Biologic risk factors for low birthweight in Al Ain,United Arab Emirates

A prospective study of biological factors for low birthweight (LBW) among UAE nationals in the Al Ain Medical District was undertaken from 15 January 1992 to 14 January 1993, using a case control method. All 293 mothers of LBW infants and an equal number of mothers of the next normal weight infants born after the LBW infant were studied. Of the 3,485 live births, 293 (8.4%) were LBW (less than 2,500 g). Maternal age less than 25 years, lighter weight at booking, nulliparity, first cousin marriage and short interpregnancy interval (IPI) of 3 months or less significantly increased the risk of LBW in this population. After adjusting for other biologic confounders, only low maternal weight and short IPI significantly increased the risk of LBW. Modification of these biologic risk factors would help to reduce the incidence of LBW among the UAE population. © 1996 Wiley-Liss, Inc.     

Unique demographic situation in the United Arab Emirates

A method which optimizes on global properties of sample recordings is proposed for the definition of and the discrimination between electroencephalogram (EEG) classes. The sample was drawn from students at the University of Heidelberg from 1974 to 1978 and consists of 15 healthy index cases clinically ascertained as belonging to the low voltage EEG group. In addition, the three clinically defined groups: diffuse β (18 index cases), borderline α (12 index cases) and monomorphous α (18 index cases) have been included in the study, as well as the first degree relatives of the index cases, thus providing a clinical classification into four groups. The proposed method provides an automatic and reliable classification algorithm using discriminant and cluster analysis. The relation between such an automatized classification and clinical classification schemes is investigated. In particular, the inheritance of the low voltage, EEG, the question on sex differences and the question of a simple Mendelian mechanism had been examined. The method of random splittings had been applied for discriminant and cluster analysis. Our findings can be summarized as follows: (1) except for the monomorphous α EEG group, the clinical classification shows rather marginal separation (discriminating performance 60% to 75%), while a new and more reliable grouping scheme improves the discriminating performance up to 87% to 91%. The latter scheme leads to the concept of personal channel pattern (PCP) and was compared to the clinical classification scheme by means of contingency tables; (2) only a weak correlation between the clinically and PCP-based groups could be found (Cramér Index: 0.27). Accordingly, we continued to investigate the extent to which the proposed EEG classification scheme can nevertheless explain the genetic mechanisms apparently involved in the low voltage EEG. We thus considered the role of sex differences manifest in our proposed new grouping scheme; (3) males occurred more frequently in the new group 3 and females more frequently in the new group 1. In this regard, a much better correlation of the new groups between mothers and children than between fathers and children was observed; and (4) with help of our new PCP scheme, we have been able to reproduce a simple two gene Mendelian scheme to explain inheritance of the clinical low voltage EEG group. In this PCP-based scheme, the low voltage property does not occur when dominance of a certain gene (called gene A) is absent. © 1996 Wiley-Liss, Inc.     

Gynaecological laparoscopy courses in the United Arab Emirates

Background

Laparoscopic surgery is important for gynaecological practice and became the method of choice for many gynaecological procedures having advantages over open surgery.

Objectives

To report our modified teaching methods, and evaluation of the gynaecological laparoscopy courses in United Arab Emirates.

Methods

Fifty five participants attended four 3-full day comprehensive hands-on gynaecological laparoscopic skills courses. Non-expensive dry/wet models have been developed for teaching. All participants were evaluated at the end of the course through MCQs and practical laparoscopic exercises. All participants filled out a questionnaire reflecting their opinion on various aspects of the course at its completion. Ethical approval has been received by Research and Ethics Committee of Al-Ain Medical District, Al-Ain, UAE.

Results

Fourteen participants had no laparoscopic experience, 35 had experience at level I and six had experience at level II. There was a statistically significant difference of the MCQ mark between the three levels of experience (p = 0.05, Kruskal Wallis test) but not for the practical part, p = 0.9, Kruskal Wallis test). The courses were highly valued having an overall average rating of 3.8 out of 4.

Conclusion

A multimodality non expensive course for teaching gynaecological laparoscopy was highly successful in United Arab Emirates. Models used may be useful for training gynaecological laparoscopy in developing countries. The long term effects of our courses on clinical practice have yet to be evaluated.     

NDM-2 carbapenemase-producing Acinetobacter baumannii in the United Arab Emirates

Screening 155 carbapenem non-susceptible Acinetobacter baumannii strains recovered in Abu Dhabi hospitals identified two metallo-ß-lactamase bla_NDM gene-carrying isolates. They were isolated 4 months apart from the urine of a cancer patient previously treated in Egypt, Lebanon and in the United Arab Emirates. They were clonally related and carried the bla_NDM-2 gene recently identified in A. baumannii in Egypt and Israel. Sequences surrounding the bla_NDM-2 gene showed significant similarities with those associated with bla_NDM-1 in Enterobacteriaceae and A. baumannii. Repeated isolation of bla_NDM-2-positive A. baumannii in the Middle East raises the possibility of the local emergence and spread of a unique clone.     

