Knowledge, Attitude and Practices Concerning Cosmetic Surgery among Female Medical Students at the University Hospital, King Saud University, Riyadh, Saudi Arabia.

Background: This study investigates the knowledge, attitudes and practices of cosmetic surgery among female medical students at King Saud University (KSU). Methods: A quantitative observational cross-sectional approach was used to carry out the study at the KSU College of Medicine. A web-based questionnaire was first developed to collect the data necessary to fulfill the objectives of the research. The population under study included a random sample in which the questionnaire was sent to all female medical students at KSU. The sample size was estimated by using a single proportion formula with an acceptable margin of error at 5%. The sample size obtained was 384. Results: A response rate of 99% was achieved. The mean age of the participants was 20.9±1.48.Out of 381 KSU female medical students in our study, almost all participants (360, 94.5%) have heard about cosmetic surgery. Television was the source of knowledge for more than one third (38%) of participants who had already heard about cosmetic surgery. Just over half (51.4%) of surveyed KSU female medical students recognized the best definition of cosmetic surgery as “a surgery that modifies or improves the appearance of a physical feature electively”. A great majority of participants (86%) reported knowing of a particular type of cosmetic surgery, namely breast augmentation. Almost all participants (92.4%) agreed that “women perform more cosmetic surgery than men”. Only 9% of participants reported undergoing cosmetic surgery, where most of them (19 out of 35) went through laser treatment for the skin and almost the same number had a cosmetic surgery for personal satisfaction. Conclusion: From this research, we recommend further studies to go beyond educational institutions to the public at large, and to study different sub-populations.

The Burden of Respiratory Syncytial Virus Disease in Pre-Term Infants.

This mini-review summarises the risk factors for acquiring Respiratory Syncitial Virus (RSV) infection, and describes the harmful effects of the infection in pre-term infants. Moreover, theoretical considerations are discussed for the prevention of RSV infection in high-risk infant categories, such as pre-term infants. Background: Neonates positive for RSV are more prone to severe infection than neonates infected with other common respiratory viruses. Despite RSV infection being more common in late neonates than in early ones, pre-term infants ≤ 35 wk gestational age (GA) are at high risk for developing severe RSV disease. Efforts to prevent infection include case management, vaccination and the identification of risk factors. The morbidity and mortality risks of RSV disease are highest in pre-term newborns with other underlying disease, such as bronchopulmonary dysplasia (BPD) or hemodynamically significant congenital heart disease (hsCHD). Associations between RSV-positive neonates and climate factors are also discussed. Nosocomial-acquired respiratory syncytial virus infections in pre-term infants in Neonatal Intensive Care Units (NICUs) are reported. The development of an RSV vaccine has been challenging, and vaccine in pre-term infants is currently unavailable. Palivizumab, a monoclonal antibody licensed for the prevention of RSV, lowers respiratory tract disease in pre-term infants. The home healthcare nurse can play an important role. By developing patient and caregiver trust, the nurse can implement an RSV prevention plan, leading to a decrease in the hospitalization of premature infants with RSV. Conclusions: Commercially-insured late pre-term infants with RSV infection are at high risk of recurrent wheezing and infantile asthma for 1 year after the initial episode, and pose a significant economic burden on the healthcare system. Education is critical for the continuing development of clinical NICU nursing practice.

Scurvy Induced Hemodynamic Instability.

Aim: Our case report aims to inform practicing clinicians of an unusual presentation of vitamin C deficiency in the setting of a developed nation where this illness is rare and underappreciated. Case Presentation: We present the case of a noncompliant 16-year-old African American female with vertically transmitted human immunodeficiency virus/acquired immune deficiency syndrome who presented to the emergency department (ED) with a CD4 count of 4 and a hemoglobin level of 5.7 g/dL. In the ED, she was found to have persistent low-grade bleeding initially believed to be of an upper gastrointestinal origin, but which was later found come from the oral mucosa. Her stools were dark in color and guaiac positive. She was hemodynamically unstable, for which she was transfused with packed red blood cells and briefly treated with continuous norepinephrine infusion. Her initial coagulation studies were noncontributory with an international normalized ratio of 1.1, a prothrombin time of 35, and a platelet count that was also within normal limits. Esophagogastroduodenoscopy and a colonoscopy were both unremarkable. Bone marrow biopsy showed normocellular marrow with 80% cellularity and trilinear hematopoiesis. Her vitamin C level was zero. She was diagnosed with scurvy and treated with vitamin C supplementation. Discussion and Conclusion: Vitamin C deficiency can lead to an often-forgotten medical condition called scurvy. It can cause defective collagen synthesis leading to fragile capillaries, gingival bleeding, and cutaneous changes. Unrecognized, this condition can lead to significant bleeding and can be lethal in select patient populations. Our case is unique in that it shows that vitamin C deficiency can masquerade as upper gastrointestinal bleeding and may present with significant hemodynamic instability requiring blood transfusions and vasopressor support. It is therefore imperative to keep in mind the diagnosis of scurvy as a potential cause of hemodynamic instability even in an industrialized nation such as the United States. Vitamin C deficiency is a rare and underdiagnosed medical entity in the hospital setting that can lead to hemodynamic instability. Scurvy patients can present with melena and oral bleeding, mimicking hematemesis.

Estradiol and/or Ibandronate Therapy Ameliorates Oxidative Status in Livers of Ovariectomized Rats.

Background: Overiectomized rats suffer from osteoporosis that mainly results from oxidative stress (OS). Studies revealed that the levels of antioxidant enzymes, such as superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione-S-transferase, catalase (CAT), and glutathione reductase could be used to determine and follow-up OP. The anti-oxidant activity of anti-osteoporotic drugs needs further investigations to be proved to add more confidence in the ability of these drugs to control the disease. Objective: To investigate the possible anti-oxidant effect of treatment with ibandronate, a highly potent nitrogen-containing bisphosphonate, on activities of catalase and glutathione peroxidase anti-oxidant enzymes, thiobarbituric reactive substance (TBARS), as a marker of lipid peroxidation and DEPPD free radicals in liver homogenates of ovariectomized rats. Methods: Fifty adult female albino rats were divided into five equal groups ( n=10 rats): Group (1): served as control injected with saline, 2nd group: rats were subjected to ovariectomy, 3rd group: rats were exposed to ovariectomy and treated with estradiol, 4th group: were ovariectomized and treated with ibandronate and 5th group: were ovariectomized and treated with both estradiol and ibandronate. Duration of therapy with either drug was 12 weeks. Results: Estradiol alone or in combination with ibandronate to ovariectomized rats showed significant increase in activities of anti-oxidant enzymes. Both drugs reduces hepatic TBARS and DEPPD free radicals in hepatic homogenates in this model of OP. Conclusion: The present study can conclude that ovariectomy leading to oxidative changes liver of tested rats. Co-administration of estradiol and ibandronate provides a kind of protection against alterations in anti-oxidative/oxidative balance. The results support the hypothesis stated by experimental studies that anti-osteoporotic treatment could also possess anti-oxidative protective property.