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Biomedical subjects

A Memon

Publications and source records attributed to A Memon.

At least 19 recordsLinked to original sources
PubMed2000

Therapeutic efficacy of Dornier MPL 9000 for prevesical calculi as judged by efficiency quotient.

PURPOSE: To study the efficacy and safety of the Dornier MPL 9000 lithotripter in the treatment of prevesical calculi using real-time ultrasound monitoring and to see if efficacy is adequately judged by the efficiency quotient (EQ). PATIENTS AND METHODS: Seventy-six patients underwent ultrasound-guided extracorporeal shockwave lithotripsy (SWL) for prevesical calculi over a period of 43 months. Their age ranged from 8 to 68 (mean 37.6) years, and the male:female ratio was 2.6:1. The size of the stones, measured in two dimensions, ranged from 4 to 25 mm (mean 9.3 mm) and 2 to 15 mm (mean 6.0 mm). No general or regional anesthesia or ureteral stents were used, and all patients were treated in the prone position. The EQ was calculated using the formula: Stone free (%) x 100/(100 + retreatment rate (%) + auxiliary procedures (%). RESULTS: Seventy patients were stone free in a mean time of 15 +/- 14.11 days. The average number of shockwaves used was 2,831 +/- 1,612, and the average number of sessions per patient was 1.7. About 92% of the patients were rendered stone free using in situ SWL alone. No major complication was encountered, and none of the patients required an inpatient stay after SWL. The EQ was 65. Five patients with failed SWL subsequently were rendered stone free, four with salvage ureteroscopy and pneumatic lithotripsy and one with cystolitholapaxy for a symptomatic fragment in the bladder. One patient was lost to follow-up. CONCLUSION: In situ SWL is a safe and effective treatment for prevesical calculi. It should be used as a first-line treatment for most such stones. Efficiency can be assessed objectively by the EQ.

Dose-Response Relationship, Radiation↗
PubMed2000

Clinical epidemiology of acute myocardial infarction in Kuwait.

OBJECTIVE: We studied the clinical epidemiological features of patients with AMI treated at a major hospital in Kuwait. The objectives of the study were to determine (i) personal and clinical characteristics of patients; (ii) prevalence of major risk factors among the patients; and (iii) factors associated with in-hospital morbidity and mortality. METHODS AND RESULTS: All patients (n = 126) who fulfilled the standard diagnostic criteria for AMI and treated at the CCU of the study hospital during the calendar year 1996 were included in the study. Patients were identified from the CCU register and information was extracted from the medical records. Multiple logistic regression was performed to study the factors independently associated with in-hospital morbidity and mortality. Of the 126 patients, 84.9% were men and 15.1% were women; and 40.5% were Kuwaiti nationals and 59.5% were expatriates. On average, male patients were younger than females (mean age = 52.4 +/- 10.4 years vs. 60.2 +/- 10.2 years), and male expatriates were the youngest sub-group in the study (mean age = 49.7 +/- 8.7 years). Overall, history of diabetes, hypertension, and CHD was recorded in 44.4%, 29.6%, and 16.8% of the patients, respectively. About 58% of the male patients were current smokers and the prevalence of smoking was significantly higher in expatriates compared with Kuwaiti patients (62% vs 36%, respectively). Kuwaiti nationals had a significantly high prevalence of diabetes compared with the expatriates (57% vs 36%, respectively). There was a significant trend in increasing prevalence of diabetes, hypertension and CHD with age whereas smoking was most prevalent (87%) in the youngest age group. As for the clinical features, 70.5% of the patients presented within 6 hours of the onset of symptoms, 73% presented with ST-segment elevation (40.5% with inferior, 32.5% with anterior ST-segment elevation), and fibrinolytic therapy was given to 63.6% of the patients. About half of the patients had an admission blood glucose level of > or = 10 mmol/l, and 70.6% had a fasting blood glucose level of > or = 6.1 mmol/l one day after admission. In the multiple logistic regression analysis, old age (> 60 years), anterior MI, and admission blood glucose level of > or = 10 mmol/l were found to be significantly associated with in-hospital cardiac morbidity. The in-hospital case fatality was about 6%. Old age and history of CHD were found to be the significant predictors of in-hospital mortality. CONCLUSION: Control of smoking and early diagnosis and appropriate treatment of diabetes may reduce the burden of AMI-related morbidity and mortality.

