Detection of human Sarcocystosis using dried blood on filter papers: An Immunofluorescent Antibody Test

@#Sarcocystosis, a parasitic infection caused by a protozoa belonging to the genus Sarcocystis, is found worldwide in both and animals. Sarcocystis spp., require two animal hosts to complete their life cycle. The infection has gathered more global attention after recent outbreaks, especially amongst wester travellers to Malaysia. Other than sporadic cases and the current outbreaks, little information is available regarding human Sarcocystis infection in Malaysia. The present study aims to determine the prevalence of sarcocystosis among humans using an immunofluorescent antibody (IFA) test applied to dried blood on filter papers. A total of 200 blood samples were collected on filter papers from autopsy cases at two Malaysian hospitals: Sungai Buloh Hospital (peninsular Malaysia) and Queen Elizabeth Hospital (Malaysian Borneo). Antigens were prepared from bradyzoites harvested from positive goats’ muscle samples. Of the 200 samples, 32 (16%) had Sarcocystis antibodies that showed positive fluorescence reactions on filter papers. There was no significant difference (t-test, p value > 0.05) in prevalence rates between samples collected from autopsies at peninsular Malaysia and Malaysian Borneo. The results demonstrated that the filter paper technique can be used as one of the alternative serological tests in the diagnostic of human sarcocystosis.

Imported Malaria in United Arab Emirates: Evaluation of a New DNA Extraction Technique Using Nested PCR

Local malaria transmission in the United Arab Emirates (UAE) came to an end in 1997. Nevertheless, UAE has been subjected to substantial importation of malaria cases from abroad, concerning both UAE nationals and immigrants from malarious countries with a total number of 2,119 cases in 2007. To evaluate a new DNA extraction technique using nested PCR, blood samples were collected from 132 individuals who presented to Infectious Diseases Department in Rashid Hospital, Dubai, and Central Department of Malaria Control with fever and persistent headache. Giemsa-stained blood films and ELISA test for malaria antibodies were carried out for detection of Plasmodium infection. Plasmodium infections were identified with the genus-specific primer set and species differentiation using nested PCR. A rapid procedure for diagnosis of malaria infections directly from dried blood spots using for the first time DNA extract from FTA Elute cards was evaluated in contrast to extraction techniques using FTA classic cards and rapid boiling technique. Our new simple technique for DNA extraction using FTA Elute cards was very sensitive giving a sensitivity of 100% compared to 94% using FTA classic cards and 62% in the rapid boiling technique. No complex preparation of blood samples was required prior to the amplification. The production cost of DNA isolation in our PCR assay was much less in comparable to that of other DNA extraction protocols. The nested PCR detected plasmodial infection and could differentiate P. falciparum from P. vivax, and also detected the mixed infection.

Imported Malaria in United Arab Emirates: Evaluation of a New DNA Extraction Technique Using Nested PCR

Local malaria transmission in the United Arab Emirates (UAE) came to an end in 1997. Nevertheless, UAE has been subjected to substantial importation of malaria cases from abroad, concerning both UAE nationals and immigrants from malarious countries with a total number of 2,119 cases in 2007. To evaluate a new DNA extraction technique using nested PCR, blood samples were collected from 132 individuals who presented to Infectious Diseases Department in Rashid Hospital, Dubai, and Central Department of Malaria Control with fever and persistent headache. Giemsa-stained blood films and ELISA test for malaria antibodies were carried out for detection of Plasmodium infection. Plasmodium infections were identified with the genus-specific primer set and species differentiation using nested PCR. A rapid procedure for diagnosis of malaria infections directly from dried blood spots using for the first time DNA extract from FTA Elute cards was evaluated in contrast to extraction techniques using FTA classic cards and rapid boiling technique. Our new simple technique for DNA extraction using FTA Elute cards was very sensitive giving a sensitivity of 100% compared to 94% using FTA classic cards and 62% in the rapid boiling technique. No complex preparation of blood samples was required prior to the amplification. The production cost of DNA isolation in our PCR assay was much less in comparable to that of other DNA extraction protocols. The nested PCR detected plasmodial infection and could differentiate P. falciparum from P. vivax, and also detected the mixed infection.

