Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Serum Copper and Zinc levels in Vitiligo Patients3643701141810.12816/0043470ENMarwa A. SalemDepartment of Dermatology STDs and Andrology
Faculty of Medicine, Fayoum UniversityTalal A. Abd El-RaheemDepartment of Dermatology STDs and Andrology
Faculty of Medicine, Fayoum UniversityNesreen M. AboraiaDepartment of Dermatology STDs and Andrology
Faculty of Medicine, Fayoum UniversityJournal Article20180819<strong>Background: </strong>vitiligo is a common, acquired, discoloration of the skin, characterized by well circumscribed, ivory or chalky white macules and patches. Researchers suggested that vitiligo may arise from autoimmune (AI), genetic, oxidative stress or neural causes. Zinc (Zn) and copper (Cu) are trace elements that are required in minutely small doses. The unique process of keratinization and melanin formation is enzyme-dependent and therefore could be influenced by trace elements deficiencies or excesses as trace elements are involved in enzymatic activities and immunologic reactions.<strong> Aim of work:</strong> this study aimed to detect the levels and roles of serum Zn and Cu in the pathogenesis of vitiligo.<strong> Patients and methods</strong>: our study included 50 vitiligo patients and 50 apparently healthy controls. Age of study groups ranged from 15 to 60 years and both sexes. Serum Zn and Cu levels were measured in each study group.<strong> Results: </strong>serum Zn levels were statistically significant lower in both the studied groups, but in vitiligo group they were much lower than the control group. Serum Cu levels were statistically insignificant higher in vitiligo group than the control group. Conclusion: there is a relationship between vitiligo and serum Zn. Further studies are needed to obtain better knowledge about effect of the trace elements in vitiligo patients.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Awareness of Radiation Protection Measures among Radiologists and Non-Radiologists3713751141910.12816/0043471ENKhaled Awdah AlgohaniRoyal Commission HospitalAli Abdullah AldahhasiKing Fahad HospitalAbdullah Hassan AlgarniKing Fahad HospitalKhaled Yahya AmrainKing Fahad HospitalMajed Abdulkarim MaroufKing Fahad HospitalJournal Article20180819<strong>Background: </strong>More than 3,600 million radiology examinations are carried out every year worldwide. In spite of the great benefits of diagnostic and therapeutic radiations, they may result in some hazards if used inappropriately. However, these hazards can be prevented through raising the awareness of health care professionals about these hazards and the protective measures to be considered. Several guidelines and regulations were issued for this purpose including; the POPUMET regulations and ALARA principle and the WHO global initiative on radiation safety in health care settings.
<strong>Aim: </strong>The current study aimed at assessing the level of radiation protection awareness among clinicians and radiologists in addition to exploring if radiation protection courses have a beneficial effect on the awareness level or not. <strong>Methods: </strong>This was a cross-sectional study where the level of radiation protection awareness was assessed using an anonymous questionnaire.
<strong>Results: </strong>A total of 101 (100%) participants responded to the questionnaire. Of which; 49 (48.5%) were residents, 30 (29.7%) were specialists and 22 participants (21.8%) were consultants.
Slightly less than half of the participants (48, 47.5%) have attended a radiation protection course before. The majority of participants who attended a course (68.8%) have heard about the POPUMET regulations (p<0.001).
Participants were asked about the procedures with risk equivalent to 0.25 mSy of radiation estimated dose equivalent. And it was found that course attendance improved the knowledge about the risk of 3 (out of 4) procedures (p<0.05). On the other hand, course attendance didn’t improve the knowledge about the approximated radiation doses of some procedures (p>0.05) or the degree of radio-sensitivity of different organs (p>0.05). The majority of the participants (96%) were not aware that there is no annual limit of radiation dose for patients. Around half of the participants (56.4%) were aware about what the word “ALARA” stands for.
<strong>Conclusion: </strong>Results of the current study suggested that the level of radiation protection awareness among health care professionals is not sufficient to ensure patients and workers’ safety. And accordingly, we suggested that more efficient awareness programs for health care professionals are conducted on regular basis with regular monitoring of awareness level to explore areas for improvement.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101A Survey on Jazan Public Awareness about The Role of The Anesthesiologists3763811142010.12816/0043472ENAhmad Ali MohajerFaculty of Medicine, Jazan UniversityAli Yehya MatiriFaculty of Medicine, Jazan UniversityAhmed Ali JaafariFaculty of Medicine, Jazan UniversityNaif Ayidh AlmalkiFaculty of Medicine, Jazan UniversityAbdulaziz Mohammed AlfaqihFaculty of Medicine, Jazan UniversityAbdulrahman Hussain GosadaFaculty of Medicine, Jazan UniversityHussein Ahmed SanbaFaculty of Medicine, Jazan UniversityKhamis Abdu KhamisFaculty of Medicine, Jazan UniversityRayan Thabet ShayaniFaculty of Medicine, Jazan UniversityJournal Article20180819<strong>Background: </strong>anesthesiology has been considered as a behind the scene specialty. Most patients lack the knowledge about the anesthetist’s role and there are few who know about anesthesia, but still considered having poor knowledge. People thought that anesthetist plays a secondary role in surgery and the role assigned to the anesthesiologist remains inaccurate for most of them.
<strong>Aimof the work</strong>: our study aimed to assess the society's perception in Gazan area of Saudi Arabia about anesthetist’s role and duties in surgery and their knowledge about anesthesia.
<strong>Method</strong>: a total of 744 responded to the questionnaire. Out of the responders, 445 (59.8%) were males, and 299 (40.2%) were females. 432 (58%) participant considered having sufficient knowledge about anesthesia, while 312 (42%) still didn’t have sufficient knowledge about it. 514 (69%) responders admitted that anesthesia is safe, while 230 (31%) responders thought that it’s not-safe.
<strong>Results</strong>: 744 participated in our study, out of which 445 (59.8%) were males and 299 (40.2%) were the participated females. 432 (58.1%) of the sample study had sufficient knowledge about anesthesia, while 312 (41.9%) didn’t having sufficient data. Our study also showed a correlation between the education level and the knowledge about anesthesia and anesthetists.
