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   Table of Contents - Current issue
January-June 2021
Volume 6 | Issue 1
Page Nos. 1-62

Online since Saturday, July 31, 2021

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Hemostatic alteration in sickle cell disease: Pathophysiology of the hypercoagulable State p. 1
Naif Mohammed Alhawiti
Sickle cell disease (SCD) is a monogenic genetic disease inherited in an autosomal recessive manner and distinguished by the presence of defective hemoglobin, known as homozygous sickled hemoglobin disease (HbSS). Sickled red blood cells lead to blood vessel obstruction, hemorrhage, and critical hemostatic function alterations. Defective hemoglobin that associated with serious health problems, such as thromboembolism among SCD patients, is clearly documented. Empirical evidence indicates that hypercoagulability states and proinflammatory phenotypes in patients with SCD are a substantial contribution of thromboembolic complications, with promoting morbidity and mortality. This review discusses the involvement of vascular endothelial cell, platelet, and coagulation cascade in the thrombogenesis of SCD.
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Diagnostic techniques for human papillomavirus detection for early diagnosis of endocervical adenocarcinoma p. 6
Abdullah Bandar Almutiri
Background: The past few decades have witnessed a shift in the rate of incidence of cervical squamous cell carcinoma (SCC) and endocervical adenocarcinoma because there has been an increase in the prevalence of the endocervical adenocarcinoma and a reduction in the SCC in countries with effective screening programs in place. Although our knowledge about the underlying reasons for this shift remains deficient, it seems that the prevalence of endocervical adenocarcinoma is on the rise partly because of greater exposure to human papillomavirus (HPV), screening delays, and more importantly, technical limitations faced in diagnosing endocervical carcinoma. Objectives: This study aims to systematically review certain diagnostic methods that detect HPV which will facilitate the early diagnosis of endocervical adenocarcinoma because adjuvant therapy has proven to be inefficient for later stages of the disease. Methodology: The relevant articles were researched online using databases such as Scopus, PubMed, ScienceDirect, ProQuest, SpringerLink, and Web of Science. The databases were electronically searched. The keywords used in the search included “human papillomavirus (HPV),” “diagnosis of endocervical adenocarcinoma,” “polymerase chain reaction (PCR),” “in situ hybridization (ISH),” and “immunohistochemistry (IHC).” The search was refined to include only those articles that were nonreviewed studies and recently published, covering the period from 2010 to the present. Results: Eight articles from different parts of the world were selected for the study and were categorized into three groups depending on the diagnostic technique used in them, which included PCR, ISH, and IHC. PCR has proven to be an efficient noninvasive method that detects HPV DNA in the early stages. ISH demonstrates high specificity and sensitivity for the detection, of which genotypes of HPVs are present in endocervical adenocarcinoma lesions. Immunohistochemical staining is a simple tool for detecting HPV, but it has limited efficiency. Conclusion: A number of diagnostic tools are available to detect HPV infection for the early diagnosis of endocervical adenocarcinoma. HPV detection tests can be used in combination with the Pap test to ensure that any abnormality is not missed during diagnosis. Nonetheless, further studies should be performed to develop novel techniques or improve existing ones, so that endocervical adenocarcinomas can be detected on time and with high accuracy, and to overcome the problems faced in the cytologic diagnosis of cervical adenocarcinomas lesions.
