Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Role of CT and MRI in Diagnosis of Pericardial Diseases107210821066310.12816/0044529ENAmr Ibrahim Ali MahmoudDepartment of Radiodiagnosis, Faculty of Medicine, Ain Shams UniversityLaila Ahmad AbdurrahmanDepartment of Radiodiagnosis, Faculty of Medicine, Ain Shams UniversityYasser Ibrahim Abdel KhalekDepartment of Radiodiagnosis, Faculty of Medicine, Ain Shams UniversityJournal Article20180810 <strong>Background</strong>: pericardial diseases are important causes of morbidity and mortality in cardiovascular diseases. CT and MRI are more than adjuncts to echocardiography in pericardial diseases assessment, as they provide an excellent pericardial anatomy delineation and precise pericardial lesions evaluation including; effusion, constrictive pericarditis, thickening, masses and congenital anomalies. Ideal management needs the proper imaging modality choosing ability. <strong>Aim of the Study:</strong> this study aimed to evaluate the role of CT and MRI versus echocardiography in the diagnosis of pericardial diseases and to show the limitations of each modality.<br /> <strong>Conclusion:</strong> tissue characterization with CMR is superior to cardiac CT and echocardiography. CMR can differentiate tumor from thrombus and is often helpful to assess the perfusion of a pericardial mass with the use of gadolinium contrast. The final diagnosis depends on typical pathologic features.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Meta-Analysis Study on Alcoholic Liver Cirrhosis108310891066410.12816/0044530ENJournal Article20180810<strong>Background:</strong> Heavy alcohol consumption is an inevitable cause of alcoholic liver disease with a high chance to progress to Alcoholic Liver Cirrhosis. Alcohol could damage the function of body organs and could cause cancer. Liver damage due to excessive alcohol consumption is usually presented as fatty liver (build-up of fats in the liver), steatohepatitis, fibrosis, alcoholic cirrhosis, and hepatocellular carcinoma. When liver fibrosis progresses, it will ultimately end up as alcoholic cirrhosis.
<strong>Objective of the Study:</strong> This article was intended to explore and investigate the possible optimal diagnosis and management of Alcoholic liver cirrhosis.
<strong>Methods:</strong> We searched the medical literatures to retrieve studies for the review till 30 November 2017. Electronic search in the scientific database from 1965 to 2017– (Medline, Embase. The Cochrane Library websites were searched for English Publications (both reprint requests and by searching the database) .Data extracted included authors, country, year of publication, characteristics of patients, pathophysiology, risk factors, clinical manifestations, different diagnostic approaches and treatment modalities.
<strong>Conclusion:</strong> Absolute abstinence remains the foundation for any treatment of any acute or chronic Alcoholic Liver Disease. It’s also important to understand that no treatment will cure cirrhosis or repair scarring in the liver that has already occurred and the only resort would be liver transplantation which is also debatable provided the complications it carries along. Nevertheless, timely diagnosis of alcoholic cirrhosis in people with alcoholic liver disease is the cornerstone for evaluation of prognosis or choosing treatment strategies such as nutritional and medical support and lifestyle change.<strong>:</strong> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Awareness of Prostate Cancer, Screening and Methods of Managements in a Hospital in Riyadh, Saudi Arabia109010921066510.12816/0044531ENAhmed Mousa AlmuhannaCollege of Medicine, King Saud University, RiyadhSulaiman AlshammariCollege of Medicine, King Saud University, RiyadhHussain Khaled AlsalmanCollege of Medicine, King Saud University, RiyadhHassan AlbeladiCollege of Medicine, King Saud University, RiyadhAli AlsubaieCollege of Medicine, King Saud University, RiyadhWaleed A. AbueissaCollege of Medicine, King Saud University, RiyadhFatimah AlkhawajaAlfaisal university, AlriyadhHussain Ali BusalehUniversity of Science and TechnologyJournal Article20180810<strong>ABSTRACT</strong><br /> <strong>Background</strong>: screening for prostate cancer (PCa) is surrounded by controversies regarding the benefits, risks and uncertainties of undergoing the screening. Current practices of prostate cancer involve measuring the level of PSA and digital rectal examination. This study aimed to measure the knowledge and awareness of undergoing a prostate cancer screening and the available treatment options amongst the participants.<br /> <strong>Method</strong>: a questionnaire-based quantitative cross-sectional study which focuses on determining the knowledge of prostate cancer screening and management in a hospital in Riyadh.<br /> <strong>Results</strong>: three hundred and twenty-three participants filled the surveys (100% males), more than 80% of all ages had heard about prostate cancer and that it is a disease of the male. A higher level of education is significantly associated with the level of awareness (P-value <0.001). More educated participants selected 40 years old as the appropriate age for PCa screening (P-value 0.009) and radiotherapy as the mode of treatment (P-value 0.01). 43.34% saw PCa as a cause of death and 41.4% saw it associated with smoking. Only 17.84% undergo continuous PCa screening most of them in 50-60 age group with “reassurance” as the main motivator. 37.8% of the participants did not know the symptoms of PCa and around 25% selected pain in micturition, difficult frequent micturition and bone pain as symptoms of PCa.<br /> <strong>Conclusion</strong>: although prostate cancer is known amongst the majority of the participants, only a minority of them has knowledge of the symptoms and undergoes regular screening.