Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Absenteeism among Saudi Medical Students1248125310606ENMahmoud F. QutubKing Saud Bin Abdulaziz University for Health Sciences (KSAU-HS)Abdulaziz A. AzahraniKing Saud Bin Abdulaziz University for Health Sciences (KSAU-HS)Mohammad A BafailKing Saud Bin Abdulaziz University for Health Sciences (KSAU-HS)Ahmad S. AlomariKing Saud Bin Abdulaziz University for Health Sciences (KSAU-HS)Wesam T. AbuznadahKing Abdulaziz Medical City, National Guard Health AffairsBasim S. Alsaywid AlsaywidKing Saud Bin Abdulaziz University for Health Sciences (KSAU-HS)Fadi M. MunshiSaudi Commission for Health Specialties, JeddahBasim S. AlsaywidKing Abdulaziz Medical City, National Guard Health AffairsJournal Article20180809<strong>Background: </strong>Student absenteeism refers to the frequent absence from classes without any good reason and thought to be the primary concern in health profession education worldwide mainly in medical school.<br /> <strong>Methods and Material: </strong>This study is a cross sectional design conducted in 152 medical students of King Saud Bin Abdulaziz University for Health Sciences (KSAU-HS), Saudi Arabia. A self-reported questionnaire was used to determine absenteeism behavior, contributing factors of absenteeism, and level of satisfaction of medical students towards the medical program of the university. Adapted questionnaire from Timmins and Kaliszer <sup>(9)</sup> was also utilized to examine factors of stress among medical students. Descriptive statistics, linear correlation and Pearson correlational coefficient utilizing SPSS v22 for the analysis of data.<br /> <strong>Results: </strong>A total of 143 (92.76%) participated in the study. 104 or 72 % were male, and 28% were female with mean age of 22.5 (±2.02) and a mean GPA of 4.4 (±0.4). 77 (53.8%) of students were absent for 5 times or more in lectures/basic and clinical sciences sessions and clinical diagnostic sessions. These absences are mainly because of study (<em>n</em>=36, 25.2%) and course dissatisfaction (<em>n</em>=32, 22.4%). However, only 3 (2.1%) who had an absence for 5 times or more in Problem Based Learning (PBL) sessions. These absences in PBL sessions are mainly because of sleep (<em>n</em>=11, 7.7%) and family commitments (<em>n</em>=10, 7.0%). There is an inverse correlation between absenteeism and academic performance.<br /> Conclusion: Absenteeism has a negative impact on the academic performance of medical students. Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101An Overview with Noninvasive Body Countering in The Management of Cellulite125412581061610.12816/0044632ENReem M. AlomairiAlmaarefa Colleges For Health Sciences,Riyadh, Saudi ArabiaLama N. AlotaibiAlmaarefa Colleges For Health Sciences,Riyadh, Saudi ArabiaMohammed Al JamalAlmaarefa Colleges For Health Sciences,Riyadh, Saudi ArabiaJournal Article20180809Nowadays cellulite, or gynoid lipodystrophy (GLD) is the most concerning and displeasing skin problem. It is a condition in which the skin appears dimpled, bumpy and "orange peel-like." It's caused by changes in the structure of the connective tissues and fat cells that lie underneath the skin's surface <strong><sup>[1].</sup></strong> This article aimed at reviewing the classification, pathophysiology and treatment in general, as well as the management of cellulite with non-invasive body countering. Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Prevalence of Early Childhood Caries125912651061710.12816/0044633ENJournal Article20180809<strong>Background: </strong>Early childhood caries (ECC) is a severe form of dental decay with multi-factorial origin. ECC can significantly affect the child’s quality of life, as it may lead to infection, swelling, pain, and other symptoms. The ECC affects children after eruption of primary teeth until age of around 5 years.
<strong>Aim of the study: I</strong>nvestigating the etiology and risk factors predisposing ECC among children and the optimal interventions for prevention.
<strong>Methods: </strong>We searched the medical literature to retrieve studies for the review to 30 November 2017. We searched Medline, Embase, the Cochrane Library websites for English Publications that were obtained from both reprint requests and by searching the database. Data extracted included authors, country, year of publication, characteristics of patients, pathophysiology, risk factors, clinical manifestations, different diagnostic approaches and prevention modalities.
Conclusion: The increase in the prevalence over time is mainly behind increased exposure to risk factors and increased number of teeth at risk. Predisposing and risk factors include living in a non-fluoridated county, low socioeconomic status and poor dietary behaviors. Preventive measures involve community, homecare and professional interventions to avoid risk factors which require to be followed with discipline in order to avoid potential incidence of ECC in the first place. We further recommended preventive strategies by increasing public awareness such as promotion of community-based interventions conducted by dental hygienists and the Inclusion of oral health screening in new child health immunization schedules and insurance legislation for children.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Fixed Zirconia Partial Denture126612741061810.12816/0044634ENJournal Article20180809<strong>Background: </strong>Ceramics have anextended history in fixed prosthodontics of attaining optimal esthetics. Yttrium tetragonal zirconia polycrystal (Y-TZP)-based systems are a recent addition to the high-strength, all-ceramic systems used for crowns and fixed partial dentures, the highly esthetic nature of zirconia coupled with its superior physical properties and biocompatibility have resulted in restorative systems that meet optimal recent demands.
<strong>Aim of the study</strong>: systematically review relevant contemporary literature regarding investigating the strength and accuracy of fit of zirconia fixed partial dentures (FPD).
<strong>Methods: </strong>A systematic review of the scientific literature from 2000 to 2017(PubMed,Embase and CENTRAL Cochrane Central Register of Controlled Trials, CINAHL, Google Scholar as well as individual Dentistry journals such as International Journal of Prosthodontics, International Journal of Periodontics and Restorative Dentistry. We followed PRISMA/STROBE guidelines. Medline abstracts were retrieved using an algorithm comprising relevant MeSH terms.
<strong>Results: </strong>The search yielded 11 studies enrolling 231 cases that met the inclusion criteria of the review. Absolute, Vertical and Horizontal margin gaps were recorded . Four of them were <em>in- vivo</em> studies while seven were <em>in Vitro</em>.The study outcome was focused on the assessment of the internal fit as well as the Marginal fit of zirconia FPDs versus the effect of various parameters of CAD ⁄ CAM and CAM systems, post-sintered and pre-sintered milling, framework configuration, veneer application and ageing. Average absolute marginal(AM) gap= 92 microns. For each system, the values were; Everest= 121 , Lava= 71, Cercon = 93.5, Procera = 51, Xawex = 147, CerecInLab = 88.8
<strong>Conclusion: </strong>It was concluded that CAD/CAM have more accurate marginal and internal fit compared to CAM in fabricating zirconia frameworks. Moreover, post-sintered milling will most likely result in complex geometry and longer span FPDs. Nevertheless, the clinical implications of this difference have yet to be determined, and the pros and cons need to be taken into account first provided the hardship of post sintered milling. Veneering zirconia frameworks resulted in deterioration in fit, ageing of zirconia had no implications on the fit. Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101The Effect of Different Surface Treatments of Carbon Fibers and Their Impact on Composites127512811061910.12816/0044635ENJournal Article20180809<strong>Background:</strong> The performance of composites profoundly depends on the quality of the fiber-matrix interface. Good interfacial adhesion provides composites with structural integrity and efficient load transfer between fiber and matrix. Nevertheless, untreated carbon fibers are extremely inert and hence have low adhesion to resin matrices. In the meantime, the relatively weak transverse and interlaminar properties significantly limit the composite performance and service life. To overcome these barriers, a fiber-based reinforcement which has strong interfacial adhesion to the matrix is highly desired to improve the overall composite properties.
