Prevalence of food allergy in asthmatic patients.

OBJECTIVES: This study was conducted to assess the role of clinical sensitivity to food on the pattern of bronchial asthma. METHODS: A total of 1341 patients with asthma were included in the present study. The clinical sensitivity to food and its relation to respiratory symptoms were assessed cross-sectionally (using detailed questionnaires), and longitudinally during their regular visits to the asthma clinic using diet diary. Total IgE was determined for a subsample of the patients (No = 392). RESULTS: The prevalence of clinical sensitivity to food was 29%; about 2 thirds of the patients had high total IgE level. Asthmatic patients with clinical sensitivity to food present with some particular features which are considered risk factors that determine the occurrence and clinical pattern of asthma. In addition, some personal characteristics in the asthmatic patients make them at increased risk to have clinical sensitivity to food. CONCLUSION: From the clinical experience of asthma management in our clinic, the authors believe and emphasize that elimination of food items from the diet of an asthmatic patient should be considered after careful investigation and observation of the patient. In addition, some personal characteristics in the asthmatic patients make them at increased risk to have clinical sensitivity to food. Early detection of food allergy is an important preventive factor for food related respiratory symptoms. The natural course of food allergy is of resolution over time although this may differ between foodstuffs and may be variably affected by avoidance of the offending allergen.

Respiratory health of young shipyard welders and other tradesmen studied cross sectionally and longitudinally.

OBJECTIVE: To assess the effectiveness of current measures for protecting shipyard welders and caulker/burners (WCBs) from the respiratory effects of fumes. METHODS: Shipyard tradesmen born after 1953 (cohort 1), and 181 older men, subjects of a previous study (cohort 2), were assessed, then followed up after an average interval of 6.7 years. The respiratory associations with shipyard trades were assessed cross sectionally and longitudinally and an estimate made of the likely effects of selection bias. Cohort 1 comprised 90% of the 462 eligible WCBs and 239 other tradesmen; there were 31 exclusions. At follow up 139 of 146 men still in the shipyard and 43% of those who had left were reassessed. The lapses were mainly due to migration. All members of cohort 2 were followed up for respiratory symptoms (from MRC questionnaire), were recorded, and indices reflecting all aspects of lung function were measured. RESULTS: At the initial assessment and independent of smoking, trade as a WCB was associated with increased prevalences of chronic cough, phlegm, and wheeze, a reduced transfer factor, and an enhanced age related deterioration in peak expiratory flow (measured cross sectionally). Continued work as a WCB was associated with enhanced deterioration in lung function despite some amelioration of respiratory symptoms; the deterioration was influenced by whether or not exhaust ventilation had been used for every weld. The effects of fume on forced expiratory volume, flow-volume curvilinearity, mean transit time, and moment ratio were independent of and at least as large as those due to smoking. Enhanced deterioration in peak expiratory flow was confined to WCBs who smoked. These effects of trade, but not those of smoking, were nearly independent of atopy. CONCLUSION: In WCBs the working practices over the period of the study did not prevent the development of mild respiratory impairment. In WCBs who used exhaust ventilation at all times, the impairment seemed to reverse by discontinuation of exposure. Thus existing hygiene measures should be applied rigorously. The biological effectiveness of these and any other necessary supplementary measures should be assessed by long term monitoring of forced expiratory volume and peak expiratory flow.

A study of pattern of body mass index (BMI) and prevalence of obesity in a Saudi population.

The present study was conducted to assess the pattern of body mass index (BMI) prevalence of obesity, and the association between obesity and other health-related problems in a Saudi population. The study was conducted in Queza district of Jeddah, Saudi Arabia. A systematic random sample of Saudi nationals aged 16 years and above were selected (total number 1037; 611 males and 426 females). The study population was clinically examined and a specially-designed questionnaire was administered to obtain the information. Anthropometric measurements, blood pressure and urine analysis were carried out. The collected data were analyzed using simple as well as multivariate statistical methods. It was observed that BMI significantly increased with age. The crude mean BMI was significantly greater in females compared to males. Prevalence of Grade I obesity among different age groups in males ranged from 15.7% to 43.0%, while in females the range was from 22.8% to 45.7%. Similar patterns for both genders were found for Grade II obesity (5.2%-18.9%; and 11.1%-47.8% respectively). Obesity was significantly associated with an increase in both systolic and diastolic blood pressure, where increase in BMI by one unit increased systolic blood pressure by 0.617 mm Hg, and diastolic blood pressure by 0.484 mm Hg. This relationship held true even after allowing for other confounding factors. The present study concluded that obesity is a problem prevalent in the community of Queza district. It is recommended that health education programs be implemented through primary health care services in the community to prevent this problem.

Flow volume curves as screening tests for early effects of smoking in asymptomatic children and young adults.

