M. Qari - Academia.edu (original) (raw)

Papers by M. Qari

Research paper thumbnail of PB0334 Immune-Mediated Thrombotic Thrombocytopenic Purpura Landscaping in Gulf Countries: A Real-World Evidence Study (ATHENA Study)

Research and Practice in Thrombosis and Haemostasis

Research paper thumbnail of Time Sensitivity Associated with Application of HEMA-free Adhesive

Journal of Dental Health, Oral Disorders & Therapy, 2016

Background: Acetone is one of the solvents incorporated in HEMA-free dental adhesives. Since acet... more Background: Acetone is one of the solvents incorporated in HEMA-free dental adhesives. Since acetone is very sensitive with high vapor pressure, acetone-based adhesives necessitate great care and attention in handling and application. Objective: The aim of this study was to determine the optimal application time of acetonebased HEMA-free adhesive by conducting micro tensile bond strength test (MTBS) at different time intervals. Materials and methods: Twelve freshly extracted non-carious human molars were collected. Two-thirds of the roots were removed and the coronal part of the teeth was subjected to horizontal cross-sectioning in order to remove their cusps and expose the superficial coronal dentin. Then, the teeth were randomly divided into 4 groups (3 teeth each) according to the adhesive application time before curing. One-step self-etch HEMAfree adhesive (G bond; GC, Japan) and universal resin composite (Kalore; GC, Japan) were used in this study. In group (A), application of adhesive was carried out for 15sec as recommended by the manufacturer instructions. In groups (B), (C) and (D), the adhesive was applied for 30sec, 1min and 5min, respectively, before curing. After 24-hour storage in distilled water at 37°C, each tooth was cross-sectioned into micro beams and subjected to MTBS test by using a universal testing machine. Results: The tests showed statistically significant differences among the groups (P = 0.00) with each group is different from the others (P=0.00). Group A had the highest mean strength value followed by groups B, C and then D with 57.7, 41.6, 29.7 and 17.1 MPa, respectively. Conclusion: The tested adhesive might be sensitive to application time as shown by superior MTBS results when its application time lasts for 15 seconds. This might be explained by evaporation of acetone in one-step acetone-based self-etch adhesives.

Research paper thumbnail of The adequacy of anticoagulation practice in a teaching hospital

International Journal of Medical and Health Research, 2018

Background: Venous thromboembolism (VTE) is a major problem in all hospitalized patients, which c... more Background: Venous thromboembolism (VTE) is a major problem in all hospitalized patients, which can be prevented by following practice guidelines. Appropriate identification and management of patients at risk is critical in order to maintain patient safety. Aim: To determine the risk of VTE and the use of anticoagulant prophylaxis according to Caprini score for hospitalized patients at King Abdulaziz University Hospital (KAUH). Methodology: We conducted a cross-sectional study at KAUH from July to August 2017. All inpatients from medical ward (aged ≥ 40 years), surgical ward (aged ≥18 years), and obstetrics and gynecology (OB/GYN) ward were included. Patients receiving anticoagulant treatment were excluded. We used the Caprini scoring system to assess the risk of VTE and recommended regimen. Results: A total of 496 inpatients were included in the study. Of those patients, 33.3% were surgical, 31% were medical, and 35.7% were OB/GYN patients. The mean participant age was 48.62 years. The percentages of patients within the risk categories (low, moderate, high, and highest) were 7.5%, 9.7%, 25.2%, and 57.7%, respectively. Among our sample, 248 (50%) patients received VTE prophylaxis. However, 213 (42.9%) received appropriate pharmacological doses. Of the 248 (50%) patients who did not receive any prophylaxis, 5.8% were in the low-risk group, 10.1% had contraindications, while the majority (34.1%) had no obvious reason. Conclusion: The majority of the patients who were eligible for prophylaxis were managed properly. But still, there is underuse of prophylaxis in the sample as whole. Also, the implementation of mechanical prophylaxis is needed in our hospital. Keywords: VTE prophylaxis, Caprini score, anticoagulants, risk assessment

Research paper thumbnail of PB2224: Impact of COVID-19 Pandemic on Patients with Sickle Cell Disease: Results from the Real World Assessment Survey for Sickle Cell Disease in Saudi (Roars)

Research paper thumbnail of P1497: Burden of Sickle Cell Disease: Results from the Real World Assessment Survey for Sickle Cell Disease in Saudi (Roars)

Research paper thumbnail of The Safety of Avoiding Transfusion Preoperatively in Patients with Sickle Cell Hemoglobinopathies

Research paper thumbnail of The proportion of different BCR-ABL1 transcript types in chronic myeloid leukemia. An international overview

Leukemia, 2019

international, national or regional registries, and between 20.0% and 94.6% in monocentric studie... more international, national or regional registries, and between 20.0% and 94.6% in monocentric studies (4-31) (Table 1S). The reported proportion of patients co-expressing the two M-bcr transcripts (e14a2 and e13a2) ranged between 2.1% and 17.7% (Table 1S). The proportion of atypical, rare transcripts was rarely reported, ranging between 0.9% and 13.0% (Table 1S). The translation of each different RNA transcript results in different protein tyrosine kinases that can potentially affect the biologic characteristics of the disease and the response to treatment. For this reason, we planned a worldwide overview of the prevalence of BCR-ABL1 transcript types. PATIENTS and METHODS An invitation to join the study and to contribute data was sent to 201 investigators in 180 centers in Africa, Asia, Australia, Europe, North America, and South America. The investigators were selected on personal basis, or as first or senior authors of clinical papers on CML published in the period 2000 to 2016. One hundred and thirteen centers (63% of those invited) contributed data, nine from Africa

Research paper thumbnail of Tinzaparin vs Warfarin for Treatment of Acute Venous Thromboembolism in Patients With Active Cancer

