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   Table of Contents - Current issue
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July-December 2022
Volume 7 | Issue 2
Page Nos. 77-142

Online since Tuesday, December 27, 2022

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ORIGINAL ARTICLES  

Is 99mtechnetium (Pertechnetate) more efficient in clinical evaluation of thyroid lesions compared to 123iodine? A scoping review p. 77
Magbool Alelyani, Mohammed Alshehri, Nasser Shubayr, Yazeed Alashban, Abulaziz Alshihri
DOI:10.4103/KKUJHS.KKUJHS_17_21  
Background: This research aims to find out which radiopharmaceutical is more efficient to evaluate thyroid lesions, such as hyperthyroidism, Graves' disease (GD), or even cold or hot thyroid nodule identification (is 99mtechnetium [99mTc] or 123iodine [123I] suitable in this case?). Materials and Methods: An extensive computerized search was done by the authors, revealing 61 studies in total. 49 studies were excluded for various reasons, so only 12 were eligible for inclusion in this review. Results: Majority of the studies suggested that the use of 99mTc over 123I. 99mTc is a suitable choice to evaluate thyroid disorders. However, 123I can be broadly used in assessing thyroid functions, detecting malignancy and causes of thyrotoxicosis, calculating therapeutic dosages of 131I, and identifying cold or hot lesions effectively due to its superior accumulation in thyroid. Conclusion: 99mTc is a nonphysiologic compound widely used to evaluate thyroid abnormalities, and it has a noticeably low biodistribution in the thyroid. On the other hand, 123I is an organic compound with excellent biodistribution that is used to gather further information on thyroid functions and susceptibility and prevalence of toxic adenoma, GD, and cold or hot thyroid nodule evaluation.
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Identification and analysis of dental education quality in Saudi Arabia p. 82
Badr Majed Othman, Mohammed Ahmed Alharbi
DOI:10.4103/KKUJHS.KKUJHS_27_22  
Objectives: Saudization can be defined as recruiting and hiring Saudis in both the governmental and private sectors. This process is being introduced by the Ministry of Labor to reduce the number of unemployed. Lowering the unemployment rate from 11.6% to 7% is one of the new vision goals to be reached by 2030. The SERVQUAL model is used to assess customer perceptions of service quality in service and retail organizations through five dimensions: tangibility, reliability, responsiveness, assurance, and empathy. This study aims to measure the effect of these quality dimensions on students' willingness to be and satisfaction being educated by Saudi faculty in dental colleges. The focus of this research is to determine which quality dimensions most affect students while being educated by Saudi faculty in dental colleges. The contribution of this research will help future research to develop strategic operational objectives to enhance education quality. Materials and Methods: A cross-sectional survey was performed. A total of 432 participants (198 male students and 234 female students) were included in the study. An electronic questionnaire with a scale from 0 to 5 using the SERVQUAL model was formulated. Results: The results were analyzed by the Statistical Package for Social Sciences software (SPSS, version 21, Chicago, Illinois, USA). The weighted scale was 4.01, 4.12, 4.03, 3.25, and 3.78 for reliability, assurance, accountability, empathy, and education quality of Saudi faculty, respectively. Furthermore, the weighted scale was 3.7 and 3.71 for students' satisfaction and student willingness to attend future lectures, respectively. Conclusion: Students had high agreement with the reliability, accountability, and education quality of Saudi dental faculty. However, the assurance dimension showed significant side effects on student willingness to attend future lectures. On the other hand, the empathy dimension showed significant side effects on participants' perception of satisfaction and student willingness to attend future lectures.
