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Biomedical subjects

M S Salek

Publications and source records attributed to M S Salek.

15 recordsLinked to original sources
PubMed2005

Khat chewing is a risk factor for acute myocardial infarction: a case-control study.

AIM: Khat chewing is a common habit in Yemen and east African countries. Millions of people chew khat leaves daily for its euphoric and energetic effects and to increase alertness. Cathinone, the main active substance in fresh khat leaves, has sympathomimetic effects which increase heart rate and blood pressure. The aim was to examine the hypothesis that khat chewing is a risk factor for acute myocardial infarction (AMI) using a hospital-based matched case-control study. METHOD: Between 1997 and 1999, we selected 100 patients admitted to the Al-Thawra teaching hospital Sana'a ICU, Yemen with acute myocardial infarction. 100 control subjects, matched to cases for sex and age, were recruited from the outpatients clinics of the same hospital. A questionnaire was completed for case and control groups covering personal history of khat chewing, smoking, hypertension, diabetes and any family history of myocardial infarction. A blood sample was collected for performing lipid profiles. Cases and controls were compared by analysis conducted using conditional logistic regression which corrected for baseline imbalances leading to less biased estimations of odds ratio (OR). The risk associated with each classical factor and khat chewing habits was then investigated. OR values greater than 2.5 indicated a significant risk factor. RESULTS: Khat chewing was significantly higher among the AMI case group than control group (OR = 5.0, 95% CI 1.9-13.1). A dose-response relationship was observed, the heavy khat chewers having a 39-fold increased risk of AMI. CONCLUSION: This study indicates that khat chewing is associated with AMI and is an independent dose-related risk factor for the development of myocardial infarction.

Adult↗
PubMed2005

Does enough quality of life-related discussion occur during dermatology outpatient consultations?

BACKGROUND: Dermatologists' assessments of how their patients' lives are affected by the skin disease are of importance for informing clinical decisions. However, there is no information about how often quality of life (QoL) issues are discussed in outpatient consultations. OBJECTIVE: To examine the relationship between the extent of QoL-related discussion during dermatology outpatient consultations, and the current impact of the disease on patients' lives. PATIENTS AND METHODS: A total of 238 consultations were observed in a teaching dermatology outpatient department for QoL-related discussion initiated by either the clinician or the patient. Following the consultation, all patients were posted a Dermatology Life Quality Index (DLQI) questionnaire to complete and return within 1 week. RESULTS: QoL discussion was absent in 40% of consultations. Consultants initiated the fewest QoL discussions with patients, and nurses the most (P < 0.0001). One hundred and twenty-eight (54%) patients returned the DLQI, 114 (48%) of which were evaluable. The mean score was 5.6, SD +/- 6.6, median 3, range 0-29. The mean DLQI score for the patients with whom there was no QoL discussion was 4.0 +/- 4.7, n = 55, compared with the mean DLQI score for patients with whom QoL was discussed 6.8 +/- 7.2, n = 59 (P < 0.001). CONCLUSION: This study demonstrates that little information concerning QoL is elicited during dermatology outpatient consultations.

Adolescent↗
PubMed2005

The feasibility, reliability and validity of the Malay McGill Quality of Life Questionnaire--Cardiff Short Form (MMQOL-CSF) in Malaysian advanced cancer population.

Health-related quality of life (HRQoL) assessment is important in healthcare outcomes. This study aimed to determine the feasibility, reliability and validity of the Malay McGill Quality of Life Questionnaire--Cardiff Short Form (MMQOL-CSF) in advanced cancer population. Patients either completed the MMQOL-CSF alone or in addition to its long version. The study recruited 116 participants (average age = 44 years old). On average, MMQOL-CSF was completed in 5.4 minutes. Most domains showed evidence of reliability (Cronbach's alpha = 0.76-0.92). Correlation with its long version was moderate to strong (r(s) = 0.54-0.87). The MMQOL-CSF was a feasible, reliable and valid HRQoL instrument in this population.

Adolescent↗
PubMed2004

Quality of life improvement in treatment of psoriasis with intermittent short course cyclosporin (Neoral).

