Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Diagnostic Imaging for Blunt Abdominal Trauma8918971070410.12816/0044323ENJournal Article20180810<strong>Background: </strong>Blunt abdominal trauma is a common cause of morbidity and mortality among patients encountering traumatic injuries, especially motor vehicle accidents, which are the leading cause of injury worldwide. Focused abdominal sonogram for trauma, computed tomography with or without contrast, and laparotomy are the most common ways of diagnosis and treatment. With advancement of diagnostic medicine, the physicians are making use of non-operative methods to achieve quick results quicker and with fewer complications. <strong>Methodology: </strong>We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: blunt abdominal injury, FAST scan, US in abdominal trauma, CT for abdominal trauma, trauma management<em><br /> </em><strong>Aim:</strong> In this review, we aimed at evaluating the various methods of diagnosis using imaging for blunt abdominal trauma.
<strong>Conclusion: </strong>The growing tendency of non-operative management necessitates early identification of the injury sites, which is aided by the increasing sophistication of the CT techniques. Additionally, CT also provides a very significant method for following up the patients and for detecting complications which were not diagnosed initially.<br /><br />https://ejhm.journals.ekb.eg/article_10704_aedf3403fcb7cf64ec11d934b051d186.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Adult Immunization8989011070510.12816/0044324ENJournal Article20180810<strong>Background: </strong>Immunization recommendations depend on epidemiological factors as well as age, sex, history
of previous vaccination, current health status, occupation and lifestyle. Several vaccines are recommended for adults including, tetanus-diphtheria-acellular pertussis, tetanus-diphtheria, influenza, human papillomavirus, varicella, measles, mumps, and rubella, and pneumococcal 13-valent conjugate or pneumococcal 23-valent polysaccharide, and hepatitis. Such diseases have shown dramatic decrease in incidence and mortality after introduction of vaccines.<br /> <strong>Methodology: </strong>We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: adult immunization, adult vaccine, recent vaccine guidelines, preventive medicine, human papillomavirus, MMR, S. pneumoniae, PCV13, PPSV23, hepatitis A, hepatitis B<em><br /> </em><strong>Aim:</strong> In this review, we aimed at reviewing the updates in adult vaccine and their effectivity.<br /> <strong>Conclusion: </strong>Vaccination for adult population has proved to be of extreme importance and has achieved great successes. Combined efforts of patients, physicians, and policy makers are needed to achieve higher levels of success and improve vaccine coverage.<br /><br />https://ejhm.journals.ekb.eg/article_10705_45274260cd5e8bfa39c38edd5d201766.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Anticoagulants: Their Adverse Effects and Reversal9029051070610.12816/0044325ENJournal Article20180810<strong>Introduction: </strong>A balance between the coagulation systems is achieved by complicated pathways that involve platelets, the vascular endothelium, the coagulation cascade, and the fibrinolytic system. In case of conditions that predispose to higher coagulability, anticoagulants are used to prevent adverse outcomes. However, strict monitoring is required to maintain the balance of thrombogeneis and prevent dangerous complications such as bleeding. <strong><br />Methodology:</strong> we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE from January 1987 to March 2017. The following search terms were used: anticoagulant, heparin, warfarin, unfractionated heparin, factor Xa inhibitor<br /> <strong>Aim of the work:</strong> In this study we aimed at understanding the different types of anticoagulants used and also focus on the adverse effects and their reversal. <br /> <strong>Conclusion: </strong>Acute bleeding remains the most important concern when using anticoagulants and its risk is present with all agents. Although this bleeding is rarely fatal, its recognition and proper treatment is crucial and significantly affects outcomes.
https://ejhm.journals.ekb.eg/article_10706_8251048d0f0117840d789b24a58cb409.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Nutritional Anemia Types and Management9069111070710.12816/0044326ENJournal Article20180810<strong>Background: </strong>Nutritional anemia or anemia due to dietary causes is the most common form, yet, it is the easiest to manage compared to other forms of anemia. Some of the most common nutritional deficiencies are iron, cobalamin, folate, and also other elements like copper. Anemia due to diet is mostly asymptomatic in the initial phase until the stores are depleted, which can take a few months to several years, depending upon the cause. <strong><br />Methodology: </strong> We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE fromJanuary 1987 toMarch 2017. The following search terms were used: nutritional anemia, dietary anemia, iron deficiency anemia, cobalamin deficiency, folic acid deficiency anemia, dietary anemia treatment<br /> <strong>Aim of the work:</strong> In this study we aimed at understanding the different types of anemia caused as a result of dietary deficiency. We also briefly studied their presentation, pathophysiology, and treatment. <br /> <strong>Conclusion: </strong>Various causes of anemia, presentations, and complications associated with the different types of nutritional anemia, which is considered the easiest to treat and manage. Most cases are due to an underlying occult disorder rather than simple dietary insufficiency. Diagnosis can be more difficult in some cases, and require thorough history and investigations and integration to reach to an accurate conclusion and consequently treat the underlying cause.
https://ejhm.journals.ekb.eg/article_10707_205a1045adde10e1d4a508f544b63291.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Sharing the Experience of Management of Neonates with Maternal Premature Rupture of Membranes9129151070810.12816/0044327ENJournal Article20180810<strong>Background:</strong> Neonates with the maternal premature rupture of membranes are commonly encountered in the clinical practice. The condition has an important implication for the management of neonates, as it is associated with certain risks of morbidity and mortality. The management varies among the physicians. The study aimed at evaluating out the neonatal outcome of the existing condition with institutional practice.
<strong>Methods:</strong> The study was conducted at King Khalid Hospital, Al Majmaah KSA from August 2016 to August 2017. Two hundred neonates born to mothers with premature rupture of membranes were evaluated, monitored and treated in neonatal unit. Septic screening was done in all the neonates and empiric antibiotics were started for all the neonates. Maternal risk factors were taken into consideration. Neonatal outcomes were considered in all cases.
<strong>Results:</strong> There were 111 male and 89 female neonates. Most of the cases were term prom while 68 cases were pre-prom. Most commonly associated complication was feeding intolerance found in 16% of cases. Only two neonates had a positive blood culture for group B streptococci. Maternal high vaginal swab yield group B streptococci in 17 cases. Sepsis developed in three cases. One hundred and ninety eight neonates were discharged home while one patient died of severe sepsis.
<strong>Conclusion:</strong> PROM is a common clinical entity that requires careful handling of the neonates to prevent the mortality and morbidity. With prompt treatment, the outcome can be significantly improved.
https://ejhm.journals.ekb.eg/article_10708_2e25e3d23d7c67c1fed2d5c9994c294e.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Acquired Angioedema in a Patient with Chronic Lymphocytic Leukaemia112111221070910.12816/0044329ENJournal Article20180810Acquired angioedema (AAE) is defined by acquired deficiency of C1 esterase inhibitor. It is a rare disorder characterized by recurrent angioedema without urticiaria, which may be associated with lymphoproliferative disorders (LPD). We are reporting a case of 71 years old female, known case of Chronic Lymphocytic Leukaemia (CLL) who presented to the emergency room (ER) with generalized body swelling during her disease course. Investigations were ordered to confirm that the symptoms were due to acquired angioedema, and the patient was managed for this diagnosis.