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Assessment of Knowledge and Attitude and Practice of Family Towards Physical Activity in Makkah City, 2017109310961066610.12816/0044532ENAssaf Nahar J AlsulamiUmm Alqura UniversityAbdullah Ali AlshehriUmm Alqura UniversityEssam Abdullah AlghamdiGeneral Surgery Department, Umm-Alqura UniversityFahad Saleh A AlsefryIbn Sina National CollegeShaima Tariq MansoorIbn Sina National CollegeJournal Article20180810<strong>Background: </strong>Physical activity could enhance the personal wellbeing and reduce the risks of many medical disease around the world<br /> <strong>Objectives: </strong>Assessing the knowledge and attitude and practice (KAP) of family towards physical activity in Makkah city in Kingdom of Saudi Arabia (KSA).<br /> <strong>Methods: </strong>This study was based on cross-sectional questionnaire sheet study conducted in Makkah City from September to November 2017among 400families from different parts of Makkah City.<br /> <strong>Results: </strong>Most of the subjects had appropriable knowledge about the importance of physical activity and risk factors of physical inactivity. The attitude of the subjects was positive among most of them toward regular physical exercise, enhancing their family to practice physical activity and practicing physical activity with their family. The level of practice was insufficient among most of the respondents regarding sports practice with their family and going for a long walk with their family. But the majority taught their children about the importance of physical activity and 50.5% let their children practice swimming and light physical activity.<br /> <strong>Conclusion: </strong>Although most of the subjects had good knowledge and attitude toward physical activity, the practice pattern was insufficient among most of them. There is a need for enhancing the physical activities among families in KSA and assessing the prevalence of chronic diseases among physically inactive subjects.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Level of Chemerin and Anti-Müllerian Hormone in Egyptian Obese Women with Polycystic Ovarian Syndrome.109711101066710.12816/0044533ENFahd A. El-OmdaGynecology and Obstetrics Department, Faculty of Medicine, Al-Azhar University, EgyptIbrahim A. EmaraBiochemistry Department, National Institute of Diabetes and Endocrinology (NIDE), EgyptDoaa M. Abdel-LatefBiochemistry Department, Faculty of Pharmacy (Girls), Al-Azhar University, EgyptRawda H. ZayanBiochemistry Department, Faculty of Pharmacy (Girls), Al-Azhar University, EgyptJournal Article20180810<strong>Background: </strong>Chemerin is a newly discovered adipokine that regulates adipocyte development, metabolic function as well as immune function. Anti-Müllerian hormone (AMH) is a dimeric glycoprotein that belongs to the transforming growth factor-beta family.<br /> <strong>Aim of the study</strong>: was to evaluate the serum levels of Chemerin and AMH in one trial to show their possible involvement in the pathogenesis of PCOS and their association with obesity.<br /> <strong>Subjects and methods: </strong>This study was performed on eighty subjects divided into 4 groups: Group I: 20 non-obese control (BMI< 30), Group II: 20 non-obese patient with polycystic ovarian syndrome (BMI< 30), Group III: 20 obese Control (BMI ≥ 30) and Group IV: 20 obese patient with PCOS (BMI ≥ 30). Serum levels of Chemerin and AMH were estimated by ELISA.<br /> <strong>Results: </strong>Results showed a significant increase in serum levels of <strong><em>Chemerin and AMH</em></strong> in (non-obese and obese) PCOS groups when compared to their controls. Results showed also a significant increase in the serum level of <strong><em>Chemerin </em></strong>in obese PCOS group when compared to non-obese PCOS group. While a significant decrease in serum level of <strong><em>AMH</em></strong> in obese PCOS group when compared to non-obese PCOS group. There were a significant positive correlation between <strong><em>Chemerin and</em></strong><strong><em> AMH </em></strong>in PCOS groups.<br /> <strong>Conclusion: </strong>Chemerin together with AMH may be used as a biomarker for early detection of PCO and Clinical parameters as Infertility and Hyper and rogenism in women with PCOS.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Meta-analysis on Subsyndromal Delirium in ICU111111161066810.12816/0044534ENJournal Article20180810<strong>Background: </strong>Subsyndromal delirium (SSD) is a frequent condition and has been commonly described as an intermediate stage between delirium and normal cognition. However, the true frequency of SSD and its impact on clinically relevant outcomes in the intensive care unit (ICU) remains unclear.
<strong>Aim of the Study:</strong> To evaluate the significance of SSD on adverse clinical outcomes especially mortality and length of hospital stay.
<strong>Methods:</strong> A systematic search was performed in the scientific database particularly MEDLINE (2000–2017), EMBASE (2000– 2017), Cochrane Central Register of Controlled Trials, CINAHL (2000–2017), Google Scholar, and individual journals to identify publications that evaluated SSD in ICU patients.
<strong>Results:</strong> The search yielded five studies involving 2453 patients. SSD was detected in 849 patients (34.6%). Three studies evaluated only surgical patients. Three studies used the Intensive Care Delirium Screening Checklist (ICDSC) and two used the Confusion Assessment Method (CAM) score to diagnose SSD. The meta-analysis showed an increased hospital length of stay (LOS) in SSD patients (0.29 (95% CI 0.11–0.48), <em>p</em> = 0.002; <em>I</em> <sup>2</sup> = 33%). Hospital mortality was described in two studies but it was not significant (hazard ratio 0.93 (0.58–1.43), <em>p</em> = 0.88 and (4 (1.0-6.9) vs 9 (3.6-20.4), <em>p</em> = 0.05). The use of antipsychotics in SSD patients to prevent delirium was evaluated in one study but it did not modify ICU LOS (6.2 (4–8) vs 7 (4–9) days, p = 0.63 and 2 (2–3) vs 3 (2–3) days, p = 0.517) or mortality (9 (25.8%) vs 7 (20.4%), p = 0.51).
