The goal of the Radiation standards and Dosimetry is to ensure that the output of the Teletherapy Unit is within ±2% of the stated one and the output of the treatment dose calculation methods are within ±5%. In the present paper, we studied the dosimetry of Cobalt-60 (Co-60) Teletherapy unit at Sher-I-Kashmir Institute of Medical Sciences (SKIMS) for last 10 years. Radioactivity is the phenomenon of disintegration of unstable nuclides called radionuclides. Among these radionuclides, Cobalt-60, incorporated in Telecobalt Unit, is commonly used in therapeutic treatment of cancer. Cobalt-60 being unstable decays continuously into Ni-60 with half life of 5.27 years thereby resulting in the decrease in its activity, hence dose rate (output). It is, therefore, mandatory to measure the dose rate of the Cobalt-60 source regularly so that the patient receives the same dose every time as prescribed by the radiation oncologist. The under dosage may lead to unsatisfactory treatment of cancer and over dosage may cause radiation hazards. Our study emphasizes the consistency between actual output and output obtained using decay method.
The methodology involved in the present study is the calculations of actual dose rate of Co-60 Teletherapy Unit by two techniques i.e. Source to Surface Distance (SSD) and Source to Axis Distance (SAD), used for the External Beam Radiotherapy, of various cancers, using the standard methods. Thereby, a year wise comparison has been made between average actual dosimetric output (dose rate) and the average expected output values (obtained by using decay method for Co-60.)
The present study shows that there is a consistency in the average output (dose rate) obtained by the actual dosimetry values and the expected output values obtained using decay method. The values obtained by actual dosimetry are within ±2% of the expected values.
The results thus obtained in a year wise comparison of average output by actual dosimetry done regularly as a part of Quality Assurance of the Telecobalt Radiotherapy Unit and its deviation from the expected output data is within the permissible limits. Thus our study shows a trend towards uniformity and a better dose delivery.
Dosimetry; Teletherapy; Output; Dose; Consistency; AAPM
This study aims to gauge the technical and soft skills of the hospital security personnel so as to enable prioritization of their training needs.
A cross sectional questionnaire based study was conducted in December 2011. Two separate predesigned and pretested questionnaires were used for gauging soft skills and technical skills of the security personnel. Extensive statistical analysis, including Multivariate Analysis (Pillai-Bartlett trace along with Multi-factorial ANOVA) and Post-hoc Tests (Bonferroni Test) was applied.
The 143 participants performed better on the soft skills front with an average score of 6.43 and standard deviation of 1.40. The average technical skills score was 5.09 with a standard deviation of 1.44. The study avowed a need for formal hands on training with greater emphasis on technical skills. Multivariate analysis of the available data further helped in identifying 20 security personnel who should be prioritized for soft skills training and a group of 36 security personnel who should receive maximum attention during technical skills training.
This statistically driven approach can be used as a prototype by healthcare delivery institutions worldwide, after situation specific customizations, to identify the training needs of any category of healthcare staff.
Hospital Security; Soft Skills; Technical Skills; Training; Statistical Analysis
Background and objective
The present study was undertaken to assess the pattern of skin malignancies in Qassim region, Kingdom of Saudi Arabia.
Data of histopathological confirmed cases of skin malignancies were collected from all the referral hospitals of Qassim region during a period from January 2000 to July 2009.
Out of 94 cases majority (90.4%) were Saudis, and males (74.5%). The most common malignant skin lesion was BCC (58.5%) followed by SCC (18.1%) and MM (11.7%), respectively. Other malignancies seen were DFSP (4.3%), sebaceous carcinoma (2.1%) and skin secondaries from lung, lymphoma and stomach (4.3%). The most common site was face for BCC, trunk for SCC, and limbs for MM. The DFSP did not show any particular pattern.
All major types of skin malignancies were seen with patterns similar to those reported from various other regions of Saudi Arabia and other countries except for Kaposi’s sarcoma which was not encountered in our study.
Saudi Arabia; Skin Malignancies; Qassim Region
To evaluate the complications, and visual and graft survival outcomes in eyes that had undergone penetrating keratoplasty (PKP) for keratoconus.
