Lernaeid parasites prevalence in commercial freshwater fish species at various fish farms in Pakistan

Abstract Reports abound on Lernaea parasitizing the brood stock, fingerlings, and marketable-sized culturable freshwater fish species in various parts of the world. We investigated seven small-scale aquaculture farms and how the prevailing Lernaea is impacting them. Randomly seven fish farms were selected to determine the prevalence percentage of lernaeid ectoparasites. Relevant information of the fishponds to estimate the various aspects such as effects of water source and quality, feed, stocking density, treatment used, and weight and length of fish, concerned with Lernaea infestation and prevalence was gathered. The results indicated that Catla catla (F. Hamilton, 1822) showed highest prevalence (41.7%) among the seven fish species, whereas Oreochromis niloticus showed zero. Other five fish species Ctenopharyngodon idella, Cirrhinus cirrhosis, Cyprinus carpio, Labeo rohita and Hypophthalmichthys molitrix showed 13.2%, 8.1%, 7.7%, 7.4%, 0.9% prevalence, respectively. In Royal Fish Farm 84.3% lernaeid infestation was observed, while no parasite was observed in the Vicents Chunnian fish farm. The water source, quality, feed, fertilizers, stocking density, water temperature, and potential treatment options displayed varying tendencies among fish farms and prevalence. Depending on the weight and length, the highest prevalence (56.7%, and 66.7%) was observed in 3501-4000 g and 81-90 cm groups. The infestation rate varied in various fish body parts with the dorsal fin the most vulnerable organ and showed 2.3% overall prevalence (while 18.4% contribution within total 12.6% infestation). Out of 147 infected fish samples, 45 were extensively contaminated by Lernaea spread. In conclusion, our findings confirm that Lernaea could pose a considerable threat to marketable fish, and various treatment options should be educated to the farmers to help mitigate the spread and potential losses. Furthermore, Catla catla is more vulnerable to Lernaea infestation (41.7%), so are the fish species being cultured at higher stocking densities.

Resumo Abundam os relatórios sobre Lernaea parasitando o estoque de cria, alevinos e espécies de peixes de água doce cultiváveis de tamanho comercial em várias partes do mundo. Investigamos sete fazendas de aquicultura de pequena escala e de que maneira a Lernaea predominante está impactando-as. Aleatoriamente, sete fazendas de peixes foram selecionadas para determinar a porcentagem de prevalência de ectoparasitas de Lernaea. Foram recolhidas informações relevantes sobre os viveiros de peixes para estimar os vários aspectos, tais como efeitos da fonte e qualidade da água, alimentação, densidade de povoamento, tratamento utilizado e peso e comprimento dos peixes, relacionados com a infestação e prevalência de Lernaea. Os resultados indicaram que Catla catla (F. Hamilton, 1822) apresentou maior prevalência (41,7%) entre as sete espécies de peixes, enquanto Oreochromis niloticus apresentou zero. Outras cinco espécies de peixes Ctenopharyngodon idella, Cirrhinus cirrhosis, Cyprinus carpio, Labeo rohita e Hypophthalmichthys molitrix apresentaram 13,2%, 8,1%, 7,7%, 7,4%, 0,9% de prevalência, respectivamente. Em Royal Fish Farm, 84,3% de infestação de Lernaea foi observada, enquanto não se observou nenhum parasita na fazenda de peixes Chunnian de Vicent. A fonte de água, qualidade, ração, fertilizantes, densidade de estocagem, temperatura da água e opções de tratamento potenciais exibiram tendências variadas entre as fazendas de peixes e prevalência. Dependendo do peso e comprimento, a maior prevalência (56,7% e 66,7%) foi observada nos grupos de 3501-4000 g e 81-90 cm. A taxa de infestação variou em várias partes do corpo dos peixes, sendo a nadadeira dorsal o órgão mais vulnerável e apresentou 2,3% de prevalência geral (enquanto 18,4% de contribuição dentro do total de 12,6% de infestação). Das 147 amostras de peixes infectados, 45 estavam amplamente contaminadas pela propagação de Lernaea. Em conclusão, nossos resultados confirmam que Lernaea pode representar uma ameaça considerável para peixes comercializáveis, e várias opções de tratamento devem ser educadas para os agricultores para ajudar a mitigar a propagação e as perdas potenciais. Além disso, Catla catla é mais vulnerável à infestação por Lernaea (41,7%), assim como as espécies de peixes sendo cultivadas em densidades de estocagem mais altas.

