The role of matrix metalloproteinase-2 and miR-196a2 in bronchial asthma pathogenesis and diagnosis

Background

Bronchial asthma is a persistent inflammatory respiratory condition that restricts the passage of air and causes hyperresponsiveness. Chronic asthma can be classified into three categories: mild, moderate, and severe. Remodeling took place as the extracellular matrix accumulated in the walls of the airways. Inflammation occurs as a result of the damage caused by matrix metalloproteinase-2 (MMP-2) to basement membrane type IV collagen. The severity of asthma may be associated with miR-196a2. The objective of our study was to investigate the underlying mechanisms and clinical relevance of miR-196a2 and MMP-2 serum levels in relation to the severity of asthma.

Methods

This study recruited 85 controls and 95 asthmatics classified as mild, moderate, or severe. Expression of miR-196a2 was measured by quantitative reverse transcriptase PCR. Using the enzyme-linked immunosorbent assay (ELISA), MMP-2, IL-6, and total immunoglobulin E (IgE) levels in the serum of asthmatics of various grades were compared to a control group. MMP-2's diagnostic and prognostic potential was determined using ROC curve analysis. This study also measured blood Eosinophils and PFTs. We examined MMP-2's connections with IgE, blood Eosinophils, and PFTs.

Results

The current investigation found that miR-196a2 expression was significantly higher in the control group than in asthmatic patients as a whole. The study found that severe asthmatics had higher MMP-2, IL-6, and IgE serum levels than healthy controls. We identified the MMP-2 serum concentration cutoff with great sensitivity and specificity. Significant relationships between MMP-2 serum level and miR-196a2 expression in the patient group with severe asthmatics were found. The MMP-2, IL-6, and IgE serum levels were considerably higher in mild, moderate, and severe asthmatics than controls. The miR-196a2 expression and MMP-2 serum concentration correlated positively with IgE and blood eosinophils % and negatively with all lung function tests in the asthmatic patient group.Conclusion: the study revealed that the elevated miR-196a2 expression and serum concentration of MMP-2, IL-6, and IgE associated with elevated blood eosinophils % is associated with pathophysiology and degree of asthma severity. The miR-196a2 expression and MMP-2 serum concentration have a promising diagnostic and prognostic ability in bronchial asthma.

Magnitude of diabetic peripheral neuropathy in Saudi Arabia: a systematic review and meta-analysis

BACKGROUND

Diabetic peripheral neuropathy (DPN), due to its potential for causing morbidity and disability from foot ulcers and amputations, is increasingly becoming a source of concern in Saudi Arabia and worldwide. However, wide variability exists in the prevalence of DPN reported in previous studies in Saudi Arabia, limiting the utility of existing data in national public health policy. Therefore, the aim of this study was to systematically evaluate the magnitude of DPN in patients living with DM in Saudi Arabia in order to inform policymakers during the implementation of appropriate preventive and treatment strategies for DPN.

METHODS

PubMed, Google Scholar, African Journals Online, Scopus, Web of Science, Embase, and Wiley Online Library were searched systematically to acquire relevant articles based on preset criteria. We evaluated heterogeneity and publication bias and employed a random-effects model to estimate the pooled prevalence of DPN from the included studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines in conducting the meta-analysis. Analysis was performed using the STATA Version 12 software.

RESULTS

Twelve studies with a total of 4,556 participants living with DM, of whom 2,081 were identified as having DPN were included in the meta-analysis. The overall prevalence of DPN was 39% (95% CI [30%, 49%]). Subgroup analysis based on diagnostic method showed that prevalence estimates for DPN using screening questionnaires and clinical examination were 48% (95% CI [46%, 50%]) and 40% (95% CI: [38%, 42%]), respectively, while the estimated prevalence using nerve conduction studies was 26% (95% CI [15%, 36%]).

CONCLUSION

This study showed a high magnitude of DPN in Saudi Arabia (39%), thus highlighting the need for sustained efforts to reduce the prevalence of diabetes mellitus and DPN in the kingdom.

Prevalence of congenital heart disease among patients with down syndrome in Southwestern Saudi Arabia

Background

There is a paucity of data on the prevalence and pattern of congenital heart disease (CHD) among patients with Down syndrome (DS) in Bisha, Saudi Arabia. The aim of the study was to determine the prevalence and patterns of CHD in patients with DS and explore the association of participants' sex with CHD in DS patients.

