Gradenigo Syndrome: A Case Report of a Rare Complication of Otitis Media.

Otitis media, a common inflammation of the middle ear, frequently complicates upper respiratory infections. Gradenigo's syndrome, a rare complication, manifests as suppurative otitis media, abducens nerve palsy, and severe trigeminal nerve pain. Prompt recognition is vital because of the proximity of the infection to critical neurovascular structures. We present the case of a 38-year-old female who presented with facial pain, otalgia, and diplopia following an upper respiratory infection. Examination revealed facial weakness and abducens nerve palsy. Laboratory results showed elevated inflammatory markers. Imaging confirmed middle ear involvement. Antibiotics were initiated, and myringotomy was performed, resulting in a successful outcome. This case report contributes to understanding Gradenigo's syndrome's clinical nuances, emphasizing the necessity of a structured diagnostic and therapeutic approach. Ongoing research is crucial for refining diagnostic criteria, optimizing treatment, and enhancing pathophysiological understanding. Increased medical education is imperative to ensure early detection and improved patient outcomes.

Combined oncolytic virotherapy gold nanoparticles as synergistic immunotherapy agent in breast cancer control.

Combining viruses and nanoparticles may be a way to successfully treat cancer and minimize adverse effects. The current work aimed to evaluate the efficacy of a specific combination of gold nanoparticles (GNPs) and Newcastle disease virus (NDV) to enhance the antitumor effect of breast cancer in both in vitro and in vivo models. Two human breast cancer cell lines (MCF-7 and AMJ-13) and a normal epithelial cell line (HBL-100) were used and treated with NDV and/or GNPs. The MTT assay was used to study the anticancer potentials of NDV and GNP. The colony formation assay and apoptosis markers were used to confirm the killing mechanisms of NDV and GNP against breast cancer cell lines. p53 and caspase-9 expression tested by the qRT-PCR technique. Our results showed that combination therapy had a significant killing effect against breast cancer cells. The findings demonstrated that NDV and GNPs induced apoptosis in cancer cells by activating caspase-9, the p53 protein, and other proteins related to apoptosis, which holds promise as a combination therapy for breast cancer.

Vaginal probiotics as an adjunct to antibiotic prophylaxis in the management of preterm premature rupture of membranes: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To investigate the efficacy of vaginal probiotics administration in combination with prophylactic antibiotics versus antibiotic prophylaxis only on perinatal outcomes in women with preterm premature rupture of membrane (PPROM). METHODS: Four different databases were searched from inception till March 2023. We selected randomized controlled trials (RCTs) that compared vaginal probiotics along with antibiotics versus antibiotics only among pregnant women who were presented with PPROM between 24 and 34 weeks of gestation. We performed the meta-analysis using Revman software. Our primary outcomes were gestational age at birth and latency period duration. Our secondary outcomes were the rate of admission in the neonatal intensive care unit (NICU), infant birth weight, length of stay in the NICU, and neonatal complications. RESULTS: Four RCTs, involving a total of 339 patients, were included in the meta-analysis. The gestational age at the time of delivery and latency period duration were significantly higher among probiotics + antibiotics group (p = 0.01 & p < 0.001). There was a significant reduction in the rate of NICU admission and length of NICU stay among the probiotics + antibiotics group compared to the antibiotics only group. A significant improvement in the infant birth weight after delivery was demonstrated among the probiotics + antibiotics group (p = 0.002). Although there was a decrease in the incidence of neonatal sepsis and respiratory distress syndrome within probiotics + antibiotics group versus antibiotics only group, these differences were not statistically significant (p > 0.05). CONCLUSIONS: The combination of vaginal probiotics and antibiotic prophylaxis has been shown to effectively improve perinatal outcomes in women with PPROM. Further trials are needed to validate our findings.

Detection of Coumarin Derivatives of Viola odorata Cultivated in Iraq.