Due to concern over long term safety of continuous treatment with cyclosporin, the aim of this 1-year study was to assess the effect of intermittent therapy with cyclosporin (Neoral) on the quality of life of patients suffering from chronic plaque psoriasis. A total of 41 patients with chronic plaque psoriasis (26 male, mean age: 36 years, range: 18-61; duration of psoriasis 17 years, range: 2-31) entered a 9-centre open study in which cyclosporin was taken as an initial dose of 5 mg/kg/daily for a maximum of 12 weeks for up to three cycles. Each patient completed a psoriasis specific QOL measure (Psoriasis Disability Index, PDI) at the beginning and end of each treatment cycle and at the end of study. Clinical parameters including Psoriasis Area and Severity Index (PASI) were measured. The PDI scores showed a significant improvement (p < 0.01) between the beginning and end of all three treatment cycles. The various clinical assessments for each treatment period also showed significant improvement (p < 0.001) for all three cycles. When comparing the last follow-up value to baseline there was a clear indication of relapse, but these scores were still significantly better than at baseline (p < 0.01). Notably, the mean PASI score improved by more than 50% (p < 0.001) between first baseline and end of the study. These findings indicate that a short course of intermittent therapy with cyclosporin in microemulsion formulation, used at starting doses of 5 mg/kg/day, improves QOL of patients with chronic plaque psoriasis. Once again, the applicability and validity of the PDI as a useful QOL tool has been demonstrated.

Adolescent↗
PubMed2003

Intramuscular alefacept improves health-related quality of life in patients with chronic plaque psoriasis.

BACKGROUND: Psoriasis profoundly affects patient quality of life (QOL). Amevive (alefacept), a novel and selective biologic agent, was clinically effective and significantly improved QOL in a phase 2 study. METHODS: The present placebo-controlled, randomized phase 3 study examined the effects of a 12-week course of intramuscular alefacept on QOL in 507 patients with chronic plaque psoriasis using both dermatology-specific questionnaires [Dermatology Life Quality Index (DLQI); Dermatology Quality of Life Scales (DQOLS)] and the Short Form-36 Health Survey (SF-36), a generic, general health questionnaire. RESULTS: All 3 QOL measures (DLQI, DQOLS, SF-36) demonstrated that alefacept 15 mg was significantly more effective than placebo in improving QOL in patients with chronic plaque psoriasis. In addition, the improvements in QOL for patients in the alefacept 15 mg group were of similar magnitude for all 3 QOL measures. CONCLUSION: The findings of this study are an important addition to the QOL literature for psoriasis treatments.

Alefacept↗
PubMed1999

The applicability of quality-of-life assessment in palliative care: comparing two quality-of-life measures.

Two self-administered quality-of-life measures, the McGill Quality of Life Questionnaire (MQOL) and the Patient Evaluated Problem Scores (PEPS) were compared in patients receiving palliative care. The MQOL is a multidimensional questionnaire consisting of 16 items in five quality-of-life (QOL) domains: physical symptoms, physical well-being, psychological, existential and support domains. The PEPS is an individualized questionnaire asking patients to identify and rate major problems affecting their QOL. Both questionnaires were completed by 36 patients during outpatient clinic visits in three palliative care settings in Wales. Of those patients who stated their questionnaire preference 60% favoured MQOL due to its comprehensiveness, while others (28%) preferred PEPS due to its simplicity. The MQOL showed excellent internal consistency (alpha = 0.90). The intrapatient analysis of answers from both questionnaires showed that MQOL was better than PEPS in reporting physical symptoms and support domain, while PEPS detected more psychosocial issues. The MQOL overall QOL score correlated highly with its existential domain (rs = 0.57, P < 0.0005) and the PEPS overall quality of life (rs = 0.77, P < 0.0005). Similarly, the PEPS overall QOL correlated well with MQOL total score (rs = 0.76, P < 0.0005) and existential domain of the MQOL (rs = 0.63, P < 0.0005). The findings support the importance of an existential domain in assessing the QOL of this population. Both MQOL and PEPS were found to be relevant and acceptable in advanced cancer patients receiving palliative care. However, with its favourable psychometric properties MQOL may be more suitable for QOL assessment in this population.

Adolescent↗
PubMed1998

The attitude of health care professionals toward the availability of hospice services for cancer patients and their carers in Saudi Arabia.

