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Biomedical subjects

A Lambourne

Publications and source records attributed to A Lambourne.

At least 19 recordsLinked to original sources
PubMed1995

High prevalence of diabetes mellitus and impaired glucose tolerance in the Sultanate of Oman: results of the 1991 national survey.

A national survey of glucose intolerance and cardiovascular disease risk factors in Oman has demonstrated a high prevalence of diabetes (10%) and impaired glucose tolerance (IGT, 13% in females and 8% in males). Prevalence of diabetes rose with age to a maximum of over 30% in both sexes. Prevalence of total glucose intolerance (diabetes and IGT combined) exceeded 50% in the seventh (females) and eighth (males) decade of life.

Adult↗
PubMed1991

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↗
PubMed1989

The oculo-emetic reflex. A rationalisation of postophthalmic anaesthesia vomiting.

Data related to the incidence of postoperative vomiting were collected during prospective studies on 607 ophthalmic surgical patients of all ages who underwent halothane anaesthesia with spontaneous ventilation. Analysis of data in respect of age, sex and surgical site variables, and time of onset of vomiting, identified a female sex-related vomiting incidence of about 13% and a squint-related vomiting incidence of about 41%; no relationship between age and vomiting was identified. The analyses showed that squint surgery predisposed particularly to emesis, and was associated with a high incidence of both early and delayed vomiting. It is suggested that the apparent absence of an age-vomiting relationship in ocular, and especially squint, surgery, and the high incidence of vomiting, particularly the early vomiting associated only with squint surgery, provide clinical evidence for the existence of an oculo-emetic reflex. Our observations show that intra- and postoperative surgical stimulation of this oculo-emetic reflex is reflected in the incidences of vomiting after ocular surgery.

Adolescent↗
PubMed1989

Proteinuria selectivity index in Saudi children with nephrotic syndrome.

Proteinuria selectivity index (PSI) was determined in 54 Saudi children with nephrotic syndrome whose renal biopsy showed minimal change in 13 and non-minimal histologic changes in 41 patients. The selectivity was determined with two pairs of proteins, IgG/transferrin and IgG/albumin. There was considerable overlap in the values of PSI in patients with minimal and non-minimal histological changes. The clinical utility of PSI in differentiating minimal change nephrotic syndrome and non-minimal change nephrotic syndrome is low.

Antibody Specificity↗
PubMed1988

Vaginal birth after cesarean section: management debate.

Obstetric performance of 1847 women with previous cesarean section (CS) during the years 1983 and 1984 were studied. Vaginal birth after cesarean section (VBAC) was attempted in 94% of females with one previous CS, 4% in those with two previous CS, and one among the 70 patients with three or more previous CS. VBAC was achieved in 51% of those with one previous CS. It was successful in 60% of parturients with CS for non-recurrent causes, 36% of CS for cephalopelvic disproportion (CPD) and in 64% of those with a prior vaginal delivery. Uterine scar dehiscence was found in 0.9% of all patients with a previous CS. A failed attempt with Ventouse to achieve VBAC caused maximum maternal and perinatal morbidity.

Adolescent↗
PubMed1988

Bacterial, parasitic and viral enteropathogens associated with diarrhoea in Saudi children.

In a 2-year study of stools from Saudi children with gastro-enteritis and from controls, rotavirus was the pathogen most frequently detected, either alone (44.3%) or in combination with other enteropathogens (7%). There were two peaks for rotavirus isolates, one during the cold months and the other during the dry, hot season. Salmonella spp. and Campylobacter jejuni were the second and third most frequently isolated enteropathogens. Enteropathogenic Escherichia coli did not contribute significantly to diarrhoea. Detection of enterotoxigenic E. coli was not attempted and its role in diarrhoea remains obscure. Giardia lamblia was detected more frequently in controls than in cases of diarrhoea. Neither Entamoeba histolytica nor Schistosoma mansoni was detected in any of the children studied.

Campylobacter fetus↗
PubMed1988

Epidemiologic study of gestational trophoblastic diseases in Saudi Arabia.

The role of cultural and socioeconomic diversities (that is, marriage, conceptions at the extremes of reproductive life, consanguinity, economic affluence and such) were analyzed for significance in the epidemiologic study of gestational trophoblastic disease (GTD) in Saudi Arabia. For the study period, the incidence of hydatidiform mole remained unchanged at a mean of one in 448 pregnancies and one in 6,130 for its malignant counterpart. In the instance of molar pregnancies, the youngest (less than 20 years of age) and the oldest (more than 40 years of age) had significantly higher than expected incidence; in contrast, in malignant GTD, the trend was for a higher than expected frequency for the older age group only (more than 40 years of age). Consanguinity showed no significant epidemiologic role.

ABO Blood-Group System↗
PubMed1988

Cerebral infarction and left ventricular mass: a clinical and echocardiographic study.

One hundred and two stroke patients were studied. Thirty-three (32 per cent) were hypertensive by the WHO criteria. Eighty-three (83 per cent) had cerebral infarction and three patients suffered from spontaneous intracerebral haemorrhage. The mean left ventricular mass was calculated from echocardiographic measurements and compared with that of controls. Neither cases nor controls had valvular or congenital heart disease, or disease processes that may be associated with myocardial infiltration. Mean left ventricular mass of all cases was significantly greater than that of controls (p less than 0.025) and that of the cases over the age of 50 years was also significantly greater than that of controls of the same age (p less than 0.02). The clinically normotensive cases had greater left ventricular mass than the normotensive controls (p less than 0.02). Meanwhile left ventricular mass in patients aged 50 and under was not significantly different from the appropriate control group (p greater than 0.2). These data indicate that the frequency of arterial hypertension among victims of cerebral infarction is greater than may be ascertained clinically particularly in those over 50.