<strong>Aim of the study: </strong>was toassess the Effect of different surface Treatments of Carbon fibers and their influence on the interfacial properties of carbon fiber/epoxy composites.
<strong>Methods:</strong> A review of the scientific literature (from 1970 to 2017).
Pubmed, Embase and CENTRAL were searched to identify studies that investigated the different types of surface treatment of carbon fibers and how this can affect the quality of carbon fiber composite. Identification of papers and data extraction were performed by different independent researchers.
<strong>Conclusion:</strong> Various combinations of surface treatment of carbon fibers are crucial to improve its adhesion with various matrices. Treatment significantly influences fiber characteristics. Nevertheless, optimization is required to select appropriate treatment method per application and desired properties.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Anti-Mullerian Hormone: An Indicator for the Severity of Polycystic Ovarian Syndrome127812881062010.12816/0044636ENYehia Abd-Elsalam WafaDepartments of Obstetrics & Gynecology, Faculty of Medicine, Al Azhar UniversityMohamed El-Sayed HammourDepartments of Obstetrics & Gynecology, Faculty of Medicine, Al Azhar UniversityDalia Abdallah HamodaDepartments of Obstetrics & Gynecology, Faculty of Medicine, Al Azhar UniversityAhmed Fathy Abd-elazizClinical Pathology, Faculty of Medicine, Al Azhar UniversityJournal Article20180809<strong>Background: </strong>Polycystic ovarian syndrome (PCOS) is a common endocrinopathy that accompanied with long term complications. <em>Purpose </em>Features of PCOS including sonographic aspects, androgens, luteinizing hormone (LH) and lutenizing and follicular stimulating hormones ratio LH/FSH ratio as well as Anti-Mullerian Hormone (AMH) were evaluated according to their diagnostic potency in detecting different degrees of PCOS severity.<br /> <strong>Objective: </strong>The aim of this study to assess the possible role of AMH as the diagnostic marker for different degrees of PCOS.<br /> <strong>Materials and Methods: </strong>In this cross-sectional study, a total of 150 women aged 18–46 years Patients were consecutively included as they presented in our clinic. 50 patients were diagnosed with sever PCOS (based on Rotterdam criteria consensus), 50 patients were diagnosed with mild PCOS, and 50 women served as controls. In day 2-4 of cycle, transvaginal sonography was performed and serum hormonal level of AMH, LH, FSH, testosterone. PCOS patients fulfilling all Rotterdam criteria were defined as having severe PCOS (<em>n </em>= 50), while patients showing oligo-/amenorrhoea and polycystic ovaries but without hyperandrogenemia were defined as having mild PCOS (<em>n </em>=50). And control group (n= 50). All patients were treated at the University Hospital of El-Hussein, Al-azhar university and at Ain Shams General Hospital Cairo Egypt.<br /> <strong>Results:</strong> The strongest group difference between controls and severe PCOS patients was observed for AMH showing an age-adjusted odds ratio of 2.56 [95 % confidence interval (CI) 2.00–3.27; <em>p </em>< 0.0001]. Age-adjusted receiver operating characteristic analysis showed that the area under the curve (AUC) of 0.88 (95 % CI: 0.80–0.95) for AMH and 0.94 (95 % CI 0.88–0.98) for antral follicle count did not differ significantly in their ability to discriminate between severe PCOS patients and controls. AMH showed higher AUC estimates than androgens, ovarian volume, LH and LH/FSH ratio and an AUC of 0.80 (95 % CI: 0.65–0.91) for detecting mild PCOS.<br /> <strong>Conclusions:</strong> this study comparing the diagnostic potency of AMH, sonographic aspects, androgens and LH/FSH ratio according to different PCOS subgroups while accounting for the age-dependency of AMH. In cases where vaginal scans are not feasible or in patients without hyperandrogenemia AMH may be used as a surrogate parameter in PCOS diagnosis, superior to androgens and gonadotropins.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Screening for Psychological Burden of Vitiligo Using Vitiligo Impact Scale128912941062110.12816/0044637ENRawan GaafarDepartment of Dermatology, Umm Al-Qura UniversityJournal Article20180809<strong>Background:</strong> Chronic skin diseases conditions have been well reported to affect a patient’s quality of life on multiple dimensions, including the psychosocial domain. Patients can suffer from lowered self-esteem, anxiety, or depression. The assessment of the psychosocial impact of skin disease on a patient could facilitate the treatment plane and procedure to be carried out by the dermatologists to deal with the disease. <strong>Aim:</strong> the aim of this study was to assess the psychological burden of vitiligo using Vitiligo Impact Patient scale (VIPs). Materials and methods: A descriptive study was conducted on 60 vitiligo patients. All patients were assessed using Vitiligo Impact Scale. Data collected were analyzed using SPSS software. <strong>Results:</strong> Among the studied patients, 68.3% were females. Almost half of the patients (43.3%) were single, whilst only 28.3% were married. Half of the patients had generalized vertigo, and 51.7% had vertigo on their faces. According to the VIP, the vast majority of patients (56.7%) were moderately affected, one fourth (25%) of them were highly affected, and only 8.5% were slightly affected. There was a statistically significant correlation between the VIP score and patient’s age, sex, disease duration, marital status, vitiligo on the face, and percentage of the involved area. <strong>Conclusions:</strong> Vitiligo is considered as a major psychological impact on patients. This psychological impact is significantly correlated with patient's age, sex, duration of disease, marital status, the presence of vitiligo in the face, and percentage of area involved. However, there is no significant correlation between the family history of vitiligo, level of education and psychological impact of vitiligo.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Effect of Sociodemographic Characteristics on the Attitude and Practice of Adult Cancer Patients Treated in the General Hospitals, Tabuk Region, Saudi Arabia129513041062210.12816/0044638ENAsma Eid AlhawitiFaculty of Medicine, University of Tabuk, Tabuk, Kingdom of Saudi ArabiaAsma Mohammed AlhawitiFaculty of Medicine, University of Tabuk, Tabuk, Kingdom of Saudi ArabiaLatifah Mohammed AlanziFaculty of Medicine, University of Tabuk, Tabuk, Kingdom of Saudi ArabiaJournal Article20180809its early stages, resulting in better prognosis and long-termsurvival. Moreover, compliance of cancer patients with treatment instructions is crucial for better prognosis. Little is known about the effect of sociodemographic factors on attitude and practice of cancer patients.<br /> <strong>Objective:</strong> The aim of this study was to assess the effect of sociodemographic status on the attitude and practice of adult patients with cancer towards the intent to start the treatment, the adherence to treatment regimen and the prognosis of the disease.<br /> <strong>Methods:</strong> this study was carried out inthe generalhospitals, Tabuk Region, Saudi Arabia. Participants were selected from the Oncology Center Outpatient Clinics. A questionnaire designed for cancer patients was used for data collection <strong>Background: </strong>many types of cancer are easily prevented through screening that can detect the disease during via direct interview. The questionnaire included questions to record sociodemographic factors, patient’s attitude (towards early diagnosis, treatment, and follow up), practice and general health status.<br /> <strong>Results:</strong> attitude score was significantly higher in the married respondents (p = 0.015). Practice score was higher in those aged less than 20 and above 60 years-old (p = 0.016), those who were in early stages of cancer (p = 0.004) and respondents with positive family history of cancer (p = 0.019). The attitude and practice scores were found to have a significant positive and moderate correlation (r = 0.487; p <0.001).<br /> <strong>Conclusion: </strong>the overall attitude and practice of the respondents towards cancer was fair in most of the points. However, their attitude and utilization of screening methods was less than satisfactory. This calls for an action to encourage Saudi population, particularly those at high risk, to seek and receive screening services. Explaining the benefits and the access to free screening services is crucial. Barriers that are responsible for this attitude and practice should be explored and addressed.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Association Between Over-Use of Social Media and Depression among Medical Students, King Khalid University, Kingdom of Saudi Arabia130513111062310.12816/0044639ENAbdullah AlsabaaniDepartment of Family and Community Medicine, College of Medicine,
