Brain abscess following rituximab infusion in a patient with pemphigus vulgaris.

BackgroundImmunocompromised patients are at increased risk for developing meningitis or, rarely, brain abscess with opportunistic organisms like Listeria monocytogenes.Case reportA 52 year-old Saudi Arabian woman who was diagnosed with pemphigus vulgaris and diabetes and had been on prednisolone and azathioprine for about 4 years. She presented with headache, low-grade fever, and left-sided weakness 2 weeks after receiving the second dose of rituximab infusion. Magnetic resonance imaging revealed an enhanced space-occupying lesion with multiple small cyst-like structures and vasogenic edema in the right temporoparietal area. Her blood culture was positive for Listeria monocytogenes, and a brain biopsy showed necrotic tissues with pus and inflammatory cells. She recovered after a 6-week course of antibiotics with ampicillin and gentamycin.ConclusionsBrain abscess due to Listeria monocytogenes is a risk that should be considered when adding rituximab to the regimen of a patient who is already Immunocompromised

Screening and Evaluation of Deleterious SNPs in APOE Gene of Alzheimer's Disease

Introduction. Apolipoprotein E (APOE) is an important risk factor for Alzheimer's disease (AD) and is present in 30–50% of patients who develop late-onset AD. Several single-nucleotide polymorphisms (SNPs) are present in APOE gene which act as the biomarkers for exploring the genetic basis of this disease. The objective of this study is to identify deleterious nsSNPs associated with APOE gene. Methods. The SNPs were retrieved from dbSNP. Using I-Mutant, protein stability change was calculated. The potentially functional nonsynonymous (ns) SNPs and their effect on protein was predicted by PolyPhen and SIFT, respectively. FASTSNP was used for functional analysis and estimation of risk score. The functional impact on the APOE protein was evaluated by using Swiss PDB viewer and NOMAD-Ref server. Results. Six nsSNPs were found to be least stable by I-Mutant 2.0 with DDG value of >−1.0. Four nsSNPs showed a highly deleterious tolerance index score of 0.00. Nine nsSNPs were found to be probably damaging with position-specific independent counts (PSICs) score of ≥2.0. Seven nsSNPs were found to be highly polymorphic with a risk score of 3-4. The total energies and root-mean-square deviation (RMSD) values were higher for three mutant-type structures compared to the native modeled structure. Conclusion. We concluded that three nsSNPs, namely, rs11542041, rs11542040, and rs11542034, to be potentially functional polymorphic

A comparison of nutritional intake and daily physical activity of girls aged 8-11 years old in Makkah, Saudi Arabia according to weight status

Abstract Background Obesity rates in Saudi Arabia are amongst the highest in the world. It is known that teenage girls are less active than teenage boys, but less is known about the diet and activity patterns in younger girls. Therefore this study sought to investigate dietary intake and daily physical activity in girls aged 8-11 years old in Saudi Arabia. Methods This was a cross- sectional observational study conducted in seven schools across the city of Makkah. A total of 266 girls had anthropometric measurements taken including height, weight, waist circumference and body fat estimations. Dietary assessment using a 4 day unweighed diet diary was undertaken in 136 of these participants, and 134 agreed to monitor their physical activity for the 4 days using an accelerometer. After exclusion for under-reporting, 109 remained in the dietary analysis and 78 in the physical activity analyses. Differences in means between BMI groups were determined using one-way ANOVA with post hoc Tukey test. Multivariable linear regression analysis was performed to look at the effect of multiple variables on body weight. Results A total of 30% of participants were classified obese or overweight. There was a significant difference in the mean daily energy intake between the BMI groups with the obese group having the highest energy, fat, carbohydrate and protein intake (obese group: 2677 ± 804 kcal/d; healthy weight group: 1806 ± 403 kcal/d, p < 0.001), but the percentage contribution of the macronutrients to energy intake remained the same across the BMI groups. There were no differences in number of steps taken per day or time spent in moderate to vigorous intensity exercise according to BMI category. Most of the girls did not meet daily physical activity guidelines (5969 to 6773 steps per day and 18.5 - 22.5 mins per day of moderate to vigorous activity). Multiple linear regression showed that energy intake positively predicted body weight (Beta = 0.279, p =0 .001), whereas, total energy expenditure per kg of body weight and family income had a significant negative influence on body weight (Beta = −0.661, p < 0.001; −0.131, p = 0.028 respectively). Conclusions The results of this cross sectional analysis suggest that obesity in girls aged 8-11 years is linked to excessive energy intake from all macronutrients and the majority of girls in all weight categories are inactive. Research should be conducted to further investigate causal relationships in longitudinal studies and develop interventions to promote dietary change and activity that is culturally acceptable for girls in Saudi Arabia

