Impact of rotavirus vaccination on viral gastroenteritis diseases

Background: Rotavirus infection causes a significant burden of diarrheal diseases in infants and young children leading to hospitalization and death. Rotavirus was a leading cause of viral gastroenteritis hospitalization among children less than the age of 5 years in Bahrain before rotavirus vaccine introduction in 2008

Objective: To evaluate the impact of rotavirus vaccination program in the viral gastroenteritis admission among patients less than 5 years of age and to evaluate the incidence of intussusception

Design: A Retrospective Data Analysis

Setting: Salmanyia Medical Complex, Bahrain

Method: Children aged less than five years hospitalized with acute gastroenteritis and intussusception based on international classification of diseases, tenth revision code, were included in the study. The patients were divided into two groups: viral gastroenteritis and intussusception; both groups were admitted to pediatric wards and reviewed from 1 January 2008 to 31 December 2012. The characteristics of patients with intussusception only were reviewed and analyzed according to age, sex, nationality and vaccination status. Patients less than five years of age with bacterial gastroenteritis were excluded

Result: One thousand nine hundred fifty-five children under five years of age were hospitalized from 1 January 2008 to 31 December 2012. The first group consisted of one thousand nine hundred one patients, admitted with viral gastroenteritis. The second group consisted of fiftyfour patients who were admitted with the diagnosis of intussusception. Thirty-seven [1.9%] were males, forty-three [2.2%] were Bahrainis and 11 [0.6%] were non-Bahrainis. No intussusceptions cases occurred within 31 days of Rotavirus vaccination

Conclusion: The study revealed that children less than 5 years of age who were hospitalized for viral gastroenteritis have declined following Rota virus vaccine introduction and no reported intussusception with 31 days of vaccination

Microbial pathogens associated with proximal dental caries in the primary dentition and their association with periodontal disease in children

Background: certain specific bacterial species from the subgingival biofilm have demonstrated etiological relevance in the initiation and progression of periodontitis. Among all the bacteria studied, three have shown the highest association with proximal caries and bone loss: Fusobacterium nucleatum [Fn], Capnocytophaga [Ca], and Campylobacter rectus [Cr]. Therefore, the relevance of having accurate microbiological diagnostic techniques for their identification and quantification is clearly justified

Aim: to identify the bacterial pathogens with alveolar bone loss and proximal caries in primary dentition and their association with periodontal disease utilizing deoxyribonucleic acid [DNA] microbial probe testing

Materials and Methods: subgingival plaque samples were collected at baseline as well as at 3, 6, and 12 months later. After extracting DNA, Fn, Ca, Cr, Aggrgatbacter actinomycetemcomitans, Porphyromonas gingivalis and several other periodontopathogens were determined by DNA microbial probe testing method

Results: samples detecting a high bacterial load of Fn, Ca and Cr in children having proximal caries associated with periodontal disease compared to children having proximal caries without periodontal disease [P

Conclusions: results suggested that there was a relationship between microbial pathogens associated with proximal dental caries in the primary dentition and periodontal disease in children. In addition, DNA microbial probe testing technology clearly analyzed the different loads of periodontopathogens in children who had with proximal caries associated with bone loss and is useful in microbial diagnostics for patients in dental practices

comparative study of bovine bone used alone and in combination with transforming growth factor-beta for the treatment of periodontal osseous defects in humans

Objectives: Transforming growth factor-betas [TGF[beta]s] are multifunctional growth factors with a broad range of biological activities in various cell types in many different tissues. The purpose of this study was to evaluate the treatment of intrabony defects with anorganic bovine bone mineral matrix combined with TGF[beta]-1 with the use of anorganic bovine bone alone

Materials and Methods: Thirty-two sites from sixteen patients were selected using a split-mouth study design for each patient, determined randomly through a biased coin randomization. One site received a mucoperiosteal flap, and the osseous defect was fi lled with the combined therapy [Group 1]. The other site treated was with anorganic bovine bone alone and served as a control [Group 2]. All the treated sites were covered with a bioabsorbable collagen membrane. The clinical parameters and radiographic follow-up examinations were recorded after 3, 6, 9, and 12 months

Results: Clinically, there was a statistically signifi cant gain in the clinical attachment level [+5.03 +/- 0.14 mm] and a statistically signifi cant reduction of pocket probing depth [?5.16 mm +/- 0.13] for Group 1 sites compared to sites in Group 2 [P

Conclusions: The use of anorganic bovine bone mineral matrix combined with TGF[beta]-1 seemed to be effective in the treatment of intrabony defects. This showed an improvement in the clinical outcome of periodontal therapy superior to the use of anorganic bovine bone on its own