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Seropositivity of COVID-19 asymptomatic nurses using Anti-SARS-CoV-2 nucleocapsid antibodies p. 91
Ahmad A Alshehri, Abdulrahim R Hakami
DOI:10.4103/KKUJHS.KKUJHS_28_22  
Background: Anti-SARS-CoV-2 antibodies in symptomatic and asymptomatic cases provides helpful insight about its clinical implications. Aims and Objectives: The aim of this study is to determine anti-nucleocapsid IgG antibodies in nurses, qualitatively, both in asymptomatic and symptomatic nurses, and to determine the rate of asymptomatic cases. Second, to compare antibody reactivity from asymptomatic and symptomatic subjects. Materials and Methods: Samples were collected from four hospitals in the Southern Region, Najran, Kingdom of Saudi Arabia (KSA). Quantitative enzyme-linked immunosorbent assay from Epitope Diagnostic, Inc were used to measure the level of anti-nucleocapsid (anti-NC) antibodies in nurses. Results: One hundred twelve samples tested positive for antibodies (70%). Other variables were assessed, including age, gender, ABO blood group, and nationality. A significant difference was found between asymptomatic nurses vs. those with negative antibodies (*P = 0.0147), suggesting they could have transmitted SARS-CoV-2 unknowingly. Forty-one nurses (25.6%) were symptomatic, while 99 nurses were asymptomatic (61.8%). Conclusion: In this study, 112 nurses (70%) tested positive for the anti-NC antibodies, 41 (25.6%) were symptomatic, 99 (61.8%) were asymptomatic, and 48 (30%) were anti-NC antibody negative. Future work should focus on the association of respiratory disease with the concentration of antibodies, and if antibodies wane rapidly after COVID-19 infection.
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Prevalence of depression and anxiety and their associated factors among ministry of health programs residents from different specialties in Abha City, Saudi Arabia p. 97
Mohammed Abadi Alsaleem, Fahad Mousa Jawman Wasili, Safar Abadi Alsaleem
DOI:10.4103/KKUJHS.KKUJHS_24_22  
Background: Identifying the magnitude and the determinants of stress-related disorders will help to improve the work environment besides minimizing its drawback on residents' medical care performance. Aim: This study aims to assess the prevalence of depression and anxiety and their associated factors among Ministry of Health (MOH) programs residents. Methodology: This cross-sectional survey targeted all MOH residents from different specialties in Abha city. The questionnaire included resident's sociodemographic information, specialty, duration, seniority, workload, shifts, and number of cared patients per shift. Resident's depression was assessed using Depression Patient Health Questionnaire-9 and anxiety was assessed using the anxiety Generalized Anxiety Disorder-7 Scale. The data were analyzed using SPSS version 21. Results: A total of 370 residents were included. Residents' age ranged from 20 to 35 years, with a mean age of 27.6 ± 6.7 years. Nearly 61.1% of residents were males and 58.6% were married. About 66.2% of the residents were normal (no depression), while 15.1% experienced minimal depression, 13% had mild depression, and 4.3% had severe depression. Considering anxiety, 85.9% of the residents showed no/minimal anxiety levels, while 7.8% had mild, 4.9% had moderate, and 1.4% showed severe anxiety levels. Conclusions: The study showed that psychological health, including depression and anxiety, was satisfactory among the study residents, where the majority of them were free of both issues. Further nationwide studies are required to assess additional factors such as work environment and autonomy.
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Depression, anxiety, stress, and satisfaction of medical students in relation to income and body mass index p. 104
Syed Mohammed Habib, Thamir Al-Khlaiwi
DOI:10.4103/KKUJHS.KKUJHS_30_22  
Objectives: The aim of this study was to explore the relationship of students' income and body mass index (BMI) with the level of depression, anxiety, stress, and academic satisfaction. Methods: A cross-sectional study with distribution of online Depression, Anxiety, and Stress Scale questionnaire online to medical students in different universities of Saudi Arabia. In addition, they filled out a predesigned pro forma that contained sociodemographic characteristics and satisfaction status regarding lectures, practical, staff, and examinations. A total of 351 participants completed the study. Students were asked about various academic issues and assessed by a three-point Likert scale (satisfied, undecided, and unsatisfied). Results: The prevalence of depression, anxiety, and stress in students with a father's monthly income of <3000 US Dollars was 72.4% (n = 79), 83.4% (n = 91), and 63.3% (n = 69), respectively. Furthermore, the prevalence of depression, anxiety, and stress in students with a father's monthly income between 3000-5000 US Dollars was 71.5% (n = 73), 74.5% (n = 76), and 48.0% (n = 49) respectively. As for the students with a father's monthly income >5000 US Dollars had a prevalence of 62.1% (n = 87), 71.4% (n = 100), and 48.5% (n = 68) for depression, anxiety, and stress respectively. Hence, it was noted that the prevalence was higher in students with a father's monthly income <3000 US Dollars in all categories (depression P = 0.056 which was marginal, anxiety P = 0.009, and stress P = 0.050).. 