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PubMed2003

Genetic Blood Disorders Survey in the Sultanate of Oman.

The Genetic Blood Disorders Survey is the first community-based survey in the Arabic world and the Middle East to determine the prevalence of the most common genetic blood disorders. The objective of the survey was to determine the prevalence of the most common genetic blood disorders reported among Omani children under 5 years of age in order to provide the planners and policy-makers with reliable information suitable for formulating health policies, planning, and evaluation. The survey was designed, executed, and financed by the Ministry of Health of the Sultanate of Oman. To reduce costs and save effort and time, data collection for the survey was implemented with the Gulf Family Health Survey (GFHS). The GFHS in the Sultanate of Oman is a research project undertaken by the Council of Health Ministers of the Gulf Co-operation Council States. The six member countries have participated in this GFHS project. A total of 6103 households were interviewed. From these households 6342 children under 5 years of age were taken by their parents to neighbourhood hospitals or health centres for blood collection. Fifty-one per cent of the sample were male and 49 per cent were female. Among the child respondents, 17.9 per cent were in the age group 0 to < 1 year, 20.3 per cent were in the age group 1 to < 2 years, 21.1 per cent were in the age group 2 to < 3 years, 20.5 per cent were in the age group 3 to < 4 years, and 20.2 per cent were in the age group 4 to 5 years. Fifty-five per cent of the mothers of the children studied were illiterate, 9 per cent could read and write but had less than primary education, 20 per cent had completed primary school, 9 per cent had attended preparatory school, 5 per cent had attended secondary school, 1 per cent had had intermediate education, while 0.6 per cent had completed university or higher education. The results of this survey revealed that haemoglobinopathies are prevalent in Oman; the prevalence of sickle cell trait was 6 per cent, and of beta-thalassaemia 2 per cent. The prevalence of sickle cell and homozygous beta-thalassaemia were 0.2 and 0.07 per cent, respectively. Other abnormal haemoglobins (Hb) have been detected in this survey; HbD (0.6 per cent), HbE (0.3 per cent), HbC (0.02 per cent). Combination of sickle cell with other abnormal Hb was also detected at low prevalence. Glucose-6-phosphate dehydrogenase (G6PD) enzyme deficiency had a high prevalence in Oman, being 25 per cent in males and 10 per cent in females. Among the children studied, three-quarters (74.5 per cent) were found to be free from haemoglobinopathies and G6PD normal, the rest (25.5 per cent), either had haemoglobinopathies (7.5 per cent), G6PD deficiency (16 per cent) or a combination of G6PD deficiency with at least one abnormal Hb (2 per cent). The prevalence of total haemoglobinopathies in Oman was 9.5 per cent. The prevalence of sickle cell trait varied between regions, North Sharqiya had the highest prevalence of 10 per cent. Dakhiliya (9 per cent), followed by Muscat and South Batinah 8 and 7.9 per cent, respectively. The prevalence of sickle cell trait declined by a half in Musandam, South Sharqiya, Dhahira, and North Batinah (4.7, 3.9, 3.9, and 2.9 per cent respectively). Dhofar had the lowest prevalence of 0.2 per cent and no cases of sickle cell trait were found in the Al-Wousta region in the sample selected. The prevalence of beta-thalassaemia trait ranged from 3.9 to 0.2 per cent. Three regions had high rates: North Batinah (3.9 per cent), Muscat (2.8 per cent), and Dakhiliya (2 per cent). The other five regions in the Sultanate have lower rates: Dhahira (1.7 per cent), Musandam (1.6 per cent), South Batinah (1.5 per cent), South Sharqiya (1.2 per cent), and North Sharqiya (1.1 per cent). The prevalence of beta-thalassaemia trait in Dhofar was 0.2 per cent and no cases were detected in the Al-Wousta region. The prevalence of G6PD deficiency reached 29 per cent in Dakhiliya, 26 per cent in South Batinah, 21 per cent in Dhahira, 19 per cent in Muscat and 17 per cent in North Sharqiya and North Batinah. The prevalence declined to 10 per cent in Musandam, 9 per cent in South Sharqiya, Dhofar had the lowest prevalence of 2 per cent and no cases of G6PD deficiency were found in Al-Wousta. The male to female ratio was 2.5:1. In all regions of the Sultanate, prevalence of G6PD deficiency in males were more than twice those in females. From the above rates, it could be calculated that in the whole Sultanate 44,733 children under 5 years of age have G6PD deficiency, 14,306 have sickle cell trait, 474 have sickle cell disease, 5393 have beta-thalassaemia trait, and 175 have beta-thalassaemia major. The study showed that the mean Hb level of children under 5 years of age was 10.9 g/dl for both males and females; the mean Hb level for males was 10.89 g/dl and for females 10.99 g/dl, the difference between males and females was significant. The study revealed that half of the children under 5 years of age were anaemic. Mild anaemia was predominant (46 per cent), while moderate and severe anaemia were 4 and 0.2 per cent respectively. The status of anaemia among children improved with age; mild anaemia was prevalent in 65 per cent of children between ages 0 to < or = 1 years then decreased with age until it reached 30 per cent at 4-5 years of age. The survey produced the first normal haematological indices for children under 5 years of age to be used as a reference in the country. The blood picture of the normal subjects in the survey showed that the mean Hb value for males was 11.9 g/dl and for females 11.8 g/dl. The children had reduced values of MCH and MCV compared to normal international values, the reason for this could be alpha-thalassaemia or iron deficiency. The children maintained high values of HbF (more than 1.2 per cent) even after their first birthday. HbF reached its normal level at 5 years of age. Marriage of first cousins among the parents of the children studied under 5 years of age was 34 per cent. Total consanguinity rate including second cousin relationships and beyond was 58 per cent. We recommend that a national prevention programme for genetic blood disorders be formulated by the authorities. The programme could be included in the Ministry of Health 5-year health development programme for prevention of non-communicable diseases which already exists.

