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PubMed1998

[The diatessaron theriaque or low people theriaque].

The traditional theriaque was made of a very large number of constituants. But in contrast, a small theriaque, called diatessaron, contained only four plants. It was described with the same therapeutical properties as the largest ones. Its composition remained nearly constant for many centuries. Its name was progressively modified into theriaque des pauvres because of its simplicity. But some of its constituants were issued from Arabic countries and were difficult to get in France; so this theriaque was not present in the pharmaceutical books which were used for low people in the XVIIth and XVIIIth centuries: indeed these books described only mixtures of french local plants.

History, Ancient↗
PubMedDate not supplied

[Prevalence of bulimia among secondary school students in Casablanca].

During the two last decades, several epidemiological studies have been conducted on bulimia nervosa. According to recent studies, prevalence rates were estimated to be 1%. There are a very few studies on eating behaviour conducted in Arab countries. The aims of the current study were to assess prospectively the prevalence of Bulimia Nervosa and its characteristics in a Moroccan context in a randomly selected and representative sample of students attending six secondary schools in Casablanca. A second group composed of the students of the French secondary school of Casablanca was included in the survey in order to verify the influence of socio-cultural factors. Subjects completed a sociodemographic questionnaire and the Bulimic Investigatory Test of Edinburgh (BITE), a 33-item self-report measure of both the symptoms and severity of bulimia nervosa. A score of 25 or higher suggests a bulimic syndrome; 2,044 subjects returned their questionnaires (participation rate = 75.8%). The group of Moroccan school included 1,887 subjects and the French school 157 subjects. Females were preponderant (59%). The mean age was 18.3 +/- 1.2 years (15-22 years). For the first group, at least one substance was taken by 290 (15.3%) students: 12.7% were addicted to tobacco and 5.7% consumed occasionally alcohol. 16.3% reported a familial history of disturbed eating behaviour. According to the BITE, the overall prevalence of bulimia was 0.8% (1.2% in female and 0.1 in male subjects). The mean age of bulimic subjects was 18.6 +/- 1.7 years (16-24 years). The only male case in our sample was aged 24 years, without personal nor familial psychiatric history, consumed regularly tobacco and alcohol. His BITE symptoms score was 20 and severity score was 17, the highest score in our sample. Analyses of correlates of bulimia nervosa in the Moroccan sample showed that the group of bulimic subjects did not differ from the non bulimic with regard to any sociodemographic characteristics except sex: the female sex was predominant (p < 0.005) with 14 cases, the prevalence of bulimic syndrome was 1.2% among girls. This prevalence was 0.1% among boys. The bulimic subjects have regularly used different compensatory behaviours to control their weight: 6 (33.3%) used appetite suppressants, 3 (16.6%) used diuretics and 4 (22.2%) were engaged in self-induced vomiting. In the group of the french school, the prevalence of bulimia was 1.9% in the whole sample (3.4% among girls and no case among boys). These results are comparable to those reported recently in occidental countries and in an Egyptian study. However, the prevalence of bulimic syndrome in our sample was lower to those reported in countries with similar culture. The elevated prevalence of 10% reported in a tunisian study could be explained by the composition of the sample (medical students, aged 22-28 years) and the cut-off point for the BITE was determined to be 20 without taking into account severity criteria. A South African survey, conducted on 1,435 college students representing South Africa's ethnically and culturally diverse population comparable to our sample regarding the age (17-25 years), found a prevalence of 5% with a cut-off of 25 in the BITE. The majority of epidemiological community-based studies estimated the prevalence of bulimia nervosa to be 1 to 3% according to the diagnostic instruments used (self-report questionnaires versus clinical interviews) and the diagnostic criterias operationalized (DSM III, III-R or IV). The rate of occurrence of this disorder in males usually one-tenth of that in females was more decreased among our sample. However, the prevalence among males was comparable to the data of literature. Except the sex, we did not find other risk factors identified in the previous papers. Although in the bulimic group, we noted a higher rate of substance abuse (26.6% versus 15.2%, p > 0.5), familial histories of disturbed eating behaviour (26.6% versus 16.2%, p > 0.3) and less regular practice of sportive activity (72.2% versus 92.3%, p > 0.1), these differences are not statistically significant. The review of the literature identified at least 5 domains associated to bulimic disorder: parental problems (lower parental contact or separation, disruptive events), vulnerability to obesity, parental psychiatric disorder (alcoholism, depression), sexual or physical abuse and a premorbid psychiatric disorder. With the enormous media coverage and the globalisation of the media, cultural differences are disappearing. In order to estimate the prevalence of bulimia nervosa in the Moroccan population and to identify the risk factors, further epidemiological community-based studies using structured psychiatric interviews are required.

