A rare case of multiple visceral vascular variations around the kidneys: morphological and clinical aspects / Um caso raro de múltiplas variações vasculares viscerais ao redor dos rins: aspectos morfológicos e clínicos

Abstract Knowledge of the anatomical variations of the visceral branches of the abdominal aorta is important information for planning any surgeries in the region. We present here a rare constellation of variations of visceral vessels around the kidneys with a brief review of the recent literature. On the right side, an accessory renal artery was observed originating just distal to the main renal artery. The middle suprarenal artery was absent on the right side and there were two inferior suprarenal arteries originating from a branch of the main right renal artery. On the left side, the testicular artery had an arched course anterior to the left renal vein mimicking an unusual variety of nutcracker phenomenon. The right kidney was drained by two renal veins into the inferior vena cava. Knowledge of the coexistence of such complex anatomical variations might be helpful for clinicians during diagnostic and therapeutic procedures.

Resumo O conhecimento das variações anatômicas dos ramos viscerais da aorta abdominal é uma informação importante para o planejamento de qualquer cirurgia nessa região. Neste relato, apresentamos um raro conjunto de variações de vasos viscerais ao redor dos rins, bem como uma breve revisão da literatura recente. No lado direito, foi observada uma artéria renal acessória originando-se distal à artéria renal principal. Não havia artéria suprarrenal média no lado direito, e havia duas artérias suprarrenais inferiores originando-se de um ramo da artéria renal direita. No lado esquerdo, a artéria testicular apresentava um curso arqueado anterior à veia renal esquerda, simulando uma variedade incomum do fenômeno do quebra-nozes. O rim direito era drenado por duas veias renais para a veia cava inferior. O conhecimento da coexistência de tais variações anatômicas complexas pode ser útil para os clínicos durante os procedimentos diagnósticos e terapêuticos.

Reconstruction of the Long Process of the Incus by Use of Glass Ionomer Cement: Our Experience

Abstract Introduction Chronic suppurative otitis media is one of the most common causes of reversible conductive hearing loss which can lead to necrosis of the ossicles. The incus, especially its long process, is the most common ossicle affected. Objectives The present study aims to assess the use of glass ionomer cement for the reconstruction of the long process of the incus. Methods The present study was conducted on 27 patients with chronic suppurative otitis media with central perforation with dry and quiescent ears with an eroded long process of the incus submitted to tympanoplasty. The audiological evaluations were done on all patients, including preoperative and postoperative evaluation of the airbone gap; the average pure tone threshold was done 6 months postoperatively. Results The average air pure tone threshold was 42.8 dB preoperatively and 22.5 dB postoperatively. The postoperative air pure tone thresholds were significantly smaller than the preoperative values (p < 0.01). The air-bone gap was 30.5 dB at 500 Hz, 31.6 dB at 1 KHz, and 24.1 dB at 2 kHz preoperatively, and 7.7 dB at 500 Hz, 7.2 dB at 1 KHz, and 7.1 dB at 2 kHz postoperatively at the end of 6 months of follow-up. There were significant hearing gains in the air-bone gap (p < 0.001). Conclusion Glass ionomer cement is a useful and effective material for bridging the defect of the long process of the incus.

Chemical profile, anti 5-lipoxygenase and cyclooxegenase inhibitory effects of ginger (Zingiber officinale) rhizome, callus and callus treated with elicitors / Perfil químico, anti-5-lipoxigenase e efeitos inibitórios da ciclooxegenase do rizoma de gengibre (Zingiber officinale), do calo e calos tratados com elicitores