JAMA, 2015

Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous throm... more Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous thromboembolism (VTE) in patients with active cancer largely based on results of a single, large trial. OBJECTIVE To study the efficacy and safety of tinzaparin vs warfarin for treatment of acute, symptomatic VTE in patients with active cancer. DESIGN, SETTINGS, AND PARTICIPANTS A randomized, open-label study with blinded central adjudication of study outcomes enrolled patients in 164 centers in Asia, Africa, Europe, and North, Central, and South America between August 2010 and November 2013. Adult patients with active cancer (defined as histologic diagnosis of cancer and receiving anticancer therapy or diagnosed with, or received such therapy, within the previous 6 months) and objectively documented proximal deep vein thrombosis (DVT) or pulmonary embolism, with a life expectancy greater than 6 months and without contraindications for anticoagulation, were followed up for 180 days and for 30 days after the last study medication dose for collection of safety data. INTERVENTIONS Tinzaparin (175 IU/kg) once daily for 6 months vs conventional therapy with tinzaparin (175 IU/kg) once daily for 5 to 10 days followed by warfarin at a dose adjusted to maintain the international normalized ratio within the therapeutic range (2.0-3.0) for 6 months. MAIN OUTCOMES AND MEASURES Primary efficacy outcome was a composite of centrally adjudicated recurrent DVT, fatal or nonfatal pulmonary embolism, and incidental VTE. Safety outcomes included major bleeding, clinically relevant nonmajor bleeding, and overall mortality. RESULTS Nine hundred patients were randomized and included in intention-to-treat efficacy and safety analyses. Recurrent VTE occurred in 31 of 449 patients treated with tinzaparin and 45 of 451 patients treated with warfarin (6-month cumulative incidence, 7.2% for tinzaparin vs 10.5% for warfarin; hazard ratio [HR], 0.65 [95% CI, 0.41-1.03]; P = .07). There were no differences in major bleeding (12 patients for tinzaparin vs 11 patients for warfarin; HR, 0.89 [95% CI, 0.40-1.99]; P = .77) or overall mortality (150 patients for tinzaparin vs 138 patients for warfarin; HR, 1.08 [95% CI, 0.85-1.36]; P = .54). A significant reduction in clinically relevant nonmajor bleeding was observed with tinzaparin (49 of 449 patients for tinzaparin vs 69 of 451 patients for warfarin; HR, 0.58 [95% CI, 0.40-0.84]; P = .004). CONCLUSIONS AND RELEVANCE Among patients with active cancer and acute symptomatic VTE, the use of full-dose tinzaparin (175 IU/kg) daily compared with warfarin for 6 months did not significantly reduce the composite measure of recurrent VTE and was not associated with reductions in overall mortality or major bleeding, but was associated with a lower rate of clinically relevant nonmajor bleeding. Further studies are needed to assess whether the efficacy outcomes would be different in patients at higher risk of recurrent VTE.

Research paper thumbnail of Paroxysmal nocturnal hemoglobinuria: Diagnosis and management protocol

Journal of Applied Hematology, 2014

ABSTRACT Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, rare clonal blood disorder, ch... more ABSTRACT Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, rare clonal blood disorder, characterized by chronic intravascular hemolysis, bone marrow failure, renal failure and pulmonary hypertension, and a heightened risk of thrombotic complications. PNH etiology is an Х-linked gene somatic mutation of the phosphatidylinositol glycan class А (PIG‑A), that results in deficiency of the glycosylphosphatidylinositol anchor structure responsible for fixing a wide spectrum of proteins on blood cell membranes, absence of these proteins, particularly CD55 and CD59, dysregulates the complement on cell membranes and results in significant chronic complement-mediated hemolysis. Early diagnosis of PNH is crucial for effective disease management. However, the heterogeneity of clinical symptoms and rarity of this disease usually results in untimely diagnosis, severe disability of patients, and increased risk of fatal complication. These recommendations are formulated by a panel of experts from the gulf cooperation countries. This information reflects their experience and to assist specialists looking after PNH patients, including hematologists, nephrologists, dialysis specialists, gastroenterologists, cardiologists, and surgeons.

Research paper thumbnail of Association between vitamin D receptor gene polymorphism and psoriasis among the Turkish population

Archives of Dermatological Research, 2002

Research paper thumbnail of Regional consensus opinion for the management of Beta thalassemia major in the Arabian Gulf area

Orphanet Journal of Rare Diseases, 2013

Thalassemia syndrome has diverse clinical presentations and a global spread that has far exceeded... more Thalassemia syndrome has diverse clinical presentations and a global spread that has far exceeded the classical Mediterranean basin where the mutations arose. The mutations that give rise to either alpha or beta thalassemia are numerous, resulting in a wide spectrum of clinical severity ranging from carrier state to life-threatening, inherited hemolytic anemia that requires regular blood transfusion. Beta thalassemia major constitutes a remarkable challenge to health care providers. The complications arising due to the anemia, transfusional iron overload, as well as other therapy-related complications add to the complexity of this condition. To produce this consensus opinion manuscript, a PubMed search was performed to gather evidence-based original articles, review articles, as well as published work reflecting the experience of physicians and scientists in the Arabian Gulf region in an effort to standardize the management protocol.

Research paper thumbnail of Guidelines for Diagnosis and Treatment of Deep Venous Thrombosis and Pulmonary Embolism

Anticoagulants, Antiplatelets, and Thrombolytics

Considerable progress has been made in the understanding of the risk factors for venous thromboem... more Considerable progress has been made in the understanding of the risk factors for venous thromboembolism (VTE). The clinical applications of molecular techniques have allowed identification of important inherited, yet not uncommon, risk factors for VTE, such as mutations that cause Factor V Leiden and prothrombin G20210A. However, advances in our understanding have raised several questions regarding the need for, and duration of anticoagulation. At the end of the treatment period, low molecular weight heparins have become the drugs of choice and standard-ofcare for VTE. In this review, cost effective diagnostic approaches for patients with suspected deep vein thrombosis, and recommended treatment options using evidence-based approaches, are described.

Research paper thumbnail of The use of fresh frozen plasma for reproduction in severe factor V deficiency

Clinical and experimental obstetrics & gynecology, 2015

OBJECTIVE Severe factor V (FV) deficiency is rare. There are case reports describing pregnancy ou... more OBJECTIVE Severe factor V (FV) deficiency is rare. There are case reports describing pregnancy outcomes in women with FV deficiency and one case report of successful pregnancy following the use of fresh frozen plasma (FFP) in several cycles of ovulation induction and intrauterine insemination and at delivery. The authors report another case to support the use of FFP for reproduction. CASE A 27-year-old woman with severe FV deficiency was given FFP at the time of ovulation induced with clomiphene citrate, human menopausal gonadotropin (hMG), and human chorionic gonadotropin. Intrauterine insemination (IUI) was done 35 hours later. She became pregnant with twins and delivered vaginally at 36 weeks of gestation with the prophylactic use of FFP. CONCLUSION Fresh frozen plasma can be offered for reproduction to women with severe FV deficiency.

Research paper thumbnail of Association of serum asymmetric dimethyl-arginine and troponin I levels as a risk of myocardial infarction in thalassemia

African Health Sciences

Background: The current study evaluated level of serum asymmetric dimethylarginine (ADMA) and its... more Background: The current study evaluated level of serum asymmetric dimethylarginine (ADMA) and its association to cardiac biomarkers in thalassemia patients for early diagnosis of abnormality in myocardial infarction. Subjects and methods: This study was conducted on 80 subjects divided into four groups each with 20 subjects. Group I: Control: healthy subjects. Group II: Myocardial infarction: Patients with elevated serum troponin T. Group III: thalassemia patients. Group IV: thalassemia with myocardial infarction patients: Included 20 thalassemia patients with Myocardial infarction. Serum samples were subjected for assay of creatine kinase (CK:MB), Lactate dehydrogenase, troponin I ,ADMA, Serum MDA level was determined. Results: Data obtained showed that serum CKMB, LDH1, AST, Troponin T and ADMA levels were significant elevated in MI with or without Thalassemia compared with control groups. Serum MDA was statistically significantly elevated in MI with or without Thalassemia compared with control groups. The serum level of troponin T showed an area under curve (AUC) of 0.92 ,(sensitivity 91.0 % and specificity, 88%). Also, the ADMA supported the diagnostic profile, showing an AUC of 0.85 with (sensitivity, 92.0%; specificity, 91,9%). Conclusion: Serum ADMA is sensitive marker for incidence of MI in thalassemia patients.

