AIM: To evaluate the aldose reductase (ALR2, rs759853), receptor for advanced glycation end products (RAGE, rs2070600), and vascular endothelial growth factor (VEGF, rs833061) association with diabetic retinopathy in type 2 diabetic patients in Khyber Pakhtunkhwa population.Methods: A Case control study was conducted on a total of 550 subjects consisting of 186 with diabetic retinopathy (DR) having type 2 diabetes, 180 had type 2 diabetes (T2DM), and 184 healthy controls (HC). All the samples were subjected to DNA isolation using salting-out method followed by SNP genotyping through Tetra-ARMS PCR. Chi square and Exact Fischer tests were used for allele and genotype distribution. Odd ratio and con dence interval values were found out by online software Medcalc Odd ratio Calculator.Results: Multiple parameters such as random blood sugar (RBS) (p<0.001), fasting blood sugar (FBS) (p<0.001), HbA1c (p<0.001), total cholesterol (p<0.001), LDL (p<0.001), HDL (p<0.001), BMI (p<0.001) and hypertension (p=0.018) showed strong association with DR as compared to DM and HC. Our results showed that VEGF rs833061 (p<.001) and RAGE rs2070600 (p<.001) polymorphism was strongly associated with an increased risk of DR. The odd ratio of CC genotype in VEGF (0.262, 95% CI=0.129-0.531) and AA genotype in RAGE (0.59, 95% CI=0.032-0.110) was noted. However, the signi cance in ALR2 rs759853 gene polymorphism was observed at (p=0.001).Conclusion: There is a statistically signi cant association of VEGF rs833061 and RAGE rs2070600 with diabetic retinopathy in type 2 diabetic patients. Also, this is the rst study to report the association of RAGE with diabetic retinopathy in type 2 diabetes in Khyber Pakhtunkhwa population.

Objective-A Medline electronic search showed a paucity of reports on calcium pyrophosphate dihydrate crystal deposition disease (CPPD-CDD) from the Gulf region. To date only a single case report has been published from this region. Therefore, this study aimed, firstly, at finding out the prevalence of chondrocalcinosis in adult Arabs in Kuwait presenting with knee arthritis and, secondly, at carrying out an observational study of CPPD-CDD among Arabs in Kuwait. Methods-For the study of the prevalence of chondrocalcinosis 100 consecutive adult patients presenting with knee arthritis were radiologically examined. For the observational study the clinical, laboratory, and radiological findings were analysed in patients with CPPD-CDD seen over a period of five years. Results-This study showed the presence of chondrocalcinosis in two (2%) of the 100 adult Kuwaiti and other Middle-Eastern Arab patients (70 men, 30 women, median age 50 (range 45-80)) who presented to the rheumatology clinic for the evaluation of knee pain. When the younger age of the group (only three patients aged >70) is taken into account the figure was comparable with that reported from Western countries. Over a period of five years a total of 2726 new patients were evaluated at the rheumatology clinic of this institution. A diagnosis of crystal arthritis was made in 85 patients (3%). Fourteen of these 85 (that is, 16.5%, but 0.5% of the total cases) were diagnosed with definite (eight patients) or probable (six patients) CPPD-CDD. DiVerent clinical presentations, including that of acute monarthritis (that is, pseudogout), premature generalised osteoarthritis, and polyarticular rheumatoid-like presentations, were seen in diVerent patients. Overlap with true gout, with the additional presence of monosodium urate crystals in the joint aspirate, was seen in two patients.

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