Hamdy F. Moselhy

A specific, accurate, and sensitive measure of total plasma malondialdehyde by HPLC

Malondialdehyde (MDA) is one of the most commonly reported biomarkers of lipid peroxidation in clinical studies. The reaction of thiobarbituric acid (TBA) with MDA to yield a pink chromogen attributable to an MDA-TBA2 adduct is a common assay approach with products being quantified by ultraviolet-Vis assay as nonspecific TBA-reactive substances (TBARS) or chromatographically as MDA. The specificity of the TBARS assay was compared with both chromatographic assays for total plasma MDA. The levels of total plasma MDA were significantly lower than the plasma TBARS in each of the samples examined, and interestingly, the interindividual variation apparent in the level of plasma MDA was not evident in the plasma TBARS assay. Each of the four online chromatographic detectors yielded a precise, sensitive, and accurate determination of total plasma MDA, and selected-ion monitoring was the most-accurate assay (101.3%, n = 4). The online diode array detectors provided good assay specificity (peak purity index of 999), sensitivity, precision, and accuracy. This research demonstrates the inaccuracy that is inherent in plasma TBARS assays, which claim to quantify MDA, and it is proposed that the TBARS approach may limit the likelihood of detecting true differences in the level of lipid peroxidation in clinical studies.

Subjective life satisfaction and mental disorders among older adults in UAE in general population

Life satisfaction is widely considered to be a central aspect of human welfare. Many have identified happiness with it, and some maintain that well‐being consists largely or wholly in being satisfied with ones life. Empirical research on well‐being relies heavily on life satisfaction studies.

Sexual Dysfunctions in Male Opiate Users: A Comparative Study of Heroin, Methadone, and Buprenorphine

ObjectiveThe aim of this study was to compare sexual dysfunctions in male patients dependent on heroin and those on methadone or buprenorphine treatment for opiate dependence. MethodsNinety-one patients (30 in the heroin group, 33 in the methadone group, and 28 in the buprenorphine group) were recruited from outpatient attendees at a community drug team in Birmingham, UK. The “Loyola University Clinic-special history sheet for men” was administered to assess sexual functioning (self-reports), and the Brief Psychiatric Rating Scale was used to assess psychopathology. ResultsA wide range of sexual dysfunctions was reported by these patients (n=90): low sex drive (n=38; 41.8%), loss of sexual fantasy life (n=17; 18.7%), loss of morning erection (n=25; 27.5%), premature ejaculation (n=54; 59.3%), and ejaculation with soft penis (n=67; 73.6%). Fewer patients on buprenorphine (as compared with those on heroin and methadone) reported loss of sexual fantasy, loss of sexual desire, loss of erection with movement, premature ejaculation, and loss of angulation of penis (all P<0.05). ConclusionsThe results of this study indicate that sexual dysfunctions are common in male opiate misusers and that buprenorphine is significantly less likely than methadone or heroin to induce this side effect. Further research is needed to explore the pathophysiology and treatment implications of these findings. From a clinical perspective, it is imperative that patients misusing opiates and those treated with methadone or buprenorphine are routinely asked about their sexual functioning and appropriate investigations and treatment planned if indicated.

Higher frequency of C.3435 of the ABCB1 gene in patients with tramadol dependence disorder

Abstract Background: Polymorphic variation at the ABCB1 gene has been shown to affect the pharmacodynamics and kinetics of various drugs. Aim: This study aimed to determine the frequency of occurrence of Single Nucleotide Polymorphism (SNP) in position A118G OPRM1 (rs1799971) gene and C.3435 (rs1045642) gene in tramadol users in comparison with normal controls. Methods: This was a cross sectional case-control outpatient study. The study sample consisted of 127 subjects (74 tramadol-dependents and 50 healthy controls). All patients fulfilled the Diagnostic and Statistical Manual IV Criteria for substance dependence (on tramadol). Genotyping of the OPRM1 gene 118 SNP and ABCB1 genes C.3435 SNP was performed by PCR, followed by restriction fragment length polymorphism identification. Results: A significant association was found between the ABCB1 gene T allele at the polymorphic site 3435 and tramadol dependence. No significant association was observed with the A118G OPRM1 gene. Conclusion: The high frequency of ABCB1 gene T allele present at the polymorphic site 3435 could provide a protective mechanism from tramadol dependence disorder. Further study, using a larger sample, would be useful in further evaluating the possible role of ABCB1 gene polymorphisms.

