The role of matrix metalloproteinase-2 and miR-196a2 in bronchial asthma pathogenesis and diagnosis.

Background: Bronchial asthma is a persistent inflammatory respiratory condition that restricts the passage of air and causes hyperresponsiveness. Chronic asthma can be classified into three categories: mild, moderate, and severe. Remodeling took place as the extracellular matrix accumulated in the walls of the airways. Inflammation occurs as a result of the damage caused by matrix metalloproteinase-2 (MMP-2) to basement membrane type IV collagen. The severity of asthma may be associated with miR-196a2. The objective of our study was to investigate the underlying mechanisms and clinical relevance of miR-196a2 and MMP-2 serum levels in relation to the severity of asthma. Methods: This study recruited 85 controls and 95 asthmatics classified as mild, moderate, or severe. Expression of miR-196a2 was measured by quantitative reverse transcriptase PCR. Using the enzyme-linked immunosorbent assay (ELISA), MMP-2, IL-6, and total immunoglobulin E (IgE) levels in the serum of asthmatics of various grades were compared to a control group. MMP-2's diagnostic and prognostic potential was determined using ROC curve analysis. This study also measured blood Eosinophils and PFTs. We examined MMP-2's connections with IgE, blood Eosinophils, and PFTs. Results: The current investigation found that miR-196a2 expression was significantly higher in the control group than in asthmatic patients as a whole. The study found that severe asthmatics had higher MMP-2, IL-6, and IgE serum levels than healthy controls. We identified the MMP-2 serum concentration cutoff with great sensitivity and specificity. Significant relationships between MMP-2 serum level and miR-196a2 expression in the patient group with severe asthmatics were found. The MMP-2, IL-6, and IgE serum levels were considerably higher in mild, moderate, and severe asthmatics than controls. The miR-196a2 expression and MMP-2 serum concentration correlated positively with IgE and blood eosinophils % and negatively with all lung function tests in the asthmatic patient group.Conclusion: the study revealed that the elevated miR-196a2 expression and serum concentration of MMP-2, IL-6, and IgE associated with elevated blood eosinophils % is associated with pathophysiology and degree of asthma severity. The miR-196a2 expression and MMP-2 serum concentration have a promising diagnostic and prognostic ability in bronchial asthma.

Magnitude of diabetic peripheral neuropathy in Saudi Arabia: a systematic review and meta-analysis.

BACKGROUND: Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and disability from foot ulcers and amputations, is increasingly becoming a source of concern in Saudi Arabia and worldwide. However, wide variability exists in the prevalence of DPN reported in previous studies in Saudi Arabia, limiting the utility of existing data in national public health policy. Therefore, the aim of this study was to systematically evaluate the magnitude of DPN in patients living with DM in Saudi Arabia in order to inform policymakers during the implementation of appropriate preventive and treatment strategies for DPN. METHODS: PubMed, Google Scholar, African Journals Online, Scopus, Web of Science, Embase, and Wiley Online Library were searched systematically to acquire relevant articles based on preset criteria. We evaluated heterogeneity and publication bias and employed a random-effects model to estimate the pooled prevalence of DPN from the included studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in conducting the meta-analysis. Analysis was performed using the STATA Version 12 software. RESULTS: Twelve studies with a total of 4,556 participants living with DM, of whom 2,081 were identified as having DPN were included in the meta-analysis. The overall prevalence of DPN was 39% (95% CI [30%, 49%]). Subgroup analysis based on diagnostic method showed that prevalence estimates for DPN using screening questionnaires and clinical examination were 48% (95% CI [46%, 50%]) and 40% (95% CI: [38%, 42%]), respectively, while the estimated prevalence using nerve conduction studies was 26% (95% CI [15%, 36%]). CONCLUSION: This study showed a high magnitude of DPN in Saudi Arabia (39%), thus highlighting the need for sustained efforts to reduce the prevalence of diabetes mellitus and DPN in the kingdom.

Prevalence of congenital heart disease among patients with down syndrome in Southwestern Saudi Arabia.

Background: There is a paucity of data on the prevalence and pattern of congenital heart disease (CHD) among patients with Down syndrome (DS) in Bisha, Saudi Arabia. The aim of the study was to determine the prevalence and patterns of CHD in patients with DS and explore the association of participants' sex with CHD in DS patients. Methodology: A total of 42 patients with confirmed DS were enrolled in the study. Relevant data were obtained from the patients' records. The spectrum of CHD was analyzed and classified accordingly. Pearson's Chi-square was used to determine the association of gender with CHD. Results: Approximately 81% of the study participants had CHD. The most common CHD was atrial septal defect (28.5%), followed by ventricular septal defect (25%), patent ductus arteriosus (16%), and atrioventricular septal defect (14.3%). No significant association was found between CHDs and sex. Conclusion: The prevalence of CHD in the study group was consistent with reports from other regions of Saudi Arabia and globally. Participants' sex was not associated with the occurrence of CHD in DS patients in this study.

