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1.  Vitamin D Deficiency and Its Association with Thyroid Disease 
Objectives
Vitamin D deficiency is a global health problem, its role as an immune modulator has been recently emphasized. The evidence is increasingly pointing towards vitamin D significant role in reducing the incidence of autoimmune diseases. However, at this time the research on its role in autoimmune and thyroid disease is not conclusive.
We aimed to examine the relationship between hypothyroidism and vitamin D deficiency and to clarify the relation between serum calcium levels with hypothyroid disease.
Subjects and Methods
Serum vitamin D (25-OH) levels were measured in 30 patients with hypothyroidism and 30 healthy subjects, utilizing the spectrophotometric method. Vitamin D deficiency was designated at levels lower than 20 ng/ml. Thyroid hormones (TSH, T3 and T4) and calcium levels were evaluated in all participants.
Results
Serum 25(OH) vit D was significantly lower in hypothyroid patients than in controls (t=−11.128, P =0.000). Its level was insignificantly decreased in females than male patients (t=− 1.32, P >0.05). Moreover, serum calcium levels recorded a significant decrease in hypothyroid patients when compared to controls (t= −5.69, P = 0.000).
Conclusion
Our results indicated that patients with hypothyroidism suffered from hypovitaminosis D with hypocalcaemia that is significantly associated with the degree and severity of the hypothyroidism. That encourages the advisability of vit D supplementation and recommends the screening for Vitamin D deficiency and serum calcium levels for all hypothyroid patients.
PMCID: PMC3921055  PMID: 24533019
Vit D deficiency; Blood calcium levels; Thyroid diseases
2.  Splice site and Germline variations of the MGMT gene in Esophageal cancer from Kashmir Valley: India 
Objectives
The aim of our investigation was to detect mutation or genetic polymorphisms in MGMT gene of esophageal cancer patients from Kashmir Valley (India)
Methodology
The genetic polymorphisms or mutations in the coding exons 2, 3, 4 and 5 of MGMT gene were searched for in DNA samples from the frozen tumor tissues of 30 esophageal cancer patients from Kashmir. The PCR products were sequenced with fluorescently labelled terminators and separated on automatic sequencer. We developed a new PCR based RFLP approach for genotyping c.459A>G (p.Gly153Gly) variation in 71 esophageal cancer patients and 60 healthy controls.
Results
Two somatic variations c.274 +4G>A and c.274 + 22G>A were identified in Exon3-intron 4 boundary. A novel germline variation c.459A>G (p.Gly153Gly) was found in the exon 5 of an esophageal cancer patient. This germline variation was not found in any of the studied esophageal cancer patients and healthy controls except the patient where it has been found by direct sequencing.
Conclusion
We identified novel sequence variants of the MGMT gene in esophageal cancer patients from Kashmir valley-India.
PMCID: PMC3921056  PMID: 24533020
Esophageal cancer; Kashmiri population; MGMT; Splice site mutations; Germline variation
3.  Comparison of two methods of digital imaging technology for small diameter K-file length determination 
Objectives
Obtaining the proper working length in endodontic treatment is essential. The aim of this study was to compare the working length (WL) assessment of small diameter K-files using the two different digital imaging methods.
Methodology
The samples for this in-vitro experimental study consisted of 40 extracted single-rooted premolars. After access cavity preparation, the ISO files no. 6, 8, and 10 stainless steel K-files were inserted in the canals in the three different lengths to evaluate the results in a blinded manner: At the level of apical foramen(actual)1 mm short of apical foramen2 mm short of apical foramen
A digital caliper was used to measure the length of the files which was considered as the Gold Standard. Five observers (two oral and maxillofacial radiologists and three endodontists) observed the digital radiographs which were obtained using PSP and CCD digital imaging sensors. The collected data were analyzed by SPSS 17 and Repeated Measures Paired T-test.
Results
In WL assessment of small diameter K-files, a significant statistical relationship was seen among the observers of two digital imaging techniques (P<0.001). However, no significant difference was observed between the two digital techniques in WL assessment of small diameter K-files (P<0.05).