<strong>Conclusion: </strong>Subsyndromal Delirium is a common and adverse condition that is manifested in almost one-third of ICU patients. According to our findings, SSD has increased the length of hospital stay only with low impact on the other outcomes. Nevertheless, studies on a bigger sample size and larger scale are needed for a better understanding of the relevance of SSD in ICU patients as well as its treatment.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Imaging View of Arterial Tortuosity Syndrome - Case Report111711201066910.12816/0044535ENSaleh F AlqahtaniCollege of Medicine, King Khalid University, AbhaMohammed A AlgathradiCollege of Medicine, King Khalid University, AbhaAhmad A AlzoaniDepartment of Neonatology,
Abha Maternity and Children Hospital, AbhaAbdullah A AlhayaniDepartment of Pediatrics, Abha Maternity
and Children Hospital, Abha, Saudi ArabiaMetrek AlmetrekJoint Program of Postgraduate Residency Training Program of Family Medicine in Khamis MushayteJournal Article20180810<strong>ABSTRACT</strong><br /> <strong>Background: </strong>Arterial tortuosity syndrome is one of the autosomal recessive diseases and caused by alterations (mutations) in the <em>SLC2A10 </em>gene. It is a rare disorder worldwide and in Saudi Arabia. Its prevalence is unknown. In the medical literature, about 100 cases have been reported.<br /> <strong>Objectives: </strong>An approach for how to diagnose a case of arterial tortuosity in newborn.<br /> <strong>Material and methods: </strong>A radiological view report of a case aged 21 days old female baby patient presented to emergency department with vomiting and feverfor one week.<br /> <strong>Results: </strong>She was managed in Abha Maternity and Child Hospital and referred to the tertiary center for advanced management and follow up.<br /> <strong>Conclusion: </strong>Arterial tortuosity syndrome usually presents with a different set of clinical features among reported cases and its manifestations going with the mutation type.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Systemic Review: Role of Tissue Plasminogen Activator for Acute Ischemic Stroke112111301067010.12816/0044536ENAbdullah Musari AlanaziNorthern Border UniversityAbdullah Munif Al-EneziNorthern Border UniversityKhalid Hashim AlanaziNorthern Border UniversityMuteb Lafi AlanaziNorthern Border UniversityNasser Nidaa AlanaziNorthern Border UniversityJournal Article20180810<strong>Background: </strong>Using recombinant tissue plasminogen activator (rt-PA) during the first 3 h up to 6 h of stroke was allowed to reduce the poor functional consequences of stroke.<br /> <strong>Objectives: </strong>assess the effects of intravenous dosage of rt-PA during the first 6 h after on early and late outcomes of acute ischemic stroke (AIS).<br /> <strong>Methods: </strong>all studies regarding the intravenous rt-PA given within 6 h of onset of acute ischemic stroke up to 2016 were searched the outcomes, and the mortality rates were evaluated at the final follow up.<br /> <strong>Results: </strong>There was a significant increase in functional outcome by using IV-tPA significantly (p <0.01).<br /> A significant decrease was found in intracranial hemorrhage in the patients treated with IV-tPA. The mortality rates were significantly decreased at the end of the follow up period in patients treated with IV-tPA.<br /> <strong>Conclusion: </strong>The study indicated that using intravenous rt-PA could increase the number of living patients favorable outcome, less disabilities and intracranial hemorrhage among acute ischemic stroke patients during the first 6 hours.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101The Relationship between Sleep Patterns and Academic Performance among Medical Students at King Saud Bin Abdulaziz University for Health Sciences113111341067110.12816/0044537ENNasser AlhazzaniKing Saud Bin Abdulaziz University, Riyadh KSAEmad MasudiKing Saud Bin Abdulaziz University, Riyadh KSAAbdularhman AlgarniKing Saud Bin Abdulaziz University, Riyadh KSASaud Mubarak AlaklabiKing Saud Bin Abdulaziz University, Riyadh KSAAhmad Salih AlomariKing Saud Bin Abdulaziz University, Riyadh KSARaid Naysh AlghamdiKing Saud Bin Abdulaziz University, Riyadh KSAJournal Article20180810<strong>ABSTRACT</strong><br /> <strong>Background</strong>: the relationship between the sleep pattern and the academic performance among medical students is not well addressed in the literature. This study aimed to assess the association between sleep pattern and academic performance among medical students at King Saud Bin Abdulaziz University for Medical Sciences.<br /> <strong>Methods: </strong>this descriptive cross-sectional study was conducted on male medical students at King Saud Bin Abdulaziz University for Health Sciences at Riyadh, Saudi Arabia. They were included and the Exclusion criteria were students in Basic sciences phase and preparatory phase. The questionnaire was obtained from Groninger Sleep Quality Questionnaire and it was distributed through official university email. Responding rate was 25.7%(n=166) out of 645 students whom were included. SPSS was used to manage and analyze the data.<br /> <strong>Results: </strong>the majority of students (27.1%) who showed adequate sleep had GPA of between 3.5 and 4.49 which was referred to good academic performance. 0.6% of those who showed adequate sleep score less than 2.5 GPA. On the other hand, 22.9% of the students showed inadequate sleep score GPA of between 3.5 and 4.49. <strong>Conclusions</strong>: our results showed that sleep quantity and quality doesn’t play significant roles in academic performance of students. Nevertheless, students should adopt a healthy sleep pattern.<br /> Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Squamous Cell Carcinoma Presenting as Cutaneous Horn: A Case Report113511361067210.12816/0044538ENSamaher AlaauldeenAl-Noor Specialist Hospital, Makkah, Saudi ArabiaKhalid Al HawsawiDermatology Department, King Abdul Aziz Hospital Makkah, Saudi ArabiaHaneen Al SufyaniKing Abdul Aziz Hospital Makkah, Saudi ArabiaLina BugisUmm Al Qura University Makkah, Saudi ArabiaAyat Al DosariMakkah, Saudi ArabiaTaghreed Al HetairshiMakkah, Saudi ArabiaJournal Article20180810<strong>Background: </strong>Cutaneous horn is a clinical term used to describe a hard, keratotic conical lesion. Its base may be a papule, plaque or nodule. <strong>Objectives: </strong>An approach for how to diagnose and manage a cutaneous horn.<br /> <strong>Materials and methods:</strong> Here-in we report an aged male 85-years old presented with a history of painful slowly progressive skin lesion over his right foot 7 months ago.