The clinical assessment of changes in bone density in rheumatoid arthritis patients': Role of DEXA scan and bone turnover biomarkers.

In addition to generalised of bone loss and a higher fracture risk, rheumatoid arthritis (RA) causes periarticular bone erosions. Improvements in bone density/erosion and turnover may not go hand in hand with a positive clinical response to biological anti-inflammatory drugs assesed by disease activity score 28 (DAS28) in RA patients. This study aimed to understand how biologic anti-inflammatory drugs affect bone density, erosion, and turnover in RA patients. We examined bone mineral density (BMD) and bone turnover biomarkers. The study population consisted of 62 RA patients, 49 (79%) of whom were female and 13 (21%) of whom were male. The patients ranged in age from 40 to 79 years old. The patients' BMD was measured using a DEXA scan, and their plasma levels of bone turnover biomarkers CTX and osteocalcin were quantified utilizing an ELISA. BMD of the hip and lumbar spine in responder patients rose after therapy by 0.001g/cm2 (0.11 percent, p0.001 vs. before treatment) and 0.0396g/cm2 (3.96 percent, p0.001 vs. before treatment), respectively. Clinically non-responder patients' DAS28 revealed minor reductions in hip BMD values of -0.008g/cm2 (-0.78 percent, p0.001 vs. before therapy), as well as an improvement in lumbar spine BMD of 0.03g/cm2 (3.03 percent, p0.001 vs. before treatment). After 12 weeks of therapy, the CTX levels in responder patients dropped from 164 125 pg/ml to 131 129 pg/ml. Osteocalcin levels in non-responder patients increased substantially from 11.6 ng/ml to 14.9 ng/ml after 12 weeks of therapy compared to baseline (p = 0.01). Treatment with biologic anti-inflammatory medicines decreases widespread bone loss in RA patients' hip and lumbar spine. The beneficial effects of therapy on BMD were not associated with changes in disease activity of RA patients. Changes in plasma levels of bone turnover biomarkers such as sCTX and osteocalcin confirmed the treatment's beneficial effects.

Patient's effective dose and performance assessment of computed radiography systems.

Computed tomography is widely used for planar imaging. Previous studies showed that CR systems involve higher patient radiation doses compared to digital systems. Therefore, assessing the patient's dose and CR system performance is necessary to ensure that patients received minimal dose with the highest possible image quality. The study was performed at three medical diagnostic centers in Sudan: Medical Corps Hospital (MCH), Advance Diagnostic Center (ADC), and Advance Medical Center (AMC). The following tools were used in this study: Tape measure, Adhesive tape, 1.5 mm copper filtration (>10 × 10 cm), TO 20 threshold contrast test object, Resolution test object (e.g., Huttner 18), MI geometry test object or lead ruler, Contact mish, Piranha (semiconductor detector), Small lead or copper block (∼5 × 5 cm), and Steel ruler, to do a different type of tests (Dark Noise, Erasure cycle efficiency, Sensitivity Index calibration, Sensitivity Index consistency, Uniformity, Scaling errors, Blurring, Limiting spatial Resolution, Threshold, and Laser beam Function. Entrance surface air kerma (ESAK (mGy) was calculated from patient exposure parameters using DosCal software for three imaging modalities. A total of 199 patients were examined (112 chest X rays, 77 lumbar spine). The mean and standard deviation (sd) for patients ESAK (mGy) were 2.56 ± 0.1 mGy and 1.6 mGy for the Anteroposterior (AP) and lateral projections for the lumbar spine, respectively. The mean and sd for the patient's chest doses were 0.1 ± 0.01 for the chest X-ray procedures. The three medical diagnostic centers' CR system performance was evaluated and found that all of the three centers have good CR system functions. All the centers satisfy all the criteria of acceptable visual tests. CR's image quality and sensitivity were evaluated, and the CR image is good because it has good contrast and resolution. All the CR system available in the medical centers and upgraded from old X-ray systems to new systems, has been found to work well. The patient's doses were comparable for the chest X-ray procedures, while patients' doses from the lumbar spine showed variation up to 2 folds due to the variation in patients' weight and X-ray machine setting. Patients dose optimization is recommended to ensure the patients received a minimal dose while obtaining the diagnostic findings.