Adolescent↗
PubMed1999

Counselling about genetic disease: an Islamic perspective.

Genetic counselling is the process by which an individual or a family obtains information about a genetic condition that may affect them, so that they can take the appropriate decisions about marriage, reproduction and health management. Islamic teaching encourages counselling and stresses that the counsellor should be considerate, compassionate and should keep the secrets of the person or family involved. He/she should not impose his/her views on the clients. Some Arab countries encourage premarital medical examination to detect carriers of common hereditary diseases such as thalassaemia. However, this is still controversial, as it infringes the human rights of individuals. Reproductive options open to carriers of hereditary diseases are outlined in this paper, such as prenatal diagnosis, adoption, donation of a sperm, ova or preembryo and preimplantation diagnosis, and their acceptability within Islam is discussed.

Attitude to Health↗
PubMed2002

Ethical considerations in Syria regarding reproduction techniques.

Ethical Islamic considerations concerning current medical infertility treatment are outlined, that allow application of all techniques as far as they are compatible with legal marriage: Homogenic insemination is allowed. Heterogenic insemination is not, although it bears slightly better outcome, because of the imperative Islamic rule not to mingle genealogical lines. Neither is surrogate motherhood because of the legal position of the mother in Islamic shari'a and consequent inheritance rights on the one hand and sociological significance of motherhood on the other. The question arises, which is the mother, the biological or the social. In all cases, special attention should be paid to the professionals involved in the procedures. The danger of embryonic sex selection following preimplantation diagnostics is hinted at, precautions should be taken. These ethical considerations are substantial in Arab countries, including Syria.

Ethics, Medical↗
PubMedDate not supplied

Leech therapy for symptomatic treatment of knee osteoarthritis: results and implications of a pilot study.

CONTEXT: Leech therapy was a mainstay in conventional treatment for pain from antiquity until the mid-19th century. Its use is still widespread in traditional healing procedures in Asia, Africa, and Arabic countries. There is renewed interest in leech therapy in the field of complementary medicine and empirical evidence for specific benefit in knee osteoarthritis. OBJECTIVES: To determine the effect of leech therapy as an adjunctive treatment in painful knee osteoarthritis, to investigate the onset of action, to evaluate patients' acceptance of this treatment, and to investigate the side effects of the procedure. DESIGN: Observational, controlled, nonrandomized pilot-study. SETTING: Subjects were inpatients of an academic teaching hospital of the University of Essen, Department of Internal and Integrative Medicine, Essen, Germany. PATIENTS: 16 inpatients (mean age 69 +/- 9 years) with a confirmed diagnosis of osteoarthritis of the knee joint; 10 patients were treated with leeches and 6 served as controls. INTERVENTION: A single trial of 4 leeches (Hirudo medicinalis) applied topically at painful periarticular sites of the knee joint in the experimental group (n = 10). Both groups received conventional treatment for pain with the exclusion of nonsteroidal anti-inflammatory drugs. MAIN OUTCOME MEASURES: Self-reported general knee pain, assessed by visual analog scale for 10 days daily and in a follow-up after 28 days. Frequency of adverse effects also was recorded. RESULTS: Periarticular application of 4 leeches led to rapid relief of pain with sustained improvement after 4 weeks in the absence of major complications. CONCLUSION: Leech therapy may be an effective treatment for rapid reduction of pain associated with osteoarthritis of the knee. Its efficacy should be tested in larger randomized controlled trials with assessment of expectation bias.

Aged↗
PubMed2003

[The change of dermatophyte spectrum in dermatomycoses].

