Assessment of skipping breakfast at home among adolescent school students in Badia Region, Jordan

@#Introduction: Healthy meals play an essential role in the healthy physical and mental development of adolescents. Breakfast at home is associated with improved nutritional choices, and skipping breakfast is detrimental. This study assessed prevalence of skipping breakfast at home among adolescent students in the Badia Region of Jordan, identifying the reasons and characteristics associated with such behavioural choice. Methods: A cross-sectional survey among adolescent students (aged 13-16 years, in 8th-9th grades) from six public schools in Badia Region, Mafraq Governorate, Jordan, was conducted through self-administered questionnaire from February to March 2022. Results: Results showed that 68.1% of 552 student participants regularly skipped breakfast at home (72.4% boys vs. 61.3% girls; p=0.007). Among those who regularly skipped breakfast, three main rationales for this choice were not feeling hungry (5.3%), lack of time (2.7%), and lack of appetite (3.5%). Conclusion: The prevalence of skipping breakfast at home among adolescents in Badia Region was high for various reasons, including lack of time, not feeling hungry, seeking to manage weight, and insufficient knowledge on the importance of healthy breakfast. Therefore, understanding the reasons and factors that contribute towards breakfast skipping may help in solving the problem, underscoring that positive beliefs should be reinforced in schools, with parents encouraging adolescents to eat healthy breakfast.

The association between vesicle-associated membrane protein - 8 A/G gene polymorphism and the risk of acute myocardial infarction / La relación entre el polimorfismo A/G del gen de la proteína de membrana asociada a vesículas-8 y el riesgo de infarto agudo de miocardio

Abstract Introduction Until now, only few studies have reported the correlation between vesicle-associated membrane protein-8 (VAMP-8) A/G gene polymorphism and acute myocardial infarction. Whereas, theoretically, VAMP-8 plays a pivotal role in the pathogenesis of acute myocardial infarction through platelet activation, secretion, and aggregation. Objective To investigate the association between VAMP-8 A/G gene polymorphism and the risk of acute myocardial infarction. Methods A cross-sectional study was carried out at Saiful Anwar General Hospital during June 2013 - May 2014. A Mae II enzyme with restriction fragment length polymorphism method was used to genotype VAMP-8 A/G gene polymorphisms in acute myocardial infarction and control groups. A multiple logistic regression test was used to analyze the association between VAMP-8 A/G gene polymorphism and the risk of acute myocardial infarction. Results A total of 35 controls and 97 acute myocardial infarction patients from our Hospital during the period were enrolled for our study. Our results found that VAMP-8 A/G gene polymorphism was not associated with the risk of acute myocardial infarction. Moreover, we also failed to confer the association between VAMP-8 A/G gene polymorphism and both smoking and hypertension among patients with acute myocardial infarction. Furthermore, in the setting of premature acute myocardial infarction, the correlation also failed to confirm. Conclusion In our population, there is no association between VAMP-8 A/G gene polymorphism and the risk of acute myocardial infarction.

Resumen Introducción Hasta la fecha, solo unos pocos estudios han reportado la correlación entre el polimorfismo A/G del gen de la proteína de membrana asociada a vesículas-8 (VAMP-8, por sus siglas en inglés) y el infarto agudo de miocardio. Si bien, en teoría, VAMP-8 juega un papel fundamental en la patogénesis del infarto agudo de miocardio a través de la activación, secreción y agregación plaquetaria. Objetivo Investigar la relación entre el polimorfismo A/G del gen VAMP-8 y el riesgo de infarto agudo de miocardio. Métodos: Se llevó a cabo un estudio transversal en Siful Anwar General Hospital entre junio del 2013 y mayo del 2014. Se utilizó la técnica de polimorfismos de longitud de fragmentos de restricción con la enzima Mae II para genotipificar los polimorfismos A/G del gen VAMP-8 en grupos de infarto agudo de miocardio y de control. Se aplicó una prueba de regresión logística múltiple para analizar la relación entre el polimorfismo A/G del gen VAMP-8 y el riesgo de infarto agudo de miocardio. Resultados Se incluyeron un total de 35 controles y 97 pacientes con infarto agudo de miocardio de nuestro Hospital durante el periodo del estudio. Nuestros resultados encontraron que el polimorfismo A/G del gen VAMP-8 no estaba relacionado con el riesgo de infarto agudo de miocardio. Por otra parte, tampoco pudimos establecer una relación entre el polimorfismo A/G del gen VAMP-8 y tanto tabaquismo como hipertensión en pacientes con infarto agudo de miocardio. Asimismo, en el contexto de infarto agudo de miocardio prematuro, tampoco se confirmó la correlación. Conclusión: En nuestra población, no existe una relación entre el polimorfismo A/G del gen VAMP-8 y el riesgo de infarto agudo de miocardio.

