Meta-analysis of liver cirrhosis and the risk of fracture

Background: Cirrhosis is the irreversible fibrosis of liver, it continues to be a common cause of morbidity and mortality. It is accompanied by inflammation and malnutrition and thus can have a negative effects on bone metabolism and promote fractures accordingly

Aim of the study: to evaluate the risk of fractures among patients with cirrhosis

Methods: A systematic review of the scientific literature following PRISMA/STROBE guidelines, Medline Cochrane Library and Embase s were retrieved using an algorithm comprising relevant MeSH terms from 1980 to 2017. Publications on the association of cirrhosis/bone fracture were ed independently by the authors and included in both gender and gender-specific meta-analyses, following recalculations of published data as appropriate. The Newcastle-Ottawa scale was used to evaluate the quality of included studies

Results: [st] 8 udies met the inclusion criteria enrolling 988 patients [286 of which are diagnosed with al coholic liver disease [ALD]. Overall, ALD demonstrated a el r ative risk [] RR of 1.825, 95%CI: 1.370 2.28, - < 0.001 P for the development of bone fractures. Bone mineral density [BMD] was not significantly different between the ALD and control groups, although there was a trend toward lower BMD in patients with ALD. Sensitivity analyses showed consistent results

Conclusion: in accordance to the present meta-analysis, there is a significant correlation between bone fractures and ALD independent of BMD

Non-alcoholic fatty liver disease

Background: Non-alcoholic fatty liver disease [NAFLD] is the most common chronic liver disease that exposes patients to a great risk of emerging cardiovascular diseases and could develop to cirrhosis or hepatocellular carcinoma if left unmanaged

Objective of the Study: this article is intended to provide an overview and explore the optimal intervention for management of NAFLD in the short and long term

Methods: Electronic search in the scientific database from 1966 to 2017 [Medline, Embase, the Cochrane Library as well as NHS center websites were searched for English Publications were obtained from both reprint requests and by searching the database. Data extracted included authors, country, year of publication, age and sex of patients, epidemiology, geographical distribution, pathophysiology, risk factors, clinical manifestations, investigations and types of surgical treatment

Conclusion: It was concluded from the extensive review of the literature that Lifestyle modification including diet, physical activity and controlling metabolic disorders are the cornerstone in current management of NAFLD. Nevertheless, Insulin-sensitizing agents and antioxidants, particularly thiazolidinediones and vitamin E, seem to be a very promising pharmacologic treatment for non-alcoholic steatohepatitis, yet further long-term multicenter studies need to be conducted for confirmation and assessment

Open vs laparoscopic splenectomy among Saudi patients

The spleen is one of the most frequently injured intraperitoneal organs, and management of splenic injuries may require splenectomy. Traditionally, surgical removal of the spleen was done by an open approach using either an upper midline or left subcostal incision. Open splenectomy is performed in two major clinical scenarios: trauma and hematologic disease. With the advent of minimally invasive techniques, laparoscopic splenectomy has become a standard procedure for elective removal of the spleen for most indications. Nowadays laparoscopic splenectomy is the approach of choice for both benign and malignant diseases of the spleen. However, some contraindications still apply. The evolution of the technology has allowed though, cases which were considered to be absolute contraindications for performing a minimal invasive procedure to be treated with modified laparoscopic approaches. Moreover, the introduction of advanced laparoscopic tools for ligation resulted in less intraoperative complications. Today, laparoscopic splenectomy is considered safe, with better outcomes in comparison to open splenectomy, and the increased experience of surgeons allows operative times comparable to those of an open splenectomy. In this review we discussed the indications and the contraindications of laparoscopic splenectomy. Furthermore, we analyze the surgical techniques

Congenital hydrocephalus in Arar, Northern Saudi Arabia

Background: Congenital hydrocephalus, an important cause of neurologic morbidity and mortality in children, is a medical condition characterized by an abnormal accumulation of cerebrospinal fluid in the brain

Objectives: To estimate the prevalence and the recent progresses in diagnosis of hydrocephalus as well as the changes in epidemiology and treatment outcomes of the disease

Methods: This is a descriptive study involved all neonates born in Maternity and child hospital in Arar city, Northern Saudi Arabia, KSA, during the period from 1 January to 31 December 2017. Among 6000 delivered infant in 2017; there was 23 cases of hydrocephalus. Data was collected by using predesigned questionnaire which include questions designed to fulfill the study objectives

Results: the prevalence of hydrocephalus among studied infants was 0.38%. Consanguinity between parents was reported among 60.9% of the cases. Other congenital anomalies reported, cardiac anomalies 39.1%, spina bifida 17.4% and cleft palate 8.7%. Cause of hydrocephalus was 65.2% hereditary and 34.8% infection [secondary cause]. Swelling of the eyelid, increased vascular clarity on the skull, transparent skin in the head, the child's tendency to sleep, disorientation, irritability and nervousness, high crying, weakness of feeding and vomiting, delayed child skills, convulsions, increased size of the head, the sun's sign in the eye and the child is always looking down were the symptoms reported by the cases. 56.5% of the cases had shunt insertion and 43.4% had ordinary medical treatment. 30.4% of the shunt cases were complicated [17.4% had shunt blockage with infection and fever, 13% shunt blockage and 69.6% had other complications]. Outcome of the case; 39.1% were stable, 13% worsen and 47.8% died [34.7% died by complications, 8.7% during operation and 4.3% did not receive treatment]

