Acute Myocardial Infarction Patients’ Knowledge Regarding the Modifiable Risk Factors of Heart Disease

Background: Acute myocardial infarction (heart attack) is a condition of the heart that occurs when blood flowto the heart muscles is stopped abruptly. The disruption in blood flow to the heart muscles is usually caused by ablockage of one or several coronary arteries. Heart attacks can be fatal owing to the critical functions performedby blood in the heart. Fatalities arising from heart attacks are witnessed all over the world. The difference infatality rates of heart attacks is highly dependent on the exposure to risk factors such as smoking and obesity.Healthy living populations will rarely encounter high cases of a heart attack. This study was set out to assess anddocument the knowledge level of acute myocardial infarction patients regarding the modifiable risk factors of aheart attack in Saudi Arabia. Patients suffering from a heart attack are at great danger of fatality. Knowledge ofmodifiable factors can promote healthy living habits and behaviors among them. Methods: A cross-sectionalsurvey was developed to assess knowledge levels of acute myocardial infarction patients in the three cities ofRiyadh, Jeddah, and Dammam. A total of 123 participants were recruited through convenient sampling across15 hospitals in the cities. The eligibility criteria for recruitment included a mandatory age of 18 years and SaudiArabian citizenship. Participants were issued with questionnaires containing different questions on modifiablerisk factors (fatty foods, vegetables, fruits, smoking, physical exercise, and obesity). Results: Five out of the sixmodifiable factors represented knowledge levels of less than 50%. Participants were only knowledgeable on therisk factor of obesity which saw 52.8% associating it with a heart attack. Conclusion: There is a need to boosteducation and awareness among acute myocardial infarction patients in Saudi Arabia.

Implantable collamer lens for the correction of post-keratoplasty myopia and astigmatism / 国际眼科杂志(Guoji Yanke Zazhi)

· AIM:To evaluate the safety,refractive outcomes and vision after phakic posterior chamber implantable collamer lens (ICL) after keratoplasty (KP).· METHODS:This retrospective single center study evaluated 32 (35 eyes) patients who received an ICL for myopia and/or astigmatism after keratoplasty.Patients underwent ICL surgery if they were unable to wear glasses or contact lenses and excimer laser surgery was contraindicated.Data were collected on uncorrected distance visual acuity (UDVA),corrected distance visual acuity (CDVA),refraction and complications.Data were analyzed for the preoperative and last postoperative visits (16.7±13mo) (P＜0.05).· RESULTS:Preoperatively,spherical equivalent (SE) ranged from-4.00 to-20.00 D and cylinder from-2.00 to -9.00 D.The mean SE decreased statistically significantly from-11.41± 3.62 D preoperatively to-1.95±1.78 D postoperatively (P ＜ 0.0001).Mean UDVA increased statistically significantly from 20/400 preoperatively to 20/ 25 postoperatively (P＜ 0.0001).There was a mean improvement in postoperative CDVA of 1.5 lines compared to preoperatively,37％ of eyes had an increase of 2 or more lines.One eye (2.8％) lost ≥ 1 line of CDVA.There were no intraoperative or postoperative complications.· CONCLUSION:Posterior chamber phakic intraocular lens implantation is a safe and effective treatment for post-keratoplasty myopia and astigmatism in patients who are unable to wear spectacles or contact lenses and where corneal refractive surgery is contraindicated.

Medicinal and biological values of Callistemon viminalis extracts: History, current situation and prospects

Callistemon viminalis (C. viminalis) is a plant that has been reported to have various medicinal values such as antibacterial, antifungal, antioxidant activities and other pharmaceutical and insecticidal properties. This review covers the potentials, applications and properties of different extracts from different parts (branches, flowers, fruits, bark, leaves) of C. viminalis. Furthermore, the chemical structures of the bioactive compounds were reported for biological activities. All the results supported the traditional uses of C. viminalis in folk medicine. In addition, some researches supported the use of C. viminalis extracts for the preparation of metal oxide nanoparticles.

Medicinal and biological values of Callistemon viminalis extracts: History, current situation and prospects

Callistemon viminalis (C. viminalis) is a plant that has been reported to have various medicinal values such as antibacterial, antifungal, antioxidant activities and other pharmaceutical and insecticidal properties. This review covers the potentials, applications and properties of different extracts from different parts (branches, flowers, fruits, bark, leaves) of C. viminalis. Furthermore, the chemical structures of the bioactive compounds were reported for biological activities. All the results supported the traditional uses of C. viminalis in folk medicine. In addition, some researches supported the use of C. viminalis extracts for the preparation of metal oxide nanoparticles.

