Biomedical subjects
Publications and source records attributed to Padmanabhan Badrinath.
Vitamin D deficiency [serum 25-hydroxyvitamin D <25 nmol/L (<10 ng/mL)] was identified in 92% of rachitic Arab children and 97% of their mothers compared with 22% of nonrachitic children and 52% of their mothers. There was a positive correlation between maternal and child vitamin D levels. We conclude that mothers of rachitic children should be investigated and treated for vitamin D deficiency.
BACKGROUND: On 30th July 2002, the Suffolk Communicable Disease Control Team received notifications of gastrointestinal illness due to Salmonella Enteritidis in subjects who had eaten food from a Chinese restaurant on 27th July. An Outbreak Control Team was formed resulting in extensive epidemiological, microbiological and environmental investigations. METHODS: Attempts were made to contact everybody who ate food from the restaurant on 27th July and a standard case definition was adopted. Using a pre-designed proforma information was gathered from both sick and well subjects. Food specific attack rates were calculated and two-tailed Fisher's exact test was used to test the difference between type of food consumed and the health status. Using a retrospective cohort design univariate Relative Risks and 95% Confidence Intervals were calculated for specific food items. RESULTS: Data was gathered on 52 people of whom 38 developed gastrointestinal symptoms; 16 male and 22 female. The mean age was 27 years. The mean incubation period was 30 hours with a range of 6 to 90 hours. Food attack rates were significantly higher for egg, special and chicken fried rice. Relative risk and the Confidence interval for these food items were 1.97 (1.11-3.48), 1.56 (1.23-1.97) and 1.48 (1.20-1.83) respectively. Interviews with the chef revealed that many eggs were used in the preparation of egg-fried rice, which was left at room temperature for seven hours and was used in the preparation of the other two rice dishes. Of the 31 submitted stool specimens 28 tested positive for S Enteritidis phage type 34a and one for S Enteritidis phage type 4. CONCLUSION: In the absence of left over food available for microbiological examination, epidemiological investigation strongly suggested the eggs used in the preparation of the egg-fried rice as the vehicle for this outbreak. This investigation highlights the importance of safe practices in cooking and handling of eggs in restaurants.
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BACKGROUND: Common vaginal infections that manifest in women are usually easily diagnosed. However, Chlamydia infection is often asymptomatic, leading to infertility before it is detected. If it occurs in pregnancy, it could lead to significant neonatal morbidity. It may also play a role with other viral infections for e.g. Human Papilloma Virus in the development of cervical cancer. The objective of this study was to determine the prevalence of Chlamydia infection in women undergoing screening for cervical abnormalities as a part of a research project in primary and secondary care institutions in the United Arab Emirates. METHODS: In this cross sectional study married women attending primary and secondary care participating in a large nationwide cervical abnormalities screening survey were offered Chlamydia testing using a commercially available test kit. This kit uses a rapid immunoassay for the direct detection of Chlamydia trachomatis antigen in endocervical swab specimens. As this study was performed in a traditional Islamic country, unmarried women were excluded from testing, as the management of any positive cases would create legal and social problems. All married women consenting to take part in the study were included irrespective of age. RESULTS: Of 1039 women approached over a period of eight months 919 (88.5%) agreed to participate. The number of women in the 16 to 19 years was small (0.01%) and 30% were aged over 40 years. The prevalence of Chlamydia infection in this study was 2.6% (95% confidence interval 1.2-3.3%), which was marginally higher in women screened in secondary care (p = 0.05). CONCLUSION: This is one of the few reports on the prevalence of Chlamydia infection in women from the Middle East. Due to cultural and social constraints this study excluded a large proportion of women aged less than 19 years of age. Hence no direct comparisons on prevalence could be made with studies from the West, which all included younger women at high risk of Chlamydia. However this study emphasizes the importance of cultural factors while interpreting results of studies from different cultures and communities.
