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Biomedical subjects

Diaa E E Rizk

Publications and source records attributed to Diaa E E Rizk.

At least 19 recordsLinked to original sources
PubMed2007

The effect of ovariectomy on biomarkers of urogenital ageing in old versus young adult rats.

The aim of this study was to compare the effects of ageing and ovariectomy on biomarkers of urogenital ageing in old and young-adult rats. Fisher 344 rats (18- and 3-months-old, n = 6 x 2) underwent ovariectomy. Age-matched sham animals received no intervention (n = 6 x 2). One month later, biomarkers of urogenital ageing were evaluated (light microscopic count of urethral and anal canal submucosal blood vessels, Western blot analysis of urethral, and anal canal submucosal collagen I and III and cytoplasmic p27(kip1) expression in the striated urethral and anal sphincters and levator ani and gel electrophoresis of isomyosin I proportion in these muscles) and compared in all groups (n = 24). All biomarkers of urogenital ageing studied were significantly increased in old compared to young-adult sham rats. Ovariectomy significantly increased these changes further in old versus young-adult rats with either smaller or larger differential effect than ageing compared to young-adult sham animals. Ovariectomy significantly exacerbates normative urogenital ageing changes in rats.

Aging↗
PubMed2006

Estrogen and ghrelin decrease cytoplasmic expression of p27kip1, a cellular marker of ageing, in the striated anal sphincter and levator muscle of ovariectomized rats.

A study was carried out to investigate the effect of estrogen and/or ghrelin on the cellular marker of ageing, p27kip1, in pelvic floor muscles of ovariectomized rats. Virgin Wistar rats (13 months old) underwent ovariectomy followed (1 month) by 42 daily intraperitoneal 17-beta estradiol (10 microg/kg), ghrelin (2 microg/kg), both hormones, or placebo vehicle (n=6x4 groups). Six more age-matched animals underwent sham surgery without ovariectomy. Cytoplasmic expression of p27kip1 in the striated urethral and anal sphincters and levator muscle was measured by Western blot analysis in all animals (n=30). p27kip1 signal intensity significantly increased postovariectomy in all muscles compared to sham animals. In the anal sphincter and levator, signal intensity decreased to sham levels with ghrelin or estrogen and decreased further after estrogen or ghrelin and estrogen/ghrelin administration. Urethral sphincter signal intensity decreased without reaching sham levels after drug administration. Estrogen and/or ghrelin replacement reverses the ovariectomy-induced exacerbation of biochemical cellular ageing in the anal sphincter and levator muscle of middle-aged rats.

Aging↗
PubMed2006

Sporadic Larsen syndrome in a preterm female originally diagnosed as positional deformities due to oligohydramnios.

Few reports describe incidental prenatal diagnosis of sporadic Larsen syndrome by ultrasound, but none of these discuss coincidental oligohydramnios or an association with fetal growth restriction. A 28-year-old woman had prolonged rupture of membranes causing marked oligohydramnios at 32 weeks gestation in her first pregnancy. Labor was induced by vaginal prostaglandins and oxytocin infusion after dexamethasone administration because of concern about placental abruption. She delivered vaginally a live female infant weighing 1960 g (< 10th percentile) with multiple skeletal malformations and characteristic facies originally suspected as positional. Newborn x-rays, however, established the diagnosis of Larsen syndrome with bilateral dislocations of the hips, knees (genu recurvatum), and ankles (club foot). The neonatal karyotype was 46,XX. Parental examination and family history were unremarkable. The newborn did well with bilateral lower extremities cast. Postnatal diagnosis of Larsen syndrome should be suspected in neonates with multiple skeletal abnormalities following oligohydramnios.

Facies↗
PubMed2006

Prevalence and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates.

