Biomedical subjects

Samir Al-Adawi

Publications and source records attributed to Samir Al-Adawi.

16 recordsLinked to original sources

PubMed2006

Seizure heralding functional recovery in a patient with apallic syndrome: A case report with retrospective-prospective observation.

BACKGROUND: It has been suggested that there exists a close relationship between seizure discharges and functional recovery from brain injury, and that paroxysmal bombardment in late seizures may herald functional recovery or may "kick-start" recovery. CASE REPORT: We report the case of a 52-year-old patient who, following a subarachnoid hemorrhage and multiple surgeries, experienced discernible apallic syndrome of long duration. His hospitalization is well documented. The patient underwent protracted, intense rehabilitation, but he remained in this prolonged state of loss of consciousness and behavioral passivity until he experienced a series of periodic seizures. Widespread improvement in his cognitive and functional abilities coincided closely with the seizure activity. The literature on this topic is reviewed. CONCLUSION: This case confirms the close relationship between seizure discharges and functional recovery reported in preclinical literature.

Humans↗

PubMed2006

The effect of methylphenidate on the sleep-wake cycle of brain-injured patients undergoing rehabilitation.

BACKGROUND AND PURPOSE: A number of neuro-stimulants are routinely used as part of post-acute care of hospitalized brain-injured patients. To our knowledge, the effect of these stimulants on the sleep-wake cycles of brain-injured patients undergoing rehabilitation has not been addressed. We examined the effect of one of the most commonly used neuro-stimulants, methylphenidate, on the sleep-wake behavior of brain-injured patients undergoing rehabilitation at a dedicated brain injury clinic. PATIENTS AND METHOD: For this study, records of patients admitted between January and December 1999 were scrutinized retrospectively for the data on observationally defined sleep-wake distribution. A total of 30 patients diagnosed with traumatic brain injury were identified as having been observed for a full 24h a day for at least 10 days. Some of these patients (n=17) were administered methylphenidate on clinical grounds. They served as the experimental group, while the unmedicated patients (n=13) served as controls. For the present analysis, the sleep-wake cycles were arbitrarily designated as nighttime and daytime, respectively. A cumulative sleep-wake quantity in a 24-h period was also observed. RESULT: The average number of hours of sleep during a 24-h period was not significantly different for the two cohorts. Similar trends emerged for the nighttime and daytime observations. On the whole, methylphenidate appears not to have unfavorable effects on sleep-wake cycles, presently defined as nighttime, daytime and 24-h, in the traumatic brain injury population. CONCLUSION: This study sought to gain better understanding of the effect of methylphenidate on daytime sleepiness and nighttime sleep, and the data suggest that administration of methylphenidate does not appear to have an adverse effect on sleep-wake quantity.

Adolescent↗

PubMed2006

The VNTR polymorphism in the human dopamine transporter gene: improved detection and absence of association of VNTR alleles with attention-deficit hyperactivity disorder.

The human dopamine transporter (DAT1) gene contains a variable number tandem repeat (VNTR) in its 3'-untranslated region because of repetition of a 40-bp core sequence. Methods available for the diagnosis of this polymorphism are limited in number. We have developed a new polymerase chain reaction (PCR) test, which is similar to that described originally by Vandenbergh's group, but provides a better detection of the VNTR alleles in the human DAT1 gene. Using two independent PCR methods, we have determined the distribution of VNTR alleles in 110 healthy Omani subjects, and in 92 children with attention-deficit hyperactivity disorder (ADHD). The frequency of the risk allele (DAT1*10) was similar in the healthy subjects and ADHD cases, indicating absence of association of this allele with ADHD in Oman.

3' Untranslated Regions↗

PubMed2005

Association of the risk allele of dopamine transporter gene (DAT1*10) in Omani male children with attention-deficit hyperactivity disorder.