Research paper thumbnail of Serum proteins C and S levels as early biomarkers for kidney dysfunction in hemophilic patients

African Health Sciences

Background: Hemophilia is an inherited genetic disease characterized by the inability to coagulat... more Background: Hemophilia is an inherited genetic disease characterized by the inability to coagulate blood after injury. The rationale of the current study was to evaluate serum proteins S and C and correlate to kidney function test in hemophilic patients for early diagnosis of abnormality in renal function. Subjects and Methods: This study was conducted on 80 males subjects divided into four groups. Group I: Control: Healthy subjects. Group II: Renal dysfunction (serum Creatinine >2mg/dl): Group III: Hemophilic patients. Group IV: Hemophilic patients with renal disorder. Serum urea, creatinine, sodium, potassium, protein C and protein S level were determined. Resuts: Protein C and S levels showed a significant decrease in hemophilic/and with renal dysfunction (P < 0.001,p<0.001). The level of plasma protein C and S levels were positively correlated with increased urinary albumin (P < 0.01). Urinary albumin was increased about 15 folds in hemophilic patients with renal dysfunction and nephrotic patients as compared with the control group. The cutoff value in 90% patients at the hemophilic patients with renal dysfunction 70%. Positive correlations were observed between urinary albumin (r=0.66), and creatinine (r=0.73). Conclusion: These biomarkers showed good predictive values with regard to ROC-AUC (0.41 and 0.75 for Proteins C and S, respectively).

Research paper thumbnail of IOF Regionals – 3rd Middle East & Africa Osteoporosis Meeting

Osteoporosis International

Aims: To determine the relationship of 25-hydroxyvitamin D (25(OH)D) serum concentration with acu... more Aims: To determine the relationship of 25-hydroxyvitamin D (25(OH)D) serum concentration with acute coronary syndrome (ACS) with review on subgroup of diabetic patients. Methods: 60 patients age between 30 and 70 year treated for ACS: STEMI and NSTE-ACS at General Hospital in Slavonski Brod, Croatia, and 60 control subjects free from ACS including DM, obesity, smoking, hypertension, and hyperlipidemia, as a control. All routine laboratory tests and plasma PTH and 25(OH)D done. Analysis was performed by use of the SPSS for Windows 11.0.3 software (SPSS Inc., Chicago, IL, USA). p<0.05. Results: The ACS group included 36 (60 %) patients with STEMI and 24 (40 %) patients with NSTEMI-ACS. Serum levels of 25(OH)D: 35.19±17.54 nmol/L in ACS patients was statistically significantly lower than in controls: 58.08± 16.29 nmol/L, ACS patients had three subgroups regarding coronary disease severity: single(SVCAD) (n=39; 68 %), double (DVCAD) (n=15; 26 %) and multiple vessel disease (MVCAD) (n=3; 6 %) and they had 25(OH)D serum levels of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L, respectively. Statistically significantly was higher rate of vitamin D insufficiency among ACS patients as compared with the control group, Vitamin D deficiency was recorded in as many as 20% of ACS patients and none of control subjects. In the ACS group, patients with DM female (F) (n=9, 40 %) and male (M) (n=13, 60 %) had the lowest mean 25(OH)D concentration of 30.45±15.05 mmol/L in comparison to all subgroups. A similar tendency toward a lower mean 25(OH)D level of 46.60±19.26 mmol/L in DM patients was also recorded in the control group, and this difference was statistically significant. In diabetic group we found STEMI (N=14;64 %)+NSTEMI (n=8;36 %) and SVCAD (n=15;68 %)+DVCAD (n=6; 27 %)+MVCAD (n=1;5 %). Conclusion: Patients with diabetes had significantly low levels of vitamin D3 in ACS. Is it an accidental finding or a distorted reflection of atherogenesis due to low levels of vitamin D in diabetes? Perhaps low vitamin D levels only increase atherogenicity and become one of the triggers for the development of ACS. Studies are needed to confirm the need for the normal level of vitamin D for prevention of ACS. Perhaps it is necessary to pay more attention to the level of vitamin D3 in diabetics. References: 1 Zittermann A et al., Am J Clin Nutr 2012;95:91. 2.von Essen MR et al., Nat Immunol 2010;11:344.

Research paper thumbnail of Bone turnover markers, glucose and lipid metabolism in relation to atherosclerosis in type-2 diabetic patients: a longitudinal study

Bone, 2012

Background: Bone metabolism is affected by risk factors of atherosclerosis and hyperglycemia indu... more Background: Bone metabolism is affected by risk factors of atherosclerosis and hyperglycemia induced low bone turnover with osteoblastic dysfunction. Limited information is available on the relationship between bone turnover markers (BTMs) and atherosclerosis or its related risk factors in patients with Type-2 diabetes mellitus (T2DM). Methods: A total of 135 patients (men=62; women=73) (age≥50 years) with poorly controlled T2DM [indicated by haemoglobin-A1c (HbA1c)] were followed-up over 12 months during glycemic control evaluation. Each patient (at baseline and visits on 3, 6, 9 and 12 months) provided fasting blood sample and second-void morning urine samples for the measurements of BTMs [serum osteocalcin (s-OC), bone alkaline phosphatase (s-bone ALP), procollagen type 1 Nterminal propeptide (s-PINP), crosslinked C-terminal telopeptide of type 1 collagen (sCTX), tartarate-resistance acid phosphatase isoform 5b (s-TRACP-5b) and urinary Ntelopeptide of type 1 collagen (u-NTX)]. Various hormones, HbA1c; lipids, glucose and creatinine were measured. Bone mineral density was determined at baseline visit and at 12-month visit. Also, the plaque score (PS) was calculated. Results: Multiple regression analysis showed that changes in s-OC were negatively correlated with HbA1c (r=-0.46, Pb0.001). Baseline s-OC levels were negatively correlated with changes in triglyceride levels (r=-0.37, Pb0.001) and positively with high-density lipoprotein-cholesterol (HDL-c) (r=0.44, Pb0.001). Changes in s-OC correlated positively with baseline PS (r=0.49, Pb0.001) and negatively with changes in PS (r=-0.41, Pb0.001) independent of other potential atherosclerosis risk factors. Conclusions: Association between s-OC with glucose, lipid metabolic indicators and PS independently of other atherosclerosis-related risk factors in patients with T2DM. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None Declared. doi:10.1016/j.bone.2012.02.442 PP254 Volumetric bone mineral density (vbmd) at tibia site and vitamin d status in premenopausal south asian and caucasian women O.A. Hakim⁎, A. Darling, K. Hart, J.L. Berry, S. Lanham-New Nutrition, University of Surrey, Guildford, UK Vitamin D Research Group, University of Manchester, Manchester, UK Abstract: Recent studies indicate thatwomenof European origin have higher areal bone mineral density (BMD) than South Asianwomen. However this has been explained by ethnic variation in bone size [1]. Few data exist on true volumetric BMD in premenopausal South Asianwomen and nodata is available at the tibia site. As part of theD-FINES (VitaminD, Food Intake,Nutrition andExposure to Sunlight in SouthernEngland) study,which investigates the interaction betweendiet and sunlight exposure and vitaminD status,we aimed to investigate differences in volumetric bone mineral density (vBMD) between South Asian (SA) and Caucasian (C)womenat the tibia and determine if there is an association betweenvBMDand serum 25(OH)D. Thirty five healthy premenopausal women (21 C and 14 SA), age ranges 1855 yrs, were scanned by peripheral Quantitative Computed Tomography (pQCT) at the tibia (non-dominant) using a Stratec XCT 2000 pQCT machine. Fasted blood samples were Recent studies indicate thatwomenof European origin have higher areal bone mineral density (BMD) than South Asianwomen. However this has been explained by ethnic variation in bone size [1]. Few data exist on true volumetric BMD in premenopausal South Asianwomen and nodata is available at the tibia site. As part of theD-FINES (VitaminD, Food Intake,Nutrition andExposure to Sunlight in SouthernEngland) study,which investigates the interaction betweendiet and sunlight exposure and vitaminD status,we aimed to investigate differences in volumetric bone mineral density (vBMD) between South Asian (SA) and Caucasian (C)womenat the tibia and determine if there is an association betweenvBMDand serum 25(OH)D. Thirty five healthy premenopausal women (21 C and 14 SA), age ranges 1855 yrs, were scanned by peripheral Quantitative Computed Tomography (pQCT) at the tibia (non-dominant) using a Stratec XCT 2000 pQCT machine. Fasted blood samples were collected for vitamin D analysis. SA women were significantly shorter (pb0.001), and slightly heavier than C women; Therefore SA had significantly higher BMI (pb0.05) than C women. SA women had significantly lower 25(OH)D concentration than C women (pb0.001) with mean values of 31.53[16.32] and 80.91[20.08] (nmol/l) respectively. SA women had significantly smaller bone size and higher vBMD than C women (pb0.05) for total, trabecular, and cortical bone at the 4% site. SA women had significantly lower total vBMD at 14% site (pb0.05) and the 38% site (pb0.01) than Caucasians. SA had significantly lower cortical density at site 14% than Caucasians (pb0.05).This was also lower at the 38% site but this was not statistically significant. There was a trend for a negative association between 25(OH)D and…

