Does the circadian pattern for acute cardiac events presentation vary with fasting?

BACKGROUND: Over one billion Muslims fast worldwide during the month of Ramadan. The impact of fasting on circadian presentation with acute cardiac events is unknown. AIM: To determine if fasting has any effect on the circadian presentation of acute cardiac events. SETTING AND DESIGN: A prospective study in a general hospital. MATERIALS AND METHODS: Patients with acute coronary events were divided into two groups based on the history of fasting. Information about age, gender, cardiovascular risk factor profiles and outcome was collected. The relationship of time of presentation of initial symptoms with fasting was evaluated using Student's t-test, Mann-Whitney U-test and chi2 analysis. RESULTS: Of the 1019 patients hospitalized during the study period, 162 were fasting. Although, fasting patients were more likely to present to the emergency department in the time periods 5-6 AM (10.5% vs 6.3%) and 11 PM (11.1% vs 7.1%) and were less likely to present in the time periods 1-2 PM (3.7% vs 7.2%) and 5-6 PM (3.7% vs 7.0%); these differences were not statistically significant. Fasting patients were less likely to have their symptoms start between 5 and 8 AM (11.1% vs 19.4%) and more likely to have symptoms between 5 and 6 PM (11.1% vs 6.0%) and 3 and 4 AM (11.1% vs 6.9%). These differences for time of initial symptoms were statistically significant (P=0.002). CONCLUSION: Exogenous factors associated with fasting, namely, the changes in food intake and/or sleep timings, affect the circadian rhythm and influence the timing of presentation of acute coronary events.

Study of HER2/neu status in Qatari women with breast carcinoma

The study is aimed at determining the prevalence of HER2/neu overexpression in Qatari women with breast cancer and to assess the survival in patients with HER2/neu positive tumors. This is a retrospective study of clinical data of 70 Qatari female patients diagnosed with breast cancer during the period 1991 through to 2001, at Hamad Medical Corporation, Doha, Qatar. We also performed a retrospective review of breast tissue sample for those patients using paraffin sections and applying immunohistochemistry staining-[Hercep test [DAKO Inc]] to determine the HER2/neu status. Eighteen patients [26%] were HER2/neu positive [2+ and 3+] with a mean age at diagnosis of 49.3years, and 52 [74%] were negative [0 and 1+] with mean age at diagnosis of 46.6 years. Of the patients with positive HER2/neu, 5 [28%] had a relapse of the disease and 4 [22%] died of the disease during follow up. Of the patients with HER2/neu, negative test 9 [17%] had a relapse of the disease and 10 [19%] died of the disease. The median survival function at mean of covariates for HER2/neu positive patients was 26 months, and for HER2/NEU negative patients was 28 months. The prevalence of HER2/neu over expression in Qatari female with breast cancer in this study is 26%, but due to a small sample size it may not reflect really the prevalence. Patient with HER2/neu positive were older at diagnosis than patients with HER2/neu negative, also they had higher relapse rate and mortality. Median survival function was better for HER2/neu negative patients

Prevalence of Helicobacter pylori infection among low socio-economic workers.

Epidemiological studies have shown that the prevalence of Helicobacter pylori infection in a community and occupational health are closely related to lifestyle and socio-economic status. There is little information on H. pylori profile in industrial workers in the literature. The aim of this study was to investigate the prevalence rate of H. pylori profiles among low socio-economic workers in the United Arab Emirates (UAE). This study was undertaken by determining IgG H. pylori antibody profiles among industrial exposed and referent workers, sera. Presence of anti-H. pylori antibodies in the frozen stored sera was determined by ELISA. Also, data on dietary and lifestyle were obtained. The result was considered positive if IgG anti-H. pylori antibody titers was > 300. People with seropositive levels of IgG antibodies to H. pylori were assumed to be infected with H. pylori. Most of the industrial workers lived in less modern accommodation, were less educated, ate their vegetable products unwashed and did not have drinking water facilities, when compared to referents. H. pylori serology by IgG was positive in 167 industrial workers (78.4%) and 137 in referent workers (64.3%) respectively, (p < 0.002). The sensitivity and specificity of the IgG serology assay were 94.5%, and 97.2% respectively. There was statistically significant difference between the exposed industrial and non-exposed control groups in respect of their H. pylori profiles.