46.8% (n = 51) of students with a father's monthly income <3000 US Dollars, 32.4% (n = 33) of students with a father's monthly income between 3000 and 5000 US Dollars, and 30.7% (n = 43) of students with a father's monthly income >5000 showed an extremely severe anxiety score. It showed that the moderate degree of depression with mean total depression score of students with a father's monthly income <3000 was 17.7 ± 11.7. It showed a severe degree of anxiety with a mean total anxiety score of 18.4 ± 11.4, and a moderate degree of stress with a mean total stress score of 19.1 ± 10.4. The prevalence of depression 69.3% (n = 172), anxiety 77.4% (n = 192), and stress 54.8% (n = 136) in students with BMI <25 was higher than in students with BMI ≥25 65.0% (n = 67), 72.8% (n = 75), and 48.5% (n = 50) with no statistically significant difference (P = 0.161, P = 0.433, and 0.572), respectively. It showed that 37.5% (n = 93) of students with BMI <25 were extremely severely anxious while students with BMI ≥25 were 33.0% (n = 34). Conclusions: The prevalence of depression, anxiety, and stress in medical students with low father monthly income was significantly high. The prevalence of severe anxiety in all groups needs more attention from the medical college's higher authorities.
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Prevalence of depression and associated factors among secondary school teachers in Medina region, Saudi Arabia p. 111
Faisal Saeed Safar Al-Qahtani
DOI:10.4103/KKUJHS.KKUJHS_23_22  
Background: Depression is one of the most common psychiatric conditions seen in primary health care clinics. On the other hand, teaching is one of the most stressful jobs. Objective: The aim was to estimate the prevalence and risk factors of depression among secondary school teachers in the Medina region. Subjects and Methods: A cross-sectional descriptive study was conducted on a representative sample of secondary school teachers of both genders in the Medina region. A multistage cluster sample technique was implemented to recruit the participants. The data were collected using a self-administered Patient Health Questionnaire-9 (PHQ-9) depression questionnaire. Results: The study included 297 teachers. More than half of them (54.2%) were males and the vast majority (97.6%) were Saudis. Major depression, based on PHQ-9 depression questionnaire was reported among 8.4% of the participants, whereas minor depression was reported among 14.1% of them. Among the studied habitual factors, the smoking of Shisha and nonpracticing of physical exercise were significantly associated with depression among teachers. Regarding obstetric and gynecological factors, female teachers with a history of postnatal depression were more likely to have major and minor depression features than those without such history. Conclusion: Depression is a common health problem among secondary school teachers in Medina region affecting almost one quarter of them. Familial instability, shisha smoking, physical inactivity, heavy teaching load, and deficiency of educational competencies are strongly correlated with depression. Further studies are needed to explore the extent of the problem among teachers at different levels of teaching across the kingdom.
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Screening of field-caught mosquitoes for the SARS-CoV-2 virus at the southwest of Saudi Arabia p. 118
Yasser Alraey, Gaffar S Zaman, Sultan M Alhefdi, Roaa A Asiri, Sarah M Alshehri, Sultan Z Alasmari, Abdulrahim Hakami, Alghamdi Ibrahim Saeed, Ayed A Dera
DOI:10.4103/KKUJHS.KKUJHS_36_22  
Background: It was observed that the severe acute respiratory syndrome-Coronavirus (SARS-CoV-2) virus is more transmissible in places that are more clustered and where mosquitoes breed in significant numbers. Therefore, we wanted to study the potential influence of mosquitoes in the COVID-19 transmission in the field settings. Materials and Methods: This research was applied in the Asir region of Saudi Arabia. A questionnaire survey was meted out to the quarantined participants diagnosed with the COVID-19 infection. Mosquito traps were located at places with the high rate of human vector contact. A total of 464 female mosquitos were screened for the SARS-CoV-2 S gene utilizing real time reverse transcriptase–polymerase chain reaction. In addition, blood-fed mosquitoes were tested through sequencing of the cytochrome b gene region to identify the source of blood meals. Results: People having low economic status and places with high population density, such as parks and malls, resulted in the individuals “high risk of being infected with the COVID-19 infection. Most of the collected blood-fed mosquitoes exhibited a high match-sequencing with human. All tested mosquitoes had not manifested any SARS-CoV-2S gene amplification. Conclusion: Our results highlight the association of low economic status of individuals and the individuals” behavior of frequently visiting parks, with an elevated risk of contracting the COVID-19 infection. Moreover, using a field experiment for the first time in Saudi Arabia, our data supported the theory that the SARS-CoV-2 virus cannot be transmitted through mosquitoes, either by blood meal or by mechanical transmission.