Insights into vaccine hesitancy from systems thinking, Rwanda

Objective To investigate vaccine hesitancy leading to underimmunization and a measles outbreak in Rwanda and to develop a conceptual, community-level model of behavioural factors. Methods Local immunization systems in two Rwandan communities (one recently experienced a measles outbreak) were explored using systems thinking, human-centred design and behavioural frameworks. Data were collected between 2018 and 2020 from: discussions with 11 vaccination service providers (i.e. hospital and health centre staff ); interviews with 161 children's caregivers at health centres; and nine validation interviews with health centre staff. Factors influencing vaccine hesitancy were categorized using the 3Cs framework: confidence, complacency and convenience. A conceptual model of vaccine hesitancy mechanisms with feedback loops was developed. Findings/ A comparison of service providers' and caregivers' perspectives in both rural and peri-urban settings showed that similar factors strengthened vaccine uptake: (i) high trust in vaccines and service providers based on personal relationships with health centre staff; (ii) the connecting role of community health workers; and (iii) a strong sense of community. Factors identified as increasing vaccine hesitancy (e.g. service accessibility and inadequate follow-up) differed between service providers and caregivers and between settings. The conceptual model could be used to explain drivers of the recent measles outbreak and to guide interventions designed to increase vaccine uptake. Conclusion The application of behavioural frameworks and systems thinking revealed vaccine hesitancy mechanisms in Rwandan communities that demonstrate the interrelationship between immunization services and caregivers' vaccination behaviour. Confidencebuilding social structures and context-dependent challenges that affect vaccine uptake were also identified.

Knowledge and Attitude towards Board of Pharmacy Specialties (BPS) Certification among Pharmacists and Pharmacy Students: A Cross Sectional Survey

Background: For decades, the American Board of Pharmacy Specialties (BPS) has provided specialty certification programs for pharmacists. As pharmacists become involved in more advanced patient care services, board certification becomes an essential component to ensuring quality care. The aim of this study was to measure the self-reported knowledge and attitude towards the BPS certification. Methods: A cross sectional study included all pharmacy students and pharmacists at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) and King Abdulaziz Medical City (KAMC), respectively. However, the administrative pharmacy staff was not included. This is a manually distributed survey was adopted from previous published observational study. The survey included 6 demographic, 12 knowledge and 15 attitude questions where the participant rank from 1 to 5 (1: very poor, 2: poor, 3: Average, 4: good and 5: very good). This study is approved by IRB. Descriptive statistics were primarily used to analyze data. Categorical responses were compared using Chi-square tests. Result: In total of 221 participants agreed to participate in the study based on convenient sampling, there were more female participants (134, 60.6%) than male (87, 39.4%). More number of participants (191, 86.4%) were under the age-group ≤ 30 years. The overall mean age was found to be 25.20 ± 5.86 (20-60) years. Among 221 participants, 118 (53.4%) were students and 103 (46.6%) were employees. The current study found that 55.2% of respondents have a good knowledge about BPS certification. However, only 48.4% of participants reported their interest in pursuing board certification in their future career. Conclusion: Many respondents were aware of BPS certification, learning the most through didactic and experiential activities, and many indicated they are considering pursuing BPS certification. College of pharmacy and professional organizations can help provide educational session regarding board certification and professional development opportunities.

