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The incidence of diabetic ketoacidosis during Ramadan fasting: a 10-year single-centre retrospective study.CONTEXT There has been an increased interest in the potential metabolic derangements and acute complications of diabetes related to the Muslims' fasting during the month of Ramadan. OBJECTIVES We compared the incidence of admissions due to diabetic ketoacidosis (DKA) during Ramadan with the admissions during other months. METHODS This is a retrospective electronic database and chart review study that included all Muslims who were admitted with DKA to Sheikh Khalifa Medical City in Abu Dhabi, United Arab Emirates. We explored the relationship of admissions to Ramadanwas explored over ten years (2005-2014). RESULTS There were 432 episodes of DKA involving 283 patients. Of these, 370 episodes (85.6%) involved 231 patients (81.6%) with type 1 diabetes. The number of admission episodes was not different during Ramadan from the average calendar month [3.6±2.6 (Range 0-15) episodes/month versus 3.3±2.1 (Range 1-7) episodes/month respectively, P=0.77]. No recurrences of admissions were observed during Ramadan. There was a non-significant numerical tendency for more episodes in March and September (4.6 episodes for both) and fewer episodes in July (2.6 episodes) than other months; P values were 0.06; 0.13, and 0.32 respectively. This seasonality was not related to the month of Ramadan. CONCLUSIONS The present study confirmed that DKA admissions during Ramadan were not significantly higher than the average monthly admissions over ten years. Seasonality trends were not related to Ramadan.Beshyah AS, Beshyah SACONTEXT There has been an increased interest in the potential metabolic derangements and acute complications of diabetes related to the Muslims' fasting during the month of Ramadan. OBJECTIVES We compared the incidence of admissions due to diabetic ketoacidosis (DKA) during Ramadan with the admissions during other months. METHODS This is a retrospective electronic database and chart review study that included all Muslims who were admitted with DKA to Sheikh Khalifa Medical City in Abu Dhabi, United Arab Emirates. We explored the relationship of admissions to Ramadanwas explored over ten years (2005-2014). RESULTS There were 432 episodes of DKA involving 283 patients. Of these, 370 episodes (85.6%) involved 231 patients (81.6%) with type 1 diabetes. The number of admission episodes was not different during Ramadan from the average calendar month [3.6±2.6 (Range 0-15) episodes/month versus 3.3±2.1 (Range 1-7) episodes/month respectively, P=0.77]. No recurrences of admissions were observed during Ramadan. There was a non-significant numerical tendency for more episodes in March and September (4.6 episodes for both) and fewer episodes in July (2.6 episodes) than other months; P values were 0.06; 0.13, and 0.32 respectively. This seasonality was not related to the month of Ramadan. CONCLUSIONS The present study confirmed that DKA admissions during Ramadan were not significantly higher than the average monthly admissions over ten years. Seasonality trends were not related to Ramadan. Beshyah AS, Beshyah SA Sheikh Khalifa Medical city Abu Dhabi DKA; Disease seasonality, Ethnicity, Muslims; Length of stay; Ramadan Diabetes Res Clin Pract. Sheikh Khalifa Medical city Abu DhabiDiabetes Res Clin Pract. DKA; Disease seasonality, Ethnicity, Muslims; Length of stay; RamadanDiabetes(18)31683-8https//www.ncbi.nlm.nih.gov/pubmed/306853492019The incidence of diabetic ketoacidosis during Ramadan fasting: a 10-year single-centre retrospective study.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
How do we strengthen the health workforce in a rapidly developing high-income country? A case study of Abu Dhabi's health system in the United Arab Emirates.BACKGROUND The United Arab Emirates (UAE) is a rapidly developing high-income country that was formed from the union of seven emirates in 1971. The UAE has experienced unprecedented population growth coupled with increased rates of chronic diseases over the past few decades. Healthcare workers are the core foundation of the health system, especially for chronic care conditions, and the UAE health workforce needs to be fully prepared for the increased rates of chronic diseases in the adult population. Abu Dhabi is the largest emirate in terms of land mass and population size, and the purpose of this paper was to assess how the health system has been using the Chronic Care Model to improve its capacity to reach out to all patients in the population. CASE PRESENTATION The Abu Dhabi health workforce has twice the number of doctors (52.4 vs. 23.2 