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Alfayumi-Zeadna S, Ghalion HA, O'Rourke N, Azbarga Z, Daoud N. Direct and indirect predictors of postpartum depression symptoms among indigenous Bedouin mothers in Israel. Res Nurs Health 2024; 47:114-124. [PMID: 38073270 DOI: 10.1002/nur.22361] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 10/27/2023] [Accepted: 11/24/2023] [Indexed: 03/25/2024]
Abstract
Postpartum depression (PPD) is a common and complex phenomenon with negative outcomes for children, women and their families. This study set out to identify both direct and indirect predictors of PPD symptoms among indigenous Bedouin mothers in Israel. The study included 305 women, 18 to 45 years of age, who were interviewed while pregnant and again, 2 to 4 months postpartum. Interviews were conducted in Arabic and included the Edinburgh Postnatal Depression Scale, administered at both points of measurement. Using path analyses, we identified four significant, direct predictors of PPD symptoms. The strongest was depressive symptoms when pregnant, followed by low relative income, low hemoglobin, and number of prior miscarriages. The latter was significantly associated with consanguinity, meaning that women married to a first cousin experienced more miscarriages which, in turn, increased PPD risk. Low relative income was the only variable that had both a direct and indirect effect upon PPD symptoms (via symptoms of depression when pregnant and hemoglobin). Education and polygamy also emerged as indirect predictors of PPD via depressive symptoms reported during pregnancy. Results suggest a high rate of PPD in this perinatal sample of indigenous women. Our findings underscore the need for tailored interventions to reduce PPD, especially for low-income Bedouin women, faced with many barriers and insufficient access to healthcare services.
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Affiliation(s)
- Samira Alfayumi-Zeadna
- Nursing Department, School of Health Sciences, Ashkelon Academic College, Ashkelon, Israel
| | - Huda Abu Ghalion
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion, University of the Negev, Be'er Sheva, Israel
- Clalit Health Services, Be'er Sheva, Israel
| | - Norm O'Rourke
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion, University of the Negev, Be'er Sheva, Israel
- Department of Psychology, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | | - Nihaya Daoud
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion, University of the Negev, Be'er Sheva, Israel
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Nuwaylati DA, Awan ZA. A novel equation for the estimation of low-density lipoprotein cholesterol in the Saudi Arabian population: a derivation and validation study. Sci Rep 2024; 14:5478. [PMID: 38443422 PMCID: PMC10914719 DOI: 10.1038/s41598-024-55921-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 02/28/2024] [Indexed: 03/07/2024] Open
Abstract
Low-density lipoprotein cholesterol (LDL-C) is typically estimated by the Friedewald equation to guide atherosclerotic cardiovascular disease (ASCVD) management despite its flaws. Martin-Hopkins and Sampson-NIH equations were shown to outperform Friedewald's in various populations. Our aim was to derive a novel equation for accurate LDL-C estimation in Saudi Arabians and to compare it to Friedewald, Martin-Hopkins and Sampson-NIH equations. This is a cross-sectional study on 2245 subjects who were allocated to 2 cohorts; a derivation (1) and a validation cohort (2). Cohort 1 was analyzed in a multiple regression model to derive an equation (equationD) for estimating LDL-C. The agreement between the measured (LDL-CDM) and calculated levels was tested by Bland-Altman analysis, and the biases by absolute error values. Validation of the derived equation was carried out across LDL-C and triglyceride (TG)-stratified groups. The mean LDL-CDM was 3.10 ± 1.07 and 3.09 ± 1.06 mmol/L in cohorts 1 and 2, respectively. The derived equation is: LDL-CD = 0.224 + (TC × 0.919) - (HDL-C × 0.904) - (TG × 0.236) - (age × 0.001) - 0.024. In cohort 2, the mean LDL-C (mmol/L) was estimated as 3.09 ± 1.06 by equationD, 2.85 ± 1.12 by Friedewald, 2.95 ± 1.09 by Martin-Hopkins, and 2.93 ± 1.11 by Sampson-NIH equations; statistically significant differences between direct and calculated LDL-C was observed with the later three equations (P < 0.001). Bland-Altman analysis showed the lowest bias (0.001 mmol/L) with equationD as compared to 0.24, 0.15, and 0.17 mmol/L with Friedewald, Martin-Hopkins, and Sampson-NIH equations, respectively. The absolute errors in all guideline-stratified LDL-C categories was the lowest with equationD, which also showed the best classifier of LDL-C according to guidelines. Moreover, equationD predicted LDL-C levels with the lowest error with TG levels up to 5.63 mmol/L. EquationD topped the other equations in estimating LDL-C in Saudi Arabians as it could permit better estimation when LDL-C is < 2.4 mmol/L, in familial hyperlipidemia, and in hypertriglyceridemia, which improves cardiovascular outcomes in high-risk patients. We recommend further research to validate equationD in a larger dataset and in other populations.
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Affiliation(s)
- Dena A Nuwaylati
- Department of Clinical Biochemistry, Faculty of Medicine, University of Jeddah, 21959, Jeddah, Saudi Arabia.
| | - Zuhier A Awan
- Department of Clinical Biochemistry, Faculty of Medicine, University of Jeddah, 21959, Jeddah, Saudi Arabia
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, 21465, Jeddah, Saudi Arabia
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3
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Al-Ashwal A, Alsagheir A, Al Dubayee M, Al-Khnifsawi M, Al-Sarraf A, Awan Z, Ben-Omran T, Al-Yaarubi S, Almutair A, Habeb A, Maatouk F, Alshareef M, Kholaif N, Blom D. Modern approaches to the management of homozygous familial hypercholesterolemia in the Middle East and North Africa. J Clin Lipidol 2024; 18:e132-e141. [PMID: 38158247 DOI: 10.1016/j.jacl.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/01/2023] [Accepted: 12/07/2023] [Indexed: 01/03/2024]
Abstract
Homozygous familial hypercholesterolaemia (HoFH) is a severe form of FH in which inheritance of two defective or null mutations in genes associated with metabolism of low-density lipoprotein cholesterol (LDL-C) results in extremely high LDL-C, premature atherosclerotic cardiovascular disease (ASCVD) and mortality. Treatment of HoFH comprises a multi-modal approach of statins, ezetimibe, lipoprotein apheresis; and inhibitors of proprotein convertase subtilisin/kexin type, angiopoietin-like protein 3 (ANGPTL3) and microsomal triglyceride transfer protein. These treatments are generally costly, and patients also often require treatment for ASCVD consequent to HoFH. Therefore, in the interests of both economics and preservation of life, disease prevention via genetic screening and counselling is rapidly becoming a key element in the overall management of HoFH. Guidelines are available to assist diagnosis and treatment of HoFH; however, while advancements have been made in the management of the disease, there has been little systematic attention paid to prevention. Additionally, the Middle East/North Africa (MENA) region has a higher prevalence of HoFH than most other regions - chiefly due to consanguinity. This has led to the establishment of regional lipid clinics and awareness programs that have thrown education and awareness of HoFH into sharp focus. Incorporation of principles of prevention, education, awareness, and data from real-world use of existing therapeutics will significantly enhance the effectiveness of future guidelines for the management of HoFH, particularly in the MENA region.
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Affiliation(s)
- Abdullah Al-Ashwal
- Medical & Clinical Affairs, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia (Dr Al-Ashwal)
| | - Afaf Alsagheir
- Pediatrics Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (Dr Alsagheir)
| | - Mohammed Al Dubayee
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 11426, Saudi Arabia (Dr Al Dubayee)
| | | | - Ahmed Al-Sarraf
- Sabah Al Ahmad Cardiac Center, Department Cardiology, Ministry of Health, Kuwait (Dr Al-Sarraf)
| | - Zuhier Awan
- Division of Clinical Biochemistry, King Abdulaziz University, Abdullah Sulayman, Jeddah, Saudi Arabia (Dr Awan)
| | - Tawfeg Ben-Omran
- Division of Genetics and Genomic Medicine, Sidra Medicine and Hamad Medical Corporation, Doha, Qatar (Dr Ben-Omran)
| | - Saif Al-Yaarubi
- Oman Medical Specialty Board, Muscat, Sultanate of Oman (Dr Al-Yaarubi)
| | - Angham Almutair
- King Abdullah Specialised Children's Hospital, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia (Dr Almutair)
| | - Abdelhadi Habeb
- Pediatric Department, Prince Mohamed Bin Abdulaziz Hospital, Madinah, Saudi Arabia (Dr Habeb)
| | - Faouzi Maatouk
- Division of Cardiology, Department of Medicine, Fattouma Bourguiba University Hospital, Tunisia (Dr Maatouk)
| | - Manal Alshareef
- National Guard Hospital, Prince Mutib Ibn Abdullah Rd, National Guard District, Riyadh, Saudi Arabia (Dr Alshareef)
| | - Naji Kholaif
- Heart Centre Cardiology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia (Dr Kholaif); Alfaisal University College of Medicine, Riyadh, Saudi Arabia (Dr Kholaif)
| | - Dirk Blom
- Division of Lipidology, Department of Medicine and Cape Heart Institute, University of Cape Town, Cape Town, South Africa (Dr Blom)
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El-Helaly S, Khashaba E, El Domiaty H, Darwish A. Parental occupational and environmental risk factors for childhood bone cancer in Mansoura oncology center: a case control study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:248-256. [PMID: 36372065 DOI: 10.1080/09603123.2022.2145271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/04/2022] [Indexed: 06/16/2023]
Abstract
Cancer is the most frequently diagnosed disease-related cause of death among children and adolescents. This study was conducted to test association of occupational, environmental risk factors such as exposure to pesticides, radiations, hazardous chemicals and smoking among children with bone cancer. A retrospective case control study was conducted in Oncology center Mansoura University (OCMU). Study groups included bone cancer cases (n = 51) and an age and sex matched control group (n = 67). An interview-based questionnaire included demographic data, occupational and environmental risk factors for both children and parents. Exposure to n nitrose compounds from burning incense among children, paternal smoking and consanguinity are significantly different between cases and control. (p < 0.05). Paternal smoking and consanguinity are significant predictors for childhood bone cancer. It is recommended to add surveillance for environmental and occupational exposures to childhood bone cancer patients.
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Affiliation(s)
- S El-Helaly
- Pediatric specialist in Belkas Central Hospital, Ministry of health and population, Dakahlia, Egypt
| | - E Khashaba
- Industrial Medicine and Occupational Health Department of Public Health and Community medicine department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - H El Domiaty
- Professor of pediatric medicine, Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - A Darwish
- Pediatric Hematology/Oncology and Bone Marrow Transplantation Unit, Department of Pediatrics, Mansoura Research Center For Cord Stem Cells, Faculty of Medicine, Mansoura University, Mansoura, Egypt
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Al Qurashi M, Alahmadi S, Mustafa A, Aga SS, Al Hindi M, Ahmed A, Mohammad H, ElSharabasy R, Abed S, AlThubaiti I, Alrashdi N. Incidence of Inborn Errors of Metabolism in Newborn Infants: Five Years' Single-Center Experience, Jeddah, Saudi Arabia. Clin Pediatr (Phila) 2023; 62:1523-1530. [PMID: 37908170 DOI: 10.1177/00099228231163511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
Inborn errors of metabolism (IEMs) are inherited biochemical/metabolic disorders that are commonly present in the immediate neonatal period. The aim of this retrospective study was to determine the incidence and distribution of IEMs in newborn infants delivered in our hospital and to evaluate its outcome. A total of 16 494 (99.9%) newborn infants were screened for IEMs. We found 29 newborn infants diagnosed with IEMs, representing an incidence of 1 per ~569 live births and a cumulative incidence of 176 per 100 000 live births of the IEM-positive newborn infants. We detected 11 different types of IEMs, and the top 6 categories were endocrinopathies followed by carbohydrates disorders, vitamin-responsive disorders, organic acid defects, and ketogenesis and ketolysis defects. This study does reflect upon the importance of educating the general population about the perils of Consanguineous Marriages (CMs) in order to reduce related disorders significantly, especially in families who have a history of IEMs.