The present study investigated the chemical profiles and evaluated the inhibitory effect against 5-Lipoxygenase (5-Lox) activity for extracts of ginger rhizome, callus, and callus treated with the elicitors; yeast extract (100, 300 and 500 mg/L), glycine (100, 200 and 300 mg/L) and salicylic acid (100 and 200 mg/L). Oils and chloroform: methanol (CM) extracts were prepared by maceration in petroleum ether and CM (1:1, v/v), respectively. Chemical profiles were determined by gas chromatography/mass spectrometry (GC/MS) analysis. Oil of the callus recorded higher 5-Lox inhibitory effect (IC50 58.33±4.66 µg/mL) than the oil of rhizome (IC50168.34±15.64 µg/mL) and comparable to that of the positive control; Nordihydroguaiaretic acid (IC50 61.25±1.02 µg/mL). The chemical profile of the callus oil contained large amounts of fatty acids, mainly the unsaturated fatty acid oleic acid (31.11%) and saturated fatty acid palmitic acid (28.56%). Elicitors modified the chemical profile of the callus and ameliorated the anti-5-Lox activity of CM extract of the callus. CM extracts of callus treated with 100 and 300 mg/L yeast extract and 50 mg/L salicylic acid significantly suppressed (P ≤ 0.05) the 5-Lox activity by 33.16%, 25.46% and 16%, respectively as compared to the CM extract of untreated callus. In conclusion, ginger callus could be considered as a valuable dietary supplement in the treatment of various inflammatory disorders.

O presente estudo teve como objetivo investigar os perfis químicos e avaliar o efeito inibitório da atividade da 5-Lipoxigenase (5-Lox) em extratos de rizoma, calo e calo de gengibre tratados com os eliciadores; extrato de levedura (100, 300 e 500 mg / L), glicina (100, 200 e 300 mg / L) e ácido salicílico (100 e 200 mg / L). Extratos de óleos e clorofórmio: metanol (CM) foram preparados por maceração em éter e CM (1: 1, v / v), respectivamente. Os perfis químicos foram determinados por análise de cromatografia gasosa / espectrometria de massa (GC / MS). O óleo do calo registrou maior efeito inibitório de 5-Lox (IC50 58,33 ± 4,66 µg / mL) do que o óleo de rizoma (IC50168,34 ± 15,64 µg / mL) e comparável ao do controle positivo; Ácido nordi-hidroguaiarético (IC50 61,25 ± 1,02 µg / mL). O perfil químico do óleo de calo continha grandes quantidades de ácidos graxos, principalmente o ácido graxo insaturado ácido oleico (31,11%) e ácido graxo saturado palmítico (28,56%). Os elicitores modificaram o perfil químico do calo e melhoraram a atividade anti-5-Lox do extrato de CM do calo. Extratos de CM de calos tratados com 100 e 300 mg / L de extrato de levedura e 50 mg / L de ácido salicílico suprimiram significativamente (P ≤ 0,05) a atividade de 5-Lox em 33,16%, 25,46% e 16%, respectivamente, em comparação com o extrato de CM de calo não tratado. Em conclusão, o calo de gengibre pode ser considerado um suplemento dietético valioso no tratamento de vários distúrbios inflamatórios.

Bacterial communities of big-headed ants (Pheidole rugaticeps) and American cockroaches (Periplaneta americana) revealed pathogens of public health importance

Aims@#Several cockroach and ant species have been revealed to infest households with inadequate insect control and food storage practices. These household insects harbor countless bacteria species of public health, agricultural and industrial importance. Many studies have reported disease-causing bacteria from both cockroaches and ant’s species collected from hospitals and residential areas. The aim of this study was to characterize the culturable bacterial communities of two common household insects, big headed ants (Pheidole rugaticeps) and American cockroaches (Periplaneta americana) using 16S rRNA genes sequencing.@*Methodology and results@#A total of 64 bacterial sequences were obtained from P. rugaticeps (48.44%) and P. americana (51.56%) and Firmicutes was the most dominant phylum from both insect species. Bacillus was the most dominant bacterial genus from both cockroach and ant samples. Other important genera isolated were Pseudomonas and Stenotrophomonas which have previously been suggested to have members that are of biotechnological importance. Food poisoning bacterial species, B. cereus and other bacterial strains such as B. subtilis, Acinetobacter baumannii, Burkholderia cepacia, P. aeruginosa, Staphylococcus epidermidis, Serratia marcescens and S. pseudintermedius with the history of human infections were isolated from some of the insect’s specimens.@*Conclusion, significance and impact of study@#Thus, these household insect pests harbor bacterial species known to cause diseases of serious public health importance that needs serious attentions. Similarly, the insects harbor other bacteria species that may provide opportunities for biotechnological exploration.