per 10?000 population) and nurses (134.7 vs. 50.4 per 10?000 population) compared to the entire UAE health workforce. In addition to an overreliance on expatriate workers, there is an excess of some specializations such as general medicine and gynecology and a severe undersupply of other specialties including trauma and injury, and medical oncology. The digital infrastructure and skills of the health workforce need to be improved to minimize the proportion of the appointment time required to complete administrative tasks for a health insurance system and maximize the doctor-patient face-to-face interaction time for consultation and lifestyle counseling. CONCLUSIONS A greater emphasis needs to be placed on developing self-management support strategies using a combination of nurse health educators and community-based patient-led health programs. The UAE Vision 2021 includes developing a world-class healthcare system, and full implementation of the Chronic Care Model seems to facilitate the detailed planning and preparation of healthcare services and workers required to achieve this goal.Paulo MS, Loney T, Lapمo LV.BACKGROUND The United Arab Emirates (UAE) is a rapidly developing high-income country that was formed from the union of seven emirates in 1971. The UAE has experienced unprecedented population growth coupled with increased rates of chronic diseases over the past few decades. Healthcare workers are the core foundation of the health system, especially for chronic care conditions, and the UAE health workforce needs to be fully prepared for the increased rates of chronic diseases in the adult population. Abu Dhabi is the largest emirate in terms of land mass and population size, and the purpose of this paper was to assess how the health system has been using the Chronic Care Model to improve its capacity to reach out to all patients in the population. CASE PRESENTATION The Abu Dhabi health workforce has twice the number of doctors (52.4 vs. 23.2 per 10?000 population) and nurses (134.7 vs. 50.4 per 10?000 population) compared to the entire UAE health workforce. In addition to an overreliance on expatriate workers, there is an excess of some specializations such as general medicine and gynecology and a severe undersupply of other specialties including trauma and injury, and medical oncology. The digital infrastructure and skills of the health workforce need to be improved to minimize the proportion of the appointment time required to complete administrative tasks for a health insurance system and maximize the doctor-patient face-to-face interaction time for consultation and lifestyle counseling. CONCLUSIONS A greater emphasis needs to be placed on developing self-management support strategies using a combination of nurse health educators and community-based patient-led health programs. The UAE Vision 2021 includes developing a world-class healthcare system, and full implementation of the Chronic Care Model seems to facilitate the detailed planning and preparation of healthcare services and workers required to achieve this goal. Paulo MS, Loney T, Lapمo LV. United Arab Emirates University, Al Ain Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates. Abu Dhabi; Chronic Care Model; Health systems; Health workforce; United Arab Emirates Hum Resour Health. United Arab Emirates University, Al Ain Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.Hum Resour Health. Abu Dhabi; Chronic Care Model; Health systems; Health workforce; United Arab EmiratesHealth workforce17(1)https//www.ncbi.nlm.nih.gov/pubmed/306786902019How do we strengthen the health workforce in a rapidly developing high-income country? A case study of Abu Dhabi's health system in the United Arab Emirates.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
Glycemic Control in Patients with Diabetes across Primary and Tertiary Government Health Sectors in the Emirate of Dubai, United Arab Emirates: A Five-Year Pattern.OBJECTIVES In the UAE, the comparative prevalence of diabetes is reported as 18.98%, but there are very few studies evaluating glycemic control. Attaining the optimum glycemic control has been a global challenge over the years. However, there is a trend of global improvement with the availability of newer options of antidiabetic medications, increasing numbers of physicians, and patient awareness. Our primary aim was to assess the level of glycemic control across Dubai Health Authority points of care over the past five years. Additionally, we aimed to compare the differences in glycemic control between primary and tertiary centers, between nationalities, and type I and II diabetes. METHODS We conducted a retrospective analysis of the electronic