Like other members of the viola family, Viola odorata may be found naturally occurring in Europe and Asia. This little plant is tough and perennially herbaceous. It's also known as sweet violet and English violet. There are several medicinal uses for this flowering plant, including its ability to fight cancer, bacteria, and inflammation., antioxidant activity, and antipyretic activity. The phytochemical studies of different parts of Viola odorata resulted in the isolation of different chemical constituents such as Coumarins, caffeic acid, methyl salicylate, flavonoids (Quercetin, kaempferol), glycosides (Rutin), and terpenoids (stigma sterol). Coumarins are important natural phenolic compounds of the family of benzopyrone. Coumarin's basic structure consists of a pyrone ring fused with a benzene ring. Umbelliferone and esculetin are the most common simple coumarins in nature. Coumarins become an attractive backbone drug with innovative impacts on illnesses and reduced side effects on healthy cells. Anti-inflammatory, anti-carcinogenic, and other biological properties are among those attributed to coumarins derivatives. In this study, Umbelliferone and esculetin of Viola odorata were identified by TLC, and HPTLC.

Design and characterization of a multi-epitope vaccine targeting Chlamydia abortus using immunoinformatics approach.

Chlamydiosis is a widespread ailment affecting humans, livestock, and wildlife, caused by C. abortus, a member of the Chlamydia genus. This disease leads to reproductive disorders in bovines and poses a zoonotic risk, resulting in adverse outcomes such as abortion, stillbirths, weak offspring, endometritis, repeat breeding, and perinatal mortality. However, current chlamydiosis vaccines have limitations in terms of safety, efficacy, and stability, necessitating the development of effective and safe alternatives. In this study, our objective was to design a multi-epitope vaccine (MEV) targeting all strains of C. abortus using bioinformatics and immunoinformatics approaches. We identified highly antigenic and non-allergic proteins (yidC, yajC, secY, CAB503, and CAB746) using VaxiJen and AlgPred tools. Physicochemical analyses and secondary structure predictions confirmed protein stability through ProtParam and SOPMA methods. Furthermore, we employed IEDB-AR, NETMHCpan, and ToxinPred2 tools to predict cytotoxic T lymphocyte (CTL), helper T lymphocyte (HTL), and B-cell epitopes, resulting in the identification of conserved epitopes for further analysis. The MEV construct, consisting of 545 amino acids, incorporated the adjuvant Beta defensin-3, along with 9 CTL epitopes and 21 HTL epitopes linked by EAAAK, KK, and AAY linkers. We assessed the safety and immunogenicity of the vaccine through comprehensive evaluations of antigenicity, toxicity, allergenicity, and physicochemical properties. Structural stability and quality were examined using 3D modeling via the ab initio approach with the Robetta platform. Molecular docking analysis explored the compatibility of the MEV with Toll-like receptor 9 (TLR9) using ClusPro, while molecular dynamics simulation with the DESMOND Maestro software predicted the stability and flexibility of the docked complex. Despite promising in silico findings, further wet lab investigations are crucial to validate the safety and efficacy of the MEV. Successful development and validation of this MEV hold significant potential in combatting chlamydiosis in both animal and human populations.Communicated by Ramaswamy H. Sarma.

Genetic Factors Associated with Morphine Consumption in Women Undergoing Laparoscopic Cholecystectomy: A Prospective Cohort Study.

Introduction: Morphine has been a crucial analgesic agent used perioperatively in various surgical procedures. Genetic factors can lead to morphine dose requirement interpatient variability. Our objective was to determine the contribution of genetic polymorphisms in human µ-opioid receptor gene (OPRM1), ATP binding cassette gene (ABCB1) and rs2952768 to the variation of the perioperative morphine consumption in women undergoing laparoscopic cholecystectomy. Methods: This is a prospective cohort study that included 102 adult Arab females undergoing laparoscopic cholecystectomy. The exposures were carrying the genetic variants of OPRM1, ABCB1 and rs2952768. Our primary outcome was total morphine or morphine equivalent dose required perioperatively. The secondary outcomes were pain score during the first 24 hours and adverse drug reactions. A standardized, general anaesthesia was used for all subjects. In addition to the genetic factors, we also investigated non-genetic factors influencing post-operative pain sensitivity and morphine consumption. Results: Both (rs1799971, A>G) in OPRM1 and (rs2952768, T>C) showed statistically significant association with intra-operative total morphine dose requirements. Patients carrying the "G" allele in OPRM1 had a significantly higher total morphine mean rank dose compared to the AA genotype [62.9 vs 47.1, p=0.008]. Furthermore, patients homozygous for the rs2952768 (T>C) minor allele "CC" had a higher mean rank compared to the other genotypes [72.7 vs 50.1, p=0.046]. Conclusion: OPRM1 (rs1799971) and rs2952768 are associated with variation of intra-operative morphine consumption in laparoscopic cholecystectomy. Clinical Trial Identifier: This study was registered at ClinicalTrials.gov, NCT04621864. https://clinicaltrials.gov/ct2/show/NCT04621864.

