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Biomedical subjects

A M Saad

Publications and source records attributed to A M Saad.

At least 19 recordsLinked to original sources
PubMed1999

Mortality due to schistosomiasis mansoni: a field study in Sudan.

Although schistosomiasis affects 200 million persons, 20 million of whom have advanced disease, little is known about the mortality pattern in areas of endemic schistosomiasis mansoni. In an attempt to assess the mortality rates in an endemic area in Sudan, we conducted two demographic surveys in a village in the Gezira area. Clinical, sonographic, and parasitologic examinations were performed in a randomly selected sample of 25% of the population in 1987 and 1994. One of us asked each head of household about the names, sex, and age of family members. Particularly, we asked about death in the family if any, history of schistosomiasis, abdominal swelling, and hematemesis. Possible causes of death were ascertained by reviewing medical records in the village dispensary and the district hospital. There were 42 deaths in the village. Four males died of hematemesis secondary to portal fibrosis. The crude mortality rate of schistosomiasis was is 51/100,000/year. The overall schistosomiasis fatality rate per year was 1/1,000 infected persons, but was as high as 11/100/infected patients with bleeding varices. These findings showed the impact of schistosomiasis on public health in this economically important region of Sudan.

Adolescent↗
PubMed1997

Decrease in canine proximal femoral ultimate strength and stiffness due to fatigue damage.

Fractures of the proximal femur represent a significant health concern especially in the elderly. Fatigue damage and microfractures have been implicated in the etiology of hip fractures; however, the extent to which these factors are sufficient to bring about significant reductions in proximal femur strength and stiffness is unknown. This study examined the hypothesis that fatigue loading of the proximal femur results in highly correlated decreases in bone stiffness and strength through the accumulation of bone microdamage. One canine femur from each of 10 pairs was monotonically loaded to failure to determine the ultimate strength. The contralateral femur was then cyclically loaded at 50% of the ultimate load value for either 3600 cycles or until a 40% reduction in stiffness was achieved. This femur was then monotonically loaded to failure. For two additional femur pairs, the fatigued femur was histologically processed to reveal bone microdamage. In support of the hypothesis, the data demonstrated a linear relationship between strength loss and stiffness loss (Adj. R2 = 0.79, p < 0.0004) with significant decreases in residual whole bone strength (p < 0.004) following cyclic loading. In addition, damage (microcracks) in the cortical bone and broken trabeculae were observed in the neck and head region of the femur fatigued until its stiffness was reduced by 40% but not fractured subsequent to cyclic loading.

Animals↗
PubMed1996

Characterization of camel leukocytes by flow cytometry and microscopic evaluation of granulocyte phagocytosis of fluorescent bacteria.

Peripheral blood was obtained from four lactating camels (Camelus bactrianus) and flow cytometry was used to characterize cell populations. The ability of the granulocytes to engulf fluorescent bacteria was studied in vitro using fluorescence microscopy. Three clusters of blood cells (mononuclear cells, neutrophils and eosinophils) were identified by flow cytometry and fluorescent microscopy. Milk, on the other hand, was dominated by cell fragments and no distinct cluster formation was found. The mean yield of blood granulocytes and monocytes isolated on Ficoll gradient was 92.2 +/- 5.4% and 7.9 +/- 5.7%, respectively. Cell viability was 95%. The mean percentage of phagocytic cells was 71.8 +/- 5.9% at 10 min and increased to 97.3 +/- 0.5% at 60 min when observation was terminated. The average number of bacteria per phagocyte was 8.7 +/- 2.1 and 13.1 +/- 0.9 at 10 and 60 min incubation time.

Animals↗
PubMed1996

The effectiveness of annual versus biennial mass chemotherapy in reducing morbidity due to schistosomiasis: a prospective study in Gezira-Managil, Sudan.