This restrospective study includes 311 patients with keratoconus who had undergone PKP between January 1, 2001, and December 31, 2002, at King Khaled Eye Specialist Hospital. All patients were followed up postoperatively (maximum follow-up, 65.77 months).
The mean age of patients with keratoconus at transplantation was 23.72 years. A preoperative best spectacle-corrected visual acuity (BSCVA) OF 20/40 or better was achieved in 13 eyes (4.2%). At a mean follow-up of 27 months, 212 eyes (68.2%) achieved a BSCVA of 20/40 or better. Postoperative visual acuity was significantly associated with preoperative visual acuity (P < 0.00). Only 6 eyes (1.9%) experienced graft failure, with a mean follow-up of 23.62 months. The graft rejection rate (6.8%) was a significant risk factor for failure (P = 0.00). Age, gender, corneal graft diameter, and intraoperative vitreous loss had no statistically significant effects on the PKP outcome (P> 0.05). Kaplan-Meier analysis revealed that the probabilities of graft survival were 99.8% at 1 year and 97.6% at 5 years after transplantation.
Performing PKP in eyes with keratoconus is associated with good visual results and an excellent graft outcome.
penetrating keratoplasty; keratoconus; graft failure
Primary Percutaneous Coronary Intervention (PCI) is the treatment of choice for ST-segment Elevation Myocardial Infarction (STEMI) if performed within 90 minutes from first medical contact. However, primary PCI is only available for less than 25% of patients with STEMI. Early PCI or Pharmaco-invasive strategy has evolved from facilitated PCI but with more delayed timing from thrombolysis to PCI.
Assess the safety and effectiveness of Early PCI.
Patients and Method
We reviewed the data of the available therapy options for patients with STEMI. Then we performed a meta-analysis for all randomized controlled trials of early PCI versus standard therapy
Five studies fulfilled our inclusion criteria. Our meta-analysis showed improved cardiovascular events with early PCI compared to standard therapy (odd ratio of 0.54; 95% Confidence interval 0.47-0.7, p<0.001). There were no significant bleeding complications when doing early PCI 4 to 24 hours after successful thrombolysis
Early PCI should be done to all STEMI patients within 24 hours after successful thrombolysis.
Pharmacoinvasive strategy; Early PCI; Acute myocardial infarction; Thrombolysis
Eccrine angiomatous hamartoma (EAH) is a rare, benign cutaneous tumor. It is characterized by the proliferation of the eccrine gland elements that are closely associated with capillary proliferation. Patients usually present with a solitary nodule on the extremities that appeared at birth or during the prepubertal years. We report a rare case of EAH in a 13-year-old boy, with clinical features suggesting melanoma. Histologically, an EAH with changes resembling a verrucous hemangioma was noted.
angiomatous hamartoma; eccrine glands; verrucous
Oral submucous fibrosis (OSMF) is a premalignant condition of oral cavity characterized by inflammation and progressive mucosal fibrosis. It has questionable pathogenesis. Mast cells (MC) have been associated with variety of inflammatory and fibrotic conditions, but little is known about their role in OSMF. Mast cells have been studied in normal gingiva, chronic inflammatory gingivitis, desquamative gingivitis, lichen planus, OSMF and oral cancer. Mast cells exhibit phenotypic plasticity. There is variation in the mast cell mediators with the change in the microenvironment, which makes the study of this cell in various diseases interesting.
A retrospective study was conducted to find possible correlation between MC in 25 cases of OSF, 10 cases of oral squamous cell carcinoma (OSCC) and 10 cases of normal buccal mucosa by means of acidified toluidine blue staining method.
The density of MC increased with disease progression. The densities of MC were significantly higher in OSMF than in normal buccal mucosa (p=0.001). The average numbers of MCs per square millimeter were 25, 49.50, 53.25 & 55.25 respectively.
The results suggest that MC have a definite role in initiation and progression of OSMF.
mast cell; oral submucous fibrosis; premalignant; squamous cell carcinoma
Cardiovascular disease (CVD) is a leading cause of death worldwide. CVD-related mortality can be substantially reduced by modifying risk factors.
