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PubMedDate not supplied

Antihypertensive drug-associated sexual dysfunction: a prescription analysis-based study.

PURPOSE: To determine whether primary care physicians take into consideration age, gender and diabetes mellitus as risk factors for sexual dysfunction (SD) when prescribing antihypertensives. METHODS: A prescribing survey on hyperternsive patients with or without diabetes mellitus in primary care setting of Bahrain was carried out. RESULTS: In 5301 hypertensive patients, we found that a beta-blocker (atenolol) was the most commonly prescribed drug and was significantly more often prescribed for young male hypertensives (< 45 years). A relatively high dose of atenolol (100 mg/d) was extensively used as both mono- and combination-therapies. With the exception of middle-aged hypertensives (45-64 years) and elderly diabetic-hypertensives (> or = 65 years), no significant age- and gender-related differences were observed regarding the prescription of thiazide diuretics. A significant trend of prescribing methyldopa in females as monotherapy was evident. Angiotensin converting enzyme (ACE) inhibitors, the second most commonly prescribed drugs, were significantly more often prescribed for young, middle-aged hypertensive males and for middle-aged diabetic-hypertensive males. beta-blocker/diuretic combination was prescribed least for the young and elderly hypertensive males. However, prescription of an ACE inhibitor with either a diuretic or a calcium channel blocker (CCBs) was less frequent and lacked gender-related differences. CONCLUSIONS: We infer that antihypertensive-induced SD received little attention as was evident from: (a) over-prescription of relatively high dose of beta-blockers to young hypertensive males; (b) lack of gender- and age-related difference regarding the type and dose of diuretics prescribed; (c) underutilization of effective and complementary combinations expected to cause least impact on sexual function, such as ACE inhibitors with either a diuretic or with a CCB; and (d) a relative lack of discrimination while selecting antihypertensive drugs, particularly as monotherapy between hypertensive versus diabetic-hypertensive patients. With the exception of ACE inhibitors alone and combination of diuretic/beta-blocker, the choice of antihypertensives did not conform to international guidelines. In view of drug-induced SD adversely influencing the quality of life and thereby drug-compliance, interventions aimed at improving physicians' awareness should be attempted.

Adult↗
PubMed1993

Contamination of genetically engineered CHO-cells by epizootic haemorrhagic disease virus (EHDV).

The characterization of a contaminating virus which was detected in genetically-engineered Chinese hamster ovary (CHO) cells during the production of biologicals is described in the present paper. Under electron microscopy, the contaminating virus had a morphology resembling that of an orbivirus. The relationship was confirmed by nucleic acid analysis which showed a RNA segment pattern characteristic of orbiviruses. With an immunoperoxidase staining of monolayer cells and through sero-neutralization tests the virus was identified as being identical to Epizootic Haemorrhagic Disease Virus (EHDV), isolate 318 (untyped) from Bahrain. Potential sources of the contaminating virus and feasible procedures to avoid adventitous virus infections in cell cultures are discussed.

Animals↗
PubMedDate not supplied

Gene deletion patterns in spinal muscular atrophy patients with different clinical phenotypes.

Spinal muscular atrophy (SMA) is an autosomal recessive disorder characterized by degeneration of lower motor neurons. We have assayed deletions in two candidate genes, the survival motor neuron (SMN) and neuronal apoptosis inhibitory protein (NAIP) genes, in 108 samples, of which 46 were from SMA patients, and 62 were from unaffected subjects. The SMA patients included 3 from Bahrain, 9 from South Africa, 2 from India, 5 from Oman, 1 from Saudi Arabia, and 26 from Kuwait. SMN gene exons 7 and 8 were deleted in all type I SMA patients. NAIP gene exons 5 and 6 were deleted in 22 of 23 type I SMA patients. SMN gene exon 7 was deleted in all type II SMA patients while exon 8 was deleted in 19 of 21 type II patients. In 1 type II SMA patient, both centromeric and telomeric copies of SMN exon 8 were deleted. NAIP gene exons 5 and 6 were deleted in only 1 type II SMA patient. In 1 of the 2 type III SMA patients, SMN gene exons 7 and 8 were deleted with no deletion in the NAIP gene, while in the second patient, deletions were detected in both SMN and NAIP genes. None of the 62 unaffected subjects had deletions in either the SMN or NAIP gene. The incidence of biallelic polymorphism in SMN gene exon 7 (BsmAI) was found to be similar (97%) to that (98%) reported in a Spanish population but was significantly different from that reported from Taiwan (0%). The incidence of a second polymorphism in SMN gene exon 8 (presence of the sequence ATGGCCT) was markedly different in our population (97%) and those reported from Spain (50%) and Taiwan (0%).