Alopecia areata y vitamina D sérica en pacientes iraquíes: un estudio de casos y controles / Alopecia Areata And Serum Vitamin D in Iraqi Patients: a case-control study

Background: Alopecia areata (AA) is a typical hair issue, which may have obliterating mental and social outcomes and is portrayed by the nearness of nonscarring alopecia. Objective: This examination has targets to assess the serum nutrient D levels , with AA; contrast the outcome and clearly sound control; and confirm relationship between AA types and serum nutrient D levels. Patients Also Methods: the examine might have been led clinched alongside Tikrit educating healing facility throughout those time starting with June 2019 of the limit for January 2020. Irrefutably the quantity of subjects associated with the assessment was ninety individuals isolated in two social events; the patients bundle were forty five the people who whimper of AA while the resulting gathering including a forty five age and sex-made solid volunteers were picked as a benchmark gathering. The degree and movement of the alopecia were noted and the patients were meticulously broke down for signs of various ailments. Research center assessments were led to patients and also to those control population, these included serum vitamin D levels were measured as 25-hydroxyvitamin D {25(OH)D} using a chemiluminescence microparticle immunoassay. Blood models were gotten starting with patients and control subjects after totally taught consent was gotten. Results : An essential complexity may have been found for serum 25-OH Vit D levels between patients other than controls. Vitamin D sufficiency were more common in controls than in patients. Serum Vitamin D was deficient in both cases and controls group; but, the deficiency was significantly more throughout AA group (35. 6%) compared to the handle group (11. 1%). Among the list patients gathering, levels associated with nutrient D were totally higher in guys in contrast with females. Conclusions: AA might be related with nutrient D deficiency as mean degrees of nutrient D of patients were seen as fundamentally lower than typical sound controls.

A case of urticaria multiforme with unusual presentation

Urticaria multiforme is a condition which manifests as acute, polycyclic, annular oedematous pink plaques with an ecchymosis hue that is associated with acral edema. The condition is often misdiagnosed as erythema multiforme, serum-sickness-like reactions, or urticarial vasculitis. Author present a case of acute annular urticaria in a 3-year-old girl who presented with unusual clinical manifestations of the condition. Through this case report, Author aim to emphasize the wide range of morphologic manifestations that can be seen in urticaria multiforme. This can assist pediatric physicians to differentiate urticaria multiforme from other clinical dermatologic conditions and prevent misdiagnosis. A detailed case history and physical examination, along with relevant diagnostic tests can enable prompt and effective management of the condition.

Pulmonary capillary hemangiomatosis: a lesson learned

Pulmonary capillary hemangiomatosis (PCH) is a rare and controversial entity that is known to be a cause of pulmonary hypertension and is microscopically characterized by proliferation of dilated capillary-sized channels along and in the alveolar walls. Clinically, it is mostly seen in adults. Clinical features are characterized by nonspecific findings such as shortness of breath, cough, chest pain, and fatigue. It can be clinically indistinguishable from pre-capillary pulmonary arterial hypertension disorders such as primary pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension. However, the diagnostic distinction, which usually requires a multidisciplinary approach, is crucial in order to avoid inappropriate treatment with vasodilator medications usually used for PAH treatment. Prognosis of PCH remains poor with lung transplant being the only definitive treatment. We report an autopsy case of pulmonary capillary hemangiomatosis unmasked at autopsy that was treated with a prostacyclin analog, usually contraindicated in such patients. We emphasize that this entity should always be on the differential diagnosis in a patient with pulmonary hypertension and requires great vigilance on the part of the clinician, radiologist and pathologist to make the diagnosis and guide appropriate management.

Phytochemical Investigation and In-vitro Antifungal Activity of Essential Oil from the Roots of Selinum vaginatum C. B. Clarke