<br /> <strong>Results:</strong> The past medical history revealed that the lesion was preceded by presence of a cutaneous horn (CH) at the same site of the current skin lesion. That CH was persistent for a year before it spontaneously fell down. Skin biopsy from the base of the CH was taken at that time, it was consistent with underlying actinic keratosis. He did not receive any treatment for his CH. Currently skin examination revealed fungating ulcer measuring 6X6 cm on the dorsum of the right foot. There was no inguinal lymphadenopathy. Punch skin biopsy was taken from the edge of the ulcer for histo-pathological examination.<br /> <strong>Conclusion: </strong>On the basis of the above clinicopathological findings, a diagnosis of well differentiated Squamous Cell Carcinoma was made. The patient was referred to Oncologist for appropriate management.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Prevalence of Benign Prostatic Hyperplasia (BPH) in Saudi Patients above 40 Years Old113711391067310.12816/0044539ENMarkhan Hammad AlmarkhanAl-jouf University, Collage of MedicineAbdullah Ismail SawmaAl-jouf University, Collage of MedicineFahad Saleh AlruwailiAl-jouf University, Collage of MedicineQusai Abdullah AlsaqabiAl-jouf University, Collage of MedicineMushari Aber AlonaziAl-jouf University, Collage of MedicineWaleed Sultan AlruwailiAl-jouf University, Collage of MedicineNafea Hamoud AlanaziAl-jouf University, Collage of MedicineHind Jaza AlotaibiAl-jouf University, Collage of MedicineJournal Article20180810<strong>Background:</strong> Benign prostatic hyperplasia (BPH) is a common disorder amongst older men, and is accountable for significant disability. <strong>Objective:</strong> The aim of the study is to determine the prevalence of benign prostatic hyperplasia in urology department of Prince Mutaib hospital in Sakaka, Aljouf.<br /> <strong>Methods:</strong> Via recoding, 345 patients attended the urology department. They were asked about their ages, if they are smokers and if they have chronic diseases.<br /> <strong>Results:</strong> The total number of patients diagnosed as having benign prostatic hyperplasia (BPH) was 82. This showed a prevalence rate of 23%. The age distribution of the patients was found to be above 60 years old. While regarding the symptoms: 23 (28%) of the patients showed mild BPH, 39 (48%) with moderate BPH, and 20 (24%) with severe BPH. <strong>Conclusion and recommendation:</strong> BPH seemed to be a problem of elderly patients, as within the studied patients, those with BPH were above 60 years. Chronic diseases such as diabetes mellitus, hypertension may be acting as risk factors for BPH. Further studies are recommended to study the prevalence of prostatic carcinoma in elderly patients.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101The Correlation between Vitamin D and Polycystic Ovary Syndrome114011481067410.12816/0044540ENJournal Article20180810<strong>Background: </strong>A deficiency of Vitamin D not only causes poor bone mineralization but also has been implicated in many other chronic diseases. Recent studies have suggested a relevance of vitamin D to reproductive physiology. Moreover, recent evidence is establishing to support the hypothesis that vitamin D status may contribute to the development of metabolic disturbances in PCOS.
<strong>Aim of the Study: To </strong> investigate the relationship between Vitamin D level and polymorphisms related to metabolic disturbances particularly Insulin resistance in women with PCOS.
<strong>Methods: </strong>A review of the scientific literature (PubMed Search 1960 to 2017)
Pubmed, Embase and CENTRAL were searched to identify randomized controlled trials that investigated The Correlation between Depression and Folate Deficiency as the primary outcome. Identification of papers and data extraction were performed by two independent researchers.
We searched for relevant trials in the Cochrane Library, MEDLINE (from 1960), Embase (from 1960), and ongoing trial databases; all searches current to October 2017.
<strong>Results: </strong>Eight studies were included enrolling 1225 women; 779 patients with depression and 446 control subjects. Univariate regression analyses of the weighted means indicated a significant correlation between vitamin D and IR predictability in both PCOS and control women. However, the significance was neutralized after factoring BMI in PCOS women.
<strong>Conclusion: </strong>There is a growing body of evidence suggesting an inverse association between vitamin D status and metabolic disturbances in PCOS in the current literature yet heterogeneity of the conducted studies made it difficult to come out with a solid conclusion. Nevertheless, normalization of vitamin D levels is recommended generally and especially for PCOS patients.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Pediatric Disseminated Bacillus Calmette-Guerin Infection (BCGitis): A Case Report114911511067510.12816/0044541ENJournal Article20180810<strong>Background:</strong> BCG is a live attenuated vaccine. It has been used to prevent tuberculosis since 1921.BCG is widely used, it is estimated that 100 million newborns are receiving it yearly. It also has a low incidence of serious adverse reactions and considered safe. However, few severe complications have been reported despite its wide use.Adverse reactions of BCG vaccination included suppurative lymphadenitis, localized abscess or a combination of both. In addition to them there was disseminated BCG-itis, which is life threatening, but very rare. <strong>Aim of the work:</strong> this study reported a case of a five-month-old child with BCG-itis which presented to us. <strong>Patient and method:</strong> left axillary swelling was increased in size with bloody discharge and associated fever. Family history of IL12 deficiency was also noted.
<strong>Results</strong>: diagnosis was made by AFB and PCR. The child responded well to anti-mycobacterial treatment. Because neonatal BCG vaccine is included in many standard vaccination schedules around the world, it is extremely difficult to avoid administering it to infants who might have PID. <strong>Conclusion</strong>: it is important to recognize BCG adverse reactions because they can be the first clue to diagnosing immunodeficiencies.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101The Prevalence and Patterns of Carpal Tunnel Syndrome and Their Associated Risk Factors Among Diabetic Population In South-West of Kingdom of Saudi Arabia115211581067610.12816/0044542ENJournal Article20180810<strong>Background: </strong>Carpal tunnel syndrome (CTS) is a constellation of symptoms and signs resulting from the local compression of the median nerve inside the carpal tunnel at the wrist. In advanced cases of CTS where the course is unnoticed, atrophy of the thenar muscles may occur, which can be irreversible.
<strong>Objective: </strong>The aim of the present study was to estimate prevalence and severity of CTS in patients with type 2 diabetes mellitus in South Western region of the Kingdom of Saudi Arabia (KSA) and to identify specific at risk groups within these populations by using nerve conduction study.