Age of Onset↗
PubMed1986

Nursing education in the United Arab Emirates.

This paper reviews the development of the nursing manpower situation in the United Arab Emirates, with particular emphasis on the trends and currents that have had an impact on the national school of nursing in Abu Dhabi, in the last decade. Special attention is placed on the design of the nursing curriculum. This is based on a framework of core concepts derived from a philosophy relating to man, health and nursing. A competency-based model, designed for three levels of nursing personnel, each with well defined responsibilities, is presented along with an educational and professional career ladder for nurses in the United Arab Emirates. A phased implementation of the proposed system of nursing education is undertaken, with the first phase nearing completion. Preparations are well underway to initiate the second phase of nursing education, that has been successfully implemented earlier in the state of Bahrain.

Curriculum↗
PubMed1996

A cross-national study of quality of life factors associated with patterns of elderly disablement.

This study examines individual-level data of non-institutionalized elderly from Bahrain, Burma, DPR Korea, Egypt, Indonesia, Jordan, Sri Lanka, Thailand and Tunisia. The Grade of Membership multivariate procedure is used to determine profiles of disablement, based upon functional disability and depression items, and to examine socio-demographic and quality of life covariates associated with such profiles. The analysis yielded six profiles or types of disablement: functionally and emotionally healthy, functionally healthy with some depressive symptoms, some strength problems, severely depressed, mobility problems and functionally frail. The healthy profile had higher probabilities associated with males, whereas the very depressed, and those with physical strength limitations, and mobility problems were more likely to be female. There is a strong positive association between age and functional disabilities. The more depressed profiles, however, tended to be among the younger age categories, and the depressed had higher probabilities associated with being not married. The examination of quality of life covariates indicates that the functional and emotional limitations generally are correlated with a lower quality of life. The more functionally disabled and the depressed profiles had more negative self-assessments of health and lower morale scores. The very depressed had less instrumental social support in terms of available kin. Also, the functionally and emotionally disabled profiles expressed less satisfaction of visits with family and friends. Country-specific patterns of elderly disablement indicate a possible disability transition such that as countries become more developed there may be an increase in the prevalence of disabled elderly. However, there are exceptions to this trend, and these may be due to both cultural factors and data limitations.

Activities of Daily Living↗
PubMed2003

Assessment of organotin contamination in marine sediments and biota from the Gulf and adjacent region.

Butyltin species were measured in sediments from coastal locations in the Gulf and Gulf of Oman. Both butyltin and phenyltin species were measured in biota samples from four countries in this region. With tributyltin (TBT) concentrations up to 60 ngSng(-1), some sediments could be classified as contaminated (i.e. TBT>1.3 ngSng(-1)), namely Dukhan (Qatar), the BAPCO industrial complex and Askar (Bahrain), and Hilf and the Raysut Port Area (Oman). Higher concentrations of total butyltins were found in oysters relative to fish, but ranging from 6.5 to 488 ngSng(-1) dry weight they are nonetheless relatively low. Diphenyltin and triphenyltin were found in some fish and bivalves from the Gulf, but not in biota from the Gulf of Oman. The environmental levels of organotin species are comparatively low by global standards and pose no immediate public health problems.

