An overview of the mosquitoes of Saudi Arabia (Diptera: Culicidae), with updated keys to the adult females

Despite the fact that mosquito-borne infections have considerable consequences for public health in Saudi Arabia, there is neither a thorough review of the species that occur in the country nor updated keys for the identification of the adult females. In this study, species accounts are given for 49 Saudi Arabian mosquito species, as well as Aedes albopictus (Skuse), which is not recorded in Saudi Arabia, but is medically important and is found in some countries of the Middle East and North Africa. Taxonomic notes provide additional information for certain taxa and/or aid their identification.

Zika virus antibody-positivity among symptomatic/asymptomatic pregnant women in the Aseer region displays pre-exposure to dengue viruses

Antibody cross-reactivity among flaviviruses is a major limitation in understanding the prevalence without vector control measures. In this study, we investigated the presence of Zika virus (ZIKV)-specific antibodies and the significance of their cross-reactivity with other flaviviruses, which could affect the serological specificity in both symptomatic and asymptomatic pregnant women. Among the results obtained from 217 serum samples tested for ZIKV-specific IgM and IgG, no specific predictions regarding seropositivity or exposure due to extensive cross-reactivity with dengue virus (DENV) serology could be made. Clear-cut positivity was observed in 1.8% (n = 4) and 1.0% (n = 2) for ZIKV IgM and IgG, respectively. The same samples assessed for DENV showed 1.3% (n = 3) seropositivity each for IgM and IgG levels. None of the samples were positive for ZIKV and DENV IgM or IgG. However, one sample (0.4%) tested positive for ZIKV and DENV IgM. No significant correlation was observed between DENV IgM and IgG when comparing the overlapped serotiters. On the other hand, the ZIKV IgG-positive sample showed higher serotiters for DENV IgG, indicating cross-reactivity with ZIKV but without statistical significance. Therefore, screening for the incidence of ZIKV becomes particularly challenging in a population where the presence or pre-exposure to DENV is observed. Our observations further suggest that unless flavivirus prevalence is properly addressed, determining the prevalence of ZIKV antibodies, which may be confounded with other uninvestigated flaviviruses, will be complicated.

Congenital Hypothyroidism in Two Sudanese Families Harboring a Novel Iodotyrosine Deiodinase Mutation (IYD R279C)

Background: Congenital hypothyroidism due to defects in iodotyrosine deiodinase has variable phenotypes and can present as hypothyroid or with normal thyroid testing. Methods: Whole exome sequencing was performed in individuals from two families originating from different regions of Sudan. Mass spectrometry of urine and serum iodotyrosines was performed on subjects from both families. Results: A novel iodotyrosine deiodinase (IYD) mutation (c.835C>T; R279C) was identified in individuals from two Sudanese families inherited as autosomal recessive. The mutation was identified by multiple in silica analyses to likely be detrimental. Serum and urine monoiodotyrosine (MIT) and diiodotyrosine (DIT) were markedly elevated in the homozygous subjects. Conclusion: Measurement of serum and urine DIT and MIT was more sensitive than that of urine iodine or serum thyroid function tests to determine the effect of the IYD mutation.

Hedgehog signalling molecule, SMO is a poor prognostic marker in bladder cancer

INTRODUCTION

Hedgehog (HH) pathway is an important signalling cascade for growth and patterning during embryonic development. Constitutive activation of Hedgehog pathway can be found in various types of malignancies including medulloblastoma, basal cell carcinoma, gastrointestinal, breast, pancreatic, prostate cancer and leukaemia. Little is known about the expression and role of Hedgehog signalling in bladder cancer.

MATERIALS AND METHODS

The purpose of this study was to investigate the immunohistochemical expression of SMO in 112 bladder cancer cases and determine their association with demographic and clinicopathological parameters. Bladder cancer tissues were obtained from the Hospital Kuala Lumpur.

RESULTS

SMO was expressed in the cytoplasm of all cases of bladder cancer. 6 cases (5.4%) showed low expression, while 106 cases (94.6%) showed high expression. Positive expression of SMO protein was correlated with a few variables which include grade and stage of tumour, lymph node metastasis and distant metastasis. SMO expression showed statistically significant association with higher grade (p=0.001) and higher stage (p=0.042) of bladder cancer. SMO expression also showed borderline association with lymph node metastasis (p=0.056).

CONCLUSION

These findings indicate that SMO expression may be a poor prognostic marker in bladder cancer.

The Muscidae (Diptera) of Saudi Arabia, descriptions of two new species, new records and updated list of species

Despite the economic and medical importance of many species of Muscidae knowledge of species occurring in Saudi Arabia is insufficient. As part of a study on the biodiversity of Diptera of south-western Saudi Arabia a survey of the Diptera fauna of Jazan, Asir and Najran was performed from 2010 to 2015 at 22 sites. Seventy one known taxa of Muscidae were identified and recorded, 29 of which were recorded for the first time from south-western Saudi Arabia and two new species; Atherigona (Acritochaeta) afrotropicalis Deeming sp. nov. and Helina ponti Deeming sp. nov. are here described. Thus, the total number of Muscidae species that has been recorded from Saudi Arabia (including previous records of 31 species) is 102 and two subspecies. A list of all species and subspecies of Muscidae recorded from Saudi Arabia is provided. The species of Muscidae listed are predominantly of Afrotropical distribution as compared to other regions. Images of 78 taxa are presented. In addition to the results of the identifications all available literature about Muscidae of Saudi Arabia is summarized. Biological information (where known) on the species recorded in this study and the Middle East distribution are included. By developing a research collection and a checklist of species of Muscidae we hope to provide the basis for systematic studies and biogeographical and faunistic analyses, and the necessary guidelines for management of these important flies. The need for further field and laboratory work and surveillance surveys is highlighted.