<strong>Methods: </strong>This cross-sectional study was conducted in Asir Central Hospital, Abha, KSA. The study randomly included all patients with type 2 diabetes mellitus with their place of birth and permanent residence being in Abha or Mohyel cities. History, physical examination, and laboratory data about fasting blood glucose, HbA1c, and lipid profile were collected. Additionally, nerve conduction study of both hands was performed.
<strong>Results: </strong>Out of 131 included subjects, 107 patients (81.7%) had CTS. Approximately one-third (35.1%) of the study subjects had unilateral CTS, and it affected both hands in 46.6% of them. In the majority of cases CTS was of very mild or mild severity (27.5% and 26.7% respectively). A significant association was found between gender, hypertension, hypothyroidism, ischemic heart disease and the development of CTS.
<strong>Conclusion: </strong>High prevalence of unilateral and bilateral CTS was found among patients with type 2 diabetes mellitus in South Western Saudi Arabia. Different grades of CTS were detected, but the severity of functional impairment was relatively mild. Development of CTS was associated with hypertension, ischemic heart disease, and hypothyroidism. Health care professionals should be aware of this high prevalence, and it will be useful to perform electrodiagnostic studies in diabetic patients in whom CTS is suspected.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Asthma among Adolescent Secondary-School Girls in Riyadh City, Saudi Arabia115911631067710.12816/0044543ENJournal Article20180810Background: Asthma is one of the most common chronic diseases in children and adults. The prevalence of asthma has increased in developed and developing countries over the last three decades. Our objective was to estimate the prevalence of physician-diagnosed asthma and to describe some related characteristics and associated symptoms of cases in a sample of adolescent secondary-school girls of Riyadh city, Saudi Arabia. Methods: A descriptive cross-sectional study was conducted in secondary schools in Riyadh city, during the academic year 2016-2017. A predesigned questionnaire was disseminated to the targeted population to complete it. Results: Out of 154 female students, the prevalence of physician-diagnosed asthma was 4.5%. The prevalence of rhinitis symptoms, exercise-induced wheezing and night coughing in the past 12 months in physician-diagnosed asthma and exercise-induced wheeze was 42.9%, 28.6% and 28.6%, respectively. Conclusion and recommendations: The prevalence of physician-diagnosed asthma in female adolescents in Riyadh, Saudi Arabia was 4.5%, there was with a high rate (42.9%)of rhinitis symptoms among the asthmatic girls. The prevalence of asthma in Riyadh, Saudi Arabia was within the reported prevalence ranges from many other parts of the world. Health education sittings is recommended to increase the public awareness about the causes and importance of seeking medical care during and between the attacks of asthma, especially in adolescent period.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Relation between Narrowed Coracohumeral Distance and Subscapularis Tears116411681067810.12816/0044544ENJournal Article20180810<strong>Purpose: </strong>The Purpose of this study is to detect differences between the values of dynamic coracohumeral distance (CHD) measured using ultrasonography (USG) in different shoulder rotations and to investigate its correlation with subscapularis tear.
<strong>Methods:</strong>We prospectively enrolled consecutive patients (n = 84) who were scheduled to have arthroscopic rotator cuff repair. Patients with a history of previous shoulder surgery or shoulder fracture and patients with external rotation less than 30 were excluded from the study. Dynamic coracohumeral distance was measured utilizing ultrasonography in 3 different shoulder positions: external rotation, neutral and internal rotation. We assessed the intrarater reliability with 3 times repetition of measurement. Patients were divided into one of 3 groups according to arthroscopic findings: intact subscapularis, partial-thickness tear, and full-thickness tear of the subscapularis. The control group (n = 12) included patients without rotator cuff tears from the outpatient clinic. Subgroup analysis according to the presence of dynamic subcoracoid stenosis, defined as a coracohumeral distance less than 6 mm measured in internal rotation was performed to find the clinical effect of dynamic subcoracoid stenosis.
<strong>Results:</strong>A partial-thickness tear of the subscapularis tendon was present in 30 patients (35.7%) and a full-thickness tear in 13 patients (15.5%) among 84 patients. The CHD was maximum in external rotation and the narrowest in internal rotation. There were no statistical differences in the CHDs between groups with different subscapularis tear status. According to the presence of dynamic subcoracoid stenosis, patients with dynamic subcoracoid stenosis had a significantly higher incidence of partial-thickness subscapularis tear than those without stenosis (P = 0.018).
<strong>Conclusions: </strong>The coracohumeral distance values were narrowest in shoulder internal rotation, which is thought to be the pathogenic position. We could not confirm the correlation between coracohumeral distance and subscapularis tear. However, patients who have dynamic subcoracoid stenosis had significantly higher incidence of subscapularis tear than others without dynamic stenosis.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Evaluation of Patients with Iron Deficiency Anemia116911731067910.12816/0044545ENJournal Article20180810<strong>Objectives: </strong>We aimed to assess the effect of anemia on subjective sleep quality in patients with iron deficiency anemia (IDA).
<strong>Methods: </strong>The present study is a prospective and cross-sectional study which has been carried out at King Abdulaziz hospital between November 2016 and April 2017. Fifty-two patients diagnosed with iron deficiency anemia and 40 healthy individuals, who are gender and age matched, were involved in the study. All participants were requested to fill 3 forms: a socio-demographic form (age, gender, marital status, income level and educational status), hospital anxiety and depression (HAD) scale and Pittsburgh sleep quality index (PSQI).
<strong>Results: </strong>According to the HAD scale, the average anxiety score was found 9.31±2.41 in patients and 7.62± 2.11 in controls. And, the average depression score was 7.49±2.08 in patients and 6.39±2.73 in controls. The total sleep quality score was 6.68±2.99 in patients and 4.27±1.71 in controls. There was a statistically significant difference in terms of anxiety, depression and sleep quality scores. Linear regression analysis showed no association between anxiety and depression with poor sleeping.