Research paper thumbnail of Serum sclerostin levels and the risk of osteoporotic fractures: The Ceor study

Research paper thumbnail of Clinically relevant bleeding in cancer patients treated for venous thromboembolism from the CATCH study

Journal of Thrombosis and Haemostasis

Research paper thumbnail of Bone turnover markers and the prediction of osteoporosis-related fractures among postmenopausal women

Bone, 2012

Background: Anemia [hemoglobin (Hb) levelb12 g/dL] is common in the elderly and low Hb levels are... more Background: Anemia [hemoglobin (Hb) levelb12 g/dL] is common in the elderly and low Hb levels are associated with low bone mass. The present population-based, prospective study examined whether anemia predicts nonvertebral fractures among postmenopausal women. Methods: We examined the association of anemia and non-vertebral fracture risk in 985 postmenopausal women in a population-based study with a mean follow-up period of 6.3±1.4 years. Multivariate Cox proportional-hazards regression models were used to analyze risk, adjusted for age, body-mass index, and other confounding risk factors. Measurements of Hb, mean corpuscular volume, blood pressure, blood lipids, serum creatinine, and bone mineral density by dual X-ray absorptiometry and questionnaire information on smoking habits, physical activity, prevalent diseases, and use of medications were collected at baseline and follow-up visits. Results: A total of 173 women sustained non-vertebral fractures. One SD lower levels of Hb were associated with a 1.32 higher risk of fracture in women studied (Pb0.001, after multiple adjustments). Women with anemia (Hb levelsb12 g/dL) had a 2.22 higher risk of ORFs than women with the highest quartile of Hb levels. Conclusions: Anemia is associated with non-vertebral fractures in postmenopausal women. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared. doi:10.1016/j.bone.2012.02.439 PP251 Serum osteocalcin is associated with insulin sensitivity and secretion in postmenopausal women with type-2 diabetes mellitus M.-S.M. Ardawi⁎, A.A. Rouzi, D.H. Akbar, A.A. AlShaikh, M.M. Ahmed, S.M. Bahlas, M.H. Qari Department of Clinical Biochemistry, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Department of Obstetrics and Gynecology, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Department of Internal Medicine, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Department of Haematology, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Abstract: Background: Animal studies showed that osteocalcin (OC) stimulated the expression of insulin islets and of adiponectin in adipocytes with elevated insulin secretion and sensitivity. Limited information is available on the relationship between OC, insulin sensitivity and secretion among postmenopausal women with Type 2 diabetes mellitus (T2DM). Methods: A total of 395 postmenopausal women (≥ 50 years) with T2DM were studied cross-sectionally. Also, we examined the response to 75 g oral glucose tolerance test (OGTT) in 42 postmenopausal women Background: Animal studies showed that osteocalcin (OC) stimulated the expression of insulin islets and of adiponectin in adipocytes with elevated insulin secretion and sensitivity. Limited information is available on the relationship between OC, insulin sensitivity and secretion among postmenopausal women with Type 2 diabetes mellitus (T2DM). Methods: A total of 395 postmenopausal women (≥ 50 years) with T2DM were studied cross-sectionally. Also, we examined the response to 75 g oral glucose tolerance test (OGTT) in 42 postmenopausal women with T2DM. Bone turnover markers (BTMs), [serum OC (s-OC), bone alkaline phosphatase (s-bone ALP), procollagen type 1 N-terminal propeptide (s-PINP), crosslinked C-terminal telopeptide of Type 1 collagen (s-CTX), tartarate-resistant acid phosphatase isoform 5b (s-TRACP-5b) and urinary N-telopeptides of type 1 collagen (u-NTX)], serum adiponectin, blood glucose, blood haemoglobin A1c (HbA1c), insulin and body fat were measured. Results: Multiple regression analysis adjusted for age, body mass index (BMI) and other confounders showed that s-OC levels negatively associated with plasma glucose, HbA1c, % trunk fat and insulin resistance, (Pb0.001) and positively with beta-cell function (Pb0.001). Marked positive association between s-OC and serum adiponectin levels were observed (Pb0.001). In the OGTT evaluation study, women divided into tertiles of s-OC, showed that those in the lowest tertile exhibited hyperglycemia and hyperinsulinemia vs those in the highest tertile following OGTT (Pb0.001). Conclusions: Serum OC levels are positively associated with insulin sensitivity and secretion among postmenopausal women with T2DM. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None Declared. doi:10.1016/j.bone.2012.02.440 PP252 Bone turnover markers and the prediction of osteoporosis-related fractures among postmenopausal women M.-S.M. Ardawi⁎, A.A. Rouzi, S.A. Al-Sibiani, N.S. Al-Senani, M.H. Qari Department of Clinical…