King Khalid University, Abha, Saudi ArabiaAbdullah Ali AlshahraniInterns, College of Medicine, King Khalid University, Abha, Saudi ArabiaAbdullah Saeed AbukaftahInterns, College of Medicine, King Khalid University, Abha, Saudi ArabiaSaleh Fahad AbdullahInterns, College of Medicine, King Khalid University, Abha, Saudi ArabiaJournal Article20180809<strong><span lang="EN-US">Background: </span></strong><span lang="EN-US">Previous researches on the association between the use of social media and depression have yielded conflicting results. As some studies reported that social media use may reduce depression, whereas other studies observed that frequent use of social media may be associated with depressive symptoms.</span><br /> <strong><span lang="EN-US">Objectives: </span></strong><span lang="EN-US">To assess the relation between overuse of social media and depression as well as identifying other risk factors related to depression among medical students.</span><br /> <strong><span lang="EN-US">Subjects and methods: </span></strong><span lang="EN-US">A cross-sectional, comparative study was carried out among a representative random sample of male and female medical students in King Khalid University, Abha, Kingdom of Saudi Arabia (KSA). Anonymous self-administrated questionnaire was utilized for data collection. It consists of socio-demographic characteristics, details of social media use and PHQ-9 instrument to assessdepression among the participants. Data were collected through sending the questionnaire online through a specific WhatsApp group for the students.</span><br /> <strong><span lang="EN-US">Results: </span></strong><span lang="EN-US">Out of 297 students invited to participate in the study, 239 responded by completing the questionnaire giving a response rate of 80.5%. Their age ranged between 19 and 26 years with a mean±SD of 21.4±1.5 years. Depression was reported among 67.4% of them, based on PHQ-9 instrument; it was mild among 41.8% and severe among 9.6% of the participants. Depression was more reported among female than male students (74.1% versus 63.6%), p=0.034. The highest age was reported among students with no depression (22.1±1.3 years) whereas the lowest age was observed among those with moderate depression (21.3±1.7 years), p=0.018. Histories of having family problems (p<0.001), financial problems (p=0.001), study problems (p<0.001), physical or emotional abuse (p<0.001), psychiatric problems (p=0.007) and family history of depression (p=0.047) were significantly associated with depression and its severity among the participants. </span><br /> <strong><span lang="EN-US">Conclusion:</span></strong><span lang="EN-US">Depression is a common hidden health problemamong medical students in Saudi Arabia. The prevalence of depressive symptoms was not significantly associated with pattern of using social media</span>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Prevalence of Thyroid Dysfunction among Type2 Diabetic Patients (T2D) in Makkah And Jeddah-KSA131213161062410.12816/0044640ENSami H HammadiClinical Pharmacology-Internist Faculty of Medicine, Umm Alqura UniversityRazan S AljawiInterns at UQUSamar S AlahdalInterns at UQUMaram M AllahyaniInterns at UQUNuha K JazzarInterns at UQUSara M MaqbolInterns at UQUBayan Z FataniInterns at UQURzan W MelibariInterns at UQUBushra W MelibariInterns at UQUBashair W MelibariInterns at UQUWalaa A AlmaghrabiInterns at UQUJournal Article20180809<strong>Background: </strong>The association between diabetes mellitus (DM) and thyroid dysfunction is well known. However, the prevalence of having DM with thyroid dysfunction is extremely variable from one study to another. Clinical relevance of thyroid disorders in diabetic patients leads to serious consequences with metabolic compensation of diabetes.<br /> <strong>Objectives: </strong>to find the prevalence of thyroid dysfunction in T2D retrospectively through the data available in our diabetic centers among those who attended the diabetic clinics for routine checkup.<br /> <strong>Patients and methods: </strong>This is a retrospective cohort study conducted from January to August 2017 at three diabetic centers in Makkah and Jeddah, Kingdom of Saudi Arabia. Nine hundred and seventy-nine patients aged between 30 and 65years, of both genders with T2D were randomly selected. The participants` data were collected from their files, using a data collection checklist prepared for the study.<br /> <strong>Results: </strong>The study included 979 T2D patients. The prevalence of thyroid dysfunction among T2D patients was 13.1%. Mean age amongT2D patients with thyroid dysfunction was 48.8 years whereas the mean age among T2D patients with hypertension was 58.5 years. Females were significantly more presented with T2D and thyroid dysfunction. Again, T2D associated with thyroid dysfunction and hypertension was significantly more in females than males. Duration of diabetes was significantly more among patients having T2D, thyroid dysfunction and hypertension than those with only T2D and thyroid dysfunction. Oral antidiabetics (OADs) were more frequently used than combination of OADs and insulin while diet and exercise only were less, however thyroid dysfunction was more among them. Majority of our participants with T2D and thyroid dysfunction reported the occurrence of T2D first<br /> <strong>Conclusion: </strong>The prevalence of thyroid disorder is quite high amongT2D patients. Prevalence was higher in female patients and relatively younger ages. Early detection of thyroid dysfunction in patients with T2Dis of great importance and consequences.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Symptoms and Prevalence of Constipation among Adult Population of Riyadh City: An Internet Based Survey131713221062510.12816/0044641ENYazeed Abdullah AlhusainyCollege Of Medicine, King Saud UniversityNasser Yousef AlhowaishCollege Of Medicine, King Saud UniversityHussam Zaid AlorabiCollege Of Medicine, King Saud UniversityAbdullah Abdulaziz AlsebtiCollege Of Medicine, King Saud UniversityHamad Sulaiman AlJutailiCollege Of Medicine, King Saud UniversityAhmad Raed TarakjiDepartment of Medicine, College of Medicine, King Saud UniversityShabana TharkarPrince Sattam Chair for Epidemiology and Public Health Research, Department of Family and Community Medicine, College of Medicine, King Saud University.Journal Article20180809<strong>Background:</strong> Constipation is commonly encountered in clinical practice. The global population is witnessing a rapid increase in its occurrence. <strong>Objectives: </strong>Since there is paucity of data in Saudi Arabia, there is a need to assess its prevalence in Saudi population. This study was performed as a pilot to determine the symptoms and prevalence of constipation among adult population of Riyadh city.