Effects of dietary flavqnoids intake in Saudi patients with coronary heart disease

The aim of the study was to assess the dietary intake of flavonoids and their effect on serum lipid levels in Saudi patients with coronary heart disease [CHD]. A cross-sectional study with a sample of 50 CHD patients and 50 controls. A 24-hour recall method was used to collect data on the dietary intake of macronutrients, flavonoids, and antioxidant vitamins. A food frequency questionnaire [FFQ] was used to collect data on habitual consumption during the year preceding the interview. Baseline data collection included medical history, anthropometric measurements, physical activity, and smoking status. CHD patients showed significantly less intake of fruits and vegetables compared to the controls. Serum lipids including total cholesterol [TC] triglycerides [TG] and low density lipoproteins [LDL] were found to be significantly higher in CHD patients than in the controls. The main sources offiavonoids in a typical Saudi diet are tea, fruits [apples], vegetables [onions], and chocolate. The intake offiavonoids and antioxidant vitamins was significantly lower in CHD patients compared to the controls. A negative correlation between the dietary intake of different flavonoids and serum LDL was observed in CHD patients. Significant correlation was found between the intake offlavonol and waist to hip ratio. The findings of the study support a potential protective effect of dietary flavonoids in relation to CHD, The study showed that consuming more Flavonoids may have positive effect on lowering blood lipids

Breast-feeding practices in Riyadh city, Saudi Arabia

Breast feeding is healthful for both the infant and mother alike. The life style in the Kingdom has changed drastically during the last two decades. Child obesity is emerging as a health risk and early weaning practices might play pivotal role in this aspect. The aim of this study is to investigate the factors that affect infant feeding practices. Mothers of 650 children aged five years or less at the time of the study who visited 10 Primary Health Care Centers [PHCC] in Riyadh City which were selected randomly from each of 5 regional zones participated in this study.65 subjects fom each PHCC were chosen by systemic random sampling from attending mothers during the three month study period. Socioeconomic data of parents was collected and mothers were interviewed using a questionnaire about breastfeeding, mixed feeding and weaning practices by trained nutrition students. The validity and reliability of the questionnaire was tested before final data collection. Data analysis was done using SPSS. X2 was used to test if there is any significance or correlation between socioeconomic variables and infant feeding practices. The results were considered statistically significant if p<0.05.83% of the subjects were Saudis and the 66.2% of the children were below one year of age. The mothers' age is between 26-35 years and only 8.4% of them were illiterates.92% of the fathers were of university education and the monthly family income was in the range of 4-7 thousand Saudi Riyals [1 US$ = 3.75 Saudi Riyals].43% of the mothers mentioned that nobody advised them about breast-feeding while 34% and 11% were advised by their mothers and nurses respectively. As the family income or education levels increased or the mother is employed, the duration of breastfeeding decreased. As the mothers' education increased, the cited reason for weaning was that there is no enough milk. However, a second pregnancy discovery was the cited reason for weaning by mothers of low educational level. Soiling the breast method of weaning is significantly correlated with high income of the family, working mother and education of the parents while separating the child method of weaning is opposite that seen in the soiling of breast practice in relation to income or education of parents. Breast-feeding practice is declining among Saudi mothers especially among high income and high education level of the parents. Breast-feeding promotion programs are needed and the benefit of breastfeeding for both the baby and mother should be emphasized

ratio between arachidonic acid 20:4 [w-6] and docosahexaenoic acid 22:6 [w-3] influences the growth and plasma fatty acid profile in rabbits after weaning