Research paper thumbnail of PB0334 Immune-Mediated Thrombotic Thrombocytopenic Purpura Landscaping in Gulf Countries: A Real-World Evidence Study (ATHENA Study)

Research and Practice in Thrombosis and Haemostasis

Research paper thumbnail of Time Sensitivity Associated with Application of HEMA-free Adhesive

Journal of Dental Health, Oral Disorders & Therapy, 2016

Background: Acetone is one of the solvents incorporated in HEMA-free dental adhesives. Since acet... more Background: Acetone is one of the solvents incorporated in HEMA-free dental adhesives. Since acetone is very sensitive with high vapor pressure, acetone-based adhesives necessitate great care and attention in handling and application. Objective: The aim of this study was to determine the optimal application time of acetonebased HEMA-free adhesive by conducting micro tensile bond strength test (MTBS) at different time intervals. Materials and methods: Twelve freshly extracted non-carious human molars were collected. Two-thirds of the roots were removed and the coronal part of the teeth was subjected to horizontal cross-sectioning in order to remove their cusps and expose the superficial coronal dentin. Then, the teeth were randomly divided into 4 groups (3 teeth each) according to the adhesive application time before curing. One-step self-etch HEMAfree adhesive (G bond; GC, Japan) and universal resin composite (Kalore; GC, Japan) were used in this study. In group (A), application of adhesive was carried out for 15sec as recommended by the manufacturer instructions. In groups (B), (C) and (D), the adhesive was applied for 30sec, 1min and 5min, respectively, before curing. After 24-hour storage in distilled water at 37°C, each tooth was cross-sectioned into micro beams and subjected to MTBS test by using a universal testing machine. Results: The tests showed statistically significant differences among the groups (P = 0.00) with each group is different from the others (P=0.00). Group A had the highest mean strength value followed by groups B, C and then D with 57.7, 41.6, 29.7 and 17.1 MPa, respectively. Conclusion: The tested adhesive might be sensitive to application time as shown by superior MTBS results when its application time lasts for 15 seconds. This might be explained by evaporation of acetone in one-step acetone-based self-etch adhesives.

Research paper thumbnail of The adequacy of anticoagulation practice in a teaching hospital

International Journal of Medical and Health Research, 2018

Background: Venous thromboembolism (VTE) is a major problem in all hospitalized patients, which c... more Background: Venous thromboembolism (VTE) is a major problem in all hospitalized patients, which can be prevented by following practice guidelines. Appropriate identification and management of patients at risk is critical in order to maintain patient safety. Aim: To determine the risk of VTE and the use of anticoagulant prophylaxis according to Caprini score for hospitalized patients at King Abdulaziz University Hospital (KAUH). Methodology: We conducted a cross-sectional study at KAUH from July to August 2017. All inpatients from medical ward (aged ≥ 40 years), surgical ward (aged ≥18 years), and obstetrics and gynecology (OB/GYN) ward were included. Patients receiving anticoagulant treatment were excluded. We used the Caprini scoring system to assess the risk of VTE and recommended regimen. Results: A total of 496 inpatients were included in the study. Of those patients, 33.3% were surgical, 31% were medical, and 35.7% were OB/GYN patients. The mean participant age was 48.62 years. The percentages of patients within the risk categories (low, moderate, high, and highest) were 7.5%, 9.7%, 25.2%, and 57.7%, respectively. Among our sample, 248 (50%) patients received VTE prophylaxis. However, 213 (42.9%) received appropriate pharmacological doses. Of the 248 (50%) patients who did not receive any prophylaxis, 5.8% were in the low-risk group, 10.1% had contraindications, while the majority (34.1%) had no obvious reason. Conclusion: The majority of the patients who were eligible for prophylaxis were managed properly. But still, there is underuse of prophylaxis in the sample as whole. Also, the implementation of mechanical prophylaxis is needed in our hospital. Keywords: VTE prophylaxis, Caprini score, anticoagulants, risk assessment

Research paper thumbnail of PB2224: Impact of COVID-19 Pandemic on Patients with Sickle Cell Disease: Results from the Real World Assessment Survey for Sickle Cell Disease in Saudi (Roars)

Research paper thumbnail of P1497: Burden of Sickle Cell Disease: Results from the Real World Assessment Survey for Sickle Cell Disease in Saudi (Roars)

Research paper thumbnail of The Safety of Avoiding Transfusion Preoperatively in Patients with Sickle Cell Hemoglobinopathies

Research paper thumbnail of The proportion of different BCR-ABL1 transcript types in chronic myeloid leukemia. An international overview

Leukemia, 2019

international, national or regional registries, and between 20.0% and 94.6% in monocentric studie... more international, national or regional registries, and between 20.0% and 94.6% in monocentric studies (4-31) (Table 1S). The reported proportion of patients co-expressing the two M-bcr transcripts (e14a2 and e13a2) ranged between 2.1% and 17.7% (Table 1S). The proportion of atypical, rare transcripts was rarely reported, ranging between 0.9% and 13.0% (Table 1S). The translation of each different RNA transcript results in different protein tyrosine kinases that can potentially affect the biologic characteristics of the disease and the response to treatment. For this reason, we planned a worldwide overview of the prevalence of BCR-ABL1 transcript types. PATIENTS and METHODS An invitation to join the study and to contribute data was sent to 201 investigators in 180 centers in Africa, Asia, Australia, Europe, North America, and South America. The investigators were selected on personal basis, or as first or senior authors of clinical papers on CML published in the period 2000 to 2016. One hundred and thirteen centers (63% of those invited) contributed data, nine from Africa

Research paper thumbnail of Tinzaparin vs Warfarin for Treatment of Acute Venous Thromboembolism in Patients With Active Cancer

