Botulinum toxin injections for the treatment of neurogenic thoracic outlet syndrome: A systematic review.

Botulinum toxin (BTX) injections into the musculature surrounding the brachial plexus have been examined as a potential treatment for neurogenic thoracic outlet syndrome (nTOS). This systematic review identified 15 publications, of which one was a randomized controlled trial. BTX injections performed with ultrasound or electromyographic guidance, and with the inclusion of the pectoralis minor muscle, in addition to the anterior and/or middle scalenes, tended to provide greater symptom improvement and may predict response to first rib resection. Importantly, most studies were of low quality; thus, the results should be interpreted with caution. Further high-quality studies are needed to confirm these findings.

Factors associated with iron depletion and iron deficiency anemia among Arabic preschool children of the United Arab Emirates.

OBJECTIVE: The purpose of this study was: 1. To estimate the prevalence of iron depletion and iron deficiency anemia in preschool Arabic children of the United Arab Emirates (UAE), and 2. To determine the risk factors associated with these conditions in this population of children. METHODS: From April through to October 2000 a questionnaire and capillary blood survey was carried out in one primary health care (PHC) centre of Al Ain, UAE. Children whose capillary hemoglobin (Hb) or mean cell volume (MCV) results fell below predetermined cutoffs were offered venous blood workup. An additional sample of children with capillary blood results above those cutoffs were offered the same workup. All blood sampling was completed by May 2001. RESULTS: Five hundred and eight parents were questionnaired and 496 children capillary blood tested. Of the 320 venous blood tested, 315 were analyzed, in relation to questionnaire responses, using univariate analysis and logistic regression. Anemia, iron depletion and iron deficiency anemia were found in an estimated 36.1%, 26%, and 9.9% of this population of children. Age was a significant independent predictor of both iron depletion and iron deficiency anemia. Mother's current pregnancy was an additional predictor of iron deficiency anemia. CONCLUSION: The prevalences of iron depletion and iron deficiency anemia in this population of children were consistent with other reports from the region. Child's age and mother's current pregnancy were predictors of iron deficiency anemia. These findings have important implications for antenatal and childcare both in hospital and primary health care clinics.

A hematological survey of preschool children of the United Arab Emirates.

OBJECTIVE: Anemia is common worldwide, particularly in developing countries including states of the Arabian Peninsular. The purpose of this study was to produce a hematological profile of preschool national children of the United Arab Emirates (UAE). METHODS: From April 2000 to October 2000, a cross-sectional community clinic-based capillary blood survey was carried out on a convenience sample of 1-5-year-old Emirati children attending a Primary Health Care Center in Al-Ain, UAE. Those children with capillary hemoglobin (Hb) and mean corpuscular volume (MCV) values below predetermined cutoffs were offered venous blood hematological workup. A random sample of children with values above those cutoffs were also offered the same workup. All venous blood sampling was completed by May 2001. RESULTS: Four hundred and ninety six children were surveyed. The mean Hb and adjusted MCV rose with increasing age but were not significantly different by gender. Two hundred and sixty-two children with Hb or MCV below the cutoffs and 50 children above the cutoffs were venous blood tested. The estimated abnormalities for this population of children were as follows: anemia 36.1%; iron deficiency anemia 9.9%; glucose-6-phosphate dehydrogenase (G6PD) deficiency 9.1%; sickle cell trait 4.6%; and beta thalassemia 8.7%. There was likely to be a high prevalence of alpha thalassemia. CONCLUSION: Rates of anemia and iron deficiency anemia in this population of children were consistent with other reports from the region, but higher than in developed countries. Hereditary red cell abnormalities were common, particularly G6PD deficiency. The gene frequency of alpha thalassemia is likely to be high but requires DNA studies.

The determinants of breast cancer screening behavior: a focus group study of women in the United Arab Emirates.

PURPOSE/OBJECTIVES: To explore perceptions, knowledge, attitudes, and beliefs about breast cancer and its screening among Emirati national women in Al Ain, United Arab Emirates. DESIGN: A qualitative study using focus group methods. SETTING: Primary healthcare centers and a community-based women's association in the United Arab Emirates. SAMPLE: 41 women, aged 25-45 years. METHODS: Four 90-minute focus group discussions exploring perceptions, knowledge, attitudes, beliefs, and practices regarding breast cancer were audiotaped, transcribed, translated, and analyzed. MAIN RESEARCH VARIABLES: Social and cultural themes related to breast cancer and its screening. FINDINGS: Focus group methodology worked well in this setting. The women's perceptions, knowledge, attitudes, and beliefs regarding cancer and screening, together with aspects of the healthcare system and social milieu, appeared to strongly influence the women's preventive practices. Some of these factors had an encouraging effect on the women's practices, and others had a deterring effect. The encouraging factors included feelings of susceptibility, high levels of knowledge in some women, attitudes and beliefs about personal responsibility for health, and a supportive social milieu. Deterring factors included anxiety and fear leading to denial; lack of knowledge about cancer and the screening program; fear, embarrassment, and mistrust of health care; and belief in predestination. CONCLUSIONS: Health planners and healthcare providers must capitalize on encouraging factors and minimize deterring factors to optimize breast cancer screening practices among these women. IMPLICATIONS FOR NURSING: Identifying and accounting for the factors that encourage or deter women in their breast cancer screening practices will help to optimize screening programs.

Glycemic index of 3 varieties of dates.

OBJECTIVE: Dates are consumed worldwide and are a dietary staple for many Arabic people. The prevalence of type-2 diabetes mellitus is high in many developing communities, including many Arabic communities. The consumption of low glycemic index diets has been shown to have benefits for glycemic and lipid control. The purpose of this study was to determine and compare the glycemic indexes of 3 varieties of commercially available dates. METHODS: The available carbohydrate content of the dates was determined by standard laboratory methods. Normal volunteer subjects were fed the commercially processed khalas, barhi, and bo ma'an dates. Glycemic indexes were calculated by standard methods. Results were calculated using means and standard deviations. Glycemic responses were compared by using paired t-tests. The study was performed at the Faculty of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates, between March 2000 and August 2001. RESULTS: The mean glycemic indexes of the dates were 35.5 for khalas, 49.7 for barhi and 30.5 for bo ma'an. There was a significant difference between the results for bo ma'an and for the other 2 varieties. CONCLUSION: Dates can be classified as low glycemic index food items. There appears to be significant and unexplained differences in glycemic index between some date varieties. Nonetheless, the consumption of the 3 varieties of dates tested in this study may be of benefit in glycemic and lipid control of diabetic patients.