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REVIEW ARTICLES
Myalgic encephalomyelitis/chronic fatigue syndrome: Review of history, clinical features, and controversies
Nigel Speight
January-June 2013, 1(1):11-13
DOI:10.4103/1658-631X.112905  
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.
  12,313 696 1
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
DOI:10.4103/1658-631X.112908  
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.
  5,757 1,018 -
ORIGINAL ARTICLES
Complications of Circumcision
Nisar A Bhat, Hamid Raashid, Kumar A Rashid
May-August 2014, 2(2):86-89
DOI:10.4103/1658-631X.136990  
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.
  5,466 318 -
REVIEW ARTICLES
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
DOI:10.4103/1658-631X.142496  
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.
  4,866 627 1
INVITED ARTICLE
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
DOI:10.4103/1658-631X.128400  
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.
  4,137 1,066 2
CASE REPORTS
Presentation of conjunctival amyloidosis as bilateral ptosis and cicatricial entropion
Kumar Sambhav, Vipul Bhandari, H Ajith
January-June 2013, 1(1):48-50
DOI:10.4103/1658-631X.112934  
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.
  4,258 203 -
REVIEW ARTICLES
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
DOI:10.4103/1658-631X.112902  
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.
  3,767 561 -
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.
  3,469 532 -
IN FOCUS
Global plan for the decade of action for road safety: Expectations from developing nations
Saurabh R Shrivastava, Prateek S Shrivastava, Jegadeesh Ramasamy
January-April 2014, 2(1):57-58
DOI:10.4103/1658-631X.128456  
Globally, 1.24 million people die every year because of road traffic accidents (RTAs) and almost 20-50 million people sustain non-fatal injuries. Realizing the magnitude and the global distribution of the problem, the current decade 2011-2020 has been proclaimed as the Decade of Action for road safety, with a target of first stabilizing and then decreasing the estimated magnitude of morbidity and mortality by intensifying the global efforts on national and international platform. The primary step is to develop a surveillance network for data collection to identify the causative factors and estimate the accurate magnitude of RTA so that rational policy can be planned for achieving the best possible allocation of limited resources, especially in developing countries. Other measures such as creating public awareness; strict enforcement of road safety legislations; establishing prompt and good quality post-crash response; and establishing monitoring and evaluation system to assess the outcome of implemented measures can be strategically implemented to counter the burden of road traffic accidents.
  3,438 539 -
ORIGINAL ARTICLES
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
DOI:10.4103/1658-631X.123658  
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.
  3,645 324 -
CASE REPORTS
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
DOI:10.4103/1658-631X.123646  
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.
  3,346 492 1
Appendiceal Endometriosis
Ayman A Al-Talib
July-December 2013, 1(2):103-105
DOI:10.4103/1658-631X.123645  
Although appendiceal endometriosis is rare, appendix is the second most common site of intestinal endometriosis. Clinical diagnosis is difficult and histopathology is the only way to establish the diagnosis. We present a case of chronic pelvic pain secondary to appendiceal endometriosis and a review of the literature. There are no pathognomonic criteria to establish an accurate preoperative diagnosis. There is no specific radiologic test for diagnose. Laparoscopy provides detailed evaluation of the appendix but gross inspection of appendix alone is not enough to rule out the problem. The appendix may harbor endometriosis and could be a cause of chronic pelvic pain. When performing surgeries in a patient with chronic pelvic pain, surgeons should be aware of the possible contribution of the problem pelvic pain in patients with endometriosis. The appendix should be examined thoroughly during endometriosis-related operations. Appendectomy should be performed if the appendix looks abnormal.
  3,557 171 -
REVIEW ARTICLES
Gastroesophageal reflux disease in children: A 2013 update
Mohammad I El Mouzan
July-December 2013, 1(2):72-81
DOI:10.4103/1658-631X.123644  
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.
  3,338 312 -
INVITED ARTICLE
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
DOI:10.4103/1658-631X.123642  
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.
  3,211 344 -
ORIGINAL ARTICLES
To treat or not to treat asymptomatic hyperuricemia
Hamid Mustafa
May-August 2014, 2(2):95-100
DOI:10.4103/1658-631X.136996  
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.
  3,032 316 -
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
DOI:10.4103/1658-631X.128403  
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.
  2,996 295 -
The continuous glucose monitoring system (CGMS) in patients with beta-thalassemia major
Waleed I Albaker, Abdullah A Yousef, Ammar H Khamis, Abdulmohsin F Aldilaijan, Nouf K AlMaghlouth
July-December 2013, 1(2):88-93
DOI:10.4103/1658-631X.123654  
Background: Blood transfusion-dependent beta Thalassemia Major (BTM) patients are at risk of hemosiderosis. Hemosiderosis of pancreas results in impaired glucose homeostasis tolerance and diabetes mellitus (DM). Since glycosylated hemoglobin has limited role in patients with hemoglobinopathies, this study was conducted as a first attempt worldwide to understand glucose homeostasis and evaluate efficacy of Continuous Glucose Monitoring (CGM) system as a diagnostic tool of abnormal glucose homeostasis in these patients. Materials and Methods: A case series study of six non-diabetic, transfusion-dependent beta-thalassemia patients aged 9-13-year-old. Clinical and laboratory data were collected on admission for their monthly transfusion. Patients were connected to CGM systems for one day. Findings: Using CGM and based on American Diabetes Association guidelines, three patients were found to have abnormal glucose levels of diabetic range. The other three showed impaired glucose tolerance. Among all patients, glycosylated hemoglobin (HbA1C) readings have an inverse relationship to CGM and calibration readings. Conclusion: CGM could be a promising tool for evaluating BTM patients. Larger studies are recommended.
