Foliar application of triacontanol ameliorates heat stress through regulation of the antioxidant defense system and improves yield of eggplant / Title in the second language of the article: Amelioration of heat stress in egg plant through application of tricontanol

Abstract Transplanting time and genotype contribute to improving crop yield and quality of eggplant (Solanum melongena L.). A field experiment was conducted to investigate the impact of foliar applied of triacontanol (TRIA) and eggplant genotypes 25919, Nirala, 28389 and Pak-10927,transplanted on 1 March,15 March, and 1 April on exposure to high air temperature conditions. The experiment was performed according to Randomized Complete Block Design and the data was analyzed by using Tuckey,s test . The TRIA was applied at 10µM at flowering stage; distilled water was used as the control. Rate of photosynthesis and transpiration, stomatal conductance, water use efficiency, and effects on antioxidative enzymes (superoxide dismutase, catalase and peroxidase) were evaluated. The 10µM TRIA increased photosynthesis rate and water use efficiency and yield was improved in all genotypes transplanted at the different dates. Foliar application of 10µM TRIA increased antioxidative enzyme activities (SOD, POD & CAT) and improved physiological as well as biochemical attributes of eggplant genotypes exposed to high heat conditions. Highest activity of dismutase enzyme 5.41mg/1g FW was recorded in Nirala genotype in second transplantation. Whereas, lowest was noted in PAK-10927 (2.30mg/g FW). Maximum fruit yield was found in accession 25919 (1.725kg per plant) at 1st transplantation with Triacontanol, whereas accession PAK-10927 gave the lowest yield (0.285 kg per plant) at control treatment on 3rd transplantation. Genotype, transplanting date and application of TRIA improved growth, yield and quality attributes under of heat stress in eggplant.

Resumo O tempo de transplante e o genótipo contribuem para melhorar a produtividade e a qualidade da cultura da berinjela (Solanum melongena L.). Um experimento de campo foi conduzido para investigar o impacto da aplicação foliar de triacontanol (TRIA) e genótipos de berinjela 25919, Nirala, 28389 e Pak-10927, transplantados em 1 de março, 15 de março e 1 de abril de exposição a condições de alta temperatura do ar. O experimento foi realizado de acordo com o Randomized Complete Block Design e os dados foram analisados pelo teste de Tuckey. O TRIA foi aplicado a 10 µM na fase de floração; água destilada foi utilizada como controle. Taxa de fotossíntese e transpiração, condutância estomática, eficiência do uso da água e efeitos sobre as enzimas antioxidantes (superóxido dismutase, catalase e peroxidase) foram avaliados. O TRIA 10 µM aumentou a taxa de fotossíntese e a eficiência do uso da água e o rendimento foi melhorado em todos os genótipos transplantados nas diferentes datas. A aplicação foliar de TRIA 10µM aumentou as atividades das enzimas antioxidantes (SOD, POD e CAT) e melhorou os atributos fisiológicos e bioquímicos de genótipos de berinjela expostos a condições de alto calor. A atividade mais elevada da enzima dismutase 5,41mg / 1g FW foi registrada no genótipo Nirala no segundo transplante. Considerando que o mais baixo foi observado em PAK-10927 (2,30 mg / g FW). A produtividade máxima de frutos foi encontrada no acesso 25919 (1,725 ​​kg por planta) no 1º transplante com Triacontanol, enquanto o acesso PAK-10927 deu a menor produção (0,285 kg por planta) no tratamento de controle no 3º transplante. Genótipo, data de transplante e aplicação de TRIA, melhoramento do crescimento, rendimento e atributos de qualidade sob estresse térmico em berinjela.

Foliar application of triacontanol ameliorates heat stress through regulation of the antioxidant defense system and improves yield of eggplant

Abstract Transplanting time and genotype contribute to improving crop yield and quality of eggplant (Solanum melongena L.). A field experiment was conducted to investigate the impact of foliar applied of triacontanol (TRIA) and eggplant genotypes 25919, Nirala, 28389 and Pak-10927,transplanted on 1 March,15 March, and 1 April on exposure to high air temperature conditions. The experiment was performed according to Randomized Complete Block Design and the data was analyzed by using Tuckey,s test . The TRIA was applied at 10µM at flowering stage; distilled water was used as the control. Rate of photosynthesis and transpiration, stomatal conductance, water use efficiency, and effects on antioxidative enzymes (superoxide dismutase, catalase and peroxidase) were evaluated. The 10µM TRIA increased photosynthesis rate and water use efficiency and yield was improved in all genotypes transplanted at the different dates. Foliar application of 10µM TRIA increased antioxidative enzyme activities (SOD, POD & CAT) and improved physiological as well as biochemical attributes of eggplant genotypes exposed to high heat conditions. Highest activity of dismutase enzyme 5.41mg/1g FW was recorded in Nirala genotype in second transplantation. Whereas, lowest was noted in PAK-10927 (2.30mg/g FW). Maximum fruit yield was found in accession 25919 (1.725kg per plant) at 1st transplantation with Triacontanol, whereas accession PAK-10927 gave the lowest yield (0.285 kg per plant) at control treatment on 3rd transplantation. Genotype, transplanting date and application of TRIA improved growth, yield and quality attributes under of heat stress in eggplant.