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Affiliation(s)
- Mansour Al Qurashi
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Shima Alahmadi
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Ahmed Mustafa
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Syed Sameer Aga
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Mohammed Al Hindi
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Abrar Ahmed
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Hadeel Mohammad
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Rasha ElSharabasy
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Sara Abed
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia
- King Abdullah International Medical Research Centre (KAIMRC), King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Iman AlThubaiti
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
| | - Nabila Alrashdi
- Neonatology Division, Department of Pediatrics, King Abdulaziz Medical City, Ministry of National Guard Health Affairs (MNGHA), Jeddah, Saudi Arabia
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Hanbazazh M, Samman A, Samargandy S, Al-Maghrabi J. Prognostic value of glucose transporter proteins-1 (GLUT1) in breast carcinoma. Libyan J Med 2023; 18:2283953. [PMID: 37988377 PMCID: PMC11018318 DOI: 10.1080/19932820.2023.2283953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023] Open
Abstract
Several studies have reported increased glucose transporters (GLUT) expression in different cancer types, including breast cancer. The primary purpose of this study is to examine GLUT1 immunoexpression in breast cancer patients in Saudi Arabia and to determine its significance. The study examined the association between GLUT1 immunophenotype and the clinicopathological characteristics in breast cancer. GLUT1 expression was analyzed in retrospectively collected tissue samples (n = 578) from breast cancer patients using immunohistochemistry. A total of 311 (54%) of the cases expressed GLUT1 cytoplasmic immunohistochemical staining. In univariate analysis, we found a significant association between GLUT1 expression and high-grade tumors (p < 0.0001). Positive estrogen and progesterone receptor results predicted lower GLUT1 immunoexpression (p < 0.0001 for both). Vascular invasion showed a significant association with GLUT1 immunoexpression (p = 0.045). Our findings support that GLUT1 immunohistochemistry can be used as a marker to determine the grade and hormonal receptor status in breast cancer.
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Affiliation(s)
- Mehenaz Hanbazazh
- Department of Pathology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Abdulhadi Samman
- Department of Pathology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Saad Samargandy
- Department of Community Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jaudah Al-Maghrabi
- Department of Pathology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pathology, King Faisal Specialist Hospital and Research center, Jeddah, Saudi Arabia
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Al Hayek AA, Al Zahrani WM, AlAblani HM, Al Dawish MA. Metabolic control, adherence to the gluten-free diet and quality of life among patients with type 1 diabetes and celiac disease. Diabetol Metab Syndr 2023; 15:189. [PMID: 37759325 PMCID: PMC10536816 DOI: 10.1186/s13098-023-01167-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/20/2023] [Indexed: 09/29/2023] Open
Abstract
AIMS In this cross-sectional study, we aimed to evaluate metabolic control, adherence to a gluten-free diet (GFD), and quality of life (QoL) in individuals with type 1 diabetes (T1D) and celiac disease (CD). METHODS We targeted individuals with T1D and CD at a major tertiary hospital in Saudi Arabia. We gathered retrospective data from medical records and prospectively assessed glycemic control using HbA1c and ambulatory glucose metrics, adherence to a GFD using the Celiac Dietary Adherence Test (CDAT), and QoL using the Celiac Disease Quality of Life survey (CD-QoL). RESULTS Forty-eight out of 1095 patients screened (4.38%) were included. Mean age and HbA1c were 21.3 (± 6.6) and 8.3% (± 0.8%). The average time in range% and above range% were 38.5 (range 24-68) and 29.6 (± 7.4). The median hypoglycemic events/month was 8, with a median duration of 80 min. The median overall CDAT and CD-QoL scores were 20.5 and 54. No significant correlations were observed between glucose management indicator (GMI), % in target, and CDAT/CD-QoL scores (all p > 0.05). CONCLUSIONS No significant effect of GFD on QoL or glycemic control was observed. Further prospective studies are warranted to establish solid evidence of the impact of GFD on individuals with T1D and CD.
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Affiliation(s)
- Ayman A Al Hayek
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia.
| | - Wael M Al Zahrani
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia
| | - Hamad M AlAblani
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia
| | - Mohamed A Al Dawish
- Department of Endocrinology and Diabetes, Diabetes Treatment Center, Prince Sultan Military Medical City, P.O. Box 7897, Riyadh, 11159, Saudi Arabia
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Abdu Y, Ahmed K, Ibrahim MIM, Abdou M, Ali A, Alsiddig H, Selim NA, Yassin MA. Perception of consanguineous marriage among the qatari population. Front Public Health 2023; 11:1228010. [PMID: 37601216 PMCID: PMC10436573 DOI: 10.3389/fpubh.2023.1228010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
Background Hereditary blood diseases are widespread among the Arab population due to the high rates of consanguineous marriages; research regarding the perception of consanguineous marriage in some countries, such as Qatar, is extremely scarce. Therefore, this study aimed to investigate the prevalence of consanguineous marriage and assess the perception of consanguineous marriage among the Qatari population. Methods A cross-sectional study used a self-administered questionnaire among 395 Qatari adults aged 18-35 who attended primary healthcare institutions in Qatar. A convenience sampling technique was used to select the study participants. An independent t-test was used to compare the significance of the mean between the two groups with positive and negative perceptions of consanguineous marriage. Categorical data were analyzed for association using the chi-square or Fisher's exact test. Finally, a multiple logistic regression analysis was conducted to determine the significant predictors of the positive perception of consanguineous marriage. A significant level was set at p < 0.05. Results Approximately 45% of the participants had a positive perception toward consanguineous marriage, and the most common reason stated by those participants was "habit and traditions." The prevalence of consanguineous marriage among married couples was 62.6%, and among those with consanguineous marriage, most were married to first cousins (81.7%). Moreover, compared to the participants with negative perceptions of consanguineous marriage, those with positive ones were significantly older, married, with lower educational levels and higher monthly income levels, did not hear about glucose-6-phosphate dehydrogenase (G6PD) deficiency, did not know what kinds of diseases are being screened in the premarital test, and were married to a relative. Conclusion The prevalence of consanguineous marriage is high among the Qatari population, and this requires an immediate need for community-based campaigns to raise public awareness about the problem and its potential impact.
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Affiliation(s)
- Yasamin Abdu
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Khalid Ahmed
- Department of Hematology, NCCCR, Hamad Medical Corporation, Doha, Qatar
| | | | - Mariam Abdou
- Community Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Arwa Ali
- College of Medicine and Surgery, University of Bahri, Khartoum, Sudan
| | | | - Nagah A. Selim
- Community Medicine Department, Primary Health Care Corporation, Doha, Qatar
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Alsultan A, Alalwan AA, Alshehri B, Jeraisy MA, Alghamdi J, Alqahtani S, Albassam AA. Interethnic differences in drug response: projected impact of genetic variations in the Saudi population. Pharmacogenomics 2023; 24:685-696. [PMID: 37610881 DOI: 10.2217/pgs-2023-0105] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023] Open
Abstract
Ethnicity is known to have an impact on drug responses. This is particularly important for drugs that have a narrow therapeutic window, nonlinearity in pharmacokinetics and are metabolized by enzymes that demonstrate genetic polymorphisms. However, most clinical trials are conducted among Caucasians, which might limit the usefulness of the findings of such studies for other ethnicities. The representation of participants from Saudi Arabia in global clinical trials is low. Therefore, there is a paucity of evidence to assess the impact of ethnic variability in the Saudi population on drug response. In this article, the authors assess the projected impact of genetic polymorphisms in drug-metabolizing enzymes and drug targets on drug response in the Saudi population.
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Affiliation(s)
- Abdullah Alsultan
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A Alalwan
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Bashayer Alshehri
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Majed Al Jeraisy
- Pharmaceutical Care Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia
- College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Jahad Alghamdi
- Saudi Food and Drug Authority, Drug Sector, Riyadh, Saudi Arabia
| | - Saeed Alqahtani
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed A Albassam
- Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
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Alamoudi RA, Al-Jabri BA, Alsulami MA, Sabbagh HJ. Prenatal maternal stress and the severity of autism spectrum disorder: A cross-sectional study. Dev Psychobiol 2023; 65:e22369. [PMID: 36811367 DOI: 10.1002/dev.22369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/08/2022] [Accepted: 01/04/2023] [Indexed: 02/10/2023]
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder linked to several genetic and environmental factors including antenatal stress. Hence, we aimed to examine whether a mother's stress during pregnancy is associated with the severity of autism spectrum disorder in children. The study was conducted with 459 mothers of children with autism (aged 2-14 years) who were attending rehabilitation and educational centers in the two major cities of Makkah and Jeddah in Saudi Arabia. Environmental factors, consanguinity, and ASD family history were assessed using a validated questionnaire. The Prenatal Life Events Scale questionnaire was used to assess whether the mothers were exposed to stress during pregnancy. Two models of ordinal regression analysis were conducted including gender, child age maternal age, parental age, maternal education, parental education, income nicotine exposure, mother taking medication during pregnancy, family history of ASD, gestation, consanguinity, exposure of prenatal life events (in model 1), and severity of prenatal life events (in model 2). Family history of ASD showed a statistically significant association with the severity of ASD in both regression models (p = .015, odds ratio [OR]: 4.261 in Model 1, and p = .014, OR: 4.901 in model 2). In model 2, the moderate severity prenatal life events showed higher statistically significant adjusted odds ratio for ASD severity compared to no stress (p = .031; OR: 3.82). Within the limitations of this study, prenatal stressors showed some potential contribution to ASD severity. Family history of ASD was the only factor that showed a persistent association with ASD severity. A study that assesses the effect of COVID-19 stress on ASD prevalence and severity is recommended.
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Affiliation(s)
- Rana A Alamoudi
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Basma A Al-Jabri
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Heba Jafar Sabbagh
- Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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Chentoufi AA, Uyar FA, Chentoufi HA, Alzahrani K, Paz M, Bahnassy A, Elyamany G, Elghazaly A. HLA Diversity in Saudi Population: High Frequency of Homozygous HLA Alleles and Haplotypes. Front Genet 2022; 13:898235. [PMID: 35754807 PMCID: PMC9218871 DOI: 10.3389/fgene.2022.898235] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
Human leukocyte antigens (HLA) diversity has a tremendous impact on shaping the transplantation practices, transfusion-associated graft versus host disease prevention strategies, and host-pathogen interactions. Here, we conducted a retrospective study of HLA class I and class II homozygosity at allelic and haplotype levels in unrelated individuals genotyped from 2012 to 2016 in a tertiary hospital in the capital of Saudi Arabia. Among 5,000 individuals, 2,773 individuals meet inclusion criteria and were retrospectively analyzed for HLA-A, -B, -C-DRB1, and -DQB1 homozygosity at allelic and haplotype levels. HLA molecular typing was performed using a commercial reverse sequence-specific oligonucleotide (rSSO) kit. We were able to identify 15 HLA-A, 20 HLA-B, 11 HLA-C, 13 HLA-DRB1, and five HLA-DQB1 homozygous alleles demonstrating a very low genetic diversity in the Saudi population. The highest homozygosity in HLA class I was found in locus C followed by A and B (20.3% > 16.1% > 15.5%; p < 0.001) where the most homozygote alleles were A*02 (9.2%), B*51 and B*50 (5.7% and 3.7%), and C*07, C*06, and C*15 (7.2%, 5.48%, and 3.3%) and in HLA class II, the highest homozygosity was found in locus DQB1 compared to DRB1 (31.71% > 19.2%; p < 0.001), with the most common homozygote alleles being DRB1*07 and DRB1*04 (5.33% and 4.2%) and DQB1*02, DQB1*06, and DQB1*03 (13.55%, 7.92%, and 7.64%). The frequency of finding an individual with one homozygote allele was (24.6%), two homozygote alleles (13.5%), three homozygote alleles (4.7%), four homozygote alleles (3.4%), and five alleles were (4.8%). The most frequent homozygote haplotypes are A*23∼C*06∼B*50∼DRB1*07∼DQB1*02 and A*02∼C*06∼B*50∼DRB1*07∼DQB1*02. This study shows low diversity of both class I and II alleles and haplotypes in the Saudi population, which would have a significant impact on shaping the transplantation practices, transfusion-associated graft versus host disease prevention strategies, and host-pathogen interactions.