Assessment of patients radiation doses associated with computed tomography coronary angiography.

Computed tomography coronary angiography (CTCA) has generated tremendous interest over the past 20 years by using multidetector computed tomography (MDCT) because of its high diagnostic accuracy and efficacy in assessing patients with coronary artery disease. This technique is related to high radiation doses, which has raised serious concerns in the literature. Effective dose (E, mSv) may be a single parameter meant to reflect the relative risk from radiation exposure. Therefore, it is necessary to calculate this quantity to point to relative radiation risk. The objectives of this study are to evaluate patients' exposure during diagnostic CCTA procedures and to estimate the risks. Seven hundred ninety patients were estimated during three successive years. The patient's exposure was estimated based on a CT device's delivered radiation dose (Siemens Somatom Sensation 64 (64-MDCT)). The participating physicians obtained the parameters relevant to the radiation dose from the scan protocol generated by the CT system after each CCTA study. The parameters included the volume CT dose index (CTDIvol, mGy) and dose length product (DLP, mGy × cm). The mean and range of CTDIvol (mGy) and DLP (mGy × cm) for three respective year was (2018):10.8 (1.14-77.7) and 2369.8 ± 1231.4 (290.4-6188.9), (2019): 13.82 (1.13-348.5), and 2180.5 (501.8-9534.5) and (2020) 10.9 (0.7-52.9) and 1877.3 (149.4-5011.1), respectively. Patients' effective doses were higher compared to previous studies. Therefore, the CT acquisition parameter optimization is vital to reduce the dose to its minimal value.

ASSESSMENT OF PATIENT'S RADIATION EXPOSURES RESULTED FROM PET/CT 18F-FCH AND 68GA-PSMA PROCEDURES.

This study has sought to evaluate patient exposures during the course of particular diagnostic positron emission tomography and computed tomography (PET/CT) techniques. A total of 73 patients were examined using two types of radiopharmaceutical: 18F-fluorocholine (FCH, 48 patients) and 68Ga-prostate-specific membrane antigen (PSMA, 25 patients). The mean and range of administered activity (AA) in MBq, and effective dose (mSv) for FCH were 314.4 ± 61.6 (462.5-216.8) and 5.9 ± 1.2 (8.8-4.11), respectively. Quoted in the same set of units, the mean and range of AA and effective dose for 68Ga-PSMA were 179.3 ± 92.3 (603.1-115.1) and 17.9 ± 9.2 (60.3-11.5). Patient effective doses from 18F-FCH being a factor of two greater than the dose resulting from 68Ga-PSMA PET/CT procedures. CT accounts for some 84 and 23% for 18F-FCH and 68Ga-PSMA procedures, accordingly CT acquisition parameter optimization is recommended. Patient doses have been found to be slightly greater than previous studies.

EXTREMELY LOW FREQUENCY ELECTROMAGNETIC EXPOSURE ASSESSMENT IN SCHOOLS: A STATISTICAL ANALYSIS OF URBAN AND SEMI-URBAN AREAS.

The aim of this research paper is to estimate the mean value of extremely low frequency (ELF) exposure in schools in Greece. Detailed ELF measurements were conducted and analyzed by the Weighted Peak Method (WPM), which estimates the overall contribution of electromagnetic waves from 1 Hz to 400 kHz, including their phases. A sample of 243 schools was sampled to calculate. The mean value of ELF magnetic fields (MFs) measured in these two groups comprising 243 schools was the principal focus of interest. ELF MF measurements taken in schools situated both far from and near ELF sources had mean and maximum values well below the current International Commission on Non-Ionizing Radiation Protection (ICNIRP) standard. The mean value of ELF MFs from all sources within the sampled schools in Greece was 0.21 µΤ. A statically significant difference between the mean MFs measured in the two groups of schools was found, but the MFs in both groups were much lower than the ICNIRP standard.

Patient Exposure during Fluoroscopy-guided Pacemaker Implantation Procedures.

