Nawal Osman

Fetal exposure to aflatoxins in the United Arab Emirates.

Abstract This is a prospective study in which aflatoxin levels were measured in umbilical cord blood from 201 women delivered consecutively in Tawam and Al Ain hospitals in order to determine whether the fetuses had been significantly exposed to the toxin. Aflatoxin B1, M1 and M2 were measured using high performance liquid chromatography. Aflatoxins were detected in 110 (54.7%) samples, 27 of which were positive for B1, 106 for M1 and 31 for M2. There was a significant negative correlation (p<0.001) between birthweight and levels of aflatoxin. The high rate of detection of aflatoxins confirms that a significant number of infants in the UAE are exposed to these toxins which reflects maternal ingestion of aflatoxin-containing food. The presence of aflatoxin resulted in lower birthweights.

Trace element composition of plasma and breast milk of well-nourished women

A wide variation in the composition of breast milk has been reported from various countries. This study was undertaken to determine the trace element content of breast milk and plasma in lactating women. Mothers of children 4 weeks to 80 weeks in age, were studied. Blood and breast milk from the mothers were analysed for trace element content. Prepared samples were analysed using ICP-MS. 209 women agreed to take part in the study, 68 of whom were from the UAE and 124 were other nationalities (17 did not fill the this part of the questionnaire). Ninety-seven infants were male. The concentration of different trace elements in blood and breast milk were little different between women from the UAE and those from outside the UAE. Molybenum, chromium and arsenic significantly increased with increasing age of the infant, while manganese, copper and zinc significantly decreased with increasing age of the infant. The trace element concentrations of breast milk and maternal blood were comparable to published values. Normal values for plasma and breast milk trace metal concentrations have been obtained for UAE women.

Prevalence of Chlamydia trachomatis infection among women in a Middle Eastern community.

BackgroundCommon vaginal infections that manifest in women are usually easily diagnosed. However, Chlamydia infection is often asymptomatic, leading to infertility before it is detected. If it occurs in pregnancy, it could lead to significant neonatal morbidity. It may also play a role with other viral infections for e.g. Human Papilloma Virus in the development of cervical cancer. The objective of this study was to determine the prevalence of Chlamydia infection in women undergoing screening for cervical abnormalities as a part of a research project in primary and secondary care institutions in the United Arab Emirates.MethodsIn this cross sectional study married women attending primary and secondary care participating in a large nationwide cervical abnormalities screening survey were offered Chlamydia testing using a commercially available test kit. This kit uses a rapid immunoassay for the direct detection of Chlamydia trachomatis antigen in endocervical swab specimens. As this study was performed in a traditional Islamic country, unmarried women were excluded from testing, as the management of any positive cases would create legal and social problems. All married women consenting to take part in the study were included irrespective of age.ResultsOf 1039 women approached over a period of eight months 919 (88.5%) agreed to participate. The number of women in the 16 to 19 years was small (0.01%) and 30% were aged over 40 years. The prevalence of Chlamydia infection in this study was 2.6% (95% confidence interval 1.2–3.3%), which was marginally higher in women screened in secondary care (p = 0.05).ConclusionThis is one of the few reports on the prevalence of Chlamydia infection in women from the Middle East. Due to cultural and social constraints this study excluded a large proportion of women aged less than 19 years of age. Hence no direct comparisons on prevalence could be made with studies from the West, which all included younger women at high risk of Chlamydia. However this study emphasizes the importance of cultural factors while interpreting results of studies from different cultures and communities.

A STUDY OF KNOWLEDGE, ATTITUDE, AND PRACTICE OF CERVICAL SCREENING AMONG FEMALE PRIMARY CARE PHYSICIANS IN THE UNITED ARAB EMIRATES

Cancer is the third leading cause of death In the United Arab Emirates (UAE), which is situated in the Arabian Gulf. A national programme for cervical cancer screening is likely to be implemented in the future. In this study, we assessed the knowledge, attitude, and practice of UAE female primary care physicians of cervical screening through a self-administered questionnaire. Of the 98 physicians who participated in the study only 40% reported ever having performed a Pap smear. In the study, we identified various training needs, and a training programme on cervical screening currently is being developed based on the results of this study.