Adult↗
PubMed2000

Use of residual fraction instead of residual volume in the evaluation of lower urinary tract symptoms.

Assessment of postvoid residual volume (PVR) has become a valuable routine investigation in the evaluation of bladder outlet obstruction. PVR has been shown to have interindividual and intraindividual variation and dependence on prevoid urinary volume, thus raising a question about its significance. The aim of this study was to investigate an alternate parameter more reliable than PVR, described as residual fraction (RF) and calculated as (PVR x 100)/prevoid volume. Ninety-three adult patients with lower urinary tract symptoms (LUTS) presenting to the urology outpatient clinic were evaluated for bladder outlet obstruction. Patients with urinary retention and neurological disorders were excluded. Evaluation was by clinical assessment, uroflowmetry, and ultrasound bladder for prevoid and postvoid urine volume estimation. The latter was compared with RF. Results were statistically analyzed using bivariate analysis and Spearman's test. In 93 evaluable patients, there were 87 (94%) males and 6 (6%) females. Residual volume ranged from 4 to 450 mL (mean 91.4+/-92.7 mL). Peak flow rate (Qmax) varied from 3 to 49 mL/s (mean 9+/-15 mLis). Two-tailed correlation between PVR and Qmax was significant at the .05 level, whereas a more significant R value at .01 was observed between RF and Qmax. There was a strong positive correlation between RF and PVR with Qmax. RF statistically correlated better with Qmax than PVR. It is recommended that RF be used instead of PVR in the routine noninvasive evaluation of LUTS.

Adult↗
PubMed2000

Three techniques for simpler, safer, and cost-effective rigid ureteroscopy.

Postureteroscopy colic, accumulation of irrigant fluid in the bladder, and advancement of the ureteroscope through narrow ureters are some of the problems commonly encountered during ureteroscopy. Three methods to overcome these problems and to make ureteroscopy technically easy, safe and cost-effective are described.

Abdominal Pain↗
PubMed1999

Measurement of serum N-acetyl beta glucosaminidase activity in patients with breast cancer.

N-acetyl-beta-glucosaminidase (NAG) activity measured in sera from 129 breast cancer patients was elevated (mean 18.2 units/l) compared with that in sera from 28 healthy women (11.6 units/l) (p=0.001). There was a weak correlation between NAG activity and carcinoembryonic antigen (CEA) and CA-153, but no relationship to age, menopausal status, node status, stage, histology of tumour or to steroid receptors. NAG, CEA and CA-153 were measured in periodic follow-up samples taken after surgery (up to 26 months) from 17 patients. NAG activity fluctuated within a narrow range, unlike CEA and CA-153. In 70% of cases the pattern was similar to at least one of the other markers, and was generally maintained at a higher level in patients who suffered relapse compared with those who remained disease-free up to the last follow-up, but was not significantly altered before relapse. The measurement of NAG activity is unlikely to be of value in predicting time or occurrence of relapse or of clinical utility in post-surgical therapy. Increased appearance in serum may aid metastasis by degrading the extracellular matrix and it may be better investigated as a predictor of progression from in situ to invasive and metastatic cancer.

Acetylglucosaminidase↗
PubMed1999

Immunoradiometric measurement of pS2 in breast cancer--correlation with steroid receptors and plasminogen activators.

pS2 was measured by radioimmunometric assay in tumour extracts from 197 breast cancer patients. Values ranged from 0 to 50 ng/mg protein (mean 9.6 and median 3 ng/mg). We found no correlation with age, menopausal status, nodal metastases, disease stage or tumour histology. There was, however, a linear relationship with both ER (p < 0.0001) (particularly nuclear ER) and PR (p < 0.0001) expression determined by enzyme immunoassay (ELISA), as well as a good correlation when high and low expressors were stratified on the basis of combined ER/PR expression using consensus cut-off points. Only 15% of ER - ve/PR - ve patients were classified as pS2 + ve compared with 83% of those who were ER + ve/PR + ve. pS2 was also directly correlated with high expression of tPA and inversely with uPA. Comparison with previous studies showed that the current ELISA method produced consistent results, in contrast to other methods, particularly those based on immunohistochemical detection. The close relationship between pS2 and both steroid receptors suggests that pS2 may be important in terms of defining hormone-responsive patients who are likely to benefit from endocrine therapy.