A pacemaker, which is used for heart resynchronization with electrical impulses, is used to manage many clinical conditions. Recently, the frequency of pacemaker implantation procedures has increased to more than 50% worldwide. During this procedure, patients can be exposed to excessive radiation exposure. Wide range of doses has been reported in previous studies, suggesting that optimization of this procedure has not been fulfilled yet. The current study evaluated patient radiation exposure during cardiac pacemaker procedures and quantified the patient effective dose. A total of 145 procedures were performed for five pacemaker procedures (VVI, VVIR, VVD, VVDR, and DDDR) at two hospitals. Patient doses were measured using the kerma-area product meter. Effective doses were estimated using software based on Monte Carlo simulation from the National Radiological Protection Board (NRPB, now The Health Protection Agency). The effective dose values were used to estimate cancer risk from the pacemaker procedure. Patient demographic data and exposure parameters for fluoroscopy and radiography were quantified. The mean patient doses ± SD per procedure (Gycm2) for VVI, VVIR, VVD, VVDR, and DDDR were 1.52 ± 0.13 (1.43-1.61), 3.28 ± 2.34 (0.29-8.73), 3.04 ± 1.67 (1.57-4.86), 6.04 ± 2.326 3.29-8.58), and 8.8 ± 3.6 (4.5-26.20), respectively. The overall patient effective dose was 1.1mSv per procedure. It is obvious that the DDDR procedure exposed patients to the highest radiation dose. Patient dose variation can be attributed to procedure type, exposure parameter settings, and fluoroscopy time. The results of this study showed that patient doses during different pacemaker procedures are lower compared to previous reported values. Patient risk from pacemaker procedure is low, compared to other cardiac interventional procedures. Patients' exposures were mainly influenced by the type of procedures and the clinical indication.

Assessment of genetic diversity of sesame accessions collected from different ecological regions using sequence-related amplified polymorphism markers.

Sequence-related amplified polymorphism (SRAP) markers were used to assess the genetic diversity among a collection of 52 sesame accessions representing different geographical environments, including eight Saudi landraces. A combination of seventeen primers generated a high number of alleles (365) with 100% polymorphism. The polymorphic information content (PIC) and primer discrimination power (DP) recorded overall means of 0.88 and 5.88, respectively. Genetic similarity values based on Jaccard coefficients ranged from 0.12 to 0.49, with an average similarity value of 0.30, indicating both high genetic distance and a wide genetic basis of the investigated accessions. The unweighted pair group method with arithmetic mean (UPGMA) dendrogram grouped 48 of 52 accessions into seven main clusters, and five accessions failed to form clusters and were separated individually. However, subclusters separated the accessions and, considering the relatedness of accessions and their geographical origin, formed distinct diversity among groups. Saudi landraces showed the widest genetic basis compared with other introduced accessions that were distributed throughout the dendrogram, indicating that agro-ecological zones were indistinguishable by cluster analysis. SRAP analysis revealed a high degree of genetic polymorphism in sesame accessions investigated and showed weak association between geographical origin and SRAP patterns. This wide genetic variability should be considered for sesame breeding programs.

Development, characterization and use of genomic SSR markers for assessment of genetic diversity in some Saudi date palm (Phoenix dactylifera L. ) cultivars

Background: The present study was undertaken towards the development of SSR markers and assessing genetic relationships among 32 date palm (Phoenix dactylifera L.) representing common cultivars grown in different geographical regions in Saudi Arabia. Results: Ninety-three novel simple sequence repeat markers were developed and screened for their ability to detect polymorphism in date palm. Around 71% of genomic SSRs were dinucleotide, 25% tri, 3% tetra and 1% penta nucleotide motives. Twenty-two primers generated a total of 91 alleles with a mean of 4.14 alleles per locus and 100% polymorphism percentage. A 0.595 average polymorphic information content and 0.662 primer discrimination power values were recorded. The expected and observed heterozygosities were 0.676 and 0.763 respectively. Pair-wise similarity values ranged from 0.06 to 0.89 and the overall cultivars averaged 0.41. The UPGMA cluster analysis recovered by principal coordinate analysis illustrated that cultivars tend to group according to their class of maturity, region of cultivation, and fruit color. Analysis of molecular variations (AMOVA) revealed that genetic variation among and within cultivars were 27% and 73%, respectively according to geographical distribution of cultivars. Conclusions: The developed microsatellite markers are additional values to date palm characterization tools that can be used by researchers in population genetics, cultivar identification as well as genetic resource exploration and management. The tested cultivars exhibited a significant amount of genetic diversity and could be suitable for successful breeding program. Genomic sequences generated from this study are available at the National Center for Biotechnology Information (NCBI), Sequence Read Archive (Accession numbers. LIBGSS_039019).

