The Frequency of CYP2D6 and CYP3A4/5 Genotypes and The Impact of Their Allele Translation and Phenoconversion-Predicted Enzyme Activity on Risperidone Pharmacokinetics in Saudi Children with Autism.

Data on the role of CYP2D6 and CYP3A4/5 polymorphisms in relation to risperidone (RIS) pharmacokinetics (PK) in children are relatively limited and inconsistent. This is partially attributable to the limited coverage of CYP2D6 and CYP3A4/5 metabolizer phenotypes, particularly those of poor and ultrarapid metabolizers (PMs and UMs), which has led to calls for studies of populations with a non-European background that may carry variants that are less frequent in Europeans. Children ≤ 18 years old with at least 8 weeks of a RIS-based regimen were recruited from three autism centers in Riyadh, Saudi Arabia. The primary outcomes measured were plasma concentrations of RIS and 9-hydroxyrisperidone (9-OH-RIS) and their dose-adjusted (C/D) ratios as a function of phenotypes and activity score (AS). For accurate DNA genotyping, targeted pharmacogenomic testing with the Axiom PharmacoFocus Array was performed via examination of a broad collection of probesets targeting CYP2D6 and CYP3A4/5 variants. The frequency of genotypes/phenotypes and the impact of their allele translation and phenoconversion-predicted enzyme activity were examined. The final cohort included 83 individuals. The most common CYP2D6 phenotype in our population was normal metabolizers (NMs, 66.3%). Inconsistent with some previous studies, the three phenotypes of intermediate metabolizers (IMs), NMs, and UMs were significantly different in terms of RIS concentration, the RIS/9-OH-RIS ratio, the RIS C/D ratio and the 9-OH-RIS C/D ratio. According to AS analyses, there were statistically significant differences in the RIS concentration (P = 0.013), RIS/9-OH-RIS ratio (P < 0.001) and RIS C/D ratio (P = 0.030) when patients were categorized into AS ≤ 1 vs. AS > 1. None of the CYP3A4/5 star allele translated phenotypes revealed a significant influence on any of the RIS PK parameters. Notably, neither CYP2D6 nor CYP3A4/5 phenotyping demonstrated a significant impact on the total active moiety, suggesting that other gene variants could modulate RIS PK. The study confirmed the previously reported partial impact of the CYP2D6 gene on RIS PK. However, future studies using contemporary genotyping techniques targeting a wide range of variants in other candidate genes must be conducted to further examine their interactive effects on RIS PK and the clinical response.

Comparative study between SpermSlow™ hyaluronan and traditional sperm selection in ICSI outcome.

The role of hyaluronic acid (HA) as a 'physiologic selector' is also well recognized in vitro: it has been demonstrated that spermatozoa that bind to immobilized HA in vitro are those having completed their plasma membrane remodelling, and cytoplasmic and meiotic maturation. Sperm selection using HA has been expected to increase the implantation rate in intracytoplasmic sperm injection (ICSI) cycles. This work was designed to evaluate an alternative product for slowing sperm motility that contains HA and measures its outcomes: fertilization rate, embryo quality, and implantation and pregnancy rates. The present study found a positive drift in embryo quality that was statistically significant in the study group (SpermSlow™-ICSI) with teratozoospermia compared with PVP-ICSI in the same group. There were differences in the pregnancy rate (statistically insignificant in normozoospermia, asthenozoospermia, oligozoospermia, and teratozoospermia) in the SpermSlow-ICSI group compared with PVP-ICSI. The HA-ICSI technique in assisted reproduction technology (ART) is an important way to improve fertilization rate, embryo quality, and pregnancy rate.

Modified Benzoxazole-Based VEGFR-2 Inhibitors and Apoptosis Inducers: Design, Synthesis, and Anti-Proliferative Evaluation.

