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Genes encoding KIRs vary in frequency among different populations and ethnic groups. This study investigated the KIR gene frequency distribution in 148 healthy unrelated Saudi subjects and compared the results with other published findings. All inhibitory and activating KIR genes were present at variable frequencies, with A haplotype-associated genes (KIR2DL1, -2DL3, -3DL1, and KIR2DS4) being observed at higher frequencies (88.9-99.5%) than B haplotype-associated genes (KIR2DS1, -2DS2, -2DS3, -2DS5, -2DL5 and -2DL2) (31.1-70.1%). Thirty-one different KIR genotypes were observed, and AA genotypes displayed the highest frequency (18.2%). This Saudi population possesses similar KIR gene distributional characteristics to those reported in other neighboring populations (e.g., Lebanese) and shows disparities in certain genes and gene contents from other populations (e.g., Australian Aborigines). These findings can be used as a reference control in future studies evaluating the functional significance of the KIR genes and their associations with specific diseases. © 2014 American Society for Histocompatibility and Immunogenetics.

Background\ud \ud Current evidence suggests that inhaled glucocorticoids (IGC) have a more profound topical none genomic effect on bronchial airways as compared to systemic glucocorticoids. The value of adding IGC to current therapy of acute asthma is not well established.\ud Methods\ud \ud We conducted a double-blind, randomized, two-arm, parallel groups, controlled clinical trial to compare the addition of budesonide 1500 mcg or placebo (normal saline) to standard acute asthma treatment (albuterol and ipratropium bromide) administered in 3 divided mixed doses within 1 hour in the emergency department (ED). Children 2-12 years of age with moderate or severe acute asthma, scoring 8-15/15 on a well-validated scoring system were included. Both groups received a single dose of prednisone 2 mg/kg/day (max. 60 mg) at the beginning of therapy. The primary outcome was admission rate within 2-4 hours from starting therapy.\ud Results\ud \ud A total of 723 children were enrolled in the study over 17 months duration, of whom 139 were allowed to re-enroll and be randomized to constitute 906 randomization assignments (458 on the treatment group and 448 on the control group); with baseline mean + SD asthma score of 10.63 + 1.73; age 5.52 + 2.76 years; 35% girls; 30.8% (16.5%) with baseline severe asthma score of ≥12 (≥ 13). Statistical Analysis plan allowed for the potential dependency in response due to reenrollments of a subset of children, using Generalized Linear Mixed Modeling (GLMM) techniques. Baseline demographic and clinical characteristics were not significantly different between the two randomized groups. Seventy-five out of 458 (16.4%) of the treatment group vs. 82/448 (18.3%) of the control group were admitted, (OR 0.85, CI: 0.59-1.23, p-value=0.39). Among the severe asthmatics with baseline score ≥13, treatment vs. placebo group, GLMM adjusted admission rate was 30% vs. 47%, indicating a 17% difference in admission rate in favor of the treatment group (adjusted OR of 0.49, CI: 0.25-0.95; p-value= 0.035) that indicated a 51% reduction in the risk of admission for the treatment vs. control group.\ud Conclusions\ud \ud Children with baseline severe asthma score ≥13 who were treated with budesonide had a significant reduction in their admission rate.

Introduction There are increasing numbers of patients who are referred for coronary artery bypass grafting (CABG) after prior percutaneous coronary intervention (PCI) due to in stent thrombosis or other coronary complications. The intent here is to characterize the risk, if any, that is associated with a prior PCI experience. Objectives To compare clinical outcomes between patients undergoing CABG with or without previous PCI. Methods This is a retrospective chart review study. Two hundred seventy eight patients underwent CABG at KING FAHAD MEDICAL CITY, KSA between January 2009 to December 2010, of whom, 60 patients had prior PCI and 218 without a previous PCI. Primary outcome measures included post CABG survival, hospital stay, post CABG inraaortic balloon, myocardial infarction, or repeat revascularization. Statistical analysis was pursed using the t-test /Wilcoxon and multiple linear regression analysis test for the continuous outcomes and the chi-square/Fisher exact test and logistic regression analysis for dichotomous outcomes. SAS version 9.3; Carey, NC, USA was used for statistical analysis. Results Overall there were 278 patients (60 in the CABG plus prior PCI group and 218 in the CABG alone group). All patients were followed up to 2 year post-CABG. All pre-CABG demographic and clinical characteristics were similar between the two groups. Overall, mean age was 59.3 years (median = 59 years); 54 (20%) females and both age and gender distributions were similar between the two groups. Mortality in the CABG alone group occurred in 6/218 patients (2.8%) compared to 2/60 (3.3%) in the CABG with prior PCI group ( p = 0.8). Sixty six (30.3%) on the CABG alone group had recent MI vs. 29/60 (49.2%) in the CABG with prior PCI, p value = 0.007. Mean + sd of hospital stay was 11.8 + 12 days on the CABG alone group vs. 13.7 + 11.6 days on the CABG with prior PCI group, p -value = 0.27. Postoperative need of inraaortic balloon occurred among 7 (11.62%) cases in the CABG alone group and among 3 cases (5.5%) in the CABG with prior PCI group, p value = 0.33. Conclusions Although the incidence of recent MI differed significantly between the two groups, no apparent differences were detected in terms of mortality, hospital stay and need for inraaortic balloon. Prospective studies as well increasing the sample size and extended follow-up are further required to validate the results.

A case-control study was conducted that involved a retrospective chart review of 181 HIV-infected women in whom cervical dysplasia had been diagnosed to examine the association between patient adherence to highly active antiretroviral therapy and the regression or stabilization of cervical dysplasia. Patient adherence to the medical regimen was evaluated using prescription refill data. Analyses of 154 case patients and 27 control patients showed that adherence to antiretroviral therapy was associated with changes in cervical dysplasia. Patients who were more adherent to treatment showed the greatest regression and the least progression of dysplasia, while those who were least adherent to treatment showed the greatest amount of progression and the least regression.

There are few reported studies on Saudi population for human leukocyte antigens (HLA) genes. We investigated allele lineages (two-digit) and haplotype frequencies of HLA-A, -B, -C, -DRB1, and -DQB1 loci in 499 healthy unrelated individuals, selected from potential bone marrow transplant (BMT) families’ donors at King Fahad Medical City (KFMC), Saudi Arabia (SA). Genotyping was performed by Sequence Specific Oligonucleotide Probe (SSOP) utilizing a Luminex-based method. Allele lineages and haplotype frequencies were evaluated along with principal component analysis (PCA) to compare findings with previously reported data on Arab related populations. A total of 18 allele lineages for HLA-A, 28 for -B, 14 for -C, 13 for -DRB1, and 5 for -DQB1 were detected. High values for linkage disequilibrium indicators were found for B:C ( D’ = 0.86599) and DRB1:DQB1 ( D’ = 0.89468) loci. Additionally, PCA results confirmed previous findings on this population, but also indicated some genetic distances from other Arab related populations. The present study helps in further investigations of this population in anthropological analysis and HLA-associated disease studies.