Misconceptions and associated factors of COVID-19 infection among internally displaced persons in Sudan

Coronavirus disease 2019 (COVID-19) is a global public health threat that has spread rapidly and caused morbidity and mortality worldwide. Reducing the myths about infectious diseases is vital for controlling transmission. This study explored the level of misconceptions and associated factors of COVID-19 among internally displaced persons in Sudan. This study is a cross-sectional, descriptive design and community-based study. We collected the data using a self-administered questionnaire via the convenience sampling technique among internally displaced persons in the camps of Zalingei town in the central Darfur region of Sudan. The total mean score of the respondents' misconception was 3.1725 (SD=0.59) with 63.2%, indicating moderate misunderstanding of COVID-19. Multiple linear regression revealed the independent variables together had a significant impact on a misconception, F(14,116)=2.429, p<0.005. The regression model explains 22.7% of the variance in misunderstanding. Analysis of the influence of single factors on the dependent variable showed that people aged 31­40 years had significantly higher levels of misconception, 0.381 (t=2.116, p<0.037), than those aged over 60 years, and university graduates had considerably lower levels of misunderstanding, −0.061 (t=−2.091, p<0.03) than non-graduates. This study found a moderate level of misconception of COVID-19. Non-graduates had higher levels of misunderstanding than graduates. The results suggest that an education campaign should focus on people with low levels of education to correct their misconceptions regarding the prevention of COVID-19 infection

Assessment of Variation in Clinical Presentation of Visceral Leishmaniasis Among Patients Attending the Tropical Diseases Teaching Hospital in Sudan

Background: Visceral leishmaniasis (also known as Kala-azar) is a systemic parasitic infection with many clinical presentations. The present study assesses the variation in presentations among patients who attended the Tropical Diseases Teaching Hospital (TDTH) in Khartoum, Sudan. Methods: This analytical cross-sectional, hospital-based study was conducted at the TDTH between November 2019 and September 2020. Medical records of patients who presented at the TDTH were reviewed using a structured data extraction checklist. The Chi-square test was used to determine the associations between sociodemographic and clinical presentations of patients. P-value < 0.05 was considered as statistically significant. Results: Out of 195 patients, 79.5% were male and 48.2% were <31 years old. Fever was the main clinical presentation (90.2%) while 53.3% presented with weight loss and 72.3% and 39% presented, respectively, with splenomegaly and hepatomegaly. HIV was detected in 4.6% of the patients. RK39 was the main diagnostic test. We found a significant association between the abdominal distention and the age of the patients (P < 0.05) ­ age groups 11­20 and 41­50 years were more likely to present with abdominal distention than other age groups. Conclusion: There is no exact clinical presentation or routine laboratory findings that are pathognomonic for visceral leishmaniasis; therefore, it should be considered in the differential diagnosis of any patient with fever, weight loss, and abdominal distention, and among patients with HIV.

Health workers with good self-perceived competency have lower actual competency levels on HIS in Eastern Ethiopia: A cross-sectional study