Conclusion
PSP and CCD digital imaging techniques were similar in WL assessment of canals using no. 6, 8, and 10 K-files.
PMCID: PMC3921057  PMID: 24533021
K-file; Digital imaging; Working length
4.  A descriptive study on compliance of spectacle-wear in children of primary schools at Qassim Province, Saudi Arabia 
Background
Uncorrected Refractive errors are the most common cause of avoidable visual impairment in children worldwide. Importance of school screening of refractive errors are one of the most important initiatives outlined in WHO Vision 2020 targets for control of avoidable visual impairment in children. But the benefit depends on the compliance of the spectacle wear by children.
Purpose
To study the prevalence and determinants of compliance of spectacle wear among children and to investigate the reasons of non compliance associated with the spectacle wear in primary school children.
Materials and Methods
This was a cross-sectional descriptive study of 631 students who had been prescribed spectacles for constant wear during school screening programme done by our Department of Optometry, College of Applied Medical Sciences, Qassim University during 2010–2011. After six months, experienced Optometrists conducted a follow-up visit where these students were assessed about spectacle compliance. Information on age, gender, type of refractive error, reasons for non compliance were collected and analyzed.
Results
The non-compliance rate of spectacle wear in primary school children is 66.80%. A significantly higher proportion of boys 244(69.13%) were not wearing their spectacles compared to girls 178 (64.03%) (P<0.05). Non-compliance was not related to age of the students (P<0.05), but older and myopic children were slightly more non-compliant. The main reasons for non-compliance in primary school boys and girls for using spectacles were disapproving spectacle wear by parents, not like to wear spectacles, broken spectacles and many children feel spectacles are not needed or causes head ache.
Conclusions
Comprehensive eye care for primary school children with refractive error is practised in Qassim Province, but limited information is available on the magnitude of the compliance for spectacle wear and their reasons. School children were not compliant because of many issues that could and should be addressed. This information is crucial for establishing a program and will strengthen its efforts for a better eye care in primary school children with refractive errors.
PMCID: PMC3921058  PMID: 24533022
Spectacle Compliance; Primary School children; Qassim; Saudi Arabia
5.  Effectiveness of Levels of Health Education on HbA1c in Al-Qassim Region, Saudi Arabia 
Objective
The aim of this study is to assess the effect of different levels of health education on diabetes outcome among patients visiting the Primary Health Care (PHC) Centers in Al-Qassim Region.
Methods
This study was conducted between October 2012 and March2013. Baseline HbA1C results recorded for all those included in the study, After 6 months of health education a well-constructed questionnaire for each other diabetic patient (male or female) visiting the PHC Center, last reading for HbA1c for each patient recorded.. The majority of the health education services included in this study was related to diabetes. Sample size calculated and increased to 420 to account for the design effect. Data entry and analysis was carried out using SPSS (version 17 for Windows.
Results
Male respondent to a self-administered questionnaire is 70.1 %. Our study revealed that more exposure to all levels of health education will result in more to control diabetes compare to one or two types of health education. HbA1c level improved after health education.
Conclusion
Improving the communication skills and health awareness among service providers in in PHC Centers through well designed programs involving health educators will improve the outcome among patients with diabetes mellitus and population in general. Moreover, medical students should be involved in such activities of health education in the community related health problems.
PMCID: PMC3921059  PMID: 24533023
Levels of health education; Diabetes Mellitus; HbA1c
6.  The response of rat submandibular salivary gland to plant protein diet; Biological and histochemical study 
Objective
This investigation aimed at studying the effect of plant protein diets on the salivary glands. It compares 3 protein’s types on the submandibular gland structure and function. The submandibular gland was chosen because it contains all the elements of the salivary glands. The different protein types were chosen to answer if the plant protein or legume plant protein can be replaced for the animal proteins.
Methods
Thirty young albino rats were divided into 3 dietary groups: group I was fed 10% skim milk and acts as a control, group II was fed corn that is a cereal plant protein, while group III was fed 10% soybean, which is a legume plant protein. The animals were sacrificed after 2 months from the beginning of the experiment and the submandibular salivary glands were prepared for the biochemical analysis and histological, as well as, histochemical studies.