The most serious complication of schistosomiasis is periportal fibrosis, which affects a large number of subjects in endemic areas. Population-based chemotherapy remains the most effective way of controlling this disease. In an attempt to find the best way to deliver chemotherapy to the endemic population, we compared the impact of repeated annual versus biennial mass chemotherapy on morbidity due to schistosomiasis in two villages in Gezira, Sudan. One village was given five rounds of mass chemotherapy annually in the years 1990-1994 while the other village was given three rounds of mass chemotherapy biennially from 1988 to 1994. Before treatment, these villages had similar intensity of infection and prevalence. One round of either annual or biennial treatment reduced the intensity of infection, but not prevalence or morbidity. After two rounds of annual chemotherapy, infection rates, bloody diarrhea, and fibrosis in those 20 years of age and less were significantly reduced. Two rounds of biennial chemotherapy had a similar effect on rates and bloody diarrhea; however, fibrosis was reduced only after the third round of biennial chemotherapy. Prevalence of hepatosplenomegaly increased after both treatment regimens. Reinfection was most prominent in those 5-14 years of age. These findings support the general notion that repeated chemotherapy may be needed in areas of high transmission of schistosomiasis. We recommend two rounds of annual mass chemotherapy to significantly reduce infection and morbidity.

Adolescent↗
PubMed1994

Predictors of upper gastrointestinal bleeding in patients with schistosomal periportal fibrosis.

A case-control study was conducted between 1985 and 1987 in the Gezira-Managil area of central Sudan to assess the major predictors of haematemesis. Eighty-four patients who had suffered at least one attack of oesophageal bleeding and had schistosomal periportal fibrosis demonstrated by ultrasonography were compared with 173 subjects without bleeding but with ultrasonographic evidence of periportal fibrosis. A splenic longitudinal dimension of more than 11 cm, periportal fibrosis worse than grade I and varices more than grade I were independently associated with a significant risk of variceal bleeding. Age, sex, presence of a palpable liver and portal vein diameter were not associated with a significant risk of bleeding after adjustment for potential confounding variables. Factors identified in this study could be helpful in the prophylactic management of patients with complicated schistosomiasis.

Adult↗
PubMed1993

Liver sonography in an area endemic for schistosomiasis haematobium.

Through the use of portable ultrasonography, eight cases (2%) of periportal fibrosis were identified in a random sample of 400 subjects selected from a village with a high prevalence and morbidity due to schistosomiasis haematobium in the White Nile Province of Sudan. In contrast, 36 cases (15%) of fibrosis were seen in an area with a similar prevalence and morbidity due to schistosomiasis mansoni in the Gezira Managil region of Sudan. Although there was only one case of Schistosoma mansoni as determined by repeated stool examination of the entire sample population in the first village, the majority of those with fibrosis and age-matched controls showed serologic evidence of active S. mansoni infection. This led to the conclusion that the cases of periportal fibrosis seen in the White Nile Province are most probably due to S. mansoni rather than to S. haematobium.

Adolescent↗
PubMed1993

Cholecystectomy with and without drainage: a prospective randomised study.

The use of subhepatic intraperitoneal drains was prospectively studied in 100 patients who underwent elective cholecystectomy for symptomatic gallstones. These patients were randomised to have subhepatic drains (group A, n = 50 patients) or to have no drains (group B, n = 50 patients). There was no difference in the age or sex composition of the two groups. The patients were followed in the post-operative period (0-7 days) for evidence of fever, wound infection, septicaemia and any evidence of intra-peritoneal bile leakage. Also post operative hospital stay of patients was noted. In group A, 14 patients (28%) developed spikes of temperature of 38 degrees C or more while only 5 patients (10%) in group B developed such episodes. The difference was statistically significant between the two groups (P < 0.05). Wound infection occurred significantly more (P < 0.05) in group A (in 15 patients) as compared to group B (in 5 patients). Septicaemia occurred in 2 patients in group A and in none in group B. There was no evidence of intraperitoneal bile leakage in either group. Patients in group A tended to have longer post operative hospital stay (mean of 10.2 days) than patients in group B (mean 8.7 days); but the difference between the two groups in this respect was not significant. We conclude that subhepatic intra-peritoneal drains offered no additional advantage in elective cholecystectomy. The evidence we had pointed to their harmful effects.

Bile↗
PubMed1992

Surgical treatment of chronic fissure-in-ano: a prospective randomised study.