<br /> <strong>Materials and Methods:</strong> A questionnaire based cross sectional survey was done through twitter among Riyadh based accounts. The study was conducted among 388 adults older than 20 years, between November 2016 and January 2017. For the diagnosis of constipation three criteria were used; self-perception, Rome III and Bristol’s criteria. <strong>Results:</strong> Our study showed that the prevalence of constipation in general population is 43%, 60% and 25% according to the three criteria, respectively. Females tend to have greater prevalence than males though not statistically significant. Multivariate analysis showed low dietary intake of fruits and vegetables, middle age (40-49years), and strained defecation significantly associated with constipation. As per Bristol’s criteria the most common stool form was Type 3 (sausage shaped with cracked surface).<br /> <strong>Conclusion:</strong> These findings suggest high prevalence of constipation among Saudi population. A wider margin of variation in rates by the three criteria is obtained. <strong>Limitation:</strong> This twitter based survey may only be considered as a pilot study and is non-representative of general population.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Hairy Leukoplakia as An Early Oral Manifestation of HIV: A Case Report and Review, Kingdom of Saudi Arabia, 2017132313261062610.12816/0044642ENAl-Sharif AbdulrhmanDental Department, Al-Sulaimaniya Primary Health Care Center, Ministry of Health,
Kingdom of Saudi Arabia.Journal Article20180809<strong>ABSTRACT</strong><br /> Oral hairy leukoplakia was reported in 1984 for the first time. It is caused by the Epstein Barr Virus, and it is an early indicator of an immune deficiency status. This lesion is usually asymptomatic and it is common in people with HIV infection. For all HIV patients, a comprehensive periodontal and dental treatment should be done because oral tissues may reflect immune deficiency status. And nearly all HIV-infected individuals develop oral lesions at some time during their illness. checkups allow detecting any potential problems that may not even be aware of it. So, detailed history and clinical examination can allow the dentist to diagnose a life-threatening disease.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Helicobacter Pylori Infection: Independent Risk Indicator of Gastric Adenocarcinoma and The Role of Surgery132713321062710.12816/0044643ENBassam Hmoud AlsuaidanAlmaarefa CollegesGhaliah Hamdan AlbugamAlmaarefa CollegesSahar Matter AlshammeryPrincess Nourah UniversityAbdulmalek Rshood Al-QwizaniImam Mohammed Bin Saud Islamic UniversityKhawlah Fraih AloqalaaKing Abdulaziz UniversityFaris Ali Abdullah AlrashedImama Abdulrahman Alfaisal UniversityAbrar Anas A TayebKing Abdulaziz UniversityDalia Abdulaziz FelembanKing Abdulaziz UniversityMohammed Suwaileh AlrehailiAlmaarefa CollegesMohammed Zuhair IsmaelKing Abdulaziz UniversityJournal Article20180809<strong>Background: </strong>Helicobacter pylori is a ubiquitous organism that is current in about half of the global population. Chronic infection with helicobacter pylori causes atrophic and even metaplastic changes in the stomach, and it has a known association with peptic ulcer disease. This bacterial species colonizes the stomach of the greater part of the total populace; notwithstanding, only a very small proportion of infected subjects improve adenocarcinoma. helicobacter pylori causes a chronic gastritis that might last periods, and a multistep precancerous process is documented for the most common histologic type of gastric adenocarcinoma: the intestinal type.<br /> <strong>Objectives:</strong> Distinguishing of individuals at high risk for gastric cancer.<br /> <strong>Conclusion:</strong> This article briefly summarizes the main aspects concerning gastric adenocarcinomas and the carcinogenic effects of HELICOBACTER pylori infection.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Awareness, Attitudes And Background Information about The Surgical Options in The Treatment of Obesity Among The General Adult Population in Riyadh City, Saudi Arabia133313401062810.12816/0044644ENJournal Article20180809<strong>Objectives</strong>: To assess the awareness, attitudes and background information about the surgical options in the treatment of obesity among the general adult population in Riyadh city, Saudi Arabia
<strong>Methods</strong>: In this cross-sectional study 420 adult residents from Riyadh from both genders were interviewed and given specifically designed questionnaire to assess their awareness about weight loss surgery and the attitude toward it as a method used in the treatment of obesity. Data were collected between September 2017 and December 2017. The questions highlighted 3 health status scales; 4 aspects including subject’s demographics characteristic, personal weight, height and BMI, and their understanding about obesity and its causes and beliefs about weight loss surgery. Scores were analysed using SPSS.
<strong>Results: </strong>More than 90% of the participant in this research identified at least three risk factors of obesity, and more than 90% of the participants had good knowledge about the lifestyle modification to prevent or reduce obesity, regarding the knowledge about bariatric surgery. Although (79%) of them knew the effectiveness of bariatric surgery as a method of reduction of weight; only (37.6%) thought that it will reduce mortality among obese people, (21.4%) knew that weight loss surgeries can result in complications but on the other hand (42.9%) of subjects thought that bariatric surgery can result in death.
The overall beliefs among the participants regarding the use of bariatric surgery as a method in the treatment of obesity was poor and only 38% had favourable beliefs about the surgery.
<strong>Conclusion: </strong>the knowledge of subjects about obesity and its preventive measures were high but the favourable perceptions about Bariatric surgeries were low. These results indicated that efficient educational programs about obesity and bariatric surgeries are needed for control of obesity and its complications as well as increasing the availability of weight loss surgeries.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Laparoscopic Versus Open Adhesiolysis in Patients with Bowel Obstruction134113451063010.12816/0044645ENJournal Article20180809<strong>Background: </strong>Adhesions are bands of scar tissue that form between organs. In the abdomen, they form after an abdominal surgery or after a bout of intra-abdominal infection (i.e., pelvic inflammatory disease, diverticulitis). More than 95% of patients who undergo abdominal surgery develop adhesions; these are nearly inevitably part of the body’s healing process. Though most adhesions are asymptomatic, some can cause bowel obstructions, infertility, and chronic pain.
<strong>Objectives:</strong> Concerning whether patients with chronic pelvic pain benefit from laparoscopic adhesiolysis or whether any appearing advantage is a placebo effect.
<strong>Materials and methods: </strong>This review was conducted using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1990, through October 31, 2017.
<strong>Results:</strong> The spectrum of treatments for a small-bowel obstruction ranges from conservative management with bowel rest to surgical intervention, sometimes involving bowel resection. The caveat with regard to surgical treatment is that while surgery may be required to release symptomatic adhesions, postoperative reformation of these adhesions is common. Debate continues as to whether laparoscopic adhesiolysis yields added benefit in terms of decreasing postoperative adhesion reformation; however, promising results have been obtained with Open approach.