The spectrum of dermatophytes out of mycotic skin lesions had changed in last 70 years. Before the Second World War in Germany Microsporum audouinii and Epidermophyton floccosum held the first position, since the fifties of last century Trichophyton rubrum is the most frequently isolated dermatophyte accounting for 80-90% of the strains, followed by T. mentagrophytes. This development is typical for Central and North Europe and is connected with the increase in the incidence of tinea pedis. In contrast to this, in Southern Europe and in Arab countries zoophilic dermatophytes, such as M. canis and T. verrucosum, are the most frequently isolated dermatophytes. An analysis of the frequency and distribution of tinea pedis in different occupations and the route of infection is also reported. The epidemiologic findings are contrary to the assumption that patients are genetically predisposed to T. rubrum infection in a dominant autosomal pattern.

Arthrodermataceae↗
PubMed2004

Multidisciplinary approach to breast cancer management in Kuwait, 1993-1998.

BACKGROUND AND OBJECTIVES: In Kuwait, breast cancer is the most common form of cancer among women. The present study reviews the clinical features, treatment methods and treatment results of breast cancer patients registered in the Kuwait Cancer Control Center (KCCC) and compares these features with those reported in other Arab countries, Europe and North America. MATERIAL AND METHODS: The present study examines 823 patients with breast cancer who were registered in the KCCC from 1993 to 1998. Patients were identified through the Kuwait Cancer Registry and their cases were followed for at least five years. RESULTS: Eleven males accounted for 1.3% of all patients. The average age was one decade younger than that reported in western countries but similar to reports from Egypt and GCC countries. Surgery was applied in 90.4% of patients. Breast conservation (lumpectomy and axillary clearance) was performed in 19.6% of patients, while mastectomy and axillary clearance was adopted in 60.8%. Radiotherapy was applied in 67.7% of patients and chemotherapy in 60.8%. The long-term overall survival and disease-free survival amounted to 76+/-6.4% and 54+/-4.6% respectively. Prognostic factors were analyzed using univariate and multivariate analysis. According to multivariate analysis the nodal status, the number of involved nodes and histopathology were independent prognostic factors. Comparable results were achieved after both breast conservation and mastectomy. CONCLUSIONS: Since breast conservation protocols yield results similar to mastectomy, its use should be extended. Search for biological prognostic indicators should continue for their potential use as guides for treatment decisions.

Journal Article↗
PubMed1990

[Wilson's disease in a Saudi Arabian female patient. Rapid changes in cerebral x-ray computed tomography].

Reports on Wilson's disease from Arab countries in the Middle East are rare, while the high frequency of consanguineous marriages should increase the prevalence of autosomal recessive diseases. The case of a 20-year old woman, born from first degree cousins in a relatively isolated area of Saudi Arabia, is reported. The presentation initially led to the diagnosis of catatonic schizophrenia but neurological deterioration occurred rapidly. Brain CT was normal 2 months after the clinical onset of the disease but showed necrosis of both putamens 15 months later. Diagnostic difficulties and the rapid brain CT changes are commented.

Adult↗
PubMed1989

Eight years study of Sudanese renal allograft recipients at Soba University Hospital.

Forty sudanese renal allograft recipients were followed up at Soba University Hospital (SUH), Khartoum, Sudan, for varying periods between January 1978 and October 1985 accruing 1417 patient-months of observation. 21 transplant operations were done in United Kingdom, 11 in Kuwait, 1 in Sudan, while the rest were done in other European and Arab countries. There were 27 males and 13 females with the age ranging between 10 and 48 years with a mean of 30.15. Thirty eight patients received live related (LR) donor kidneys and two were transplanted with cadaver kidneys. Four patients had a second graft because of early loss of the first. Seven patients died, 3 because of chronic rejection, 3 had severe intractable diarrhoea and one died because of an unrelated cause. The 30 patients who had their transplantation 2 years ago or more were studied for the 2-year survival. Twenty seven of these were alive and well with functioning grafts giving a patient and graft survival of 90%. The complications encountered are discussed.

Adolescent↗
PubMed1984

Inflammatory bowel disease in Kuwait.