RésuméContexte: Il existe peu de données sur la prévalence et le profil des cardiopathies congénitales (CHD) chez les patients atteints de duvet. syndrome (DS) à Bisha, Arabie saoudite. Le but de l'étude était de déterminer la prévalence et les modèles de CHD chez les patients atteints de DS et explorer l'association du sexe des participants avec la maladie coronarienne chez les patients atteints de DS. Méthodologie: Un total de 42 patients atteints de DS confirmé ont été recrutés dans l'étude. Les données pertinentes ont été obtenues à partir des dossiers des patients. Le spectre de CHD a été analysé et classé en conséquence. Pearson Le chi carré a été utilisé pour déterminer l'association du sexe avec la maladie coronarienne. Résultats: Environ 81% des participants à l'étude avaient une CHD. La maladie coronarienne la plus fréquente était la communication interauriculaire (28,5%), suivie d'une communication interventriculaire (25%), persistance du canal artériel (16%) et communication inter-auriculo-ventriculaire (14,3%). Aucune association significative n'a été trouvée entre les maladies coronariennes et le sexe. Conclusion: la prévalence de la maladie coronarienne dans le groupe d'étude était cohérent avec les rapports d'autres régions d'Arabie saoudite et du monde entier. Le sexe des participants n'était pas associé au survenue de CHD chez les patients DS dans cette étude. Mots-clés: Cardiopathie congénitale, syndrome de Down, Arabie saoudite.

Impact of a longitudinal faculty development program on the quality of multiple-choice question item writing in medical education.

Background: Like many other academic programs, medical education is incomplete without a robust assessment plan. Objective: The study aimed to evaluate the impact of longitudinal faculty development program (FDP) on the examination item quality (EIQ) from a cohort of medical college faculty members. Methods: Item analysis (IA) of multiple-choice questions (MCQs) from a cohort of medical tutors over a 3-year period (2017 [S1], 2018 [S2], and 2019 [S3]) before and following once-per-week FDP was conducted. The questions were from three randomly selected courses: man and his environment (MEV) from phase 1, central nervous system (CNS) from phase 2, and internal medicine (MED) from phase 3. Data assessed were 480 MCQs from the final exams in the courses. The parameters considered in IA were the difficulty index, index of discrimination, nonfunctional distractors (NFDs), distractor efficiency for each question item, and Cronbach's alpha (CA) for the test as a whole. Comparison over the 3 years was made using Fisher's exact test and repeated-measures ANOVA with Bonferroni test as post hoc test. Results: Overall, out of 480 MCQs, 272 had no NFD (52 [19.52%], 104 [38.24%], and 116 [42.65%] in 2017, 2018, and 2019, respectively) with a significant difference between S3, S2, and S1 (P < 0.0001). The mean CA for the exams in S1, S2, and S3, respectively, were 0.51, 0.77, and 0.84, P < 0.0001. Conclusion: There was an improvement in EIQ following the implementation of longitudinal FDP. Thus, the need for active training and retraining of the faculty for a better EIQ cannot be overemphasized.

RésuméContexte: Comme beaucoup d'autres programmes universitaires, la formation médicale est incomplète sans un plan d'évaluation solide. Objectif: L'étude visait à évaluer l'impact du programme longitudinal de formation professorale (FDP) sur la qualité des éléments d'examen (EIQ) d'une cohorte de membres du corps professoral des facultés de médecine. Méthodes: Analyse des éléments (IA) des questions à choix multiples (QCM) d'une cohorte de tuteurs médicaux une période de trois ans (2017 [S1], 2018 [S2] et 2019 [S3]) avant et après le déroulement du FDP hebdomadaire a été effectuée. Les questions venaient de trois cours choisis au hasard: l'homme et son environnement (MEV) de la phase 1, le système nerveux central (SNC) de la phase 2 et interne médecine (MED) de la phase 3. Les données évaluées étaient 480 QCM des examens finaux des cours. Les paramètres considérés dans IA étaient l'indice de difficulté, l'indice de discrimination, les distracteurs non fonctionnels (NFD), l'efficacité du distracteur pour chaque question et le alpha (CA) pour le test dans son ensemble. La comparaison au cours des 3 années a été faite en utilisant le test exact de Fisher et l'ANOVA à mesures répétées avec Test de Bonferroni comme test post hoc. Résultats: Dans l'ensemble, sur 480 QCM, 272 n'avaient pas de NFD (52 [19,52%], 104 [38,24%] et 116 [42,65%] en 2017, 2018 et 2019, respectivement) avec une différence significative entre S3, S2 et S1 (P <0,0001). L'AC moyenne pour les examens en S1, S2 et S3, respectivement, était de 0,51, 0,77 et 0,84, P <0,0001. Conclusion: Il y a eu une amélioration de l'EIQ après la mise en œuvre du FDP. Ainsi, la nécessité d'une formation active et d'un recyclage de la faculté pour un meilleur QEI ne peut pas être surestimée.

Variation in the lobar pattern of the right and left lungs: A case report.

The right lung has three lobes and two fissures while the left lung has two lobes and one fissure. During a routine dissection we observed a variant complete fissure and three incomplete fissures in the right lung while the left lung presented with a variant transverse fissure separating the superior lingual and anterior bronchopulmonary segments. In the right lung, the incomplete fissures lie between the apical and posterior bronchopulmonary segments; medial and lateral bronchopulmonary segments; apical and basal bronchopulmonary segments. The complete variant fissure separates the medial basal bronchopulmonary segment from the remaining basal segments. Such variant fissures and lobes are clinically important in cases of lobotomy.