Synthesis and screening of some new fluorinated quinazolinone-sulphonamide hybrids as anticancer agents

The aim of the present research was to synthesise several novel fluorinated quinazoline-sulphonamide derivatives and to evaluate their in vitro cytotoxic activity. Eight compounds were synthesised. The compounds' anticancer activities were determined through the [3-[4,5-dimethyl-2-thiazolyl]-2,5-diphenyltetrazolium bromide] [MTT] assay using a three-cell-line panel consisting of National Cancer Institute [NCI] lung cancer cells, Michigan Cancer Foundation-7 [MCF-7] breast cancer cells, and Human Embryonic Kidney-293 [HEK-293] normal kidney cell. The values of C log P correlations were determined to interpret the results. One compound exhibited significant anticancer activity with low toxicity compared with the methotrexate as the reference drug. The biological screening showed good to moderate anticancer activity for the title compounds compared with the reference drug. The reference drug exhibited an IC[50] value of 2.4 micro M, whereas compound 9, which was identified as the most active compound, exhibited an IC[50] value of 2.51 micro M on the NCI cell line. The other compounds showed IC[50] values that ranged from 2.89 to 46.34 micro M on the three cell lines. The newly synthesized compounds had lower toxicity on the normal cell line than did methotrexate. The newly synthesized compounds may provide a valuable template for future design and optimization to produce analogues that act as more active anticancer agents

prevalence, causes, and relativity of dental anxiety in adult patients to irregular dental visits

To assess the frequency and causes of dental anxiety and their relation to irregular dental visits among adult dental patients. The Dental Anxiety Question [DAQ] included within a self-administered questionnaire was distributed to 1025 patients attending the Interns' Dental Clinics in the Department of Preventive Dental Sciences, College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia from March 2012 to February 2013. A cross-sectional study design was used. The questionnaire consisted of 22 closed-ended questions divided into 4 sections; 1] demographics, 2] regularity of dental visits, and related causes, 3] DAQ, cancellation of dental appointments, history of previous trauma, dental anxiety provoking factors within dental environment and procedures, and 4] patients' status in dental clinics, preferences of dentists, and perceptions regarding dental anxiety. The prevalence of dental anxiety among the study sample was 27%. Anesthetic injection was the main factor of dental fear [88.2%], while dental surgical procedures [35.7%] and extractions [23%] were the most terrifying dental procedures. Lack of time [79.5%], cost [71.5%], far-situated dental services [62.2%], and fear [57.1%] were causes listed for irregular dental visits; while 31.3% had no specific reason. Irregular dental visits were not related to dental anxiety. Dental anxiety continues to be an obstacle despite the vast improvement in dentistry; and this raises an alert regarding personal and communication factors in the patient-dentist relationship. Factors such as equal distribution of dental services, time, and cost should also be addressed

Pediatric pulmonary services in Saudi Arabia

The purpose of this study was to assess the available pediatric pulmonary services, in terms of workforce, resources, and distribution across Saudi Arabia. This would help in proper utilization of resources and direct future planning. A cross-sectional survey among pediatric pulmonologists registered in the Saudi Thoracic Society. Among 43 practicing pediatric pulmonologist in Saudi Arabia, 29 have responded to the survey [response rate of 67.4%]. The majority of practicing pediatric pulmonologists were young graduates with less than 5 years' experience [44.8%] and were North American training programs graduates [69%]. The majority of the respondents [51%] were located in Riyadh, 27% in Jeddah, 14% in the Eastern region and 3% in Madinah and Al-Majma'a. Most of the respondents had access to basic diagnostic tools required in the subspecialty, a majority of them [85%] lack dedicated pediatric pulmonary function laboratories. Nearly, 80% of the hospitals performed less than 50 flexible bronchoscopies/year. Pediatric pulmonology is a growing subspecialty in Saudi Arabia with well-trained and experienced physicians. Our study represents an overview of the available pediatric pulmonology services in Saudi Arabia, which would help in future planning and better utilization of the available resources

Helicobacter pylori and Egyptian infantile colic

Excessive infant crying is a common and often stress-inducing condition for parents that can ultimately result in infant abuse. Although the infantile colic is reported commonly and causes appreciable distress for both parents and pediatricians, its pathogenesis remains unclear, despite 40 years of research. This work studied the role of H. pylori in infantile colic. This study was conducted in a primary health care office in Sharkia Governorate. The study included 50 infants with infantile colic according to Wessel's criteria, along with age and sex matched 50 healthy controls. All- infants without apparent cause for their colic underwent full history taking, clinical examination and H. pylori antigen in their stools. This study supports the new evidence for the role of H. pylori in the pathogenesis of infantile colic. H. pylori stool antigen was present in 31 [62%] of cases in contrast to 10 [20%] of controls [P<0.0001]. Normal vaginal delivery, male, vomiting and breast feeding may be risk factors for H. pylori infection in this age period