Photosynthetic acclamatory response of Panicum antidotale Retz. populations to root zone desiccation stress

Abstract Growth of plants is severely reduced due to water stress by affecting photosynthesis including photosystem II (PSII) activity and electron transport. This study emphasised on comparative and priority targeted changes in PSII activity due to progressive drought in seven populations of Panicum antidotale (P. antidotale) collected from Cholistan Desert and non-Cholistan regions. Tillers of equal growth of seven populations of P. antidotale grown in plastic pots filled with soil were subjected progressive drought by withholding water irrigation for three weeks. Progressive drought reduced the soil moisture content, leaf relative water content, photosynthetic pigments and fresh and dry biomass of shoots in all seven populations. Populations from Dingarh Fort, Dingarh Grassland and Haiderwali had higher growth than those of other populations. Cholistani populations especially in Dingarh Grassland and Haiderwali had greater ability of osmotic adjustment as reflected by osmotic potential and greater accumulation of total soluble proteins. Maximum H2O2 under water stress was observed in populations from Muzaffargarh and Khanewal but these were intermediate in MDA content. Under water stress, populations from Muzaffargarh and Dingarh Fort had greater K+ accumulation in their leaves. During progressive drought, non-Cholistani populations showed complete leaf rolling after 23 days of drought, and these populations could not withstand with more water stress condition while Cholistani populations tolerated more water stress condition for 31 days. Moreover, progressive drought caused PSII damages after 19 days and it became severe after 23 days in non-Cholistani populations of P. antidotale than in Cholistani populations.

Resumo O crescimento das plantas é severamente reduzido devido ao estresse hídrico, afetando a fotossíntese, incluindo a atividade do fotossistema II (PSII) e o transporte de elétrons. Este estudo enfatizou as mudanças comparativas e prioritárias na atividade do PSII devido à seca progressiva em sete populações de Panicum antidotale (P. antidotale) coletadas no Deserto do Cholistão e regiões fora do Cholistão. Perfilhos de igual crescimento de sete populações de P. antidotale cultivadas em vasos de plástico cheios de solo foram submetidos à seca progressiva, retendo a irrigação com água por três semanas. A seca progressiva reduziu o teor de umidade do solo, teor de água relativo nas folhas, pigmentos fotossintéticos e biomassa fresca e seca dos brotos em todas as sete populações. Populações de Dingarh Fort, Dingarh Grassland e Haiderwali tiveram maior crescimento do que as de outras populações. As populações de Cholistani, especialmente em Dingarh Grassland e Haiderwali, apresentaram maior capacidade de ajuste osmótico, refletido pelo potencial osmótico e maior acúmulo de proteínas solúveis totais. H2O2 máximo sob estresse hídrico foi observado em populações de Muzaffargarh e Khanewal, mas estas foram intermediárias no conteúdo de MDA. Sob estresse hídrico, as populações de Muzaffargarh e Dingarh Fort tiveram maior acúmulo de K+ em suas folhas. Durante a seca progressiva, as populações não cholistanesas mostraram rolagem completa das folhas após 23 dias de seca, e essas populações não conseguiram suportar mais condições de estresse hídrico, enquanto as populações cholistani toleraram mais condições de estresse hídrico por 31 dias. Além disso, a seca progressiva causou danos ao PSII após 19 dias e tornou-se severa após 23 dias em populações não cholistanesas de P. antidotale do que em populações cholistanesas.

Photosynthetic acclamatory response of Panicum antidotale Retz. populations to root zone desiccation stress / Reação fotossintética aclamatória de Panicum antidotale Retz. populações submetidas ao estresse da dessecação da zona radicular

