Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Glucose-6-phosphate dehydrogenase deficiency (G6PD) (Favism) in Dammam, Eastern Province of Saudi Arabia7137171106010.12816/0043971ENMeshael Kareem O AlmutairiImam Abdulrahman bin Faisal University, DammamAmnah Abdulrahman H AlsayyidImam Abdulrahman bin Faisal University, DammamNagah Mohamed Abo El-FetohFamily and Community Medicine Department, Faculty of Medicine, Northern Border UniversityAbdulelah Aziz Eissa AlenziNorthern Border University, Arar, KSAJournal Article20180814<strong>Background</strong>: Glucose-6-phosphate dehydrogenase deficiency is an X linked recessive disorder expressed mostly in males. It is the most common enzyme deficiency worldwide, causes a spectrum of disease including neonatal hyperbilirubinemia, acute hemolysis, and chronic hemolysis.
<strong>The aim of the study</strong> was to determine prevalence, risk factors of G6FD deficiency and its symptoms among general population of Dammam, Eastern Province of Saudi Arabia.
<strong>Methods:</strong> A cross-sectional study was conducted during the period from 1 March 2016 to 30 July 2017. Data was collected from 182 individuals. Systematic random sampling technique was followed. Data was collected by using predesigned online questionnaire. <strong>Results:</strong> The overall prevalence of favism was 17%, of them, 67.7% were females and 32.3% were males. 15.2% of cases and 26.9% of the total sample had family history of the disease. Among the studied cases, 48.4% complained of pallor, 45.2% headache, 45.2% drowsiness, 12.9% nausea, 32.3% back pain, 64.5% tiredness, 25.8% abdominal pain, 38.7% discoloration of urine, 29% foot pain, 16.1% low grade fever and 19.4% complained of jaundice. Regarding risk factors of favism; 32.3% reported excess beans intake, 12.9% antibiotic intake and only 9.7% reported bacterial or viral infection. <strong>Conclusions:</strong> Glucose-6-Phosphate Dehydrogenase deficiency is a common disorder as it affects 17% of the study population of Dammam, Eastern Province of Saudi Arabia. It was more common in females than males. Health education sessions and further epidemiological studies are required because early detection and prevention is the key strategy for successful management and control of this genetic disease. https://ejhm.journals.ekb.eg/article_11060_aa777292916175ddd7c48e2a4ee2c9cb.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101How Intern Doctors Deal with Hepatitis B in Riyadh and Eastern Saudi Arabia7187221106810.12816/0043972ENSaad K BoqursainKing Faisal UniversityHawraa R AlsurojKing Faisal UniversityMusaab I AlhawasMaternity and Children HospitalAbeer A AlkhalafPrincess Noura UniversityHussain S AlmazyadiWroclaw Medical UniversityMuhannad M AldubaykhiQassim UniversityAmjaad S AlJelbanKing Khalid UniversityShahad T AldawsariKing Saud UniversityMouhab R JamalaldeenKing Saud UniversityMohammed H AlshehriKing Saud UniversityMaitham S AlzaerWroclaw MedicalMatra M FagihiPrince Mansour MilitaryMohammed S AlharthiPrince Mansour MilitaryFahad F. AlmutairiAlmaarefa CollegeSajjad M AlmusawiWroclaw Medical UniversityMohammed H AlmahdiKing Fahad Hospital in HofufJournal Article20180814<strong>Background:</strong> Hepatitis B is one of popular health problem and is considered as major global infectious hazard. It represents an occupational risk for all people who are working in healthcare, including doctors, nurses, laboratory staff, and training interns as well as the student who is trained in hospitals. This can be correlated with their contact with body fluids during clinical rotations and activities. However, protection from getting any infection logically is mandatory for healthcare worker. <strong>Aim</strong>: Our problem in this study was to assess how our new doctors in Saudi Arabia, specifically those in Riyadh Region and Eastern Region are safe and are protected from hepatitis B infection by evaluating their knowledge, attitude and practice towards Hepatitis B. <strong>Method</strong>: That was a cross-sectional study which was conducted to intern doctors in Riyadh and Eastern Regions. Random sampling technique was used to select 350 intern doctors. Study tool was a self-administrated questionnaire that is made online by using Google drive forms and sent as an internet link to all interns via WhatsApp mobile application. Data analysis was done using computer application SPSS 24. Comparison between results and many variables was done using Chi-Square test and statistical significance is considered when P-Value < 0.05.
<strong>Result</strong>: In this study, 131 intern doctors participated out of 350 who received the questionnaires (response rate 94.6%). Regarding the level of knowledge, attitude, and practice, around 86% of participants have good knowledge, 63% of them have a positive attitude and 85% have a good practice. Chi-Square test was applied to compare our results of KAP with gender and region. No difference between males and females was found in the level of knowledge and attitude (P-value > 0.05). Males were better than females in practice (P < 0.05). Intern doctors in Riyadh region were better than those in Eastern region in knowledge and attitude (P-value < 0.05), no difference was found between them in practice (P-value > 0.05). <strong>Conclusion</strong>: It was obvious that our new doctors in Eastern and Riyadh regions have good knowledge, attitude and practice for Hepatitis B. People in Eastern region have less knowledge and attitude compared to those in Riyadh with a significant difference between them. Also, males interns have a better practice than females interns in general.
<strong> </strong>https://ejhm.journals.ekb.eg/article_11068_b525618fe1593d822623cdd9ab306b60.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101The Knowledge and Attitude of King Abdul-Aziz University Hospital Out Patient Clinic Visitors toward Coronavirus7237271107110.12816/0043973ENMaha Al-AlalawiDepartment of Internal Medicine – Medical College, King Abdulaziz University, Jeddah, KSAAbdulilah Alsolami AlsolamiDepartment of Internal Medicine – Medical College, King Abdulaziz University, Jeddah, KSAAbdullah AlghanmiDepartment of Internal Medicine – Medical College, King Abdulaziz University, Jeddah, KSAHatan SaidDepartment of Internal Medicine – Medical College, King Abdulaziz University, Jeddah, KSAAdam AlatawiDepartment of Internal Medicine – Medical College, King Abdulaziz University, Jeddah, KSAAbdullah LhajoojDepartment of Internal Medicine – Medical College, King Abdulaziz University, Jeddah, KSAJournal Article20180814<strong>Background: </strong>The Middle East respiratory syndrome (MERS) is a virus-like respiratory disease generated by a coronavirus (Middle East respiratory syndrome coronavirus, or MERS-CoV). Coronaviruses are capable of causing severe transmittable infection to humans, and was primarily found in 2012 in Saudi Arabia. Consequently, similar cases showed up in Qatar, Saudi Arabia, other Middle Eastern countries, Europe, and the United States. Nevertheless, Saudi Arabia remains the epicenter of this dangerous respiratory infection which is also associated with high mortality rate. Research and investigation regarding this unusual coronavirus started as more death related cases were reported.
Objective: The goal of this research was to understand the knowledge and attitude of people of Saudi Arabia belonging to various age groups regarding Middle East respiratory disorder and MERS-CoV.
Participants and methods: A structured close-ended set of questions about MERS-CoV was distributed manually and electronically to the visitors of King Abdulaziz University Outpatient Clinic which included men and women of different ages. The questionnaire comprised items concerning methods of the transmission of MERS-CoV infection, medical components, outcome of infection, techniques of protection and prevention, and the accessibility of information.
Results: Out of 1000 distributed questionnaires, 876 completed ones were received and were analyzed. The majority of respondents were of 45-65-year age group (36%). With regards to knowledge of coronavirus and disease caused by it, the majority of respondents had sufficient knowledge about the disease (52%) and the majority of respondents were also aware of the mode of its transmission (72%). However, most of them (58%) were not aware that this disease is transmitted by camel and that this infection can be treated by supportive treatment approach alone (55%). However, a large number of respondents had less knowledge with respect to common time of disease transmission (45%), the incubation period (41%), and indication of Corona virus antibodies as medical finding (32%). Between the two genders, the males were more informed than females. Additionally the married and the youth had much more information about the infection as compared to the singles and older adults. The difference of knowledge was statistically significant (p<0.05). The major sources of information among majority of respondents were social media (58%).
