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Biomedical subjects

A K Abdullah

Publications and source records attributed to A K Abdullah.

At least 19 recordsLinked to original sources

Idiopathic pulmonary calcinosis: a variant of alveolar microlithiasis.

Diffuse pulmonary calcinosis has been observed in hyperparathyroidism, chronic renal disease, vitamin D intoxication, but has never been reported in the absence of any underlying disease. We report the case of a young man in whom diffuse pulmonary calcifications was found without any underlying disease and whose clinical and histological features suggest a variant or an incomplete form ('forme fruste') of alveolar microlithiasis.

Adult↗

Nationwide community survey of tuberculosis epidemiology in Saudi Arabia.

In the first nationwide community-based survey of the epidemiology of tuberculosis in Saudi Arabia, 7721 subjects were screened in the 5 provinces (using an equal proportional allocation formula) for 2 parameters: (1) prevalence of positive Mantoux test in non BCG vaccinated subjects; (2) prevalence of bacillary cases on sputum culture. The prevalence of positive Mantoux reaction in children aged 5-14 years was 6% +/- 1.8; higher in urban areas (10%), and lower in rural areas (2%), thus classifying Saudi Arabia among the middle prevalence countries. These relatively good results (by Third World standards) could reflect the rise of the standard of living and wide availability of free treatment for active cases with a lowered risk of infection in the community. This view is supported by the fact that in our survey, only one subject grew Mycobacterium tuberculosis in the sputum. However, there were foci of high prevalence of Mantoux reaction in the urban communities in the Western province (20% +/- 8.7 urban; 1% +/- 1.9 rural). The problem may be caused by the fact that the province receives every year over a million pilgrims, some of whom are known to settle illegally and escape the usual screening for tuberculosis imposed on foreign labourers. In conclusion, even in the absence of an enforceable national programme for the eradication of tuberculosis, the economic standard and wide availability of free treatment for active cases has resulted in relatively low rates of prevalence of tuberculin sensitivity in children. The foci of high prevalence in the Western Province require special screening arrangements.

Adolescent↗

The lungs in heatstroke.

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Disseminated Intravascular Coagulation↗

The significance of positive Mantoux reactions in BCG-vaccinated children.

As the interpretation of tuberculin skin tests is controversial in subjects who have received BCG vaccine, we administered Mantoux tests to 2588 randomly selected Saudi children aged 5-13, 1945 of whom had been vaccinated with BCG at birth and 643 were unvaccinated. Only 7.8% of the BCG-vaccinated children were Mantoux positive (greater than or equal to 10 mm induration) at the age of 5 years, which was not significantly different from the unvaccinated children. The tuberculin sensitivity rose more steeply with age in the BCG-vaccinated than the unvaccinated children so that the difference between both groups became statistically significant in those aged 12 and 13 (20% versus 3.9%, 15.5% versus 4.1% respectively). These findings support the previously expressed theoretical postulates that BCG-vaccinated subjects display an increased ability to respond immunologically to encounters with environmental mycobacteria. In communities with low prevalence of environmental mycobacteria, this would result in a slow but persistent rise of skin reactivity to tuberculin which, if given time, will become greater than that of unvaccinated subjects.

Adolescent↗

Tuberculin survey in the Eastern Province of Saudi Arabia.

We present the results of the Mantoux test (5 units tuberculin) survey in the Eastern Province of Saudi Arabia, which was conducted as part of a nationwide epidemiological survey of tuberculosis. A total of 1105 subjects were screened out of whom 630 gave a history of BCG vaccination in the past and 363 were BCG-negative. Among BCG-negative children aged 5-14 years, only 5% had a positive Mantoux, a rate lower than most Third World countries but higher than developed countries were under 2% of children are tuberculin reactors. This calls for continuation of free treatment of active cases and increased efforts towards screening of contacts. The results also vindicate the current policy of giving BCG vaccine at birth and probably indicates the need to revaccinate at school leaving age, in accordance with WHO recommendations. Tuberculin reactivity rose steeply with age (32% at age 15-24 and 72% at age 45-64 years) indicating the presence of a large pool of subjects at risk of breaking into active disease. Finally, 71% (201/283) of children aged 5-14 years who had received BCG vaccine at birth, reacted negatively to the Mantoux test. This supports the findings of previous studies that in the majority of subjects, BCG-induced tuberculin sensitivity fades a few years after vaccination.

Adolescent↗

Solitary bronchial papilloma presenting with recurrent dyspnea attacks: case report with computed tomography findings.

A case of solitary bronchial papilloma is reported which, because of its unusual location near the carina and marked mobility, presented with attacks of dyspnea that were misdiagnosed as asthma for many years. It caused no abnormality on a plain chest X-ray, but could be visualized on linear and computed tomograms. The computed tomograms further demonstrated the absence of extraluminal extension of the tumor or mediastinal lymphadenopathy which could not be excluded by linear tomography or bronchoscopy. Transbronchial resection resulted in complete relief of symptoms.

Asthma↗

Cranial and epidural mycetoma caused by streptomyces somaliensis.

