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Pancreatic rest - an unusual cause of dyspepsia: A case report with literature review
Ibrahim Masoodi, Abed Al-Lehibi, Khalid Almohaimeed, Shabnum Hussain
September-December 2016, 4(3):225-228
DOI:10.4103/1658-631X.188261  PMID:30787736
Ectopic pancreatic tissue, also known as a pancreatic rest, is an uncommon congenital anomaly defined as extrapancreatic tissue located far from the pancreas and without any connection via vascular or anatomical means. The pancreatic rests are usually asymptomatic, but a variety of clinical symptoms have been described in the literature. This report describes the clinical scenario of severe dyspeptic symptoms of eight weeks duration in a young female. She underwent upper gastroscopic examination, which revealed a nodular lesion in the antral portion of the stomach. After partial gastrectomy and proton pump inhibitors of 1-month duration her symptoms improved. The histological specimen revealed the presence of pancreatic rest and no evidence of malignancy was noted. The patient is symptom-free and has been followed up in our clinic for the last 18 months.
  16,401 398 1
Myalgic encephalomyelitis/chronic fatigue syndrome: Review of history, clinical features, and controversies
Nigel Speight
January-June 2013, 1(1):11-13
Myalgic encephalomyelits/chronic fatigue syndrome (ME/CFS) has been both a medical mystery and a source of controversy in Western medicine for over 50 years. This article reviews the major historical developments over this period, describes the clinical pattern and spectrum of severity, and then explores the current major controversies surrounding the subject.
  15,516 1,016 1
Complications of Circumcision
Nisar A Bhat, Hamid Raashid, Kumar A Rashid
May-August 2014, 2(2):86-89
Objective: Circumcision is one of the most frequently performed elective procedures in male. In general, post circumcision complications are minor and treatable but complications requiring expert intervention are seen when the circumcision is perrformed by inexperienced/untrained person and in non-sterile setting and inadequate equipments. Materials and Methods: From March 2008 to May 2012, 59 patients with circumcision related complications were received at age range of 6 months to 5 years with a mean age of 2.4 years. The most common complication was urethra-cutaneous fistulae in 18 patients, followed by meatal stenosis in 9, bleeding in 6, incomplete circumcision in 6, buried penis in 5, glanular injury in 4, skin bridge in 4, complete amputation of phallus 3, hole in the prepuce in 3 patients and one patient with coronal constriction and fistula. Results: Urethral fistulae were closed in all 18 patients with recurrence in 16%. Two patients with extensive bleeding required blood transfusion and all 6 children required hematoma evacuation under general anesthesia in the operating room. The circumcision was revised in those with an incomplete procedure, a hole in prepuce, burried penis and residual skin bridge. Meatotomy was the procedure of choice in 6 of 9 patients with meatal stenosis, but in the remainder meatal dilatation was efffective. Glanular injuries were managed conservatively. A short residual after glanular injury needed grafting. Conclusion: Circumcision is considered a simple and minor surgical procedure, yet it needs to be performed competently by only medically qualified and trained personnel and with a great care.
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Social media in healthcare: Uses, risks, and barriers
Abdul R Alsughayr
May-August 2015, 3(2):105-111
Establishing a social media presence has never been more important for the healthcare industry. With patients going online to discuss their health and research their conditions, it is essential for healthcare professionals and organizations to maintain a social web presence and have a voice in these conversations. Though there are many potential benefits for social media in healthcare, there are also risks to be taken into consideration when planning to engage in these relatively new forms of media. Privacy and security are top consumer concerns on sharing health information. Social media is about dialogue, interactivity, spontaneity, people, and technology. One of the goals of social media is to help patients become better informed, equipped to participate in their care, and be able to partner with their healthcare providers to develop plans of care that meet their individual needs. This review will present important social media elements and discuss their barriers and risks.
