Insights on the pathogenesis of type 2 diabetes as revealed by signature genomic classifiers in an African American population in the Washington, DC area.

AIMS: African Americans (AA) in the United States have a high risk of type 2 diabetes mellitus (T2DM) and suffer from disparities in the prevalence, mortality, and comorbidities of the disease compared to other Americans. The present study aimed to shed light on the molecular mechanisms of disease pathogenesis of T2DM among AA in the Washington, DC region. METHODS: We performed TaqMan Low Density Arrays (TLDA) on 24 genes of interest that belong to three categories: metabolic disease and disorders, cancer-related genes, and neurobehavioural disorders genes. The 18 genes, viz. ARNT, CYP2D6, IL6, INSR, RRAD, SLC2A2 (metabolic disease and disorders), APC, BCL2, CSNK1D, MYC, SOD2, TP53 (Cancer-related), APBA1, APBB2, APOC1, APOE, GSK3B, and NAE1 (neurobehavioural disorders), were differentially expressed in T2DM participants compared to controls. RESULTS: Our results suggest that factors including gender, smoking habits, and the severity or lack of control of T2DM (as indicated by HbA1c levels) were significantly associated with differential gene expression. APBA1 was significantly (p-value <0.05) downregulated in all diabetes participants. Upregulation of APOE and CYP2D6 genes and downregulation of the INSR gene were observed in the majority of diabetes patients. CONCLUSIONS: Tobacco smoking and gender were significantly associated with case-control differences in expression of the APBA1 and APOE genes (connected with Alzheimer's disease) and the INSR and CYP2D6 (associated with metabolic disorders). The results highlight the need for more effective management of T2DM and for tobacco smoking cessation interventions in this community, and further research on the associations of T2DM with other disease processes, including cancer and neurobehavioral pathways.

Peroxisome Proliferator-Activated Receptor-α (PPARα) Expression in a Clinical Population of Pakistani Patients with Type 2 Diabetes and Dyslipidemia.

Poor glycemic control and dyslipidemia are hallmarks of type 2 diabetes mellitus (T2DM), which predispose to cardiovascular diseases. Peroxisome proliferator-activated receptor-α (PPARα) has been associated with atherosclerosis, but its role in T2DM is less clear. Previously, we studied PPARα expression levels in diabetics with and without dyslipidemia (DD). In this study we described the association with fasting blood glucose, HbA1c levels and lipid levels of the study population. Patient demography and biochemical data were collected from hospitals in Islamabad, Pakistan, and RT-PCR data of PPARα expression were retrieved from our previous study from the same cohort. We performed t-tests and regression analysis to evaluate the relationships between PPARα expression and demographic and clinical variables. As expected, body mass index and HbA1c were elevated in T2DM and DD patients compared to controls. Blood lipids (total cholesterol, triglycerides, LDL and HDL) were significantly higher in the DD group compared to the other two groups. In the T2DM and DD groups, the PPARα expression was not associated with any of the physical and biochemical parameters measured in this study. Expression of the PPARα gene was independent of blood lipids and glycemic control in this study. Further research is necessary to better understand the biological parameters of PPARα expression.

Evaluation of correlation between expression of P53 and Malondialdehyde levels in prostate cancer patients.

The analytical study was conducted at the National University of Sciences and Technology, Islamabad, Pakistan from Nov 2012 to Nov 2013 to find out, correlate and assess negative correlation of serum malondialdehyde (MDA) with expression of p53 gene, and comprised 32 samples. Expression of p53 and MDA levels were determined by real time quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA) technique respectively. Mean value of MDA in prostate carcinoma (CaP) and control group were compared, and the difference was statistically significant (p=0.002). Mean cycle threshold (CT) value of CaP was compared with control group, and the difference was statistically significant (p<0.05). Expression of p53 was 0.18 folds decreased in CaP compared to control group. MDA may be used as marker to determine prognosis of CaP. Expression of p53 may be helpful in the diagnosis of CaP.

Eating Disorders and Disordered Eating Behaviors Among Undergraduate Students in Pakistan as Measured by Eating Disorder Examination Questionnaire (EDE-Q).