<strong>Conclusion: </strong>IDA affects sleep quality irrespective of psychological symptoms such as depression and anxiety.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Risk Factors of Coronary Heart Disease among Medical Students in Almaarefa Colleges, Riyadh, Saudi Arabia117411841068010.12816/0044546ENJournal Article20180810<strong>Background:</strong> Nowadays, cardiovascular diseases (CVDs) represent an escalating worldwide public health problem. Providing consistent data on the magnitude and risk factors of cardiovascular diseases (CVDs) among young population will help in controlling the risks and avoiding their consequences.
<strong>Objective:</strong> The objective was to estimate the prevalence of risk factors of coronary heart disease (CHD) among medical students during their clinical clerkship (4th-6th years).
<strong>Methods:</strong> A cross-sectional study was done during the educational year 2016-2017 at Almaarefa Colleges. Ethical standards were follow and a multistage stratified random sample method was used for selection of 214 medical students. Data was collected through an interviewing questionnaire, measurements and laboratory investigations. Both descriptive and analytical statistics were done by SPSS version 21. Coronary heart disease (CHD) risk percent in thirty years was calculated using Framingham algorithm for each student, then the risk among all students was determined.
<strong>Results:</strong> The commonest risk factors of coronary heart disease (CHDs) were daily intake of high fat diet (73.4%), physical inactivity (57.9%), overweight/or obesity (31.2%) and daily consumption of fast food (13.1%). Hypercholesterolemia (17.2%) and hypertension (9.3%) were also prevalent risk factors. Smoking prevalence was low (2.8%). Males had significantly higher mean scores for most of coronary heart disease (CHD) risk factors compared to females (p < 0.05). Systolic Blood Pressure was higher among males (119.47 ± 11.17) compared to females (112.26 ± 9.06). A highly statistical significant difference was present (Students test = 4.74, p < 0.001). Framingham Risk Score revealed that coronary heart disease (CHD) risk percent in thirty years among all students was 10.7%, 2.3% and 0.5% for mild, moderate and severe risk, respectively.
<strong>Conclusion:</strong> An alarmingly high prevalence of coronary heart disease (CHD) risk factors was prevailed among medical students, especially among males. However, a low prevalence of smoking may indicate the success of “Smoke-free Campus” program. Screening risk factors of coronary heart disease (CHD) among medical students and implementation of intervention programs are recommended. Programs to raise awareness about coronary heart disease (CHD) risk factors, encourage young adult students to adopt a healthy dietary behavior and promote physical exercise should be initiated.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101The Extent of Knowledge and Awareness of Prostate CancerScreening Among Saudi Men Aged More Than 40 Years118511891068210.12816/0044547ENJournal Article20180810<strong>Background: </strong>Prostate cancer is a serious health problem that is very common among men aged more than 50 years. In 2012, the age standardized incidence rate of prostate cancer in Saudi Arabia was 4.5/100,000.Screening of prostate cancer with prostate specific antigen (PSA) can help in early detection of prostate cancer which will eventually lead to more appropriate treatment and less mortality. The rate of PSA screening is almost twice among individuals with good knowledge compared to those with poor knowledge. The current study was conducted to assess the awareness level about the importance of prostate cancer screening among men aged more than 40 years in Saud Arabia.
<strong>Objectives: </strong>This study was conducted to assess the awareness level about prostate cancer screening among Saudi men aged more than 40 years.
<strong>Subjects and methods: </strong>This was a cross-sectional study. An anonymous web-based questionnaire about demographic characteristics in addition to participants’ knowledge in relation to prostate cancer vaccination was filled by 328 adult men from Saudi Arabia.
<strong>Results: </strong>Less than 30% of the participants gave correct answers about the age at which prostate cancer screening should be done. The level of knowledge was found to be affected by several factors including age, marital status, occupation, educational level and family history of cancer. In addition, periodic visits to healthcare center to undergo examination and discussion with clinical doctors were found to positively affect participant’s knowledge.
<strong>Conclusion: </strong>It’s very important to ensure a high level of awareness of prostate cancer screening among adult men in order to allow early detection and more efficient treatment in Saudi Arabia.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Awareness of Diabetic Complications, Perceived knowledge, Compliance to Medications and Control of DiabetesAmong Diabetic Population of Makkah City, Kingdome Saudi Arabia: Cross-Sectional Study119011951068310.12816/0044548ENJournal Article20180810<strong>Background: </strong>According to World Health Organization (WHO) in 2012, an estimated 1.5 million deaths were a direct outcome to diabetes and another 2.2 million deaths were attributively related to high blood glucose in a global population. As a consequence, researches confirmed that diabetics have a shorter life expectancy than non-diabetic individuals and this extravagant mortality is predominantly due to diabetic complications.
<strong>Methods:</strong> We have conducted a descriptive cross-sectional study on Makkah Region population, Saudi Arabia. All Saudi patients diagnosed with DM, regardless the type, and living in Makkah regions were included in this study. The total sample obtained was 299 patients. A self-administered questionnaire, about knowledge of diabetes mellitus complications, was filled by participants.
<strong>Results:</strong> Participants were classified into five categories according to age. Male and female groups percent was (39.1%) and (60.9%) respectively. Nearly two thirds of participants have the disease for more than five years (63.2%), and nearly two thirds were compliant to their medications (62.5%). Three quarters of participants (76.9%) had positive family history of diabetes mellitus. (26.1%) of participants had only one family member with diabetes mellitus, (16.7%) had two members, and (14.7%) had five members or more with diabetes mellitus.<strong>Conclusion: </strong>To develop effective patient education and improve patients’ diabetic control and own complications, educational strategies are needed so as they may help diabetic patients to improve self-knowledge and recognition of early signs and symptoms of DM complications, and this will prevent further deterioration, which will improve life quality and increase life expectancy for those patients.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Divorce Rates among Cancer Patients – A Saudi Arabian Study119612001069010.12816/0044549ENJournal Article20180810<strong>Introduction: </strong>divorce has been a serious problem of major prevalence in our community. According to Saudi Ministry of Justice, divorce rate was estimated to be 27.84% in 2015. Therefore, this study aimed to obtain the incidence of divorce among cancer patients in Princess Noura Oncology Center to know whether being diagnosed with cancer would affect the marital status in terms of divorce.
