Strain-strain rate imaging of impaired left atrial function in patients with metabolic syndrome

Background: Metabolic syndrome (MS) predisposes to left ventricular dysfunction and heart failure, however, alterations in left atrial (LA) function in MS are unknown. Objectives: We aimed to use strain/strain rate (SR) imaging to investigate the effect of MS on LA function. Subjects and Methods: This prospective case control study included a total of 100 subjects divided in to 75 metabolic syndrome (MS) patients referred to Al-Azhar university hospital outpatient clinic for evaluation and treatment of hypertension and/or diabetes mellitus and 25 age and sex matched apparently healthy volunteers as a control group. All subjects underwent conventional echocardiographic examination and assessment of LA function by speckle tracking. Partial correlation and multiple stepwise regression analyses were used to determine the risk factors for impaired LA function. Results: Compared with the controls, the MS patients showed significantly lower levels of mean strain, mean peak systolic SR and mean peak early diastolic SR (P<0.05 for all), with no difference in the mean peak late diastolic SR. Central obesity, hypertension, dyslipidemia and uncontrolled diabetes were independent risk factors for impaired LA function. Conclusion: SR imaging is reliable in assessing LA function in MS patients

Assessment of the awareness toward cancer cervix, early detection and prevention of risk factors among Saudi males and females

Background: Cervical cancer is the third most common malignancy in women worldwide, and it remains a leading cause of cancer-related death for women in developing countries

Aim and objectives: the aim of the paper is to assess and increase the awareness toward cancer cervix, early detection and prevention of risk factors among Saudi males and females

Materials and Methods: a cross-sectional descriptive study was carried out among 740 Saudi males and females above the age of 16 years. The participants were randomly enrolled in this study

Results: the participants 446 [60.3%] females and 294 [39.7%] males were included in the study. Majority of the participants [n= 547, 73.9%] have heard about cervical cancer but most of them didn't know that it is a preventable disease [n= 359, 48.5%]. We found that; only 17.6% of the study group has heard about HPV Vaccine. It could be attributed to low level of knowledge about the virus itself, since only 19.9% of the population knew about the virus

Conclusion: there is a great need to increase the educational standards of the society and improve the information and knowledge about this important disease to reduce the number of patients as well as raising the health status of the populations

Perceptions, perceived barriers and practices of physicians' towards evidence-based medicine

Objective: To investigate physicians' perceptions and practices towards Evidence-Based Medicine [EBM] and physicians perceived barriers in one institute of Saudi Arabia

Methods: One hundred seventeen practicing physicians at King Abdulaziz University Hospital, Jeddah were included in the study. A validated questionnaire was used for collecting data. The questionnaire had four parts and included questions addressing perceptions and practices about EBM as well as associated variables and barriers to practicing it

Results: The majority of the respondents had a positive attitude toward EBM. Only 23.9% of participants reported that they are incorporating EBM into their practice. Knowledge about EBM databases was not good. The most common "regularly" read journal was the New England Journal of Medicine [31.6%], followed by the British Medical Journal [12.0%]. Some of the respondents had an understanding and were able to explain to others the technical terms use in EBM such as odds ratio [19.7%], relative risk [22.2%], absolute risk [23.9%] and others. The major perceived barriers to practicing EBM was the lack of free personal time [27.4%], availability and access to information [27.4%], difficulties in involving in whole practice [12.0%] and lack of investment by health authorities [12.8%]

Conclusion: The attitude of the practicing doctors towards EBM was good, but knowledge and practice were not up to the mark

Value of cerebrospinal fluid tumor necrosis factor-alpha [TNF-ALPHA] for rapid diagnosis of bacterial meningitis

Meningitis is common in tropical areas and also in Egypt and has a world-wide distribution This study evaluated the potential role of CSF TNF alpha in diagnosis and differential diagnosis of acute meningitis [bacterial versus aseptic meningitis]. This case-control study was conducted between Ain Shams University Tropical Medicine Department and Embaba Fever Hospital. Fifty patients with suspected meningitis were recruited during from January 2014 to June 2014. They were divided according to culture results into 2 groups: GI: 40 patients with acute bacterial meningitis [proved by CSF culture], G2: 10 patients matched according to age and sex with clinical sings of CNS infection but without laboratory evidence of bacterial origin, [Suspected cases, and negative culture]. Both groups were subjected to thorough history taking, full clinical examination, and laboratory investigations including CSF analysis and CSF TNF was measured by ELISA. The results showed a highly significant difference between cases and control regarding CSF TNF [P=0.00]. The criteria's of diagnostic validity test was 100% for all at cutoff >/= 275ng/ml and 0.05]

Snake bite in Gezira revision of 63 envenomed child

Sixty three patients admitted to the Gezira National Center of Pediatric Surgery with snake bite were analyzed. All patients were envenomed and the snake was positively identified. In 39 patients [61.9%] the offending snake was [washash] [Echis carinatus] and in 24 patients [38.1%] [Abdafan] [atractaspis microlepidata was identified. All patients were from rural Gezira where children are actively involved in agriculture and harvesting. The median age group was 9.3 years. Females were equally involved as males. The mean time elapsed since the bite was 56 hours. Quicker arrival at hospital was seen in severe envenomation. Fifty patients had already received native remedies which was observed to increase the local wound complications. Most bites [79%] occurred in the leg .The majority of the bites occurs in the early rainy summer months. All patients presented initially with progressive painful swelling. Local necrosis was observed in seventeen patients [26.9%]. Fourteen patients [22.2%] developed compartment syndrome and three patients [4.76%] developed fingertip gangrene, one patient [1.6%] developed extensive bilateral common iliac vein thrombosis. D1C developed in 21 patients [33.3%]. Two patients [3.2%] of theses developed intracranial haemorrhage. Four patients [6.3%] with local necrosis presented few month later with extensive chronic osteomyelitis.Treatment options included cardiovascular support, local wound debridement, fasciotomy and minor amputation. Patients with DIC were managed with fresh frozen plasma, blood transfusion and heparin. Antivenin was not administered to our patients. All patients eventually recovered except one child [1.6%] who succumbed of massive intracerebral haemorrhage