medical records of all patients who attended primary and tertiary care centers within the Dubai Health Authority between 2012 and 2016. All patients with any type of diabetes were included in this assessment. RESULTS A total of 26 447 patients were included in the study; of these, 73.8% (n = 19 508) were UAE nationals while the other nationalities accounted for 26.2% (n = 6939) of patients. The overall mean glycated hemoglobin (HbA1c) levels from 2012 to 2016 was 7.76%. Patients attending primary care clinics had a mean HbA1c of 7.64% compared to 7.68% for the tertiary care cohort. Out of the total population, 37.7% achieved HbA1c < 7%. Over 40% of the patients attending primary care centers achieved HbA1c < 7% compared to 34.9% of those who attended tertiary care centers. CONCLUSIONS Optimum glycemic target was achieved by less than 40% of patients. Glycemic control is still below the desired levels. However, there has been a trend of improvement in the last few years and we are achieving the international average targets. Further collaborative actions from clinical, educational, and strategic sectors are needed to improve our goals further.Alawadi F, Abdelgadir E, Bashier A, Hassanein M, Rashid F, Alsaeed M, Hafidh K, Elsayed MA, Abuelkheir S, Farooqi MH.OBJECTIVES In the UAE, the comparative prevalence of diabetes is reported as 18.98%, but there are very few studies evaluating glycemic control. Attaining the optimum glycemic control has been a global challenge over the years. However, there is a trend of global improvement with the availability of newer options of antidiabetic medications, increasing numbers of physicians, and patient awareness. Our primary aim was to assess the level of glycemic control across Dubai Health Authority points of care over the past five years. Additionally, we aimed to compare the differences in glycemic control between primary and tertiary centers, between nationalities, and type I and II diabetes. METHODS We conducted a retrospective analysis of the electronic medical records of all patients who attended primary and tertiary care centers within the Dubai Health Authority between 2012 and 2016. All patients with any type of diabetes were included in this assessment. RESULTS A total of 26 447 patients were included in the study; of these, 73.8% (n = 19 508) were UAE nationals while the other nationalities accounted for 26.2% (n = 6939) of patients. The overall mean glycated hemoglobin (HbA1c) levels from 2012 to 2016 was 7.76%. Patients attending primary care clinics had a mean HbA1c of 7.64% compared to 7.68% for the tertiary care cohort. Out of the total population, 37.7% achieved HbA1c < 7%. Over 40% of the patients attending primary care centers achieved HbA1c < 7% compared to 34.9% of those who attended tertiary care centers. CONCLUSIONS Optimum glycemic target was achieved by less than 40% of patients. Glycemic control is still below the desired levels. However, there has been a trend of improvement in the last few years and we are achieving the international average targets. Further collaborative actions from clinical, educational, and strategic sectors are needed to improve our goals further. Alawadi F, Abdelgadir E, Bashier A, Hassanein M, Rashid F, Alsaeed M, Hafidh K, Elsayed MA, Abuelkheir S, Farooqi MH. Dubai Hospital, Dubai Rashid Hospital, Dubai, Dubai Diabetes Center, Dubai Diabetes Mellitus; Endocrinology; Medicine; Middle East; Public Health; United Arab Emirates Oman Med J.Dubai Hospital, DubaiRashid Hospital, Dubai,Dubai Diabetes Center, DubaiOman Med J.Diabetes Mellitus; Endocrinology; Medicine; Middle East; Public Health; United Arab EmiratesDiabetes34(1)https//www.ncbi.nlm.nih.gov/pubmed/306711802019Glycemic Control in Patients with Diabetes across Primary and Tertiary Government Health Sectors in the Emirate of Dubai, United Arab Emirates: A Five-Year Pattern.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
Glycemic and lipids control in patients with diabetes and cardiovascular or renal diseases across all the government health sectors in the Emirate of Dubai, United Arab Emirates.The guidelines suggest setting the glycemic and lipid targets according to the stage of the disease and other co -existing complications in the patients with diabetes. AIMS We aimed to evaluate the HbA1c and lipids level in patients with high risk diabetes from 2012-2016, attending different level of care in Dubai health authority. MATERIALS AND METHODS This is a retrospective analysis of the electronic medical records of all patients who attended the Dubai Health authority between 2012-2016. All patients with an ICD code of any type of diabetes in addition to cardiovascular or renal