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Biomedical subjects

M B Ahmed

Publications and source records attributed to M B Ahmed.

At least 19 recordsLinked to original sources

Changing the prescribing patterns of sexually transmitted infections in the White Nile Region of Sudan.

BACKGROUND: The number of inappropriate prescriptions for sexually transmitted infections (STIs) in Sudan is suspected to be high. Simple multifaceted interventions directed at prescribers may improve prescribing patterns in the Sudan. OBJECTIVE: To evaluate the effect of multifaceted interventions on prescribing for STIs in the White Nile State, Sudan. METHODS: The study involved 20 health centres randomly assigned to four different multifaceted interventions to improve prescribing. RESULTS: Prescriber targeted interventions involving audit and feedback together with academic detailing and practice guidelines reduced the number of inappropriate prescriptions by 50% (p < 0.001). Audit and feedback together with seminars and practice guidelines reduced inappropriate prescriptions by 43% (p < 0.001). Audit and feedback alone reduced inappropriate prescriptions by 16% (p = 0.127). CONCLUSION: Prescribing for STIs in the White Nile State of Sudan needs improving. Multifaceted interventions appear effective in improving prescribing.

Analysis of Variance↗

Evaluation of the protective potential of Ambrosia maritima extract on acetaminophen-induced liver damage.

The hepatoprotective activity of the aqueous-methanolic extract of Ambrosia maritima was investigated against acetaminophen (paracetamol, 4-hydroxy acetanilide) induced hepatic damage. Acetaminophen at the dose of 640 mg/kg produced liver damage in rats as manifested by the significant (P < 0.001) rise in serum levels of glutamate oxaloacetate transaminase (AST), glutamate pyruvate transaminase (ALT) and alkaline phosphatase (ALP) to 1178.5 +/-118.05; 607.5 +/- 32.6 and 274.16 +/- 8.89 IU/l (n = 10), respectively, compared with respective control values of 97.83+/-3.23; 46.0 +/- 3.92 and 168.67 +/- 7.86 IU/l. Pretreatment of rats with the plant extract (100 and 200 mg/kg) lowered significantly (P < 0.001) the respective serum AST to 203.3+/-5.74 and 157.1 +/- 8.78 IU/l, ALT to 138.67 +/- 7.7 and 87.5 +/- 3.6 IU/l and ALP levels to 238.0 +/- 5.89 and 206.5 +/- 7.5 IU/l, respectively. Treatment of rats with acetaminophen led to a marked increase in lipid peroxidation as measured by malondialdehyde (MDA) (42%). This was associated with a significant reduction of the hepatic antioxidant system e.g. reduced glutathione (GSH) (65%), glutathione reductase (GSH-R) (35%), total glutathione peroxidase (GSH-Px) (32%) and glutathione-S-transferase (GST) (16%). These biochemical alterations resulting from acetaminophen administration were inhibited by pretreatment with A. maritima L. extract. These data suggest that the plant A. maritima L. may act as a hepatoprotective and antioxidant agent.

Acetaminophen↗

Alzheimer's disease: recent advances in etiology, diagnosis, and management.

Alzheimer's disease is a chronic and progressive neurodegenerative disorder characterized by cognitive and functional deficit and by behavior disturbance. This disease presents a major clinical and social challenge. Increasing evidence suggests that early intervention can delay the progression of the disease and improve symptoms and cognitive functioning. Recent research focuses on genetic susceptibility. Genetic testing may eventually prove to be useful in identifying persons at risk before the onset of symptoms, but at this stage, this testing plays a limited role in identifying and confirming the diagnosis and in genetic counseling. The diagnostic work in all suspected cases of dementia should be started by family physicians; confirmed cases should be treated as soon as possible by the family physician or referred to a psychiatrist or neurologist for appropriate treatment. Donepezil, new cholinesterase inhibitors, and vitamin E have proved effective in delaying progression of Alzheimer's disease.

Alzheimer Disease↗

Psychological and legal aspects of mental incompetence.

The elderly population in the United States is increasing gradually. Estimates project that during the next 50 years 21% of the population, or approximately 70 million people, will be older than 65 years. Various medical and psychiatric disorders produce cognitive disturbances that result in temporary or permanent incompetence. That incompetence will affect an individual's decision-making capacity and ability to give informed consent. Problems exist related to obtaining informed consent from the elderly and distinguishing between incapacitated versus incompetent individuals. Physicians are responsible for providing information to their patients about a durable power of attorney for health care, a living will, and "do not resuscitate" orders, before they lose their capacity to make decisions related to their health care. Informed consent, living wills, durable power of attorney for health care, and guardianship are discussed.

Advance Directives↗

Biochemical effects of Catha edulis, cathine and cathinone on adrenocortical functions.

Catha edulis is a plant that grows in certain areas of East Africa and the Arab Peninsula. The stimulating properties of fresh material were described more than seven centuries ago and today the habit of inducing a state of euphoria and subjective well-being by chewing Catha edulis prevails among the inhabitants of these regions. Oral administration of this plant and its active constituents (cathine and cathione) on experimental animals might have stimulating effects on adrenocortical function. This was indicated by the significant decrease in adrenal cholesterol, ascorbic acid, glycogen, and the increase in adrenal phosphorylase activity. In addition, the level of urinary 17-hydroxycorticosteroids and plasma free fatty acids were increased.

Adrenal Cortex↗

High-risk adolescents and satanic cults.