This work is one of our efforts to discover potent anticancer agents. We modified the most promising derivative of our previous work concerned with the development of VEGFR-2 inhibitor candidates. Thirteen new compounds based on benzoxazole moiety were synthesized and evaluated against three human cancer cell lines, namely, breast cancer (MCF-7), colorectal carcinoma (HCT116), and hepatocellular carcinoma (HepG2). The synthesized compounds were also evaluated against VEGFR-2 kinase activity. The biological testing fallouts showed that compound 8d was more potent than standard sorafenib. Such compound showed IC50 values of 3.43, 2.79, and 2.43 µM against the aforementioned cancer cell lines, respectively, compared to IC50 values of 4.21, 5.30, and 3.40 µM reported for sorafenib. Compound 8d also was found to exert exceptional VEGFR-2 inhibition activity with an IC50 value of 0.0554 µM compared to sorafenib (0.0782 µM). In addition, compound 8h revealed excellent cytotoxic effects with IC50 values of 3.53, 2.94, and 2.76 µM against experienced cell lines, respectively. Furthermore, compounds 8a and 8e were found to inhibit VEGFR-2 kinase activity with IC50 values of 0.0579 and 0.0741 µM, exceeding that of sorafenib. Compound 8d showed a significant apoptotic effect and arrested the HepG2 cells at the pre-G1 phase. In addition, it exerted a significant inhibition for TNF-α (90.54%) and of IL-6 (92.19%) compared to dexamethasone (93.15%). The molecular docking studies showed that the binding pattern of the new compounds to VEGFR-2 kinase was similar to that of sorafenib.

Better outcome of COVID-19 positive kidney transplant recipients during the unremitting stage with optimized anticoagulation and immunosuppression.

INTRODUCTION: COVID-19 is an ongoing pandemic with high morbidity and mortality and with a reported high risk of severe disease in kidney transplant recipients (KTR). AIM: We aimed to report the largest number of COVID-19-positive cases in KTR in a single center and to discuss their demographics, management, and evolution. METHODS: We enrolled all the two thousand KTR followed up in our center in Kuwait and collected the data of all COVID-19-positive KTR (104) from the start of the outbreak till the end of July 2020 and have reported the clinical features, management details, and both patient and graft outcomes. RESULTS: Out of the one hundred and four cases reported, most of them were males aged 49.3 ± 14.7 years. Eighty-two of them needed hospitalization, of which thirty-one were managed in the intensive care unit (ICU). Main comorbidities among these patients were hypertension in 64.4%, diabetes in 51%, and ischemic heart disease in 20.2%. Management strategies included anticoagulation in 56.7%, withdrawal of antimetabolites in 54.8%, calcineurin inhibitor (CNI) withdrawal in 33.7%, the addition of antibiotics in 57.7%, Tocilizumab in 8.7%, and antivirals in 16.3%. During a follow-up of 30 days, the reported number of acute kidney injury (AKI) was 28.7%, respiratory failure requiring oxygen therapy 46.2%, and overall mortality rate was 10.6% with hospital mortality of 13.4% including an ICU mortality rate of 35.5%. CONCLUSION: Better outcome of COVID-19-positive KTR in our cohort during this unremitting stage could be due to the younger age of patients and early optimized management of anticoagulation, modification of immunosuppression, and prompt treatment of secondary bacterial infections. Mild cases can successfully be managed at home without any change in immunosuppression.

The role of social media in compensating for the lack of field studies: Five new fish species for Mediterranean Egypt.

In the Mediterranean Sea, where biological invasions constitute a serious threat, the combination of citizen science and social networks amplified the power of proper field studies, recording species that would have otherwise presumably passed unnoticed. Based on data collected on several Facebook groups, we hereby first report the presence of five fish taxa (Kyphosus sp., Heniochus intermedius, Pomacanthus imperator, Pomacanthus maculosus and Abudefduf sp.) new for the Mediterranean Egypt, revise their distribution in the Mediterranean Sea and discuss their possible introduction pathways. Finally, we provide some considerations on the potentiality of social media for citizen science projects.

Influence of Primary Intimal Tear Location in Type B Aortic Dissection as a Factor Portending Retrograde Type A Aortic Dissection after Endovascular Repair.