<strong>Conclusion</strong>: our study revealed the poor knowledge of Gazan inhabitants about anesthesia, anesthetists and pre-operative care. The poor knowledge may be due to the limited interaction between the anesthetist and the patient, thus the anesthetist has the duty to visit the patient before surgery.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101The Incidence and Surgical Treatment of Gallstone Cholecystitis in Rural Saudi Arabia3823851142110.12816/0043473ENMohammed Khaldun AlalwanPrince Sattam bin Abdulaziz UniversityNaif Theeb AlqahtaniPrince Sattam bin Abdulaziz UniversityHumaidan Hamoud AlmalkiPrince Sattam bin Abdulaziz UniversityAbdulrahman Mohammed AljowairPrince Sattam bin Abdulaziz UniversityAnthony MorganPrince Sattam bin Abdulaziz UniversityJournal Article20180819 Cholecystolithiasis and its complications remain to be one of the leading burdens in general surgery which require surgical intervention in majority of cases. In Saudi Arabia, this pathology has huge impact on its health system and society. In current management of acute and chronic cholecystitis as a result of cholecystolithisis, laparoscopic cholecystectomy has become a procedure of choice. The aim of this cross-sectional study was to estimate the incidence of cholecystitis as the complication of cholecystolithiasis in central rural area of Saudi Arabia with relatively large population and analyze current management outcome in selected group of patients, who underwent laparoscopic cholecystectomy procedure. Multiple criteria including demographics, results of investigations and surgical outcome were analyzed and compared. The incidence of acute cholecystitis in this study was 4.4/100,000 of population per year with prevalence of 24% and female to male ratio 11.9:1. The results demonstrated satisfactory surgical outcomes with low complications rate and cost effectiveness.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Management of Acute Vision Loss3863911142210.12816/0043474ENHadil Mohammed AleneziNorthern Border UniversityArwa Ziad AlromaihImam Abdulrahman Bin Faisal UniversityAisha Abdullah Al-EssaImam Abdulrahman Bin Faisal UniversityRazan Abdullah AldawodImam Abdulrahman Bin Faisal UniversityBashaer Abdulaziz AltowairqiJazan UniversityZainab Habib AlmomenImam Abdulrahman Bin Faisal UniversitySara Mohammed BeayariUmm Al-Qura UniversitySakhr Ahmed DawariAl-Imam Mohammad Ibn Saud Islamic UniversityJournal Article20180819Acute visual loss is a mutual complaint with variable presentations amid patients of different ages. The degree of difference diagnoses of vision loss is immense. Generally, monocular vision loss regularly specifies an ocular problem. Binocular vision loss is commonly cerebral in origin. Monocular vision loss can respect the horizontal midline. Binocular vision loss can respect the vertical midline. Many diverse causes of sudden visual loss are recognized; though, the most common cause for painless visual loss is ischemia. Vision loss with positive scotoma may be seen with migraine. Vision loss with a negative scotoma may be seen with amaurosis fugax. Ischemia, often via mechanical obstruction, can affect any aspect of the visual system. Those who develop ischemia of the eye often have other evidence of atherosclerotic disease, such as coronary artery disease and peripheral vascular disease, which increases their susceptibility to ischemic events in other parts of the body. Risk factors include smoking, hypercholesterolemia, and hypertension.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Laparoscopic versus Open Inguinal Hernia Repair in Adults3923961142310.12816/0043475ENMansour Ali ShaibanJazan UniversityLayan Mazen KhushaimIbn Sina National CollegeRoaa Khalid AlghamdiIbn Sina National CollegeFatimah Murtadha AlawamiMaastricht UniversityMouhab Rafiq JamalaldeenKing Saud UniversityGhadah Abdulsalam AljoufiPrincess Nourah Bint Abdulrahman UniversityMohammed Hasan AlsharifUmm Alqura UniversityFetoon Nasser AlsharifIbn Sina National CollegeKhaled Saad AlzahraniKing Abdulaziz UniversitySultan Omar AlbarakatiIbn Sina National CollegeAlqahtani Yousif AbdulrahmanImam Abdulrahman Bin Faisal UniversityAlmutairi Ahmad SaudSzeged University- HungaryMahdi Hussain Al-SaadKing Faisal UniversityEbtihal Mohammad Al-KhiderPrince Mohammed Bin Nasser Hospital – GizanMohammed Zuhair IsmaelKing Abdulaziz UniversityJournal Article20180819 Hernias are abnormal protrusions of a viscus (or part of it) through a normal or abnormal opening in a cavity (usually the abdomen). They are most commonly seen in the groin; a minority are para-umbilical or incisional. In the groin, inguinal hernias are more common than femoral hernias. Inguinal hernias occur in about 15% of the adult population, and inguinal hernia repair is one of the most commonly performed surgical procedures in the world. Although open, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons, produces excellent results comparable to those of open repair. We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1985, through June 15, 2017.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Hyperbaric Oxygen Therapy in Plastic Surgery3974021142410.12816/0043476ENAbdulelah Ahmed AlwadaiBurn Unit - Aseer Central HospitalAbdullah Abdu Haidan AlasmariAhad Rafidah General HospitalJournal Article20180819<strong>Objective:</strong> In this review the literature aims to familiarize the reader with several of the more common plastic surgery problems and to review the appropriate use of HBO for each condition. Plastic surgery is a broad specialty encompassing a variety of areas including the treatment of traumatic soft tissue injury, burn care, hand surgery, microsurgery and limb replantation, problem wound management, flap reconstruction, cosmetic surgery, and congenital deformity. In recent years an emphasis on less anecdotal and more scientific research has provided a better understanding of the role of hyperbaric oxygen therapy (HBO) for many plastic surgical conditions. Patient selection remains the key to successful outcome. The rationale for HBO treatment of a specific plastic surgery problem should be based on scientific research if possible. If supportive research is not available or applicable to a specific case, then the decision to treat should be based on sound physiological principles.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Evaluation of Topical Monotherapy for Early Primary Open Angle Glaucoma Patient4034081142510.12816/0043477ENSaber Hamed El-SaiedDepartment of Ophthalmology, Faculty of Medicine, Menoufia University, EgyptAdel Galal ZakyDepartment of Ophthalmology, Faculty of Medicine, Menoufia University, EgyptAhmed El-Refaie AliAbou El-AghaDepartment of Ophthalmology, Faculty of Medicine, Menoufia University, EgyptJournal Article20180819<strong>Background</strong>: primary open-angle glaucoma is asymptomatic optic neuropathic ocular disease characterized by enlarging optic disc cupping and visual field loss. World Health Organization estimated in a systemic review that glaucoma is the second commonest cause of blindness worldwide and topical ocular hypotensive medication was effective in delaying the onset of open angle glaucoma in individuals with elevated ocular pressure.<strong> Aim of the work</strong>: the study aimed to evaluate the safety and pressure-lowering efficacy of travoprost (0.004%) compared to timolol 0.5% and compared to brimonidine tartrate 0.2% as monotherapy in patients with primary open-angle glaucoma
<strong>Patients and methods:</strong> patients were randomized to 3 groups, the first group was received travoprost 0.004%, the second group was received timolol 0.5% and the last group was received brimonidine tartrate 0.2%. This study was carried out in Menoufia University during the period from January 2016 to January 2017.
<strong>Result: </strong>this study included 45 patients who were randomized to 3 groups, the first group received prostaglandins analogue, the second group received beta blockers and the last group received alpha agonists. Collected data indicated that the intraocular pressure–lowering efficacy of travoprost was significantly better compared to timolol and brimonidine at months 3, 6, 9, 12 (P <.001).