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Affiliation(s)
- Aziz Alami Chentoufi
- King Fahad Medical City, Riyadh, Saudi Arabia.,Department of Medical Microbiology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - F Aytül Uyar
- Department of Physiology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | | | | | - Maria Paz
- King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Ghaleb Elyamany
- Department of Central Military Laboratory and Blood Bank, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Assem Elghazaly
- King Fahad Medical City, Riyadh, Saudi Arabia.,Department of Hematology/Oncology, King Saud Medical City, Riyadh, Saudi Arabia
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12
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Yasir ZH, Basakran FA, Alhumaid NA, Balous MA, Banaeem AS, Al-Shangiti AK, Khandekar R. Prevalence and determinants of refractive error and related ocular morbidities among Saudi adolescence population in Riyadh, Saudi Arabia. Oman J Ophthalmol 2022; 15:25-30. [PMID: 35388239 PMCID: PMC8979385 DOI: 10.4103/ojo.ojo_114_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 08/19/2021] [Accepted: 08/28/2021] [Indexed: 11/05/2022] Open
Abstract
PURPOSE The purpose of this study was to determine the magnitude and determinants of refractive error (RE) and related ocular morbidities among preparatory and secondary Saudi students in Riyadh. METHODS This study was conducted in 2017-2018 at preparatory (12-14 years) and secondary (15-18 years) schools. A "Spot Screener" was used to determine if the child passed or failed a refraction test. Fail test meant RE ≥ ± 0.50 D. Data were collected on refractive status in each eye, anisometropia, and strabismus. The type of RE was estimated and analysis was performed for an association to gender, age, and education levels. The use of spectacle while screening defined the compliance of spectacle wear. RESULTS The study sample was comprised of 708 Saudi students. There were 59.5% of boys. The prevalence of RE was 43.6% (95% confidence interval [CI]: 40.0, 47.3). The prevalence of RE in preparatory and secondary students was 44.5% and 43.2%, respectively. The proportion of myopia (≥ -0.5 D) and hyperopia (≥ +0.5 D) among students with RE was 82.2% and 17.8%, respectively. Family history of RE was positively associated to RE in students (odds ratio: 1.8 [95% CI: 1.3, 2.5]). The current screening initiative identified 45 (6.4%) new cases of RE who required spectacles. The compliance rate for using visual aid among students with RE was 74.6%. The prevalence of anisometropia and strabismus was 3.0% and 4.1%, respectively. CONCLUSIONS A high proportion of Saudi adolescence in Riyadh have RE. Periodic ophthalmic assessment and refractive services are recommended as part of school health screening initiatives.
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Affiliation(s)
- Ziaul Haq Yasir
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia,Address for correspondence: Dr. Ziaul Haq Yasir, King Khaled Eye Specialist Hospital, 2775 AlUrubah Road, Umm AlHamam AlGharbi, Unit 2, Riyadh, Saudi Arabia. E-mail:
| | | | - Nora Ali Alhumaid
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | | | | | - Rajiv Khandekar
- Department of Research, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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13
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Zaien SZ, El-Houfey AA, Alqahtani H, El Sayed HAE, Elgzar WT, Essa RM, Bayomy H, Ibrahim HAF. Predictors of premarital screening and genetic counseling knowledge and attitude among deaf and hard hearing females in Tabuk, Saudi Arabia. J Med Life 2022; 15:379-386. [PMID: 35450002 PMCID: PMC9015174 DOI: 10.25122/jml-2021-0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 12/27/2021] [Indexed: 11/21/2022] Open
Abstract
According to Saudi Arabia's 2030 vision, research should be directed to prevention, early detection, and intervention to reduce all types of disability. The current study aimed to investigate the predictors of Premarital Screening and Genetic Counseling (PMSGC) knowledge and attitude among deaf and hard hearing females' in Tabuk, Saudi Arabia. Descriptive correlational design was conducted on a convenience sample of 67 deaf and hard hearing students from the Tabuk region. Data were collected by an electronic questionnaire elaborated to the participants using sign language. The results revealed that most participants had incorrect answers regarding most PMSGC questions. Around two-thirds (68.7%, 65.7%, and 71.6%) of them strongly agree that PMSGC is very important, compatible with Islamic principles, and prevents family social and psychological problems, respectively. Older, urban area residents and university-educated participants have significantly higher knowledge and attitude scores than their peers (t=2.239, 4.887, 4.790 & p<0.05), respectively. Multiple regression shows that age (b=0.302, t=-2.795, p=0.007), education (b=0.336, t=2.425, p=0.019), mothers' education (b=0.314, t=2.345, p=0.023), and monthly income (b=-0.337, t=-2.503, p=0.015), are significant predictors of PMSGC knowledge. Furthermore, age (b=0.659, t=4.024, p=0.000), residence (b=0.293, t=2.233, p=0.030), education (b=-0.395, t=3.028, p=0.004), and type of disability (b=-0.443, t=-3.763, p=0.000) are significant predictors of PMSGC attitude. Although most deaf and hard hearing females have incorrect knowledge regarding PMSGC, most have a positive attitude. The study concluded that participants' education, mothers' education, and monthly income are significant predictors of PMSGC knowledge. Moreover, age, residence, education, and type of disability were significant predictors of higher PMSGC attitudes.
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Affiliation(s)
- Sahar Zedan Zaien
- Department of Special Education, College of Art & Education, Tabuk University, Tabuk, Saudi Arabia
| | - Amira Abdallah El-Houfey
- Community Health Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt,Department of Nursing, Jizan University, Jizan, Saudi Arabia
| | - Hanadi Alqahtani
- Department of Special Education, College of Art & Education, Tabuk University, Tabuk, Saudi Arabia
| | - Hanan Abd Elwahab El Sayed
- Department of Medical Science Assistance, Community College, Tabuk University, Tabuk, Saudi Arabia,Department of Community Health Nursing, Faculty of Nursing, Benha University, Benha, Egypt
| | - Wafaa Taha Elgzar
- Department of Obstetrics and Gynecologic Nursing, Damanhour University, Damanhour, Egypt,Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran, Saudi Arabia,Corresponding Author: Wafaa Taha Elgzar, Department of Maternity and Childhood Nursing, Nursing college, Najran University, Najran, Saudi Arabia. E-mail: ;
| | - Rasha Mohamed Essa
- Department of Obstetrics and Gynecologic Nursing, Damanhour University, Damanhour, Egypt
| | - Hala Bayomy
- Department of Nutrition and Food Science, University of Tabuk, Tabuk, Saudi Arabia,Department of Food Science and Technology, Damanhour University, Damanhour, Egypt
| | - Heba Abdel-Fatah Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran, Saudi Arabia,Department of Obstetrics and Woman Health Nursing, Benha University, Benha, Egypt
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14
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Alanazi AM, Alenazi NSN, Alanazi HSK, Almadhari SAF, Almadani HAM. Status Epilepticus in Pediatric Patients in Saudi Arabia: A Systematic Review. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/tol3efkk8d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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15
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Alzahrani SH, Alzahrani NM, Al Jabir FM, Alsharef MK, Zaheer S, Hussein SH, Alguwaihes AM, Jammah AA. Consanguinity and Diabetes in Saudi Population: A Case-Control Study. Cureus 2021; 13:e20836. [PMID: 35004072 PMCID: PMC8723996 DOI: 10.7759/cureus.20836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND AND AIM Diabetes mellitus (DM) of both types is a genetically determined disorder and is prevalent in the Saudi population. Furthermore, the rate of consanguineous marriages is also high among Saudis. Therefore, we aimed to determine the prevalence of consanguinity among people with DM and investigate the effect of consanguinity on the occurrence of diabetes at different levels. METHODS A descriptive cross-sectional study was carried out at the Obesity, Metabolism and Endocrine Center of King Fahad Medical City in Riyadh, Saudi Arabia in January 2021. Information on patients' demographics (age, gender), family history of DM, and presence of consanguinity, and degree of consanguineous marriage were collected. RESULTS We included 324 people with DM, 143 (44.1%) with type 1 diabetes (T1DM), and 181 (55.9%) with type 2 diabetes (T2DM). We included 201 people without DM for T1DM control and 300 people for T2DM control. The mean age was 26.6 ± 11.1 years for the T1DM group and 57.8 ± 11.6 years for the T2DM group. Consanguinity was noted among 73 (51.4%) T1DM patients, but T1DM was not significantly related to consanguinity. T2DM was significantly correlated with consanguinity (r=0.132, p=0.004) particularly among patients with a degree of consanguinity as first-cousins for both paternal and maternal sides (odds ratio [OR]=1.151 and 1.476). Gender and positive family history for DM and consanguineous marriage between cousins were significant factors for T2DM. After controlling for gender and a positive family history of DM, consanguineous marriage between cousins from both the paternal and maternal sides remained significant. CONCLUSION T2DM occurrence increases in presence of consanguinity in the Saudi population. This relationship might contribute to the higher risk of DM prevalence. Further studies are needed to elucidate this relationship deeply. It's unclear whether lowering consanguineous marriages would decrease the prevalence of diabetes or not. However, a clear message about this correlation has to be delivered to the public.
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Affiliation(s)
- Saad H Alzahrani
- Obesity and Endocrine Metabolism Center, King Fahad Medical City, Riyadh, SAU
| | - Nawaf M Alzahrani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Fahad M Al Jabir
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Mohammed K Alsharef
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Shawana Zaheer
- Obesity and Endocrine Metabolism Center, King Fahad Medical City, Riyadh, SAU
| | | | - Abdullah M Alguwaihes
- Endocrinology Division, Department of Medicine, King Saud University Medical City, Riyadh, SAU
| | - Anwar A Jammah
- Endocrinology Division, Department of Medicine, King Saud University Medical City, Riyadh, SAU
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16
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Strategic priorities for hematopoietic stem cell transplantation in the EMRO region. Hematol Oncol Stem Cell Ther 2021; 16:162-169. [PMID: 34688625 DOI: 10.1016/j.hemonc.2021.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/23/2021] [Indexed: 11/22/2022] Open
Abstract
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.
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17
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Ali Alghamdi M, Alrasheedi A, Alghamdi E, Adly N, AlAali WY, Alhashem A, Alshahrani A, Shamseldin H, Alkuraya FS, Alfadhel M. Molecular autopsy by proxy in preconception counseling. Clin Genet 2021; 100:678-691. [PMID: 34406647 PMCID: PMC9290025 DOI: 10.1111/cge.14049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/15/2021] [Accepted: 08/17/2021] [Indexed: 01/06/2023]
Abstract
Monogenic diseases that result in early pregnancy loss or neonatal death are genetically and phenotypically highly variable. This often poses significant challenges in arriving at a molecular diagnosis for reproductive planning. Molecular autopsy by proxy (MABP) refers to the genetic testing of relatives of deceased individuals to deduce the cause of death. Here, we specifically tested couples who lost one or more children/pregnancies with no available DNA. We developed our testing strategy using whole exome sequencing data from 83 consanguineous Saudi couples. We detected the shared carrier state of 50 pathogenic variants/likely pathogenic variants in 43 families and of 28 variants of uncertain significance in 24 families. Negative results were seen in 16 couples after variant reclassification. In 10 families, the risk of more than one genetic disease was documented. Secondary findings were seen in 10 families: either genetic variants with potential clinical consequences for the tested individual or a female carrier for X‐linked conditions. This couple‐based approach has enabled molecularly informed genetic counseling for 52% (43/83 families). Given the predominance of autosomal recessive causes of pregnancy and child death in consanguineous populations, MABP can be a helpful approach to consanguineous couples who seek counseling but lack molecular data on their deceased offspring.
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Affiliation(s)
- Malak Ali Alghamdi
- Medical Genetic Division, Pediatric Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Medical Genetics Division, Department of Pediatrics, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ameinah Alrasheedi
- Department of Pediatrics, College of Medicine and Medical Sciences, Qassim University, Al Qassim, Saudi Arabia
| | - Esra Alghamdi
- College of Medicine, Imam Mohammed Ibn Saud Islamic University, Riyadh, Saudi Arabia
| | - Nouran Adly
- College of Medicine Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Wajeih Y AlAali
- Dr. Sulaiman Al Habib Medical Group, Riyadh, Saudi Arabia.,Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Amal Alhashem
- Department of Pediatrics, Prince Sultan Military Medical City, Riyadh, Saudi Arabia.,College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Hanan Shamseldin
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fowzan S Alkuraya
- Department of Translational Genomics, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Majid Alfadhel
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia.,Genetics and Precision Medicine department, King Abdullah Specialized Children Hospital, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
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18
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Baaqeel R, Banaganapalli B, Al Mahdi H, Salama M, Alhussaini B, Alaifan M, Bin-Taleb Y, Shaik N, Al-Aama J, Elango R, Saadah O. TagSNP approach for HLA risk allele genotyping of Saudi celiac disease patients: effectiveness and pitfalls. Biosci Rep 2021; 41:BSR20210509. [PMID: 34042155 PMCID: PMC8202064 DOI: 10.1042/bsr20210509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/04/2021] [Accepted: 05/24/2021] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Celiac disease (CD) is a genetically complex autoimmune disease which is triggered by dietary gluten. Human leukocyte antigen (HLA) class II genes are known to act as high-risk markers for CD, where >95% of CD patients carry (HLA), DQ2 and/or DQ8 alleles. Therefore, the present study was conducted to investigate the distribution of HLA haplotypes among Saudi CD patients and healthy controls by using the tag single nucleotide polymorphisms (SNP). METHODS HLA-tag SNPs showing strong linkage value (r2>0.99) were used to predict the HLA DQ2 and DQ8 genotypes in 101 Saudi CD patients and in 103 healthy controls by using real-time polymerase chain reaction technique. Genotype calls were further validated by Sanger sequencing method. RESULTS A total of 63.7% of CD cases and of 60.2% of controls were predicted to carry HLA-DQ2 and DQ8 heterodimers, either in the homozygous or heterozygous states. The prevalence of DQ8 in our CD patients was predicted to be higher than the patients from other ethnic populations (35.6%). More than 32% of the CD patients were found to be non-carriers of HLA risk haplotypes as predicted by the tag SNPs. CONCLUSION The present study highlights that the Caucasian specific HLA-tag SNPs would be of limited value to accurately predict CD specific HLA haplotypes in Saudi population, when compared with the Caucasian groups. Prediction of risk haplotypes by tag SNPs in ethnic groups is a good alternate approach as long as the tag SNPs were identified from the local population genetic variant databases.