diseases were. Patients were categorized based on their HbA1c into control of8%. While lipids were categorized as f LDL < 70?mg/dl, and the Non-HDL < 70?mg/dl was achieved by 27.8% of the patients. CONCLUSION In patients with diabetes and multiple complications, the glycemic and lipids control is suboptimal. However, the pattern showed numerical improvement over the years.Rashid F, Abdelgadir E, Alsaeed M, Alemadi B, Khalifa A, Farooqi MH, Alawadi F, Bashier A.The guidelines suggest setting the glycemic and lipid targets according to the stage of the disease and other co -existing complications in the patients with diabetes. AIMS We aimed to evaluate the HbA1c and lipids level in patients with high risk diabetes from 2012-2016, attending different level of care in Dubai health authority. MATERIALS AND METHODS This is a retrospective analysis of the electronic medical records of all patients who attended the Dubai Health authority between 2012-2016. All patients with an ICD code of any type of diabetes in addition to cardiovascular or renal diseases were. Patients were categorized based on their HbA1c into control of8%. While lipids were categorized as f LDL < 70?mg/dl, and the Non-HDL < 70?mg/dl was achieved by 27.8% of the patients. CONCLUSION In patients with diabetes and multiple complications, the glycemic and lipids control is suboptimal. However, the pattern showed numerical improvement over the years. Rashid F, Abdelgadir E, Alsaeed M, Alemadi B, Khalifa A, Farooqi MH, Alawadi F, Bashier A. Dubai Hospital, Dubai Diabetes; Diabetes control; High risk patients with diabetes; Individualized glycemic target; LDL-C control; UAE Diabetes Metab Syndr. Dubai Hospital, DubaiDiabetes Metab Syndr. Diabetes; Diabetes control; High risk patients with diabetes; Individualized glycemic target; LDL-C control; UAEDiabetes and cardiovascular or renal diseases13(1)https//www.ncbi.nlm.nih.gov/pubmed/306417712019Glycemic and lipids control in patients with diabetes and cardiovascular or renal diseases across all the government health sectors in the Emirate of Dubai, United Arab Emirates.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
Patterns and trends in insulin initiation and intensification among patients with Type 2 diabetes mellitus in the Middle East and North Africa region.AIM Current and future estimates of the burden of diabetes in the Middle East and North Africa (MENA) region are among the highest in the world. VISION, an 18-month observational study, explored patterns of insulin initiation and intensification in T2DM patients in the MENA region. METHODS 1,192 patients aged =18 years were enrolled from Algeria, Egypt, Saudi Arabia and the UAE. Treating physicians recorded participants' data. Patient-reported outcomes (PROs) were assessed using questionnaires completed by participants. RESULTS 67.6% patients had HbA1c =9% at insulin initiation, with a mean HbA1c of 9.9%, despite 68.3% patients being on =2 oral anti-diabetics, indicating a significant delay in insulin initiation. Basal insulin was initiated in 50.6% and premixed insulin in 46.3% patients. After 18 months, changes in insulin therapy were observed in 33.7% patients, while 39.6% patients achieved HbA1c levels ofJabbar A, Abdallah K, Hassoun A, Malek R, Senyucel C, Spaepen E, Treuer T, Bhattacharya I.AIM Current and future estimates of the burden of diabetes in the Middle East and North Africa (MENA) region are among the highest in the world. VISION, an 18-month observational study, explored patterns of insulin initiation and intensification in T2DM patients in the MENA region. METHODS 1,192 patients aged =18 years were enrolled from Algeria, Egypt, Saudi Arabia and the UAE. Treating physicians recorded participants' data. Patient-reported outcomes (PROs) were assessed using questionnaires completed by participants. RESULTS 67.6% patients had HbA1c =9% at insulin initiation, with a mean HbA1c of 9.9%, despite 68.3% patients being on =2 oral anti-diabetics, indicating a significant delay in insulin initiation. Basal insulin was initiated in 50.6% and premixed insulin in 46.3% patients. After 18 months, changes in insulin therapy were observed in 33.7% patients, while 39.6% patients achieved HbA1c levels of Jabbar A, Abdallah K, Hassoun A, Malek R, Senyucel C, Spaepen E, Treuer T, Bhattacharya I. Dubai Health Authority, Dubai Medcare Hospital, Dubai, Clinical inertia; Insulin regimens; Middle East and North Africa; Observational; Type 2 diabetes mellitus Diabetes Res Clin Pract. Dubai Health Authority, DubaiMedcare Hospital, Dubai, Diabetes Res Clin Pract. Clinical inertia; Insulin regimens; Middle East and North Africa; Observational; Type 2 diabetes mellitusType 2 diabetes mellitus(18)31384-6https//www.ncbi.nlm.nih.gov/pubmed/306539942019Patterns and trends in insulin initiation and intensification among patients with Type 2 diabetes mellitus in the Middle East and North Africa region.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