Breast Neoplasms↗
PubMed1999

Seroprevalence of HIV, HBV, and syphilis and associated risk behaviours in male transvestites (Hijras) in Karachi, Pakistan.

In Pakistan, male sex workers are predominantly transvestites and transsexuals known as Hijras. In 1998 in Karachi, Pakistan, we studied the seroprevalence of HIV, HBsAg and syphilis and associated risk factors in Hijras. Study subjects were verbally administered a structured questionnaire that determined risk behaviours for sexually transmitted and blood-borne diseases and knowledge of AIDS/STDs. After pre-test counselling, verbal consent was taken for serological testing. The results were provided on a one-on-one post-test counselling session. Three hundred male transvestites were approached; all agreed to answer the questionnaire, 208 consented to blood testing. Of 300, 81% acknowledged commercial sex with men. Of 208, prevalence of syphilis was 37%; HBsAg 3.4%; HIV 0%. The prevalence of HIV and hepatitis B virus (HBV) is low in transvestite sex workers but that of syphilis is high. Intervention programmes implemented at this stage can have an impact on HIV and STD prevention.

Adolescent↗
PubMed1999

Earwitness recall and identification: comparison of the cognitive interview and the structured interview.

77 undergraduates instructed to act as kidnap victims heard taped instructions given by a mock abductor. Two days later witnesses' recall of the culprit's monologue was tested using either a Cognitive Interview or a Structured Interview. Participants then rated the abductor's voice for nine speech characteristics and attempted to identify his voice from an audiotaped lineup. No significant differences were found between the two interview conditions for accuracy or error rates in free recall, for ratings of descriptive voice characteristics, or for performance in voice identification. These earwitness results are consistent with eyewitness investigations which have yielded no positive influence of the cognitive interview on identification. It is concluded that the success of the cognitive interview is best explained through its influence on social components of interviewing.

Adult↗
PubMed1999

Age differences in accuracy and choosing in eyewitness identification and face recognition.

Studies of aging and face recognition show age-related increases in false recognitions of new faces. To explore implications of this false alarm effect, we had young and senior adults perform (1) three eye-witness identification tasks, using both target present and target absent lineups, and (2) and old/new recognition task in which a study list of faces was followed by a test including old and new faces, along with conjunctions of old faces. Compared with the young, seniors had lower accuracy and higher choosing rates on the lineups, and they also falsely recognized more new faces on the recognition test. However, after screening for perceptual processing deficits, there was no age difference in false recognition of conjunctions, or in discriminating old faces from conjunctions. We conclude that the false alarm effect generalizes to lineup identification, but does not extend to conjunction faces. The findings are consistent with age-related deficits in recollection of context and relative age invariance in perceptual integrative processes underlying the experience of familiarity.

Adolescent↗
PubMed1999

Water as an irrigant in transurethral resection of the prostate: a cost-effective alternative.

The safety of water as an irrigant solution in transurethral resection of the prostate (TURP) has been a controversial issue. Although it has been mostly abandoned in more affluent countries, it is still widely used in developing countries simply because of financial reasons. With this study, we attempted to show in a representative number of cases that this method can be applied without major fluid absorption, as would be indicated by changes in sodium (Na), creatinine (Crea), blood urea nitrogen (BUN), and free haemoglobin (fHb) levels in serum. Prospectively, we assessed the occurrence of clinical symptoms of TUR-syndrome, as well as changes in serum parameters in 60 patients irrigated during TURP with sterile water. Values of patients with some degree of resorption, as indicated by a drop in serum sodium, were compared to patients without any resorption. There was no TUR-syndrome in our patients, and serum levels of all parameters did not change significantly after TURP with water. Patients with a drop in sodium post-TURP did not have significant changes in Crea, BUN or fHb. The average saving was 162.60 USD per treatment. In our study population, water was a safe irrigation solution. Even with some degree of resorption, there were no significant haemolysis or metabolic imbalances. Saving for the patient are considerable and render the treatment affordable.

Aged↗
PubMed1998

Factors associated with the initiation of smoking by Kuwaiti males.