Adult↗
PubMed1987

Cesarean section; changing patterns in Saudi Arabia.

Analysis of 8000 cesarean births in the Maternity and Children's Hospital, Riyadh, Saudi Arabia documents an increase in the cesarean section (CS) rate from 3.9% in 1979 to 9.9% in 1984. This increase is mainly attributed to indications such as repeat section (37.2%) and fetal distress (28.5%). Increase in the diagnosis of fetal distress was related to the introduction of electronic fetal monitoring and this diagnosis was not substantiated by Apgar score of the neonate. Because of the social preference for large families in Saudi Arabia, over-use of cesarean section should be avoided. For this reason, critical analysis of fetal distress and adequate trial of labor for patients with previous cesarean section is mandatory.

Apgar Score↗
PubMed1987

Relationship of post-tetanic count and train-of-four response during intense neuromuscular blockade caused by atracurium.

Atracurium-induced intense neuromuscular blockade was evaluated in 60 randomly selected patients using the post-tetanic count (PTC) and train-of-four (TOF) methods. Thirty patients were anaesthetized with thiopentone, nitrous oxide and halothane, and 30 patients received thiopentone, nitrous oxide and fentanyl. In all patients, the response to post-tetanic single twitch stimulation appeared before the response to TOF stimulation, and a close correlation was found between the number of post-tetanic twitches (PTC) and the time interval between the PTC and the first detectable TOF response. A PTC of zero indicated that the time to first response to TOF stimulation was always more than 8 min. A PTC of 1 meant that the TOF response would appear in, on average, 9 min (95% confidence limits: 4-14 min). Halothane significantly prolonged the time from injection of atracurium to the first response to post-tetanic single twitch stimulation. It is concluded that the relationship between PTC and the time to first response to TOF nerve stimulation makes the PTC method a valuable supplement to TOF nerve stimulation for neuromuscular monitoring during clinical anaesthesia involving atracurium.

Adolescent↗
PubMed1987

Vomiting after ophthalmic surgery. Effects of intra-operative antiemetics and postoperative oral fluid restriction.

The usefulness of intra-operative antiemetics and postoperative oral fluid restriction in the prevention of vomiting following anaesthesia for ophthalmic surgery, was studied in 200 patients. They were allocated into four groups of 50 and given either saline (as control), droperidol, metoclopramide or prochlorperazine. Oral intake was restricted postoperatively in half of the patients of each group. Anaesthesia comprised morphine and atropine premedication and a halothane, nitrous oxide and oxygen spontaneous breathing technique. No significant beneficial effects resulted from intra-operative antiemetics; vomiting incidences of 26% after saline and droperidol, 28% after metoclopramide and 14% after prochlorperazine were observed. Younger patients and females vomited most frequently. Restriction of oral fluids did not decrease the incidence of vomiting but demonstrated that approximately half of those patients who vomit do so with their first postoperative oral intake. Vomiting was observed more frequently after non intra-ocular surgery than after intra-ocular surgery (37% cf. 16%, p less than 0.01) and postoperative analgesics were required by more non intra-ocular patients than by intra-ocular patients (25% cf. 5%, p less than 0.001). Squint patients vomited most frequently (48%) and most frequently required postoperative analgesia (35%).

Adult↗
PubMed1987

Performance of men and women medical students at King Saud University, Riyadh: a 10-year retrospective study.

This study was carried out using the results of medical students at the College of Medicine at King Saud University, Riyadh between 1975 and 1985. The purpose of the study was to ascertain whether any correlation existed between school performance and college performance, whether results from males were different from results from females, and whether the semester system, in operation since 1981, produced different results from the annual system. Significant correlations were found between school Grade Point Average (GPA) results and college results, being highest for premedical courses and lowest for clinical courses. However, these correlations were too small to be of practical use. Men students were found to perform better at preclinical subjects whereas women had better results at clinical subjects. The overall performance on the semester system was significantly higher than that on the annual system.

Education, Medical, Undergraduate↗
PubMed1987

Relationship between posttetanic count and response to carinal stimulation during vecuronium-induced neuromuscular blockade.

The correlation between degree of peripheral neuromuscular blockade and response to carinal stimulation was evaluated in two groups of 25 patients: one group was anaesthetized with thiopental, N2O and halothane, and the other group received thiopental, N2O and fentanyl. The degree of peripheral blockade was evaluated using train-of-four (TOF) and posttetanic twitch (PTC) stimulation of the ulnar nerve. The degree of diaphragmatic paralysis was evaluated indirectly by stimulating the carina and observing the corresponding muscular response, which was graded as severe, mild or absent. During halothane anaesthesia a PTC of 0 always indicated that no response to carinal stimulation could be elicited. On the appearance of the first response to posttetanic twitch stimulation (PTC = 1), 2% of the patients showed a mild response to carinal stimulation. At the first response to TOF stimulation, 48% of the patients reacted with a mild response. During thiopental, N2O, fentanyl anaesthesia one of 25 patients showed a mild response to carinal stimulation at a PTC of 0. When PTC was 1, 20% of the patients reacted mildly to the stimulation. At the first response to TOF stimulation, 92% showed a response to carinal stimulation; 24% of these responses were severe, necessitating intervention. It is concluded that the TOF response elicited peripherally is a late sign of neuromuscular recovery of the diaphragm, and that the method of counting posttetanic twitches is superior to the TOF response in evaluating early recovery of this muscle. Further, to ensure total diaphragmatic paralysis, the neuromuscular blockade of the peripheral muscles should be so intense that no response to posttetanic twitch stimulation (PTC = 0) can be elicited.

Adolescent↗