Knowing the association between acquired angioedema and lymphoproliferative disorder is crucial, because AAE can be treated medically and responds within hours but delayed diagnosis can lead to unnecessary invasive procedures or asphyxiation and death due to laryngeal oedema.
Finally, treating the underlying cause as CLL in our case could prevent further recurrence of angioedema.
https://ejhm.journals.ekb.eg/article_10709_7f823041cf1f5ace7893251a1f77469e.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Assessment of Knowledge, Attitude and Practice towards Cervical-Spinal Injury Among Adults in Dammam City, 20179189231071010.12816/0044331ENJournal Article20180810<strong>Background: </strong>Spinal cord injuries (SCI) are life threatening and most prevalent crises around the world thus the first aid from society population could be helpful for proper management by health care professionals
<strong>Objectives: </strong>Evaluate the KAP of Saudi adults toward CSIs in Dammam City, Kingdom of Saudi Arabia (KSA). <strong>Methods: A</strong> cross sectional community questionnaire based survey that was carried out in 30 shopping malls of Dammam City among 700 Saudi subjects from May to July 2017.
<strong>Results: Most </strong>of the subjects (90.4%) had excellent and good knowledge about CSI, 58.9% had positive attitude, 7.3% showed a right practice, while practice of 69.5% was right but not complete and the rest had poor practice. There was a significant relation between knowledge score and Attitude score but not with the practice score. Also, there was a positive relation between the practice score and the attitude score. The older age and working status showed a significant relation with the knowledge score and the male showed a more significant right practice compared to females.
<strong>Conclusion: </strong>Most of the subjects had significant knowledge, attitude. However, low level of right and complete practices was obvious due to inadequate educational training programs attended by the participants about first aid of CSI patients.
https://ejhm.journals.ekb.eg/article_10710_fbc763a3881951e2dcc091d6dbbf81d5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Evaluation of Nutritional Quality of Green Tiger Prawn, Penaeus Semisulcatus from Land Fisheries (Alexandria) and Market (India)9249341071110.12816/0044332ENJournal Article20180810Seafood in general, shrimps and prawns in particular, are highly nutritious with good source of protein and amino acids<strong><sup>.</sup></strong> The present study was conducted to evaluate the nutrient value in males and females of green tiger prawn, <em>P. semisulcatus</em>. Twenty specimen were collected from land fisheries in Mediterranean Sea (Alexandria) and from markets (India). The results showed that the highest values of lipid contents were measured in the female and male edible muscles (<em>P. semisulcatus</em> at Mediterranean Sea (Alexandria) compared to female and male edible muscles of the same species from market (India). The carbohydrate contents in the male edible muscles of <em>P. semisulcatus </em>were higher compared to females in the studied regions. Sixteen amino acids have been determined in edible muscle of <em>P.</em> <em>semisulcatus,</em> among these, nine essential amino acids (EAAs) and seven non- essential amino acids (NEAAs) were estimated in both sexes from two regions. The quantities of amino acids vary considerably between sexes. The fatty acid contents from the muscles of the <em>P. semisulcatus</em> showed the presence of fifteen individual fatty acids, which include seven saturated fatty, three mono and five polyunsaturated fatty acids (MUFA and PUFA). Twelve protein bands were detected in males of <em>P. semisulcatus</em> (12 bands); while the females had 13 bands from market (India) compared to 9 bands of both males and females from Mediterranean Sea (Alexandria). Conclusion: The present study clearly indicated that the nutritional value of <em>P. semisulcatus</em> is very well as food and health care.
https://ejhm.journals.ekb.eg/article_10711_828a3e46702372bf90e7b2e0dae80a43.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Management and Follow-up of Dyslipidemia in Primary Health Care Setting9359381071210.12816/0044335ENJournal Article20180810<strong>Introduction: </strong>Management of dyslipidemia is an important part of most practice guidelines with many variations between these guidelines. Unfortunately, usually these guidelines are not followed widely on the level of primary care, possibly due to insufficient qualification of health care staff in primary care, non-participation in recent guidelines, and unrealistic target assigned to patients that leads them to non-compliance with medication and follow-up. <strong>Methodology: </strong>We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: dyslipidemia, primary health care dyslipidemia management, follow-up of dyslipidemia.<em><br /> </em><strong>Aim:</strong> In this review, we aimed at evaluating the management expected from primary health care for risk assessment, treatment and follow-up of patients with dyslipidemia. <br /> <strong>Conclusion: </strong>Many guidelines exist for the proper management of dyslipidemia in the primary care setting. Screening is crucial for preventing the cardiovascular sequelae of dyslipidemia. Management modalities include lifestyle modification and pharmacotherapy, while the significance of follow-up cannot be neglected.<br /><br />https://ejhm.journals.ekb.eg/article_10712_505cab986a680d3cc04c2af5df8942e5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Assessment of Knowledge, Attitudes and Practices of Expectant Mothers in Relation to Antenatal Care in Abha9399421071310.12816/0044337ENJournal Article20180810<strong>Background: </strong>Antenatal Care (ANC) is the care before birth that include complete screening, treatment, promoting and monitoring of the safety of the mother and fetus.
<strong>Objectives: </strong>Assessment of knowledge, attitudes and practices of expectant mothers in relation to antenatal care in Abha. <strong>Methods: </strong>This is a cross-sectional questionnaire based study conducted in Abha City from August to October 2017among 300 expectant women from different parts of Abha city.
<strong>Results: </strong>Most of the subjects had appropriate knowledge about the importance of ANC visits which resulted in good attitude and practice pattern among the majority of them. The majority of included women had good knowledge about the importance of ANC visits for supplementing women with vitamins and folic acid, giving them information about breast feeding and postpartum care, correct signs of labor, its importance for maintain women and child health, importance of ANC visits for the fetal developmental stages, decreasing the rates of maternal mortality, providing adequate knowledge about the danger symptoms and the complications of pregnancy and the importance of booking, following up and delivering later in the same place that they booked in. <strong>Conclusion: </strong>Most of the women had good knowledge, attitude and practice toward ANC visits.