BACKGROUND: Our objective was to determine the prevalence, sociodemographics, and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates, as there are no national data on this subject. METHODS: Adolescent girls aged 12-18 years who were at least 1 year postmenarchal were selected from five private and five public schools (n=70 x 10 = 700) in Al-Ain city using a multistage stratified cluster-sampling technique. Subjects were interviewed about cyclic and recurrent behavioral and somatic premenstrual symptoms during the last 3 months based on the American College of Obstetricians and Gynecologists' criteria and their impact on quality of life using a structured and validated questionnaire. RESULTS: The prevalence of premenstrual syndrome was 16.4% (n=115). On logistic regression analysis, premenstrual syndrome was significantly associated with Emirati nationality (p=0.001), presence of the condition in sister(s) (p=0.002), and dysmenorrhea (p<0.001). Only 52 affected subjects (45.2%) were currently taking treatment for premenstrual syndrome and the majority (60%) used pharmacological therapy. Premenstrual syndrome had a moderate but significant negative impact (p<0.001) on the quality of life of affected girls, particularly school performance, social interactions, lifestyle, and emotional well-being. Difficulty in performing school functions and decrease in stigma were the two most adversely affected parameters. CONCLUSION: Premenstrual syndrome is a prevalent, yet undertreated, disorder in adolescent schoolgirls in the United Arab Emirates, which adversely affects their emotional well-being and educational performance, representing a significant public health problem. Premenstrual syndrome is significantly associated with ethnicity, family history, and dysmenorrhea in this group.

Adaptation, Psychological↗
PubMed2006

Are senior UAE medical and nursing students ready for interprofessional learning? Validating the RIPL scale in a Middle Eastern context.

The success of interprofessional education initiatives depends substantially on attitudes and readiness of health care students to this type of learning. To our knowledge, nothing is known about this subject in a non-western educational context. Using a self-administered extended 29 item version of the Readiness for Interprofessional Learning Scale (RIPLS), this study examined attitudes and readiness for interprofessional education of senior medical (n = 90) and nursing (n = 88) students' from the United Arab Emirates University and Institute of Nursing. The researchers also tested the validity of the RIPLS in this Middle Eastern context. Three main factors, comprising 20 statements emerged from statistical analysis of the data. Sub-scales were labelled "teamwork and collaboration", "professional identity" and "patient-centredness" and each had a strong internal consistency (0.86, 0.80, 0.80 respectively). Both groups of students believed that there are potential academic and clinical benefits of interprofessional learning. Nevertheless, analysis of variance indicated significant differences between the two groups of students in respect of key statements on each factor. The extended RIPLS was validated for use in an undergraduate Middle Eastern community and thus provides programme developers and evaluators with a useful tool to assess medical and nursing students' readiness for interprofessional learning in this context.

Adolescent↗
PubMed2005

Ultra-structural morphological abnormalities of the urinary bladder in streptozotocin-induced diabetic female rats.

The objective of this study was to evaluate the ultra-structural changes in the urinary bladder of diabetic rats in relation to disease duration since the morphological bases of diabetes-induced bladder dysfunction are poorly understood. Urinary bladders were examined chronologically by electron microscopy in a female Wistar-rat model of streptozotocin-induced diabetes mellitus and compared to control samples. Numerous dark mitochondria with swollen cristae and electron lucent, large, calcified and degenerated mitochondria were observed first in the urothelium. Intraepithelial capillaries surrounded by thick collagen were also present. Gap junctions between myocytes were interrupted or extensively widened with reduced mitochondria and caveolae. Collagen accumulation, degenerated nerve fibres and myelin bodies were seen between myocytes with increased collagen content and frequent mast cells, phagocytes and lymphocyte aggregates in the stroma. All ultra-structural lesions became augmented with longer duration of diabetes. Diabetes induces time-dependent pathologic changes in the urinary bladder of rats that might account for bladder dysfunction.

Animals↗
PubMed2005

Determinants of the length of episiotomy or spontaneous posterior perineal lacerations during vaginal birth.