  13,218 942 2
Study of environmental noise pollution in the university of dammam campus
Mahmoud F El-Sharkawy, Ali Alsubaie
December 2014, 2(3):178-184
Context: Noise pollution has been well-recognized as one of the major trepidations that can adversely affect public health and quality-of-life in urban areas across the globe. Community noise, or environmental noise, includes the primary sources of road, rail and air traffic, industries, and public works. Aims: The main aim of this study is to assess the noise level inside the University of Dammam (UD) campus. Settings and Design: Three different locations were selected for measuring noise levels during this study; outside walls, the internal streets, and inside several buildings of the UD campus. Materials and Methods: Levels of the environmental noise pollution were measured at three different periods of the academic year 2011-2012; during study days, final exams and the holiday periods. Statistical Analysis Used: Results of this research were statistically analyzed by the Statistical Package for the Social Sciences SPSS program. Results: Levels of noise outside walls of the UD campus were higher than those inside the campus walls at all periods. Inside the UD campus, levels of noise were the highest at locations that are characterized by the high traffic movement. In addition, the highest level of noise was recorded during the studying period, while the lowest level was obtained during the holiday period. Levels of the indoor noise inside buildings of the campus were nearly the same or very slightly higher than those of the outdoor levels which indicate that the effect of human activity inside university buildings on noise pollution can be neglected comparing with the outdoor sources. Conclusion: Both levels of noise inside and outside buildings were higher than their guideline values. These high noise levels require effective environmental control strategies and increasing awareness between all staff members inside universities camps.
  13,013 715 1
Prevalence, severity, and secular trends of dental caries among various saudi populations: A literature review
Asim A Al-Ansari
December 2014, 2(3):142-150
The prevalence of dental caries is increasing across different nations around the globe. A review of the literature shows that dental caries is adversely affecting the oral health of children, adolescents, adults and elderly populations in Saudi Arabia. The objective of this review is to report the prevalence, severity, and progression of dental caries in different age groups of Saudi communities. Digital databases such as PubMed, Medline, Google scholar, and the Saudi Dental and Medical Journals were searched to retrieve the published articles and reports on dental caries in Saudi Arabia. Search strategy included key words such as "dental caries," dental decay, decayed missing filled teeth (dmft/DMFT), and oral health. Cross-sectional, retrospective and cohort studies (from 1982 to 2012) reporting the prevalence, incidence and severity of caries among children, adults and older individuals were included in the review. In children with primary dentition ages 3-7 years, the highest caries prevalence was almost 95% and maximum estimate of dmft was 7.34 during the last decade. Approximately, 91% was the highest caries prevalence and greatest DMFT value was 7.35 among the children/adolescents ages 12-19 years. The adults with a mean age between 30 and 45 years had maximum caries prevalence of 98% and DMFT of 14.53 while older individuals had greatest DMFT score of 24.3. Children, adults, and elderly populations demonstrate a higher prevalence and greater severity of caries, and secular trends also show a striking increase in dmft/DMFT and caries prevalence rates over the past few decades in Saudi Arabia.
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Public health in the saudi health system: A search for new guardian
Waleed A Milaat
May-August 2014, 2(2):77-80
Saudi Arabia has witnessed a significant improvement in its health indicators. The kingdom has spent generously on the curative health services and established hundreds of hospitals and primary health care centers. However, we believe that this huge health expenditures and the presence of curative services is not the only reason for this improvement. Public health services have also had a significant impact on people's health and that this improvement is due to a combination of public health programs such as immunization, environmental sanitation and health education with good formulation of sound health policies and health delivery systems. It is noted that health plans and expenditure in the health system are concentrating on the curative aspects and there is a significant weaknesses in public health services. Additionally, most jobs are allocated for curative care and there is scarcity of job titles related to public health in the health structure, such as public health officers, public health inspectors and public health specialists. A suggested body namely, Ministry of public health, will work to confirm that all issues related to health of the public in every aspect of daily life in the kingdom are within the genuine interest of all policy makers.