The majority of the subjects were highly educated thus further large population studies are needed to be conducted all over KSA cities and include rural areas.
https://ejhm.journals.ekb.eg/article_10713_fd7709ab815ad3cbdf2d001f31d2d2a9.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Prevalence of Unplanned Pregnancy and Its Psychological Effect among Pregnant Patients in King Khalid University Hospitals9439471071410.12816/0044339ENJournal Article20180810<strong>Purpose: </strong>To identify the prevalence of unplanned pregnancy and the most common associated factors that might increase the incidence along with psychological effect.<strong> Material and methods: </strong>Self-administrated survey was conducted among pregnant women attending obstetric clinics during January, February and March 2017 at King Khalid university hospitals. Of whom 358 answered the survey<strong>. </strong>SPSS version 22 was used for completed and partial completed survey entry and analysis. <strong>Result: </strong>Prevalence of unplanned pregnancy among pregnant women attending the clinics was (12.3%) and majority (53.1%) found to be planned. We found that there were specific significant factors (age, gravidity and parity) which could play a role in determining the pregnancy was either planned or unplanned. Unplanned pregnancy associated with minimal psychological effect or distress when compared to planned pregnancy found when applied a screening test. <strong>Conclusion: </strong>Unplanned pregnancy has been associated with poor outcomes to the mother and baby along with psychological effect. Increasing the level of awareness and identifying the role of contraception in preventing unplanned pregnancy need to be conducted.
https://ejhm.journals.ekb.eg/article_10714_042e2d20d327514c9c3b7396af57c822.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Emerging Trends in Dental Specialty and Employment Choice Among Male Dentists Graduating from King Saud University between 2005 and 20159489541071510.12816/0044341ENSami AlshahraniCollege of Dentistry, King Khalid University AbhaNazish MasudDepartment of Medical Education,
College of Medicine, King Saud bin Abdulaziz University for Health Sciences RiyadhAfaf MoukaddemDepartment of Medical Education,
College of Medicine, King Saud bin Abdulaziz University for Health Sciences RiyadhTariq AlswayyedDepartment of Advanced Restorative Dentistry, King Abdulaziz Medical City RiyadhHussain MasoudCollege of Dentistry, King Khalid University AbhaMothen AlmothenMinistry of Health Riyadh, Saudi ArabiaYasmeen AlshammariDentist at private sectorJournal Article20180810<strong>Aim of the work: </strong>specialization in any field is known to be associated with higher productivity. Postgraduate dental education has a key role in providing the proper training for practitioners. This study aimed to assess the dental specialization trends among dentists who graduated from 2005 to 2015.<br /> <strong>Method: </strong>this observational descriptive study was conducted with the dental graduates of King Saud University. The participants were identified randomly and contacted via telephonic communication based on the list provided by the university academic affairs. The structured interview included 12 multiple choice questions to identify the specialty preferences of the graduate dentists. Chi-square and Fisher’s exact test were used where applicable. The p-value < 0.05 was considered significant for all applied statistical tests. <br /> <strong>Results: </strong>this study included 233 dental graduates the majority of which were working in the government sector (70%). Almost half of the subjects (49%) were general practitioners and had no specialization. Most of them had an interest in a postgraduate degree with prosthodontics being the most aspired specialty (30%). The overall trend of specialization between 2005-2015 showed a marked decline in both local and international post-graduation (p-value 0.013). <strong>Conclusion:</strong>specialization in the Saudi dentistry field is experiencing a decline in the number of graduates both locally and internationally. From here arises the importance of career and specialization orientation especially among the final year students to guide them in choosing their future specialties, while considering the needs and requirements of the community. This should be coupled with a proper recognition of the dental needs of the Saudi population.<br /> https://ejhm.journals.ekb.eg/article_10715_cec7bf2b3b37a66e72237e70762b24ea.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Detection of Methicillin Resistant Staphylococcus aureus with Reduced Susceptibility to Vancomycin9559601088310.12816/0044342ENHala Badr El-Din Ali OthmanClinical Pathology Department, Faculty of Medicine, Ain Shams UniversityRania Mohamed Abdel HalimClinical Pathology Department, Faculty of Medicine, Ain Shams UniversityMaha Soliman Abdel HamidClinical Pathology Department, Faculty of Medicine, Ain Shams UniversityFatma Alzahraa Mohamed GomaaMicrobiology and Immunology, Department, Faculty of Pharmacy (for girls), Al-Azhar UniversityJournal Article20180812<strong>Background: </strong>As there is no molecular-based assays available for the detection of hVISA and VISA. However, increasing amounts of data support a number of methods for the screening and confirmation of heterogeneous vancomycin intermediate S. aureus (hVISA) and vancomycin intermediate S. aureus (VISA) infection. The vancomycin MIC result alone is unable to accurately distinguish hVISA from VSSA isolates, and the use of MIC testingalone will fail to detect hVISA strains that are relatively common among isolates of <em>Staphylococcus aureus (S. aureus</em>) with broth MICs of 2 g per ml.
<strong>Objective:</strong> The aim of the present work was to detect the efficacy of phenotypic and automated methods for detection of MRSA with reduced susceptibility to vancomycin. It aimed also, to determine the best MIC concentration in vancomycin screening agar for detection of VISA among MRSA isolates.
<strong>Methods: </strong>One hundred MRSA isolates were obtained from 100 patients from different departments of Ain Shams University Hospitals during the period from October 2015 to the end of April 2016. They were isolated from different clinical specimens; sputum, wound swabs, blood, pus, urine, and body fluid that were referred to central microbiology laboratory for routine culture and sensitivity. Detection of <em>S. aureus</em> with reduced susceptibility to vancomycin was done by vancomycin screening agar with different concentrations 2,4,6 ug/ml with and without casein, MIC broth microdilution method for vancomycin according to <strong><em>CLSI 2015</em></strong>, and Vitek 2 automated system for determination of vancomycin MIC.
<strong>Results: </strong>Out of 100 MRSA isolates, vancomycin screening agar 2ug/ml with casein showed highest detection rate for VISA isolates (48 %) among other screening agars. Vancomycin screening agar 6 ug/ml without casein gave the lowest detection rate (29%). So, adding casein to vancomycin screening agar did not increase detection of VISA in any of vancomycin screening agar except for that with 2ug/ml vancomycin. Vancomycin screening agar 2ug/ml with casein gave the best sensitivity among all vancomycin screening agar tested. VITEK 2 system failed to detect any isolates with reduced susceptibility to vancomycin. They were sensitive to linezolid (100%) followed by tigecyclin (99%) then Quinupristin-dalfopristin (91%). However, most of the isolates were resistant to tetracycline (85%) followed by gentamicin (80%) then ciprofloxacin (63%).
<strong>Conclusion: </strong>BHI agar with 2ug/ml vancomycin and 16 g/l casein is a reliable, easy to perform, and inexpensive method to screen large number of <em>S. aureus </em>isolates for detection of reduced susceptibility to vancomycin on a daily basis. Applying quadruplicate technique in vancomycin screening agar may increase the yield for detection of VISA isolates. Although vancomycin screening agar 6 ug/ml is recommended by CLSI as a screening method for detection of VISA, yet it did not perform well and underestimated VISA isolates. VITEK 2 system is not an appropriate method for detection of <em>S. aureus </em>with reduced susceptibility to vancomycin (VISA). MRSA isolates with reduced susceptibility to vancomycin can be treated effectively with Linezolid.https://ejhm.journals.ekb.eg/article_10883_38c41ef63d1b3f16f2ce6ab551382afd.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Glanzmann’s Thrombasthenia: Epistaxis Treatment and Outcomes in Children9619641088410.21608/ejhm.2018.10884ENThikra Mohammed AlblowiHail University, Collage of MedicineFahad Nashmi AlshammariHail University, Collage of MedicineBashayer Aqeel AlshammariHail University, Collage of MedicineAhmed Ali ElazabHail University, Collage of MedicineThamer Menwer AlbilasiHail University, Collage of MedicineHind Jaza AlotaibiHail University, Collage of MedicineJournal Article20180812<strong>Background:</strong> Glanzmann’s Thrombasthenia (GT) is a rare inherited blood clotting (coagulation) disorder characterized by the impaired function of specialized cells (platelets) which are essential for proper blood clotting. <strong>Objectives:</strong> The present study aimed to assess the management steps of epistaxis in children with GM disease and assess the clinical outcome and the success rate or field of management.