Stigmatisation of Obesity and its Relation to the Perception of Controllability in Riyadh, Saudi Arabia: A cross-sectional study

Objectives: This study assessed the stigmatisation of obesity among a sample of the general population in Riyadh and its association with the perception of controllability. Methods: A cross-sectional analytical study was carried out in Riyadh, Saudi Arabia, during January–February 2021 and included 384 participants who were recruited through a convenience sampling method. The data were collected using a self-administrated online questionnaire. Statistical analysis was performed using John’s Macintosh Project Version 16.0.0. Results: Most of the participants had a low level of stigma towards obesity (72.8%), and gender and BMI were significantly associated with the level of stigma at (p = .0023) and (p = .0360) respectively. The association between the perception of controllable factors and the level of stigma was also significant (p = 0.0001). Conclusions: The data supported the hypothesis that there would be a significant association between stigmatisation on obesity and perception of controllability among the general population in Riyadh City. Regarding recommendations, the authors suggest that they should be based on joint international consensus statements for ending the stigma of obesity in different settings and categories, and should include the education of healthcare service providers and obese patients on the relationships shown in the findings. Keywords: Obesity, stigmatisation, perceptio

Evaluation of the Prevalence and Correlated Factors for Decreased Bone Mass Density among Pre- and Post-menopausal Educated Working Women in Saudi Arabia

Most of the previous studies on osteoporosis have focused on post-menopausal women, and more research is needed to evaluate its prevalence in pre-menopausal women. This study was carried out to evaluate the prevalence and correlated factors for decreased bone mass density among pre- and post-menopausal women. This was a cross-sectional study carried out in Applied Medical Sciences College under King Saud University. All pre- and post-menopausal women working there were invited to participate in the study. Measurement of bone mass density was done by quantitative ultrasound densitometry. One-fourth of the pre-menopausal females had osteopaenia. There was a significant correlation between having osteoporosis and increasing age, fertility period, parity, menopausal duration, gynaecological age, and presence of comorbidity, especially hypertension and diabetes mellitus. Pre-menopausal females had high prevalence of osteopaenia (24.8%), and it is recommended to implement health education campaigns demonstrating the preventive measures of osteoporosis

The Gut Microbiota’s Role in Drug Absorption, Metabolism and Efficacy: Implications for Personalized Medicine

Advances in microbiome profiling technologies enable the assessment of individual gut microbiota composition, paving the way for personalized drug therapy. Tailoring medications based on a patient’s microbiome could enhance efficacy and minimize side effects. Pharmacogenomics, combined with microbiome analysis, could lead to more accurate predictions of drug responses and optimized treatment plans. In this review, we explore the relationship between drug metabolism and efficacy and the gut microbiome, with a specific focus on enzymatic processes of how gut bacteria metabolize drugs, drugs affected by gut microbiota, and drugs associated with dysbiosis and resulting complications. A comprehensive literature search was performed using PubMed and Google Scholar databases. Articles published between 2013 and 2024 were prioritized to ensure up-to-date findings. The gut microbiota significantly impacts drug absorption by altering drug solubility and permeability through microbial metabolism, modulation of the intestinal barrier, and interactions with transport proteins. Furthermore, medications can significantly impact gut microbiota, leading to dysbiosis and various complications. More studies are needed to elucidate the specific mechanisms through which gut microbiota influences drug action

PPIP5K2 and PCSK1 are Candidate Genetic Contributors to Familial Keratoconus

Keratoconus (KC) is the most common corneal ectatic disorder affecting &gt;300,000 people in the US. KC normally has its onset in adolescence, progressively worsening through the third to fourth decades of life. KC patients report significant impaired vision-related quality of life. Genetic factors play an important role in KC pathogenesis. To identify novel genes in familial KC patients, we performed whole exome and genome sequencing in a four-generation family. We identified potential variants in the PPIP5K2 and PCSK1 genes. Using in vitro cellular model and in vivo gene-trap mouse model, we found critical evidence to support the role of PPIP5K2 in normal corneal function and KC pathogenesis. The gene-trap mouse showed irregular corneal surfaces and pathological corneal thinning resembling KC. For the first time, we have integrated corneal tomography and pachymetry mapping into characterization of mouse corneal phenotypes which could be widely implemented in basic and translational research for KC diagnosis and therapy in the future

Relation between Hyperuricemia and Metabolic Syndrome among Obese Women.