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Antibacterial potency of extracted essential oils of some plant species against common gram-positive and gram-negative bacteria p. 18
Gaffar Sarwar Zaman
Background: In the last decades, due to the rapid emergence of multidrug resistant pathogens, the antibiotic-resistance phenomenon has become a global health crisis. Therefore, there is a need to find new remedies against pathogenic microbes. Objectives: The main intention of this research was to appraise the antibacterial potency of extracted essential oils (EEOs) from various plant species versus human disease-causing bacterial strains. Materials and Methods: Antibacterial and bactericidal activity of EEOs was tested on human disease-causing strains which included Gram-positive as well as Gram-negative bacteria. Antibacterial analysis for various extracts of the different plants was performed by utilizing the method of disc diffusion and deduction of minimum inhibitory concentration (MIC) by microbroth dilution assays of the EEOs against the bacterial strains. Standard antibiotics (amoxicillin, metronidazole, rifampicin, clarithromycin, oxacillin, and clindamycin) were used to compare with EEO antibacterial activity. Results: Eclipta alba EEO was most effective against Streptococcus Pyogenes (2.06 ± 0.15), Neisseria gonorrhoeae (1.50 ± 0.20), Streptococcus aureus (0.05 ± 0.02), and Pseudomonas aeruginosa (4.56 ± 0.25). Leucas linifolia EEO was most effective against E. coli (3.13 ± 0.25) and Klebsiella Pneumoniae (4.33 ± 0.23). Bactericidal activity EEO from E. alba with minimum bactericidal concentration (MBC) ranged from 0.11 ± 0.03 to 10.60 ± 0.55; Atriplex hortensis (8.73 ± 2.62–12.07 ± 0.65); Hedyotis scandens (9.13 ± 0.50–15.30 ± 0.43); L. linifolia (0.94 ± 0.05–10.73 ± 0.20); Murraya koenigii (9.0 ± 0.55–12.90 ± 0.18); and Phlogacanthus thyrsiflorus (5.96 ± 1.15–13.0 ± 0.52). Bactericidal activity E. alba EEO was highest against S. Pyogenes (4.06 ± 0.15), N. gonorrhoeae (3.06 ± 0.40), and S. aureus (0.11 ± 0.03). L. linifolia EEO was most effective against P. aeruginosa (0.94 ± 0.05) and K. Pneumoniae (8.73 ± 0.41). Against E. coli (5.96 ± 1.15), the bactericidal activity of P. thyrsiflorus EEO was most effective. Conclusions: Comparison to the antibacterial activity of EEOs from six different plant species used in the study was more effective than the tested antibiotics. MIC and MBC values show that E. alba EEO plant species was the most effective against the tested human pathogenic bacterial strains.
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Impact of COVID-19 pandemic on health services provided to elderly population in Saudi Arabia p. 24
Hayfa AlHefdhi, Faten Alkahtani, Fatemah Shamakhi, Fayzah Alrazhi, Anhar Alqahtani, Abeer Alsharaif, Sara Habtar
Background: Pandemics are not becoming infrequent events anymore. It is estimated that over 12,000 outbreaks have occurred since the year 1980, thanks to ease of travel and change in land use (Smith et al., 2014; Joes et al., 2008). The current coronavirus disease of 2019 (COVID-19) pandemic have exposed the lack of preparedness in well-connected, economically stable, developed countries. All aspects of life have changed dramatically. COVID-19 infection affects older adults with higher morbidity and mortality and those with chronic underlying medical disorders [Zhang et al., 2020]. There is an indirect effect of COVID-19 pandemic on elderly, related to quarantine and social isolation. Prolonged social isolation leads to several neurological, psychological, and medical morbidities in the elderly [Plagg et al., 2020]. On the other hand, hospital-based and community-based medical care for acute and chronic diseases was disrupted substantially during the pandemic, adding to the suffering endured by older adults. Such impact received little focus in contemporary research, especially in Saudi Arabia. Objectives: The main aim of our current investigation is to evaluate the impact of quarantine and medical care disruption on geriatric health during the COVID-19 pandemic in Saudi Arabia. Materials and Methods: We surveyed the elderly population in Saudi Arabia using a pre-designed electronic online questionnaire in Arabic language. The items were developed by collaborating with practicing family physicians, geriatricians affiliated to King Khalid University, and with service users. The link to the questionnaire was released unto social media and the elderly -and their carers- were encouraged to participate in the study. We collected sociodemographic as well as clinical data. A pilot study was conducted for a period of two months before the final version of the research tool was released. We utilized χ2 tests to evaluate the effect of categorical demographic and clinical variables. Statistical tests were 2-tailed. Significance level was set at probability (type 1 error) = 0.05. The statistical software used was SPSS, Version V27 for Windows. The study received approval from the Ethics committee in King Khalid University. Results: A total of (n = 297) Saudi elderly persons were included in the survey, of whom (n = 35, 11.8%) were men and (n = 262, 88.2%) were women. (n = 190, 64.0%) were between 65 and 74 years of age and (n = 107, 36.0%) were 75 or older. The most frequently encountered health problem was Diabetes Mellitus in (n = 126, 42.4%) followed by hypertension in (n = 117, 39.4%). (n = 117, 39.4%) reported having their urgent care needs delayed because of fear of COVID-19 infection. (n = 164, 55.2%) reported that the pandemic posed a negative effect on their mood, and further (n = 108, 36.4%) had their physical activities negatively affected. Treatment plan was impaired in (40, 13.5%) of the participants. In independent subjects (n = 24, 32.9%) were not enjoying daily activities post-pandemic, compared to (n = 63, 34.1%) who were partially dependent and (n = 7, 17.9%) who were totally dependent on others (P = 0.037). Conclusion: We surveyed a sample of elderly people in Saudi Arabia to explore their experience of interruption in healthcare services. We found 21% did not receive their medications and 39.4% had their urgent needs delayed. Physical activities, mood and enjoyment sense were all impaired. We should take into account the disruption in health services provision caused by the current COVID-19 pandemic when planning for post-pandemic geriatric healthcare.