The main objectives of this study were to assess cancer care and the need for establishing hospice/palliative care for cancer patients and their carers in Saudi Arabia. Six-hundred-and-ninety-five participants (136 cancer patients, 161 informal carers, and 398 health care professionals) were recruited from oncology centres in four major regions of Saudi Arabia. Each group was asked to complete a questionnaire specifically designed to meet the aims of the study. The data obtained from the three different questionnaires indicated that the level of cancer care in the Ministry of Health hospitals was poor compared to other hospitals such as the King Faisal Specialist Hospital and Research Centre, military hospitals or university hospitals in the kingdom, perhaps due to the absence of home care services or periodic follow-up by their regional hospitals. It was also reported that the shortage of drugs used in cancer management, the severe restriction of prescribing narcotic analgesics and lack of cancer care knowledge were the major impediments to providing good cancer care. Thus, the strong inter-relationship among Saudi families, the present poor status of cancer care, cancer patients' and their carers' acceptability of hospice services and of the willingness of health care professionals to receive training in palliative care, illustrate the need for initiating the provision of palliative care services in the Saudi health system.

Adaptation, Psychological↗
PubMed1996

Basal cell carcinomas cause little handicap.

Basal cell carcinoma (BCC) is the most common type of skin cancer and the incidence of BCC is expected to rise, with increased demand on dermatology resources. Little is known of the effect on people's lives of having skin cancer. The aim of this study was to quantify the handicap caused gy basal cell carcinomas before and after therapy. Forty-four patients (22 males, mean age = 65 yrs, range = 35-81 yrs) with 48 BCCs were recruited and 37 patients completed the study. Each patient completed the UK Sickness Impact Profile (UKSIP) and the Dermatology Life Quality Index (DLQI) at the initial visit to the dermatology clinic, 1 week after treatment and 3 months after treatment. Lesions had been present for a mean of 25 months (range = 1-240 months), their mean diameter was 9.6mm (range = 3-35mm) and the sites were head and neck (79%), trunk (17%) and limbs (4%). There was no relationship between the quality of life score and size of lesion. Overall the scores at presentation were very low, rising 1 week after treatment and falling to below the initial scores at 3 months (mean UKSIP 0.4%, 0.7%, 0.13%; mean DLQI 5.3% 8.7%, 1.2%). BCCs cause little handicap. This may explain the delay in seeking medical attention and should be considered in planning public health education about BCCs.

Adult↗
PubMed1996

Questionnaire techniques in assessing acne handicap: reliability and validity study.

The purpose of this study was to examine and compare the reliability and validity of two acne-specific measures, the Cardiff Acne Disability Index (CADI), the Acne Disability Index (ADI) and a general health status instrument, the United Kingdom Sickness Impact Profile (UKSIP). The test-retest reliability was carried out for the UKSIP, ADI and CADI with an interval of 10 days in 70 patients with acne. The correlation coefficient for the overall UKSIP score was high (r = 0.99, p < 0.001) for the CADI was 0.96 (p < 0.001) and for the ADI was 0.98 (p < 0.001). Individual category score correlations in the UKSIP and ADI were greater than 0.83. Tests of internal consistency of the instruments scored highly. A further 100 patients with acne and 50 controls completed all three instruments. The overall UKSIP mean score of patients was 5.6 (sd = 4.7) and of controls was 0.45. The ADI mean patient score was 40.3%, controls 17.6%. The CADI mean patient score was 42.1%, controls 13.2%. The CADI was the only instrument that correlated with the clinical acne severity score (p < 0.05); the UKSIP score correlated with the CADI score (p < 0.05) but not with the ADI score. This study has established aspects of the reliability and validity of the UKSIP, the ADI and the CADI.

Acne Vulgaris↗
PubMed1996

Cyclosporine in severe childhood atopic dermatitis: a multicenter study.