Detection and genotyping of GBV-C virus in the United Arab Emirates

GB virus-C/Hepatitis G virus (GBV-C/HGV), collectively known as GBV-C, is spread widely and has been reported to be associated with non A-E hepatitis. The aim of the current project was to determine the rate of infection and genotypic characteristics of GBV-C in the United Arab Emirates (UAE). A total of 379 plasma/serum samples representing different populations in the UAE and comprising healthy as well as patients positive for HBV and HCV were screened using RT-PCR/nested PCR of the 5'-untranslated region (UTR). National subjects (n=168) and non-nationals residing in the UAE (n=211) were tested. The results obtained showed that the rate of GBV-C infection in healthy nationals, and those positive for HCV or HBV were 11.1%, 14.3%, and 5.7%, respectively, compared to 8.3%, 33.3%, and 8.6%, respectively, in non-nationals. No statistically significant correlation between infection with GBV-C and HCV or HBV (P>0.05) was found. Sequence analysis of the 5'-UTR using 37 and 46 clones from 8 and 6 healthy nationals and non-nationals, respectively, revealed the prevalence of the European/North American genotype 2 when compared to the five reference genotypes in GenBank.     

VIM-4 carbapenemase-producing Enterobacter cloacae in the United Arab Emirates

Screening 34 carbapenem non-susceptible Enterobacteriaceae recovered in Abu Dhabi hospitals identified an Enterobacter cloacae strain carrying bla_VIM-4, bla_CMY-4 and bla_CTX-M-15. It was isolated from the urine of an Egyptian patient repeatedly hospitalized and treated with broad-spectrum antibiotics, including carbapenems, in the United Arab Emirates. The blaVIM-4 coding class 1 integron, highly similar to In416, was carried on a 175-kilobase non-conjugative incA/C type plasmid also hybridizing with the bla_CMY-4 probe. This is the first detailed report on the isolation of a Verona integron-encoded metallo-β -lactamase (VIM) -producing enteric bacterium in the Arabian Peninsula with characteristics suggestive of spreading from the Mediterranean region.     

Prevalence of overweight among adolescent females in the United Arab Emirates

The purpose of the study was to investigate the prevalence of overweight in adolescent females in the United Arab Emirates (UAE). A total of 898 females, ages 11–18 years, were recruited from five of the seven Emirates with the highest resident Emirati population. Height, weight, triceps skinfold thickness (TSF), and mid‐upper‐arm circumference were measured in each subject. Reference data from the National Health and Nutrition Examination Surveys (NHANES) were used for comparison. At risk for overweight or overweight were defined as a body mass index (BMI, kg/m²) ≥85–95th percentile and ≥95th percentile, respectively. Mean values for BMI and TSF at all ages were higher than the 50th percentile (median) of the NHANES reference data. Using the BMI classification, 14% and 9% of all subjects were classified as at risk for overweight or overweight, respectively. The proportion of subjects at risk for overweight ranged between 7–19% and the prevalence of overweight ranged between 6–15%. The proportion of subjects with a BMI ≥85 percentile ranged from 15% at age 17 years to 33% at age 11 years. Furthermore, 27% and 28% of subjects ages 11 and 12 years, respectively, were above the TSF 90th percentile. These two age groups also showed a high prevalence of overweight using the BMI classification. In conclusion, the findings from our study suggest that a high proportion of adolescent females in the UAE are overweight or at risk for overweight. The consequences of this are a serious concern for public health and need to be addressed. Am. J. Hum. Biol. 15:758–764, 2003. © 2003 Wiley‐Liss, Inc.     

Prevalence of obesity among school children in the United Arab Emirates

The objective of this study was to investigate the prevalence of obesity among schoolchildren in the United Arab Emirates, using the body mass index (BMI) as the indicator. The sample included 1,787 males and 2,288 females 6–16 years. Physicians and trained nurses measured height and weight, and the BMI (kg/m²) was calculated. The 50^th centile of the BMI was not different from that for the US. Similarly, the height and weight of UAE children approximate the US reference data. About 8% of UAE boys and girls have BMI's ≥95^th percentile of US reference values. Using the 85^th percentile as the criterion, 16.5% and 16.9% of males and females, respectively, are classified as overweight. This composite figure does not differ from the expected 15% based on reference data. The data thus indicate that high levels of obesity are present among UAE children and adolescents. These findings have public health implications for this generation of UAE youth during their adult years, including heart disease and diabetes, because the rate of morbid obesity is approximately twice that expected in reference data. Am. J. Hum. Biol. 12:498–502, 2000. © 2000 Wiley-Liss, Inc.     

