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Biomedical subjects

M E Ahmed

Publications and source records attributed to M E Ahmed.

At least 19 recordsLinked to original sources
PubMed2005

Experimental approaches and analytical technique for determining heavy metals in fallen dust at ferrosilicon production factory in Edfu, Aswan, Egypt.

In this study aimed to evaluate the pollution extent of metals and nonmetals inside and outside the ferrosilicon production factory in Edfu, Aswan, Egypt, raw materials (quartz, cokes, iron oxides), ferrosilicon alloy, silica fume, dust and suspended dust (at different sites) samples were collected from the factory, and fallen dust samples were collected from outside the factory, horizontally (at different sites and different distance and directions) and vertically (at different floors in the selected buildings). Gravimetric methods, X-ray fluorescence (XRF), flame photometer, wide range carbon determinator and atomic absorption spectroscopy tools were used for elements determination. The results indicating that the fallen dust and its element contents on southern factory walls being higher than those on eastern factory walls may be due to the nature of the dusts and effects of wind force and wind direction. Fallen dust levels in different regions outside the factory were found to be affected by the distance, direction and floors. The nature of dust samples was affected by gravity and the suspended dust in different factory units depended on the work capacity and method of handling materials by personnel in different production units. Silica fume was a complicated problem, had dangerous effect against the workers' health, and was characterized by high concentrations of SiO(2) (90.6%approximately 93.6%) and heavy metals (Mn, 420.6 x 10(-6) approximately 520.3 x 10(-6); Fe, 2354 x 10(-6)approximately 2685 x 10(-6); Co, 80.7 x 10(-6) approximately 101.6 x 10(-6) and Ni, 5.3 x 10(-6) approximately 6.05 x 10(-6)). The TSP (Total Suspended Particulate) levels in all factory units were higher than the recommended air quality value (70 microg/m(3)) under Egyptian law. The effect of ferrosilicon factory fallen dust on the surrounding regions decreased with increasing distance between the factory and these regions. The suspended dust samples in the factory units and their components greatly exceeded national and international standards, so health and environmental criteria must be enforced on these units.

Dust↗
PubMed2001

A calculus within an anal fistula tract in a diabetic patient.

A non-insulin dependent diabetic patient with a chronic anal fistula underwent fistulectomy. At operation a calculus was discovered. The patient had an uneventful recovery and healing of the wound in 4 weeks duration. The only case reported previously was in a nondiabetic patient and interestingly from this department.

Anus Diseases↗
PubMed2001

Resting ECG abnormalities among asymptomatic Arab men and comparison with other ethnic populations.

The aim of this study was to detect the frequency of the resting electrocardiogram (ECG) abnormalities among asymptomatic Arab men in Saudi Arabia, since no similar studies had been conducted in this ethnic population. The ECG tracings of 314 men (mean age 44.2 years) who attended a health clinic in Abha, Southern Saudi Arabia, were analyzed according to the definitions of the major ECG textbooks and the Minnesota code. Abnormal ECG findings were encountered in 99 men (31.5%); 39 (12.4%) had non-specific changes, while 60 (19.1%) had potentiallysignificantabnormalities. Serious abnormalities, such as ischemic changes, left ventricular hypertrophy, and atrial fibrillation were seen in only 22 subjects (7%) and were associated with hypertension and an age greater than 40 years. On the other hand, early repolarization, the most frequent abnormality encountered, and Wolf-Parkinson-White syndrome (WPW) were mostly prevalent among young subjects. The significance of these ECG abnormalities with regard to long-term morbidity and mortality in asymptomatic subjects should be considered in relation to the age of the person and the presence of any underlying cardiovascular disease.

Adult↗
PubMed2000

Aminoglycoside usage and monitoring in a Saudi Arabian teaching hospital: a ten-year laboratory audit.