Saudi regulations for the accreditation of sleep medicine physicians and technologists

The professional content of sleep medicine has grown significantly over the past few decades, warranting the recognition of sleep medicine as an independent specialty. Because the practice of sleep medicine has expanded in Saudi Arabia over the past few years, a national regulation system to license and ascertain the competence of sleep medicine physicians and technologists has become essential. Recently, the Saudi Commission for Health Specialties formed the National Committee for the Accreditation of Sleep Medicine Practice and developed national accreditation criteria. This paper presents the newly approved Saudi accreditation criteria for sleep medicine physicians and technologists

Saudi initiative for asthma - 2012 update: guidelines for the diagnosis and management of asthma in adults and children

This an updated guidelines for the diagnosis and management of asthma, developed by the Saudi Initiative for Asthma [SINA] group, a subsidiary of the Saudi Thoracic Society. The main objective of SINA is to have updated guidelines, which are simple to understand and easy to use by non-asthma specialists, including primary care and general practice physicians. This new version includes updates of acute and chronic asthma management, with more emphasis on the use of Asthma Control Test in the management of asthma, and a new section on "difficult-to-treat asthma." Further, the section on asthma in children was re-written to cover different aspects in this age group. The SINA panel is a group of Saudi experts with well-respected academic backgrounds and experience in the field of asthma. The guidelines are formatted based on the available evidence, local literature, and the current situation in Saudi Arabia. There was an emphasis on patient-doctor partnership in the management that also includes a self-management plan. The approach adopted by the SINA group is mainly based on disease control as it is the ultimate goal of treatment

Awareness of healthcare workers regarding preventive measures of communicable diseases among Hajj pilgrims at the entry point in Western Saudi Arabia

To determine the level of knowledge of healthcare workers [HCWs] towards preventive measures for communicable diseases among pilgrims, and to highlight the difficulties faced by HCWs in implementing preventive measures at entry point. A cross-sectional study was conducted at King Abdulaziz International Airport Hajj Terminals in Jeddah, Kingdom of Saudi Arabia during Hajj season from October to November 2009 including 325 healthcare workers [HCWs]. Data were collected using a self-administered questionnaire. Difficulties reported by HCWs were refusal of vaccine, or chemoprophylaxis by some pilgrims, language barriers, and difficulties in organizing pilgrims. The different items related to meningococcal meningitis were answered correctly by most HCWs except for preventive measures applied to infants and children. Less than one half were aware of the period of validity for Yellow Fever vaccine certificate and measures to be taken for unvaccinated pilgrims. Only 32.9% were aware of preventive measures that should be applied against influenza A [H1N1]. Physicians, those reading guidelines, and those with high experience a showed significantly better level of knowledge than other categories. The HCWs have difficulties in some preventive measures, especially among non-physicians, those with less years of experience, and those who did not read the written guidelines, which highlighted the importance of training courses before Hajj season

Coronary events in Bahrain: descriptive study

In Bahrain, cardiovascular death accounts for about 19.5% annually. Prevalence of Ischemic Heart Diseases [IHD] was 174.4 per 100,000 populations. Coronary events found to be the fourth leading cause of discharge from Salmaniya Medical Complex [SMC] in 2005. To evaluate the pattern and profile of patients with coronary events. Salmaniya Medical Complex, Kingdom of Bahrain. Retrospective Cross-sectional Study. Two hundred twenty-six patients were selected by a systematic random sampling technique from patients admitted with coronary events in SMC from 1 January 2004 to 31 December 2004. Data were reviewed and documented from the medical record. One hundred thirty-eight [61.1%] suffered from unstable angina, 66 [29.2%] had myocardial infarction and 22 other coronary events. Pre-existing cardiovascular diseases [previous IHD, atherosclerotic diseases, other heart diseases and stroke] suffered by almost half of the patients. Hypertension was reported in 97 [42.9%] patients, while diabetes was reported in 82 [36.3%] patients. More than two-third of cases diagnosed with coronary events had unstable angina and nearly one-third of cases had myocardial infarction. The majority of patients had preexisting morbidities, which include diabetes mellitus, hypertension and chronic cardiac conditions

Clinical presentation and demographic characteristics of diagnosed adult hypothyroidism at primary health care centers in Kingdom of Bahrain

