Religious Mosque Leaders (Khateebs): Awareness, Perceptions, Practices and Attitude towards Mental Health, Riyadh Region, Saudi Arabia

Background:Mosques are the most holy places in the eyes of Allah-Exalted and Glorified, and the religious mosque leaders (Khateebs) who read 15-20 minutes Khutbah prior to Friday Prayers have great knowledge in religion of Islam and are considered the peace-building leaders through delivering the pertinent Friday sermons around the world.Objective:This online consenting cross-sectional survey explored the mental health awareness, perceptions, attitudes and practices of Khateebs of Riyadh region, Saudi Arabia.Methods:This survey used 14-items self-designed culturally competitive questionnaire and sociodemographic proforma to tap religious mosque leaders’ knowledge, perceptions, practices and attitude towards mental health. Results:Majority of mosque leaders were middle aged with higher education and extensive experience as a model of true interlocutor (Khateeb). Their knowledge and practices revealed were replete with religious and spiritual healing approaches but religious mosque leaders did not completely overlook the role of psychiatric medications and mental health professionals in the management of mentally ill persons. However, religious mosque leaders showed some negative attitudes towards patients with mental disorders, and recommended 10 corrective guides including integration of mosques and religious leaders into mental health system.Conclusion:Despite mosque leader’s good mental health literacy,they need further training to plug certain loopholes traced in their mental health literacy. Researchers should conduct further similar research overcoming the caveats of this survey not only in Saudi Arabia but also globally in Muslim world

MDCT at LUMHS: detection the small pulmonary nodules by use of maximum intensity projection images

Objective: To assess the benefit of computed tomography by using Maximum Intensity Projection [MIP] compare to Volume Rendering [VR] reconstructions to study pulmonary metastases

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at Radiology Department of Liaquat Medical University Hospital Hyderabad from July 2015 to April 2016

Materials and Methods: Computed tomography studies of 30 pulmonary metastatic cases were reviewed retrospectively. Images were evaluated as number of the nodules. Two viewers on VR and MIP reconstructions on axial-source images assessed these parameters. Independent evaluation of the MIP and VR images was done by well experienced chest radiologist. In the course of independent image assessment, each pulmonary nodule was indicated by an arrow as well as recorded in the Performa

Results: A total of 30 cases were integrated in our study. The mean age of the cases was 52.12 +/- 7.33 years. Out of 30 cases male were in majority 24[80%]. Total 334 nodules were detected by MIP images, while out of them 276 were detected by VR images and 58 were missed, therefore MIP images is the significantly more detectable technique for pulmonary nodules detection. P= value 0.001. Following by central 253 nodules were detected by MIP images, out of them 40 nodules missed by VR images and 113 were detected, with significant difference P value = 0.001. Similarly all the peripheral nodules were also significantly more detected by MIP images, as compare to VR images. P value = 0.001

Conclusion: Maximum intensity projection is more useful and best technique, to detect the small pulmonary nodules especially in central lung

Evaluation of some micronutrients in patients infected with Giardia lamblia in Hawler city

Background and objective: The micro aerophilic flagellated protozoan parasite, Giardia lamblia, is the most common intestinal pathogen infecting human and a major diarrheal disease found throughout the world. It can cause acute or chronic diarrhea contributing to nutritional status, growth, and intellectual function. This prospective study evaluated the association between giardiasis and blood minerals disorders in Hawler city

Methods: The present study was carried out at the College of Medicine, Hawler Medical University, via collaborating study between the Department of Biochemistry and the Department of Microbiology. The study was carried out on 50 patients with giardiasis and 65 age and sex matched healthy controls. Examination of fecal samples for detection of Giardia cyst and/or trophozoite was carried out using the direct wet smear, while serum zinc, iron and copper levels were measured for both groups spectrophotometrically using commercial diagnostics kits

Results: The levels of serum zinc and iron in patients infected with Giardia lamblia were significantly lower [P <0.01] compared to normal healthy control, while the differences in the level of serum copper was significantly higher [P <0.01]

Conclusion: In the frame of this work we delineate that Giardia lamblia infection had a significant effect on serum trace elements reflected by, significant decrease in serum zinc and iron levels, whereas the level of copper increased too in a statistically significant manner

Role of fluorescence in situ hybridization in the diagnosis of malignant biliary stricture

Introduction: Biliary stricture is a fixed narrowing of a focal segment of the bile duct that result in proximal biliary dilatation and clinical features of obstructive jaundice. A wide spectrum of hepatobiliary and pancreatic diseases, both benign and malignant, can result in the development of biliary strictures. Although trans abdominal ultrasound, computed tomography, and magnetic resonance imaging are sensitive for detecting bile duct pathology, they do not reliably distinguish strictures as being malignant or benign. FISH utilizes fluorescently labeled DNA probes to chromosomal centromeres or unique loci to detect cells that have numerical or structural abnormalities indicative of malignancy

Aim of the study: To evaluate the accuracy of FISH in the diagnosis of malignant biliary stricture