Resumo O tempo de transplante e o genótipo contribuem para melhorar a produtividade e a qualidade da cultura da berinjela (Solanum melongena L.). Um experimento de campo foi conduzido para investigar o impacto da aplicação foliar de triacontanol (TRIA) e genótipos de berinjela 25919, Nirala, 28389 e Pak-10927, transplantados em 1 de março, 15 de março e 1 de abril de exposição a condições de alta temperatura do ar. O experimento foi realizado de acordo com o Randomized Complete Block Design e os dados foram analisados pelo teste de Tuckey. O TRIA foi aplicado a 10 µM na fase de floração; água destilada foi utilizada como controle. Taxa de fotossíntese e transpiração, condutância estomática, eficiência do uso da água e efeitos sobre as enzimas antioxidantes (superóxido dismutase, catalase e peroxidase) foram avaliados. O TRIA 10 µM aumentou a taxa de fotossíntese e a eficiência do uso da água e o rendimento foi melhorado em todos os genótipos transplantados nas diferentes datas. A aplicação foliar de TRIA 10µM aumentou as atividades das enzimas antioxidantes (SOD, POD e CAT) e melhorou os atributos fisiológicos e bioquímicos de genótipos de berinjela expostos a condições de alto calor. A atividade mais elevada da enzima dismutase 5,41mg / 1g FW foi registrada no genótipo Nirala no segundo transplante. Considerando que o mais baixo foi observado em PAK-10927 (2,30 mg / g FW). A produtividade máxima de frutos foi encontrada no acesso 25919 (1,725 kg por planta) no 1º transplante com Triacontanol, enquanto o acesso PAK-10927 deu a menor produção (0,285 kg por planta) no tratamento de controle no 3º transplante. Genótipo, data de transplante e aplicação de TRIA, melhoramento do crescimento, rendimento e atributos de qualidade sob estresse térmico em berinjela.

Blood Pressure Values in Apparently Healthy Sudanese Population

Introduction: Blood pressure is one of the most often measured clinical parameters, and assessment of blood pressure has a considerable impact on diagnostic decisions. Objectives: To establish blood pressure normal reference values in Sudanese. Methods: A cross-sectional study was conducted from September 2016 to November 2018. Eight hundred eighty-eight healthy adult Sudanese between the ages of 18 and 60 (203 men and 685 women) were randomly selected from the states of Khartoum, Northern, Gezira, Red Sea, and North Darfur. Clinical, anthropometric, and blood pressure measurement data were collected. Results: The mean for all volunteers was 113.93 ± 9.917 mmHg, systolic blood pressure (SBP) and 75.29 ± 6.79 mmHg, diastolic blood pressure (DBP). SBP in men was 118.6 + 7.642 mmHg compared to 112.53 + 9.121 mmHg in women, while DBP in men was 77.51 + 5.984 mmHg compared to 74.63 + 6.844 mmHg in women. Beside the gender variations, blood pressure values also showed geographical variability. There was a positive connection between blood pressures (SBP and DBP), BMI, and age. (P < 0.05) was used for significance. Conclusion: Blood pressure of Sudanese was found to be within the normal international range with gender and geographical variability. It showed positive correlation with age and BMI.

Efficiency of exogenous zinc sulfate application reduced fruit drop and improved antioxidant activity of 'Kinnow' mandarin fruit / A eficiência da aplicação de sulfato de zinco exógeno reduziu a queda da fruta e melhorou a atividade antioxidante da tangerina 'Kinnow'