Assessment of Knowledge, Attitude, and Practice Towards Migraine Among the General Population in the Kingdom of Bahrain.

OBJECTIVE:  The primary objective of this research is to assess the general population's knowledge, attitude, and practice towards migraine. METHOD:  A cross-sectional study was conducted on a total sample of 255 participants. The data were obtained from a self-administered electronic questionnaire (Appendix) distributed through social media. Data analysis was done using the IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp. For statistics, frequency, percentage, median, and standard deviation were calculated.  Results: Among the Bahraini population, knowledge about migraine definition, triggers, risk factors, symptoms, and treatment is satisfactory. However, knowledge about migraine prophylaxis is limited. Attitude and practice towards the disease showed adequate responses among the population, as they prefer consulting a doctor and believe that lifestyle modification is the best migraine treatment. CONCLUSION:  The general population of the Kingdom of Bahrain needs more awareness regarding migraine. Although the majority of the population showed good responses, which displayed some knowledge of the disease, community-based campaigns are still needed.

Effects of genetic and environmental variables on biofilm development dynamics in Achromobacter mucicolens.

Background and Objectives: The study aimed to investigate whether Achromobacter mucicolens IA strain biofilm formation, which contributes to antibiotic resistance, could be enhanced by readily available nutrient sources like carbohydrates and environmental factors such as pH and NaCl. Additionally, the study aimed to identify any inherent genes that support biofilm formation in this strain, which is an opportunistic pathogen that affects immunocompromised patients and is resistant to many antibiotics. Materials and Methods: Biofilm growth in different carbohydrate, pH, and NaCl concentrated media was measured using crystal violet microtiter assay. All the treatments were subjected to biostatistics analysis for normality, Test of Homogeneity, one way ANOVA analysis. Whole-genome sequencing of our IA strain was conducted to identify various gene sequences. Results: Biofilm formation was measured at different carbohydrate concentrations, and the optimum biofilm formation was observed at 3M glucose and 0.5M NaCl, while the lowest results were seen at 2M maltose concentration. Whole-genome sequencing identified potential genes involved in biofilm formation, pathogenicity, protein metabolism, flagellar motility, cell wall component synthesis, and a multidrug efflux pump. Conclusion: These findings suggest that biofilm formation is influenced by extrinsic and intrinsic factors, which could aid in the development of effective treatments for resistant infections.

Erratum: Rotavirus Genotypes and Vaccine Effectiveness from a Sentinel, Hospital-Based, Surveillance Study for Three Consecutive Rotavirus Seasons in Lebanon.

[This corrects the article DOI: 10.1371/journal.pone.0161345.].

An efficient edge/cloud medical system for rapid detection of level of consciousness in emergency medicine based on explainable machine learning models.

Emergency medicine (EM) is one of the attractive research fields in which researchers investigate their efforts to diagnose and treat unforeseen illnesses or injuries. There are many tests and observations are involved in EM. Detection of the level of consciousness is one of these observations, which can be detected using several methods. Among these methods, the automatic estimation of the Glasgow coma scale (GCS) is studied in this paper. The GCS is a medical score used to describe a patient's level of consciousness. This type of scoring system requires medical examination that may not be available with the shortage of the medical expert. Therefore, the automatic medical calculation for a patient's level of consciousness is highly needed. Artificial intelligence has been deployed in several applications and appears to have a high performance regarding providing automatic solutions. The main objective of this work is to introduce the edge/cloud system to improve the efficiency of the consciousness measurement through efficient local data processing. Moreover, an efficient machine learning (ML) model to predict the level of consciousness of a certain patient based on the patient's demographic, vital signs, and laboratory tests is proposed, as well as maintaining the explainability issue using Shapley additive explanations (SHAP) that provides natural language explanation in a form that helps the medical expert to understand the final prediction. The developed ML model is validated using vital signs and laboratory tests extracted from the MIMIC III dataset, and it achieves superior performance (mean absolute error (MAE) = 0.269, mean square error (MSE) = 0.625, R 2 score = 0.964). The resulting model is accurate, medically intuitive, and trustworthy.