Aim: The study was to evaluate the phytogenic chemical compounds and Antifungal Activity of essential oil from roots of Selinum vaginatum C.B. Clarke, growing in the Himalayan region of Jammu & Kashmir. Methodology: The essential oil was analyzed by Gas Chromatography & Gas Chromatography-Mass Spectrometry in relation with their Kavot indices and mass spectra. Results: The oil was found completely dominated by oxygenated sesquiterpenoids (71.9%) which includes 14-hydroxy-δ-cadinene (37.5%), khusinol (20.7%), viridiflorol (8.0%), acorenone -B (4.2%) and 14-oxy-α-muurolene (1.1%) whereas δ-cadinene (8.9%), α-copaene (6.8%), germacrene-A (2.5%), and β-caryophyllene (1.3%) were the major compounds among sesquiterpenoids. Monoterpenoids constituted as the minor portion (3.8%) of essential oil. The oil was found almost free from oxygenated monoterpenoids (0.2%). The roots of S. vaginatum are used in folk lore medicines in Jammu & Kashmir. The oil from the roots showed marked antifungal activity. The oil had shown 100% mycelia growth inhibition against A. tenuis, C. graminicola, R. solani and S. sclerotiorum at a concentration of 500 µg/ml, 2000 µg/mL, 2000 µg/mL and 300 µg/mL respectively. However F. oxysporum was found less susceptible to the root oil of S. vaginatum. The IC50 values showed a range from 57.4 µg/mL–74.7 µg/mL as compared to standard fungicides with IC50 values 32.8 µg/mL–98.6 µg/mL. The spore germination inhibition test revealed the root oil as a potent inhibitor with IC50 values as 201.4 µg/mL, 414.7 µg/mL and 784.7 µg/mL for A. tenuis, C. graminicola and F. oxysporum. Conclusion: Our study showed that14-hydroxy-δ-cadinene (37.5%), khusinol (20.7%), & viridiflorol (8.0%) are the major components in this oil and possessed potent antifungal activity against test fungal strain, respectively.

In-hospital outcome of patients with cardiogenic shock complicating acute myocardial infarction: results from Royal hospital percutaneous coronary intervention registry, Oman

Objectives: Cardiogenic shock [CS] is still the leading cause of in-hospital mortality in patients presenting with acute myocardial infarction [AMI]. The aim of this study was to determine the in-hospital mortality and clinical outcome in AMI patients presenting with CS in a tertiary hospital in Oman

Methods: This retrospective observational study included patients admitted to the cardiology department between January 2013 and December 2014. A purposive sampling technique was used, and 63 AMI patients with CS admitted to [36.5%] or transferred from a regional hospital [63.5%] were selected for the study

Results: Of 63 patients, 73% [n = 46] were Omani and 27% [n = 17] were expatriates: 79% were male and 21% were female. The mean age of patients was 60 +/- 12 years. The highest incidence of CS [30%] was observed in the 51-60 year age group. Diabetes mellitus [43%] and hypertension [40%] were the predominant risk factors. Ninety-two percent of patients had ST-elevation MI, 58.7% patients were thrombolysed, and 8% had non-ST-elevation MI. Three-quarters [75%] of CS patients had severe left ventricular systolic dysfunction [defined as ejection fraction <30%]. Coronary angiogram showed single vessel disease in 17%, double vessel disease in 40%, and triple vessel disease in 32% and left main disease in 11%. The majority of the patients [93.6%] underwent percutaneous coronary intervention [PCI], among them 23 [36.5%] underwent primary PCI. In-hospital mortality was 52.4% in this study

Conclusions: CS in AMI patients presenting to a tertiary hospital in Oman have high in-hospital mortality despite the majority undergoing PCI. Even though the in-hospital mortality is comparable to other studies and registries, there is an urgent need to determine the causes and find any remedies to provide better care for such patients, specifically concentrating on the early transfer of patients from regional hospitals for early PCI

Exploring the extent of knowledge of CPR skills among school teachers in Riyadh, KSA

Objectives: Cardiopulmonary resuscitation [CPR] is one of the most evolving areas in modern medicine. CPR is a lifesaving technique that is useful in combating different types of emergencies. In cases of emergencies, school teachers are expected to play a key role in performing CPR on school children. The purpose of this study is to assess the knowledge of CPR among school teachers in Riyadh, KSA

Methods: This cross-sectional study was conducted using a 12-statement questionnaire about CPR knowledge that was administered to teachers of general educational schools in Riyadh

Results: As many as 43% of school teachers knew about CPR, but 57% had no previous information about CPR. Sources of information about CPR included previous study at a university [29.3%], training courses [15.2], TV [24.2%], and the Internet [18.2%]. When faced with a case that needed CPR, 38.9% of teachers performed CPR, while 37% called an ambulance. Approximately 53% agreed that CPR training courses should be mandatory. Only 63% of teachers knew the contact numbers for emergency services

Conclusions: This study has revealed a critical issue that a majority of school teachers do not have adequate knowledge about CPR. We recommend the mandatory implementation of CPR and basic life-support training and refreshing courses for all school teachers across KSA. In addition to enrolling in training courses, teachers must be aware of the availability of first aid kits at schools and the contact numbers of the Saudi Red Crescent Services

Imported malaria to Makkah district, Saudi Arabia: is there any risk of local transmission?