PURPOSE: To investigate the effect of a primary intimal tear's position on the distal convexity as a factor predisposing patients to developing a retrograde type A aortic dissection (RTAAD) after endovascular repair for type B aortic dissections. MATERIALS AND METHODS: From January 2010 to December 2015, 334 patients with type B aortic dissections identified from a retrospective thoracic endovascular repair database were assigned to 2 groups based on the location of primary intimal tears in the distal aortic arch. Other potential risk factors were analyzed, and Kaplan-Meier survival curves were constructed. RESULTS: The location of the primary intimal tear was identified in 230 patients (68.9%) in the convexity group and in 104 patients (31.1%) in the concavity group. After intervention, 20 patients (convexity: 7.8%, concavity: 1.9%) developed an RTAAD. Univariate analysis identified that the location of the primary intimal tears (P = .053), the areas involved by dissection (P = < .001), and the covering of the brachiocephalic trunk (P = .024) were significantly associated with RTAAD. Multivariate analysis revealed that a primary entry tear at the distal convexity might be a predictor for developing RTAAD (P = .053), with a relative risk of 4.243 (95% confidence interval, 0.984-18.286). CONCLUSIONS: Patients with primary intimal tears located in the distal convexity may be more likely to develop RTAAD than patients with primary intimal tears in the distal concavity.

Utilization of amplicon-based targeted sequencing panel for the massively parallel sequencing of sporadic hearing impairment patients from Saudi Arabia.

BACKGROUND: Hearing Impairment (HI) can have genetic or environmental causes and in some cases, an interplay of both. Genetic causes are difficult to determine as mutations in more than 90 genes have been shown recently to be responsible for HI. Providing a genetic diagnostic test for HI is therefore a challenge especially for ethnic groups where GJB2 mutations are shown to be rare. RESULTS: Here we show the design and implementation of an amplicon-based targeted sequencing panel that allows the simultaneous sequencing of 87 HI genes. Mutations identified included known pathogenic mutations and novel variants with unknown significance. The diagnostic rate of this panel is 28 % when only pathogenic variants were reported. However, an additional 28 % harbored recurrent combinations of novel or rare single nucleotide variants in the OTOF or PCDH15 genes. Such combinations were not identified in healthy individuals. CONCLUSIONS: Targeted sequencing approach is a very useful strategy for the identification of mutations affecting the HI genes because of its relatively fast turn-around time and cost effectiveness compared to whole-exome sequencing. Further novel or rare variants could be identified by implementing a large-scale screening of HI using our panel which will eventual lead to a higher diagnostic rate.

Decrease in Sperm Parameters in the 21st Century: Obesity, Lifestyle, or Environmental Factors? An Updated Narrative Review.

Semen quality represents a compelling factor for fertility, and delineating the normal values has proven difficult. In the last four decades, several authors have reported a noticeable decline in sperm parameters. Also, studies investigating 'time to pregnancy' have shown that fecundity begins to be reduced when sperm numbers decrease below 30 million, even though according to the 6th edition of the WHO manual, the normal value is currently 16 million/mL or 39 million per ejaculate. There exists sufficient data to suggest a decline in sperm counts over time, even though the clear reason for this adverse trend is not well established, but some associations have been hypothesised, such as maternal smoking during pregnancy. Additional potential factors have yet to be fully illustrated but involve poor diet, increased obesity, and exposure to environmental toxins. Moreover, the change in environmental conditions and more common exposure to endocrine-disrupting chemicals (EDCs), such as pesticides and herbicides, as well as bisphenol A, phthalates, polychlorinated biphenyls, and heavy metals, starting from prenatal life and continuing into adulthood, may exhibit probable features explaining the reduction in sperm parameters. Therefore, the main goal of this narrative review is to furnish an overview of the possible effects of exposure to EDCs on testicular function and spermatogenesis and, also, to summarise the evidence regarding a decrease in sperm quality and examine its potential consequences.

Exploring the benefit of different methods to perform assisted hatching in the ART laboratory: A narrative review.

In the last decades, to enhance success rates in assisted reproductive technology (ART) cycles, scientists have continually tried to optimize embryo culture and selection to increase clinical outcomes. In this scenario, the application of laser technology has increased considerably worldwide and is currently applied across ART in several ways: for assisted hatching (AH) or thinning of the zona pellucida (ZP), embryo biopsy, to immobilize and select the sperm during intracytoplasmic sperm injection, as well as to induce artificial blastocyst shrinkage before cryopreservation. Laser-AH has been suggested as a procedure to improve embryo implantation: the concept is that drilling holes through or thinning of the ZP could improve the hatching process and implantation. The artificial disruption of the ZP can be performed by different approaches: mechanically, chemically and with the laser, which is one of the most favourable and easy methods to remove part of the ZP and to augment the possibilities of implantation in patients defined as having a poor prognosis of success, or when the ZP is too thick. However, in the current literature, there is not sufficient evidence about the potential risk or impairment that laser utilization might induce on embryo development; therefore, the main aim of the current review is to provide an overview of the existing knowledge on the ZP and the mechanisms of manipulating it to improve the effectiveness of ART. Also, it emphasizes the positive aspect of laser application as a powerful tool that might increase the chance of pregnancy for infertile couples undergoing ART cycles.

