Correlation Between Obesity and Mental Health Status in Riyadh, Saudi Arabia.

INTRODUCTION: Recent studies show an increase in the incidence and prevalence of obesity worldwide. In Saudi Arabia, the prevalence of obesity, according to the latest studies, was estimated to be 24.7%. Rising rates of obesity are becoming a serious public health concern with well-documented physical and mental health consequences. Our study aims to measure the effect and the relationship between obesity and mental health status and to assess the impact on the quality of life in Riyadh, Saudi Arabia. METHODS: A cross-sectional observational study was conducted in Riyadh, Saudi Arabia. Data collection involved an electronic questionnaire encompassing patient demographics, their perspectives on obesity and its impact on mental health, as well as screening for common mental health disorders using GAD-2 and PHQ-9. Subsequently, the data were coded, entered, and analyzed utilizing both descriptive and inferential statistical methods, with the assistance of IBM Corp. Released 2015. IBM SPSS Statistics for Windows, Version 23.0. Armonk, NY: IBM Corp. RESULTS: A total of 480 adult Saudi participants were included in the current study. Most of them were males (61.5%) in the age group of 18 to 40 years (77.3%). 13.1% of the participants had a first-degree family history of psychiatric illness, and 10.6% had a previous medical history of psychiatric illness. 86% of the participants think that obesity has a negative effect on the quality of life and mental health, and 98.1% believe that losing weight and treating obesity will play a role in improving the quality of life and mental health in general. Regarding the prevalence of mental health issues according to the PHQ-2 score, 151 (31.5%) of the participants were positive, out of whom 47 (31.1%) had mild depression, and 147 (30.5%) of the participants were positive using the GAD-2, out of whom 41 (27.9%) had mild anxiety, and the same percentage had moderate anxiety. There was a significant association between BMI and a previous history of psychiatric illness among females (P = 0.044). CONCLUSION: Obesity and a higher BMI were found to be associated with a higher prevalence of depression and anxiety among the study participants. About one-third of the total participants had depression, and another one-third had an anxiety disorder.

Endovascular Treatment of Carotid-Internal Jugular Venous Fistula in a Bomb Blast Victim.

Carotid-internal jugular venous fistula is one of the rarest presentations among victims of bomb blast injuries. Treatment of such fistula is open surgery with high mortality and morbidity. Endovascular treatment with covered stent seems to have an optimal result with low complications. We present a case report of a bomb blast victim having carotid-jugular venous fistula with hemodynamic compromise. The patient was successfully managed with endovascular graft stent. There was an optimal result with no immediate and long-term complications.

Traction force during vacuum extraction: a prospective observational study.

OBJECTIVE: To investigate the traction force employed during vacuum extractions. DESIGN: Observational cross-sectional study. SETTING: Obstetric Department, Karolinska University Hospital, Sweden, and the Swedish National Congress of Obstetrics and Gynaecology, 2013. POPULATION: Two hundred women with vacuum extraction at term and 130 obstetricians participating in a simulated setting. METHODS: In a normal clinical setting, we used a specially adapted device to measure and record the force used to undertake vacuum extraction. In a subsequent part of the study, the force employed for vacuum extraction by a group of obstetricians in a fictive setting was estimated and objectively measured. MAIN OUTCOME MEASURES: Applied force during vacuum extraction in relation to the estimated level of difficulty in the delivery; perinatal diagnoses of asphyxia or head trauma; estimated force compared with objectively measured force employed in the fictive setting. RESULTS: The median (minimum-maximum) peak forces for minimum, average and excessive vacuum extraction in the clinical setting were 176 N (5-360 N), 225 N (115-436 N), and 241 N (164-452 N), respectively. In 34% of cases a force in excess of 216 N was employed. There was no correlation between the umbilical arterial pH at delivery and the traction force employed during extraction. Four cases of mild hypoxic ischaemic encephalopathy were observed, three of which were associated with a delivery whereby excessive traction force was employed during the vacuum extraction. In the fictive setting, the actual exerted force was twice the quantitative estimation. The measured forces in the clinical setting were four times higher than that estimated in the fictive setting. CONCLUSIONS: Higher than expected levels of traction force were used for vacuum extraction delivery. As obstetricians tend to underestimate the force applied during vacuum extraction, objective measurement with instantaneous feedback may be valuable in raising awareness.

