The Cardiac Comeback-Beating Stronger: Exploring the Remarkable Resilience of the Heart in COVID-19 Recovery through Cardiac Autonomic Analysis.

Background and Objectives: Analyzing the cardiac autonomic function in COVID-19 patients can provide insights into the impact of the virus on the heart's regulatory mechanisms and its recovery. The autonomic nervous system plays a crucial role in regulating the heart's functions, such as heart rate, blood pressure, and cardiac output. This study aimed to investigate the impact of COVID-19 on heart rate variability (HRV) during a 6-min walk test (6MWT). Materials and Methods: The study included 74 participants, consisting of 37 individuals who had recovered from mild to moderate COVID-19 and 37 healthy controls. The study assessed heart rate variability (HRV) and blood pressure both before and after a 6-min walk test (6MWT). Results: The study found significant differences in a few time domains (SDNN and pNN50) and all frequency domain measures, whereas there were no significant differences in demographic characteristics or blood pressure between COVID-19-recovered individuals and healthy controls at rest. There were significant 6MWT effects on average HR, time-domain (SDNN and pNN50) measures of HRV, and all frequency domain measures of HRV. A significant group × 6MWT interaction was found for SDNN, pNN50, total power, Ln total power, LF, HF, Ln LF, Ln HF, and LF nu. Conclusions: Cardiac Autonomic analysis through HRV is essential to ensure the continued health and well-being of COVID-19 survivors and to minimize the potential long-term impacts of the disease on their cardiovascular system. This suggests that HRV analysis during the recovery phase following exercise could serve as a valuable tool for evaluating the physiological effects of COVID-19 and monitoring the recovery process.

Comparative study of TNF-α and vitamin D reveals a significant role of TNF-α in NSCLC in an ethnically conserved vitamin D deficient population.

Growing evidence has implicated tumor necrosis factor-alpha (TNF-α) as an important regulator of the tumor microenvironment. Moreover, various molecular epidemiological studies have proposed vitamin D deficiency to be a mediator of cancer progression. Here we comparatively analyzed the role of TNF-α and vitamin D in non-small cell lung cancer (NSCLC) in an ethnically conserved vitamin D deficient population. Confirmed NSCLC cases (n = 190) matchedfor age, gender, dwelling, and smoking against cancer-free healthy controls ((n = 200) were genotyped for TNF-α promoter polymorphisms (rs361525 and rs1800629) by PCR-RFLP. 48 NSCLC tumor and adjacent normal tissues were quantified for TNF-α mRNA expression by RT-qPCR. 48 NSCLC cases and 60 healthy controls were analyzed for TNF-α and vitamin D serum levels by ELISA and chemiluminescence respectively. Our study indicates thatrs361525 and rs1800629 bear a significant risk towards NSCLC. Both mutant genotype and mutant allele of rs361525 elicit a likelihood of NSCLC reflected by their odds ratio (OR) of 3.16 and 1.81 respectively. In case of rs1800629, the heterogeneous genotype (GA) showed two fold higher risk for NSCLC (OR-2.07, P = 0.006), which could be attributed to the presence of the mutant allele as reflected by overall frequency of mutant A allele vs wild G allele (OR-1.92, P = 0.01). A combined effect of genotypes for rs361525 and rs1800629 revealed a 3.7 fold higher risk towards NSCLC for the presence of heterozygous genotype at both loci. Our preliminary expression results showed significant increase of TNF-α mRNA expression in tumor tissues of NSCLC as compared to adjacent normal tissues [cases- 8.56 ± 3.90vs controls-4.88 ± 2.96, P < 0.0001)] which was further affirmed by extrapolation of TNF-α expression in serum (Cases- 55.75 ± 22.50vs controls- 21.46 ± 27.75, P < 0.0001). Multivariate regression analyses revealed TNF-α mRNA expression to be significantly associated with NSCLC cases less than 50 years of age (P < 0.05). In comparison to the putative role of TNF-α in NSCLC as suggested by the results observed, vitamin D showed no significance towards any of the analyzed parameters or with the risk of NSCLC. This study suggests that TNF-α could be a potential mediator of NSCLC which bears important clinical implications and could be an important therapeutic marker in NSCLC.