In this cross-sectional study conducted in King Abdulaziz Medical City, Riyadh, we estimated and compared prevalence of self-reported risk factors for CVD among physicians and a comparative group of non-physician health workers. We postulated that prevalence of CVD risk factors would be significantly lower in physicians. Participants filled in a structured self-administered questionnaire on CVD risk factors.
The study included 200 participants (100 respondents each group). Participants in the two groups were of similar age (P = 0.46) and Body Mass Index (BMI) P = 0.11. There was no statistical difference in smoking, frequency and length of physical exercise per week (P = 0.53, 0.57, 0.47 respectively). Diet habits showed daily intake of more protein, less fat and highly processed food, and similar vegetables, fruit and carbohydrate among physicians. Health status (presence of hypertension, diabetes, or dyslipidemia, or other diseases) didn’t differ between the two groups. Physicians showed a significantly higher familial cardiovascular risk, with mothers and siblings having more dyslipidemia, but there was no significant difference in parental dyslipidemia, diabetes or hypertension.
These findings indicate that high awareness of CVD and associated risk factors alone is not enough to prevent their occurrence. Programs to routinely screen these risk factors and improve the lifestyle of physicians are needed.
Cardiovascular disease; risk factors; physicians; Saudi Arabia
This study is intended to examine the effect of hypothyroidism and thyroxin replacement on axial and appendicular skeletal growth, growth plate thickness and to observe associated microscopic changes within the growth plates.
Experimental albino rats were developed with carbimazole and carbimazole plus thyroxin. Animals were administered with these drugs throughout pregnancy (prenatally) and for a period of six weeks, postnatally. At the end of the experiment the animals were sacrificed, measured and processed to demonstrate the bony and cartilaginous parts. Ulna and tibia of both sides were removed and processed for light microscopy and growth plate measurement.
At the end of the experiment, reduction in the crown rump length was observed in the carbimazole treated animals. It was 8.77%, 13.26% and 7.25% in the prenatal, two weeks and six weeks age group animals respectively. In carbimazole plus thyroxin treated animals, this reduction was 3.22%, 2.94% and 3.42%, when compared to their age matched controls. Reduction in the thickness of the Epiphyseal growth plate (EGP) was 16.89% and 12.80% in the ulna of the two and six weeks age group and 18.06 % and 15.65% in the tibia of the these animals respectively. The carbimazole plus thyroxin treated animals showed an increase in the thickness of EGP as compared to their age-matched controls though the crown rump length of these animals was less than the controls. Prenatally treated hypothyroid rats showed disrupted growth plates without any well-formed microscopic zones.
The results of this study showed that the pre and postnatally, carbimazole induced hypothyroidism and its replacement therapy affected the axial and appendicular skeletal growth. Proximal limb bones of the prenatally induced hypothyroid animals showed the greatest skeletal change in this study.
Growth plate; Hypothyroidism; skeletal growth; Prenatal growth; Thyroid dysfunction
To investigate the effects of exercise training and anabolic androgenic steroids (AAS) on hemodynamics, glycogen content, angiogenesis, apoptosis and histology of cardiac muscle.
Forty rats were divided into 4 groups; control, steroid, exercise-trained and exercise-trained plus steroid groups. The exercise-trained and trained plus steroid groups, after one week of water adaptation, were exercised by jumping into water for 5 weeks. The steroid and trained plus steroid groups received nandrolone decanoate, for 5 weeks. Systolic blood pressure and heart rate (HR) were monitored weekly. Heart weight/body weight ratio (HW/BW ratio) were determined. Serum testosterone, vascular endothelial growth factor (VEGF), cardiac caspase-3 activity and glycogen content were measured.
Compared with control, the steroid group had significantly higher blood pressure, HR, sympathetic nerve activity, testosterone level, HW/BW and cardiac caspase-3 activity. Histological examination revealed apoptotic changes and hypertrophy of cardiomyocytes. In exercise-trained group, cardiac glycogen, VEGF and testosterone levels were significantly higher while HR was significantly lower than control. HW/BW was more than control confirmed by hypertrophy of cardiomyocytes with angiogenesis on histological examination. Trained plus steroid group, had no change in HR, with higher blood pressure and HW/BW than control, cardiac glycogen and serum VEGF were higher than control but lower than exercise-trained group. Histological examination showed hypertrophy of cardiomyoctes with mild angiogenesis rather than apoptosis.
