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Biomedical subjects

A G Ahmed

Publications and source records attributed to A G Ahmed.

At least 19 recordsLinked to original sources
PubMed2006

Pharmacological treatments for psychosis-related polydipsia.

BACKGROUND: Polydipsia is the intake of more than three litres of fluids per day. Primary polydipsia occurs when excessive drinking cannot be explained by an identified medical condition, and is not secondary to polyuria. The prevalence of this problem in psychiatric inpatients has been estimated at between 6 and 17%. It can hinder standard care and be a highly disabling, even life-threatening condition. OBJECTIVES: To review the effect of pharmacological interventions for the treatment of psychosis-related polydipsia. SEARCH STRATEGY: We searched the Cochrane Schizophrenia Group's Register (January 2002 and February 2005) which is compiled by up-to-date methodical searches of BIOSIS, The Cochrane Library, CINAHL, Dissertation abstracts, EMBASE, LILACS, MEDLINE, PSYNDEX, PsycINFO, RUSSMED and Sociofile and is supplemented with hand searching of relevant journals and numerous conference proceedings. References of all identified studies were also searched for further trials. SELECTION CRITERIA: We included all randomised controlled trials involving people with a psychotic illness and secondary polydipsia, which evaluated drug treatments, and measured clinically meaningful outcomes. DATA COLLECTION AND ANALYSIS: Working independently, we inspected citations, ordered papers, and then re-inspected and quality assessed the studies and extracted data. For homogeneous dichotomous data, we calculated the relative risk (RR), 95% confidence interval (CI), and, where appropriate, the number needed to treat (NNT) and the number needed to harm (NNH), on an intention-to-treat basis. We assumed that people who left the study early or who were lost to follow-up had no improvement. We calculated weighted mean differences (WMD) for continuous data. We excluded data if loss to follow-up was greater than 50%. MAIN RESULTS: We identified two small trials (Alexander 1991 and Nishikawa 1996) which fulfilled the inclusion criteria, (total n=17, duration 3-6 weeks). Few data were reported and, because of inappropriate use of crossover methodology, we could not include all of the data in this review. For the few chronically ill people in these trials, neither the 'active' tetracycline bacteriostatic agent, oral demeclocycline, nor the opiate antagonist naloxone, nor placebo, gave any suggestion of serious adverse effects for a period of up to six weeks. The studies did not report any useful data on measures of polydipsia, physical symptoms secondary to increased fluid intake, mental state, general functioning or economic outcomes. AUTHORS' CONCLUSIONS: The trials offer little useful data to the clinician hoping to treat psychosis-related polydipsia with drugs, except that further evaluative studies need to be conducted in this area. Treatment of any sort for psychosis related polydipsia might only be informative within a well designed, conducted and reported randomised study. The two pioneering studies suggest that larger trials, though difficult, would not be impossible with adequate support and co-ordination.

Drinking↗
PubMed2002

Pharmacological treatments for psychosis-related polydipsia.

BACKGROUND: Polydipsia is the intake of more than three litres of fluids per day. Primary polydipsia occurs when excessive drinking cannot be explained by an identified medical condition, and is not secondary to polyuria. The prevalence of this problem in psychiatric inpatients has been estimated at between 6 and 17%. It can hinder standard care and be a highly disabling, even life-threatening condition. OBJECTIVES: To review the effect of pharmacological interventions for the treatment of psychosis-related polydipsia. SEARCH STRATEGY: The reviewers searched the Cochrane Schizophrenia Group's Register (January 2002) which is compiled by up-to-date methodical searches of BIOSIS, The Cochrane Library, CINAHL, Dissertation abstracts, EMBASE, LILACS, MEDLINE, PSYNDEX, PsycINFO, RUSSMED and Sociofile and is supplemented with hand searching of relevant journals and numerous conference proceedings. References of all identified studies were also searched for further trials. SELECTION CRITERIA: All randomised controlled trials involving people with a psychotic illness and secondary polydipsia, which evaluated drug treatments, and measured clinically meaningful outcomes. DATA COLLECTION AND ANALYSIS: Reviewers, working independently, inspected citations, ordered papers, and then re-inspected and quality assessed the studies. They also worked independently to extract data. For homogeneous dichotomous data, the relative risk (RR), 95% confidence interval (CI), and, where appropriate, the number needed to treat (NNT) and the number needed to harm (NNH), were calculated on an intention-to-treat basis. Reviewers assumed that people who left the study early or were lost to follow-up had no improvement. Weighted mean differences (WMD) were calculated for continuous data. Data was excluded if loss to follow-up was greater than 50%. MAIN RESULTS: The reviewers identified two trials which fulfilled the inclusion criteria, (total n=17, duration 3-6 weeks). Few data were reported and, because of inappropriate use of crossover methodology, it could not all be used in this review. For the few chronically ill people in these trials, neither the 'active' tetracycline bacteriostatic agent, oral demeclocycline, nor the opiate antagonist naloxone, nor placebo, gave any suggestion of serious adverse effects for a period of up to six weeks. The two small studies did not report any useful data on measures of polydipsia, physical symptoms secondary to increased fluid intake, mental state, general functioning or economic outcomes. REVIEWER'S CONCLUSIONS: The trials offer little to the clinician hoping to treat psychosis-related polydipsia with drugs, except that further evaluative studies need to be conducted in this area. Treatment of any sort for psychosis related polydipsia might only be informative within a well designed, conducted and reported randomised study. The two pioneering studies suggest that larger trials, though difficult, would not be impossible with adequate support and co-ordination.

