Prevalence of pulmonary tuberculosis among expatriates subjected to medical visa screening in Abu Dhabi, United Arab Emirates

All applicants for work and/or residence in Abu Dhabi are screened for tuberculosis at the time of issuing or renewing their residence visa. The purpose of this study is to assess the prevalence of TB among visa applicants and the likelihood of testing positive among different subgroups. Data from the electronic visa screening system was used for a total of 948,504 applicants screened for residence in Abu Dhabi from January to December 2010. The screening identified 4577 suspected cases of pulmonary tuberculosis [PTB]; 1558 people with chest X-ray findings suggestive of prior PTB; 235 smear-positives; and 132 culture-positive cases. The prevalence of active PTB was 39/100,000, with new applicants significantly more likely to test positive compared with renewals [OR: 2.05, 95% CI: 1.5-2.7, P < .001]. People coming from African countries had the highest prevalence of TB compared with people from other regions [OR: 21.25, 95% CI: 6.72-67.17, P < .001]. The number of active PTB cases among applicants for visa screening is still of a real concern. Without a rigorous screening system, the disease can spread to the community and hit other people. Certain subgroups were more likely to have the disease; this could provide the scientific foundation for future amendments in the screening requirements

Rapid detection of methicillin-resistant staphylococcus aureus [MRSA] in nose, groin, and axilla swabs by the BD GeneOhm MRSA achromopeptidase assay and comparison with culture

To compare the BD GeneOhm Methicillin Resistant Staphylococcus aureus [MRSA] Achromopeptidase [ACP] polymerase chain reaction [PCR] assay with the culture method for the detection of MRSA colonization. One hundred and two patients were admitted to the Intensive Care Unit in King Khalid Hospital, Najran, Kingdom of Saudi Arabia from July 2010 to February 2011. Separate swabs from the nose, axilla, and groin of each patient were processed by the culture method [sheep blood agar plate and mannitol salt agar plate] and BD GeneOhm MRSA ACP assay. Of the 287 samples, 62 [21.6%] were MRSA positive by the PCR assay and 26 [9%] were MRSA positive by the culture method. The PCR method showed 88.4% sensitivity and 98.6% negative predictive value. The number of MRSA-PCR positive groin specimens was nearly the same as nasal specimens. The PCR method gave positive results in 22.5% of patients by nasal specimens, 27.5% of patients by nasal and groin specimens, and 30.4% of patients by nasal, groin, and axilla specimens. The PCR method detected 30.4% of patients as MRSA positive while the culture method detected 19.6% of patients as positive for MRSA. The BD GeneOhm MRSA ACP assay has high sensitivity and NPV and hence is a useful screening method to exclude patients who are not colonized with MRSA

[Relationship between diabetes mellitus type 2 and depression]

Relation between diabetes and depression is bidirectional. Diabetics are at higher risk for developing depression, which is a risk factor for the onset of type 2 diabetes and its complications. We will illustrate these links through the cases of two patients. The first patient had a major depressive episode that has resisted treatment, and in whom the management of a discovered diabetes has improved the depressive symptoms. The second patient suffered from diabetic complications stabilized after treatment of a neglected depression. Several factors favor the occurrence of depression in diabetic patients: the low socioeconomic and education level, loneliness, stress, high levels of glycated hemoglobin and the presence of diabetic complications, especially neuropathic ones. Furthermore, depression can lead to eating disorders and sedentary lifestyle, favoring the development of obesity and type 2 diabetes; depression is also accompanied by biological changes that may increase vulnerability to diabetes. Therapeutic response to antidepressants is probably lower in diabetics

[Psycho-socio-pathological aspects of ulcerative colitis]

Ulcerative colitis is a chronic, severe and disabling disease whose etiology remains unclear. Studies are controversial regarding the role of psychopathological factors in its onset and evolution. psychiatrists have studied this disease for a long time. First, through the psychosomatic and psychoanalytic approaches, and then, with the development of neuro-physiology and the concept of stress. Thus, authors have described a number of characteristics in those patients, including the alexithymic dimension of personality; others have emphasized the role of stress and psycho-neuro-endocrine regulation mechanisms. Ulcerative colitis has also been linked with a higher incidence of psychiatric disorders, including anxiety and depression. But only the findings on the psychosocial impact of this disease are universally accepted. The development of psychosocial interventions aiming at ameliorating the quality of life of patients has also improved the prognosis of this disease