Cervical smear abnormalities in the United Arab Emirates : A pilot study in the arabian gulf

OBJECTIVE To gather epidemiologic data on cervical abnormalities and make recommendations pertaining to a national cervical screening policy in the United Arab Emirates (UAE). STUDY DESIGN A cross-sectional survey of patients and physicians in the UAE with regard to cervical cytology was carried out. Knowledge, attitudes and practices (KAP) of a group of female primary care physicians on cervical cytology were assessed by a self-administered questionnaire. Pap smears and Chlamydia testing were offered to women attending selected primary care centers and secondary health care facilities. RESULTS Results of Chlamydia prevalence and KAP were published elsewhere; this report addresses the cytologic aspects of this study. There were 2,013 smears collected from primary health centers and 2,042 from secondary care. The overall rate of cervical screening among women in this survey was 85.5% in primary care and 77% in secondary care. The proportion of unsatisfactory smears was < 5%. The prevalence of cervical abnormalities according to the Bethesda System 2001 was 3.6%. There were 9 (primary care) and 21 (secondary care) cases of low grade squamous intraepithelial lesion (LSILs), for a prevalence of 0.77%. There were 4 primary care and 17 secondary care cases of high grade squamous intraepithelial lesion (HSIL), for a prevalence of 0.54%. The combined prevalence for LSIL and HSIL is 1.32%. There were 3 cases of glandular abnormalities. The atypical squamous cells of undetermined significance/SIL ratio was 1.71. No cases of squamous cell carcinoma were detected. No tissue follow-up information is available. The prevalence of cervical abnormalities is low in the UAE. We first recommend the institution of a more organized approach to opportunistic screening in the UAE with appropriate clinical follow-up rather than the immediate launch of a cervical mass screening program.

Social impact and healthcare-seeking behavior among women with urinary incontinence in the United Arab Emirates

To determine the prevalence and social impact of urinary incontinence (UI) and healthcare‐seeking behaviors among women in the United Arab Emirates (UAE).

Toxicokinetics of Aflatoxin in Pregnant Mice

Our objective was to study the toxicokinetics of aflatoxin (AF) in pregnant mice. Aflatoxin B1 (AFB1) was administered intraperitoneally (IP) to groups of pregnant mice in single doses of 20 mg/kg on gestation day (GD) 13 and orally at the same gestational age. Controls received (IP and oral) a proportionate volume of solvent only. Maternal blood was collected at 15, 30, 45, 60, 90, 120, and 150 minutes posttreatment. Their AFB1 contents were determined. Aflatoxin B1 concentrations following maternal exposure to AFB1 were highly correlated with time after exposure. The serum concentrations were predictable and the highest serum levels were seen immediately at 15 minutes in mice given AFs IP and at 30 minutes in those given it orally. The absorption was 5.0 μg/min and elimination was 3.0 μg/min. The toxicokinetics of AFB1 have been delineated. Aflatoxins are easily and rapidly absorbed both from the gastrointestinal tract (GI) tract and through the peritoneum.