Relationship of salivary adipocytokines, diet quality, physical activity, and nutrition status in adult Emirati females in United Arab Emirates.AIMS The United Arab Emirates (UAE) ranks as the fifth most obese country with increasing cardio-metabolic risks. In this paper, relationships of salivary adipocytokines (markers of cardio-metabolic syndrome), diet quality and physical activity in 90 normal-weight, overweight and obese (30 subjects in each group) Emirati adult females were investigated. METHODS A cross-sectional research design was adopted. Anthropometric measurements, diet quality and physical activity questionnaires were administered. Overnight fasting saliva was collected to determine levels of adiponectin, interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-a). RESULTS Salivary adiponectin was significantly lower, while TNF-a was higher in obese than normal-weight subjects. IL-10 displayed a lower trend in obese subjects. Though diet quality and physical activity did not exhibit significant differences among the three groups, better diet quality and higher physical activity level were reported among normal-weight subjects. Salivary TNF-a correlated positively with body mass index (BMI) (r?=?0.37; p?Attlee A., Hasan H, AlQattan A, Sarhan N, Alshammari R, Ali S, Nabil M, Alattrash A, Raigangar V, Madkour M, Unnikannan H, Awadallah S.AIMS The United Arab Emirates (UAE) ranks as the fifth most obese country with increasing cardio-metabolic risks. In this paper, relationships of salivary adipocytokines (markers of cardio-metabolic syndrome), diet quality and physical activity in 90 normal-weight, overweight and obese (30 subjects in each group) Emirati adult females were investigated. METHODS A cross-sectional research design was adopted. Anthropometric measurements, diet quality and physical activity questionnaires were administered. Overnight fasting saliva was collected to determine levels of adiponectin, interleukin-10 (IL-10) and tumor necrosis factor-alpha (TNF-a). RESULTS Salivary adiponectin was significantly lower, while TNF-a was higher in obese than normal-weight subjects. IL-10 displayed a lower trend in obese subjects. Though diet quality and physical activity did not exhibit significant differences among the three groups, better diet quality and higher physical activity level were reported among normal-weight subjects. Salivary TNF-a correlated positively with body mass index (BMI) (r?=?0.37; p? Attlee A., Hasan H, AlQattan A, Sarhan N, Alshammari R, Ali S, Nabil M, Alattrash A, Raigangar V, Madkour M, Unnikannan H, Awadallah S. United Arab Emirates University, Al Ain University of Sharjah Diet quality; Obesity; Physical activity; Salivary adipocytokines; United Arab Emirates Diabetes Metab Syndr. United Arab Emirates University, Al Ain University of SharjahDiabetes Metab Syndr. Diet quality; Obesity; Physical activity; Salivary adipocytokines; United Arab EmiratesSalivary adipocytokines, diet quality, physical activity, and nutrition status13(1)https//www.ncbi.nlm.nih.gov/pubmed/306417322019Relationship of salivary adipocytokines, diet quality, physical activity, and nutrition status in adult Emirati females in United Arab Emirates.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
Kunafa knife and play dough is an efficient and cheap simulator to teach diagnostic Point-of-Care Ultrasound (POCUS).BACKGROUND Point-of-Care Ultrasound (POCUS) is a useful diagnostic tool. Nevertheless, it needs proper training to reach its required level of competency. Educators who work in low-income countries find it difficult to purchase expensive training computer-based simulators. We aim in this communication to describe the methods to build up and use an efficient, simple, and cheap simulator which can be used for teaching POCUS globally. METHODS It took our group 2 years to develop the simulator to its current form. The required material for the simulator includes a Kunafa knife, a carton gift box and its cover and colored play dough. The Kunafa knife with its blade is an excellent simulator for the small print convex array probe (3-5 MHz) and its ultrasound sections. It is useful to teach two important principles. First, the three basic hand movements used to control the ultrasound probe (fanning, tilting, and shifting). Second, the thin blade of the knife (1 mm thick) simulates the shape of the two-dimensional ultrasound