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CASE REPORTS Top

Prompt response to resin infiltration with or without bleaching in the treatment of teeth pigmentation and teeth discoloration p. 125
Nada Ahmad Alamoudi
DOI:10.4103/KKUJHS.KKUJHS_60_21  
Discoloration and pigmentation of teeth are two common esthetic issues in dentistry that prompt patients to seek treatment as soon as possible. Overall, the etiology of discoloration and pigmentation is multifactorial, with different treatment options showing long-term effects. Such treatment options have been evaluated and shown to reduce tooth pigmentation and discoloration; however, the long-term effects of resin infiltration with or without bleaching at a 1-year follow-up are not investigated. Therefore, we presented a case report of two cases that were successfully treated using resin infiltration with or without bleaching, and both of these cases responded well by the end of 2 weeks, with lasting effects at 1-year follow-up. For the case report, the care checklist was used. Two females with discoloration and pigmentation of teeth presented to the King Khalid University postgraduate dentistry clinic who wanted to get treated for these conditions. After taking their personal, dietary, medical, and family history, performing oral examination, and tooth analysis, treatment plans were made for both cases. The first case was a 54-year-old female who presented with mild-to-moderate fluorosis, and she was successfully treated mainly with bleaching plus resin infiltration with positive findings. A faint line and discoloration were present before treatment that got disappeared after the treatment, and the smile of the patient also got improved. There was also a significant difference found in the frontal view of the teeth before and after treatment. In contrast, the other case was a 20-year-old young girl who presented with the chief complaint of white teeth pigmentation after finishing orthodontic treatment. She was mainly treated with resin infiltration with positive effects of treatment with improvements in the smile and favorable changes in the frontal view of teeth, reduction in pigmentation, and improvement in oral hygiene. The response to the treatment in both the cases was rapid, and it appeared at the end of 2 weeks. The findings of these two case reports reveal the significance of the persistent favorable effects of resin infiltration with or without bleaching at the follow-up of 1 year. However, more randomized clinical trials are required to confirm these findings in many patients.
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Right testicular pain and epididymo-orchitis caused by Enterobius vermicularis p. 134
Mohammed Alorini
DOI:10.4103/KKUJHS.KKUJHS_32_22  
A rare case of epididymo-orchitis due to nematode infection by Enterobius vermicularis is reported. A 38-year-old male presented with right testicular pain. He was diagnosed with acute right epididymo-orchitis. Right epididymo-orchiectomy was performed. Microscopic examination showed parts of the body of the oxyurid in one section, thus confirming the diagnosis of pinworm infection. Although ectopic pinworm infections are broadly reported, testicular involvement is very rare. To our knowledge, this is the third reported case in the literature.
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Enhanced anterior esthetic using crown lengthening and depigmentation at single visit: Report of two cases and review of literature p. 137
Saad M AlQahtani
DOI:10.4103/KKUJHS.KKUJHS_33_22  
Gingival hyper-pigmentation becomes more obvious when it is associated with excessive gingival display. The treatment of excessive gingival display and depigmentation collectively are the key to patient satisfaction. The objective of the present article was to evaluate 6 months' result of surgical protocol that integrated surgical depigmentation, gingivectomy, and an apically positioned flap with osseous resective surgery to correct hyper-pigmentation and excessive gingival display in maxillary anterior teeth among different patients. The author has discussed in detail the selection of surgical techniques in different clinical conditions to achieve pleasant and long-term results. The selected techniques for depigmentation and crown lengthening resulted in excellent color and contour of the gingiva at the 6-month follow-up.
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