Paper Type	::	Research Paper
Title	::	The Relationship between Type 2 Diabetes and Total Ghrelin Level in a Population Sample in the United Arab Emirates
Country	::	United Arab Emirates
Authors	::	Alaa Farajallah|| AbdElazim Ahmed|| Nihal Abdullah|| Salah Abusnana|| Prem Andrew
Page No.	::	01-08
Paper Index	::	DOI : 10.9790/3013-0406010108
ANED	::	DOI :05.3013/0460108

There is a debate about the relation between ghrelin and insulin. Many researchers have found low ghrelin level in diabetic patients while others claim that no correlation between them. Thus further investigations are needed to clarify the precise role of ghrelin in the development and/ or treatment of diabetes. To date and up to our knowledge, this is the first study to be conducted on Emirati people in the United Arab Emirates (UAE) to explore the relationship between ghrelin concentration and type 2 diabetes. This research aimed for better understanding about the role of ghrelin hormone in the pathogenesis process of diabetes disease, in an attempt to help patients who find it difficult to control their diabetes by studying the relation between serum total ghrelin levels; insulin and insulin resistance in patients with type 2 diabetes mellitus in the UAE and relate them to the glycemic condition. A cross sectional study was conducted at Rashid Centre for Diabetes and Research (RCDR) in Ajman, UAE. Thirty patients were selected from the outpatient clinic at RCDR and fifteen healthy controls were included in this study. The Blood sample was collected from each participant and analyzed for HbA1c, insulin, glucose and total ghrelin level. Ghrelin level was measured using the enzyme-linked immunosorbent assay (ELISA) technique. The results of this study showed that mean ghrelin level was low in both insulin-resistant and non-insulin resistant diabetic patients as compared to the control group. In conclusion, low ghrelin level is associated with poor diabetes control and bad prognosis parameters in type 2 diabetic patients.

 

KEYWORDS:Ghrelin, Diabetes, Insulin resistance, United Arab Emirates (UAE).

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Insulin resistance has a central role, not only to predict the future development of type 2 diabetes and incident cardiovascular diseases; as well as can be used as a therapeutic target after hyperglycemia is diagnosed. The use of surrogate markers therefore be useful to know the status of insulin resistance. The HOMA IR can perform same function, and the ratios calculated from the lipids and lipoprotein may also be useful to know the status of the insulin resistance in type 2 diabetic patients. In the present study 150 type 2 diabetic subjects and 150 age & sex matched healthy controls were included, to find the cut off value of HOMA IR as well as lipid & lipoprotein ratios to predict insulin resistance. The ROC curve analysis gave the cut off value of >2.41 for HOMA IR with highest sensitivity and specificity, further type 2 diabetics were divided on the basis of cut off value of HOMA IR from present study. Significant increases in TG, VLDL-C, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C ratios were found in patients with HOMA IR cut off value of >2.41 than with HOMA IR cut off value of ≤ 2.41. Also the ROC curve analysis for lipids and lipoproteins indicated that, TC, TG, TC/HDL-C, TG/HDL-C, LDL-C/HDL-C, CRF and Non HDL-C serves the better discriminator for insulin resistance. Therefore, the lipoprotein ratios along with the lipid and lipoprotein levels may be used as markers for insulin resistance.

 

Key-words:Type 2 diabetes mellitus, Insulin resistance, Lipoprotein ratios, Triglyceride, total Cholesterol, ROC curve analysis