We studied the effect of dietary fatty acids on plasma fatty acid profile as well as growth performance [total food consumption TFC, weight gain WG, and feed efficiency FE] in rabbits fed three different diets varying in their omega-3 [w-3] and omega-6 [w-6] long-chain polyunsaturated fatty acid [LCPUFA] concentrations for four weeks after weaning. The first diet was the control negative diet [CND] with no LCPUFA; the second was fortified with egg yolk [EY] as a source of Arachidonic Acid A A 20:4 [w-6] and Docosahexaenoic Acid DHA 22:6 [w-3] with the ratio of [1:0.5] respectively; and the third was fortified with egg yolk and fish oil [EY + FO] as sources of AA and DHA with the ratio of [1:1] respectively, breast feeding infant rabbits were used as a control positive diet [CPD] group [breast milk contains LCPUFA 20:4 and 22:6]. There was a significant increase [p<0.05] in WG thereby FE in the [EY + FO] group in comparison with [EY] and [CND] groups, while no significant differences [p<0.05] were obtained in [TFC] among the fed groups. However, there was a significant increase in PUFA particularly Oleic Acid OA 18:l [w-9] in [EY + FO] group compared to [EY] and [CND] groups, and significant increase in OA, Linoleic Acid LA 18:2 [w-6] and Alpha Linolenic Acid ALA 18:3 [w-3] in plasma of the [CPD] group compared to the fed groups. Four weeks after weaning, there was slightly increase in LCPUFA particularly AA in plasma of the [EY + FO] group in comparison with [EY] and [CND] groups, and DHA in plasma of the [EY] group in comparison with [EY + FO] and [CND] groups. Despite this insignificant increase in the level of AA and DHA which was observed in the fed groups in this study due to fortification with the suggested ratios; therefore, our study recommends more research in this area taking into account the ratio between AA and DHA

Laparoscopic approach to liver hydatid cyst Is it safe?

To evaluate the feasibility and safety of laparoscopic approach in the management of hydatid liver cyst From December 2002 to August 2003, six consecutive cases of solitary liver hydatid cyst managed by laparoscopic surgery are reported. Age, sex, duration of surgery, surgical morbidity, hospital stay, time until return to work, and evidence of hydatid cyst recurrence were measured to evaluate the feasibility and safety of this procedure. The laparoscopic approach was performed on six patients [three women and three men] with a mean age of 42 years [range, 17-67 years] who had a solitary cyst with a mean diameter 8.5 centimeters [range, 7-10 centimeter], the operative time range between 40-120 minutes. The mean follow up period was 5 months [range, 2-9 months]. One patient had anaphylaxis during the procedure which was managed successfully, but continued to have positive serology tests in her follow up visit to the out patient clinic. Hospital stay was 2-4 days and return to work was within 8-10 days. The laparoscopic approach is feasible and safe in selected patients. It has established its role in the management of hepatic hydatidosis if precautions have been followed as in open technique. A prospective multicentric and randomized studies, that can provide sufficient scientific evidence to clarify most of the controversies related to the real applicability of laparoscopy for hepatic hydatid disease, are needed

What dose the patient want to know about his Anaesthesia and surgery?

The aim of the current study was to determine what the patients at King Abdul-Aziz University Hospital [KAUH] want to know before their anesthesia and surgery and to establish some order of priority on these information. A questionnaire was developed from 10 pieces of information, each developed into a statement. A short introduction about the demographics was asked at the beginning of each questionnaire. The patients showed a huge desire to know about all of the information concerning their procedure. However, the three statements with the highest percentage of importance to know were meeting their surgeons before operations, knowing all the common possible complications of their operations and meeting the anesthesiologists before the operations, in that order

New Trends in Medical Education the clinical skills laboratories

A clinical skills laboratory or center is a facility in which students, physicians, nurses and other health care professionals learn clinical, communication and information technology skills to a specified level of competence prior to or coordinated with direct patient contact. The purpose of the clinical skill laboratory is to support the acquisition, maintenance and enhancement of the clinical skills of students in health care professions. Within this non-threatening environment, patient volunteers, simulated patients, mannequins and information technology are employed to provide h and s-on learning experiences for the practice of the essential clinical skills. The skills laboratory helps to ensure that all students have necessary learning opportunities and appropriate assessment and feedback before approaching real patients. As more and more schools integrate skills laboratories into their curricula, it is important to review this new trend, to introduce the reader to its nature, factors that led to its development, advantages and problems related to its implementation. This review will also suggest some guidelines that may help in overcoming the implementation problems