The authors report a rare case of cranial and intracranial mycetoma which presented with occipital sinuses, extensive involvement of skull vault and base, an extradural granuloma and intracranial hypertension. Radiological appearances are reviewed. The computerized tomography findings are the first of their kind for this condition. The diagnosis and treatment of this disease are discussed.

Adult↗

Serum IgE levels in adults with asthma.

Serum total immunoglobulin E (IgE) was measured in 88 normal adults and 100 adults with asthma using Phadebas IgE PRIST kits. The geometric mean IgE in our normal subjects was found to be higher than that reported by some investigators but was similar to or lower than that reported by others without showing any geographic pattern. It increased progressively from 92 kU/L in normal controls through 205 kU/L in cases of asthma with low atopic scores to 464 kU/L in asthma cases with high atopic scores. There was wide variation in IgE levels among individuals, making it difficult to use it to classify any subject into one of these groups. However, as a group, female asthmatics had lower mean IgE levels (182 kU/L) than did men (577 kU/L), and a higher proportion of them had low atopic scores (60% of the women versus 47% of the men). This suggests that probably more women had intrinsic asthma, while extrinsic asthma was more common among men in the population studied.

Adult↗

Adult respiratory distress syndrome and disseminated intravascular coagulation complicating heat stroke.

Fifty two consecutive patients with heat stroke were examined for evidence of adult respiratory distress syndrome (ARDS) and disseminated intravascular coagulation (DIC). Twelve patients were found to have ARDS (incidence of 23 percent) of whom nine (75 percent) died. All of these 12 patients had DIC as compared to only one among the 40 patients without ARDS. Review of the evidence in literature linking ARDS and DIC and our own observations in this study lead to the conclusion that the coagulopathy may be an essential mediator of lung damage in heat stroke and is a reliable marker of its occurrence. This suggests the possibility that screening of heat stroke victims for DIC may identify patients at increased risk of developing overt ARDS and allow early institution of measures which may possibly improve survival.

Adult↗

Ventilatory function in normal Saudi Arabian adults. Observations and comparison with some Western and Eastern reference values.

Ventilatory function was studied in healthy non-smoking Saudi Arabian adult males from Riyadh area, and findings compared with those of some Western and Eastern populations. It was found that while the FVC and FEV1 in our subjects were lower than in American, Canadian, Jordanian, and Hongkong Chinese, these were higher than in Indian and Singapore Chinese. Most parameters of expiratory flowrate (e.g. PEF, MEF75, MEF50), however, were equal to or higher in our subjects than in American, Canadian, and Jordanian, as well as Indian and Chinese subjects. Compared to the findings in normal subjects from Jeddah, Saudi Arabia, FVC was equal to, but FEV1 and FEF 25-75 were higher in our subjects.

Adolescent↗

Measurement of reversibility of airways obstruction: which parameters to use?

Maximum expiratory flow-volume (MEFV) curves recorded before and after salbutamol inhalation on 100 patients with various lung diseases were studied. Improvement was found to occur more frequently in MEF50, FEF25-75, FVC and MEF25, than in FEV1, FEV1/FVC%, or MTT. If improvement in only one of the first four parameters was taken as a measure of reversibility of airways obstruction, many cases showing improvement in the others were missed. Improvement in any of the last three parameters was rarely missed if improvement in any of the first four was present. It was concluded that there is no single best measurement for assessment of bronchodilator response. FVC, FEF25-75, MEF50 and MEF25 should all be measured. A flow-volume record of forced expiration from which all these measurements can be derived would therefore be preferable for this purpose to the time-volume spirometer record from which only FVC and FEF25-75 can be determined.

Adolescent↗

Tuberculous oesophagopulmonary communication: effectiveness of antituberculous chemotherapy. A case report and review of literature.

A patient with tuberculous oesophagopulmonary communication diagnosed by oesophagography and confirmed by endoscopy was successfully treated by medical means: a tuberculous aetiology was suggested by the detection of tubercle bacilli in the gastric washings and on culture. On reviewing the medical literature, successful results were reported in 3 adults and 2 children.

Adult↗

Precordial ST-segment changes and serum enzyme levels in acute myocardial infarction.

Serial study of 72-lead precordial ST-maps, SGOT, and SLDH was done in 30 cases of acute myocardial infarction. Infarct size was estimated by sum of ST elevation in all leads (sigma ST), number of sites showing ST elevation (NST), peak SGOT, and peak SLDH levels, and correlated with each other and with clinical features and hospital course. sigma ST correlated well with NST (r=0.92), but the correlations of sigma ST with SGOT (r=0.99) and SLDH (r=3.84) were better than those of NST with SGOT (r=0.22) and SLDH (r=0.53). There were close agreements between sigma ST and peak SGOT and peak SLDH except in the cases of non-transmural infarction, in whom smaller sigma ST suggesting small infract occurred with higher enzyme peaks indicating moderate or large infarct. Longer duration of chest pain, larger number of associated conditions (e.g. angina, hypertension, diabetes), complications (e.g. congestive heart failure, shock, arrhythmias) and mortality were associated with larger infarcts.

Adult↗