The Impact of Periodontal Inflammation on the Severity of Coronary Atherosclerosis.

Introduction Through plausible biological mechanisms, periodontitis causes systemic inflammatory burden and response, thus resulting in damage far beyond the oral cavity. Studies have demonstrated periodontitis to be a significant risk factor for coronary heart disease (CHD) and stroke. The larger the quantum of periodontal inflamed tissue, the greater the chances of periodontitis eliciting bacteremia and systemic inflammatory responses. Studies have reported that periodontitis and other common oral infections play an important role in the development of atherosclerosis. Therefore, the quantity of inflamed periodontal tissue assumes significance in determining the severity of atherosclerosis. Hence, this study investigates the impact of periodontal inflamed surface area (PISA) on the severity of coronary atherosclerosis. Materials and methods In this cross-sectional study, a total of 160 patients who presented at the department of periodontics of The British University in Egypt (BUE) from 1 January 2023 to 30 September 2023 were enrolled. Patients were only enrolled if they had undergone coronary angiography within the last six months, were less than 60 years of age, shared their previous medical history and coronary angiographic report, and gave informed written consent. Data on classic coronary risk factors and periodontal inflammatory status and angiographic findings were recorded and subjected to appropriate statistical analysis. Results The results revealed that the periodontal inflamed surface area (p = 0.002) apart from age (p < 0.047) and low-density lipoprotein cholesterol (LDL-C) (p < 0.001) is a significant independent predictor of the severity of coronary atherosclerosis. Conclusions The periodontal inflamed surface area is an independent predictor of the severity of coronary atherosclerosis.

The Role of Pro-Inflammatory Chemokines CCL-1, 2, 4, and 5 in the Etiopathogenesis of Type 2 Diabetes Mellitus in Subjects from the Asir Region of Saudi Arabia: Correlation with Different Degrees of Obesity.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is becoming a major global health concern, especially in developing nations. The high prevalence of obesity and related diabetes cases are attributed to rapid economic progress, physical inactivity, the consumption of high-calorie foods, and changing lifestyles. OBJECTIVES: We investigated the roles of pro-inflammatory chemokines CCL1, 2, 4, and 5 in T2DM with varying levels of obesity in the Asir region of Saudi Arabia. MATERIALS AND METHODS: In total, 170 confirmed T2DM subjects and a normal control group were enrolled. Demographic data, serum levels of CCL-1, 2, 4, and 5, and biochemical indices were assessed in the subjects and control groups by standard procedures. RESULTS: T2DM subjects were divided into four groups: A (normal body weight), B (overweight), C (obese), and D (highly obese). We observed that male and female control subjects had similar mean serum concentrations of pro-inflammatory chemokines CCL-1, 2, 4, and 5. T2DM subjects in all the four groups showed significantly higher levels of all the four chemokines compared to the controls, regardless of gender. In T2DM subjects with obesity and severe obesity, the rise was most significant. There was a progressive rise in the concentrations of CCL-1, 2, and 4 in T2DM subjects with increasing BMI. Serum CCL5 levels increased significantly in all T2DM subject groups. The increase in CCL5 was more predominant in normal-weight people, compared to overweight and obese T2DM subjects. CONCLUSIONS: Male and female control subjects had similar serum levels of pro-inflammatory chemokines CCL-1, 2, 4, and 5. The progressive rise in blood concentrations of three pro-inflammatory chemokines CCL-1, 2, and 4 in T2DM subjects with increasing BMI supports the idea that dyslipidemia and obesity contribute to chronic inflammation and insulin resistance. Serum CCL5 levels increased significantly in all T2DM subject groups. The selective and more pronounced increase in CCL5 in the T2DM group with normal BMI, compared to subjects with varying degrees of obesity, was rather surprising. Further research is needed to determine if CCL5 underexpression in overweight and obese T2DM subjects is due to some unexplained counterbalancing processes.

Color Doppler ultrasound in high-low risk pregnancies and its relationship to fetal outcomes: a cross-sectional study.