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A review on the hypoglycemic effect of nigella sativa and thymoquinone
Abdullah O Bamosa
January-April 2015, 3(1):2-7
Nigella sativa (black seeds) is a very famous and popular herb used for centuries in many communities. N. sativa has been shown to possess therapeutic potential to many illnesses. Hypoglycemic effect of N. sativa has been studied extensively in the literature. This review gathered and analyzed the results reported in the literature related to the hypoglycemic effect of N. sativa. A search was done for N. sativa and black seeds as key words in PubMed and Google scholar databases. Published studies document a hypoglycemic effect of N. sativa in normal and diabetic animals and humans. Volatile oil and thymoquinone seem to be the most effective fractions of the seed in producing its hypoglycemic effect. The mechanism of N. sativa hypoglycemic effect is multifactorial including increasing insulin level, decreasing insulin resistance, stimulating β cells activity, direct insulin-like effect, and decreasing intestinal glucose absorption. Further, basic followed by clinical research to explore N. sativa ingredient responsible for its promising hypoglycemic effect is recommended.
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Molecular classification of breast cancer: An overview with emphasis on ethnic variations and future perspectives
Mohamed A Shawarby, Dalal M Al-Tamimi, Ayesha Ahmed
January-June 2013, 1(1):14-19
Morphologically identical breast cancers can display divergent clinical outcomes and responses to therapy. This can predominantly be attributed to molecular class differences that exist amongst histologically similar cancer types. Consequently, molecular classification can be more powerful than histopathology as a predictive factor for the different treatments. This article reviews the molecular classification of breast cancer and emphasizes that ethnic variations may exist in molecular class prevalence patterns. It also highlights key insights into the currently defined molecular classes as provided by ongoing research on primary breast cancers using recent state-of-the-art technology. Such research is revealing that significant molecular heterogeneity may exist within the molecular classes themselves. More diverse ethnic variations may also be unraveled. The results of ongoing and upcoming research may provide more precise prognostic and predictive information about breast cancer and perhaps a breakthrough step toward "personaliziation" of breast cancer treatment. Forty-one relevant articles (2000-2012) extracted through PubMed and Google advanced searches and at our institute's library were utilized to prepare the article, along with results of published and ongoing research by the authors.
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Factors associated with diabetic septic foot among patients attending the diabetic septic foot unit in the military hospital, Khartoum State, Sudan
Siham A Balla, Haidr A Ahmed, Suzan F Alhassan
July-December 2013, 1(2):98-102
Context: Diabetic septic foot (DSF) is a serious outcome complication of diabetes mellitus. Patients having DSF are at a high risk of amputations and surgical hazards. Aim: The aim of this study was to identify the self-care of foot and factors associated with DSF among diabetic patients attending the DSF unit in the Military Hospital. Materials and Methods: A case-control study was conducted among diabetic patients attending the diabetic clinic in the Military Hospital during May-June 2012. Thirty DSF cases and 30 controls were interviewed using a structured questionnaire and DSF was observed and graded by Wagner's classification. Statistical Analysis: Descriptive statistics of the cases was presented and Fisher's exact test was used to test the risk factors associated with DSF. Results: The mean age for the study groups was 55.60 ΁ 11.9 years. Based on the Wagner classification, 83.3% of septic feet were classified as grades 3, 4 and 5. Considering the delay in presentation with DSF to the hospital, 86.7% presented after 1 week up to more than 2 months from the start of the lesion. Low socioeconomic status, lack of self-care of foot, peripheral neuropathy and foot ischemia and deformity were associated with developing DSF (P-value < 0.05). Conclusion: Most patients with DSF seek care late and present with advance grade lesions. Lack of self-care of foot, peripheral neuropathy and foot ischemia and deformity are the risk factors of DSF.