Objectives Eating disorders (ED) are an emerging public health issue globally, especially in young adults studying at the undergraduate level. This study aims to assess the frequency of eating disorders, their types, and disordered eating behaviors among such students. Moreover, it aims to identify factors like weight concern, shape concern, eating concern, and restraint, along with assessing the shifting trend of BMI impact on eating disorders using a standardized Eating Disorder Examination Questionnaire (EDE-Q). Methods In this cross-sectional study, 400 undergraduate students (aged 18-25) from four public universities participated from July 2022 to November 2023. Data was collected using the Eating Disorder Examination Questionnaire (EDE-Q). The frequency of eating disorders was computed using SPSS version 27. Results Among the participants, 21.75% (n=84) were identified as having a score surpassing the clinical cut-off. This group comprised 5.5% males (n=22) and 16% females (n=64). The highest prevalence among the four subscales was observed in the Shape Concern subscale (10.5%). Objective binge episodes (19.3%) emerged as the most notable disordered eating attitude. Atypical anorexia nervosa accounted for 13.8% of different eating disorders, while disordered eating was noted in 19.5% (n=78) of individuals. Discussion This study offers critical insights into eating disorders among Pakistan undergraduate students, utilizing the EDE-Q 6.0. Disordered eating behaviors, particularly shape concern and objective binge eating, exhibit significant correlations with these disorders. Weight dissatisfaction emerges as a prominent predictor, suggesting societal influence. The study also reveals a moderate correlation between BMI and eating disorders, challenging conventional assumptions. Furthermore, a changing trend in the prevalence of eating disorders is observed among the male population.

Evaluation of anti-CCP antibody for diagnosis of rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis is a common, world wide, systemic disease that affects mainly joints. Rheumatoid factor is the only marker to diagnose rheumatoid arthritis; however these antibodies are present in other disorders and even in up to 15% of the healthy population. Many auto antibodies have been reported to diagnose rheumatoid arthritis e.g. APF and AKA, etc. but they are not specific and due to tedious laboratory procedure, they have not been generally adopted. Anti-CCP antibodies have been reported for their high sensitivity and specificity. This study was planed to determine the prevalence of anti-CCP antibodies and RA factor in clinically diagnosed patients of rheumatoid arthritis. METHODS: Anti-CCP antibody was determined by ELISA technique and RA-factor was done by latex agglutination method. RESULTS: Forty five patients, 36 female and 9 male, were recruited for this study. Twenty-five (55.6%) patents were positive for anti-CCP antibodies while 20 patients were negative for anti-CCP antibodies and comparison between anti-CCP positive and anti-CCP negative was statistically significant (p = < 0.01). Thirty-one (68%) patients were seropositive (SPRA) for RA while 14 (31%) patients were seronegative (SNRA). Among SPRA patients, 18 were positive for anti-CCP antibody and among 14 SNRA patients, 7 patients had anti-CCP antibody and the difference between these two groups was not statistically significant. CONCLUSIONS: Anti-CCP antibody and RA-factor should be used concomitantly to diagnose RA.

Impact of simple conventional and Telehealth solutions on improving mental health in Afghanistan.

For more than a century Afghanistan has been unstable, facing decades of war, social problems, and intense poverty. As a result, many of the population suffer from a variety of mental health problems. The Government recognises the situation and has prioritised mental health, but progress is slow and services outside of Kabul remain poor. An international collaborative implemented a project in Badakshan province of Afghanistan using conventional and simple low-cost e-Health solutions to address the four most common issues: depression, psychosis, post-traumatic stress disorder, and substance abuse. Conventional town hall meetings informed community members to raise awareness and knowledge. In addition, an android-based mobile application used the World Health Organization's Mental Health Gap Action Programme guidelines and protocols to: collect information from community healthcare workers; provide referral services to patients; provide blended learning to improve providers' mental health knowledge, skills, and practice; and to provide store-and-forward and live consultations. Preliminary evaluation of the intervention shows enhanced access to care for remote communities, decreased stigma, and improved quality of health services. Primary care workers are also able to bridge the gap in consultations for rural and remote communities, connecting them with specialists and providing better access to care.

Effect of hepatitis C virus on C-reactive protein and interleukin-6 in hemodialysis patients.

INTRODUCTION: Patients with end-stage renal disease are at a high risk of hepatitis C virus (HCV) infections. These patients are on maintenance hemodialysis where they are exposed to dialysis fluid and dialysis membrane that generate an acute-phase response, which leads to inflammation, reflected in increased inflammatory markers like C-reactive protein (CRP) and interleukin-6 (IL-6). The aim of this study was to investigate levels of IL-6 and CRP in patients on hemodialysis and to determine effects of HCV on these markers. MATERIALS AND METHODS: A total of 43 patients (39.5% men and 60.5% women; age range, 21 to 65 years) on maintenance hemodialysis for a period of at least 3 months were included. Twenty-four of them were HCV positive. Serum IL-6 and CRP were assessed in all patients. RESULTS: Of HCV-positive patients, 11 (45.8%) had high levels of CRP, while 13 (54.2%) had low levels and increased levels of IL-6 (1064 ± 544.2 pg/mL, P = .19). Of 19 HCV-negative patients, 13 (68.4%) had high levels of CRP, while 6 (31.6%) had low levels, and all these patients had low levels of IL-6, as compared to HCV-positive patients. No significant correlation was observed between the levels of CRP or IL-6 and the duration of dialysis. CONCLUSIONS: In our study, we found high serum IL-6 and CRP levels in HCV-positive hemodialysis patients, compared with HCV-negative ones. However, we failed to show the significance of these differences. More studies with large sample sizes and evaluation of the other inflammatory markers are warranted.