Association between neurological and rheumatological manifestations in vitamin D deficiency and vitamin D levels

We aimed to investigate the associations between the neurological manifestations of vitamin D deficiency and bone profile as well as the levels of 25-hydroxyvitamin D. We conducted a case series on patients with vitamin D deficiency who were followed up at King Abdulaziz Medical City, Jeddah between January 2010 and December 2011. We collected patients' demographic data and gathered information on etiological factors for vitamin D deficiency as well as clinical presentations [typical, neurological and rheumatological] and radiological findings. The t-test was used to determine whether there was an association between the neurological manifestations of vitamin D deficiency and vitamin D levels and bone profile. We enrolled 60 patients with vitamin D deficiency. Of these, 44 [73.3%] had neurological presentations, namely progressive muscle weakness and proximal weakness, which was observed more often than distal weakness. In addition, gait disturbances were observed in 61.7% of all patients with neurological and rheumatological presentations. There was no significant association between neurological and rheumatological manifestations and bone profile or vitamin D levels. We found a significant association between difficulty in walking and the levels of serum calcium and phosphate [P = 0.043 and 0.037, respectively]. Neurological and rheumatologic manifestations of vitamin D deficiency are not associated with 25-hydroxyvitamin D levels or bone profile

Pseudotumor cerebri and prolactin secreting pituitary adenoma. Association or coincidence?

The occurrence of pseudotumor cerebri [PTC] and hyperprolactinemia related to a prolactinoma are extremely rare, and the link between these pathologies has not been examined adequately in the post-MRI era. We report a patient with a small intrasellar prolactinoma who also developed PTC. Magnetic resonance venography did not show any evidence of compression of the cavernous or any other sinuses. She initially responded to treatment with acetazolamide and cabergoline. However 9 months later, her PTC symptoms recurred despite a normal serum prolactin level and a mild reduction of the pituitary tumor size on MRI. She improved after a lumboperitoneal shunt. We conclude that the findings in our patient do not support an association between PTC and hyperprolactinemia or prolactinoma. However, the case supports the need for clinicians to consider the diagnosis of PTC when patients with small pituitary lesions exhibit raised intracranial pressure features

Mycoflora, mycotoxins, bacteriological analysis and molecular assay of some bacterial species from coffee beans in Saudi Arabia

The mycoflora analysis of some coffee beans in Saudi Arabia showed a wide range of fungal contamination in 31 samples collected from different markets in El-Riyadh. Thirty four species belonging to 16 genera and 28 species belonging to 18 genera were isolated from coffee beans on glucose and cellulose Czapek's agar medium at 25°C from seed-plate method. Aspergillus niger and A. flavus were the most prevalent species, but Penicilliun oxalicum was isolated in moderate occurrence, while 12 genera comprised 16 species and 8 genera comprised 10 species were isolated on the same types of media at 25°C from seed suspension method. A. niger was the most common species, while A. flavus and P. funiculosum were isolated in moderate occurrence. A. niger, also was the most prevalent on 20% sucrose-Czapek's agar medium at 25°C, but the genus Eurotium [3 spp] appeared in moderate occurrence. Five fungal species belonging to four genera were isolated on starch yeast extract agar medium at 45°C. A. fumigatvs and A. niger were the most prevalent thermo tolerant species, while three species of thermophilic fungi were of low or rare incidence. Thin layer chromatographic analysis of chloroform extracts of 31 coffee beans samples revealed that 20 samples were free from mycotoxins, while 11 samples were contaminate with aflatoxins B[1], B[2], G[1] and G[2] of concentrations ranged from 110-600 micro g/kg, but 6 samples were contaminate with sterigmatocystin ranged from 60-600 micro g/kg. Screening of the characteristic mycotoxins of 25 fungal isolates revealed that 17 of them produced, aflatoxin B[1] at 450 micro g/kg, ochratoxin A at 600 micro g/kg, ochratoxin B at 400 micro g/kg, and sterigmatocystin 280 micro g/kg from Aspergillus species, while three isolates of Penicillium produced penicillic acid [ranged from 720-240 micro g/kg] and one isolate of Trichoderma produced Trichodermine at 360 micro g/kg. The bacteriological analysis of the coffee bean samples indicated that Bacillus cereus was detected in six samples at levels [2x10 cfu/g], E. coli in two samples [14x10 and 89x10 cfu/g], Feacal coliform was detected in one sample only, while Staphylococcus appeared in 29 samples [55x103 cfu/g]. All samples were free from Salmonella. PCR assay for detection of some bacterial species revealed that all samples were negative for Yersinia enterocolitica, Campylobacter and Listeria monocytogenes, while the results of B. cereus and Salmonella were similar to the results obtained using cultural method