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Affiliation(s)
- Reham H. Baaqeel
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Babajan Banaganapalli
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Hadiah Bassam Al Mahdi
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biology, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed A. Salama
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Biology, Faculty of Science, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Bakr H. Alhussaini
- Pediatric Gastroenterology Unit, Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Meshari A. Alaifan
- Pediatric Gastroenterology Unit, Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Yagoub Bin-Taleb
- Pediatric Gastroenterology Unit, Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Noor Ahmad Shaik
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Jumana Yousuf Al-Aama
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ramu Elango
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al-Brahim Center of Excellence in Research of Hereditary Disorders, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Omar I. Saadah
- Pediatric Gastroenterology Unit, Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Mahzari M, Zarif H. Homozygous Familial Hypercholesterolemia (HoFH) in Saudi Arabia and Two Cases of Lomitapide Use in a Real-World Setting. Adv Ther 2021; 38:2159-2169. [PMID: 33829367 PMCID: PMC8107066 DOI: 10.1007/s12325-021-01720-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 03/18/2021] [Indexed: 12/19/2022]
Abstract
Introduction Homozygous familial hypercholesterolemia (HoFH) is a rare, genetic condition in which mutations in key peptides involved in the low-density lipoprotein receptor (LDL-R) pathway result in markedly elevated levels of circulating LDL-cholesterol (LDL-C). Patients are at high risk of developing early-onset atherosclerotic cardiovascular disease with associated mortality risks. Treatment options are extremely limited, and aspects of society and medical care in Saudi Arabia have the potential to increase incidence and limit treatment pathways in HoFH. Methods Along with a brief review of the evidence available on HoFH we describe the treatment of two Saudi Arabian patients with HoFH diagnosed and treated in accordance with local clinical practices and with the microsomal triglyceride transferase protein inhibitor lomitapide. Results HoFH in Saudi Arabia is characterized by problems associated with consanguinity, a lack of access to lipoprotein apheresis, and pressures to proceed to liver transplant. Among the case histories, the first patient was commenced on lomitapide therapy, and underwent a dramatic decrease in LDL-C levels from 16.5 to 2.2 mmol/L (87% decrease). This patient had problems with access to lomitapide and cessation of the drug resulted in rebound in LDL-C to 22 mmol/L. The second patient experienced delayed commencement of lomitapide therapy. Despite a 45% decrease in LDL-C levels from 15.3 to 6.9 mmol/L, the patient died the following year at age 26 years from complications subsequent to cardiovascular surgery. Lomitapide was well tolerated in both patients Discussion The experience of these two cases highlights the need for prompt, effective, and sustained intervention in HoFH to prevent cardiovascular morbidity and mortality. Lomitapide is an effective therapy for HoFH, and we look forward to improved access to this drug in Saudi Arabia, where there is a chronic unmet medical need in HoFH.
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Affiliation(s)
- Moeber Mahzari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
- Department of Medicine, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia.
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.
| | - Hawazen Zarif
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Medicine, Ministry of National Guard Health Affairs, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
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Interactions of Consanguinity and Number of Siblings with Childhood Acute Lymphoblastic Leukemia. BIOMED RESEARCH INTERNATIONAL 2021; 2020:7919310. [PMID: 33490255 PMCID: PMC7787732 DOI: 10.1155/2020/7919310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/24/2020] [Accepted: 11/27/2020] [Indexed: 11/17/2022]
Abstract
Acute lymphoblastic leukemia (ALL) is a common malignancy in children. Consanguinity has a high prevalence in developing countries and increases the probability of homozygosity for many genes which may affect ALL and its prognosis. We conducted a study to explore the impact of consanguinity and number of siblings on ALL as there are currently no studies to describe this effect. Data were collected from patients' records from the Children's University Hospital of Damascus University, which is the major cancer centre for children in Syria. This study included 193 children with ALL over one year. Number of siblings was not with the French-American-British (FAB) classification, gender, ALL subtype, or risk of ALL children. When comparing consanguinity degrees and complete blood counts at diagnosis, significant contradicting data were found in the third-degree and fourth-degree consanguinity when compared to one another and to not having consanguineous parents as third degree consanguinity was associated with normal platelets but lower WBC counts, and fourth-degree consanguinity was associated with normal haemoglobin levels and WBC counts, but lower platelet counts. Having consanguineous parents was also associated with acquiring ALL at an older age, L2 FAB classification, having a positive family history for malignancies, and not having hepatosplenomegaly (P < 0.05). Although L2 is known to be a poor prognosis indicatory, no association was found with consanguinity and risk. Finally, no association was found with ALL subtype or risk (P > 0.05). Although consanguinity and number of siblings have affected some variables and prognostic features of childhood ALL, the aetiology is not clear and we need further studies to clarify such an association as this will help in optimising therapy and accurately determine the risk.
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21
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Diagnosis and management of X-linked hypophosphatemia in children and adolescent in the Gulf Cooperation Council countries. Arch Osteoporos 2021; 16:52. [PMID: 33660084 PMCID: PMC7929956 DOI: 10.1007/s11657-021-00879-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/04/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION X-linked hypophosphatemia (XLH) is a rare inherited cause of hypophosphatemic rickets and osteomalacia. It is caused by mutations in the phosphate-regulating endopeptidase homolog, X-linked (PHEX). This results in increased plasma fibroblast growth factor-23 (FGF23), which leads to loss of renal sodium-phosphate co-transporter expression leading to chronic renal phosphate excretion. It also leads to low serum 1,25-dihydroxyvitamin D (1,25(OH)2D), resulting in impaired intestinal phosphate absorption. Chronic hypophosphatemia in XLH leads to impaired endochondral mineralization of the growth plates of long bones with bony deformities. XLH in children and adolescents also causes impaired growth, myopathy, bone pain, and dental abscesses. XLH is the most frequent inherited cause of phosphopenic rickets/osteomalacia. Hypophosphatemia is also found in calcipenic rickets/osteomalacia as a result of secondary hyperparathyroidism. Thus, chronic hypophosphatemia is a common etiologic factor in all types of rickets. RESULTS There is considerable overlap between symptoms and signs of phosphopenic and calcipenic rickets/osteomalacia. Wrong diagnosis leads to inappropriate treatment of rickets/osteomalacia. Nutritional rickets and osteomalacia are common in the Gulf Cooperation Council countries which include Saudi Arabia, United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman. Due to high levels of consanguinity in the region, genetic causes of phosphopenic and calcipenic rickets/osteomalacia are also common. CONCLUSION This guideline was developed to provide an approach to the diagnosis of XLH, especially where there is no family history of the disease, and that other related conditions are not mistaken for XLH. We also guide the medical management of XLH with conventional treatment and with burosumab, a recombinant human IgG1 monoclonal antibody to FGF23.
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Aga S, Alghamdi Y, Alghamdi A, Khan M. Knowledge, awareness, and attitude of medical students concerning genetics and premarital screening. JOURNAL OF NATURE AND SCIENCE OF MEDICINE 2021. [DOI: 10.4103/jnsm.jnsm_47_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Deeb A, Juraibah FA, Dubayee MA, Habeb A. X-linked Hypophosphatemic Rickets: Awareness, Knowledge, and Practice of Pediatric Endocrinologists in Arab Countries. J Pediatr Genet 2020; 11:126-131. [DOI: 10.1055/s-0040-1721400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/25/2020] [Indexed: 10/22/2022]
Abstract
AbstractX-linked hypophosphatemic rickets (XLHR) is a genetic disease caused by inactivating pathogenic variants in PHEX, which results in reduced mineralization of bone, teeth, and renal phosphate wasting. XLHR is traditionally treated by phosphate and vitamin D analogs. Recently, burosumab, a recombinant anti-fibroblast growth factor-23 (FGF-23) monoclonal antibody was approved as specific XLHR therapy. We aimed to assess the awareness, knowledge, and management of XLHR among members of the Arab Society for Pediatric Endocrinology and Diabetes (ASPED). Of the 97 physicians who answered the online questionnaire, 97% were aware of XLHR, and while 90% screen family members of the index case, only 29% manage children with XLHR. In children with rickets, 40% of participants measure serum/urine phosphate routinely, and 31% request serum FGF-23 in suspected XLHR cases. Almost all responders use conventional XLHR therapy, and 4% used Burosomab. Only 14% were satisfied with the conventional treatment, and 69% reported therapeutic complications in up to 25% of their patients. Multidisciplinary care for XLHR is practiced by 94%, but 82% of providers did not have transition clinics. Pediatric endocrinologists in ASPED countries are aware of XLHR but have variable practice and are unsatisfied with its conventional treatment. Raising awareness of the recognition and modern management of XLHR is needed.
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Affiliation(s)
- Asma Deeb
- Department of Pediatric Endocrinology, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Fahad Al Juraibah
- Department of Pediatrics, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Pediatrics, College of Medicine, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Muhammad Al Dubayee
- Department of Pediatrics, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
- Department of Pediatrics, College of Medicine, King Saud bin Abdulaziz University for Health Science, Riyadh, Saudi Arabia
| | - Abdelhadi Habeb
- Department of Pediatrics, Ministry of National Guard Health Affairs, Madinah, Saudi Arabia
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Almazroua AM, Alsughayer L, Ababtain R, Al-shawi Y, Hagr AA. The association between consanguineous marriage and offspring with congenital hearing loss. Ann Saudi Med 2020; 40:456-461. [PMID: 33307738 PMCID: PMC7733643 DOI: 10.5144/0256-4947.2020.456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 10/03/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Consanguinity is a commonly recognized practice among marriages in the Middle East and may lead to an increase in the prevalence of inherited disorders. Autosomal recessive deafness is the most common form of inherited congenital hearing loss (CHL). OBJECTIVES Determine the association of consanguineous marriages with congenital sensorineural hearing loss (SNHL) and auditory neuropathy. DESIGN Descriptive and analytical cross-sectional study. SETTING Ear specialist hospital. PATIENTS AND METHODS Children with severe-to-profound congenital SNHL, who had been referred to the specialist hospital for cochlear implant were analyzed. Patients were divided into subgroups based on degree of consanguinity. MAIN OUTCOME MEASURE The relative risk of having more than one child with SNHL in offspring of a consanguineous marriage. SAMPLE SIZE 189 parents and children with CHL. RESULTS The parents of 157 children (83.1%) were blood-related. Of those, 48 had more than one child with CHL (31.4%), while only two parents who were not blood-related had more than one child with CHL (6.25%; P=.005). Among the 189 children, 131 (69.3%) parents were direct cousins. Only 39 (20.6%) and 43 (22.8%) children had family histories of CHL on the paternal and maternal sides, respectively. There was no statistically significant difference in the prevalence of auditory neuropathy between the offspring of consanguineous and non-consanguineous marriages (P=.648). CONCLUSION The risk of having more than one child with SNHL in the offspring from a consanguineous marriage is 3.5 times higher than that of a non-consanguineous mating. LIMITATION The association of hearing loss degree with consanguinity was not studied. CONFLICT OF INTEREST None.
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Affiliation(s)
| | - Luluh Alsughayer
- From the College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rayanh Ababtain
- From the College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yazeed Al-shawi
- From the Department of Otolaryngology, King Abdullah Ear Specialist Center, King Saud University, Riyadh, Saudi Arabia
- From the Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Abdulrahman A. Hagr
- From the Department of Otolaryngology, King Abdullah Ear Specialist Center, King Saud University, Riyadh, Saudi Arabia
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Al Dandan O, Hassan A, AbuAlola H, Alzaki A, Alwaheed A, Alalwan M, Al Shammari M, AlShamlan N, Alsaif HS. Clinical and imaging profiles of pulmonary embolism: a single-institution experience. Int J Emerg Med 2020; 13:47. [PMID: 32867676 PMCID: PMC7457516 DOI: 10.1186/s12245-020-00303-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/05/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pulmonary embolism (PE) is a common life-threatening condition with non-specific clinical presentations. The diagnosis of PE depends highly on imaging studies, which may also provide prognostic information. This study aimed to describe the clinical and imaging profiles of patients with PE, emphasizing the differences between central and peripheral PE. METHODS After ethics review board approval, this retrospective observational study examined the non-negative results in adult patients who underwent computed tomography pulmonary angiography (CT-PA) at our hospital between May 2016 and December 2019. Demographic and clinical information and imaging findings were collected from the electronic medical records. RESULTS The study included 85 cases that were identified after re-interpreting the 103 non-negative CT-PA scans. Six cases were excluded for incomplete data and 12 cases were false-positive. Central PE was found in 63.5% of the cases. Obesity was the most common risk factor seen in 37.6% of the cases. Furthermore, 9.4% of the patients had sickle cell disease, which tended to be associated with peripheral PE. There was no difference between the peripheral and central PE in most clinical and imaging parameters evaluated (P > 0.05). However, patients with isolated subsegmental PE were more likely to develop hemoptysis (P = 0.04). CONCLUSION This study suggests that patients with obesity and sickle cell disease constitute an important proportion of all PE cases. Furthermore, the clinical and imaging profiles in patients with peripheral PE are similar to those in patients with central PE. Future research should focus on the clinical value of peripheral PE in patients with sickle cell disease.
