[show abstract][hide abstract] ABSTRACT: Serum progesterone level is used as an indictor of ovulation and several assays are commercially available for its routine measurement. Target values suggestive of ovulation, deficient luteal phase and anovulation have been proposed and are widely sighted in the literature. In this study, we com- pared the use of two different assays namely: Amerlite (Johnson & Johnson, United Kingdom), and AxSym (Abbott Diagnostics, Germany) for measure- ment of serum progesterone. In patients being investigated for infertility (n = 93), serum progesterone levels showed good correlation (r = 0.92) between the two methods; however, values were significantly different (P < 0.005). Using published cut-offs levels for progesterone, 28.3%, 60.8%, and 10.9% of pa- tients had ovulatory, anovulatory, ad deficient luteal phase, respectively, as measured by the Amerlite assay, compared to 32.6%, 60.8%, and 6.5% when using the AxSym assay. Thus when using the AxSym assay, higher per- centage of patients would be classified as having ovulaory cycle. This study indicated that methodological differences on their own right play a significant role in the determination of ovulatory statue of patients. The study showed that laboratory-based target values need to be established.
[show abstract][hide abstract] ABSTRACT: The aim of this study is to determine the prevalence of insulin resistance syndrome among type-II Saudi diabetics.
The study involved type-II Saudi diabetics followed at the Out-patient Clinic of King Abdul-Aziz University Hospital, Jeddah, Kingdom of Saudi Arabia, from January 1997 to December 1998. Their age, sex and body mass index was recorded. Serum samples were analyzed for glucose. Insulin C-peptide level and insulin glucose index was calculated. Serum cholesterol, high density lipoproteins, low density lipoproteins, triglyceride, and uric acid were measured.
A total of 109 patients were studied, (67 females and 42 males) with an age range from 28 to 105 years. Median body mass index was 27 in males and 30.2 in females. Percentage of male and female patients with the following abnormalities were as follows: Total cholesterol >5.3 mmol/L (47.6% males, 40.9% females), high density lipoproteins-cholesterol <1.2 mmol/L (71.4% males, 40.9% females), low density lipoproteins-cholesterol >3.4 mmol/L (42.8% males, 37.9% females), triglyceride >2.3 mmol/L (40.5% males, 31.8% females), insulin >24 mIU/l (23.8% males, 29.7% females), C-peptide >1324 pmol/L (21.2% males, 13% females) and hypertension (33.3% males, 43.8% females). Uric acid >420 umol/L was found in 35.5% males and >390 umol/L in 25.6% females. Body mass index >27.8 was found in males (35.7%) and >27.3 in females (67.7%). Insulin resistance as defined by insulin glucose index >5.4 was found in 19.8% of the study group (23.8% males, 15.9% females). Insulin resistance syndrome was found in 16.5% (17.1% males, 15.9% females).
Insulin resistance syndrome is common among type-II Saudi diabetics.
Saudi medical journal 09/2002; 23(9):1045-8. · 0.62 Impact Factor
[show abstract][hide abstract] ABSTRACT: To determine the prevalence of sub clinical diabetic neuropathy in Saudi diabetics and the risk factors associated with symptomatic diabetic neuropathy.
A prospective study of Saudi diabetics attending King Abdulaziz University Hospital out patient clinic from January 1998 until April 1999. Detailed information of each patients' age, sex, body mass index, type and duration of diabetes mellitus, mode of treatment, degree of blood glucose control, presence of hypertension, hyperlipidemia, smoking, family history of diabetes mellitus and hypertension were recorded. Patients were assessed for diabetic neuropathy using the Michigan Neuropathy Program. Patients who were asymptomatic and scored less than 2 on simple clinical examination were referred to a neurologist for a complete neurological examination and nerve conduction studies.
A total of 237 patients were studied with a mean age of 54.19 years and mean duration of diabetes 10.6 years. Symptomatic diabetic neuropathy was present in 132 (56%) patients while subclinical neuropathy was present in 58 (57%) of asymptomatic patients. Old age, type II diabetes with long duration, poor control and smoking were risk factors associated with symptomatic diabetic neuropathy (p<0.001, p=0.09, p<0.001, p=0.04, p=0.08).
Subclinical diabetic neuropathy is common. Early diagnosis is important for possible prevention of late neuropathic complications (foot ulcers and infections). Prolonged poorly controlled diabetes mellitus, old age and smoking are risk factors for symptomatic diabetic neuropathy. Meticulous blood glucose control is important for nerve function protection. Researches are urgently needed for satisfactory therapy.