Conclusion: At the end of this study, it was found that the amount of knowledge about MERS-Corona Virus amongst the Saudi population was relatively low and needs to improvement. Different kinds of awareness seminars and consulting camps should be conducted at local level. Also, direct communication with the physicians and doctors should be made more accessible and easy in order to increase authentic knowledge between general populations.
https://ejhm.journals.ekb.eg/article_11071_c77d4bf55af9cbd7fe1aba7cfbded9e5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Rectosigmoid Adenocarcinoma That is Synchronous with an Anal Fistula (Case Report) in Saudi Arabia7287301107410.12816/0043974ENMahdi Y AlYousefKing Faisal University Al AhsaRiyadh Hakami MDKing Faisal Specialist Hospital and Research Center, RiyadhHassan A Al WtayyanKing Faisal University Al AhsaMustafa A Bo KhamseenKing Faisal University Al AhsaJournal Article20180814Rectosigmoid mucinous adenocarcinoma that is Synchronous with an anal fistula is a very rare condition thus its diagnosis and management are challenging. Here, we showed the diagnosis and management of a single case for a 57-year-old Saudi male presented with low rectal mass and gluteal abscess and a history of recurrent perianal abscesses that was managed as benign tumor and without a family history of neoplasms of re colorectal parts. After reviewing the literature concerning the aetiopathogenesis of this case and the suggested treatment. The clinical examination showed a perianal fistula and a digital rectal examination was conducted after incision and drainage of the right gluteal abscess then rigid sigmoidoscopy was performed and biopsy was collected showing invasive moderately differentiated adenocarcinoma. The decision was to avoid radiation preoperative due to abscess and extensive perianal disease and a treatment plan was initiated and the patient was followed up with regular CT examination.
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https://ejhm.journals.ekb.eg/article_11074_58455b6c9e57f30b182fb1eb9bc8b337.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101The Relation between Serum Homocystiene Level and Recurrent Abortion in Egyptian Women7317381107610.12816/0043975ENDoaa M Abd- EllatefBiochemistry Department, Faculty of Pharmacy (Girls), Al-Azhar UniversityGehad A BetehaBiochemistry Department, Faculty of Pharmacy (Girls), Al-Azhar UniversityManal M HasanObstetrics and Gynecology Department, Faculty of Medicine Tanta UniversityManal A EidClinical Pathology Department, Faculty of Medicine Tanta UniversityJournal Article20180814<strong>Background: </strong>Early pregnancy loss is defined as the termination of pregnancy before 20 weeks'
gestation or with a fetal weight of <500 g. Of those that are recognized, 15-<em>20% </em>result in spontaneous abortions (SABs) or ectopic pregnancies. Approximately 5% of couples trying to conceive have two consecutive miscarriages, and approximately 1% of couples have three or more consecutive early pregnancy loss. Increased levels of homocysteine may be due to inadequate dietary intake of folate and vitamin B12 and inherited defects within the methionine-hmocysteine pathway such as MTHFR c677T gene polymorphism. Hyperhomocysteinemia is associated with the syndromes of repeated miscarriage.
<strong>Objective: </strong>The aim of the current study is to estimate the serum levels of Homocystine and vitamin B12 and their relation to prevalence of recurrent spontaneous abortion in pregnancies with history of recurrent miscarriage. <strong>Subjects and Methods: </strong>In this study <strong>80</strong> pregnant women classified into two groups: GroupI:<strong>60 </strong>consecutive pregnant women who had suffered from two or more miscarriages, and Group II: <strong>20</strong> pregnant women with no history of abortion .The following estimations were done (for each woman in the study): serum homocysteine and vitaminB12 were estimated using ELISA technique. <strong>Results</strong>: Results showed a significant increase in serum level of homocysteine in the first group compared to control group(p<0.0001) and a low serum level of vitamin B12 which was significantly decreased in the study group (group 1) compared to control group(p<0.0001). Moreover, Our results showed a negative correlation between homocysteine and vitamin B12. <strong>Conclusion:</strong> The elevated serum homocysteine levels during pregnancy were significantly associated with recurrent pregnancy losses. Moreover, reduced serum vitamin B12 level was considered a risk for recurrent miscarriage. Homocysteine is most sensitive and specific<br />parameters in the recurrent pregnancy losses.
<strong> </strong>https://ejhm.journals.ekb.eg/article_11076_ce56a38fcbbc70ab89993a2f8de3a681.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Meta-Analysis Study on Alcoholic Liver Cirrhosis7397441107710.12816/0043976ENHussam Musallam AlfarsiKing Abdulaziz UniversityAbdullah Obaid BinobaidAlfaisal UniversityThamer Saeed AlghamdiKing Abdulaziz UniversityFedaa Hussain AlbeladiArabia Gulf UniversityHassan Talal Abdulaziz AlqudaihiImam Abdulrahman bin Faisal UniversityEman Ahmed Hassan AlabdrabalrasolImam Abdulrahman bin Faisal UniversityUmaima Ibrahim Khalfan Al BarashdiMaabaila HC, MuscatMohammed Ali Mohammed AlSaghiratImam Abdulrahman bin Faisal UniversityHayfa Ahmed HassanImam Abdulrahman bin Faisal UniversityQusai Abdullah AlsaqabiAljouf UniversityAhmad Fahad Eid Al-RashidiAl Adan Hospital, Internal Medicine Department, KuwaitFahad Yahya Ahmad HakamiSabia PHCJournal Article20180814<strong>Background:</strong> Heavy alcohol consumption is an inevitable cause of alcoholic liver disease with a high chance to progress to Alcoholic Liver Cirrhosis. Alcohol could damage the function of body organs and could cause cancer. Liver damage due to excessive alcohol consumption is usually presented as fatty liver (build-up of fats in the liver), steatohepatitis, fibrosis, alcoholic cirrhosis, and hepatocellular carcinoma. When liver fibrosis progresses, it will ultimately end up as alcoholic cirrhosis.
<strong>Objective of the Study:</strong> This article was intended to explore and investigate the possible optimal diagnosis and management of Alcoholic liver cirrhosis.
<strong>Methods:</strong> We searched the medical literatures to retrieve studies for the review till 30 November 2017. Electronic search in the scientific database from 1965 to 2017– (Medline, Embase. The Cochrane Library websites were searched for English Publications (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> Absolute abstinence remains the foundation for any treatment of any acute or chronic Alcoholic Liver Disease. It’s also important to understand that no treatment will cure cirrhosis or repair scarring in the liver that has already occurred and the only resort would be liver transplantation which is also debatable provided the complications it carries along. Nevertheless, timely diagnosis of alcoholic cirrhosis in people with alcoholic liver disease is the cornerstone for evaluation of prognosis or choosing treatment strategies such as nutritional and medical support and lifestyle change.
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https://ejhm.journals.ekb.eg/article_11077_36134150971c5c8b4c789e0654fca4b5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Psychological Interventions for The Management of Bipolar Disorder7457531107810.12816/0043977ENSaeed Khalil Saeed Bin JabalArabian Gulf UniversityKhalid Ibrahim S AlbulushiKing Abdulaziz University, JeddahMohammad Ehsan M ShokriKing Abdulaziz University, JeddahMaan Ahmed AlsaaidArabian Gulf UniversityAbdulrahman Mohammed M AloufiKing Khalid UniversityRawan Abdullah AlsaediKing Fahad HospitalFatimah Radi SlaisAlamal Complex, DammamHasan Sharif H BukhariUmm Al-Qura UniversityAbdulaziz Khalid M AddasKing Abdulaziz UniversityTurki Ali AbdullahAbha Psychiatric HospitalBayan Mohammed AlKhaliliIbn Sina National CollegeWisam Hassan Y FataniBatterjee Medical CollegeJournal Article20180814<strong>Background:</strong> Bipolar disorder is a chronic relapsing and mostly severe psychiatric disorder accompanied with a significant psychiatric comorbidity, considerable role impairment, and significant risk of suicide attempts according to recent researches. Mood stabilizers and antipsychotic medications have proved to be effective in managing symptoms for many patients. Nevertheless, medication noncompliance for some patients is a raising concerns. Additional risk for increased symptom severity and relapse when subjected to high levels of psychosocial stress, such as living in a negative family environment has also been reported. Psychosocial treatments, such as cognitive-behavioral therapy (CBT) and family-focused therapy (FFT) were hence introduced in hope of an integrated strategy for the management of bipolar disorder.
<strong>Objective of the Study:</strong> This article is intended to review the optimal approach for the management of bipolar disorder. Advances in biopsychosocial treatments are also briefly reviewed, including new health service models for providing care.