Patient and methods: Forty eight patients with indeterminate bile duct stricture presented with obstructive jaundice were prospectively enrolled and underwent ERCP and FISH over a period of 20 month from June 2013 to February 2015. Four patients were excluded because of loss follow-up. Thus, 44 patients were included in data analysis [17 males and 27 females]

Results: The final diagnosis of stricture type was 32 malignant and 12 benign cases. FISH was positive in 30 cases and negative in 14 cases, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 93.75, 100.00, 100.0, 85.7, 95.5 and 0.969 respectively

Conclusion: FISH increase the diagnostic accuracy of malignant biliary stricture. The sensitivity of FISH could improve the clinical management of patients being evaluated for malignant bile duct stricture by enabling a definitive diagnosis at an earlier stage in the clinical evaluation

Peripheral neuropathy: incidence and clinical presentation in the cases of diabetic mellitus

To assess the incidence and clinical presentation of peripheral neuropathy in the cases of diabetic mellitus. Cross sectional study. This study was conducted at Medicine Department of LUMHS with the duration of time February 2011 to January 2012. Total 200 cases were chosen for this study after diagnosis of diabetic mellitus. All equitable laboratory investigations were carried out, along with HbAlC. All the cases were excluded from the study those were less than 5 HbAlc levels, history of any trauma leading to neurological deficit that can compromise assessment of sensory system along with history of renal failure. All the data regarding demographic characteristics,incidence and clinical pattern of the cases with peripheral neuropathy was entered in the predesigned Performa. Mean age of the cases was 56.3 +/- 10.21 years. Mostly cases were noted from urban area 60.0%. 46.0%cases were smoker and mostly smoker were male, while 26 [13.0%] patients [totally male] were with history of alcohol consumption. Mostly patients were poor socioeconomically. Incidence of the neuropathy was noted 60%further according to the classification, 16% cases were found with mild neuropathy, 21%were with severe while majority of the cases 32% were found with moderate neuropathy. According to the clinical presentation mostly cases were found with burning, 85.0%, Pain 66.6%, numbness 75.0%, while Sensitive touch, Itching, Foot ulcer,Muscle cramp and Tingling were found as 60 [50.0%], 36[30.0%], 18[15.0%], 45[37.5%] and 51[42.5%] respectively. In this study it is concluded that incidence of diabetic peripheral neuropathy is very high, and it increases with the increasing time of diabetes, uncontrolled diabetes and ignorance diabetes. Majority of the cases had found with sensory loss having foot ulcers, and they were unaware regarding this condition

Evaluation of some 1H-pyrazole derivatives as a dual acting antimalarial and anti-leishmanial agents

The synthesis of a novel series of 1H-pyrazole derivatives was achieved by condensation of pyrazole aldehyde 1 with hydrazine hydrate to give hydrazone 7. On the other hand, cyclization of alpha, beta-unsaturated ketone counterpart 2 using hydrazine hydrate in liquid aliphatic acids rendered compounds 4-6 and hydrazine hydrate in ethanol afforded compound 3. The later was allowed to react with aroyl chloride giving rise to compounds 8, 9. All compounds were tested for their in vivo anti-malarial and in vitro antileishmanial activities. The anti-malarial activity was performed using Plasmodium berghei infected mice, while the anti-leishmanial activity of the compounds was determined against Leishmania aethiopica promastigotes using alamar blue reduction assay. Compound 3, 1-[4-methylphenyl]-3-phenyl-4-[3-[2-thienyl]-2-pyrazolin-5-yl]-1H-pyrazole, possessed the highest anti-malarial activity with suppression of 70.26%. The highest anti-leishmanial activity was exhibited by compound 2, 1-[4-methylphenyl]-3-phenyl-4-[1-[2-thienyl]-prop-2-en-1-one]-1H-pyrazole, with an IC[50] of 0.079 microg/ml. Hydrazone 7 showed appreciable dual anti-malarial [suppression = 62.30%] and anti-leishmanial activity [IC[50] = 1.823 microg/ml]

Frequency of impaired glucose tolerance in patients of cirrhosis due to hepatitis c

Impaired glucose tolerance [I.G.T.] is defined as two - hour glucose levels of 140 to 199 mg/dL. [7.8 to 11.0 mmol] after 75 g oral glucose tolerance test. The objective of this study was to determine the frequency of impaired glucose tolerance in patients with liver cirrhosis due to hepatitis C. It was a cross - sectional study. This study was conducted in a East Medical Ward of Mayo Hospital, Lahore. The study was carried out from August 2010 to February 2011. A total of 200 patients of liver cirrhosis due to hepatitis C admitted to East Medical Ward through emergency and outdoor were recruited. Purposive [non-probability] sampling technique was used for sample collection. Cirrhotic patients of either sex or age above 12 years were included in this study. Results of study were accessed on SPSS version 12. In 200 patients, 120 [60%] were males and 80 [40%] were females. The mean age of the patient was 56.31 years, for females it was 50.36 years and for male it was 49.25 years with standard deviation of 6.992. It was observed in 200 selected patients 68 [34%] had impaired glucose tolerance of which males were 43 [63%] and female were 25 [36%]. All the patients developed impaired glucose tolerance after developing cirrhosis due to hepatitis C infection. The percentage of patients showing impaired glucose tolerance turned out to be 34% in our study. The principle conclusion of the study was that patients with decompensated cirrhosis due to hepatitis C had significantly higher frequency of impaired glucose tolerance test