PURPOSE: To estimate the age patterns in cumulative probability of smoking initiation among Kuwaiti adult males and to study the differentials in smoking initiation in relation to factors such as age-cohort, marital status, educational level, income, type of residence, and history of smoking among family members and friends. METHODS: A stratified three stage cluster sampling design was implemented for the selection of the sample. A self-administered questionnaire was completed by 1798 Kuwaiti adult males working in different ministries. RESULTS AND IMPLICATIONS: Of the 1798 respondents, 34.4% were classified as current smokers, 17.7% as former smokers and 47.9% as non-smokers. The highest probability of smoking initiation (among current and former smokers) was found for the age group 15-20 years, where almost 29% of the respondents initiated smoking. In the univariate analysis, marital status, education, income, type of residence, and history of smoking among family members and friends showed significant variation in the age-patterns of initiation. In the Cox proportional hazard regression model, education, type of residence, and history of smoking among family members and friends were found to be independently associated with the risk of initiation. The highest risk of initiation (Relative Risk (RR) = 1.85; 95% CI: 1.62-2.10) was found among those who had a history of smoking in family and friends. Individuals in the lowest education category (RR = 1.64; 95% CI: 1.32-2.04) and those residing in apartments (RR = 1.65; 95% CI: 1.43-1.92) were at a higher risk of initiation compared with those who had university education or those who resided in villas. The results of the study should prompt further efforts to develop tobacco control policies in Kuwait and the other Arabian Gulf countries to help establish norms for not initiating smoking through persistent messages to not start or to stop smoking. There is also a need to enhance awareness about the influence of smokers in family or friends on other people to initiate smoking.

Adolescent↗
PubMed1998

Incidence of hip fracture in Kuwait.

BACKGROUND: Hip fracture as a consequence of osteoporosis is an important cause of morbidity and mortality among the elderly. Due to improving life expectancy, the number of elderly individuals is increasing more rapidly in the developing countries of Asia, the Middle East, Africa, and South America. Incidence of hip fracture, which rises exponentially with age, varies substantially between countries and according to the age, sex, and ethnic distribution of the population. Highest rates are observed in Scandinavia and in whites in the US, intermediate in western Europe, and the lowest rates in Asia. Little is known about the epidemiology of hip fractures in the Middle Eastern populations. In particular, there are no published reports from any of the Arab countries. We have therefore estimated the incidence of hip fracture in Kuwait and compared it with other populations. METHODS: The study was conducted at a specialized orthopaedic hospital which provides services to residents in the three governorates--representing about 70% of the total population of Kuwait. All new hip fracture patients who were operated on or treated conservatively during the 4-year period (1992-1995) were included in the study. Hip fracture was defined as clinical and radiological evidence of fracture of the proximal femur. For comparison with other populations, age-specific incidence rates in females and males aged > or =50 years were standardized to the 1985 US population. RESULTS: A total of 513 cases of hip fracture (205 females, 308 males) were recorded during the study period: 293 (57.1%) cases occurred among Kuwaiti nationals and 220 (42.9%) among non-Kuwaitis (expatriates). Age-standardized rates (per 100,000) of hip fractures were, in Kuwaitis, 295 for females (95% CI: 238.8-350.8) and 200 for males (95% CI: 163.3-236.5)--much higher than those observed in other Asian countries such as Korea, Singapore, China, Malaysia, and Japan (41-202 for females, 49-100 for males). Rates in Kuwaiti females were similar to those observed in some of the European countries (Italy, UK, France) and in Asian females in the US. In contrast, rates in Kuwaiti males, which were relatively high, were almost equal to those observed in white males in the US. Rates of hip fracture in non-Kuwaitis (374 for females [95% CI: 247.6-500.8], 215 for males [95% CI: 126.5-302.9]), who predominantly (96%) originate from southeast Asian and Arab countries, were similar to those observed in Kuwaiti nationals. CONCLUSIONS: The incidence of hip fracture in the Kuwaiti population is higher than that reported from other countries in Asia and is comparable to the incidence in some of the western European and North American populations.

Aged↗
PubMed1998

Uroflowmetry and evaluation of voiding disorders.