A prospective randomised study compared anal dilatation (n = 37), posterior internal sphincterotomy (n = 21) and lateral sphincterotomy (n = 20) in the surgical treatment of chronic anal fissures in 78 consecutive patients. All the operations were performed under general anaesthesia using standard techniques. Anal dilatation relieved anal pain early (immediate relief in 57% of patients; the mean pain-days +/- SD of 3.2 +/- 5.4 days). Anal fissures after this operation healed in a mean time +/- SD of 20.3 +/- 12.5 days, coming in second place to lateral sphincterotomy. Anal dilatation was followed by insignificant wound infection but its main disadvantage was a high rate of post operative anal incontinence (in 24.3% of patients). Fissurectomy and posterior internal sphincterotomy was followed by the longest period of post operative anal pain (mean +/- SD of 32.4 +/- 10 days) as compared to the other two operations. It was the least favourable operation. Lateral sphincterotomy was followed by early relief of pain (immediate relief in 95% of patients). It was not followed by wound infection. It had the quickest healing time for the fissures (a mean +/- SD of 14.7 +/- 8.7 days). It was followed by anal incontinence in only one patient. In conclusion lateral sphincterotomy was the most favourable operation and it is perhaps the operation of choice to perform in patients with chronic anal fissures needing surgical treatment.

Adult↗
PubMed1992

Primary surgical care.

Explore the source record for details and available documents.

Ambulatory Surgical Procedures↗
PubMed1991

Oesophageal varices in a region of the Sudan endemic for Schistosoma mansoni.

In a field study of two villages in the Gezira, an area of the Sudan endemic for Schistosoma mansoni, liver ultrasonography was used to detect subjects with Symmers' hepatic periportal fibrosis, some of whom underwent oesophagoscopy to detect oesophageal varices. The prevalence of oesophageal varices in subjects undergoing oesophagoscopy was 54 per cent and 67 per cent respectively, occurring mainly in males aged about 30 years. The varices were usually asymptomatic. Symptomatic varices (with a positive history of haematemesis) occurred in 4 per cent and 3 per cent respectively of subjects with sonographic evidence of liver periportal fibrosis. By detecting oesophageal varices in an asymptomatic phase, hepatic ultrasonography and fibreoptic oesophagoscopy may elucidate the natural history of the varices and their response to periodic anti-schistosomal chemotherapy.

Adult↗
PubMed1991

An oral practical examination in emergency clinical surgery.

A body of students were asked about their views regarding an oral practical examination in clinical surgery that had been in practice for over 12 years. This is an examination with the planned objective to test problem-solving abilities and professional attitudes in emergency surgery. Verbal emergency simulation aided by appropriate pathological specimens, surgical instruments and X-rays are put forward by the examiners, and the candidate is asked to respond. One hundred and ninety-four students returned their questionnaire out of a total of 196 students (99% response rate). Candidates who were satisfied with their answers in the examination numbered 127 (65%), while 67 candidates were dissatisfied (35%). Reasons for dissatisfaction were cited as difficult and complex emergency simulation questions, expressed by 44 candidates (23%), and anxiety generated by confrontation of the examiners, expressed by 23 candidates (12%). One hundred and thirteen students (58%) thought a change in the format of the examination was not needed, while 47 students (24%) suggested a change mostly towards standardization of the examination. Emergency clinical surgery is an important area of the surgical curriculum that needs to be assessed properly. A more standardized version of this oral practical examination could perhaps provide a useful tool of assessment.

Attitude of Health Personnel↗
PubMed1990

Influence of exogenous estradiol on the concentration of antitrypsin, albumin, N-acetyl-beta-D-glucosaminidase and somatic cells in milk of cows at various lactation stages.