Human chorionic gonadotrophin is an endothelium-independent inhibitor of rat aortic smooth muscle contractility

The study tested the hypothesis that human chorionic gonadotrophin (hCG) attenuates isolated vascular smooth muscle contractility and investigated the role of the vascular endothelium in hCG-induced altered responses of vascular smooth muscle. The contractile responses of isolated aortic rings from normal, hCG-treated, and estrogen-treated female virgin Wistar rats to phenylephrine, angiotensin II, KCl, and CaCl2 were compared. The effect of pretreatment with N-monomethyl-L-arginine (L-NMMA), methylene blue, indomethacin, calcium-free medium, and de-endothelialization on responses to phenylephrine of aortic rings from control and hCG-treated rats were also examined. Intraperitoneal administration of hCG caused attenuation of contractile responses of isolated aortic rings to all agents. The attenuated responses to phenylephrine were not reversed by de-endothelialization, or pretreatment of the rings with L-NMMA, methylene blue, or indomethacin. It was concluded that hCG attenuates vascular smooth muscle contractility. The effect is independent of the vascular endothelium, not agonist-specific, and appears to involve alterations of calcium availability.

Calcium Supplementation Is Associated With Endothelium Dependent Attenuation of Vascular Smooth Muscle Reactivity in Normotensive Pregnant and Nonpregnant Rats

The study tests the hypothesis that the blood pressure lowering effect of a high calcium diet is mediated through attenuation of vascular reactivity and examined the mechanisms involved in both normotensive pregnant and nonpregnant rats. The contractile responses of aortic rings of Wistar rats fed on high (1.7%, 2.1%) and normal (0.9%) calcium diets to phenylephrine, angiotensin II, KCl, and CaCl2 were studied. The relaxations to acetylcholine and potassium chloride, as well as the effects of endothelial denudation, pretreatment with indomethacin (10[-6] mol/L), methylene blue (10[-6] mol/L), and calcium free solution on the responses to phenylephrine were also examined. In both pregnant and nonpregnant rats, the contractile responses of aortic rings of animals fed a high calcium diet to all the agents were significantly attenuated, compared with those of controls. After endothelial denudation, or treatment with methylene blue, but not with indomethacin, the responses of the rings to phenylephrine were enhanced and not different from similarly treated rings from rats on a normal calcium diet. There was no difference in the contractile responses to phenylpehrine in calcium free solution. The relaxation to acetylcholine, but not to potassium chloride, was enhanced in rings from rats on a high calcium diet. The diminution in reactivity was not associated with corresponding changes in sensitivity of the tissues. It is concluded that in normotensive rats a high calcium diet is associated with diminished vascular smooth muscle reactivity that is endothelium dependent, and involves increased stimulation of the nitric oxide-guanylate cyclase pathway but not of the sodium-potassium ATPase or prostacyclin.

The role of the vascular endothelium in the contractile responses of human chorionic plate artery in pre-eclampsia to prostaglandin F2alpha, 5-hydroxytryptamine, and potassium chloride

This study characterises the reactivity of chorionic plate artery in preeclampsia to prostaglandin F2alpha (PGF2alpha), 5-hydroxytryptamine (5-HT), and potassium chloride (KCl) and examines the role of the vascular endothelium in these responses. Ring segments of the chorionic plate arteries of women after normal and pre-eclamptic pregnancies were contracted by PGF2alpha, 5-HT, and KCl. The experiments were carried out in the presence and absence of endothelium, and on intact rings treated with 10−6M indomethacin. The maximal contractile responses of rings from pre-eclamptic women to 5-HT, PGF2alpha, or KCl were significantly greater than those of rings from normotensive pregnant women. The EC50 values of responses were significantly lower in rings from pre-eclamptic subjects. Endothelium removal and treatment of the rings with indomethacin had no effect on the contractile responses of rings from normotensive pregnant women to all the agents, but significantly increased the EC50 value and decreased the maximal contractile responses of rings from pre-eclamptic women to 5-HT and PGF2alpha. While de-endothelialisation increased the EC50 value for responses of the rings from pre-eclamptic women to KCl, pretreatment with indomethacin did not significantly affect the KCl-induced responses. The results of the study suggest that pre-eclampsia enhanced the reactivity of human chorionic plate artery to 5-HT, PGF2alpha, and KCl through the involvement of endothelial derived contracting factors. The increased responses to 5-HT and PGF2alpha were inhibited by indomethacin, but those to KCl were not.