Death anxiety (Thanatophobia) among drug dependents in an Arabic psychiatric hospital

Aim: The primary aim of this study was, for the first time to our knowledge, to examine the level of death anxiety (thanatophobia) in drug dependents attending the outpatient clinic in a psychiatric hospital and to examine the relationship of demographic variables to death anxiety. Method: Eighty-five patients were recruited from outpatient psychiatric attendees at the psychiatric hospital, Kingdom of Bahrain. The death anxiety scale was administered to assess death anxiety, and a clinical psychiatric interview was used to assess psychopathology. Results: The mean age of the sample was 36.8 years (SD = 8.8). All subjects who participated in the study were Arabic males; the majority of them were primary school (i.e. first 5 years of education or schooling) educated (n = 57; 67%) and single (n = 48; 56.5%). The total mean of death anxiety score of the drug abusers was high (3.52±.95). One-way ANOVA showed that there was no significant difference among the scores the drug dependents received on the death anxiety scale related to different groups of age, education, type of the drug used, or the number of times of taking drugs per day. However, there was a significant difference in the level of control of use, marital status, duration of use, cigarettes smoking, and level of religiosity. Conclusion: The results of this study indicate that the level of death anxiety is high, in general, among drug abusers and that being divorced, not actively practicing a religious faith, having at least 1–10 years or more than 20 years history of drug abuse, and smoking at least 20 or more cigarettes per day significantly increases the level of death anxiety.

Impact of political violence on the mental health of school children in Egypt

Abstract Background: Since the beginning of the Egyptian political conflict, Tahrir Square has been the epicentre of intense political violence. Students attending schools located near this square witnessed and/or directly experienced the consequences of a series of violent events. Aim: This study will investigate the presence of psychiatric symptoms in children attending these schools to explore patterns of responses according to their perceptions of the revolution on their lives, adjusted for, gender and socio-economic status. Method: A descriptive cross-sectional study conducted with 515 Egyptian school children attending government, experimental, and private language schools located within 1 km of Tahrir Square. To assess psychiatric symptoms in these children, a specially designed questionnaire was used to detect, depression, anxiety, and post-traumatic stress disorder (PTSD) symptoms and impairments. Results: Children attending schools near Tahrir Square showed high rates of depression, PTSD and anxiety symptoms. The risk factors identified for developing psychiatric symptoms were a negative perception of the effect of the revolution, knowing someone exposed to trauma during the events, female gender and low socio-economic class. Discussion: These results highlight the need for large-scale studies to explore the consequences of ongoing political violence on children and to establish baseline data on the mental health of Egyptian children.

Secondary association of PDLIM5 with paranoid schizophrenia in Emirati patients.

Schizophrenia is a clinically and genetically heterogeneous disorder of unknown etiology. PDLIM5 variants have been linked to schizophrenia and other related neuropsychiatric disorders and upregulated in the brain of schizophrenia patients suggesting a possible pathogenic role in disease progression. The aim of this study is to examine the potential association of schizophrenia in Emirati patients with previously reported variants in PDLIM5, PICK1, NRG3 or DISC1 genes. Consequently, we found a secondary association between PDLIM5 variants and the paranoid subtype of schizophrenia in Emirati Arabs suggesting that PDLIM5 may represent a determinate/marker for schizophrenia subtype specification. However, no associations were found with variants in PICK1, NRG3 or DISC1 genes.