Introduction: Utilization of health information is critical to meeting service performance goals and for making informed decisions. However, in resource limited countries, health data is rarely used in decisions around program improvements. This study aimed to assess the determinants of competency levels for health workers who utilized data from health information systems in Eastern Ethiopia. Methods:A cross-sectional study was carried out from April -May 2021 at selected public health facilities in the Dire Dawacityand Harar regions. A total of 129 health professionals were included in the study and simple random sampling techniques were used to select health facilities. Data was collected using face-to-face interviews and competency levels were measured using a tool adapted from the Performance of Routine Information Systems Management (PRISM) framework. STATA version 16 was used for data analysis. A linear regression model was applied to determine the linear relationship between self-perceived competency and the actual competency levels of the healthcare workers.Adjusted beta (ß) along with a 95% confidence interval (CI) was used to measure the strength of the association with a p-value < 0.05. Results:The overall mean for the actual competency levels of health workers who utilized data was 20.45 [95% CI: 16.71, 24.19]. Being head of a hospital/health center (ß: 19.24, 95% CI: 4.42, 34.06), perusing HIS training (ß: 14.38, 95% CI: 6.10, 22.67) and good perceived competency to perform RHIS tasks (ß: -12.96, 95% CI: -25.49, -0.43) were significantly associated with actual competency levels.Conclusion:The Health workers with high perceivedcompetency levels were found to have actual competency levels that were low. Health information systemfocused trainings were found to be positively associated with actual competency levels and being a hospital or health center head was found to be associated negatively to the actual competency levels of health workers. This research has found that providing health information system training for health workers could prove to be beneficial. There is also a need for initiatives aimed at enhancing competency in order to improve the health information systems related competency levels and data use.[Ethiop. J. Health Dev. 2022;36(SI-1)]

Postnatal Care Utilization and Associated Factors among Mothers who gave Birth in the Aysaeta District, Northeast Ethiopia: A Community Based Cross-sectional Study

BACKGROUND: Postnatal care is given to mothers and newborn babies within 42 days of delivery. It is a period of high maternal and newborn mortality and is also the most neglected in terms of maternal health services in many parts of the world. This study aimed to assess postnatal care and associated factors among mothers who gave birth in the year preceding the survey of the Ayssaeta district. METHODS: A community-based cross-sectional study was conducted among 406 mothers who gave birth in the year preceding the survey from August 02­30, 2020. Bivariable and multivariable logistic regression analyses were done to identify factors associated with postnatal care utilization. RESULTS: Slightly greater than four out of ten mothers have visited postnatal care units at least once. Living in urban areas, giving birth in a health facility, having complications during labor and after, and getting advice during antenatal care visits were associated with higher odds of postnatal care utilization. CONCLUSION: Less than half of the mothers received postnatal care following the delivery of their last child. Living in an urban, place of delivery, experiencing labor and postpartum complications, and receiving postnatal care advice during antenatal care have affected the utilization of postnatal care. Promoting skilled delivery and antenatal care with a focus on rural areas can help mothers learn about postnatal care and increase the number of mothers who use it

Misconceptions and traditional practices toward infant teething symptoms among mothers in eastern Sudan: a cross-sectional study

There is no much published data on the mothers' false beliefs about signs and symptoms associated with teething in Sudan. Aim: This cross-sectional hospital-based study was conducted to assess mothers` knowledge about infant teething process and to evaluate mothers' practices used to alleviate teething disturbances in Gadarif city, eastern Sudan. Methods: Questionnaires were used to collect data. Multivariate logistics regression models were performed and adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated. Results/Conclusion: Of a total of 384 participating mothers, 126 (32.8%) had good knowledge about infant teething. The mothers' knowledge was associated with a higher number of children in the family (adjusted odds ratio [AOR] = 1.14) and with having a job (AOR = 2.22). Mothers residing in rural areas (AOR = 0.40) and mothers with lower than secondary education (AOR = 0.43) were less likely to have good knowledge about teething. Diarrhea (88.5%), fever (86.5%), an urge to bite (76.6%), and poor appetite (71.9%) were the signs and symptoms most attributed to teething by mothers. Only the mother's knowledge about teething was associated with reporting fever as a sign. A considerable number (317; 82.6%) of mothers reported performing "Dokhan" (acacia wood smoke), 313 (81.5%) preferred to administer paracetamol or other systemic analgesics, 262 (68.2%) agreed that a child with tooth eruption should be taken to a hospital or health center, and 216 (56.3%) believed that antibiotics relieved symptoms related to teething

Assessment of back pain and disability status among automotive industry workers, in Ethiopia