<strong>Patients and Methods: </strong>the study included 125 patients with age of 15-70 years, have been married, and diagnosed with cancer. Patients were interviewed in the clinic. For data analysis, we used SPSS. Institutional Review Board approval was obtained.
<strong>Results: </strong>divorce rate among cancer patients was significantly lower than that of the general population (P value <0.001). It was found to be higher in patients with breast cancer 50%, followed by non-solid tumor 33% of all divorces. 66% of divorced cancer patients were females.
<strong>Conclusion: </strong>divorce rate in cancer patients is lower than that of the general population. Therefore, we believe that cancer has led to stronger relationships. Cancer by itself does not increase the rate of divorce. Interestingly, it is generally found to be higher in female patients and breast cancer.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Evaluation of Awareness and Attitudes towards Common Eye Diseases among the General Population of Northwestern Saudi Arabia120112081069110.12816/0044550ENJournal Article20180810<strong>Background: </strong>assessing of the population’s awareness concerning eye diseases would provide a fundamental basis and acts as a future reference to executing such health promotion initiatives.
<strong>Objective: </strong>this study aimed to evaluate the public awareness and attitudes towards common eye diseases in Tabuk, Saudi Arabia.
<strong>Materials and Methods: </strong>this cross-sectional study was conducted in Tabuk, Saudi Arabia during the period from June 2017 to December 2017. A convenient sample of 397 participants of adults aged above 18 years old was chosen by a stratified method. A self-administered online survey included multiple choice and true-false questions was used to obtain information about respondent’s awareness regarding common eye diseases including cataract, refractive errors, glaucoma and diabetic retinopathy.
<strong>Results: </strong>77.6% of participants were females, 41.4% were between 18 and 25 years, 52% of the respondents had sufficient knowledge regarding common eye problems. The most frequent sources of information were the internet (46.7%), relatives (38.5%) and mass media (35.4%). The participant's knowledge ranged from 66.3%for the cataract to 36.3% for refractive errors. Only educational level and job were significantly associated with knowledge about refractive errors. The majority of the respondents (75%) reported visiting ophthalmologists only when they have complaints and just 10% of them visited ophthalmologists regularly. When they had eye problems, almost two-thirds visited the ophthalmologist directly whereas 9% and 7.4% of them did nothing or depended on home therapy, respectively.
<strong>Conclusion</strong>: awareness and knowledge of adult population in Tabuk, Saudi Arabia is suboptimal. Health education campaigns are needed to improve their knowledge and protect them them from adverse complications of these diseases.
<strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101A Case Report of Partial Molar Pregnancy Associated with A Normal Dizygotic Twin122112231069310.12816/0044552ENJournal Article20180810Partial molar pregnancy is an uncommon thing in which there is usually a triploid atypical fetus accompanying with a large placenta with cystic changes. The incidence of a normal diploid fetus and a partial molar placenta is really uncommon. Here we report a case of partial molar pregnancy in which a normal looking fetus with diploid karyotype coexist. A focal placental abnormal region was noticed at 13 weeks of pregnancy as enlargement associated with cystic changes. Fetus showed no clear deformity. Concerning these findings, the patient continued her pregnancy under close observation and advanced sonographic evaluations were made to rule out other differentials. There were no obstetric complications until the 28th gestational week when vaginal bleeding occurred. The patient underwent caesarian section and the products were sent for pathologic assessment which confirmed the partial molar changes.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Pharmacist’s Knowledge, Practice and Attitudes Toward Pharmacovigilance and Adverse Drug Reactions122412271069410.12816/0044553ENJournal Article20180810<strong>Background: </strong>It is observed that the adverse drug reactions are one of the many reasons contributing in the deterioration of health and wellbeing.
<strong>Objectives: </strong>This study was carried out to list the numerous elements affecting the knowledge, attitude, and practice of pharmacists and pharmacy technicians towards pharmacovigilance and adverse drug reactions.
<strong>Material and methods: </strong>A certain prepared questionnaire is performed over numerous pharmacies from the areas around in addition to the data collected from similar researches which performed the same method.
<strong>Results:</strong> Based upon the findings of our study, we came to a vision of the superiority of pharmacists over pharmacy technicians when it comes to acknowledging how to deal with pharmacovigilance and adverse drug reactions.
<strong>Conclusion:</strong> Pharmacists are more knowledgeable when it comes to ADRs than pharmacy technicians, yet both of them needs to go under training for enhancing their knowledge.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Late Presentation of Neuroblastoma with Brain Metastases: Critical Care Case Report122812291069510.12816/0044554ENJournal Article20180810<strong>Aim of the work</strong>: neuroblastoma of the adrenal gland is an extremely rare tumor in adulthood although it is one of the most common malignancies in childhood. <strong>Patient and method:</strong> a case of 14-year-old Saudi girl developed brain metastases after neuroblastoma mass resection. <strong>Results:</strong> the patient received Multi-agent chemotherapy and the condition of patient was improved. <strong>Conclusion:</strong> chemotherapy may provide good prognosis in treating neuroblastoma.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Awareness of School Teachers about Diabetes Mellitus123012331069610.12816/0044555ENJournal Article20180810<strong><em>Background: </em></strong><em>Diabetes mellitus was defined by World health Organization as a metabolic disorder which characterized by chronic hyperglycemia. It is a disease with several etiologies. It is one of common diseases in children. School children with diabetes need special care while they are in school as they may experience problems in glucose levels or other problems. Teachers are persons responsible for children in school, so they should have adequate information and good level of awareness about diabetes to deal with diabetic children especially in emergency case. </em>
<strong>Aim:</strong> To assess the awareness of school teachers about diabetes.