Saudi medical journal 06/2000; 21(5):433-7. · 0.62 Impact Factor
[show abstract][hide abstract] ABSTRACT: Granulocyte-macrophage colony-stimulating factor (GM-CSF), one of the haemopoietic growth factors, has rarely been detected in human serum. It has, therefore, been suggested that a paracrine model can explain its behaviour where the substance is produced and acts locally. An alternative explanation might be due to blood sampling time with GM-CSF concentrations undetectable at the nadir of secretion.
We hypothesised that endogenous production of GM-CSF in humans is subject to diurnal rhythm.
Blood samples were obtained from 17 healthy individuals and 17 neutropenic hospitalised patients with haematological malignancies on myelosuppressive therapy at 6, 12, 18 and 24 hours. In the neutropenic patients, samples were collected at the nadir of the neutrophil count (ANC < 0.2 x 109/L). Serum was assayed for GM-CSF levels using an enzyme-linked immunosorbent assay method.
There were significant differences in the mean levels of GM-CSF within the two groups (P < 0.001). In normal subjects, peak GM-CSF levels were reached at six hours (mean = 10.1 pg/ml). Peak levels were reached in hospitalised neutropenic patients at 18 hours (mean = 13.7 pg/ml). The difference between the peak GM-CSF levels in the two groups was not significant (P = 0.11). On factorial design analysis, there was a significant interaction between the time of blood collection and the subject groups (P < 0.001).
Our data are consistent with a diurnal secretion pattern for GM-CSF in both normal and neutropenic patients. As this finding might have practical implications, including timing of administration of GM-CSF in neutropenic patients, further studies are suggested.
Irish Journal of Medical Science 01/2000; 169(1):55-7. · 0.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: Analysis of renal stones may help in elucidating the pathogenesis of nephro-lithiasis. This study compared the use of 2 methods for the analysis of renal stones. One method is qualitative dry 'spot tests' whereas the other is quantitative 'wet chemistry.' In the wet chemistry method, dissolved stone material were analysed using automated chemistry analysers, whereas, the dry method involved spot colour end-point detection. Stones (n = 64) were analysed by both methods. The majority of stones were calcium oxalate as determined by wet chemistry (57.4 per cent) and spot tests (50.0 per cent). Fewer mixed stones were obtained by the wet chemistry method (16.8 per cent) compared with the spot tests method (39.0 per cent), whereas, more uric acid stones were obtained by the wet chemistry method (5.6 per cent) compared with the spot tests method (1.9 per cent). 'Pure' calcium phosphate stones (3.0 per cent) were only obtained by the wet chemistry method. In the wet chemistry method, dissolved stone material did not show significant deterioration on storage for up to 9 days.
Irish Journal of Medical Science 01/1999; 168(2):114-8. · 0.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: To our knowledge, only a few epidemiological reports on the prevalence of hepatitis E antibodies in Saudi blood donors have been published. Men of several nationalities, donating blood at King Khalid National Guard Hospital (Jeddah, Saudi Arabia) were selected (n = 593) for this study examining the seroprevalence of hepatitis E virus (HEV) in the local male donor population and testing the relationship of the antibody to HEV (anti-HEV) to donor characteristics using Odds Ratio (OR) and Chi-square statistic. The prevalence of anti-HEV in the group examined was 16.9 per cent (100/593). The seroprevalence for Saudi donors was 14.8 per cent compared with 33.3 per cent for non-Saudis of Middle Eastern origin. Donors who were 40 yr and over had significantly higher seroprevalence than those donors who were 30 yr or younger (OR = 2.5, p = 0.006). There was a significant association between anti-HEV and anti-HCV with donors who were positive to anti-HCV having about 5 times the risk of HEV than those who were anti-HCV negative (p = 0.02). These findings demonstrate the high seroprevalence rate of anti-HEV among male blood donors in Saudi Arabia.
Irish Journal of Medical Science 01/1998; 167(2):94-6. · 0.51 Impact Factor
[show abstract][hide abstract] ABSTRACT: Friedreich's ataxia (FA) was studied in a large inbred Arab family living near Jeddah, Saudi Arabia, in which DNA linkage studies localised the disease gene to 9q13-q21.1. Five siblings (aged 19-35 years), and their 27 year old cousin, had the typical features of FA, however in two patients, tendon reflexes were retained and were indeed brisk in the lower limbs, 13 and 19 years respectively after onset of symptoms: retention of lower limb tendon reflexes is exceptional in FA. Another 6 deceased individuals from two related families are presumed to have had FA.