[1]. AA Momin, MP Bankar, GM Bhoite, B Shaheen, RD Yadav: Association of cardiovascular risk factors with insulin & insulin resistance in type-2 Diabetes Mellitus patients. Sch. J. App. Med. Sci., 2(1B), 2014, 152-156
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Several evidences for nongenomic action of ecdysteroids through membrane receptor (mEcR) in programmed cell death (PCD) of the Bombyx mori anterior silk glands (ASGs) have been reported. The isolation, characterization and sequencing of mEcR still remain elusive. In the present work, monoclonal antibodies against mEcR has been raised, for the first time, and expected to facilitate any further molecular characterization of that novel receptor. The solubilized ASGs membrane fractions were used for immunizing mice. Three out of 4 injected mice showed immune-reactive signal, as revealed by dot blot assay. Out of the 3 mice, only one mouse sera showed to react with [3H]PonA binding protein, as revealed by double antibody capture assay (DACA). Out of 117 primary hybridoma cell lines prepared only 43 were selected by using dot blot assay, while 7 out of the 43 were selected by using DACA. From the 7 selected clones, clone (13-2) of the highest bound dpm in DACA was used for limiting dilution assay. The pattern of immune-reactivity of 7 out of 8 of the diluted cultures were very similar and showed two signal bands of 65 and 42 kDa, as revealed by western blot analysis. From which, a single clone designated (13-2-23) of the highest bound dpm in DACA was reacted with a single protein band of 42 kDa, suggesting its probable specificity to the extracellular binding domain of mEcR. This work will pave the way for more understanding of the molecular mechanism of ecdysteroid rapid actions during PCD of ASGs in Bombyx mori.

 

KEY WORDS:Bombyx mori, ASGs, membrane ecdysone fraction, hybirdomas, monoclonal antibody

[1]. Norman AW, Mizwicki MT, Norman DP: Steroid-hormone rapid actions, membrane receptors and a conformational ensemble model. Nat Rev Drug Discov , 3, 2004, 27–41.
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Background: Cardiovascular diseases(CVDs) are the top of the ten causes of hospital deaths in Malaysia. Increasing knowledge and awareness on CVDs and its risk factors is crucial for the prevention of CVDs. Identification of factors which are associated with the knowledge and awareness is important for the proper design of future awareness programs. Objectives: This study was carried out to find out factors which are associated with the current knowledge and awareness of cardiovascular diseases (CVDs) and its risk factors among the general public in Penang-Malaysia. Method: Four hundred and fifty-six (456) from the general public participated in the study by filling a structured questionnaire offered in three languages, English, Malay and Chinese. The knowledge and the awareness scores were computed as continuous variables then simple liner regression (SLR) followed by general linear regression (GLR) were used to find factors associated with the levels of knowledge and awareness. Findings: The GLR final model revealed that the knowledge and awareness of CVDs and its risk factors was associated with the level of education, the previous attendance of health campaign on CVDs and having any CVDs or family history of CVDs. Conclusion: The study provides insights into factors associated with the knowledge and awareness of CVDs and its risk factors among the general public. Tailored awareness programs are required to address specific demographic groups of the general public.

 

KEYWORDS - Cardiovascular diseases, Knowledge, Awareness, Risk factors, Public Health, Malaysia, Community Pharmacist

[1] WHO, Global Atlas on Cardiovascular Diseases Prevention and Control. World Health Organization, World Heart Federation, World Stroke Organization, 2012.
[2] Laslett, L.J., et al., The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J Am Coll Cardiol, 2012. 60(25 Suppl): p. S1-49.
[3] MOH, Ministry of Health: Health Facts 2013. 2013, Ministry of Health, Malaysia.
[4] WHO, Cardiovascular diseases (CVDs). 2012, Media Center, World Health Organization

The concept of drug abuse, drug-depandence, drug addiction and abstinence synderome need some clarity. Drug is a chemical substance, associated with distinct physical and psychological effects.It alters a person's normal bodily processes or functions, but this defination is too broad. In medical terms a drug is substances prescribed by a physician or manufactured expressely for the purpose of treating and previnting diseasease and ailment by its chemival nature and effect on yhe structure and functions of a living organism. In the psychological and sological context, drug is a term of habit formaing substance which directly effect upon the brain or nervous system. On the other hand any chemical substance which affect bodily function, mood, perception or consciousness, which has potential for misuse and which may be harmful to the individual or the socity. In terms of this defination the frequient use of drug is considered so dangerous and sometime even immoral and anti-social that it arouses the veriety of indegent and hostile sentiments on the part of general public.

