Biological and clinical responses of west African sheep to Crimean-Congo haemorrhagic fever virus experimental infection

Color and lightness constancy with respect to changing illumination was studied with three different perceptual tasks: ranking of colored papers according (1) to their lightness and (2) to their chromatic similarity in photopic, mesopic, and scotopic states of adaptation, and (3) recognition of remembered colored papers after changes of illumination in photopic vision. Constancy was found in the second task, only. Excitations of light receptors and luminance channels were computed to simulate the empirical rank orders. Results of the first task can be predicted with the hypothesis that luminance channels are activated, if lightness is asked for. Sequences arranged with respect to chromatic similarity were found independent of the illuminant spectra, even if the calculated rank orders of cone excitation were changed in the altered illumination.     

Clinical features of Crimean-Congo haemorrhagic fever in the United Arab Emirates

Crimean-Congo haemorrhagic fever (C-CHF) re-emerged recently in the United Arab Emirates. The clinical outcome of 11 cases of viral haemorrhagic fever patients admitted to hospital between June 1994 and January 1995 is described. Four cases were laboratory confirmed retrospectively as C-CHF, the other patients were diagnosed likely to have the same disease on epidemiological and clinical grounds. In 72.7% of the patients, infection was fatal. Symptoms started 3.5 days before hospitalization. On admission, 81.8% of patients had high fever, 45.5% were vomiting, 63.6% had diarrhoea, 45.5% had haemorrhagic signs, and 18.2% had throat pain. Fatalities occurred 6.8 days after admission. Survivors were hospitalized for 9.3 days. Nosocomial transmission was not observed.     

Outbreak of Crimean-Congo haemorrhagic fever in Quetta, Pakistan: contact tracing and risk assessment

In December 1994 in a private hospital in Quetta, Pakistan, 3 health-workers contracted Crimean-Congo haemorrhagic fever (CCHF) after surgery on a bleeding patient who later died. We conducted a retrospective study to determine transmission risks among contacts. Fifty contacts gave blood for antibody tests and answered questions about exposure. Two of four people exposed percutaneously and one of five with cutaneous exposure contracted CCHE The person with cutaneous exposure was a surgeon who tore his glove during surgery and noted blood on his hand but no cut. There were no anti-CCHF antibodies or CCHF cases among persons whose skin came into contact with body fluids other than blood (0/4), who had skin-to-skin contact (0/16) with patients or were physically close to them (0/21). Three index case relatives reported that although 10 family members had cutaneous exposure, none developed CCHF. The family refused blood tests. CCHF transmission in resource-constrained settings can be limited by focusing on avoiding health worker contact with blood.     

Adaptation of Crimean-Congo hemorrhagic fever virus to culture in Vero-E6 cells

Adaptation of the Crimean-Congo hemorrhagic fever (CCHF) virus to continuous culturing in Vero-E6 cells was studied by coculturing of infected and intact cells. Adapted strain Hoja-A exerted a complete cytocidal effect and was characterized by a high level of virus accumulation in the early period of the infection. The resultant strain survived through more than 80 passages and retained the newly acquired properties; lyophilized, it can be stored for a long time. Availability of such a strain opens new vistas in studies of the CCHF agent.     

Anti-toxoplasma antibodies in butchers and slaughtered sheep and goats in Jeddah Municipal abattoir, Saudi Arabia

Toxoplasma gondii is a zoonotic parasite of world-wide distribution. It is more or less endemic in all countries of the Middle East. In Jeddah Municipal abattoir, anti-Toxoplasma IgG was found to be 39% in sheep and 28% in goats as indicated by IHAT. On the other hand, anti-Toxoplasma IgG and IgM in butchers were 80% and 20% respectively, as indicated by the micro-ELISA. The risk of Toxoplasma transmission particularly, from meat inadequately cooked was discussed.     

