Effect of proton pump inhibitors on Magnesium levels in Type II diabetic patients: a single centre study from Saudi Arabia.

OBJECTIVE: In recent years, increasing evidence suggests an association between low Magnesium levels and type 2 diabetes mellitus. It has also been reported that the use of proton pump inhibitors may induce hypomagnesemia. Although some case reports have described patients with Proton Pump Inhibitor-induced hypomagnesemia, the impact of Proton Pump Inhibitor use on hypomagnesemia has not been fully clarified in comparative studies. The objective of the study was to determine the Magnesium levels in patients with diabetes who are taking proton pump inhibitors and also to correlate the Magnesium levels in diabetic patients who take proton pump inhibitors with those not taking proton pump inhibitors. PATIENTS AND METHODS: A cross-sectional study was carried out in the study population comprising adult patients attending internal medicine clinics in King Khalid Hospital, Majmaah, KSA. A total of 200 patients who gave informed consent were recruited into the study over one year. RESULTS: Overall prevalence of hypomagnesemia was observed among 128 patients out of 200 (64%) diabetic patients. Relatively more patients with hypomagnesemia were found in group 2 (without PPI use) (38.5%) compared to group 1 (with PPI use) (25.5%). A statistically significant difference was not observed in group 1 using proton pump inhibitors and group 2 not using proton pump inhibitors (p-value = 0.473). CONCLUSIONS: Hypomagnesemia is seen in diabetic patients and patients who take proton pump inhibitors. There was no statistically significant difference in Magnesium levels in diabetic patients, irrespective of proton pump inhibitor use.

Cancer cells resist hyperthermia due to its obstructed activation of caspase 3.

AIM: It is well known that inducing hyperthermia is a type of cancer treatment but some research groups indicate that this treatment is not effective. This article finds and explains the mechanism of this treatment and its possible problems. BACKGROUND: Hyperthermia is commonly known as a state when the temperature of the body rises to a level that can threaten one's health. Hyperthermia is a type of cancer treatment in which body tissue is exposed to high temperatures (up to 45 °C). Research has shown that high temperatures can damage and kill cancer cells, usually with minimal injury to normal tissues. However, this mechanism is not known. MATERIALS AND METHODS: We recently treated cancer cells with different temperatures ranging from 37 °C to 47 °C and further measured their caspase 3 secretion by ELISA, western blot and cell survival rate by microscope. RESULTS: We found that most cancer cells are able to resist hyperthermia more than normal cells most likely via non-activation of caspase3. We also found that hyperthermia-treated (≥41°) cancer cells extend a long pseudopod-like extension in comparison to the same cancer cells under normal conditions. CONCLUSION: Our data here indicates that cancer cells have resistance to higher temperatures compared to normal cells via non-activation of caspase 3. This is a significant issue that needs to be brought to attention as the medical community has always believed that a high temperature treatment can selectively kill cancer/tumor cells. Additionally, we believe that the pseudopod-like extensions of hyperthermia-treated cancer cells must be related to its resistance to hyperthermia.

Gis predictive mapping of terrestrial gamma radiation in the Northern State, Sudan.

This study presents the evaluation of absorbed dose in air due to gamma-emitting nuclides from (238)U and (232)Th series, (40)K and (137)Cs and the corresponding geographical information system (GIS) predictive mapping for the Northern State. Activity concentration of (238)U, (232)Th , (40)K and (137)Cs in soil samples collected from different locations have been measured using high-resolution gamma spectrometry. On  average, activity concentrations were 19±4 ((238)U), 47±11 ((232)Th), 317±65 ((40)K) and 2.26 Bq kg(-1) for (137)Cs. Absorbed dose rate in air at a height of 1 m above ground surface was calculated using seven sets of dose rate conversion factors (DRCFs) and the corresponding annual effective dose was estimated. On average, the values obtained fall within a narrow range of 44 and 53 nGy h(-1), indicating that the variation in absorbed dose rate is insignificant for different DRCFs. The corresponding annual effective dose ranged from 53 to 65 µSv y(-1). Using GIS, prediction maps for concentrations of (238)U, (232)Th, (40)K and (137)Cs were produced. Also, a map for absorbed dose rate in air at a height of 1 m above the ground level was produced, which showed a trend of increasing from the west towards south-east of the State.

Does perfusion computed tomography facilitate clinical decision making for thrombolysis in unselected acute patients with suspected ischaemic stroke?