 

KEY WORDS:Role of drug and its pschological effect Drug related issues and reforming psychology of drug addicts

[1]. Stark,rodney," Alcoholosim and drug addiction" in social problems, Random house, Toronto 1975
[2]. Nowlis,Helen H., Drug on the college campus, Anchor books, New york, 1969
[3]. McClelland,David, The drinking man, Free press, New York,1977
[4]. Hirshi, Travis, Causes of delinquency, University of California press, Barkeley, 1969
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[7]. Akers, Ronald.L, Deviant behaviour; A social learning approach, Belmont, Wadsworth,1973
[8]. Carey,Jarnes,L "The college drug sceane" Prentice-Hall, Englewood cliffs, 1968
[9]. Jullian,Joseph, Social problem, Printice-Hall, Englewood cliffs, 1968

Helicobacter pylori is perhaps the most prevalent and successful human pathogen worldwide. Since it was initially suggested in 1983 by Marshall and Warren to be implicated in gastritis and peptic ulcer disease, H. pylori has also been implicated in gastric carcinoma and was classified as a class I carcinogen. Over half of the world's population is colonised with this gram-negative bacterium with most infections being acquired early in life and may persist for the life of the individual. H. pylori infection represents a key factor in the etiology of various gastrointestinal diseases, ranging from chronic active gastritis without clinical symptoms to peptic ulceration, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue lymphoma. While infected individuals mount an inflammatory response that becomes chronic, along with a detectable adaptive immune response, these responses are ineffective in clearing the infection. H. pylori has unique features that allow it to reside within the harsh conditions of the gastric environment, and also to evade the host immune response. Therefore, disease outcome is the result of the complex interplay between the host and the bacterium. Host immune gene polymorphisms and gastric acid secretion largely determine the bacterium's ability to colonise a specific gastric niche. Bacterial virulence factors such as the cytotoxin-associated gene pathogenicity island-encoded protein CagA and the vacuolating cytotoxin VacA aid in this colonisation of the gastric mucosa and subsequently seem to modulate the host's immune system. In this review, the various virulence factors expressed by this bacterium and how they interact with the host epithelium to influence pathogenesis are discussed.

 

KEY WORDS:Helicobacter pylori, cytotoxin-associated gene A, CagA, vacuolating cytotoxin A, VacA, bacterial virulence, host immunity, gastric carcinoma.

[1] J Warren, B Marshal. Unidentified curved bacilli on gastric epithelium in active chronic gastritis, Lancet, 1983, 1273-1275.
[2] D Parkin, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002, CA Cancer J. Clin., 2005, 55, 74-108.
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[4] R Peek, Crabtree J. Helicobacter infection and gastric neoplasia, J. Pathol., 2006, 208, 233-248.
[5] A Nomura, et al. Helicobacter pylori cagA seropositivity and gastric carcinoma risk in a Japanese American population, J. Infect. Dis.,186, 2002, 1138-1144.

A Clinical surveys was carried out in North Eastern Uttar Pradesh,India and 200 samples of nail infections were collected.Seven fungal species were isolated from infected nails viz.,Aspergillus flavus,A.fumigatus,A.niger,Candida albicans,Epidermophyton floccosum,Fusarium oxysporum,Trichophyton rubrum. They were microscopically examined that showed the dominance of Candida and Trichophyton on the basis of percent occurrence on infected nails of peoples of different age groups.These species were also present in both sterilized and unsterilized infected nails. From the leaves of 32 higher plants essential oils were isolated and tested against Candida and Trichophyton.,found dominantly associated with nail infections in peoples of North Eastern U.P districts. The essential oil of Ageratum houstonianum Mill(Asteraceae )was found strongest toxicant against the test fungi inhibiting mycelial growth at 500ppm. The minimum inhibitory concentration (MIC) of the oil was 400 ppm against Candida albicans and Trichophyton rubrum. However, it was found fungicidal at 500ppm against both test fungi respectively.The oil was effective on heavy doses of inoculums ( up to 10 discs of 5 mm each) at 400ppm.. The (MKT) of the oil was 30 sec against Candida albicans and 40 sec against T. rubrum.. The oils efficacy was thermo stable up to100°C and for 180 days of storage, the maximum taken into consideration. Moreover, on autoclaving there was no effect on fungitoxicity of oil.

