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Biomedical subjects

A E Omu

Publications and source records attributed to A E Omu.

At least 19 recordsLinked to original sources
PubMed2003

Nitric oxide production is not altered in preeclampsia.

BACKGROUND: Preeclampsia remains a disease of theories as the real aetiology has remained elusive. Altered nitric oxide production has been associated with preeclampsia although conflicting results showing elevation, decrease or no change in nitric oxide levels have emerged from previous studies. OBJECTIVE: The aim of the study was to measure the serum levels of nitrate and nitrite in normal pregnancies and pregnancies complicated by pre-eclampsia. MATERIALS AND METHODS: Venous blood was extracted from 39 normal pregnant women (control) and 34 women with preeclampsia (study group). Serum concentrations of nitrate and nitrite were determined using the HPLC method. Other special investigations including renal function tests were performed. The patients were managed according to protocol and the outcome of the pregnancies evaluated. RESULTS: There was no significant difference in the mean maternal age and gestational age at delivery between the groups. However the mean systolic and diastolic blood pressure of the study group (150.5 mmHg and 98.8 mmHg) were significantly higher than the levels in the control group, (110.86 and 85.5), p<0.0001. There was no significant difference in the mean serum nitrate levels (19.157+/-13.407 vs. 19.189+/-16.805) p=0.993. The fetal and maternal outcomes were comparable. CONCLUSION: Our study has demonstrated that there was no alteration in nitric oxide production in preeclampsia, thus contributing to the existing unresolved role of nitric oxide in the pathogenesis of preeclampsia. Further research is called for.

Adult↗
PubMed2002

Hormone profile of Kuwaiti women with hyperemesis gravidarum.

OBJECTIVE: To evaluate the incidence of hyperemesis gravidarum among pregnant women in Kuwait and the status of HCG, TSH, Total T4 and Free T4 in the serum of patients with hyperemesis gravidarum compared with a control group of women. METHODOLOGY: During a 6-month period all patients admitted to Maternity Hospital with features of hyperemesis gravidarum (excessive vomiting and ketonuria) were enlisted into the study. In fifty of these patients and their fifty normal controls, the status of serum total (beta)hCG, TSH, total T4 and freeT4 were evaluated with AXSYM micro particle enzyme immunoassay. RESULTS: The incidence of hyperemesis in the maternity population was 45 per 1000 deliveries. Total (beta)hCG and Total T4 and FreeT4 were significantly higher in the hyperemesis patients than in the normal controls (p<0.0001, p=0.004 and p=0.01 respectively). TSH levels were significantly lower in hyperemesis patients than in their normal controls (p<0.0001). There was a strong positive correlation between the total (beta)hCG and the gestational age (r=0.8). CONCLUSION: There is a high incidence of hyperemesis gravidarum in the Kuwaiti population. Total (beta)hCG, Total T4 and Free T4 titers were significantly higher in patients with hyperemesis gravidarum, but none of the patients showed signs of hyperthyroidism.

Adult↗
PubMed2001

Lymphocyte subpopulation frequency and presence of anti-cardiolipin and anti-nuclear antibodies in peripheral blood of Kuwaiti women experiencing recurrent pregnancy loss.

Recurrent pregnancy loss (RPL) is often associated with elevated levels of serum antiphospholipid antibodies, which contribute to the pathology of the disorder by promoting formation of thromboses, leading to placental infarction and fetal loss. Patients with recurrent pregnancy loss also exhibit pathological alterations in composition and activity of peripheral blood lymphocytes, which may be indicative of an autoimmune processes. This investigation examines the correlation between levels of anticardiolipin antibody (AC) and specific subsets of the lymphocyte repertoire in RPL patients, with the objective of further characterising the immunological basis for RPL. Non-pregnant Kuwaiti women with a history of RPL were subdivided into two cohorts based on presence or absence of elevated plasma antibodies to cardiolipin. Whole blood from these individuals was analysed by flow cytometry for selected lymphocyte subsets and compared with a non-RPL control population. When compared with controls and low AC titre subjects, women with a high AC titre exhibited significantly elevated percentages of pathogenic CD5+ B cells; two categories of activated T cells including CD4+CD25+ and CD8+CD25; NK cells and CD3+NK cells; naive (CD4+CD45RA+) cells; and transitional (CD45RO+CD45RA+) cells. In conclusion, women with elevated levels of AC antibodies possess substantially higher levels of activated T cells and pathogenic B cells, suggesting a fundamental predisposition to immune-mediated rejection of the fetus by these patients. Further characterisation of this phenomenon may allow development of novel intervention methods for management of RPL.