The role of stinging nettle (Urtica dioica L.) in the management of rotenone-induced Parkinson's disease in rats.

Parkinson's disease (PD) is one of the most common neurodegenerative conditions. Alpha-synuclein deposition, Lewy bodies (LBs) formation, disruption of the autophagic machinery, apoptosis of substantia nigra dopaminergic neurons, oxidative stress, and neuroinflammation are all pathologic hallmarks of PD. The leaves of the stinging Nettle (Urtica dioica L.) have a long history as an herbal cure with antioxidant, anti-inflammatory, anti-cancer, immunomodulatory, and neuroprotective properties. The current study aims for the first time to investigate the role of Nettle supplementation on Rotenone-induced PD. Rats were divided into five groups; a Saline control, Nettle control (100 mg/kg/day), Rotenone control (2 mg/kg/day), Rotenone + Nettle (50 mg /kg/day), and Rotenone + Nettle (100 mg/kg). After four weeks, the rats were examined for behavioral tests. The midbrains were investigated for histopathological alteration and immunohistochemical reaction for Tyrosine hydroxylase in the dopaminergic neurons, α-synuclein for Lewy bodies, caspase 3 for apoptotic neurons, LC3 and P62 for autophagic activity. Midbrain homogenates were examined for oxidative stress markers. mRNA expression of TNFα and Il6; inflammatory markers, Bcl-2, BAX and Caspase 3; apoptosis markers, were detected in midbrains. The results showed that Nettle caused recovery of midbrain dopaminergic neurons, by inhibiting apoptosis, inflammation, and oxidative stress and by restoring the autophagic machinery with clearance of α-synuclein deposits. We can conclude that Nettle is a potentially effective adjuvant in the treatment of Parkinson's disease.

Strategic priorities for hematopoietic stem cell transplantation in the EMRO region.

The World Health Organization-designated Eastern Mediterranean region (EMRO) consists of 22 countries in North Africa and Western Asia with a collective population of over 679 million. The area comprises some of the wealthiest countries per capita income and some of the poorest. The population structure is also unique and contrasts with western countries, with a much younger population. The region sits in the heart of the thalassemia belt. Many countries have a significant prevalence of sickle cell disease, and cancer is on the rise in the region. Therefore, the strategic priorities for the growth and development of hematopoietic stem cell transplantation (HSCT) differ from country to country based on resources, healthcare challenges, and prevalent infrastructure. Thirty-one reporting teams to the Eastern Mediterranean Blood and Marrow Transplantation Group have active HSCT programs in 12 countries; allogeneic transplants outnumber autologous transplants, and the proportion of allotransplants for non-malignant conditions is higher in the EMRO region than in Western Europe and North America. The vast majority (99%) of allotransplants are from matched related donors. Matched unrelated donors and other alternate donor transplants are underutilized. The chance of finding a matched related donor for allografts is higher, with a significant chance of finding matched donors among non-sibling related donors. Reasons for relatively lower rates of transplants compared with other countries are multifactorial. Capacity building, development of newer centers, innovative funding, and better utilization of information technology are required to make transplantation as an accessible modality to more patients. Cost-effectiveness and cost-containment, regulation, and ensuring quality will all be priorities in planning HSCT development in the region.

Ultrasensitive aptasensor using electrospun MXene/polyvinylidene fluoride nanofiber composite for Ochratoxin A detection.