<strong>Conclusion:</strong> using primary monotherapy, the intraocular pressure–lowering efficacy of travoprost 0.004% was superior to timolol 5% and superior to brimonidine tartrate 0.2% in patients with primary open-angle glaucoma. Travoprost, timolol and brimonidine reduced intraocular pressure effectively in primary open angle glaucoma.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Emergency Airway Management in Neck Trauma4094131142610.12816/0043478ENEbtesam Eissa Ali MadkhaliJazan UniversitySakinah Ali AlbatiUmm Alqura UniversityHalah Foud AhmadKing Abdulaziz UniversitySoud Mohammad AlzhraniKing Abdulaziz UniversityAsmaa Yaseen NassirIbn Sina National CollegeBassam Mohammed Oudah AlbalawiImam Mohammed Bin Saud UniversityAnas Saleh HejiUmm Alqura UniversityAli Ghalib AlhashimImam Faisal Bin Abdulrahman UniversityAnas Abdullrahman AlarfajKing Faisal UniversityAmnah Hassan Mansour AlsaffarMaternity And Children Hospital – DammamMohammed Ghazi AlharbiHera General HospitalBatool Mohammed AlsadahRoyal College Of Surgeons In Ireland (RCSI)Omar Khalid AlghamdiImam Mohammed Bin Saud UniversityTalal Mislat AlotaibiMajmaah UniversityJournal Article20180819Airway management in patients who have sustained direct trauma to the airway is among the most challenging problems for emergency clinicians. Blunt or penetrating injuries to the head, oropharynx, neck, or upper chest can result in immediate or delayed airway obstruction. Immediate, definitive airway management is needed when the patient cannot protect his airway or is unable to sufficiently oxygenate or ventilate. Emergent or urgent airway management is specified when a patient develops respiratory distress or when symptoms are progressing rapidly. In addition, airway management often is indicated when the patient appears clinically stable, but the clinician anticipates clinical decline (e.g., smoke inhalation, edema, subcutaneous air, hematoma) or feels that an unprotected airway presents a risk to the patient who requires transport to another facility or to radiology for extensive diagnostic studies. The higher rate of complicated airways in this population mandates that the clinician has to be prepared to use advanced airway techniques, including a surgical airway.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Laparoscopic Surgery Compared to Open Surgery in Excision of Rectal Cancer: A Systematic Review4144181142710.12816/0043479ENSaud Abdulaziz Musa AlqahtaniFaculty of Medicine, Jazan University, Saudi ArabiaAbdulsalam Siddiq Mohammed ArishiFaculty of Medicine, Jazan University, Saudi ArabiaMeshal Salem Ahmed BajonedFaculty of Medicine, Jazan University, Saudi ArabiaMeshari Fahad Abdullah AlasmariFaculty of Medicine, Jazan University, Saudi ArabiaMoath Abdullah Yahya QadriFaculty of Medicine, Jazan University, Saudi ArabiaMohammad Abdallah Yahya AlhakamyFaculty of Medicine, Jazan University, Saudi ArabiaAhmad Sameer Ahmad AlrefaieFaculty of Medicine, Jazan University, Saudi ArabiaAlalaa Hussain Othman HakamiFaculty of Medicine, Jazan University, Saudi ArabiaJournal Article20180819<strong>Background: </strong>The laparoscopic surgery for rectal cancer, such as open surgery, is associated with many surgical complications, especially if the surgeon does not have sufficient experience in open total mesorectal excision and advanced laparoscopic surgery. This review aiming at comparing the effectiveness and the complications rate of laparoscopic surgery to those of open surgery.
<strong>Methods: </strong>The comprehensive electronic search was conducted in Medline and Embase databases. The search resulted in 102 relevant clinical trials, which were subjected to primary screening and exclusion of ineligible studies. Finally, 32 potentially relevant clinical trials were included in the secondary screening from which nine clinical trials were included in this review. Data were collected from included studies using data extraction forms, then the qualitative synthesis of extracted data was conducted.
<strong>Results: </strong>Small differences between interventions were reported by the included studies. Five-years survival rates tend to be slightly higher in the open surgery, whereas 3-years survival rates were higher in the laparoscopic surgery. It be attributed to the wider safe margin for tumor excision obtained in open surgery. The complications rates were slightly lower in the laparoscopy groups among most of the included studies.
<strong>Conclusions: </strong>This review found comparable outcomes of laparoscopy and open surgery in treatment of rectal cancer with minimal differences in survival and complications rates.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Effect of Different Fluoridated Mouth Rinses on the Surface Characterization of Nano-filled Resin Composite Materials4194251142810.12816/0043480ENAram Soliman AlnouryFaculty of dentistry, King Abdulaziz UniversitySarah Ayman BarzanjiFaculty of dentistry, King Abdulaziz UniversityAhmed Soliman AlnouryFaculty of dentistry, King Abdulaziz UniversityJournal Article20180819<strong>Background:</strong> The influence of recently marketed fluoridated mouth rinses on the surface roughness of the newly nano-filled composite resins has not yet been adequately investigated.
<strong>Objectives: </strong>This study aiming at evaluating the effects of different types of mouthwashes on surface roughness of different types of composite resins.
<strong>Materials and Methods: </strong>This experimental in vitro study included 3 types of mouthwashes (Colgate Plax, Listerine, and Aloe Dent) and 3 types of composite resins (Z350, Z250, and Art). Six specimens were prepared for each material in each group. All specimens were fabricated at room temperature 23°C. Pre-test measurements were recorded for all specimens in the three test groups using the profilometer after storing all specimens in distilled water for 24 hours. Post- test measurements were recorded after storing each specimen for 1 minute/day for 1 week. Means and standard deviations were calculated and the differences in means (before and after) between the tested groups were performed using Paired Sample t-test with p value <0.05 as a significant level.
<strong>Results: </strong>The pre-test means and SDs for the tested groups according to the type of mouthwash were 140.7±53.86 for group B, 159.63±44.34 for group C, and 166.55±51.16 for group D. The after-test readings were 158.42±47.63, 176.11±49.30, and 171.49±31.81 for the same group, respectively. The highest difference in means between before and after measurements was found in group B with a value of 17.73±10.82 with high significant level (P <0.001). The difference in means for group C was 16.48±8.42 which was also highly statistically significant (P <0.001). The lowest difference, however, was found between the means in group D with a value of 4.94±48.22 with no significant level (P >0.05).
<strong>Conclusion: </strong>Among the tested storage mouth rinses, Aloe Dent was found to have the least effect on surface roughness.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101The Awareness of The Risk of Chronic Use of Steroid Causing Cataract in Tabuke City, Saudi Arabia,20174264291142910.12816/0043481ENAl Khozym Saeed Ali ATabuk universityJournal Article20180819<strong>Background:</strong> Cataracts could result in very dangerous consequences including worldwide blindness which imposes a great economic burden on people and health authorities.
<strong>Objectives:</strong> Evaluate the knowledge of Saudi subjects in Tabuk City toward the cataract induced by chronic use of steroids. <strong>Methods: </strong>It is a cross sectional community survey based on a questionnaire sheet that was carried out among sample of adult subjects from different shopping malls, community pharmacists, coffees and masjids of Tabuk City from July to September 2017.
<strong>Results: </strong>All the subjects have already heard about cataract and only 6.4% of them suffered from cataract. The most common source of knowledge among participants were relatives and friend (75.1%). Only 9.1% of the subjects used steroid therapy for long periods as 59.4% of them used topical steroids, followed by 20.3% by oral therapy. Most of the subjects (81.4%) showed inadequate knowledge about the steroid induced cataract. The older age had significant association with good knowledge.