Psychosocial and vascular risk factors of depression in later life

BACKGROUND: Research on the aetiology of late-life depression has typically focused on either risk factors from the psychosocial stress-vulnerability domain or degenerative biological changes (for instance, vascular disease). We examined whether vascular risk factors could be interpreted within the stress-vulnerability model of depression. METHODS: The data came from a case-control design, nested in a community survey of elderly people. We compared 83 persons with a recently started episode of major or minor depression with 83 controls, with respect to the occurrence of stressful life events, long-term difficulties, neuroticism, and vascular risk factors (hypertension, heart disease, stroke). RESULTS: The (non-significant) association of vascular risk factors and onset of depressive episodes was not modified by neuroticism or the presence of long-term difficulties. Quite unexpectedly, vascular risk factors seemed to neutralize the depressogenic effect of stressful life events. The effect of vascular risk was significantly stronger in depressive episodes not preceded by a life event than in onsets following an event. CONCLUSIONS: Vascular risk factors cannot be interpreted within the stress-vulnerability model, but represent another pathway to depression. Why vascular risk factors reduce the depressogenic effect of stressful life events is not clear. Replication is critical to exclude the possibility of a chance finding.     

Cognitive vulnerability to depression: An exploration of dysfunctional attitudes and ruminative response styles in the United Arab Emirates

Background. There has been little exploration of Beck's cognitive theory of depression and Nolen‐Hoeksem's response styles theory within Arab populations. Objectives. The study investigates the generalizability of these clinically influential models to Emirati citizens residing within United Arab Emirates (UAE). Method. An opportunity sample of 450 undergraduate participants was assessed for dysfunctional attitudes using an Arabic/English 40‐item version of Weissman and Beck's Dysfunctional Attitudes Scale (DAS). Participants also completed Arabic/English versions of Nolen‐Hoeksema's ruminative response styles (RRS) scale and the Beck Depression Inventory–II (BDI‐II). Results. Correlation and regression analyses showed depression to be associated with both RRS and dysfunctional attitudes. Conclusion. The study supports the generalization of these clinically influential theories of depression within a UAE context.     

Molecular and clinical analysis of Ellis-van Creveld syndrome in the United Arab Emirates

Background  

Ellis-van Creveld (EvC) syndrome is an autosomal recessive chondrodysplastic condition with clinical manifestations that include short-limbs and ribs, postaxial polydactyly and dysplastic nails and teeth. In about two thirds of patients, mutations in either EVC or EVC2 genes have been found to be the underlying cause.     

老年前期抑郁症患者心理社会因素及其临床特点分析

采用世界卫生组织抑郁障碍标准化评定表格 WHO/SADD,及 Hamilton 抑郁量表,对30例(50—60岁)老年前期抑郁症患者。及30例50岁以下抑郁症患者进行对照研究。结果提示前者在负性生活事件、躯体疾病及躯体化症状,焦虑情绪及疑病倾向等方面,明显多于后者,有显著性异差,而两者之抑郁症的核心症状无明显差异。     

Childhood obesity in United Arab Emirates schoolchildren: A national study

Objective: The study assessed the national prevalence of obesity among schoolchildren in the United Arab Emirates (UAE). Subjects: A stratified 10% random sample of 16?391 children was drawn from 145?492 pupils in the UAE. Methods: Height and weight were measured by physicians and trained nurses, and the body mass index (BMI; weight (kg)/height (m)²) was computed. BMIs for UAE were compared to recently published international standards. Results: Comparison of BMIs to international reference data revealed that UAE children are at increased risk for overweight (>25?kg?m^?2 and ≤30?kg?m^?2) and obesity (≥30?kg?m^?2). For example, 10-year-old male UAE children had 1.7 times the rate of overweight compared to international standards and 1.9 times at 18 years. Similarly, female UAE children have 1.8 times the rate of overweight compared to international standards at 10 and 18 years of age. Obesity was 2.3-fold higher among UAE males at 14 years compared to international standards, and increased to 3.6 times at 18 years of age. Among UAE female children, obesity was same as males at 14 years, 2.3 times than the international standards. At 18 years of age, UAE female obesity was 1.9-fold higher than the international standard, nearly one-half the rate of obesity among UAE males at the same age. Conclusion: The frequency of obesity among UAE youth is two to three times greater than the recently published international standard. Profound public health implications of childhood obesity for UAE children and young adults are seriously increased because of adult chronic disease processes (e.g. cardiovascular disease, diabetes) normally attendant to increased obesity rates.     