Abstract Growth of plants is severely reduced due to water stress by affecting photosynthesis including photosystem II (PSII) activity and electron transport. This study emphasised on comparative and priority targeted changes in PSII activity due to progressive drought in seven populations of Panicum antidotale (P. antidotale) collected from Cholistan Desert and non-Cholistan regions. Tillers of equal growth of seven populations of P. antidotale grown in plastic pots filled with soil were subjected progressive drought by withholding water irrigation for three weeks. Progressive drought reduced the soil moisture content, leaf relative water content, photosynthetic pigments and fresh and dry biomass of shoots in all seven populations. Populations from Dingarh Fort, Dingarh Grassland and Haiderwali had higher growth than those of other populations. Cholistani populations especially in Dingarh Grassland and Haiderwali had greater ability of osmotic adjustment as reflected by osmotic potential and greater accumulation of total soluble proteins. Maximum H2O2 under water stress was observed in populations from Muzaffargarh and Khanewal but these were intermediate in MDA content. Under water stress, populations from Muzaffargarh and Dingarh Fort had greater K+ accumulation in their leaves. During progressive drought, non-Cholistani populations showed complete leaf rolling after 23 days of drought, and these populations could not withstand with more water stress condition while Cholistani populations tolerated more water stress condition for 31 days. Moreover, progressive drought caused PSII damages after 19 days and it became severe after 23 days in non-Cholistani populations of P. antidotale than in Cholistani populations.

Resumo O crescimento das plantas é severamente reduzido devido ao estresse hídrico, afetando a fotossíntese, incluindo a atividade do fotossistema II (PSII) e o transporte de elétrons. Este estudo enfatizou as mudanças comparativas e prioritárias na atividade do PSII devido à seca progressiva em sete populações de Panicum antidotale (P. antidotale) coletadas no Deserto do Cholistão e regiões fora do Cholistão. Perfilhos de igual crescimento de sete populações de P. antidotale cultivadas em vasos de plástico cheios de solo foram submetidos à seca progressiva, retendo a irrigação com água por três semanas. A seca progressiva reduziu o teor de umidade do solo, teor de água relativo nas folhas, pigmentos fotossintéticos e biomassa fresca e seca dos brotos em todas as sete populações. Populações de Dingarh Fort, Dingarh Grassland e Haiderwali tiveram maior crescimento do que as de outras populações. As populações de Cholistani, especialmente em Dingarh Grassland e Haiderwali, apresentaram maior capacidade de ajuste osmótico, refletido pelo potencial osmótico e maior acúmulo de proteínas solúveis totais. H2O2 máximo sob estresse hídrico foi observado em populações de Muzaffargarh e Khanewal, mas estas foram intermediárias no conteúdo de MDA. Sob estresse hídrico, as populações de Muzaffargarh e Dingarh Fort tiveram maior acúmulo de K+ em suas folhas. Durante a seca progressiva, as populações não cholistanesas mostraram rolagem completa das folhas após 23 dias de seca, e essas populações não conseguiram suportar mais condições de estresse hídrico, enquanto as populações cholistani toleraram mais condições de estresse hídrico por 31 dias. Além disso, a seca progressiva causou danos ao PSII após 19 dias e tornou-se severa após 23 dias em populações não cholistanesas de P. antidotale do que em populações cholistanesas.

Cross-Cultural Adaptation, Validation, and Arabic Translation of the Eustachian Tube Dysfunction Questionnaire (ETDQ-7)

Abstract Introduction The Eustachian Tube Dysfunction Patient Questionnaire (ETDQ-7) scale is used to assess the effectiveness of the treatment and to determine the severity of the eustachian tube dysfunction (ETD). There is currently no validated Arabic version of the ETDQ-7. Objectives The aim of the present study is to test the validity and the reliability of a translated Arabic version of the ETDQ-7. Methods A multicenter prospective validation study was conducted in Riyadh, Saudi Arabia. The ETDQ-7 was adapted and translated into Arabic using a standard validation methodology. Fifty-one patients diagnosed with Eustachian tube dysfunction and 45 healthy individuals were enrolled in the study. The known-groups method was used in the validity analysis. The test-retest method, item-total score correlation, and internal consistency analysis were used for the reliability analyses. Result The overall internal consistency of the Arabic ETDQ items was measured using Cronbach α (Cronbach α = 0.803). The average and total ETDQ scores were significantly higher in the ETD group (17.6) than in the control group (9.87) (p < 0.001). The results indicate a good to excellent correlation (> 0.7). The area under the curve for the total ETDQ score was 88.6% (95% confidence interval [CI]: 80.3-96.8%) Conclusion The Arabic version of the ETDQ-7 scale is a valid instrument for evaluating ETD. It can also be used as an important tool for diagnosis, patient follow-up, and treatment management.