Results
The biochemical analysis revealed that total protein in soybean fed group was nearly the same as that of the control, while being significantly decreased in the corn fed group. The histological appearance of the submandibular salivary gland of both study groups showed shrinkage in the acini and ducts. The histochemical results showed an intense precipitation for total protein in the soybean group, while the corn fed group showed a mild precipitation. The reaction for DNA and RNA was intense in the control group as compared with both study groups.
Conclusion
From this study, it was apparent that the plant protein had adverse effects on the submandibular salivary gland and impairs its function. Thus, plant protein including the soybean cannot replace animal protein which is ideal for the normal growth and function of the gland.
PMCID: PMC3921060  PMID: 24533024
Rat; submanibular salivary glands; animal protein; cereal plant protein and legume plant protein
7.  Pharmaceuticals Safety Practices-A Comparative Pilot Study 
Introduction
The safety of medicine is essential for the safety of patients. Inappropriate drug storage, expiration dates, sharing prescription drugs, self medication habits and misuse of some drugs are contributing factors affecting medication safety. One or more of these factors may lead to serious health complications and even death.
Objectives
The purpose of this study was to highlight the common errors and pharmaceutical malpractices that people usually engage in on a daily basis and to correlate these to culture, gender and educational levels. This may spread awareness in an easy and understandable manner and provide certain guidelines to drug consumers ensuring that pharmaceutical preparations are used correctly and safely.
Methods
Two hundred questionnaires were randomly distributed in two countries; Saudi Arabia and India. The collected data were statistically analyzed.
Outcomes and conclusion
Results showed that alarming percentages of various participants were using pharmaceuticals inappropriately due to carelessness, unawareness or intentional mistakes. Therefore, active participation by health care professionals is essential for the prevention of drug misuse. Increasing population awareness about self medication, products expiration, pharmaceuticals labels and optimum storage conditions would minimize the adverse effects and may even be life saving.
PMCID: PMC3921061  PMID: 24533025
Pharmaceuticals; medication safety; patient safety; errors; storage; misuse; self medication; adverse effects
8.  Clinical measurement of the height of the interproximal contact area in maxillary anterior teeth 
Objectives
To clinically quantify the apicoincisal height of interproximal areas directly in patients’ mouths.
Methodology
Thirty participants (11 females and 9 males, mean age=26±1.5 years) were recruited into this study. Measurement of interproximal contact areas was carried out directly in patients’ mouths using digital caliper (TERENSA, USA) with measuring accuracy of 0.01 mm. The interproximal contact areas that were measured are: central incisor to central incisor, central incisor to lateral incisor, lateral incisor to canine, and canine to first premolar on both sides of the jaw. Statistical significance was based on probability values less than 0.05 (p<0.05).
Results
The largest contact point was the one present between central incisors and it ranged from 2.9 to 6.5 mm. On the other hand, the contact point between canine and first premolar was the smallest on both sides of the arch and ranged from 0.6 to 2.5 mm. The dimensions of the contact points declined as we move from anterior area backwards. Statistical analysis using t-test showed that there were significant differences between the measurements of interproximal points of each tooth (P<0.05).
Conclusions
the apicogingival dimension of the contact point decreased as we moved from anterior to posterior teeth. The contact area between the central incisors was largest and the one between canine and premolar was the smallest. This study is the first to report direct intra-oral clinical measurement of contact points. Clinical evaluation of contact point dimensions using digital caliber is a viable, quick and accurate method to use.