The objective of this study was to measure the length of episiotomy or spontaneous posterior perineal laceration and their relationship to perineal measurements and obstetric variables. The length of the perineum and genital hiatus and vertical length of episiotomy or posterior perineal tears were measured in 114 consecutive parturients with spontaneous singleton term deliveries. Seventy-four (65%) women underwent episiotomy while 40 (35%) sustained spontaneous posterior tears. Perineal or genital hiatus length was significantly correlated to episiotomy (r=0.34, p=0.003) or laceration (r=0.37, p=0.02) length, respectively. This association was significant (p=0.001) in a generalized linear model with duration of second stage of labor (p=0.005), degree of tear (p=0), and parity (p=0). Perineal length was significantly related to maternal age (p=0.036) and weight (p=0.037) and hiatal length (p=0). Short perineum and genital hiatus, long second stage of labor, and low parity are associated with longer posterior perineal injury.

Adult↗
PubMed2005

Estrogen and ghrelin increase number of submucosal urethral and anal canal blood vessels in ovariectomized rats.

OBJECTIVES: Urinary and fecal control deteriorates after menopause, but it is not clear whether this is age or hormone related. This study investigates whether administration of estrogen and/or the anti-aging growth hormone-releasing peptide, ghrelin, improves the adverse effects of menopause/aging on urethral and anal canal submucosal blood vessel counts in middle-age rats. METHODS: Female Wistar rats (13 months old) underwent ovariectomy, followed 1 month later by intraperitoneal once-daily administration of 17-beta estradiol (10 microg/kg), ghrelin (2 microg/kg), both hormones, or vehicle (n = 6 in each of four groups) for 42 days. An age-matched sham group (n = 6) received no intervention. Submucosal blood vessels were counted by light microscopy in five randomly selected fields from five nonconsecutive sections (5 microm thick) per rat of formalin-fixed and paraffin-embedded tissue blocks of the urethra and anal canal stained with hematoxylin-eosin. The results are expressed as the mean vessel number per high power field (x400). RESULTS: Ovariectomy significantly reduced submucosal urethral and anal vascular counts below the sham values (7.41 +/- 0.98 versus 5.46 +/- 0.82, P = 0.003 and 7.16 +/- 1.11 versus 4.92 +/- 0.65, P = 0.0009, respectively). Estrogen restored the urethral counts (7.76 +/- 0.88, P = 0.5) and ghrelin or combined estrogen and ghrelin administration significantly increased the counts to greater than the sham counts (8.68 +/- 0.99, P = 0.04 and 9.72 +/- 1.21, P = 0.004, respectively). Estrogen, ghrelin, and combined estrogen and ghrelin administration also restored the anal counts to sham levels (7.26 +/- 0.97, P = 0.8; 6.56 +/- 0.78, P = 0.3; and 7.76 +/- 0.88, P = 0.3, respectively). CONCLUSIONS: Combined or individual replacement of estrogen and ghrelin produces a beneficial effect by reversing the ovariectomy-induced decrease in urethral and anal canal submucosal vessel numbers in middle-age rats.

Anal Canal↗
PubMed2005

Determinants of women's choice of their obstetrician and gynecologist provider in the UAE.

