Prevalence and risk factors of ibs among medical and nonmedical students in the jouf university.

BACKGROUND: Irritable bowel syndrome is common in the community and its prevalence is higher among the medical students. AIM: The current study was carried out to estimate the prevalence and evaluate the risk factors of irritable bowel syndrome among medical and nonmedical students of the Jouf University. SUBJECTS AND METHODS: This cross-sectional study was carried out among medical and nonmedical students of the Jouf University. Study targeted 200 medical and nonmedical students using the convenience sampling technique. A self-administered questionnaire was adopted for the study and consisted of three parts with questions on demographic characteristics, lifestyle, eating habits, academics, and irritable bowel syndrome. Descriptive statistics were carried out to present the demographic characteristics. Chi-square test, odds ratio with 95% CI was calculated for analyzing differences between study variables using SPSS version-16. Multivariate analysis of lifestyle and dietary predictors of IBS was carried out by the enter method. RESULTS: With a response rate of 90.5%, 181 students completed the questionnaire. Around 53 (29.28%) were found to be suffering from IBS with 41 (77.35%) being males. Male gender, married status, and living status of participants were significantly associated with the occurrence of IBS. Prevalence of IBS was found to be more in students who were from the medical college (P = 0.000), students who smoke (P = 0.003), who slept less than 8 h (P = 0.042), and students who often take carbonated drinks (P = 0.003). Smoking, frequency of exercise, coffee intake, and intake of carbonated drinks were strong predictors of IBS on multivariate analysis of lifestyle and dietary factors. CONCLUSION: We conclude that there is an increased prevalence of irritable bowel syndrome among medical students. Male gender, married status, living in hostel, smoking, less than 8 h sleep, and carbonated drinks were predictive factors for IBS in our study. We recommend screening of medical students for irritable bowel syndrome and institution of interventional measures.

Functional Brain Plasticity Associated with ACL Injury: A Scoping Review of Current Evidence.

Anterior cruciate ligament (ACL) injury is a common problem with consequences ranging from chronic joint instability to early development of osteoarthritis. Recent studies suggest that changes in brain activity (i.e., functional neuroplasticity) may be related to ACL injury. The purpose of this article is to summarize the available evidence of functional brain plasticity after an ACL injury. A scoping review was conducted following the guidelines of the Joanna Briggs Institute and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The terms "brain," "activity," "neuroplasticity," "ACL," "injury," and "reconstruction" were used in an electronic search of articles in PubMed, PEDro, CINAHL, and SPORTDiscus databases. Eligible studies included the following criteria: (a) population with ACL injury, (b) a measure of brain activity, and (c) a comparison to the ACL-injured limb (contralateral leg or healthy controls). The search yielded 184 articles from which 24 were included in this review. The effect size of differences in brain activity ranged from small (0.05, ACL-injured vs. noninjured limbs) to large (4.07, ACL-injured vs. healthy control). Moreover, heterogeneity was observed in the methods used to measure brain activity and in the characteristics of the participants included. In conclusion, the evidence summarized in this scoping review supports the notion of functional neuroplastic changes in people with ACL injury. The techniques used to measure brain activity and the presence of possible confounders, as identified and reported in this review, should be considered in future research to increase the level of evidence for functional neuroplasticity following ACL injury.

Reliability and measurement error of the Osteoarthritis Research Society International (OARSI) recommended performance-based tests of physical function in people with hip and knee osteoarthritis.

OBJECTIVE: To estimate the reliability and measurement error of performance-based tests of physical function recommended by the Osteoarthritis Research Society International (OARSI) in people with hip and/or knee osteoarthritis (OA). DESIGN: Prospective repeated measures between independent raters within a session and within-rater over a week interval. Relative reliability was estimated for 51 people with hip and/or knee OA (mean age 64.5 years, standard deviation (SD) 6.21 years; 47% females; 36 (70%) primary knee OA) on the 30s Chair Stand Test (30sCST), 40m Fast-Paced Walk Test (40mFPWT), 11-Stair Climb Test (11-step SCT), Timed Up and Go (TUG), Six-Minute Walk Test (6MWT), 10m Fast-Paced Walk Test (10mFPWT) and 20s Stair Climb Test (20sSCT) using intra-class correlation coefficients (ICC). Absolute reliability was calculated using standard error of measurement (SEM) and minimal detectable change (MDC). RESULTS: Measurement error was acceptable (SEM < 10%) for all tests. Between-rater reliability was: optimal (ICC > 0.9, lower 1-sided 95% CI > 0.7) for the 40mFPWT, 6MWT and 10mFPWT; sufficient (ICC >0.8, lower 1-sided 95% CI > 0.7) for 30sCST, 20sSCT; unacceptable (lower 1-side 95% CI < 0.7) for 11-step SCT and TUG. Within-rater reliability was optimal for 40mFPWT, and 6MWT; sufficient for 30sCST and 10mFPWT and unacceptable for 11-step SCT, TUG and 20sSCT. CONCLUSIONS: The 30sCST, 40mFPWT, 6MWT and 10mFPWT, demonstrated, at minimum, acceptable levels of both between and within-rater reliability and measurement error. All tests demonstrated sufficiently small measurement error indicating they are adequate for measuring change over time in individuals with knee/hip OA.

Medium-term clinical outcomes following surgical repair for vaginal prolapse with tension-free mesh and vaginal support device.