<strong>Methods: </strong>Data was taken via scanning all the patients’ files in ENT clinic and 4 children with GM were identified as receiving therapy. Furthermore, data collected from each file were primary complaint needing a duration of hospitalization, intensive care unit (ICU) admission, coagulation management, hematologic results, medical therapy administration, blood products transfusion and the surgical intervention performed.
<strong>Results:</strong> With a total of 25 hospital presentations, the highest percentage of the present symptoms was for epistaxis with 68% <sup>(17)</sup>, then 16% <sup>(4)</sup> for gingival bleeding and 8% for each of menorrhagia and hematemesis. <strong>Conclusion and recommendation:</strong> Our study carried out the most effective technique that control epistaxis is Fresh Frozen (FFP) Plasma. The epistaxis in GT should be concern as sever threating life condition and should be managed with effective treatment.https://ejhm.journals.ekb.eg/article_10884_17c4897fa4ff63de653148d875ff9607.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101The Prevalence of Asthma and its Related Risk Factors among the Children in Riyadh, Saudi Arabia9659731093210.12816/0044345ENYoussef Fayez HoraibAlmaarefa Colleges, Riyadh, Saudi Arabia.Esra Saleh ALAmriAlmaarefa Colleges, Riyadh, Saudi Arabia.Wala Al-anaziAl-Maarefa College for Science and Technology, Riyadh, Saudi ArabiaEman Ahmed SharahiliAlmaarefa Colleges, Riyadh, Saudi Arabia.Abdulmajeed Mohammed AlolayahAlmaarefa Colleges, Riyadh, Saudi Arabia.Munirah Abdulrahman AlrobianAlmaarefa Colleges, Riyadh, Saudi Arabia.Journal Article20180813<strong>Background:</strong> The prevalence of asthma has increased considerably in the last few years. This study aimed at assessing the prevalence of asthma and its related risk factors among children in Riyadh, Saudi Arabia.
<strong>Methods:</strong> A cross sectional prospective study was carried out. Pretested well-designed questionnaires were distributed during the period from May to October 2016.
<strong>Results:</strong> Parents of 1700 children out of 4000 have completed the questionnaire with a response rate of 42.5%, 1082 (63.6%) of them were male. Asthma prevalence among girls (14.4%) was higher than boys (12.4%), but this difference was insignificant. Asthma prevalence was significantly higher among Saudi participants (14.4%)compared to non- Saudi (5.9%). Nature of residency, the presence of a plant or presence of pets at home had no significant effect on asthma prevalence. A smoking of family member and a history of asthma in the family had an important association on asthma prevalence rate. The highest prevalence of asthma (29.7%) was among the younger children (<3 years). Symptoms of asthma enhanced during exercise. The positive association between asthma and both cough and breathlessness was noted. Asthma had no effect on schools absenteeism, visiting or admission to hospitals. Body mass index had no effect on the prevalence of asthma.
<strong>Conclusion:</strong> The asthma prevalence rate among children was 13.1%, whereas, smoking and a history of asthma in the family increased this rate. Further studies are recommended to investigate asthma prevalence based on clinical and laboratory diagnosis to explore the link between asthma and obesity.
https://ejhm.journals.ekb.eg/article_10932_cf0df59dba21278befcbf0ecf6bfeb4b.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Mitochondrial Translocase Expression Profile in Renal Cancer9749791094210.12816/0044346ENBelal Ahmed SolimanDepartment of Zoology, Faculty of Science, Suez Canal UniversityMohamed Hassany AliDepartment of Zoology, Faculty of Science, Suez Canal UniversityEman Ali Toraih2 Department of Histology and Genetics, Faculty of Medicine, Suez Canal UniversityMohamed Abdelhamid Hasan AhmedDepartment of Pathology, Faculty of Medicine, Suez Canal UniversityJournal Article20180813<strong>Background: </strong>mitochondrial appropriate function depends on ideal mitochondrial translocation machinery, of which translocase of outer mitochondrial membrane (TOMM) have a vital role in normal functioning cell. Any disturbance in the translocation machinery leads to either tumorigenesis or apoptosis.
<strong>Aim of the work</strong>: This study aimed to investigate the expression of TOMM34 in renal cell carcinoma (RCC). TOMM34 expression was assessed in 42 samples of RCC patients using immunohistochemistry technique.
<strong>Results: </strong>immunohistochemical staining revealed significant accumulation of TOMM34 protein in RCC cases compared to their corresponding non-cancerous renal tissues. TOMM34 protein expression was significantly associated with age and gender categories in contrast to the other clinicopathological features.
<strong>Conclusion</strong>: according to protein expression level this study demonstrated that TOMM34 is a marker of poor outcome in RCC.
https://ejhm.journals.ekb.eg/article_10942_79e39367c276f422d4fa4f93e53dc041.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101A Testicular Torsion and Contralateral Hydrocele in a Neonate9809811094410.12816/0044347ENMohammed S. AlbarrakDepartment of Pediatric Surgery, Maternity & Children Hospital, Alahsa,Saudi ArabiaAli H. AlameerDepartment of Pediatric Surgery, Maternity & Children Hospital, Alahsa,Saudi ArabiaAshjan Ali AlbarrakDepartment of Pediatric Surgery, Maternity & Children Hospital, Alahsa,Saudi ArabiaJournal Article20180813<strong>Background:</strong> A testicular torsion is an acute surgical emergency which needs a prompt work up. Neonatal testicular torsion is an uncommon event.
<strong>Aim of the work: </strong>This article aim to describe a case report of a neonate presented with testicular torsion and contralateral hydrocele.
<strong>Results:</strong> Clinical and radiological management were discussed.
<strong>Conclusion</strong>: The casedemonstrated that the possibility of uncommon presentation of acute scrotum such as testicular torsion with contralateral hydrocele can occur.
https://ejhm.journals.ekb.eg/article_10944_d2a931d2e28f7eba2396765e4f068089.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Comparison of Cotinine Salivary Levels Between Smokers, Smokers and Non-Smokers Passive9829891094710.12816/0044349ENArwa Ahmad FallatahUmm Alqura UniversityRania HanafiUmm Alqura UniversityIbtesam AfifiUmm Alqura UniversityJournal Article20180813<strong>Background: </strong>Cotinine is the predominant metabolite of nicotine which found in tobacco. At present, smoking cigarettes and hookah are on the rise in the Middle East countries; therefore, the number of people exposed to passive cigarette smoking is increasing too. <strong>Objective: </strong>To compare the salivary cotinine level in saliva in smokers, non-smokers, passive smokers. Also to combat the wrong opinion that hookah is not harmful.
<strong>Material and methods: </strong>In this cross-sectional study, unstimulated salivary samples were collected from 30 female subjects including students and workers at College of Dentistry, Umm Al-Qura university, Makkah. The study participants were divided into 3 groups (each of 10 subjects) aged 19-50 years;
<strong><em>First group: </em></strong>with history of cigarettes or hookah smoking at least one session/day for 20-30 minutes for at least 2 years.