'Kinnow' mandarin (Citrus nobilis L.× Citrus deliciosa T.) is an important marketable fruit of the world. It is mainstay of citrus industry in Pakistan, having great export potential. But out of total production of the country only 10% of the produce meets the international quality standard for export. Pre-harvest fruit drop and poor fruit quality could be associated with various issues including the plant nutrition. Most of the farmers do not pay attention to the supply of micro nutrients which are already deficient in the soil. Furthermore, their mobility within plants is also a question. Zinc (Zn) is amongst those micronutrients which affect the quality and postharvest life of the fruit and its deficiency in Pakistani soils is already reported by many researchers. Therefore, this study was carried out to evaluate the influence of pre-harvest applications of zinc sulfate (ZnSO4; 0, 0.4%, 0.6% or 0.8%) on pre-harvest fruit drop, yield and fruit quality of ‘Kinnow’ mandarin at harvest. The treatments were applied during the month of October i.e. 4 months prior to harvest. The applied Zn sprays had significant effect on yield and quality of the "Kinnow" fruit. Amongst different foliar applications of ZnSO4applied four months before harvest, 0.6% ZnSO4 significantly reduced pre-harvest fruit drop (10.08%) as compared to untreated control trees (46.45%). Similarly, the maximum number of fruits harvested per tree (627), fruit weight (192.9 g), juice percentage (42.2%), total soluble solids (9.5 °Brix), ascorbic acid content (35.5 mg 100 g-¹) and sugar contents (17.4) were also found significantly higher with 0.6% ZnSO4 treatment as compared to rest of treatments and control. Foliar application of 0.6% ZnSO4 also significantly improved total antioxidants (TAO) and total phenolic contents (TPC) in fruit. In conclusion, foliar [...].

A tangerina 'Kinnow' (Citrus nobilis L. × Citrus deliciosa T.) é uma importante fruta comercializável do mundo. É o esteio da indústria cítrica no Paquistão, com grande potencial de exportação. Mas, da produção total do país, apenas 10% da produção atendem o padrão internacional de qualidade para exportação. A queda da fruta antes da colheita e a baixa qualidade da fruta podem estar associadas a vários problemas, incluindo a nutrição da planta. A maioria dos agricultores não se preocupa com o fornecimento de micronutrientes que já são deficientes no solo. Além disso, sua mobilidade dentro das plantas também é uma questão. O zinco (Zn) está entre os micronutrientes que afetam a qualidade e a vida pós-colheita da fruta, e sua deficiência em solos paquistaneses já é relatada por diversos pesquisadores. Portanto, este estudo foi realizado para avaliar a influência da aplicação pré-colheita de sulfato de zinco (ZnSO4; 0, 0,4%, 0,6% ou 0,8%) na queda dos frutos na pré-colheita, produtividade e qualidade dos frutos da tangerina 'Kinnow' em colheita. Os tratamentos foram aplicados durante o mês de outubro, ou seja, 4 meses antes da colheita. As pulverizações de Zn aplicadas tiveram efeito significativo no rendimento e na qualidade da fruta 'Kinnow'. Entre as diferentes aplicações foliares de ZnSO4 efetuadas quatro meses antes da colheita, 0,6% de ZnSO4 reduziu significativamente a queda de frutos antes da colheita (10,08%) em comparação com as árvores de controle não tratadas (46,45%). Da mesma forma, número máximo de frutos colhidos por árvore (627), peso do fruto (192,9 g), porcentagem de suco (42,2%), sólidos solúveis totais (9,5 ° Brix), teor de ácido ascórbico (35,5 mg / 100 g-¹) e os teores de açúcar (17,4) também foram significativamente maiores com o tratamento com 0,6% de ZnSO4 em comparação com o restante dos tratamentos e o controle. A aplicação foliar de 0,6% de ZnSO4 também melhorou significativamente os [...].

Efficiency of exogenous zinc sulfate application reduced fruit drop and improved antioxidant activity of Kinnow mandarin fruit

Abstract Kinnow mandarin (Citrus nobilis L.× Citrus deliciosa T.) is an important marketable fruit of the world. It is mainstay of citrus industry in Pakistan, having great export potential. But out of total production of the country only 10% of the produce meets the international quality standard for export. Pre-harvest fruit drop and poor fruit quality could be associated with various issues including the plant nutrition. Most of the farmers do not pay attention to the supply of micro nutrients which are already deficient in the soil. Furthermore, their mobility within plants is also a question. Zinc (Zn) is amongst those micronutrients which affect the quality and postharvest life of the fruit and its deficiency in Pakistani soils is already reported by many researchers. Therefore, this study was carried out to evaluate the influence of pre-harvest applications of zinc sulfate (ZnSO4; 0, 0.4%, 0.6% or 0.8%) on pre-harvest fruit drop, yield and fruit quality of Kinnow mandarin at harvest. The treatments were applied during the month of October i.e. 4 months prior to harvest. The applied Zn sprays had significant effect on yield and quality of the Kinnow fruit. Amongst different foliar applications of ZnSO4applied four months before harvest, 0.6% ZnSO4 significantly reduced pre-harvest fruit drop (10.08%) as compared to untreated control trees (46.45%). Similarly, the maximum number of fruits harvested per tree (627), fruit weight (192.9 g), juice percentage (42.2%), total soluble solids (9.5 °Brix), ascorbic acid content (35.5 mg 100 g-1) and sugar contents (17.4) were also found significantly higher with 0.6% ZnSO4 treatment as compared to rest of treatments and control. Foliar application of 0.6% ZnSO4 also significantly improved total antioxidants (TAO) and total phenolic contents (TPC) in fruit. In conclusion, foliar spray of ZnSO4 (0.6%) four months prior to harvest reduced pre-harvest fruit drop, increase yield with improved quality of Kinnow mandarin fruit.