PMCID: PMC3921062  PMID: 24533026
Contact point; Interproximal contact; anterior teeth; dental aesthetics
9.  The Emergent Concern of Hepatitis B globally with special attention to Kingdom of Saudi Arabia 
Chronic viral hepatitis is highly prevalent and creates a substantial burden to healthcare systems globally. The World Health Organization (WHO) estimates that over 350 and 250 million people worldwide are chronic carrier of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection respectively. These two diseases are the cause of significant global mortality and morbidity with approximately 1 million deaths each year attributable to them and their sequelae, liver disease and primary liver cancer. Although the efforts have been met with the long-lasting level of success and holds the promise for large reductions in disease burden in spite of the huge numbers of HBV infected population. The viral hepatitis has also been emerged as a leading public health concern and continues to be major disease burden in the Eastern Mediterranean. The WHO, estimates that approximately 4.3 million persons are infected with HBV in the Region each year. Saudi Arabia has been classified as a country with an intermediate prevalence of HBV showed up to 7% in Saudi children in late 1980s but declined to as low as 0.3% in 1997 since the introduction of universal vaccination of all Saudi children in 1989. In spite of this remarkable decline, the burden of decompensated liver disease secondary to hepatitis B is estimated to increase drastically in the next 40 years as the previously infected children start aging.
PMCID: PMC3921063  PMID: 24533027
10.  Acantholytic squamous cell carcinoma arising in a nevus sebaceous: A case report 
Although nevus sebaceous (NS) is known to develop various types of secondary neoplasms, it rarely causes carcinoma and only fifteen cases of secondary squamous cell carcinoma (SCC) have been reported. We report a rare variant of SCC (acantholytic type) arising in nevus sebaceus.
PMCID: PMC3921064  PMID: 24533028
Nevus sebaceous; squamous cell carcinoma; tumors
11.  Symptomatic hemorrhagic pleural effusion: A rare presentation of ovarian hyperstimulation syndrome: A Case Report 
Isolated unilateral pleural effusion is uncommon presentation of ovarian hyperstimulation syndrome. The pathogenesis of this syndrome involves an increased permeability of ovarian capillaries and mesothelial vessels triggered by the release of vasoactive substances by the ovaries under human chorionic gonadotropin stimulation. Physicians should consider this potentially life-threatening diagnosis in all patients who undergo ovarian hyperstimulation. This case highlights a rare clinical manifestation of isolated hemorrhagic pleural effusion associated with ovarian hyperstimulation
PMCID: PMC3921065  PMID: 24533029
ovarian hyperstimulation syndrome; pleural effusion
14.  Perceived quality, clarity, and accuracy of manually processed and self-developing radiographs in endodontics 
Objectives
To evaluate perceived quality, clarity, and accuracy of self-developing films compared to conventional D- and E-speed manually processed films, and to evaluate their ease of use and satisfaction amongst pre-clinical dental students.
Methodology
Mesiobuccal root canals of 30 extracted mandibular molar teeth were instrumented and size 10 K-files were glued into the canals at 3 different levels. Each tooth was exposed thrice with the same angulation using conventional E-speed, D-speed, and self-developing films. Conventional films were processed manually and self-developing films according to the manufacturer’s instructions, which required 50 seconds of contact time with the solution. Radiographs were evaluated by 4 examiners for quality, clarity, and apical position of the file. A questionnaire-based survey was conducted to evaluate the ease of use, quality, and satisfaction of undergraduate students. Data were analyzed using one-way ANOVA and Tukey–Kramer multiple comparison test, significant at p < 0.05.
Results
The quality and clarity of conventional E-speed films was perceived as significantly better than that of D-speed and self-developing films (p < 0.05). There was no statistically significant difference amongst the 3 film types for recorded file positions (p > 0.05). The results of the student survey corroborated the examiners’ views that the self-developing radiographic films were of poor quality.
Conclusion
Manually processed E-speed films provided significantly superior quality and clarity of images, but for apical file position, no significant differences were found amongst the 3 film types. Conventional E-speed, D-speed, and self-developing films are all adequate for measuring endodontic working lengths.
PMCID: PMC3883600  PMID: 24421739
15.  M.R.I Diagnosis of Tumours and Tumour-Like Conditions Affecting the Pterygopalatine Fossa 
Objectives
To create awareness to the radiologist and clinicians for the magnetic resonance imaging (MRI) appearance of Pterygopalatine fossa (PTF) tumours and to evaluate the role of MRI in the diagnostic of PTF lesions.
