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Biomedical subjects

R N Pugh

Publications and source records attributed to R N Pugh.

At least 19 recordsLinked to original sources
PubMed1998

Injury mortality and morbidity among children in the United Arab Emirates.

UNLABELLED: The objective of this study was to identify the major causes of accident mortality and morbidity among children (0-14 years) in Al-Ain, United Arab Emirates (UAE). A retrospective descriptive study was set in the Al-Ain Hospital and Preventive Medicine Department, Ministry of Health, Al-Ain. Subjects were all patients aged 0-14 years who were seen at Al-Ain Hospital for injury during the 12-month period January to December 1995, and all recorded deaths aged 0-14 years in Preventive Medicine Department from 1980 to 1995. RESULTS: Mortality: 301 children (69.4% males, 30.6% females) died after accidents from 1980 to 1995. UAE citizens and other Arabs represented the majority of deaths. Most mortality (28.6%) occurred in the 1-4 year age group. Head and neck injury was the major type of injury causing death (57.5%). The most common cause of accidental death was road traffic accidents (boys 67.1%, girls 60.4%), followed by drowning and burns (8%). Morbidity: Pediatric trauma cases seen during 1995 totaled 17,498, representing one third of all patients attending the Hospital Emergency Room. About 70% of encountered injuries occurred among boys; 44.6% of cases were UAE citizens. The most common trauma type was contusion (40.2% boys; 40.6% girls), the most common type of trauma in boys and girls (30.4% and 36%, respectively). In the age group <5 years, the most common causes of trauma were fall (41.1%), blunt trauma (38.7%) and burns or scalds (64%), while in 5-9 year olds, the most common cause was road traffic accidents (40%). Finally, in 10-14 year olds, the most frequent causes were traffic accidents (32.8%) sharp objects injuries (38.3%), and fights and sporting (28.9%). CONCLUSION: More boys than girls presented with injury and the majority were nationals. Road traffic accidents mainly occurred in children over 10 years.

Accidental Falls↗
PubMed1998

Arabian Peninsula men tend to insulin resistance and cardiovascular risk seen in South Asians.

OBJECTIVE: To test the hypothesis that peninsular Arabs and South Asians share a tendency to insulin resistance, differing from other ethnic groups living in the United Arab Emirates (UAE). METHODS: A representative sample of 358 apparently healthy men aged 35-49 years drawn from a multiethnic office-based workforce in the UAE was tested. The sample included a reference group of expatriate South Asians, in whom insulin resistance has already been described as the cause of high coronary heart disease (CHD) mortality. All subjects were screened for CHD risk factors, including glucose tolerance and 2-h serum insulin determinations. RESULTS: There was a high prevalence of previously undiagnosed cases of diabetes (10.1%) and hypertension (14.2%). South Asian and peninsular Arab men shared the tendency to significantly higher 2-h glucose and insulin levels, lower HDL cholesterol concentrations and abdominal obesity especially compared to Europeans, who were five times less likely to be glucose-intolerant (OR 5.40, P = 0.015). Three other Arab groups were intermediate in most trends. CONCLUSION: Susceptibility to insulin resistance in Arabian peninsula men is strongly supported, suggesting that control of obesity and promotion of exercise are the best approach to CHD prevention.

Adult↗
PubMed1997

The associations between feeding modes and diarrhoea among urban children in a newly developed country.

The protective effect of breastfeeding against infantile diarrhoea may be less pronounced in areas with modern water supply and sanitation facilities. This finding raises the question whether protection by breastfeeding against infantile diarrhoea in developing countries will decline with improvement in water supply and sanitation. To address this question a historical cohort study of the associations between feeding modes and diarrhoea incidence and severity in children aged 0-14 months at baseline was done in Al Ain city, United Arab Emirates. In this city in a newly developed country, modern water supply and sanitation facilities have become available to everyone during the last two decades. During three months of follow-up of 249 children, the nonbreastfed had more diarrhoea than did the partly breastfed, who in turn had more diarrhoea than did the fully breastfed. After multivariate adjustment, this dose-response effect was consistent for three measures of diarrhoeal morbidity in each child: occurrence or non-occurrence of incidence episodes, number of episodes, and total severity score. However, significant differences were seen only between the nonbreastfed and fully breastfed subgroups. These results indicate that in Al Ain, despite the universal access to modern water supply and sanitation facilities, breastfeeding plays an important role in reducing the incidence and severity of infantile diarrhoea. This observation is particularly important given the growing concern that, as an unwanted effect of 'modernisation', breastfeeding is on the decline in Al Ain and comparable populations elsewhere.