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Affiliation(s)
- Omran Al Dandan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Ali Hassan
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia.
| | - Hossain AbuAlola
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Alaa Alzaki
- Department of Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Abrar Alwaheed
- Department of Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Mohannad Alalwan
- Department of Internal Medicine, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
| | - Malak Al Shammari
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nouf AlShamlan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hind S Alsaif
- Department of Radiology, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia
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Abu-Shaheen A, Heena H, Nofal A, Riaz M, AlFayyad I. Knowledge of obstetric danger signs among Saudi Arabian women. BMC Public Health 2020; 20:939. [PMID: 32539821 PMCID: PMC7296941 DOI: 10.1186/s12889-020-09075-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Accepted: 06/08/2020] [Indexed: 11/16/2022] Open
Abstract
Background In the Middle East, tremendous efforts have been made to promote both maternal and child health. However, there is little information in the literature about maternal knowledge of obstetric danger signs. Thus, this study aims to investigate Saudi Arabian women’s knowledge of obstetric danger signs and their determinant factors. Methods A community-based, cross-sectional survey was conducted in primary health care centers (PHCCs) in Riyadh City. A proportionate random sample of women who have delivered during the past 2 years was selected from the PHCCs. Data were then collected through structured interviews; the questionnaire was developed based on the literature review. Results A random sample of 1397 women were included in the final analysis of this study. During pregnancy, 21.1% of the participants reported that they knew about swollen hands or faces. During labor, 23.1% of the participants reported that they knew about prolonged labor (> 12 h). At postpartum, 26.3% of the participants reported that they knew about foul-smelling vaginal discharge. In this study, women in the northern region of Riyadh who visited government hospitals had significantly higher odds of knowing at least one obstetric danger sign. A statistically significant difference was found between the participants’ knowledge of at least one obstetric danger sign and her 11–15 times of antenatal care visit. Conclusions A dedicated health education guide, and a kingdom-wide maternal and child health preventive care promotion program could improve the health and wellbeing of expectant mothers. In these programs, it is essential to focus on birth preparedness, with danger signs recognition, and the integrate health-related data for the whole kingdom.
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Affiliation(s)
- Amani Abu-Shaheen
- Research Center, King Fahad Medical City, P.O. Box: 59046, Riyadh, 11525, Saudi Arabia.
| | - Humariya Heena
- Research Center, King Fahad Medical City, P.O. Box: 59046, Riyadh, 11525, Saudi Arabia
| | - Abdullah Nofal
- Emergency Medicine Department, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Muhammad Riaz
- Department of Statistics, University of Malakand, Lower Dir KPK, Pakistan
| | - Isamme AlFayyad
- Research Center, King Fahad Medical City, P.O. Box: 59046, Riyadh, 11525, Saudi Arabia
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Alassiri AH, Alyami AA, Alshabibi MI, Alhusain AM, Nasradeen MH, Barri AT, Shirah BH, Algahtani HA. The spectrum of muscle pathologies: Three decades of experience from a reference laboratory in Saudi Arabia. Ann Diagn Pathol 2020; 47:151532. [PMID: 32464352 DOI: 10.1016/j.anndiagpath.2020.151532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 04/06/2020] [Accepted: 04/22/2020] [Indexed: 01/09/2023]
Abstract
BACKGROUND When investigating patients with a suspected neuromuscular disorder, a muscle biopsy is considered an instrumental tool to reach a definitive diagnosis. There is a paucity of publications that assess the diagnostic utilization and yield of muscle biopsies. We intend to present our experience in this regard over an extended period of more than three decades. METHODS This is an observational retrospective cohort study in which we collected pathology reports for muscle biopsies diagnosed at our reference lab between 1986 and 2017. RESULTS We identified a total of 461 cases of muscle biopsy performed, which fulfilled the inclusion criteria. Pediatric cases defined as ≤14 years of age constituted a significant proportion of cases (n = 275, 60%). Normal biopsies were reported in 27% of cases (n = 124), and in 4%, the biopsies were non-diagnostic. The most common pathologies reported were non-specific myopathy (n = 72, 16%), dystrophy (n = 71, 15%), and neurogenic disorders (n = 60, 13%). CONCLUSION In conclusion, the muscle biopsy will continue to play a crucial role, as a gold standard or as a complementary investigation, in the diagnosis of certain neuromuscular disorders. Increasing the yield and accuracy of muscle pathology should be the main concern and priority to neuropathologists reporting muscle biopsies. In addition, utilizing next-generation sequencing and other molecular techniques have changed the location of muscle biopsy in the algorithm of the diagnosis of neuromuscular disorders. This paper is an urgent call to establish the Saudi Neuropathology Society and the muscle pathology and neuromuscular disorders registry.
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Affiliation(s)
- Ali H Alassiri
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia; College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Ali A Alyami
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Mohammed I Alshabibi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah M Alhusain
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Majed H Nasradeen
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdulelah T Barri
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Bader H Shirah
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Hussein A Algahtani
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia; King Abdulaziz Medical City, Jeddah, Saudi Arabia.
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Shaikh AA, Shirah B, Alzelaye S. A homozygous mutation in the insulin gene (INS) causing autosomal recessive neonatal diabetes in Saudi families. Ann Pediatr Endocrinol Metab 2020; 25:42-45. [PMID: 32252216 PMCID: PMC7136508 DOI: 10.6065/apem.2020.25.1.42] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 09/02/2019] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Insulin gene (INS) mutations are a rare cause of permanent neonatal diabetes and mature-onset diabetes of the young (MODY10). Homozygous mutations have been reported to cause diabetes by decreasing insulin biosynthesis through distinct mechanisms. In this study, we report a homozygous mutation c.-331C>G in the INS gene causing autosomal recessive neonatal diabetes in Saudi families and share our experience with diagnosis and management. METHODS We retrospectively reviewed all cases diagnosed with diabetes during the first week of life. We identified 18 cases, and all underwent genetic testing to identify the cause. Most had mutations in common genes (9 in KCNJ11 and 5 in ABCC8). The inclusion criterion for this study was a mutation in the INS gene. RESULTS Four patients from 3 Saudi families had mutations in the INS gene. All patients were born with low birth weight and were diagnosed with neonatal diabetes at the age of 2 days. Sanger sequencing analysis identified a homozygous INS pathogenic promoter variant, c.-331C>G. All patients were managed by insulin therapy. Two patients had persistent diabetes and in 2 cases diabetes resolved. CONCLUSION This report indicates that a homozygous mutation in the INS gene is a probable and important cause of neonatal diabetes in Saudi Arabia. The c.-331C>G variant in the INS gene identified in our study showed variability both within and between families and different outcomes ranging from early resolution of diabetes after 2 months of life to permanent diabetes.
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Affiliation(s)
- Adnan Al Shaikh
- King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia,Address for correspondence: Adnan Al Shaikh, MD Consultant Pediatric Endocrinology, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia, Jeddah. P.O. Box: 9515, Jeddah, 21423 Saudi Arabia Tel: +966122266666 Fax: +966122266200 E-mail:
| | - Bader Shirah
- King Abdulaziz Medical City, King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Somaya Alzelaye
- Pediatric Endocrine & Diabetes Consultant, Endocrine & Diabetes Center, Alqounfudah General Hospital, Al Qunfudah, Saudi Arabia
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Prevalence and pattern of consanguineous marriage among educated married individuals in Riyadh. J Biosoc Sci 2019; 52:768-775. [PMID: 31779725 DOI: 10.1017/s0021932019000786] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Consanguineous marriage is preferred in many countries, especially by Muslims. Despite the increasing education rate in Saudi Arabia, the prevalence of consanguineous marriage does not seem to be decreasing as quickly as expected. The present study aimed to investigate the current prevalence of consanguineous marriage among educated married adults in Riyadh and to determine the factors favouring it. The cross-sectional study was conducted in 2017-18 using an online questionnaire. A total of 550 questionnaires were sent to married adults of both sexes and 417 responded, giving a response rate of 75.8%. The questionnaire consisted of two parts: the first section asked for demographic data such as age, sex, educational level, residential area and family size. The second part was about consanguineous marriage and its degree if present, family history of consanguineous marriage and level of awareness of its potential negative impact on offspring. It was found that the prevalence of consanguineous marriage among the participating educated adults was 39.8% and most of these were married to a first cousin. Neither level of education nor age affected the likelihood of consanguineous marriage, but predictors for the practice among the educated participating adults were having a family history of consanguineous marriage, having consanguineous parents and having a personal preference for consanguineous marriage. In conclusion, the prevalence of consanguineous marriage among educated adults in Riyadh was still high in 2018, especially among first-cousin relatives, and this was related to family history and personal preference rather than educational level or age. It is recommended that further research is conducted to assess the level of knowledge about, and attitude towards, consanguineous marriage among adults in Saudi Arabia.
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Riaz M, Tiller J, Ajmal M, Azam M, Qamar R, Lacaze P. Implementation of public health genomics in Pakistan. Eur J Hum Genet 2019; 27:1485-1492. [PMID: 31101884 PMCID: PMC6777461 DOI: 10.1038/s41431-019-0428-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 02/10/2019] [Accepted: 04/30/2019] [Indexed: 02/06/2023] Open
Abstract
There has been considerable recent progress in the implementation of public health genomics policy throughout the developed world. However, in the developing world, genetic services still remain limited, or unavailable to most. Here, we discuss challenges and opportunities related to the implementation of public health genomics in developing countries. We focus on Pakistan, a country with one of the world's highest rates of inter-family marriages and prevalence of inherited genetic conditions. Pakistan still lacks a national newborn screening programme, clinical genetic testing services, or public health genomics framework. The medical infrastructure in Pakistan, characterized by limited publicly-funded health services and a significant burden of infectious disease, may contribute to de-prioritization of genetic health services. In addition, there are a number of societal, cultural and religious factors to consider. Recently a number of large research studies have been conducted in populations of Pakistani descent, mostly in collaboration with major US, UK and European institutions. Some of these have yielded high-impact scientific findings, but have yet to translate into public health outcomes in Pakistan. Before the benefits of genomics can be realized in developing countries, the first initial steps towards strategic prioritization, resourcing, and long-term goal setting are required. We propose some practical recommendations and possible first steps forward.
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Affiliation(s)
- Moeen Riaz
- Public Health Genomics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Jane Tiller
- Public Health Genomics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Muhammad Ajmal
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Maleeha Azam
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Raheel Qamar
- Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
- Pakistan Academy of Sciences, Islamabad, Pakistan
| | - Paul Lacaze
- Public Health Genomics, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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Kornilov SA, Tan M, Aljughaiman A, Naumova OY, Grigorenko EL. Genome-Wide Homozygosity Mapping Reveals Genes Associated With Cognitive Ability in Children From Saudi Arabia. Front Genet 2019; 10:888. [PMID: 31620175 PMCID: PMC6759945 DOI: 10.3389/fgene.2019.00888] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 08/22/2019] [Indexed: 11/28/2022] Open
Abstract
Recent studies of the genetic foundations of cognitive ability rely on large samples (in extreme, hundreds of thousands) of individuals from relatively outbred populations of mostly European ancestry. Hypothesizing that the genetic foundation of cognitive ability depends on the broader population-specific genetic context, we performed a genome-wide association study and homozygosity mapping of cognitive ability estimates obtained through latent variable modeling in a sample of 354 children from a consanguineous population of Saudi Arabia. Approximately half of the sample demonstrated significantly elevated homozygosity levels indicative of inbreeding, and among those with elevated levels, homozygosity was negatively associated with cognitive ability. Further homozygosity mapping identified a specific run, inclusive of the GRIA4 gene, that survived corrections for multiple testing for association with cognitive ability. The results suggest that in a consanguineous population, a notable proportion of the variance in cognitive ability in the normal range in children might be regulated by population-specific mechanisms such as patterns of elevated homozygosity. This observation has implications for the field's understanding of the etiological bases of intelligence and its variability around the world.