Assessment of patient dose and radiogenic risks during endoscopic retrograde cholangiopancreatography.

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive technique that has been used for over 30 years in the diagnosis and management of pancreaticobiliary disorders. The objectives of this study were to evaluate the patient entrance surface air kerma doses (ESAK) and estimate the organ and effective doses during ERCP in three hospitals in Khartoum. A total of 55 patients were examined in three hospitals in Khartoum state, Sudan. Calibrated thermoluinescent dosimeters (TLD) were used to measure patients' ESAK. Organ and effective doses were estimated using National Radiological Protection Board (NRPB) software. The overall mean of ESAK for all ERCP procedures was 42.4mGy. The mean patient ESAK in Fedail (A), Soba (B) and Ibn sena (C) hospitals were 26.7mGy, 26.0mGy and 72.4mGy, respectively. The effective doses in three hospitals were 1.60, 1.56 and 2.67mSv in that order and the overall mean effective dose was 1.94mSv. Patient radiation doses vary widely among the hospitals. Patient ESAK is low compared to previous studies in the light of the current practice. Patient dose was decreased significantly in the last two decades.

Assessment of genetic diversity among faba bean genotypes using agro-morphological and molecular markers.

Forty faba bean (Vicia faba L.) genotypes were evaluated for their agro-morphological performance and molecular diversity under Central Region of Saudi Arabia conditions during 2010-11 and 2011-12 seasons. Field performance results showed that faba genotypes exhibited a significant amount of variation for their agro-morphological studied parameters. Giza40 recorded the tallest genotype (139.5 cm), highest number of seeds per plants (100.8), and the highest seed yield per plant (70.8 g). The best performing genotypes were Giza40, FLIP03-014FB, Gazira1 and Goff1. Genetic variability among genotypes was determined using Sequence Related Amplified Polymorphism (SRAP) and Amplified Fragment Length Polymorphism (AFLP) markers. A total of 183 amplified fragments (alleles) and 1758 polymorphic fragments (bands) in SRAP and 202 alleles and 716 bands in AFLP were obtained using six SRAP and four AFLP primer combinations respectively. Polymorphism information content (PIC) values for AFLP and SRAP markers were higher than 0.8, indicating the existence of a considerable amount of genetic diversity among faba tested genotypes. The UPGMA based clustering of faba genotypes was largely based on origin and/or genetic background. Result of cluster analysis based on SRAP showed weak and not significant correlation while, it was highly significant based on AFLP analysis with agro-morphological characters (r = 0.01, p > 0.54 and r = 0.26, p < 0.004 respectively). Combined SRAP and AFLP markers proved to be significantly useful for genetic diversity assessment at molecular level. They exhibited high discrimination power, and were able to distinguish the faba bean genotypes with high efficiency and accuracy levels.

Dose reduction in chest CT examination.

Computed tomography (CT) examinations involve relatively high doses to patients. The objectives of this study were to optimise the radiation dose for patient during CT chest scan and to estimate the lifetime cancer risk. A total of 50 patients were studied: control group (A) (38 patients) and optimisation group (B) (12 patients). The optimisation protocol was based on CT pitch increment and lowering tube current. The mean volume CT dose index (CTDI vol) was 21.17 mGy and dose length product (DLP) was 839.0 mGy cm for Group A, and CTDI vol was 8.3 mGy and DLP was 339.7 for Group B. The overall cancer risk was estimated to be 8.0 and 3.0 cancer incidence per million for Groups A and B, respectively. The patient dose optimisation during CT chest was investigated. Lowering tube current and pitch increment achieved a radiation dose reduction of up to 60 % without compromising the diagnostic findings.