<strong>Conclusion: </strong>Laparotomy with open adhesiolysis has been the treatment of choice for acute complete bowel obstructions. Patients who have partial obstructions, with some enteric contents traversing the obstruction, might similarly require surgery if nonoperative measures fail.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Awareness and Attitude toward Smoking E-Cigarettes (Vape) among Smokers in Saudi Arabia 2017134613511063110.12816/0044646ENMohammad Ali KarboujiCollege of Medicine, Taibah University, Almadinah Almunawarah, Saudi ArabiaAlhasan Mohamed AbduldaemCollege of Medicine, Taibah University, Almadinah Almunawarah, Saudi ArabiaAbdulrahman Muslim AllogmaniCollege of Medicine, Taibah University, Almadinah Almunawarah, Saudi ArabiaAhmad Salem AlharbiCollege of Medicine, Taibah University, Almadinah Almunawarah, Saudi ArabiaOmar AlnozhaCollege of Medicine, Taibah University, Almadinah Almunawarah, Saudi ArabiaAbdulmohsen H. Al-ZalabaniCollege of Medicine, Taibah University, Almadinah Almunawarah, Saudi ArabiaJournal Article20180809<strong>Background:</strong>E-cigarettes was described as battery-operated products designed to deliver nicotine. Its use is rapidly increasing worldwide specially among youth owing to marketing and media which play a major important role in making people believe that smoking vape is less harmful than the tobacco cigarettes. However, chemical analysis of e-cigarettes juices has shown that many carcinogens present in cigarette smoke are also found in a range of e-cigarette products. Therefore, this study was conducted to evaluate the awareness and the attitude toward the risk of smoking e-cigarettes vape among smokers in Saudi Arabia.<br /> <strong>Method<em>: </em></strong>this cross-sectional study involved 1404 individual living in Saudi Arabia. Adult smoker participants involved in this study were in the age range 18-60 years old. A self-administrated web-based questionnaire that include questions about smoking e-cigarettes vape was used to collect data. The collected data were analyzed using SPSS version 22.0.<br /> <strong>Result<em>:</em></strong> our sample study involved 95% males and 5% females. 68.9% were using e-cigarette, with 58.7% admit to use it daily. 31.1% had never experienced vaping. Those who thought that vaping is absolutely safe represented 13.7% of our sample study. While 67.5% regarded it dangerous.<br /> <strong>Conclusion</strong><strong><em>: </em></strong>there was a high degree of awareness among Saudis about e-cigarettes and vaping, which highlights the importance of health programmes as well as media targeting youth and the government role toward the Saudis health.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Prevalence and Associated Risks of depression Among Patients Attending the Primary Healthcare Centers in Tabuk, Saudi Arabia135213551063310.12816/0044647ENAbdulhadi Turki AlsubaieCollege of Medicine, University of Tabuk, TabukHyder O. MirghaniDepartment of Medicine,
University of Tabuk, Tabuk, Saudi ArabiaJournal Article20180809<strong>Background: </strong>Depression is on the rise globally and is associated with a high rate of mortality, morbidity, and suicide.<br /> <strong>Objective:</strong> To evaluate depression and associated risk factors among patients visiting primary healthcare centers in Tabuk, Saudi Arabia.<br /> <strong>Subjects and methods: </strong>This cross-sectional study conducted in Tabuk, Saudi Arabia during the period from June 2016 to July 2017, 560 participants were recruited from primary health care centers by a stratified sampling technique. Participants were invited to sign a written informed consent, then interviewed using the PHQ-9 questionnaire. The questionnaire consisted of nine questions with four choices each and asking about interest or pleasure in doing things, feeling down or hopeless, the pattern of sleep, tiredness, appetite, the degree of movement or speaking, concentration, or thought of better dead off or hurting self. The Statistical Package for Social Sciences (SPSS) was used for data analysis and the ethical committee of the Medical College, the University of Tabuk approved the research. <br /> <strong>Results:</strong> Participants (61.2% females), 63.9% were in the range of 18 and 24 years; the majority had higher education, nearly two thirds 66.3% were single. Mild depression was evident in 21.6%, moderate depression in 21.3%, while 4.1% had severe depression. Women had more depression than men with a significant statistical difference (P-value<0.05, no differences in severity of depression was found regarding age, and marital status (P-value>0.05). <br /> <strong>Conclusion</strong>: Depression is prevalent among patients attending primary healthcare centers in Tabuk and was commoner among females. No relationship was observed between depression severity, marital status, and age.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Updated Review on Surgical Management of Male Hypogonadism135613611063410.12816/0044648ENMoaz Hassan AlharbiPrince Sattam Bin Abdulaziz UniversityMohammad Abdullah AlelyaniPrince Sattam Bin Abdulaziz UniversityMohammed WalidadhamPrince Sattam Bin Abdulaziz UniversityAhmad Abdullah AlgarniPrince Sattam Bin Abdulaziz UniversityKhaled Faisal AlgahtaniPrince Sattam Bin Abdulaziz UniversitySultan JaberalfaifiPrince Sattam Bin Abdulaziz UniversityJournal Article20180809In this review, we discuss the treatment options for male hypogonadism and the associated benefits and potential short- and long-term risks. The choice for treatment may depend on the cause of hypogonadism and the desire for maintaining or improving fertility. We also highlight surgical management of male hypogonadism. Comprehensive searching strategy through Well-known medical databases (MIDLINE/ PubMed, and Embase) searching articles that published in English language up to December 2017, and discussing the surgical management of male hypogonadism. Malehypogonadism is identified by the presence of symptoms or signs of male hypogonadism and consistent serum testosterone levels that are below the normally accepted adult male range. Once the medical diagnosis is confirmed, the primary goal of treatment is testosterone substitution to accomplish serum testosterone levels that remain in the mid-adult range and the symptoms and signs of hypogonadism are eliminated. Recent developments led to numerous delivery systems for testosterone. For patients with primary hypogonadism testosterone therapy is the approach of choice. The patient needs to be completely informed about expected benefits and side-effects of the treatment option. The option of the preparation should be a joint decision by a notified patient and the doctor.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Prevalence of Gall bladder Disease in King Faisal Medical Complex (Taif): A Retrospective Study136213641063510.12816/0044649ENSamah Saud Al JuaidTaif University, College of MedicineFatmah Meteb AlNofeiTaif University, College of MedicineHanan Abid Al QurashiTaif University, College of MedicineAdel Dakhel AlmaymuniTaif University, College of MedicineMohamed Abdul Samie MitkisTaif University, College of MedicineMuhammad AsadullahTaif University, College of MedicineMohamed GhilaniTaif University, College of MedicineJournal Article20180809<strong>Background:</strong> gallstone disease is defined as the presence of gallstones accompanied by symptoms attributable to their presence (Biliary colic) or complications such as cholecystitis,cholangitis and biliary pancreatitis. In addition, the disease is thought to be a risk factor for developing pancreaticobiliary cancer. <strong>Objective</strong>: this study aimed to determine the rate of biliary disease in King Faisal Medical Complex as a reflection of the prevalence of the disease in Taif region.