The nature of diversity of HLA-DRB1 exon 3.

Exon 3 of DRB1 is known to be polymorphic, but thought to be conserved within allelic groups. This implies that exon 3 polymorphisms would not need to be considered in evolutionary studies or clinical settings when assessing immunogenicity of allelic mismatches in stem cell transplantation. To further assess this, we determined the sequences of DRB1 exon 3 by hemizygote amplification and direct sequencing on 55 selected DNA samples containing 42 DRB1 alleles for which no exon 3 sequence data were previously available. The data confirmed the high degree of overall sequence conservation. The DRB4- and DRB5-associated alleles were completely conserved within their DRB1 groups. However, it could be shown that exon 3 is more diverse than previously expected. Multiple allelic differences within each group of DRB3-associated DRB1 alleles were found, without identifying unique group-related sequence motifs differentiating between these groups. For DRB1*1402 and DRB1*1406, it could be shown that they originated from DRB1*0302. In several samples previously typed as DRB1*1401, a novel DRB1 allele was identified: DRB1*1454. Thus, from a clinical viewpoint, the availability of exon 3 sequence information may be useful for optimizing typing as well as matching strategies. Additionally, it will allow for more detailed evolutionary studies, further elucidating the origin of alleles and the mechanisms driving sequence diversification.

Antibodies to platelet glycoprotein V in polytransfused patients with haematological disease.

Polytransfused patients often develop platelet-reactive antibodies (PRAb). These give positive reactions in the platelet immunofluorescence test (PIFT) and may be either lymphocytotoxic (LCTAb) or platelet-specific antibodies (PSAb). The latter may be detected in the PIFT using chloroquine-treated platelets (Chl-PIFT) or by immunoblotting. Serial samples from 106 multiply transfused patients with bone marrow failure were screened by PIFT using a microplate method and flow-cytometric analysis. PSAb activity was confirmed by Chl-PIFT. In 45 (42%) of the patients studied PSAb were detected; 37 (35%) formed LCTAb and 19 (51%) had co-existent PSAb. Sera from 25 of 27 patients with a positive Chl-PIFT, retested by immunoblotting, recognised determinants of Mr 82-160 kD on whole platelets. A large group became sensitised to a component of Mr 105-115 kD reduced (99 kD non-reduced) with similar electrophoretic mobility to GPIIIa using a monoclonal anti-GPIIIa and two human polyclonal anti-HPA-1a sera; some also produced anti-GPIIb. The largest group recognised a determinant of Mr 80-83 kD, probably glycoprotein V (GPV). Three sera were immunoblotted against thrombin-treated platelets and the results confirmed GPV specificity.

Production of a cytotoxic human monoclonal antibody with specificity for HLA-DR4 and -DRw10 by cells derived from a highly sensitized kidney recipient.

A human monoclonal antibody which reacts preferentially with HLA-DR4 and -DRw10 B-cell targets has been produced. A human B-cell line, secreting antibody which reacted preferentially with DR4 and DR1 targets, was derived from a highly sensitized kidney recipient who had rejected two grafts. This line was fused with the mouse myeloma P3X63Ag8.653 and a selected hybridoma cloned. The clones secrete IgM(lambda), which reacts strongly with HLA-DR4 and -DRw10 and more weakly with -DRw14 and a proportion of -DR1 B cells in cytotoxicity assays. Using B-cell lines as targets in cytotoxicity and enzyme-linked immunosorbent assays, the antibody gives a broader pattern of reaction, reacting with HLA-DR1, -DR4, -DR9, -DRw10, -DRw14, and some -DR2 targets. The antibody (NI) is currently in use as a reagent for tissue typing.