images. The play dough is used to simulate different organs to be cut in different directions like the aorta and inferior vena cava. RESULTS The simulator was used to teach 88 fifth year medical students during the period of November 2017 to November 2018 at the College of Medicine and Health Sciences, UAE University. The simulator was valid, simple, portable, and sustainable. The students greatly enjoyed its use. The cost of the simulator is less than 10 US dollars. CONCLUSIONS Surgical educators who work in low-income countries are encouraged to develop their educational tools that are tailored to their own needs. Our simulator can help our colleagues who want to teach POCUS and cannot purchase expensive mannequins and computer-based simulators.Abu-Zidan FM, Cevik AA.BACKGROUND Point-of-Care Ultrasound (POCUS) is a useful diagnostic tool. Nevertheless, it needs proper training to reach its required level of competency. Educators who work in low-income countries find it difficult to purchase expensive training computer-based simulators. We aim in this communication to describe the methods to build up and use an efficient, simple, and cheap simulator which can be used for teaching POCUS globally. METHODS It took our group 2 years to develop the simulator to its current form. The required material for the simulator includes a Kunafa knife, a carton gift box and its cover and colored play dough. The Kunafa knife with its blade is an excellent simulator for the small print convex array probe (3-5 MHz) and its ultrasound sections. It is useful to teach two important principles. First, the three basic hand movements used to control the ultrasound probe (fanning, tilting, and shifting). Second, the thin blade of the knife (1 mm thick) simulates the shape of the two-dimensional ultrasound images. The play dough is used to simulate different organs to be cut in different directions like the aorta and inferior vena cava. RESULTS The simulator was used to teach 88 fifth year medical students during the period of November 2017 to November 2018 at the College of Medicine and Health Sciences, UAE University. The simulator was valid, simple, portable, and sustainable. The students greatly enjoyed its use. The cost of the simulator is less than 10 US dollars. CONCLUSIONS Surgical educators who work in low-income countries are encouraged to develop their educational tools that are tailored to their own needs. Our simulator can help our colleagues who want to teach POCUS and cannot purchase expensive mannequins and computer-based simulators. Abu-Zidan FM, Cevik AA. United Arab Emirates University, Al Ain Basic physics; Fanning; Learning; Point-of-care; Simulation; Teaching; Ultrasound World J Emerg Surg. United Arab Emirates University, Al Ain World J Emerg Surg. Basic physics; Fanning; Learning; Point-of-care; Simulation; Teaching; UltrasoundPoint-of-Care0.584027778https//www.ncbi.nlm.nih.gov/pubmed/306369692019Kunafa knife and play dough is an efficient and cheap simulator to teach diagnostic Point-of-Care Ultrasound (POCUS).0x01000BE60DE9C7F7DF4B8EA8A830051652C8
Dyslipidemia, subclinical inflammation, hepatic cholestasis and endothelial dysfunction in schoolchildren with excess fat: A study from the United Arab Emirates.BACKGROUND The impact of obesity on cardiovascular health of young children is still to be fully illustrated. This study measured biomarkers for glycemic control, lipid metabolism, systemic inflammation, endothelial dysfunction, and hepatic cholestasis in schoolchildren. Its main purpose was to determine whether metabolic derangements could be detected in young children with excess fat. METHOD This cross-sectional study involved 967 children in the second, sixth, and tenth grades (median age, 7.3, 11.3, and 15.4 years, respectively). Using the International Obesity Task Force interpretation (IOTF) of body-mass-index (BMI), children were stratified as thin (Aburawi EH, Al Hamad S, Yasin J, Almekhaini LA, Souid AK.BACKGROUND The impact of obesity on cardiovascular health of young children is still to be fully illustrated. This study measured biomarkers for glycemic control, lipid metabolism, systemic inflammation, endothelial dysfunction, and hepatic cholestasis in schoolchildren. Its main purpose was to determine whether metabolic derangements could be detected in young children with excess fat. METHOD This cross-sectional study involved 967 children in the second, sixth, and tenth grades (median age, 7.3, 11.3, and 15.4 years, respectively). Using the International Obesity Task Force interpretation (IOTF) of body-mass-index (BMI), children were stratified as thin ( Aburawi EH, Al Hamad S, Yasin J, Almekhaini LA, Souid AK. United Arab Emirates University, Al Ain N/A PLoS OneUnited Arab Emirates University, Al Ain PLoS OneN/ADyslipidemia14(1)https//www.ncbi.nlm.nih.gov/pubmed/306252182019Dyslipidemia, subclinical inflammation, hepatic cholestasis and endothelial dysfunction in schoolchildren with excess fat: A study from the United Arab Emirates.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