Acceptance, Knowledge, and Attitude of Parents Toward the Human Papillomavirus Vaccine in the Eastern Region of Saudi Arabia: A Cross-Sectional Study.

Background Human papillomavirus (HPV) is a common sexually transmitted virus associated with conditions such as skin warts and cervical cancer. Although many individuals clear the infection, some face persistent risks. Cervical cancer, which is linked to certain types of HPV, is a major health concern both globally and in Saudi Arabia, with preventive measures including HPV vaccination. However, parental knowledge and attitudes toward vaccinating their children vary. Therefore, this research aims to assess parental acceptance and understanding of the HPV vaccine in the Eastern Region of Saudi Arabia. Methodology This cross-sectional study was conducted in the Eastern Region of Saudi Arabia using an online questionnaire during 2022-2023. The data were cleaned in Excel and analyzed using SPSS version 29 (IBM Corp., Armonk, NY, USA). The study assessed parents' knowledge and acceptance of HPV vaccination. Results A total of 380 participants were included in this study, the majority of whom were female, married, well-educated, and residents of Al-Ahsa, Saudi Arabia. Awareness about the HPV vaccine was modest, with only 46.6% of participants having heard of it. Most parents reported that their doctors did not mention the vaccine (62.9%), and 67.1% stated that their children had not received it. Factors influencing acceptance included support from the Ministry of Health and belief in the vaccine's effectiveness. Concerns about side effects and vaccine effectiveness were the main barriers to vaccination. Sociodemographic factors, including gender, age, education, employment, and number of children, significantly influenced both knowledge and acceptance. Notably, awareness of HPV was strongly associated with acceptance. Conclusions Our study revealed limited knowledge and vaccine acceptance among parents in the Eastern Region of Saudi Arabia. Sociodemographic factors, including gender, age, education, employment, and number of children, significantly influenced both knowledge and acceptance. Thus, sociodemographic factors played a significant role in shaping these attitudes, emphasizing the need for targeted awareness campaigns and improved communication between healthcare providers and parents to enhance vaccine uptake.

Nature-Based Resilience: Experiences of Five Cities from South Asia.

As in many other parts of the world, the urban areas of the South Asian region are increasingly expanding. While cities today are the heart of commercial, technological and social development, they are also vulnerable to a variety of natural and anthropogenic threats. The complex urban infrastructure, and the ever-expanding population in cities, exacerbate the impacts of climate change and increase the risk of natural hazards. Throughout history, various hydrological disasters including floods, tidal surges, and droughts, and non-hydrological disasters such as earthquakes, landslides, and storms have led to catastrophic social, economic and environmental impacts in numerous South Asian cities. Disaster risk reduction is therefore central to ensure sustainability in urban areas. Although Nature-based Solutions (NbS) are identified as a promising strategy to reduce risk and increase resilience, there appears to be a lack of evidence-based approaches. NbS are measures that can be practiced to obtain benefits of nature for the environmental and community development through conserving, managing, and restoring ecosystems. Against this backdrop, the South Asian cities provide opportunities to evaluate capacities for achieving Nature-based Resilience (NbR) through NbS. This study documents insights from five cities of five different countries of the South Asian region which are subjected to a wide array of disasters: Barishal (Bangladesh), Phuentsholing (Bhutan), Gurugram (India), Kathmandu (Nepal), and Colombo (Sri Lanka). The primary objective of this study is to provide evidence on how NbS are being practiced. Thus, some success stories in cities under consideration are highlighted: restoration of natural canals through integrated development plans and community participation (Barishal), concepts of Gross National Happiness (GNH) and minimal nature interventions (Phuentsholing), "Greening cities'' including eco-corridors, vegetation belts, biodiversity parks (Gurugram), proper land use planning aims at different disasters (Kathmandu), and wetland restoration and management with multiple benefits (Colombo). These cases could therefore, act as a "proxy" for learning from each other to prepare for and recover from future disasters while building NbR.

Biologically Synthesized Copper Nanoparticles Show Considerable Degradation of Reactive Red 81 Dye: An Eco-Friendly Sustainable Approach.