Background:Back pain is a very common public health problem in the manufacturing industry and a major cause of disability that affects work performance and wellbeing. Currently, manufacturing sectors in Ethiopia, including automotive manufacturing is growing well but there is poor culture of work place safety. The aim of this study wasto assess the prevalence of back pain and disability status at Bishoftu automotive industry workers.Methods:A cross sectional study was conducted among 412 workers in a period of February to May 2018. Simple random sampling technique was applied to select participants. Data was collected by face-to-face interview using standard Nordic and Oswestry back pain disability index tools. Analysis was done by using SPSS version 24. Bivariate and multivariate logistic regression analyses were used to determine associations.Results:Prevalence of work related back pain among automotive production factory workers during last 12 months and last seven days were 51.7% and 25% respectively and related disability was 87%. The risk factors of the work related back pain that were identified include; work experience (11-15 years) AOR: 0.02, 95% CI (0.001-0.46), tasks that involve bending and twisting AOR: 2.03, 95% CI (1.19-3.45) and lifting of heavy loads AOR: 4.89, 95% CI (2.83-8.47).Conclusions:High prevalence of back pain among automotive industry workers was seen. Furthermore, this study verified workers with back pain and more specifically those working in tasks that involve with the identified associated risk factors were suffer from disability. The problem should need more attention to promote the health and safety of workers

Determinant factors of maternal near miss in selected health facilities of Berak Woreda, Oromia national regional state, Ethiopia

Background:Maternal near miss is one of the related concepts to maternal mortality where women survive merely by chance, luck, or by good hospital care. The present study was aimed to fill the prevailing knowledge gap on maternal near miss ratio and events and identify factors associated with near miss in selected health facilities of berak woreda.To determine associated factors of maternal near miss in selected health facilities of Berak woreda, Oromia national regional state, Ethiopia.Methods:Institutional based case control study was conducted in selected health facilities of barek woreda to asses determinant factors of maternal near miss among delivered women. Data of 1272 (344 cases and 928 controls) women were included in the analysis registered from 11 September 2014to 30 March 2018. Cases were women due to severe acute maternal morbidity while controls were women for normal labor. Simple random sampling technique was used in the delivery unit. The data were collected using WHO standard tool. Data were entered using epi data version 3.1 and exported to SPSSV.20 for data analysis.Results:Majority of cases were due to obstructed labor 270 (78.8%) followed by hemorrhage 33 (9.6%), preeclampsia 29 (8.14%), abortion 6 (1.74%), anemia 3 (0.87%), congenital heart disease2 (0.58%) and gestational infection1 (0.29%).Conclusions:Independent variables residence, duration of labor, ANC utilization, past obstetrics complication and number of live births were statistically significant with the outcome variable near miss. Maternal health policy needs to be concerned preventing major cause of near miss

Survival Rates among Elderly Population with Advanced Colorectal Cancer in Saudi Arabia

Introduction: Colorectal cancer (CRC) is one of the most common causes of cancer-related mortality. Previous studies conducted in Saudi Arabia and provided information about the current situation regarding CRC but still, no enough data was found about the elderly population. Objectives: We aim to evaluate the overall survival of advanced CRC patients in the elderly population and to assess treatment tolerance. Methods: We conducted a retrospective analysis for the medical records department at Princess Norah Oncology Center (PNOC), King Abdulaziz Medical City, Jeddah, Saudi Arabia. We included patients treated at PNOC in the period between 2010 and 2015. Only patients aged above 70 years old with the advanced colon. Results: We included 57 cases with advanced colon cancer in our final analysis. For all the patients in this cohort study, the average age of diagnosis was 76.51 ± 9.28 years, and 71.93% were males. Overall 1-year, 2-year, and 5-year survival rates were 84.3%, 72%, and 54%, respectively. Survival analysis suggested surgical treatment, local radiation, younger ages, recurrent patients, female patients, and Non-mucinous Adenocarcinoma were associated with better survival. Multivariate Cox regression analysis showed that younger age (HR: 1.05, 95%CI=1.00-1.11, p-value=0.050), surgical treatment (HR: 0.15, 95%CI=0.04-0.60, p-value=0.007) and local radiotherapy (HR: 0.04, 95%CI=0.00-0.70, p-value=0.027) were significantly associated with longer survival. Newly diagnosed patients, males and mucinous adenocarcinoma were associated with shorter survival with no statistically significant difference. Conclusion: Survival rates among outpatients were higher than previous local studies. 5-year survival rate was 54%. Survival and regression analysis showed younger age, surgical treatment and local radiotherapy were significantly associated with longer survival.