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The uses of melatonin in anesthesia and surgery
Hany A Mowafi, Salah A Ismail
December 2014, 2(3):134-141
Melatonin is a hormone secreted by the pineal gland. It is available as a dietary supplement, taken primarily for the relief of insomnia. Increasing evidence from human and animal studies suggests that melatonin may be efficacious as a preoperative anxiolytic, a postoperative analgesic, and a preventative for postoperative delirium. It has also been reported to decrease intraocular pressure. Melatonin's high efficacy, wide safety profile in terms of dose, and virtual lack of toxicity make it of interest in anesthetic and surgical practice. This review examines clinical trial data describing the efficacy and safety of melatonin in the perioperative anesthetic and surgical settings. We shall, also, focus attention on animal and human experimental studies that concern these issues.
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Insulin lipohypertrophy: A non-fatal dermatological complication of diabetes mellitus reflecting poor glycemic control
Ishrat H Dar, Showkat H Dar, Sumayya Wani
July-December 2013, 1(2):106-108
Lipohypertrophy has been a recognized complication of insulin therapy. Despite improvements in insulin purity and the introduction of recombinant human insulin, its prevalence has remained high particularly in those with a poor glycemic control. Injection of insulin into a site of lipohypertrophy, although painless, may lead to erratic absorption of insulin, with the potential for poor glycemic control and unpredictable hypoglycemia. Rotation of injection sites can reduce the frequency of the problem but does not abolish it. The importance of this complication is not only cosmetic but also in its impact on insulin absorption, and hence glycemic control. Lipohypertrophy is characterized by a benign "tumor-like" swelling of fatty tissue secondary to subcutaneous insulin injections. A strong association of lipoatrophy and lipohypertrophy with insulin antibodies might suggest that autoimmune phenomena with insulin play a role in the development of both. Presented here is a young type 1 diabetic on human insulin with poor glycemic control who developed lipohypertrophy at the injection sites around the umbilicus.
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Prognostic and predictive markers for oral squamous cell carcinoma: The importance of clinical, pathological and molecular markers
Saman Warnakulasuriya
January-April 2014, 2(1):12-16
The overall 5-year survival rate following treatment for oral squamous cell carcinoma is around 50% in most published series. The major prognostic factors are stage at the time of diagnosis, unexpected close margins at resection, depth and pattern of tissue invasion by carcinoma and extracapsular spread. Grading by gross histological differentiation does not influence prognosis, unless deeply invasive margins are evaluated by the pathologist. Because stage at diagnosis is the most important factor affecting outcome, early detection results in better prognosis in most cases.
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Cutaneous leishmaniasis in Al-Ahsa Oasis in Saudi Arabia and in Sudan: A comparative study
Ahmed M El Hassan
July-December 2013, 1(2):64-71
This is a comparative study of cutaneous leishmaniasis (CL) in the Eastern Province of the Kingdom of Saudi Arabia and Sudan. The disease in both countries is caused by Leishmania major of different syndromes and the vector is Phlebotomus papatasi. The animal reservoir host in Saudi Arabia is Psammomys obesus and the Nile rat in Sudan. The clinical manifestations are similar, but some forms encountered in Sudan were not seen in Saudi Arabia. The pathology, immunology, diagnosis and treatment of CL are discussed.
  6,076 2,525 1
To treat or not to treat asymptomatic hyperuricemia
Hamid Mustafa
May-August 2014, 2(2):95-100
Background: Hyperuricemia is a term given to serum uric acid levels higher than 7.0 mg/dL; asymptomatic hyperuricemia may precede gouty attacks with several years. This progression is variable from a person-to-person and may not even develop. Owing to this, there is a great controversy in whether to treat asymptomatic hyperuricemia or not. Objective: The objective of the following study is to determine the treatment habits of asymptomatic hyperuricemia in Makkah Region, Kingdom of Saudi Arabia. Materials and Methods: This survey was carried out using a structured questionnaire that was answered through face-to-face interviews with 104 physicians who diagnose and treat hyperuricemia. The data was collected on the second half of 2012. The specialties included in the study were general practitioners, family physicians, orthopedicians and rheumatologists. Results: Half of the doctors in our study (50.9%) chose to observe and follow asymptomatic hyperuricemic patients and 84% depend on the serum uric acid levels to help them decide when to start their treatment, 53% asked about co-morbid diseases as renal stones, diabetes mellitus and ischemic heart disease whereas 49% asked about family history. When doctors are to start the treatment, 84.1% will start with allopurinol and 42.5% will advise on the change of dietary and life-style habits. Conclusions: The results showed that the doctors in Makkah Region depend on the serum uric acid levels to decide when to start the treatment, not abiding by the international guidelines. They still chose the life-style and dietary modification, as well as starting treatment with allopurinol with a starting dose of 100 mg/dL daily.