<strong><em>Second group: </em></strong>exposed to cigarette smoke or hookah.
<strong><em>Third group: </em></strong>non-smoker.
TheNicAlert™ (NYMOX pharmaceutical corporation, Canada) nicotine saliva test was used to determine salivary levels of cotinine.
<strong>Results: </strong>Salivary cotinine level was detected in all study groups with the different levels. The highest level was in a group of smokers while 50% of non-smokers showed level one. There were no significant differences in salivary cotinine levels between hookah, cigarette and both smokers and a significant relation between duration and salivary cotinine level.Also a non-significant relation was found between age and salivary cotinine level.
<strong>Conclusion: </strong>Salivary cotinine levels were higher in smokers compared to passive smokers and non-smokers, in descending order.
<strong> </strong>https://ejhm.journals.ekb.eg/article_10947_25945d801b810ba4ccaf9a7c1e40d327.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Awareness of Systemic Lupus Erythematosus amongStudents in King Faisal University9909931095510.12816/0044350ENAbdullah Ahmed AlKhalafFaculty of Family Medicine, King Faisal UniversityRasha GhalebFaculty of Family Medicine, King Faisal UniversityMustafa Hussain Al ShawafFaculty of Family Medicine, King Faisal UniversityAmmar Ahmed AbdrabalnabiFaculty of Family Medicine, King Faisal UniversityAbdullah Ahmed Al-Shabib Al-ShabibFaculty of Family Medicine, King Faisal UniversityAhmed Hassan Al-KhatemFaculty of Family Medicine, King Faisal UniversityYousif Taher Al MalakFaculty of Family Medicine, King Faisal UniversityHussain Ali Al QattanFaculty of Family Medicine, King Faisal UniversityHashim Essa Al-KhalafFaculty of Family Medicine, King Faisal UniversityJournal Article20180813<strong>Background</strong>: Systemic lupus erythematosus (SLE) is an autoimmune disease where the body's immune system mistakenly attacks healthy tissue. It can affect the skin, joints, kidneys, brain, and other organs.
<strong>Objective</strong>: to assess knowledge toward Systemic Lupus Erythematosus (SLE) among Students of King Faisal University.
<strong>Subjects and Methods</strong>: this is a cross-sectional study enrolling 161 students atKing Faisal University to fill a survey on SLE awareness. The study targeted students of computer science, engineering, science and education colleges. The data was analyzed using SPSS software version 20.
<strong>Results</strong>: the study reported that 98 students (60.9%) have no idea about SLE. The majority of respondent did not have clear idea regarding diagnostic, treatment and complications of disease. 55.9% respondent had idea that SLE is more prevalent among men. However, this disorder is reported more prevalent in women.
<strong>Conclusion</strong>: this cross-sectional survey indicates that the students have low awareness and some misconception regarding the SLE. Therefore, the awareness programs are needed to increase the awareness about SLE, as these campaigns have proved that public awareness might be helpful to manage and control disease and associated complications.
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https://ejhm.journals.ekb.eg/article_10955_a9122eee09258d973001162f7905dd51.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Combinational Effect of 5-Flourouracil and Resveratrol against N-Nitroso-N-methyl urea Induced Colorectal Cancer99410061095910.12816/0044352ENBelal Ahmed SolimanZoology Department, Faculty of Science, Suez UniversityAbdel Razik Hussein Farrag2Pathology Department, National Research CenterHowayda Al Sayed KhaledZoology Department, Faculty of Science, Suez UniversityAlyaa A.Mostafa MohamedZoology Department, Faculty of Science, Suez UniversityJournal Article20180813<strong>Background</strong>: colorectal cancer is considered to be the third most common cause of deaths in both men and women. The incidence of colorectal cancer cases has been rising at an alarming rate. In most cases, colon cancer treatment involves chemotherapy. However, toxicity and tumor cell drug resistance are outstanding obstacles to this treatment. Scientific studies suggested that combining certain chemotherapy treatments with specific antioxidants at defined dosages can improve drug efficacy or may reduce side effects severity.5-Fluorouracil, which is used in the treatment of breast, stomach and pancreatic cancer, remains the cornerstone of CRC treatment, although widely used in combination with several other drugs. Many effective drugs, including those actually used for cancer treatment, have been developed from botanical sources. Resveratrol is a pleiotropic phytochemical which is belong to the stilbene family. Although, it is only significantly present in grape products. Many preclinical studies investigated its anticancer properties in a plethora of cellular and animal models. <strong>Aim of the work</strong>: in the present study, the anticancer effects of Resveratrol alone or combined with 5-Fu were assessed on experimentally induced colorectal cancer in rats. <strong>Results:</strong> the results of this study indicated that RES had a better therapeutic effect against N-methylnitrosourea induced colorectal cancer than 5-Fu alone and when in combination with each other they diminished the cytotoxic effect of 5-Fu and enhanced normal histological appearance of colon tissue, which could be a promising alternative for resistant colorectal cancer. However, the exact mechanisms involved needs to be further explored. <strong>Conclusion</strong>: our results suggested that both natural compounds could be in the future a possible alternative to enhance the efficiency of 5-Fu in resistant colon cancer cells. This study supports the potential of plant extracts as source of bioactive compounds with biomedical applications.