Animals↗
PubMed2000

Generation of a mosaic pattern of diversity in the major merozoite-piroplasm surface antigen of Theileria annulata.

The polypeptide Tams1 is an immunodominant major merozoite piroplasm surface antigen of the protozoan parasite Theileria annulata. Generation and selection of divergent antigenic types has implications for the inclusion of the Tams1 antigen in a subunit recombinant vaccine or use in the development of a diagnostic ELISA. In this study a total of 129 Tams1 sequences from parasites isolated in Bahrain, India, Italy, Mauritania, Portugal, Spain, Sudan, Tunisia and Turkey were obtained to estimate the extent of Tams1 diversity throughout a wide geographical range. Significant sequence diversity was found both within and between isolates and many of the sequences were unique. No geographical specificity of sequence types was observed and almost identical sequences occurred in different geographical areas and a panmictic population structure is suggested by our results. A sliding window analysis identified sub-regions of the molecule where selection for amino acid changes may operate. Evidence is also presented for the generation of diversity through intragenic recombination with switching of corresponding variable domains between alleles. Recombination to exchange variable domains appears to occur throughout the length of the gene sequence, and has the potential to generate a mosaic pattern of diversity.

Amino Acid Sequence↗
PubMed2000

Hepatitis B epidemiology in Asia, the Middle East and Africa.

Asia and Africa have previously been classified as areas of high endemicity for hepatitis B virus (HBV), but in some countries highly effective vaccination programmes have shifted this pattern towards intermediate or low endemicity. Thus, China is now the only country in Asia where HBV endemicity is high. Countries with intermediate endemicity include India, Korea, the Philippines, Taiwan and Thailand, and those with low endemicity include Japan, Pakistan, Bangladesh, Singapore, Sri Lanka and Malaysia. Most countries in Africa have high HBV endemicity, with the exceptions of Tunisia and Morocco, which have intermediate endemicity. Zambia has borderline intermediate/high endemicity. In the Middle East, Bahrain, Iran, Israel and Kuwait are areas of low endemicity, Cyprus, Iraq and the United Arab Emirates have intermediate endemicity, and Egypt, Jordan, Oman, Palestine, Yemen and Saudi Arabia have high endemicity. All of these Middle East countries reach a large proportion of their population with hepatitis B vaccination, which is reducing the infection rate, particularly in Saudi Arabia. The vaccination programme in Taiwan has also greatly reduced the HBV infection rate. Future vaccination programmes must take into account the mode of transmission of HBV, the healthcare infrastructure to deliver vaccination, and the socioeconomic and political factors in each individual country, to determine the most cost-effective way of infection control.

Africa↗
PubMed1996

Bottom sediments of the Arabian Gulf--II. TPH and TOC contents as indicators of oil pollution and implications for the effect and fate of the Kuwait oil slick.

Measurements of total petroleum hydrocarbon (TPH) concentrations in 77 core samples collected in 1992 from the bottom sediments of the Arabian Gulf were used to delineate oil pollution levels and their distribution in the region. Seven chronic moderately (TPH 50-89 microg g(-1)) and heavily (TPH 266-1448 microg g(-1)) polluted areas were identified; three in the northern part of the region and four in the southern part. Oil pollution in these areas was attributed to natural oil seepage, accidental damage to pipelines, accidental spillage from tankers, the Nowruz oil slick, and tanker deballasting. Present-day intermediate (TPH 50-114 microg g(-1)) and high (TPH 200-1122 microg g(-1)) pollution levels were identified in 10 areas. Of these, three polluted areas in the northeastern corner, offshore Saudi Arabia and offshore Bahrain, Qatar and United Arab Emirates are probably directly affected by the Kuwait oil slick. A new scenario is suggested for the movement and fate of the oil slick, in which additional large oil discharges from northern sources, as well as substantial quantities of eroded oiled sediments and oil floating from heavily impacted tidal flats along the Saudi Arabian coastline, serve as sources of oil pollution. A definite relationship exists between the grain-size distribution and the TPH content of bottom sediments, with the highest TPH concentrations in the muddy sediments, suggesting that adsorption onto muds is the primary mechanism of oil pollutant accumulation in the Arabian Gulf. Total organic carbon measurements do not correlate positively with the grain-size distribution and TPH contents of the sediments, and hence cannot be used as indicators for petroleum hydrocarbon pollution in the Arabian Gulf.

