Association of single nucleotide polymorphisms in microRNAs with susceptibility to hepatitis B virus infection and HBV-related liver complications: A study in a Saudi Arabian population.

The aim of this study was to evaluate the association of 10 SNPs in different microRNAs (miRNAs) with susceptibility to hepatitis B virus (HBV) infection, HBV clearance, persistence of chronic HBV infection, and progression to liver cirrhosis and hepatocellular carcinoma (HCC). Patients were categorized into the following groups: inactive HBV carrier, active HBV carrier, HBV-cleared subject and cirrhosis+HCC. Samples were analysed for 10 SNPs in microRNAs using either PCR-based genotyping or the TaqMan assay. We found that rs1358379 was associated with susceptibility to HBV infection, HBV clearance, persistent chronic HBV infection and liver cirrhosis+HCC. In addition, we found that rs2292832 and rs11614913 were associated with risk of HBV infection, viral clearance and cirrhosis+HCC, whereas rs2910164 was associated with proneness to HBV infection, and ability to clear the virus. There was evidence of associations between rs6505162 and HBV clearance and the development of liver disease, whereas a single association was found between rs2289030 and HBV clearance. Similarly, rs7372209 and rs4919510 were specifically associated with the development of HBV-induced liver complications. SNPs in miRNAs affect the susceptibility, clearance and progression of HBV infection in Saudi Arabian patients. We found, using Gene Ontology or pathway analyses, that these genes may contribute to the pathophysiology of HBV infection and related liver complications. However, differences in the association of examined SNPs with various clinical stages indicate variations in the respective functional roles of these polymorphisms and their miRNAs, and thus, further investigation to fully explore their therapeutic potential is warranted.

Discriminant value of serum HBV DNA levels as predictors of liver fibrosis in chronic hepatitis B.

Current guidelines recommend antiviral therapy in chronic hepatitis B (HBV) patients with significant histological disease. We aimed to compare histological fibrosis (METAVIR, ≥F2) in patients with HBV DNA ≥20,000 IU/mL vs. ≥2000 IU/mL and identify predictors of fibrosis. We performed prospective liver biopsies on 203 HBeAg-negative patients in four groups: Group I (n = 55): HBV DNA ≥20,000 IU/mL and persistently elevated alanine aminotransferase (ALT) levels (PEALT; >40 U/L); Group II (n = 34): HBV DNA ≥20,000 IU/mL and persistently normal ALT (PNALT); Group III (n = 40): HBV DNA <20,000 IU/mL and PEALT; and Group IV (n = 74): HBV DNA <20,000 IU/mL, and PNALT. We reanalysed all groups in relation to updated cut-off for treatable viremia (2000 IU/mL). Genotype D was detected in 86% of patients. Hepatic fibrosis ≥F2 was detected in 72.7%, 52.9%, 57.5% and 18.9% in Groups I-IV, respectively (P < 0.0001). Except in Group II with a trend for lower ≥F2 fibrosis (P = 0.067), there was no significant difference by using HBV DNA cut-off 20,000 vs. 2000 IU/mL. Multivariate logistic regression analysis identified study Group IV (OR, 0.0276; CI: 0.088-0.868; P = 0.0276) and milder (A0-1) necroinflammatory grade (OR, 0.135; CI: 0.063-0.287; P < 0.0001) as independent predictors of ≥F2 fibrosis. The specificity, positive and negative predictive values for PEALT in detection of ≥F2 fibrosis for viremia ≥2000 IU/mL (80%, 69% and 65%, respectively) or ≥20,000 IU/mL (86%, 73% and 63%, respectively) were similar, with a marginal gain in sensitivity (51% vs. 42%, respectively). Significant fibrosis is prevalent in a large proportion of HBeAg-negative patients with high viremia and persistently normal ALT. Lower HBV DNA cut-offs could be adopted with marginal gains in fibrosis detection and without loss of diagnostic accuracy.

Elemental and nutritional analysis of sea buckthorn (Hippophae rhamnoides ssp. turkestanica) Berries of Pakistani origin.