Epidemiologic aspects of pre-eclampsia in Saudi Arabia

Pre-eclampsia is pregnancy induced hypertension of unknown aetiology. There is a paucity of maternal data on the disease from this region and this study was undertaken to identify maternal and possible aetiologic factors associated with the disease in the north western region of Saudi Arabia. Seven hundred and five consecutive maternities which delivered from October 1990 till January 1991 at the Armed Forces Hospital were analysed. 2.8% of women in this community study developed pre-eclampsia. Women at extremes of maternal age, the nulliparous and high parity women; women with high body mass index, blood group O and those with no antenatal care or late booking in this study were at greater risk of developing pre-eclampsia when compared with controls who delivered in the same period. Of the babies born to mothers with pre-eclampsia, 46.7% were of low birthweight (< 2500g) while only 10.4% of controls were low birthweight. It is concluded that mothers with pre-eclampsia have to be identified early. Potential modifiable factors include reducing pregnancies at extremes of maternal age, among high parity women and encouraging early booking as well as regular attendance at the antenatal clinic.     

Smoking behaviour and attitudes among adult Saudi nationals in Riyadh City, Saudi Arabia

Nine massive hemipelvic allografts were used to reconstruct the pelvic ring and the hip articulation after resection of malignant tumors. At follow up of 3 to 10 years, six patients were free of oncologic disease. In the 3 acetabular massive allografts, functional results were close from those standard THR. After resection of hemipelvis and adjacent muscles, patients resume a normal family life (painless hip, poor active motion, walking with a crutch) with a functional result much better than after amputation. Considering these encouraging results in oncologic surgery, we used similar technics for reconstruction of very severe bone loss after iterative failures of THR revisions: some examples are reported at medium follow up.     

Psychotherapy in the Eastern Province of Saudi Arabia.

Discusses the meaning of psychotherapy within the Saudi Arabian cultural context and examines the special manner in which psychotherapy is practiced. Issues regarding culture-related transference and countertransference, the sick role in a society, culturally appropriate denial of anger, and differences in therapeutic procedures and activities are discussed. It is suggested that issues of trust and identity must be discussed openly early in therapy so that the therapy will be grounded in reality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dengue virus replication in cultures of peripheral blood leukocytes during the course of dengue haemorrhagic fever

A preliminary study was made of the ability of cultured human peripheral blood leukocytes (PBL) to support dengue 2 infection. Leukocyte donors, children hospitalized with primary (one case) or secondary dengue infections (12 cases), were studied during the acute and convalescent stages of illness. D2 virus replication occurred infrequently in PBL cultures obtained from children before the 10th day after onset of symptoms (2/23 samples), but frequently thereafter (8/13 samples). The absence of virus permissive cells during the acute stage of illness might be explained by several different mechanisms, including the possibility that permissive PBL are exhausted as the result of a severe dengue infection. An unexpected finding was the appearance of dengue hemagglutination-inhibition antibodies in cultures of PBL obtained from children during the acute stage of secondary dengue infections.     

Some aspects of cutaneous leishmaniasis in Riyadh. Saudi Arabia

One hundred and sixty nine out of 310 outpatients of Riyadh's hospitals and 104 out of 209 inhabitants from El Kharj showed Leishmania bodies in smears obtained by puncture of indurated edge of sores. Collection of sand flies yielded P. papatasi, Paraphlebotomus caucasicus and S. squamipleuris. The results were discussed.     

Inflammatory bowel disease in Saudi Arabia: presentation and initial management

Elective cholecystectomy in the asymptomatic patient has elicited considerable controversy, going back to the prelaparoscopy cholecystectomy era. Surgical services often see patients with known or unidentified cholelithiasis who, having been asymptomatic, present with serious complications, potentially lethal, in whom emergency operations are associated with technical difficulties that lead to high conversion rates and significant mortality and morbidity. Elective cholecystectomy is a safe procedure associated with low morbidity and no mortality. Based on an analysis of our experience and a review of the literature, we discuss the indications for elective laparoscopic cholecystectomy in asymptomatic patients at high risk of developing complications of their asymptomatic disease. The following high-risk criteria are proposed for elective cholecystectomy: life expectancy > 20 years; calculi > 2 cm in diameter; calculi < 3 mm and a patent cystic duct; radiopaque calculi; polyps in the gallbladder (GB); nonfunctioning GB; calcified ("porcelain") GB; concomitant diabetes; women < 60 years; and individuals in geographic regions with a high prevalence of GB cancer.     