  3,017 228 1
Effect of time on electronic working length determination with a novel endodontic module in preclinical endodontic training
Emad O AlShwaimi, Udaya B Narayanaraopeta
January-April 2014, 2(1):37-42
DOI:10.4103/1658-631X.128451  
Aim: To evaluate electrical conductivity of the medium provided with ModuPRO endodontic modules, and compare it with those of alginate and vinyl polysiloxane impression materials over varying time intervals. Materials and Methods: A 24 Real Endo-t teeth were mounted in the ModuPRO Endo™ modules using three different mounting media [Groups A (Apex Putty), B (alginate), C (extra-light body vinyl polysiloxane)]. The working lengths were predetermined by microscopy, and the root canals were prepared with ProFile rotary instruments before mounting. Working lengths were checked with an electronic apex locator at 24 and 48 hours; 1, 4, and 6 weeks; and 6 months. Data were analyzed using one-way analysis of variance (ANOVA), the Tukey-Kramer multiple comparison tests, and the Wilcoxon Signed Rank Sum test, with significance set at P < 0.05. Results: Group C showed higher measurements and significant differences from groups A and B for up to 6 weeks (P < 0.05). There was no difference between groups A and B (P > 0.05). After 6 months, all groups showed significantly higher working lengths from those predetermined, but no statistically significant differences were observed among them (P > 0.05). For all groups, differences from predetermined working lengths were lowest at the 1-week interval. Conclusions: Both alginate and the Apex Putty can be used for determining the working lengths using an apex locator over a longer time period. Our study has shown that ModuPRO Endo™ modules, along with the Apex Putty, are effective tools for teaching working length determination with apex locators in preclinical endodontic training.
  3,019 208 1
REVIEW ARTICLES
Variceal bleeding: Current issues
Ibrahim A Al Mofleh
January-April 2014, 2(1):3-11
DOI:10.4103/1658-631X.128397  
Portal hypertension (PHT) is a serious sequel of liver cirrhosis. Eventually, varices develop, grow in size, and bleed. Several diagnostic modalities including transient elastography (TE), capsule endoscopy, CT scanning, and platelets count/spleen diameter ratio (PSR) have recently been introduced. Predictors of bleeding include large varices, red signs, severe liver disease, and hepatic venous pressure gradient (HVPG)12 mmHg. Oral nonselective (NSBB) are recommended for primary prophylaxis in patients with medium-to-large size esophageal varices (EV) that have not bled. Patients with acute variceal bleeding (AVB) should be resuscitated and managed in an intensive care unit. Vasoactive drugs should be started immediately aimed at a better control of bleeding and facilitation of a subsequent endoscopy. Terlipressin controls bleeding and mortality and is considered as the drug of choice. Antibiotic prophylaxis significantly improves survival compared with placebo. Early diagnostic and therapeutic endoscopy in patients with major bleeding enhances control of bleeding, reduces risks of rebleeding and mortality. The use of erythromycin prior to endoscopy clears the stomach, reduces the need for second endoscopy and blood transfusion, and shortens the length of hospital stay. Restricted transfusion strategy prevents portal pressure rise and improves the survival rate. The current recommendation is to treat AVB with a combination of vasoactive agent, EVL, and antibiotics. All patients who survive an episode of AVB should undergo secondary prophylaxis. Transjugular intrahepatic portosystemic shunt (TIPS) using covered stent represents the first-choice rescue treatment. Early TIPS insertion significantly reduces treatment failure, rebleeding, and mortality. Also, insertion of esophageal SX-Ella Danis stent in patients with refractory VB effectively controls bleeding. The data required for this review were obtained mainly through PubMed and Google search.
  2,686 272 -
CASE REPORTS
Unusual presentation of kimura's disease
Amol W Diwan, Gauri P Godbole, Himanshu S Pophale, Suhas R Kulkarni
January-April 2014, 2(1):52-56
DOI:10.4103/1658-631X.128455  
Kimura's disease is a rare form of chronic eosinophilic inflammatory disorder with associated lymphadenopathy in head and neck region and serous cavity effusions and marked predilection for the head and neck with a tendency to present as a discrete, enlarging mass. Although many cases of Kimura's disease with head and neck lymphadenopathy and nephrotic syndrome have been described in the literature, only two cases of Kimura's disease presenting with pleural effusion have been reported recently. There are no reports of Kimura's disease with ascites. We report the case of a 38-year-old nondiabetic, normotensive man who had undergone inguinal node biopsy consistent with Kimura's disease, 8 months before he presented to us. On admission, he had right moderate pleural effusion, but no ascites or any lymph nodal involvement. He developed recurrent pleural effusion and ascites in the ward. Initially he showed good remission with systemic steroids, but later on was refractory to further necessary treatment. He also rapidly developed signs of nephrotic syndrome. In spite of vigorous treatment, patient died of severe hypovolemia, hypoproteinemia, and nephropathy.