Methodology
Retrospective evaluation of MRI features of 29 patients with pathologically proved pterygopalatine fossa (PTF) lesions was performed. The study included 18 males and 11 females with ages ranging between 15 and 68 years. All patients were examined on 1.5 Tesla magnets before and after injection of Gadolinium Meglumine. TI WI 5mm section sagittal scout views, followed by axial T1 5mm sections for the skull base and same sliced thickness during PD and T2 WI in axial and coronal planes.
Results
MRI features of various masses in pterygopalatine fossa were reviewed and correlated with those demonstrated in the literatures. Out of 29 PF masses, 7 masses were proved to be angiofibroma and 6 were nasopharyngeal carcinoma, entering the PTF.
Conclusion
MRI is a useful imaging test which helps in the differential diagnosis of pterygopalatine fossa lesions with precise evaluation of their extensions and nature of lesion and helping to reach the correct diagnosis. However, MRI has limitation for evaluation of associated bony erosion, for which adjuvant CT scan is needed.
PMCID: PMC3883601  PMID: 24421740
16.  Patients seen at the Dermatology ambulatory office in a tertiary care center in Qassim region, Saudi Arabia 
Background
In Saudi Arabia where there is lack of dermatologists in primary health care centers, patients with simple or minor skin conditions have to attend to hospitals to be treated. We analyzed the data of patients with cutaneous disorders attending the tertiary referral hospital in Qassim region of Saudi Arabia, with the aim to identify the most common conditions that patients complain of, in order to define the areas where the education of General Practitioners in Dermatology must focus.
Methodology
All patients seen at the Dermatology ambulatory office in the Emergency Department of Qassim University affiliated hospital from January 2011 to December 2011 were included in this retrospective analysis. The medical records of the patients (history, physical examination and laboratory investigations) were analyzed to ascertain the diagnosis and the management of cases. All patients were evaluated by qualified dermatologists.
Results
A total of 1147 patients attended the Dermatology ambulatory office. Most patients were young adults in the age group 21–30 years (34.4%). Allergic skin diseases (65.2%), mostly dermatitis (48.8%) and urticaria (10.5%) were the most common for attendance, followed by infectious diseases (25.8%) and inflammatory and autoimmune disorders (5.3%). The management of the vast majority of cases (94.1%) consisted of systemic treatment and 58.2% patients required topical treatment. A reevaluation plan as outpatients was planned in 9.0% patients while only 0.3% of patients required admission in the hospital.
Conclusion
Allergic and infectious skin diseases were the most common cutaneous diseases in patients attending this tertiary University hospital, while the management of most patients did not require specialized care. On the basis of the present data, the training of primary health care providers in Dermatology should emphasize these common conditions, with the aim of improving primary care and alleviating the burden on hospital care.
PMCID: PMC3883602  PMID: 24421741
Dermatology; ambulatory office; Saudi Arabia
17.  Knowledge, attitude and practices among Gynecologists regarding Oral Health of expectant mothers of Vadodara City, Gujarat 
Background and Objectives
To assess the knowledge, attitude and practices among Gynecologists’ regarding oral health of expectant mothers of Vadodara city, by using self designed, structured, pre-tested close ended questionnaire.
Methodology
Total of 130 gynaecologists are included in the study. Ethical approval was obtained by the Ethics committee, Sumandeep Vidyapeeth, Vadodara. Prior to study, questionnaire was pre-tested and validated. Those individuals who participated in the pilot study were not considered for the main study to prevent possible bias. The informed consent was obtained and information sheet was given. The questionnaire was administered on first day of visit and on the next day it was collected back. For statistical analysis SPSS package version 17 and Pearson’s Chi Square test was used.
Results
The study revealed that majority of gynecologists had good knowledge, attitude and practices regarding oral health of expectant mothers and there is no significant difference in relation with age, sex and years in practice.
Conclusion
Majority of gynecologists had good knowledge, attitude and practices but still there is a need for more active participation and involvement of medical specialists like gynecologists and pediatricians, in continuing education programs and forums on dentistry.
