Biomedical subjects
A G Ahmed
Publications and source records attributed to A G Ahmed.
The khat users: a study of khat chewing in Liverpool's Somali men.
This study reports the demographic and social characteristics and level of psychological dysfunction in regular khat users compared with matched non-users. The results indicate that khat users resemble non-users on a number of psychosocial variables and GHQ scores, with no evidence to suggest higher morbidity amongst users. The two groups appear to differ only in the level of their use of nicotine and also in their perception of the harmful effects associated with khat use.
Practice of seclusion: a five-year retrospective review in north Cheshire.
This study examines, retrospectively, the trends and factors associated with the use of seclusion over a five-year period in a regional secure unit located within a large psychiatric hospital that serves the population of North Cheshire. Ninety-four patients (15.3% of total admissions to the unit) spent some time in seclusion on 186 occasions. The average time spent in seclusion was 85 minutes (minimum 15 minutes and maximum 10 hours). Sixty-seven per cent of patients were secluded once, 20% secluded twice, and 13% more than three times. Patients with a clinical diagnosis of personality disorder (11.4%) accounted for 44.2% of seclusions whereas those with a defined mental disorder (55%) accounted for 35% of all seclusions. The rate of seclusion, characteristics of secluded patients, reasons, and average duration spent in seclusion, did not vary significantly over the study period, despite the significant reduction of the unit's admission rate from 150 to 63 per year. The consistent and regular occurrence of the practice over a five-year period may suggest that seclusion of some disturbed patients will inevitably continue to be used as an effective intervention and, probably at times, the only acceptable method that may ensure the safety of patients and staff.
Sonographic assessment of ovarian and endometrial changes during long-term Norplant use and their correlation with hormonal levels.
OBJECTIVE: To study the probability of ovulation and subclinical abortion during long-term use of Norplant and to assess the concomitant endometrial development. DESIGN: This was a prospective nonrandomized comparative study. The ovaries and endometrium were assessed daily by ultrasonography during 59 menstrual cycles in 50 women who were using Norplant for > 1 year. Serum concentrations of E2, P, FSH, LH, pregnancy specific beta 1 glycoprotein (Sp1), and hCG were also daily measured. The findings were compared with those in 35 ovulatory cycles in normal fertile women not using contraception. SETTING: Clients of the Family Planning Clinic of Assiut University Hospital (Norplant users) and the hospital women staff (controls). RESULTS: Sonographic and hormonal evidence of ovulation were observed in one third of Norplant users; two of them resulted in conception. However, the majority of these ovulatory cycles showed low midcycle peaks of E2, FSH, and LH and evidence of luteal phase defect (LPD). Excessive follicular enlargement was observed in 46% of the cycles. Norplant users had significantly thinner endometrium that did not exhibit the normal phasic changes in sonographic texture. Apart from conceptive cycles, no rise in Sp1 or hCG was observed. CONCLUSIONS: Norplant acts mainly by inhibiting ovulation, but when this occurs, it is associated with LPD and subnormal endometrial development. Subclinical abortion does not contribute to the contraceptive effect.
An outbreak of dracunculiasis in central Sudan.
This paper describes an outbreak of dracunculiasis in Mazmum, a town in central Sudan. The study included collection of clinical and epidemiological data from 319 patients treated in hospital, a review of the hospital records, a house survey covering a sample of 757 subjects, a school survey covering 1390 schoolchildren, and examination of water sources. The overall incidence of the disease was 23.4%, with most cases appearing in the agricultural season (July-October). Incidence was highest in young females but most severe disability occurred in male patients aged > or = 20 years, of whom more than 60% were unable to work for more than 4 weeks. The disease is transmitted in shallow natural pools, artificial ponds and trenches in rocky hills that hold rain water. All these sources were found to be infested with Cyclops. The outbreak is attributed to deterioration in the structure and management of the water sources, together with a massive population influx from other endemic areas. These observations underscore the importance of co-ordinating efforts to eradicate the disease from African countries.
Five-year experience with Norplant implants in Assiut, Egypt.
This report describes the five-year experience of the first 250 acceptors of NORPLANT implants in Assiut, Egypt. The five-year net continuation rate was 58.6 per 100 women. The five-year net cumulative pregnancy rate was 1.6 per 100 women. About three-fourths of those who continued use of this contraceptive through the fifth year reported having regular cycles. There was definite improvement in the bleeding pattern with time. The five-year net termination rate because of bleeding problems was 17.7 per 100 women. After 5 years of NORPLANT use there was a slight, statistically insignificant increase in weight, systolic and diastolic blood pressures. Of those who used contraceptives after the end of the five-year term of NORPLANT, about one-third opted to have reinsertion of the implants for a second term. About 96% of those who used NORPLANT through the fifth year reported that their experience with the contraceptive had been satisfactory.
Estimation of gestational age by last menstrual period, by ultrasound scan and by SP1 concentration: comparisons with date of delivery.
The date of delivery in 62 normal pregnant women was predicted by last menstrual period, by ultrasound scan and by the serum concentration of Schwangerschaftsprotein 1 (SP1). It was found that SP1 concentration in the first trimester gave as reliable an indication of when labour would occur as did the last menstrual period or ultrasound scan.
Postpartum decline in serum concentration of placental proteins in an abdominal pregnancy.
