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Biomedical subjects

H Shaheen

Publications and source records attributed to H Shaheen.

At least 19 recordsLinked to original sources

The prevalence and determinants of health care-seeking behavior for fecal incontinence in multiparous United Arab Emirates females.

PURPOSE: This study was designed to determine the prevalence and sociodemographics of fecal incontinence in United Arab Emirates females. METHODS: A representative sample of multiparous United Arab Emirates females aged 20 years or older (N = 450) were randomly selected from the community (n = 225) and health care centers (n = 225). Patients were interviewed about inappropriate stool loss in the past year using a structured and pretested questionnaire. RESULTS: Fifty-one participants (11.3 percent) admitted fecal incontinence; 26 (5.8 percent) were incontinent to liquid stool and 25 (5.5 percent) to solid stool. Thirty-eight patients (8.4 percent) had double (urinary and fecal) incontinence. Sixty-five patients (14.4 percent) were incontinent to flatus only but not to stools. The association between having fecal incontinence and chronic constipation was significant (P < 0.0001), but there was no significant association with other known risk factors such as age, parity, and previous instrumental delivery, episiotomy, perineal tears, or anorectal operations. Only 21 incontinent patients (41 percent) had sought medical advice. Patients did not seek medical advice because they were embarrassed to consult their physician (64.7 percent), they preferred to discuss the difficulty with friends, assuming that fecal incontinence would resolve spontaneously (47.1 percent) or was normal (31.3 percent), and they chose self-treatment as a result of low expectations for medical care (23.5 percent). Sufferers were bothered by the inability to pray (92.2 percent) and to have sexual intercourse (43.1 percent). Perceived causes of fecal incontinence were paralysis (90.2 percent), old age (80.4 percent), childbirth (23.5 percent), or menopause (19.6 percent). CONCLUSIONS: Fecal incontinence is common yet underreported by multiparous United Arab Emirates females because of cultural attitudes and inadequate public knowledge.

Adult↗

Knowledge and practice of contraception in United Arab Emirates women.

OBJECTIVE: To determine the knowledge and practice of contraception among United Arab Emirates (UAE) women. METHOD: Four hundred and fifty UAE women at risk of pregnancy were randomly selected from the community and primary health care centres and interviewed about knowledge and practice of contraception using a structured questionnaire. RESULTS: Four hundred women (89%) gave consent to participate in the study. One hundred and sixty-six participants (41.5%) were using contraception. All used natural methods backed with other methods. There were significant associations between using contraception and each of age, high level of education and low family income (p < 0.0001 for the three variables). Religious beliefs and low expectation of success of birth control were the reasons given for non-use. Eighty-five percent of subjects did not accept sterilisation without medical indications, nor using contraception before the first pregnancy. Of the women, 42.5% believed that contraceptive methods should not be used after the age of 40, and 78% were unaware that they could be used for treatment of gynaecological diseases. Disturbed bleeding patterns occurred in 48.7% of users, and these were most bothered by the inability to pray (100%) and to have sexual intercourse (97.5%). CONCLUSION: Contraception is not commonly used by UAE women because of sociocultural traditions, religious beliefs and poor knowledge.

Adult↗

Water deprivation reveals early neuromyopathy in diabetic mice.

The effects of water deprivation on peripheral nerve and muscle function were investigated in flexor digitorum superficialis muscle of control and diabetic mice. Twenty mice (30 g average body weight) were injected once with streptozotocin solution (200 mg/kg) to induce experimental diabetes and another 20 mice of similar body weight served as controls. Two weeks later, comparative analyses of in situ muscle isometric contractile characteristics were performed by direct muscle stimulation and indirect nerve stimulation (at 1, 5 and 30 Hz) in urethane-anesthetized (2 mg/g, i.p.) control and diabetic mice. One day prior to the experiments, 10 control and 10 diabetic mice were deprived of water. The study contained four groups: hydrated (H) control, dehydrated (DH) control, H diabetic and DH diabetic. There were no significant differences in synaptic delay or twitch tension between H control and DH control. Comparing H control and H diabetic groups, no differences were noticed in synaptic delay or twitch tension; except at 30 Hz where twitch tension was reduced in H diabetic mice. Significant differences were observed when comparing DH control and DH diabetic mice. DH diabetic showed a significant increase in synaptic delay (from 7.4 to 9.3 ms) and a significant decrease in twitch tension evoked either by indirect nerve or by direct muscle stimulation (from 4.4 g to 1.9 g and from 4.4 g to 2.3 g, respectively). These results revealed that water deprivation enhances diabetes effects at the neuromuscular junction and at the muscle leading to further complication of neuromyopathy.

Animals↗

Measurement-specific quality-of-life satisfaction during the menopause in an Arabian Gulf country.