Objective: To calculate the multivessel color Doppler indices in high-risk and low-risk pregnancies and relate these to fetal outcomes. Methods: The investigation involved 60 patients who were pregnant. The patients were separated into groups according to assessment of low and high risk. The patients underwent color Doppler ultrasonography to detect the maternal and fetal blood vessels, and the measured Doppler indices were then analyzed for any association with fetal outcomes. Results: The gestational stages (in weeks) of the participants at the respective times of investigation and delivery were 32.06 ± 2.98 and 36.2 ± 1.78 in the low-risk group and 29.21 ± 1.95 and 29.83 ± 1.86 in the high-risk group. The pulsatility index (PI), resistive index (RI), and systolic/diastolic ratio (SD) decreased with gestation length in the low-risk group, whereas in the high-risk group, these values increased in the uterine and umbilical arteries. With increased gestational stage, MCA-PSV (peak systolic velocity) in the middle cerebral artery (MCA) increased, while PI decreased. Pulsatile and reversal flow of the uterine vein, the vein of Galen, and the umbilical vein were noted in high-risk pregnancies, and these negatively affected the fetal outcome. The fetal venous parameters were more specific and sensitive for predicting an unfavorable fetal outcome than the arterial factors, with a greater negative predictive value. Conclusion: The results of our study indicate that abnormal Doppler indices of the blood vessels in high-risk pregnant patients will result in adverse clinical outcomes. Therefore, the patients can be monitored and managed accordingly using Doppler ultrasonography.

A Retrospective Cohort Study of the Association Between Calcium Serum Level and Hypertension in Older Adults.

INTRODUCTION:  One of the major global risk factors for cardiovascular morbidity and death is hypertension. Earlier research has been conducted on the connection between calcium consumption and blood pressure. OBJECTIVE: This study aims to investigate the association between calcium serum levels and hypertension in older hypertensive adults. METHODS:  A retrospective cohort study of 121 of hypertension patients was conducted in Prince Faisal Bin Khalid Cardiac Center. The data of all patients were collected by records, including lab, pathology, and medical review, in order to determine the effects on patients, providers, and institutions. Statistical analyses were performed using SPSS Statistics version 26.0. A p-value of <0.05 was considered statistically significant. RESULTS:  The study included 121 adult hypertensive patients with a mean of age 60.29 ± 13.92. The majority of included patients were male (81%). More than one-third of patients were obese (39.7%), about one-third (33.9%) were overweight, and 26.4% of patients were in normal weight. The majority of patients had co-morbidities (68.3%); about one-half of them had diabetes mellitus (52.1%). The calcium level mean was 5.07 ± 1.26. The creatine kinase (CK) (initial day) mean ± SD was 813.22 ± 1146.37 became 221.4 ± 330.67 on the last day. The CK-myocardial band (CK-MB) (initial day) was 65.43 ± 118.9 and became 24.38 ± 23.26 on the last day. Additionally, the troponin (initial day) mean was 23.49 ± 104.26 and became 1.65 ± 2.66 on the last day. The most common discharge medications were anti-platelets (95%), beta-blockers (78.5%), statins (70.2%), and proton-pump inhibitors (PPI) (64.5%). The hospital stay days ranged from 1 to 20 days with a mean of 4.83 ± 3.38. The ICU stay days ranged from 1 to 15 days with a mean of 3.57 ± 2.72. Most of the patients (90.9%) improved. CONCLUSION: There is no significant correlation between calcium levels in hypertensive patients and the demographic characteristics of patients, home or current medications, ECHO findings, or procedures done. However, there is a significant correlation between the calcium level and CK level among patients with hypertension. Further investigations are required to verify the relationship between CK and calcium levels in hypertensive patients.

Blood Parameter Profiles and Their Clinical Implications in Hypertensive Patients: A Retrospective Chart Review.