The objectives of this study were to investigate the early effects of smoking on ventilation function of the lungs of children and young adults, and to determine the suitable lung function tests that can be used for screening of this effect. Medical and personal questionnaires, spirometric tests for twelve different lung function indices as well as anthropometric measurements were conducted on 538 randomly selected asymptomatic subjects (134 smokers, 404 non-smokers). Smokers had significantly lower values for peripheral airway lung function tests compared to non-smokers and this is evident within a few years of initiating smoking. The number of cigarettes smoked per day was also significantly associated with decrease to these lung function parameters. Lung function tests suitable for screening were identified. The number of cigarettes and duration of smoking seem to interact to increase the insult on the peripheral airway function in children and young adults suggesting an irritant effect, probably mediated through an airway inflammation which starts at the periphery of the lungs. Lung function tests used here can be the early indicators of early changes in asymptomatic children and young adults and can be a valuable screening tool.

Factors affecting the use and attitude towards medical resources and educational methods in a Saudi medical school.

Medical colleges are using various teaching methods and educational resources in education. In order to explore the attitude of medical students towards these educational methods and resources and the factors playing a major role in their use in a medical school in an Arabic culture, a self answered questionnaire was directed to 283 medical students in their clinical years. Questions on the possible factors which affect the attendance and the use of these education resources were also included. Traditional methods of teaching, lectures, and clinical rounds were found to be the backbone of the educational process in this college. Attendance to lectures was related to both quality of subjects and to the lecturer, emphasizing the importance of a good lecture and lecturer. Clinical bedside teaching was found to be a popular and effective way of teaching medical knowledge, skill, and patient interactions to medical students. The library in this college was the least used resource and student appreciation of its importance was very low. General recommendations are to reduce dependence on lectures gradually in clinical years and to introduce new methods of clinical teaching.

Epidemiological study of patients with acute asthma attending accident and emergency department.

A study of episodes of asthma was conducted in patients attending the Accident and Emergency (A&E) Department of King Abdulaziz University Hospital (KAUH) from August 1989 to July 1990. The total number of cases reporting to the A&E Department during this period was 89,178; of which 5,101 presented with episodes of asthma. The estimated prevalence of asthma was calculated to be 5.72% in relation to all other diseases reported to the A&E Department during this period; asthma was found more frequently among boys. A majority of patients with acute asthma attended the A&E Department during late afternoon and a night. Repeated episodes of asthma increased proportionately with age, and were more severe in males compared to females. A significant seasonal trend was noted, with two peaks noted during December and May. Hospital admissions for patients experiencing acute asthma was approximately 1.5% of all reported asthma episodes. No deaths were reported during the study period.

Factors affecting the duration of breastfeeding in a rural population of Saudi Arabia.

A study was conducted to demonstrate factors influencing duration of breastfeeding in Al-Jamoom Western region of Saudi Arabia. Information was obtained on 476 children under the age of three years and their mothers in nine of the villages in this area. A predesigned questionnaire was administered to the mothers to obtain information on age, education, fertility parameters and antenatal care during pregnancy with the index children. Multiple regression analysis was used to analyze the effect of different biological and environmental factors on the duration of breastfeeding. The data showed that over 57% of the mothers breastfed their children for more than a year, and the mean duration of breastfeeding was 14.61 +/- 3.53 months. A considerable proportion of the mothers (42.3%) stopped breastfeeding during the first year. The most common reason for terminating breastfeeding during the first year was insufficient milk (30.9%), and recurrence of pregnancy (27.3%). A minority of the mothers (6.5%) were given advice about breastfeeding by health care professionals (physicians and nurses). Other factors such as the age of the mother, age of the infant when a supplement diet was first introduced, birth order of the child and attendance in an antenatal care clinic had a significant effect on the duration of breastfeeding. It is therefore recommended that Maternal and Child Health services must be strongly reinforced in the Primary Health Care Centers of the Ministry of Health and other health care providers.

Indirect estimation of maximal oxygen uptake for study of working populations.

A total of 345 shipyard workers (aged 23 to 47) volunteered to perform progressive exercise on a cycle ergometer (15 W/min increments) up to the symptom limited maximum. The results were used to obtain maximal oxygen uptake (nO2 max), the oxygen uptake at a respiratory exchange ratio of unity (nO2 at R1.0), and cardiac frequency at an oxygen uptake of 45 mmol/min (fC45). In this group 156 men (45% of initial population) attained nO2 max as defined, 108 (31%) withdrew or did not exercise maximally, and 49 (14%) had transient electrocardiographic abnormalities. For the 156 men extrapolation of the relation of cardiac frequency on oxygen uptake to the predicted maximal cardiac frequency resulted in overestimation of nO2 max by 9.6%. nO2 Max per kg body mass was negatively correlated with body mass. nO2 Max (mean value 130.6 mmol/min) was described in terms of age, fat free mass, smoking (yes or no), and level of habitual activity (rated 1 to 4): the standard error of the estimate (SEE) was 17.3 mmol/min (R2 0.42); the equation was suitable for reference values. For estimating the nO2 max of individual men an empirical relation based on nO2 at R1.0, fC45, fat free mass, and % body fat had an SEE of 12.1 mmol/min (R2 0.67). Seventy six per cent of men (88% of those who exercised) attained nO2 at R1.0 (oxygen uptake approximately 73% of maximum). Thus the nO2 max could be estimated in a higher proportion of men than could achieve nO2 max. The estimate is appropriate for assessing exercise capacity in relation to employment.(ABSTRACT TRUNCATED AT 250 WORDS)