BACKGROUND AND OBJECTIVE: In 1989, a therapeutic drug monitoring service was established in Assir Central Hospital, Abha, Saudi Arabia, by the Department of Clinical Pharmacology and Therapeutics of the College of Medicine, King Saud University Abha Branch (now King Khalid University). We report a 10-year follow-up of the results of monitoring the commonly used aminoglycosides (amikacin, gentamycin and tobramycin) obtained from our adult patients on first monitoring. METHOD: Two educational seminars for doctors and nurses were conducted 6 months before the initiation of this study. Drug assay requests were made on specially designed forms. Drug dosages were determined by the attending physicians. Samples for peak and trough drug level determinations were drawn after the fourth dose. The results of first time monitoring were sent to the wards with appropriate comments for dosage modifications where indicated. RESULTS: The results for 2022 patients were analysed. Of these, 929, 899 and 194 were for amikacin, gentamycin and tobramycin, respectively. Therapeutic trough concentrations were 71.2%, 28.3% and 28.3% of patients on amikacin, gentamycin and tobramycin, respectively. A total of 8.8%, 17.6% and 11.9% had trough concentrations considered toxic for amikacin, gentamycin and tobramycin, respectively. Peak therapeutic concentrations were achieved in 31.6%, 42.3% and 39.7% of patients on amikacin, gentamycin and tobramycin. A total of 53.3% of patients on amikacin, 50.3% on gentamycin and 57.2% on tobramycin had peak serum drug concentrations in the subtherapeutic range. Toxic concentrations were noticed mainly in patients aged over 60 years and in the critically ill in the intensive care, coronary care and bums units of the hospital. CONCLUSION: To be cost-effective, intensive therapeutic monitoring of aminoglycosides in adults should continue to be monitored mainly for the old and sick patients in critical care units to optimize patient management.

Adult↗
PubMed2000

Intrafamilial clustering of Helicobacter pylori infection in Saudi Arabia.

AIM: To study the pattern of Helicobacter pylori infection among family members in the Saudi population. METHODS: A cross-sectional, population-based, seroepidemiological study of family members was undertaken in a Saudi population using saliva H pylori immunoglobulin (Ig) G antibodies (Helisal kit). RESULTS: A total of 42 families comprising 271 children and 84 parents were studied (355 subjects; mean age 23 years, SD 19 years) The overall frequencies of H pylori IgG antibodies in mothers, fathers and children were 67%, 64% and 23%, respectively. There was no significant difference in the infection rate between mothers and fathers, or between boys and girls. The infection rate among children increased when one or both parents were seropositive, and the infection rate among parents was proportionally related to the number of infected children per family. The frequency of H pylori antibodies was significantly higher in spouses of seropositive parents than in spouses of seronegative parents (45% compared with 19.2%). CONCLUSIONS: These data confirm that the intrafamilial clustering of H pylori infection in Saudi Arabia occurs in a similar pattern to that described in the developed countries, and that living conditions and social conditions lead to person to person transmission of H pylori infection.

Adolescent↗
PubMed1999

Target organ involvement in hypertensive patients in Eastern Sudan.

Hypertension has become a major cause of cardiovascular morbidity and mortality in both the developed and the developing nations. In a cross-sectional study we assessed the state of blood pressure (BP) control and the pattern of target organ complications in 198 Sudanese patients treated in a teaching hospital in Kassala town in Eastern Sudan, (mean age 53 years, 76% women). Excellent BP control (BP <140/90 mm Hg) was achieved in 46% of the patients. Stage 2 or Stage 3 target organ involvement, particularly albuminuria and ischaemic heart disease, were detected in one-third of the patients. These complications were found to be related to both the severity and the duration of hypertension as well as to the frequency of cigarette smoking. Factors such as poor compliance, adverse socioeconomic status, as well as obesity and cigarette smoking may account for poor BP control and hence the development of hypertensive complications. We conclude that optimal BP control is not yet achieved in the majority of hypertensives in the Sudan. Reasons for this failure should be identified and corrected in order to avoid hypertensive target organ damage.

Adult↗
PubMed1999

Respiratory complications after thyroidectomy and the need for tracheostomy in patients with a large goitre.

BACKGROUND: Thyroidectomy for a large goitre carries a relatively high risk of postoperative respiratory obstruction which may necessitate tracheostomy. METHODS: One hundred and three patients with a large goitre who underwent thyroidectomy were studied prospectively. The presence or absence of six preoperative predictive factors for the development of serious postoperative respiratory obstruction was recorded. These factors were: goitre for more than 5 years, preoperative recurrent laryngeal nerve palsy, significant tracheal narrowing and/or deviation, retrosternal extension, difficult endotracheal intubation and thyroid cancer. Tracheostomy was performed on the basis of clinical judgement. RESULTS: Postoperative respiratory complications occurred in 32 patients (31 per cent), and were obstructive in 24 patients and not obstructive in eight. Tracheostomy was necessary in 13 patients (13 per cent). Tracheomalacia was the most common indication (n = 5). There were no deaths. At least four of the six risk factors were present in nine of the 13 patients who underwent tracheostomy compared with two of the 90 patients who did not. CONCLUSION: Multiple preoperative risk factors in a patient with a large goitre may be useful in predicting the need for planned tracheostomy following thyroidectomy.

Adolescent↗
PubMed1999

Helicobacter pylori and intestinal metaplasia with its subtypes in the gastric antrum in a Saudi population.