Breast Feeding↗
PubMed1995

The prevalence and correlates of anaemia among young children and women of childbearing age in Al Ain, United Arab Emirates.

During 1992 and 1993, 309 children aged 1-22 months (mo) and their mothers visiting an immunization facility in Al Ain city, Abu Dhabi Emirate, United Arab Emirates, were studied to (1) define blood haemoglobin (Hb) levels; (2) estimate the prevalence of anaemia; (3) examine the role of iron deficiency in causing anaemia; (4) identify the correlates of anaemia prevalence; and (5) assess the acceptability to parents of an anaemia screening test for their young children. The levels of Hb in all subjects and the levels of serum ferritin in anaemic (Hb < 11 g/dl) children aged > or = 6 mo and in non-pregnant women with Hb < 11 g/dl were determined by a HemoCue Photometer and an enzyme immunoassay, respectively. Each woman was interviewed to obtain pertinent data. In children, anaemia was detected in 3% of those aged 1-2 mo (Hb < 9 g/dl), in 8% of those aged 3-5 mo (Hb < 10 g/dl), and in 25-39% of those aged > or = 6 mo (Hb < 11 g/dl). Of 19 children tested, ten (53%) were iron-depleted (serum ferritin < 12 micrograms/l). After multivariate adjustment, the only significant positive correlate of anaemia in children was older age (1-5 mo vs 6-22 mo; odds ratio [OR]: 9.51; 95% confidence interval [CI]: 3.92-23.08). Anaemia was detected in 14% of pregnant women (Hb < 11 g/dl) and 16% of non-pregnant women (Hb < 12 g/dl).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Bacterial meningitis: still a cause of high mortality and severe neurological morbidity in childhood.

Among 121 cases of bacterial meningitis (age 2 months to 12 years; mean, 35 months) treated over a 3-year period, Neisseria meningitidis was the most common pathogen (33 per cent), then Haemophilus influenzae (32 per cent) and Streptococcus pneumoniae (15 per cent). In the H. influenzae group, 95 per cent were aged below 2 years. Overall mortality was 12 per cent: higher in the S. pneumoniae (17 per cent) and less common organism (21 per cent) groups. Neurological sequelae in 21 (20 per cent) of the 106 survivors included hearing impairment in 17 and quadriparesis in eight. Meningitis caused by S. pneumoniae contained a significantly higher proportion of children with neurological morbidity (P = 0.0128). The addition of dexamethasone treatment during the third year produced an apparent but not significant trend towards less mortality (P = 0.7568), fewer neurological sequelae (P = 0.3401) and less hearing impairment (P = 0.3903). Despite the availability of effective chemotherapy, bacterial meningitis will remain an important cause of high mortality and considerable morbidity.

Brain Diseases↗
PubMed1995

Diabetes, obesity and hypertension in urban and rural people of bedouin origin in the United Arab Emirates.

In the United Arab Emirates, coronary heart disease has emerged as the leading cause of mortality over a 20-year period of rapid socioeconomic development. CHD risk factors of non-insulin dependent diabetes mellitus (NIDDM), obesity and hypertension were investigated by community based survey among a bedouin-derived Emirati population sample of 322 subjects (> or = 20 years). Diagnosis of diabetes was based on a random capillary blood glucose level > or = 11.1 mmol l-1. Overall diabetes prevalence was 6% (11% in male and 7% in female subjects aged 30-64 years). Urban residence was associated with higher blood glucose levels (P = 0.000), and with higher Body Mass Index (BMI) values (P = 0.002): 27% of all urban residents were obese (BMI > or = 30). The Shamsi were positively associated with higher blood glucose levels compared with other tribal groups (P = 0.000). Female gender was associated with higher BMI values (P = 0.000). Between 19 and 25% of all subjects (male or female; urban or rural residents) have systolic hypertension (> 140 mm Hg). Male gender was associated with raised diastolic BP (P = 0.023). Diabetes was associated with higher mean systolic (P = 0.0274) and diastolic (P = 0.0132) BP levels. Differences in lifestyle between urban and rural residents are becoming blurred with further socioeconomic development and it is expected that the incidence of these CHD risk factors will continue to rise. Further studies are needed to specify changes associated with urbanization. Tribal influence also merits further study given the tradition of consanguinity in the UAE and the genetic basis to NIDDM.

Adult↗
PubMed1991

Clinical presentation of enteric fever: its changing pattern in Kuwait.