Estradiol benzoate (0.02 mg/kg of body weight) was injected (i.m.) daily to 13 ovariectomized cows in their first or third lactations during early (60-90 days), mid (140-200 days) and late (240-300 days) lactation. The majority of the udder quarters were free of bacteria throughout the experiment. Signs of clinical mastitis were observed after 9-19 days of treatment in cows at mid and late lactation. This was accompanied by a decrease in milk yield, an increase in milk somatic cell count (MSCC) and increases in milk concentration of antitrypsin and serum albumin (as indicator of increased permeability); and milk NAGase activity (as indicator of epithelial cell damage or release of the enzyme from phagocytes). NAGase activity was first to increase and on some occasions was not accompanied by an increased MSCC. The response was either absent (first lactation) or relatively mild (third lactation) in cows at the early stages of lactation. The intensity of the inflammatory response increased with advancing lactation stage. Generally, the response of cows in the third lactation was greater than that of cows in the first lactation at a corresponding stage of lactation. Three cows which received the control treatment with vehicle alone showed no changes in any of the parameters except a slight decrease in antitrypsin. All inflammatory indicators correlated negatively with quarter milk production; milk NAGase activity was superior in this respect (r = -0.75). All correlation coefficients were generally higher after, rather than before the hormone treatment.

Acetylglucosaminidase↗
PubMed1990

Influence of estradiol administration to lactating cows on bacterial growth in milk whey.

Bacterial growth (E. coli) in whey was studied by turbidometric technique during estradiol benzoate administration (0.02 mg/kg of body weight/day for 12-19 days) to 13 ovariectomized cows at three stages (early, mid and late) of the 1st- and 3rd-lactations. Whey samples from cows at early stage (60-90 days) of 1st-lactation promote the growth of E. coli during the estradiol treatment. This included a significant increase in the maximum turbidity and a decrease in the generation time. Bacterial growth was inhibited in whey from cows at other stages of lactation during the hormone treatment. The degree of inhibition varied at different stages of lactation. No significant alterations in the ability of whey to support bacterial growth were observed in 3 ovariectomized cows treated with the drug vehicle (arachis oil) alone. Majority of the quarters included in the present study were bacteriologically negative throughout the study.

Animals↗
PubMed1990

Flow cytofluorometric studies on the alteration of leukocyte populations in blood and milk during endotoxin-induced mastitis in cows.

Alterations in the various leukocyte populations in milk, blood, and mammary lymph were studied by use of the flow cytometric method during acute mastitis episodes induced by endotoxin infusion (50 micrograms of lipopolysaccharide of Salmonella typhimurium SH 4809) via the teat canal. Lymph samples were collected via a semipermanent catheter from an afferent duct to the supramammary lymph node. Milk somatic cell count increased at 4 hours after infusion of endotoxin. Neutrophils were the predominant cell population for up to 59 hours after infusion. Numbers of lymphocytes and monocytes-macrophages in milk also increased after the endotoxin infusion. The total cell count in milk started to decrease during the third postinfusion day and returned to preinfusion values during the fourth day. Lymphocyte numbers remained high for about 1 week after the infusion, and lymphocytes were the predominant cell population between postinfusion days 4 and 8. Total blood leukocyte count decreased during the first 6 hours after infusion, followed by an increase until postinfusion hour 31. The proportion of neutrophils in blood increased during the first day, whereas that of lymphocytes decreased. Lymph flow rate and leukocyte numbers in lymph increased after endotoxin infusion. The proportion of neutrophils in the lymph increased during the first 6 hours, whereas that of lymphocytes decreased. After postinfusion hour 6, the inverse course of events was seen.

Animals↗
PubMed1989

Alterations in neutrophil phagocytosis and lymphocyte blastogenesis in dairy cows around parturition.

The bovine blood neutrophil phagocytosis and the blood and milk lymphocyte proliferative response upon stimulation with Phytohaemagglutinin, Concanavalin A and Pokeweed mitogens was studied from 3 weeks prior to calving until 3 weeks after calving. Neutrophil phagocytosis and the total and differential blood leukocyte counts were performed by flow cytometry. A gradual increase in the percentage of phagocytized bacteria and the average number of bacteria per phagocyte was observed before calving followed by a sharp fall on the first postpartum. This was followed by a steady increase in the above parameters reaching the highest levels at two weeks postpartum. There was a gradual increase in the number of neutrophils in blood as calving approached followed by a sharp decrease after calving. The number of lymphocytes in blood dropped before calving, being at the lowest level on the day before calving. The proliferative response of blood and milk lymphocytes upon stimulation with the three mitogens was low during the week preceding parturition with the lowest value on the day before calving. The response of blood lymphocytes returned to a higher level the second week after calving while that of milk lymphocytes remained at a low level during the first and the second postpartum weeks.

Animals↗