Optical properties of polyvinyl alcohol membrane with n-HAp for bio-medical applications

Composite membrane as a flexible materials have found diverse applications in industrial and biomedical simultaneously, the recent studies have shown intrinsic improvement for membrane properties by inclusion of nanoparticles as a fillers with high portion ratio in inorganic polymers, the combination between two parts polymer and filler is as a result of collection the advantage of two component systems parts together. In this work, samples of polyvinyl alcohol (PVA)-nanoHaydroxyapatite (nHAp) composites were prepared by using casting method. The effects of addition of (nHAp) with different concentration on the optical properties of (PVA- nHAp) composite membrane have been studied by using wavelength range (220-820) nm. The absorption spectra, transmittance spectra, absorption coefficient, energy gap, refractive index, optical conductivity and extinction coefficient have been determined. The results show that the optical constants change with the increase of nHPA concentrations.

Furosemide: Would it help to improve the lungs as evaluated by sonography and compliance during aortic coarctation surgery

Background: We evaluated furosemide on attenuating lung injury and/or edema during coarctation repair surgery. We evaluated dynamic lung compliance. We measured the degree of lung edema by means of lung ultrasound (LUS). We recorded the (PaO2/FiO2ratio) as an indicator for oxygenation. Materials and Methods: A study was conducted on 56 patients. Patients were divided into two groups: control group (Group C) which did not receive furosemide and furosemide group (Group F) at a dose of 1 mg/kg at induction of anesthesia. Dynamic lung compliance was calculated at induction (Cdyn 1) and at the end of the surgery (Cdyn 2). The (PaO2/FiO2ratio) was calculated at start and end of surgery as (PF 1) and (PF 2), respectively. LUS was performed after induction (LUS 1) and at the end of the surgery. LUS 2 using the 12 regions method plotting the results on scale from 0 to 36. Mechanical ventilation days were recorded. Results: Administering furosemide attenuated the lung injury/edema and other pulmonary complications. Furosemide administration improved the dynamic lung compliance in the F Group compared to the C Group. Furthermore, it increased the (PaO2/FiO2ratio) in the F Group compared to the C Group. LUS scale values were lower in the F Group compared to the C Group. There was also less postoperative mechanical ventilation days. Conclusions: The use of furosemide was accompanied by improved lung injury/edema profile as indicated by a much less drop in dynamic lung compliance, better oxygenation, a more favorable LUS scale with less parenchymal lung affection.

Y-chromosomal STR variation in Kurds and Arabs population in Iraqi Kurdistan

Background: The Iraqi Kurdistan local population involves more than eight gatherings of tenants. The Muslim Kurds make up most of the population and after that the Yezidi Kurds. Alternate gatherings incorporate Armenians, Assyrian, Chaldea, Syriacs, and little minority of Arab and Turkmen individuals.Methods: A total of 36 unrelated males from the two population groups in Iraqi Kurdistan: Kurds and Arabs were analyzed for eight Y-chromosome STRs (DYS19, DYS392, DYS437, DYS448, DYS456, DYS458, DYS635 and Y-GATA-H4). Total DNA from blood cells was extracted using DNA extraction Kit.Results: A number of genetic parameters such as mean number of alleles, allele frequency, gene diversity, polymorphic information content (PIC), and genetic distance were calculated using Power Marker V3.25 software. The DYS458 had the highest diversity (GD: 0.883), while loci DYS456 and Y-GATA-H4 had the lowest (GD: 0.574). The Dendrogram separated the populations into two main clades, the Kurd group and the Arab group except in one case only from the whole population.Conclusions: This study confirms the discriminating power of high-resolution Y-STR typing and provides first primary dataset on Iraqi Kurdistan samples. The comparison of Kurdish and Arab datasets reveals an interesting overall picture of isolation of Kurdish group. The primers DYS19, DYS448, DYS458, and DYS635 can be considered the best for their high PIC power.