Gradient-echo MRI assessment of microbleed in ischemic stroke patients

Cerebral microbleeds are considered evidence of [microangiopathy], thus, they are commonly found in patients with severe leukoaraiosis and lacunar infarction. The aim of the present study was to evaluate the possible risk factors or [determinants] of microbleeds in patients with ischemia stroke, especially highlighting the association of the presence of microbleeds with small vessel vasculopathy [leukoaraiosis and lacunar infarcts]. The study included 52 patients with ischemic stroke, divided into 3 groups according to MRI findings: Group [A] patients with microbleeds +/- leukoaraiosis, Group [B] patients with leukoaraiosis without microbleeds and Group [C] patients with neither leukoaraiosis nor microbleeds [considered as a control group]. Assessment was done through clinical examination, laboratory investigations, carotid duplex, MRA and MRI brain with gradient-echo T2-weighted technique. Among the patients with microbleeds, the commonest site of microbleeds was in the deep grey nuclei followed by the hemispheric subcortical region then the brain stem while the cerebellum was involved in only 4 patients. Both groups [A] and [B] differed significantly from group [C] as they were older, hypertension was more commonly encountered and was poorly controlled. Stroke recurrence was more common among groups [A] and [B]. Furthermore, group [A] differed from group [C] in having longer duration of hypertension and more history of previous antiplatelet therapy. Group [A] differed from group [B] only concerning control of hypertension [larger number of poorly controlled patients] and number of lacunar infarcts [larger number of lacunar infarcts]. Cerebral microbleeds are commonly associated with lacunar infarctions and leukoaraiosis. Lack of proper control of hypertension [not just its mere presence or its duration] is an important determinant factor for both microbleeds and lacunar infarction, which might be complicated in the future by intra-cerebral hemorrhage

Echocardiographic diagnosis of organic and functional mitral regurgitation in Yemeni population

Cardiovascular disease is one of the major health problems all over the world. Yemen is one of the least developed countries in the Gulf and cardiovascular diseases contribute a big economic burden. Echocardiography has revolutionized the practice of cardiology and its role as a non-invasive diagnostic tool for both congenital and acquired cardiac lesions, however complex is well established. Along with 2-D, M mode and Doppler. New echocardiographic modalities like stress Echo, tissue Doppler, harmonic imaging and contrast echocardiography are also emerging in Yemen. The aim of this study was to find the prevalence of both organic and functional mitral regurgitation [MR] by echocardiography in our population. Using Sonos 1000 and 5500 HP Echocardiography machines, all the cases of MR diagnosed over the past 6 months in Al-Thawra Modern Teaching Hospital, Sana'a, were retrospectively reviewed. Mitral regurgitation was classified as organic if the mitral apparatus was found to be abnormal, and functional in the case of MR with a normal looking mitral valve. A total of thirteen hundred and thirty cases of MR were diagnosed during the study period. The mean age was 44.7 years with a standard deviation [SD] of +/- 19.4 and the age group of 51-60 years was the dominant group making up 20.8%. Mitral regurgitation was slightly more common in males than females with 56.5% vs 43.5%. Functional MR was slightly more common than organic [51 .7% vs 48.3%]. Rheumatic heart disease [22.9%] was the most common cause of organic MR while Mitral valve prolapse was only found in 6.3% of this group. Hypertensive heart disease 21 .7% was the most frequent etiology of functional MR. On the basis of severity, mild MR was the diagnosis in 65.5%, trivial in 15.4%, moderate in 12.9% and severe MR was found in 5.7%

Drug prescribing indicators in primary health care centers in Bahrain

To estimate drug use indicators in primary health care centers in the Ministry of Health, Bahrain. Four out of 20 primary health care centers in Bahrain were selected and prescriptions of one day [July 30, 2003], were collected, reviewed and analyzed. The study showed that the average number of drugs per encounter was 2.6, while the percentage of prescriptions containing injections were 8.3%, and antibiotics were 26.2%. The percentage of drugs prescribed by generic name was 14.3%, and those from the National Drug List were 99.8%. Parameters, such as average number of drugs prescribed, are in line with many countries. However, injection prescribing was higher than European countries, but low in comparison with many countries in Asia and Africa. Antibiotic prescribing was close to European countries, and lower when compared to some Asian and African countries. We need an intervention program to promote the use of generic names, as it is quite low