<strong> </strong>https://ejhm.journals.ekb.eg/article_10959_05df0d3a28c602e4c49d061c773cf9bc.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Diagnosis and Management of Gastrointestinal Stromal Tumor in the Upper Gastrointestinal Tract- Case Report100710111096210.12816/0044353ENAqeel Jazaa AlshammariCollege of Medicine, University of HailKhaled Mandeel HammodKing Khalid Hospital, HailFouad Taiwilaa AlshammariCollege of Medicine, University of HailSaleh Muflih AlghaythiCollege of Medicine, University of HailSattam Saad AlshammariCollege of Dentistry, University of Hail, Saudi ArabiaJournal Article20180813 <strong>Aim of the work</strong>: gastrointestinal stromal tumours (GISTs) are a type of mesenchymal tumours of the gastrointestinal (GI) tract. The tumour can originate anywhere from the oesophagus to the rectum, but most often comes from the stomach or small intestine. Despite the fact that GISTs are the most common mesenchymal neoplasms of the GI tract, they remain a diagnostic challenge because of the overlapping clinicopathologic features with GIST. Large GISTs are usually associated with complications such as gastrointestinal (GI) haemorrhage, GI obstruction, and bowel perforation. GISTs are predominantly found in people in their 60s, but a small population can develop it a younger age. <strong>Patient and methods</strong>: this was a report the case of a 65-years old male presented to our hospital with upper gastrointestinal bleeding<strong>. Results</strong>: vomiting and severe anaemia findings were detected in diagnostic image studies which suggested a gastric GIST without evidence of metastatic disease; therefore, totally tumour excision was performed. Cytologic and inmuno-histochemistry analysis confirmed diagnosis of GISTs.<br /> <strong>Conclusion: </strong>the present case report highlighted the need of early recognition and appropriate investigation of gastrointestinal symptoms at all ages for ruling out potential malignancy.<br /> <strong> </strong>https://ejhm.journals.ekb.eg/article_10962_dd4a5001dc91a9dad84090ed532cc10a.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Eosinopenia as a Diagnostic Marker of Sepsis in Critically Ill Patients101210241097810.12816/0044354ENMahmoud A. Salem, Mohammed A. AliDepartment of Anesthesiology, Intensive Care Medicine and Pain Management
Faculty of Medicine, Ain shams UniversityAshraf M. Hazem, Hoda S. AbdelsamieDepartment of Anesthesiology, Intensive Care Medicine and Pain Management
Faculty of Medicine, Ain shams UniversityJournal Article20180813<strong>Background: </strong>sepsis refers to the presence of a serious infection that correlates with systemic and uncontrolled immune activation. Few studies had analyzed eosinophil count as a prognostic marker of outcome in patients with infection. Eosinopenia is an interesting biomarker because the eosinophil count is always measured in clinical practice and the additional costs would therefore be negligible.<strong>The aim of this wrk: </strong>this studyaimed to test the value of eosinopenia in the diagnosis of sepsis in critically ill patients admitted to ICUs. <strong>Patients and Methods:</strong> this prospective observational, randomized study was conducted on 50 adult critically ill patients who were admitted to ICU of Ahmed Maher Teaching Hospitalin the period from March 2017to July 2017. They either had sepsis on admission or not. An informed written consent was obtained from patients and/or relatives before starting this study. <strong>Inclusion criteria</strong> were patients more than 18 years old and less than 60 years that were critically ill either in sepsis or not. <strong>Exclusion criteria</strong> were patients less than 18 years old and more than 60 years old, patient or relatives who refused to be included in this study, those with hematological cancer, HIV infection, bronchial asthma and other atopic disorders like hay fever, atopic dermatitis and allergic conjunctivitis and increased levels of eosinophil count as part of any parasitic infection or trauma patients. <strong>Results:</strong> comparison between infected and non-infected studied patients was statistically significant as regard variables of SOFA score, APACHE II score at admission, TLC and Eosinophil count at admission (p-value˂0.05). There were no statistical significant differences as regard length of ICU stay (p˃0.05). Multivariate regression analysis showed statistically significant differences and was independent predictors for infection as follow: total leucocytic count, eosinophil count at admission and SOFA score. The AUC for eosinophil count to predict was 95% with optimal cut off value was 50 cells/mm<strong><sup>3</sup></strong> with a sensitivity of 92.85% and specificity of 93.33% with P value <strong><</strong>0.001.<strong>Conclusion: </strong>the result of the present study revealed that eosinophil counts was ˂50 cells/mm3 at admission time to ICU was a predictor for diagnosis of sepsis in critically ill patients. However, eosinophil counts at admission time to ICU were not a specific indicator of mortality.<strong> Recommendations: </strong>eosinophil counts are cheap and easily accessible test can be used to guide for sepsis diagnosis and treatment.Larger studies are needed to determine the prognostic value of this test and establish better cutoff values.
<strong> </strong>https://ejhm.journals.ekb.eg/article_10978_e782a611612a2b77a07471347a61b529.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Assessment of Self-Awareness and Perception of Diabetic Foot Disease among People with Type 2 Diabetes Mellitus in Tabuk102510291097910.12816/0044356ENAhmad Awadh AlatawiFaculty of Medicine, University of Tabuk, Tabuk/ KSAMohammed Hamad AlrashediFaculty of Medicine, University of Tabuk, Tabuk/ KSAAbdulelah Mohammed AlqarniFaculty of Medicine, University of Tabuk, Tabuk/ KSAAbdullah Hamad AlmotiriFaculty of Medicine, University of Tabuk, Tabuk/ KSASultan Saleh AlbalawiFaculty of Medicine, University of Tabuk, Tabuk/ KSAMohammed Abdullah AlshamraniFaculty of Medicine, University of Tabuk, Tabuk/ KSAAbdulelah Faiz AlasmariFaculty of Medicine, University of Tabuk, Tabuk/ KSAJournal Article20180813<strong>Background:</strong> effective self-management of type-2 diabetes mellitus (T2DM) is crucial to reduce the risk of diabetes-specific complications. Self-management activities included adherence to diet and nutrition advice, physical activity, taking mediations as prescribed and weight and stress management. Evidence suggested that there is poor adherence to self-care practices among diabetes patients globally. Thus, it has become necessary to identity factors that play significant roles in influencing the T2DM patients, adherence to self-care practices. Knowledge about the illness is likely to inform patients about specific actions in the diabetes management process. Thus, the more knowledge patients have about their illness, the more likely they are to comprehend their illness.
<strong>Methods: </strong>We have conducted a descriptive cross-sectional study in Tabuk city population, Saudi Arabia. The study was conducted during the period from October to December 2017. The participants were selected by random sampling. Sampling included the different geographical areas of the city. The total sample included 120 pupils. All the pupils were approached to obtain the desired sample size. A self-administered questionnaire about diabetes mellitus and diabetic foot disease was filled by the participants.
<strong>Results:</strong> In this study age of participants was ranged from 30 to 65 year old, with a mean (SD) of 46.67 (9.218) ,the majority were males (65%) and 73.4% were with basic educational level. The mean of duration of T2DM among the people was 7.49(SD=7.377) with range=35. Three quarters of participants reported positive family history of T2DM. Regarding number of family members with history of T2DM, the mean was 1.3(SD=0.975) and range was 5. Participants who reported that their blood sugar was uncontrolled were more than those who reported that their blood sugar was controlled, (Uncontrolled blood sugar 58.3% and controlled blood sugar 41.7%).
<strong>Conclusion: </strong>More attention is needed on primary prevention programs that focus on awareness and assessment of the diabetic foot disease, and the danger of complications of T2DM and its risk factors.
<strong> </strong>https://ejhm.journals.ekb.eg/article_10979_aab624a15d4607aa18e012fc5c605482.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Evaluation of Knowledge about Risk Factors of Heart Disease in Tabuk City between Adult Population103010341098010.12816/0044357ENKhalid Awd AlbalawiFaculty of Medicine, University of Tabuk, Tabuk/ KSASaleh Hammad AlhawitiFaculty of Medicine, University of Tabuk, Tabuk/ KSAJournal Article20180813<strong>Background: </strong>According to World Health Organization (WHO), heart disease especially coronary heart disease is the leading cause of death globally and one of the major health burdens worldwide. A report released by the Media and Health Awareness Information Center at the Ministry of Health (MOH) in Saudi Arabia, pointed out that, cardiovascular diseases (CVD), including heart attacks and strokes, are the cause of 42 percent of the Kingdom's non-communicable diseases deaths in 2010. Vascular injury accumulates in adolescence, making it necessary for primary preventive measures to be taken from childhood. Therefore, there is increasing emphasis on preventing atherosclerosis by modifying risk factors, such as healthy diet, exercise and avoidance of smoking.