Anemia, Sickle Cell↗
PubMed1997

The position of AIDS in Pakistan, UAE and Jordan.

AIDS is a term used for Acquired Immuno-Deficiency Syndrome. It is, by definition, the end-stage disease manifestation of an infection with a virus called human immunodeficiency virus (HIV). The virus infects mainly two system of the body i.e. the immune system and central nervous system (CNS) and the occurrence of disease is due to the damage of these two systems. The statistics on AIDS are alarming, especially for Sub-Saharan Africa India. Some scientific studies indicated that upto one-third of all sexually active adults living in this region are already infected, up to 40% of all women and one in 10 to one in 5 children born in this part are actively infected with HIV and will be dead before having reached their fifth birthday. The information on HIV infected young adults were collected both from official and non-official sources of the following countries, Jordan, UAE, Pakistan. A big difference in number of patients was found between official and non-official data. Anyhow, both data (official & non-official) are alarming due to the increase in number of HIV cases. 21st century is especially dangerous to the next generation of Pakistan and Arab World because of increase in percentage of HIV cases during the last 5 years.

Journal Article↗
PubMedDate not supplied

[Medical school's experience with Arabization 1993-2003: Gezira University].

This paper examines the importance of teaching in the mother tongue and looks at the political decisions taken in this respect. The preparations for Arabization in the Faculty of Medicine, Gezira University (in 1993) are reviewed and the experience of implementation from 1994 to 2002 is analysed by questioning the students and professors. The successes, failures, problems and obstacles are discussed in detail. The paper concludes with discussion and recommendations on how to boost success in Arabization based on previous experience.

Arab World↗
PubMed1991

[Palatine amygdalectomy through the ages].