Diospyros kaki leaf extract was used in this study as a favorable basis for the synthesis of copper nanoparticles (Cu NPs). X-ray diffraction (XRD) and UV-visible spectroscopy approaches were used to characterize the biologically synthesized copper nanoparticles. The XRD analysis showed that copper nanoparticles were face-centered cubic structure. Various experimental levels like conc. of dye, concentration of Cu NPs, pH, reaction time, and temperature were optimized to decolorize reactive red 81 dye using the synthesized Cu NPs. Reactive red 81 dye was decolorized maximum using Cu NPs of 0.005 mg/L. Additionally, reactive red 81 dye was decolorized at its maximum at pH = 6, temperature = 50°C. Our study reported that chemical oxidation demand (COD) and total organic carbon (TOC) deduction efficacies were 74.56% and 73.24%. Further degradation study of reactive red 81 dye was also carried out. Cu NPs have the ability and promising potential to decolorize and degrade reactive red 81 dye found in wastewater.

Sonographic appearances of hobnail papillary thyroid carcinoma: A case report of a rare tumour.

Introduction: Hobnail papillary thyroid carcinoma is a rare, recently described papillary thyroid carcinoma variant, with potential for a more aggressive clinical course of disease and poorer prognosis. Case report: A 53-year-old man presented with a left thyroid mass. The ultrasound features of this mass included a predominantly cystic appearance with mobile internal echoes, vascularised internal septations, and murally based solid material. These ultrasound features were not deemed malignant by classification standards, which led to the patient being managed with active surveillance. However, the mass grew quickly and the patient underwent diagnostic hemithyroidectomy which led to hobnail variant papillary thyroid carcinoma being found on pathology. Discussion: The ultrasound features of the hobnail variant of papillary thyroid carcinoma have not been previously described in detail in the literature and, in this case, are features that would not be deemed malignant by classification standards. The rapid growth of the mass is what led to clinical suspicion of malignancy and resulted in diagnosis. Conclusion: The hobnail variant of papillary thyroid carcinoma may not have typical ultrasound findings associated with malignancy. Careful clinical correlation is advised in order to discern this difficult diagnosis and to facilitate appropriate treatment.

THE POTENTIAL ROLE OF EPSTEIN BARR VIRUS IN MULTIPLE SCLEROSIS MOLECULAR AND SEROLOGICAL STUDY.

OBJECTIVE: The aim: To identify the relation between EBV infection/reactivation and multiple sclerosis, compared to the normal controls. PATIENTS AND METHODS: Materials and methods: A case-control study conducted in 120 MS patients, aged between 12-42 years, and 120 apparently healthy age- and sex-matched volunteers as controls. Viral DNA was extracted from 100µl of plasma samples, and then viral DNA was detected and quantified by quantitative real time-polymerase chain reaction (q-PCR). Serum samples were used for the detection of anti-EBNA-1 IgG. RESULTS: Results: Quantitative polymerase chain reaction of EBV showed absence of EBV viremia in all MS patients and control. However, anti EBNA-1 IgG antibody was positive in 51.7% (62/120) of MS patients and 39.2% (47/120) of controls, (P=0.035). The median of anti EBNA-1 IgG level in MS patients and controls were 81.08 U/ml and 67.73 U/ml, respectively (P=0.043). Additionally, EBNA-1 antibody was significantly higher in younger age groups. Patients with the first-line and second-line treatment showed no significant differences in anti EBNA-1 IgG levels, while the median level in patients without treatment (newly diagnosed) was higher. CONCLUSION: Conclusions: EBNA-1antibody could play a significant role in development of MS, as it is significantly higher in MS patients than in controls, especially at younger age groups, at early stages of the disease and in female patients.

Transcriptomic and functional genetic evidence for distinct ecophysiological responses across complex life cycle stages.