 

KEY WORDS:Antifungal activity;essential oil;nail infecting fungi;plant drug.

[1]. Bocher,O.E(1938)Antibiotics.In;Modern methods of plant analysis.Eds.Peach K and Tracey M.V(ed.).Modern methods of plant analysis vol iii,651,Springer-Verlag,BerlinChaturvedi,R(1979)Evaluation of higher plants for their fungitoxicity against Helminthosporium oryzae.Ph.D Thesis Gorakhpur Uniersity,Gorakhpur,India.

[2]. Chi CC, Wang SH, Chou MC (2005). "The causative pathogens of onychomycosis in southern Taiwan". Mycoses 48 (6): 413–20.
[3]. Clevenger, J.F., (1928): Apparatus for the determination of volatile oil. J. Am. Pharm. Assoc.,17:346.

[4]. Dixit,S.N.,Chandra,H.,Tiwari,R and Dixit,V(1995)Development of botanical fungicide against blue mould of mandarins.J.Stored Prod.Res.,31(2);165-172.
[5]. Garber, R.H., Houston, B.R., (1959): An inhibitor of Verticillium alboatrum in cotton seed. Phytopathology, 49: 449-450. [6]. Grover R.K and Moore J.D(1962)Toximetric studies of fungicides against brown rot organism,Sclerotinia fructicola and S.laxa.Phytopath 52;876-880. [7]. Kaur, R., B. Kashyap and P Bhalla(2008) Onychomycosis-Epidemiology, Diagnosis and Management. Indian Journal of Medical Microbiology. 26: 108-116.

[8]. Kumar,N and Tripathi,N.N(2004)Repellent property of volatile oil isolated from Putranjiva roxburghii against Trogoderma granarium associated with stored groundnut seeds.Proc.Nat.Acad.Sci India 74B(11);179-187.

[9]. Langenau,E.E(1948)The examination and analysis of essential oils;synthetics and isolates.In;Guenther,E(Ed.)The essential oils Vol,1.Krieger Publishing Co.,Hutington,New York pp 227-348.

[10]. Mishra D.,Chaturvedi,R.V and Tripathi, S.C(1995)The fungitoxic effect of the essential oil of the herb Nardostachys jatamansi D.C. Tropical Agri 72(1);48-52.

Objectives : To analyze the demographic and clinical aspects of chronic suppurative otitis media (CSOM) Materials and Methods : Prospective observational study over a period of 6 years (January, 2007 to December, 2013), 1717 patients with CSOM have been cared for in the department of ENT , Burdwan Medical College, Burdwan.
Results : CSOM commonly occurs in the age group from 11 to 30 years (40.50%). Female predominate male. Tubotympanic type (86.02%) is more common. Complications were associated with atticoantral type of CSOM.
Conclusion : CSOM is a common public health problem that is often wrongly trivialized by people.Health awareness campaign, improved health education and easy accessibility to health care facilities can reduce the morbidity and mortality of this disease and therefore can reduce the incidence of this disease.

KEY WORDS: CSOM ; Tubotympanic type ; atticoantral type ; Intracranial complication ; Extracranial