<strong>Conclusion: </strong>The level of knowledge about risks factors of chronic usage of steroid therapy and its effects on cataract was inadequate among most of the subjects, although they were university graduates.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Anterior Technique in Spinal Deformity Correctional Surgery4304351143010.12816/0043482ENKhalid Mohammed Yahya ManiaFaculty of Medicine, Jazan UniversityKhamis Abdu Khamis KhamisFaculty of Medicine, Jazan UniversityAbdulwadood HefdhiFaculty of Medicine, Jazan UniversityMohammad Hassan Ali HaroobiFaculty of Medicine, Jazan UniversityFahad Mousa Mohsen MaashiKing Fahad Central Hospital, JazanAbdulrahman Yahya Ahmad AlqasemFaculty of Medicine, Jazan UniversityJournal Article20180819The aim of this review is to classify spinal deformities, provide knowledge in correctional surgery of spinal deformities and highlight the anterior technique. PubMed and Medline database search was performed for published articles up to October 2017 related to surgical techniques for spinal deformities. Spinal deformity may be the pathology of one vertebra or may develop with pathologies of multiple vertebras, ribs or the pelvis. The spine must be analyzed in different planes before starting the treatment because it can be accompanied by multiple organ pathologies. Different surgery types can be used and anterior method is one of them, which can give better result in cases with advanced kyphosis. The therapy of serious spinal deformity is challenging and needs a careful analysis of the patient by the orthopedic surgeon, anesthesiologist, pulmonologist, and neurologist especially when neurologic deficits are existing. Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Primary Giant Cell Tumor of Soft Tissues: A Case Report and Literature Review4364381143110.12816/0043483ENFurat Abdulrahman AlmayoufCollege of Medicine, Qassim University, Saudi ArabiaJournal Article20180819Giant cell tumor of soft tissue (GCT-ST) is a rare tumor of low malignant potential. Grossly and histologically similar to its bone counterpart. Majority has benign clinical course and rarely <em>metastasizes. This is a case of a 46-year-old woman with a giant cell tumor of soft tissue of the knee. This tumor was not suspected clinically and was initially diagnosed as septic infra-patellar bursitis. The diagnosis of GCT-ST was made after histopathological examination. Herein, we describe the clinical, histologic, and immunohistochemical features of this rare neoplasm.</em>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Early Epinephrine Administration in Patients with Cardiac Arrest in Case of Shockable Rhythm in ER4394451143210.12816/0043484ENKhalid Yahya AlzahraniKing Abdulaziz UniversityAbdulaziz Saud AlghamdiKing Abdulaziz UniversityOmar Hussain AlghamdiKing Abdulaziz UniversityYasser Musallam AlrehailiKing Fahad HospitalMahmoud Shehab HalawaniOhud HospitalSaleh Jameel AlmatrafiIbn Sina National CollegeAbdulkareem Khaled AlmotairiIbn Sina National CollegeBayan Jamal AlMulhimKing Faisal UniversityNaif Khaled AlomarImam Mohammed Bin Saud Islamic UniversityAman Abdullah AlkishiAlfaisal UniversityAbeer Abdullah AlreshidiInternational Academy for Health ScienceBasil Mohammed AlrajhiAlbatterjee Medical College, SAJournal Article20180819 The objective of the review was to investigate the scientific production and evaluate the effectiveness of epinephrine in the treatment of cardiac arrest in terms of survival and neurological status. PubMed, Embase, and Google Scholar databases were searched up till November 2017 for published studies in English language and human subjects discussing early epinephrine administration in patients with cardiac arrest in case of shockable rhythm in emergency medicine. Prehospital epinephrine management may increase short-term survival (ROSC) yet does not improve survival to release, or neurologic results after out-of-hospital cardiac arrest OHCA. Although there is no clear proof of long-lasting advantages complying with the use of epinephrine in OHCA, there is insufficient evidence to sustain altering present guidelines which recommend its management (1 mg every 3-5 min) throughout resuscitation. As a result, there is a need for additional clinical trials to analyze whether lower dosages or alternative regimes of epinephrine administration. Furthermore, one of the most important aspects of care in cardiac arrest is basic life support (BLS) measures, consisting of adequate compressions and early defibrillation.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Narrative Review on Different Clinical Aspects of Thrombocytopenia4464511143310.12816/0043485ENAbdulaziz Saud Alghamdiking Abdulaziz UniversityKhalid Yahya Alzahraniking Abdulaziz UniversityOmar Hussain Alghamdiking Abdulaziz UniversityAbdulraouf Muhammad Altalebking Abdulaziz UniversityMajed Abdulaziz Mauqaryking Abdulaziz UniversitySaleh Ibrahim Alrufayyiqking Saud Bin Abdulaziz University For Health SciencesFaisal Fahad Alanizyking Saud Bin Abdulaziz University For Health SciencesOlfa Ahmed HalawaniIbn Sina National CollegeMohammad Hamdin AlhasnaniUmm Al-Qura UniversityYasser Musallam AlrehailiKing Fahad HospitalAbdullah Mahmoud AldorOctober 6 UniversityJournal Article20180819 This review article aims to summarize the major causes of thrombocytopenia and characterize the main general symptoms of thrombocytopenia. As well we summarize the diagnosis and treatment methods. We conducted the search using electronic biomedical databases such as; Medline, and Embase, for studies published up to September 2017 in the English language concerning the thrombocytopenia in general. Thrombocytopenia can either be primary or secondary, in that it could go along with a broad spectrum of syndromes and diseases and may be triggered by different systems. Trigger investigation and recognition might be important and sometimes life-saving as in TTP, heparin-induced thrombocytopenia, acute leukemia or perhaps severe ITP. Taking a detailed history and a thorough physical examination can give clues concerning possible underlying illness and clinical treatments. Cautious evaluation of the peripheral blood smear is necessary. When the differential diagnosis is problematic, sometimes a short trial of therapy could help to clarify the reason. For instance, it might be difficult to differentiate inherited thrombocytopenia (without a family history) from immune thrombocytopenia (ITP); in this example, intravenous immunoglobulin infusion will likely have no effect in inherited thrombocytopenia, however, will generally be useful in ITP.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Assessment and Evaluation of the Quality of Life of Saudi Patients Underwent Coronary Artery Bypass Graft (2-5 years)4524571143410.12816/0043486ENThamer Menwer AlbilasiAl-jouf University, Collage of MedicineBader Menwer AlbilasiAl-jouf University, Collage of MedicineMushari Aber Alonazi AlonaziAl-jouf University, Collage of MedicineWaleed Sultan Al-ruwailiAl-jouf University, Collage of MedicineMarkhan Hammad AlmarkhanAl-jouf University, Collage of MedicineNafea Hamoud AlanaziAl-jouf University, Collage of MedicineHind Jaza AlotaibiAl-jouf University, Collage of MedicineJournal Article20180819<strong>Background: </strong>Cardiovascular disease (CVD) is a cluster of diseases that involve heart and blood vessels <sup>(10)</sup>. They also include coronary heart disease (CHD), coronary artery disease (CAD), and acute coronary syndrome (ACS). This paper aimed at measuring the quality of life after coronary artery bypass graft procedure and determine the factors that affect the quality of life.
<strong>Methods:</strong> Data was collected via a structured close-ended questionnaire in which 100 (male and female, aged 40-60) were questioned. Patients were chosen after underwent CABG surgery 2 to5 years.
