95 research outputs found
Respiratory Disease and Infection
No full textMedicine is an ever-changing science. Every day we are encountered with the new developments and knowledge in the pathogenesis, mechanism of disease, newer diagnostic modalities, treatment options and new challenges in the management of the various diseases. The same holds true for respiratory diseases with the emergence of new respiratory pathogens having significant impact on the respiratory system. Respiratory Diseases are an important contributor to the morbidity and mortality of mankind since antiquity and its prevalence is on rise in with new disease are being recognized, however little importance has been given to the respiratory disease due to low level of awareness in physicians and general public. This book has been designed to deliver the detailed knowledge about the various respiratory infections including viral, bacterial, and helminthic infections
Respiratory Disease and Infection
No full textMedicine is an ever-changing science. Every day we are encountered with the new developments and knowledge in the pathogenesis, mechanism of disease, newer diagnostic modalities, treatment options and new challenges in the management of the various diseases. The same holds true for respiratory diseases with the emergence of new respiratory pathogens having significant impact on the respiratory system. Respiratory Diseases are an important contributor to the morbidity and mortality of mankind since antiquity and its prevalence is on rise in with new disease are being recognized, however little importance has been given to the respiratory disease due to low level of awareness in physicians and general public. This book has been designed to deliver the detailed knowledge about the various respiratory infections including viral, bacterial, and helminthic infections
Tuberculosis
No full textData are rapidly accumulating from all over the world regarding the efficacy of standardized treatment regimens for drug-sensitive, drug-resistant TB and latent TB infection. While we are facing the menace of multi drug-resistant TB [MDR-TB], extensively drug-resistant tuberculosis [XDR TB] has emerged threatening to undermine global efforts at TB control. Hence we have included chapters to cover all aspects of the diagnosis and management of MDR TB. This book will cover all these developments in great detail. With the widespread availability of internet globally various standard web resources available on TB have also been included so that the readers may get the comprehensive and updated guidelines from these resources. The changing clinical presentation of TB, advances in laboratory, imaging diagnostic modalities, therapeutic measures and emergence of MDR TB all suggest a pressing need to have a updated book on TB. Furthermore, while all physicians encounter the TB disease in their clinical practice, there have been a lot of controversies and misconceptions over various issues for the diagnosis and management of TB. Paucity of a well referenced, updated, standard book of TB has prompted us to undertake this venture sharing the clinical experience of global experts of TB. Our book contains chapters on epidemiology, immune-pathology, diagnosis, treatment and latest advances for TB, highlighting the global perspective of tuberculosis. World-wide resurgence of MDR TB indicates that the battle against this foe of mankind will continue in the coming years. TB still remains to be a research priority of paramount importance from medical, social and financial aspects and we have attempted to highlight all the aspects for the treatment of TB. We believe that this book will serve as a practical guide for the diagnosis and management of TB for practicing physicians (especially pulmonologists and internists) and all those who are involved in the management of TB
Tuberculosis
No full textData are rapidly accumulating from all over the world regarding the efficacy of standardized treatment regimens for drug-sensitive, drug-resistant TB and latent TB infection. While we are facing the menace of multi drug-resistant TB [MDR-TB], extensively drug-resistant tuberculosis [XDR TB] has emerged threatening to undermine global efforts at TB control. Hence we have included chapters to cover all aspects of the diagnosis and management of MDR TB. This book will cover all these developments in great detail. With the widespread availability of internet globally various standard web resources available on TB have also been included so that the readers may get the comprehensive and updated guidelines from these resources. The changing clinical presentation of TB, advances in laboratory, imaging diagnostic modalities, therapeutic measures and emergence of MDR TB all suggest a pressing need to have a updated book on TB. Furthermore, while all physicians encounter the TB disease in their clinical practice, there have been a lot of controversies and misconceptions over various issues for the diagnosis and management of TB. Paucity of a well referenced, updated, standard book of TB has prompted