<strong>Methods</strong>: Electronic search in the scientific database from 1960 to 2017– The studies in this comprehensive review were selected for inclusion based on clinical relevance, importance, and robustness of data related to diagnosis and treatment of bipolar disorder. The search terms that were initially used on MEDLINE/PubMed and Google Search terms included “bipolar disorder,” “mania,” “bipolar depression,” “mood stabilizer,” “atypical antipsychotics,” and “antidepressants.” High-quality, recent reviews of major relevant topics were included to supplement the primary studies.
<strong>Results:</strong> Bipolar disorder is a major public health concern. Management includes a lifetime course of medication and attention to psychosocial issues for patients and their families. Standardized treatment guidelines for the management of acute mania have been developed. New potential treatments are being investigated.
<strong>Conclusion:</strong> Bipolar disorder have a very dynamic and chronic nature and thus, careful selection of a treatment should be tailored to the phases of the disorder, together with the safety profile identified in clinical trials. Nevertheless, Psychosocial interventions, such as CBT and FFT should be employed in combination with pharmacological therapy for bipolar patients in order to increase medication compliance, decrease depressive symptoms and recognize early warning signs of an affective episode should ideally help to optimize the course and outcome of this devastating condition.
https://ejhm.journals.ekb.eg/article_11078_9791466ca010511c5a3a50e09ccb1149.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Meta-analysis on Corneal Changes following Phacoemulsification in Diabetic vs. Non-diabetic Cataract Patients7547611107910.12816/0043978ENFaisal Ali A AlotaibiKing Abdulaziz Specialist HospitalRawan Ariman AlosaimiJordan universityFatimah Hassan AlyahyaKing Abdulaziz UniversityMohammad Mustafa AlaliImam Abdulrahman Bin Faisal UniversityFaris Ali Nasser AyidhKing Khalid UniversityFarhan Musafiq AlanaziAljouf universityFaisal Fahad AlanizyKing Saud Bin Abdulaziz University for Health SciencesNora Faisal AlsaudAlfaisal UniversityAhmad Sami A HimaydaUmm al-Qura UniversityNouf Awad S AlbalawiTabuk UniversityWissam Abdullatif AlsuwailmKing Faisal UniversityMohammed Abdullah M AlamriKing Faisal UniversityJournal Article20180814<strong>Aim of the Study:</strong> was to investigate the influence of phacoemulsification on corneal endothelial cells and
its injury risk factors in diabetic cataract patients and non-diabetic patients.
<strong>Methods:</strong> electronic databases were searched: Scopus, EMBASE, and Google Scholer), PubMed/MEDLINE, Scopus, The Cochrane Library, and Web of Science. Econlit from 1990 to 2017. This was completed with a manual search of references of relevant papers. Risk of bias in methodology of studies was measured using the Newcastle-Ottawa Scale.
<strong>Results:</strong> Observation of corneal endothelial cell density, coefficient of variation and percentage of hexagonal cells preoperatively, 1 day, 1week, 1 and 3 months postoperatively was carried out, and multiple Logistic regression analysis for risk factors of corneal endothelial cell injury was taken.
<strong>Results:</strong> Out of 779 retrieved papers, 9 studies with a total of 1129 individuals were finally included (579 diabetic eyes and 550 non-diabetic eyes). For the dynamic changes between preoperative and postoperative values, significant differences were identified between the two groups in endothelial cell density (ECD) and hexagon cells (HC%) at 1 day, 1 week, 1 month, and 3 months postoperatively, in central corneal thickness (CCT) at 1 month postoperatively, and in coefficient variation (CV) at 1 week and 1 month postoperatively. However, no significant differences were observed in CCT at 1 day, 1 week and 3 months postoperatively or in CV at 1 day and 3 months postoperatively.
<strong>Conclusion:</strong> it could be concluded from the current literature that aged-cataract patients with diabetes mellitus manifested poor tolerability to cataract phacoemulsification surgery in contrast to senile cataract patients.
https://ejhm.journals.ekb.eg/article_11079_94289d7bd87b295e7cd89c1ca8e6a132.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Abnormal Uterine Bleeding in Women in Child Bearing Period of Arar City, Northern Saudi Arabia76276511081ENShoug Zeid Trad AleneziFaculty of Medicine, Northern Border University, Arar, KSAReem Faleh Abdullah AlanaziFaculty of Medicine, Northern Border University, Arar, KSAAnwar Eid Mohammed AlruwailiFaculty of Medicine, Northern Border University, Arar, KSANajah Dhaher Yahia AlanziFaculty of Medicine, Northern Border University, Arar, KSAMaha Mukhlef Ramadan AlanaziFaculty of Medicine, Northern Border University, Arar, KSAReem Hulayyil AlanaziFaculty of Medicine, Northern Border University, Arar, KSAMarwah Khaled Ibrahim AltawyanFaculty of Medicine, Northern Border University, Arar, KSAZuhur Dhaher Munahy AlfuhigiFaculty of Medicine, Northern Border University, Arar, KSAMaha Hazzaa Fraiwan AlshalanFaculty of Medicine, Northern Border University, Arar, KSAAtheer Bader Faihan AlanziFaculty of Medicine, Northern Border University, Arar, KSAReem Hamoud Sulaiman AlshammariFaculty of Medicine, Northern Border University, Arar, KSAWaad Hameed AltarfawiFaculty of Medicine, Northern Border University, Arar, KSAOhud Falah Munukh AlanaziFaculty of Medicine, Northern Border University, Arar, KSAJournal Article20180814<strong>Background:</strong> Abnormal uterine bleeding (AUB) affects as many as one-third of reproductive-aged women. Women with AUB may experience pain, embarrassment and inconvenience that can have a significant impact on their lives. This study was carried out <strong>aiming</strong> to assess the pattern and possible causes of abnormal uterine bleeding in reproductive aged women in Arar city, Northern Saudi Arabia. <strong>Methods</strong>: The study was conducted at Maternal and Child Hospital of Arar City, during the period from 1/5/2017 to 30/7/2017. Data collected by personal interview with cases and filling a pre-designed online questionnaire. Collected data was coded and analyzed using statistical package for the social sciences (SPSS, version 16). Descriptive statistics for the quantitative and qualitative variables were used. <strong>Results:</strong> In our study 100 women were included, with mean age 30.5±6.9, mean age of menarche was 13.1 (±1.8) and 52% of them had regular menses. Pattern of bleeding was menorrhagia in 52%. The cause of bleeding was dysfunctional uterine bleeding in 59% of cases, Intrauterine device complications in14%, Uterine fibroid in 12% of cases and contraceptive pills complications in 15%. Only 13% of them treated surgically while 87.0% treated medically.<strong> Conclusion:</strong> The most common cause of abnormal uterine bleeding was endometrial hyperplasia (in 59%), and the contraceptive pills complications comes in the second place (in 15%), then the Intrauterine device complications (in 14%) and the uterine fibroid (in 12%). Health education sittings is recommended to increase the public awareness about the causes and importance of seeking medical care during AUB attacks specially in premenopausal period. https://ejhm.journals.ekb.eg/article_11081_a28683ed6c15d825f4a422f70f056c11.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Mental Illnesses Stigma and its Association with Quality of Life in Adult Saudi Patients7667701108210.12816/0043980ENAbdullah Ahmad Al MulhimConsultant Psychiatrist, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, DammamHassan Ali Y Al DehneenImam Abdulrahman Bin Faisal UniversityMohammed Riyadh A AlabbadImam Abdulrahman Bin Faisal UniversityNedal Mohammed AlhababiImam Abdulrahman Bin Faisal UniversityAli Mohammed H AlhijabImam Abdulrahman Bin Faisal UniversityJafar Yassen AlmomatenImam Abdulrahman Bin Faisal UniversityAqeel Ghassan A AlhashemImam Abdulrahman Bin Faisal UniversityHasan Muneer M AlbahraniImam Abdulrahman Bin Faisal UniversityAli Hussain AlluwaymImam Abdulrahman Bin Faisal UniversitySaoud SultanConsultant Psychiatrist, North East London NHS Foundation TrustAbdullah Mohammad AlmarzooqImam Abdulrahman Bin Faisal UniversityQasem Mohammed AlhababiImam Abdulrahman Bin Faisal UniversityMohammed Nasser AlrasasiImam Abdulrahman Bin Faisal UniversityHussain Abdullah Abu ZaidArabian Gulf UniversityJournal Article20180814<strong>Background:</strong> Mental health patients with self-stigma often loss their self-esteem.