Hypothyroidism is second only to diabetes mellitus as the most common endocrine disorder, but has attained little attention in the literature.The prevalence internationally is reported as 2-5% increasing up to 15% by age 75 years. To provide a baseline clinical profile of diagnosed adult hypothyroidism patients at primary health care in the kingdom of Bahrain. Primary health care centers in Bahrain Cross sectional descriptive study. Medical records of 239 hypothyroid patients selected from a list of patients who underwent thyroid function test [TFT] during the year 2005 at primary health care centers in Bahrain were reviewed and all patients were contacted by phone. Socio demographic and clinical data were recorded. Mean age of patients was 48 years. Females represented 88% of the study sample. Family history was positive in 47% of patients. The two main presenting symptoms were fatigue 66% and sleepiness 47% followed by emotional liability, weight gain and constipation. The majority of the patients [55%] were diagnosed during the past five years. The study is a primary one on hypothyroidism in Bahrain. Results showed that hypothyroidism is more common in females and the most common presenting symptoms were fatigue and sleepiness

Paraumbilical hernia repair during cesarean delivery

Pregnant women with paraumbilical hernia usually postpone hernia repair until after delivery, but some patients request that it be done during cesarean delivery. Therefore, we evaluated the outcome of combined cesarean delivery and paraumbilical hernia repair in a prospective study at a tertiary referral university hospital. In a prospective study, we compared the outcome of 48 patients undergoing cesarean delivery combined with paraumbilical hernia repair versus 100 low-risk patients undergoing cesarean delivery alone. The main outcome measures were operation time, blood loss, severity of pain, peripartum complications, hospital stay, hernia recurrence, and patient satisfaction. The combined procedure took significantly longer than cesarean delivery alone [75.2 minutes versus 60.5 minutes, P < .001]]. There were no major complications. Wound infection occurred in 6 patients [4.1%]. Hospital stay did not differ significantly from those of controls. Pain at the hernia site repair occurred in two patients, and one hernia recurred in the hernia repair group during a mean follow-up period of 22 months [range, 6-36 months]. All hernia patients reported that they preferred the combined operation. Combined cesarean delivery and paraumbilical hernia repair had the advantage of a single incision, single anesthesia, and a single hospital stay while avoiding re-hospitalization for a separate hernia repair. Our results indicate that the combination approach is safe, effective, and well accepted

study of the androgen receptor gene polymorphism and the level of expression of the androgen receptor in androgenetic alopecia among Egyptians

Androgenetic alopecia [AGA] occurs in men and women. The nature of the genetic predisposition to androgenetic alopecia is still unresolved. The aim of the work is to study the genotype of the androgen receptor gene [Stui polymorphism] and its relationship to AGA in a case control study and to determine the level of androgen receptor expression [AR] in the balding scalp relative to the non-balding scalp area. This study was conducted on one hundred individuals; 60 cases with AGA [36 males and 24 females] and 40 age and sex matched control patients [20 males and 20 females]. Stui restriction fragment length polymorphism [RFLP] of exon 1 was detected by PCR based assay using genomic DNA of subjects with AGA and controls. Immunohistochemical detection of the androgen receptor [AR] using antihuman AR antibody was implemented to compare its level in the balding scalp and in the non-balding area in individuals having AGA. Analysis of Stul restriction fragment length polymorphism in exon 1 of the androgen receptor [AR] gene revealed a relatively commoner incidence of the cut allele in males with AGA relative to age and sex matched controls [the association was of border line significance p = 0.07. Interestingly, all persons who had maternal uncles suffering from AGA had the Stui cut variant of AR gene [p = 0.03 using Chi square test]. Semiquantitative immunohistochemical analysis of AR in the bold scalp biopsies showed higher expression in the level of AR than the non bold bioposies within the same individual. To the best of our knowledge this is the first study of AR gene polymorphism and AR expression in AGA amongst Egyptians. This study contributes in the understanding of the molecular pathogenesis of AGA which could help in finding better therapeutic alternatives for such trait in the future

Role of abrasives in dentistry

A dental abrasive is an important part of dental services. This specialty deals with the finishing and polishing of dental appliances like complete dentures, removable partial dentures, crown and bridges and the direct dental restorative materials. Effective finishing and polishing of direct or indirect dental restorations may not only responsible for good aesthetics but also provide healthy oral environment and the longevity of the restorative material. This review is based on latest technology and the material used in dentistry which provides an overview of basic principles based on dental abrasives. The overall aim is to provide the awareness and broader knowledge of the principles and tools available to produce an optimal surface finishing and Polishing in dental restoratives techniques

Role of serum interleukin-6 and osteocalcin in prediction of bone loss in postmenopausal women