Pitfalls in cerebrospinal fluid test for the diagnosis of neurosyphilis

To determine the usefulness of cerebrospinal fluid tests in the diagnosis of neurosyphilis. Two hundred and seven cerebrospinal fluid-Venereal Disease Research Laboratories tests were performed at King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia between 1992 and 1997. The records of 14 cases with progressive neurological disease and reactive serum fluorescent treponemal absorbent antibodies or treponemal pallidum hemagglutination test were reviewed for clinical presentation, cerebrospinal fluid analysis and Venereal Disease Research Laboratories, neuro-imaging abnormalities and compatibility with the diagnosis of neurosyphilis. The diagnosis of neurosyphilis was made if the patient had reactive serum fluorescent treponemal absorbent antibodies or treponemal pallidum hemagglutination, history of progressive neurological disease and increased cerebrospinal fluid cells or protein. None of the 207 cerebrospinal fluid-Venereal Disease Research Laboratories tests were reactive. The diagnosis of neurosyphilis was made in 10 out of 14 cases with progressive neurological disease and reactive serum rapid plasma reagin, fuorescent treponemal absorbent antibodies and treponemal pallidum hemagglutination. We conclude that if reactive cerebrospinal fluid-Venereal Disease Research Laboratories is required to confirm or diagnose neurosyphilis, most cases will be overlooked

Scorpion sting in children from northwestern area of Riyadh, Saudi Arabia

The assess the clinical severity of envenomation in children by scorpion species in Riyadh region and the potential benefit of antivenin administration. Retrospective medical record review study. Teaching and tertiary-care hospital. Children aged 12 years and younger experiencing scorpion sting over a period of 15 years [1983-1998]. Sixty three patients with an age range of 2 months to 12 years [median 6 years] and 20.6% of the patients were below the age of 3 years while 50 [79.4%] were above that age. Forty eight [76.2%] were males while 15 [23.8%] were females with a male/female ratio of 3.2:1. Fifteen [23.8%] patients were stung at the upper half of the body while 48 [76.2%] were stung at lower half. We found that there was a significantly higher occurrence of scorpion sting in children above the age of 3 years and also among the males. The lower half of the body was significantly affected. The manifestations of the illness in Riyadh were not severe and antivenin therapy did not affect the outcome of the illness

Health services delivery in Asir, Saudi Arabia: regional experience of integration

This paper presents the local experience of the General Directorate of Health Affairs in Asir, Saudi Arabia, regarding integration of health services. The geographical, sociodemographic and administrative situations of the region necessitate this approach. A historical background of the development of health services in the region in the recent past is presented. Restructuring of the health system, changes in management functions and advantages of integration of health services are discussed

Normal canthal index and intercanthal dimensions in Saudi Arabian young men and boys of semitic origin

Knowledge of the normal dimensions of interocular and intercanthal distances in the local population could be helpful in syndrome diagnosis. In order to establish baseline standard values, we measured interpupillary distance [IPD], inter-inner-canthal and inter-outer-canthal distances, and calculated the canthal index [CI] in 200 boys [age 6 to 15 years] and 200 young men [age 16 to 22 years], phenotypically normal and of Saudi Arabian Semitic [as opposed to African] descent. A projected photographic technique was used. Average IPD for boys was 53.3 mm [range 50.6 to 60.1 mm; standard error of mean [SEM] 2.7 mm], and for young men 63.6 mm [range 62.1 to 65.2 mm; SEM 1.2 mm]. Average CI for boys was 39.1 [range 32.1 to 45.2; SEM 2.5], and for young men 36.9 [range 27.3 to 43.9; SEM 2.9]; this was higher than in comparative populations of North American Caucasian, African American, and Japanese descent. The underlying reason was found to be a relative ocular hypotelorism in the examined local population. Regression equations for the measured variables are offered. We also found that physically measured IPD was not significantly different from the IPD calculated mathematically

Study of the effects of long-term exposure to noisy air conditioners on hearing acuity

This study included 100 persons who have been exposed to noise levels emitted from compact air conditioners units in closed places for long periods reached up to 21 years. Results obtained denoted that persons only exposed to compact air conditioners units showed a very slight higher [0.6%] hearing impairment than the corresponding 62 control subjects. On the other hand, impairment of hearing was [2.4%] among subjects used to listen at the same time the other noisy equipments, and aged 50 years and over