Cancer is the third leading cause of death In the United Arab Emirates (UAE), which is situated in the Arabian Gulf. A national programme for cervical cancer screening is likely to be implemented in the future. In this study, we assessed the knowledge, attitude, and practice of UAE female primary care physicians of cervical screening through a self-administered questionnaire. Of the 98 physicians who participated in the study only 40% reported ever having performed a Pap smear. In the study, we identified various training needs, and a training programme on cervical screening currently is being developed based on the results of this study.
OBJECTIVE: The objective of this cross sectional survey was to study the feasibility of conducting research on issues related to physical and sexual maturation in a predominantly Islamic society and to identify the factors influencing menarche in this multi ethnic community. METHODS: This study was conducted in Al-Ain, United Arab Emirates (UAE) between January 1999 through to February 1999. Fifteen female secondary schools located in different geographical regions in Al-Ain were chosen in consultation with the District Education Department. All girls aged 12-16-years were selected. Information regarding whether they had attained menarche including month and the year, age at menarche and the factors influencing it such as height and weight, diet, physical activity were gathered. Univariate and multiple linear regressions were used in analysis. RESULTS: Of the 1500 questionnaires distributed, 1416 questionnaires were returned but only 890 had the required information and were used in the analysis. Ninety-three (10.4%) had not attained menarche and as expected these girls were younger (p<0.0001) than those who had attained menarche. Mean age at menarche was 12.68 (SD 1.27) years. In the univariate analysis UAE nationality, vegetarians (p=0.001), higher income group (p=0.008), low body weight (p=0.009) and a diagnosis of anemia (p<0.05) in the year before menarche were all positively associated with the age at menarche. Only anemia achieved borderline significance (p=0.056) in multivariate analysis and no other variables were significant. CONCLUSION: This study highlights the difficulties of conducting research on issues considered to be sensitive by the community and provide data on factors influencing menarche in a multi ethnic community.
OBJECTIVE: To compare obstetrical and perinatal outcome of twin pregnancies after assisted reproductive techniques (ART) with that of twins conceived spontaneously. STUDY DESIGN: Hospital based retrospective study. RESULTS: There were 132 twin deliveries of which 36 were conceived after ART. Patients of the ART group were mostly nulliparous and slightly older. There was no statistically significant difference in the frequency of preterm delivery or mean gestational age at delivery. Elective Caesarean delivery was more frequent in twin pregnancies conceived after ART, and there were no other differences in maternal complications. There was also no difference in the mean birth weight or frequency of neonatal complication between the two groups. CONCLUSION: In this comparative study, the obstetric and neonatal outcomes between spontaneous twins and those conceived after ART are similar except for higher operative deliveries in the latter group of twins.
BACKGROUND: Increased transforming growth factor beta1 (TGF-beta1) levels have been reported in bronchoalveolar lavage fluid and bronchial biopsy specimens from asthmatic patients. However, systemic TGF-beta1 levels have not been reported in asthma. OBJECTIVE: To evaluate the levels of plasma TGF-beta1 in asthmatic patients and matched, healthy controls to determine the associations with atopic status, disease severity, and duration. METHODS: Asthmatic patients and healthy controls were recruited prospectively from a university hospital outpatient department between January 2001 and May 2002. Plasma TGF-beta1 and serum IgE levels were estimated using established methods. Patients were classified as atopic or nonatopic based on the presence or absence of serum specific IgE directed to common allergens. RESULTS: Of the 56 patients recruited for the study, 32 were atopic and 24 nonatopic. The median value of plasma TGF-beta1 was significantly higher in nonatopic asthmatic patients (2.5 ng/mL) compared with controls (1.5 ng/mL, P = .002) and atopic asthmatic patients (1.4 ng/mL, P = .008). The median absolute neutrophil count in the nonatopic asthmatic patients (4.0 x 10(9)/L) was significantly higher compared with atopic asthmatic patients (3.0 x 10(9)/L) and healthy controls (3.5 x 10(9)/L) (P = .01 and P = .04). There was no significant correlation between the duration or severity of asthma and plasma TGF-beta1 levels. The distribution of moderate-persistent asthma cases was similar in atopic and nonatopic groups. CONCLUSION: Compared with atopic asthmatic patients and healthy controls, patients with nonatopic asthma have elevated plasma TGF-beta1 levels and leukocytosis. These data suggest that nonatopic asthmatic patients exhibit an altered inflammatory response, perhaps to a respiratory infection.