JAMA, 2015

Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous throm... more Low-molecular-weight heparin is recommended over warfarin for the treatment of acute venous thromboembolism (VTE) in patients with active cancer largely based on results of a single, large trial. OBJECTIVE To study the efficacy and safety of tinzaparin vs warfarin for treatment of acute, symptomatic VTE in patients with active cancer. DESIGN, SETTINGS, AND PARTICIPANTS A randomized, open-label study with blinded central adjudication of study outcomes enrolled patients in 164 centers in Asia, Africa, Europe, and North, Central, and South America between August 2010 and November 2013. Adult patients with active cancer (defined as histologic diagnosis of cancer and receiving anticancer therapy or diagnosed with, or received such therapy, within the previous 6 months) and objectively documented proximal deep vein thrombosis (DVT) or pulmonary embolism, with a life expectancy greater than 6 months and without contraindications for anticoagulation, were followed up for 180 days and for 30 days after the last study medication dose for collection of safety data. INTERVENTIONS Tinzaparin (175 IU/kg) once daily for 6 months vs conventional therapy with tinzaparin (175 IU/kg) once daily for 5 to 10 days followed by warfarin at a dose adjusted to maintain the international normalized ratio within the therapeutic range (2.0-3.0) for 6 months. MAIN OUTCOMES AND MEASURES Primary efficacy outcome was a composite of centrally adjudicated recurrent DVT, fatal or nonfatal pulmonary embolism, and incidental VTE. Safety outcomes included major bleeding, clinically relevant nonmajor bleeding, and overall mortality. RESULTS Nine hundred patients were randomized and included in intention-to-treat efficacy and safety analyses. Recurrent VTE occurred in 31 of 449 patients treated with tinzaparin and 45 of 451 patients treated with warfarin (6-month cumulative incidence, 7.2% for tinzaparin vs 10.5% for warfarin; hazard ratio [HR], 0.65 [95% CI, 0.41-1.03]; P = .07). There were no differences in major bleeding (12 patients for tinzaparin vs 11 patients for warfarin; HR, 0.89 [95% CI, 0.40-1.99]; P = .77) or overall mortality (150 patients for tinzaparin vs 138 patients for warfarin; HR, 1.08 [95% CI, 0.85-1.36]; P = .54). A significant reduction in clinically relevant nonmajor bleeding was observed with tinzaparin (49 of 449 patients for tinzaparin vs 69 of 451 patients for warfarin; HR, 0.58 [95% CI, 0.40-0.84]; P = .004). CONCLUSIONS AND RELEVANCE Among patients with active cancer and acute symptomatic VTE, the use of full-dose tinzaparin (175 IU/kg) daily compared with warfarin for 6 months did not significantly reduce the composite measure of recurrent VTE and was not associated with reductions in overall mortality or major bleeding, but was associated with a lower rate of clinically relevant nonmajor bleeding. Further studies are needed to assess whether the efficacy outcomes would be different in patients at higher risk of recurrent VTE.

Research paper thumbnail of Paroxysmal nocturnal hemoglobinuria: Diagnosis and management protocol

Journal of Applied Hematology, 2014

ABSTRACT Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, rare clonal blood disorder, ch... more ABSTRACT Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired, rare clonal blood disorder, characterized by chronic intravascular hemolysis, bone marrow failure, renal failure and pulmonary hypertension, and a heightened risk of thrombotic complications. PNH etiology is an Х-linked gene somatic mutation of the phosphatidylinositol glycan class А (PIG‑A), that results in deficiency of the glycosylphosphatidylinositol anchor structure responsible for fixing a wide spectrum of proteins on blood cell membranes, absence of these proteins, particularly CD55 and CD59, dysregulates the complement on cell membranes and results in significant chronic complement-mediated hemolysis. Early diagnosis of PNH is crucial for effective disease management. However, the heterogeneity of clinical symptoms and rarity of this disease usually results in untimely diagnosis, severe disability of patients, and increased risk of fatal complication. These recommendations are formulated by a panel of experts from the gulf cooperation countries. This information reflects their experience and to assist specialists looking after PNH patients, including hematologists, nephrologists, dialysis specialists, gastroenterologists, cardiologists, and surgeons.

Research paper thumbnail of Association between vitamin D receptor gene polymorphism and psoriasis among the Turkish population

Archives of Dermatological Research, 2002

Research paper thumbnail of Regional consensus opinion for the management of Beta thalassemia major in the Arabian Gulf area

Orphanet Journal of Rare Diseases, 2013

Thalassemia syndrome has diverse clinical presentations and a global spread that has far exceeded... more Thalassemia syndrome has diverse clinical presentations and a global spread that has far exceeded the classical Mediterranean basin where the mutations arose. The mutations that give rise to either alpha or beta thalassemia are numerous, resulting in a wide spectrum of clinical severity ranging from carrier state to life-threatening, inherited hemolytic anemia that requires regular blood transfusion. Beta thalassemia major constitutes a remarkable challenge to health care providers. The complications arising due to the anemia, transfusional iron overload, as well as other therapy-related complications add to the complexity of this condition. To produce this consensus opinion manuscript, a PubMed search was performed to gather evidence-based original articles, review articles, as well as published work reflecting the experience of physicians and scientists in the Arabian Gulf region in an effort to standardize the management protocol.

Research paper thumbnail of Guidelines for Diagnosis and Treatment of Deep Venous Thrombosis and Pulmonary Embolism

Anticoagulants, Antiplatelets, and Thrombolytics

Considerable progress has been made in the understanding of the risk factors for venous thromboem... more Considerable progress has been made in the understanding of the risk factors for venous thromboembolism (VTE). The clinical applications of molecular techniques have allowed identification of important inherited, yet not uncommon, risk factors for VTE, such as mutations that cause Factor V Leiden and prothrombin G20210A. However, advances in our understanding have raised several questions regarding the need for, and duration of anticoagulation. At the end of the treatment period, low molecular weight heparins have become the drugs of choice and standard-ofcare for VTE. In this review, cost effective diagnostic approaches for patients with suspected deep vein thrombosis, and recommended treatment options using evidence-based approaches, are described.

Research paper thumbnail of The use of fresh frozen plasma for reproduction in severe factor V deficiency

Clinical and experimental obstetrics & gynecology, 2015

OBJECTIVE Severe factor V (FV) deficiency is rare. There are case reports describing pregnancy ou... more OBJECTIVE Severe factor V (FV) deficiency is rare. There are case reports describing pregnancy outcomes in women with FV deficiency and one case report of successful pregnancy following the use of fresh frozen plasma (FFP) in several cycles of ovulation induction and intrauterine insemination and at delivery. The authors report another case to support the use of FFP for reproduction. CASE A 27-year-old woman with severe FV deficiency was given FFP at the time of ovulation induced with clomiphene citrate, human menopausal gonadotropin (hMG), and human chorionic gonadotropin. Intrauterine insemination (IUI) was done 35 hours later. She became pregnant with twins and delivered vaginally at 36 weeks of gestation with the prophylactic use of FFP. CONCLUSION Fresh frozen plasma can be offered for reproduction to women with severe FV deficiency.

Research paper thumbnail of Association of serum asymmetric dimethyl-arginine and troponin I levels as a risk of myocardial infarction in thalassemia

African Health Sciences

Background: The current study evaluated level of serum asymmetric dimethylarginine (ADMA) and its... more Background: The current study evaluated level of serum asymmetric dimethylarginine (ADMA) and its association to cardiac biomarkers in thalassemia patients for early diagnosis of abnormality in myocardial infarction. Subjects and methods: This study was conducted on 80 subjects divided into four groups each with 20 subjects. Group I: Control: healthy subjects. Group II: Myocardial infarction: Patients with elevated serum troponin T. Group III: thalassemia patients. Group IV: thalassemia with myocardial infarction patients: Included 20 thalassemia patients with Myocardial infarction. Serum samples were subjected for assay of creatine kinase (CK:MB), Lactate dehydrogenase, troponin I ,ADMA, Serum MDA level was determined. Results: Data obtained showed that serum CKMB, LDH1, AST, Troponin T and ADMA levels were significant elevated in MI with or without Thalassemia compared with control groups. Serum MDA was statistically significantly elevated in MI with or without Thalassemia compared with control groups. The serum level of troponin T showed an area under curve (AUC) of 0.92 ,(sensitivity 91.0 % and specificity, 88%). Also, the ADMA supported the diagnostic profile, showing an AUC of 0.85 with (sensitivity, 92.0%; specificity, 91,9%). Conclusion: Serum ADMA is sensitive marker for incidence of MI in thalassemia patients.

