Ibrahim Fahal

• MBBS, MD, FRCP, FRCP(Glas.)
• Consultant at Queen Mary University of London

The term uraemic myopathy has been used loosely to describe the skeletal muscle abnormalities in uraemic patients. However, it does not fully explain the observed abnormalities as recent research has documented a normal skeletal muscle physiology in the presence of reduced muscle force, selective structural changes and significant muscle wasting. A...

Professor Salih Yassin Salih was a lifelong advocate of medical education, an inspiring teacher, a medical writer, and a humble person. He was born in Omdurman on 27 September 1942, and educated at Omdurman schools and the faculty of medicine, University of Khartoum. He graduated in 1968 after a very distinguished undergraduate career. He held hou...

Aluminium toxicity in dialysis patients is well described. Aluminium has a close chemical affinity with silicon. Silicon may have a role in protection against aluminium toxicity. We measured serum aluminium and silicon levels from haemodialysis patients from four different centres. Though no relationship was seen across all centres combined, in one...

Muscle weakness is a common but unexplained feature of dialysis patients. This study investigated the prevalence and causes of muscle weakness in dialysis patients by examining the quadriceps muscle force and contractile properties. The quadriceps femoris was studied in terms of force, force-frequency curve, and speed of muscle relaxation in 49 dia...

1. Chronic fatigue syndrome is characterized by muscle fatigue and pain at rest, symptoms which are usually exacerbated with exercise. Although various studies have shown minor, non-specific morphological and biochemical changes in muscle of patients with chronic fatigue syndrome, no consistent defect has been identified. Some have suggested that a...

Thrombosis is a frequent cause of morbidity and mortality in patients with the nephrotic syndrome. Venous thrombotic complications are well recognized but arterial complications are rare. Thrombosis is multifactorial, and has been attributed to a hypercoaguable state due to alterations in blood levels of the various factors involved in the coagulat...

The reproducibility and reliability of cardiac output (CO) measurement by transthoracic electrical bioimpedance (TEB) and dual beam Doppler ultrasound methods were compared in 9 uremic patients during treatment with continuous ambulatory peritoneal dialysis (CAPD). CO was measured simultaneously by each method during supine rest and 70 degree passi...

Serum concentrations of silicon and aluminium have been compared in patients with end-stage renal disease on haemodialysis treatment. Both serum silicon and aluminium were elevated in comparison with non-renal failure healthy controls and gave an overall significant but relatively weak positive correlation. The silicon concentrations observed howev...

Seventeen severely anaemic and transfusion-dependent haemodialysis patients with a haemoglobin less than 7 g/dl were treated with recombinant human erythropoietin (r-Hu-EPO). Aluminium toxicity was diagnosed by a positive desferrioxamine (DFO) test and bone biopsy. Seven out of eight patients without aluminium toxicity responded to r-Hu-EPO therapy...

Four patients on regular dialysis treatment whose blood pressure was well controlled, developed malignant hypertension while receiving maintenance recombinant human erythropoietin (r-Hu-EPO). None of these patients had a haematocrit greater than 35% at any stage, and clinically, none had any evidence of fluid overload. Initially, they were all mana...

Haemodialysis-related porphyria cutanea tarda is a rare, but serious and mutilating skin condition, resulting from extremely high plasma porphyrin levels because of their inadequate clearance by haemodialysis. The treatment is very difficult as chloroquine is ineffective and venesection, the conventional treatment of this disease, is not always an...