<strong>Results</strong>: Carried out as good 36% for their general heath and 24% very
good. The activities indicated that there was a significant difference between males and females. Moreover, female participants were significantly different from male (<em>P. </em>value <0.05) in their perception towards own health. Elder participants (56-60 years) were feeling better in comparison with middle age (40-49 years), (<em>P. </em>value 0.002). <strong>Conclusion and recommendations:</strong> The core domains related with the quality of life, that affected are physical functioning, bodily pain, social functioning and emotion, Therefore, health care specialists must plan for interventions towards improving the HRQOL to decrease the complications of CABG surgery. We recommend the establishment of a special center for rehabilitation of patients underwent CABG. Moreover, providing a further minimal invasive procedure to improve HRQOL.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Type 1 Diabetes Mellitus among Adolescent Girls in Riyadh City, Saudi Arabia4584631143510.12816/0043487ENKhulud Falah M AlanaziNorthern Border University, ArarNajah Salah F AlanaziNorthern Border University, ArarMona Salah F AlanaziNorthern Border University, ArarAbdurhman Aiash AlrwailiNorthern Border University, ArarBader ArarShadad AlruwailiNorthern Border University, ArarAbdulaziz Ayad ALanaziNorthern Border University, ArarMaram Khalf Ayad AlenziNorthern Border University, ArarBdoor Attaulla AleneziNorthern Border University, ArarManal Nashi AlshammariNorthern Border University, ArarSafiah Bader Al-EidImam Abdulrahman bin Faisal University, DammamNaif Salem AlshammariNorthern Border University, ArarAishah Mohammad AlkhaldiNorthern Border University, ArarMatar Mohammed AlharbiAlfaisal University, Riyadh, KSAJournal Article20180819<strong>Background:</strong> Diabetes mellitus (DM) is rapidly becoming one of the main health issues among humans in the 21<sup>st</sup> century. The increase in the incidence of type 1 diabetes has been observed as a global public health problem in children and adolescents. This work was conducted aimed to estimate the prevalence of type I diabetes and to describe some related characteristics of cases in a sample of adolescent primary and secondary school girls of Riyadh city, KSA. <strong>Methods:</strong> A cross-sectional study was conducted during the academic year 2016-2017. Data were collected via a predesigned and pretested questionnaire to gather the relevant data. The total number of participants was 154 adolescent girls. <strong>Results:</strong> The overall prevalence of type I diabetes among the studied adolescent girls was 5.2% with Mean(±SD) age was 14.08 (± 3.4). All diabetic girls were Saudi. Only 25% of the cases were using a hormonal contraception. No smoking history or other chronic diseases was detected among them. <strong>Conclusion:</strong> The present study establishes the prevalence of type 1 DM among Saudi adolescent girls to be 5.2%. We suggest repeating this study periodically, with concentration on the various possible etiological and risk factors. Also we recommend conducting similar studies in other areas of Saudi Arabia to get more information about Diabetes. Awareness campaigns and continuous medical education is of utmost importance to detect the disease to guard against development of complications. Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Association between Cretinism and Prolactin Secretion4644681143610.12816/0043488ENOmar Ahmad Almontasser Al-khayariImam Mohammed Bin Saud UniversityHebah Adel MansourJeddah Eye Hospital, King Abdulaziz UniversitySafiya Ali Ahmed LotfallahBeirut Arab UniversitySulaiman Abdullah AlawajiQassim UniversityAbdulrahman Bader AlharbiQassim UniversitySarah Abdulaziz Hamid FallatahGP King Abdulaziz Hospital JeddahAhmed Abdullah Ahmed BahatabSaudi National HospitalFahad Yahya Ahmad HakamiSabia PHCAnouf Fawzi EnaniPrince Sultan Primary Health CareHafsa Ibrahim BilalBatterjee Medical CollegeFatimah Shafiq Al-MubarakPHC in Al-KhoberRami Mohammed Hamed Almutairi*Ohud* Hospital MedinaJournal Article20180819<strong>Objective:</strong>To compare the serum prolactin level in hyperthyroid and normal control females. Hyperthyroidism is a mutual disease. Even though a direct relation has been demonstrated amid hypothyroidism and increased prolactin levels, this association has not been established for hyperthyroidism.
<strong>Materials and Methods: </strong>Cross sectional study was carried out on cases and control groups. To select the cases, all women referred to the laboratories of Saudi National Hospital with a thyroid-stimulating hormone (TSH) level ≤0.5 mIU/L and met the inclusion criteria were entered in the study. A total of 62 women aged 16 to 49 years were enrolled. The case group included 24 hyperthyroid women, and the control group included 38 women with normal thyroid function matched by age.
<strong>Results: </strong>The mean (SD) serum level of prolactin was 16.4 (0.96) ng/mL (95% confidence interval [CI], 15.39 ng/mL to 15.69 ng/mL) in the controls and 23.02 (1.47) ng/mL (95% CI, 22.7 ng/mL to 23.4 ng/mL) in the case subjects. Hyperprolactinemia was more common in the hyperthyroid group (16.4 [0.96] ng/mL versus 23.02 [1.47] ng/mL; P<.001). The prolactin level decreased with age. Hyperthyroidism and estradiol increased the prolactin level. After adjusting for age and estradiol, hyperthyroidism increased the serum prolactin level (P<.001).
<strong>Conclusion: </strong>The outcomes of the present study showed that hyperprolactinemia is more frequent in hyperthyroid females. Serum prolactin level can be increased in hyperthyroidism.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101The Use of Butyl Bromide Medication amid Colonoscopy4694721143710.12816/0043489ENFadi Mohammed AlbulayhishiKing Faisal UniversityIbrahim Abdulkarim AlsayeghKing Fahad Specialist Hospital BuraydahAsaad Abdellahi Bilal( General Practitioner ) King Abdulaziz UniversityAbdullah Sami DahlawiKing Abdulaziz UniversityHanan Rashed Hassan AlsohabiSouth Qunfuda General HospitalAlzayer Mohammed Ali YImam Abdulrahman Bin Faisal UniversityNorah Mohammed H AlharthiArabian Gulf UniversityAbrar Ghazi A NajjarUmm Alquraa UniversityRedwan Muneer A FarghalUniversity Of JeddahRami Mohammed Hamed AlmutairiOhud* Hospital MedinaSaber Mutlaq BaseemAljouf UniversityJournal Article20180820<strong>Objective</strong>: the hyoscine-n-butylbromide (Buscopan) is ought to be avoided during colonoscopy in patients with a history of angle-closure glaucoma. Angle-closure glaucoma, nonetheless, is not very common, is asymptomatic before onset and is treated definitively by a single laser treatment (if spotted early). Open-angle glaucoma is not affected by hyoscine.
<strong>Purpose</strong>: the purpose of this study was to evaluate the use of hyoscine amid colonoscopists, with certain reference to glaucoma. <strong>Materials and Methods</strong>: a short questionnaire was electronically managed to members of the Saudi Society of Gastroenterology and the Association of Coloproctology of KSA. The use of Hyoscine among colonoscopists and the effect of glaucoma history upon the prescribing practice.