An overview of the Syrphidae (Diptera) of Saudi Arabia

Despite the species richness of hoverflies (Diptera: Syrphidae) world-wide (about 6,200 species) and their role as agents for controlling plant pests, their significance as pollinators, and as bioindicators of site quality, hoverfly fauna of Saudi Arabia is poorly known. In exploring the biodiversity of Diptera in southwest Saudi Arabia a survey of the hoverfly fauna of Jazan, Asir, Najran and Al-Baha was performed mainly using Malaise traps, sweep nets and light traps from 2011 to 2014. Forty known species of Syrphidae were identified and recorded in this study, 19 of them new to Saudi Arabia. This makes the total number of Syrphidae species recorded in Saudi Arabia (including one species recorded by others) is 41. In addition, three taxa belonging to the genera Eumerus Meigen, Orthonevra Macquart, and Paragus Latreille that could not be identified safely to species level because there were no adequate identification keys or males were missing in the collected material. A key to the genera of Syrphidae occurring in Saudi Arabia is provided. The fauna of Syrphidae recorded in this study consists much more of Afrotropical zoogeographical elements than Palaearctic ones. A complete checklist of Syrphidae of Saudi Arabia is provided. Biological data, where known, and world-wide distribution of the studied taxa are provided. This paper is published with the purpose of assisting biogeographical, biological or ecological studies on syrphids in Saudi Arabia.

Induction of apoptosis and role of paclitaxel-loaded hyaluronic acid-crosslinked nanoparticles in the regulation of AKT and RhoA

Cancer is a complex multifactorial disease and leading causes of death worldwide. Despite the development of many anticancer drugs, there is a reduced survival rate due to severe side effects. The nontargeted approach of convention drugs is one of the leading players in context to toxicity. Hyaluronan is a versatile bio-polymer and ligand of the receptor (CD44) on cancer cells. The MCF-7 and HT-29 cancer cell lines treated with hyaluronic acid-paclitaxel (HA-PTX) showed the distinguishing morphological features of apoptosis. Flow cytometric analysis showed that HA-PTX induces apoptosis as a significant mode of cell death. The activation level of tumor suppressor protein (p53) increased after PTX treatment in MCF-7, but no changes observed in HT-29 might be due to hereditary mutations. The lack of suppression in AKT and Rho A protein suggest the use of possible inhibitors in future studies which might could play a role in increasing the sensitivity of drug towards mutated cells line and reducing the possibilities for cancer cell survival, migration, and metastasis.

An overview of the Chloropidae (Diptera) of Saudi Arabia

Chloropidae are of major economic importance, since the larvae of some species are pests of cereals and grasses, some are parasitoids and predators, and adults of some Hippelates spp. visit and transmit or are suspected of transmitting yaws sores in man and animals and by feeding around the eyes are vectors of Brazilian Purpuric Fever. Within the framework of the exploration of the biodiversity of Diptera in Southwest Saudi Arabia a survey of the grass flies fauna in 18 sites in Jazan, Asir, and Najran in south-western Saudi Arabia was performed mainly using Malaise traps and sweep nets from 2010- to 2016. Sixty six species of 43 genera and three subfamilies of Chloropidae were identified and are recorded from Saudi Arabia, 20 of them for the first time and three are described as new species: Elachiptera arabica Deeming sp. n.; Kwarea ismayi Deeming sp.n. and Tricimba turneri Deeming sp.n.. This makes the total number of Chloropidae species in Saudi Arabia 95 (including 29 species previously recorded). Seventy images are presented. The species of Chloropidae listed are predominantly of Afrotropical/ Palaearctic origin. An updated checklist of Chloropidae species of Saudi Arabia is presented.This study adds new records of Chloropidae to the Saudi Arabian Diptera fauna, which will become reference points for research detailing the systematic geographic distribution and for identifying other specimens submitted for identification. Further species will undoubtedly be discovered with more research involving collecting and rearing methods.

An overview of the Ephydridae (Diptera) of Saudi Arabia

Despite the species richness of Ephydridae world-wide (2000 species) and its prominent environmental roles as a minor pest and as a food for wildlife, only 13 species have been recorded from Saudi Arabia. Between 2012 and 2016, a biodiversity study of Diptera was conducted at Jazan, Asir, and Najran in south-western Saudi Arabia, at 22 sites, was performed mainly using Malaise traps and sweep nets. In this study, 43 known species of Ephydridae were identified, 37 of them for the first time from southwestern Saudi Arabia and 16 from Arabian Peninsula. This brings the total number of Ephydridae species in Saudi Arabia to 49 (including previous records). There were a further four species, which could not be identified authoritatively to species level. A list of all species of Ephydridae recorded from Saudi Arabia is appended. Images of thirty-two species are presented. The species recorded in this study are more Palaearctic in origin as compared to other regions. Biological information (where known) and world-wide distribution are included. This study has added new records to the Saudi Arabian checklist of Ephydridae, which will provide the basis for systematic studies and fauna analyses of future work on the family. The need for further field and laboratory work and surveillance is highlighted.