Abstract: Bakgraound: Many studies found an association between hyperuricemia& blood pressure elevation, obesity & metabolic syndrome.Methods & Subjects: The present study was conducted on 108 obesewomen to investigate the relationship between hyperuricemia and traditional cardiovascular risk factors including metabolic syndrome.Women enrolled in the study did not have heart, liver or kidney disease,and were not on oral contraceptives, thiazides, loop diuretics, or low-dose aspirin. After explaining the aim of the research and obtaining consent of the patients, personal and medical history were taken, blood pressure was measured, anthropometric measurements to calculate body mass index (BMI) and waist hip ratio (WHR) were done. After an overnight fast, a venous blood sample was taken to assess serum uric acid, fasting blood glucose and serum lipid profile. Hyperuricemia is defined as serum uric acid level ≥7 mg/dl (in men) or ≥6.0 mg/dl (in women). Metabolic syndrome was defined using AHA/NHLBI (American Heart Association/National Heart, Lung, and Blood Institute) criteria. Results: The present study showed that hyperuricemia was positively associated with systolic and diastolic blood pressure elevation, BMI, age, and serum triglycerides levels (TG), but negatively correlated to high density lipoprotein. Hyperuricemia was an independent predictor to blood pressure elevation. The diastolic and systolic blood pressure, HDL-C, age, and waist circumference were responsible for 59.1% of the serum uric acid variance. It seemed that there is a mutual relationship between hyperuricemia and metabolic syndrome; each contributes to aggravation of the other. Hyperuricemia which is an independent risk for cardiovascular disease may also be induced by medications for metabolic syndrome. Conclusion: Serum uric acid level should be monitored in patients with metabolic syndrome and those at risk for coronary artery disease. Since hyperuricemia is potentially modifiable, exclusion of hyperuricemic agents and inclusion of anti-uricemic measures in the dietary and therapeutic prophylactic regimens seems to carry better prognosis for patients at risk for developing cardiovascular disease.King saud universit

Doctors' knowledge of patients' rights at King Fahd Hospital of the University

OBJECTIVES: To assess the level of physicians' knowledge about the contents of patients' bill of rights (PBR) and its implementation. MATERIALS AND METHODS: This cross-sectional study was carried out at a university hospital in the Eastern Province of Saudi Arabia. All physicians working in the hospital received a self-administered questionnaire to measure their level of knowledge of PBR. Scoring was done to determine the knowledge of the details. The study was approved by the Institutional Review Board of the University Hospital and permission sought from the administration. Data analysis performed with SPSS; descriptive analyses included frequency and percentages for categorical variables, and mean and standard deviations for continuous variables. Bivariate analyses were carried out to determine association between sociodemographic variables and the level of knowledge (adequate/inadequate). Logistic regression analysis were performed to calculate adjusted odds ratio at 0.05 significance level. RESULTS: Most (52.7%) of the physicians were females, were aged between 25 and 30 years (58.5%), and Saudi (80.2%). The majority of the physicians belonged to the residency program (44.9%) and had work experience of 1–5 years (45.4%). About 44% physicians had adequate knowledge about PBR and 55.56% had inadequate knowledge. Regarding physician's response to each item of PBR, the majority (98.1%) gave correct answer to Item 2: “Patients should know the identity and professional status of the healthcare providers responsible for their treatment” (98.1%). Item 25: “Doctors are entitled to withhold any procedures related to a patient's condition if the patient refuses their choice of treatment” was the item with the least correct response (15.5%). CONCLUSION: Reinforcement and strict implementation of PBR are necessary. The institution should provide training and motivate physicians, especially younger doctors regarding PBR to ensure good health for all and safeguard the integrity of both the physician and the hospital