<strong>Methods: </strong>We have conducted a descriptive cross-sectional study in Tabuk city population, Saudi Arabia. The study was conducted during the period from May to September 2017. The participants were selected by random sampling. Sampling was stratified for the different geographical areas of the city. The total sample obtained was 460. All the pupils were approached to obtain the desired sample size. A self-administered questionnaire about heart disease risk factors knowledge and awareness was filled by participants.
<strong>Results: </strong>the majority of participants showed right answers and were aware about some of the risk factors of heart disease. The majority agreed to the following statements: (Being overweight increases a person's risk for heart disease-96.7%), (Smoking is a risk factor for heart disease-92.4%), (High cholesterol is a risk factor for developing heart disease-92.4%) and (High blood pressure is a risk factor for heart disease-86.5%). <strong>Conclusion: </strong> more attention is needed on primary prevention programs that focus on diet, exercise and the danger of heart disease and its risk factors should be emphasized.
<strong> </strong>https://ejhm.journals.ekb.eg/article_10980_7d83b32f1a6b6af524a35d8a41b0adf1.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Prevalence of High Risk Group of Obstructive Sleep Apnea Among Western Region Population in Saudi Arabia103510381098110.12816/0044358ENMohammed Abdullah AssiriCollege of Medicine, Taif UniversityHabibullah Ammar Hussain MKing Abdullah Medical City in MakkahAbdulaziz Saud AljuaidCollege of Medicine, Taif UniversitySaud Mohammed AleisaCollege of Medicine, Taif UniversityMohammed Ateih AlsofyaniCollege of Medicine, Taif UniversityMamdouh AlshareefAlhada Military Hospital in TaifJournal Article20180813<strong>Background: </strong>Obstructive sleep apnea is a chronic morbid condition characterized by frequent attacks of upper airway collapse during sleep leading to interrupted sleep cycle and daytime fatigue.
<strong>Objectives: </strong>Assessment of the most affected group of adults by obstructive sleep apnea disorder in western area of Saudi Arabia and help them to get a good quality of life.
<strong>Methods: </strong>Cross sectional study involving 214 adults with age between 18 and 80 years old in the western area of Kingdom of Saudi Arabia. <strong>Results: </strong>There was no relationship between specific genders with high risk of OSA, while there was strong relationship between participants from male gender with low risk of OSA. Also, there was no relationship between age and high risk of having OSA among our participants. In addition, there is no relationship between age and low risk of having OSA among our participants. There was a relationship between overweight participants from both gender and high risk of having OSA, while there was relationship between underweight participants from both gender and low risk of having OSA.
<strong>Conclusion: </strong>Our study showed that around 28% of populations are in high risk group of having OSA. Also, sleep apnea in older patients is less severe than sleep apnea in the young.
<strong> </strong>https://ejhm.journals.ekb.eg/article_10981_bf91393a871f02cd7e169b3ab0436626.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Prehospital Tracheal Intubation versus Emergency Department Intubation for Trauma Patients103910461098210.12816/0044359ENJournal Article20180813<strong>Background:</strong> Patients with severe traumatic brain injury (TBI) are at high risk for airway obstruction and hypoxia at the accident scene, and routine prehospital endotracheal intubation has been widely advocated.
Aim of the Study: to evaluate and compare the outcome and mortality rates of trauma patients undergoing Prehospital Tracheal Intubationversus those undergoing Emergency Department Intubation.
<strong>Methods:</strong> A literature search was carried out on MEDLINE (including MEDLINE in-process), CINAHL, Embase and the Cochrane Library (from 1990 to October 2017). Databases using “Prehospital Tracheal Intubation”, “Emergency Department Intubation “, “Adults’ trauma”, and “mortality” as a MeSH heading and as text word. High yield journals were also had searched.
<strong>Results: </strong>Eleven studies enrolling 17317 patients were included, out of which 4545 underwent PTI while 12772 underwent EDI. Median mortality rate in patients undergoing pre-hospital intubation was 52.12% (7.8–90.16%), compared to 27.98% (6.25–41.56%) in patients undergoing intubation in the emergency department. The overall quality of evidence was very low. Six of the eleven studies found a significantly higher mortality rate after pre-hospital intubation whilst five found no significant differences.
<strong>Conclusion: </strong>Study outcome suggests that EDI was superior to PHI. Nevertheless, prehospital intubation was a marker for more severely ill patients who would have had higher mortality thus, the <strong>suggestion of the association between pre-hospital intubation and a higher mortality rate does not essentially oppose the importance of the intervention, but rather a need for further</strong> investigation of the possible causes for this finding.
https://ejhm.journals.ekb.eg/article_10982_f84c71215f7cad4e1be749ecb2a2d512.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101The Correlation between Vitamin D and Cognition: A Review104710551098310.12816/0044361ENWesal Ibrahim H. Alzain1- Jarwal Phcc Makkah AlmukaramahMeshal Mohammed AltowairqiPrince Sultan Medical Military CityDuaa Khalid M AlalawiWarsaw Medical UniversityNorah Mohammed A AlthubaitiKing Abdulaziz UniversitySiyadah Anwar Abduljawad AbduljawadIbn Sina CollegeSami Muslim AlloqmaniPHC at MadinahAmani Hussain AlshawafPHC at Al-AhsaAbdullah Saleh AlqahtaniUmm Alqura’a UniversityAhmad Ibrahim M AlbridiKing Khalid UniversityAbdullah Jameel MotaharUmm Alqura’a University, Mohamad Fahad M AlreshoudiQassim UniversityLaila Mossa MahdiAseer Central HospitalJournal Article20180813therapeutic tool in a number of neurological pathologies. More recently, experimental and pre-clinical data suggest a link between vitamin D status and cognitive function. Human studies strongly support a correlation between low levels of circulating 25-hydroxyvitamin D (25(OH)D) and cognitive impairment or dementia in aging populations transcription regulators - has emerged as a serious candidate in nervous system development and function and a. In parallel, animal studies show that supplementation with vitamin D is protective against biological processes <strong>Background:</strong> During the last 25 years, vitamin D -being a member of the superfamily of nuclear steroid associated with Alzheimer’s disease (AD) and enhances learning and memory performance in various animal models of aging and AD. More recently epidemiological associations have been made between low vitamin D and psychiatric disorders not typically associated with abnormalities in brain development such as depression and Alzheimer's disease
<strong>Aim of the Study: </strong>was to review the recent literature to investigate the correlation between vitamin D status
and neurocognitive function.
<strong>Methods:</strong> We searched the medical literature to retrieve studies for the review to 30 November 2017. electronic search in the scientific database from 1965 to 2017– (Medline, Embase, AMED, Psych INFO, the Cochrane Library websites were searched for English Publications were obtained from both reprint requests and by searching the database. Data extracted included authors, country, year of publication, characteristics of patients, pathophysiology, risk factors, clinical manifestations, different diagnostic approaches and treatment modalities.