In Makkah, Saudi Arabia, there is an impending risk of imported malaria. This risk comes from the fact that millions of people, in majority from tropical and subtropical countries where malaria is endemic, visit the country to perform Hajj and Umrah every year. Moreover, millions of expatriates from endemic countries come to Makkah for work. Likewise, many Saudi citizens travel to endemic areas overseas for business and pleasure. We performed a retrospective analysis of all reported malaria cases in Makkah region, Saudi Arabia for years 2014 and 2015. In addition, sorting of mosquito populations in Makkah region was undertaken. Based on national data regarding reported malaria cases, 235 malaria cases were recorded in years 2014 and 2015. Of the reported cases 232 were non-Saudi and only 3 cases were Saudi. Those recorded Saudi cases were just returning from a travel to an endemic area. Most of the cases [79.6%] were P. falciprum and the remaining was P. vivax. Infected male represent 62% and female represent 38%. Age of the majority of reported cases [71.5%] lie between 31 and 50 years. Most of reported cases were from Chad, Pakistan, Nigeria and Sudan. Sorting of mosquito populations revealed the absence of malaria vectors in Makkah District

Rectal diverticulum presenting with obstructed defecation: a case report

Diverticular disease of the colon is a common condition in western and developed countries. Distal colon is the mainly stricken part, being the sigmoid colon affected in up to 70% of the patients. The occurrence of rectal diverticula is very rare, with only sporadic reports in the literature since 1911. Symptomatic rectal diverticula are encountered even less frequently. Most patients are diagnosed incidentally, inflammatory processes may have developed at the time of the diagnosis .Treatments of these complicated events range from conservative treatments to major surgical interventions. Here we present a patient who was diagnosed with rectal diverticulum causing constipation and difficult defecation

Positive and Negative Symptoms in Patients of Schizophrenia: A Cross Sectional Study.

Background: Analysis of positive and negative symptoms of schizophrenia has been increasingly needed for a systematic management plan. Unfortunately, this type of study was lacking in Bangladesh. Aims: Th e study aims were to fi nd out the predominant symptom pattern and associating factors in schizophrenia. Methods: Th is was a cross sectional, analytical and descriptive study done in a tertiary care hospital with a sample size of 78. Th e SCID-I and pre designed socio demographic questionnaire was applied. Positive and negative symptoms were assessed by using the Positive and Negative Symptom Scale (PANSS). Statistical analysis was done through SPSS version 17. Results: Among 78 patients, schizophrenics with positive symptoms (57.7%) were predominant over schizophrenics with negative symptoms (42.3%). Delusion (64.1%) and blunted aff ect (55.1%) were the most frequent positive and negative symptoms respectively. Negative symptoms were signifi cantly associated with poverty, unemployment and lack of education. Limitations: Single centered cross sectional study with small sample size. Conclusions: Schizophrenic patients with positive symptoms visit clinicians more readily than those with negative symptoms.

Establishment of Blastocystis hominis in-vitro Culture Using Fecal Samples from Infants in Slum Area of Mirpur, Dhaka, Bangladesh.