Ochratoxin A (OTA) has harmful effects to human and animal health; therefore, sensitive and selective detection of OTA is highly demanded. Herein, an ultrasensitive electrochemical aptasensor electrode comprising electrospun MXene/polyvinylidene fluoride (Ti3C2Tx/PVDF) nanofiber composite is presented. Addition of Ti3C2Tx up to 13% effectively increased the fiber diameter and lowered the ß-phase of PVDF nanofibers, consequently lowering the charge transfer resistance. The nanofiber composite is then coated on the screen-printed carbon electrode to chemically functionalized with saline and aldehyde groups for efficient aptamer loading. The optimized aptasensor demonstrated sensitive detection of OTA over the dynamic concentration range from 1 fg mL-1 to 1 ng mL-1 with a limit of detection of 2.15 fg mL-1 and quantification limit of 6.52 fg mL-1, with high selectivity. The aptasensor could detect the OTA at femtogram per milliliter concentration in grape juice samples, demonstrating its enormous potential for OTA detection in food industry.

Ti3C2Tx MXene-Polymeric Strain Sensor with Huge Gauge Factor for Body Movement Detection.

In this work, a composite strain sensor is fabricated by synthesizing MXene and deposition of polypyrrole on top of the flexible electrospun PVDF nanofibers. The fabricated sensor exhibits a conductive network constructed with MXene and polypyrrole of microcracks network structure, demonstrating its strain sensing properties. The presence of these microcracks serves as mechanical weak points, which leads to sensitivity enhancement, while the electrospun fiber substrate act as a cushion for strain loading under large deformations. The as-prepared MXene@Polypyrrole PVDF sensor has a gauge factor range of 78-355 with a sensing range between 0-100%. Besides strain deformations, the sensor can operate in torsional deformation and human motion, indicating the sensor's potential as a wearable health monitoring device.

Recent Advances in Graphene-Based Nanocomposites for Ammonia Detection.

The increasing demand to mitigate the alarming effects of the emission of ammonia (NH3) on human health and the environment has highlighted the growing attention to the design of reliable and effective sensing technologies using novel materials and unique nanocomposites with tunable functionalities. Among the state-of-the-art ammonia detection materials, graphene-based polymeric nanocomposites have gained significant attention. Despite the ever-increasing number of publications on graphene-based polymeric nanocomposites for ammonia detection, various understandings and information regarding the process, mechanisms, and new material components have not been fully explored. Therefore, this review summarises the recent progress of graphene-based polymeric nanocomposites for ammonia detection. A comprehensive discussion is provided on the various gas sensor designs, including chemiresistive, Quartz Crystal Microbalance (QCM), and Field-Effect Transistor (FET), as well as gas sensors utilising the graphene-based polymer nanocomposites, in addition to highlighting the pros and cons of graphene to enhance the performance of gas sensors. Moreover, the various techniques used to fabricate graphene-based nanocomposites and the numerous polymer electrolytes (e.g., conductive polymeric electrolytes), the ion transport models, and the fabrication and detection mechanisms of ammonia are critically addressed. Finally, a brief outlook on the significant progress, future opportunities, and challenges of graphene-based polymer nanocomposites for the application of ammonia detection are presented.

Chemopreventive and Anticancer Property of Selenoproteins in Obese Breast Cancer.

Obesity is a significant risk factor for various cancers including breast cancer resulting in an increased risk of recurrence as well as morbidity and mortality. Extensive studies on various pathways have been successful in establishing a biological relationship between obesity and breast cancer. The molecular classification of breast cancer includes five groups each having different responses to treatment. Increased levels of inflammatory cytokines seen in obese conditions drive the pro-proliferative pathways, such as the influx of macrophages, angiogenesis, and antiapoptotic pathways. Increased peripheral aromatization of androgens by aromatase increases the circulating estrogen levels which are also responsible for the association of obesity with breast cancer. Also, increased oxidative stress due to chronic low-grade inflammation in obese women plays an important role in carcinogenesis. Despite the availability of safe and effective treatment options for breast cancer, obese women are at increased risk of adverse outcomes including treatment-related toxicities. In the recent decade, selenium compounds have gained substantial interest as chemopreventive and anticancer agents. The chemical derivatives of selenium include inorganic and organic compounds that exhibit pro-oxidant properties and alter cellular redox homeostasis. They target more than one metabolic pathway by thiol modifications, induction of reactive oxygen species, and chromatin modifications to exert their chemopreventive and anticancer activities. The primary functional effectors of selenium that play a significant role in human homeostasis are selenoproteins like glutathione peroxidase, thioredoxin reductase, iodothyronine deiodinases, and selenoprotein P. Selenoproteins play a significant role in adipose tissue physiology by modulating preadipocyte proliferation and adipogenic differentiation. They correlate negatively with body mass index resulting in increased oxidative stress that may lead to carcinogenesis in obese individuals. Methylseleninic acid effectively suppresses aromatase activation thus reducing the estrogen levels and acting as a breast cancer chemopreventive agent. Adipose-derived inflammatory mediators influence the selenium metabolites and affect the proliferation and metastatic properties of cancer cells. Recently selenium nanoparticles have shown potent anticancer activity which may lead to a major breakthrough in the management of cancers caused due to multiple pathways. In this review, we discuss the possible role of selenoproteins as chemopreventive and an anticancer agent in obese breast cancer.