Drinking↗
PubMed2002

Homicide in the Canadian Prairies: elderly and nonelderly killings.

OBJECTIVE: To examine the psychosocial and clinical characteristics of male perpetrators of elderly and nonelderly homicides in the Canadian Prairies. METHOD: We examined data drawn from a study of 901 adult homicide offenders who were incarcerated or on parole between 1988 and 1992 in Alberta, Saskatchewan, and Manitoba. RESULTS: Of those studied, 67 men were convicted of homicide involving 79 elderly victims, and 671 were convicted of homicide involving 675 nonelderly victims. Most perpetrators were single and engaged in irregular patterns of employment at the time of their index offence. Fourteen (20.8%) offenders with elderly victims had a history of psychiatric treatment, compared with 98 (14.6%) offenders with nonelderly victims; however, this difference was not statistically significant. Approximately 30% of both groups were diagnosed with personality disorders. A comparison of the index- offence characteristics showed no significant differences between the 2 groups. CONCLUSION: Our findings suggest that elderly individuals are more likely to be killed in their own homes by strangers. Social isolation appears to be a significant risk factor in cases of elderly homicide.

Aged↗
PubMed2001

Polydipsia, psychosis, and familial psychopathology.

OBJECTIVE: To compare the demographic and clinical factors and familial psychopathology of chronic psychiatric inpatients with, and without, polydipsia. METHOD: We undertook a case-control study of chronic psychiatric inpatients both with, and without, polydipsia. Clinical and demographic data were gathered using a predesigned questionnaire, the Positive and Negative Syndrome Scale (PANSS), the Abnormal Involuntary Movement Scale (AIMS), the Mini-Mental State Examination Scale (MMSE), and the Family History-Research Diagnostic Criteria (FH-RDC). RESULTS: The prevalence rate of polydipsia was 20.2%. The group with polydipsia was significantly younger, both at the time of their first-ever psychiatric and current psychiatric admissions, compared with the group without polydipsia. The 2 groups were similar in terms of their illness characteristics and psychiatric diagnoses. In the group with polydipsia, alcohol abuse predated the psychotic illness by a mean of 10.5 (SD 4.4) years, compared with 4.8 (SD 1.6) years for the same period in the unaffected group. The 2 groups did not differ significantly regarding the antipsychotic medication dosage, the proportion on concomitant anticholinergic medication, the documented previous response to antipsychotic medication, or past treatment with electroconvulsive therapy (ECT). First-degree relatives of patients with polydipsia were found to have significantly higher rates of alcohol dependence. CONCLUSION: This study provides further evidence for the higher rate of polydipsia among chronic psychiatric patient populations and for high rates of alcohol-related problems among their first-degree relatives.

Adult↗
PubMed2001

Seclusion practice in a Canadian forensic psychiatric hospital.

In this study, seclusion practice was examined in a multilevel, secure psychiatric hospital, serving federally sentenced individuals in the Prairie Region, as defined by the Correctional Service of Canada. Between August 1996 and February 1999, 183 patients (27.7% of total admissions) were secluded on 306 occasions. The mean duration of seclusion was 90.3 hours (minimum I hour; maximum 908 hours). A higher proportion of female patients (60%) was secluded than of male patients (25%). Sixty-five percent of the patients were secluded once, 29.5 percent two to four times, and 5.5 percent more than four times. Suicidal threats and self-harm gestures were the reasons for initiating seclusion in 27.4 percent of cases. Patients with diagnosed substance-related disorders accounted for 40.8 percent of all seclusion episodes, whereas those with schizophrenia and related psychoses accounted for 28.1 percent. These findings suggest that seclusion remains a relatively common intervention in some disturbed patients in a forensic setting.

Canada↗
PubMed1999

Psychiatric disorders in first-degree relatives of patients with opiate dependence.