Journal Article↗
PubMed2001

Effect of repeated doses of dexamethasone on the incidence and severity of respiratory distress syndrome in multifetal gestation between 24 and 34 weeks.

The objective of the study was to evaluate the effects of antenatal corticosteroid therapy in multiple pregnancy on the incidence and severity of respiratory distress syndrome (RDS). Twenty-two women with twin, 12 with triplet and 2 with quadruplet pregnancies and an emergency group of 20 mothers with twin pregnancies, who only had one course of dexamethasone, were compared with controls. Corticosteroid therapy was associated with a reduction in moderate to severe RDS in all groups (twins p < 0.01, triplets and quadruplets p < 0.008) and the emergency group with dexamethasone therapy (p < 0.036) when compared to their individual controls. Dexamethasone reduced the duration of stay in the neonatal intensive care unit of the emergency twin group (p < 0.01). Neonatal birth weights were significantly less in all groups treated with repeated doses in comparison to the controls.

Adrenal Cortex Hormones↗
PubMed2001

Differential levels of interleukin 6 in maternal and cord sera and placenta in women with pre-eclampsia.

BACKGROUND: Interleukin 6 (IL-6) is a T helper 2 cytokine with a variety of properties including pro-inflammatory characteristics. It has, therefore, been implicated in the pathophysiology of abnormal pregnancies. OBJECTIVE: To investigate the association between IL-6 and pre-eclampsia by estimating the differential levels of IL-6 in maternal and cord serum and supernatant of homogenized placental tissue. METHODS: 50 primigravidae with pre-eclampsia and 50 matched normotensive primigravidae served as controls. At delivery, maternal and cord blood were collected and the serum extracted. Placental blocks were homogenized and sonicated in RPMI solution and the supernatant collected. The total protein concentration was determined and IL-6 levels assayed with an ELISA technique. RESULTS: Placental IL-6 (170 and 186 pg/mg protein) was threefold that in the maternal (64 and 58 pg/mg protein) and cord serum (63 and 72 pg/mg protein; p < 0.01). There was no significant difference in the mean IL-6 levels in maternal and cord serum or placenta in both pre-eclamptic women and normotensive controls nor in pre-eclamptic patients with babies with intra-uterine growth restriction or in pre-eclamptic patients with babies with an appropriate birth weight and in normotensive controls. CONCLUSION: There are no differences in the maternal and cord sera and placental levels of IL-6 in pre-eclamptic and normotensive women, indicating that IL-6 may not have a role in the pathophysiology of pre-eclampsia.

Adult↗
PubMed1999

Seminal immune response in infertile men with leukocytospermia: effect on antioxidant activity.

OBJECTIVE: To investigate the incidence of leukocytospermia and relation to T helper cytokines, tumor necrosis factor alpha (TNFalpha) and interleukin-4 (IL-4), antisperm antibodies and antioxidant activity. DESIGN: Semen samples from 176 infertile men and 24 fertile controls were investigated. METHODOLOGY: The protocol included tubal patency test, hysterosalpingography and laparoscopy and dye test and ovulation through mid-luteal phase progesterone for the wives. The husbands had semen analysis, cytomorphology evaluation and semen culture. Seminal TNFalpha and IL-4, antisperm antibodies, total antioxidant activity, superoxide dismutase and zinc were determined. RESULTS: Leukocytospermia occurred in 44.3% of the infertile men compared to 12.5% of the fertile men (P<0.01). Thirty-six (20.5%) men had pathogenic bacterial organisms which constituted 46.2% of those with leukocytospermia. Sperm parameters were worse with leukocytospermia in terms of sperm count (P<0.01), total motility progressive motility (P<0.01), morphology, asthenozoospermia, sperm membrane integrity and antisperm antibodies. TNFalpha and IL-4 had an inverse relationship; the expression of TNFalpha was higher with leukocytospermia and bacteriospermia (P<0.001), while IL-4 was higher in fertile controls (P<0.005). Incidence of antisperm antibodies was higher with leukocytospermia. Total antioxidant activity, superoxide dismutase and zinc were lower with leukocytospermia. CONCLUSION: Leukocytospermia impairs sperm function through reduced antioxidant activity and enhanced T helper 1 modulation.