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Urine Albumin/creatinine ratio: A reliable marker of renal injury in sickle cell nephropathy
Ibrahiem S Abdul-Rahman
January-April 2014, 2(1):17-23
Objective: Albumin/creatinine ratio is a sensitive marker of glomerular damage in patients with diabetes mellitus, hypertension and post-infection glomerulonephritis. Whether or not the albumin/creatinine ratio has the same value in sickle cell anemia (SCA) patients is not yet explored. This study was conducted to determine the prevalence of glomerular damage in SCA and the clinical correlation between albumin/creatinine ratio and renal insufficiency in this group of patients. Materials and Methods: Seventy-nine adult patients with SCA (hemoglobin SS subtype) were included in this study. Albumin excretion rates (expressed as albumin/creatinine ratio) and renal function (creatinine clearance) were determined and clinical and hematologic evaluations were conducted. Results: Increased albumin/creatinine ratio (micro- and macroalbuminuria) occurred in 57% of the patients. The development of graded albuminuria was time dependent; therefore, at the end of the study, 26.6% of the patients had macroalbuminuria. There were no differences in hemoglobin levels between patients with normoalbuminuria and those with micro- or macroalbuminuria. By multivariate analysis, albuminuria correlated with age and creatinine clearance (Cr Cl) but not with blood pressure (BP) or hemoglobin levels. Conclusion: Albumin/creatinine ratio is a sensitive marker of glomerular damage in SCA patients, and it correlated well with Cr Cl; therefore, patients with abnormal albumin/creatinine ratio should be monitored closely for progression of renal disease. The development of micro- and macroalbuminuria is related to age but not to the degree of anemia, suggesting that sickle cell glomerulopathy is not solely related to hemodynamic adaptations to chronic anemia.
  6,416 508 -
Nurses' attitude towards patients with mental illness in a general hospital in Kuwait
Anwar Al-Awadhi, Farid Atawneh, M. Ziad Y Alalyan, Altaf Ahmad Shahid, Sulaiman Al-Alkhadhari, Muhammad Ajmal Zahid
January-April 2017, 5(1):31-37
DOI:10.4103/1658-631X.194249  PMID:30787749
Introduction: Stigma and discrimination have been reported to cause unnecessary delay in mentally-ill patients seeking help, which adversely affects a patient's outcome. The attitude of health care professionals has been described as being, even more, negative than that of the general public, which worsens the prognosis for patients with a mental illness. Aims: The aim of this study was to describe the attitude of nurses toward mentally-ill patients in a general hospital. Methods: All the nurses in the hospital were administered a 40-item Community Attitudes Toward the Mentally-Ill (CAMI) questionnaire which determines whether the mentally-ill are viewed as “inferior;” deserve “sympathy;” perceived as a “threat” to society or “acceptable” if residing in community dwellings. The analysis of variance was performed to determine association of the four subscales with the individual characteristics, including age, gender, education, qualification type, position held, contact and contact type. Results: Out of a total of 990 nurses, 308 (31%) completed the CAMI questionnaire. The mean scores for the authoritarian (2.85), benevolent (3.66), social restrictiveness (2.97) and community mental health ideology (3.48) subscales reflected a negative attitude of nurses toward mentally-ill patients. The direct or indirect utilization of the mental health facilities resulted in significantly higher authoritarian and lower benevolence scores, indicating a positive attitude change in this group of nurses. Conclusion: Despite the small size and selective nature of the sample, the nurses' negative attitude toward the mentally-ill patients provides useful baseline data for further large-scale studies and underscores the need for psychoeducation of different health care professionals, including nurses.
