Mucocutaneous disease in Arabs with systemic lupus erythematosus: clinical expression and relevance to autoantibodies.

Both criterial and non-criterial mucocutaneous manifestations of 42 Arabs with systemic lupus erythematosus are reviewed. Photosensitivity occurred in 40.5%, malar rash in 35.75% and oral ulcers in 26% of patients. Subcutaneous nodules and subcutaneous lupus erythematosus (SCLE) were not seen, and there were few cases of discoid rash (DLE), Raynaud's phenomenon, livedo reticularis and SLE-related sicca and anticardiolipin syndromes. In the clinical relevance of autoantibodies in these patients, there was a significant association between anti-Sm antibodies and oral ulcers (P= 0.033) and, interestingly, between anti-cardiolipin (aCL) antibodies and lack of photosensitivity (P = 0.014). The report also reviews previously presented data on mucocutaneous LE in Arab and non-Arab patients and emphasises the presence of intra- and inter-racial variations of SLE expression including the clinical relevance to autoantibodies.

Serological markers in Arabs with lupus nephritis.

The aim of this study was to characterize the autoantibody profile of Arabs with lupus nephritis (LN). Therefore, the records of 42 Arabs with classical systemic lupus erythematosus (SLE) were reviewed. Twenty one (50%) with LN and 21 without. Most patients with LN have developed their nephropathy within the first five years of the disease. Only C3 hypocomplementemia achieved statistically significant correlation in nephritic patients and anti ribonucleoprotein (RNP) antibodies in non-nephritic patients. The difference in anti double stranded DNA (dsDNA) antibodies was insignificant (P=0.107), as both groups had markedly high prevalence of these antibodies. In addition, there was no significant negative association between detectable rheumatoid factor (RI) and patients with LN. We also examined the spectrum of specific entities of antibodies that had previously been reported in association with LN in other series (anti Smith (Sm), RNP and SS-A without anti SS-B, anti SS-A and SS-B, anti RNP and Smith, anti RNP and dsDNA and anti RNP and SS-A antibodies). None has shown any correlation with renal disease, P=1.00, P=0.591, P=0.613, P=0.195 and P=0.148, respectively. In conclusion, the study demonstrates that Arab patients with LN do not exhibit a distinctive serological profile, nonetheless it provides useful information to studies of SLE in different ethnic or racial groups.

The demographic and clinical spectrum of Arab versus Asian patients with ankylosing spondylitis in the UAE.

Ankylosing spondylitis is a rather uncommon condition in the UAE. Over a period of 10 years. 28 hospital-based patients diagnosed as having AS were retrospectively studied. They included 17 Arabs and 11 Asians. The onset of AS in most patients in this study was in adulthood (mean age at onset was 27.7 years in Arabs and 28.75 years in Asians). HLA B27 was positive in 56 and 81% in these two populations, respectively (P > 0.05). Analysis of these figures, however, along with previous relevant published data, could indicate that Arabs with AS are less likely to be B27-positive than Asians. Among the Arab patients there was not a single case from the local community, which could be attributed to the extremely low rate of B27 phenotype in their normal population. The interracial variations in the frequency of clinical features were statistically insignificant, therefore indicating some degree of similarity in the form and disease expression in both groups. AS is characterized as being predominantly axial in the majority of our patients. Extraspinal (oligo-poly) arthropathy involved mainly hips and knees, and there have been fewer extra-articular manifestations compared with other series published.

The need for prophylactic antibiotics after female sterilization: tetracycline in Bangladesh.

All female sterilization patients in Bangladesh receive five-day courses of tetracycline capsules every six hours as a postoperative prophylactic. A double-blind randomized study was conducted by the Bangladesh Fertility Research Programme (BFRP) to determine whether prophylactic antibiotics reduced infection after minilaparotomy, and to compare the prophylactic effectiveness of tetracycline and ampicillin. Women recruited from throughout Bangladesh (N = 1350) received five-day courses of 250 mg tetracycline, 250 mg ampicillin, or placebo. The infection rate was significantly lower with tetracycline than with placebo (6% vs 10% with placebo), but did not differ significantly between the ampicillin and placebo groups or between the tetracycline and ampicillin groups.

Experience in the control of khat-chewing in Somalia.

The chewing of the leaves of the plant called khat (Catha edulis Forsk) is a common habit in some countries of East Africa and the Arabian Peninsula. Khat-chewing has a stimulating effect on the central nervous system, which is the reason for the widespread abuse of this plant. From the mid-1960s to the early 1980s, khat-chewing spread from the limited area of the north-western part of Somalia to the whole country, assuming epidemic proportions. Khat-chewing was recognized as a real national problem with adverse consequences for the health and socio-economic development of the country. A law prohibiting the use, importation, cultivation and trade of khat was enacted in 1983, and it has been strongly enforced by a comprehensive national programme that has mobilized the whole country to achieve its objectives. Committees to co-ordinate action on khat control were established at the national, regional and local levels. An information and education campaign through the use of the mass media has been carried out to support the national programme. After the successes achieved in the enforcement of the prohibition law, the national authorities, hampered by a shortage of financial resources, have had major difficulties in providing farmers with adequate compensation for damage caused to them by the destruction of khat plantations. Difficulties were also experienced in coping with the unemployment of those who were involved in the khat business and in establishing the recreational facilities needed to provide healthy social alternatives to khat-chewing sessions. These difficulties have only been partly solved.(ABSTRACT TRUNCATED AT 250 WORDS)