Adult↗
PubMed1999

Significance of simultaneous determination of serum and seminal plasma alpha-tocopherol and retinol in infertile men by high-performance liquid chromatography.

High-performance liquid chromatography was used for the simultaneous determination of alpha-tocopherol and retinol in serum and semen of 40 subfertile men. The serum levels of the two vitamins were significantly higher in serum than in semen (3- to 10-fold) (P < 0.001). The mean alpha-tocopherol levels were higher in the serum and semen of men with normal sperm parameters (20 +/- 5 and 5 +/- 4 mumol L-1) than those with oligozoospermia (10 +/- 4 and 3 +/- 2 mumol L-1), azoospermia (8 +/- 3 and 3 +/- 1 mumol L-1) and asthenozoospermia (9 +/- 6 and 3 +/- 2 mumol L-1) (P < 0.002). Mean retinol levels in serum were similar in men with normal sperm parameters (2.4 +/- 2 mumol L-1) as in those with defective sperm parameters such as oligozoospermia (2.5 +/- 2 mumol L-) and asthenozoospermia (2.1 +/- 1.0 mumol L-) (P = 0.15), but significantly lower in men with azoospermia (1.3 +/- 0.3 mumol L-1) (P < 0.05). The alpha-tocopherol:retinol ratio was significantly higher in semen than in serum of men with normal sperm parameters (11.5) and those with asthenozoospermia (10.3) compared with ratios in those with oligozoospermia (8.3) and azoospermia (6.3). This may be related to reduced antioxidant activity in sperm dysfunction as a result of lipid peroxidation, from increased generation of reactive oxygen species.

Chromatography, High Pressure Liquid↗
PubMed1999

Comparative maternal lactate-pyruvate ratios in singleton and twin pregnancies and in babies delivered at term.

The lactate-pyruvate (L/P) ratio was used for assessment of anaerobic metabolism, hypoxia or oxygen debt in uterine contractile muscle during labour and immediately after parturition. The mean blood lactate level was significantly higher in mothers with twin pregnancies (P<0.001) than in singleton pregnancies at term. L/P ratios were markedly elevated in established labour both in mothers of singleton as well as in mothers of twin pregnancies and were also higher in cord blood of the twins than those of singleton babies (P<0.001). The twins delivered second had higher L/P ratios (P<0.05) than the leading twins.

Journal Article↗
PubMed1999

Differential levels of T helper cytokines in preeclampsia: pregnancy, labor and puerperium.

BACKGROUND: There are suggestions that T helper 1 cytokines may be detrimental to early pregnancy and T helper 2 cytokines protective of the pregnancy. Their role in preeclamptic pregnancy, labor and puerperium, is not clear. MATERIALS AND METHODS: Twenty-eight preeclamptic women and their matched controls were evaluated, at the Departments of Obstetrics and Gynecology, Faculty of Medicine, Kuwait University and Maternity Hospital, Kuwait. Outcome measures evaluated were serum levels of TNF alpha and interleukin-4 at 12, 24, 36 weeks of gestation, advanced labor and at 1 hour and daily postpartum until they were undetectable, using ELISA technique. RESULTS: T helper cytokines showed higher serum levels in preeclampsia than normotensive pregnancy (p < 0.01, 0.01), in established labor (p < 0.05) and at 1 hour postpartum (p < 0.01 for IL-4) and p < 0.02 for TNF alpha. There was significant increase of IL-4 between 12 to 24 weeks in normal pregnancy compared to preeclampsia (p < 0.001) but not for TNF alpha. By 24 hours postpartum, IL-4 was still detectable in eight parturients compared to one patient with detectable TNF alpha (p < 0.04). Detectable IL-4 levels after 24 hours postpartum were associated with intrauterine growth retardation (p < 0.03). CONCLUSION: IL-4 has a dichotomous role in pregnancy. Normotensive pregnancy is associated with high increase in IL-4 in the first half of the pregnancy, but in the second half of pregnancy and puerperium, high levels of IL-4 are associated with preeclampsia.

Adult↗
PubMed1999

Relationship between unexplained infertility and human leukocyte antigens and expression of circulating autogeneic and allogeneic antisperm antibodies.