Introduction: Blastocystis hominis (B. hominis) is an obligate anaerobic protozoan found in the human large intestine, and is the most common eukaryotic organism reported in human fecal samples. Method: Multiple stool samples from 460 children (53.9% male and 46.07% female) were collected and examined for the presence of Blastocystis hominis in Parasitology Laboratory of International Centre for Diarrhoeal Diseases Research, Bangladesh during the period of 9th January to 28th December, 2011. Among them, 255 were diarrheal patients (56.47% male and 43.53% female). Direct microscopy was done for each of the samples and each sample was cultured in vitro for 48 hours and observed again for the presence of the pathogen. Th e aim of the study was to develop a sustainable technique to identify the pathogen. Results: In culture, several morphological forms were observed. Th rough microscopy, various morphological forms were clearly observed. Within 5679 tested samples, 795 samples (0.14%) were positive for B. hominis. As multiple forms were observed in the same sample, the most prevalent was cyst (0.125%) whereas least prevalent was granular (0.0072%). Th e highest percentage for all the morphological forms was observed in age group 25-36 months. In direct microscopy from fresh samples, children from 37-48 months showed the highest percentage (22.9%) of infection (p=0.000). In culture, the same age group showed the most infection rate (p=0.000). Among the diff erent morphological forms observed in culture, the highest prevalence of cyst was in age group 37-48 months (p=0.000). Th e highest prevalence of vacuolar form(5.7%) was observed in the same age group (p=0.015). In contrast, the amoeboid forms were mostly observed in children of 25-36 months (p=0.002).Th e children aged in between 37 to 48 months are at the most risk of the infection. Conclusion: Th e sensitivity of direct microscopy was found only 38.46% in respect to in-vitro culture which strongly suggests that in-vitro culture is the gold standard for the diagnosis of this parasite.

Obesity among university students: a cross-sectional study in Ajman, UAE

Objectives: This research was conducted to determine the proportion of obesity among university students and the factors associated with it

Materials and Methods: A cross sectional study was conducted among students enrolled in the preclinical years, in the six academic programs. A validated, self-administered questionnaire with domains such as socio-demographic characteristics, self-reported physical activity, dietary habits, and anthropometric measurements was used. Height and weight were measured and Body Mass Index was calculated and categorized according to WHO criteria. The data were analyzed by SPSS 21, Descriptive analysis and Chi square test were performed

Results: Out of 233 participants, 181 [78.4%] were <20 years and majority of them were females [172, 76.8%]. 142 [60.9%] were 1[st] year students and 111 [46.7%] were from Eastern Mediterranean region. Among the total, 41 [17.6%] were having overweight and 16 [6.9%] with obesity. 65% performed physical activity in the last month, of which 100 [66%] performed vigorous physical activity. 212 [95.5%] reported a diet history of mixed Diet. No significant association was noted except for gender and year of study with BMI where 34.6% of males were overweight and obese compared to females [21.5%] and 29.6% of them were 1[st] year students as compared to the 2[nd] year students [16.5%]. Overweight and obesity were found more among participants who were not doing physical activity [32.1%] as compared to those doing physical activity [20.4%], of which obesity was less among those who performed vigorous activity [19%]. Participants who follow vegetarian diet [80%] had normal BMI as compared to the mixed diet followers of 59%

Conclusion: Almost a one fourth was found to be overweight and obese. A statistically significant association between obesity and year of study was observed. Participants who follow a mixed diet had noticed with higher percentage of overweight and obesity as compared to those students on a vegetarian diet. There is a need to address the obesogenic environment to the university students and the students need to be involved in promoting healthy lifestyles

Organophosphate poisoning: a 10-year experience at a tertiary care hospital in the Kingdom of Saudi Arabia

Introduction: Toxicity resulting from pesticides is an important global public health hazard concern, particularly in developing countries. The objectives of this retrospective study were to determine the presenting clinical features, complications and length of stay of patients poisoned with organophosphates [OP]

Materials and Methods: The medical records of all OP poisoning patients admitted to King Fahd Hospital of the University in the period between 2000 and 2010 were reviewed

Results: There was a total of 50 patients: Thirty-four males [68%] and 16 females [32%], 39[78%] of whom were >18 years of age. The most common route of exposure was ingestion, which was observed in 20 patients; vomiting was the most common clinical presentation. Thirteen patients were intubated at the Emergency Department on account of respiratory failure. Thirty-two patients required admission to the Intensive Care Unit and the mean length of stay in the hospital was 5 days. Two patients had cardiac arrest

Conclusions: This relatively high prevalence of OP poisoning makes it necessary to have tighter governmental controls and awaken public awareness to this problem

Prevalence of sleep deprivation and relation with depressive symptoms among medical residents in King Fahd university hospital, Saudi Arabia