<strong>Results</strong>: sixty-three colonoscopists responded to some or all of the questions. 41/61 (67.2%) of respondents claimed they were aware of the guidelines. 53/62 (85.5%) sometimes or always use hyoscine, while 9/62 (14.5%) never do. 45/59 (76.3%) always enquire about glaucoma history prior to administration, even though 48/58 (82.8%) make no differentiation between open-angle or angle-closure forms. 42/59 (71.2%) would (incorrectly) withhold hyoscine if the patient declares a history of any form of glaucoma. 46/59 (78.2%) do not substitute glucagon as an antispasmodic. 2/60 (3.3%) had encountered ophthalmic complications post-administration. <strong>Conclusions</strong>: current guidelines pertaining to hyoscine use and glaucoma are inappropriate. Patients undergoing colonoscopy who have received hyoscine should, instead, be advised to seek urgent medical advice if they develop ophthalmic symptoms.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101The Relationship of Diet and Acne4734771143810.12816/0043490ENLuai Mohammed E AssaediUmm Al-Qura UniversitySaud Adel Al-TaisanAl-Ahsa (Al-Salmaniah PHC)Abdulrahman Ghaeb AlharbiImam Abdulrahman Bin FaisalAbdulaziz Mohammed AlsahliKing Abdulaziz UniversityRawan Ahmed GaafarUmm Al-Qura UniversitySomaya Khalid AlsharifUmm Al-Qura UniversityFaris Ali Nasser AyidhKing Khalid UniversityAli Hassan J AlzahraniKing Abdulaziz University,Rabigh BranchToqa Eissa AljowaidIbn Sina CollegeAlfaifi Adel Ali A Ali AKing Khalid UniversityKhadijah Salem M BanjarUmm Al-Qura UniversityMazad Ali S AllehyaniUmm Al-Qura UniversityJournal Article20180820<strong>Background: </strong>Earlier, medical literature replicated that diet was not a proven cause of acne. Nonetheless, studies in recent years have demonstrated a relation between certain dietary factors and acne. It is uncertain whether patients are aware of recent research findings.
<strong>Purposes: </strong>Acne patients were surveyed to explore beliefs concerning the relationship between diet and acne, to determine whether these beliefs translated into behavior change and to recognize health information sources.
<strong>Materials and Methods: </strong>Surveys were managed to 104 acne patients at King Abdulaziz Hospital from March2016 till February 2017, with 98 completed in full and included in this analysis.
<strong>Results: o</strong>f the 104 questionnaires administered, 98 were completed in full and were included in the analysis. The mean age of patients was 29 years (range, 15 to 45 years); 76 were female and 22 were male. Six respondents had an under-weight BMI of less than 18; 62 respondents had a normal BMI between 18–25; 26 respondents were overweight with BMI 25–30; and 4 respondents were qualified as obese with BMI greater than 30. A majority,( 90 of 98 ) of respondents, was educated at the college level .
<strong>Conclusion: </strong>In this exploratory study, patients reported utilizing a diversity of information sources, a majority from the Internet. In those surveyed, there was a persistence of long-held belief that fried/greasy foods and chocolate may serve as acne triggers, and less belief in trigger foods supported by recent research, including refined carbohydrates and sugar. Given the multiplicity of beliefs and utilized sources among acne patients in our survey, there is a need to establish an up-to-date and reliable methods to educate patients the relationship between diet and occurrence of acne.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Assessment of Patients with Thoracic Trauma in Emergency Department4784821143910.12816/0043491ENAbdulrahman Fayez KinsaraKing Faisal Hospital MakkahWarda Dakheel Al.MasodiFaculty of Medicine , Umm Al-Qura UniversityAbdullah Musari AlanaziPrince Abdulaziz Bin Musaed Hospital- ArarAbdulaziz Abdulrahman AlghamdiRoyal College Of Surgeons, RCSI, Dublin, IrelandTurki Jafar AbdulmajidImmam Abdulrahman Al Faisal Hospital , ResidentHanan Showei H Hanan Showei H Fageeh Hanan Showei H FageehEast Jeddah HospitalAhmed Abdulelah Al JishiAnak General HospitalBadr Wadee S AbulhamailKing Abdulaziz University HospitalAlsuhaymi, Zuhair Hamdan AMikhwah General HospitalNouf Awad S AlbalawiTabuk UniversityAlruwaili Amirah Radhi MTabuk UniversityMishari Talal Al-HarbiKing Faisal Hospital MakkahJournal Article20180820<strong>Objective: </strong>Thoracic trauma is a common cause of significant morbidity and mortality. The present study presents a series of thoracic trauma and evaluation of epidemiologic features, distribution of pathologies, diagnosis, additional systemic injuries, management and outcome.
<strong>Materials and Methods: </strong>Between May 2016 and April 2017, all patients with thorax trauma admitted to the emergency service of King Abdulaziz hospital were retrospectively reviewed with respect to age, gender, etiological factors, distribution of pathologies, additional systemic injuries, diagnosis, treatment modalities, referral and outcome.
<strong>Results: </strong>A total of 228 patients with thorax trauma were encompassed in the study. Of all the patients, (140) , 61.4% were male and 88 (38.6%) were female. The majority of the patients presented with blunt thoracic trauma (218 of 228 [95.6%]), whereas 10 (4.4%) presented with penetrating injuries. Etiological factors included falls in 158 (69.3%) patients, motor vehicle accidents in 52 (22.8%), animal related accidents in 8 (3.5%) and penetrating injuries in 10 (4.4%). Among penetrating injuries, 6 (2.6%) were stabbing injuries and 4 (1.8%) were firearm injuries. The patients aged between 16 and 85 (mean 52.2±16.9) years. The vast majority (69.3%) of the patients aged between 31 and 70 years. Blunt thoracic traumas were observed most frequently in patients aged 51-70 years (36.8%), while penetrating traumas were observed most frequently in those aged 31-50 (32,5%) years.
<strong>Conclusion: </strong>Even though majority of the patients with thorax trauma received treatment as outpatients; thoracic traumas can be a life threatening condition, and should be recognized and treated immediately. Mortality differs based on etiological factors, additional systemic pathologies, capabilities of the hospital especially diagnostic and treatment facilities in emergency services. We believe that a multidisciplinary method to the patients with severe thorax trauma, and the opportunities of emergency bedside thoracotomy in emergency services will significantly decrease the morbidity and mortality.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101The Incidence of Inguinal Hernia among Children4834861144010.12816/0043492ENRakan Abdulrahman AlrzoqImam Muhammad bin Saud Islamic UniversityAmmar Mustafa A AlhajiMCH in DammamIbrahim Yousef Ibrahim AlolaytUniversity of HailAbdullah Ibrahim AlmulhimKing Faisal UniversitySaad Ahmad AlthobaitiUmm Alqura UniversityIsmail Atiah AlzahraniKing Fahad Hospital in AlbahaDuaa Ahmed A AlabbasPHC in Al-AhssaShahad Awad AlraddadiKing Abdulaziz UniversityIbrahim Sulaiman A AlhajjamKing Abdulaziz UniversityMethaq Abdullah AlrubyyiMCH in DammamSarah Abdullah AltaroutiB.A.U ln lebanonZainab Wasel A AlhashimImam Abdulrahman Bin Faisal UniversityJournal Article20180820<strong>Objectives: </strong>The aim of this study was to document clinical features of inguinal hernia (IH) in the pediatric populace. It delivers data to assess related risk factors of incarcerated hernia, its reappearance in addition to the occurrence of contra lateral metachronous hernia.