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Thyroid cancer awareness among women in the asir region of Saudi Arabia p. 27
Majed Saad Al Fayi
Background: Thyroid cancer (TC) is one of the most common malignancies among females in Saudi Arabia, accounting for approximately 11% of newly diagnosed cancers in the kingdom. Over the past few decades, an increasing prevalence of TC has been documented in the kingdom. In Saudi Arabia, and especially in the Asir region, no studies have been conducted to address TC awareness among females. Objectives: This study aims to assess the level of TC awareness among women in the Asir region of Saudi Arabia. This study focuses on knowledge of the risk factors, signs, prevalence, treatment, and diagnosis of TC. Materials and Methods: This study uses a cross-sectional survey design. An online survey was conducted among 310 females in the Asir region of Saudi Arabia over 3 months. The questionnaire was divided into four subsections, namely, a demographic section, a knowledge score section, an awareness section, and practices to detect TC section. Results: A total of 75 (24.8%) participants had a low level of knowledge about TC, while only five (1.7%) participants had a high level of knowledge about TC, with the remainder having a moderate level of knowledge. The knowledge scores of participants were found to be significantly correlated with their education levels (0.048), while knowledge of TC did not significantly correlate with their age group (0.790), marital status (0.471), or number of visits to a health center per year (0.211). The majority of the respondents claimed that TC is uncommon in Saudi Arabia (54.6%), more common in males/females (75.2%), and more common in those aged over 40 years. Conclusion: The study depicted the suboptimal awareness levels of women regarding TC in the Asir region and its association with education levels. Women's awareness of TC in routine practice is urgently required.
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Safety and efficacy of corneal cross-linking in children with keratoconus p. 33
Saeed S Alqahtani
Background: Keratoconus is categorized by advanced corneal protrusion and thinning, important to uneven impairment and astigmatism in ophthalmic purpose, secondary to alter in the arrangement and association of collagen. Objective: This study intended to explain the protection and efficiency of cross-linking corneal for pediatric keratoconus. Materials and Methods: This was a retrospective investigation of 32 eyes of 26 patients, age < 17 years that undertook corneal collagen for advanced keratoconus. Inclusion criteria were progressive keratoconus eyes recognized by successive topography for 6 months. The central significances procedures comprised pachymetry, keratometry, vision, and difficulties following epithelial-off cross-linking with the Dresden procedure. Results: Vernal keratoconjunctivitis (VKC) patients were extra probable to be male; 81.6% of the non-VKC patients and 96.3% of VKC patients were male . Relating pretreatment to the 2-year follow-up, around no statistically substantial modification in the mean sharp or flat keratometry, uncorrected visual acuity (UCVA) and corneal thickness or best spectacle-corrected graphic acuity in either group. There were no statistically substantial modifications in the mean visual, adverse event outcomes between the two groups. The percentage displaying advance of ectasia at 2 years was 18.5% in the VKC group and 16.7% in the non-VKC group (P = 0.83). Conclusions: Cross-linking corneal appears to be protected and active in pausing the advancement of keratoconus in pediatric patients. In addition, it can hypothetically inhibit amblyopia, progress the proper of lenses, and prevent an initial piercing keratoplasty.
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Assessment of awareness of ultrasound safety among ultrasound users in King Saudi Arabia p. 42
Mohamed Adam, Moawia Gameraddin, Magbool Alelyani, Abdullah Laghbi, Ibtisam Abdallah, Nada A Alqahtani
Background: Ultrasound (US) is an imaging method with significant diagnostic value; it is one of the most important diagnostic tools used by a wide range of health-care professionals across many applications. Objective: Evaluate the knowledge on implementation of the safety of diagnostic ultrasound (US) and the extent of perception of users in South King Saudi Arabia (KSA) regarding safety aspects of diagnostic methods. Methodology: This cross-sectional descriptive survey was conducted in Saudi Arabia between October 2019 and September 2020. US operators used an online questionnaire in public and private Hospitals. Data were analyzed using the SPSS software program using appropriate statistical tests. Results: A total of 105 respondents of US operators completed the questionnaires. Most of them specialized in radiology (71.4%), whereas the remaining are physicians and obstetricians. A 50.5% of the US operators responded to the correct answer for US safe in the first trimester, 21.9% responded it is safe in the second trimester, and 34.3% in the third trimester. In comparison between operators about the knowledge safety issue, sonographers have a better knowledge of US safety than others (P = 0.02), whereas females have significant experience than males (P = 0.033). Qualified US operators with postgraduate studies were significantly more knowledgeable about US safety than others (P = 0.04). Conclusions: The qualification of US users has a significant impact on US safety knowledge. Practice and awareness of US safety among US operators in KSA need further training. Further efforts are made to teach and train diagnostic medical US devices to implement safety standards.