<br /> <strong>Methods:</strong> thisa cross sectional retrospective analysis included 565 patients with gallstone disease , in King Fisal Medical Complex during 1 year (from 1 July 2015 to 30 Jun 2016). Data of the patients were collected from patient's files which included 4 departments. 1-Emrgency Room 2-Surgical Outpatient Department 3-Operating Room and 4-Histopathological Department. <strong>Result:</strong> this study included 565 patients with gallstone disease, (10 years and above) . 398(70%) females, 167(30%) males. Mean age for females was 44.89 years (SD+15.93), Mean age for males was 48.45 years (SD+19.67). The overall ratio of gall bladder disease to all general surgery operation was 24%. The Majority of them diagnosed with chronic cholecystitis present to OPD (57%), while acute cholecystitis presented to ER was 43%. Most of them were females (77%)while, males were 23%. 85% of patients underwent to lap cholecystectomy with 1% rate of conversion. 14% of patients underwent ERCP and 1% open cholecystectomy.There was significant gender differences in type of operation (P value=.013). 38% of male patients with gallstone disease came to the emergency department compared to 62 % of females.Variety of GBD diagnosis was observed , chronic calculous cholcystitis (50%) acute calculous cholecystitis and empyema (30%), obstructive jaundice (14%), Biliary colic (5%),GB mass (1%). <strong>Conclusions: </strong>the number of patients presented with gall stones disease and it's complications to King Faisal Medical Complex, Taif alone showed significant high number, mostly due to hypoxia as our region is one of the highest altitude region in the Middle East. Prevalence of disease was more in female population and it showed the target population which should be educated regarding prevention of disease.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Assessment of Adherence to Hypertension Medications and Awareness of Hypertension Medications among People with Hypertension in Tabuk136513701063710.12816/0044650ENAbdulelah Mohammed AlqarniFaculty of Medicine, University of Tabuk, Tabuk/ KSAAlhawiti Saleh HammadFaculty of Medicine, University of Tabuk, Tabuk/ KSAMohammed Ahmed AlhejailiFaculty of Medicine, University of Tabuk, Tabuk/ KSAAhmad Awadh AlatawiFaculty of Medicine, University of Tabuk, Tabuk/ KSAMohammed Hamad AlrashediFaculty of Medicine, University of Tabuk, Tabuk/ KSAMeshari Faisal AleneziFaculty of Medicine, University of Tabuk, Tabuk/ KSAKhalid Awd AlbalawiFaculty of Medicine, University of Tabuk, Tabuk/ KSAMeshal Saleh AlatawiFaculty of Medicine, University of Tabuk, Tabuk/ KSAJournal Article20180809<strong>Background:</strong> in 2015, there were 1.13 billion people living with high blood pressure worldwide. The prevalence of hypertension worldwide is of about 40%. In Saudi Arabia it reached 3.2% among those aged between 15-24 years, 51.2% among those aged 55-64 years and up to 70% among those aged 65 years and older. It has been observed that there is an increase in prehypertension cases, reaching 46.5% (3 millions) among males and 34.3% (more than 2 million) among females. Worldwide, raised blood pressure is estimated to cause 7.5 million deaths, about 12.8% of the total of all deaths. <strong>Aim of the work</strong>: this study aimed to assess knowledge of hypertension and to determine factors affecting the compliance of hypertensive patients to their antihypertensive drugs. <strong>Methods: </strong>we have conducted a descriptive cross-sectional study in Tabuk city population, Saudi Arabia. This study was conducted during the period from August to December 2017. The participants were selected by random sampling. Sampling included the different geographical areas of the city. The total sample included 108 pupils. All the pupils were approached to obtain the desired sample size. A self-administered questionnaire about hypertension and complications was filled by the participants.<br /> <strong>Results: </strong>in this study, participants classified to three groups according to age: less than 40 years old from 40 to 65 years old and 65 years old or above. Male and female groups contributed to 72.2% and 27.8% respectively. The majority of participants were university graduates (55.6%) and about 33.3% were secondary education. The majority of participants with hypertension were on one medications prescribed for treatment of their high blood pressure and the majority of participants(66.7%) were poorly compliant to their hypertension medication.<br /> <strong>Conclusion: </strong>more attention is needed on preventive educational programs that focus on awareness and assessment of the hypertension medications adherence, complications of hypertension, and the danger of poor control of it.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Relationship Between Corneal Astigmatism and Intraocular Pressure137113761063910.12816/0044651ENAbdulrahman E. AlgarniCollege of Medicine, King Saud Bin Abdulaziz University for Health Sciences, RiyadhMohammad AbahussinOptometry Department, College of Applied Medical Sciences, King Saud University, RiyadhNuha S. Al SalamehCollage of Medicine, King Saud University, RiyadhAhmad S. AlomariCollage of Medicine, King Saud Bin Abdulaziz University for Health Sciences, RiyadhYara M. MokarkiCollege of Medicine, Jazan University, Jazan UniversityJournal Article20180809<strong>Aim of the work:</strong> this study aimed to investigate the relationship between the Intraocular Pressure(IOP) readings measured by Goldmaan Tonometry and the amount of corneal astigmatism in healthy young subjects and to assess the reliability of the measurements obtained with the instruments.<br /> <strong>Method</strong>: intraocular pressure measurements were obtained by Goldmann Applanation Tonometer (GAT) (Haag-Streit International, Koeniz, Switzerland), while keratometry readings for corneal curvature were obtained by an Auto-Kerato-Refractometer (ARK-KR.8800, Topcon, Tokyo, Japan). An interval was kept between the keratometric measurements and the IOP measurements. The sequence of measurement was randomized with all participants. Three measurements were taken within ten minutes and the reading was set to one immediately after any measurement were taken.<br /> <strong>Result</strong>: the average age of the volunteers was 22.4 ± 1.5 years (mean age ± SD; range: 20–26 years). Mean Intraocular Pressure (IOP) of the right and left eyes in the first visit (Paired t-test: P = 0.6471) and second visit (Paired t-test: P = 0.5805). The session one means GAT ; IOP was 16.48 ± 3.33 mmHg and 16.59 ±3.47mmHg (right and left eye respectively), while in session two it was15.714±3.10 mmHg and 15.82 ± 2.76 (right and left eye respectively) . The mean corneal astigmatism was -0.24 ± 1.48D, -0.38 ± 1.53 D, right and left respectively in the first visit and -0.34 ± 1.44D, -0.40 ± 1.64D right and left eye second visit respectively.<br /> <strong>Conclusion</strong>: the GAT-IOP was less affected by the amount of corneal astigmatism and GAT-IOP was not significantly higher in eyes with greater corneal astigmatism and the repeatability results, although the differences were stastistically significant, they were not clinically significant.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Assessment of Knowledge, Attitude and Practice towards Irritable Bowel Syndrome and Risk Factors in Riyadh City, 2017137713801064110.12816/0044652ENGhadah Abdulrahman AlgabrPavol Jozef šafárik UniversityTurki Khalid AlotaibiKing Saud UniversityAfnan Mutlaq AlshaikhIbn Sina National CollegeYasmen Taha MaimaniIbn Sina National CollegeMosab Shaher AlShehriAl-Imam Muhammad Ibn Saud Islamic UniversityJournal Article20180810<strong>Background: </strong>Irritable bowel syndrome (IBS) is a worldwide problem which affect the health and the economy of countries; thus it is the focus of many researchers till now.