<strong>The</strong> <strong>objectives:</strong> This study was conducted to determine the prevalence rate of mental illnesses stigma and its association with quality of life in adult Saudi patients attending the out patient’s in psychiatry department in King Fahad University Hospital at Al Khobar, KSA. <strong>Methods:</strong> This is a cross sectional study. A demographic data including age, sex, marital status and occupation were collected in addition to a 32 question-based questionnaire with different variables divided into three parts; To gain further perspective on discrimination experienced by persons with mental illness. To study rejection experienced by mentally ill patients. To evaluate the patients coping ways to stigma which characterized by secrecy, avoidance and withdrawal, and advocacy and confrontation. <strong>Results:</strong> There were 71 (34.6%) women, 112 (54.6%) men. About third (36.6%) of respondent agrees that people think of mentally ill patients as untrustworthy. Almost half of them (44.9%) disagree that people find them dangerous. The same percent (44.9%) agree that people take them less seriously.41.5% of them feel that people avoid them. More than half of them 51.2% disagree that someone will not take them as close friend. But 54.6% didn’t feel any avoidance from relative, neighbors or colleagues (missing data 11.2%). 67.8% also, didn’t feel any avoidance from family members. More than half (55.1 %) tries to hide the fact that they are mentally ill and 72.2% will not avoid getting married or starting a family because of their mental illness history. <strong>Conclusion:</strong> Our study indicated that most of mental health patients in our community have experienced moderate to severe level of stigma. Future researches are needed to study the prevalence of stigma and rejection in mental health patients allover Saudi Arabia. Community awareness campaigns to raise the knowledge that mental illness is a disease like other body diseases and there is no shame of being mental health patient. https://ejhm.journals.ekb.eg/article_11082_f7d481abb0d7eda59226d86ba26b0ee2.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101The Correlation between Infants’ Congenital Heart Defects and Maternal Folic Acid Supplementation7717761108310.12816/0043981ENAlruwaili Fahad Saleh HassanAljouf UniversityBasmeh Mohammed I HowsawiKing Abdulaziz HospitalMuayad Youssof Al AwwasAlsalmanyiah PHC In AlahsaZainab Hassan AlzeinMedical University of Warsaw, Aljouf UniversityFarhan Musafiq AlanaziAljouf UniversityHaya Hussain FaqehiJazan UniversityEhab Osama MugharbalOhud HospitalMuath Ayidh AlrehailiQassim UniversityKhalid Ahmed Abdullah AlshehriAl Imam Mohammed Bin Saud Islamic UniversityReem Adel BuzeidImam Abdulrahman Bin Faisal UniversityKhalid Jazi AlharbiQassim UniversityMusab Abdulrahman AlrzoqJournal Article20180814<strong>Background: </strong>Congenital heart defects (CHDs) are significant drivers of mortality and morbidity in children, folic acid supplementation for the pregnant month during or before delivery is said to influence risk reduction of congenital heart defects (CHDs). However, there are controversial claims and the hypothesis is concluded from limited epidemiologic studies. <strong>Aim of the Study: </strong>Conduct a systematic review and meta-analysis of published studies to reliably evaluate the correlation between Folic acid or multivitamins containing FA supplementation taken during pregnancy and the risk of CHDs. <strong>Methods:</strong> A systematic review and meta-analysis was conducted. PUBMED and EMBASE were searched to identify prospective cohort and case-control studies that had reported on the association between 1960 and 2017.Studies conducted in primarily high-risk populations (Case control and cohort studies) while participants in randomized controlled trials were excluded.
<strong>Results: </strong>The search yielded 10 studies published between 2000 and 2013 enrolling 13126 female participants. These studies included only one cohort study, and nine case-control studies. The overall results of this meta-analysis provide evidence that maternal folate supplementation is associated with a significantly decreased risk of CHDs (RR = 0.69, 95% CI: 0.54–0.84). Statistically significant heterogeneity was detected (Q = 79.43, P < 0.001, I2 = 70.2%).
<strong>Conclusion:</strong> FA supplementation during pregnancy significantly decreases the risk of CHDs in newborns.https://ejhm.journals.ekb.eg/article_11083_caf085ba52a8ca04512f50b39628f719.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Antibiotic Prophylaxis in Plastic Surgery7777851108410.12816/0043982ENOsama Talaat KhoujKing Abdul Aziz University HospitalFaisal Saud YousufUniversity of JeddahHaitham Abdullah AlnahedhAl Iman General HospitalHind Mohammed AlhodalyKing Abdulaziz UniversityKhaled Hamad Mohammed AlbaradiKing Abdulaziz UniversityAfnan Abdulaziz AlshaifaniUnaizah College of Medicine, Qassim UniversityFadaa Magthel H AlotaibiKing Khalid UniversitySahar Matter AlshammeryPrincess Noura UniversityIbrahim Ghaleb DaiwaliBattarji college of medicineMohammed Ahmed Musatfa AliBattarji college of medicineNorah Ahmed Ibrahim Al MallohiUnaizah College of Medicine, Qassim UniversityJabir Mohammed A AlnabhaniKing Abdulaziz UniversityJournal Article20180814<strong>Background:</strong> prophylactic antibiotics are effective in preventing surgical-wound infections. However, the clarity about the compelling need for antibiotic administration and the risk associated with their use is missing. The use of antimicrobial prophylaxis against surgical site infection (SSI) is common in plastic surgery, while results from prospective randomized controlled trials are scarce.
<strong>Aim of the Study: </strong>was to evaluate the need for antibiotic prophylaxis in the field of plastic surgery.
<strong>Methods: E</strong>lectronic search of available Literatures in the scientific database of recent randomized controlled trials evaluating the indications for and use of antibiotics to reduce and treat SSIs for patients undergoing plastic surgery from 1960 to 2017– (Medline, Embase, the Cochrane Library as well as NHS centre websites were searched for English Publications from both reprint requests and by searching the database. Data extracted included antibiotic dosage, duration and incidence of surgical site infection.
<strong>Conclusion: </strong>surgical procedures must be distinguished based on the risk of infection and the need for antibiotic prophylaxis should be determined accordingly, i.e. on a case by case basis.No prophylaxis is required for superficial skin’s and clean surgeries such as mucosal excisions, nevertheless, Antibiotic prophylaxis is recommended microsurgical operations, prosthetic surgery, incisional hernias, clean non-prosthetic osteoarticular surgery, oral cavity and genitourinary system procedures.
Still, antibiotic use should be prescribed with caution to avoid profound side effects such as developing resistant bacterial strains, severe allergies and other accompanied comorbidities.https://ejhm.journals.ekb.eg/article_11084_aa3e91681a502613bd65cf8b12e82e43.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101The Effects of Immunomodulatory Molecule- Lipoxin A4- on The Physiology of Cystic Fibrosis Human Bronchial Epithelium7867901108510.12816/0043983ENMohammad SindiFaculty of Molecular Medicine, Beaumont HospitalMagdalena Mroz MrozFaculty of Molecular Medicine, Beaumont HospitalJournal Article20180814<strong>ABSTRACT</strong>
Cystic fibrosis (CF) is a disease characterised by the depletion of Airway Surface Liquid (ASL) height. Lipoxin A<sub>4</sub> was found to be effective in restoring ASL back to normal by acting on ENaC. The signalling mechanisms involved in lipoxin effect were investigated by testing the action of a calcium chelator (Bapta-AM) and Protein kinase C inhibitor (GF 109203X) on NuLi-1 and CuFi-1 cells. Drug’s efficacy was monitored by conducting Ussing chamber experiments and confocal microscopy. Results showed that calcium has a major contribution to the lipoxin A<sub>4</sub> effects while PKC has a limited role. However, our data might lack accuracy due to shortage of time to conduct more experiments.
<strong> </strong>https://ejhm.journals.ekb.eg/article_11085_f8d590084d1dea6a9c056c0d72eb1103.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Patients Satisfaction after Endodontic Treatment in Saudi Arabia79179511086ENYasmeen AlshammariPrivate SectorMuthhin AlmuthhinMinistry of HealthAlzahra AlarajahPrivate SectorGhaidaa Mohammed BarriPrivate SectorHajr AlshammariAlfarabi Dental CollegeSami AlshahraniKing Khalid University AbhaJournal Article20180814<strong>Background: </strong>Dental anxiety and fear appear to vary according to the type of treatment. Endodontic treatments have been shown to cause higher levels of anxiety than restorative or prophylactic treatments. Patient’s pretreatment decisions and post-treatment satisfaction may be strongly influenced by social, psychological, and behavioral aspects including knowledge, beliefs, attitudes, preferences, and behaviors.
<strong>Aim: </strong>This study aimed at investigating the percentage of patient’s satisfaction toward the endodontic treatment done by endodontic specialists.