Introduction Hypertension (HTN) is a chronic condition that serves as a major risk factor for cardiovascular diseases, leading to increased mortality and morbidity. It is a frequent modifiable illness affecting global health, resulting in catastrophic fatalities and morbidity. Aim This study aims to investigate blood parameter profiles and their clinical implications in hypertensive patients at the Prince Faisal bin Khalid Cardiac Center in Abha, Saudi Arabia. Methods Utilizing retrospective data from 121 patients at the Prince Faisal bin Khalid Cardiac Center in Abha, Saudi Arabia. The hematological parameter examined were hemoglobin (HB), platelets, hematocrit (HCT), calcium, phosphorus, sodium, potassium, urea, creatinine, and uric acid. The SPSS version 28 software was used for data analysis. Results Significant correlations between various hematological parameters were found in the results, pointing to potential connections between kidney function, the production of blood cells, and electrolyte balance in hypertensive patients. The results align with earlier studies carried out in the area and offer insightful information for clinicians and researchers interested in managing HTN and its complications. Conclusion The study emphasized the significance of considering hypertensive patients' age, gender, and lifestyle when interpreting their blood parameter profiles. The findings imply that a thorough comprehension of these blood parameter values and their potential effects on HTN is necessary for effectively managing HTN in this population. This study on the blood parameter profiles in hypertensive patients in Saudi Arabia provides the relationships between various hematological parameter and their clinical implications. These findings should be considered when creating targeted interventions and strategies to address the specific requirements and difficulties of managing HTN and its associated complications in this population. More research is required to comprehend the underlying reasons for the observed variations in hematological parameter profiles and their effects on the management of HTN.

The attitude of the Public Toward Social History Taking in Southern Saudi Arabia.

Background: Social history taking is an important element of a medical interview. No previous studies, however, addressed public attitudes regarding social history taking in Saudi Arabia. Objective: This study explores public attitudes about the importance of social history taking by doctors in Southern Saudi Arabia. Methods: A cross-sectional study was conducted to collect public opinion about social history taking using a self-administered questionnaire. Social history taking was defined as questions about general sociodemographics (job, income, marital status, housing conditions, and animal contact) and social habits (travel, smoking, alcohol drinking, illicit drug use, and sexual history). Descriptive statistics were conducted, along with a comparison between categorical variables. Results: A total of 510 respondents completed the questionnaire, of which 381 (74.7%) had a medical history taken before. A complete social taking was not obtained from those with medical history previously taken. Marital status (73.2%), smoking (49.1%), and occupation (32.8%) were the commonest inquiries, while income (3.7%) and sexual history (6.6%) were the least. Most respondents had no reservations about answering questions about their social history. Among the general demographic questions, job and marital status were more likely to be answered, whereas income and housing inquiries were less likely to be answered. Among social habits, sexual history followed by illicit drug use and alcohol drinking inquiries were less likely to be answered. Conclusion: Detailed social history taking is uncommon among doctors. The public is open to discussing their social status and habits. However, questions involving income, housing, and some social habits like illicit drugs, alcohol, and sexual history are less likely to be faithfully reported and thus need to be handled appropriately. It is crucial for healthcare providers to approach social history taking with sensitivity and respect and to create a private environment for patients where they can freely and accurately share their social histories.

Serum Magnesium in Patients With Acute Myocardial Infarction and Its Effect on Cardiac Complications and Mortality in Myocardial Infarction Patients.

Background Magnesium is an essential micronutrient for people and is crucial in maintaining healthy cardiac function. It functions as a cofactor in a number of the body's enzyme systems, and myocardial cells are one of its target tissues. The upkeep of the myocardium's normal functional integrity depends on a lot of things including magnesium ions. Magnesium plays an important role in the pathophysiology of cardiovascular disorders. Aim This study aims to estimate serum magnesium levels and their correlation with cardiac complications and mortality in patients with acute myocardial infarction (AMI). Methods Patients with acute myocardial infarction who visited the Prince Faisal Bin Khalid Cardiac Center within 12 hours of the onset of symptoms were the subjects of this study. On the first and fifth days following admission, the level of serum magnesium was assessed. Statistical Package for Social Sciences (SPSS) version 20 (IBM SPSS Statistics, Armonk, NY) was used to analyze the collected data. Results The current study comprised 160 patients with acute myocardial infarction; there were 84 (52.5%) who experienced a low level of serum magnesium on admission. Significantly higher proportions of patients who experienced low magnesium levels had diabetes mellitus (P=0.0072) and a history of diuretics (P=0.03) and were administrated beta-blockers (P=0.01), calcium channel blockers (P=0.04), and statins (P=0.007) after admission. Significantly higher proportions of patients with low serum magnesium experienced atrial fibrillation (P=0.03), angina (P=0.03), and cardiogenic shock (P=0.003). Conclusion Low magnesium levels are associated with poor outcomes in most patients admitted with acute myocardial infarction.