When exercise is augmented with AAS, exercise-associated cardiac benefits may not be fully gained with potential cardiac risk from AAS if used alone or combined with exercise.
During the last decades a large number of cucurbitacins have been isolated from various plant species belonging to other plant families than Cucurbitaceae. Although the roots and the fruits of plant belong to these Cucurbitaceae species are very bitter, they have been used as folk medicines in some countries because of their wide spectrum of pharmacological activities such as anti-inflammation and anticancer effects. In the last ten years, cucurbitacins had been shown to inhibit proliferation and induced apoptosis utilizing a long array of in vitro and in vivo cancer cell models. Several molecular targets for cucurbitacins have been discovered, such as fibrous-actin, signal transducer and activator of transcription (STAT), cyclooxygenase-2, etc. This review aimed at elucidating the natural sources of some cucurbitacin compounds, their chemical structure and derivatives, physical properties, biological activities and mechanism by which they reduce the proliferation human cancer cells. This widens our armaments against a devastating disease that we are failing to face.
Cucurbitacin; STAT; Janus kinase (JAK); anti-tumor; anti-inflammation; apoptosis
A significant proportion of children in developing countries are having plaque-induced gingivitis. A public health strategy may involve teachers and peer leaders to motivate and train school children for regular and thorough removal of dental plaque. The monitoring and evaluation of such a strategy may require teachers and peer leaders to assess oral hygiene status of children at periodic intervals.
To validate the simplified dental examination performed by teachers and peer leaders to detect dental plaque and calculus.
This longitudinal study involved 632 adolescents studying in sixteen schools of Karachi, Pakistan. Eight schools each were randomly allocated to the peer-led and teacher-led strategies of examination. One section of class six was selected at random in each school to be included in the study. In each selected section of class six the trained teacher-in-charge or a peer-leader undertook dental examinations at baseline, 6-month and 18-month intervals and their findings were compared with those of a dentist. The outcome measures included the Kappa values for examiner agreement as well as the sensitivity, specificity, positive and negative predictive values.
All teachers and peer leaders showed a substantial degree of agreement (Kappa ≥ 0.8) with the dentist in detecting plaque and calculus at all three examinations. The values of validity measures for teachers’ and peer leaders’ examination were in the range of 87–90%.
The examinations performed by teachers and peer leaders were reasonably valid to detect plaque and calculus. However, booster training sessions are needed to maintain their performance as dental examiners.
Validity; teachers; peers; oral examination; dental examination; plaque; calculus
Allergy and asthma can reduce HRQOL as a result of profound physical and psychosocial complications. Most patients with asthma also suffer from rhinitis, which also impairs quality of life. However, the impact of allergic rhinitis on asthmatic patients has not been investigated.
To assess Quality of life (QOL) in asthmatic patients and assess relative burden of allergic rhinitis on asthmatics’ QOL.
Patients and Methods
we analysed HRQOL questionnaire (SF-36) answers of 219 patients (118 allergic rhinitis, 79 asthma and 22 asthma with allergic rhinitis) and controls (30 healthy individuals), in addition to analysis of questionnaire scores according to patients’ characteristic including gender, BMI and duration of symptoms. Moreover, pulmonary function test were done for all patients and control.
HRQOL parameters were significantly lower in females more than males and in patients with BMI>25 if compared with those with BMI<25. Moreover, HRQOL was significantly lower in all 3 patients’ groups if compared with control group (P<0.001) in all parameters except mental health and role emotional. Significantly higher scores (SF-36 sub-scales for physical functioning, role-physical, bodily pain) were found among allergic rhinitis patients compared with asthmatics with or without allergic rhinitis. Although, quality of life was worse in asthmatic patients compared to patients with rhinitis alone, no significant difference was found between asthmatics and those with both diseases. Both PCS and MCS scores are significantly lower in patients’ groups compared with the control (p<0.05). Asthmatic patients with or without rhinitis tended to have lower PCS and MCS scores than subjects with isolated allergic rhinitis, the difference between the groups was statistically significant only for PCS scores. Moreover, highly significant positive correlation between PCS score and FEV1 in asthmatics with or without allergic rhinitis was detected denoting that PCS score is markedly affected by severity of asthma. (r=0.949, P<0.001).
