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Biomedical subjects

A Salim

Publications and source records attributed to A Salim.

At least 19 recordsLinked to original sources
PubMed2006

Folic acid supplementation during treatment of psoriasis with methotrexate: a randomized, double-blind, placebo-controlled trial.

BACKGROUND: The value of folate supplementation in methotrexate (MTX)-treated patients remains controversial. OBJECTIVES: To determine the effect of folic acid (FA) on the efficacy of MTX and the frequency of side-effects associated with MTX therapy. METHODS: A 12-week double-blind clinical trial was conducted in patients with psoriasis stable on their long-term MTX doses but not receiving FA. They were randomized into two arms of either FA 5 mg or placebo daily. MTX doses were not changed throughout the study. Patients were monitored every 3 weeks by the same observer. Assessments included Psoriasis Area and Severity Index (PASI), a visual analogue scale (VAS) of patients' perception of their psoriasis severity and the Dermatology Life Quality Index (DLQI). Adverse events were systematically recorded. Haematological and biochemical monitoring was performed. RESULTS: Twenty-two patients with psoriasis were recruited. Age, sex and weekly MTX doses were similar in both groups. All 22 patients completed the study. The mean PASI in the FA group increased from 6.4 at baseline to 10.8 at 12 weeks. In the placebo group the mean PASI fell from 9.8 at baseline to 9.2 at 12 weeks. The mean change from baseline in the FA group was 4.4 vs. -0.6 in the placebo group (P < 0.05). Similar trends were observed in the changes in VAS and in the DLQI and differences between the groups were significant for both these parameters (P < 0.05). Few adverse effects were reported. CONCLUSIONS: This study suggests that supplementation with FA during long-term MTX treatment reduces the efficacy of MTX in the control of psoriasis. Due to the relatively small sample size and short duration of this study, no conclusions can be drawn regarding the possibility that FA may reduce the side-effects of MTX.

Adult↗
PubMed2005

Clustering of protective factors for glucose intolerance and insulin resistance: a cross-sectional study.

AIMS: A cluster of interrelated factors: a body mass index (BMI) < 25 kg/m(2), moderate exercise and alcohol intake, non-smoking and a favourable dietary pattern has been linked with markedly reduced risk of Type 2 diabetes. The aim of this study was to estimate the prevalence of a similar low-risk group in a sample of middle-aged Irish men and women, and determine whether this cluster is associated with a reduced risk of glucose intolerance (IFG and Type 2 diabetes according to ADA/WHO criteria) and insulin resistance [homeostasis model assessment (HOMA) score in upper quartile of distribution]. METHODS: A cross-sectional study involving a stratified random sample of 1018 general practice patients, aged 50-69 years. We defined a low-risk group based on the following variables: BMI < 25 kg/m(2); waist-hip ratio < 0.85 for women and 0.90 for men; never smoking status; participation in medium to high level of physical activity; light drinking (3.5-7 units of alcohol per week) and a 'prudent' dietary pattern. Valid data were available for glucose tolerance status and HOMA score and all exposure variables from 684 and 671 participants, respectively. RESULTS: A total of 7.5% of participants had none of the 'protective factors', 24.9% had one, 31.0% two, 23.3% three, 10.0% four, 3.0% five and 0.3% had six protective factors. In multivariate analyses the odds ratios for insulin resistance were 0.59, 0.48, 0.14 and 0.04 in persons with one, two, three and four or more low-risk factors, respectively, relative to those with none. Similar linear inverse trends were observed for glucose intolerance. CONCLUSIONS: The findings are consistent with an inverse linear relation between a cluster of core protective, lifestyle-related factors and the prevalence of both glucose intolerance and insulin resistance.

Aged↗
PubMed2004

Prudent diet and the risk of insulin resistance.

BACKGROUND AND AIM: Diet is a potentially modifiable risk factor for diabetes. Dietary patterns may exert greater effects on health than individual foods, nutrients or food groups. Data on associations between dietary patterns and the risk of insulin resistance and type 2 diabetes are sparse. The aim of the study was to examine associations between dietary patterns and the risk of insulin resistance. METHODS AND RESULTS: We performed a cross sectional study involving a group of 1018 men and women, sampled from 17 general practice lists in the South of Ireland, with a response rate of 69%. Participants completed a detailed health and lifestyle questionnaire and provided fasting blood samples for analysis of glucose, insulin and lipids. Dietary intake was assessed using a food frequency questionnaire. The food frequency questionnaire was a modification of the UK arm of the European Prospective Investigation into cancer, EPIC study, which was based on that used in the US Nurses' Health Study. Dietary patterns were assessed by K cluster analysis. Insulin resistance was estimated on the basis of fasting glucose and insulin, using the glucose homeostasis model (HOMA scores). Insulin resistance was defined as the upper quartile of the HOMA scores. Three dietary patterns were identified by cluster analysis (traditional Irish diet, a prudent diet and an alcohol and convenience foods diet). Participants in clusters 1 (traditional Irish diet) and 3 (high alcohol and convenience foods) had a lower intake of more 'healthy' food groups (such as fruit, vegetables, low fat dairy products, poultry, fish and whole grain products) and higher intake of foods richer in total and SFA content (such as high fat dairy products, butter, meat and meat products). Cluster 2 (prudent dietary pattern) was characterized by a higher intake of food groups that are typically recommended in health promotion programs and a lower intake of meat (read meat), meat products, sweets, high fat dairy and white bread (white bread and unrefined cereal). The prudent diet had the lowest HOMA scores in analysis of covariance. The prevalence of insulin resistance in the prudent diet was lower than that in the traditional diet (OR=0.53; 95%CI, 0.33-0.85 in fully adjusted analysis). CONCLUSION: A prudent diet may be associated with enhanced insulin sensitivity and a lower risk of type 2 diabetes.

