Dawodu A.,Cincinnati Childrens Hospital Medical Center |
Saadi H.F.,United Arab Emirates University |
Bekdache G.,Tawam Hospital |
Javed Y.,United Arab Emirates University |
And 2 more authors.
Journal of Clinical Endocrinology and Metabolism | Year: 2013
Background: Vitamin D (vD) deficiency in pregnancy is a global health problem and the amount of vD supplementation to prevent vD deficiency is controversial. Objective: The objective of the study was to determine effectiveness and safety of prenatal 2000 IU and 4000 IU/d compared with 400 IU/d vD3 supplementation in a randomized controlled trial in population in which vD deficiency is endemic. Design/Methods: Arab women were randomized at 12-16 weeks of gestation to 400, 2000, and 4000 IU/d vD3, which were continued to delivery. Serum 25-hydroxyvitamin D [25(OH)D] concentrations were measured during pregnancy and at delivery. The primary outcome was the maternal and cord blood 25(OH)D, and the secondary outcomes were the achievement of sufficient serum 25(OH)D of 32 ng/mL or greater (≥80 nmol/L) at delivery. Setting: The locations were primary care and tertiary perinatal care centers. Results: Of 192 enrolled, 162 (84%) continued to delivery. Mean serum 25(OH)D of 8.2 ng/mL (20.5 nmol/L) at enrollment was low. Mean serum 25(OH)D concentrations at delivery and in cord blood were significantly higher in the 2000 and 4000 IU than the 400 IU/d group (P < .001) and was highest in the 4000 IU/d group. The percent who achieved 25(OH)D greater than 32 ng/mL and greater than 20 ng/mL concentrations in mothers and infants was highest in 4000 IU/d group. Safety measurements were similar by group and no adverse event related to vD supplementation. Conclusions: Vitamin D supplementation of 2000 and 4000 IU/d appeared safe in pregnancy, and 4000 IU/d was most effective in optimizing serum 25(OH)D concentrations in mothers and their infants. These findings could apply to other populations in which vD deficiency is endemic. Copyright © 2013 by The Endocrine Society.
El-Hattab A.W.,Tawam Hospital
Molecular Genetics and Metabolism | Year: 2016
l-serine is a non-essential amino acid that is biosynthesized via the enzymes phosphoglycerate dehydrogenase (PGDH), phosphoserine aminotransferase (PSAT), and phosphoserine phosphatase (PSP). Besides its role in protein synthesis, l-serine is a potent neurotrophic factor and a precursor of a number of essential compounds including phosphatidylserine, sphingomyelin, glycine, and d-serine. Serine biosynthesis defects result from impairments of PGDH, PSAT, or PSP leading to systemic serine deficiency. Serine biosynthesis defects present in a broad phenotypic spectrum that includes, at the severe end, Neu-Laxova syndrome, a lethal multiple congenital anomaly disease, intermediately, infantile serine biosynthesis defects with severe neurological manifestations and growth deficiency, and at the mild end, the childhood disease with intellectual disability. A serine transport defect resulting from deficiency of the ASCT1, the main transporter for serine in the central nervous system, has been recently described in children with neurological manifestations that overlap with those observed in serine biosynthesis defects. l-serine therapy may be beneficial in preventing or ameliorating symptoms in serine biosynthesis and transport defects, if started before neurological damage occurs. Herein, we review serine metabolism and transport, the clinical, biochemical, and molecular aspects of serine biosynthesis and transport defects, the mechanisms of these diseases, and the potential role of serine therapy. © 2016 Elsevier Inc.