OBJECTIVES: To determine the frequency of the VNTR alleles in the human dopamine transporter gene (DAT1) in the Omani population and to investigate association of the VNTR alleles with attention-deficit hyperactivity disorder (ADHD). DESIGN AND METHODS: 92 Omani children with ADHD and 110 healthy Omani subjects were genotyped for the DAT1-VNTR polymorphism in a case-control study using two independent PCR tests (one developed in our laboratory) followed by agarose gel electrophoresis. RESULTS AND CONCLUSIONS: We determined the DAT1-VNTR alleles in 202 Omani subjects. There were two common alleles (DAT1*9 and *10) and five rare ones. The DAT1*10 allele distribution was essentially the same both in the control (60.9%) and the patient group (64.6%). There was, however, a relatively higher occurrence of the DAT1*10 allele in ADHD males (69.4%) than females (55%), but this gender difference was not present in the control group (males 60%, females 62%).

Alleles↗

PubMed2005

Hikikomori, is it a culture-reactive or culture-bound syndrome? Nidotherapy and a clinical vignette from Oman.

Hikikomori, a form of acute social withdrawal, is becoming a silent epidemic in Japan. As it has not been reported from other parts of the world, hikikomori fulfills the criteria for "a culture-bound syndrome." We report a case from Oman, in the southern part of Arabia, with all the essential features of hikikomori. We speculate that the social environment of Japanese and Omani society could reinforce behavior akin to hikikomori although this condition may also transcend geography and ethnicity.

Adult↗

PubMed2004

Acquired brain injury, visual attention, and the useful field of view test: A pilot study.

OBJECTIVE: To compare the findings of the Useful Field of View (UFOV) test with those of conventional neuropsychologic tests to determine the utility of the UFOV test as a measure of attention in a population with brain injury. DESIGN: Cohort study. SETTING: Freestanding rehabilitation hospital. PARTICIPANTS: Fifteen inpatients with severe brain injury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: UFOV test, FIM\T instrument, length of stay (LOS), and standard neuropsychologic testing. RESULTS: The UFOV subtest UF2 correlated strongly with the other 2 subtests, UF1 and UF3. The UF2 subtest correlated most strongly with paper and pencil tests of visual attention. The UF2 predicted 52% of the FIM change and 60% of the LOS variance, second only to admission FIM score, which predicted 75% and 80% of FIM change and LOS variance, respectively. CONCLUSIONS: Among the patients in our study, the UFOV test can be used to determine the visual divided attention of patients with acquired brain injury. The results also showed that the UFOV test correlated with LOS and FIM change in patients with acquired brain injury recovering in a rehabilitation facility. Because the UFOV test is much more quickly administered and scored than other measures of attention and divided attention, these results suggest that the UFOV test may provide an easy means to measure a critical variable in the population with head injury.

Adult↗

PubMed2004

Functional outcomes following anoxic brain injury: a comparison with traumatic brain injury.

PRIMARY OBJECTIVE: To compare the functional outcomes of patients with anoxic brain injury (ABI) and patients with traumatic brain injury (TBI) following inpatient rehabilitation. RESEARCH DESIGN: Retrospective chart review. METHODS AND PROCEDURES: Data on 68 patients with brain injury (34 with ABI and 34 with TBI) were collected. MAIN OUTCOMES AND RESULTS: The ABI and TBI groups were demographically similar, except that patients with ABI were more likely to be married. Both groups significantly improved their function and were similar upon discharge. For the ABI group, there were trends toward a shorter length of stay, increased total FIM efficiency and decreased cost of stay when compared with the TBI group. The patients with ABI tended to be discharged to a sub-acute rehabilitation facility more than those in the TBI group. CONCLUSIONS: This study is important because it shows that patients with ABI benefit from inpatient rehabilitation and made significant functional gains comparable to the gains of patients with TBI.

Activities of Daily Living↗

PubMed2004

Apathy and depression in cross-cultural survivors of traumatic brain injury.

The disturbance of motivation and its relationship to depression continues to spark contradictory findings among European and North American populations. Could a cross-cultural study shed some light on the situation? This study aims to detect the prevalence of apathy and to test whether the Apathy Evaluation Scale (AES) can spot the presence or absence of depression in survivors of traumatic brain injury (TBI) in Oman. Eighty subjects who sustained a TBI were given an Arabic version of the AES and were also interviewed with the semistructured Composite International Diagnostic Interview (CIDI). The authors found that the incidence of apathy and depression among Omani people who sustained TBI is similar to that reported elsewhere. The AES has poor discriminatory power in identifying cases of depression. These findings emphasize the importance of developing assessment tools that are culturally sensitive in light of the rising incidence of TBI in developing countries such as Oman.