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Affiliation(s)
- Sergey A. Kornilov
- Baylor College of Medicine, Department of Molecular and Human Genetics, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Mei Tan
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Oxana Yu Naumova
- Department of Psychology, University of Houston, Houston, TX, USA
- Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Elena L. Grigorenko
- Baylor College of Medicine, Department of Molecular and Human Genetics, Houston, TX, United States
- Department of Psychology, University of Houston, Houston, TX, USA
- Child Study Center, Yale University, New Haven, CT, USA
- Moscow State University for Psychology and Education, Moscow, Russia
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Alharbi KK, Al-Sheikh YA, Alsaadi MM, Mani B, Udayaraja GK, Kohailan M, Ali Khan I. Screening for obesity in the offspring of first-cousin consanguineous couples: A Phase-I study in Saudi Arabia. Saudi J Biol Sci 2019; 27:242-246. [PMID: 31889843 PMCID: PMC6933162 DOI: 10.1016/j.sjbs.2019.09.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 08/26/2019] [Accepted: 09/01/2019] [Indexed: 01/19/2023] Open
Abstract
Consanguineous or cousin marriages are very common in Saudi Arabia. However, owing to limited studies and insufficient knowledge about genetic diseases/disorders, many couples are unaware of the increased health risks for their offspring. Among the inherited and complex diseases from parents’ consanguinity, obesity is common; therefore, we examined the prevalence of obesity in the offspring of first-cousin consanguineous couples in Saudi Arabia. In this questionnaire-based study, 657 individuals (mean age = 18.7 ± 10.2 years; age range = 2–65 years) who were residing in Riyadh, Saudi Arabia participated. Among them, almost 90% were native Saudis. Participants mean body mass index (BMI) was 24.5 ± 9.1 kg/m2. Sex- stratified demographic details confirmed a significant association between age and BMI (p < .001). We confirmed that adolescents and adults were more prone to develop obesity. Adults and non-Saudi participants were three times more likely to develop obesity if they had first-cousin consanguineous parents than those who did not. Of the 30% of participants who were obese, 100 will be selected for Phase II, in which we plan to perform exome sequencing.
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Affiliation(s)
- Khalid Khalaf Alharbi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Yazeed A Al-Sheikh
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Muslim M Alsaadi
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | | | | | | | - Imran Ali Khan
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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Al-Mendalawi MD. Clinical Patterns and Linear Growth in Children with Congenital Adrenal Hyperplasia, a 11 Year Experience. Indian J Endocrinol Metab 2019; 23:501-502. [PMID: 31741916 PMCID: PMC6844163 DOI: 10.4103/ijem.ijem_303_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mahmood D. Al-Mendalawi
- Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq
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A population-based study of inter-generational attitudes towards consanguineous marriages in north-eastern Brazil. J Biosoc Sci 2019; 51:683-697. [PMID: 30862325 DOI: 10.1017/s0021932018000433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this cross-sectional study was to investigate beliefs, attitudes and reproductive behaviours in relation to consanguinity in a population living in the backlands of north-eastern Brazil. Data were collected by face-to-face interview from 147 high school students aged 13-20 years and from 532 elderly individuals aged 60 years and over from Brejo dos Santos in the state of Paraíba in 2017. The frequency of consanguineous marriage was found to have increased over the generations, being 15.9% in the parents of the elderly participants, 17.1% in the elderly participants themselves and 20.5% in their descendants. Although 258 (50.9%) of the elderly interviewees opposed consanguineous union, 341 (65.3%) would approve of the marriage of their children with relatives. Both the young (n=108 or 78.3%) and elderly (n=398 or 80.4%) interviewees believed that consanguineous marriages were no more durable than non-consanguineous marriages (p=0.578). Additionally, 408 (82.4%) of the elderly individuals and 108 (80.6%) of the students recognized that spouses in consanguineous unions experience conflicts, just like other couples do (p=0.625). In both groups, the majority of the participants did not believe that consanguinity increased the risk of having children with disabilities. The regression of the two continuous variables 'age' and 'positive attitudes score' showed a significant correlation, suggesting that younger individuals are more susceptible to the influence of cultural factors contributing to consanguinity, such as the opinions of their parents and grandparents. The belief that consanguineous unions are more durable showed a significant difference between elderly individuals in consanguineous and non-consanguineous unions (p=0.001); the former were 2.42 more likely to believe that marriages between relatives contributes to marriage durability.
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Almana Y, Mohammed R. Current concepts in pediatric inflammatory bowel disease; IL10/IL10R colitis as a model disease. Int J Pediatr Adolesc Med 2019; 6:1-5. [PMID: 31304220 PMCID: PMC6603158 DOI: 10.1016/j.ijpam.2019.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel disease (IBD) is a heterogeneous group of disorders composed mainly of ulcerative colitis (UC) and Crohn's disease (CD) and undetermined IBD. The peak incidence of occurrence is mainly beyond the pediatric age group. Recent knowledge about genetic factors had been strongly linked to pediatric IBD (PIBD). Recent advances in genomic technologies have prompted the identification of genetic defects underlying rare, very early-onset IBD (VEO-IBD) as a disease subgroup noted especially in populations with higher consanguinity rates. A better understanding of key players in the complex homeostasis of the immune system in the gut and illustrating the relationships between intestinal microbiome, systemic immune dysregulation and primary immunodeficiency have received growing recognition over the years. In this article, we provide a review of the key players of the immunity of the gut, compare between adult and pediatric IBD as an interesting module to investigate the relationship between monogenic and multifactorial/polygenic diseases, list genetic mutations confirmed to be linked to VEO IBD and summarize the scientific work that led to the discovery of one of the monogenic mutations related to infantile colitis, namely IL10 and IL10 receptor defects.
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Affiliation(s)
- Yousef Almana
- Department of Pediatrics, Section of Pediatric Allergy and Immunology, King Faisal Specialist Hospital & Research Centre (KFSHRC), Riyadh, Saudi Arabia
| | - Reem Mohammed
- College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
- Corresponding author. P.O. Box 3354, Riyadh, 11211, Saudi Arabia.
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Hebbar P, Abubaker JA, Abu-Farha M, Tuomilehto J, Al-Mulla F, Thanaraj TA. A Perception on Genome-Wide Genetic Analysis of Metabolic Traits in Arab Populations. Front Endocrinol (Lausanne) 2019; 10:8. [PMID: 30761081 PMCID: PMC6362414 DOI: 10.3389/fendo.2019.00008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/09/2019] [Indexed: 12/16/2022] Open
Abstract
Despite dedicated nation-wide efforts to raise awareness against the harmful effects of fast-food consumption and sedentary lifestyle, the Arab population continues to struggle with an increased risk for metabolic disorders. Unlike the European population, the Arab population lacks well-established genetic risk determinants for metabolic disorders, and the transferability of established risk loci to this population has not been satisfactorily demonstrated. The most recent findings have identified over 240 genetic risk loci (with ~400 independent association signals) for type 2 diabetes, but thus far only 25 risk loci (ADAMTS9, ALX4, BCL11A, CDKAL1, CDKN2A/B, COL8A1, DUSP9, FTO, GCK, GNPDA2, HMG20A, HNF1A, HNF1B, HNF4A, IGF2BP2, JAZF1, KCNJ11, KCNQ1, MC4R, PPARγ, SLC30A8, TCF7L2, TFAP2B, TP53INP1, and WFS1) have been replicated in Arab populations. To our knowledge, large-scale population- or family-based association studies are non-existent in this region. Recently, we conducted genome-wide association studies on Arab individuals from Kuwait to delineate the genetic determinants for quantitative traits associated with anthropometry, lipid profile, insulin resistance, and blood pressure levels. Although these studies led to the identification of novel recessive variants, they failed to reproduce the established loci. However, they provided insights into the genetic architecture of the population, the applicability of genetic models based on recessive mode of inheritance, the presence of genetic signatures of inbreeding due to the practice of consanguinity, and the pleiotropic effects of rare disorders on complex metabolic disorders. This perspective presents analysis strategies and study designs for identifying genetic risk variants associated with diabetes and related traits in Arab populations.
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Affiliation(s)
- Prashantha Hebbar
- Genetics and Bioinformatics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- Doctoral Program in Population Health, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jehad Ahmed Abubaker
- Genetics and Bioinformatics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Mohamed Abu-Farha
- Genetics and Bioinformatics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jaakko Tuomilehto
- Genetics and Bioinformatics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Genetics and Bioinformatics Unit, Dasman Diabetes Institute, Kuwait City, Kuwait
- *Correspondence: Fahd Al-Mulla
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Al-Mendalawi MD. Comment on: Growth characteristics in children with congenital adrenal hyperplasia. Saudi Med J 2018; 39:1164. [PMID: 30397718 PMCID: PMC6274667 DOI: 10.15537/smj.2018.11.23467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Mahmood D Al-Mendalawi
- Department of Paediatrics, Al-Kindy College of Medicine, University of Baghdad, Baghdad, Iraq. E-mail.
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Algahtani H, Shirah B, Algahtani R, Naseer MI, Al-Qahtani MH, Abdulkareem AA. Ataxia with ocular apraxia type 2 not responding to 4-aminopyridine: A rare mutation in the SETX gene in a Saudi patient. Intractable Rare Dis Res 2018; 7:275-279. [PMID: 30560021 PMCID: PMC6290838 DOI: 10.5582/irdr.2018.01107] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Ataxia with ocular apraxia type 2 is an autosomal recessive disorder caused by a mutation in the senataxin (SETX) gene. The disease is characterized by early onset cerebellar ataxia, cerebellar atrophy, axonal sensorimotor neuropathy, oculomotor apraxia, and increased levels of α-fetoprotein. Reported here is a rare homozygous frameshift deletion c.5308_5311del, p.(Glu1770Ilefs*15) in the SETX gene in a Saudi family. Ataxia with ocular apraxia type 2 was diagnosed based on the patient's history, an examination, and genetic testing. Genetic testing remains the only definitive method with which to identify the gene responsible. This is the third case report of this rare mutation in the literature. Ataxia with ocular apraxia type 2 continues to be a challenging disease to manage with no therapeutic options available to date. In the current case, the medication 4-aminopyridine was inefficacious in improving walking or balance. Further research is needed to identify potential treatments for this challenging condition.
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Affiliation(s)
- Hussein Algahtani
- King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Address correspondence to:Dr. Hussein Algahtani, King Abdulaziz Medical City, King Saud bin Abdulaziz University for Health Sciences, Contact No.: 00966556633130. P.O. Box: 12723, Jeddah, Saudi Arabia 21483. E-mail:
| | - Bader Shirah
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Raghad Algahtani
- King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Muhammad Imran Naseer
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammad H. Al-Qahtani
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia
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Thong MK, See-Toh Y, Hassan J, Ali J. Medical genetics in developing countries in the Asia-Pacific region: challenges and opportunities. Genet Med 2018; 20:1114-1121. [DOI: 10.1038/s41436-018-0135-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 07/03/2018] [Indexed: 12/12/2022] Open
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Jastaniah W, Aljefri A, Ayas M, Alharbi M, Alkhayat N, Al-Anzi F, Yassin F, Alkasim F, Alharbi Q, Abdullah S, Abrar MB, Alsultan A. Prevalence of hereditary cancer susceptibility syndromes in children with cancer in a highly consanguineous population. Cancer Epidemiol 2018; 55:88-95. [PMID: 29859499 DOI: 10.1016/j.canep.2018.05.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 05/08/2018] [Accepted: 05/15/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIM Hereditary cancer susceptibility syndromes (HCSS) are reported in up to one-third of children with cancer. Diagnosis of HCSS is crucial for implementation of surveillance protocols. We identified children who fulfilled criteria for HCSS in Saudi Arabia using the American College of Medical Genetics and Genomics (ACMG) guidelines, addressing the utility of these guidelines in a highly consanguineous population. METHODS This multi-center cross-sectional study recruited 1858 children with cancer between January 2011 and December 2014. HCSS criteria were based on the ACMG guidelines. RESULTS Seven hundred and four (40.4%) out of 1742 eligible patients fulfilled criteria for HCSS. Consanguinity was reported in 629 (38%) patients, with 50 (2.9%) first-degree, 535 (30.7%) second-degree, and 272 (15.6%) third-degree relatives affected with cancer. Two hundred and eighty eight (17.4%) leukemia and 87 (5.3%) brain tumour patients fulfilled HCSS criteria, with parental consanguinity being the most frequent criterion in both (leukemia 85.4%, brain tumors 83.9%). However, leukemia was less frequent in patients of consanguineous parents (p = 0.023). CONCLUSION Four out of 10 children with cancer fulfilled criteria for HCSS, most often due to consanguinity. This higher than expected prevalence suggests the need to validate consanguinity as a criterion for HCSS in highly consanguineous populations.
