<0.001. CONCLUSION: Our study indicates that in premenopausal female patients with sickle cell anemia, testosterone may play a role in the preservation of bone mass.

Tuberculosis-associated Immune Thrombocytopenia: A Case Report.

Various hematological manifestations are known to occur with tuberculosis (TB), but its association with immune thrombocytopenia is uncommon and not well recognized. Here, the case of a 39-year-old male who presented with a history of epistaxis and hematuria is described. The patient was found to have diffuse lymphadenopathy both clinically and radiologically. He was diagnosed with immune thrombocytopenia; however, there was a delay in the diagnosis of TB because of the patient's refusal of lymph node biopsy and late recognition of the association between TB and immune thrombocytopenia. Treatment with steroids without antituberculosis medications may have led to reactivation and dissemination of tuberculous infection in this patient. Later, the patient was readmitted with a suspected community-acquired pneumonia and the sputum smear was positive for acid-fast bacilli. Unfortunately, the patient died after he developed sepsis and multiorgan failure. The purpose of this case report is to highlight this rare combination and create awareness among clinicians to consider TB as an underlying etiology of immune thrombocytopenia, especially if there are other associated physical findings such as the presence of lymphadenopathy.

Effect of Nigella sativa supplementation over a one-year period on lipid levels, blood pressure and heart rate in type-2 diabetic patients receiving oral hypoglycemic agents: nonrandomized clinical trial.

BACKGROUND: Diabetic patients with hypertension and dyslipidemia are at a high risk of cardiovascular complications. OBJECTIVES: To determine the effect of Nigella sativa supplementation on the lipid profile, mean arterial pressure, and heart rate in persons with type 2 diabetes on oral hypoglycemic agents (OHA). DESIGN: Single-blind, nonrandomized. SETTING: Diabetes clinic of a university hospital in Saudi Arabia. PATIENTS AND METHODS: Type-2 diabetic patients were recruited by purposive sampling and assigned to treatment or control at the discretion of the investigator with the patient blinded to treatment. Before the in.tervention and every 3 months thereafter until the end of the treatment period, the following parameters were measured: triglycerides (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), and body mass index (BMI). Results at the baseline and each subsequent visit were compared between the two groups. MAIN OUTCOME MEASURE(S): Lipid and cardiovascular parameters, and BMI. RESULTS: Fifty-seven patients were assigned to receive N sativa 2 g daily for one year and 57 were assigned to receive an identical regimen of placebo, along with OHA. A significant decrease in HDL-C and increase in the TC/HDL-C and LDL-C/HDL-C ratios were seen in the control group. The N sativa group had a signifi.cant decline in TC, LDL-C, TC/HDL-C and LDL-C/HDL-C ratios, compared with the respective baseline data and the control group. HDL-C was significantly elevated in the N sativa group. The control group showed a significant elevation in MAP. The N sativa group had a significant reduction in SBP, DBP, MAP and HR and a significant decrease in DBP, MAP and HR as compared with the control group. CONCLUSION: N sativa supplementation improves total cholesterol, mean arterial pressure and heart rate in type 2 diabetes patients on oral hypoglycemic agents. LIMITATIONS: There were 9 subjects in each group lost to follow up; thus the sample size could not be maintained as per the sample size calculation. The study was nonrandomized and thus there was a possibility of allocation bias. (Clinical trial registration number: CTRI/2013/06/003781, Clinical Trial Registry of India).

Health education to diabetic patients before the start of Ramadan: Experience from a teaching hospital in Dammam.

BACKGROUND AND OBJECTIVE: Studies have shown that pre-Ramadan structured educational program for patients with diabetes mellitus (DM) is beneficial. In this study, our aim was to evaluate the degree of adherence of treating physicians to such programs and their influence on the patient's knowledge and behavior. MATERIALS AND METHODS: This cross-sectional study was carried out on adult patients with DM attending a university hospital, who were observed while fasting during Ramadan 1436/2015. Data was collected using a questionnaire-based interview. Baseline characteristics were obtained, and patients were asked whether they had had pre-Ramadan education or not and who the provider was. Patients' knowledge of the components of the recommended structured pre-Ramadan educational program was also tested. Comparison between patients who had the education and those who did not was done using Chi-square test and independent samples Student's t-test; p ≤ 0.05 was considered statistically significant. RESULTS: A total of 298 patients with type 1 or type 2 DM were included in the study; 75.5% of the patients were aged 40 years or older. Only 30% had pre-Ramadan education delivered mainly by diabetic educators or the treating physicians (52% and 44%, respectively). Patients who had the education were younger (mean age: 45.6 ± 17.4 vs. 50.3 ± 14.4, respectively, p = 0.0048), had higher educational qualifications, were more likely to be employed, and self-monitored their blood glucose more frequently (p = 0.0001). There was no difference between the two groups with regard to their knowledge of diet and exercise. CONCLUSION: The adherence to the pre-Ramadan educational program by the treating physician was low. It is necessary to increase the awareness about the importance of these programs among health-care professionals. The programs should target the less educated, the unemployed, and older patients.