Genetic diversity of Duffy binding protein 2 region II of Plasmodium cynomolgi from wild macaques in Peninsular Malaysia

@#Recent reports of natural human infection by Plasmodium cynomolgi indicate the increased risk of zoonotic transmission by this simian parasite. The P. cynomolgi Duffy binding protein 2 (PcDBP2) has a potential role in the invasion pathway of host erythrocytes, and it is a possible vaccine candidate against cynomolgi malaria. This study investigates the genetic diversity, haplotypes, and natural selection of PcDBP2 region II from isolates collected from wild macaques in Peninsular Malaysia. Blood samples from 50 P. cynomolgi-infected wild macaques were used in the study. Genomic DNA extracted from the blood samples was used as template for PCR amplification of the PcDBP2 region II. The amplicons were cloned into a plasmid vector and sequenced. MEGA X and DnaSP ver.6.12.03 programmes were used to analyse the DNA sequences. A genealogical relationship of PcDBP2 region II were determined using haplotype network tree on NETWORK ver.10.2. Result showed high genetic diversity (ð = 0.017 ± 0.002; Hd = 1.000 ± 0.001) of the PcDBP2 region II. The Z-test indicates a purifying selection, with population expansion as shown in Tajima’s D analysis. A total of 146 haplotypes of PcDBP2 region II were observed. Phylogenetic tree analysis showed that these haplotypes were grouped into three allelic types (136 for Strain B type, 9 for Berok type, and 1 recombinant type). In the haplotype network, PcDBP2 region II revealed no geographical groupings but was divided into two distinct clusters.

Fucoxanthin suppresses OxLDL-induced inflammation via activation of Nrf2 and inhibition of NF-κB signaling

Objective: To explore the impact of fucoxanthin on oxidized low-density lipoprotein (OxLDL)-induced stress and inflammation in human endothelial cells and its underlying mechanisms. Methods: HUVECs were treated with OxLDL and/or fucoxanthin for a range of time points and concentrations. We evaluated the effects of fucoxanthin on OxLDL-induced HUVECs using the MTT assay, reactive oxygen species accumulation assay, ELISA, RT-PCR, immunofluorescence, and Western blotting. Results: Fucoxanthin enhanced the cell viability in a dose dependent manner after OxLDL exposure. Furthermore, fucoxanthin pretreatment significantly decreased OxLDL-induced reactive oxygen species production and prevented the activation of the nuclear factor kappa-B pathway, which led to substantial suppression of pro-inflammatory gene expressions. OxLDL-induced upregulation of interleukin-6, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, interleukin-1β, monocyte chemotactic protein-1, cyclooxygenase-1, and tumor necrosis factor-α was significantly reduced by fucoxanthin. Conclusions: Fucoxanthin can inhibit OxLDL-induced vascular inflammation and oxidative stress in HUVECs by targeting Nrf2 signaling pathways.

Fucoxanthin suppresses OxLDL-induced inflammation via activation of Nrf2 and inhibition of NF-κB signaling

Objective: To explore the impact of fucoxanthin on oxidized low-density lipoprotein (OxLDL)-induced stress and inflammation in human endothelial cells and its underlying mechanisms. Methods: HUVECs were treated with OxLDL and/or fucoxanthin for a range of time points and concentrations. We evaluated the effects of fucoxanthin on OxLDL-induced HUVECs using the MTT assay, reactive oxygen species accumulation assay, ELISA, RT-PCR, immunofluorescence, and Western blotting. Results: Fucoxanthin enhanced the cell viability in a dose dependent manner after OxLDL exposure. Furthermore, fucoxanthin pretreatment significantly decreased OxLDL-induced reactive oxygen species production and prevented the activation of the nuclear factor kappa-B pathway, which led to substantial suppression of pro-inflammatory gene expressions. OxLDL-induced upregulation of interleukin-6, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, interleukin-1β, monocyte chemotactic protein-1, cyclooxygenase-1, and tumor necrosis factor-α was significantly reduced by fucoxanthin. Conclusions: Fucoxanthin can inhibit OxLDL-induced vascular inflammation and oxidative stress in HUVECs by targeting Nrf2 signaling pathways.