<strong>Materials and Methods: </strong>We report a retrospective analytic study comprising 230 children presenting with IH and operated from April 2015 to June 2017 in the pediatric surgery department, King Abdulaziz Hospital.
<strong>Results: </strong>We managed 36 girls (15.6%) and 194 boys (84.4%). The mean age was 3 years; The median age in the studied group was 3 years (range 22 days to 12 years). Males were predominantly affected (84.4%, n = 194). The rate of IH was more important in the youngest group (age < 2 years); thus, we accounted 43.5% (n = 100) infants. The cumulative incidence of hernia in the 2–6-year age group was 34.7% (n = 80). Thirteen percent (n = 31) of these patients presented with an incarceration mostly on the right side (62.6%, n = 154). We recognized that the total rate of incarcerated hernia incidence in premature group was evaluated at 27%. This rate was high, particularly in neonates and infants. Prematurity and hypotrophy were documented in 9% and 7% respectively. The mean follow-up period was 3.8 years. We think that incarceration can be related to several risk factors such as feminine gender, prematurity, and the initial left side surgical repair of the hernia.
<strong>Conclusion: </strong>IH occurs mainly in male infants. Prematurity and male gender was identified as risk factors of incarceration. Contralateral metachronous hernia was reported, especially in female infants and after a left side surgical repair of the hernia.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Irritable Bowel Syndrome in the Saudi Population4874901144110.12816/0043493ENYaser Yousef KhogheerEast Jeddah HospitalAlruwaili Amirah Radhi MTabuk UniversityMuataz Abdulmoghni AljunaidKing Abdulaziz UniversityFeras Hammad AlhussainyArabian Gulf UniversitySalem Waleed Bin JabalArabian Gulf UniversitySaleh Hussain S AlramadanImam Abdulrahman Bin Faisal University,Yousef Saleh AlwosidiKing Saud Bin Abdulaziz For Health SciencesAhmed Nasser A AlharbiQassim UniversityZainab Ali AlsairafiAnak General HospitalReem Ibrahim H Al RadhidyQassim University -UCMAli Hussain A AlDawodImam Abdulrahman Bin Faisal UniversityYasir Hameed H AlbeladiArmed Forces Hospitals , JazanJournal Article20180820<strong>Background: </strong>Irritable Bowel Syndrome (IBS) is a very common gastrointestinal dysfunction. Notwithstanding strong evidence of high prevalence of depression and anxiety in IBS there is very limited research on this topic in KSA.
<strong>Materials and Methods: </strong>Cases of irritable bowel syndrome and controls with non-ulcerative dyspepsia were employed between March 2016 to May 2017 from the gastroenterology department in King Abdulaziz hospital, KSA. Presence of anxiety disorder and depression were evaluated by utilizing the Hamilton Anxiety rating scale and Hamilton Depression rating scale respectively. Occurrence rates of anxiety and depression were established and Odds Ratio (OR) was calculated to determine the association of depression and anxiety disorders with IBS.
<strong>Results: </strong>In IBS cases, the prevalence of depression and anxiety disorder was 37.2% and 31.5% respectively. In patients with irritable bowel syndrome the OR for depression was 6.1 (95% CI 1.7-23.6, P=0.008) and the OR for anxiety disorder was 7.3 (95% CI 1.5-36.2, P=0.011).
<strong>Conclusion: </strong>The occurrence of depression and anxiety disorder in IBS is very high. As a result, screening of IBS patients for anxiety and depression would facilitate better interventions and consequently better outcomes and medical treatment.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Assessment of Knowledge, Attitude and Practice of Hand Hygiene among Health Care Workers in Arar City, Saudi Arabia4914981144210.12816/0043494ENRawan Deham I AledeilahPrimary Health Care Center, Arar, KSANagah Mohamed Abo El-FetohFamily and Community Medicine Department,
Faculty of Medicine, Sohag University, Egypt &Northern Border University, Arar, KSAAmnahFarhan AlbakerPrimary Health Care Center, RiyadhAlaa Ahmed AljabbabArar Central Hospital, ArarSarah Jamal AlkhannaniPrimary Health Care Center, RiyadhSaja Jamal AlkhannaniFaculty of Medicine,
Northern Border University, Arar, KSATasneem Saeed AlmahroosPrimary Health Care Center, RiyadhAbdalla Mohamed Bakr AliFaculty of Medicine, Sohag University, EGYPTJournal Article20180820<strong>Background: </strong>Hand hygiene before and after each contact with any patient, is simple, easily implemented and an effective practice to prevent hospital acquired infection.This study<strong> aimed </strong>to assess the knowledge, attitude and practice of hand washing among health care workers (HCW) in health care units in Arar city, Northern Saudi Arabia, based on WHO’s ‘Five Moments of Hand Hygiene Questionnaire’.<strong> Methodology: </strong>A descriptive cross sectional study was carried out at health care unites in Arar city during the period from July to September 2017. The World Health Organization (WHO) "Hand Hygiene Knowledge Questionnaire"- revised 2009 edition was used. Results: In total, 116 respondents including 32 residents, 92 nurses and 37 nursing assistants enrolled in this study,68% of them were females and 32% were males, 41% were resident, 32.8% nurses, 12.9% Nursing assistant and 12.9% Technician. The mean score of HH knowledge in residents technicians, nurses and nurse assistants was 18 (±1.8), 17.7(±1.7), 18.3(±1.2) and 18.1(±1.4) respectively. While the mean score of attitude was the highest in nurses 6.9(±1.17) then the technicians 6.8(±1.6), and the lowest score was found in the nursing assistants 6.2(±0.56). The mean score of practice was found to be 4(±1.6) in technicians, 3.9(±1.0) in nurses, 3.8(±0.9) in residents and 3.5(±0.6) in nurse assistants. The majority of the participants (90.5%) had a high level of knowledge of HH. The attitude level was found moderate in 81.9% and high in only 17.2%. Level of practice of HH was high in 23.3%, moderate in 75.9% and almost none of our participants was found with a low level of practice. <strong>Conclusion:</strong> This study highlighted the importance of applying the multimodal training program addressing providers' knowledge regarding hand hygiene, as well as strategies for emotional and behavioral methods such as patient engagement in hand-hygiene interventions.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Assessment of Knowledge and Attitude and Practice towards Breast Cancer Screening among Female in Abha City,20174995021144310.12816/0043495ENReem Ali AlmanieKing Khalid UniversityRoaa Fahad AlshabanahKing Khalid UniversityNorah Ibraheem AlmanieKing Khalid UniversityTahani Saeed AlmohayyaKing Khalid UniversityEbtesam Mohammed AlahmariKing Khalid UniversityEman Mohammed AlmaherTaibah UniversityJournal Article20180820<strong>Background: </strong>Assessing the knowledge, attitude and practices of Saudi women toward breast cancer preventive practices improve the possibility of reducing the percentage of deaths from breast cancer as well as its prevalence. <strong>Objectives: </strong>Evaluating the knowledge and attitude and practice (KAP) towards breast cancer screening among female in Abha city in Kingdom of Saudi Arabia (KSA).