Uroflowmetry (UFM) is a simple, noninvasive way of evaluating the dynamics of micturition. The amount of information provided by UFM, along with ultrasonic estimation of residual urine in the bladder, usually is enough in the routine evaluation of elderly men with lower urinary tract symptoms (LUTS). A small subgroup, however, will require more detailed urodynamic testing. It also has made the decision concerning treatment of patients with stricture urethrae, managed by urethrotomy or dilatation, more objective. The role of UFM as an initial tool in the evaluation of all patients presenting with LUTS, irrespective of age and gender, is evolving. The addition of new parameters, performing UFM in the domiciliary setup, and the introduction of new software to facilitate interpretation will further enhance its ability in the evaluation of micturition disorders. The main limitation of UFM is its inability to discriminate between poor detrusor function and bladder outlet obstruction (BOO), for which pressure flow studies are necessary. This article reviews the current opinion concerning the principles and practice of UFM in the evaluation of LUTS.

Adult↗
PubMed1997

Steroid receptor measurement in breast cancers: comparison between ligand binding and enzyme-immunoassay in cytosolic and nuclear extracts.

We have analysed cytoplasmic and nuclear extracts of breast-cancer tissue from a total of 799 patients, measuring both oestrogen and progesterone receptors (ER, PR) using either the ligand binding assay (LBA) or the enzyme immunoassay technique (EIA). Mean and median receptor levels were much lower than those widely reported by others. For ER, this may in part be a consequence of the younger median age of the patient group. The frequency of positivity, using consensus cut-off values for clinical evaluation, was also lower than that reported by the EORTC Receptor Study Group. Although the measurements comparing the 2 methods were statistically correlated in terms of positivity, based on the above criteria for clinical assessment, concordance was considered to be relatively poor, particularly for ER when assayed in the same samples by the 2 methods. In cytosolic but not nuclear extracts, the LBA method gave a higher median value for ER than the EIA (except in the group that had EIA values greater than 15 fmol/mg protein); for PR, median values were higher with EIA in both cell fractions. There was an excellent correlation between receptor amounts in cytosolic and nuclear extracts for both ER and PR using the EIA; this was significantly better than with LBA. We also observed a correlation between ER and PR in both cytosolic and nuclear fractions which was most pronounced when the analysis was done by EIA. The amounts of ER in the cytosolic fraction were also correlated with the those of PR in the nuclear fraction and ER in the nuclear fraction with PR in the cytosolic fraction, but only when the EIA method was used. We conclude that the EIA method appears to be more sensitive and gives biologically more reliable results. However, the disagreement between the methods may be due to legitimate recognition of altered forms of the receptor and may be of biological significance. Although the presence of receptor in the cytosolic fraction is artifactual, its measurement by EIA does parallel the amounts of nuclear receptor, which may be a more relevant biological parameter.

Adult↗
PubMed1997

Eyewitness performance in cognitive and structured interviews.

This paper addresses two methodological and theoretical questions relating to the Cognitive Interview (CI), which previous research has found to increase witness recall in interviews. (1) What are the effects of the CI mnemonic techniques when communication techniques are held constant? (2) How do trained interviewers compare with untrained interviewers? In this study, witnesses (college students) viewed a short film clip of a shooting and were questioned by interviewers (research assistants) trained in conducting the CI or a Structured Interview (SI)--similar to the CI except for the "cognitive" components--or by untrained interviewers (UI). The CI and SI groups recalled significantly more correct information compared to the UI group. However they also reported more errors and confabulated details. Theoretical and practical implications of the results are discussed in terms of precisely identifying the CI facilitatory effects and consequent good practice in the forensic setting.

Adolescent↗
PubMed1997

Efficacy and safety of mebendazole in children with worm infestation.

Children aged between 2-16 years, were screened for worm infestation. Fifty-five children fulfilling the inclusion criteria were included in the study. They were treated with mebendazole 100 mg twice daily for three consecutive days and followed-up for 15 days to assess cure rate and side effects. Fifty children completed the study with their stools being tested by direct smear and concentration methods and blood CBC done before treatment and at the end of the study. The cure rate for ascaris was 100% and for trichuris 75%. The drug was well tolerated and apart from mild diarrhoea occurring in 22% children, no untoward effects were reported. Nemazole (mebendazole) has shown promise and seems useful in treating children with worm infestation.

Adolescent↗