Advancing male age differentially alters levels and localization patterns of PLCzeta in sperm and testes from different mouse strains / 亚洲男科学杂志(英文版)

Sperm-specific phospholipase C zeta (PLCζ) initiates intracellular calcium (Ca

Unique position of a pancreatic head insulinoma during laparoscopic enucleation: case report

Insulinomas are benign pancreatic neuroendocrine tumors that require surgical intervention as a therapeutic measure. We describe an 18-year-old male patient who presented to the emergency department with a history of syncope, blurred vision, and diaphoresis. His blood sugar level was low upon admission, and a 72-hour fasting plasma glucose test showed low serum glucose, high serum insulin, and high C-peptide. An abdominal computed tomography scan and magnetic resonant imaging revealed a solitary tumor in the pancreatic head with no sign of ductal dilatation. Laparoscopic enucleation was performed, and a histopathological examination revealed findings consistent with insulinoma. The patient’s postoperative course was uneventful, and his follow-up examination was unremarkable. In conclusion, physicians should have a high clinical suspicion index for insulinomas, especially in young patients with a history of syncope, blurred vision, and diaphoresis, in order to avoid delayed diagnosis.

Prevalent Beliefs and Attitude toward Vitiligo among Public in Al Baha Province, Southern Saudi Arabia

ntroduction: Vitiligo is an apparent skin condition that has a psychological impact on the affected individuals and their families. Its prevalence is estimated to be about (0.5-2%) globally. Misunderstandings, and negative attitudes toward vitiligo patients are the most important factors affecting the quality of life of vitiligo patients. Objective:The objective of this study was to identify the common misconceptions and attitudes about the nature, causes and prognosis of vitiligoin Al-Baha region, Saudi Arabia. Methods:A cross sectional study collected data from the general population in the public malls in Al-Baha region, Saudi Arabia. We used a questionnaire which was developed by the authors, the questionnaire included questions regarding vitiligo cause, nature, prognosis and the attitude toward vitiligo Results:A total of (453) responses were analysed, of which (53%) were females, and (90.9%) were Saudis. Theparticipants’ ages ranged from (16 -64) with a mean of (28.3). The majority of our sample had a high level of education; university (65.1%), High school (26%) and less than high school (6%). Our population believed that gecko and its saliva were the commonest cause (38.1%). Most of the respondents (44.4%) thought that the condition is exaggerated by stress and anxiety. Regarding attitude; (31.5%) are unwilling to marry a vitiligo patient. Conclusion:The results of the present study show that the misconceptions and attitudes toward vitiligo are prevalent. Health awareness campaigns should be implanted to educate the people and improve the quality of life of the affected individuals

The Association between Hypoglycemia Requiring Emergency Medical Intervention and Patient Health Outcomes

Objectives: To examine the association between hypoglycemia requiring presentation at an emergency department and patient health outcomes in terms of duration of hospital stay and mortality rate. Method: A retrospective chart review study of all patients with hypoglycemia as the primary diagnosis admitted to the emergency department and met the inclusion criteria was conducted at King Abdulaziz Medical City in Riyadh (Saudi Arabia) between January 2015 and March 2016. Data were collected from an electronic health records database (Best care) and medical charts and pharmacy records were reviewed. Results: A total of 51 patients were included in the study. Twenty-two patients (42.31%) were admitted because of hypoglycemia. The total mortality rate was 3.92% (2 patients). The total length of hospitalization was higher in deceased patients (4.00 ± 4.24 days) compared to that in surviving patients (1.45 ± 1.21 days). At presentation, 22 patients (44.00%) had no prior interventions; nine were hypoglycemic, while 13 were non-hypoglycemic. In contrast, five patients (10.00%) received hypoglycemic intervention prior to arrival in the ER; one was hypoglycemic, and four were non-hypoglycemic. There was a zero mortality rate among patients who received pre-arrival interventions compared to a rate of 9.09% among patients who did not receive pre-arrival interventions. The chi-square test was used to assess statistical significance. Conclusion: In conclusion, this study shows no correlation between hypoglycemia and mortality or the total duration of hospitalization. In addition, there was no significant relationship between the incidence of hypoglycemic events and different comorbidities.