Resumo A tangerina Kinnow (Citrus nobilis L. × Citrus deliciosa T.) é uma importante fruta comercializável do mundo. É o esteio da indústria cítrica no Paquistão, com grande potencial de exportação. Mas, da produção total do país, apenas 10% da produção atendem o padrão internacional de qualidade para exportação. A queda da fruta antes da colheita e a baixa qualidade da fruta podem estar associadas a vários problemas, incluindo a nutrição da planta. A maioria dos agricultores não se preocupa com o fornecimento de micronutrientes que já são deficientes no solo. Além disso, sua mobilidade dentro das plantas também é uma questão. O zinco (Zn) está entre os micronutrientes que afetam a qualidade e a vida pós-colheita da fruta, e sua deficiência em solos paquistaneses já é relatada por diversos pesquisadores. Portanto, este estudo foi realizado para avaliar a influência da aplicação pré-colheita de sulfato de zinco (ZnSO4; 0, 0,4%, 0,6% ou 0,8%) na queda dos frutos na pré-colheita, produtividade e qualidade dos frutos da tangerina Kinnow em colheita. Os tratamentos foram aplicados durante o mês de outubro, ou seja, 4 meses antes da colheita. As pulverizações de Zn aplicadas tiveram efeito significativo no rendimento e na qualidade da fruta Kinnow. Entre as diferentes aplicações foliares de ZnSO4 efetuadas quatro meses antes da colheita, 0,6% de ZnSO4 reduziu significativamente a queda de frutos antes da colheita (10,08%) em comparação com as árvores de controle não tratadas (46,45%). Da mesma forma, número máximo de frutos colhidos por árvore (627), peso do fruto (192,9 g), porcentagem de suco (42,2%), sólidos solúveis totais (9,5 ° Brix), teor de ácido ascórbico (35,5 mg / 100 g-1) e os teores de açúcar (17,4) também foram significativamente maiores com o tratamento com 0,6% de ZnSO4 em comparação com o restante dos tratamentos e o controle. A aplicação foliar de 0,6% de ZnSO4 também melhorou significativamente os antioxidantes totais (TAO) e os teores fenólicos totais (TPC) nas frutas. Em conclusão, a pulverização foliar de ZnSO4 (0,6%) quatro meses antes da colheita reduziu a queda de frutos antes da colheita e aumentou o rendimento com a melhoria da qualidade da fruta tangerina Kinnow.

Patient Satisfaction with Emergency Department Care at a Care Center in Saudi Arabia

Patient satisfaction plays a crucial role in assessments of the effectiveness of healthcare delivery. It is of absolute importance in the quality assessment as its comprehensive analysis can highlight both well-functioning and problematic aspects of a hospital. This descriptive cross-sectional study aimed to assess the satisfaction of 375 patients admitted to the emergency department (ED) of King Abdulaziz Medical City in Saudi Arabia between December 2016 and September 2017 and to determine the related factors. The patients, selected through non-randomized convenience sampling, completed a validated questionnaire in two phases: August-September and December-January. The mean (standard deviation) score of overall satisfaction was 57.59 (8.69) (range: 19-70). The domain that had the highest “excellent” score was admission (171; 45.8%), while that with the highest “poor” score was nursing care (141; 37.6%). Most participants rated their level of satisfaction as good (96; 50.8%). Those who had been hospitalized in the three days prior to filling out the questionnaire and those who waited longer to see the doctor were significantly less satisfied (p=0.007 and p<0.001, respectively) compared with the other patients. Higher satisfaction levels were observed among patients who were treated in the main ED, were admitted during the morning shift, visited the ED during the slower season (August-September), and had experienced less waiting time to see the doctor. Patients were mostly satisfied with admission and least satisfied with nursing care.