Allergic rhinitis has a limited role in reduction of HRQOL. HRQOL is markedly reduced in patients with asthma with or without rhinitis than in those with allergic rhinitis only; this could be related to the severity of asthma more than the presence of associated allergic rhinitis. These findings indicated that allergic rhinitis does not seem to further impair quality of life in subjects with asthma. We recommend that patients with bronchial asthma with or without allergic rhinitis in need of great help from physicians and social workers to improve their physical and mental health. Moreover, further studies with larger populations and longer duration are needed in order to determine the extent to which asthma and rhinitis comorbidities are associated in HRQOL.
asthma; allergic rhinitis; HRQOL; SF-36 questionnaire
Anal cancer accounts for only 1.5% of gastrointestinal malignancies but this disease has shown a steady increase in incidence particularly in HIV positive males. The understanding of pathophysiology and treatment of anal cancer has changed radically over last thirty years. Risk factors have been identified and organ preservation by chemoradiotherapy has become a standard. This article aims to review the clinical presentation, diagnostic evaluation, and treatment options for anal cancer in the light of current literature.
anal cancer; anal canal; anal margin; chemoradiotherapy; HIV; HPV; salvage; recurrence; imaging
Bladder exstrophy is a very rare congenital disorder, in which the first stage of reconstruction is usually performed within the first 72 hours of life. The most feared form of failure of the reconstruction is postoperative dehiscence of the bladder and abdominal wall. We present an 11-year-old girl with bladder exstrophy. She underwent three iliac bone supra-acetabular osteotomies with repair of the bladder exstrophy. Unfortunately the diastasis of the symphysis recurred widely open with dehiscence of bladder and abdominal wall.
Bilateral pubic and ischial rami osteotomies with adequate soft tissue release were carried out, which allowed the urology team to perform a tension-free repair of the bladder and the abdominal wall.
Here we report an osteotomy with the soft tissue release that succesfully allowed the closure of the pelvis, bladder and anterior abdominal wall in a recurrent case with more than three years follow up.
Bladder exstrophy; Ischail osteotomy; Pelvic osteotomy; Pubic osteotomy; Recurrent repair; SMS osteotomy; Steel osteotomy
Vitamin D plays an important role in diverse physiological functions in addition to its role in bone health. Vitamin D deficiency is very common in elderly people, but there are few reports on its prevalence in young adults.
A cross-sectional study was carried out on a total of 465 young adult Saudi females aged 19 to 40 years old who were selected from primary health care centers of King Abdulaziz medical city, Riyadh, KSA. A questionnaire was used to identify socio-demographic characteristics and risk factors such as sunlight exposure and dietary intake. 25-hydroxy vitamin D [25(OH)D], Parathyroid hormone (PTH) and bone biochemical parameter were measured. The cutoff values for Vitamin D were defined as follows: deficient (<25nmol/L), insufficient (25–75 nmol/L) and normal (≥ 75 nmol/L).
Overall, hypovitaminosis D were identified in all participants, with a mean level of 18.34 ±8.2 nmol/L. Of all the participants, 79.1% exhibited severe vitamin D deficiency (serum 25(OH) D < 25 nmol/L), while 20.9% exhibited vitamin D insufficiency (serum 25(OH) D between 25–50 nmol/L). There was a significant inverse correlation between serum 25 (OH) D concentrations and PTH, where secondary hyperparathyroidism was evident in 61.4% of participants with deficient vitamin D compared to 39.2% of participants with insufficient vitamin D.
Despite the abundant sunlight in Saudi Arabia, the prevalence of hypovitaminosis D among young healthy Saudi females is 100%. This finding should be considered a public health problem. Case identification, health education and prevention should be encouraged.
Vitamin D; prevalence; women; Saudi; secondary hyperparathyroidism; sunlight; dietary supplement
DPN is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of DPN results in fewer foot ulcers and amputations.
The purpose of this study was to compare different screening tests in the detection of DPN in primary care setting.