The clinical experience with enteric fever (1985-89) at a general hospital in Kuwait is presented. There were 90 cases of typhoid and 10 cases of paratyphoid fever, with a mortality rate of 2%. Typhoid complications of bowel perforation, haemorrhage or septic shock were present in 5% and abortion in 2%. Neurological or psychiatric manifestations were a feature in 15%. Most infections were imported (78%). Despite rapid economic development, enteric fever may still be acquired locally but less frequently with time. This contributed to initial diagnostic uncertainty in 18% of cases, and especially in children. Another changing pattern emerged with the recent finding of five drug-resistant Salmonella typhi isolates, two in 1988 and three in 1989. Efforts are clearly needed to diagnose enteric fever more rapidly and to utilize new antibiotics for drug-resistant cases.

Adolescent↗
PubMed1991

Clinical report of Blastocystis hominis infection in children.

During a 9-month hospital-based survey, the intestinal parasite Blastocystis hominis was detected in high numbers (five or more organisms per oil immersion field) in faecal specimens from 39 (2%) of 1960 children under 13 years old. Abdominal pain or discomfort with or without diarrhoea was present in 32 children categorized as acute (14), subacute (7) or chronic (11) cases with respective mean ages of 6.4, 7.3 and 8.7 years. They included three with other enteropathogens (Giardia lamblia, Cryptosporidium sp. or Hymenolepis nana). The remaining seven children had no gastrointestinal symptoms. The 14 acute cases (symptoms duration 1-11 days) were characterized by cramp-like abdominal pain, watery diarrhoea and vomiting. The seven subacute (3-4 weeks) and 11 chronic (3-12 months) cases presented with abdominal discomfort and/or loose non-watery stools. Four complained of flatus and eosinophilia was noted in six. All symptoms resolved with eradication of B. hominis or reduction to low numbers after metronidazole chemotherapy (28 cases) or with no treatment (four cases). This study would appear to support the role of the parasite as an enteropathogen in some children. A case control study is clearly needed to clarify the status of B. hominis as a pathogen.

Animals↗
PubMed1990

Leprosy in Kuwait: an epidemiological study of new cases.

The latency of infection in leprosy is long so that new cases may present several years after emigration from endemic areas. This is of concern to the health authorities in Kuwait, since there is a sizeable immigrant population. An epidemiological study of new cases was, therefore, conducted to assess the extent of the leprosy problem. A total of 121 (99 male, 22 female) consecutive new leprosy patients were diagnosed nationwide over a six-year period (1983-1988). Over 95% of the patients were foreign born, emphasizing that the problem in Kuwait is mainly a reflection of immigration patterns. There were 74 cases of Asio-Indian origin, 13 Oriental and 34 Arab (including two Kuwaiti). This represents a respective mean incidence of the disease in Kuwaitis and other nationalities of 0.49 and 18.92 per 100,000 per year. Polar lepromatous (LL) leprosy was the most frequent type in the Arab group (44.1%) and polar tuberculoid (TT) the most frequent in the Asio-Indian group (37.8%). LL and borderline lepromatous (BL) types of leprosy were significantly more frequent in patients over 45-years-old and in females (P less than 0.05), contributing to the higher rate of LL in the Arab cases. The mean lag time from symptoms onset to presentation to doctor was 9.4 (range 0-192) months, with lepromatous cases tending to present later than other types. The longest lag times occurred in Arab women with LL, suggesting that cultural influences may delay presentation of leprosy. The mean interval from presentation to diagnosis was 4.1 weeks. The mean latency from entry into Kuwait to diagnosis was 44.7 (range 0-180) months; which stresses the need for physicians to remain vigilant in considering leprosy, especially in any patient with dermatological, neurological or ophthalmic manifestations of disease.

Adolescent↗
PubMed1990

Cryptosporidium gastroenteritis in immunocompetent children from Kuwait.

During an 18 months' survey of children admitted to hospital with gastroenteritis, oocysts of the protozoan Cryptosporidium were detected in 35 cases (1.6% of the total 2205 surveyed). The affected children (age range 5 months to 8 years; mean 34.2 months) were immunocompetent, and had green and offensive watery diarrhoea. Vomiting (94%) with dehydration (80%), fever (66%) and abdominal pain (26%) were major clinical features of the diarrhoeal illness which lasted a mean 8.2 (range 3-14) days. Five children were infected with other enteropathogens. The illness was self-limiting in all cases and none were excreting oocysts 2 weeks after cessation of diarrhoea. Peak incidence occurred during the months of March and April, with no cases during the hottest months of July and August. There was no known contact with animals or pets; 4 children had other siblings affected and 2 conformed to cases of travellers' diarrhoea. The significance of cryptosporidiosis in Kuwait and the need for epidemiological studies are discussed.

Animals↗