Validation of an HPLC method for the simultaneous determination of diminazene diaceturate and phenazone in injectable veterinary granules and bulk powders

A validated HPLC method for the simultaneous determination of diminazene diaceturate and phenazone has been established for the analysis of the compounds in veterinary granules for injection and in bulk powders. The compounds were separated using a Symmetry RP 18 analytical column and detected by UV absorbance at 250 nm. Linearity, accuracy as well as the intra-assay precision, inter-day precision and specificity of the method were established. The limits of detection and quantification were 3.2 and 9.7 microg mL[-1] for diminazene diaceturate and 9.57 and 28.99 microg mL[-1] for phenazone. Method had the potential to determine these drugs simultaneously from dosage forms without any interference with each other

Psychiatric morbidity in medical, surgical and gynecological in -patient

The Present study aims i] to assess the prevalence of psychiatric morbidity in hospitalized medical, surgical and gynecological patients and irrespective of their diagnoses [if] to see if there is a difference in prevalence of psychiatric morbidity among these specialties. Non randomize, cross sectional observational study. A tertiary care 300 bedded multidisciplinary teaching hospital of Baqai Medical University, located in the suburbs of Karachi Pakistan. Patients: One hundred and four in-patients; medicines 32, surgery 34, gynecology 38, males 44, females 60; mean age 34.5. AKUADS [Aga Khan University Anxiety and Depression Scale] an indigenous and validated screening instrument for anxiety-depression syndromes in Urdu which is the national language. 38 patients scored positively giving an overall prevalence of 36.5% for anxiety and depression in hospitalized medical, surgical and gynecological patients. There was a marked difference in prevalence among medical [prevalence 61.1%] surgical [prevalence 32.3%] and gynecological [prevalence 18.4%] patients. [1] There is high prevalence of anxiety and depression among admitted medical, surgical and gymecological patients [36.5%] [2] Prevalence in medical in-patients [61.1%] is almost twice as high as in surgical in-patients.[32.3%] and about three and half times as compared to gynecological patients [18.4%]

Prevalence, knowledge, attitude and practice of shisha smoking among medical and dental students of Karachi, Pakistan

To determine the prevalence of shisha smokers among medical and dental students of Karachi and assess their knowledge, attitude and practice regarding shisha, and the effect of discipline [medical/dental] and year of professional education with their responses. Cross sectional, observational study. One thousand two hundred and four students from the six medical/dental colleges of Karachi participated in the study. The present study was conducted during April and May of the year 2007. The questionnaire consisted of personal questions like gender, field of study, name, and year of study; smoking habits, frequency and place of smoking, attitude and knowledge about diseases developed due to shisha smoking. Chi-square test was used to find relationship between independent variables i.e. field of study [medical/ dental], and year of study [1[st], 2[nd], 3[rd], 4[th] and final year] with response variables. The mean age of the participants was 20.2 +/- 1.6 years. Two hundred and seventy three students [22.7%] indicated that they smoke shisha. One hundred and nineteen of the male students [41.2%] and 154 female students [16.8%] indicated positively for shisha smoking. Dental students showed 13% higher prevalence of shisha smoking than medical students [p<0.0001]. Eighty percent of respondents selected either restaurants or 'shisha bar' for the place of smoking. Sixty four percent of the respondents were influenced by their friends to adopt this habit. Eighty one percent of the respondents admitted that shisha smoking was harmful. Twenty eight percent of the respondents believed an association between shisha smoking and cancer, and about a quarter related it with heart diseases. Thirty eight percent of the shisha smokers were also involved in cigarette smoking. High prevalence of shisha smoking was observed among medical and dental students. However, most of them had adopted this habit as leisure and for socialization. The awareness about the health hazards due to shisha smoking is needed as an intervention to extricate them from this habit

Perineo-scrotal gangrene

perineoscrotal gangrene is a dangerous nectrotizing infection of the tissues of the perineum and scrotum. Objective and this is a retrospective study of the cases referred to Al Mouassat University Hospital in Damascus. Patients: during the 21- month period from September 1997 to May of 1999, 16 male patients with cutaneous gangrene of the external genitalia were observed. this lesion accounts for 0.2% of our hospitalizations. The commonest etiology, in 37.5% of our cases, is from the genitourinary tract. A proctologic origin was found in 19.75% of our cases. The condition appeared to be primary in 43.75% of our cases. Concomitant diseases were found in 68.75% of cases with diabetes being the commonest [37.5%]. The diagnosis is clinically evident. The majority of the patients are seen late, after 5-10 days. The necrotizing process spreads rapidly. perineo-scrotal gangrene is a primary or secondary multidisciplinary emergency requiring intensive care, antibiotics, and surgical excision of all necrotic tissues with urinary and/or fecal diversion in some cases. The extensive skin loss requires surgical reconstruction procedures. The prognosis is grave, though there were no deaths in our series