Organisms with complex life cycles demonstrate a remarkable ability to change their phenotypes across development, presumably as an evolutionary adaptation to developmentally variable environments. Developmental variation in environmentally sensitive performance, and thermal sensitivity in particular, has been well documented in holometabolous insects. For example, thermal performance in adults and juvenile stages exhibit little genetic correlation (genetic decoupling) and can evolve independently, resulting in divergent thermal responses. Yet, we understand very little about how this genetic decoupling occurs. We tested the hypothesis that genetic decoupling of thermal physiology is driven by fundamental differences in physiology between life stages, despite a potentially conserved cellular stress response. We used RNAseq to compare transcript expression in response to a cold stressor in Drosophila melanogaster larvae and adults and used RNA interference (RNAi) to test whether knocking down nine target genes differentially affected larval and adult cold tolerance. Transcriptomic responses of whole larvae and adults during and following exposure to -5°C were largely unique both in identity of responding transcripts and in temporal dynamics. Further, we analyzed the tissue-specificity of differentially expressed transcripts from FlyAtlas 2 data, and concluded that stage-specific differences in transcription were not simply driven by differences in tissue composition. In addition, RNAi of target genes resulted in largely stage-specific and sometimes sex-specific effects on cold tolerance. The combined evidence suggests that thermal physiology is largely stage-specific at the level of gene expression, and thus natural selection may be acting on different loci during the independent thermal adaptation of different life stages.

Interleukin-37 gene polymorphism and susceptibility to pulmonary tuberculosis among Iraqi patients.

BACKGROUND: Control of tuberculosis (TB) depends on a balance between host's immune factors and bacterial evasion strategies. Interleukin-37 (IL-37) is among the immunomodulatory factors that have been proposed to influence susceptibility to tuberculosis. METHODS: A case-control study was conducted on 105 patients with pulmonary TB (37 active, 41 multi-drug resistant and 27 relapse) and 79 healthy controls to determine serum levels and single nucleotide polymorphisms (SNPs) of IL-37. The IL-37 level was assessed with an enzyme-linked immunosorbent kit, while DNA-sequencing was used to detect SNPs in the promoter region of IL37 gene. RESULTS: Median level of IL-37 was markedly increased in serum of TB patients compared to controls (325.0 vs. 169.1 pg/mL; p < 0.001). This increase was universally determined in subgroups of patients distributed according to gender, age groups, and clinical type of disease, while no significant differences were found between the subgroups in patients or controls. Analysis of receiver operating characteristic curve confirmed these findings and IL-37 occupied a very good area under the curve, which was 0.816 (95% CI = 0.744-0.888; p < 0.001). At a cut-off value of 185.6 pg/mL, the sensitivity and specificity of IL-37 were 81.0 and 82.3%, respectively. Of the nine detected SNPs (rs2466449 G/A, rs2466450 A/G, rs2723168 G/A, rs3811042 G/A, rs3811045 T/C, rs3811046 G/T, rs3811047 A/G, rs3811048 G/A and rs200782323 G/A), only rs3811048 showed a significant association with TB; the G allele showed a significantly decreased frequency in TB patients compared to controls (25.2 vs. 44.9%; OR = 0.41; p < 0.001). It was possible to assign five haplotypes, and three showed significant differences between patients and controls. Frequency of haplotype A-A-G-A-C-T-G-A-G (0.331 vs. 0.213; OR = 2.10; p = 0.015) was significantly increased in TB patients compared to controls. On the contrary, frequencies of haplotypes A-A-G-A-C-T-G-G-G (0.029 vs. 0.116; OR = 0.24; p = 0.01) and A-A-G-G-T-G-A-G-G (0.140 vs. 0.275; OR = 0.45; p = 0.015) were significantly decreased in patients. CONCLUSIONS: IL-37 was up-regulated in the serum of TB patients irrespective of their gender, age or clinical type of disease. SNPs in the promoter region of IL37 gene were proposed to be associated with susceptibility to TB.

Effect of CYP2C19 genetic variants on bleeding and major adverse cardiovascular events in a cohort of Arab patients undergoing percutaneous coronary intervention and stent implantation.