Large Squamous Papilloma In Unusual Site: A Case Report And Review Of The Literature

Squamous papilloma is a benign proliferation of the stratified squamous epithelium, resulting in a papillary mass, which appears as sessile or pedunculated growth with cauliflower-like projection. The most common sites are palate, uvula followed by tongue and lip. Most of the time it usually presents as a solitary, exophytic growth with an average size of less than 1 cm.Here, we report the case of a 28-years-old male patient presented with a solitary sessile, white growth with multiple papillary projections on the right buccal mucosa measuring approximately 4 x 3 cm. An incisional biopsy followed by surgical excision of the lesion was performed confirming the diagnosis of squamous papilloma. This paper highlights a case of unusually large-sized papilloma in an uncommon site.

Effect of body weight on serum homocysteine level in patients with polycystic ovarian syndrome: a case control study

Background: Polycystic ovarian syndrome [PCOS] represent one of the common endocrine disorders which influence around 8% of reproductive women whom usually suffering from obesity and increase cardiovascular risk. Serum homocysteine levels are associated with bad impact on endothelial functions and considered as an independent risk factor for cardiovascular disease

Objective:The aim was to study the level of plasma homocysteine in obese and non-obese Iraqi patients with PCOS

Materials and Methods:This study was carried out on 207 women. Of theme, 101 women with PCOS and 106 PCOS- free women served as controls. Blood sample was taken from each participant on the 2[nd] day of menstruation morning after an overnight fasting. Serum levels of follicle-stimulating hormone [FSH], luteinizing hormone [LH], free testosterone and androstenedione were measured. Moreover, total lipid profile and plasma homocysteine levels were measured in both groups

Results: Sixty percent of PCOS women were overweight or obese and 56% of them had a waist circumference >88cm. Moreover plasma homocysteine concentrations were found to be higher in patients with PCOS [11.5 +/- 5.41micro mol/L] as compared with control [8.10 +/- 1.89 micro mol/L] [p<0.002]. Furthermore the homocysteine concentrations were 13.19 +/- 5.97 micro mol/L and 9.38 +/- 2.99 micro mol/L in both obese and normal-weight PCOS women respectively which was significantly higher than obese [p<0.002] and normal-weight [p<0.004] control women

Conclusion:Increase in body weight is not an independent risk factor to increase plasma homocysteine levels in PCOS women

Association between Vitamin D deficiency and the severity of chronic liver disease and liver cirrhosis: systematic literature review

Background: Vitamin D deficiency is believed to cause variety of abnormalities such as liver stifihess and fibrosis. It is also shown that vitamin D deficiency may result in chronic liver disease or liver cirrhosis. In this study, we aimed to systematically review the literature wherein the relationship between vitamin D deficiency and the severity of chronic liver disease or liver cirrhosis had been investigated

Materials and Methods: PubMed, Scopus, and Google scholar were searched using the following search method [vitamin D deficiency OR vitamin D insufficiency OR insufficient vitamin D] AND [chronic liver disease OR chronic hepatitis OR cirrhosis OR liver cirrhosis] AND [severity OR intensity] to evaluate the role of vitamin D deficiency or vitamin D inadequacy in the occurrence and severity of chronic liver disease. Articles were collected and the data were extracted

Results: Totally, 641 articles were found through searching the databases and reference list scanning. Of the collected documents, only 19 articles with 4895 studied patients were included and analyzed. The results of this study showed that almost 80% of patients with chronic liver disease had severe vitamin D deficiency

Conclusion: Vitamin D deficiency is associated with the occurrence of chronic liver disease. The severity of liver cirrhosis is also associated with the level of 25 [OH] in progressive liver disease

Portal hypertension treatment with candesartan plus propranolol for nine months restores normal portal circulation hemodynamic pattern

Post HCV liver cirrhosis is one of the most prominent etiologies behind the abnormal portal circulation hemodynamics. It occurs as a result of distorted balance between portal venous flow [PVF] and intrahepatic resistances [IHR]. PVF is partially controlled by using both specific and non-specific beta blockers [NSBBs] that have insignificant effects on IHR. Angiotensin receptor blockers [ARBs] inhibit the activated hepatic stellate cell [HSC] contraction and thought to reduce the dynamic portion of MR. The study aimed to slow down the venous blood flow and to reduce the IHR of portal vein vasculature to control sequelae of the enhanced post cirrhosis portal venous turbulence. We evaluated the effects of Candesartan plus propranolol compared to each of them individually in management of portal hypertension [PH]. Three groups of 25 patients each, presented with chronic HCV infection and grade II- III esophageal varices [OV], were randomly assigned to one of three treatment regimens: Propranolol or Candesartan or both. Subjects were screened every three month by Doppler Ultrasound for a total of nine months. Damping Index [DI], pulse Pulsatility index [PT], Portal Venous Flow [PVF] Volume, Portal Venous Peak Velocity [PVPV], and Portal Vein Diameter [PVD] were evaluated once every third month. Our study concluded that combined therapy [Propranolol + Candesartan] induced highly significant improvements that led to restoration of normal values of DI, PI, PVF volume and PVPV overtime compared to monotherapy regimens [P>0.001]. Data strongly recommended using Propranolol plus Candesartan in overtime management of portal hypertension

Levofloxacin Reverses Hydroxyzine Induced Psychomotor Performance Deterioration: A Randomized Crossover Study.