Al-Jabi Y.,Royal College of Surgeons in Ireland |
El-Shawarby A.,Tawam Hospital
British Journal of Neurosurgery | Year: 2010
Aim. The aim of this manuscript is to review the current state of knowledge regarding C-reactive protein (CRP) kinetics after standard neurosurgical procedures, and to determine the value of CRP as a screening test for early post-operative infectious complications as opposed to other more commonly used tests, and as a marker of peri-operative surgical insult. Methods. Over 18 months period, CRP levels, alongside with ESR and WCC were assessed pre-operatively (at day 0) and post-operatively (at days 1,2,3,4 and 5) in 50 consecutive female patients and 50 consecutive male patients undergoing seven neurosurgical procedures. Each of the seven procedures involved a different level of intra-operative trauma. Factors of possible influences on CRP, including volume of blood transfused intra-operatively, type of anaesthetic administered, use of anti-inflammatory drugs and antibiotics levels were recorded. Results. The median age of our study population was 29.1 (mean±SD: 28.4±10.2; range: 20.4-53.8). Of the 100 patients recruited for our study, 13 developed post-operative infectious complications. In these patients, a secondary CRP rise or failure to decrease as expected had sensitivity, specificity, negative and positive predictive value of 100%, 93.1%, 100% and 68.4%, respectively, for detecting infectious complications. The mean post-operative CRP levels were highest in the most surgically traumatic procedure - Lobotomy for epilepsy intervention and lowest in the least surgically traumatic procedure - stereotactic brain biopsy (p<0.001). Volume of blood transfused intra-operatively, type of anaesthetic administered, use of anti-inflammatory drugs and antibiotics levels did not affect CRP kinetics. Conclusion. The results of this study suggest that CRP is a more reliable screening test for post-operative infectious complications in the practice of neurosurgery than other more commonly used tests (WCC and ESR). Furthermore, the results suggest that peak post-operative CRP levels mirrors the level of incurred intra-operative surgical insult. © 2010 The Neurosurgical Foundation.
Radwan H.,Tawam Hospital
BMC Public Health | Year: 2013
Background: Breastfeeding is the preferred method of feeding for the infant. The present study aimed at investigating the different infant feeding practices and the influencing factors in the United Arab Emirates (UAE). Methods. A convenient sample of 593 Emirati mothers who had infants up to 2 years of age was interviewed. The interviews included a detailed questionnaire and conducted in the Maternal and Child Health Centers (MCH) and Primary Health Centers (PHC) in three cities. Results: Almost all the mothers in the study had initiated breastfeeding (98%). The mean duration of breastfeeding was 8.6 months. The initiation and duration of breastfeeding rates were influenced by mother's age (P<0.034)and education(P<0.01), parity(OR=2.13; P<0.001), rooming in(OR=21.70; P<0.001), nipple problem(P<0.010) and use of contraception(P<0.034). As for the feeding patterns, the results of the multiple logistic analyses revealed that rooming in (OR=4.48; P<0.001), feeding on demand (OR=2.29; P<0.005) and feeding more frequently at night (P<0.001) emerged as significant factors associated with exclusive or predominantly breastfeeding practices. Among the 593 infants in the study, 24.1% had complementary feeding, 25% of the infants were exclusively breastfed, and 49.4% were predominantly breastfed since birth. About 30% of the infants were given nonmilk fluids such as: Anis seed drink (Yansun), grippe water and tea before 3 months of age. The majority of the infants (83.5%) in the three areas received solid food before the age of 6 months. A variety of reasons were reported as perceived by mothers for terminating breastfeeding. The most common reasons were: new pregnancy (32.5%), insufficient milk supply (24.4%) and infant weaned itself (24.4%). Conclusions: In conclusion, infant and young child feeding practices in this study were suboptimal. There is a need for a national community-based breastfeeding intervention programme and for the promotion of exclusive breastfeeding as part of a primary public health strategy to decrease health risks and problems in the UAE. © 2013 Radwan.
El-Hattab A.W.,Tawam Hospital
Clinics in Perinatology | Year: 2015
Inborn errors of metabolism (IEM) are individually rare but collectively common. Approximately 25% of IEMs can have manifestations in the neonatal period. Neonates with IEM are usually healthy at birth; however, in hours to days after birth they can develop nonspecific signs that are common to several other neonatal conditions. Therefore, maintaining a high index of suspicion is extremely important for early diagnosis and the institution of appropriate therapy, which are mandatory to prevent death and ameliorate complications from many IEMs. © 2015 Elsevier Inc.