Aged↗
PubMed2004

Alcohol intake and insulin resistance. A cross-sectional study.

BACKGROUND AND AIM: The development of insulin resistance is a critical step in the pathogenesis of type 2 diabetes. The effect of alcohol intake on insulin sensitivity/resistance is not well defined. The aim of this study was to examine the association between alcohol intake and insulin resistance in a sample of middle-aged men and women with data on a wide range of potential confounding factors, including diet. METHODS: We performed a cross sectional study involving a group of 1018 men and women, sampled from 17 general practice lists in the South of Ireland, with a response rate of 69%. Participants completed a detailed health and lifestyle questionnaire and a food frequency questionnaire and provided fasting blood samples for analysis of glucose and insulin. Insulin resistance was estimated on the basis of fasting glucose and insulin, using the glucose homeostasis model (HOMA scores). Insulin resistance was defined as the upper quartile of the HOMA scores. RESULTS: We found evidence of a U-shaped relationship between alcohol intake and insulin resistance fitted as a continuous variable (HOMA scores) with lowest levels in light drinkers (between 0.5 to 0.99 units per day) relative to the other drinking categories. However no significant association between alcohol intake and HOMA score was observed in fully adjusted analyses, including adjustment for dietary saturated fat and fruit and vegetables intake. In logistic regression analysis with insulin resistance (categorical) as the dependent variable, we observed that ex-drinkers were at higher risk of insulin resistance compared to occasional drinkers independently of age, sex, BMI and waist circumference, (OR=2.4, 95% CI, 1.1-5.7, p=0.04). On further adjustment for potential confounders including diet this association was also attenuated and was non-significant. CONCLUSIONS: The reported effects of alcohol intake on insulin resistance may be confounded by other aspects of lifestyle, especially diet.

Alcohol Drinking↗
PubMed2004

Dietary patterns in middle-aged Irish men and women defined by cluster analysis.

OBJECTIVES: To identify and characterise dietary patterns in a middle-aged Irish population sample and study associations between these patterns, sociodemographic and anthropometric variables and major risk factors for cardiovascular disease. DESIGN: A cross-sectional study. SUBJECTS AND METHODS: A group of 1473 men and women were sampled from 17 general practice lists in the South of Ireland. A total of 1018 attended for screening, with a response rate of 69%. Participants completed a detailed health and lifestyle questionnaire and provided a fasting blood sample for glucose, lipids and homocysteine. Dietary intake was assessed using a standard food-frequency questionnaire adapted for use in the Irish population. The food-frequency questionnaire was a modification of that used in the UK arm of the European Prospective Investigation into Cancer study, which was based on that used in the US Nurses' Health Study. Dietary patterns were assessed primarily by K-means cluster analysis, following initial principal components analysis to identify the seeds. RESULTS: Three dietary patterns were identified. These clusters corresponded to a traditional Irish diet, a prudent diet and a diet characterised by high consumption of alcoholic drinks and convenience foods. Cluster 1 (Traditional Diet) had the highest intakes of saturated fat (SFA), monounsaturated fat (MUFA) and percentage of total energy from fat, and the lowest polyunsaturated fat (PUFA) intake and ratio of polyunsaturated to saturated fat (P:S). Cluster 2 (Prudent Diet) was characterised by significantly higher intakes of fibre, PUFA, P:S ratio and antioxidant vitamins (vitamins C and E), and lower intakes of total fat, MUFA, SFA and cholesterol. Cluster 3 (Alcohol & Convenience Foods) had the highest intakes of alcohol, protein, cholesterol, vitamin B(12), vitamin B(6), folate, iron, phosphorus, selenium and zinc, and the lowest intakes of PUFA, vitamin A and antioxidant vitamins (vitamins C and E). There were significant differences between clusters in gender distribution, smoking status, physical activity, body mass index, waist circumference and serum homocysteine concentrations. CONCLUSION: In this general population sample, cluster analysis methods yielded two major dietary patterns: prudent and traditional. The prudent dietary pattern is associated with other health-seeking behaviours. Study of dietary patterns will help elucidate links between diet and disease and contribute to the development of healthy eating guidelines for health promotion.

Alcohol Drinking↗
PubMed2004

Prediction of stability factors at the domain interface of human gammaB crystallin maintaining the transparency of the eye lens.