Evaluation and Assessment of Community Awareness About Coronary Artery Disease in the Aseer Region.

Background Coronary artery disease (CAD), a severe cardiovascular disorder, still remains the major reason for death among adults. In Saudi Arabia, the most common risk factors noticed were hypertension, diabetes, smoking, and dyslipidemia. To date, various therapies have been used for managing CAD, but primary prevention remains the cornerstone to reducing the incidence of CAD-linked mortality and morbidity. The present research aimed to evaluate public awareness levels about CAD in the Aseer region of Saudi Arabia. Materials and methods A structured questionnaire was used to assess the demographic variables, information regarding risk factors, and knowledge and awareness about CAD. To analyze the knowledge and awareness of the general population regarding CAD, 26 well-constructed questions were framed and asked. General characteristics like knowledge, awareness, risk factors, signs and symptoms, complications, effects, treatment, and prevention of CAD were recorded by asking questions with different options. The data obtained were then subjected to statistical analysis using SPSS version 20.0 software (IBM Corp., Armonk, NY). Results Out of 651 participants, 66.51% were males and 33.48% were females, and 36.40% were aged between 26 and 35 years. Of the participants, 14.13% had a positive family history of CAD, 66.05% had inactive lifestyle habits, and 59.60% did not report any stress. A total of 61.29% were unaware of CAD, but many of them were aware of the risk factors, symptoms, and complications of the disease. A total of 5.529% were suffering from CAD, with a time period of less than one year. Only 1.84% of participants were taking medicines for CAD. Conclusion Our study suggested that the community of the Aseer region of Saudi Arabia has meager knowledge and awareness about CAD. Westernized lifestyles and urbanization have caused poor physical well-being in people, leading to increased risk factors for CAD. Thus, we suggest that different educational public health awareness programs should be implemented by the Ministry of Health, Saudi Arabia to decrease the prevalence of these life-threatening diseases.

Differential Association of Selected Adipocytokines, Adiponectin, Leptin, Resistin, Visfatin and Chemerin, with the Pathogenesis and Progression of Type 2 Diabetes Mellitus (T2DM) in the Asir Region of Saudi Arabia: A Case Control Study.

BACKGROUND: Sedentary lifestyles, urbanization and improvements in socio-economic status have had serious effects on the burden of diabetes across the world. Diabetes is one of the 10 leading causes of death globally, and individuals with diabetes have a 2-3-fold increased risk of all-cause mortality. Adipose tissue is increasingly understood as a highly active endocrine gland that secretes many biologically active substances, including adipocytokines. However, the exact and discrete pathophysiological links between obesity and T2DM are not yet fully elucidated. METHODS: In the current study, we present the association of five diverse adipocytokines, adiponectin, leptin, resistin, visfatin and chemerin, with T2DM in 87 patients (46 males and 41 females) with type 2 diabetes mellitus and 85 healthy controls (44 males and 41 females) from the Asir region of Saudi Arabia. The patients were divided into four groups: normal BMI, overweight, obese and severely obese. The baseline biochemical characteristics, including HbA1c and anthropometric lipid indices, such as BMI and waist-hip ratio, were determined by standard procedures, whereas the selected adipokine levels were assayed by ELISA. RESULTS: The results showed significantly decreased levels of adiponectin in the T2DM patients compared to the control group, and the decrease was more pronounced in obese and severely obese T2DM patients. Serum leptin levels were significantly higher in the females compared to the males in the controls as well as all the four groups of T2DM patients. In the male T2DM patients, a progressive increase was observed in the leptin levels as the BMI increased, although these only reached significantly altered levels in the obese and severely obese patients. The serum leptin levels were significantly higher in the severely obese female patients compared to the controls, patients with normal BMI, and overweight patients. The leptin/adiponectin ratio was significantly higher in the obese and severely obese patients compared to the controls, patients with normal BMI, and overweight patients in both genders. The serum resistin levels did not show any significant differences between the males and females in thr controls or in the T2DM groups, irrespective of the BMI status of the T2DM patients. The visfatin levels did not reveal any significant gender-based differences, but significantly higher levels of visfatin were observed in the T2DM patients, irrespective of their level of obesity, although the higher values were observed in the obese and highly obese patients. Similarly, the serum chemerin levels in the controls, as well as in T2DM patients, did not show any significant gender-based differences. However, in the T2DM patients, the chemerin levels showed a progressive increase, with the increase in BMI reaching highly significant levels in the obese and severely obese patients, respectively. CONCLUSION: In summary, it is concluded that significantly altered concentrations of four adipokines, adiponectin, leptin, visfatin and chemerin, were found in the T2DM patient group compared to the controls, with more pronounced alterations observed in the obese and highly obese patients. Thus, it can be surmised that these four adipokines play a profound role in the onset, progression and associated complications of T2DM. In view of the relatively small sample size in our study, future prospective studies are needed on a large sample size to explore the in-depth relationship between adipokines and T2DM.