Efficacy of live attenuated vaccine derived from the Streptococcus agalactiae on the immune responses of Oreochromis niloticus

Streptococcus agalactiae species have been recognized as the main pathogen causing high mortality in fish leading to significant worldwide economical losses to the aquaculture industries. Vaccine development has become a priority in combating multidrug resistance in bacteria; however, there is a lack of commercial live attenuated vaccine (LAV) against S. agalactiae in Malaysia. The aim of this study is to compare two methods using attenuated bacteria as live vaccine and to evaluate the efficacy of selected LAV on the immune responses and resistance of Oreochromis niloticus (tilapia) against S. agalactiae. The LAV derived from S. agalactiae had been weakened using the chemical agent Acriflavine dye (LAV1), whereas the second vaccine was weakened using serial passages of bacteria on broth media (LAV2). Initial immunization was carried out only on day one, given twice-in the morning and evening, for the 42 day period. Serum samples were collected to determine the systemic antibody (IgM) responses and lysozymal (LSZ) activity using ELISA. On day 43 after immunization, the fish were injected intraperitoneally (i.p) with 0.1 mL of S. agalactiae at LD₅₀ = 1.5 × 10⁵ (CFU)/fish. Fish were monitored daily for 10 days. Clinical signs, mortality and the relative percent of survival (RPS) were recorded. Trial 1 results showed a significant increased (P < 0.05) in serum IgM titers and LSZ activity as compared to LAV2 and the control group (unvaccinated fish). The efficacy of LAV1 was proven effective as determined by the RPS values, LAV1 at 81.58% as compared to LAV2 at 65.79%. Trial 2 of LAV1 and control group were further determined by administering primary and booster doses revealed a RPS value for LAV1 of 82.05%, with the significant enhancement on the immune responses of tilapia as compared to control group. In conclusion, LAV revealed to elevate antibody IgM levels, LSZ activity and provide long-term protection when added to feed. LAV is a low-cost vaccine shown to rapidly increase the immune response of fish and increase survival rates of fish against S. agalactiae infection.

Acquaintance of dental implants as a treatment modality in edentulous states among health workers in Aseer Province, KSA

Purpose

To identify the acquaintance of dental implant (DI) as a treatment modality in edentulous states among health workers in the Aseer region and also to assess the level of understanding about DI among them.

Materials and Methods

A questionnaire set of 18 questions was used for 500 health workers from the concerned area about DI. Questionnaire set basically consists of questions to assess the attitude, perception, and knowledge among them about DI. The data collected and association with the factors were tested for significance using the Chi-square test and P < 0.05 was considered statistically significant.

Results

The response rate was 89%. More than 75% were aware of DI, but only 50% of the total respondents were knowing about the difference between the DI, fixed prosthesis, and removable prosthesis. Of the latter, 47.4% have suggested implants for patients and about 55% respondents were agreeing to get DI done for themselves. Dental health care workers have more knowledge than the medical health workers, and the difference was found to be statistically significant. Of respondents, >90% were willing to know more about DI.

Conclusion

The practice of implant dentistry is growing in the Aseer region. However, general health workers are not fully aware of proper DI information. In addition, all the efforts should be made to include basic implant education in all the branches of health sciences and the CDE program should be conducted regularly to enhance the knowledge, so that correct information can be channelized to the patients.

Quantitative CrAssphage real-time PCR assay derived from data of multiple geographically distant populations

After its computational inference from human stool metagenomes, the CrAssphage has proven to be the most prevalent phage in the human gut, with presumably very wide geographic distribution. The currently available molecular assays do not sufficiently reflect the CrAssphage sequence variability. Here, we report a novel real-time PCR assay whose primers and probes are derived from data of multiple CrAssphage strains obtained from gut viral metagenomes of European, Asian, and African subjects. This assay can be useful in analyses of putative bacterial host co-occurence, and in association studies of non-infectious diseases where the phage may modify the content of gut bacteriomes.

Immunohistochemical expression of NANOG in urothelial carcinoma of the bladder

Urothelial carcinoma is a common malignant neoplasm that has a poor prognosis and a high frequency of recurrence and metastasis. Constant disease surveillance with periodic and long term cystoscopy examination is necessary for management of the disease. However, the monitoring and therapy regimen is expensive, incurring a massive burden to patients and the government. Therefore, the development of specific biomarkers for urothelial carcinoma at an early stage and recurrence detection becomes a priority. Homeobox genes are a family of genes that are involved in tumourigenesis. They might be potential prognostic markers for urothelial carcinoma. The study investigated the expression pattern of NANOG which is one of a homeobox gene in different stages and grades of urothelial carcinoma. NANOG expressions were also correlated with patient demographic factors and clinicopathological parameters. The expression of NANOG in 100 formalin-fixed paraffin-embedded urothelial carcinoma tissues was determined by immunohistochemistry. Immunohistochemistry showed positive expression of NANOG in all specimens with detection in the cytoplasm, nuclei and the nuclear membrane of the cancer cells. The immunohistochemical expression of NANOG increased across stages and grades of the tumour. The expression of NANOG was not significantly associated with demographic factors; gender (p = 0.376), race (p = 0.718) and age (p = 0.058) as well as with most of the clinicopathological parameters; pathological stage (p = 0.144), grade (p = 0.625), lymph node involvement (p = 0.174) and distant metastasis (p = 0.228). However, NANOG expression showed significant correlation with tumour invasion (p = 0.019). We concluded that NANOG might be a potential biomarker for early diagnosis of urothelial carcinoma of the bladder.

Physicochemical and sorption characteristics of Malaysian Ceiba pentandra (L.) Gaertn. as a natural oil sorbent

Ceiba pentandra (L.) Gaertn (kapok) is a natural sorbent that exhibits excellent hydrophobic-oleophilic characteristics. The effect of packing density, the oil types and solvent treatment on the sorption characteristics of kapok was studied in a batch system. Oil sorption capacity, retention capacity, entrapment stability and kapok reusability were evaluated. Based on SEM and FTIR analyses, kapok fiber was shown to be a lignocellulosic material with hydrophobic waxy coating over the hollow structures. Higher packing density at 0.08 g/ml showed lower sorption capacity, but higher percentage of dynamic oil retention, with only 1% of oil drained out from the test cell. Kapok remained stable after fifteen cycles of reuse with only 30% of sorption capacity reduction. The oil entrapment stability at 0.08 g/ml packing was high with more than 90% of diesel and used engine oil retained after horizontal shaking. After 8h of chloroform and alkali treatment, 2.1% and 26.3% reduction in sorption capacity were observed, respectively, as compared to the raw kapok. The rigid hollow structure was reduced to flattened-like structure after alkali treatment, though no major structural difference was observed after chloroform treatment. Malaysian kapok has shown great potential as an effective natural oil sorbent, owing to high sorption and retention capacity, structural stability and high reusability.