The FTO rs9939609 A allele is associated with impaired fasting glucose and insulin resistance in Emirati population.BACKGROUND Fat mass and obesity-associated protein gene variants have shown diverse influence on body weight and metabolism across different populations. Overweight, obesity and metabolic syndrome are multifactorial major health problems in the UAE and worldwide. Insulin resistance represents the link between overweight and development of metabolic syndrome and type 2 diabetes mellitus. We investigated two (FTO) variants in Emirati population, in relation to insulin resistance and different parameters of metabolic syndrome. METHODS We recruited 259 Emiratis through the UAE National Diabetes and Lifestyle Project. Ethical approval was obtained. Besides basic data collection, venous blood samples were collected. Fasting blood glucose, Lipid profile, and insulin levels were measured. Genotyping for (FTO) rs9939609 (A>T) and rs9930506 (G>A) were performed using real time-PCR. Insulin resistance were identified using HOMA2-IR calculation; with a cut-off point of 1.4 for female and 1.18 for male subjects. RESULTS The study included 259 Emiratis (age range 30-53?years, mean 41.76?years, 54.4% females), 24.5% are diabetic and 30.8% are hypertensive, with body mass index of 28.4?±?5.9 and 28.7?±?5.7?kg/m2 in female and male subjects, respectively. Homozygous A of rs9939609 showed significantly higher fasting glucose compared to other genotypes (p?=?0.04) with a trend of higher insulin level and HOMA-2IR. The A/A diabetic patients (n?=?13) showed significantly higher insulin levels compared to other genotypes. G allele of rs9930506 showed a trend of higher fasting glucose and HOMA-2IR, but lower insulin level and HbA1c. No association of genotypes was detected with other components of metabolic syndrome. CONCLUSION There is an association of FTO rs9939609 A/A genotype and impaired fasting glucose and insulin resistance. Homozygous A genotype diabetic patients may be more vulnerable to blood glucose fluctuation. Focused genotyping can help the health care providers to identify high risk groups of both normal population and diabetic patients to intervene accordingly.Saber-Ayad M, Manzoor S, El Serafi A, Mahmoud I, Hammoudeh S, Rani A, Abusnana S, Sulaiman N.BACKGROUND Fat mass and obesity-associated protein gene variants have shown diverse influence on body weight and metabolism across different populations. Overweight, obesity and metabolic syndrome are multifactorial major health problems in the UAE and worldwide. Insulin resistance represents the link between overweight and development of metabolic syndrome and type 2 diabetes mellitus. We investigated two (FTO) variants in Emirati population, in relation to insulin resistance and different parameters of metabolic syndrome. METHODS We recruited 259 Emiratis through the UAE National Diabetes and Lifestyle Project. Ethical approval was obtained. Besides basic data collection, venous blood samples were collected. Fasting blood glucose, Lipid profile, and insulin levels were measured. Genotyping for (FTO) rs9939609 (A>T) and rs9930506 (G>A) were performed using real time-PCR. Insulin resistance were identified using HOMA2-IR calculation; with a cut-off point of 1.4 for female and 1.18 for male subjects. RESULTS The study included 259 Emiratis (age range 30-53?years, mean 41.76?years, 54.4% females), 24.5% are diabetic and 30.8% are hypertensive, with body mass index of 28.4?±?5.9 and 28.7?±?5.7?kg/m2 in female and male subjects, respectively. Homozygous A of rs9939609 showed significantly higher fasting glucose compared to other genotypes (p?=?0.04) with a trend of higher insulin level and HOMA-2IR. The A/A diabetic patients (n?