The alpha and the beta forms of Schwangerschaftsprotein 1 (SP1) and chorionic gonadotrophin (hCG) were measured after delivery in an abdominal pregnancy with the placenta left in situ. All three proteins declined more slowly than after normal delivery; the half-lives ranging from 6.2-6.5 days. Traces of the proteins could still be detected in the maternal circulation 9 weeks after delivery. These findings are construed as further support for the belief that the placenta plays a major role in the synthesis of these proteins.
Serum concentration of placental proteins in non-pregnant and pregnant subjects.
Chorionic gonadotrophin (hCG) and Schwangerschaftsprotein 1 (SP1) were measured in 35 menstrual cycles in 20 women. During the follicular phase, 3 samples were positive for hCG and two of these were also positive for SP1. All these positives occurred on the day of ovulation or immediately before. In the luteal phase 25 specimens showed both hCG and SP1 and two showed only SP1, the positive results occurring 3-15 days after ovulation. The placental proteins were also measured in a further eight women who became pregnant. The pattern in these was quite different. The first positives were detected 8 days after ovulation and by 12 days all the subjects were positive for both proteins. Thereafter both proteins increased sharply in concentration. A group of 139 subjects who, on biological grounds, could not have conceived, showed no positive results.
Observations on the dating of pregnancy.
The relationship between the concentrations of placental proteins and the stage of gestation has been examined. Human chorionic gonadotrophin and Schwangerschaftsprotein 1 were measured in two groups of patients: one a group of 13 women studied daily from conception to 21 days after ovulation and the other 43 normal pregnancies studied from 5 to 16 wk gestation. The results of assessment of the stage of gestation as determined by placental protein assay were compared with the dating obtained from last menstrual period and ultrasonic scan. The measurement of placental proteins was at least as accurate as the last menstrual period or ultrasonic scan in determining the stage of gestation.
Concomitant secretion of Schwangerschaftsprotein 1 and human chorionic gonadotrophin following conception.
Daily measurements of serum oestradiol, progesterone, Schwangerschaftsprotein 1 (SP1) and hCG were made in 13 menstrual cycles during which conception occurred. The assays were continued until 21 d after ovulation. SP1 was detected in maternal blood 8-14 d after ovulation and hCG 9-13 d after ovulation. We conclude that these two proteins are secreted simultaneously but independently by the syncytiotrophoblast.
Placental proteins in male serum.
Placental proteins such as human chorionic gonadotrophin (hCG), Schwangerschaftsprotein 1 (SP1) and pregnancy-associated plasma protein A (PAPP-A) are found in the blood of pregnant women and in subjects suffering from cancer. They can also be found in the blood of healthy non-pregnant women and in the seminal fluid of males. Surprisingly, hCG and SP1 could not be found in male serum, although PAPP-A occasionally occurs there.
Detection of subclinical abortion by assay of pregnancy specific beta 1 glycoprotein.
Explore the source record for details and available documents.
Placental proteins in the normal menstrual cycle, in occult pregnancy and in early normal pregnancy in the same subject.
Assays of SP1 and of hCG were done in three successive menstrual cycles in a woman undergoing artificial insemination from a donor. The day of ovulation was determined by basal body temperature, and by assays of oestradiol and progesterone. In the first cycle no placental proteins were detected, in the second cycle there was a transient peak of SP1 and hCG 4 days after ovulation. In the third cycle both proteins were first detected 12 days after ovulation, then increased rapidly in concentration and the patient went on to a normal pregnancy.
Determination of the stage of gestation by the assay of chorionic gonadotrophin and Schwangerschaftsprotein 1.
Serial assays of Schwangerschaftsprotein 1 (SP1), SP1 alpha, SP1 beta and human chorionic gonadotrophin were performed in 12 subjects from ovulation until the pregnancies had reached 16 weeks. From these data formulae were devised for deducing the stage of gestation from the concentration of the placental protein. These formulae were then tested by assays on 34 women not included in the original study. Assays of hCG do not give reliable indications of the stage of gestation when this has progressed beyond 9-10 weeks but SP1 assays give predictions of gestation corresponding closely to that derived from the last menstrual period up to 16 weeks gestation.
Assay of Schwangerschafts protein 1 (SP1) as test for pregnancy.
Explore the source record for details and available documents.
The concentrations of SP1 beta and SP1 alpha in retroplacental and peripheral blood at term.
The concentrations of the two components of Schwangerschaftsprotein 1 (SP1 beta and SP1 alpha), human chorionic gonadotrophin (hCG) and human placental lactogen (hPL), were measured in peripheral venous blood and in retroplacental blood at term delivery in 22 women. Like hCG and hPL, the values of SP1 alpha were higher in the retroplacental than in the peripheral blood, as might be expected with placental secretory products. On the other hand, the concentration of SP1 beta showed a reverse gradient, being higher in the peripheral than in retroplacental blood.
Studies on the half-life of Schwangerschaftsprotein 1 (SP1).
Schwangerschaftsprotein 1 (SP1) was measured in 10 women at intervals after delivery of the placenta. SP1 alpha decreased more sharply than SP1 beta and showed evidence of a two-compartmental distribution in the mother. Trace amounts of both proteins could still be detected 5 weeks after delivery. It is concluded that the findings support the view that the two proteins are separate biological entities and that there is a possibility that SP1 beta is generated from SP1 alpha in the maternal compartment.