High rates of psychiatric disorders, particularly major depression, alcoholism, drug-use disorder and antisocial personality disorder in the relatives of opiate-dependent patients compared with normal controls, have been reported in some previous studies. This study was designed to evaluate the prevalence rates of drug-use and other psychiatric disorders in the first-degree relatives of opiate-dependent patients and compare these with rates in the first-degree relatives of surgical and psychiatric patients. A case-control study was conducted to compare the prevalence of psychiatric and drug-use disorders (which were estimated by the Family History Method) in 241 biological first-degree relatives of 50 opiate-dependent patients to that in 235 and 222 first-degree relatives of 50 surgical and 50 psychiatric patients respectively. The main outcome measure was the relative risk (expressed as odds ratio) of psychiatric and drug-use disorders. First-degree relatives of opiate-dependent patients were found to have significantly higher rates of drug-use and antisocial personality disorders, compared with relatives of surgical and psychiatric probands. The odds ratio for alcoholism appeared significantly higher only in first-degree female relatives of opiate users, suggesting effect modification by sex. The study provides further evidence for the higher rate of drug-use disorder in the first-degree relatives of opiate-dependent patients. These findings suggest that familial drug-use disorder contributes to a vulnerability to opiate misuse. Implications of these findings for the classification and treatment of opiate dependence are discussed.

Adult↗
PubMed1998

The khat users: a study of khat chewing in Liverpool's Somali men.

This study reports the demographic and social characteristics and level of psychological dysfunction in regular khat users compared with matched non-users. The results indicate that khat users resemble non-users on a number of psychosocial variables and GHQ scores, with no evidence to suggest higher morbidity amongst users. The two groups appear to differ only in the level of their use of nicotine and also in their perception of the harmful effects associated with khat use.

Adolescent↗
PubMed1998

Practice of seclusion: a five-year retrospective review in north Cheshire.

This study examines, retrospectively, the trends and factors associated with the use of seclusion over a five-year period in a regional secure unit located within a large psychiatric hospital that serves the population of North Cheshire. Ninety-four patients (15.3% of total admissions to the unit) spent some time in seclusion on 186 occasions. The average time spent in seclusion was 85 minutes (minimum 15 minutes and maximum 10 hours). Sixty-seven per cent of patients were secluded once, 20% secluded twice, and 13% more than three times. Patients with a clinical diagnosis of personality disorder (11.4%) accounted for 44.2% of seclusions whereas those with a defined mental disorder (55%) accounted for 35% of all seclusions. The rate of seclusion, characteristics of secluded patients, reasons, and average duration spent in seclusion, did not vary significantly over the study period, despite the significant reduction of the unit's admission rate from 150 to 63 per year. The consistent and regular occurrence of the practice over a five-year period may suggest that seclusion of some disturbed patients will inevitably continue to be used as an effective intervention and, probably at times, the only acceptable method that may ensure the safety of patients and staff.

England↗
PubMed1993

Sonographic assessment of ovarian and endometrial changes during long-term Norplant use and their correlation with hormonal levels.

OBJECTIVE: To study the probability of ovulation and subclinical abortion during long-term use of Norplant and to assess the concomitant endometrial development. DESIGN: This was a prospective nonrandomized comparative study. The ovaries and endometrium were assessed daily by ultrasonography during 59 menstrual cycles in 50 women who were using Norplant for > 1 year. Serum concentrations of E2, P, FSH, LH, pregnancy specific beta 1 glycoprotein (Sp1), and hCG were also daily measured. The findings were compared with those in 35 ovulatory cycles in normal fertile women not using contraception. SETTING: Clients of the Family Planning Clinic of Assiut University Hospital (Norplant users) and the hospital women staff (controls). RESULTS: Sonographic and hormonal evidence of ovulation were observed in one third of Norplant users; two of them resulted in conception. However, the majority of these ovulatory cycles showed low midcycle peaks of E2, FSH, and LH and evidence of luteal phase defect (LPD). Excessive follicular enlargement was observed in 46% of the cycles. Norplant users had significantly thinner endometrium that did not exhibit the normal phasic changes in sonographic texture. Apart from conceptive cycles, no rise in Sp1 or hCG was observed. CONCLUSIONS: Norplant acts mainly by inhibiting ovulation, but when this occurs, it is associated with LPD and subnormal endometrial development. Subclinical abortion does not contribute to the contraceptive effect.

Abortion, Spontaneous↗
PubMed1993

An outbreak of dracunculiasis in central Sudan.