OBJECTIVE: The aim of this study was to use an instrument, the menopause-specific quality-of-life satisfaction questionnaire for the postmenopausal period, in the United Arab Emirates (UAE). DESIGN: A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian Gulf women. Measurement-specific quality-of-life satisfaction questionnaires were used and face-to-face interviews were performed. SETTING: The study was based in primary health-care clinics in Al Ain City, Sharjah and Dubai Emirates, UAE. SUBJECTS: A multistage sampling design was used, and a representative sample of 450 UAE females aged 45 years and above were included during January-April 1999. RESULTS: Of the 450 women living in both urban and rural areas, 390 women agreed to participate (86.7%) and responded to the study. The mean age and standard deviation (SD) of the subjects was 56.5 +/- 6.6 years, and the median age of natural menopause in the present study was 48 years (mean +/- SD 48.4 +/- 3.8). The rate of consanguinous marriages in the sample was found to be 47.2%. The most common disease was found to be diabetes mellitus (10.3%), followed by osteoarthritis (7.7%), hypertension (7.2%) and asthma (6.2%), but the majority of subjects (68.7%) had no specific disease. Out of 29 possible symptoms, the mean number of symptoms was 7.57 (range 0-24). The most frequent symptom was 'aches in the back of the neck or head' at 46.4% followed by 'aches in the muscles/joints' at 34.6%. The least reported symptom was 'facial hair' at 15.9%. Increasing education resulted in more symptoms reported, and increasing parity resulted in fewer symptoms reported. In the present study, it was found that employed women experienced more symptoms and disorders. Of the total sample, 28.5% of the subjects reported no symptoms. In the four domains, 69% reported physical symptoms, 58.7% reported psychosocial symptoms, 40% reported vasomotor symptoms and 37.9% reported sexual symptoms. Spearman's rank correlation coefficient indicated that there is highly statistically significant concordance between the four domains (p < 0.01). CONCLUSION: The present study showed that menopause-related symptoms in UAE women are fewer and of less severity than in Western women. The postmenopausal women, despite a continued decline in estrogen levels, reported few symptoms as part of a normal life stage, suggesting that they were able to cope with stress.

Asthma↗

The prevalence and determinants of health care-seeking behavior for urinary incontinence in United Arab Emirates women.

The aim of this study was to determine the prevalence and sociodemographics of urinary incontinence (UI) in women in the United Arab Emirates (UAE). Women at risk, such as multiparous and climacteric women, were selected from the community (n = 200) and health-care centers (n = 200) and interviewed about inappropriate urine loss in the past 12 months, using a structured and pretested questionnaire. Of these, 81 (20.3%) admitted UI; only 25 of these (30.9%) had sought medical advice. The reasons were embarrassment (38.2%), choice of self-treatment because of low expectations from medical care (38.2%), and preferring to discuss the matter with friends, assuming that UI is normal (23.3%). Sufferers were troubled by their inability to pray (90%) and to have sexual intercourse (33.3%). Perceived causes of UI were paralysis (45%), childbirth (35.4%) and old age or menopause (33.7%). UI is common yet underreported by UAE women because of cultural attitudes and inadequate public knowledge.

Adult↗

Factor VII deficiency detected in pregnancy: a case report.

Factor VII deficiency is a rare hereditary coagulation disorder with an incidence estimated at 1 in 500,000 individuals. In this report, we describe the 13th case in pregnancy. The diagnosis of severe factor VII deficiency (factor VII level <5%) was established at 10 weeks' gestation after initial laboratory testing showed a markedly prolonged prothrombin time and a normal activated partial thromboplastin time. There was a history of two preterm deliveries, but there was no evidence of previous bleeding manifestations. Antenatal progress of the index pregnancy was unremarkable. Prophylactic treatment with fresh frozen plasma was started at the onset of labor and the patient had a vaginal delivery of a live girl at 36 weeks' gestation. There was no postpartum hemorrhage and mother and newborn were discharged in good condition. The patient's postpartum level of factor VII remained undetectable. Two aspects are outlined: the absence of any significant increase in factor VII clotting activity during this pregnancy and the need to give replacement therapy at labor in patients with severe factor VII deficiency to decrease the risk of postpartum hemorrhage.

Adult↗

Phenotypic diversity of enterotoxigenic Escherichia coli strains from a community-based study of pediatric diarrhea in periurban Egypt.