Clinical-Epidemiology of Tension-Type Headache among the Medical and Dental Undergraduates of King Khalid University, Abha, Saudi Arabia.

Introduction (background): Headache is the primary complaint among students. Headaches mostly have multifactorial causes. The degree of headache severity significantly impacts attitudes, behavior, and academic performance. Objectives: Here, we investigate the demographic epidemiology of tension-type headaches (T.T.H.), and determine the clinical presentation and triggers of the tension-type among headache sufferers. Methods (settings, design): An institutional-based cross-sectional study (descriptive) was conducted on the medical and dental undergraduates at King Khalid University, Abha, Saudi Arabia, from 1 July 2021 to 31 December 2021. Data were gathered using a pre-designed questionnaire. A consecutive sampling method was used in a COVID-19-constrained environment. After preliminary screening of the study population, 460 samples were included. An electronic questionnaire was shared with them, and they were requested to respond. Results: More than half of the participants (258, 56.1%) experienced tension-type headaches, while the remaining 202 (43.9%) never felt a headache. Tension-type headaches manifested as heaviness of the head (44, 17.0%), tightness (126, 48.8%), and dull aching pain (66, 25.7%). Conclusions: T.T.H. is a prevalent condition with a significant impingement on academic work, and psychological health. Tension-type headache sufferers are advised to keep daily diaries to determine triggers, and plan for prevention and treatment progression.

Clinical Implications of Glyoxalase1 Gene Polymorphism and Elevated Levels of the Reactive Metabolite Methylglyoxal in the Susceptibility of Type 2 Diabetes Mellitus in the Patients from Asir and Tabuk Regions of Saudi Arabia.

Diabetes mellitus constitutes a big challenge to the global health care system due to its socioeconomic impacts and very serious complications. The incidence and the prevalence rate are increased in the Gulf region including the KSA. Type 2 diabetes mellitus (T2DM) is caused by diverse risk factors including obesity, unhealthy dietary habits, physical inactivity, smoking and genetic factors. The molecular genetic studies have helped in the detection of many single nucleotide polymorphisms (SNP) with different diseases including cancers, cardiovascular diseases and T2DM. The glyoxalase 1 (GLO1) is a detoxifying enzyme and catalyzes the elimination of the cytotoxic product methylglyoxal (MG) by converting it to D-lactate, which is not toxic to tissues. MG accumulation is associated with the pathogenesis of different diseases including T2DM. In this study, we have investigated the association of the glyoxalase 1 SNPs (rs2736654) rs4746 C>A and rs1130534 T>A with T2DM using the amplification refractory mutation system PCR. We also measured the concentration of MG by ELISA in T2DM patients and matched heathy controls. Results show that the CA genotype of the GLO rs4647 A>C was associated with T2DM with OR = 2.57, p-value 0.0008 and the C allele was also associated with increased risk to T2DM with OR = 2.24, p-value = 0.0001. It was also observed that AT genotype of the rs1130534 was associated with decreased susceptibility to T2DM with OR = 0.3, p-value = 0.02. The A allele of rs1130534 was also associated with reduced risk to T2DM with PR = 0.27 = 0.006. In addition, our ELISA results demonstrate significantly increased MG concentrations in serum of the T2DM patients. We conclude that the GLO1 SNP may be associated with decreased enzyme activity and a resultant susceptibility to T2DM. Further well-designed studies in different and large patient populations are recommended to verify these findings.

