Prevalence and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates

BACKGROUND: Our objective was to determine the prevalence, sociodemographics, and impact of premenstrual syndrome in adolescent schoolgirls in the United Arab Emirates, as there are no national data on this subject. METHODS: Adolescent girls aged 12-18 years who were at least 1 year postmenarchal were selected from five private and five public schools (n=70 x 10 = 700) in Al-Ain city using a multistage stratified cluster-sampling technique. Subjects were interviewed about cyclic and recurrent behavioral and somatic premenstrual symptoms during the last 3 months based on the American College of Obstetricians and Gynecologists' criteria and their impact on quality of life using a structured and validated questionnaire. RESULTS: The prevalence of premenstrual syndrome was 16.4% (n=115). On logistic regression analysis, premenstrual syndrome was significantly associated with Emirati nationality (p=0.001), presence of the condition in sister(s) (p=0.002), and dysmenorrhea (p<0.001). Only 52 affected subjects (45.2%) were currently taking treatment for premenstrual syndrome and the majority (60%) used pharmacological therapy. Premenstrual syndrome had a moderate but significant negative impact (p<0.001) on the quality of life of affected girls, particularly school performance, social interactions, lifestyle, and emotional well-being. Difficulty in performing school functions and decrease in stigma were the two most adversely affected parameters. CONCLUSION: Premenstrual syndrome is a prevalent, yet undertreated, disorder in adolescent schoolgirls in the United Arab Emirates, which adversely affects their emotional well-being and educational performance, representing a significant public health problem. Premenstrual syndrome is significantly associated with ethnicity, family history, and dysmenorrhea in this group.     

Advancing the pharmacy practice research agenda: views and experiences of pharmacists in Qatar

Background There is little emphasis on pharmacy practice research in Qatar, with a lack of relevant education and training and a notable lack of exposure to processes of research. Objective To describe views and attitudes of pharmacists in Qatar to pharmacy practice research prior to and following a 2 day introductory research workshop. Method All pharmacists (n = 350) were invited to express interest in attending. All participants were required to complete a questionnaire covering views and attitudes relating to research. Workshop sessions were on: research questions; critically appraising literature; developing research methods; collecting and analysing data; and disseminating findings. Participants completed a post-course evaluation questionnaire. Results Of the ninety expressing interest, 47 were selected and participated in the first training day, with 40 of these also attending the second day. Participants expressed positive views and attitudes towards research. Most (46/47) strongly agreed/agreed that it was their professional duty to be involved; all strongly agreed/agreed with importance of an evidence base to support practice; but there were issues around time, support and training. The research workshops were positively evaluated by participants. Conclusion Findings indicate pharmacists’ willingness to participate in research training in Qatar. However, there is a need to ensure that views and attitudes translate into research participation thus enhancing the evidence base.     

Indications for cerebrospinal fluid drainage and avoidance of complications

An understanding of normal CSF physiology is a prerequisite to treating problems such as CSF fistulae and pseudomeningoceles. CSF diversion techniques fall into two categories, external and internal.External lumbar drainage is useful when temporary CSF diversion is necessary (eg, in cases necessitating manipulation and retraction of the brain to gain access to deep lesions) and in treating otorrhea or rhinorrhea following traumatic or iatrogenic insults to the cranial base.Drawbacks include insertion discomfort and limited duration of therapy.LP and VP shunts came into widespread use in the 1970s, and both systems share risks of bowel perforation, obstruction, over drainage and wound-related complications. In addition, VP shunts add the risks of intracerebral hematoma and ventriculitis. New valve technology has made it possible to alter the volume drained, thus alleviating problems of over-and under drainage.     