Preparation and characterization of tungsten-loaded titanium dioxide photocatalyst for enhanced dye degradation

Tungsten-loaded TiO(2) photocatalyst has been successfully prepared and characterized. TEM analysis showed that the photocatalysts were nanosize with the tungsten species forming layers of coverage on the surface of TiO(2), but not in clustered form. This was confirmed by XRD and FT-Raman analyses where tungsten species were well dispersed at lower loading (<6.5 mol%), but were in crystalline WO(3) at higher loadings (>12 mol%). In addition, loading with tungsten could stabilize the anatase phase from transforming into inactive rutile phase and did not shift the optical absorption to the visible region as shown by DRUV-vis analysis. PZC value of TiO(2) was found at 6.4, but the presence of tungsten at 6.5 mol% WO(3), decreased the PZC value to 3. Tungsten-loaded TiO(2) was superior to unmodified TiO(2) with 2-fold increase in degradation rate of methylene blue, and equally effective for the degradation of different class of dyes such as methyl violet and methyl orange at 1 mol% WO(3) loading.

The psychological impact of vitiligo in adult Sudanese patients

OBJECTIVE

Vitiligo is a chronic skin disease that causes loss of pigment, resulting in irregular pale patches of skin. The disease has profound psychological consequences. These effects range from mild embarrassment to a severe loss of self-confidence and social anxiety, especially for those who have lesions on exposed skin. The study sought to determine the psychological impact of vitiligo in Sudanese patients.

METHOD

This study is a cross-sectional, clinical-epidemiological and hospital-based study, undertaken in Khartoum Dermatologic Hospital (KDH). The data was collected between June 2007 and November 2007. 111 adult patients were enrolled sequentially during the study period and they were tested using the 12-item General Health Questionnaire (GHQ-12).

RESULTS

Psychological disturbances as a consequence of vitiligo were found in 36 (31 %) adult patients. Patients with mild psychological disturbances were found in 20 of these patients and severe disturbances in 16.

CONCLUSION

Psychological consequences are common in patients with vitiligo.

Tabanidae (Diptera) of saudi arabia

Samples were collected from southern, central and eastern regions of Saudi Arabia using Malaise traps and sweep nets. Nine species of Tabanidae were identified, two for the first time from Saudi Arabia, Hybomitra peculiaris (Szilády) and Atylotus pulchellus (Loew). Therefore, the total number of Tabanidae in Saudi Arabia is 31 species. Remarks of the species recorded in this study were given. A key to the genera of Tabanidae occurring in the Arabian Peninsula is also provided. Available literature for Saudi Arabian Tabanidae is summarized and provided. It is concluded that the tabanid fauna of Saudi Arabia is more similar to that of the Palaearctic region than to the Afrotropical region.

Increase in tumour-infiltrating lymphocytes with regulatory T cell immunophenotypes and reduced zeta-chain expression in nasopharyngeal carcinoma patients

The pathological significance of the mechanisms of tumour immune-evasion and/or immunosuppression, such as loss of T cell signalling and increase in regulatory T cells (T(regs)), has not been well established in the nasopharyngeal carcinoma (NPC) microenvironment. To evaluate the T(reg) immunophenotypes in tumour-infiltrating lymphocytes (TILs), we performed a double-enzymatic immunostaining for detection of forkhead box P3 (FoxP3) and other markers including CD4, CD8, and CD25 on 64 NPC and 36 non-malignant nasopharyngeal (NP) paraffin-embedded tissues. Expression of CD3 zeta and CD3 epsilon was also determined. The prevalence of CD4(+)FoxP3(+) cells in CD4(+) T cells and the ratio of FoxP3(+)/CD8(+) were increased significantly in NPC compared with those in NP tissues (P < 0.001 and P = 0.025 respectively). Moreover, the ratio of FoxP3(+)/CD25(+)FoxP3(-) in NPC was significantly lower than that in NP tissues (P = 0.005), suggesting an imbalance favouring activated phenotype of T cells in NPC. A significant negative correlation between the abundance of FoxP3(+) and CD25(+)FoxP3(-) cells (P < 0.001) was also identified. When histological types of NPC were considered, a lower ratio of FoxP3(+)/CD25(+)FoxP3(-) was found in non-keratinizing and undifferentiated carcinomas. Increased CD4(+)FoxP3(+)/CD4(+) proportion and FoxP3(+)/CD8(+) ratio were associated with keratinizing squamous cell carcinoma. A reduced expression of CD3 zeta in TILs was found in 20.6% of the NPC tissues but none of the NP tissues. These data provide evidence for the imbalances of T(reg) and effector T cell phenotypes and down-regulation of signal-transducing molecules in TILs, supporting their role in suppression of immune response and immune evasion of NPC.

A case of methotrexate embryopathy with holoprosencephaly, expanding the phenotype

BACKGROUND

Methotrexate (MTX) embryopathy was described nearly 50 years ago, when this agent began to be used as a cancer treatment and abortifacient. In this report we describe a case with typical features of MTX syndrome together with new features to expand the phenotype.

CASE

A 29-year-old woman decided to terminate her unwanted pregnancy because of ill health, as she had conceived soon after her last delivery by cesarian section. At 6 weeks of gestation, she took 2.5 mg of MTX 3 times a day for 7 days. The pregnancy termination failed, and the pregnancy was carried to term. A female infant was delivered who was growth retarded and had characteristic features of MTX embryopathy in addition to holoprosencephaly and other brain malformations, facial hypertrichosis, and long eyelashes--features that have not hitherto been described.