Sea buckthorn (Hippophae rhamnoides ssp. turkestanica) is a very important medicinal plant in northern areas of Pakistan. The fruit of sea buckthorn is rich in nutrients and medicinal compounds such as vitamins, carotene, flavonoids, essential oil, carbohydrates, organic acids, amino acids, and minerals. In order to compare various populations of sea buckthorn for chemical composition, eight populations from different areas of northern Pakistan were compared using fruit characteristics. Phytochemical analysis of berries showed vitamin C (250-333 mg/100 g), seed oil (7.69-13.7%), oil in softer pulp (19.2-29.1%), phytosterol content of seed oil (3.3-5.5%), and anthocyanin (0.5-25 mg/L), while the mineral element composition analysis revealed high contents of potassium (140-360 ppm), sodium (20-80 ppm), calcium (70-98 ppm), magnesium (150-240 ppm), iron (40-150 ppm), and phosphorus (110-133 ppm). This study established sea buckthorn berries as a good source of biochemical and mineral elements. The high variation between different populations shows the potential of selecting and breeding of the raw material for various defined purposes.

Prevalence and serology of hydatidosis in large ruminants of Pakistan.

Hydatidosis was seen in 38.90% of cattle, 33.06% of buffaloes and 58.9% of camels slaughtered at a local abattoir. No statistically significant seasonal difference in prevalence was observed. Most cysts (63.14%) were infertile. Protein and carbohydrate contents of fluid from fertile and infertile cysts did not differ significantly. Sensitivity, specificity and efficiency of indirect haemagglutination test and enzyme-linked immunosorbent assay were low.

An on-farm health monitoring of small ruminants: design, data and disease frequencies.

The purpose of this study was to investigate the three-year incidence risk of various diseases of adult sheep and goats through on-farm herd health monitoring. The study was conducted, between April 1989 and March 1992, in three sheep and three goat herds with a rolling average total population of 704 adult animals. A system for on-farm data recording was established at the beginning of the study. The data were recorded on a specially-designed form by a veterinary stock assistant stationed on the farms, and collected by the investigating veterinarian during weekly visits. The results were used to determine the three-year incidence risk, three-year recurrence probability and time to first occurrence of various health problems. The associations between occurrences of various health problems were also determined. In the study herds, the three-year incidence risk was highest for diarrhoea, enterotoxaemia, cough/nasal discharge, laboured breathing with elevated body temperature, and abortion. Significant and strong associations were recorded between digestive disorders and death, and between respiratory disorders and death. Temporal occurrence of these health problems was recorded to determine the seasonality of occurrence. Areas for further research are discussed.

Widespread tuberculous calcification.

We are reporting an unusual case of widespread abdominal calcifications, in the peri-colic mesentery, liver and spleen. The diagnostic laparoscopy showed multiple encapsulated calcified hard rounded masses of varying size and shape, with marked adhesions in and around the bowel and mesentery. Histopathology identified them as calcified lymph nodes, but was unable to highlight the pathogenesis of these calcifications. The diagnosis of post tuberculous calcification of lymph nodes is made on the basis of exclusion. The subject was reviewed, to the best of our knowledge, there is no similar case, with such an extent of abdominal calcifications reported in the literature.

Laboratory diagnosis of transboundary animal diseases in Pakistan.

Control of animal and poultry diseases is one of the primary objectives of government livestock departments in Pakistan. Main emphasis is given to the prevention and control of transboundary animal diseases (TADs), i.e. rinderpest, foot and mouth disease (FMD), Peste des petits ruminants (PPR) and avian influenza (AI) in the country. Recently (2007), the Office International des Epizooties has certified Pakistan as a rinderpest-free country but other TADs are still a threat to the livestock and poultry sectors in the country and the region at large. Keeping in view the significance of livestock and poultry industry for the livelihood of the farmers as well as the economy of the country, a network of diagnostic facilities has been established both at federal and provincial levels. The National Veterinary Laboratory (NVL) Islamabad has been designated as a referral laboratory for the diagnosis of rinderpest, FMD and PPR. Presence of these viruses is confirmed using ELISA. Diagnosis and monitoring of AI is the responsibility of National Reference Laboratory for Poultry Diseases Animal Health, Animal Sciences Institute, Islamabad where hemagglutination, agar-gel-precipitin test (AGPT), ELISA and PCR are employed to confirm the diseases. In each of the four provinces, the Veterinary Research Institute (VRI) plays a central role to investigate an outbreak and implement measures to contain infection. Besides VRIs, district diagnostic laboratories have also been established to provide basic diagnostic facilities to the farmers. Undiagnosed cases or samples collected from TADs are referred to either the concerned VRI or the NVL for further analysis. The Animal Sciences Institute (ASI) at the National Agricultural Research Centre and eight veterinary universities/faculties also play an important role in the development/improvement of new assays/biologics and dissemination of knowledge to other institutes in the country. The present status of TADs and recommendations for harmonizing the diagnostic tools for these diseases are discussed.