Sleep deprivation is common among medical residents of all specialties. This study aimed to determine the prevalence of sleep deprivation and depressive symptoms among medical residents in King Fahd University Hospital [KFUH] in Al Khobar, Saudi Arabia. Furthermore, the association between sleep deprivation, sleepiness and depressive symptoms was examined. This cross-sectional study took place between February and April 2012 and involved 171 KFUH medical residents of different specialties. Data were collected using a specifically designed questionnaire eliciting demographic information, working hours and number of hours of sleep. In addition, validated Arabic versions of the Epworth Sleepiness Scale and the Beck Depression Inventory-2 [BDI-2] were used. The prevalence of acute sleep deprivation and chronic sleep deprivation among residents in KFUH was 85.9% and 63.2%, respectively. The prevalence of overall sleepiness was 52%; 43.3% reported being excessively sleepy in certain situations while 8.8% reported being excessively sleepy regardless of the situation. Based on the BDI-2, the prevalence of mild, moderate and severe depressive symptoms was 43.3%, 15.2% and 4.7%, respectively. Significant associations were found between sleep deprivation and depressive symptoms; depressive symptoms and sleepiness, and depressive symptoms and being a female resident. The vast majority of medical residents had acute sleep deprivation, with more than half suffering from chronic sleep deprivation. The number of hours and quality of sleep among the residents were strongly associated with depressive symptoms. New regulations are recommended regarding the number of working hours and night duties for medical residents. Further studies should assess these new regulations on a regular basis

Does type 1 diabetes mellitus affect bone quality in prepubertal children?

Type 1 diabetes mellitus [T1DM] in children often starts before the achievement of peak bone mass. This may constitute a landmark in predicting bone fracture risk later in their lives. This study aims to determine the serum levels of bone markers in children with T1DM in combination with their bone mineral density [BMD]. Children diagnosed with T1DM for 3 years or more without signs of puberty were included in the diabetic group. Another group of age-matched healthy non-diabetic controls was recruited froma local school. The serum levels of a group of biochemical markers for bone formation and resorption were determined in both study groups, and BMD was measured by ultrasound absorptiometry. Thirty six children with T1DM and 39 normal children were included in this study. The results showed that 24/36 [66.7%] diabetic children had a Z score below zero. Of these, five scored below -1. In contrast, 12/39 [30.8%] children from the control group had a Z score below zero, but none had a score below -1. Significantly lower levels of osteocalcin and procollagen N-terminal peptide were detected in the diabetic group. The serum levels of bone resorption markers were significantly higher in the diabetic group. T1DM decreases BMD and some bone formation and increases some bone resorption biomarkers. BMD and bone markers are useful diagnostic tools for the early detection of alterations in the bone quality of children with T1DM. This, if treated in a timely manner, may decrease future bone fracture susceptibility

Missed traumatic abdominal wall hernia: report of a case and literature reviewing

Blunt trauma to the abdominal wall can cause a hernia, quite a rare condition. Once diagnosed, it should be repaired, because any delay in the management results in an increase in morbidity and mortality. We report a case of a 41 year old female that developed Traumatic Abdominal Wall Hernia in the right upper quadrant following a Road Traffic Accident. She was diagnosed one month later by physical examination which was proved by a Computed Tomography scan of the abdomen. An open surgical repair with mesh was done, and the post-operative course was uneventful

Cholesterol granuloma of the orbit: An atypical presentation.

Cholesterol granuloma is a rare, well-defined lesion of the orbit. In the orbit, diploe of the frontal bone is involved almost exclusively. We report an atypical case of cholesterol granuloma involving superomedial quadrant of orbit. A 42-year-old male presented with progressive, painless, proptosis with inferotemporal displacement of left eye. A large mass was felt beneath the bony orbital margin in the superomedial quadrant of the left orbit. Computerized tomography (CT) scan revealed an extraconal superomedial, heterogeneous enhancing mass which was isodense with brain and pushing the globe inferolaterally and anteriorly. Excision biopsy of the tumor revealed the typical features of a cholesterol granuloma without any epithelial elements. Cholesterol granuloma of the orbit is a rare entity, but it can be diagnosed and differentiated from other lesions of the superior orbit by its characteristic clinical, radiological and histopathological features. An appropriate intervention in time carries a good prognosis with almost no recurrence.