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Affiliation(s)
- Wasil Jastaniah
- Department of Pediatrics, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia; Chairman Princess Noorah Oncology Center, King Saud Bin Abdulaziz University and King Abdulaziz Medical City, Jeddah, Saudi Arabia.
| | - Abdullah Aljefri
- Consultant Pediatric Hematology/Oncology/BMT, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Mouhab Ayas
- Consultant Pediatric Hematology/Oncology/BMT, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Musa Alharbi
- Consultant Pediatric Hematology/Oncology/BMT and Chairman of the Cancer Center, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Nawaf Alkhayat
- Consultant Pediatric Hematology/Oncology/BMT, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Faisal Al-Anzi
- Chief Executive Officer and Consultant Pediatric Hematology/Oncology/BMT, Prince Faisal Bin Bandar Cancer Center, Qaseem, Saudi Arabia
| | - Fawwaz Yassin
- Consultant Pediatric Hematology/Oncology/BMT, King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
| | - Fawaz Alkasim
- Consultant Pediatric Hematology/Oncology/BMT, King Saud Medical City, Riyadh, Saudi Arabia
| | - Qasim Alharbi
- Consultant Pediatric Hematology/Oncology/BMT, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Shaker Abdullah
- Consultant Pediatric Hematology/Oncology/BMT and Head Section of Pediatric Hematology/Oncology/BMT, Princess Noorah Oncology Center, King Saud Bin Abdulaziz University and King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Mohammed Burhan Abrar
- Princess Noorah Oncology Center, King Saud Bin Abdulaziz University and King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Abdulrahman Alsultan
- Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Consultant Pediatric Hematology/Oncology/BMT, Department of Pediatric Hematology/Oncology, King Abdullah Specialist Children's Hospital, Riyadh, Saudi Arabia
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The first Saudi Arabian national inventory study revealed the upcoming challenges of highly diverse non-tuberculous mycobacterial diseases. PLoS Negl Trop Dis 2018; 12:e0006515. [PMID: 29799845 PMCID: PMC5991771 DOI: 10.1371/journal.pntd.0006515] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 06/07/2018] [Accepted: 05/09/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Incidences of nontuberculous mycobacteria (NTM) causing pulmonary and extrapulmonary diseases are reportedly increasing globally and the current epidemiologic situation in Saudi Arabia remains unclear. To study such trend, we carried out a nationwide systematic epidemiological study focusing on NTM diseases for the first time in the country. METHODS/PRINCIPLE FINDINGS A nationwide collection of NTM isolates with clinical and demographical data was conducted for a period of 24 months. Primary species identification was carried out by line probe assays followed by sequencing of 16S rRNA, 16S-23S ITS region, rpoB and hsp65 genes. The laboratory findings were comprehensively analysed against demographical and clinical data. A total of 527 isolates were enrolled with a higher proportion of Saudi citizens (76.5%), elderly (>60 years) patients (34.2%), and male gender (65.3%) respectively. Overall, 75.1% isolates were pulmonary origin with a proven clinical significance of 44.7%. In total, 34 NTM species including 17 rare species were identified, in addition to 8 'undefined' isolates. M.simiae (22.6%), M.fortuitum (18.1%) and M.abscessus (17.8%) were predominant species. Interestingly, 27 new cases of clinically relevant M.riyadhense were also noticed (Primary data on emergence of rare NTM species and M.riyadhense has been recently reported). Results showed, rare clinical events such as mycobacteremia, cecum abscess, peritonitis and ascites caused by M.wolinskyi, M.holsaticum, M.duvalii and M.monacence respectively. Diabetes mellitus (P value-0.04) and previous history of tuberculosis (P value- 0.001) were identified as independent risk factors associated with NTM diseases. CONCLUSIONS/SIGNIFICANCE NTM disease spectrum and pathogen diversity is an emerging challenge to any nation, including Saudi Arabia. Therefore, more priorities will be given to NTM's with an immediate initiative to develop diagnostic infrastructures and disease management plans.
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Type 1 Diabetes Mellitus in Saudi Arabia: A Soaring Epidemic. Int J Pediatr 2018; 2018:9408370. [PMID: 29853923 PMCID: PMC5964576 DOI: 10.1155/2018/9408370] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 03/04/2018] [Accepted: 03/28/2018] [Indexed: 12/12/2022] Open
Abstract
Type 1 diabetes mellitus (T1DM) is quite prevalent in the world, with a proportion of 1 in every 300 persons and steadily rising frequency of incidence of about 3% every year. More alarmingly, the incidence of T1DM among infants is also increasing, with children as young as 6 months succumbing to it, instead of that at a rather established vulnerable age of around seven and near puberty, when the hormones antagonize the action of insulin. These reports pose a unique challenge of developing efficient T1DM management system for the young children. The Kingdom of Saudi Arabia (KSA) is the largest country in the Middle East that occupies approximately four-fifths of the Arabian Peninsula supporting a population of more than 33.3 million people, of whom 26% are under the age of 14 years. As per the Diabetes Atlas (8th edition), 35,000 children and adolescents in Saudi Arabia suffer from T1DM, which makes Saudi Arabia rank the 8th in terms of numbers of TIDM patients and 4th country in the world in terms of the incidence rate (33.5 per 100,000 individuals) of TIDM. However, in comparison with that in the developed countries, the number of research interventions on the prevalence, incidence, and the sociodemographic aspects of T1DM is woefully inadequate. In this review we discuss different aspects of T1DM in Saudi Arabia drawing on the published literature currently available.
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Milaat WA, Ibrahim NK, Albar HM. Reproductive health profile and circumcision of females in the Hali semi-urban region, Saudi Arabia: A community-based cross-sectional survey. Ann Saudi Med 2018; 38:81-89. [PMID: 29620540 PMCID: PMC6074365 DOI: 10.5144/0256-4947.2018.81] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Improving the reproductive health of females has be.come the focus of the developmental efforts of many nations. OBJECTIVES To identify the reproductive health style of married females, and to determine the prevalence and predictors of circumcision among girls aged less than or equal 18 years in Hali semi-urban region. DESIGN A cross-sectional household survey SETTING: Houses in Hali, Al-Qunfudhah governorate, western Saudi Arabia during 2017. SUBJECTS AND METHODS A multistage systematic cluster random sampling method was used to select participants. A validated questionnaire was used in interviewing the head of the selected houses. MAIN OUTCOME MEASURES Reproductive health profile of women, and circumcision of girls. SAMPLE SIZE 365 households. RESULTS Reproductive life starts early in the Hali region as 41.4% of women are married at or before 18 years of age. Consanguinity was recorded in 57.0% of houses. The prevalence of grand multiparity (GMP) was 54.7%; it was significantly associated with current maternal age, age at marriage, low educational levels of both parents and husbands with non-professional jobs. Current use of birth control methods was reported by 28.9% of families, and oral contraceptives (OCs) were the commonest method. Contraceptive use was significantly associated with higher educational levels of both parents and with women having professional work. The prevalence of circumcision was 80.3%. Circumcision was most frequent (59.4%) at age 7 years or less, and almost always done by doctors (91.4%). Hemorrhage (2.9%) and fever (2.3%) were the minimal recorded complications. Girls with higher parental education, enough income, no parental consanguinity, and whose mothers married at an older age had slightly lower rates of circumcision, but the difference was without statistical significance. CONCLUSION The pattern of early female marriage, high consanguinity, GMP, low contraceptive use, and a high frequency of circumcision in girls was apparent in Hali. Public health education and legislative policies are needed. LIMITATIONS Recall bias may affect the reported frequency of circumcision, and related complications. CONFLICTS OF INTEREST None.
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Affiliation(s)
| | - Nahla Khamis Ibrahim
- Nahla Khamis Ibrahim, Department of Family and Community Medicine, King Abdulaziz University Faculty of Medicine,, Jeddah 21551, Saudi Arabia, M: +966501632237, , ORCID: http://orcid.org/0000-0001-5834.6862
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Morad FA, Rashidi OM, Sadath SS, Al-Allaf FA, Athar M, Alama MN, Edris SE, Bondagji NS, Shaik NA, Banaganapalli B, Awan Z. In Silico Approach to Investigate the Structural and Functional Attributes of Familial Hypercholesterolemia Variants Reported in the Saudi Population. J Comput Biol 2017; 25:170-181. [PMID: 29172679 DOI: 10.1089/cmb.2017.0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Familial hypercholesterolemia (FH) is a metabolic disorder that leads primarily to premature cardiovascular diseases, the main cause of mortality in Saudi Arabia (SA). FH is underreported and underdiagnosed in SA with statistical evidence of high expected prevalence in such a consanguineous community. Lacking knowledge of which and how these alterations are actually impacting lipid metabolism is one of the main reasons why FH is insufficiently diagnosed in the region. The aim of this study was to develop a fast prediction approach using an integrated bioinformatics method for future screening of the potential causative variants from national registries. A total of 21 variants were detected with majority rate in LDLR (81%). Variants were classified based on the type of mutation. Missense variants resulting in amino acid changes, c.1429G>A (p.D477N), c.1474G>A (p.D492N), c.1731G>T (p.W577C), and c.1783C>T (p.R595W) in LDLR gene, in addition to c.9835A>G (p.S3279G) in APOB, were shown to be deleterious by concordant analysis. Furthermore, functional interaction deformities showed a significant loss and gain of energies in the mutated proteins. These findings will help in distinguishing the most harmful mutations needed to be screened for clinically diagnosed FH patients in SA. Such computational research is necessary to avoid time consumption and the usage of expensive biological experiments. This can be a fast track to facilitate the future filtering and screening of causative mutations from national registries.
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Affiliation(s)
- Fatima A Morad
- 1 Department of Biology, Genomic and Biotechnology Section, Faculty of Science, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Omran M Rashidi
- 2 Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Saida S Sadath
- 3 Department of Biochemistry, Faculty of Science, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Faisal A Al-Allaf
- 4 Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University , Makkah, Kingdom of Saudi Arabia .,5 Department of Science and Technology, Umm Al-Qura University , Makkah, Kingdom of Saudi Arabia
| | - Mohammad Athar
- 4 Department of Medical Genetics, Faculty of Medicine, Umm Al-Qura University , Makkah, Kingdom of Saudi Arabia .,5 Department of Science and Technology, Umm Al-Qura University , Makkah, Kingdom of Saudi Arabia
| | - Mohamed N Alama
- 6 Adult Interventional Cardiology, Cardiology Unit, King Abdulaziz University Hospital (KAUH) , Jeddah, Kingdom of Saudi Arabia
| | - Sherif E Edris
- 1 Department of Biology, Genomic and Biotechnology Section, Faculty of Science, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
| | - Nabeel S Bondagji
- 7 Obstetrics and Gynecology Unit, King Abdul Aziz University Hospital , Jeddah, Kingdom of Saudi Arabia
| | - Noor A Shaik
- 8 Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD) , Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Babajan Banaganapalli
- 8 Princess Al-Jawhara Al-Brahim Centre of Excellence in Research of Hereditary Disorders (PACER-HD) , Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Zuhier Awan
- 2 Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University , Jeddah, Kingdom of Saudi Arabia
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Sanyelbhaa H, Kabel A, Abo El-Naga HAER, Sanyelbhaa A, Salem H. The risk ratio for development of hereditary sensorineural hearing loss in consanguineous marriage offspring. Int J Pediatr Otorhinolaryngol 2017; 101:7-10. [PMID: 28964313 DOI: 10.1016/j.ijporl.2017.07.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 07/15/2017] [Accepted: 07/17/2017] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This study aims to define the relative risk of development of hearing loss in offspring of consanguineous marriages. MATERIALS AND METHODS This is a retrospective case-control study conducted in a tertiary referral center in Jeddah, KSA. The study group included 1600 probands (848 males, 752 females), with age range 0.5-12 years (6.6 ± 3.6). The study group comprised of two equal, age and sex matched subgroups; Hearing Loss (HL) group and Normal Hearing (NH) group. The children included in the HL group should have idiopathic or non syndromic genetic sensorineural hearing loss. RESULTS The HL Group comprised 800 children with variable degrees of sensorineural hearing loss. Profound and severe degrees of hearing loss were the most prevalent degrees (P <0.05%). The prevalence of consanguineous marriage offspring in the NH group was 42.5%, while in the HL group it was 68.9% (P < 0.05). The differences between both study subgroups regarding the distribution of different degrees of parental consanguinity (first, second, double first, and first once removed cousins) were insignificant (P > 0.05). The relative risk and 95% confidence interval (RR, 95% CI) for development of hearing loss in offspring of consanguineous marriage was 1.76 (95% CI 1.57-1.97, P < 0.001). CONCLUSIONS There was 76% increased risk for consanguineous marriage progeny to develop SNHL when compared to non consanguineous progeny.