  6,130 635 2
A concise history of genome-wide association studies
Bobby P. C. Koeleman, Amein Al-Ali, Sander W van der Laan, Folkert W Asselbergs
January-June 2013, 1(1):4-10
Genome-wide association studies (GWASs) have had a tremendous impact on the pace of genomic research of common diseases. The number of identified genetic variants associated has grown exponentially. For some diseases, such as coronary heart disease (CHD), the number of known susceptibility genes has grown from a handful to more than 45. A substantial number of genes point to unexpected mechanism involved, and functional data from the "Encyclopedia of Deoxyribonucleic Acid Elements" (ENCODE) project is helpful in uncovering the functional relevance to diseases. The rapidly evolving techniques have made the shift from family-based linkage studies to GWASs possible. Advanced single nucleotide polymorphism (SNP) arrays containing hundreds of thousands of variants efficiently assess the extent of genome-wide disease-associated genetic variation. Along with SNP arrays came breakthroughs in statistical analyses and study designs leading to the exponential growth of the GWAS catalog. Pathway analyses of GWASs results with manually curated software programs have been insightful. Next-generation sequencing (NGS) of the exome or even the whole genome will undoubtedly shift the balance in focus from common variants to more rare variations impacting common diseases. Moreover, the combined power of GWASs, sequencing, pathway analysis, and functional data to study common disease shall only be limited by our ability to comprehend.
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Stress and job satisfaction among pharmacists in Riyadh, Saudi Arabia
Amal K Suleiman
September-December 2015, 3(3):213-219
Objective: The aim of the study was to measure job satisfaction and stress levels among pharmacists in Riyadh, Saudi Arabia, and to explore the main causes of dissatisfaction and stress-related factors. Materials and Methods: A self-administered survey was hand-distributed using a cluster area sampling technique. Data were entered into a statistical analysis system database with a significance level of P < 0.05, using Chi-square, descriptive statistics, and regression analysis. Results: The setting of a pharmacy was found to significantly affect the job satisfaction of pharmacists. 48% of independent community pharmacists were satisfied with their job compared with 62% of dispensary pharmacists and 74% of chain community pharmacists. Marital status and years of experience significantly affected job satisfaction, and married pharmacists had lower levels of satisfaction than their unmarried counterparts. Pharmacists who dispensed a higher number of prescriptions had higher levels of satisfaction. Furthermore, job-related stress factors, such as the setting of the pharmacy and years of experience, had a significant effect on the stress level related to the responsibility of patient care. Participants also reported other job stressors: Long working hours, difficulty in obtaining casual or sick leave, and low salaries. Conclusion: Independent community pharmacists in Riyadh had lower levels of job satisfaction than their counterparts in dispensaries and chain pharmacies. Primarily, efforts should be made to raise the levels of job satisfaction for pharmacists in order to improve their motivation and competence. Failure to reduce stress among workers puts both pharmacists and patients at risk.
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The impact of valsalva's versus spontaneous pushing techniques during second stage of labor on postpartum maternal fatigue and neonatal outcome
Yasmeen A Haseeb, Anwar N Alkunaizi, Haifa Al Turki, Fathia Aljama, Soheir I Sobhy
May-August 2014, 2(2):101-105
Objectives: The objective of the following study is to find out the effects of two different pushing techniques in the second stage of labor on postpartum maternal fatigue and APGAR score of neonates in Saudi females, as very few such studies are available in these patients. Hence this study was carried out in this population to see the results and to do a comparison with other studies in literature as well as to find out how we can make labor awareness in our females. Design: Quasi experimental study. Settings: It was carried out in two hospitals in the eastern province of Saudi Arabia from 1 January, 2011 up to 31 December, 2011. One hundred Saudi women who fulfilled criterion were included in the study. They were randomized and the results seen. Results: There was a significant difference in postpartum fatigue within 60 min and 24 h in two groups as P = 0.001, P < 0.001 respectively. There was a significant difference of APGAR score of newborn in both groups, i.e., P < 0.001. Conclusion: It is concluded that physiological pushing technique has a better outcome with regard to postpartum maternal fatigue and neonatal APGAR score when compared to directed pushing during the second stage of labor.