PMCID: PMC3883603  PMID: 24421742
Gynecologists; Expectant mother; Oral health
18.  The views of Academic Staff on Biostatistics Education in Health Sciences 
Objective
The aim of this study was to assess the level of importance, adequacy and need of biostatistics and biostatistics education regarding health sciences in Turkey.
Methodology
Within the scope of the study a survey (questionnaire) was applied to a total of 237 academicians (academicians holding various titles employed by different departments) officiating at medical, veterinary medicine and health sciences faculties of six universities (Afyon Kocatepe, Gazi, Ankara, Hacettepe, Marmara ve Düzce) in Turkey. With this survey were taken views of academics on the status of the training they had received regarding biostatistics, their need for biostatistics education, the importance of biostatistics education and its level of adequacy, the source and adequacy of current information on biostatistics, the solutions to meet biostatistics needs and the statistical techniques which were required.
Results
According to the results, 27.8% of the participants have not received biostatistics education. It was determined that the importance of biostatistics education was emphasized as “very and exactly important” by 88.19% of the participants. 14.35% of the participants reported that biostatistics education was far from adequate for post graduate. They needed biostatistics knowledge mainly in the analysis of researches data (χ̄=4.01). On the other hand, they met biostatistics knowledge needs mostly by “help from friends”.
Conclusions
The study revealed that most of the academicians found biostatistics education important but claimed it had been inadequate. They emphasized the need for the organization of courses, seminars, etc. regarding biostatistics at sufficient intervals. As a consequence of that, this study reveals the importance of biostatistics and biostatistics education once again in the data analysis process in health sciences.
PMCID: PMC3883604  PMID: 24421743
Biostatistics; Biostatistics education; Health sciences
19.  Perceptions of the educational environment of a new medical school, Saudi Arabia 
Background
Educational environment hugely impacts the learning process. An assessment of perceptions of students about the educational environment at Qassim University College of Medicine (QUCOM) would assist educators and college administration in gauging the quality of the learning in this venue. The aim of this study is to see the educational environment of an innovative undergraduate medical program through the eyes of students.
Methods
During the academic year 2011/2012, a survey was performed at QUCOM using the Dundee Ready Education Environment Measure (DREEM) questionnaire. All undergraduate students participated in the survey. Comparisons between, students’ responses according to their study years in the college and gender were taken into consideration. Data were entered and analyzed using SPSS version 17.0. The scores assigned by the students to questionnaire items were converted into and continuous variables and summarized as means.
Results
Out of 467 students enrolled at QUCOM 454 students (61% males and 39% females)participated in the study (response rate of 97%). The mean age of the participants was 21.4 (standard deviation: 2.2). The mean total score was 112, out of a possible maximum of 200. The mean total score for Perception of Learning was 26/48; for Perceptions of Teaching 25/44; for Academic Self perceptions 20/32; for Perceptions of Atmosphere 26/48 and for Social Self Perceptions 15/28. The mean score of 1.13 for Item 3 “There is a good support system for students who get stressed” was the lowest and is indicative of the pressures felt by the students. While the mean score of 3.24 for Item 15 “I have good friends in this school” was the highest showing good relationship between students. There were no significant differences of perceptions between genders and between basic sciences and clinical phases.
Conclusion
Students perceive the educational environment at QUCOM as having more positives than negatives. Certain areas need further exploration and improvements, which should serve as a decision support mechanism for educationists at QUCOM in rationalizing their priorities for reforms.
PMCID: PMC3883605  PMID: 24421744
Educational climate; Educational environment; Medical culture; Medical education
20.  Effect of Transforming Growth Factor Beta 1 on Wound Healing in Induced Diabetic Rats 
Objective
Delayed wound healing is one of the complications of diabetes mellitus, exhibited by profound inflammation and decreased granulation tissues. The current study was carried out to evaluate wound healing in both normal and diabetic rats. In addition, it evaluated the potential protective effect of transforming growth factor β1 (TGF β1), that has the broadest spectrum of actions, affecting all cell types that are involved in all stages of wound healing to accelerate wound healing in normal & diabetic rats.