[Depression in chronic hepatitis C: diagnosis and pharmacological treatment]

Interferon-alpha combined with Ribavirin is currently the standard treatment for chronic hepatitis C. although frequently effective, IFN-alpha induces has as series of psychiatric side effects responsible for the breakdown the treatment. Depression induced by IFN-alpha is the most common manifestation. It covers approximately one third of patients. Its symptoms are often overlooked during routine clinical interviews. For the diagnosis of this depression, it is recommended to use diagnostic tools such as the Mini-International Neuropsychiatric Interview for DSM-IV, translated and validated in Moroccan Arabic. The psychiatric evaluation before treatment, the initiation of antidepressant medication at the onset of the depressive episode and close monitoring of patients are needed to ensure safety and promote compliance to antiviral treatment. Although controversial, the preventive treatment with antidepressant medication might be beneficial for patients with significant depressive symptoms prior to antiviral therapy

Use of diode laser [810] nm in frenectomy

Frenula consist of a mucosal fold in the labial, buccal and occasionally the lingual surface of the alveolar ridge. Their high attachment may cause orthodontic problem eg. [Diastima], prosthodontic problems eg. [Poor retention of denture], periodontic problems [gingival recession and inflammation] and speech problem [tongue tied in ligual frenum]. The removal of frenum could be done by surgical excision using scalpel through different techniques eg. [Vertical, Z plasty and hemostat]. Modern technology now offers an alternative mode of treatment like laser surgery. eight patients [14-75 years old] with freni indicated for excision were referred for laser clinic in police hospital. Laser used was diode with wavelength [810] nm [Oralaser Jet 20 - Germany], energy 1.8 Jul/sec and frequency 10,000 Hz using PPR1 [pulse pause relation] program with fiber tip diameter of 400 micron in contact mode. Laser safety measures were followed. showed dry and bloodless field during operation, no post operative swelling, no pain or discomfort, with normal healing process. as these were first cases to be treated by laser in Sudan, we suggest and stimulate the use of laser for soft tissue surgery because of its time saving, patients comfort and easy manipulation

Improved design for in-vitro measurement of adhesion parameters of bioadhesive pharmaceutical systems

A simple apparatus was designed to measure the adhesion parameters, the detachment force and the work of adhesion, for solid and semisolid bioadhesive dosage forms. Validation of the new design using natural and synthetic bioadhesives showed that the system gave reproducible results. Two model membranes, the bovine cheek membrane and the bovine intestine, were tested as the biological platform using carbopol 934/HPMC systems in the ratios [100:0, 90:10, 50:50]. The bovine intestine gave more reproducible results than the bovine cheek membrane. Carbopol 974p/HPMC and carbopol 974p/HPC are the systems used to determine the effect of contact time on the adhesion parameters and to confirm the linear relationship between the detachment force and the work of adhesion

Lumbar spines brucellosis: presentation, diagnosis and treatment

Nineteen cases with lumbar spines brucella were studied during a 3 year period. The diagnosis was based on history of exposure, compatible symptoms and signs, plain radiographs, CT [in some cases] and high antibody titre. Combined antibiotic treatment [tetracycline, streptomycin and rifampicim] for long duration [3 months] was considered the most effective tool in the treatment. The adequacy of treatment was best monitored with repeated agglutination titers, and the duration of treatment proved to be more important than the antibiotic agent itself

Spinal extradural abscess

Twenty-one patients of extradural abcess have been studied. All cases are males and their ages ranged from 16 to 50 years. The clinical presentations, eatiological factors, surgical treatment and prognosis are analysed. Blood borne infection occurred in 13 patients, postlumbar puncture infection occurred in 6 patients, direct innocculation of infection after laminectomy occurred in 1 and the last case was due to direct extension from disc space infection. Dorsal region is the site of predilection for blood borne infection. Back pain is constant complaint in every case which is followed by paraplegia in 15 patients, paraparesis in 3 patients and sphencteric disturbance in one patient. Myelographic block is an essential finding to confirm the diagnosis. Proper and prompt diagnosis and treatment by laminectomy and drainage under cover of strong antibiotic are the best line of treatment, which may lead to good prognosis. Emphasis on rapid surgery before occurrance of major neurological deficits was found as determinate factor in the prognosis