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Background: Management of small intestinal diseases in the emergency setting, imposes a challenge and is associated with incidence of perioperative mortality and morbidity. Many factors may contribute to this adverse outcome, it may be patient-related factors, associated colonic injuries or related to presenting derangement locally or systemically. Objective: To rate the reported morbidity and mortality after small bowel emergencies with resections and re-anastomosis and the impact of preoperative, operative and postoperative factors on patients’ outcomes. Patients and Methods: A total of 60 patients who underwent emergent small bowel resection were included in this study. This study was performed using data from patients of both sexes aged above 12 years old who presented with small bowel emergencies that needed emergency resection, which were managed in the General Surgery Department of Aswan University Hospital, during the period from March 2019 until February 2020. Results: There was a statistically significant difference between them regarding age groups, the prevalence of comorbidities and previous abdominal surgeries. We found that associated injuries were associated with the most added risk of morbidity and time of presentation in the multivariate module, followed by hemodynamic instability. The two independent modifiable variables were the hemodynamic instability after initial resuscitation and the choice of simplest shortest appropriate operative option. Conclusion: Regarding morbidity, there was significant effect of age and the presence of comorbidities. These results may aid the acute-care surgeons in identifying patients with a high-risk for postoperative complications and fatal outcomes.

sBasidiobolomycosis is a fungal infection caused by Basidiobolus ranarum which affects the skin and subcutaneous tissue and rarely the gastrointestinal tract. We report seven cases of gastrointestinal basidiobolomycosis with interesting clinical, radiological, and histological presentations. To our knowledge, this is the first case series of abdominal basidiobolomycosis to be reported from Sudan.

Amyloidosis is a group of rare, serious disorders caused by deposition of amyloid protein in tissues, such as the kidney, heart and brain. However, there is no case reported from Sudan. Here, we report one male case of renal amyloidosis, possibly secondary to abdominal tuberculosis (Tb). A male, 30 years of age, complained of systemic body swelling, shortness of breath, and decreased urine output with abnormal color for 2 months. He had been diagnosed with abdominal Tb 10 years prior, for which he received systemic anti-Tb treatment. Clinical examination exhibited anasarca, particularly in the abdomen. Abdominal ultrasound indicated massive ascites, and echocardiography indicated the ejection fraction reduced to 60%. Renal biopsy revealed renal amyloidosis. The patient was treated with ceftriaxone, furosemide, prednisolone, pantoprazole, spironolactone, calcium and mycophenolate mofetil, and his condition improved. The patient was discharged 2 weeks after treatments. Hence, this is the first case of renal amyloidosis, possibly secondary to abdominal Tb, in Sudan. This case report should serve as an alert to physicians working in high-prevalence Tb regions.

Background There is an aging population all over the world, and Saudi Arabia is no exception to it. An aging population poses several challenges to the health-care sector. Aim The aim of this study was to examine the health status and functional abilities of elderly people visiting primary health-care centers in Khamis Mushait, Saudi Arabia. Methods This cross-sectional study involved elderly male Saudi nationals aged 60 years and above. Self-rated health status and body pain, functional status, geriatric review of systems and other relevant data were collected using the Geriatric Health Questionnaire of University of Iowa Health Care. All statistical analyses were performed using SPSS version 21. Results The study results showed that the overall health of the elderly was either good (32.9%) or very good (32.3%), while 14.2% rated their health as excellent. Only two participants rated their health as poor. The majority of the participants (71.9%) had no functional impairment in basic activities of daily living (BADL), while 35.7% had mild impairment in instrumental activities of daily living (IADL). Only two participants were found to have total impairment in IADL. The most common limitation among BADL was walking (21.1%) and among IADL was doing the housework. The notable factors associated with functional impairment in BADL and IADL were old age (≥80 years), poor eyesight, memory impairment, having trouble with control of bladder, falls twice or more, taking more than two medications, being sexually inactive, poor self-rated general health and severe self-rated body pain (all P

Background: Breast cancer (BC) is the leading malignancy among women in Najran, Saudi Arabia. However, not much is known about the public’s awareness of BC. This study explored the general knowledge, early warning signs, risk factors and sources of information about BC. Methods: An online-based, anonymous, self-rating, cross-sectional and survey-based study was conducted from March-2019 to April-2019. Three-hundred female students and/or faculty from College of Medicine, Najran University (Najran, Saudi Arabia) participated in the study. Results: A total of 232 students (77.3%) and 68 faculty (22.7%) responded to the survey. Our study showed that nulliparity (83.8%) and early menarche before 12 years of age (29.7%) were the most pertinent obstetric risk factors of BC. Conversely, lack of physical activity (66.3%) and family history of BC (18%) were the most substantial non-obstetric risk factors of BC. According to pre-defined criteria, while the surveyed research subjects demonstrated ‘good’ general knowledge about BC (75.3%), they unfavorably exhibited ‘poor’ knowledge about the warning signs of BC (94.3%). The predictors of ‘good’ overall knowledge (general knowledge plus signs knowledge about BC) included age, marital status, educational level and family history (all p