It is a cross-sectional study in a random sample (N = 242) of type 2 diabetes mellitus participants at primary care setting. Different screening tests for detecting DPN such as Michigan Neuropathy Screening Instrument (MNSI), Semmes-Weinstein Monofilament (SWM), vibration sensation and ankle reflex were performed for each patient and compare between them.
45% of the participant had DPN based on MNSI, The detection rate using the 128-Hz tuning fork and 10-g SWM was nearly same (32.6 & 31.4%) respectively and significantly higher than ankle reflexes (23.1%). Although, the prevalence of DPN determined by the combined two tests (38.79%) was higher than that through the single test.
this study showed different results of DPN screening tests, even in the same group of patients. However there was a significant correlation between them. 128-Hz tuning fork and 10-g SWM monofilament would appear to be an appropriate, cheap and easy to use tool for identifying patients at risk of having neuropathy in primary care setting.
This study investigated the adverse effects of excessive consumption of garlic on the small intestine (jejunum and ileum) of adult male Wistar rats.
Sixteen (16) Wistar rats with average weight of 181.5 g were grouped into two: Control Group A which received distilled water, and Treatment Group B which received 1000 mg/kg/ml aqueous extract of garlic, orally for 28 weeks. The aqueous extraction of raw garlic was done to obtain a concentration of 1000 mg/kg/ml. The animals were sacrificed by cervical dislocation after the last day of administration, and tissues for histological studies were fixed in buffered formalin, while those for enzyme studies were homogenised, and appropriate biochemical kits used to study the activities of acid phosphatase (ACP), alkaline phosphatase (ALP) and lactate dehydrogenase (LDH).
The histological sections of the jejunum of animals that received the high dose of aqueous garlic extract revealed the presence of vacuolations, cell death and loss of epithelium, and intact muscle layer; the Periodic-Acid Schiff (PAS) positivity also reduced, while the ileum also showed degeneration of the brush borders, loss of epithelial cells, reduction in the number of goblet cells, vacuolations, and a reduced intensity of PAS positivity. Activities of ACP, ALP and LDH in the jejunum and ileum were increased.
Consumption of excessive amount of garlic could cause structural changes to the intestinal tract, which are capable of affecting intestinal functions, such as decrease in glycogen activity in the small intestine, and impairment of the absorptive activities.
The purpose of this study was to identify the sources of stress among dental students enrolled at Pharos University in Alexandria (PUA) - Egypt, and to explore the role of gender, level of undergraduate study and residence with parents on perceived stressors.
Materials and Methods
A thirty-item self-reported modified version of the Dental Environment Stress (DES) questionnaire was administered to 537 junior and mid-senior undergraduate dental students during the academic fall semester 2010, with a response rate of 79.89%.
Workload, performance pressure, and self-efficacy beliefs constituted the most stress-provoking factors. Female students experienced greater stress than males for all stressor items except for “Self-Efficacy Beliefs” and “Faculty & Administration” with no statistically significant difference by gender. Mid-senior dental students registered higher levels of perceived stress for “Workload”, “Self-Efficacy Beliefs”, and “Personal Factors” stressors in comparison to their junior peers. Those students who lived away of their parents were at higher risk of perceived stress than those students who lived with their parents. “Uncertainty about future dental career” was the first best predictor variable by gender. Whereas, “Difficulty of classwork” was the first predictor variable by both level of undergraduate study and residence with parents.
Female dental students had higher mean overall problem scores compared to their male counterparts, mid-senior students showed some higher perceived problems compared to junior students, and students who lived away from their parents revealed higher levels of perceived stress.
dental students; perceived stress; gender; level of undergraduate study; residence with parents
Fine-needle aspiration (FNA) of the thyroid gland is a widely accepted and accurate method for triaging patients with thyroid nodules. Thyroid FNA suffers from a reporting confusion due to multiplicity of category terminologies. To address this, The Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) was recently introduced for unifying the terminology and morphologic criteria along with the corresponding risk of malignancy.
The aim of this study was to report the diagnostic utility of TBSRTC at our institution and report the malignancy risk for FNA of thyroid lesions among Saudi patients using this system at KAUH (King Abdulaziz University Hospital), Jeddah, Saudi Arabia.