Adolescent↗

PubMed2004

Awareness of hepatitis B virus among undergraduate medical and non-medical students.

OBJECTIVE: To investigate the awareness of Omani medical and non-medical students of hepatitis-B virus (HBV) infection. METHODS: A structured questionnaire of 31 different statements concerning basic knowledge of HBV, its modes of transmission, diagnosis, risk behaviors, prevention, treatment, beliefs as well as attitudes towards patients with HBV infection were distributed to 280 students (154 females and 126 males). Of these 138 were pre-clinical medical students and 142 were non-medical students. The study was conducted at Sultan Qaboos University, Muscat, Sultanate of Oman during the period of 2001 to 2003. RESULTS: The majority of the students (75%) were aware that HBV is a common cause of hepatitis and 50.7% of them think that HBV infection is preventable. Availability of vaccine is a fact appreciated more by medical (65.2%) than by non-medical (35.2%) students (p<0.05). Approximately 70% of the cohort believed that screening blood for HBV renders blood safe for transfusion. Hepatitis B virus infected student or colleague in the same classroom or working place was accepted by 58% of medical and 46.5% of non-medical students. However, the majority of students (63.2%) hesitate to take care of a HBV infected patient. CONCLUSION: The majority of students showed some knowledge regarding HBV transmission, risk behaviors and prevention. However, there are still misconceptions regarding the attitudes, which reflect a false perception of the disease among students. This calls for well-structured health education programs stressing on such misconceptions.

Adolescent↗

PubMed2003

Patient's perspective on epilepsy: self-knowledge among Omanis.

Improving patients' knowledge has been suggested to improve their symptoms and prognosis. Very little is known about epileptic patient's knowledge of their illness in cross-cultural settings. This pilot study investigated what Omani patients know about their disorder. Patients attending a tertiary hospital completed a structured knowledge questionnaire to elicit information pertaining to aetiology, safety, compliance with medication regimes, legal and employment issues concerning epilepsy.Although correctly endorsing issues related to their medication, this cross-cultural sample was found to have limited knowledge about their condition. In particular, most patients were unable to give accurate indications of epilepsy, neither were they able to give correct responses to questions pertaining to safety and compliance. There is a need for improving patient's knowledge. As with other chronic disorders, people with epilepsy in Oman should receive systematic health education about how to manage the condition most effectively.

Adolescent↗

PubMed2003

A mysterious temporal penetrating head wound without fracture.

Unwitnessed head injuries are often diagnostic and management dilemmas. Low-velocity penetrating head wounds are rare. This paper describes a case of an accidental low-velocity penetrating head wound through the soft tissue of the temporal region. This lesion resulted in a deep intra-cerebral haemorrhage, after the initial assessment revealed no evidence of skull fracture, missile or missile track. The diagnostic evaluation and medical course of this case are presented. This is the first case in the medical literature of a brain injury by an object that penetrated the calvarium at low velocity but which did not produce a fracture of the skull. The evolving diagnostic dilemma is outlined to its conclusion, through 3 years of follow-up observation.

Adult↗

PubMed2003

Eye-movements and ongoing task processing.

This study tests the relation between eye-movements and thought processing. Subjects were given specific modality tasks (visual, gustatory, kinesthetic) and assessed on whether they responded with distinct eye-movements. Some subjects' eye-movements reflected ongoing thought processing. Instead of a universal pattern, as suggested by the neurolinguistic programming hypothesis, this study yielded subject-specific idiosyncratic eye-movements across all modalities. Included is a discussion of the neurolinguistic programming hypothesis regarding eye-movements and its implications for the eye-movement desensitization and reprocessing theory.

Choice Behavior↗

PubMed2002

Central noradrenergic blockade prevents autotomy in rat: implication for pharmacological prevention of postdenervation pain syndrome.