Methodology

A total of 42 patients with confirmed DS were enrolled in the study. Relevant data were obtained from the patients' records. The spectrum of CHD was analyzed and classified accordingly. Pearson's Chi-square was used to determine the association of gender with CHD.

Results

Approximately 81% of the study participants had CHD. The most common CHD was atrial septal defect (28.5%), followed by ventricular septal defect (25%), patent ductus arteriosus (16%), and atrioventricular septal defect (14.3%). No significant association was found between CHDs and sex.

Conclusion

The prevalence of CHD in the study group was consistent with reports from other regions of Saudi Arabia and globally. Participants' sex was not associated with the occurrence of CHD in DS patients in this study.

Impact of a longitudinal faculty development program on the quality of multiple-choice question item writing in medical education

Background:

Like many other academic programs, medical education is incomplete without a robust assessment plan.

Objective:

The study aimed to evaluate the impact of longitudinal faculty development program (FDP) on the examination item quality (EIQ) from a cohort of medical college faculty members.

Methods:

Item analysis (IA) of multiple-choice questions (MCQs) from a cohort of medical tutors over a 3-year period (2017 [S1], 2018 [S2], and 2019 [S3]) before and following once-per-week FDP was conducted. The questions were from three randomly selected courses: man and his environment (MEV) from phase 1, central nervous system (CNS) from phase 2, and internal medicine (MED) from phase 3. Data assessed were 480 MCQs from the final exams in the courses. The parameters considered in IA were the difficulty index, index of discrimination, nonfunctional distractors (NFDs), distractor efficiency for each question item, and Cronbach's alpha (CA) for the test as a whole. Comparison over the 3 years was made using Fisher's exact test and repeated-measures ANOVA with Bonferroni test as post hoc test.

Results:

Overall, out of 480 MCQs, 272 had no NFD (52 [19.52%], 104 [38.24%], and 116 [42.65%] in 2017, 2018, and 2019, respectively) with a significant difference between S3, S2, and S1 (P < 0.0001). The mean CA for the exams in S1, S2, and S3, respectively, were 0.51, 0.77, and 0.84, P < 0.0001.

Conclusion:

There was an improvement in EIQ following the implementation of longitudinal FDP. Thus, the need for active training and retraining of the faculty for a better EIQ cannot be overemphasized.

Adjacent digit fingerprint white line count differences: a pointer to sexual dimorphism for forensic application

Background

Sex determination is one of the leading criterion in identification and verification of an individual. However, the potential roles of differences in adjacent fingerprint white line count (FWLC) in sex inference are not well elucidated in the literature especially among Hausa population. The study was conducted to determine sexual dimorphism and predict sex using adjacent digit FWLC difference (adj. DFWLCD) among Hausa population of Kano state, Nigeria.

Methods

The study population involved 300 participants. FWLC was determined from a plain fingerprint captured using live scanner. The formula for adj. DFWLCD of thumb and fifth digit is dR15 for right hand. The same applied for possible combination in cephalocaudal direction. Mann-Whitney and t tests were used for comparison of variables between sexes. Binary logistic regression analyses were employed for determination of sex.

Results

We observed a significantly larger adj. DFWLCD in males compared with females in most of the digit combination. A significant sexual dimorphism was observed in most of the adj. DFWLCD involving ring digit in both right (dR14, dR24, and dR34) and left (dL14, dL24, and dL34). The best discrimination was observed in adjacent FWLC difference of second and fourth digits in both right and left digits (dR24 and dL24). This was further supported by stepwise logistic regression analyses.

Conclusion

The adj. DFWLCD exhibits sexual dimorphism. The best prediction potentials were found to be dR24 and dL24 for right and left hands respectively.