CONCLUSIONS

We report the first case of holoprosencephaly in association with MTX exposure during the first 6 weeks of gestation. Physicians and the public should be aware of the effects of MTX on the fetus during pregnancy.

Anthraquinones production, hydrogen peroxide level and antioxidant vitamins in Morinda elliptica cell suspension cultures from intermediary and production medium strategies

The effects of medium strategies [maintenance (M), intermediary (G), and production (P) medium] on cell growth, anthraquinone (AQ) production, hydrogen peroxide (H2O2) level, lipid peroxidation, and antioxidant vitamins in Morinda elliptica cell suspension cultures were investigated. These were compared with third-stage leaf and 1-month-old callus culture. With P medium strategy, cell growth at 49 g l(-1), intracellular AQ content at 42 mg g(-1) DW, and H2O2 level at 9 micromol g(-1) FW medium were the highest as compared to the others. However, the extent of lipid peroxidation at 40.4 nmol g(-1) FW and total carotenoids at 13.3 mg g(-1) FW for cultures in P medium were comparable to that in the leaf, which had registered sevenfold lower AQ and 2.2-fold lower H2O2 levels. Vitamin C content at 30-120 microg g(-1) FW in all culture systems was almost half the leaf content. On the other hand, vitamin E content was around 400-500 microg g(-1) FW in 7-day-old cultures from all medium strategies and reduced to 50-150 microg g(-1) FW on day 14 and 21; as compared to 60 microg g(-1) FW in callus and 200 microg g(-1) FW in the leaf. This study suggests that medium strategies and cell growth phase in cell culture could influence the competition between primary and secondary metabolism, oxidative stresses and antioxidative measures. When compared with the leaf metabolism, these activities are dynamic depending on the types and availability of antioxidants.

The effect of custom tray material type and fabrication technique on tensile bond strength of impression material adhesive systems

The purpose of this investigation was to evaluate the tensile bond strengths of two impression material systems (polysulphide and polyvinyl siloxane) to two custom tray materials [autopolymerizing and visible light-cured (VLC) acrylic resin]. The effect of polymerizing the tray materials directly against wax spacer and tin foil was evaluated for each material. Polymerizing tray materials against tin foil significantly increased the bond strengths of polysulphide and polyvinyl siloxane impression materials to VLC and autopolymerizing acrylic resin tray materials. Polyvinyl siloxane VLC cured against tin foil combination produced the strongest bond. The VLC resin tray material generated greater bond strength than autopolymerizing acrylic resin when polymerized against tin foil.

Growth and anthraquinone production of Morinda elliptica cell suspension cultures in a stirred-tank bioreactor

The effects of medium strategy, number of impellers, aeration mode, and mode of operation on Morinda elliptica cell suspension cultures in a stirred-tank bioreactor are described. A lower number of impellers and continuous aeration contributed toward high cell growth rate, whereas a higher number of impellers reduced cell growth rate, although not anthraquinone yield. The semicontinuous mode could indirectly imitate the larger scale version of production medium strategy and improved anthraquinone production even with 0. 012% (v/v) antifoam addition. Production medium promoted both growth (maximum dry cell weight of 24.6 g/L) and anthraquinone formation (maximum content of 19.5 mg/g of dry cell weight), without any necessity for antifoam addition. Cultures in production medium or with higher growth rate and anthraquinone production were less acidic than cultures in growth medium or with lower growth rate and anthraquinone production. Using the best operating variables, growth of M. elliptica cells (24.6 g/L) and anthraquinone yield (0.25 g/L) were 45% and 140%, respectively, lower than those using a shake flask culture after 12 days of cultivation.

Pulmonary haemosiderosis in Saudi children: report of two cases and review of the literature

Two children with idiopathic pulmonary haemosiderosis are reported. These are the first cases of this disease from Saudi Arabia and highlight the diagnostic problem caused by their presentation as cases of iron deficiency anaemia. The aetiopathogenesis, clinical presentation, diagnosis and management are discussed. The attention of paediatricians is drawn to this relatively rare cause of iron deficiency anaemia.

Arthrogryposis, renal dysfunction and cholestasis syndrome

We report for the first time from the Arabian Gulf area 3 patients with arthrogryposis multiplex congenita, cholestasis and renal tubular dysfunction from a Saudi family with 2 other siblings and 3 cousins who possibly died with a similar clinical picture. We also document for the second time in literature other findings in this syndrome including cerebral abnormalities (hypoplastic corpus callosum), congenital heart disease and nerve deafness. We suggest that some of these cases might benefit from ursodeoxycholic acid therapy. We believe that this autosomal recessive disorder is possibly under-diagnosed in this region with a high consanguineous marriage rate.

Adolescent endocrinology in Saudi Arabia

OBJECTIVE

The importance of providing special health care services for adolescents has been recently stressed. In Saudi Arabia, adolescents have no special services. In this study, we describe our first 5 years experience of an adolescent endocrinology clinic in Security Forces Hospital. We believe it is the first clinic with this objective in the Kingdom.

METHODS

An adolescent endocrinology clinic was run by a team composed of pediatric endocrinologist, diabetic nurse educator, clinic nurse and a dietician in collaboration with other supportive staff and consultants from other disciplines. The methodology of setting up, staffing and running the clinic is described.

RESULTS

About 223 cases were registered over 5 years. The most common problems were short stature 53 (24%), diabetes mellitus 49 (22%), obesity 40 (18%), thyroid disorders 28 (13%), delayed puberty 20 (9%) and rickets (8%). The clinic was well accepted by parents and their families. We learned a lot on how to handle these problems locally.