<strong>Methodology: </strong>Some cases (78) from different ages were asked to apply a questionnaire to show the percentage of satisfaction toward endodontic treatment of patients received by endodontic specialists during the year of 2017 in Saudi Arabia.
<strong>Results:</strong> percentage of satisfaction was different among the cases toward the various steps in endodontic treatment, but it was evident that more satisfaction was related to qualitative and proper treatment procedure but the correlation between satisfaction and pain score was negative.
<strong>Conclusion:</strong> Patients satisfaction toward the endodontic treatment is related to different factors, some of these factors related to the patient himself like his health status and the others depend on the nature of endodontic procedure itself.
https://ejhm.journals.ekb.eg/article_11086_7159f6a361e0051e5cc5c4c5d6a02a52.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Ionizing Radiation Among Saudi Females: Awareness and Staff Efforts7968001108710.12816/0043985ENMooataz Mohammed AashiDepartment of Medicine, King Abdul-Aziz University, JeddahDanah Mahmoud OmranDepartment of Radiology,
King Abdul-Aziz University, Jeddah, Saudi ArabiaHisham Abdulhamid AlghanmiDepartment of Medicine, King Abdul-Aziz University, JeddahSaleh Ageel ShaheenDepartment of Medicine, King Abdul-Aziz University, JeddahJournal Article20180814<strong>Background:</strong> Radio-diagnostics has become widespread nowadays for identification of diseases, however, a lot of patients, especially females of reproductive age lack awareness of risk factors involved with ionizing radiations. This study aimed to assess the awareness regarding the risk of radiation exposure to female patients and evaluation of the medical staffs' efforts to exclude pregnancy prior to sending patients for radiology examination.
<strong>Methods:</strong> Three-part questionnaires were used for evaluation of reproductive aged female patients who were undergoing investigations with ionizing radiations in January 2017 at Radiology Department in King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia.
<strong>Results: </strong>43.7%, 65.3%, and 89.6% of physicians, radiologists and receptionists respectively, ask about pregnancy while only a few of them asked about possibility of pregnancy and the first day in last menstrual cycle of the patient. Overall, 91 % and 75.2% of patients estimated the risk of cancer from chest radiography and CT respectively; being very small. However, 76.6% of patients correctly thought that CT gave more amounts of radiation than X-rays and 61.3% of patients agreed that it is more important for their physician to diagnose their condition with CT than to worry about the radiation exposure.
<strong>Conclusion:</strong> These data suggests that females have incomplete understanding about risks associate with radiations, in addition to which most of clinical practitioners also do not ask about the possibility of pregnancy which puts patients at a greater risk.
https://ejhm.journals.ekb.eg/article_11087_89b400ca70657424eb8e96294e3fd7e5.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Classical Isolated Scrotal Kaposi's Sarcoma in Non-HIV Patient Case report from KAUH, Jeddah, Saudi Arabia8018051108810.12816/0043986ENMohamed Emad BayoumiKing Abdulaziz University, Jeddah, Saudi ArabiaJournal Article20180814<strong>Background: </strong>Kaposi Sarcoma (KS) is a rare neoplastic vascular disorder. The pathogenesis of KS remains controversial. However, suppression of the immune response was almost necessary. Classical KS most likely affects the male genitalia. Penile KS is the most common, while isolated scrotal KS has been unusual to see. In this case report, we review a rare case of scrotal KS in a non-HIV patient with history, clinical, laboratory, imaging findings.
<strong>Presentation of Case: </strong>A 60 years old male patient, known to have ischemic heart disease. Presented with progressive painful scrotum swelling for 3 weeks. He had dysuria and gave a history of weight loss. Not complaining of prostate disease. By examination, there were swelling, warmness, tenderness to palpation in his scrotum. A biopsy was taken which was shown a Kaposi sarcoma.
<strong>Discussion: </strong>Despite it names as a sarcoma, it is not considered a real sarcoma because the tumour does not arise from mesenchymal tissue. It arises from endothelium tissue. The pathogenesis of KS still not clearly understood and remains controversial. However, what we know is all forms of KS are strongly associated with HHV-8 infections. The partial or complete suppression of the immune response was almost necessary. Therefore, KS is usually associated with HIV infection. KS of the scrotum has been reported in non-HIV patients. Very few cases have been presented with scrotal KS. First reported case of an isolated scrotal KS around the world was in 1976. While In 1979 had been the first time to performed total scrotectomy and bilateral orchiectomy for scrotal KS patient. A Turkish study In 2011 reviewed only one patient had scrotal KS out of 32 cases with HIV-negative KS in the Middle East. In this case, the patient received 3 cycles of chemotherapy with no improvement so we preferred local excision because these lesions were small and stable for about 3 years. After 3 years of follow-up no recurrence was observed.
<strong>Conclusion:</strong> Classical KS is generally observed in the lower extremities, it can rarely affects scrotal skin as isolated lesions. Thus. Genital examination should also include for those patients. In addition, the isolated scrotal Kaposi sarcoma is absolutely cannot be cured by medication. Adjuvant chemotherapy still in many cases show incomplete improvement. Orchiectomy might be the conclusive curative option.
https://ejhm.journals.ekb.eg/article_11088_1e75d1b1ae4a543d9a154939ee042373.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Knowledge, Attitude and Practices About Pneumococcal Infection among Algerian Hajj Pilgrims8068171108910.12816/0043987ENMohammed Saleh DumyatiUmm Al-Qura UniversitySaeed Abu Bakr BalubaidUmm Al-Qura UniversityBasam Zuhaer SindiUmm Al-Qura UniversityAbdulrahman AlthobaitiTaif UniversityHani Amanullah AzizurrehmanAlbattarji medical collegeJournal Article20180814<strong>Background: </strong>Hajj attendance increases the risk of respiratory infections including pneumonia. Pneumococcal infections are caused by Streptococcus pneumonia, a gram-positive, catalase-negative organism normally mentioned as pneumococcus. S pneumonia is the most mutual reason of community acquired pneumonia (CAP), bacteremia, otitis media, and bacterial meningitis, in addition to a significant cause of sinusitis, osteomyelitis, septic arthritis, endocarditis, and peritonitis. Complications of each of these diagnoses are common. Clinical symptoms, signs and physical examination findings alone cannot differentiate S pneumonia disease from infections caused by other pathogens.
<strong>Methods: </strong>This was a cross-sectional study among Algerian in al Hajj Pilgrimage. A sample size of 964 Algerian was collected. Data collection took place in September 2016. A structured questionnaire was developed to cover the research objectives. The questionnaire was originally developed in English and then translated into Arabic; its validity was reviewed by selected health care experts and professionals and tested on a sample of the target population. Selected candidates were interviewed by trained medical students; a brief description of the study. If they agreed to participate, the student administered the questionnaire verbally. Almost 10 minutes were needed to complete the questionnaire. The process continued till the required sample size was completed.
<strong>Results: </strong>All data showed that education is correlated to prevent infection and help them to deal with patient infected with pneumococcus.
<strong>Conclusion: </strong>Before Hajj doctors must teach and inform all the participants about how to deal with any infectious disease, particularly pneumonia.
https://ejhm.journals.ekb.eg/article_11089_3dfa7cac7db6a9e42b5bc2bfbfa38bab.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101The Prevalence and Risk Factors of Persistent Pain after Mastectomy in Saudi Females8188231109010.12816/0043988ENFahad Mousa MaashiKing Khalid UniversityThuraya Yahya MoafaJazan UniversityMaria Ali HakamiJazan UniversityMohammad Ali MahnashiJazan UniversityAthar Mohammed ArishiJazan UniversityMariam Mohammed AyashiJazan UniversityJournal Article20180814<strong>Background: </strong>Chronic pain is known to develop after several surgeries including mastectomy. Mastectomy is the surgical treatment for breast cancer. The prevalence of chronic pain after breast surgery varied between different studies and several risk factors for developing pain were reported.
<strong>Aim: </strong>To investigate the prevalence of persistent pain and its possible risk factors after mastectomy.
<strong>Methods: </strong>This crosssectional study was performed by establishing online survey from October 2017 to December2017. The study included 380 female who performed unilateral mastectomy.
<strong>Results: </strong>Persistent pain was prevalent in 47.4% of participants whose mean age was 63±12.1 years old and mean BMI equal 28.9±5.2. Positive lymph node was more common in patients with pain 78.3%, more women with pain 60.5% received radiotherapy. ALND was more common in individuals without pain 67.5%, while SN was more common in patients with pain 46.7%.