<strong>Methods: </strong>This cross-sectional study was performed in the period between October 2017 and November 2017 on school teachers in Makah region using a questionnaire. Data were analyzed by SPSS program.
<strong>Results: </strong>There were 58.4% males and 41.6% females in this study, the correlations between level of knowledge and different variables were as follow; the age of teachers significantly (P-value=0.009) affected the level of awareness, where teachers with older age (≥50 years) had the highest awareness among other participants, while those with age 40-49 years were the dominant group to have both moderate 30 (58.8%) and low awareness 20 (39.2%). Gender also was a significant factor that affected the level of awareness (P-value=0.004), where males 23 (33.8) had high level of awareness than females 3 (12.6%).
<strong>Conclusion: </strong>There was moderate level of knowledge about diabetes among school teachers. Age, gender, level of education and monthly income affected the level of knowledge.
Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Community Pharmacists' Knowledge, Attitude and Practices towards123412371069710.12816/0044556ENFakhir Thamir AlotaibiSecurity Forces Hospital of MakkahAttiah Abdullrhman KhobraniSecurity Forces Hospital of MakkahMesfer Safar AlmalkiSecurity Forces Hospital of MakkahHassan Abdullah AljabriAlnahdi Medical GroupJournal Article20180810<strong>Background: </strong>As a result of the wide antibiotic abuse in many communities all over, bacterial resistance against different antibiotic formulas has aroused. It is an actual matter of importance because it touches up the most crucial principles of pharmacy and devoted work for medicine field in general.<br /> <strong>Objectives: </strong>We have come to the aim of assessing the knowledge, attitude, and practice of pharmacists concerning dispensing antibiotics without prescription. We are discussing the ethical and legal elements contributing in the judgment of the final results and decision about the matter.<br /> <strong>Material and methods: </strong>We are using the questionnaire test method to assess the knowledge and measure the attitude and practice of those pharmacists in marks and degrees.<br /> <strong>Results: </strong>the pharmacists working in community pharmacies lack the knowledge of the legality of DAwD, though they know the greatly bad influence of it over the resistivity in bacteria and viruses. That of course goes along with the knowledge degree of the patients themselves<br /> <strong>Conclusion: </strong>We have come to a conclusion that most of the pharmacists had no prior knowledge of the illegality of dispensing antibiotics without prescription "DAwP". And of course, we recommend to enhance the awareness and knowledge of them by raising educational training programs.<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Knowledge, Attitude and Practice of Pharmacists123812411069810.12816/0044557ENMesfer Safar AlmalkiSecurity Forces Hospital of MakkahAttiah Abdullrhman KhobraniSecurity Forces Hospital of MakkahFakhir Thamir AlotaibiSecurity Forces Hospital of MakkahHassan Abdullah AljabriAlnahdi Medical GroupJournal Article20180810<strong>Background:</strong> Dietary supplement "DS" products are sold in the pharmacies very widely. However, there is no specific approval or definition to the legal and scientific usage of such products. <strong> </strong><br /> <strong>Objectives: </strong>We aim in this study to show the level of knowledge of pharmacists concerning the non-scientifically medically prescribed medication and formulas which is known as "Complementary and alternative medicines". Also, there is a variety of pharmacist’s attitude concerning such treatment methods we need to evaluate and prove.<br /> <strong>Material and methods: </strong>Questionnaire form to assess the knowledge and measure the attitude and practice of those pharmacists by direct meeting for the larger pharmacies and postal distribution for the lesser pharmacies.<br /> <strong>Results: </strong>Based upon our study in hand, we affirm that there are several elements contributing in forming the general attitude and practice of pharmacists in treating with Dietary supplements.<br /> <strong>Conclusion: </strong>knowledge of pharmacists of Dietary supplement (DS) products depends on both educational and environmental factors which form the knowledge base for them while dealing with customers and patients<br /> <strong> </strong>Pan Arab League of Continuous Medical EducationThe Egyptian Journal of Hospital Medicine1687-200270720180101Assessment of Knowledge, Awareness, and Behavior of Folic Acid124212471069910.12816/0044558ENSamr Abdullah AlblowiObstetrics & Gynecology department, King Fahad Specialist Hospital, Tabuk/Saudi ArabiaMona Hameed AlomayriObstetrics & Gynecology department, King Fahad Specialist Hospital, Tabuk/Saudi ArabiaJournal Article20180810<strong>Background:</strong> A balanced diet is very important for pregnant women, which consists of proteins, carbohydrates, vitamins, minerals and fats. Supplements do not replace a healthy diet but rather ensure that a woman is taking enough daily nutrients.Folic acid (FA) is a B vitamin, which is found in different foods but can be best got through a multi-vitamin. Things such as leafy green vegetables, fortified cereals, orange juice and strawberries are just some of many foods that contain folic acid.Congenital anomalies affect an evaluated 3% of newborns worldwide. Nearly 50 years ago, it was found that the B-vitamin folic acid play a role in improving normal embryonic development. This study done to investigate the level of awareness among female college students on the importance of preconception folic acid supplementation in preventing neural tube defects (NTDs). <br /> <strong>Methods: </strong>We have conducted a descriptive cross-sectional study in Tabuk city population, Saudi Arabia. A self-administered questionnaire requires information about Knowledge, awareness, perception of Folic Acid importance and use among females during the childbearing period, has been filled by participants.<br /> <strong>Results: </strong>In this study, there was a significant relation between age and if ever heard about folic acid (p<0.001), and for work and if ever heard about folic acid (p<0.001). Those who heard about folic acid were ninety four, and the majority of them aged from eighteen to thirty years (65.9%). Among those who heard about folic acid, the majority were university graduated (73.4%).<br /> <strong>Conclusion: </strong>We need to apply more efforts to increase the knowledge and emphasize on the importance of the use of folic acid among females in Tabuk city.<br />