BACKGROUND: There is a close association between intestinal metaplasia (IM) and the development of gastric cancer as well as a relationship between Helicobacter pylori, IM, and gastric cancer. Our aim was to study the frequency and subtypes of IM in a Saudi population with dyspepsia, a population with a low prevalence of gastric cancer. METHODS: Endoscopic antral biopsy specimens were histologically studied for the presence of IM and H. pylori in consecutive patients who underwent upper gastrointestinal endoscopy for evaluation of dyspepsia. Hematoxylin and eosin and Giemsa stain were used to study IM, inflammation, and H. pylori, whereas Alcian blue, pH 2.5/periodic acid-Schiff and high iron diamine/Alcian blue, pH 2.5, were used to study IM subtypes. RESULTS: Seven hundred and seventy-eight consecutive patients were recruited in this study, 415 men and 363 women, with a mean age of 43 +/- 17.6 years. Of the 778 patients, IM was identified in 118 (15.2%). The mean ages of patients with IM (48.8 +/- 18.7) and without IM (41.9 +/- 17.4) were statistically significant (P < 0.0001), whereas the patients' sex did not influence the presence of IM. Most had type-I IM (59.3%), whereas 26.3% and 14.4% had types II and III, respectively. The overall rate of infection with H. pylori was 75.4%. There was no difference in the frequency of IM in patients with or without H. pylori (15.5% versus 14.1%; P = 0.65). Of the 118 patients with IM, the 91 patients (77.1%) who also had H. pylori were older (55 +/- 23 years) than those without H. pylori (47 +/- 17 years, P = 0.05). CONCLUSION: This study has documented mainly that the prevalence of IM and IM subtype III is low in our population. Furthermore, we found no significant relationship between a high rate of H. pylori infection with either IM in general or with IM subtype III in particular, possibly accounting for a low incidence of gastric cancer in the Saudi population.

Adolescent↗
PubMed1998

Patterns of atrial fibrillation at a regional hospital in Saudi Arabia.

The objective of this retrospective study was to report on the clinical presentation, etiology, and laboratory tests of both chronic and acute atrial fibrillation (AF) admitted to the cardiology unit of a teaching hospital in southern Saudi Arabia. We studied 219 records; 132 (60.3%) and 87 (39.7%) had documented chronic AF (group 1), and acute AF (group 2) respectively. The mean age (SD) was significantly higher in group 1 (64.6 [SD 19.4] vs 52.9 [SD 15.6]) (P<0.001). Palpitation, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea was the most common presentation in the chronic type. On the other hand, heart failure and embolic complications were reported significantly in group 1, but the frequency of acute respiratory problems and acute myocardial infarction was similar in both groups. The most common causes of both types of AF were rheumatic valvular diseases (26%), IHD (24.2%), hypertension (23.7%), and lung diseases (13.2%); however, in 28 patients (12.8%) no cause was detected. The echocardiography findings of chamber dilatation, valve lesions, and depressed left ventricular function were significantly frequent in group 1 (P<0.01). Although rheumatic valvular diseases are still common in Saudi Arabia, ischemic heart disease and hypertension are emerging as important causes of AF in this developing nation, and therefore require prevention and control.

Age Factors↗
PubMed1997

Knowledge of blood pressure measurement among a teaching hospital staff in a developing nation.

Hypertension is a common and potentially serious disease and accurate measurement of blood pressure (BP) is important for its diagnosis and management. The aim of this study was to assess the knowledge of hospital staff on the basic principles of BP measurement. Consultants, junior doctors and nurses in a large teaching hospital in southern Saudi Arabia were requested to answer a questionnaire about the most important aspects pertaining to BP measurement. The overall response rate was about 70%. There was a wide diversity of responses reflecting a poor knowledge of some of the basic techniques of BP measurement. This included inconsistencies regarding the knowledge of cuff size, recording of diastolic BP, position of the arm and rate for deflating the cuff. Overall, 60% of the respondents had insufficient knowledge. Inaccurate BP measurement can seriously affect the diagnosis and management of the patient with this common disease. Hospital staff need to improve their knowledge about BP measurement, and teaching programmes about BP measurement should be developed as part of continuing education.

Adult↗
PubMed1997

Amputation and prostheses in Khartoum.