=?13) showed significantly higher insulin levels compared to other genotypes. G allele of rs9930506 showed a trend of higher fasting glucose and HOMA-2IR, but lower insulin level and HbA1c. No association of genotypes was detected with other components of metabolic syndrome. CONCLUSION There is an association of FTO rs9939609 A/A genotype and impaired fasting glucose and insulin resistance. Homozygous A genotype diabetic patients may be more vulnerable to blood glucose fluctuation. Focused genotyping can help the health care providers to identify high risk groups of both normal population and diabetic patients to intervene accordingly. Saber-Ayad M, Manzoor S, El Serafi A, Mahmoud I, Hammoudeh S, Rani A, Abusnana S, Sulaiman N. University of Sharjah Diabetes mellitus; Emirati population; FTO; Fat mass and obesity-associated protein gene; HOMA; Insulin resistance; Metabolic syndrome; Obesity; Overweight; rs9930506; rs9939609 Gene.University of SharjahGene.Diabetes mellitus; Emirati population; FTO; Fat mass and obesity-associated protein gene; HOMA; Insulin resistance; Metabolic syndrome; Obesity; Overweight; rs9930506; rs9939609Insulin resistance10https//www.ncbi.nlm.nih.gov/pubmed/302736622019The FTO rs9939609 A allele is associated with impaired fasting glucose and insulin resistance in Emirati population.0x01000BE60DE9C7F7DF4B8EA8A830051652C8
Recessive pediatric-onset cone-rod dysfunction or dominant maculopathy in a consanguineous family harboring the peripherin mutation p.Arg220Gln.PURPOSE Heterozygous peripherin mutation is associated with a wide range of typically adult-onset retinal phenotypes which can include asymptomatic maculopathy. There are few reports of biallelic peripherin mutations, only one of which detailed the ophthalmic phenotype. This report documents the retinal phenotype associated with homozygosity for a known peripherin mutation (c.659G>A; p.Arg220Gln), highlights its similar appearance to what was described in the one previous report, and shows how examination of family members can be useful in genetic diagnosis. METHODS Retrospective case series. RESULTS A 13-year-old Emirati boy was referred for low vision. The parents felt he was blind at birth but noted improvement with time. Retinal examination was significant for central macula horizontal ovoid discoloration as was documented for young adults with homozygous peripherin mutations in the one previous report. Electroretinography revealed cone-rod dysfunction. Both asymptomatic parents were examined and found to have central macular abnormalities. Sanger sequencing of peripherin based on clinical features uncovered the pathogenic variant c.659G>A; p.Arg22Gln (NM_000322.4) in homozygosity in the child and in heterozygosity in each parent. Exome sequencing in the child excluded pathologic variants in other retinal dystrophy genes. CONCLUSIONS The experience with this family highlights clinical features suggestive for biallelic peripherin mutations, documents cone-rod dysfunction as associated with homozygosity for the p.Arg220Gln peripherin mutation, and is an example of how examination of family members can help to guide genetic testing.Khan AOPURPOSE Heterozygous peripherin mutation is associated with a wide range of typically adult-onset retinal phenotypes which can include asymptomatic maculopathy. There are few reports of biallelic peripherin mutations, only one of which detailed the ophthalmic phenotype. This report documents the retinal phenotype associated with homozygosity for a known peripherin mutation (c.659G>A; p.Arg220Gln), highlights its similar appearance to what was described in the one previous report, and shows how examination of family members can be useful in genetic diagnosis. METHODS Retrospective case series. RESULTS A 13-year-old Emirati boy was referred for low vision. The parents felt he was blind at birth but noted improvement with time. Retinal examination was significant for central macula horizontal ovoid discoloration as was documented for young adults with homozygous peripherin mutations in the one previous report. Electroretinography revealed cone-rod dysfunction. Both asymptomatic parents were examined and found to have central macular abnormalities. Sanger sequencing of peripherin based on clinical features uncovered the pathogenic variant c.659G>A; p.Arg22Gln (NM_000322.4) in homozygosity in the child and in heterozygosity in each parent. Exome sequencing in the child excluded pathologic variants in other retinal dystrophy genes. CONCLUSIONS The experience with this family highlights clinical features suggestive for biallelic peripherin mutations, documents cone-rod dysfunction as associated with homozygosity for the p.Arg220Gln peripherin mutation, and is an example of how examination of family members can help to guide genetic testing. Khan AO Cleveland Clinic, Abu Dhabi Cone-rod; peripherin; recessive Ophthalmic Genet.Cleveland Clinic, Abu DhabiOphthalmic Genet.Cone-rod; peripherin; recessiveMutation40(1)https//www.ncbi.nlm.nih.gov/pubmed/308222352019Recessive pediatric-onset cone-rod dysfunction or dominant maculopathy in a consanguineous family harboring the peripherin mutation p.Arg220Gln.0x01000BE60DE9C7F7DF4B8EA8A830051652C8

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