Women's attitudes towards psychosocial support in labour in United Arab Emirates

Objective. The objective of this study was to determine women's attitudes and preferences regarding psychosocial support during childbirth in United Arab Emirates (UAE). Methods. A consecutive sample of 400 mothers with singleton normal pregnancies delivered vaginally during 2 months was interviewed postpartum about their experience and satisfaction with supportive care during labour using structured questionnaire. Results. Birth attendant continuously accompanied 237 (59.3%) participants including mother (59.5%), sister (31.2%), friend (7.2%), other family member (1.3%) or husband (0.8%). Preference in the no-companion group (n=163, 40.7%) was health professional (56.4%), mother (25.8%), sister (16.6%) or husband (1.2%). Labour was significantly shorter (P<0.0001) with less need for analgesia (P<0.0001), oxytocin augmentation (P<0.0001) and neonatal intensive care (P=0.03) in the companion group. Rates of instrumental delivery, episiotomy and perineal tear were similar in both groups. Three hundred and fifty (87.5%) subjects felt that psychosocial support during childbirth is essential and best provided by non-professional attendant (companion group) or midwife/obstetrician (no-companion group). 59.3% and 19.7% of mothers, respectively, reported less satisfaction and negative feelings about their perinatal experience that was more frequent in the no-companion group (P=0.001, P<0.0001; respectively). Conclusion. Perceptions, experiences and outcomes of companion support during childbirth in UAE, although relatively less available, are therefore not different from those described elsewhere.     

Satisfactory radioiodination of rabbit fibrinogen using chloramine-T.

A method for radioiodination of fibrinogen using chloramine-T is described. Samples of greater than 90 per cent clottable counts were obtained. Electrophoretic mobility and immunodiffusion showed that the entire radioactivity was present in the fibrinogen band. In vivo studies on the turnover of this labeled product in rabbits showed a half-life of 52.8 to 61.7 hours in two batches of animals. The results compare very well with the reported results obtained from fibrinogen labeled with radioactive iodine by the iodine-monochloride method. The advantages of the new method are indicated.     

Illicit Drug Users in the Tanzanian Hinterland: Population Size Estimation Through Key Informant-Driven Hot Spot Mapping

We mapped hot spots and estimated the numbers of people who use drugs (PWUD) and who inject drugs (PWID) in 12 regions of Tanzania. Primary (ie, current and past PWUD) and secondary (eg, police, service providers) key informants identified potential hot spots, which we visited to verify and count the number of PWUD and PWID present. Adjustments to counts and extrapolation to regional estimates were done by local experts through iterative rounds of discussion. Drug use, specifically cocaine and heroin, occurred in all regions. Tanga had the largest numbers of PWUD and PWID (5190 and 540, respectively), followed by Mwanza (3300 and 300, respectively). Findings highlight the need to strengthen awareness of drug use and develop prevention and harm reduction programs with broader reach in Tanzania. This exercise provides a foundation for understanding the extent and locations of drug use, a baseline for future size estimations, and a sampling frame for future research.     

Neutralization of multiple staphylococcal superantigens by a single-chain protein consisting of affinity-matured, variable domain repeats

Staphylococcus aureus secretes various toxins that act as superantigens by stimulating a large fraction of the host's T cells. Toxin binding to variable domains of T cell receptor beta chains (Vbeta) leads to massive release of inflammatory molecules and potentially to toxic shock syndrome (TSS). Previously, we generated soluble forms of different Vbeta domains with a high affinity for binding superantigens. However, a broader spectrum antagonist is required for the neutralization of multiple toxins. In the present study, we expressed Vbeta domains in tandem as a single-chain protein and neutralized the clinically important superantigens staphylococcal enterotoxin B and TSS toxin-1 with a single agent.     

Die mechanische Kreislaufunterstützung in der Herzinsuffizienz

Background

After exhaustion of all conservative measures in the treatment of acute and chronic heart insufficiency, there is the possibility to temporarily or permanently support or replace the pump performance of the heart by mechanical circulatory support (MCS) systems.

Objective

Presentation of the most important cardiac support systems for intensive care medicine, their indications and important risk factors.

Material and methods

Critical review of device manufacturer’s specifications, current research and expert opinions.

Results

The spectrum of available MCS procedures include mechanical chest compression devices, catheter-based micropumps and complete artificial hearts. Device selection depends on the severity of heart failure (monoventricular or biventricular pump failure), the expected duration of treatment and the degree of lung function impairment. The decision between minimally invasive and open surgical procedures depends on the options established at the specific healthcare institution and whether the heart function is to be temporarily or permanently replaced. Compliance with the anticoagulation regimens defined by the manufacturer is especially important as they differ vastly between devices and are critical to avoid bleeding or thromboembolic complications.

Conclusion

Due to the increasing number of patients on long-term mechanical circulatory support, the chances are that physicians in the initial emergency admission are unfamiliar with these devices but need to operate them in emergency cases. Therefore, knowledge of these procedures and their complications becomes increasingly important.