<strong>Conclusion:</strong> Accumulating evidence in the current literature indicate that vitamin D deficiency is highly prevalent among patients with cognitive impairment, and that low vitamin D status may negatively impact cognition and that hypovitaminosis D is usually associated with increased risk of developing AD and dementia. Nevertheless, while vitamin D supplementation is safe for those with cognitive impairment, there is no solid proof that they will see significant improvement in their symptoms.
https://ejhm.journals.ekb.eg/article_10983_b7ed7ed1c25eb85920759486818e01c6.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Misuse of Antibiotics Therapy in General Population of Saudi Arabia105610611098410.12816/0044362ENNaif Negikhan AlOtaibiSecurity Force HospitalMajed Dakhel AlmutairiSecurity Force HospitalYoussef Zaid Al-NamshanKing Saud UniversityMohammad Abdulrahman Al DhohayanQassim UniversityRakan Deeb AlotibiSecurity Force HospitalJournal Article20180813<strong>Background:</strong> The misuse of antibiotic treatment is an important cause of emerging bacterial resistance. Taking antibiotics without prescription through self-medication, friends or relative opinions, or pharmacist advice is a very common behavior in the developing countries.
<strong>Methods:</strong> The sample was selected from the most important and most populated area in Saudi Arabia (Riyadh region). The data were collected through self-administered questionnaires for educated participants and with interviewers for non-educated participants. The participants were selected randomly from outpatient attendants of hospital and health centers. The data were analyzed using SPSS software program, with descriptive and inferential statistics. <strong>Results:</strong> The response rate was 96% with mean age of 32 ± 12.79 years, ranging from 14 – 80 years. Male subjects were a little more than females. Most of these subjects were university students. About 73% were not health staff and approximately 70% of subjects reported that they had health insurance. Most subjects (65.7%) took the antibiotics based on specialist prescription. For those who took their drugs without prescription, around 67.2% reported that was because they used it before. Following doctor’s instructions about the time of taking the drug was reported by 80.3% of subjects. Following doctor’s instructions regarding the appropriate dose was reported by 88% while, taking all the prescribed doses was only reported by 56% of the subjects. Significant association was found between health insurance and the way the subjects take their drug. Also, significant associations were found between education and income with following the doctor’s instruction regarding taking all doses.
<strong>Conclusion: </strong>Misuse of antibiotic is still higher. There is extremely need for public educational programs in addition to application of the laws.
https://ejhm.journals.ekb.eg/article_10984_93ddf23ca22d7e144dc42fcce51c97b5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101Association Between Stroke and Hypertension and Deep Vein Thrombosis in Northern Saudi Arabia: Community-Based Study106210651098510.12816/0044363ENAhmad Soud AlzayedCollege of Medicine, University of Hail, HailHussain Gadelkarim AhmedCollege of Medicine, University of Hail, Molecular Diagnostics and Personalized Therapeutics Unit, University of Hail, Hail, Saudi ArabiaFaisal Soud AlzayedCollege of Medicine, University of Hail, HailKareem Saleh AlshammariCollege of Medicine, University of Hail, HailAqeel Jazzaa AlshammariCollege of Medicine, University of Hail, HailAmjad Tallaa Ali TallaaCollege of Medicine, University of Hail, HailAbdulaziz Farhan AlharbiCollege of Medicine, University of Hail, HailMohannad Yousef AljarallahCollege of Medicine, University of Hail, HailZiyad Ali AlosayfirCollege of Medicine, University of Hail, HailJournal Article20180813<strong>Background: </strong>Deep venous thrombosis (DVT) is a serious complication of various medical conditions including acute stroke.
<strong>Objectives: </strong>We aimed to analyze the association between stroke toward hypertension (HP) and deep vein thrombosis (DVT) in northern Saudi palpitations.
<strong>Methods: </strong>Cross-sectional study was performed, all incident stroke events during follow‐up were identified by searching the hospital discharge diagnosis registry, and previous patient’s medical records. Also, we conducted a questionnaire survey among population of North Saudi Arabia including 15 cities.
<strong>Results: </strong>Our study showed that HP, and DVT which is definitely associated with stroke occurs only in approximately 5% of patients and significantly affects mortality among population from northern Saudi.
<strong>Conclusion: </strong>Severe HP events with no stroke incidence is associated with increased risk of DVT especially in Male and age group above 55 years. Therefore, it may be reasonable to provide this group of patients with additional care and proper DVT prophylaxis in order to minimize the risk of stroke. Also, those patients with HP should be managed and followed regularly especially elderly patients who are at risk.
https://ejhm.journals.ekb.eg/article_10985_538b7176288caddd1bfc9643fc152074.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270620180101The Patterns of Surgically Treated Thyroid Disease in Central Rural Region of Saudi Arabia1066107110986ENAbdulhkam AljarbouDepartment Of General Surgery, Prince Sattam Bin Abdulaziz University Al Kharj City ,Saudi ArabiaAnthony MorganDepartment Of General Surgery, Prince Sattam Bin Abdulaziz University Al Kharj City ,Saudi ArabiaFawaz AlshaalanDepartment Of General Surgery, Prince Sattam Bin Abdulaziz University Al Kharj City ,Saudi ArabiaDhafer AlshehriDepartment Of General Surgery, Prince Sattam Bin Abdulaziz University Al Kharj City ,Saudi ArabiaMohammed AlshathriDepartment Of General Surgery, Prince Sattam Bin Abdulaziz University Al Kharj City ,Saudi ArabiaKhalaf AlsayyaliDepartment Of General Surgery, Prince Sattam Bin Abdulaziz University Al Kharj City ,Saudi ArabiaJournal Article20180813<strong>Objective:</strong> It is well recognized that incidence of thyroid disease is increasing in Saudi Arabia and varies in geographical areas of Saudi Arabia. This study was aiming to evaluate the patterns of thyroid pathology in Al Kharj region, which is a rural agricultural area in central Saudi Arabia with relatively large (3.1%) population.
<strong>Methods:</strong> The retrospective study was designed covering period from 2012 to 2016, which include only patients, who received surgical treatment for the various thyroid pathologies. All data was collected from Department of Surgery at King Khaled Hospital (KKH), which is the university hospital, serving over 600,000 population of Al Kharj region. 92 thyroidectomies performed for various thyroid disorders where analyzed.
<strong>Result:</strong> The incidence of thyroid disease for females in Al Kharj region was estimated as 2.7/100.000 of population per year comparing to males of 0.4/100.000 respectively. Female to male ratio of 6.7:1 was observed in relation to the overall thyroid pathologies. The mean age of all studied cases was 41.3 years ranging from 19 to 77 years. The majority of the thyroid diseases was in the age group 20-50 years (79.3%). Cancerous lesions were found in 35 cases (38%) and presented mainly as papillary or follicular carcinomas with the female to male ratio of 10.5:1. Theprevalence of thyroid cancer in Al Kharj region in current study was 1.1/100.000 of population per year for females and 0.1/ 100.000 of population per year for males respectively.
<strong>Conclusion:</strong> This study showed that in central rural province of Saudi Arabia females are dominantly affected by thyroid pathologies. The female to male ratio requiring surgical intervention was higher in Al Kharj region compared to the other Saudi Arabian areas. Incidence of thyroid pathology and prevalence for thyroid cancer was significantly higher in females compare to male population.
<strong><br /></strong>https://ejhm.journals.ekb.eg/article_10986_a483d3e472820363a718f2efdd5a51d5.pdf