Variation of facial features among three African populations: Body height match analyses

Body height is one of the variables that show a correlation with facial craniometry. Here we seek to discriminate the three populations (Nigerians, Ugandans and Kenyans) using facial craniometry based on different categories of body height of adult males. A total of 513 individuals comprising 234 Nigerians, 169 Ugandans and 110 Kenyans with mean age of 25.27, s=5.13 (18-40 years) participated. Paired and unpaired facial features were measured using direct craniometry. Multivariate and stepwise discriminate function analyses were used for differentiation of the three populations. The result showed significant overall facial differences among the three populations in all the body height categories. Skull height, total facial height, outer canthal distance, exophthalmometry, right ear width and nasal length were significantly different among the three different populations irrespective of body height categories. Other variables were sensitive to body height. Stepwise discriminant function analyses included maximum of six variables for better discrimination between the three populations. The single best discriminator of the groups was total facial height, however, for body height >1.70m the single best discriminator was nasal length. Most of the variables were better used with function 1, hence, better discrimination than function 2. In conclusion, adult body height in addition to other factors such as age, sex, and ethnicity should be considered in making decision on facial craniometry. However, not all the facial linear dimensions were sensitive to body height.

Study of lip print types among Nigerians

Lip prints in a narrow sense are normal lines and fissures in the form of wrinkles and grooves present in the zone of transition of lips. The aims of this study were to determine the types and association of lip prints as well as the role of the lip print as genetic marker in ethnic differentiation in multi-ethnic population of Nigeria. A total of 820 individuals (414 males and 406 females) participated. The study sample was drawn from different ethnic groups of Nigeria. The three major ethnic groups were identified and the minor groups were lumped together. This was to provide clear evidence on the ethnic differentiation based on lip print types among Nigerians. The lip prints were collected on microscopic glass slides and developed using carbon black powder. Each print was then divided into 10 compartments and analyzed using a magnifying lens. Chi-squared test was used for association between ethnicity and lip print types; p<0.05 was set as a level of significance. The result of the study showed the following lip print pattern in Nigerian population where Type V (31.39%) was predominant, followed by Type III (24.18%), Type IV (18.70%), Type I (14.87%), Type II (10.29%) and least frequent was Type I' (0.57%). Statistically significant association (p<0.05) of lip print types with ethnicity was found in upper left lateral compartments (ULL). It was concluded that lip prints show ethnic differences. Hence, they may hold potential promise as a supplementary tool in ethnic differentiation and in personal identification.

Variation in the lobar pattern of the right and left lungs: A case report

The right lung has three lobes and two fissures while the left lung has two lobes and one fissure. During a routine dissection we observed a variant complete fissure and three incomplete fissures in the right lung while the left lung presented with a variant transverse fissure separating the superior lingual and anterior bronchopulmonary segments. In the right lung, the incomplete fissures lie between the apical and posterior bronchopulmonary segments; medial and lateral bronchopulmonary segments; apical and basal bronchopulmonary segments. The complete variant fissure separates the medial basal bronchopulmonary segment from the remaining basal segments. Such variant fissures and lobes are clinically important in cases of lobotomy.

Regression equation for estimation of length of humerus from its mophometry in a Nigerian population

BACKGROUND

While intact long bones are most ideal in estimation of the stature of unidentified individual, in forensic cases as may occur when natural or man-made disasters present bone fragments, regression equations derived from measurements of these bone fragments have been used to determine the length of the intact long bone.

OBJECTIVE

The study reports on the morphometry of the humerus and the estimation of its length using regression equations in a Nigerian population.

METHODS

The maximum length of the humerus was measured using an osteometric board while theAnatomical neck circumference (ANC), Anatomical neck diameter (AND), mid shaft diameter (MSD), olecranon vertical diameter (OVD), olecranon transverse diameter (OTD), transverse diameter of the inferior articular surface (IASD), transverse trochlea diameter (TTD) proximal point of the caput humeri and collum anatomicum (CHCAD), proximal edge of the fossa olecrani (PEFO) and the most distal point of trochlea humeri (FOTHD) and the biepicondylar width (BEW) of the distal segment were measured using a digital vernier caliper. Partial correlation and Persian regression were used to derive the linear regression equations for the measured parameters that showed correlation with the humeral length.

RESULTS

Estimation of the maximum length of the humerus from the measures of its ANC, FOTHD, and MSD was achieved with relative accuracy. In deriving regression equations for the length of the humerus of the right and left sides, irrespective of side, the ANC and MSD were both significant in estimating the maximum length of the humerus; on the right side only the ANC exhibited significant correlation, while on the left side both the ANC and FOTHD exhibited significant correlation.

CONCLUSION

These previously unreported findings may help in anthropometric, forensic, and archaeological investigations for the estimation of the stature of the remains of unknown bodies by using regression equations in a Nigerian population.