Value of sentinel lymph node biopsy in early breast cancer

Between November 1999 and March 2001, 20 patients with early breast cancer underwent sentinel lymphadenectomy [SLND] followed by Completion Axillary Dissection [CAD]. All sentinel lymph nodes were examined with frozen section followed postoperatively with hematoxylin and eosin staining. Negative SLN were examined immunohistochemically. The results were compared with nonsentinel nodes in axillary lymphadenectomy specimens from each patient. The SLN was successfully identified in 70% of the procedures. There was a clear learning curve. The SLN accurately identified the axillary node status in 43% with a false negative result in one case [7%]. The technique is an evolving one and in the future with increased familiarity with SLND, it would be possible to identify those patients in whom axillary lymph node dissection [ALND] and its associated morbidity may be avoided

Evaluation of two anestheltic techniques for mainernance of anesthesia during open heart surgery

Previous studies have highlighted the disadvantages of high-dose opioid anesthesia during cardiac surgery. On the other hand, the pharmacokinetic profile of propofol may constitute another advantage when used for maintenance of anesthesia by continuous infusion in open-heart surgery. This study investigated the use of an infusion of either propofol or fentanyl, for maintenance of anesthesia, in twenty adult patients undergoing elective open-heart surgery for valve replacement. After induction, anesthesia was maintained with either 4-10 mg/kg/hr propofol [P group], or 0.2 micro g/kg/min fentanyl supplemented with 0 - 1% isoflurane [F group]. In ICU, sedation was provided with an infusion of either propofol [in PG] or midazolam [in FG]; together with morphine infusion for analgesia. Heart rate [HR] and mean arterial pressure [MAP] were registered prior to induction of anesthesia [baseline], after intubation and sternotomy, before and 15 min after CPB, and at the end of operation. Other hemodynamic variables were also recorded before induction, before 15 min after CPB, and at the end of operation. In ICU, timing of extubation and adverse events were recorded. There was no significant hemodynamic response to tracheal intubation or sternotomy in both groups. Compared to the baseline values, significant increase in HR, and decreases in MAP and SVRI were observed 15 minutes after CPB [p<0.05]. Also, fifteen minutes of CPB resulted in significant increases in CO and CI, which were further increased at the end of surgery [p<0.05]. This increase was more in PG than in FG [p<0.05]. The changes in CVP and PCWP were insignificant over the observation period. There were no significant differences between groups in terms of CPB time, duration of anesthesia or hemodynamic changes [except CO and CI]. Patients in PG were extubated earlier [p<0.05] than those in FG [mean times were 354 +/- 65 min and 745 +/- 117 min; respectively]. No patient had recall of intraoperative events and there were no perioperative complications. We conclude that the use of propofol infusion, for maintenance of anesthesia during open-heart surgery and for sedation in ICU, is a safe technique as it produces cardiovascular stability similar to that associated with fentanyl, facilitates early extubation and reduces the possibility of intraoperative awareness that may occur with the use of high-dose opioid anesthesia

Pigeon, duck and chicken ileal loop response to E coli isolated from pigeons, turkeys, ducks, and chicken

A total of 257 E. Coli isolates were recovered from blood and/ or internal organs of 250 pigeons, 128 turkeys and 100 ducks with septicaemic manifestations. 137 E. Coli isolates could be serotyped. In pigeons, there were 86 E. Coli isolates belonging to the O-groups 1,2,11,22,22,29,48,53,99,101,110,116,119,123,126,147 and 156 in turkeys they were 31 E. coli isolates belonging to the O-groups 1,2,11,17,29,53,79,86,99 and 111 and in ducks they were 20 E. coli isolates belonging to the O-groups 11,17,22,71,86,99,11,119,137 and 157. It was succeeded to carry out the ileal loop test for determination of the enterotoxicity of E. coli in pigeons, ducks and chickens using E. coli isolates recovered. From these birds. Chickens were also found to be suitable for testing E. coli isolated from pigeons, turkeys and ducks. Distention of the ileal loops was achieved by 24.6% of the tested 65 isolates. On the other hand 69.2% of the isolates caused congestion and haemorrhages when their bacteria-free filtrates were injected in 10 days old chicken embryos. The oral administration of live bacterial suspensions of 10 E. coli O-groups caused diarrhoea of live bacterial suspensions of 10 E.coli O-groups caused diarrhoea in all chickens used in the experiment. The mortality rate varied between 0 and 80%