CONCLUSION

Based on our experience, we recommend establishing special health care services for adolescents both at the primary care, as well as secondary and tertiary care levels.

Case of partial trisomy 2q3 with clinical manifestations of Marshall-Smith syndrome

We describe a girl with physical anomalies, accelerated skeletal maturation, failure to thrive, and respiratory difficulties consistent with a diagnosis of Marshall-Smith syndrome (MSS). Chromosome analysis showed an inverted duplication of chromosome 2 [46,XX,inv dup(2)(q37q32) de novo] identified by G banding and confirmed by FISH. Several cases of trisomy 2q3 have been reported and established a syndrome, but the present case is the first to be associated with accelerated skeletal maturation and a clinical picture resembling MSS. This raises the possibility that the cause of MSS involves the q3 region of chromosome 2. Few reports of MSS include study of the karyotype, although the chromosomes were apparently normal in those cases where they have been examined. We suggest that karyotyping be undertaken with particular attention to the 2q3 region in patients with suspected MSS. It also would be prudent to assess bone age in all children with trisomy 2q.

Effect of frequency and amplitude of vibration on void formation in dies poured from polyvinyl siloxane impressions

STATEMENT OF PROBLEM

Numerous factors are involved in making a void-free dental stone cast from a polyvinyl siloxane impression.

PURPOSE

The aim of this study was to determine whether frequency and amplitude of vibration had any effect on the formation of voids on the cast surface poured from polyvinyl siloxane impression with a mechanical model vibrator.

MATERIAL AND METHODS

Impressions were poured in dental stone with a mechanical model vibrator that was set at vibration frequency 3000 cycles/min (low) and 6000 cycles/min (high) by a knob. The amplitude of vibration is provided in 5 steps and remained constant for the step set on the instrument. A total of 240 casts were prepared. The vibrator was set at low frequency and 30 impressions were poured for each of the 5 steps of amplitude. The vibrator was then set at high frequency and 30 impressions were poured for each of the 5 steps of amplitude. The resultant casts were examined for the presence of surface voids under 10 x magnification.

RESULTS

Means for voids in all cast groups calculated for low and high vibration frequencies indicated that an increase in the amplitude of vibration caused an increase in the number of voids on the die surface.

CONCLUSION

Use of high frequency of vibration 6000 cycles/min and 0.40 mm amplitude produced significantly fewer voids (P < .0001) compared with steps 4 (0.45 mm) and 5 (0.80 mm) amplitude.

Childhood goitre in Saudi Arabia

Thirty-two Saudi children (aged 1.5-14 years) with goitre were seen over a 6.5-year period in a paediatric endocrinology clinic. There was a female to male ratio of 1.9:1. Of these, 27 (84.3%) had diffuse thyroid enlargement and five (15.7%) nodular goitre. The commonest causes were dyshormonogenesis (37.5%) followed by Hashimoto's thyroiditis (34.4%). Three boys and one girl had Graves' disease. There were three (9.4%) with simple goitre and one case each of iodine deficiency goitre and tuberculous thyroiditis. Further study of the prevalence and causes of goitre, including iodine deficiency goitre, in Saudi Arabia is suggested.

Tuberculous anterior neck mass simulating goitre

A 13-year-old Saudi boy was referred to the paediatric endocrinology clinic for evaluation of rapidly progressive goitre with weight loss of 6 months duration. A clinical diagnosis of possible thyroid malignancy was made. On exploration the mass was found to be tuberculous in origin, attached to the thyroid gland, and responded to partial excision and anti-tuberculous chemotherapy. Tuberculosis should be considered in the differential diagnosis of anterior midline neck masses.

A cross-sectional study of canine dimorphism in establishing sex identity: comparison of two statistical methods

The occurrence of canine tooth dimorphism in Indian subjects has been investigated and the use of two statistical methods of evaluation compared. These were the methods of N.G. Rao and co-workers published in 1988 and quadratic discriminant analysis for correct classification of sex. Parameters considered were (i) the mesiodistal width of maxillary and mandibular canines, (ii) the maxillary canine arch width (intercanine distance) and (iii) the mandibular canine arch width. The results indicated significant dimorphism of the maxillary and mandibular canine teeth. When the results of the arch widths were subjected to the two statistical methods, differing results were obtained in the accuracy of sex classification. The percentage of correct classifications of sex was higher when using quadratic discriminant analysis.

Sex reassignment: A challenging problem - current medical and islamic guidelines

Sexual ambiguity is a complex and often confusing medical problem. In addition to the life-threatening adrenal crises which may accompany some forms, ambiguity of the genitalia may lead to incorrect sex assignment by parents and/or health personnel. Children who present to medical attention beyond the neonatal period constitute a challenging problem due to the grave consequences of this condition. Thirty cases in whom sex reassignment was indicated were seen at King Khalid University Hospital, Riyadh, over a 10-year period. Of these, 27 (90%) were genetic females (20 were 21- and seven were 11-hydroxylase deficient) and three (10%) were genetic males (two partial androgen insensitive and one 5alpha-reductase deficient). All genetic males who were incorrectly assigned as females accepted reassignment. But 9 out of 27 (33%) of the genetic females who were incorrectly assigned as males refused reassignment. Preference for male sex assignment, delayed diagnosis and sociocultural circumstances seem to be the contributing factors for refusal. A national consensus about this important issue strengthened by the existing religious recommendations in demanded.

Distribution and ecology of the mosquito fauna in the southwestern Saudi Arabia

A mosquito Larval survey was carried out in the Southwestern region of Saudi Arabia for a two subsequent years period. Nine mosquito species were identified; 4 Anopheline species; Anopheles arabiensis, An. sergentii, An. multicolor and An. tenebrosus and 3 Culicine species, Culex pipiens, Cx. quinquefaciatus and Cx. theileri as well as one Aedine species, Aedes caspius and Culiseta subochrea. A map was made showing the distribution of the encountered species and a full description of all breeding places was made also. The association of different species in each breeding site was also recorded.