A Survey to Assess Quality of Life of Gastro‐Oesophageal Reflux Disease (GERD) Patients in Saudi Arabia

Gastrointestinal Esophagus Ailment is a chronic disease that usually results in complications. GERD symptomsinclude chest pain, acid regurgitation, heartburn, nausea, chronic cough, asthma, and hoarseness. A considerablenumber of research studies have shown that old age, obesity, drug and substance abuse are significant factorsthat exacerbate the present condition. The findings from the present research study illustrate that the conditionhas a major impact on psychological problems. Precisely, the consequences of the condition appeared to vary indifferent age groups. In particular, this difference was determined with chi-square while taking into considerationthe existing variables. Furthermore, the results ascertained that some variations were registered in terms ofseveral factors that differ significantly across gender. Eating pattern between males and females also emerged asa major factor in the research study. The difference is also evident in the age group category as the age group18-25 shares different sentiments in various aspects.

Human leukocyte antigen (HLA) class II association in chronic hepatitis B patients with hepatocellular carcinoma in a Malay population: A pilot study

@#Asian countries account for almost three quarter of hepatocellular carcinoma (HCC) reported globally and chronic hepatitis B infection is one of the main contributors. Clinical observations show that Malay patients with chronic hepatitis B and HCC tend to have a worse outcome, when compared to other two major races in Malaysia. The objectives of this study was to determine the frequency of human leukocyte antigen (HLA) class II alleles in chronic hepatitis B patients with HCC among Malays compared to the general population to identify potential associations of HLA alleles with this disease. HLA class II typing was performed in chronic hepatitis B patients with hepatocellular carcinoma (n=12) by -polymerase chain reaction, sequence specific primer (PCR-SSP) method. There were higher allelic frequencies of certain HLA-DQB1 and HLA-DRB1 alleles; HLA-DQB1*03 (07) (41.7%), and HLA-DRB1*12 (41.7% vs 28.6%) and compared to controls (41.7% vs 29.7%). However, there was no significant statistical correlation found when compared with the normal healthy general population. This study provides an insight into the HLA Class II association with chronic hepatitis B and hepatocellular carcinoma in Malays. However, findings from this study should be validated with a larger number of samples using a high resolution HLA typing.

History of cupping (Hijama): a narrative review of literature / 中西医结合学报

Cupping (Hijama in Arabic) is an ancient, holistic method for the treatment of a variety of diseases. Though the exact origin of cupping therapy is a matter of controversy, its use has been documented in early Egyptian and Chinese medical practices. Diverse human civilizations have contributed to the historical development and continuation of cupping therapy. This narrative review describes the history of cupping, historical definitions, cupping instruments and uses of cupping therapy. Electronic searches of relevant databases (PubMed, Google Scholar and OvidSP) were conducted using keywords and Boolean operators. Manual searches and references of published articles and books were also conducted. A number of articles (N = 625) were retained for extensive review, and finally 83 articles were included in this paper. The historical descriptions of cupping therapy were found in ancient human civilizations of the Eastern and Western world. There were inconsistent data concerning the origin of cupping, definitions, instruments, procedures, definite advancements and research in Hijama over centuries. Cupping therapy fell out of favor in 17th and mid-18th centuries but recovered popularity in modern medicine. Currently, cupping therapy is used for health promotion, prophylaxis and treatment of a variety of diseases around the world. Cupping therapy with a good safety profile has a checkered history and is a well-recognized traditional method for managing medical conditions. Currently, the scope of cupping therapy is expanding, and a growing body of research is providing additional evidence-based data for the further advancement of cupping therapy in the treatment of a variety of diseases.

systematic review of the safety of nipple sparing mastectomy

Background: Breast cancer is a complex disease, and local recurrence and cancer-related death is likely multifactorial. Over the past three decades there has been a move towards breast conservation and a focus on aesthetic outcomes while maintaining oncological safety. For some patients, mastectomy is the preferred option. There is growing interest in the potential use of nipple sparing mastectomy [NSM]. However, oncological safety remains unproven, and the benefits and indications have not been clearly identified

Methods: A Systematic search in the scientific database [Medline, EMBASE, Google Scholer and Ovid] from 1980 to 2016 was conducted for all relevant retrospective studies including; randomized controlled trials, cohort studies and case-studies involving women undergoing either NSM were analyzed and included based on the preset inclusion criteria