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Affiliation(s)
| | | | | | | | - Hatem Salem
- Ministry of Health, Kingdome of Saudi Arabia, Saudi Arabia
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Alsafiah HM, Goodwin WH, Hadi S, Alshaikhi MA, Wepeba PP. Population genetic data for 21 autosomal STR loci for the Saudi Arabian population using the GlobalFiler ® PCR amplification kit. Forensic Sci Int Genet 2017; 31:e59-e61. [PMID: 29030116 DOI: 10.1016/j.fsigen.2017.09.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 08/24/2017] [Accepted: 09/28/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Hussain M Alsafiah
- Forensic Genetics Laboratory, General Administration of Criminal Evidences, Public Security, Ministry of Interior, Saudi Arabia; School of Forensic and Applied Sciences, University of Central Lancashire, Preston, United Kingdom.
| | - William H Goodwin
- School of Forensic and Applied Sciences, University of Central Lancashire, Preston, United Kingdom
| | - Sibte Hadi
- School of Forensic and Applied Sciences, University of Central Lancashire, Preston, United Kingdom
| | - Mohammed A Alshaikhi
- Forensic Medicine Department, Security Forces Hospitals Programme/Dammam, Ministry of Interior, Saudi Arabia
| | - Pet-Paul Wepeba
- School of Forensic and Applied Sciences, University of Central Lancashire, Preston, United Kingdom
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Alfadhel M, Al Othaim A, Al Saif S, Al Mutairi F, Alsayed M, Rahbeeni Z, Alzaidan H, Alowain M, Al-Hassnan Z, Saeedi M, Aljohery S, Alasmari A, Faqeih E, Alwakeel M, AlMashary M, Almohameed S, Alzahrani M, Migdad A, Al-Dirbashi OY, Rashed M, Alamoudi M, Jacob M, Alahaidib L, El-Badaoui F, Saadallah A, Alsulaiman A, Eyaid W, Al-Odaib A. Expanded Newborn Screening Program in Saudi Arabia: Incidence of screened disorders. J Paediatr Child Health 2017; 53:585-591. [PMID: 28337809 DOI: 10.1111/jpc.13469] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 11/01/2016] [Accepted: 11/13/2016] [Indexed: 11/29/2022]
Abstract
AIM To address the implementation of the National Newborn Screening Program (NBS) in Saudi Arabia and stratify the incidence of the screened disorders. METHODS A retrospective study conducted between 1 August 2005 and 31 December 2012, total of 775 000 newborns were screened from 139 hospitals distributed among all regions of Saudi Arabia. The NBS Program screens for 16 disorders from a selective list of inborn errors of metabolism (IEM) and endocrine disorders. Heel prick dry blood spot samples were obtained from all newborns for biochemical and immunoassay testing. Recall screening testing was performed for Initial positive results and confirmed by specific biochemical assays. RESULTS A total of 743 cases were identified giving an overall incidence of 1:1043. Frequently detected disorders nationwide were congenital hypothyroidism and congenital adrenal hyperplasia with an incidence of 1:7175 and 1:7908 correspondingly. The highest incidence among the IEM was propionic acidaemia with an incidence rate of 1:14 000. CONCLUSION The article highlights the experience of the NBS Program in Saudi Arabia and providing data on specific regional incidences of all the screened disorders included in the programme; and showed that the incidence of these disorders is one of the highest reported so far world-wide.
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Affiliation(s)
- Majid Alfadhel
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Ali Al Othaim
- King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia.,Department of Pathology, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Saif Al Saif
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Fuad Al Mutairi
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Moeenaldeen Alsayed
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Zuhair Rahbeeni
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hamad Alzaidan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohammed Alowain
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Zuhair Al-Hassnan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.,The National Newborn Screening Program, Ministry of Health, Riyadh, Saudi Arabia
| | - Mohamad Saeedi
- Noncommunicable Disease, Ministry of Health, Riyadh, Saudi Arabia
| | - Saeed Aljohery
- Noncommunicable Disease, Ministry of Health, Riyadh, Saudi Arabia
| | - Ali Alasmari
- Medical Genetic Section, King Fahad Medical City, Children's Hospital, Riyadh, Saudi Arabia
| | - Eissa Faqeih
- Medical Genetic Section, King Fahad Medical City, Children's Hospital, Riyadh, Saudi Arabia
| | | | - Maher AlMashary
- Armed Forces Medical Services Directorate, Riyadh, Saudi Arabia
| | | | - Mohammed Alzahrani
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Abeer Migdad
- Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Osama Y Al-Dirbashi
- Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE.,Children Hospital of Eastern Ontario Research Institute, Ottawa, Canada
| | | | | | - Minnie Jacob
- Research Center, Ministry of Health, Riyadh, Saudi Arabia
| | | | | | - Amal Saadallah
- Research Center, Ministry of Health, Riyadh, Saudi Arabia
| | | | - Wafaa Eyaid
- Department of Pediatrics, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Riyadh, Saudi Arabia.,Ministry of National Guard-Health Affairs (NGHA), Riyadh, Saudi Arabia
| | - Ali Al-Odaib
- Research Center, Ministry of Health, Riyadh, Saudi Arabia.,King Salman Center for Disability Research, Riyadh, Saudi Arabia
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Varghese B, Enani M, Shoukri M, AlThawadi S, AlJohani S, Al- Hajoj S. Emergence of Rare Species of Nontuberculous Mycobacteria as Potential Pathogens in Saudi Arabian Clinical Setting. PLoS Negl Trop Dis 2017; 11:e0005288. [PMID: 28076350 PMCID: PMC5261817 DOI: 10.1371/journal.pntd.0005288] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 01/24/2017] [Accepted: 12/28/2016] [Indexed: 12/29/2022] Open
Abstract
Background Clinical relevance of nontuberculous mycobacteria (NTM) is increasing worldwide including in Saudi Arabia. A high species diversity of NTM’s has been noticed in a recent study. However, the identification in diagnostic laboratories is mostly limited to common species. The impact of NTM species diversity on clinical outcome is so far neglected in most of the clinical settings. Methodology/Principal Findings During April 2014 to September 2015, a nationwide collection of suspected NTM clinical isolates with clinical and demographical data were carried out. Primary identification was performed by commercial line probe assays. Isolates identified up to Mycobacterium species level by line probe assays only were included and subjected to sequencing of 16S rRNA, rpoB, hsp65 and 16S-23S ITS region genes. The sequence data were subjected to BLAST analysis in GenBank and Ez-Taxon databases. Male Saudi nationals were dominated in the study population and falling majorly into the 46–59 years age group. Pulmonary cases were 59.3% with a surprising clinical relevance of 75% based on American Thoracic Society guidelines. Among the 40.7% extra-pulmonary cases, 50% of them were skin infections. The identification revealed 16 species and all of them are reporting for the first time in Saudi Arabia. The major species obtained were Mycobacterium monascence (18.5%), M. cosmeticum (11.1%), M. kubicae (11.1%), M. duvalli (7.4%), M.terrae (7.4%) and M. triplex (7.4%). This is the first report on clinical relevance of M. kubicae, M. tusciae, M.yongonense, M. arupense and M.iranicum causing pulmonary disease and M. monascence, M. duvalli, M. perigrinum, M. insubricum, M. holsaticum and M. kyorinense causing various extra-pulmonary diseases in Saudi Arabia. Ascites caused by M. monascence and cecum infection by M. holsaticum were the rarest incidents. Conclusions/Significance To the first time in the country, clinical significance of various rare NTM’s are well explored and the finding warrants a new threat to the Saudi Arabian clinical settings. Nontuberculous mycobacteria (NTM) are ubiquitous in nature and they are opportunistic pathogens. In the last decade, infections caused by NTM’s increased—around the world in immune-suppressed and immune-competent individuals and Saudi Arabia is not an exception. Developments in diagnostic technologies increased the identification of several new or rare species of NTM’s. Indeed, the species diversity of NTM has a direct impact on clinical outcome and therapies. Saudi Arabian clinics so far report only the common species of NTM’s and rare species are mostly neglected due to the lack of proper infrastructure or ignorance. To the first time in the country, an exploration on the existence of clinically relevant rare NTM species was conducted on a nationwide level. The findings showed a huge diversity of rare NTM species causing both pulmonary and extra-pulmonary diseases. Clinical relevance of pulmonary infection based on American Thoracic Society guidelines was confirmed as an aggressive 75%, which is really alarming. Interestingly, 16 species of NTM’s were isolated in the study, and all of them are reporting for the first time in country. Overall finding shows Saudi Arabia faces serious threat from rare NTM species with high clinical significance and warrants the immediate need for more advanced infrastructure.
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Affiliation(s)
- Bright Varghese
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- * E-mail: (BV); (SAH)
| | - Mushira Enani
- Medical Specialties Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Mohammed Shoukri
- National Biotechnology Centre, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Sahar AlThawadi
- Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and research Centre, Riyadh, Saudi Arabia
| | - Sameera AlJohani
- Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Sahal Al- Hajoj
- Department of Infection and Immunity, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- * E-mail: (BV); (SAH)
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Abstract
Seizures in children are among the most common neurological disorders. A pediatrician should know how to approach a child who presents with a seizure. This review will focus on points that are important in the evaluation of children who have experienced seizures. A comprehensive and neurologically focused framework for history taking and a thorough clinical examination are the cornerstones in diagnosing and managing seizures. This article reviews the clinical approach to the diagnosis, investigation, and management of epilepsy in children, excluding neonatal seizures. A pediatrician should also be aware of common epilepsy syndromes that occur in children such as Benign Childhood Epilepsy with Centro-Temporal Spikes, and childhood absence epilepsy.
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Affiliation(s)
- Fahad A Bashiri
- Department of Pediatrics, College of Medicine, King Saud University Medical City, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail:
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50
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Mosli M, Alzahrani A, Showlag S, Alshehri A, Hejazi A, Alnefaie M, Almaymuni A, Abdullahi M, Albeshir M, Alsulais E, Jawa H, Aljahdli E, Bazarah S, Qari Y. A cross-sectional survey of multi-generation inflammatory bowel disease consanguinity and its relationship with disease onset. Saudi J Gastroenterol 2017; 23:337-340. [PMID: 29205186 PMCID: PMC5738795 DOI: 10.4103/sjg.sjg_125_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
UNLABELLED Background\Aim: Consanguinity influences the phenotypic variations of some hereditary and immune-mediated disorders, including inflammatory bowel disease. This study estimated the prevalence of consanguinity among the ancestors of patients with inflammatory bowel disease and examined the effect of various consanguinity levels on inflammatory bowel disease onset. PATIENTS AND METHODS Patients with inflammatory bowel disease who were seen at two gastroenterology outpatient clinics were consecutively recruited and surveyed for demographics, disease onset, and presence of ancestral consanguinity within three generations. The prevalence of different consanguinity levels was calculated. The association between age at inflammatory bowel disease onset and consanguinity was examined. RESULTS Two hundred seventeen patients were recruited. The mean age, mean age at diagnosis, and mean illness duration were 32.9 ± 13.4, 18.6 ± 11.5, and 8.6 ± 7.7 years, respectively. Of the cohort, 53.5% were women, and 74.2% were native Saudis. Cigarette smoking was reported in 17.1%; 51% had Crohn's disease, while the remaining patients had ulcerative colitis. A family history of inflammatory bowel disease was reported in 29.5% of patients; consanguinity within three generations was reported in 57.6%. Consanguinity in more than one generation was reported in 38.7%; 17.5% had consanguinity in three consecutive generations. There was no association between inflammatory bowel disease onset and multi-generation consanguinity, but there was an association with disease subtype in favor of ulcerative colitis (b coefficient = 7.1 [95% confidence interval = 4.1, 10]). CONCLUSIONS Consanguinity is extremely common among Saudi patients with inflammatory bowel disease but does not seem to influence age at disease onset. Genetic studies are needed to further clarify the effect of consanguinity on disease behavior.
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Affiliation(s)
- Mahmoud Mosli
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia,Address for correspondence: Dr. Mahmoud Mosli, Department of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. E-mail:
| | - Abdulelah Alzahrani
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Showlag Showlag
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Abdullah Alshehri
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Ahmed Hejazi
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Majed Alnefaie
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Adel Almaymuni
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mubarak Abdullahi
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Mohammed Albeshir
- Department of Medicine, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia
| | - Eman Alsulais
- Department of Medicine, King Fahad Specialist Hospital, Dammam, Kingdom of Saudi Arabia
| | - Hani Jawa
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Emad Aljahdli
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Salem Bazarah
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
| | - Yousif Qari
- Department of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia
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