  5,984 599 3
Gastroesophageal reflux disease in children: A 2013 update
Mohammad I El Mouzan
July-December 2013, 1(2):72-81
Gastroesophageal reflux (GER) refers to the passage of gastric contents (acid, pepsin, etc) in the esophagus. It is a worldwide physiologic condition most common in infants. This physiologic condition (GER) should be differentiated from the pathologic reflux called gastroesophageal reflux disease (GERD). The distinction between GER and GERD is based on severity of the reflux episodes. [1],[2] The most common mechanism of reflux is transient lower esophageal sphincter relaxation (TLESR) and less commonly low resting LES pressure. [3] GER presents with regurgitation and occasional vomiting only without effects on growth and development whereas GERD usually has additional presentations. The objective of this review is to provide update on recent developments in the diagnosis and management of this condition.
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Presentation of conjunctival amyloidosis as bilateral ptosis and cicatricial entropion
Kumar Sambhav, Vipul Bhandari, H Ajith
January-June 2013, 1(1):48-50
Primary localized amyloidosis of the conjunctiva is a rare occurrence. This case report describes a 35-year-old male, who presented with drooping of both upper eyelids and a pricking sensation in the left eye. Examination of the conjunctiva showed granular swellings. The biopsy revealed amyloid deposition. Systemic amyloidosis was ruled out on further investigation. To our knowledge, this is the first report of amyloidosis of the conjunctiva and tarsus, presenting as ptosis with entropion, from India.
  5,870 344 -
Melioidosis: Spectrum of radiological manifestations
Hind S Alsaif, Sudhakar K Venkatesh
May-August 2016, 4(2):74-78
DOI:10.4103/1658-631X.178286  PMID:30787702
Melioidosis, a bacterial infection caused by Burkholderia pseudomallei is expanding in its endemicity around the world. Melioidosis most commonly infects adults with an underlying predisposing condition, mainly diabetes mellitus. Primary skin and soft tissue involvement is more common in younger patients. Almost every organ can be affected, but the most commonly affected organ is the lung followed by the spleen. Melioidosis has a wide range of radiological manifestations making it a mimicker. Diagnosis requires a high index of clinical suspicion in patients with septicemia or a fever of unknown origin living in or with a travel history to endemic areas. We present a pictorial review of the radiological manifestations of melioidosis, which is a useful knowledge for radiologists to help arrive at an early diagnosis. In this pictorial review, we present the radiological manifestations chosen from 139 patients with culture proven melioidosis. Illustrated examples are chosen from our clinical experience of the past 15 years at the National University Hospital in Singapore.
  5,502 629 3
Mandibular implant-supported overdentures: Prosthetic overview
Fahad A Al-Harbi
January-April 2018, 6(1):2-7
DOI:10.4103/sjmms.sjmms_101_17  PMID:30787808
Implant-supported overdentures are becoming the treatment of choice for the completely edentulous mandible. They significantly improve the quality of life in edentulous patients. For this review article, the literature was searched to identify pertinent studies. No meta-analysis was conducted because of high heterogeneity within the literature. Accordingly, in this review article, the author provides an update on implant-supported mandible overdentures with regard to the number of implants, type of loading, stress–strain distribution, mode of implant-to-denture attachment, occlusal considerations and complications.
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Abdulaziz A Al-Quorain
December 2014, 2(3):133-133
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