DNA fingerprinting of Candida dubliniensis isolates using the species-specific probe Cd25 previously showed that this species consists of two distinct groups, termed Cd25 group I and Cd25 group II. The present study investigated the population structure of 30 C. dubliniensis oral isolates from Saudi Arabia and Egypt using Cd25 fingerprinting and rRNA gene internal transcribed spacer region-based genotyping. Cd25 fingerprinting analysis of these isolates revealed two distinct populations, the first of which consisted of 10 closely related genotype 1 isolates (average similarity coefficient [S AB ] value, 0.86). The second population of 20 isolates was much more heterogeneous (average S AB value, 0.35) and consisted of two distinct subpopulations, one of which consisted of genotype 3 isolates (n ‫؍‬ 13) and the other of genotype 4 isolates (n ‫؍‬ 7). A mixed dendrogram generated from the fingerprint data from the 30 Saudi Arabian and Egyptian isolates, 5 Israeli isolates, and 51 previously characterized international isolates (32 of Cd25 group I and 19 of Cd25 group II) revealed the presence of three distinct main clades. The first corresponded to the previously described Cd25 group I and contained all the Saudi Arabian, Egyptian, and Israeli genotype 1 isolates mixed with international isolates. The second clade corresponded to the previously described Cd25 group II and contained three Israeli isolates, one genotype 2 isolate, one genotype 3 isolate, and a genotype 4 variant isolate, which were mixed with international isolates. The third clade has not been described before and consisted solely of the 20 Saudi Arabian and Egyptian genotype 3 and 4 isolates identified in this study and a previously described genotype 4 Israeli isolate. All 20 Cd25 group III isolates exhibited high-level resistance to 5-flucytosine (MIC > 128 g/ml), whereas all Cd25 group I and Cd25 group II isolates tested (10 Saudi Arabian and Egyptian, 16 Israeli, and 24 international) were susceptible to 5-flucytosine (MIC < 0.125 g/ml). The results of this study show for the first time the presence of a novel 5-flucytosine-resistant clade of C. dubliniensis (Cd25 group III) that is predominant among isolates from Saudi Arabia and Egypt and absent from a previously characterized international collection of 98 isolates from 15 countries.

This study was carried out to find out whether Ramadan fasting would affect the renal function in kidney transplant recipients with normal or impaired graft function. Twenty-three transplant recipients, 17 with a normal function and 6 with an impaired but stable function with plasma creatinine levels not exceeding 300 mmol/l, were included in this study. The mean posttransplant period was 2.0 (range 0.6–6.3) years. Urinary and serum biochemical parameters, ciclosporin A level, and hematocrit were checked weekly, during Ramadan as well as 1 week before and after. Statistical analysis showed no significant changes in all parameters before, during, and after Ramadan. In conclusion, our findings indicate that fasting during the month of Ramadan does not seem to be associated with any significant adverse effects in kidney transplant recipients with normal or impaired graft function and suggest that it is safe for those patients to fast during Ramadan after 1 year of renal transplantation.

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To assess the quality of life (QOL) of Saudi Arabian patients undergoing hemo-dialysis (HD) and to determine the impact of gender, age, education and comorbidities on the QOL of these patients, we conducted a cross-sectional study and used the short form-36 (SF-36) questionnaire, a generic instrument for measuring QOL. This questionnaire is composed of eight scales that summarize the physical component scale (PCS) and mental component scale (MCS) of health status. We calculated the PCS and MCS scores for each patient. We studied 205 HD patients (123 men; ages 18-75 years) from the King Fahd General Hospital, Jeddah, Saudi Arabia. The mean SF-36 score was 59.4 ± 21.7 in men and 41.9 ± 20.9 in women (P <0.0001). Patients older than 60 years had the worst score (41.5 ± 21.2), followed by patients aged 40-59 years (53.6 ± 22.8); patients aged 18-39 years had the best SF-36 score (57.5 ± 22.5; P <0.0001). Education had a positive impact on QOL (P <0.0001), whereas comorbid conditions had a negative impact. Peripheral vascular disease was associated with the worst outcome (SF-36 score, 40.4 ± 23.0; P <0.0001), followed by dyslipidemia (42.9 ± 22.4; P = 0.001) and diabetes mellitus (45.0 ± 22.0; P = 0.012). Among the comorbid conditions, hypertension was associated with the best SF-36 score (50.6 ± 22.7; P = 0.034). We conclude that old age, female gender, poor education and comorbid conditions have a negative impact on the QOL of HD patients in Saudi Arabia. These findings indicate a general need for social support for female patients on HD and early diagnosis and management of comorbid conditions.