Clinical Neurology and Neurosurgery 03/1996; 98(1):8-11. · 1.23 Impact Factor
[show abstract][hide abstract] ABSTRACT: Interleukin-6 (IL-6) is one of the cytokine mediators of the acute phase response. The value of IL-6 determination in the investigation of patients suspected of acute myocardial infarction and unstable angina is not fully established. In 26 patients being investigated for AMI and UA, IL-6, Creatine Kinase (CK) and Troponin T (TnT) were elevated with peak values at 12 hours (for IL-6 and CK) and at 0 and 24 hours (for TnT) following admission. CK values in AMI were significantly different from UA patients at 0, 6, 12, and 25 hours following admission, whereas, IL-6 values showed significant difference only at 24 hours. TnT showed a significant difference between the groups at 0 and 24 hours following admission. There was poor negative correlation between IL-6 and CK levels and percentage left ventricular ejection fraction. This study showed that, although IL-6 was elevated in AMI and UA patients, the spread of the data indicated that its measurement is of limited value in the diagnosis of AMI.
[show abstract][hide abstract] ABSTRACT: We studied a 28-year-old Yemeni woman with typical Seckel syndrome. Two deceased sibs, a twin sister and a brother, had also been affected. The father of these individuals was married to his cousin's daughter: the pedigree suggests autosomal recessive inheritance. Classical Seckel syndrome has not been reported previously in Arabs, and this appears to be the first report from the Middle East.
American Journal of Medical Genetics 08/1994; 51(3):224-7.
[show abstract][hide abstract] ABSTRACT: Few epidemiologic reports on the prevalence of hepatitis C in Saudi blood donors have been published.
Men (of several nationalities) donating blood at the King Khalid National Guard Hospital (Jeddah, Saudi Arabia) were randomly selected (n = 744) for this study examining the prevalence of hepatitis C virus (HCV) in the local donor population, the relationship of antibody to HCV (anti-HCV) to the surrogate markers alanine aminotransferase (ALT) and antibody to hepatitis B core antigen (anti-HBc), and the effect of the use of these markers on the discard rate.
The prevalence of anti-HCV in the group examined was 3.2 percent (24/744), with a significantly high prevalence of 24.5 percent (12/49) in donors who were Egyptian (p < 0.0001). Exclusion of this group would lower the prevalence to 1.7 percent (12/695). Anti-HCV prevalence peaked in the group aged 30 to 39, and a significant relationship was found between anti-HCV and ALT level > 65 U/L (p < 0.0001). There was no significant relationship between anti-HCV and anti-HBc (p = 0.66). The prevalence of anti-HCV in the Saudis studied was 1.7 percent (9/528). The prevalence of anti-HCV in non-Bedouin Saudis was significantly greater than that in Bedouin Saudis (7/165 [4.2%] vs. 2/363 [0.5%]; p < 0.01). The prevalence of anti-HBc was found to be 28.7 percent (214/744). The use of elevated ALT (> 90 U/L) and anti-HBc as surrogate markers would increase the current discard rate (8.3%) by 2.8 and 23.8 percent, respectively.
These findings demonstrate the practical difficulties of using anti-HBc as a surrogate marker for hepatitis C in areas endemic for hepatitis B virus.
[show abstract][hide abstract] ABSTRACT: Tachycardia as a presenting symptom and part of Wernicke’s encephalopathy was detected in ahtient who was having a discharging fistula from the small bowel for which he received total parenteral nutrition for approximately five weeks. Thiamine deficiency is known to occur during total parenteral nutrition and this case report describes the evolution of the cardiac and neurological manifestations of this disorder. إن تسارع ضربات القلب بصفته أحد الأعراض المصاحبة لالتهاب المخ النصفي ( فيرنكس) كان قد تم اكتشافه في أحد المرضى المصابين بناصور الأمعاء الدقيقة والذي ظل يغذي تغذية صناعية لفترة خمسة أسابيع تقريباً . كما تعرض هذا المريض لنقص فيتامين (ب1) كنتيجة طبيعية لاعتماده كليا على التغذية الصناعية . ويوضح التقرير الطبي لهذه الحالة الظواهر القلبية والعصبية المصاحبة لذلك
Journal of King Abdulaziz University : Medical Sciences. 01/1993;
[show abstract][hide abstract] ABSTRACT: Fifty-two normally pregnant women underwent echocardiography to examine their pericardium in the first, second and third trimester. Pericardial effusion was noted in 15.3% of the women (n = 8) in the first trimester, 19.2% (n = 10) in the second trimester and 44.2% (n = 23) in the third trimester of pregnancy. Pericardial effusion during pregnancy was found to be completely resolved in all patients who underwent an echocardiogram 6 weeks post delivery (n = 11). There was no statistically significant difference in age, hemoglobin, total protein, albumin/globulin ratio or mean blood pressure during pregnancy between those who developed pericardial effusion and those who did not. The frequency of occurrence of pericardial effusion in primigravidas at 69.2% (9/13) was higher than that in multigravidas, with a ratio of 35.9% (14/39), the difference being statistically significant (p less than 0.025). The frequency of occurrence of pericardial effusion in patients who gained more than 12 kg during pregnancy at 67.7% (11/17) was higher than in patients who gained less than 12 kg, with a ratio of 34.3% (12/35), the difference being statistically significant (p less than 0.025).