Inflammatory bowel disease is considered to be rare or nonexistent in some Arab countries. During a period of 6 years, 91 patients with ulcerative colitis and 17 with Crohn's disease were seen for initial diagnosis in the Gastroenterology Department of Amiri Hospital, which serves 55% of the population of Kuwait. From this group, 43 patients with ulcerative colitis and 14 patients with Crohn's disease were followed up for an average of 30.9 months. In the remaining 51 patients, the diagnosis was established in the same manner as in this series, but these patients were sent back to the referring physicians and therefore were not available for follow-up. The severity of the disease in the majority of patients with ulcerative colitis was mild to moderate. Nine of 14 patients with Crohn's disease underwent surgery as a diagnostic procedure in an acute abdominal emergency or for treatment of complications. The duodenum was involved in two patients with Crohn's disease and the endoscopic picture and histology of these were initially interpreted as immunoproliferative small intestinal disease which is highly prevalent in this area. We suggest that the assumption that inflammatory bowel disease is uncommon in our population is wrong.

Adolescent↗
PubMed1981

A comparison of the behavioral effects of l- and dl-cathinone and d-amphetamine.

The leaves of the Catha edulis plant (Khat) are chewed extensively by inhabitants of several African and Arab countries. It has been postulated that the behavioral effects of Khat are similar to those of amphetamine and that one of its components, cathinone, is the principal active alkaloid. In the first study, the ability of i.v. l-cathinone (0.0008-0.05 mg/kg/infusion), dl-cathinone (0.0016-0.1 mg/kg/infusion) and d-amphetamine (0.0016-0.025 mg/kg/infusion) to maintain responding under a fixed-ratio 10 schedule of delivery was determined. All three drugs functioned as positive reinforcers. Relative to amphetamine, lower doses of l-cathinone maintained responding, whereas the function for dl-cathinone was shifted to the right of amphetamine. However, potency comparisons are complicated by the fact that the dose-infusion functions for both l- and dl-cathinone were broader and peaked at higher rates than those generated by d-amphetamine. Because response rates under ratio schedules of drug delivery are determined by several properties of a drug, the relative potency of cathinone and d-amphetamine was investigated further. In a second experiment, the effects of i.v. l- and dl-cathinone (0.025-3.2 mg/kg) and d-amphetamine (0.0125-1.6 mg/kg) on responding maintained under a multiple fixed-ratio 30 fixed-interval 5-min schedule of food delivery were determined in three monkeys. Although there were some increases in overall rats, these drugs primarily produced dose-dependent decreases in responding under both schedules. d-Amphetamine was 2 to 4 times more potent than l- and dl-cathinone which were equipotent. This may indicate that the lower rates of responding maintained by d-amphetamine in the first experiment were due to its greater potency in disrupting responding.

Alkaloids↗
PubMed1993

N-acetylation phenotyping with sulfamethazine in an Iranian population.

The acetylation polymorphism is one of the most common inherited variations in the biotransformation of drugs and chemicals. Its association with drug toxicity and increased risk of developing certain diseases and certain types of chemically induced cancers has made it one of the oldest and best studied examples of pharmacogenetic conditions. N-Acetylation of sulfamethazine was studied in 74 unrelated healthy Iranian volunteers. The frequency of slow acetylators, determined by using free and total plasma sulfamethazine concentrations, was 78.4%. The mean acetylation ratio was 19.48% for slow acetylators, and the frequency of the recessive allele controlling slow acetylation was found to be 0.88. This percentage is similar to that observed in various Arab countries and higher than that observed in Europeans.

Acetylation↗
PubMedDate not supplied

Pyruvate kinase (PK) deficiency in Jordan.

BACKGROUND AND METHODS: The clinical and biochemical aspects of two cases of PK deficiency associated with chronic hemolytic anemia in two unrelated patients are reported. The residual erythrocyte PK enzymes in both patients were characterized by the recommended methods of the International Committee for Standardization in Hematology (ICSH). RESULTS AND CONCLUSIONS: Patient (W.Q.) had 60% residual PK activity and may be considered homozygous on the basis of consanguinity in the family. This patient suffered from moderate hemolytic anemia that improved after splenectomy. The enzymatic properties were: low activity, moderate thermal stability, reduced affinity for phosphoenol-pyruvate (PEP), and normal electrophoretic mobility. Patient (E.O.) had 42% residual PK activity and may be considered compound heterozygous since his parents are not related. He suffered from moderate hemolytic anemia. The enzymatic properties were: low activity, moderate thermal stability, reduced affinity for PEP and minimal retardation in electrophoretic migration. Theses two cases of PK deficiency are the first to be discovered in Jordan and probably the first in any Arab country.