The prevalence of Toxoplasma gondii specific IgG and IgM antibodies in blood donors in Al Ain, United Arab Emirates indicates a potential risk to recipients.

The results of a prospective cross-sectional study on the anti-toxoplasma IgG and IgM specific antibody profile among blood donors in Al Ain United Arab Emirates are presented. The overall infection rate was 34%. Based on IgM specific antibody positive rate, acute toxoplasmosis was evident among 3% of the blood donors studied. The theoretical implications of these findings are discussed.

Bronchial asthma and wheeze in a desert country.

A cross-sectional, population-based study was conducted among school children (3300), aged 7-12 years, in the Kingdom of Saudi Arabia, during the period January, 1988-February, 1990. The aim of the study was to investigate the association between asthma, allergic rhinitis, wheeze and eczema among Saudi school children. The relationship between pet-ownership and respiratory allergy was also studied. Detailed information was collected about wheeze and asthma in 3041 children and history of asthma and allergic rhinitis in their parents. The population sample had a high prevalence rate of diagnosed asthma (6.8%), history of wheeze (10.5%), allergic rhinitis (17.9%), and eczema (10.8%). Allergic rhinitis was the most frequently seen respiratory illness when compared to other respiratory symptoms. The prevalence rate of asthma, allergic rhinitis and eczema among parents reflected the same pattern as that seen in the children. Prevalence rate for asthma in children with pets is twice that of children without pets (OR: 2.4; 95%, Cl: 1.8-3.1). The odds of having chronic cough (OR: 3.9; 95% Cl: 2.8-5.2), chronic wheeze (OR: 4.2; 95%, 3.3-5.4), allergic rhinitis (OR: 8.0; 95% Cl: 6.3-10.3) and eczema (OR: 2.8: 95 Cl: 2.1-3.7) was higher in children with pets than in children without pets. The present study revealed that pet-ownership was associated with increased respiratory symptoms.

Reaction to tuberculin testing in Saudi Arabia.

An epidemiological study of tuberculosis infection in the Kingdom of Saudi Arabia was conducted, between January 1987 to February 1990. A proportional to population size sampling method was used for the whole country, and 1933 subjects were screened. A pre- designed questionnaire was used to collect details of BCG scar, age, sex, residence area, nationality, education, occupation and tuberculosis test. The relative importance of these factors was assessed by using Logistic Regression Analysis. The extent to which these factors affected the severity of tuberculosis was also examined. A number of statistically significant association were found between positive tuberculin test (> 10mm) and age (p < 0.0001), sex (p = 0.018), nationality (p = 0.009), residence area (p = 0.05) and occupation (p = 0.0003).

Prevalence of asthma and wheeze in two different climatic areas of Saudi Arabia.

In a cross-sectional study, the prevalence of asthma and wheeze was studied in 2300 school going children in two different environment and climate regions of Saudi Arabia, Dammam (humid-coastal) and Riyadh (dry-inland). The age range of children studied was 7-12 years (56% boys and 44% girls in Dammam; and 47% boys and 53% girls in Riyadh). A self-administered questionnaire was completed by parents of the children which includes information on age, sex, area, occupation and educational level of parents, history of asthma, allergic rhinitis, eczema, cough, wheeze, animals and pets exposure, family history of allergy and parental smoking habits. The results showed that prevalence of wheeze was more common in Riyadh (11.86%) than in Dammam (6.54%). Also, cough occurred more frequently in Riyadh (7.9%) than in Dammam (6%). The frequency of rhinitis was significantly more common in both areas than wheeze (Riyadh 17% and Dammam 12%). Also, the attack of breathlessness or tightness occurred more frequently in Riyadh (12.13%) than in Dammam (6.10%). When a more formal diagnosis of asthma was sought, this having been made by a doctor, the figures were 9.28% for Riyadh and 3.59% for Dammam. These figures showed major differences between the coastal and inland areas in the prevalence of bronchial asthma and wheezing with Dammam being relatively low risk whereas children in Riyadh region describe this more commonly.