Literature Review on Pathogenesis and Treatment of Depression

Background: Among various psychiatric disorders, depression is one of the most frequently encountered intoday’s world. Depression confers a significant risk of recurrence in the subsequent years following the firstepisode. In order to deal this disorder, it is crucial to comprehend the pathogenesis and properly implement theavailable management options. Objectives: We intend to explore the pathogenesis and patho-physiology ofdepression and highlight the available methods to treat and manage this psychiatric disorder including bothpharmacotherapy and psychotherapy. Methods: A review of relevant articles published from 1988 till date inEnglish language was done using the electronic databases of PubMed, Pico and, Google Scholar with presetkeywords. Conclusion: Depression is a highly prevalent psychiatric disorder that requires a multidimensionalapproach. The pathogenesis of depression comprises of 30-40% genetic contribution and about 60-70%environmental factors. Environmental factors include stressful life events at any point in an individual’s lifetimeand alter the stress response by the hypothalamic-pituitary-adrenal axis. The patho-physiology of depressioninvolves altered brain structure and function in addition to modified levels of neurotransmitters. Serotonin andits precursor tryptophan are decreased in the brain in depression in addition to various changes incatecholamines i.e. dopamine and norepinephrine. The treatment of depression is recommended by acombination of psychotherapy and pharmacotherapy which has higher efficacy than either therapy alone. Thepreferred forms of psychotherapy include interpersonal psychotherapy and cognitive behavioral therapy. Themost commonly used pharmacotherapy include SSRIs, which are the most efficacious and tolerableantidepressants while other second generation antidepressants such as SNRI, TCA and MOA inhibitors,mirtazapine and trazodone are chosen on the basis of patient preference, cost, comorbidities and side effectprofile.

Rate and Predictors of Type 1 Diabetes Mellitus Poor Glycemic Control In Tabuk

Background: Recently, great advances in the quality of careregarding type 1 diabetes have been achieved. Despite of that,glycemic control remains suboptimal for many patients withtype 1 diabetes even in Western countries.Objectives: To identify rate and predictors of glycemic controlamong type 1 diabetic patients in Tabuk Region, Saudi Arabia.Subjects and Methods: A cross-sectional study was carriedout in Tabuk city, Saudi Arabia. All type 1 diabetic patientsattending the military hospital in Tabuk throughout the studyperiod (December, 2018-February, 2019) constituted the targetpopulation for the study. Data collection questionnairedeveloped by the researcher and validated by threeDiabetology consultants (face validity) was used. Glycosylatedhemoglobin (HBA1c) Levels above 8%, independent of agewas considered as poor control, and levels below or equal 8%were considered as acceptable control.Results: The study included 150 type 1 diabetic patients. Theirage ranged between 8 months and 27 years with amean±standard deviation of 15.44±4.73 years. The prevalenceof poor glycemic control among type 1 DM patients was 70.7%.Multivariate logistic regression analysis revealed thatadmission to the hospital twice or more than twice wereassociated with higher risk of poor glycemic control (Adjustedodds ratio (AOR) and their 95% confidence intervals (CI) were2.19, 1.03-8.01 (p=0.046) and 3.02, 1.79-11.13 (p=0.009),respectively. With increase in age at diagnosis of type 1 DMby one year, there was a reduction in poor glycemic control by38% (AOR=0.62, 95% CI=0.54-0.71, p<0.001) while withincrease in the duration of diabetes by one year, the risk ofpoor glycemic control increased by 31% (AOR=1.31, 95%CI=1.09-1.98, p=0.001). Non availability of glucose test devicewas associated with almost 4-folds risk of poor glycemiccontrol (AOR=4.12, 95% CI=2.23-5.03, p=0.007). Conclusion:Majority of type 1 diabetic patients in Tabuk Region, KSA hadpoor glycemic control. Many factors were associated with poorcontrol, some of them are modifiable. Therefore, efforts mustbe done to overcome these factors.