Materials and methods
A retrospective study identifying 250 thyroid FNAs performed among Saudi patients between Jan 2005–Dec 2010 was undertaken. Cytology specimen data was collected through a computerized search of our cytopathology archives.
Among the 250 thyroid FNAs, 84 were followed by surgical resection. The overall surgical yield of malignancy was 23.8%. The malignancy rate for the 6 categories was as follows: non diagnostic: 20%, benign: 3.1%, atypia of undetermined significance: 50%, suspicious for follicular neoplasm: 20%, suspicious for malignancy: 80%, malignant: 100%.
Retrospective classification of FNAs of thyroid lesions among Saudi patients using TBSRTC at KAAUH, Jeddah, Saudi Arabia, validates the diagnostic reproducibility of this system and yields similar results for risk of malignancy as reported by others. However the associated rates found for non diagnostic (20%) raise the possibility of malignancy risk in this category and validate the past observations that sample inadequacy is a common cause of false negative thyroid FNAs.
This paper highlights the importance of root canal disinfection. It discusses the different endodontic irrigants available and comments on how these can be used most effectively. Eliminating bacteria from the root canal system is an essential stage in endodontic therapy. An objective of endodontic treatment is removal of diseased tissue, elimination of bacteria from the canal system and prevention of recontamination. (1) Disinfection of the root canal system, as part of endodontic therapy, by preparation and irrigation is a key in reducing the number of bacteria within the root canal and helping to control periapical disease.
Inflammatory bowel diseases (IBD) are among the leading cause of financial burden, morbidity and employee absenteeism in developed countries because of their chronic remitting and relapsing courses. IBD is estimated to affect the Canadian economy to the tune of 100 million dollars per year. The data regarding exact prevalence in Asian countries, including Saudi Arabia, is still incomplete as there is underreporting and lack of proper registry of the diagnosed cases. The prevalence of inflammatory bowel disease (Ulcerative colitis, Crohn’s disease) has increased over the last decade in Saudi Arabia due to increased IBD awareness among population, as more patients seek medical help and also due to unknown reasons. There is a need of proper registration of IBD patients and establishment of Crohn’s & colitis foundation of Saudi Arabia (CCFSA) as in other parts of the world. The Crohn’s & colitis foundation of Saudi Arabia will be a forum which will co ordinate IBD treatment and research in the country in addition to health education among IBD population.
To check for the association of genetic polymorphisms related to the methylenetetrahydrofolate reductase (MTHFR) gene namely C677T and A1298C with hypertension in Saudi affected subjects from Qassim region.
Subjects and methods
Participants included 123 Saudi hypertensive cases (83 males and 40 females) in addition to 250 (142 males and 108 females) unrelated healthy controls from the same locality. Their age mean ±SD was 50.93 ± 15.43 years. For all subjects, DNA was extracted followed by real-time PCR amplifications for characterization of genotypes and alleles related to MTHFR C677T and A1298C gene polymorphisms
Total cases showed significantly higher carriage rate for the mutant allele 677T compared to controls (40.7% vs. 26%, OR=1.9, 95% CI= 1.2–3.1) with a lower frequency of the wild type 677CC genotype (59.3% vs. 74%, p=0.004). The same was observed among cases-subgroups of hypertension associated with obesity with a notably higher odds ratio (OR=2.6, 95% CI=1.3–5.01, p=0.004). Total cases showed also significantly higher frequency of mutant 1298 C allele carriage rate compared to controls (59.3% vs. 42.4%, OR=1.98, 95% CI= 1.3–3.1) with a lower frequency of the normal AA genotype (40.7% vs. 57.6%, p=0.003). The same was observed among cases-subgroups of hypertension associated with both diabetes and obesity and among cases of hypertension with obesity, also with higher odds ratio (OR=2.6 and 2.2 respectively).
This work showed that genetic polymorphisms related to the MTHFR gene are associated with the risk of hypertension particularly when accompanied with obesity and diabetes among Saudi subjects.
Methylenetetrahydrofolate reductase; hypertension; Saudi; Genetic polymorphisms