Introducing and Managing Quality Scheme for RMC Industry in Saudi Arabia

There is tremendous growth in the use of ready-mixed concrete (RMC) for construction in developing countries. In Saudi Arabia, the production and use of RMC is now widespread, but the quality of concrete construction is still generally substandard. The RMC industry is not regulated or monitored. This has contributed to a general disregard for the basics of good quality as well as cheating by some RMC producers. To rectify the situation and to improve the performance of RMC producers, systematic external monitoring and inspection is required. Recently, the Municipality of Riyadh has started implementing a mandatory quality scheme for RMC plants operating in the city. The scheme was designed considering the difficulties and constraints common to implementing a quality scheme in developing countries. This paper gives details of the quality scheme as developed for RMC in Riyadh, Saudi Arabia. Specifically, the scheme's objectives, its elements, as well as the major difficulties and challenges encountered during its development and implementation are highlighted and discussed. This scheme's impact on the performance of RMC producers and the quality of concrete produced during the first two years are presented. The implementation of the scheme has resulted in tangible improvement in all aspects of RMC operation and product quality. Based on the experience and progress achieved so far, it can be concluded that a mandatory quality scheme can be introduced successfully into the existing RMC industry in developing countries with immediate benefits to the industry and its customers.     

Electroencephalographic findings in epilepsy in Asir region of southern Saudi Arabia

People recovering from pneumonia are often weak for no apparent reason. Clinical features such as postural hypotension, arrhythmia and syndrome of inappropriate ADH have, in other circumstances, been attributed to impaired autonomic function. The aim of this study was to see whether elderly patients with pneumonia had impaired autonomic cardiovascular reflexes and, if so, how long this persisted. We compared healthy elderly controls, elderly controls with trauma (fractured femoral neck) and elderly patients with pneumonia. Thirty-eight subjects were studied in a series of cardiovascular autonomic function tests. Results suggest that elderly people have a high prevalence of impaired cardiovascular autonomic reflexes in the immediate post-pneumonic phase, and that this improves significantly after six weeks, with a further improvement by six months. Elderly patients recovering from pneumonia are predisposed to the adverse effects of drugs and other factors which can further impair autonomic cardiovascular reflexes.     

Isolation of enterotoxigenic Escherichia coli from British troops in Saudi Arabia

Specimens from 181 patients with diarrhoea were examined by a Military General Hospital in a 3-month period during deployment of troops to Saudi Arabia in 1990/1. DNA probes for heat labile (LT) and heat stable (ST) enterotoxin genes identified enterotoxigenic Escherichia coli (ETEC) in 47 of the specimens (26%) and 49 ETEC strains were isolated. The majority (55%) belonged to a novel ETEC serotype having the O-antigen 159 and a flagellar antigen designated as a provisional new type. They produced ST and the coli surface associated antigen (CS)6. Strains of serotype O6:H16 represented 22% of the ETEC examined. They produced ST, LT and CS3 together with either CS1 or CS2. The remaining ETEC belonged to seven O:H serotypes. Overall, ST was the only enterotoxin gene identified in 73% of the ETEC and 67% of the strains expressed CS6 in the absence of other colonization antigens. Resistance to three or more antibiotics was observed in 53% of the ETEC, including most of the O159 strains.     