<strong>Conclusion: </strong>The prevalence of persistent pain was high with moderate severity. Older age, high BMI, positive lymph node, radiation therapy and SN axillary procedure were risk factors for developing persistent pain after mastectomy.
https://ejhm.journals.ekb.eg/article_11090_16a3404b11b60c8f12be4991788bc0e8.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Knowledge, Behaviors, and Attitudes about Noise-induced Hearing Loss among Adults in Albaha Region: A Cross-sectional Study8248271109110.12816/0043989ENRaed A.M. AlzahraniFaculty of Medicine, Albaha University, AlbahaAbdulrazaq O.S. AlzahraniFaculty of Medicine, Albaha University, AlbahaAbdulrahman A.M. AlghamdiFaculty of Medicine, Albaha University, AlbahaAli M.A. AlamriFaculty of Medicine, Albaha University, AlbahaAbdulrahman H.A. AlghamdiFaculty of Medicine, Albaha University, AlbahaSaleh G.S. AlghamdiFaculty of Medicine, King Abdulaziz University, Jeddah, Saudi ArabiaFares A.M. AlzahraniFaculty of Medicine, Albaha University, AlbahaJournal Article20180814Background: Worldwide, more than one billion people are affected by hearing loss. Noise-induced hearing loss (NIHL) is reported among the most prevalent occupational diseases. However, little is known about the current level of knowledge and attitude towards NIHL among general population.<br />Objective: The purpose of this study was to investigate the knowledge, behaviors, and attitudes of adult population in Albaha Region of the Kingdom of Saudi Arabia concerning the factors that contribute to Noise-induced hearing loss (NIHL) and the use of hearing protection.<br />Methods: A 16-item self-administrated questionnaire was used to measure the knowledge, habits, attitudes, and perception of NIHL and each participant's use of hearing protection. The questionnaire included multiple choice and fill-in-the-blank format questions. The questionnaire was divided into two sections: 1) demographic information, including age, sex, college major, and prior coursework regarding hearing in noise; 2) knowledge of hearing, the auditory mechanism, and noise-induced hearing impairment.<br />Results: we received 296 valid responses. Fifty-nine percentage were male, 37 % percentage were students, 21 % were soldiers and 17 % were teachers. Only 19 % said that hearing loss cannot be cured and 53 % knew that it can happen at any age. Interestingly, 94 % never wore an ear plug before.<br />Conclusion: Our study showed low percentage of correct answers about causes and protective measures against hearing loss. Future health care program should consider initiatives and public health campaigns to improve the public’s knowledge and attitude.<br /> https://ejhm.journals.ekb.eg/article_11091_8781757200bc7a9ff17c073ea860baee.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Gastroesophageal Reflux Disease among Pilgrims during the Hajj Period (1438 Hegira): Prevalence and Impact on the Quality of Life8288341109510.12816/0043990ENSultan Salem Murayziq AlgethamiFaculty of Medicine, Taif University, TaifHamad Sulayyih Hamad AlosaimiFaculty of Medicine, Taif University, TaifMeshari AhmadAali Al-MalkiFaculty of Medicine, Taif University, TaifAbdullah Matar AlmalkiFaculty of Medicine, Taif University, TaifMohammed Thamer Shaker AlghalibiFaculty of Medicine, Taif University, TaifTurki Fehaid Musayfir AlgethamiFaculty of Medicine, Taibah University, Al-MadinahAbdulaziz Turki Hassan AlmalkiFaculty of Medicine, Taif University, TaifTurki Hamed AlghamdiFaculty of Medicine, Taif University, TaifAfnan Salem Murayziq AlgethamiFaculty of Medicine, Taif University, TaifDalia Dakheel Allah AlgthamiFaculty of Medicine, Taif University, TaifAsayil Nasser Bin MadhiFaculty of Pharmacy, Taif University, Taif, KSAJournal Article20180814<strong>Background: </strong>Gastroesophageal reflux disease (GERD) is a chronic motility disorder resulting in reflux of stomach contents in to the esophagus. It has a prevalence rate of 10-20% in the western world. In the Gulf region, the prevalence of GERD is not yet well characterized. Annually, millions of Muslims gather from across the world embark on a religious pilgrimage to Mecca in Saudi Arabia. They represent a population with various socio-demographic characteristics, life styles, dietary habits and social life stresses that might affect the prevalence of this chronic disorder. <strong>Objective</strong>: the aim of this study was to determine the prevalence and impact of GERD on the pilgrims in Mecca region during the Hajj period in the year 1438 Hegira.
<strong>Methods: </strong>participants were asked to fill a self-administered questionnaire, GERD questionnaire (GERDQ) and GERD-HRQL were used for making the diagnosis of GERD and to assess its impact on the patient’s quality of life. <strong>Results</strong>: the prevalence of GERD among the study population was 29.0%, with a statistically significant association with age and nationality. Neither smoking nor the presence of other diseases showed statistically significant relationship with the presence of GERD (p>0.05). GERD-HRQL scale showed a statistically higher median in GERD patients compared to healthy subjects. Moreover, 58 participants (52.73%) showed poor quality of life compared to 52 participants (47.27%) who expressed good quality.
<strong>Conclusion</strong>: this study showed a prevalence rate of GERD among pilgrims in Mecca region to be 29.0%, which has an impact on their daily life activities. These data indicate a need for a comprehensive approach to GERD management in the health-care system. https://ejhm.journals.ekb.eg/article_11095_123b541574a1e8c9140a4effe9ac12fa.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Awareness and Knowledge of Poor Vision among Students in Hail University8358441109610.12816/0043991ENManal Zayed AlshammaryFaculty of Medicine, Hail University, Hail, KSAFatimah Saud AlshammariFaculty of Medicine, Hail University, Hail, KSAHadeah Salem AlsahammariFaculty of Medicine, Hail University, Hail, KSATahany Faisal AlshammariFaculty of Medicine, Hail University, Hail, KSAAbdullah Saud AlshammariFaculty of Medicine, Hail University, Hail, KSAMona ShaheenFaculty of Medicine, Hail University, Hail, KSAJournal Article20180814<strong>Background:</strong> Awareness of common eye diseases particularly impaired vision and their prevention and treatment can play an important role in encouraging people to seek timely eye care and can therefore help in reducing the burden of visual impairment.
<strong>Objective: </strong>This cross sectional observational study was carried out to assess the level of awareness and knowledge about the problem of poor vision among Saudi students in Hail University.
<strong>Methods: </strong>A standardized questionnaire was randomly distributed to students aged 18-24 years of both sexes. A total of 1484 subjects agreed to participate, answered the questionnaire and were involved in the study.
<strong>Results: </strong>Findings showed that1330 students considered poor vision to be a problem. Most of them considered elders the most susceptible age group followed by teenagers. More than half of the students did not know which gender is more affected by poor vision. More than one-third (37.5%) of them considered poor vision as a genetic disorder. Others reported errors of refraction, cataract and senility (10.6%, 8.4% and 6.55%respectively). However, 28.3% of the students did not know exactly the predisposing causes of poor vision. Two-thirds of the study population thought that poor vision could be prevented. Regular periodic examination of the eyes and prevention of the predisposing factors were recommended (31.3% and 32.7% respectively) as the best methods to prevent poor vision. There was significant association between the level of awareness and knowledge of the students about poor vision and the gender, type and level of education.