Background: Levofloxacin is a third generation fluoroquinolone chemotherapeutic agent used in the treatment of severe and resistant bacterial infections; it exerts antibacterial effects in both blood and inflamed tissues. Levofloxacin leads to central nervous system stimulation via inhibition of GABA-A receptor complex like beta-lactam antibiotics. Hydoxyzineis used for the treatment of insomnia, allergic reactions and for preoperative sedation because of blocking H-1 receptors and so blocking histaminergic signals. Objectives: The aim of the present study is to elucidate the exciting effect of levofloxacin in hydroxyzine induced psychomotor performance deterioration in normal healthy volunteers. Methods: Thirty healthy medical student volunteers, aged between 22-25 years were allocating arbitrarily. All participants were habituated with the study measures and skilled on the Leeds psychomotor tester before and after levofloxacin (500 mg/day) alone or with hydroxyzine (10 mg/day). Results: Hydroxyzine impaired psychomotor performance and cognitive function, it prolongs the total reaction time, movement reaction time, recognition reaction time and distort critical flicker and fusion frequency significantly p<0.05. While levofloxacin activates psychomotor performance and cognitive function, it shortens the total reaction time, movement reaction time, recognition reaction time and regulate critical flicker and fusion frequency significantly p<0.05. The combined effect of levofloxacin and hydroxyzine produced insignificant effects on psychomotor performance and cognitive function p>0.05. Conclusion: Levofloxacin significantly improves psychomotor performance in normal, healthy volunteers and produced CNS stimulation that is able to reverse deteriorations in psychomotor performance and cognitive function induced by hydroxyzine.

Promoting excellence in teaching and learning in clinical education

Clinical learning is the essence of medical education. Many factors have been demonstrated to influence students' development of clinical competence. These factors include students' exposure to a large volume and variety of clinical experiences, learning in authentic clinical settings, self-directed learning, and the provision of a supportive environment. Clinical teachers have an extremely important role in the effectiveness of clinical education in supporting learners, encouraging reflection, and providing constructive and regular feedback. Early and frequent clinical experiences should be planned and integrated in curricula. The provision of such opportunities is associated with the development of appropriate attitudes and the acquisition of commendation and diagnostic skills among undergraduate medical students. The experiences of undergraduate medical students at clinical venues should be documented to enable monitoring of the quality of their exposure and planning for appropriate interventions. The combination of teaching in family practice centers and hospitals will probably provide the most effective approach and will combine the recognized advantages from different sites. The recent challenges facing the health care system necessitate the need for innovative teaching strategies, such as simulation, to meet the inadequacy of clinical cases at the teaching sites. The quality of clinical teaching should be maintained through regular evaluations of clinical teachers and all teaching activities. This article addresses the possible factors that could affect the process of student learning and suggests measures to promote the quality of clinical teaching and learning

Potential additive effects of garcinia cambogia on atorvastatin treated hyperlipidemic patients: randomized crossover clinical study.

Dyslipidemia is a major risk factor linking in the direction of the progression of ischemic heart diseases, which is measured to be the chief principal reason of international morbidity and mortality. Numerous lessons seeming for substitute treatments include attempted herbal medicine for reducing the expansion of ischemic heart and vascular diseases. Along with herbs with hypolipidemic actions were garlic, garcinia cambogia, gum guggul and others plants. Garcinia cambogia is an herbal agent found in different fruit plants inhibit lipid synthesis via its active materials hydroxycitric acid that inhibit cytoplasmic adenosine triphosphate-dependent citrate lyase, which responsible for hepatic lipogenesis in dose dependent manner. Thus, the objective of this experimental research was for elucidation the potential combined effects of atorvastatin and garcinia cambogia resting on lipid profile in hyperlipidemic patients. Methods: A total of 25 hyperlipidemic patients enrolled in this clinical trial under scientific approval committee and spoken consent taken from all patients. Five patients were withdrawn from this study due to incompliance so, only 20 patients (12 males + 8 females) continue this clinical trial. All patients not took any medications through 2 weeks and all non-diabetic or hypertensive with age ranged 45-65 years. The patients divided into two groups: Group A: 10 patients (4 females + 6 males) take atorvastatin 40/day. Group B: 10 patients (6 males + 4 females) take atorvastatin 40/day + garcinia cambogia 500/day. The duration of treatment was 8 weeks, and baseline lipid profile measurements were done and regarded as control. Results: The atorvastatin effects during 8 weeks treatment at dose of 40 mg/day produced significant effects on all lipid profile p < 0.05, mainly on serum cholesterol and low-density lipoprotein (LDL) levels and less significant effects on atherogenic index (AI), triglyceride and very LDL (VLDL). While garcinia cambogia produced significant reductions in serum lipid and improve other lipid parameters, garcinia cambogia 500 mg/day significantly improve serum cholesterol, VLDL, and LDL p < 0.05 but produced insignificant effect on high-density lipoprotein and AI p >0.05. The combined effects of garcinia cambogia 500 mg/day and atorvastatin 40 mg/day showed significant effects on all lipid profiles and AI p < 0.05. Conclusion: This study scrutinizes the value of garcinia cambogia in treatment of hyperlipidemia alone or in combination with atorvastatin. It produced significant additive effect with atorvastatin and hence atorvastatine doses can be reduced and substituted with garcinia cambogia for reduction serious atorvastatin associated adverse effects.