Journal Article↗
PubMed1996

Bottom sediments of the Arabian Gulf--III. Trace metal contents as indicators of pollution and implications for the effect and fate of the Kuwait oil slick.

The trace metal contents of 71 core samples collected in 1992 from the bottom sediments of the Arabian Gulf are used to determine the regional distribution of concentration and pollution levels of these substances in the region. Chronic contamination was recorded in seven locations: the northwestern area (Fe), the northeastern area (Fe, V and Ni), the north-central area (V and Ni), the central area (Fe, Pb, V and Ni), the south-central area (Cu), the eastern area (Cu) and the southeastern area (Fe, V and Ni). Present-day contamination was identified in three locations only: the north-central area (V), the central area (Pb, V and Ni) and the southeastern area (Fe, V and Ni). Diversified natural and anthropogenic inputs may have provided the sources of this contamination. The V/Ni ratios of recent marine sediments cannot be used in identifying oil spillages or in oil-sediment correlation studies. Positive correlations are found between increasing trace metal concentration and decreasing carbonate content and grain size, verifying that adsorption onto muds is the primary mechanism of trace metal concentration in marine sediments. Correlations with TOC (total organic carbon) contents indicate that organic matter is a significant concentrator only in the case of Pb and Cu. With the exception of the Fe contamination in the northwest area due to river transport, all chronic and present-day trace metal concentrations are within the permissible natural background levels in the western offshore areas, including the two areas thought to be polluted by the Kuwait oil slick, thereby supporting the idea that airborne fallout from oil fires was deposited in a limited coastal area between Kuwait and Bahrain, and verifying that the oil slick had minimal effect on the state of pollution by trace metals in the Arabian Gulf.

Journal Article↗
PubMed2002

Incidence and control of brucellosis in the Near East region.

In countries of the Near East region, brucellosis was reported in almost all domestic animals, particularly cattle, sheep and goats. Brucellosis in camels has been reported in Saudi Arabia, Kuwait, Oman, Iraq, Iran, Sudan, Egypt, Libya and Somalia. It has been reported even in racing camels in the United Arab Emirates. In Egypt, brucellosis has been reported also in buffaloes, equines and swine. Brucella melitensis biovar 3 is the most commonly isolated species from animals in Egypt, Jordan, Israel, Tunisia and Turkey. B. melitensis biovar 2 was reported in Turkey and Saudi Arabia, and B. melitensis biovar 1 in Libya, Oman and Israel. B. abortus biovar 1 was reported in Egypt, biovar 2 in Iran, biovar 3 in Iran and Turkey, and biovar 6 in Sudan. The countries with the highest incidence of human brucellosis are Saudi Arabia, Iran, Palestinian Authority, Syria, Jordan and Oman. Bahrain is reported to have zero incidence. Most human cases are caused by B. melitensis, particularly biovar 3. However, B. abortus has been responsible for an increasing number of cases in recent years, e.g. in Yemen, where B. abortus was identified in 45 cases and B. melitensis in 7 cases out of 330 cultures performed in 1995. Concerning control of brucellosis in animals, there is a controversy on the choice of policy. In some countries, the test and slaughter policy together with the vaccination of young females is adopted, in others, particularly with regard to sheep and goats; mass vaccination has been recently started. The most commonly used vaccines are B. abortus S19 and B. melitensis Rev.1 vaccines. B. abortus RB51 vaccine is used in some countries on small scale. Vaccination is limited to cattle and small ruminants.