Methods
: The present study was performed on 40 male albino rats. Each 10 rats were designed as a group. Group I saved as control. They received incisional wound in their tongues 1 cm length and 1/2 cm depth. Group II received 500 ng/kg of TGF β1 5 minutes before wounding. Group III diabetes was induced then rats were treated as second group. At the 14th day post wounding, sections of tongues were taken for hematoxylin and eosin and Masson's trichome staining to examine the histological changes. The intracellular actions of TGF β1 were studied by TEM.
Results
A higher cell proliferation rate and a denser and more organized new extracellular matrix and complete wound closure was detected at the 14th days in the TGF β1 treated wound in comparison with the 14th days for the untreated, control groups. There were delayed wound healing in diabetic rats, decreased re-epithelialization, granulation tissue thickness, matrix density, number of infiltrated cells, and number of capillaries. In TGF β1 treated diabetic rats, showed significant healing improvement was obvious as compared with diabetic rats.
Conclusions
A single intravenous injection of TGF β1 was sufficient to enhance wound healing in rat's tongue. This approach represents a new strategy that may be applied to the treatment of incisional wounds in human diabetic patients.
PMCID: PMC3883606  PMID: 24421745
Transforming growth factor β1; wound healing; diabetes mellitus; tongue mucosa
21.  Occupational Bloodborne Exposure Incident Survey & Management of Exposure Incidents in a Dental Teaching Environment 
Objectives
The purpose of this study was to investigate the prevalence of occupational exposure incidents among undergraduate dental students and the factors associated with it in the educational dental clinics at Pharos University in Alexandria – Egypt, and to measure the commitment with applying infection control policy in the form of compliance with post-exposure management protocol and reporting exposure incidents.
Materials and Methods
An anonymous self-administered questionnaire consisting of thirteen multiple-choice questions was distributed among 350 undergraduate dental students in mid-senior and senior levels during lectures at the end of the second semester of 2011, with a response rate of 90.00%.
Results
About 62.00% of the senior students reported that exposures occurred outside the patient’s mouth. A high percentage of both the mid-senior and senior students (74.70% and 70.70%, respectively) reported that they were exposed to multiple sources of incidents. The vast majority of studied groups stated that they didn’t follow Infection Control Protocol after Incident Exposure.
Conclusion
The findings of this study confirm that dental students experience exposure incidents but are not likely to report them, thus it is important that the principles of infection control training and reporting of all exposure incidents continue to be emphasized throughout undergraduate dental education.
PMCID: PMC3883607  PMID: 24421746
exposure incident; bloodborne exposure; risk factors; infection control protocol
22.  Neurotoxic effect of lead on rats: Relationship to Apoptosis 
Background
Lead toxicity has been subjected to intensive research work, but some aspects of its mechanism needs to be elucidated.
Objectives
In the current study we aim to investigate the impact of lead toxicity on some different intermediates of apoptotic signaling pathway in experimental rats.
Design and methods
We measured caspase-8 and caspase-9 [by chemilumenescence], Bax and Bcl-2 [by ELISA] in Experimental rats, injected intraperitoneally with lead acetate for 7days at the dosage of 25, 50 and l00 mg/kg body weight and compared to control rats injected with deionized distilled water instead. instead.
Results
Lead acetate significantly increased the levels of caspase 8, caspase 9 and Bax in liver, kidney and brain of experimental animals especially those with high doses. Meanwhile, caspase 8 and Bax significantly increased in brain tissue at low dose of lead, while Bcl-2 significantly increased only with advanced toxicity. Furthermore, Bax/bcl2 ratio was significantly high in kidney (p<0.05), liver (p<0.01) and brain (p<0.01) at higher doses of lead toxicity. However, brain tissues showed significant Bax/Bcl2 ratio (p<0.05) at low lead dose. A significant positive correlation was noticed between the blood level of lead and enzymatic level of caspase 8, caspase 9 and Bax in different tissues.
Conclusion
: we concluded that lead might have toxic effect through intrinsic and extrinsic induction of apoptotic pathway with prominent effect on brain tissue even at low dose.