Experimental antibacterial activity of selective cyclooxygenase antagonist.

Background: From the history of the development of pharmaceutical compounds it is evident that any drug may have the possibility of possessing diverse functions and thus may have useful activity in completely different fields of medicine and different studies showed that newer antimicrobials have revealed antimicrobial action involved in the management of diseases of non-infectious etiology. This study was done to determine in vitro antibacterial activity of selected selective cyclooxygenase-2 inhibitor. Methods: Twenty two strains of gram positive and gram negative bacteria, which were isolated from skin and urinary tract infected patient. These bacteria were being cultured on specific optimal growth media. The antibacterial activity of selective COX-2 (meloxicam, celecoxib, valdecoxib and nimesulide). Inhibitors determined by measuring zone of inhibition and minimal inhibitory concentration (MIC). Results: Results showed that MIC of celecoxib and meloxicam in μg/ml was ranged from 5-80μg/ml on selected bacteria compared with negative control distilled water (D.W) ,valdecoxib was 80-160μg/ml, while and nimesulide was ranged from 5-40 μg/ml .All the selected bacteria were showed sensitivity for all coxib used in this experimental study except Pseudomonas aeruginosa which showed resistant to meloxicam and valdecoxib, Klebsiella pneumoniae resist to nimesulide while Staphylococcus aureus was resist to valdecoxib. The smaller zone of inhibition showed by valdecoxib and celecoxib which was 3mm against Klebsiella pneumoniae, while the larger zone of inhibition showed by nimesulide which was 26mm against Escherichia coli. Conclusions: In conclusion selective cyclooxygenase (cox-2) inhibitor possesses antibacterial activity this is especially for nimesulide and little by valdecoxib. Escherichia coli are sensitive bacteria to all coxib. Consequently; coxib may be regarded as anti-inflammatory and antibacterial agent especially for urinary tract infection where Escherichia coli are the major causative organism.

Favorable impact of Nigella sativa seeds on lipid profile in type 2 diabetic patients

The atherogenic pattern of dyslipidemia associated with type 2 diabetes mellitus [DM] has been increasingly discussed. We have recently reported a hypoglycemic effect of Nigella sativa [NS] seeds in patients with type 2 DM. In this study we sought to assess the impact of NS seeds on lipid profile in type 2 diabetic patients. A total of 94 patients with type 2 DM were recruited and divided into 3 dose groups. Capsules containing NS were administered orally in a dose of 1, 2, and 3 g/day for 12 weeks. All patients were subjected to measurement of total cholesterol [TC], triglycerides [TG], low-CJ density lipoprotein cholesterol [LDL-c], and high-density lipoprotein cholesterol [HDL-c] before treatment and 4, 8, and 12 weeks thereafter. Patients receiving 1 g/day NS seeds for 12 weeks [group 1] showed I nonsignificant changes in all the parameters except for a significant increase in HDL-c after 4 weeks of treatment. However, patients ingested 2 g/day NS displayed a significant decline in TC, TG, and LDL-c, and CD a significant elevation in HDL-c/LDL-c, compared with their baseline data and to group 1 patients. Increasing

Barriers to feedback in undergraduate medical education: male students' perspective in central Saudi Arabia

To explore the views of undergraduate medical students regarding the presence and sources of barriers to effective feedback in their setting. This cross-sectional study was conducted at the College of Medicine, Department of Medical Education, King Saud bin Abdul-Aziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia from April to June 2010. A self-administered questionnaire was used to explore the objectives of the study. One hundred and eighty-six male undergraduate medical students participated in this study. Approximately 45% indicated presence of barriers to effective feedback. These include: absence of a clear system of feedback; inadequate skills of teachers for provision-effective feedback; and to a lesser extent, students' fear of insult due to feedback. Most participants showed their interest and readiness to receive more professional feedback in the future. This study has showed the presence of barriers as perceived by medical students, which could significantly minimize utilization of feedback in medical education. The reported barriers should be addressed to utilize the vital role of feedback in the learning process of undergraduate medical students.