Phenological, nutritional and molecular diversity assessment among 35 introduced lentil (Lens culinaris Medik.) genotypes grown in Saudi Arabia.

Morphological, nutritional and molecular analyses were carried out to assess genetic diversity among 35 introduced lentil genotypes (Lens culinaris Medik.). The genotypes exhibited significant differences for their field parameters and some of them showed noticeable superiority. The nutritional and proximate analysis showed that some genotypes were excellent sources of proteins, essential amino acids, minerals, anti-oxidants, total phenolic contents (TPC) and total flavonoid contents (TFC) and hence, highlights lentil nutritional and medicinal potential. Sequence-related amplified polymorphism (SRAP) and amplified fragments length polymorphism (AFLP) markers were used to estimate the genetic variability at the molecular level. The existence of a considerable amount of genetic diversity among the tested lentil genotypes was also proven at the molecular level. A total of 2894 polymorphic SRAP and 1625 AFLP loci were successfully amplified using six SRAP and four AFLP primer pair combinations. Polymorphism information content (PIC) values for SRAP and AFLP markers were higher than 0.8, indicating the power and higher resolution of those marker systems in detecting molecular diversity. UPGMA (unweighted pair group method with arithmetic average) cluster analysis based on molecular data revealed large number of sub clusters among genotypes, indicating high diversity levels. The data presented here showed that FLIP2009-64L and FLIP2009-69L could be used as a significant source of yield, total protein, essential amino acids, and antioxidant properties. The results suggest potential lentil cultivation in the central region of Saudi Arabia for its nutritional and medicinal properties, as well as sustainable soil fertility crop.

Molecular diversity assessment using Sequence Related Amplified Polymorphism (SRAP) Markers in Vicia faba L.

Sequence-related amplified polymorphism (SRAP) markers were used to assess the genetic diversity and relationship among 58 faba bean (Vicia faba L.) genotypes. Fourteen SRAP primer combinations amplified a total of 1036 differently sized well-resolved peaks (fragments), of which all were polymorphic with a 0.96 PIC value and discriminated all of the 58 faba bean genotypes. An average pairwise similarity of 21% was revealed among the genotypes ranging from 2% to 65%. At a similarity of 28%, UPGMA clustered the genotypes into three main groups comprising 78% of the genotypes. The local landraces and most of the Egyptian genotypes in addition to the Sudan genotypes were grouped in the first main cluster. The advanced breeding lines were scattered in the second and third main clusters with breeding lines from the ICARDA and genotypes introduced from Egypt. At a similarity of 47%, all the genotypes formed separated clusters with the exceptions of Hassawi 1 and Hassawi 2. Group analysis of the genotypes according to their geographic origin and type showed that the landraces were grouped according to their origin, while others were grouped according to their seed type. To our knowledge, this is the first application of SRAP markers for the assessment of genetic diversity in faba bean. Such information will be useful to determine optimal breeding strategies to allow continued progress in faba bean breeding.

Radiation dose measurement in gastrointestinal studies.

Barium studies investigations (barium swallow, barium meal and barium enema) are the basic routine radiological examination, where barium sulphate suspension is introduced to enhance image contrast of gastrointestinal tracts. The aim of this study was to quantify the patients' radiation doses during barium studies and to estimate the organ equivalent dose and effective dose with those procedures. A total of 33 investigations of barium studies were measured by using thermoluminescence dosemeters. The result showed that the patient entrance surface doses were 12.6 ± 10, 44.5 ± 49 and 35.7 ± 50 mGy for barium swallow, barium meal, follow through and enema, respectively. Effective doses were 0.2, 0.35 and 1.4 mSv per procedure for barium swallow, meal and enema respectively. Radiation doses were comparable with the previous studies. A written protocol for each procedure will reduce the inter-operator variations and will help to reduce unnecessary exposure.