Conclusion: The prevalence of hydrocephalus is comparable to that of other countries. More research is recommended because it is probable that the real prevalence of congenital hydrocephalus was underestimated and no account of how often abortions are performed among mothers of hydrocephalic fetuses. So more efforts from the ministry of health is needed

Predictors, complications and outcome of coronary artery bypass surgery patients attending the cardiac center of arar city, northern saudi arabia

Background: The increased incidence of cardiovascular disease between patients nowadays led to upsurge in the number of cardiac operations. After coronary artery bypass surgery, most patients remain free of symptoms for up to 15 years. The surgery also reduces the risk of heart attack and improves survival

Objective: to determine the predictors and outcome of coronary artery bypass surgery in patients attending the cardiac center in Arar, KSA all over the study period

Methods: The current study is a cross sectional study conducted during the period from September 2017 to March 2018. The current study included 72 individuals attending the cardiac center in Arar City. Collecting patients’ data was conducted through interviewing the patients included in the study and reviewing their medical files. A predesigned questionnaire was used for data collection

Results: We found that 81.9% of cases were males, 61.1% aged from 30 to 39 years old, 34.4% of cases have a myocardial infraction as a clinical diagnosis before the operation, 25% had angina pain, and 50.0% were smokers. Hyperlipidemia, chronic kidney disease, and chronic obstructive lung disease were found in 59.7%, 83.3% and 77.8% respectively. There were 41.6% who had postoperative arrhythmia, 13.9% had bacterial infection in the site of operation and another 13.9% had hypotension, 11.1% re-operated due to bleeding, and 6.9% got postoperative acute myocardial infarction. After 6 month of the operation, 69.4% of cases were quite good while recurrence of chest pain found in12.5%, heart failure in 2.8% and 8.3% died. There was significant association between outcome of cases after 6 months of operation and patients age [P<0.05] and all the dead cases were males

Conclusion: Our findings indicated that, among cardiac patients attending the cardiac center in Arar, KSA, the preoperative characteristics are suggestive of 30 to 39 years old males with myocardial infraction, angina pain, smokers, have hyperlipidemia, chronic kidney disease, and chronic obstructive lung disease is undergoing coronary artery bypass surgery. The death rate was low and 69.4% of cases were quite good

Cruciate ligament injury among students of northern border university, saudi arabia

Background: cruciate ligament consists of the anterior cruciate ligament [ACL] and posterior cruciate ligament [PCL] and they go from the femur to the tibia. The cruciate ligaments function is mainly to stabilize the knee and these ligaments have a risk to be injured in the athletes as well as non-athletes

Objective: address the prevalence of cruciate ligament injuries and its association with different types of injuries among Northern Border University students, Arar, KSA

Methods: A cross-sectional study was conducted among a representative sample of Northern Border University students in Arar City, Kingdom of Saudi Arabia, during the academic year 1439-1440. The students received the questionnaire to complete it. The parameters included in the questionnaire included age, sex, cause of cruciate ligament injury as during football playing, motor car accident, side and type of injury, type of treatment whether surgical treatment, physiotherapy or medical treatment

Results: This study reported the prevalence of cruciate ligaments injury among the studied Northern Border University students in Arar city, Kingdom of Saudi Arabia was 5.7%. The age of the studied ACL injury cases ranged from 18 to 30 years with mean age [+/- SD] was 23.0 +/- 4.2 years. Most of cases [98.6%] were males. Playing football was the most common cause by 78.9% followed by motorcar accidents 7%, fall from stairs 5.6%, swimming 4.2% and fall from height 2.8%. As regards the side of the injured cruciate ligament, 60.6% had anterior cruciate ligaments injury, 8.5% had posterior cruciate ligament injury, and 18.3 % had injury in both sides. In the majority [54.9%] of cases, ACL tear was complete; partial in 38.0%. 14.1% received medical treatment, surgical treatment and physiotherapy by the same percent 32.4%, medical treatment and physiotherapy 15.5%. As regards outcome of treatment, this study reported 74.6% of patients become good and stable, 23.9% still complaining and 1.4% suffering from disability

Conclusion: This study reported the prevalence of cruciate ligaments injury among the studied Northern Border University students in Arar city, Kingdom of Saudi Arabia was 5.7%. Most of cases [98.6%] were males. Playing football was the most common cause by 78.9% followed by motorcar accidents 7%. As regards outcome of treatment, this study reported 74.6% of patients become good and stable, 23.9% still complaining and 1.4% suffering from disability

Assessment and evaluation of the level of satisfaction after Lasik among myopic patients in Aljouf city

Background: laser in situ keratomileusis [LASIK] has being used as the most effective and common refractive surgical procedure of choice for correction and elimination of myopic errors. The use of refractive surgeries has aided subjects to get rid of contact lenses either soft or rigid as well as eye glasses. Objective: Evaluate the level of satisfaction and the impact on the quality of life in myopic patients after a LASIK operation

Methods: this is a cross-sectional and community based survey study in which 111 participants were enrolled. All patients underwent a data collection and Satisfaction assessment including a 29 Likert model statements

Results: high levels of satisfaction [81.9%] and quality of life [76.5%] were found among myopic patients. Most of patients did LASIK to get rid of their glasses and to have good visual results regarding to reading, driving, swimming at day light or at night. The majority of subjects revealed that the surgery achieved their goal, and 83.8% would praise LASIK for friends. Females showed a significant higher motive for performing LASIK to improve their general look. The medical professions showed lower levels of satisfaction toward quality of vision than educational professions

Conclusion: a high level of satisfaction, quality of life and vision satisfaction was found in the present study after LASIK among myopic patients in Aljouf city