BACKGROUND: Despite use in clinical practice and major positive trials of thrombolysis, non-contrast computed tomography (NCCT) is not sensitive for identifying penumbral tissue in acute stroke. This study evaluated how physiological imaging using CT perfusion (CTP) could add to the diagnostic utility of an NCCT and inform clinical decisions regarding thrombolysis. METHODS: Forty imaging datasets containing NCCT and CTP were retrospectively identified from a cohort of consecutive acute stroke patients. Two sets of observers (n = 6) and a neuroradiologist evaluated the images without knowledge of clinical symptoms. Inter-observer agreement was calculated using the κ statistic for identifying acute ischaemic change on NCCT: perfusion abnormalities (namely cerebral blood volume, cerebral blood flow and time to peak), and penumbral tissue on perfusion maps obtained by two image processing algorithms. RESULTS: Inter-rater agreement was moderate (κ = 0.54) for early ischaemic change on NCCT. Perfusion maps improved this to substantial for cerebral blood volume (κ = 0.67) and to almost perfect for time to peak (κ = 0.87) and cerebral blood flow (κ = 0.87). The agreement for qualitative assessment of penumbral tissue was substantial to perfect for images obtained using the two different perfusion algorithms. Overall, there was a high rate of decision to thrombolyse based on NCCT (81.25%). CTP strengthened the decision to thrombolyse based on NCCT in 38.3% of cases. It negatively influenced the decision in 14.6% of cases, this being significantly more common in experienced observers (p = 0.02). CONCLUSIONS: We demonstrate that the qualitative evaluation of CTP produces near perfect inter-observer agreement, regardless of the post-processing method used. CTP is a reliable, accessible and practical imaging modality that improves confidence in reaching the appropriate diagnosis. It is particularly useful for less experienced clinicians, to arrive at a physiologically informed treatment decision.

Lacunar stroke attributable to radiation-induced intracranial arteriopathy.

We report the rare presentation of lacunar stroke syndrome secondary to single perforator mouth occlusion from radiation-induced middle cerebral artery (MCA) stem arteriopathy. A 30-year-old female had acute-onset right-sided ataxic hemiparesis and dysarthria. As a child, she had a medulloblastoma of the posterior fossa and had surgery followed by cranial radiotherapy. She had no significant vascular risk factors. Acute CT showed extensive bilateral basal ganglia and left thalamic calcification; DWI showed a left internal capsule lacunar infarct; and MRA and CTA showed a 50% stenosis of the proximal left MCA.

Comparison of the effects of thioridazine and mesoridazine on the QT interval in healthy adults after single oral doses.

We compared the effects of single doses of thioridazine and mesoridazine on the heart rate-corrected QT (QTc) interval in healthy adult volunteers. QTc intervals and plasma concentrations of thioridazine, mesoridazine, and metabolites were measured after single oral doses of thioridazine hydrochloride 50 mg, mesoridazine besylate 50 mg, or placebo in a double-blind, crossover study. Mean maximum increases in the QTc interval following thioridazine (37.3+/-4.1 ms, P=0.023) and mesoridazine (46.6+/-7.4 ms, P=0.021) were similar and significantly greater than following placebo (12.9+/-8.1 ms). The area under the effect-time curve over 8 h following drug administration was similar between the two drugs (129.3+/-22.1 vs 148.3+/-43.0 ms h). In conclusion, thioridazine and mesoridazine are associated with similar effects on the QTc interval.

Submicroscopic Plasmodium falciparum infections during pregnancy, in an area of Sudan with a low intensity of malaria transmission.

There are few published studies on the burden of malaria during pregnancy from areas of sub-Saharan Africa where the intensity of malarial transmission is low, and few on submicroscopic malarial infections in pregnant women. The present study was conducted in New Halfa, an area of low-intensity transmission in eastern Sudan, between August 2003 and July 2004. The main aims were to assess the prevalences of submicroscopic and multiple Plasmodium falciparum infections in pregnant women (using the P. falciparum merozoite surface protein-2 as a polymorphic marker in PCR-based assays) and to determine the effects of such infections on anaemia during pregnancy. Of the 142 pregnant women who were recruited, only 17 (11.9%) were found smear-positive for P. falciparum by microscopy. The results of the PCR-based assays revealed, however, that 40 (32%) of the 125 smear-negative women had submicroscopic P. falciparum infections. Blood samples from 32 (80%) of those with submicroscopic infections showed only the FC 27 allele (of merozoite surface protein-2), six (15%) showed only the ICI allele, and two (5%) showed both of these alleles. Although the age, parity, gestational age and haemoglobin concentrations of the women with submicroscopic P. falciparum infections were not significantly different from those of the women who were smear- and PCR-negative, such infections may have a significant impact on materno-foetal health.

Cleidocranial dysostosis: report of a case.

This case of cleidocranial dysostosis showed nearly 40 accessory teeth and the unerupted teeth on radiological examinations. Other diagnostic procedures found hypoplasia in maxillary and zygomatic bones, deep palate, open fontanel and open sutures, the collapse of sagittal suture, and aplasia of the clavicle. There were some abnormalities of the fingers. Under general anesthesia eleven supernumerary teeth in the mandible and eight in the maxilla were surgically extracted. Upper and lower removable acrylic appliances were fabricated.