Preferred characterization of orbital infection (cellulitis) with exposure dose and relative medication

Background: A retrospective study presenting the endemic orbital infection (cellulitis) that breakout during dusty storm season; aiming to ascertain and showing the precedence of MRI for diagnosis of orbital infection rather than CT and revealing the diagnostic abilities of cross-sectional matrices spectrum.Methods: Based on retrospective collection of diagnostics (CT and MRI) information for randomly selected patients with cellulitis and the targeting the relevant data (image interpretation, exposure dose (DLP and CTDIvol), age, BMI and matrix cross-section spectrum findings).Results: The exposure dose of orbital CT exam was 59.4 (mGy) as CT dose index (CTDIvol) and 917.3 (mGy/cm) as dose length product (DLP) that increase by increment of age and BMI. The obese patients only exposed to dose exceeding the National Diagnostic Reference by 2.8%. MRI confirmed the inflammation around the optic nerve and extension to posterio-inferior portion of the globe and affecting the optic nerve with left sided proptosis (0.5cm) better than CT. The cross-sectional matrix successfully revealed that: the Lt optic nerve’s gray value (density) increases by a factor of 17.7 (a u) and enlarged by 5 pixels greater than the Rt optic nerve. Thickening, rough surface increased gray value by 30.5 (a u), muco-thickening and choncheal enlargement at the medial boarder of Lt orbit as 10.0 pixel and Lt eye ball enlarged by a factor of 10.9 pixels.Conclusions: MRI wisely diagnose orbital infection with more details and overcoming patient radiation exposure and usage of image spectrum gives detailed characterization of lesion morphology.

Role of electroencephalogram in diagnosis of attention deficit hyper activity disorder

Introduction: Attention deficit hyper activity disorder (ADHD), is the most prevalent neurodevelopmental disorder of childhood, which is characterized by the presence of inattention, hyperactivity, and/or impulsivity, EEG is the substrate of brain activity underlying cognition and behavior.Objective: To detect the abnormalities in the electroencephalogram (EEG) in patients with ADHD also to find the relation between attention deficit hyperactivity disorder symptom severity and results of EEG. Method: sixty patients of ADHD and 60 age and sex matched control were evaluated with EEG to detect abnormal waves. Results: Patients with ADHD show abnormal EEG results in the form of background slowing in3 patients (5%) and epileptiform discharge in 19 patients (32%) frontal slowing in 13 patients(22%) normal EEG in 25 patients (42%).Conclusion: There is increased low frequency activity and decreased high frequency activity in children with ADHD, this may aid as an indicator in the diagnosis of ADHD

Assessment of auditory function in obese children

Obesity is a chronic condition, associated with multiple comorbidities. Great attention has been paid to the obesity comorbidities such as cardiovascular disease and insulin resistance up to diabetes mellitus (T2DM), there’s evidence suggests that obesity affects hearing. The aim of the current study was to evaluate the relationship between obesity and hearing in a group of obese children. The present study was a controlled study that was carried out on 80 children of both genders and divided into study group, 40 healthy obese children, they were subdivided after the study has been completed into; group I, 26 healthy obese children with normal middle ear function. Group II 14 obese children with middle ear dysfunction. Control group included forty nonoverweight children. Our study revealed that there was significant increase of the pure tone threshold in obese children with middle ear affection in comparison to obese with normal middle ear and the control group. Positive correlation between pure tone with the anthropometric measures, lipid profile and insulin resistance in obese children with diseased middle ear. Cochlear affection in obese children with normal middle ear evidenced by a negative correlation between transient otoacoustic emission with the anthropometry, liver enzymes and insulin resistance. Obesity considered as a risk for conductive hearing loss and cochlear affection.