Second Report of Chronic Granulomatous Disease in Jordan: Clinical and Genetic Description of 31 Patients From 21 Different Families, Including Families From Lybia and Iraq.

Chronic granulomatous Disease (CGD) is a rare innate immunodeficiency disorder caused by mutations in one of the six genes (CYBA, CYBB, NCF1, NCF2, NCF4, and CYBC1/EROS) encoding the superoxide-producing nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase complex in phagocytes. In the Western population, the most prevalent form of CGD (about two-thirds of all cases) is the X-linked form (X-CGD) caused by mutations in CYBB. The autosomal recessive forms (AR-CGD), due to mutations in the other genes, collectively account for the remaining one-third of CGD cases. We investigated the clinical and molecular features of 22 Jordanian, 7 Libyan, and 2 Iraqi CGD patients from 21 different families. In addition, 11 sibling patients from these families were suspected to have been died from CGD as suggested by their familial and clinical history. All patients except 9 were children of consanguineous parents. Most of the patients suffered from AR-CGD, with mutations in CYBA, NCF1, and NCF2, encoding p22 phox , p47 phox , and p67 phox proteins, respectively. AR-CGD was the most frequent form, in Jordan probably because consanguineous marriages are common in this country. Only one patient from non-consanguineous parents suffered from an X910 CGD subtype (0 indicates no protein expression). AR670 CGD and AR220 CGD appeared to be the most frequently found sub-types but also the most severe clinical forms compared to AR470 CGD. As a geographical clustering of 11 patients from eight Jordanian families exhibited the c.1171_1175delAAGCT mutation in NCF2, segregation analysis with nine polymorphic markers overlapping NCF2 indicates that a common ancestor has arisen ~1,075 years ago.

Graphene impregnated electrospun nanofiber sensing materials: a comprehensive overview on bridging laboratory set-up to industry.

Owing to the unique structural characteristics as well as outstanding physio-chemical and electrical properties, graphene enables significant enhancement with the performance of electrospun nanofibers, leading to the generation of promising applications in electrospun-mediated sensor technologies. Electrospinning is a simple, cost-effective, and versatile technique relying on electrostatic repulsion between the surface charges to continuously synthesize various scalable assemblies from a wide array of raw materials with diameters down to few nanometers. Recently, electrospun nanocomposites have emerged as promising substrates with a great potential for constructing nanoscale biosensors due to their exceptional functional characteristics such as complex pore structures, high surface area, high catalytic and electron transfer, controllable surface conformation and modification, superior electric conductivity and unique mat structure. This review comprehends graphene-based nanomaterials (GNMs) (graphene, graphene oxide (GO), reduced GO and graphene quantum dots) impregnated electrospun polymer composites for the electro-device developments, which bridges the laboratory set-up to the industry. Different techniques in the base polymers (pre-processing methods) and surface modification methods (post-processing methods) to impregnate GNMs within electrospun polymer nanofibers are critically discussed. The performance and the usage as the electrochemical biosensors for the detection of wide range analytes are further elaborated. This overview catches a great interest and inspires various new opportunities across a wide range of disciplines and designs of miniaturized point-of-care devices.

Kidney Injury Molecule 1 (KIM-1) as an Early Predictor for Acute Kidney Injury in Post-Cardiopulmonary Bypass (CPB) in Open Heart Surgery Patients.