PURPOSE: The association between unexplained infertility, human leukocyte antigens (HLA) and expression of circulating antisperm antibodies was studied in 52 couples with unexplained infertility and 15 infertile and 9 fertile couples. METHODOLOGY: Evaluation parameters included Terasaki's HLA microlymphocytotoxicity test, circulating antisperm antibodies using immunofluorescence technique. RESULTS: Fifty-two couples (8.7%) out of 600 consecutive clinic attendants had unexplained infertility. Unexplained infertility was associated with circulating antisperm antibodies (22 versus 13 and 0% for men and 18.5 versus 13 and 0% for women). HLA class 1 B6 and B52 and Cw7 and HLA class 2 DR4 and DR6 and sharing of HLA B6, DR4 and DR6 were found more in couples with unexplained infertility. Combined expression of antisperm antibodies by couples, demonstrated more homozygosity for HLA B6 and DR4. CONCLUSION: Homozygosity for these antigens, B6, DR4 and DR6, may enhance the expression of antisperm antibodies, and cause infertility.

Antibodies↗
PubMed1998

Human leucocyte antigens in pregnant women with pre-eclampsia associated with intrauterine growth retardation and in normal controls.

OBJECTIVE: To investigate the association between maternal HLA class II and intrauterine growth retardation with associated birthweight of the newborn, in women with preeclampsia. METHODOLOGY: Thirty preeclamptics and 30 normotensive matched for age, parity and gestation were investigated for HLA class II profile using Terasaki microlymphocytotoxicity test as the typing technique. The outcome of the pregnancy in terms of intrauterine growth retardation, birthweight and placental weight, were investigated to elucidate a susceptibility factor in the HLA Class II profile of the preeclamptic women. RESULTS: HLA class II DR2, DR4, DRw11, DRw14 and DQw2 were more common in the preeclamptic women (p < 0.04, 0.03, 0.05, 0.03, 0.05), while DQw3 was more common in the controls (p < 0.05). Mean birthweight was 2.71 +/- 0.73 kg with preeclampsia compared to 3.4 +/- 0.4 kg for controls (p < O.01). Low birthweight was 56.7% versus 6.1% (p < 0.001) and mean placental weight was 474.8 +/- 100.8 gm versus 692.1 +/- 107.3 gm (p < 0.01). DR4 and DQW2 were significantly associated with intrauterine growth retardation with associated low birthweight and placental weight (p < 0.01). CONCLUSION: HLA class II hyaplotypes DR4, and DQw2 are associated with intrauterine growth retardation with associated low birthweight and placental weight through preeclampsia. The association between intrauterine growth retardation and HLA may be a direct susceptibility factor. This needs further elucidation.

Adult↗
PubMed1998

Treatment of asthenozoospermia with zinc sulphate: andrological, immunological and obstetric outcome.

OBJECTIVES: The role of zinc therapy on infertility caused by defective sperm quality is examined. STUDY DESIGN: In this study, 100 men with asthenozoospermia were randomised into two groups--250 mg twice daily zinc therapy for 3 months and no therapy. The patients were followed up for another 6 months. Sperm parameters, circulating antisperm antibodies, sex hormones and T helper cytokines were evaluated before and after treatment for the two groups. RESULTS: There was significant improvement in the sperm quality; sperm count (P<.02), progressive motility (P<.05), fertilising capacity (P<.01) and a reduction in the incidence of antisperm antibodies (P<.01). Zinc/cadmium was higher in the zinc therapy group (P<.02). T helper cytokine, interleukin-4 level was significantly higher after zinc therapy (P<.02) while TNFalpha showed a significant decrease (P<.05). CONCLUSIONS: Zinc therapy has a role in improving sperm parameters in men with asthenozoospermia, probably through its membrane stabilising effect as an antioxidant and its effect on cellular and humoral immunity by reducing the levels of antisperm antibodies and TNFalpha and increasing that of IL-4.

Adult↗
PubMed1998

ABO blood group and expression of antisperm antibodies in infertile couples in Kuwait.

Two hundred and fifty infertile couples and 102 fertile controls were evaluated to determine the association between ABO blood group status and seminal blood group substances among infertile couples and expression of circulating antisperm antibodies. Antisperm antibodies occurred in 18.8 and 17.7% of the infertile men and women, compared to 3.9% in the fertile women (p < 0.01). The 23 ABO blood group combinations in the infertile and fertile couples revealed no significant association with infertility except the predominance of B+/O+ spouses in the fertile group (p < 0.03). Although 76.8% of the men were secretors of seminal blood group substances, there was no significant association with development of antisperm antibodies. This shows that ABO blood group is not directly associated with infertility nor antisperm antibody formation.