Endoscopic features of Helicobacter pylori induced gastritis.

It's still controversial whether certain macroscopic endoscopic features can be used to diagnose Helicobacter pylori (HP) related gastritis. The literature dealing with this subject is confusing, because of the lack of precise terminology, no large control trials, major discrepancies in interpretations of macroscopic changes and poor correlation of the macroscopic appearance and histological finding of gastritis. We conducted a prospective study of 208 dyspeptic patients, who underwent upper gastrointestinal endoscopies from February 1997 to June 1997. Only those patients who had either normal looking gastric mucosa or macroscopic gastritis were included in the study. Endoscopically normal looking mucosa was seen in 67 patients (65.6%), erythematous gastritis in 51 (74%), mosaic appearance in 18 (88%), erosive gastritis in 14 (85%), nodular gastritis in 17 (94%), atrophic gastritis in 12 (75%), and fundal rugae hypertrophies in 5 (80%). We suggest that the antral nodularity, raised erosions, mosaic appearance and mixed findings, are the reliable indicators of the underlying HP induced gastritis. However, these endoscopic findings are very specific, though not sensitive, for HP gastritis.

Leukaemia cases in Central Hospital, Riyadh (Saudi Arabia)

A total of 293 cases of various types of leukaemia admitted in Central Hospital (Riyadh) were studied from January 1981 to December 1988. The incidence of leukaemia was worked out to be 0.13% of the total hospital population during this period. Acute non-lymphocytic leukaemia (ANLL) or acute myeloid leukaemia (AML) group was the most frequent (37.54%), followed by acute lymphocytic leukaemia (24.23%) followed by chronic myeloid leukaemia [corrected] (19.11%), chronic lymphocytic leukaemia (CLL) group (18.77%) and lymphosarcoma cell leukaemia (LSCL) (0.35%). Acute leukaemias were further classified into subtypes on the basis of FAB (French-American-British) classification. In ANLL or AML group, the pattern was M2 greater than M4 greater than M3 greater than M6 greater than M1 greater than M5. In ALL group, the pattern was L2 greater than L1 greater than L3. Among FAB subtypes of acute leukaemias, the pattern was L2 greater than M2 greater than M4 greater than M3 greater than M6 greater than M1 and L1 greater than L3 greater than M5. The age range of these patients was 5 years to 80 years; only 9 cases were less than 11 years of age. In childhood and young adults, acute leukaemias (ALL and AML) were the commonest types (particularly ALL was common in childhood), whereas CML was common in adults and CLL in old age. Males dominated the females in all the types of leukaemia (male to female ratio was 2.4:1). Out of 293 leukaemia cases, 149 (51.0%) were Saudi Arabs, the rest were expatriates. AML was found to be the most common type in central, western and southern Saudi Arabia.(ABSTRACT TRUNCATED AT 250 WORDS)

Peginterferon alpha-2b plus ribavirin compared with interferon alpha-2b plus ribavirin for initial treatment of chronic hepatitis C in Saudi patients commonly infected with genotype 4.

AIM: Comparing the efficacy of peginterferon alpha-2b plus ribavirin with interferon alpha -2b plus ribavirin in Saudi patients with chronic hepatitis C virus (HCV) commonly infected with genotype 4. METHODS: A total of 96 patients with chronic HCV infection were randomly assigned to two treatment groups. Forty-eight patients received once weekly 100 microg of peginterferon alpha-2b plus ribavirin given orally 800 mg/day (peginterferon group). Another 48 patients received thrice weekly 3 million units of interferon alpha-2b plus ribavirin 800 mg/day (interferon group). At the end of treatment (48 weeks) and sustained (72 weeks) biochemical and virologic responses were determined. RESULTS: In the peginterferon group, 70.8% (34/48) patients attained both biochemical and virologic responses at the end of the treatment as against 52.1% (25/48) patients in the interferon group. (P=0.09 for both). Similarly, sustained biochemical and virologic responses in the peginterferon group were attained in 52.1% (25/48) and 43.8% (21/48) patients as against 43.8% (21/48) and 29.2% (14/48) patients in the interferon group, respectively (P=0.54 and 0.20, respectively). The sustained virologic response rates in patients with genotype 4 were 42.9% (12/28) in the peginterferon group and 32.3% (10/31) in the interferon group (P=0.43). Patients in peginterferon group had higher, although statistically not significant adverse reactions. CONCLUSIONS: Saudi patients with chronic HCV attained a higher, although statistically not significant sustained virologic response with pegylated interferon plus ribavirin compared with interferon plus ribavirin.