[show abstract][hide abstract] ABSTRACT: Fructosamine, a compound used to measure serum glycosylated proteins was assayed in 105 Saudi diabetic subjects and 54 healthy
non-diabetic Saudi subjects. Fructosamine concentrations in diabetics were significantly higher than in healthy controls (p<0.0005).
Fructosamine concentrations correlated significantly with fasting blood glucose and HbA1 in diabetics (r=0.677, p<0.0005, and r=0.598, p<0.0005, respectively). The correlation between fructosamine and HbA1 was significant in the oral hypoglycemic-treated diabetics and poor in the insulin-treated diabetic group (r=0.568, p<0.0005,
and r=0.526, p=0.01). Fructosamine concentrations correlated poorly with the duration of diabetes (r=0.221, p<0.05).
[show abstract][hide abstract] ABSTRACT: Fructosamine, a compound used to measure serum glycosylated proteins was assayed in 105 Saudi diabetic subjects and 54 healthy non-diabetic Saudi subjects. Fructosamine concentrations in diabetics were significantly higher than in healthy controls (p less than 0.0005). Fructosamine concentrations correlated significantly with fasting blood glucose and HbA1 in diabetics (r = 0.677, p less than 0.0005, and r = 0.598, p less than 0.0005, respectively). The correlation between fructosamine and HbA1 was significant in the oral hypoglycemic-treated diabetics and poor in the insulin-treated diabetic group (r = 0.568, p less than 0.0005, and r = 0.526, p = 0.01). Fructosamine concentrations correlated poorly with the duration of diabetes (r = 0.221, p less than 0.05).
[show abstract][hide abstract] ABSTRACT: Subclavian vein catheterization, the most commonly used temporary vascular access for hemodialysis, is associated with a variety of complications. This retrospective study was done on 96 patients who had 150 percutaneous subclavian vein catheterizations over a one year period using Quinton double lumen polyurethane catheters. A total of 56 complications were seen of which 12 were immediate and 44 delayed. Immediate complications seen were six cases of failure of insertion of catheter and three cases each of subclavian artery puncture and inadvertent entry of the catheter into the jugular vein. Delayed complications seen were infection in 33 cases, thrombosis of subclavian vein in six patients, delayed pneumothorax in four cases and hemothorax in one. One patient, who required repeated catheterizations since he refused creation of AV fistula, died of septicemia. The remaining patients responded well to the treatment of the respective complications.
Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 5(4):479-82.
[show abstract][hide abstract] ABSTRACT: The prevalence of antibody to hepatitis C virus (HCV) in hemodialysis (HD) patients is high and variable. One hundred and thirty nine patients undergoing maintenance HD at three different renal units in Jeddah, Kingdom of Saudi Arabia, were studied for prevalence of anti-HCV antibody. The overall prevalence in the group examined was 52.5% (73/139). There was a significant correlation between prevalence of anti-HCV and duration of HD; 53/ 74 (71.6%) in patients on HD for > 3 years as against 20/65 (30.8%) for patients on HD for < 3 years (P< 0.05). We were unable to demonstrate a correlation of anti-HCV positivity with history of blood transfusions, previous exposure to hepatitis-B virus, sex, age, or ethnic group. The very high prevalence of anti-HCV found in patients on maintenance HD and the positive correlation between anti-HCV reactivity and duration on dialysis suggest that factors within the dialysis unit might contribute to the spread of the virus.
Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 6(2):128-31.