<strong>Conclusion: </strong>The detected levels of knowledge is still not the optimum especially among female students, non-scientific colleges and in the earlier levels of university education. This emphasizes the need to involve such students in a proper eye health education program. This will help increasing the awareness of the community at large.https://ejhm.journals.ekb.eg/article_11096_7a901aa672486c8402eb88c3f42dd841.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101How Intern Doctors deal with Hepatitis B in Riyadh and Eastern Saudi Arabia.8458491109710.12816/0043992ENSaad K BoqursainKing Faisal UniversityHawraa R AlsurojKing Faisal UniversityMusaab I AlhawasMaternity And Children HospitalAbeer A AlkhalafPrincess Noura UniversityHussain S AlmazyadiWroclaw Medical UniversityMuhannad M AldubaykhiQassim UniversityAmjaad S AljelbanKing Khalid UniversityShahad T AldawsariKing Saud UniversityMouhab R JamalaldeenKing Saud UniversityMohammed H AlshehriKing Saud UniversityMaitham S AlzaerWroclaw Medical UniversityMatra M FagihiPrince Mansour Military HospitalMohammed S AlharthiPrince Mansour Military HospitalFahad F. AlmutairiAlmaarefa CollegeSajjad M AlmusawiWroclaw Medical UniversityMohammed H AlmahdiKing Fahad Hospital In HofufJournal Article20180814<strong>Background:</strong> Hepatitis B is one of popular health problem and is considered as major global infectious hazard. It represents an occupational risk for all people who are working in healthcare, including doctors, nurses, laboratory staff, and training interns as well as the student who is trained in hospitals. This can be correlated with their contact with body fluids during clinical rotations and activities. However, protection from getting any infection logically is mandatory for healthcare worker. <strong>Aim</strong>: Our problem in this study was to assess how our new doctors in Saudi Arabia, specifically those in Riyadh Region and Eastern Region are safe and are protected from hepatitis B infection by evaluating their knowledge, attitude and practice towards Hepatitis B.<br /> <strong>Method</strong>: That was a cross-sectional study which was conducted to intern doctors in Riyadh and Eastern Regions. Random sampling technique was used to select 350 intern doctors. Study tool was a self-administrated questionnaire that is made online by using Google drive forms and sent as an internet link to all interns via WhatsApp mobile application. Data analysis was done using computer application SPSS 24. Comparison between results and many variables was done using Chi-Square test and statistical significance is considered when P-Value < 0.05. <strong>Result</strong>: In this study, 131 intern doctors participated out of 350 who received the questionnaires (response rate 94.6%). Regarding the level of knowledge, attitude, and practice, around 86% of participants have good knowledge, 63% of them have a positive attitude and 85% have a good practice. Chi-Square test was applied to compare our results of KAP with gender and region. No difference between males and females was found in the level of knowledge and attitude (P-value > 0.05). Males were better than females in practice (P < 0.05). Intern doctors in Riyadh region were better than those in Eastern region in knowledge and attitude (P-value < 0.05), no difference was found between them in practice (P-value > 0.05). <strong>Conclusion</strong>: It was obvious that our new doctors in Eastern and Riyadh regions have good knowledge, attitude and practice for Hepatitis B. People in Eastern region have less knowledge and attitude compared to those in Riyadh with a significant difference between them. Also, males interns have a better practice than females interns in general.https://ejhm.journals.ekb.eg/article_11097_cfbef5e00296b86e4653d43490a21b66.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Awareness of Osteoporosis among Saudi Population in Saudi Arabia Especially Taif governorate8508541127010.12816/0043993ENAbdulaziz Saleh AlharthiTaif UniversityJournal Article20180816<strong>Background:</strong> Osteoporosis is a worldwide health problem leading to an increased susceptibility to fractures and even more other complications. Awareness and perceptions of susceptibility and belief in the seriousness of a disease can help in its prevention and control.
<strong>Objective:</strong> this study was aimed to evaluate knowledge and perceptions of osteoporosis among Saudi population from different country regions and different educational levels.
<strong>Methodology</strong>: 986 participants from all over Saudi Arabia regions and the majority of them were from Taif governorate they were involved in a self- administered online questionnaire that was conducted in August, 2017 through the period to November, 2017 and was available online and easy to access to wide group of people, to evaluate the extent of knowledge about osteoporosis among Saudi population from those different regions of the country. <strong>Results: </strong>986 participants from all over Saudi Arabia regions and the majority of them were from Taif governorate they were involved in a self- administered online questionnaire to evaluate the extent of knowledge about osteoporosis among Saudi population from those different regions of the country.The majority of the participants were aware of some knowledge about osteoporosis but female respondents were more knowledgeable in some very important points in this manner. Age was negatively correlated with the level of awareness though Awareness of osteoporosis was significantly different between educational groups. <strong>Conclusion:</strong> It is important to raise the awareness and knowledge of osteoporosis and its prevention measures as osteoporosis is a preventable disease among Saudi population. Saudi Ministry of health need to determine the population’s knowledge of and attitudes towards osteoporosis to plan effective education programs to be able to avoid late complications and to safe highly cost methods of treating such a conditions.
https://ejhm.journals.ekb.eg/article_11270_91575e51030d9620f3949f08da39663f.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Sonographic Dimensions of Normal Kidney Among Children8558581127110.12816/0043994ENAnas Sulaiman AlorainiCollege of Medicine, King Saud UniversityAli Mekbel AldahmashiKing Saud University, College of Medicine,
Umm Al-Qura University, Saudi ArabiaJournal Article20180816<strong>Background:</strong> the measurement techniques vary between operators, and there is a lack in standards for measuring either renal length or volume. Individual observation shows that optimal sonographic technique varies with sonography system and transducer combination.
<strong>Objectives: </strong>the purpose of this review was to combine the sonographic measurements and morphology of normal kidney among children obtained.
<strong>Materials and Methods: </strong>An electronic search was conducted in CINAHL, EMBASE, and MEDLINE databases. The search resulted in 42 relevant studies, from which 8 studies were met the inclusion criteria. The information was extracted from these studies.
<strong>Results: </strong>in the included studies, the length of right kidney ranged from 4 cm to 7.9 cm. Three studies from the all eight studies of this review revealed that the mean length of the right kidney was 7.6 cm, the rest five studies was with length ranged between 4.2 cm to 6.8 cm and the length of left kidney ranged between 4 cm to 8.4 cm. There are two studies found that length was equal both in right and left kidneys.
<strong>Conclusion:</strong> Assessment of kidney size using sonography can be an early screening technique for these conditions especially among children.
https://ejhm.journals.ekb.eg/article_11271_e5d297e5387e12bd566a749775aec985.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Effect of Obesity in The Outcomes of Patients Admitted to Intensive Care Unit8598651127210.12816/0043995ENKhalid Nasser Mohamed SinnahMedicine College, King Khalid University, Saudi ArabiaJournal Article20180816<strong>Background:</strong> The physiological changes associated with obesity may impair the ability to withstand the stress of critical illness, and particularly in surgical postoperative patients, the effects on cardiovascular and respiratory systems may translate into prolonged time on a ventilator or intensive care unit survival.
<strong>Objectives: </strong>This review aiming at evaluation of the effect of obesity in patients admitted to intensive care unit.
<strong>Materials and Methods: </strong>An electronic search was conducted in Medline using this built search strategy. The search was limited to the human studies conducted in the last 10 years. The search resulted in 368 articles and after exclusion of irrelevant, duplicated, and review articles only 26 articles were included in this review. The information about general characteristics and outcomes of these studies were collected using data sheets.
<strong>Results: </strong>The predominance of weight has been consistently expanding around the world, and obesity itself is viewed as an interminable illness and additionally a noteworthy general medical issue. However, not very many information is accessible on the relationship amongst BMI and basic care result. Additionally, examine is expected to recognize vital associates of basic care in relationship to BMI with the goal that this data can be utilized to nurture patients and enhance results.
<strong>Conclusion:</strong> BMI demonstrated no noteworthy effect on bleakness or mortality in basically sick patients. Mortality in basic care was related with seriousness of sickness at affirmation and ICU-related intricacies.
<strong> </strong>https://ejhm.journals.ekb.eg/article_11272_7e943a4cff0824ee9911bc63db0732c2.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101The Use of Preoperative Magnetic Resonance Imaging in the Screening and Diagnosis of Breast Cancer8668681127410.12816/0043996ENAli Mekbel AldahmashiCollege of Medicine, Umm Al-Qura University, Saudi ArabiaAnas Sulaiman AlorainiCollege of Medicine, King Saud UniversityJournal Article20180817<strong>Background:</strong> Understanding the clinical applications for breast MRI that are supported by the scientific evidence is important to ensure proper use of this medical resource. The use of MRI increased from 2005 to 2008 for women with both in situ carcinoma and invasive carcinoma.
<strong>Objectives</strong>: this review aiming at assessing the evidence supporting use of MRI in the screening and diagnosis of breast cancer.
<strong>Methods:</strong> a systematic search was conducted in main databases using keywords. The relevant studies that met inclusion criteria were included in this review. The findings of the included studies were discussed in this narrative review. The protocol of this review was approved by technical and ethical committee.
<strong>Results:</strong> many studies found that breast MRI is advantageous when used to examine patients with high risk for breast cancer, assessment the ipsilateral and contralateral breasts in patients with diagnosis of new breast carcinoma, assessing patients with metastasis and unknown primary, patients monitoring with chemotherapy. When used in these clinical scenarios, high sensitivity of MRI results in early detection of cancer or greater accuracy of detection compared with existing clinical and imaging tests.