Animals↗
PubMed2003

Cross-cultural adaptation and validation of an Arabic Health Assessment Questionnaire for use in rheumatoid arthritis patients.

OBJECTIVE: To test the reliability and validity of a modified and translated version of the original Health Assessment Questionnaire (HAQ) on patients with rheumatoid arthritis (RA). METHOD: A cohort of 184 RA patients from different Arabic countries (Egypt, Saudi Arabia, Sudan, Syria, Bahrain, Kuwait and Morocco) were recruited and asked to participate in the study. Two questions had been changed to suit the Arabic culture and to tackle some aspects that are commoner to be performed in the Arabic culture. After modification, translation and retranslation of the questionnaire, it was administered to the selected patients and tested for internal consistency, reliability and construct validity by correlating the yield of the questionnaire with other disease activity parameters. The questionnaire was administered again after a 1-week interval for evaluation of the reliability of this test. The modified questions were tested for their loyalty to the principal component and comparing their correlation with that of the other unchanged items. RESULTS: Test-retest showed strong reliability with a high percentage of agreement and high values for Kappa. Internal consistency showed a high value for standardized alpha (Cronbach's): 0.979 that did not show any significant change if any of the 20 items had been eliminated. The modified questionnaire had shown a strong validity when correlating its results with other disease activity parameters. This correlation was the strongest with tender joint count (TJC), Ritchie articular index (RAI), morning stiffness (MS) and visual analogue scale (VAS) and the least (but still significant) with rheumatoid factor (RF). CONCLUSION: The Arabic HAQ is a reliable and valid instrument that can be self-administered to Arabic RA patients to evaluate their functional disability. Its measurement properties were comparable to versions in other languages.

Activities of Daily Living↗
PubMed1974

An outbreak of cholera in Australia due to food served in flight on an international aircraft.

An outbreak of cholera occurred in November 1972 among passengers on an aircraft that had flown from London to Sydney. The infection was confined to economy-class passengers and the available evidence indicates that it was due to a dish of hors d'oeuvres served on the aircraft between Bahrain and Singapore. Although one person died, the infection was generally mild, and almost half of those infected were symptomless. There was a significant difference between the immunization status of persons with clinical illness and the immunization status of other passengers. Current cholera immunization appeared to play a significant role in preventing symptoms of the disease, but it did not prevent a person becoming a carrier of the organism.

Adult↗
PubMed1986

Stage-specific antigenicity in Theileria annulata: a case report.

Blood from sick cattle in Bahrain transmitted piroplasms of Theileria annulata to a splenectomized calf. Larvae of Hyalomma anatolicum anatolicum were infected on the calf and, after moulting, induced clinical theileriosis, associated with numerous schizonts, in the same calf. The animal was cured by specific treatment. Antigenic differences thus shown between piroplasms on the one hand, and sporozoites and schizonts on the other hand, were confirmed in the indirect fluorescent antibody test, as a significant titre to T. annulata piroplasm antigen developed after the inoculation of blood, but to schizont antigen only after the infective ticks had induced the appearance of schizonts.

Animals↗
PubMedDate not supplied

Height, weight and menarcheal age of adolescent girls in Oman.

A cross-sectional survey was carried out on 683 school girls aged 11.5-18.5 years in Oman, in order to assess their physical growth. Height, weight and age at menarche were measured. Results showed that median height and weight of Omani girls fluctuates between 25th and 5th percentiles and 25th and 10th percentiles of the North American reference standard (NCHS), respectively. The mean age at menarche was 13.3 +/- 0.09 years. In general Omani girls are shorter and lighter than girls of similar age in other Arabian Gulf countries (Bahrain and Kuwait).

Adolescent↗
PubMed2000

Long-term monitoring and analysis of hourly solar UV radiation in the 290-380 nm range in the middle region of Saudi Arabia.