<br /> <strong>Objectives: </strong>Evaluating the knowledge, attitude and practice (KAP) of the Saudi community in Riyadh City toward the signs and risk factors of IBD in Kingdom of Saudi Arabia (KSA).<br /> <strong>Methods: </strong>A cross sectional study conducted at 12 different malls in Riyadh city from October to December 2017 among 977 Saudi adult educated subjects from both genders aged from 20-60 years old.<br /> <strong>Results: </strong>The prevalence of IBS among the Saudi community was 10.8% (106 out of 97 subjects).<br /> The majority of the subjects has proper awareness regarding the IBS and its risk factors (81.1%) while only 18.9% had poor knowledge about the syndrome. Most of the subjects had positive attitude toward using diet, medications and counselling as the proper management of IBS. The level of knowledge showed a significant association with the higher level of education. <strong>Conclusion: </strong>The majority of subjects had proper knowledge about the nature, prognosis and risk factors of the disease. Other studies should be conducted to measure the KAP of other Saudi population toward IBS from different regions of KSA.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101DWI in Assessing Aggressiveness of Rectal Cancer138113871064310.12816/0044653ENMuhammad Yusuf Abd El-KaderRadiology Department, Faculty of Medicine, Ain Shams UniversityRasha Salah El-Din HusseinRadiology Department, Faculty of Medicine, Ain Shams UniversityWaseem Mohamed Mahmoud El-GendyRadiology Department, Faculty of Medicine, Ain Shams UniversityHanaa Abd El-Kader Abd El-HamidRadiology Department, Faculty of Medicine, Ain Shams UniversityJournal Article20180810<strong>Background:</strong> diffusion-weighted magnetic resonance imaging (DW-MRI) permits non-invasive assessment of tumor characteristics.<br /> <strong>Aim of the work:</strong> this study was aimed to emphasize the role of DWI in assessing aggressiveness of rectal cancer with the histopathological correlation.<br /> <strong>Patients and methods: </strong>this was a prospective study that included thirty patients with histopathological proved rectal carcinoma referred from the Surgical Department, Ain Shams University Hospitals to the MRI Radiology Unit for Rectal Cancer Staging.<br /> Pelvic MRI study with conventional sequences and DWI were performed.<br /> <strong>Results: </strong>81% of moderately differentiated adenocarcinoma (ADC) (grade II) showed restricted diffusion with low signals in ADC sequence, while none of the poorly differentiated adenocarcinoma (grade III) showed restricted diffusion with high signals in ADC sequence (T2 shin-through). There was a high statistically significant difference in characterization of poorly (grade III) and moderately differentiated adenocarcinomas (grade II).<br /> <strong>Conclusion: </strong>significant correlations were detected between mean ADC values and differentiation grade. ADC may be useful as an imaging tool for re-staging of tumor aggressiveness, but it cannot serve as an independent tool for primary staging of rectal cancer.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Metabolic Syndrome: Pathophysiology and Treatment138813921064410.12816/0044654ENJournal Article20180810<strong>Background: </strong>Metabolic syndrome is a group of abnormal laboratory and physical findings, such as dyslipidemia, hypertension, glucose intolerance, proinflammatory state, and prothrombotic state that results in a patient having significantly higher risk for atherosclerosis, cardiovascular disease, and overall mortality. There are slight differences between institutions in defining metabolic syndrome across the world. To achieve adequate management and treatment and decrease the risk of subsequent diseases, proper identification of symptomatic patients with metabolic syndrome is necessary.
<strong>Aim:</strong> In this review, we aimed to study the pathophysiology behind the development of metabolic syndrome, and also to explore the approach to its management.
<strong>Materials and Methods:</strong> We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: metabolic syndrome, pro-thrombotic state, pro-inflammatory state, diabetes mellitus, insulin resistance, obesity and cardiovascular mortality. <strong>Results: </strong>The major aspects of treatment include weight reduction by diet, medication, as well as bariatric surgery (in some cases), and managing hyperglycemia and insulin resistance with diet and medication. <strong>Conclusion: </strong>The most important intervention in managing patients with metabolic syndrome is lifestyle modification with improved diet and exercise. To achieve adequate treatment and decrease the risk of adverse outcomes, proper identification of symptomatic patients with metabolic syndrome is necessary.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Neoplasms of the Palate: A Review139314001064910.12816/0044655ENNaif A. Allah Abu RassMinistry of HealthEmad Ridha SurougiMinistry of HealthShahad Mohammed BaheydarahKing Abdulaziz UniversityAlbatool Hassan BaroomBatterjee Medical College for Sciences and
TechnologyHannah ALGhamdiBatterjee Medical College for Sciences and
TechnologyHala Kamal AlTuwayjiriRiyadh Colleges of Dentistry and PharmacyNada Nasser AlMansourUniversity of HailJournal Article20180810<strong>Background:</strong> The palate is defined as the roof of the mouth. It is alienated into soft palate which is essential for nasal passage protection and formation of speech sound and the bony hard palate which acts as a barrier between the mouth and the nasal cavity. A natural opening in the palate for nerves and blood vessels can create a passage for neoplasms to spread into the nasal cavity such as epidermoid carcinoma, adenocarcinoma and benign mixed tumors and rarely Melanoma, lymphosarcoma and Myosarcoma.<br /> Neoplasms of the palates results in significant masticatory, speech and swallowing disturbance and surgery remains the recommended treatment modality. However, provided the profound functional and cosmetic importance of the oral cavity, management of Palates cancers requires a thorough understanding of disease progression, approaches to management and options for reconstruction.<br /> <strong>Aim of the study: </strong>wasto review the different types of neoplasms of the Palates along with the etiology, diagnosis and with emphasis on the surgical intervention.<br /> <strong>Methods:</strong> electronic search of available Literature review in the scientific database of retrospective studies and systematic reviews investigating incidence, prevalence, etiology, symptoms, risk factors, diagnosis and surgical intervention of different types of oral cavity particularly palatal neoplasm from 1960 to 2017– (Medline, Embase, the Cochrane Library , NHS center websites as well as an individual Dentistry journals such as International Journal of Prosthodontics, International Journal of Periodontics and Restorative Dentistry. Search included English Publications which were obtained from both reprint requests and by searching the database.<br /> <strong>Conclusion:</strong> Cancer of the oral cavity is mostly trigger by smoking, alcohol abuse. The most common neoplasms of the hard palate are MSGTs and SCCs for the soft palate. Primary surgical resection with or without postoperative adjuvant therapy remains the upmost recommended treatment approach. It is also critical to have a Multidisciplinary treatment to help improve the oncologic and functional results in oral cancer patients.