Potential impact of GCK, MIR-196A-2 and MIR-423 gene abnormalities on the development and progression of type 2 diabetes mellitus in Asir and Tabuk regions of Saudi Arabia.

Type 2 diabetes mellitus (T2DM) is a metabolic disorder characterized by persistent hyperglycemia and is associated with serious complications. The risk factors for T2DM include both genetic and lifestyle factors. Genome­wide association studies have indicated the association of genetic variations with many diseases, including T2DM. Glucokinase (GCK) plays a key role in the regulation of insulin release in the pancreas and catalyzes the first step in glycolysis in the liver. Genetic alterations in the GCK gene have been implicated in both hyperglycemia and hypoglycemia. MicroRNAs (miRNAs/miRs) are small non­coding RNA molecules that are involved in the important physiological processes including glucose metabolism. In the present study, the association of the single nucleotide polymorphisms (SNPs) in the GCK, MIR­196A­2 and MIR­423 genes with susceptibility to T2DM in patients from two regions of Saudi Arabia were examined, using the tetra­primer amplification refractory mutation system. The results showed that the AA genotype and the A allele of GCK rs1799884 were associated with T2DM [odds ratio (OR)=2.25, P=0.032 and OR=1.55, P=0.021, respectively]. Likewise, the CT genotype and T allele of MIR­196A­2 rs11614913 were associated with an increased risk of T2DM (OR=2.36, P=0.0059 and OR=1.74, P=0.023, respectively). In addition, the CA genotype of MIR­423 rs6505162 C>A was found to be linked with T2DM (OR=2.12 and P=0.021). It was concluded in the present research study that gene variations in GCK, MIR­196A­2 and MIR­423 are potentially associated with an increased risk of T2DM. These results, in the future, may help in the identification and stratification of individuals susceptible to T2DM. Future longitudinal studies with larger sample sizes and in different ethnic populations are recommended to validate these findings.

The association of anemia as a risk of heart failure.

AIM: The present study was conducted to assess the presence of anemia in patients with advanced heart failure (HF) and compared the clinical characteristics of patients with anemia and without anemia. METHODOLOGY: The present study was conducted on 102 patients (60 males, 42 females) with advanced HF admitted in hospital. In all, general physical and clinical examinations were performed. All were subjected to complete blood count (CBC), hematocrit, and assessment of urea, creatinine, sodium, potassium, and brain natriuretic peptide (BNP). The levels of serum iron, ferritin, iron saturation, and iron-binding capacity were also evaluated. The causes of HF were assessed. RESULTS: Mean age was 48.2 ± 5.7 and 42.2 ± 6.2 years in males and females patients, respectively. Left ventricular ejection fraction (LVEF) was 0.26 ± 0.8 in males and 0.24 ± 0.5 in females. 71.5% males and 76.3% females were on inotropic support. The etiology of HF was ischemia in 29% males and 27% females, high blood pressure in 15% males and 12% females, obesity in 18% males and 19% females, valvular heart disease in 7% males and 5% females, diabetes in 11% males and 6% females, and idiopathy in 20% males and 31% females. There was a significant difference in mean age, initial HB, final HB, hypertension, creatinine, BNP, and initial hematocrit level in patients with anemia and without anemia (P < 0.05). Deaths in hospital were also significant (P < 0.05). CONCLUSION: Anemia was seen in one-third of the patients with HF. Anemia was an independent marker with poor prognosis. Anemic patients were older than non-anemic patients.