The UV and global solar radiation on a horizontal surface at ground level in Riyadh City (latitude 24 degrees 34' N, longitude 46 degrees 43' E) have been measured and analyzed. Measurements of UV radiation (295-385 nm) were recorded every 10 min for five years (January 1983-December 1987). The maximum recorded hourly mean irradiance UV radiation was 28 W/m2 and occurred in July, while the minimum was 14 W/m2 in December. A steady monthly value of [formula: see text] was obtained and equaled 2.9%. A similar trend was found for the monthly variation of [formula: see text] and [formula: see text]. Maximum values of 90% and 2.6% were recorded in June for Kt and Kv, respectively, while minimum values of 35% and 1%, respectively, were obtained in December. A linear correlation was obtained between Kv and Kt. These findings were discussed and connected to the meteorological events. The results were compared with the regions of Kuwait, Bahrain, Dhahran, and Makkah.

Environmental Monitoring↗
PubMed2001

Application of "VITALS": visual indicators of teaching and learning success in reporting student evaluations of clinical teachers.

CONTEXT: At the College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain, a system has been introduced in which clerkship students evaluate clinical faculty using Visual Indicators of Teaching and Learning Success (VITALS). OBJECTIVE: To describe the use of VITALS in reporting student feedback on teaching and learning effectiveness of clinical faculty in the clerkship. DESIGN: Descriptive study. SUBJECTS: A total of 210 clerkship students evaluated 76 clinical tutors over a period of 3 years. Feedback was also obtained from seven programme managers and one supportive staff member. METHOD: Nine indicators of effective clinical teaching were identified through a literature search. Students individually reported on clinical faculty teaching capabilities using a 5-point, Likert-type scale. Cumulative reports of students' feedback on clinical faculty teaching were prepared using opposing bar graphs, reflecting perceived areas of strength or weakness in each teacher's performance. RESULTS: A total of 1450 evaluation forms were completed by 180 of 210 students (85.7%). VITALS graph representations of students' perceptions of clinical tutors were communicated to each clinical tutor at the end of each clerkship and academic year. Twenty-one students out of 53 who gave written comments were related to VITALS. They reflected a positive view of VITALS as a process or tool of faculty evaluation. Clinical faculty (18), programme managers(7) and supporting staff (1) gave comments indicating acceptance of the system. CONCLUSION: This preliminary study suggests that VITALS could be an effective tool for improving clinical teaching. It is acceptable to students, faculty and managers of educational programmes. The database reflecting their teaching and educational profiles were used to provide clinical faculty with constructive feedback.

Journal Article↗
PubMed1994

Development of a live, oral, attenuated vaccine against El Tor cholera.

Vibrio cholerae El Tor strains from Peru, Bangladesh, and Bahrain were attenuated by deletion of a genetic element that encodes virulence factors and RS1. The B subunit of ctx (ctxB) was reintroduced into the recA gene of the deletion mutants, rendering them unable to recombine with exogenous genetic elements and generating Peru-3, Bang-3, and Bah-3. Fifteen volunteers received one dose of various vaccine strains at 4 x 10(6) to 1 x 10(8) cfu. All strains colonized the gut. A > or = 4-fold rise in vibriocidal titer was observed in 14 volunteers, with titers of > or = 1600 in 13. Peru-3 was the least reactogenic, but 2 of 6 volunteers had loose stools. Peru-14, a filamentous motility-deficient mutant of Peru-3, was well tolerated and colonized 18 of 21 volunteers at doses of 2 x 10(6) to 1 x 10(9) cfu. Also, when 8 Peru-3 or Peru-5 vaccinees, 5 Peru-14 vaccinees, and 8 controls were challenged with 2 x 10(6) cfu V. cholerae El Tor Inaba (N16961), 11 vaccinees were protected compared with no controls. Peru-14 shows promise as a safe, effective, single-dose oral vaccine against El Tor cholera.

Adolescent↗