Research paper thumbnail of Serum proteins C and S levels as early biomarkers for kidney dysfunction in hemophilic patients

African Health Sciences

Background: Hemophilia is an inherited genetic disease characterized by the inability to coagulat... more Background: Hemophilia is an inherited genetic disease characterized by the inability to coagulate blood after injury. The rationale of the current study was to evaluate serum proteins S and C and correlate to kidney function test in hemophilic patients for early diagnosis of abnormality in renal function. Subjects and Methods: This study was conducted on 80 males subjects divided into four groups. Group I: Control: Healthy subjects. Group II: Renal dysfunction (serum Creatinine >2mg/dl): Group III: Hemophilic patients. Group IV: Hemophilic patients with renal disorder. Serum urea, creatinine, sodium, potassium, protein C and protein S level were determined. Resuts: Protein C and S levels showed a significant decrease in hemophilic/and with renal dysfunction (P < 0.001,p<0.001). The level of plasma protein C and S levels were positively correlated with increased urinary albumin (P < 0.01). Urinary albumin was increased about 15 folds in hemophilic patients with renal dysfunction and nephrotic patients as compared with the control group. The cutoff value in 90% patients at the hemophilic patients with renal dysfunction 70%. Positive correlations were observed between urinary albumin (r=0.66), and creatinine (r=0.73). Conclusion: These biomarkers showed good predictive values with regard to ROC-AUC (0.41 and 0.75 for Proteins C and S, respectively).

Research paper thumbnail of IOF Regionals – 3rd Middle East & Africa Osteoporosis Meeting

Osteoporosis International

Aims: To determine the relationship of 25-hydroxyvitamin D (25(OH)D) serum concentration with acu... more Aims: To determine the relationship of 25-hydroxyvitamin D (25(OH)D) serum concentration with acute coronary syndrome (ACS) with review on subgroup of diabetic patients. Methods: 60 patients age between 30 and 70 year treated for ACS: STEMI and NSTE-ACS at General Hospital in Slavonski Brod, Croatia, and 60 control subjects free from ACS including DM, obesity, smoking, hypertension, and hyperlipidemia, as a control. All routine laboratory tests and plasma PTH and 25(OH)D done. Analysis was performed by use of the SPSS for Windows 11.0.3 software (SPSS Inc., Chicago, IL, USA). p<0.05. Results: The ACS group included 36 (60 %) patients with STEMI and 24 (40 %) patients with NSTEMI-ACS. Serum levels of 25(OH)D: 35.19±17.54 nmol/L in ACS patients was statistically significantly lower than in controls: 58.08± 16.29 nmol/L, ACS patients had three subgroups regarding coronary disease severity: single(SVCAD) (n=39; 68 %), double (DVCAD) (n=15; 26 %) and multiple vessel disease (MVCAD) (n=3; 6 %) and they had 25(OH)D serum levels of 36.44 nmol/L, 33.65 nmol/L and 31.70 nmol/L, respectively. Statistically significantly was higher rate of vitamin D insufficiency among ACS patients as compared with the control group, Vitamin D deficiency was recorded in as many as 20% of ACS patients and none of control subjects. In the ACS group, patients with DM female (F) (n=9, 40 %) and male (M) (n=13, 60 %) had the lowest mean 25(OH)D concentration of 30.45±15.05 mmol/L in comparison to all subgroups. A similar tendency toward a lower mean 25(OH)D level of 46.60±19.26 mmol/L in DM patients was also recorded in the control group, and this difference was statistically significant. In diabetic group we found STEMI (N=14;64 %)+NSTEMI (n=8;36 %) and SVCAD (n=15;68 %)+DVCAD (n=6; 27 %)+MVCAD (n=1;5 %). Conclusion: Patients with diabetes had significantly low levels of vitamin D3 in ACS. Is it an accidental finding or a distorted reflection of atherogenesis due to low levels of vitamin D in diabetes? Perhaps low vitamin D levels only increase atherogenicity and become one of the triggers for the development of ACS. Studies are needed to confirm the need for the normal level of vitamin D for prevention of ACS. Perhaps it is necessary to pay more attention to the level of vitamin D3 in diabetics. References: 1 Zittermann A et al., Am J Clin Nutr 2012;95:91. 2.von Essen MR et al., Nat Immunol 2010;11:344.

Research paper thumbnail of Bone turnover markers, glucose and lipid metabolism in relation to atherosclerosis in type-2 diabetic patients: a longitudinal study

Bone, 2012

Background: Bone metabolism is affected by risk factors of atherosclerosis and hyperglycemia indu... more Background: Bone metabolism is affected by risk factors of atherosclerosis and hyperglycemia induced low bone turnover with osteoblastic dysfunction. Limited information is available on the relationship between bone turnover markers (BTMs) and atherosclerosis or its related risk factors in patients with Type-2 diabetes mellitus (T2DM). Methods: A total of 135 patients (men=62; women=73) (age≥50 years) with poorly controlled T2DM [indicated by haemoglobin-A1c (HbA1c)] were followed-up over 12 months during glycemic control evaluation. Each patient (at baseline and visits on 3, 6, 9 and 12 months) provided fasting blood sample and second-void morning urine samples for the measurements of BTMs [serum osteocalcin (s-OC), bone alkaline phosphatase (s-bone ALP), procollagen type 1 Nterminal propeptide (s-PINP), crosslinked C-terminal telopeptide of type 1 collagen (sCTX), tartarate-resistance acid phosphatase isoform 5b (s-TRACP-5b) and urinary Ntelopeptide of type 1 collagen (u-NTX)]. Various hormones, HbA1c; lipids, glucose and creatinine were measured. Bone mineral density was determined at baseline visit and at 12-month visit. Also, the plaque score (PS) was calculated. Results: Multiple regression analysis showed that changes in s-OC were negatively correlated with HbA1c (r=-0.46, Pb0.001). Baseline s-OC levels were negatively correlated with changes in triglyceride levels (r=-0.37, Pb0.001) and positively with high-density lipoprotein-cholesterol (HDL-c) (r=0.44, Pb0.001). Changes in s-OC correlated positively with baseline PS (r=0.49, Pb0.001) and negatively with changes in PS (r=-0.41, Pb0.001) independent of other potential atherosclerosis risk factors. Conclusions: Association between s-OC with glucose, lipid metabolic indicators and PS independently of other atherosclerosis-related risk factors in patients with T2DM. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None Declared. doi:10.1016/j.bone.2012.02.442 PP254 Volumetric bone mineral density (vbmd) at tibia site and vitamin d status in premenopausal south asian and caucasian women O.A. Hakim⁎, A. Darling, K. Hart, J.L. Berry, S. Lanham-New Nutrition, University of Surrey, Guildford, UK Vitamin D Research Group, University of Manchester, Manchester, UK Abstract: Recent studies indicate thatwomenof European origin have higher areal bone mineral density (BMD) than South Asianwomen. However this has been explained by ethnic variation in bone size [1]. Few data exist on true volumetric BMD in premenopausal South Asianwomen and nodata is available at the tibia site. As part of theD-FINES (VitaminD, Food Intake,Nutrition andExposure to Sunlight in SouthernEngland) study,which investigates the interaction betweendiet and sunlight exposure and vitaminD status,we aimed to investigate differences in volumetric bone mineral density (vBMD) between South Asian (SA) and Caucasian (C)womenat the tibia and determine if there is an association betweenvBMDand serum 25(OH)D. Thirty five healthy premenopausal women (21 C and 14 SA), age ranges 1855 yrs, were scanned by peripheral Quantitative Computed Tomography (pQCT) at the tibia (non-dominant) using a Stratec XCT 2000 pQCT machine. Fasted blood samples were Recent studies indicate thatwomenof European origin have higher areal bone mineral density (BMD) than South Asianwomen. However this has been explained by ethnic variation in bone size [1]. Few data exist on true volumetric BMD in premenopausal South Asianwomen and nodata is available at the tibia site. As part of theD-FINES (VitaminD, Food Intake,Nutrition andExposure to Sunlight in SouthernEngland) study,which investigates the interaction betweendiet and sunlight exposure and vitaminD status,we aimed to investigate differences in volumetric bone mineral density (vBMD) between South Asian (SA) and Caucasian (C)womenat the tibia and determine if there is an association betweenvBMDand serum 25(OH)D. Thirty five healthy premenopausal women (21 C and 14 SA), age ranges 1855 yrs, were scanned by peripheral Quantitative Computed Tomography (pQCT) at the tibia (non-dominant) using a Stratec XCT 2000 pQCT machine. Fasted blood samples were collected for vitamin D analysis. SA women were significantly shorter (pb0.001), and slightly heavier than C women; Therefore SA had significantly higher BMI (pb0.05) than C women. SA women had significantly lower 25(OH)D concentration than C women (pb0.001) with mean values of 31.53[16.32] and 80.91[20.08] (nmol/l) respectively. SA women had significantly smaller bone size and higher vBMD than C women (pb0.05) for total, trabecular, and cortical bone at the 4% site. SA women had significantly lower total vBMD at 14% site (pb0.05) and the 38% site (pb0.01) than Caucasians. SA had significantly lower cortical density at site 14% than Caucasians (pb0.05).This was also lower at the 38% site but this was not statistically significant. There was a trend for a negative association between 25(OH)D and…