[1].Vikram BK, Khaja N, Udayashankar SG et al. Clinico-epidemiological study of complicated and uncomplicated chronic suppurative otitis media. The Journal of Laryngology & Otology 2008; 122:442-226.
[2]. Ibekwe TS, Nwaorgu OG. Classification and management challenges of otitis media in a resource-poor country. Niger J Clin Pract. 2011;14:262–9.
[3]. 3.Sengupta Arunbha, Anwar Tarique, Ghosh Debasish, Basak Bijan. A study of surgical management of chronic suppurative otitis media with cholesteatoma and its outcome. Indian J Otolaryngol Head Neck Surg. 2010;62(2):171–76. DOI:10.1007/s12070-010-0043-3.
[4]. Adhikari P, Sinha BK, Pokharel NR, Aryal R, Ma J. Prevalence of chronic suppurative otitis media in school children of Kathmandu district. Journal of Institute of Medicine. 2007;29:310–12.s.
[5]. Akinpelu OV, Amusa YB, Komolafe EO et al. Challenges in management of chronic suppurative otitis media in a developing country. The Journal of Laryngology & Otology 2008;122:16-20.

There are limited published data available about the provision of pharmaceutical care in community pharmacies in the UAE. Almost no documentation of efforts was taking place in community pharmacy. Objectives: This study is done to evaluate pharmacists perception of their current practice, as well as their knowledge of drug regulations/ classification by the Ministry of Health (MOH). Also, investigate their opinion on the possible pharmacist patient communication barriers. Methods: 300 cross sectional surveys were distributed to community pharmacies in Ajman and Sharjah. In addition, a pharmacist played the role of a patient with a prescription to measure pharmacists' knowledge. Results: The response rate of the participants was 73.6%. Most of the pharmacists couldn't identify drug- related problems in the prescription and dispensed antibiotic without a prescription . In addition, most pharmacists were satisfied by the dispensing role in the community pharmacy. Conclusion: Community pharmacists roles must be expanded and they must look for new challenges in their profession in order to improve their experience and capabilities.

 

KEYWORDS: community pharmacists, drug-related problems, obstacles, patient counseling, Pharmaceutical care.

[1]. Abasaeed, A., Vlcek, J., Abuelkhair, M., & Kubena, A. (2009). Self-medication with antibiotics by the community of Abu Dhabi Emirate, United Arab Emirates.The Journal of Infection in Developing Countries, 3(07), 491-497.
[2]. Dameh, Majd, James Green, and Pauline Norris. "Over-the-counter sales of antibiotics from community pharmacies in Abu Dhabi." Pharmacy world & science 32.5 (2010): 643-650.
[3]. Fahmy, S. A., Abdu, S., & ABUELKHAIR, M. (2010). Pharmacists' attitude, perceptions and knowledge towards the use of herbal products in Abu Dhabi, United Arab Emirates. Pharmacy Practice, 8(2), 109-115.
[4]. Hasan, S., Sulieman, H., Chapman, C., Stewart, K., & Kong, D. (2011). Community pharmacy in the United Arab Emirates: characteristics and workforce issues. International Journal of Pharmacy Practice, 19(6), 392-399.
[5]. Ramaswamy-Krishnarajan, J., & Hill, D. S. (2005). Pharmaceutical Care in Canada An Exploratory Study of 81 Community Pharmacies. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 138(4), 46-50.

Type 1 diabetes mellitus (T1 DM) is a chronic autoimmune disease associated with selective destruction of insulin-producing pancreatic β-cells. Several features characterize type 1 DM as an autoimmune disease: presence of immuno-competent and accessory cells infiltrated pancreatic islets. This is a prospective study which was carried out to investigate the possible association of T1 DM with IL-17A. Sixty patients with Type 1 diabetes mellitus (T1 DM) who were diagnosed according to American Diabetes Association criteria (ADA) 1997 were selected from the Center of Endocrinology and Diabetes /AL-Kindey / Hospital/Baghdad. All patients were treated with daily replacement doses of insulin. Their age ranged 5- 40 years. As a control group, sixty apparently healthy volunteers whose their age (8- 40) years, and sex (Females: Males 1:1.31) were matched the patients' group. The study revealed that the high frequencies of T1 DM was at the age group 10-19 years while the lower frequency among age group <10 years old. Regarding cytokine level, it was noticed that there was highly significant elevation in the mean of IL-17A in the sera of diabetic group (1312.06 Pg/ ml) in comparison with healthy control (332.28 pg/ml) (P=0.003). Conclusion, there appears to be an important role for IL-17A in increasing the chance of enhancing the susceptibility for disease development or providing protection against it.