Non-fatal strangulation: an uncommon parachute-related accident

A case of non-fatal strangulation of the neck by rigging lines of a parachute during military training is presented. It is an unusual but potentially life-threatening injury. Probable factors leading to such injury are discussed.

Congenital adrenal hypoplasia: A disorder frequently missed

Congenital adrenal hypoplasia is a rare disease which is known to cause severe salt wasting in the neonatal period. In this report, we describe three patients from two different families who were seen at King Khalid University Hospital, Riyadh, Saudi Arabia. All patients presented with classical clinical, biochemical, hormonal and radiological findings of congenital adrenal hypoplasia. To the best of our knowledge, no similar cases were reported from this part of the world.

Study of the acceptability of lateral interocclusal records by a modular articulator

Semiadjustable articulators are extensively used for routine restorative procedures. The instruments may be adjusted by lateral interocclusal records. However, it has been reported that semiadjustable articulators do not accept lateral interocclusal records from all patients. The Hanau modular system 194 semiadjustable articulator was introduced to develop occlusion with minimal error. The manufacturer recommends that the instrument should be adjusted by means of lateral interocclusal records. This study investigated the acceptability of lateral interocclusal records. Sixty lateral interocclusal records were made for 30 edentulous subjects, and the acceptability of the records was evaluated by use of the split-cast mounting procedure. Out of 60 lateral interocclusal records, 52 (87%) records were accepted by the articulator. A Z test was used for two proportions and was statistically significant (p < 0.05).

Congenital adrenal hyperplasia in a referral hospital in Saudi Arabia: Epidemiology, pattern and clinical presentation

Eighty-two children (30 males and 52 females) with congenital adrenal hyperplasia (CAH) were seen at King Khalid University Hospital (KKUH) over a 10-year period. Of these, 74 (90.2%) were Saudis and eight (9.8%) non-Saudis. Fifty-nine (72%) patients were 21-hydroxylase deficient. Of these, 56 (95%) had variable degrees of salt depletion. Nineteen (23.2%) patients had a deficiency of 11-ss-hydroxylase enzyme and four (4.8%) showed deficiency of 3-ss-hydroxysteroid dehydrogenase. The consanguinity rate was high (71.2%) and positive family history was documented in 45.8%. Thirty-nine infants deaths occurred within 25 families. The diagnosis was often delayed. Of the 52 females, 27 (52%) were initially assigned male sex. These results indicate the importance of physicians' awareness and the need for a neonatal screening program for early detection and appropriate management.

Effect of gender, birth weight and gestational age on serum 17-hydroxyprogesterone concentration and distribution among neonates in Saudi Arabia

Blood samples from 813 newborns were spotted on to filter paper and the 17-hydroxyprogesterone concentration was measured using the Delfia (R) fluorometric immunoassay. The median, mean, and standard deviation (SD) for the total population were 20, 21 and (11) nmol/L respectively. Males had significantly higher levels than females with median, mean and (SD) of 22, 22 and (12) nmol/L. Similarly, low birth weight babies were found to have significantly higher levels than normal birth weight babies with median, mean and (SD) of 21, 24 (12) nmol/L. Preterm babies were also found to have significantly higher levels than full term babies, with median, mean and (SD) of 25, 29 (16) nmol/L. As experienced elsewhere, those factors should be taken into consideration when considering a cut-off point in any neonatal screening program for congenital adrenal hyperplasia.

Ambiguous genitalia: comparative role of pelvic ultrasonography and genitography

Ambiguous genitalia represents a true medical and social emergency which needs a multi-disciplinary team approach for elucidation. The paediatric radiologist plays an important role in defining the genital anatomy which remains one of the most important factors in sex determination. Aiming to compare the predictive value of pelvic ultrasonography and genitography in sex determination in patients with ambiguous genitalia, we retrospectively reviewed the medical records of 69 patients, 53 females and 16 males, where both procedures were employed. In female pseudohermaphroditism, the presence of a uterus with or without vagina was predicted in 46 (86.8%) patients by ultrasound compared with 44 (83%) patients in whom a genitogram revealed a vagina +/- uterus. In six (11.3%) patients, a genitogram revealed a male-type urethra. The combination of ultrasound and genitogram, however, was more sensitive and predicted the presence of a uterus with or without vagina in 52 (98.1%) patients. In male pseudo-hermaphroditism, there was no false positive by ultrasound, and a genitogram revealed a male-type urethra in 12 (75%) patients. In conclusion, although real time pelvic ultrasonography is less invasive than genitography, its yield in elucidating genital anatomy is comparable. The combination of both procedures is more informative and has a better yield.

Gangrene of the penis

A case of gangrene of the penis, rarely seen at our University Hospital is reported. Urolithiasis, urinary tract infection, infected piles and anaemia were found to be associated with the condition. Because of rapid spread of the gangrene, partial amputation was required in this reported case.

Substrate concentration affects the in vitro metabolism of 17-hydroxyprogesterone by ovaries of the carp, Cyprinus carpio

Carp ovarian tissue was incubated with (3)H-17-hydroxyprogesterone in the presence of 0, 0.1, 1, 10, and 100 μg ml(-1) unlabeled 17-hydroxyprogesterone. The pattern of metabolites formed showed a marked variation with substrate concentration. Formation of glucuronide and sulphate conjugates was important only at low substrate concentration. At high substrate concentration (10 and 100 μg ml(-1)) 17,20α-dihydroxy-4-pregnen-3-one was the major metabolite, but at intermediate concentrations polar 7α-hydroxypregnanetetrols predominated. The results support the hypothesis that at low substrate concentrations conjugating, 5α-reducing and 7α-hydroxylating enzymes, of high activity but low capacity, act as scavengers to deactivate any steroids formed during the relatively low pituitary gonadotrophin secretions which are necessary for oocyte development, but that during the prespawning gonadotrophin surge when high levels of substrate are present these enzymes are saturated and 17,20α-dihydroxy-4-pregnen-3-one (17,20αP) becomes the major ovarian steroid. The possible role of 17,20αP during oocyte final maturation requires further examination.