Osteoporosis is defined as a reduction of bone mass density or the presence of fragility fracture. This reduction in bone tissue is accompanied by deterioration in the architecture of the skeleton, leading to a markedly increased risk of fracture. Interleukin-6 [IL-6] and osteocalcin have been associated with the risk of chronic disease such as osteoporosis. In this study, we assessed the relationships between interleukin-6 and osteocalcin in the prediction of postmenopausal osteoporosis. The study included 80 women whose age ranged from 18 to 80 years and were classified into the following four groups according to the duration of menopause: Control group, this group comprised 20 premenopausal healthy females, they had regular menstrual cycles. Group I [Post Menopausal Patients], this group comprised 20 patients of osteoporosis, with menopause less than 5 years. Group II [Post Menopausal Patients], this group comprised 20 patients of osteoporosis, with menopause from 5-10 years. Group III [Post Menopausal Patients], this group comprised 20 patients of osteoporosis, with menopause more than 10 years. Patients of group I showed a significant increase of both IL6 [p<0.05] and osteocalcin [p<0.001] compared to control group. On the other hand, patients of both group II and III showed non significant change of interleukin-6 while a highly significant increase of osteocalcin [p<0.001], as compared to control group. We concluded that interleukin-6 appears to be a potent osteotropic factors that may play an important role in prediction of bone loss in early menopause as it is easy to measure and can be measured routinely. We recommend for the investigation on role of interleukin-6 in pathophysiology of bone loss

Cancer prevention: role of primary care professionals

Review the current inputs of primary care professionals in Bahrain in the area of cancer prevention, Three key tasks performed at primary care level were reviewed [female cancer screening, tobacco control, Hepatitis B immunization]. The review is based on data collected from various health statistics, annual reports and national and regional surveys. Cancer is an important cause of morbidity and mortality in Bahrain. Evidence reported that a large proportion of cancer is preventable in nature, and suggest that primary care professionals have a critical role to play in cancer prevention and control. Although the coverage of cervical and breast screening was low [30% and 40%, respectively], yet, the current screening program covers women of lower risk. There is an urgent need to involve primary care professionals in tobacco control and tobacco cessation activities in particular. Follow up for Hepatitis B cases and contacts are identified as a priority area and need further improvement. Guidelines for screening and management of Hepatitis B cases at Primary care level need to be established Primary care professionals can increase their inputs in cancer prevention. Public education about cancer risk factors is priority activity. They require to be involved more in tobacco cessation programs. New measures for female cancer screening are required to improve the role of primary care professionals

Trajectories with velocity corrections in the impulsive transfer orbits

The main goal of this paper is to acquire the precise final elliptic orbit stemming from an initial orbit via an optimal transfer orbit, by applying small tangential impulses at peri-apse and apoapse. We consider two systems; the generalized Hohmann and the generalized bi-elliptic transfer orbits. For the first system, we obtain the four relationships connecting the increments in major axes and eccentricities with the correctional increments in velocities delta vA and delta vB at points A, B. For the second system, we derive the three relationships, connecting slight changes in major axes with small increments in velocities at points A, B and C due to motor thrusts. Forminimum fuel consumption, we consider the initial impulse applied at periapse of initial orbit

Solution for the lambert's problem

In this work, we have formulated and solved the well known Lambert problem, one of the most important topics in celestial mechanics. As Lambert stated, the transfer time depends only on the unknown parameter a [semi major axis], the two radii and the chord length are already known from the definition of the problem. It should be possible to write the transfer time as a function of the semi major axis only [t[2] -t[1]=delta t =f[a]]. Also the transfer time can be written as a function of some other parameter such as AE, this allows for a well-behaved iteration, and is the chosen method for the universal variable formulation. We solve Lambert problem by using this method, for two cases, elliptic orbits and hyperbolic orbits. Parabolic orbits are of no practical importance. We consider the Earth - Mars trajectory case, as a numerical example

Profile of elderly attending primary health care centers in Bahrain

This cross-sectional study is aimed at describing some demographic, health and social characteristics of elderly attending health centers in Bahrain Of the 22 health center in Bahrain 4 were randomly selected for conducting the study All the elderly attending the selected health centers during the study period [17-28 July 1999] were interviewed by the study group member Total of 201 elderly were included in this study with 106 [53%] males and 95[47%] females 80% of them were young-old [65-75 years] and most of them were illiterate [77,6%] 81,1% were living with their children [with or without the spouse]The prevalence of health problem among elderly was high with 36,3% for Diabetes mellitus, 39.3% for Hypertension and 15,4% for cardiovascular diseases 58,2% had joints problem, 79,1% had visual problems and 39,8% had hearing problems