INTRODUCTION: One-third of patients have clopidogrel resistance that may lead to major adverse cardiac events (MACEs). By contrast, it was found that some clopidogrel-treated patients have hyperresponsive platelets that are associated with higher bleeding risk. Several studies have shown that polymorphisms in the gene encoding the CYP2C19 contribute to the variability in response to clopidogrel. Data on genetic and nongenetic factors affecting clopidogrel response in the Arab population are scarce. In this prospective cohort study, we sought to assess the association between the increased function allele (CYP2C19*17) and bleeding events, and validate the effect of the CYP2C19 genetic variants and nongenetic factors on the incidence of MACEs. METHODS: Blood samples were collected from patients that were undergoing percutaneous coronary intervention and receiving clopidogrel at the Heart Hospital, a specialist tertiary hospital in Doha, Qatar. Patients were followed for 12 months. Genotyping was performed for CYP2C19*2, *3, and *17 using TaqMan assays. RESULTS: In 254 patients, the minor allele frequencies were 0.13, 0.004, and 0.21 for *2, *3, and *17, respectively. Over a 12-month follow-up period, there were 21 bleeding events (8.5 events/100 patient-year). CYP2C19*17 carriers were found to be associated with increased risk of bleeding (OR, 21.6; 95% CI, 4.8-96.8; P < 0.0001). CYP2C19*2 or *3 carriers were found to be associated with increased risk of baseline and incident MACE combined (OR, 8.4; 95% CI, 3.2-23.9; P < 0.0001). CONCLUSION: This study showed a significant association between CYP2C19*17 allele and the increased risk of bleeding, and CYP2C19*2 or *3 with MACE outcomes.

SNP-PCR genotyping links alterations in the GABAA receptor (GABRG3: rs208129) and RELN (rs73670) genes to autism spectrum disorder among peadiatric Iraqi Arabs.

INTRODUCTION: Autism spectrum disorder (ASD) is an increasing concern among the Iraqi Arab population. The genetic alterations that cause ASD are likely to converge at the synapse. This study investigated polymorphisms in the GABAA receptor subunit (GABRG3) and the RELN gene as putative biomarkers of ASD in a pediatric population in Iraq. METHODS: The case control study included 60 patients with a clinical diagnosis of ASD (mild, moderate, or severe) according to DSM-IV criteria and matched healthy controls (n = 60). Blood samples were collected for DNA genotyping of SNPs rs736707 and rs208129 for RELN and GABRG3 using allele specific PCR. Assessment of genotype and allele distributions in patient groups used odd ratios (OR) with 95% confidence intervals and the Chi-square test. All statistical analysis was performed used SPSS software. RESULT: The patient cohort was highly consanguineous, with increased ratio (p > 0.05) of males to females (3:1) in both ASD (mean age, 6.66 ± 3.05) and controls (mean age, 5.76 ± 2.3). Both GABRG3 rs208129 genotypes TT (OR 4.33, p = 0.0015) and TA (OR 0.259, P = 0.008), and the T and A alleles were significantly associated with ASD. The RELN rs736707 TC genotype (OR 2.626, P = 0.034) was the only significant association with ASD. CONCLUSION: GABRG3 SNP rs208129 is a leading biomarker to predict genetic vulnerability to ASD in Iraqi Arabs. Expanded SNP panels and increased sample sizes are required for future GABRG3 studies, and to reach a consensus on RELN utility. Future ASD screening programs in Iraq should include genetic metrics in addition to clinical phenotype assessments.

Antiangiogenic Activity of Sweet Almond (Prunus dulcis) Oil Alone and in Combination with Aspirin in both in vivo and in vitro Assays.

Objective: Angiogenesis is new blood vessels formations that are necessary for certain physiological and pathologic conditions. Almond oil represents adjuvant therapies for numerous health benefits; It has ability for prevent the formation angiogenesis in tumour, due to its high concentration of unsaturated fatty acids, polyphenols, flavonoids and other ingredients content. Aspirin is non-steroidal ant-inflammatory drug; significantly reduce the angiogenesis of cancer. The aim of the study is to investigate the role of Prunus dulcis oil alone and in combination with aspirin, as an anti-angiogenic. Method: A sequential concentrations ex-vivo rat aorta ring assay, investigate the anti-angiogenic activity of Prunus dulcisoil in vivo. After three days of incubation, small holes were created on the fine pinpoint. Acute toxicity study was evaluated after administration of Prunus dulcis oil via intraperitoneal route. Results: the obtained results displayed that the serial concentration dose-response has a significant inhibition effect of blood vessels growth when compared to the negative control (DMSO 1%), the dose depended percentage of inhibition, sweet almond oil in combination with aspirin synergism effect to inhibition growth blood vessels as anti-angiogenic activity. The zone of inhibition was been measured as the mean of inhibition area of blood vessel on eggs in millimetre (mm) ± standard deviation. Conclusion: Almond oil dose has inhibition effect on cancer and can be used as (anti-angiogenesis), the activity of almond oil with Aspirin synergism can significantly reduce blood vessel's growth in rate aorta ring and CAM assay.