us to undertake this venture sharing the clinical experience of global experts of TB. Our book contains chapters on epidemiology, immune-pathology, diagnosis, treatment and latest advances for TB, highlighting the global perspective of tuberculosis. World-wide resurgence of MDR TB indicates that the battle against this foe of mankind will continue in the coming years. TB still remains to be a research priority of paramount importance from medical, social and financial aspects and we have attempted to highlight all the aspects for the treatment of TB. We believe that this book will serve as a practical guide for the diagnosis and management of TB for practicing physicians (especially pulmonologists and internists) and all those who are involved in the management of TB
Comorbidities associated with COPD in the Middle East and North Africa region: association with severity and exacerbations
No full textBassam Mahboub,1 Ashraf Alzaabi,2 Mohammed Nizam Iqbal,3 Hocine Salhi,4 Aïcha Lahlou,5 Luqman Tariq,6 Abdelkader El Hasnaoui6 1Department of Pulmonary Medicine and Allergy, University of Sharjah, Sharjah, 2Respirology Division, Zayed Military Hospital, Abu Dhabi, 3Department of Pulmonary Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab Emirates; 4Foxymed, Paris, France; 5MS Health, Rabat, Morocco, 6GlaxoSmithKline, Dubai, United Arab Emirates Objective: To assess the frequency of comorbidities in subjects with COPD and their association with respiratory symptom severity and COPD exacerbations.Materials and methods: This was an analysis of the BREATHE study, a cross-sectional survey of COPD conducted in the general population of eleven countries in the Middle East and North Africa, including Pakistan. The study population consisted of a sample of subjects with COPD for whom the presence of comorbidities was documented. Three questionnaires were used. The screening questionnaire identified subjects who fulfilled an epidemiological case definition of COPD and documented any potential comorbidities; the detailed COPD questionnaire collected data on respiratory symptoms, COPD exacerbations, and comorbidities associated with COPD; the COPD Assessment Test collected data on the impact of respiratory symptoms on well-being and daily life.Results: A total of 2,187 subjects were positively screened for COPD, of whom 1,392 completed the detailed COPD questionnaire. COPD subjects were more likely to report comorbidities (55.2%) than subjects without COPD (39.1%, P<0.0001), most frequently cardiovascular diseases. In subjects who screened positively for COPD, the presence of comorbidities was significantly (P=0.03) associated with a COPD Assessment Test score ≥10 and with antecedents of COPD exacerbations in the previous 6 months (P=0.03).Conclusion: Comorbidities are frequent in COPD and associated with more severe respiratory symptoms. This highlights the importance of identification and appropriate management of comorbidities in all subjects with a diagnosis of COPD. Keywords: comorbidity, COPD exacerbation, diabetes, cardiovascular disease, MENA region 
Joint statement for the diagnosis, management, and prevention of chronic obstructive pulmonary disease for Gulf Cooperation Council countries and Middle East–North Africa region, 2017
No full textBassam H Mahboub,1,2 Mayank Gian Vats,2 Ashraf Al Zaabi,3 Mohammed Nizam Iqbal,2 Tarek Safwat,4 Fatma Al-Hurish,5 Marc Miravitlles,6 Dave Singh,7 Khaled Asad,8 Salah Zeineldine,9,10 Mohamed S Al Hajjaj11College of Medicine, University of Sharjah, Sharjah, 2Department of Pulmonary Medicine, Rashid Hospital, Dubai Health Authority, Dubai, 3Department of Pulmonary Medicine, Zayed Military Hospital, Abu Dhabi, United Arab Emirates; 4Chest Department, Ain Shams University, Cairo, Egypt; 5Department of Pulmonology and Allergy, Al-Sabah Hospital, Kuwait City, Kuwait; 6Department of Pneumology, Hospital Universitari Vall d’Hebron, Barcelona, Spain; 7Centre for Respiratory Medicine and Allergy, University of Manchester, University Hospital of South Manchester, Manchester, UK; 8Pulmonary and Critical Care, Istishari Hospital, Amman, Jordan; 9Faculty of Medicine, 10Hariri School of Nursing, American University of Beirut, Beirut, Lebanon Abstract: Smoking and subsequent development of COPD is an ever-increasing epidemic in Arabian Gulf and Middle East countries, with no signs of decline. The important fact to be highlighted is that this COPD epidemic of increasing incidence and prevalence is mostly unrecognized by patients, due to the common attribution of symptoms to “smoker’s cough”, and the underdiagnosis and undertreatment by physicians because the common signs and symptoms masquerade as asthma. Consequently, there are long-term adverse effects of missing the diagnosis. The purpose of this review article is to focus upon the status of COPD in Arabian Gulf and Middle East countries, stressing the increasing burden of smoking and COPD, to emphasize the specific factors leading to rise in prevalence of COPD, to bring to light the underdiagnosis and undermanagement of COPD, and to treat COPD in conformity with standard guidelines with local and regional modifications. This review ends with suggestions and recommendations to the health department to formulate policies and to generate awareness among the general public about the side effects of smoking and consequences of COPD. Keywords: COPD, Gulf Cooperation Council countries, Middle East, prevalence of smoking, water pipe, shisha, medwakh, bakhou