BACKGROUND: The objective of this study is to evaluate women's priorities and preferences in selecting their obstetrician and gynecologist in a non-Western society. METHODS: Consecutive sample of 508 patients attending the obstetric and gynecologic services of AL-Ain Hospital; AL-Ain; United Arab Emirates during 4 months was recruited. Participants were interviewed by using a structured 26-item questionnaire administered by means of face-to-face interview within 24 h of admission in the ward or before consultation in the outpatient clinic. Respondents were asked about their preferences, priorities, determinants of choice of their obstetrician and gynecologist, their view of his/her role as a medical provider, and their perception of importance of each of provider's characteristics and roles on a five-point Likert scale. RESULTS: Four hundred thirty-nine (86.4%) participants preferred female physicians. Sixty-one (12%) had no preference and eight (1.6%) preferred male physicians. Reasons for female selection were privacy during intimate examination (89.1%) or counseling (68.8%), religious beliefs (74.3%), and cultural traditions (45.3%). Female preference was significantly associated with higher parity (P = 0.002), religion (P = 0.005), nationality (P = 0.01), occupation (P = 0.02), education (P = 0.04), and poor recognition of physician's role as professional/expert (P < 0.00001). Male preference was significantly associated with experience at previous encounter (P = 0.03), obstetric consultation (P = 0.04), and perceiving physician's role as skilled communicator (P = 0.01) or health educator (P = 0.04). Other physician characteristics affecting choice were professionalism, bedside manners, empathy, communication, competence, availability, and religion. CONCLUSIONS: Physician's attitude, professional profile, sex, and religious faith determine women's choice of obstetricians and gynecologists. Most women prefer female providers because of embarrassment during pelvic examination and reproductive counseling, religious beliefs, and sociocultural values.

Adult↗
PubMed2005

Magnetic resonance imaging of uterine version in a multiethnic, nulliparous, healthy female population.

OBJECTIVE: To determine measurement and topography of uterine position in asymptomatic women with different ethnicity. STUDY DESIGN: The angle and direction of uterine version were measured using magnetic resonance imaging in nulliparous, young volunteers from 5 ethnic groups (Emiratis, other Arabs, Indians/Pakistanis, Filipinos and Europeans/ Caucasians; N=55) and compared using Europeans/Caucasians as the reference group. RESULTS: The uterus was anteverted on the vagina in 46 (83.6%) and retroverted in 9 (16.4%) women, with no significant difference between Europeans/Caucasians and non-Caucasians. The angle of uterine version was significantly less (i.e., the cervix was more anteverted or retroverted on the vagina) in Europeans/Caucasians as compared to other women (p=0.002), particularly Indians/Pakistanis (p < 0.00001). CONCLUSION: The degree of uterine version is different in healthy, nulliparous European/Caucasian and non-Caucasian women.

Adolescent↗
PubMed2005

Pharmacological therapy of female urinary incontinence.

BACKGROUND: Although not a life threatening condition, UI is a common problem in women that produces embarrassing and debilitating symptoms, severely affects the quality of life and represents a significant public health problem. The bladder and urethra in women constitute a functional unit that is controlled by a complex interplay between the central and peripheral cholinergic and noradrenergic nervous systems and local regulatory factors. A substantial part of urethral tone in women is also mediated through the effect of estrogen on urethral mucosal function. Theoretically, detrusor instability can be improved by agents that decrease detrusor contractility and genuine stress incontinence by agents that increase outlet resistance. OBJECTIVE: To review the use of various drugs in treatment of female urinary incontinence [UI] and present the current evidence-based recommendations. METHODS: Systematic review of literature. RESULTS: The strength of evidence for the use of such agents, however, varies from data obtained from pharmacological and physiological experiments to those derived from clinical studies. Hence, the use of some of the currently prescribed drugs for treatment of female UI is founded more on tradition than on evidence based on results from controlled clinical trials. There is also an urgent medical need for a new smooth muscle agent for treating UI in women because current drug therapy of UI is either inadequate or ineffective. Therefore, further clinical experience with drugs that selectively modulate the electrophysiological properties and the intracellular pathways of the smooth muscles of the lower urinary tract in women as therapeutic agents for UI is awaited with interest.

Adrenergic Agents↗
PubMed2004

Dynamic assessment of pelvic floor and bony pelvis morphologic condition with the use of magnetic resonance imaging in a multiethnic, nulliparous, and healthy female population.