BACKGROUND: Severe atopic dermatitis (AD) remains difficult to treat. Cyclosporine is effective in adults but has not previously been investigated in children with AD. OBJECTIVE: The aims were to investigate the efficacy, safety, and tolerability of cyclosporine in severe refractory childhood AD. METHODS: Subjects 2 to 16 years of age were treated for 6 weeks with cyclosporine, 5 mg/kg per day, in an open study. Disease activity was monitored every 2 weeks by means of sign scores, visual analogue scales for symptoms, and quality-of-life questionnaires. Adverse events were monitored. Efficacy and tolerability were assessed with five-point scales. RESULTS: Twenty-seven children were treated. Significant improvements were seen in all measures of disease activity. Twenty-two showed marked improvement or total clearing. Quality of life improved for both the children and their families. Tolerability was considered good or very good in 25 subjects. CONCLUSION: Cyclosporine may offer an effective, safe, and well-tolerated short-term treatment option for children with severe AD.

Administration, Oral↗
PubMed1993

Cyclosporin greatly improves the quality of life of adults with severe atopic dermatitis. A randomized, double-blind, placebo-controlled trial.

A multicentre, randomized, double-blind, controlled crossover clinical trial was conducted on 33 patients with severe refractory atopic dermatitis, to determine the effects of cyclosporin (5 mg/kg/day) on their health-related quality of life. Treatments were administered for 8-week periods. One group (n = 16) received placebo followed by cyclosporin, and the other (n = 17) received cyclosporin and then placebo. Health-related quality of life was assessed at 0, 8 and 16 weeks using a general measure, the United Kingdom Sickness Impact Profile (UKSIP), an eczema-specific measure, the Eczema Disability Index (EDI), and a global 5-point rating scale of overall health (very good to very poor). In addition, clinical assessments (i.e. extent and activity of disease) were made by the investigators. UKSIP and EDI scores indicated significant improvement in quality of life (P < 0.05-P < 0.01) of patients with atopic dermatitis after treatment with cyclosporin. Although no patient required withdrawal from the study, 20 patients receiving cyclosporin reported adverse events, compared with eight taking placebo. There was a close correlation (P < 0.05-P < 0.01) between the UKSIP and EDI scores. In contrast, there was either no correlation, or only a very poor correlation, between the quality of life parameters and clinical measures of extent and activity of eczema. When cyclosporin was stopped, relapse was rapid, but the mean scores for disease activity and extent of disease were less than their baseline values (i.e. an improvement of greater than 25% was maintained in 11 patients at week 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Activities of Daily Living↗
PubMed1991

Double-blind, controlled, crossover study of cyclosporin in adults with severe refractory atopic dermatitis.

A few patients remain severely affected by atopic dermatitis into adult life despite treatment with systemic steroids, azathioprine, and photochemotherapy. 33 patients took part in a double-blind, placebo-controlled, crossover study to assess the efficacy and safety of cyclosporin (5 mg/kg per day) in adults with severe refractory atopic dermatitis. Treatments were given for eight weeks each with one group (n = 16) receiving placebo followed by cyclosporin and another (n = 17) receiving cyclosporin and then placebo. Disease activity, extent of disease, sleep and itch, topical steroid use, and adverse events were assessed every two weeks. Both extent and activity of dermatitis were significantly improved (p less than 0.001) as were subjective measures of disease. 20 patients receiving cyclosporin reported adverse events compared with 8 taking placebo, although no patient required withdrawal from the study. Cyclosporin therapy led to an increase in the mean serum urea, creatinine, and bilirubin concentrations, although only the rise in bilirubin was significant (p = 0.001). Our results confirm that cyclosporin is a safe and effective short-term treatment for severe, refractory atopic dermatitis.

Adolescent↗
PubMed1990

Validation of Sickness Impact Profile and Psoriasis Disability Index in Psoriasis.

A prospective cross-sectional questionnaire study of 32 patients with psoriasis was carried out in order to validate the use of the Sickness Impact Profile (SIP) in psoriasis and compare its sensitivity with the Psoriasis Disability Index (PDI). Overall PDI scores, but not overall SIP scores, correlated well with PASI scores (P less than 0.05). There was good correlation between the PDI and overall SIP scores (P less than 0.01). Psychosocial factors are more severely impaired than physical activities in patients with psoriasis. It is now possible to directly compare the disability experienced by psoriatic patients with that experienced by patients suffering from other systemic diseases, using the SIP. The PDI is an appropriate method to give a rapid overall measure of psoriasis disability.

Activities of Daily Living↗