INTRODUCTION: Postoperative acute kidney injury is associated with a higher mortality, a more complicated hospital course with longer hospital stay. Urinary kidney injury molecule 1 may play an important role as an early predictor of acute kidney injury post-cardiopulmonary in open heart surgery. METHODS: We evaluated 45 patients who underwent open heart surgery from January 2016 to June 2016. Both urinary kidney injury molecule 1 and serum creatinine were evaluated before operation and 3hs and 24hs after operation. Acute kidney injury was diagnosed according to Kidney Disease: Improving Global Outcomes, 2012 guidelines. RESULTS: In this study, 27 patients developed acute kidney injury. The three hour-post-surgery urinary kidney injury molecule 1 was significantly higher in the acute kidney injury group (P<0.015) and, at the same time, we did not find any significant difference in the serum creatinine levels between the two groups. CONCLUSION: Although serum creatinine is still the gold standard for diagnosis of acute kidney injury searching for other new markers is mandatory. Urinary kidney injury molecule 1 can be used as simple noninvasive and specific biomarker for early diagnosis of acute kidney injury.

Genetic diversity and phylogenetic analysis of HPV 16 & 18 variants isolated from cervical specimens of women in Saudi Arabia.

Human papillomavirus (HPV) are well known to be associated with the development of cervical cancer. HPV16 and HPV 18 are known as high-risk types and reported to be predominantly associated with cervical cancer. The prevalence and genetic diversity of HPV have been well documented globally but, in the Kingdom of Saudi Arabia, data on HPV genetic diversity are lacking. In this study, we have analyzed the genetic diversity of both HPV16 and HPV18 based on their L1 gene sequence because L1 gene is a major capsid protein gene and has been utilized to develop a prophylactic vaccine. In January 2011-2012, a total of forty samples from cervical specimens of women in Saudi Arabia were collected. The association of HPV16, HPV18 was detected by polymerase chain reaction, sequenced and submitted to GenBank. The sequences identity matrix and the phylogenetic relationship were analyzed with selected HPVs. The highest sequence identity (99.5%) for HPV16 and (99.3%) for HPV was observed with selected HPVs. The phylogenetic analysis results showed that HPVs from Saudi Arabia formed a closed cluster with African, Asian, East Asian as well as American HPVs distributed into multiple linages from various geographical locations. The results provided the valuable information about genetic diversity, but there is an urgent need to generate full genome sequence information which will provide a clearer picture of the genetic diversity and evolution of HPVs in Saudi Arabia. In conclusion, the generated data will be highly beneficial for developing molecular diagnostic tools, analyzing and correlating the epidemiological data to determine the risk of cervical cancer and finally to develop a vaccine for Saudi Arabian population.

Design of a Remote Real-Time Monitoring System for Multiple Physiological Parameters Based on Smartphone.

Background: Utilization of the widely used wearable sensor and smartphone technology for remote monitoring represents a healthcare breakthrough. This study aims to design a remote real-time monitoring system for multiple physiological parameters (electrocardiogram, heart rate, respiratory rate, blood oxygen saturation, and temperature) based on smartphones, considering high performance, autoalarm generation, warning transmission, and security through more than one method. Methods: Data on monitoring parameters were acquired by the integrated circuits of wearable sensors and collected by an Arduino Mega 250 R3. The collected data were transmitted via a Wi-Fi interface to a smartphone. A patient application was developed to analyze, process, and display the data in numerical and graphical forms. The abnormality threshold values of parameters were identified and analyzed to generate an autoalarm in the system and transmitted with data to a doctor application via a third-generation (3G) mobile network and Wi-Fi. The performance of the proposed system was verified and evaluated. The proposed system was designed to meet main (sensing, processing, displaying, real-time transmission, autoalarm generation, and threshold value identification) and auxiliary requirements (compatibility, comfort, low power consumption and cost, small size, and suitability for ambulatory applications). Results: System performance is reliable, with a sufficient average accuracy measurement (99.26%). The system demonstrates an average time delay of 14 s in transmitting data to a doctor application via Wi-Fi compared with an average time of 68 s via a 3G mobile network. The proposed system achieves low power consumption against time (4 h 21 m 30 s) and the main and auxiliary requirements for remotely monitoring multiple parameters simultaneously with secure data. Conclusions: The proposed system can offer economic benefits for remotely monitoring patients living alone or in rural areas, thereby improving medical services, if manufactured in large quantities.