This paper describes the development of the techniques of amygdalectomy through the ages. It would appear that Susruta de Bénares performed such an operation as early as the first century, but I personally have no documents on him. On the other hand, the operation is described in scrupulous detail by Celse, at the same period, and was not greatly different from our current dissection. The Judeo-Arab world was familiar with amygdalectomy from the very beginning, and the techniques of Abulcassis, Avicenne and Haly Abbas used dissection, pulling-out and cauterization as early as the 10th century. Guillemeau, a student of Paré, was the first to propose a ligature. In the 18th century, Benjamin Bell remained faithful to the ligature technique, and devised on uvulotome, which gave Physick the idea of an amygdalotome, from which derived the instrument of Sluder-Ballenger, incorrectly called the guillotine, given that its principle was based on pulling-out rather than cutting. Nevertheless, dissection remains today the technique most widely employed.

Amygdala↗
PubMed1996

Issues in forensic psychiatry in Islamic jurisprudence.

There are few other specialties in psychiatry where the cultural nature and social norms of a society has more impact than the specialty of forensic psychiatry. In the Muslim and Arab worlds, Islamic principles govern the foundation of thoughts required to make laws. Those necessarily include legal issues in psychiatry. The impact of these matters on individuals as patients and the community at large can not be overestimated. Those issues will include laws of involuntary hospitalization and evaluation of mental competence toward different life functions such as commercial interaction, writing a will, marriage, divorce, and child custody. Islamic law has a definite position on criminal responsibility as well as other vital matters such as compensation of damages, including medical malpractice. This article discusses problems and peculiarities involved in the canonization of these laws in islamic communities, considering different arguments presented from one point of view versus another.

Child↗
PubMed1997

[Pharmacy and the great contribution of Arab-Islamic science to its development].

The differentiation and separation of two scientific disciplines, medicine and pharmacy begins during the 12th century. Each differentiation by itself brings certain improvement and upgrading but at any level, this happens only when proper conditions are met. Therefore, in order for pharmacy to appear as a profession and to promoted to the level of science, certain conditions had to be met, namely the society and cultural forces had matured to the level of differentiation of these two disciplines, which have begun existing as completely independent disciplines in that time. For the history of pharmacy, it is very important to note the fact that we find the first beginnings of professional pharmacy among Arabic population. The first drug stores in the world were established in Arabic world (Baghdad 754). Considering the fact that Arabs had brought a great deal to pharmaceutical science and the fact that their search included some 2.000 substances, the goal of this work was formulated and medicinal herbs used in the treatment listed. The forms used that period are still used in the therapy and some formulations of drugs can be found in pharmacopeas even today. If we add to these reports the fact that most of the literature appearing in the field was also of Arabic origin and that many editions and translations of the pharmaceutical works from Arabic to Latin had been published ever since, the obvious contribution of Arabic science in the development of pharmacy becomes even more obvious.

Arab World↗
PubMed1998

The role of Galen in the development and progress of medical sciences.

Early Roman medicine was a mixture of religion and witchcraft, but as time went by, it became more influenced by the Greek medical sciences, which were more developed. The most famous Greek physician during the Roman period was Galen (129-200 AD). In the 4th century A. D. The Byzantine physicians of the Emperor Julian, made the Galenic writings available to ordinary practitioners, and so Greek medicine spread throughout Syria and was carried by the Nestorians into Persia, where it became available to the Islamic World.

Arab World↗
PubMed2001

[The historiography of Arabic medicine and the challenges of the XXI century].

This is a critical review of the work and methods of past and present Western historians of Arabic medicine. It points out traditional errors, prejudices and limitations, and proposes to modernize the way we approach this field of research. Up to now, many Western scholars have deemed that Arabic medicine could be understood by knowing the important theoretical treatises (even in unreliable translations) and by reading the frequently outdated secondary literature. Modern research must turn to the texts that reflect the actual medical practices, focus on social aspects of medicine or reflect the actual medical practices, focus on social aspects of medicine or the interaction of learned and folkloric medicine, and must even try to find out the truth about the questionable statements we read in our textbooks. The field urgently needs interdisciplinary and international cooperation and wider diffusion of the recent bibliography.

Arab World↗