Childhood obesity in United Arab Emirates schoolchildren: a national study

OBJECTIVE: The study assessed the national prevalence of obesity among schoolchildren in the United Arab Emirates (UAE). SUBJECTS: A stratified 10% random sample of 16,391 children was drawn from 145,492 pupils in the UAE. METHODS: Height and weight were measured by physicians and trained nurses, and the body mass index (BMI; weight (kg)/height (m)2) was computed. BMIs for UAE were compared to recently published international standards. RESULTS: Comparison of BMIs to international reference data revealed that UAE children are at increased risk for overweight (>25 kg m-2 and =30 kg m-2) and obesity (=30 kg m-2). For example, 10-year-old male UAE children had 1.7 times the rate of overweight compared to international standards and 1.9 times at 18 years. Similarly, female UAE children have 1.8 times the rate of overweight compared to international standards at 10 and 18 years of age. Obesity was 2.3-fold higher among UAE males at 14 years compared to international standards, and increased to 3.6 times at 18 years of age. Among UAE female children, obesity was same as males at 14 years, 2.3 times than the international standards. At 18 years of age, UAE female obesity was 1.9-fold higher than the international standard, nearly one-half the rate of obesity among UAE males at the same age. CONCLUSION: The frequency of obesity among UAE youth is two to three times greater than the recently published international standard. Profound public health implications of childhood obesity for UAE children and young adults are seriously increased because of adult chronic disease processes (e.g. cardiovascular disease, diabetes) normally attendant to increased obesity rates.     

Carbapenem-resistant and OXA-23-producing Acinetobacter baumannii isolates in the United Arab Emirates

Five carbapenem-resistant Acinetobacter baumannii isolates, collected from the United Arab Emirates in 2006, were investigated to identify the mechanism(s) responsible for carbapenem resistance. Genotyping was performed by pulsed-field gel electrophoresis, and the location of the bla _OXA-23 gene was determined by using the endonuclease I Ceu I technique and mating-out assays. The four isolates in which the bla _OXA-23 gene was located on the chromosome within a Tn 2006 composite transposon were clonally related. The single non-clonally related isolate harboured the bla _OXA-23 gene on a 70-kb transferable plasmid. This study reports on the dissemination of OXA-23-producing A. baumannii isolates in the Middle East.     

The age and symptomatology of natural menopause among United Arab Emirates women

Objectives: To determine the median age of natural menopause in United Arab Emirates women, the factors affecting that age and the prevalence of climacteric symptoms amongst those women. Methods: A population-based survey was conducted on a community sample of United Arab Emirates women who had had natural menopause defined as cessation of menstruation for at least 6 months at the end of reproductive years. A total of 742 women aged 40 years and above were recruited from both urban and rural areas of the country using the multi-stage stratified cluster sampling technique. Data were collected using a structured questionnaire and face to face interviews and included a number of familial, reproductive and life-style variables. Results: The median age of the menopause in the United Arab Emirates is 48 years (mean=47.3±3.29, range 40–59). This is significantly lower than the median age reported from the West (50.3 years). The subject median age of the menopause was significantly related to that of the mother (P<0.001), older sister (P<0.001), parity (P<0.0001) and the previous use of oral contraceptive pills for more than 1 year (P<0.001). Hot flushes were the commonest feature of the menopause occurring in 45% of women. Conclusion: The age of natural menopause in United Arab Emirates women, as in other developing countries, is less than in Western women and may be influenced by genetic factors, parity and previous use of oral contraceptives. Climacteric symptomatology, however, is similar in the different patient groups.     

HLA class I allele lineages and haplotype frequencies in Arabs of the United Arab Emirates

The high degree of polymorphism of the HLA system provides suitable genetic markers to study the diversity and migration of different world populations and is beneficial for forensic identification, anthropology, transplantation and disease associations. Although the United Arab Emirates (UAE) population of about nine million people is heterogeneous, information is limited for the HLA class I allele and haplotype frequencies of the Bedouin ethnic group. We performed low‐resolution PCR‐SSP genotyping of three HLA class I loci at HLA‐A, ‐B and ‐C for 95 unrelated healthy Bedouins from the cities of Al Ain and Abu Dhabi in the UAE. A total of 54 HLA allele lineages were detected; the most frequent low‐resolution allele lineages at each HLA locus were A*02 (0.268), B*51 (0.163) and C*07 (0.216). The inferred estimates for the two most frequent HLA‐A and HLA‐B haplotypes were HLA‐A*02 ~ HLA‐B*50 (0.070) and HLA‐A*02 ~ HLA‐B*51 (0.051), and the most frequent 3‐locus haplotype was HLA‐A*02 ~ HLA‐B*50 ~ HLA‐C*06 (0.068). The HLA allele lineage frequencies of the UAE Arabs were compared to those previously reported for 70 other world populations, and a strong genetic similarity was detected between the UAE Arabs and the Saudi Arabians from the west with evidence of a limited gene flow between the UAE Arabs and Pakistani across the Gulf from the east, and the UAE Arabs and Omani from the south of the Gulf Peninsula.