ABO Blood-Group System↗
PubMed1998

Antibiotic therapy for seminal infection. Effect on antioxidant activity and T-helper cytokines.

OBJECTIVE: To investigate the effect of antibiotic therapy on seminal infection. STUDY DESIGN: The seminal plasma of 50 men was evaluated in three groups: (1) men with seminal infection (20), (2) men with leukocytospermia only (18), and (3) men of proven fertility (12). The evaluation protocol included semen analysis, culture and antibiotic sensitivity test, total antioxidant activity, alpha-tocopherol and retinol, T-helper cytokines, IL-2, IL-8, IL-4 and antisperm antibodies. RESULTS: Sperm parameters were worse with seminal infection: 25 versus 84 million per milliliter for fertile men. Antioxidant activity, total alpha-tocopherol and retinol were reduced in leukocytospermia (P < .02, .01) and seminal infection (P < .01, .05) as compared to controls. Antisperm antibodies IL-2 and IL-8 were highly expressed, while IL-4 was low in men with leukocytospermia and bacteriospermia. Gram-negative organisms were more associated with expression of T-helper 1 cytokines than T-helper 2 cytokines. Antibiotic therapy significantly improved the sperm parameters, antioxidant activity and IL-4 but reduced IL-2 and IL-8 and had no effect on antisperm antibody titer. CONCLUSION: Antibiotic therapy improves sperm parameters by increasing antioxidant activity and IL-4 and by reducing IL-2 and IL-8.

Adult↗
PubMed1997

Comparison of the lactate-pyruvate ratio during labour and delivery in singleton and twin pregnancy.

Oxygen utilisation at the tissue level was investigated by the use of lactate-pyruvate (LP) ratio in forty women; twenty with term twin pregnancy, with a matched controlled group of twenty women with term singleton pregnancy. The lactate-pyruvate ratio in twin pregnancy was significantly higher than in singleton pregnancy at term (p < 0.05). There was also significantly higher LP ratio in advanced labour in twin pregnancy than in singleton pregnancy (p < 0.001). Similarly, the venous cord blood LP ratio of twin II was higher than in twin I. Our findings have thus demonstrated more marked anaerobic metabolism in twin pregnancy than in singleton pregnancy. Secondly, the second twin is more involved in anaerobic metabolism as a result of relative oxygen deficiency, than twin I. This may to some extent account for the higher morbidity and mortality in twin pregnancy, compared to singleton pregnancy, and in twin II compared to twin I.

Female↗
PubMed1997

Effects of hormone replacement therapy on sexuality in postmenopausal women in a mideast country.

OBJECTIVE: During the postmenopausal period, sexual interest and activity seem to decline, as part of the menopausal effect of oestrogen deficiency. The aim of this study was to evaluate other factors that could contribute to sexual dysfunction and the effect of hormone replacement therapy among postmenopausal women in Kuwait. METHOD: Between June 1992, and June 1994, details of sexual history were compiled from 261 postmenopausal women that attended the Menopause Clinic at the Maternity Hospital, Kuwait. The effect of hormone replacement was analysed from the sexual history and the bacteriology of the lower genital tract. RESULTS: About 71% of the 261 postmenopausal women were still sexually active. Among those not sexually active, 38% had loss of interest, 22% because of divorce or death of husband, 20% from loss of interest by husband, and in 13% because the husbands had impotence from medical problems. Of the sexually active women, 41.1% had reduced libido. Contributing factors included vaginal symptoms like dyspareunia and vaginal dryness, vaginal infection, disturbances in the premenopausal menstrual pattern and disharmony with husbands. About 23 to 45% of the postmenopausal women with oestrogen replacement therapy, had significant relief of their symptoms of sexual dysfunction. Vasomotor symptoms had better response compared to sexual dysfunction (p < 0.01). Natural oestrogen gave slightly better relief of symptoms of sexual dysfunction than other forms of oestrogen therapy. Livial gave complete relief of dyspareunia and vaginal dryness in 9.1% and 3.9% respectively, but none of those with libido and vaginal discharge had any relief. CONCLUSION: There is a decline in sexual response and activity in postmenopausal women in Kuwait. This is however, multifactorial in origin. Although oestrogen replacement therapy gives significant relief in symptoms of sexual dysfunction, other contributory factors should always be evaluated.

Adult↗