Oral manifestations and radiographic changes in the jaw-bones of patients with end-stage renal disease onmaintenance hemodialysis: a descriptive study / Estudo descritivo das manifestações bucais e alterações radiográficas em maxilares de pacientes com doençarenal terminal e sob hemodiálise

Objectives: The purpose of the present study was to assess the oral manifestations and radiographic changes in the jawbones of patients undergoing hemodialysis, diagnosed with end-stage renal disease (ESRD). Methods: Forty patients on maintenance hemodialysis were clinically examined for oral manifestations and evaluated for radiographic changes in the jaws with panoramic and intra-oral periapical radiographs. Results were expressed as Percentage. Results: Out of 40 patients, 37 patients (92.5%) showed at least one or more oral manifestations. The most common oral manifestations were mucosal pallor (70%), xerostomia (57.5%), petechiae and ecchymoses (37.5%), and less common were taste alterations (15%), uremic odor (7.5%), coated tongue (10%) and mucosal pain (2.5%). Radiographic changes seen were loss of lamina dura (22.2%), altered trabecular pattern (5.5%), multiple radiolucent lesions (5%), and pulp calcification (2.7%). Conclusions: Most of the patients presented with oral signs and symptoms. However it was observed that patients demonstrating radiographic changes were mostly those who were on dialysis for a relatively long duration.

Objetivos: O objetivo do presente estudo foi avaliar as manifestações orais e alterações radiográficas nos maxilares de pacientes submetidos à hemodiálise e com diagnóstico de doença renal em estágio terminal (DRET). Métodos: 40 pacientes em hemodiálise de manutenção foram examinados clinicamente e avaliados radiograficamente por meio de radiografias panorâmicas e periapicais em busca de manifestações orais nas mandíbulas. Resultados: Dos 40 pacientes, 37 pacientes (92,5%) apresentaram pelo menos uma ou mais manifestações orais. As manifestações orais mais comuns foram: palidez da mucosa (70%), xerostomia (57,5%), petéquias e equimoses (37,5%); e menos comuns: alterações do paladar (15%), odor urêmico (7,5%), língua saburrosa (10%) e mucosa dolorida (2,5%). As alterações radiográficas observadas foram a perda da lâmina dura (22,2%), padrão trabecular alterado (5,5%), lesões radiolúcidas múltiplas (5%) e calcificação pulpar (2,7%). Conclusões: A maioria dos pacientes apresentava sinais e sintomas orais. Entretanto, foi observado que os pacientes demonstrando alterações radiográficas foram principalmente aqueles que estavam em diálise por um período relativamente longo.

Pharmacokinetic concerns in the management of drug induced vomiting in co-morbid tuberculosis patient: A case report from Malaysia.

A 46 years old patient with history of type II diabetes mellitus (DM) approached chest clinic with complaints of productive cough, low grade fever and night sweating. Positive sputum smear and cavities in upper lobe of left lung confirmed him as a pulmonary tuberculosis patient (PTB). He was prescribed World Health Organization recommended six months therapy for tuberculosis (TB). During treatment, patient suffered from persistent vomiting for which he was prescribed metoclopramide tablet (10mg). Total duration of TB treatment was prolonged up to 10 months which was attributed to frequent vomiting and uncontrolled blood sugar level throughout therapy. Appropriate glycaemic control is cornerstone in management of PTB patients with type II DM. According to United State Pharmacopoeia, dissolution time specification for rifampicin in fixed dose combination (FDC) is 45 minutes. This indicates that anti TB drugs must remain in gastrointestinal tract for at least 45 minutes. Administration of metoclopramide at least one hour before taking anti TB drugs can trim down episodes of vomiting.

Pattern of skeletal injuries in physically abused children

The aim of this study is to identify the frequency and patterns of skeletal injuries among victims of child abuse in Bahrain. Retrospective. Child Protection Unit at Salmaniya Medical Complex. Child's characteristics, type of skeletal injuries, location, pattern, radiological findings, and associated other injuries of 36 children were reviewed. Data management and analysis was done using SPSS for Windows, version 18. Thirty-six children with skeletal injuries resulting from child physical abuse were seen from 1991 to 2009. Twenty-three [64%] were males and 13 [36%] were females; the mean age was 3.8 years. Twenty-three [64%] were