Prevalence of symptoms and risk of sleep apnea in Dubai, UAE
No full textBassam Mahboub, Shahid Afzal, Hassan Alhariri, Ashraf Alzaabi, Mayank Vats, Annie SoansSleep Disorders Center, Department of Medicine, Rashid Hospital, Dubai Health Authority, Dubai, United Arab EmiratesPurpose: The United Arab Emirates (UAE) ranks 18th on the 2007 Forbes list of fattest countries with 68.3% of its citizens with an unhealthy weight and it is well known that weight gain and obesity are important determinants in the progression of obstructive sleep apnea syndrome (OSAS). The purpose of this study is to estimate the prevalence of symptoms and risk of OSAS in the primary health care setting in Dubai, and the relationship between obesity and sleep apnea.Methods: In this prospective survey, a trained medical nurse administered the Berlin Questionnaire to a consecutive random sample of patients in the age group older than 14 years, who attended the primary health care center in Dubai Health Authority, Dubai, UAE, from September 2011 to March 2012. Based on the questionnaire answers, individuals were classified into high risk and low risk groups for OSAS.Results: Based on the responses and measurement of the Berlin Questionnaire of 1214 subjects studied, 58% (n = 704) of the respondents were female, while 42% (n = 510) were male. Two-hundred-fifty-four respondents met the criteria for the high risk scoring. This gives a prevalence rate of 20.9% (out of which 22.9% of the male respondents were high risk for OSAS, while 19.5% of the females were high risk for OSAS), while the remainder of the participants were classified as low risk. The overall mean age of the high risk for OSAS female respondents was 39.95 years (standard deviation [SD] 11.73 years) and was 41.18 years (SD 14.95 years) for male respondents The highest prevalence was observed between age 51 to 60 in both genders. Seventy percent of the high risk group had a body mass index (BMI) &ge; 30 kg/m2 and nearly 75% of the low risk group had a BMI &lt; 30 kg/m2, and the mean BMI was 32.06 kg/m2 (SD 5.67 kg/m2) for males and 33.59 kg/m2 (SD 6.44 kg/m2) for females.Conclusion: In the primary health care setting, the prevalence of symptoms of OSAS among adult UAE citizens is very high, and UAE patients are at risk for OSAS and may benefit from proper evaluation for OSAS.Keywords: obstructive sleep apnea, snoring, daytime sleepiness, prevalence primary care, Berlin Questionnaire, Duba
Analysis of a posteriori error estimates of the discontinuous Galerkin method for nonlinear ordinary differential equations
No full textAbstractWe develop and analyze a new residual-based a posteriori error estimator for the discontinuous Galerkin (DG) method for nonlinear ordinary differential equations (ODEs). The a posteriori DG error estimator under investigation is computationally simple, efficient, and asymptotically exact. It is obtained by solving a local residual problem with no boundary condition on each element. We first prove that the DG solution exhibits an optimal O(hp+1) convergence rate in the L2-norm when p-degree piecewise polynomials with p≥1 are used. We further prove that the DG solution is O(h2p+1) superconvergent at the downwind points. We use these results to prove that the p-degree DG solution is O(hp+2) super close to a particular projection of the exact solution. This superconvergence result allows us to show that the true error can be divided into a significant part and a less significant part. The significant part of the discretization error for the DG solution is proportional to the (p+1)-degree right Radau polynomial and the less significant part converges at O(hp+2) rate in the L2-norm. Numerical experiments demonstrate that the theoretical rates are optimal. Based on the global superconvergent approximations, we construct asymptotically exact a posteriori error estimates and prove that they converge to the true errors in the L2-norm under mesh refinement. The order of convergence is proved to be p+2. Finally, we prove that the global effectivity index in the L2-norm converges to unity at O(h) rate. Several numerical examples are provided to illustrate the global superconvergence results and the convergence of the proposed estimator under mesh refinement. A local adaptive procedure that makes use of our local a posteriori error estimate is also presented
The role of mobile phones as a possible pathway for pathogen movement, a cross-sectional microbial analysis
No full textIntroduction
Mobile phones are used the world over, including in healthcare settings. This study aimed to investigate the viable microbial colonisation of mobile phones used by healthcare personnel.