Natural history of affective disorders: Comorbidity as a predictor of suicide attempts

OBJECT: Comorbidity of psychiatric illnesses and substance misuse can lead to an increase in suicide attempts. METHOD: Retrospective data collection from case notes of 81 consecutive admissions to an acute psychiatric ward. Previous diagnoses, substance misuse and suicidal attempts were all examined. RESULTS: The rate of suicide attempts among all groups was 40.7%. Alcohol abuse or use of illegal drugs was reported in 69.7% of suicide attempters. More than half of the patients (66.7%) overconsumed alcohol. CONCLUSION: Clinical implication of the effect of comorbidity on suicidal behaviour and length of stay are discussed.

Impact of self-reported life events on the profile of opioid dependence syndrome.

Aim: The aim of this work was to investigate the impact of life events on the profile of opioid dependent patients. Method: Recruitment was achieved through outpatient drug treatment clinic in Birmingham, UK, and data were collected through semistructured interviews. One-hundred and twenty subjects with opioid dependence syndrome were interviewed, and 100 controls of non-drug-using family members and friends. Result: The mean age of the opioid group was 33.3 years, SD = 8.8. The majority individuals of the sample were White British (80.8%), unemployed (69.2%), and male (75%). The mean severity of dependence as measured by two scales indicated severe level of dependence according to the authors of each scale. The mean number of traumatic events for the opioid dependence group was 4.8, SD = 3.57 vs. 3.55; SD = 3.65 in control group with significant difference (t = 2.56, df = 218, p = .01). Significant predictors of severe opioid dependency were age of second exposure to events, change of residence, break-up with boy/girlfriend, and conflict with father. Conclusion: The data presented indicate that a significant group of opioid dependent patients experience adverse life events in both childhood and adulthood. It is by attending to and addressing these issues that health care workers can alleviate ongoing distress and promote confidence.

Benzhexol-dependence resulting from self-medication for intermittent explosive disorder

Objective. Recent observations in Iraq during the period of sanction suggest the existence of benzhexol prescribing linked to its calming effects on explosive behaviours. This inspired our group to research the existence of this practice and the characteristics of those involved in it. Method. All patients from the psychiatric service in Merjan Hospital, Al Hilla City, Babylon Governate, Iraq, who had a prescription for benzhexol between January 1991 and December 2000, were identified. All participants received their diagnosis based on the clinical criteria of the DSM-IV, after taking a comprehensive medical and psychiatric history, mental state examination and collateral information from family members. The patients were evaluated by the same qualified consultant psychiatrist at the initial assessment and all through the period of follow-up. Results. In the 10-year period under study, 354 patients were prescribed benzhexol. A total of 190 patients diagnosed as intermittent explosive disorder (IED) and 164 suffering from severe mental disorders or personality disorders were excluded from the study. The average age of the IED group was 29.5 years. On direct questioning, the main reason patients gave most frequently for using benzhexol was to control the aggressive outbursts (N=92, 48.4), to get high (N=49, 25.8), to relax (N=26, 13.7), to get rid of boredom (N=23, 12.1). In total, the whole group were prescribed benzhexol, at an average dose of 12.5 mg/day (range 2–20 mg/day). At the time of final assessment the mean dose of prescribed benzhexol had fallen slightly to 12 mg/day (2–20 mg/day), with 10 patients being benzhexol free. Of the 190, three patients had a diagnosis of obsessive compulsive disorders, 36 patients had a diagnosis of benzodiazepines dependence, and a further five had a diagnosis of alcohol dependency syndrome. Eighty percent felt satisfied with the effect of the drug and 95 were not motivated to stop it. Conclusions. There are a significant number of patients who are routinely prescribed benzhexol as a replacement therapy. The main original reason for starting it is to control outbursts and improves their reaction to stress situations. This growing issue raises the need for awareness, by both public and medical practitioners, of the potential adverse effects of benzhexol and its untoward consequences.