BACKGROUND: Classification of pleural effusions into transudates and exudates is based on pleural fluid absolute lactic dehydrogenase value (FLDH), fluid to serum ratio of LDH (LDHR) and fluid to serum ratio of total protein (TPR) used in a parallel combination strategy. Combining multiple tests in a parallel strategy to improve diagnostic accuracy is useful only if the pair-wise correlation of the individual tests is less than 0.75. So far, this concept has not been tested in patients with pleural effusions. MATERIAL/METHODS: Biochemical data from our 200-patient series with a known cause of pleural effusion were included in this study. Correlation between the three possible combinations of tests was determined. RESULTS: There were 116 males and 84 females. The mean age was 62+/-1.1 years (mean+/-SEM). Of the 200 effusions, 156 were exudates and 44 were transudates. There was a significant correlation between FLDH and LDHR (r=0.93, p<0.00). However, the correlation between FLDH and TPR (r=0.27) and TPR and LDHR (r=0.22) was not significant. CONCLUSIONS: The operative mechanism for LDHR and FLDH used in the classification of transudate and exudates appears to be similar, and therefore unsuitable for a parallel combination strategy in the diagnostic separation of pleural effusion. FLDH and TPR have a dissimilar operating mechanism, and can therefore be combined in this process. Therefore, the diagnostic separation of pleural effusion can be done cost effectively by utilizing FLDH and TPR alone, as the cost for estimating serum LDH is eliminated in this approach.
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BACKGROUND: To determine the accuracy of serum-effusion albumin gradient (SEAG) and pleural fluid to serum albumin ratio (ALBR) in the diagnostic separation of pleural effusion into transudate and exudate and to compare SEAG and ALBR with pleural fluid LDH (FLDH) the most widely used test. METHODS: Data collected from 200 consecutive patients with a known cause of pleural effusion in a United Kingdom district general hospital. RESULTS: The median and inter quartile ranges (IQR) for SEAG 93.5 (33.8 to 122.5) g/dl, ALBR 0.49 (0.42 to 0.62) and FLDH 98.5 IU/L(76.8 to 127.5) in transudates were significantly lower than the corresponding values for exudates 308.5 (171 to 692), 0.77 (0.63 to 0.85), 344 (216 to 695) all p < 0.0001. The Area Under the Curve (AUC) with 95% confidence intervals (Cl) for SEAG, ALBR and FLDH were 0.81 (0.75 to 0.87), 0.79 (0.72 to 0.86) and 0.9 (0.87 to 0.96) respectively. The positive likelihood ratios with 95%CI for FLDH, SEAG, and ALBR were: 7.3(3.5-17), 6.3(3-15) 6.2(3-14) respectively. There was a significant negative correlation between SEAG and ALBR (r= -0.89, p < 0.0001). CONCLUSION: The discriminative value for SEAG and ALBR appears to be similar in the diagnostic separation of transudates and exudates. FLDH is a superior test compared to SEAG and ALBR.
OBJECTIVE: To examine the perinatal outcome in women of extreme grandmultiparity (EGMP) in a setting with good socio-economic conditions and modern perinatal care. METHODS: About 1015 pregnant women with a parity of 10 and above who delivered at Al-Mafraq hospital, Abu Dhabi between 1992 and 1998 were compared with 2044 women of parity <5 and 1662 with parity of 5-9. RESULTS: Pregnant women with parity of 10 and above had an increased incidence of gestational diabetes (P<0.001) and macrosomia (P<0.001) and a reduced incidence of preterm delivery (P<0.0001) and induction of labor (P<0.0001). There were no significant differences between the groups regarding, antepartum hemorrhage, cesarean section rate and neonatal outcomes. CONCLUSION: Extreme grandmultiparity does not appear to be an independent risk factor for adverse perinatal outcome in the setting of good perinatal care.