No past studies of diarrhea in children of the Middle East have examined in detail the phenotypes of enterotoxigenic Escherichia coli (ETEC) strains, which are important pathogens in this setting. During a prospective study conducted from November 1993 to September 1995 with 242 children under 3 years of age with diarrhea living near Alexandria, Egypt, 125 episodes of diarrhea were positive for ETEC. ETEC strains were available for 98 of these episodes, from which 100 ETEC strains were selected and characterized on the basis of enterotoxins, colonization factors (CFs), and O:H serotypes. Of these representative isolates, 57 produced heat-stable toxin (ST) only, 34 produced heat-labile toxin (LT) only, and 9 produced both LT and ST. Twenty-three ETEC strains expressed a CF, with the specific factors being CF antigen IV (CFA/IV; 10 of 23; 43%), CFA/II (5 of 23; 22%), CFA/I (3 of 23; 13%), PCFO166 (3 of 23; 13%), and CS7 (2 of 23; 9%). No ETEC strains appeared to express CFA/III, CS17, or PCFO159. Among the 100 ETEC strains, 47 O groups and 20 H groups were represented, with 59 O:H serotypes. The most common O serogroups were O159 (13 strains) and O43 (10 strains). O148 and O21 were each detected in five individual strains, O7 and O56 were each detected in four individual strains, O73, O20, O86, and O114 were each detected in three individual strains, and O23, O78, O91, O103, O128, and O132 were each detected in two individual strains. The most common H serogroups were H4 (16 strains), 12 of which were of serogroup O159; H2 (9 strains), all of which were O43; H18 (6 strains); H30 (6 strains); and H28 (5 strains); strains of the last three H serogroups were all O148. Cumulatively, our results suggest a high degree of clonal diversity of disease-associated ETEC strains in this region. As a low percentage of these strains expressed a CF, it remains possible that other adhesins for which we either did not assay or that are as yet undiscovered are prevalent in this region. Our findings point out some potential barriers to effective immunization against ETEC diarrhea in this population and emphasize the need to identify additional protective antigens commonly expressed by ETEC for inclusion in future vaccine candidates.

Bacterial Proteins↗

Parasite-specific antibody profile in human fascioliasis: application for immunodiagnosis of infection.

The antibody isotype response to an adult Fasciola worm antigen preparation (FWAP) was examined in sera from 60 Egyptians with parasitologically confirmed fascioliasis by an ELISA. The FWAP-specific IgG1 and IgG4 antibodies were found in 97-100% of the patients. The ratio of the mean absorbance values between infected patients and healthy controls was 9.7 and 29.7 for IgG1 and IgG4 antibodies, respectively. The IgM, IgA, IgG2, and IgG3 antibodies were less dominant. In contrast to IgG1 antibodies, which were often detected in sera from patients infected with Schistosoma, Echinococcus granulosus, Ascaris lumbricoides, Ancylostoma duodenale, or Hymenolepis nana, FWAP-specific IgG4 antibodies were detected exclusively in the sera of patients with fascioliasis. The data thus support the conclusion that an IgG4/ELISA with crude FWAP as antigen may be used for sensitive and accurate immunodiagnosis of human fascioliasis.

Adolescent↗

Clinicopathological features and management of Pakistani patients with multiple myeloma.

OBJECTIVE: Purpose of the study was to evaluate the clinicopathological features of multiple myeloma in Pakistan and to study the influence of therapeutic management in these cases. METHODS: We retrospectively analyzed 99 newly diagnosed patients with multiple myeloma seen from 1988 to 1996. Diagnostic criteria included bone marrow plasmacytosis, monoclonal gammopathy in serum or urine and radiological evidence of skeletal lesions. RESULTS: There were 57 males and 42 females. Mean age of the patients was 58 years with a range of 23 to 86 years. One-third of the patients were bed ridden at the time of presentation. Common presenting symptoms included bone pain (82%), fatigue (78%) and backache (73%). Physical findings, laboratory features and radiologic assessment revealed pallor (56%), severe anaemia with hemoglobin < 8.5 gm/dl (39%), creatinine > or = 2 2 mg/dl (57%), serum calcium > or = 12 gm/dl (23%), uric acid > or = 8 gm/dl (47%) and albumin < or = 3.5 gm/dl (63%). Commonest monoclonal gammopathy was igG kappa. Majority (71%) of the patients presented with stage III disease. Commonest chemotherapeutic regimen utilized was melphalan and prednisolone which was administered to 88% of the patients. Complete remission was observed in 25% and partial remission in 36% of the evaluated patients. Commonest complication during the course of disease was related to skeletal involvement followed by renal failure and bone marrow suppression. Median survival of the patients was 34 months. CONCLUSION: Multiple myeloma patients in Pakistan are younger, more frequently have poor performance status and more often present with advanced stage of disease. Response to therapy, however, is adequate and survival is comparable to Western patients.

Adult↗

Serodifferentiation of human fascioliasis from schistosomiasis.

A dot enzyme-linked immunosorbent assay (dot-ELISA) was developed using excretory-secretory (ES) antigens of Fasciola gigantica adult worms and freeze-thaw antigen (AFT) of adult Schistosoma mansoni worms. Specific IgG and IgM antibodies were simultaneously investigated in sera from 17 febrile eosinophilic hospitalized patients and 20 healthy controls. Dot-ELISA was shown useful and could differentiate fascioliasis from schistosomiasis prior to parasite egg detection in patient's stool. This assay is field and laboratory applicable.