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Review of Current Concepts Femoral of Head Osteonecrosis140114081065110.12816/0044656ENMazen Ali AlqahtaniCollage of Medicine, King Khalid UniversityAbdulrahman Jalwi KorkomanCollage of Medicine, King Khalid UniversityLamyaa Omar Saad Al-GelbanCollage of Medicine, King Khalid UniversityAsma Saad AlahmariCollage of Medicine, King Khalid UniversityDhuha Saeed MotlagCollage of Medicine, King Khalid UniversityJournal Article20180810<strong>Background:</strong> The avascular necrosis (AVN) or osteonecrosis of the femur head (ONFH), an illness with several etiological factors, impacts young populace and otherwise handled prompt, causes the collapse of femur head eventually requiring hip arthroplasty. <strong>Objective</strong>: the present article aims to provide an overview of epidemiology, pathophysiology of osteonecrosis along with diagnosis methods and non-surgical in early stages and surgical treatment methods. <strong>Methodology:</strong> Comprehensive search of the literature was conducted in the following databases; PubMed, and SciVerse Scopus for studies published before November 2017. The PubMed database was searched using an algorithm comprising relevant MeSH terms including “Osteoporosis”, “femoral head osteonecrosis” AND “management” “diagnosis”.<br /> <strong>Conclusion:</strong> Osteonecrosis is a destructive pathology that eventually results in bone death through loss of blood to the bone, it involves almost every bone including the femoral head while early start of osteoarthritis could ultimately demand hip arthroplasty when non-operative procedures and joint-sparing treatments fail. Nevertheless, recent technological advances in surgical treatment methods have improved outcomes and should help patients recover from this functionally debilitating joint disease.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Relation of Hepatitis C and its Severity Assessed by PCR to the Presence and Severity of Coronary Artery Disease Assessed by Syntax Score140914151065910.12816/0044657ENAhmed Mohamed OnsyDepartment of Cardiovascular Diseases, Faculty of Medicine - Ain Shams UniversityAdham Ahmed AbdeltawabDepartment of Cardiovascular Diseases, Faculty of Medicine - Ain Shams UniversityAbd El-Salam Gebril SenussiDepartment of Cardiovascular Diseases, Faculty of Medicine - Ain Shams UniversityJournal Article20180810<strong>Background: </strong>Egypt has the highest prevalence rate of hepatitis C virus in the world, making it the most challenging public health problem facing the country. Cardiovascular disease continues to be the principal cause of death worldwide. Several studies have been conducted to confirm, or disprove, an independent association between HCV infection and atherosclerotic disorders, including coronary artery disease.
<strong>Objective: </strong>the aim of this study was to assess the correlation between hepatitis C virus infection severity and extent of coronary artery disease.
<strong>Patients and Methods: </strong>this prospective study was carried out in the Cardiovascular DiseasesUnit in Ain Shams University Hospitals. This study involved sixty one patients with positive test for HCV antibodies.
<strong>Results: </strong>PCR level was highly correlated to the absolute Syntax score (SS) and to the Syntax score group, yet it was not found to be significantly correlated to the presence of significant coronary lesion nor to the number of vessels affected. On the other hand SS was highly correlated to the presence of significant coronary lesion and to the number of vessels affected.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Surgical Management of Cholelithiasis141614201066010.12816/0044658ENJournal Article20180810<strong>Background:</strong> 15% of adults in the United States suffer from gallstones, with about 1 million cases diagnosed each year. The risk factors leading to a higher risk of developing gallstones include obesity, along with older age and females with multiple pregnancies where 60% of them undergo cholecystectomy. There are various different managements, mainly including open cholecystectomy, laparoscopic surgery, as well as medical treatments.
<strong>Aim:</strong> In this review, we aim to study the diagnosis, presentation, and different management approach of gall stones, along with their indication and contraindication.
<strong>Materials and Methods:</strong> We conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE, January 2001, through February 2017. The following search terms were used: cholelithiasis, open cholecystectomy, laparoscopic surgery, prophylactic cholecystectomy, medical management of gall stones.
<strong>Conclusion:</strong> Gallstones are still a major cause of undergoing surgery worldwide. Correct recognition of gall stone disease, with appropriate management technique results in high success rate. Most patients undergo surgery only after they are symptomatic.Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Case of Idiopathic Peripapillary Subretinal Neovascular Membrane in an otherwise Healthy Young Male: A case report141214141066110.12816/0044659ENRaed Awadh AlharthiDepartment of Ophthalmology, King Abdul-Aziz Specialist Hospital, Taif, Saudi Arabia.Ashwaq Mohammed AlmalkiDepartment of Ophthalmology, King Abdul-Aziz Specialist Hospital, Taif, Saudi Arabia.Faisal Ali AlotibiDepartment of Ophthalmology, King Abdul-Aziz Specialist Hospital, Taif, Saudi Arabia.Hatim Fozi JabrDepartment of Ophthalmology, King Abdul-Aziz Specialist Hospital, Taif, Saudi Arabia.Journal Article20180810<strong>Aim of work:</strong> to report a rare case of idiopathic peripapillary subretinal neovascular membrane (PCRNVM) in an otherwise healthy young male
<strong>patient and method</strong>: A case report study of 31-years old healthy male came to ophthalmology clinic complaining of blurred vision.
<strong>Result</strong>: Fundus examination revealed left idiopathic peripapillary subretinal neovascular membrane (PCRNVM)and its presence was confirmed by optical coherence tomography (OCT) and fundus fluorescein angiography (FFA).
<strong>Conclusion</strong>: Idiopathic peripapillary subretinal neovascular membrane(PSRNVM)is rare condition in healthy young with no predisposing factors and our case was responded well to single dose of Anti-VEGF (ranibizumab).Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270820180101Meta-Analysis of Liver Cirrhosis and The Risk of Fracture141514201066210.12816/0044660ENJournal Article20180810<strong>Background:</strong> Cirrhosis is the irreversible fibrosis of liver, it continues to be a common cause of morbidity and mortality. It is accompanied by inflammation and malnutrition and thus can have a negative effects on bone metabolism and promote fractures accordingly.
<strong>Aim of the study: </strong>to evaluate the risk of fractures among patients with cirrhosis.
<strong>Methods:</strong> A systematic review of the scientific literature following PRISMA/STROBE guidelines, Medline Cochrane Library and Embase abstracts were retrieved using an algorithm comprising relevant MeSH terms from 1980 to 2017. Publications on the association of cirrhosis/bone fracture were abstracted independently by the authors and included in both gender and gender-specific meta-analyses, following recalculations of published data as appropriate. The Newcastle-Ottawa scale was used to evaluate the quality of included studies.
<strong>Results:</strong> 8 studies met the inclusion criteria enrolling 988 patients (286 of which are diagnosed with alcoholic liver disease (ALD). Overall, ALD demonstrated a relative risk (RR) of 1.825, 95%CI: 1.370-2.28, <strong><em>P</em></strong> < 0.001 for the development of bone fractures. Bone mineral density (BMD) was not significantly different between the ALD and control groups, although there was a trend toward lower BMD in patients with ALD. Sensitivity analyses showed consistent results.
<strong>Conclusion:</strong> in accordance to the present meta-analysis, there is a significant correlation between bone fractures and ALD independent of BMD.