Increased substrate concentration causes a shift from production of 11-oxygenated androgens to 17,20-dihydroxyprogestogens during the in vitro metabolism of 17-hydroxyprogesterone by goldfish testes

Goldfish testes were incubated with [3H]17-hydroxyprogesterone in the presence of 0 to 100 micrograms/ml of unlabeled substrate and metabolites examined by thin-layer and high performance liquid chromatography. Conjugated steroids, predominantly sulfates, accounted for 50% of recovered activity with radiolabeled substrate alone, but percentage yields decreased to very low levels with substrate concentrations of 1 micrograms/ml and above. The 11-oxygenated androgens, androstenetrione and 11-ketotestosterone, were the major products with 0 to 0.1 micrograms/ml substrate, but at concentrations of 1 to 100 micrograms/ml the major products were 17,20 alpha-dihydroxy-4-pregnen-3-one (30% of recovered activity) with smaller amounts of the 20 beta-epimer. 11-Deoxycortisol was a minor product at all substrate concentrations. Production of 11-oxygenated androgens in the medium reached a maximum value of 40 ng/100 mg tissue/3 hr with 2 micrograms substrate, but progestogen production continued to increase up to the maximum substrate used (30 micrograms at 200 micrograms substrate). The results demonstrate a clear switch from production of 11-oxygenated androgens to that of 20-reduced progestogens with increased substrate concentration. This switch shows similarities to that observed for in vivo plasma steroid concentrations during the prespawning period of many male teleosts and it is suggested that this, at least in part, may be due to increased substrate availability resulting from elevated gonadotropin secretion.

The in vitro metabolism of 17-hydroxyprogesterone by ovaries of the goldfish, Carassius auratus, is affected by substrate concentration

Ovaries of mature goldfish (Carassius auratus) were incubated with 17-[3H]hydroxyprogesterone and 0, 0.01, 0.1, 1, 10, and 100 micrograms/ml 17-hydroxyprogesterone (17P). The major products were quantified after separation by thin-layer and high-performance chromatography. The results show that substrate concentration markedly affects the pattern of metabolites. Glucuronides and sulfates decreased from 7.2 +/- 2.0 and 28.5 +/- 4.4% of recovered radioactivity, respectively, in the absence of added 17P to insignificant yields at 10 micrograms/ml 17P. 7 alpha-Tetrols were the major products (36-52%) with 0-1 microgram/ml substrate, but at 10 and 100 micrograms/ml 17,20 alpha-dihydroxy-4-pregnen-3-one (17,20 alpha P) was the major metabolite and there were low yields of other products. 11-Deoxycortisol was produced in significant amounts only at low substrate concentrations. The results support the hypothesis that 5 alpha-reduced-7 alpha-hydroxylated metabolites are formed by enzymes of high activity but low capacity and serve to limit secretion of 17,20 alpha P and its 20 beta epimer to the period of maximum GtH stimulation.

Antithyroid antibodies and thyroid dysfunction in Saudi children with Down syndrome

Fifty children (ages seven months to nine years) with Down syndrome compared with age and sex matched controls were tested for antithyroid antibodies. Seven (14%) of the Down group were found to b seropositive; six (12%) for antimicrosomal antibodies; three for both antimicrosomal and antithyroglobulin; none was positive for antithyroglobulin alone. All the control group were seronegative and had no clinical evidence of thyroid disease. Three (6%) of the Down group had hypothyroidism, two due to autoimmune thyroiditis and one had disease. Thyroid dysfunction was not previously suspected in the two symptomatic children. In view of our findings, recommendations are made to regularly screen these children for autoantibdies and evidence of thyroid dysfuntion.

Predation of Acacia seeds by bruchid beetles and its relation to altitudinal gradient in south-western Saudi Arabia

The distribution of the Acacia trees and their bruchid seed beetles in south-western Saudi Arabia revealed that each of the host-insect pair occupied a specific range along the altitudinal gradient from sea level to 2500 m. At low to intermediate altitudes, between sea level and 1750 m, at hot to worm environments, the following host-insect pairs were recorded: Acacia asak--Bruchidius. sp., A. ehrenbergiana--B.saudicus, A.hamulosa--B.sp., A.oerfota--B.sp., A.seyal--B. sp., A.tortilis--B. aurivilli and A.tortilis--B. sahelicus. At high altitudes between 1750 and 2500m, at cool environment the following host insect pairs were recorded: A.negrii--B.arabicus and A.gerrardii--B.arabicus. The rate of seed predation varied among Acacia spp., but the highest were recorded in A. tortilis and A. ehrenbergiana.

Effect of different polymerization techniques on dimensional stability of record bases

In this study, discrepancies in the adaptation of the posterior borders of maxillary record bases to their casts were analyzed with five polymerization techniques: (1) bench curing, (2) curing under a coat of petroleum jelly, (3) curing in a monomer atmosphere, (4) curing under air pressure, and (5) curing under warm water and air pressure. Ten record bases were made with each of the five techniques and were tested immediately for dimensional accuracy. Measurements of adaptations were made at three points that represent the right and left crest of the ridge and midpalatal region with a measuring microscope equipped with a filar unit-measuring eyepiece. Dimensional changes were observed under all test conditions. The monomer atmosphere technique produced the least dimensional change when compared with other techniques.