Antibodies, Anti-Idiotypic↗

Evaluation of enzyme-linked immunosorbent assay for detection of Salmonella typhi antigen and antibodies.

Enteric fever is considered a major health problem in developing countries. The need for a rapid, accurate and conclusive method for diagnosis is important for adequate and proper treatment. The usefulness and reliability of the ELISA test in detection of S. typhi O antigen and specific IgG and IgM antibodies were assessed using sera obtained from 63 subjects clinically suspected to have enteric fever, 22 febrilenon-enteric subjects and 20 normal subjects. ELISA detection of S. typhi somatic antigen was positive in 75% of subjects with positive clot cultures. IgG and IgM antibodies to S. typhi lipopolysaccharide (LPS) were detected in sera from 83% and 88% of enteric fever subjects, respectively. While anti-LPS IgM was negative in all sera from febrile non-enteric subjects, 9% were positive for anti-LPS-IgG. The use of an ELISA for detection of anti-S. typhi LPS antibody in combination with the Widal test and/or the O antigen detection ELISA would provide a useful (95.8% sensitivity) adjunct to standard culture methods and allow for an earlier and more rapid diagnosis of enteric fever.

Adolescent↗

Epidural spinal cord compression from metastatic cancer: clinical features and management.

We retrospectively analyzed thirty-three patients (21 males, 12 females) with malignancy induced spinal cord compression (SCC). The mean age of the patients was 42.8 years and almost half (51%) of them presented with SCC. Mean duration of symptoms was 4.5 months and the mean interval between the original diagnosis of cancer and the development of SCC was 14.6 months. Back pain was the most frequent (97%) symptom with an equal number of patients having subjective or objective evidence of lower limb weakness. Majority (73%) of the patients were non-ambulatory at the time of diagnosis. Spinal level involvement was mostly thoracic (62%) followed by lumber (38%). Breast cancer was the commonest underlying malignancy (21%). Lung (12%), prostrate (12%), multiple myeloma (9%), and carcinoma with unknown primary (12%) were also frequently encountered. There was an overall response rate of 22% to the therapeutic interventions: mostly observed in the ambulatory patients. Only 7% of the non-ambulatory patients regained ability to walk. None of the responders had bladder or bowel dysfunction. Twenty-two percent of the responders are still ambulatory with a mean follow-up of six months.

Adolescent↗

Total leucocytic count, eosinophilia and cellular immune response in acute and chronic schistosomiasis.

Among school children in a rural area the serological diagnosis (ELISA) was more accurate than the parasitological tests. The mean total leucocytic and eosinophilic counts, and the blastogenic response to S. mansoni egg antigen were significantly higher in early than in chronic schistosomal cases. Blastogenic response to mitogens and S. mansoni adults preparation was insignificantly different.

Acute Disease↗

Circulating immune complex levels in patients with schistosomiasis and complications.

Circulating immune complexes (CIC), adult schistosome antibody, and total immunoglobulin concentrations were estimated in sera from 35 chronic Schistosoma mansoni patients with different infection intensities and different pathological complications. High CIC levels were present in about one-third (10/35) of the sera. Most of the patients (9/10) with elevated CIC levels also had hepatomegaly or hepatosplenomegaly. This finding is significant in the pathogenesis of schistosomal liver fibrosis and may also apply to other liver diseases, especially cirrhosis. No correlation was found between infection intensity as judged by stool egg counts and CIC levels. A reverse relationship was observed between the level of anti-adult worm IgG and CIC levels. CIC levels were elevated within 7 and 28 days after treatment in most patients. Hypergammaglobulinaemia was detected in most sera.

Adolescent↗

Quantitative immunodiffusion assay of serum protein patterns in protein calorie malnutrition (PCM).

Serum protein components were evaluated by the specific radial immunodiffusion technique in a number of protein energy malnourished infants and young children, as well as in a group of parallel controls. Results show a drop in both serum prealbumin and albumin in concordance with the severity of the condition in both KWO and marasmus. Serum level of varies as 1-acidic glycoprotein was elevated, being more marked in KWO than in marasmus. Serum oc1-antitrypsin, haemopexin, ceruloplasmin and transferrin were all reduced but to a varying extent in both KWO and marasmus. The levels of serum IgA and IgM were above normal in all disease entities except for a slight decrease of IgA in 2nd grade marasmus. On the other hand, serum IgG was reduced in the majority of cases. The ratio of serum cerutoplasmin to transferrin in KWO was found to be of diagnostic value in different grades of the disease.

Alpha-Globulins↗