Adult↗
PubMed2005

Ethnic differences in social participation and social capital in Malmö, Sweden: a population-based study.

The aim of this study was to investigate ethnic differences in different aspects of social participation in Malmö, Sweden. The public health survey in Malmö 1994 is a cross-sectional study. A total of 5600 randomly chosen individuals aged 20-80 years were asked to complete a postal questionnaire. The participation rate was 71%. The population was divided into categories born in Sweden, Denmark/Norway, other Western countries, former Yugoslavia, Poland, Arabic speaking countries and all other countries. The age-adjusted and multivariate analyses were performed using a logistic regression model in order to investigate the importance of possible confounders (age, education, economic stress and unemployment) on the differences by country of origin in different aspects of social participation. Men and women born in Arabic speaking countries and other countries (Iran, Turkey, Vietnam, Chile and subsaharan Africa) participate to a significantly lower extent in a variety of civic and social activities when compared to the reference population born in Sweden. The differences in participation in these groups compared to the group born in Sweden are observed both for social participation items at the core of the definition of social capital and cultural and other activities unrelated to social capital. This pattern is particularly pronounced for women born in Arabic speaking countries. These women even sharply differ from the participation rates of men born in Arabic speaking countries. The ethnic differences in most cases do not seem to be explained satisfactorily by education, economic stress or possibly unemployment.

Adult↗
PubMed2002

Ethnic differences in daily smoking in Malmö, Sweden. Varying influence of psychosocial and economic factors.

BACKGROUND: The aim was to investigate ethnic differences in daily smoking in Malmö, Sweden, and whether these differences could be explained by psychosocial and economic conditions. METHODS: The public health survey in Malmö 1994 is a cross-sectional study. A total of 5,600 individuals aged 20-80 years were randomly chosen to respond to a postal questionnaire. The participation rate was 71%. The study population was divided into seven categories according to country of birth; Sweden, Denmark/Norway, other Western countries, former Yugoslavia, Poland, Arabic-speaking countries and all other countries. A multivariate analysis was performed using a logistic regression model in order to investigate the importance of possible confounders on the ethnic differences in daily smoking. Finally, variables measuring social network, social support and economic conditions were introduced. RESULTS: The prevalence of daily smoking was significantly higher among both men and women born in Denmark/Norway (39.1% and 37.0%), men born in other Western countries (32.9%), Poland (34.0%) and Arabic-speaking countries (36.4%) than among Swedish men (21.7%) and women (23.8%). Women born in Arabic-speaking countries had a significantly lower smoking prevalence (7.1%). The multivariate analysis, including age, education and snuff, did not affect these results. A reduction of the odds ratio of daily smoking was observed for men born in Arabic-speaking countries and Poland after the introduction of the psychosocial and economic factors in the model. Only small changes were observed for women. CONCLUSION: There were significant ethnic group differences in daily smoking. Psychosocial and economic conditions in Sweden may be of importance in some ethnic groups.

Adult↗
PubMed2000

Neonatal audit in the United Arab Emirates: a country with a rapidly developing economy.

We aimed to determine whether birth-weight-specific mortality rates and causes of neonatal death could identify interventions needed to reduce neonatal mortality rates. Data were collected from three hospitals responsible for 99% of births in Al-Ain Medical District. There were 8083 live births weighing > or = 500 g, of which 54 (0.67%) died. The mortality rate among very low-birth-weight infants was higher in this district than from centres with more advanced neonatal technology and resources. Problems of preterm births, lethal malformations and asphyxia accounted for 95% of deaths and half of the malformations were autosomal recessive syndromes. Improved management of lower-birth-weight infants, asphyxia and genetic counselling could lead to a further decline in neonatal mortality rates.

Cause of Death↗