<strong>Methods: </strong>A cross-sectional study was done and based on a questionnaire sheet conducted in Abha City during the period of September to November 2017 among421 educated Saudi women aged from 20-60 years old. <strong>Results: </strong>The female’s knowledge about the symptoms was restricted to pain in the breast and presence of lump either in the breast or under the armpit, but most of them underestimated the other signs of breast cancer including changing the position and pulling of the nipple, bleeding or discharge from the nipple, nipple rash and redness of the breast. Also, the most significant identified risk factors for breast cancer were family history (59.1%) followed by using hormonal replacement therapy (30.2%). Most of the subjects has negative attitude toward using mammography for screening while a positive attitude was shown toward seeking for medication. The KAP score was adequate among only 32.5% of the subjects toward breast cancer.
<strong>Conclusion: </strong>The level of knowledge about breast cancer was insufficient among the included subjects and resulted in inappropriate attitude and practice pattern.The majority have never checked for breast cancer or either admitted to clinical examination of breast using mammography screening technique .Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Assessment of Knowledge toward Initial Management of Acute Poisoning among Medical Students in Riyadh City KSA, 20175035061144410.12816/0043496ENFatmah Ali Abdullah HakamiKing Khalid UniversityAtheer Ibrahim AlqubaysiKing Khalid UniversityAsaad Abdellahi BilalKing Abdulaziz UniversityMohammed Ghazi AlharbiHera General HospitalJournal Article20180820<strong>Background:</strong> Acute poisoning is a common situation that occurs due to administrating harmful substances that impact the health with significant costs and increasing the rates of admission to emergency departments.
<strong>Objectives:</strong> Assessing the knowledge of Saudi medical students toward the initial management of acute poisoning in Riyadh Region, Kingdom of Saudi Arabia (KSA). <strong>Methods:</strong> A cross-sectional study was done based on a questionnaire sheet conducted at Riyadh region in KSA from August to October 2017 among medical students. <strong>Results: </strong>Most of the subjects were at the seventh semester (69.7%), followed by 23.7% in the fifth academic semester and 13.7% at the sixth academic year. About 69.7% and 65.3% had previous exposure to first aid training and training in emergency setting. Most of the subjects had good knowledge about the definition of poisoning, early stages of acute poisoning, importance of maintaining airway, respiration and circulation as well as initial management using gastric lavage, char coal and antidotes. The level of knowledge was good among 77.3% of students but was insufficient among 22.7% of subjects. There were a significant association between higher educational semesters, training about first aid as well as training in emergency departments. <strong>Conclusion: </strong>The level of knowledge about initial management of acute poisoning was adequate among most of the students and was associated with training programs and experience in emergency departments. This study presented the importance of educational and training programs from the first year of the college to increase the knowledge and practice to save more lives. Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Assessment of Knowledge, Attitude and Practice (KAP) of Saudi Adult toward Blood Donation in Riyadh City, 20175075101144510.12816/0043497ENSultan Hamad AlmutairiKing Saud Bin Abdulaziz University for Health SciencesAbdulrahman Ahmed AlmalaqUniversity of HailYousef Musallam AlbalawiTabuk UniversityRayan Mohammed AloufiTabuk UniversityMoodhi Rabih Al-MutairiQassim UniversityAmjad Fawzi AlbiekTaibah UniversityJournal Article20180820<strong>Background:</strong> Blood donation can save the lives of people who are in serious conditions thus it is a global concern of all societies.
<strong>Objectives:</strong> Evaluating the knowledge, attitude and practice (KAP) of Saudi adult subjects toward blood donation in Riyadh City.
<strong>Methods:</strong> A cross sectional community survey design was conducted among 500 adult Saudi subjects who were interviewed in shopping malls of Riyadh City during the period from May to July 2017. The questionnaire included interview regarding the demographics of respondents, knowledge, attitude and practice regarding blood donation.
<strong>Results: </strong>All the participants had significant knowledge about their blood group and the importance of blood donation. Also, the majority of respondents had adequate knowledge about the most common site of blood donation, the specificity of blood groups and the dangerous of donation of subjects with infection. Also, a good knowledge was found among most of respondents regarding the time, the complications and the precautions of blood donation. The attitude and practice pattern of participants were good among most of the participants .The KAP was adequate among 71% of respondents regarding blood donation and there was a significant association between the respondents good KAP with young age, male gender and higher educational degree.
<strong>Conclusion: </strong>The KAP of most of Saudi subjects was good and showed a high prevalence of blood donation among them with a favorable attitude to donate blood.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101When a Simple Serum Ferritin Level Measurement Misleads the Diagnosis of a Neonate in the NICU: A Case Report and Review of Literature5115131144610.12816/0043498ENTaha B. AljishiDepartment of Medicine, King Fahd Hospital, Imam Abdulrahman Bin Faisal University, DammamMohammad A. Al GhamdiDepartment of Pediatrics, Imam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaJournal Article20180820<span lang="EN-US">This case report describes a newborn girl born with non-immune hydrops fetalis with bicytopenia and elevated iron indexes. A genetic study which was done revealed a positive result for the H63D homozygous mutation. Iron overload is rare in patients homozygous for the H63D mutation because of its variable penetrance, especially in the neonatal period. The possibility of neonatal hemochromatosis (NH) on top of positive results for hereditary hemochromatosis (HH) was anticipated. Despite all the recommended healthcare measurements being provided for both diagnoses, the child developed liver failure of unspecified etiology and was deceased afterward. </span>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270320180101Wound Management in Primary Care: A Review5145191144710.12816/0043499ENMohammed Yossef Al-HabibKing abdulaziz university, JeddahSarah Naif AlsayilGuryat General Hospital, GuryatOmar Salem Al-QasimKing Faisal UniversitySarah Fahad AlrayyesPrince Mutaib bin Abdulaziz Hospital, sakakaJumanah Ahmed Al-SaediUmm al-Qura universityAbdulrahman Mubarak AlshammariHail University, Ha'ilAmnah Ahmed Al-JaffarMohammed almana college, DammamIbrahim Mohammed Al-JassimDammam university, DammamMohammed Awwadh AlmutairiMajmaah university, AL Majma'ahHend Faleh AlreshidiHail university, Ha’ilHind Naif AlshammariHail university, Ha'il, Saudi ArabiaJournal Article20180820In this review, we discuss assessments methods of patient’s step by step in primary care. We outline the cleansing methods of wounds and guidelines for wound management depending on the type of wound. We review the most updated studies in the management approaches wound in primary care, but we also included some studies which have been published earlier since 1995 December, up to November, 2017. The Midline (PubMed) and Embase databases were searched for relevant articles related to our concern subject. Holistic assessment involves identifying, gathering and interpreting information about the patient and wound to ensure accurate diagnosis, appropriate treatment, ongoing monitoring and prevention of complications. For successful management of patients wounds, physicians need proper understanding of the recovery procedure. The use of a standardized, systematic method of evaluation assists the practitioner in the accurate investigation of the wound, with the general goal of assuring optimal wound healing in addition to patient outcomes. Acute wound management varies based upon the wound location and characteristics. No single method can be applied to all wounds; however, a systematic technique to acute wound care integrated with current best practices gives the structure for exceptional wound management