<strong>Conclusion:</strong> MRI is an excellent tool for determining the extent of tumor, and should be performed especially in the dense breasts. To avoid overestimation and to diminish false positive examinations, MRI should be performed in the second week of the menstrual cycle and after the interruption of hormonal therapy.https://ejhm.journals.ekb.eg/article_11274_86a71db2c00971e618c7a7f8720bb646.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Stress, Depression and Anxiety among Medical Students of Imam Mohammed Ibn Saud Islamic University, KSA8698711127610.12816/0043997ENAbdullah Ali AlshehriImam Muhammad Bin Saud University, Riyadh, KSAFares Abdullah AlaskarImam Muhammad Bin Saud University, Riyadh, KSAFahad Khalid AlbahiliImam Muhammad Bin Saud University, Riyadh, KSAJournal Article20180817Background: Exposure of Physicians to some stress factors during the occupational environmental work could induce some psychological problems. The first postgraduate years are particularly susceptible to these problems. In Arab countries, epidemiological data about psychological morbidity among medical undergraduate students are scarce. The Objective of the present study was to assess anxiety and depression levels among the third-year imam medical college students. Methods: A cross sectional study was done on the medical students of the 3rd year at Imam University; College of Medicine in Riyadh city on 2013. The sample consisted of 50 male medical students. The Higher Education Stress Inventory (HESI) was used in data collection. Results: Our results showed that 24% of the students were with minimal depression, 18% of students was with mild depression, 8% of student was with moderate depression, 2% of student was with moderately severe depression and none (0%) of student was reported with severe depression. Conclusion: The study indicated that medical students are extra sensitive to deal with the environmental occupational atmosphere which stress factors could prevail, so, depression and anxiety are common among medical students. Large, prospective, multicenter, multi-method studies are needed to identify personal and curricula features that influence stress, depression, anxiety and coping strategies among medical students. The study findings highlighted the need of psychiatric counseling and preventive mental health services to be an integral part of the routine clinical facilities caring for medical students.
https://ejhm.journals.ekb.eg/article_11276_6ec3506e6ce7e43976fa1049b5e9db5c.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Prevalence of Migraine Among Medical Students in Jazan University and Its Impact on Their Daily Activities8728761127910.12816/0043998ENWejdan ShabiJazan UniversityAmeera AkourJazan UniversityAsrar AgeeliJazan UniversityKadejah NajmiJazan UniversityYousif HassanJazan UniversityJournal Article20180817<strong>Background: </strong>Headache is considered as one of the most common disorders of the central nervous system , and there are many types of it . One of them is migraine headache. Worldwide it is a common disabling primary headache syndrome. Medical students most of the time are exposed to its various triggers. This might have huge impact on their lives and their academic performance. This topic has been studied in many countries to highlight the prevalence of migraine headache and to study its impact on the students’ life and academic performance. Unfortunately, no similar study was conducted neither in Jazan Area nor in Saudi Arabia as a whole
<strong>Objectives</strong>: The main goal of this study was to know the prevalence of migraine headache among medical students at Jazan University and to assess its effect on their daily activities .
<strong>Method</strong><strong>s</strong>: A cross-sectional survey was conducted during 2016-2017 academic year in Jazan university. 260 students were examined. The data were collected by using self-administered questionnaire which included demographic data and specific questions on headache based on international Headache Society criteria for diagnosis of migraine and other headache types. The collected data were analyzed by using SPSS program .
<strong>Results</strong>: The results showed that the prevalence of migraine among medical students was 5.0%. There was no significant difference between the gender according to p-value , but regarding the years of university studying there was significant difference in which the prevalence increased in parallel with advancing academic years at the university.
<strong>Conclusion:</strong> the prevalence of migraine among medical students was found to be less than what seen in similar studies in different countries , without significant difference between the gender. All the students reported that the headache was interfering with their daily activities. Fatigue, too little sleep, and bright light were the most common triggering factors were identified in our study.
https://ejhm.journals.ekb.eg/article_11279_d18c332d11c03553a902bb9c94dc486b.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Bevacizumab for the Treatment of Macular Edema8778811128010.12816/0043999ENYazid Abdulrahman AlhadlgRoyal College of Surgeons in IrelandAbdulrahman Khalaf AlkhalafRoyal College of Surgeons in IrelandJournal Article20180817<strong>Background: </strong>anti-vascular endothelial growth factor (anti-VEGF) has been suggested for the treatment of macular edema. In this study we are assessing the efficacy of one type of anti-vascular endothelial growth factor which is Bevacizumab (Avastin) in the reduction of macular thickness.
<strong>Patients and Methods: </strong>from the period of February 2012 to February 2015, we have gathered the data of 54 patients (39=males, 15 =females) suffering from macular edema who received variable number of intraocular injections of Bevacizumab to be included in a retrospective study. One eye from each patient was chosen randomly and then we observe their follow-up Optical Coherence Tomography (OCT) for any changes in the thickness of the macula.
<strong>Results: </strong>after receiving a single Bevacizumab injection, 16 patients (29.6%) did not show any improvement while 22 (40.7%) patients show an improvement that was less than 50 microns of reduction in magnitude, 5 patients (9.2%) showed an improvement that was greater than 50 microns in reduction of macular thickness and the remaining 11 patients (20.3%) had a reduction of macular thickness that was greater than 100 microns.
<strong>Conclusion: </strong>despite being used originally for metastatic colon cancer, Bevacizumab (Avastin) can be used in the treatment of diabetic macular edema.
https://ejhm.journals.ekb.eg/article_11280_e07088c0a9097bf19d7bd0b67eada7cf.pdfPan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270520180101Bacterial Infections and Biofilm Formation Associated with Intra Uterine Contraceptive Device among Females Attending Al- Glaa Teaching Hospital in Cairo8828901128110.12816/0044000ENAml El-sayedAbdouMicrobiology Departments, Faculty of Medicine
(For Girls)- Al-Azhar University, Cairo, EgyptEmanAbd El Azeem MohamadMicrobiology Departments, Faculty of Medicine
(For Girls)- Al-Azhar University, Cairo, EgyptAmany Mohamad TawfiekMicrobiology Departments, Faculty of Medicine
(For Girls)- Al-Azhar University, Cairo, EgyptReda El- BelbasyCommunity Medicine**Departments, Faculty of Medicine
(For Girls)- Al-Azhar University, Cairo, EgyptJournal Article20180817<strong>Background: </strong>Intrauterine device (IUD) is a convenient, effective and one of a long term contraceptive procedures. However, it may act as a reservoir of reproductive tract infections.
<strong>Aim of the study: </strong>to isolate the microorganisms in the cervix and on the removed IUDs after different times in situ ,examine their association with microbial biofilm formation on the removed intrauterine devices, and also to detect some common sexually transmitted bacteria.
<strong>Subjects and Methods:</strong> a total of 40 women selected randomly from the Gynecological outpatient clinic of Al-Glaa Teaching Hospital in Cairo were included. Cervical swabs and the removed IUDs were bacteriologically examined. The removed IUDs were analyzed by electron microscope to identify the presence of a microbial biofilm. Real time polymerase chain reaction (PCR) was performed to detect some common sexually transmitted infections (STIs) organisms.
<strong>Results: </strong>The mean age of the studied women was 32.12±6.7 years and the mean duration of IUDs in situ was 2.55±0.87 years . Mixed organisms (<em>E. coli, Enterococcus faecalis, Candida , Staph aureus and others</em>) were detected with no significant differences between the isolated organisms from the removed IUDs (116 ) and that from cervical swabs (134 ) ; neither nor to the duration of IUDs in situ (p>0.05). <em>Chlamydiae trachomatis(55%,70%),Neisseria gonorrheae(30% ,30%) and </em>Mycoplasma<em> (7.5%,0.0%), </em>were detected STIs organisms by PCR from IUDs and swabs respectively with no statistical significant differences (p> 0.05). Thick biofilm of multiple microorganisms was detected on the surfaces of the removed IUDS.
<strong>Conclusion</strong>:The insignificant association between microorganisms that were isolated from the cervix, removed IUDs and biofilms may indicate the pre-existence of those organisms before and spread by IUDs insertion . IUD may act as a reservoir for resistant microorganisms. The presence of some asymptomatic sexually transmitted infections (STIs), may point to ,that women may act as STIs transmitters. Prior to and throughout IUDs use, appropriate management of reproductive tract infections is vital. IUDs related prospective studies are also recommended.
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<strong> </strong>https://ejhm.journals.ekb.eg/article_11281_eda5c2f70c8cf6fd8fb5ec4ebdbc5b0c.pdf