This paper describes an outbreak of dracunculiasis in Mazmum, a town in central Sudan. The study included collection of clinical and epidemiological data from 319 patients treated in hospital, a review of the hospital records, a house survey covering a sample of 757 subjects, a school survey covering 1390 schoolchildren, and examination of water sources. The overall incidence of the disease was 23.4%, with most cases appearing in the agricultural season (July-October). Incidence was highest in young females but most severe disability occurred in male patients aged > or = 20 years, of whom more than 60% were unable to work for more than 4 weeks. The disease is transmitted in shallow natural pools, artificial ponds and trenches in rocky hills that hold rain water. All these sources were found to be infested with Cyclops. The outbreak is attributed to deterioration in the structure and management of the water sources, together with a massive population influx from other endemic areas. These observations underscore the importance of co-ordinating efforts to eradicate the disease from African countries.

Adolescent↗
PubMed1987

Five-year experience with Norplant implants in Assiut, Egypt.

This report describes the five-year experience of the first 250 acceptors of NORPLANT implants in Assiut, Egypt. The five-year net continuation rate was 58.6 per 100 women. The five-year net cumulative pregnancy rate was 1.6 per 100 women. About three-fourths of those who continued use of this contraceptive through the fifth year reported having regular cycles. There was definite improvement in the bleeding pattern with time. The five-year net termination rate because of bleeding problems was 17.7 per 100 women. After 5 years of NORPLANT use there was a slight, statistically insignificant increase in weight, systolic and diastolic blood pressures. Of those who used contraceptives after the end of the five-year term of NORPLANT, about one-third opted to have reinsertion of the implants for a second term. About 96% of those who used NORPLANT through the fifth year reported that their experience with the contraceptive had been satisfactory.

Adult↗
PubMed1985

Postpartum decline in serum concentration of placental proteins in an abdominal pregnancy.

The alpha and the beta forms of Schwangerschaftsprotein 1 (SP1) and chorionic gonadotrophin (hCG) were measured after delivery in an abdominal pregnancy with the placenta left in situ. All three proteins declined more slowly than after normal delivery; the half-lives ranging from 6.2-6.5 days. Traces of the proteins could still be detected in the maternal circulation 9 weeks after delivery. These findings are construed as further support for the belief that the placenta plays a major role in the synthesis of these proteins.

Adult↗
PubMed1985

Serum concentration of placental proteins in non-pregnant and pregnant subjects.

Chorionic gonadotrophin (hCG) and Schwangerschaftsprotein 1 (SP1) were measured in 35 menstrual cycles in 20 women. During the follicular phase, 3 samples were positive for hCG and two of these were also positive for SP1. All these positives occurred on the day of ovulation or immediately before. In the luteal phase 25 specimens showed both hCG and SP1 and two showed only SP1, the positive results occurring 3-15 days after ovulation. The placental proteins were also measured in a further eight women who became pregnant. The pattern in these was quite different. The first positives were detected 8 days after ovulation and by 12 days all the subjects were positive for both proteins. Thereafter both proteins increased sharply in concentration. A group of 139 subjects who, on biological grounds, could not have conceived, showed no positive results.

Adolescent↗
PubMed1985

Observations on the dating of pregnancy.

The relationship between the concentrations of placental proteins and the stage of gestation has been examined. Human chorionic gonadotrophin and Schwangerschaftsprotein 1 were measured in two groups of patients: one a group of 13 women studied daily from conception to 21 days after ovulation and the other 43 normal pregnancies studied from 5 to 16 wk gestation. The results of assessment of the stage of gestation as determined by placental protein assay were compared with the dating obtained from last menstrual period and ultrasonic scan. The measurement of placental proteins was at least as accurate as the last menstrual period or ultrasonic scan in determining the stage of gestation.

Adolescent↗
PubMed1985

Concomitant secretion of Schwangerschaftsprotein 1 and human chorionic gonadotrophin following conception.

Daily measurements of serum oestradiol, progesterone, Schwangerschaftsprotein 1 (SP1) and hCG were made in 13 menstrual cycles during which conception occurred. The assays were continued until 21 d after ovulation. SP1 was detected in maternal blood 8-14 d after ovulation and hCG 9-13 d after ovulation. We conclude that these two proteins are secreted simultaneously but independently by the syncytiotrophoblast.

Chorionic Gonadotropin↗
PubMed1985

Placental proteins in male serum.

Placental proteins such as human chorionic gonadotrophin (hCG), Schwangerschaftsprotein 1 (SP1) and pregnancy-associated plasma protein A (PAPP-A) are found in the blood of pregnant women and in subjects suffering from cancer. They can also be found in the blood of healthy non-pregnant women and in the seminal fluid of males. Surprisingly, hCG and SP1 could not be found in male serum, although PAPP-A occasionally occurs there.

Adolescent↗