OBJECTIVE: betagamma-crystallins are among the most long lived globular proteins known today. Interaction of the two domains through a hydrophobic interface is one of the major contributors to the stability of these crystallins. Changes in these interactions are either due to the amino acid substitutions or the changes in the orientations of the same amino acids leading to cataract formation. We have carded out a detailed analysis to observe the stabilizing effects of hydrophobic core residues at the domain interface of the predicted human gammaB-crystallin structure. METHODS: Human gammaB-crystallin model was built by Homology Modeling hsing MODELLER4 based on the crystal structure coordinates of bovine gammaB-crystallin. In lens gammaB-crystallin, there are six non polar residues, three each in the two domains which form a hydrophobic core at the domain interface. We performed mutational studies at position 56 and analyzed the changes in the protein structure. Three mutants (Phe-->Trp. Phe-->Ala, Phe-->Asp) were constructed and analyzed for hydrogen bonding, ion pairs and accessibility by WHATIF web server. RESULTS: Being the largest amino acid among the six residues taking part in the hydrophobic interactions at the domain interface, Phe was predicted to be responsible for the greatest contribution to the stability at this region. Phe-->Ala mutant showed the largest structural changes in the vicinity of the mutated residue. CONCLUSION: The results obtained clearly emphasize the importance of hydrophobic interactions to the stability of crystallins. Mutations at the domain interphase could decrease the interactions between these domains thus causing destability.

Amino Acid Sequence↗
PubMed2003

A simple procedure for reducing lead content in fish.

The efficiencies of medicinal herbs (damaseisa, and rosemary); plants solutions (radish and barley); polypeptide solutions (nisin); neutral solutions (sodium chloride) and acidic solutions (acetic acid), as well as tap water, in the elimination of lead from naturally contaminated bolty fish were examined. The results indicate the efficient role of washing by nisin, damaseisa, radish, barley and rosemary compared with acetic acid and sodium sodium chloride solutions. It was noticed that nisin and damaseisa solutions (10%) eliminated lead completely. On the other hand, washing with tap water provided the least effective role in elimination of lead from fish.

Acetates↗
PubMed2003

Randomized comparison of photodynamic therapy with topical 5-fluorouracil in Bowen's disease.

BACKGROUND: Bowen's disease (BD; intraepithelial squamous cell carcinoma) is therapeutically challenging because lesions, which may be multiple, are frequently located at sites that heal poorly. There is a small risk of progression to invasive carcinoma. Photodynamic therapy (PDT) is an effective treatment for certain non melanoma skin cancers, but comparison studies with other, better-established therapies are limited. OBJECTIVES: To compare the efficacy and tolerability of PDT and topical 5-fluorouracil (5-FU) in BD. METHODS: Forty patients from two centres were randomized to either topical PDT or 5-FU. The PDT group was treated with 20% 5-aminolaevulinic acid (ALA) applied 4 h before illumination with 100 J cm-2 narrowband red light (630 +/- 15 nm). 5-FU was applied to lesions for 4 weeks. A repeat treatment cycle was performed after 6 weeks if required. Results Twenty-nine of 33 (88%) lesions treated with PDT initially responded completely, compared with 22 of 33 (67%) after 5-FU. After 12 months, two recurrences in the PDT group and six in the 5-FU group reduced complete clinical clearance rates to 82% and 48%, respectively. PDT was significantly more effective (P = 0.006, odds ratio 4.78, 95% confidence interval 1.56-14.62). In the 5-FU group, severe eczematous reactions developed around seven lesions, ulceration in three and erosions in two. No such reactions occurred following PDT. There was no difference in overall pain experienced during each therapy. CONCLUSIONS: Topical ALA-PDT is more effective than topical 5-FU in the treatment of BD, with fewer adverse events. ALA-PDT should be considered one of the first-line therapeutic options for BD.

Administration, Topical↗
PubMed2002

Steroid responsive cutaneous Rosai-Dorfman disease associated with uveitis and hypothyroidism.

We report a patient with steroid responsive cutaneous Rosai-Dorfman disease (RDD) associated with bilateral anterior uveitis and hypothyroidism. RDD is a rare histiocytic disorder of unknown aetiology. There is characteristic histology in which large pale-staining histiocytes exhibit emperipolesis and stain positive for S-100 protein. This condition is thought to be a reactive process rather than a neoplastic one and viral and immune mediated causes have been postulated.

Aged↗
PubMed2002

When to operate on abdominal gunshot wounds.

Historically, penetrating abdominal trauma was managed expectantly until the late 19th century. In World War I, with the high mortality and morbidity associated with penetrating abdominal trauma, operative management replaced expectant management. It was soon realized that not all penetrating abdominal injuries required an operation. Since the 1960's, selective nonoperative management of stab wounds to the anterior abdomen has become the standard of care. However, gunshot wounds to the abdomen are still treated by mandatory exploration based on an allegedly high incidence of intra-abdominal injuries and low rate of complications, if laparotomy turns out negative. A number of series have recently surfaced, reporting successful outcomes, while decreasing morbidity and hospital length of stay, with selective non-operative management of gunshot wounds to the abdomen. This review will address the current controversies surrounding selective nonoperative management of gunshot wounds to the abdomen and will present our experience and current approaches.

Abdominal Injuries↗