One hundred and seventy patients with major lower limb amputation (MLLA) presenting to The National Prosthetic-Orthotic Centre (NPOC) in Khartoum over a 1-year period were studied. There were 141 males and 29 females giving a M:F ratio of 4.9: 1.0, with mean age of 37 years (range 5-72 years). Forty-one patients (24%) underwent amputation of diabetic septic foot, 30 patients (17.6%) underwent amputation as a result of trauma from road traffic accidents and Madura foot, and war injuries accounted for 29 amputations (17%). One hundred and eleven patients had below knee amputation (BKA), 52 had above knee amputation (AKA) and seven patients had Syme's amputation. Diabetic amputees had higher rate of revisional surgery compared with others because of sepsis and/or flap necrosis. Stump pain was reported by amputees with excessive scarring of the stump and those with undue prominence of bony ends. There are two types of prostheses provided by the NPOC for both BKA and AKA: the peg leg and the conventional prostheses. The Syme's amputees were fitted with either simple hoof or articulated prostheses with solid ankle cushion heel (SACH). The peg leg consists of a leather lined side bearing metal socket connected to a rocker base by side steels. It is used by the country natives as it suits different weather and job conditions, particularly farming, and it can be repaired locally. The urban population use the conventional prostheses which is lighter in weight, can be put on and taken off easily and is cosmetically acceptable. However, these prostheses are more expensive and require frequent repair or replacement. The functional outcome of patient's rehabilitation with the prostheses was significantly affected by the level and indication of amputation. Those with BKA and those amputated because of trauma or Madura foot experienced better functional outcome compared with the diabetics, independent of age. 50% of patients with the AKA and 19% of those with BKA reported poor functional outcome. Surgeons should be more involved with the long-term evaluation of functional outcome in such patients, to offer help if feasible and to modify their technique for future procedures.

Adolescent↗
PubMed1996

Pattern of postoperative pyrexia in Khartoum.

The pattern of postoperative pyrexia in Khartoum was prospectively studied in 260 patients who underwent a variety of surgical operations. Ninety four patients (36.1%) developed postoperative pyrexia. The commonest causes of pyrexia encountered were wound sepsis (10%), malaria (9.6%) and respiratory tract infection (7.3%). Less frequent causes were urinary tract infection, thrombophlebitis, intra-abdominal sepsis and deep vein thrombosis. In 14.6% of the patients, the cause of pyrexia was undetermined. The risk factors for postoperative pyrexia were the patient's age, diabetes mellitus, obesity, preoperative chest infection, smoking, duration of surgery, operator's surgical experience and urethral catheterisation. The postoperative pyrexia was associated with 7.4% mortality rate which was due to intra-abdominal sepsis and pulmonary embolism. The incidence of postoperative pyrexia can be minimised by adequate preoperative preparation, meticulous surgical technique and good postoperative care.

Adolescent↗
PubMed1996

Solitary thyroid nodule in Khartoum.

Ninety four patients with solitary and significantly dominant thyroid nodules were studied. Inadequate sampling was reported in 5 patients (5.9%). In the remaining 89 patients, 64 had simple goitre (72%), 12 follicular adenoma (13.5%), 12 were malignant nodules (6 follicular, 5 papillary and one anaplastic) (13.5%) and one patient had Hashimoto's thyroiditis. The incidence of malignancy in the clinically solitary nodules was 14% (10/70) compared to 10% (2/19) for the dominant nodules which increased to 16% (8/49) versus 10% (4/40) respectively after ultrasonography and histopathological confirmation of the nature of the gland. There is a low positive predictive value for follicular neoplasm with fine needle aspiration cytology (FNAC) (44%). This is due to the fact that reports of suspicious follicular pattern is agreed not to imply definite malignancy, however total lobectomy was done for those patients whereas terms like "not suspicious" and "highly suspicious" are considered to mean, benign and malignant respectively and in those latter groups the prediction was 100%. The study stresses the importance of FNAC techniques in reducing the surgical load with minimal false negative results, increasing the yield of carcinoma and projecting the importance of a significantly dominant nodule in endemic areas.

Adolescent↗
PubMed1994

Acute myocardial infarction at high altitude: the experience in Asir Region, southern Saudi Arabia.

In the first report from southern Saudi Arabia, we studied retrospectively 124 patients admitted to Asir Central Hospital, Abha, with proved acute myocardial infarction. There were 116 men (94%) and 98 patients were Saudi (79%). The majority of non-Saudi patients were Egyptians and Pakistanis. The mean age was 57 (SD = 13) years. Diabetes mellitus, cigarette smoking, and hypercholestrolemia were the most common risk factors. Most of the patients had anterior acute myocardial infarction and, remarkably, both the incidence of complications and the mortality rate were lower than those reported from the rest of Saudi Arabia and the western world. A possible explanation for this trend, among others, could be prolonged residence at high altitude, which may have acted as a protective factor to the myocardium.

Adult↗