During the last decade the number of teenagers involved in violent behavior and drug abuse increased significantly. Some of these adolescents were involved in Satanic cult activities. Although sensationalism is created by isolated incidents like the Matamoros murders and Geraldo's media coverage of satanism, our observation, in a private psychiatric hospital, reveals that in fact adolescents involved in satanic cults do not differ from other adolescents admitted with a variety of other problems. Psychodynamic factors, family dynamics, and treatment strategies for management of adolescents who are involved in satanic cult activities are discussed.

Adolescent↗

How to help patients stop smoking.

Counseling against smoking is an important aspect of preventive health care. The physician must be acutely conscious of the need for this type of intervention. Awareness of the available facilities and an understanding of the various techniques permit the physician to tailor the treatment to the patient. Social support, behavior modification, self-help and hypnotic techniques are generally more effective than drugs.

Aversive Therapy↗

Developing a community board for a mental health center.

Federally funded community mental health centers are required to have governing boards made up of community residents to ensure that services are meeting the community's needs. Sound View-Throgs Neck Community Mental Health Center in Bronx, New York, met that requirement by developing three local advisory boards, one for each subcatchment area served by an outpatient clinic. Later a central community board with 12 members, four from each of the local advisory boards, was formed. The central board has several standing committees that parallel the organization of the center, including community, hospital, and rehabilitation services; research and development; and administration. Board members and center staff meet regularly. They have found that they must act as partners and learn to share power, privileges, and knowledge.

Catchment Area, Health↗

A study of outpatient satisfaction with mental health center services.

In 1972 the authors conducted a study to determine the effect of encouraging patients to express their dissatisfaction with services received at a community mental health center in New York City. Half of the out-patients admitted to the center over a six-month period, a total of 270, were sent welcoming letters signed by the center director soliciting suggestions and complaints about services and listing staff members to whom they could be reported. Follow-up telephone interviews both with recipients of the letter and with nonrecipients, who formed a control group, showed that the recipients had fewer complaints about the center's services than did the nonrecipients. However, they failed to use the suggested channels to report a number of relatively serious complaints. The authors discuss the implications of the findings.

Adult↗

Attitudes of mental health center staff: changes over a five-year period.

The author compares a study of attitudes of staff toward priorities and problems in eight community mental health centers with a study five years later, using the same questionnaire, of attitudes of staff in one of the centers. Between 1968 and 1973 the number of psychiatrists decreased and the number of psychologists and social workers increased. The most significant change in priorities in 1973 was the higher ranking of consultation and education services. While staff saw their problems in 1968 as a diffusion and inadequate program planning, by 1973 they were concerned with administrative problems and with shortcomings in the quality of clinical care, due to a lack of resources.

Attitude of Health Personnel↗

Community residents and mental health center staff: assessment of program and priorities.

Mental health professionals have emphasized the importance of establishing priorities and goals and gearing the delivery of mental health services to the needs of area residents. Sound View-Throgs Neck Community Mental Health Center of New York has made such an effort to involve the community residents and the mental health center staff in establishing priorities for development of the new program for services in the community. We have outlined the methods of gathering such information, and implementation of the conclusions derived from the survey which has resulted in developing comprehensive children's services and a geriatric program in our catchment area.

Adolescent↗

Evaluation of an inpatient service by consumer feedback.

Over the past few years, the Sound View-Throgs Neck Community Mental Health Center has conducted a number of studies of client satisfaction with our services. The findings suggest that the majority of clients are generally satisfied with the help they receive. However, the level of satisfaction apparently depends on specific aspects or features of the program being evaluated, as well as the particular unit which is providing the services. We have used face-to-face, telephone, and mail survey procedures in these studies; and we have sampled both clients who have completed their treatment and those in the early phases of the treatment process. In one of the studies, the former SVTN-CMHC patients we surveyed had been hospitalized in the inpatient unit located at Bronx Municipal Hospital Center. We randomly selected one hundred patients who had been discharged from the unit during the first six months of 1971. After excluding children under the age of sixteen, patients who were subsequently hospitalized or were too symptomatic to be interviewed, and those living outside New York City, we interviewed twenty-five ex-patients. We asked questions about their feelings related to the need for hospitalization, their present problems, whether hospitalization had helped them, their satisfaction or dissatisfaction with ward life, and their feelings about discharge. The results indicated that these ex-patients felt at least moderately satisfied with their hospital experience. However, they were relatively dissatisfied with provisions for privacy on the ward, the fact that doctors and other hospital staff were not readily available to them, the doctor's understanding of their problems, and the evening recreation programs. There was some discrepancy between the ratings, which were mostly favorable, and the comments, which were predominantly unfavorable. There are various possible explanations for this, ranging from the limited validity of rating items in such a study to the possibility that this group of ex-patients were so accustomed to negative experiences that their overall assessments were not significantly influenced by them. There is some possibility that the highly positive ratings may stem from an unexpected source. For approximately half of the sample, the major purpose of hospitalization was to provide an opportunity to get away from their usual surroundings. The in-hospital treatment per se was relatively unimportant to them, and their favorable ratings may be a way of indicating that the hospital simply served as a refuge, which they were seeking. Since a patient may approach the hospital with self-defined needs either for treatment or mainly for refuge--it may be worth while to provide alternative programs to meet these different needs. A "refuge" program, for example, may not require an in-hospital environment; and even if it does, the staffing pattern should be different from that of a hospital with a treatment-oriented program.

Adaptation, Psychological↗