Results: The search yielded 1193 articles, of which 55 studies with 9053 patients met our selection criteria. After a mean follow up of 41 months [range, 7.1-78 months], the overall pooled locoregional recurrence rate [LRR] was 3.25%, the overall complication rate was 21.8% [1309 of 6003], and the overall incidence of nipple necrosis, either partial or total, was 6.6 % [561 of 8438]. Significant heterogeneity was found among the published studies and patient selection was affected by tumor characteristics

Conclusion: There is growing evidence that NSM has been marked as oncologically safe in women with small, peripherally located tumors, without multicentricity, or when performed as a prophylactic mastectomy. Hence, NSM has been recommended only if carefully selected for a particular group of patients

Trends of reported human cases of brucellosis, Kingdom of Saudi Arabia, 2004-2012

Human brucellosis is an important zoonotic disease and is especially concerning in the Kingdom of Saudi Arabia [KSA], where livestock importation is significant. We analyzed reported human brucellosis disease trends in KSA over time to help policymakers understand the magnitude of the disease and guide the design of prevention and control measures. By using data from the national registry from 2004 to 2012, we calculated the cumulative numbers by age group and months. Trends of incidence rates [IRs] by gender, nationality, and region were also calculated. We found that there was a greater number of cases [19,130] in the 15-44 years age group than in any other age group. The IRs significantly decreased from 22.9 in 2004 [95% confidence interval [CI] = 22.3, 23.5] to 12.5 in 2012 [95% CI = 12.1, 13]. Males had a significantly greater IR than females. Most cases were reported during spring and summer seasons. The IR of Saudi citizens was significantly greater than that of non-Saudis, but this difference reduced over time. The IRs of Al-Qassim, Aseer, and Hail were in the highest 25th percentile. Young, male Saudi citizens living in highly endemic areas were at greatest risk of acquiring brucellosis. We recommend vaccinating susceptible animals against brucellosis and increasing the public's awareness of preventive measures

Cardiovascular risk profiles of adults with type-2 diabetes treated at urban hospitals in Riyadh, Saudi Arabia

Diabetes mellitus substantially increases cardiovascular disease [CVD] risk. Among Saudi Arabian citizens with diabetes, little is known about the prevalence and control of other CVD risk factors. We extracted data from medical records of a random selection of 422 patients seen between 2008 and 2012 at two diabetic clinics in Riyadh, Saudi Arabia. We calculated the proportion of patients who had additional CVD risk factors: obesity [body mass indexP 30 kg/m[2]], hypertension [BPP 140/90 mmHg], elevated cholesterol fractions, and multiple risk factors]. Further, we calculated the proportion of patients meeting the American Diabetes Association's recommended care targets for each risk factor. Of 422 patients [mean age, 52 years], half were women, 56% were obese, 45% had hypertension, and 77% had elevated LDL concentrations. In addition to diabetes, 70% had two or more CVD risk factors. Although 9%met both target HbA1c and BP values, only 3.5% had optimum HbA1c, BP, and lipid values. In Saudi Arabia's best diabetes clinics, most patients have poor control of their disease. This huge disease burden and related care gaps have important health and financial implications for the country

Evaluation of tuberculosis public health surveillance, Al-Madinah province, Kingdom of Saudi Arabia, 2012

The objective of the study is to evaluate the quality of the data, the sensitivity of the surveillance, and the completeness of identification and investigation of tuberculosis [TB] patient's contacts. The study covered the TB surveillance program in Al-Madinah province in 2011. First, we reviewed all the notifications, treatment cards, and register books, as well as monthly and quarterly reports, for completeness and accuracy of data. Then, we searched for the missed cases that were not reported. Finally, we reviewed all the patients' household contacts' reports to assess the degree of completion of identification and investigation. There were 444 cases detected during the study period; only 200 cases were reported. The sensitivity of the TB surveillance system was 45%. Among the 200 reported cases, the results revealed high completeness rates for demographic and disease data and low completeness rates for the test result fields. The contact identification and investigation showed that 34.4% of smear-positive cases' contacts were not identified. Only 67% of identified contacts were investigated. The review of hospital records and lab registers showed that 244 cases were not reported. In conclusion, the TB surveillance system has several areas that need improvement