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Nomophobia associated with depression, anxiety, and stress in nursing students: A cross-sectional study in college of nursing, Jeddah, Saudi Arabia p. 46
Hawazen Rawas, Nusrat Bano, Uzma Asif, Muhammad Anwar Khan
Background: Nomophobia is described as the fear of losing contact with mobile phones. It is widely reported in nursing students who may also experience depression, anxiety, and stress. Little is known about the relationship of nomophobia with depression, anxiety, and stress. Objectives: This study was designed to (a) assess nomophobia in nursing students and to (b) evaluate the impact of depression, anxiety, and stress on nomophobia in nursing students. Material and Methods: The study was carried out in College of Nursing, Jeddah, Saudi Arabia. Study sample (n = 311) comprised students enrolled in all levels of bachelor of science in Nursing degree. A self-administered survey was conducted using the Nomophobia Questionnaire tool for nomophobia and DASS-21 for depression, anxiety, and stress. Results: Undergraduate nursing students were presented with mild (12.9%), moderate (46.9%), and severe (40.2%) nomophobia. The highest mean score yielded for nomophobia Factor 1 – not being able to communicate (4.74 ± 1.77), whereas the lowest score was noted for nomophobia Factor 2 – losing connectedness (4.07 ± 1.96). A significant positive correlation was noted between depression and Factor 4 – giving up convenience of nomophobia (r = 0.11, P < 0.05). A high prevalence of nomophobia was noted. Severity of depression contributed positively to severity of nomophobia. Conclusion: Findings indicate the coexistence of depression, anxiety, or stress in nomophobia.
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Topiramate, as prominent dual inhibitor, targeting beta-secretase and voltage-gated sodium channel: An In silico study for the management of epilepsy-associated alzheimer's disease p. 52
Mohammed Abohashrh
Background: Alzheimer's disease (AD) is evidenced by decreased cognitive function and increased prevalence of seizures. The association of epilepsy with AD is of clinical importance. Besides, memory impairment is common in epilepsy patients. Anti-epilepsy drugs have been used in various neurodegenerative disorders other than epilepsy. Objective: To validate the assumption that an AED could be effective against AD. The therapeutic target in the cure of epilepsy is the voltage-gated sodium channel (VGSC), while beta-secretase (BACE) is a vital target in AD treatment. Materials and Methods: In this study, we describe the molecular interactions of topiramate with BACE and VGSC by “Autodock 4.2.” Free binding energy and inhibition constant of “topiramate-BACE” and “topiramate-VSC” interactions were found to be “−5.67 kcal/mol and 69.69 μM;” and “−5.64 kcal/mol and 73.88 μM,” respectively. Results: Both hydrophobic interactions and H-bond exhibit a vital role in the binding of topiramate with the BACE and VGSC. Conclusion: The study suggests that topiramate might act as a prominent dual inhibitor against BACE and VGSC, which may prove to be a promising treatment option for epilepsy-associated AD.
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Factors motivating nurses to transition from clinical to academic education p. 57
Ahmed S AlKarani, Ahmed AbdElbagy Ibrahem
Background: Around the world, there are some problems facing nursing education and production of new nurses; one of the problems is a shortage of qualified nurse faculty members. Objectives: The objectives of the study are (1) to explore factors motivated Saudi nurses working at nursing faculties to transition from clinical practice to academy and (2) to clarify the challenges of the transition into nursing colleges at universities. Subjects and Methods: This was a descriptive, qualitative study. A semi-structured interview was implemented with nine lecturers from four Saudi Universities. Data were analyzed using thematic analysis. Results: This study publicized three themes from the experience of Saudi nurses moving from clinical practice to academy: appealing factors in academic work, including four subthemes; factors that helped integrate into academic work, including two subthemes; and factors that contributed to the transition from clinical practice to academy, including two subthemes. Conclusion: Searching for change, continuing postgraduate studies, academic social life, and a positive academic work environment are common factors motivating nurses to transfer from clinical bedside nursing care into academic teaching.
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