Research paper thumbnail of Serum sclerostin levels and the risk of osteoporotic fractures: The Ceor study

Research paper thumbnail of Clinically relevant bleeding in cancer patients treated for venous thromboembolism from the CATCH study

Journal of Thrombosis and Haemostasis

Research paper thumbnail of Bone turnover markers and the prediction of osteoporosis-related fractures among postmenopausal women

Bone, 2012

Background: Anemia [hemoglobin (Hb) levelb12 g/dL] is common in the elderly and low Hb levels are... more Background: Anemia [hemoglobin (Hb) levelb12 g/dL] is common in the elderly and low Hb levels are associated with low bone mass. The present population-based, prospective study examined whether anemia predicts nonvertebral fractures among postmenopausal women. Methods: We examined the association of anemia and non-vertebral fracture risk in 985 postmenopausal women in a population-based study with a mean follow-up period of 6.3±1.4 years. Multivariate Cox proportional-hazards regression models were used to analyze risk, adjusted for age, body-mass index, and other confounding risk factors. Measurements of Hb, mean corpuscular volume, blood pressure, blood lipids, serum creatinine, and bone mineral density by dual X-ray absorptiometry and questionnaire information on smoking habits, physical activity, prevalent diseases, and use of medications were collected at baseline and follow-up visits. Results: A total of 173 women sustained non-vertebral fractures. One SD lower levels of Hb were associated with a 1.32 higher risk of fracture in women studied (Pb0.001, after multiple adjustments). Women with anemia (Hb levelsb12 g/dL) had a 2.22 higher risk of ORFs than women with the highest quartile of Hb levels. Conclusions: Anemia is associated with non-vertebral fractures in postmenopausal women. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared. doi:10.1016/j.bone.2012.02.439 PP251 Serum osteocalcin is associated with insulin sensitivity and secretion in postmenopausal women with type-2 diabetes mellitus M.-S.M. Ardawi⁎, A.A. Rouzi, D.H. Akbar, A.A. AlShaikh, M.M. Ahmed, S.M. Bahlas, M.H. Qari Department of Clinical Biochemistry, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Department of Obstetrics and Gynecology, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Department of Internal Medicine, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Department of Haematology, Center of Excellence for Osteoporosis Research and Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia Abstract: Background: Animal studies showed that osteocalcin (OC) stimulated the expression of insulin islets and of adiponectin in adipocytes with elevated insulin secretion and sensitivity. Limited information is available on the relationship between OC, insulin sensitivity and secretion among postmenopausal women with Type 2 diabetes mellitus (T2DM). Methods: A total of 395 postmenopausal women (≥ 50 years) with T2DM were studied cross-sectionally. Also, we examined the response to 75 g oral glucose tolerance test (OGTT) in 42 postmenopausal women Background: Animal studies showed that osteocalcin (OC) stimulated the expression of insulin islets and of adiponectin in adipocytes with elevated insulin secretion and sensitivity. Limited information is available on the relationship between OC, insulin sensitivity and secretion among postmenopausal women with Type 2 diabetes mellitus (T2DM). Methods: A total of 395 postmenopausal women (≥ 50 years) with T2DM were studied cross-sectionally. Also, we examined the response to 75 g oral glucose tolerance test (OGTT) in 42 postmenopausal women with T2DM. Bone turnover markers (BTMs), [serum OC (s-OC), bone alkaline phosphatase (s-bone ALP), procollagen type 1 N-terminal propeptide (s-PINP), crosslinked C-terminal telopeptide of Type 1 collagen (s-CTX), tartarate-resistant acid phosphatase isoform 5b (s-TRACP-5b) and urinary N-telopeptides of type 1 collagen (u-NTX)], serum adiponectin, blood glucose, blood haemoglobin A1c (HbA1c), insulin and body fat were measured. Results: Multiple regression analysis adjusted for age, body mass index (BMI) and other confounders showed that s-OC levels negatively associated with plasma glucose, HbA1c, % trunk fat and insulin resistance, (Pb0.001) and positively with beta-cell function (Pb0.001). Marked positive association between s-OC and serum adiponectin levels were observed (Pb0.001). In the OGTT evaluation study, women divided into tertiles of s-OC, showed that those in the lowest tertile exhibited hyperglycemia and hyperinsulinemia vs those in the highest tertile following OGTT (Pb0.001). Conclusions: Serum OC levels are positively associated with insulin sensitivity and secretion among postmenopausal women with T2DM. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None Declared. doi:10.1016/j.bone.2012.02.440 PP252 Bone turnover markers and the prediction of osteoporosis-related fractures among postmenopausal women M.-S.M. Ardawi⁎, A.A. Rouzi, S.A. Al-Sibiani, N.S. Al-Senani, M.H. Qari Department of Clinical…