Methods
Swabs collected on the same day from 30 mobile phones belonging to healthcare workers from three separate paediatric wards of an Australian hospital were cultured on five types of agar plate, then colonies from each phone were pooled, extracted and sequenced by shotgun metagenomics. Questionnaires completed by staff whose phones were sampled assisted in the analysis and interpretation of results.
Results and discussion
All phones sampled cultured viable bacteria. Overall, 399 bacterial operational taxonomic units were identified from 30 phones, with 1432 cumulative hits. Among these were 58 recognised human pathogenic and commensal bacteria (37 Gram-negative, 21 Gram-positive). The total number of virulence factor genes detected was 347, with 1258 cumulative hits. Antibiotic resistance genes (ARGs) were detected on all sampled phones and overall, 133 ARGs were detected with 520 cumulative hits. The most important classes of ARGs detected encoded resistance to beta-lactam, aminoglycoside and macrolide antibiotics and efflux pump mediated resistance mechanisms.
Conclusion
Mobile phones carry viable bacterial pathogens and may act as fomites by contaminating the hands of their users and indirectly providing a transmission pathway for hospital-acquired infections and dissemination of antibiotic resistance. Further research is needed, but meanwhile adding touching mobile phones to the five moments of hand hygiene is a simple infection control strategy worth considering in hospital and community settings. Additionally, the implementation of practical and effective guidelines to decontaminate mobile phone devices would likely be beneficial to the hospital population and community at large
Assessing the Impact of Storage Conditions on RNA From Human Saliva and Its Application to the Identification of mRNA Biomarkers for Asthma
No full textIntroduction: Human saliva was used to develop non-invasive liquid biopsy biomarkers to establish saliva as an alternate to blood and plasma in translational research. The present study focused on understanding the impact of sample storage conditions on the extraction of RNA from saliva and the RNA yield, to be applied in clinical diagnosis. In this study, genes related to asthma were used to test the method developed.
Methods: Salivary RNA was extracted from three subjects using the Qiazol® based method and quantified by both spectrophotometric (NanoDrop) and fluorometric (Qubit®) methods. RNA integrity was measured using a bioanalyzer. Quantitative PCR was used to monitor the impact of storage conditions on the expression of housekeeping genes: GAPDH and β-actin, and the asthma related genes: POSTN and FBN2. In addition, an independent cohort of 38 asthmatics and 10 healthy controls were used to validate the expression of POSTN and FBN2 as mRNA salivary biomarkers.
Results: Approximately 2 µg of total RNA was obtained from the saliva stored at 40°C without any preservative for 2 weeks showing consistent gene expression with RNA stored at room temperature (RT) for 48 h with RNAlater. Although saliva stored with RNAlater showed a substantial increase in the yield (110 to 234 ng/μL), a similar Cq (15.6 ± 1.4) for the 18s rRNA gene from saliva without preservative showed that the RNA was stable enough. Gene expression analysis from the degraded RNA can be performed by designing the assay using a smaller fragment size spanning a single exon as described below in the case of the POSTN and FBN2 genes in the asthma cohort.
Conclusion: This study showed that samples stored at room temperature up to a temperature of 40°C without any preservative for 2 weeks yielded relatively stable RNA. The methodology developed can be employed to transport samples from the point of collection to the laboratory, under non-stringent storage conditions enabling the execution of gene expression studies in a cost effective and efficient manner
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