Diabetes mellitus and male osteoporosis. Is there a relationship?

OBJECTIVE: To evaluate the relationship between male osteoporosis and type 2 diabetes mellitus (DM). METHODS: We screened 154 male Saudi Arabian patients over the age of 50 years for osteoporosis between May and December 2005, at the Endocrine and Orthopedic Clinics of King Fahd University Hospital, Al-Khobar, Kingdom of Saudi Arabia. Patients body mass index was calculated. Fasting blood glucose was measured in all patients. All patients with type 2 DM hemoglobin A1c levels were measured at follow up. All had bone mineral density (BMD) measurement of hip area and the lumbar spine using the dual energy x-ray absorptiometry scan, and osteoporosis and osteopenia was assessed on the basis of the World Health Organization guidelines. The data was entered in the database and analyzed using the Statistical Package for Social Sciences software with statistical significance of <0.05 and a confidence interval of 95%. RESULTS: There were 57 patients in group A (type 2 DM) with an average age of 59.76 years, 34 in group B (impaired fasting glucose) with an average age of 60.90 years and 63 in group C (normal glucose level), with an average age of 62.53 years. Bone mineral density analysis revealed 10 patients (17.5%) in group A, 7 (20%) in group B and 12 (19%) in group C were normal. Analysis did not show any statistical significance among the 3 groups with regard to BMD, T-Score and Z-Score. CONCLUSION: The study indicates that the prevalence of osteopenia and osteoporosis is common among the Saudi Arabian males. The presence of type 2 diabetes mellitus in these patients did not influence or increase the incidence of osteopenia or osteoporosis.

Genetic influence on circulating vitamin D among Saudi Arabians.

OBJECTIVES:  To examine the effect of most common studied single nucleotide polymorphisms (SNP) on serum 25-hydroxyvitamin D (25OHD) levels in Saudi Arabian population.  METHOD: A cross-sectional observational study was carried out between July 2014 and October 2015, at King Fahd Hospital of the University (KFHU), Al-Khobar, Kingdom of Saudi Arabia. After informed consent, blood samples from 283 subjects living in the Eastern province were collected for 25-OHD measurement and genetic analysis of SNPs in vitamin D receptor (VDR) [rs2228570 and rs1544410], Cytochrome, P450 family 2 (CYP2R1) [rs10741657 and rs1993116], and Group-specific components (GC) [rs2282679 and rs4588].  RESULTS: Vitamin D deficiency was found in 87.6% and insufficiency in 7.7%. The percentages of the different alleles of the 6 SNPs tested ranged between 0-62.5%. There was significant difference between the AA, AG, and GG alleles of VDR rs2228570. The carries of GG allele was associated with increased risks of vitamin D insufficiency (p less than 0.002) and deficiency (p less than or equal to 0.005). The CYP2R1 rs10741657 gene showed that AG and GG allele carriers had significant risk of vitamin D deficiency. AG allele (normal versus Insufficiency p less than 0.02 and normal versus deficiency p less than 0.08) and GG allele normal versus deficiency (p less than 0.002) and insufficiency versus deficiency (p less than 0.001). For group-specific components (GC rs4588), there was only significant difference between the normal and deficiency for the AC allele (p less than 0.0001). CONCLUSION: The presence of GG allele of the SNP rs2228570 of VDR gene, SNPs rs4588 of GC gene and CYP2R1 rs10741657 gene was associated with vitamin D deficiency.

Nigella sativa: A potential natural protective agent against cardiac dysfunction in patients with type 2 diabetes mellitus.

OBJECTIVES: To study the effect of Nigella sativa supplementation on cardiac functions in Type 2 diabetic patients treated with oral hypoglycemic agents. BACKGROUND: Diabetes mellitus is associated with a high risk of cardiovascular morbidity and mortality. A number of reported beneficial effects of N. sativa on cardiovascular function were the inspiration for this study. MATERIALS AND METHODS: Sixty patients with uncontrolled diabetes (hemoglobin A1c [HbA1c] >7%) and with no known cardiovascular complications were recruited from the outpatient diabetes clinic. They were assigned, by convenience, to two groups; the control group received activated charcoal as placebo while the test group received 2 g/day of powdered N. sativa for 1-year. All patients continued with their standard oral hypoglycemic agents. Echocardiography was used to evaluate the diastolic function, systolic function, and left ventricular mass (LVM) before the intervention and after 6 and 12 months of the treatment. RESULTS: HbA1c decreased significantly in the N. sativa group but did not change in the control group. Echocardiographic assessment in the control group showed impairment in diastolic function after 12 months, but there were no significant changes in fractional shortening (FS) or ejection fraction (EF). Furthermore, left ventricular (LV) dimensions at diastole and systole, LVM, and LVM index were significantly increased. In N. sativa group, no significant changes were found in diastolic function or LVM. LV dimension at systole was decreased while FS and EF were significantly increased after 6 and 12 months. CONCLUSION: N. sativa supplementation may protect the hearts of type 2 diabetic patients from diastolic dysfunction while improving LV systolic function.