Following transection of peripheral nerve, rats exhibit autotomy, which is considered to be the animal model of postdenervation pain syndrome. It has been suggested that phantom limb pain is a result of peripheral denervation leading to reorganization of somatosensory pathways, particularly in the cerebral cortex, which is shown to depend upon central noradrenergic activity. In this study, sciatic and saphenous nerves were sectioned in the left hindpaw of 30 adult rats resulting in complete loss of pain sensation in the hindpaw. A group of rats received normal saline, compared to another group which received N-(2-) Chloroethyl-N-ethyl-2-bromobenzylamine (DSP4) injection 24 h prior to transection. The latter group was also compared to a third group whose central noradrenergic system were also blocked by bilateral injection of 6-OHDA into the ascending noradrenergic bundle 1 week prior to transection. A fourth group received contralateral cortical ablation in addition to peripheral nerve transection and was compared to the first group whose cortex remained intact. The animals were observed daily for 60 days and autotomy was scored in accordance to the system of Wall et al. After 1 week, control animals began to exhibit autotomy. In contrast, autotomy was absent in rats treated with DSP4, similar to rats which received 6-OHDA. Rats which had contralateral cortical ablation showed a considerably delayed onset of autotomy and a reduction in final autotomy scores. We conclude that autotomy, as a model of postdenervation pain syndrome, can be prevented by blockade of noradrenergically mediated cortical reorganization. The clinical implications of this finding are discussed.

Afferent Pathways↗

PubMed2002

Deliberate self-poisoning in Oman.

OBJECTIVE: To describe the demographics, precipitating factors, substances and methods used for deliberate self-harm in Oman. METHODS: Data were extracted from the Accident and Emergency (A & E) records of patients treated at the A & E units in Muscat from 1993 to 1998. Data were obtained form the history, and clinical findings resulting form deliberate self-harm. RESULTS: During the 5-year study period, 123 persons presented to various hospitals in the Muscat area with injuries that resulted form deliberate self-harm. Most of these cases were women, students and unemployed. There was a high incidence of family, marital and psychiatric or social problems. The methods of self-harm were most often analgesics (such as paracetamol) and non-pharmaceutical chemicals. CONCLUSIONS: The rate of self-injurious behaviour is low in Oman, compared with other countries, including other Islamic countries. The data illustrate a rising rate and a tendency to ingest toxic doses of analgesics or non-pharmaceutical chemicals.

Acculturation↗

PubMed2002

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents.

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.

Adolescent↗

PubMed2002

Perception of and attitude towards mental illness in Oman.

BACKGROUND: As conceptions of mental illness are often dictated by prevailing socio-cultural factors and the philosophy of the time, there is little research to substantiate how mental illness is perceived in the Arab world in the light of both traditional and more recent modernization and acculturation processes. AIMS: To examine whether social factors exert an influence on a person's attitude towards people with mental illness (PWMI) in the rapidly changing country of Oman. METHODS: This study compares the response elicited from medical students, relatives of psychiatric patients and the general Omani public on the causes of mental illness, attitudes toward PWMI and the care and management of people with mental illness. RESULTS: This study found no relationship between attitudes towards PWMI, and demographic variables such as age, educational level, marital status, sex and personal exposure to people with mental illness. Both medical students and the public rejected a genetic factor as the cause of mental illness; instead they favoured the role of spirits as the aetiological factor for mental illness. There were favourable responses on statements regarding value of life, family life, decision-making ability, and the management and care of mental illness. However, both medical students and the public thought that PWMI tend to have peculiar and stereotypical appearances and the majority preferred that facilities for psychiatric care should be located away from the community. Although the relatives of psychiatric patients were concerned about the welfare of mental patients, their responses varied and were often contingent upon their expectations. CONCLUSIONS: The data suggest that neither socio-demographic factors nor previous exposure to PWMI was related to attitudes towards PWMI. Although the attitudes of Omanis toward PWMI appear to fluctuate in complex ways, traditional beliefs on mental illness have yet to be eroded by exposure to a biomedical model of mental illness. This study largely supports the view that the extent of stigma varies according to the cultural and sociological backgrounds of each society.

Adult↗