OBJECTIVE: The purpose of this study was to determine dynamic pelvic floor and bony pelvis morphologic condition in asymptomatic multiethnic women. STUDY DESIGN: Pelvic floor anthropometry, at rest and after the Valsalva maneuver, and pelvimetry were compared with the use of magnetic resonance imaging in nulliparous young volunteers from 5 ethnic groups (n=11 x 5 volunteers: Emirati, other Arab, Filipino, Indian/Pakistani, and European/white volunteers), with the white volunteers as the reference group. RESULTS: The white volunteers were significantly taller (P <.0001) than the other women. Their levator hiatus was significantly longer than the Emirati women (P=.03) and wider than the Filipino women (P=.04). The bladder neck descent on straining was also significantly greater than the other groups (P <.00001). The white women also had the longest transverse diameter of the pelvic inlet (P=.002). Their sagittal outlet diameter was significantly longer than the Emirati and Arab women (P=.02), and their interspinous diameter was significantly longer than the Arab women (P=.002). CONCLUSION: Nulliparous, healthy white women have larger levator hiatus and bony pelvis with greater bladder neck descent on straining than non-white women.

Adult↗
PubMed2004

Effects of ovariectomy and hormone replacement on submucosal collagen and blood vessels of the anal canal of rats.

OBJECTIVE: To study the effects of oestrogen and progesterone on submucosal collagen fibres and vascular plexus of the anal canal. MATERIALS AND METHODS: Experiments were performed on sections of the anal canal of ovariectomized rats following 28 daily subcutaneous injections of 17-beta oestradiol (n = 6, OVX + E, Group 1), medroxyprogesterone acetate (n = 6, OVX + P, Group 2), both drugs (n = 6, OVX + E + P, Group 3) or vehicle (n = 6, OVX) and after sham surgery without castration or injection (n = 6). Investigations included immunohistochemistry of oestrogen and progesterone receptors and collagen fibres, Western blot analysis of collagen types I and III and counting of perianal vessels by light microscopy. RESULTS: There was positive immunostaining for oestrogen and progesterone receptors in the mucosa and for collagen types I and III in the submucosa in all samples. Type I collagen levels increased significantly with ovariectomy but were normalized with treatment with oestrogen and progesterone. Type III collagen levels decreased after ovariectomy. Administration of oestrogen and progesterone appeared to restore level to near sham values. Semi-quantitative measurement of Type I/III collagen ratios by signal intensity demonstrated a very high ratio after ovariectomy. This appeared to be restored by both oestrogen and progesterone administration either individually or in combination. Mean vessel count was significantly lower in sham animals compared to values in OVX animals (P = 0.006). However, while only oestrogen treatment increased significantly the number of vessels compared to sham animals (P = 0.04), replacement with progesterone did not affect and in combination with oestrogen reduced submucosal vessel number. CONCLUSION: Oestrogen and progesterone have synergistic effects on collagen types I and III and probably antagonistic effects on the vascular plexus of the anal canal submucosa in adult female rats.

Anal Canal↗
PubMed2004

Self-reported assessment by medical students and interns of unprofessional practice.

BACKGROUND: Medical trainees should learn appropriate professional attitudes requisite for practicing medicine. PURPOSE: Describe self-reported assessment of medical students and interns of unprofessional practice. METHODS: A cross-sectional study was conducted on 88 participants (65 senior students and 23 interns) using self-administered questionnaire of 6 clinical and academic scenarios portraying a fictitious doctor engaged in unprofessional practice. RESULTS: Eighty-one (92.1 percent) participants believed professional misconduct is wrong, particularly failure to consult a specialist, disrespect to patients' autonomy, and research fraud. Seventy-three (83 percent) respondents would not perform these activities. There were no significant differences in responses by gender or year of study. Women and students, respectively, were significantly more lenient than men (p =.001) and interns (p =.002) regarding penalties appropriate for unprofessional behavior. Sixty-four (72.7 percent) participants would take action if colleagues failed to achieve professional standards. CONCLUSIONS: Perceptions of professional misconduct are not different in United Arab Emirates medical undergraduates from those observed elsewhere.

Cross-Sectional Studies↗