  2,638 161 -
ORIGINAL ARTICLES
Hormonal, metabolic and clinical profile of Saudi women with polycystic ovary syndrome
Abdulaziz A Al-Mulhim, Adel A Abul-Heija, Ayman A Al-Talib, Haifa A Al-Turki, Turki G Gasim
January-June 2013, 1(1):30-34
DOI:10.4103/1658-631X.112920  
Objective: To establish the hormonal, metabolic and clinical profile for Saudi women with polycystic ovary syndrome (PCOS). Design: This is a prospective, cross-sectional study conducted at the University Hospital. All women were seen at the gynecology clinic. One hundred women aged between 18 and 45 years were included in the study; 50 women with polycystic ovary disease (PCOS) comprised the study group and 50 women without PCOS comprised the control group. The hormonal, metabolic and clinical profiles were assessed for both groups. Results: There are significantly higher levels of luteinizing hormone, prolactin, free testosterone dehydroepianosterone sulfate, 17α-hydroxy progesterone and fasting insulin in the study group. There were no differences in the levels of total testosterone, estradiol and cortisone levels between both groups. The levels of follicular stimulating hormone and sex hormone binding globulin were significantly lower in the study group. There were no differences in the blood sugar level, cholesterol, triglycerides and low- and high-density lipoproteins. The womens' ages, body mass index, blood pressure, uterine dimensions and endometrial thickness were similar in both groups. The size of both ovaries was significantly greater in the study group. There were more follicles in the ovaries of the study group. Conclusion: Hormonal profile of Saudi women with PCOS was similar with what is already published in the medical literature. But, despite the fact that Saudi women with and without PCOS are overweight, they do not suffer from raised blood pressure and metabolic syndrome; this may be due to the fact that women included in this study were relatively young and the sample size might be too small to draw effective conclusions.
  2,418 374 -
REVIEW ARTICLES
The uses of melatonin in anesthesia and surgery
Hany A Mowafi, Salah A Ismail
December 2014, 2(3):134-141
DOI:10.4103/1658-631X.142495  
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.
  2,342 410 -
REVIEW ARTICLE
Social media in healthcare: Uses, risks, and barriers
Abdul R Alsughayr
May-August 2015, 3(2):105-111
DOI:10.4103/1658-631X.156405  
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.
  2,474 249 -
ORIGINAL ARTICLES
Physical and psychological aspects of low back pain among Saudi patients: A case-control study
Ali M Alshami
January-April 2014, 2(1):24-29
DOI:10.4103/1658-631X.128407  
Context: Low back pain (LBP) is a common public health problem, and has a multifactorial etiology that includes not only physical risk factors, but also psychosocial factors. There were several studies that investigated physical and psychosocial factors and their relationship with LBP. However, up to the researchers' knowledge, no studies have been conducted in Saudi Arabia. Aims: To investigate physical and psychological factors in Saudi population with LBP. Settings and Design: A case-control study using self-report measures. Materials and Methods: Arabic versions of the following self-report measures were applied: A 10-cm Visual Analogue Scale (VAS) to measure pain intensity; the International Physical Activity Questionnaire (IPAQ) to record average physical activity levels over the last 7 days; and Depression, Anxiety and Stress Scale (DASS) to measure the negative emotional states of depression, anxiety and stress. The above self-report measures were handed to the participants and were collected immediately. Thirty-one patients with LBP and thirty-one control participants matched in body mass index and age participated. Statistical analysis used: Independent t-tests and Pearson Correlation Analysis were used to calculate differences in VAS, IPAQ and DASS between the two groups. Results: Patients with LBP had moderate stress compared to control participants (19.8 and 4.4 respectively, P = 0.0013). Both groups did not present with anxiety or depression. No significant difference was found in any level of activity between the groups. Conclusions: Stress was present in this group of Saudi patients with LBP. Targeting psychological factors associated with LBP, not only physical factors may help improve the management of patients with LBP.
  2,380 279 -
CASE REPORTS
Management of adult intralobar pulmonary sequestration: A novel approach
Battal O Aldosary, Yasser M Aljehani, Nawal I Algubaisi, Yahya A. A. Sabaah, Khaled M Alkattan
January-April 2014, 2(1):49-51
DOI:10.4103/1658-631X.128454  
Pulmonary sequestration is a known congenital pulmonary malformation. It has been classified into intralobar and extralobar types. We report a case of a symptomatic adult intralobar pulmonary sequestration which was managed in a rather unconventional approach. Such an approach, arterial embolization, has clearly shown to be safe with good outcome in infants and pediatric population. The patient made a full recovery with good outcome. Such case reports show feasibility and safety of embolization as a less invasive management option for adult pulmonary sequestration.
  2,501 146 1
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