Genetic and antigenic analysis of human rotavirus prevalent in Al-Taif, Saudi Arabia

The subgroup, serotype and electropherotype diversity of human rotavirus strains was investigated in Al-Taif, Saudi Arabia. Out of 349 faecal samples collected from diarrhoeic children, 150 (43 percent) tested rotavirus positive by a group-A specific enzyme-linked immunosorbent assay (ELISA). The majority (87 percent) of the infected children were below 2 years of age. Subgrouping and serotyping of rotaviruses with specific monoclonal antibodies showed that of the 150 rotavirus positive specimens, 17 percent belonged to subgroup I, 59 per cent belonged to subgroup II, and 24 percent were neither subgroup I nor subgroup II. The specimens were typed, as serotype 1 (43 percent), serotype 2 (5 percent), serotype 3 (11 percent), serotype 4 (10 percent) or mixed serotypes (3 percent). The remaining 41 (27 percent) specimens were untypeable. None of the serotypes showed association with a particular age group. An electrophoretic analysis of viral RNA revealed 11 distinct patterns (six long and five short). The majority, 78 percent were long patterns and 22 percent were short patterns. Analysis of the specimens for which subgroups, serotypes and electropherotypes were available indicated that a given RNA pattern does not correspond to a particular subgroup or serotype.     

Antibiotic sensitivity of isolates of Pseudomonas aeruginosa in Buraidah, Saudi Arabia

To help account for the variable quality and quantity of RNA in human brain, we have studied the effect of premortem (agonal state) and postmortem factors on the detection of poly(A)+mRNA and eight mRNAs. For comparison, the influence of the same factors upon gene products encoded by the mRNAs was studied immunocytochemically or by receptor autoradiography. Brain pH declined with increasing age at death and was related to agonal state severity, but was independent of postmortem interval and the histological presence of hypoxic changes. By linear regression, pH was significantly associated with the abundance of several of the RNAs, but not with poly(A)+mRNA, immunoreactivities, or binding site densities. Postmortem interval had a limited influence upon mRNA and protein products. Freezer storage time showed no effect. Parallel rat brain studies showed no relationship between postmortem interval (0-48 h) and amounts of total RNA, poly(A)+RNA, or two individual mRNAs; however, RNA content was reduced by 40% at 96 h after death. pH is superior to clinical assessments of agonal state or mode of death in predicting mRNA preservation. It provides a simple means to improve human brain gene expression studies. pH is stable after death and during freezer storage and can be measured either in cerebrospinal fluid or in homogenised tissue.     

Projected needs of health manpower in Saudi Arabia, 1974-90

Although our projections are not completely accurate, due to inadequate data and crude methods of approximation, three conclusions are inescapable: 1. The nation should give priority to planning new schools for health administrators and rural health workers, and to generally expanding present schools for paramedicals. 2. Plans should proceed rapidly for the two new medical schools. 3. A Health Manpower plan based on census information and special studies should be developed over the next 2 years. This plan should have input from all concerned ministries. (The Ministry of Health has regarded a proposal from University Associate "a group of Harvard, Johns Hopkins and A.U.B. professors" for technical cooperation in health services planning.)     

Ethnic differences in the severity of varicella in adults in northern Saudi Arabia

The severity of varicella infection in 124 expatriates from the Asian continent was compared to that in 120 Saudi nationals, seen in Arar Central Hospital, Arar, Saudi Arabia, between January 1992 and December 1994. Persistent fever (defined as a raised body temperature more than 37.4 degrees C lasting more than 5 days), extensive skin eruptions (defined as extensive, when more than 50% of the body surface was affected) and transient elevation of hepatic enzymes (aspartate transaminases > 37 U/L and alanine transaminases > 40 U/L) after excluding other possible causes, occurred significantly more in expatriates than in Saudis. The mean duration of the illness in expatriates was 15.9 +/- 3.41 days as compared to a mean duration of 13.1 +/- 3.52 days in Saudis. This difference was statistically significant (p < 0.01 Student's t-test). The findings in this study suggest that varicella infection runs a more severe course in expatriates from the Asian continent as compared to the Saudis. Treatment with the antiviral agent acyclovir may be indicated in this group of expatriates with varicella infection.