 

KEYWORDS: Diabetes mellitus, IL-7A, ELISA

[1]. Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care; (2003); 26 Suppl 1: S5-20.
[2]. Rosenbloom AL, Joe JR, Young RS. & Winter WE. "Emerging epidemic of type 2 diabetes in youth." Diabetes Care (1999); 22: 345-354.
[3]. Akerblom HK, Vaarala O. & Hyoty H. "Environmental factors in the etiology of type 1 diabetes." Am. J. M. Gene. (2002); 115: 18-29.
[4]. Bending D, De La Pena H, Veldhoen M, Phillips JM, Uyttenhove C, Stockinger B. & Cooke A. "Highly purified Th 17 cells from BDC2.5NOD mice convert into Th 1-like cells in NOD/ SCID recipient mice." J. Clin. Invest. (2009).
[5]. Zhou, X, Bailey-Bucktrout SL, Jeker LT, Penaranda C, Martinez- Llordella M, Ashby M, Nakayama M, Rosenthal W. & Bluestone JA. "Instability of the transcription factor Foxp3 leads to the generation of pathogenic memory T cells in vivo." Nat. Immunol. (2009); 10: 1000-1007.

BACKGROUND: SLE is an autoimmune disease characterized by the production of unusual antibodies in the blood. The cause is unknown1 CASE PRESENTATION: In this case report a 49 year old lady who is a known hypertensive on medication (losartan potassium 50mg od), admitted at the cardiovascular medicine department of MNH with the chief complains of: productive cough, difficulty in breathing, awareness of heart beat and episodes of tonic clonic seizures,on examination she had rashes on her trunk and extremities, clinical and laboratory finding are suggestive of SLE and it was confirmed according to American Rheumatology Association criteria's.

CONCLUSION: SLE is a rare autoimmune disorder in Africa black population, it is more common in Asia and Europe, but we shoulkd be very alert that due to enviromental changes the disorder shoukd not be overlooked, and we need to understand its presentation so that it might not go unnoticed.

 

KEYWORDS: SLE, DsDNA, ANA, ASOT,African, Where SLE- systemic lupus erythematosus, DsDNA- double strand deoxybonucleated acid, ANA- Antinuclear antibody,ASOT- Anti streptolysin O titre,CBC- complete blood count

[1]. Mayo clinic textbook of internal medicine 8th edition
[2]. http://emedicine.medscape.com/article/332244
[3]. http://www.healthline.com/health/systemic-lupus-erythematosus

[4]. Crow MK. Etiology and pathogenesis of systemic lupus erythematosus. In: Firestein GS, Budd RC, Gabriel SE, et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, Pa: Saunders Elsevier;2012:chap XX
[5]. http://www.nlm.nih.gov/medlineplus/ency/article/000435.htm

Background: A myxoma is a benign tumor in the heart most commonly found in the left atrium. About 75% of myxomas are in the left atrium usually beginning in the wall that divides the lower chambers of the heart (ventricles) and growing into the atrium1.

Case presentation: we present a 74 year old man, who was referred to muhimbili national hospital, cardiovascular medicine department with the chief complains of difficulty in breathing on exertion and lower limb swelling for 4/12. Echocardiogram was done and revealed a mass in the left atria about 4*4cm with stalk attached mostly to the interatrial septum and part to the anterior leaflet of the mitral valve confirming a left atrial myxoma.

 

conclusion: It is important to learn and comprehend how left atrial myxoma presents and diagnosed because of its high risk of embolization or cardiovascular complication, including sudden death.

[1]. www.emedicine.medscape.com/article/151362
[2]. www.ncbi.nlm.nih.gov/pubmed/8407260
[3]. www.ncbi.nlm.nih.gov/pubmed/11388092
[4]. icvts.oxfordjournals.org/content/6/5/636.full
[5]. www.cardiologyres.org