INTRODUCTION AND HYPOTHESIS: This study was designed to evaluate clinical outcomes ≥2 years following surgery with polypropylene mesh and vaginal support device (VSD) in women with vaginal prolapse, in a prospective, multi-center setting. METHODS: Patients re-consented for this extended follow-up (n = 110), with anatomic evaluation using Pelvic Organ Prolapse Quantification (POP-Q) and validated questionnaires to assess pelvic symptoms and sexual function. Complications were recorded (safety set; n = 121). RESULTS: Median length of follow-up was 29 months (range 24-34 months). The primary anatomic success, defined as POP-Q 0-I, was 69.1%; however, in 84.5% of the cases, the leading vaginal edge was above the hymen. Pelvic symptoms and sexual function improved significantly from baseline (p < 0.01). Mesh exposure rate was 9.1%. Five percent reported stress urinary incontinence and 3.3% required further prolapse surgery. CONCLUSION: These results indicate this non-anchored mesh repair is a safe and effective treatment for women with symptomatic vaginal prolapse in the medium term.

Pain scores during surgical drains removal after obstetrics and gynaecological surgery.

Removing surgical drains can be painful. Currently, there is no evidence to predict which patients may experience greater pain than others. This prospective study is the first to determine the predisposing factors to higher pain scores during drains removal. Multivariate analysis determined if operation type, drain type, duration of drainage, speed of drain removal or pain perceived just before drain removal 'background pain' could be used to predict pain during drain removal. A total of 80 consecutive women were included. There was a positive correlation between pain scores during drain removal and background pain scores (p = 0.0007). Pain scores during drain removal were not related to operation type (p = 0.6), drain type (p = 0.9), duration of drainage (p = 0.4), analgesia type (p = 0.4), duration since last analgesics (p = 0.35) or speed of drain removal (p = 0.5). Because of the positive correlation between 'background' pain and pain during drain removal, techniques to reduce pain during drain removal should target women with significant pre-existing discomfort.

Diurnal variation in 5-HT1B autoreceptor function in the anterior hypothalamus in vivo: effect of chronic antidepressant drug treatment.

1. Intracerebral microdialysis was used to examine the function of the terminal 5-hydroxytryptamine (5-HT) autoreceptor in the anterior hypothalamus of anaesthetized rats at two points in the light phase of the light-dark cycle. 2. Infusion of the 5-HT1A/1B agonist 5-methoxy-3-(1,2,3,6-tetrahydro-4-pyridyl)-1H-indole (RU24969) 0.1, 1.0 and 10 microM through the microdialysis probe led to a concentration-dependent decrease (49, 56 and 65% respectively) in 5-HT output. The effect of RU24969 (1 and 5 microM) was prevented by concurrent infusion of methiothepin (1 and 10 microM) into the anterior hypothalamus via the microdialysis probe. Infusion of methiothepin alone (1.0 and 10 microM) increased (15 and 142% respectively) 5-HT output. 3. Infusion of RU24969 (5 microM) through the probe at mid-light and end-light resulted in a quantitatively greater decrease in 5-HT output at end-light compared with mid-light. 4. Following treatment with either paroxetine hydrochloride (10 mg kg(-1) i.p.) or desipramine hydrochloride (10 mg kg)(-1) i.p.) for 21 days the function of the terminal 5-HT1B autoreceptor was more markedly attenuated at end-light. 5. The data show that, as defined by the response to RU24969, the function of the 5-HT1B receptors that control 5-HT output in the anterior hypothalamus is attenuated following chronic desipramine or paroxetine treatment in a time-of-day-dependent manner.

Bicornuate and unicornuate uterus associated with unilateral renal aplasia and abnormal solitary kidneys: report of 3 cases.

We present 3 cases of a genital abnormality associated with unilateral renal aplasia in which the single kidney was abnormal. Renal aplasia associated with unicornuate uterus or uterus didelphia is rare but it has been reported previously. However, except for vesicoureteral reflux the single kidney usually is normal. Modern methods of evaluating renal function and urodynamics will be helpful when abnormal kidneys are found and will avoid unnecessary surgery. It is mandatory to suspect abnormalities of the urinary tract when genital maldevelopment is encountered and vice versa.

[The influence of orally applicable antibiotics on the activities of human enterokinase and disaccharidases (author's transl)]. / Beeinflussung der Aktivitäten von Enterokinase und Disaccharidasen beim Menschen durch oral applizierbare Antibiotika

In this study the influence of 14 antibiotics, 12 of them orally applicable, on human enterokinase was investigated. The effects of these substances on the activities of human disaccharidases were also examined. The enterokinase activity is more sensitive to the studied antibiotics than is human lactase, saccharase or isomaltase. Unphysiologically high concentrations of penicillins, cephalexin and chloramphenicol (10(-2) Mol/l) inhibited enterokinase, tetracycline (doxycycline) in a dose of 10(-3) m reduced the activity of this enzyme by 50%, neomycinsulphate and the sulphates of polymyxin B and E have no effect on the disaccharidases. On the contrary, these substances are the best inhibitors of enterokinase among the tested antibiotics. Neomycin or polymyxin (10(-4) Mol/l) causes a 50% inhibition of a physiological quantity of this enzyme. Therapeutic doses of both antibiotics may reduce the enterokinase activity by 70% to 90%, while the activity of trypsin is not affected unless a concentration greater than 10(-2) m is used. The inhibition is not only caused by the anion (SO4) of these antibiotics, since sulphates reduce the enterokinase only in concentrations higher than 10(-3) Mol/l in man. The mechanism of inhibition is not effected by binding cholic acids under test conditions. Both polymyxin and neomycin inhibit the enterokinase activity with and without glycodeoxycholic acid. Further studies showed that the type of inhibition is competitive in both cases. The inhibition constant K2 of neomycin-B-sulphate is 8.7X10(-5) Mol/l, of polymyxin-E-sulphate 8.6X10(-5) Mol/l. The inhibition type of penicillins, cephalosporins and doxycycline is noncompetitive, thus contrasting that of neomycin and polymyxin.