PMCID: PMC3883608  PMID: 24421747
Lead toxicity; Rats; Apoptosis; Bcl-2; Bax; Caspase 8 and Caspase 9
23.  Cardiovascular responses induced by Catalase Inhibitior into the Fourth Cerebral Ventricle is changed in Wistar rats exposed to sidestream cigarette smoke 
Objectives
This experimental study aimed to evaluate the effects of central catalase inhibition on cardiovascular responses in rats exposed to sidestream cigarette smoke (SSCS) for 3 weeks.
Methodology
A total of 20 males Wistar rats (320–370g) were implanted with a stainless steel guide cannula into the fourth cerebral ventricle (4thV). Femoral artery and vein were cannulated for mean arterial pressure (MAP) and heart rate (HR) measurement and drug infusion, respectively. Rats were exposed to SSCS for three weeks, 180 minutes per day, 5 days/week [carbon monoxide (CO): 100–300 ppm)]. Baroreflex was tested with one pressor dose of phenylephrine (PHE, 8 μg/kg, bolus) and one depressor dose of sodium nitroprusside (SNP, 50 μg/kg, bolus). Cardiovascular responses were evaluated before and 15 minutes after 3-amino-1, 2, 4-triazole (ATZ, catalase inhibitor, 0.001g/100μL) injection into the 4th V.
Results
Vehicle treatment into the 4th V did not change cardiovascular responses. Central catalase inhibition increased tachycardic peak, attenuated bradycardic peak and reduced HR range at 15 minutes, increased MAP at 5, 15 and 30 min and increased HR at 5 and 15 min. In rats exposed to SSCS, central ATZ increased basal MAP after 5 min and increased HR at 5, 15 and 30 minutes, respectively, and attenuated bradycardic peak at 15 minutes.
Conclusion
This study suggests that brain oxidative stress caused by SSCS influences autonomic regulation of the cardiovascular system.
PMCID: PMC3883609  PMID: 24421748
Baroreflex; Oxidative Stress; Catalase inhibition; Medulla Oblongata; sidestream cigarette smoking
24.  Winter Hypertension: Potential mechanisms 
Hypertension exhibits a winter peak and summer trough in countries both north and south of the equator. A variety of explanations have been proposed to account for the seasonal nature of hypertension. It is likely that this reflects seasonal variations in risk factors. Seasonal variations have been demonstrated in a number of risk factors may play essential roles for seasonality of hypertension such as noradrenalin, catecholamine and vasopressin, vitamin D, and serum cholesterol. However, a number of studies have also suggested a direct effect of environmental temperature and physical activity on blood pressure. This paper was design to review the available evidence on seasonal variations in hypertension and possible explanations for them.
PMCID: PMC3883610  PMID: 24421749
25.  Review of the treatment of mycosis fungoides and Sézary syndrome: A stage-based approach 
Mycosis fungoides (MF) and Sézary Syndrome (SS) are the most common subtypes of cutaneous T-cell lymphomas. Most of patients have indolent and incurable course of disease. Therefore, treatment should be reaching the optimal benefit with minimizing the toxicity as much as possible. To achieve this aim, the management should follow a -stage-based-approach.
Treatment of early-stage MF (IA–IIA) involves skin-directed therapy (SDT) including topical corticosteroids, phototherapy, topical chemotherapy, topical retinoids and radiotherapy.
For aggressive/recalcitrant early-stage MF or advanced-stage MF, systemic therapy should be considered including interferone-alpha, oral retinoids including bexarotine and more recently acitretin, histone deacetylase inhibitors (HDACi), fusion toxin denileukin diftitox and chemotherapy drugs. Combined drug regimens can be considered in some situations to get the synergistic effect while lowering the individual drug’s doses on the other hand. By exception of aggressive stages, chemotherapy should always come after other systemic drugs have been tried or contraindicated. Novel drugs should be considered in situations when all systemic drugs have failed.
PMCID: PMC3883611  PMID: 24421750
Ctaneous T-cell lymphoma; Mycosis fungoides; Sézary Syndrome

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