Background: Breast diseases cover several conditions. The majority of breast diseases are noncancerous. Some of these lesions are clinically unremarkable, which needed minimal intervention. However, some symptoms may be of clinical value and attract the attention of both the patient and the attending physician, especially when they become persistent. The study aimed to assess the prevalence, pattern, types, and clinical profile of breast diseases among females in the South-western region, during the period from 2018-2020. Methods: A retrospective record-based descriptive approach was used through reviewing medical records of all cases with breast disease attended King Khalid Hospital during the period from January 2018 to January 2020. Data extracted throng pre-structured questionnaire. Results: The study included 211 cases whose ages ranged from 18 to 58 years old with a mean age of 28.9 ± 12.8 years. Breast mass was the most recorded complaint (95.1%) followed with breast pain (32%), skin changes. Benign findings based on the final pathology report were recorded for more than two thirds of the cases, with the most common finding were fibroadenoma. Excisional biopsy and modified radical mastectomy were the most reported surgical interventions. Conclusions: In conclusion, the study revealed that the majority of the cases had benign breast disease (BBD), where fibroadenoma was the most frequent.

Background Wrist pain is a challenge, and imaging plays an important role in the evaluation of wrist pain. Purpose Assessment of the role of ultrasonography (USG) versus magnetic resonance imaging (MRI) in the diagnosis and evaluation of wrist pain Results Out of 50 patients, 35 males (70%) and 15 females (30%) (age range 12–62 years; mean = 31.7 years) were included in the study. The sensitivity, specificity, and accuracy of MRI and USG for tendinopathy were 95%, 100%, and 97.5% and 95%, 100%, and 97.5% respectively. The sensitivity, specificity, and accuracy of MRI and USG for TFCC tear were 75%, 100%, and 87.5% and 0%, 50%, and 50% respectively. The sensitivity, specificity, and accuracy of MRI and USG for simple ganglion were 100%, 100%, and 100% and 75%, 100%, and 87.5% respectively. The sensitivity, specificity, and accuracy of MRI and USG for solid mass were 100%, 100%, and 100% and 100%, 100%, and 100% respectively. The sensitivity, specificity, and accuracy of MRI and USG for foreign body were 50%, 100%, and 75% and 100%, 100%, and 100% respectively. The sensitivity, specificity, and accuracy of MRI and USG for carpal tunnel syndrome (CTS) were 77.8%, 100%, and 88.9% and 88.9%, 100%, and 94.4% respectively. Overall sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of USG Vs MRI were 79.2%, 96.1%, 95.0%, 83.3%, and 88.0% and 89.8%, 98.0%, 97.8%, 90.9%, and 94.0% respectively. Conclusion USG is near equal to MRI in the assessment of tendon abnormalities and better than MRI in the diagnosis of CTS and foreign body, but MRI is better than USG in the assessment of TFCC and in the assessment of swelling (simple ganglion) and characterization of masses.

Background: Genetic blood disorders are common in Arab countries which are related to many physical and mental disorders. Premarital counseling has been one of the strongest ways to prevent hereditary diseases. It can provide a capability to intervene according to identified risks, vaccinations, genetic consulting, nutrition, consulting regarding behavior and advice regarding contraception. This study aimed to assess university students' knowledge, attitude and practice of pre-marital counseling (PMC) in king Khalid University. Methodology: A cross-sectional study was conducted at King Khalid University in Abha city from May to August 2018. The students were selected using two stage stratified cluster sampling technique (medical and non-medical). A total sample of 541 students were included. A structured questionnaire with close-ended questions was designed by the authors following an extensive review of the literature on knowledge, practice, and attitude of premarital screening program. The questionnaire was developed in English and then translated to Arabic by experts at the College of Medicine. Results: A total sample of 541students were involved with ages ranged from 18 years to 27 years old and 56.6% at medical colleges. Exact 73.4% of the students were aware of PMC and 95.2% reported its importance. 96.5% of the students reported their welling to do PMC on marriage and 72.1% see that it should be mandatory. Conclusions: Nearly three out of each four students had good awareness level regarding PMC. Most of the students have a positive attitude towards PMS and their readiness to adopt the counseling before marriage.

The objective of present work was to study the effects of some drugs misused by Sudanese women as body weight gain treatments on complete blood count concentration (CBC) of female rabbits. Sixteen sexually mature female rabbits were procured from local markets of Elnuhod locality, West Kordofan state. A randomized complete block design with three replicates was used; treatments consisted of two drugs i.e. dexamethasone, cyperoheptadine and their combination administered orally with doses of 0.9 mg/kg of body weight with drugs two times a day for 45 days. Experimental animals were divided into four groups each group with four rabbits. First group as a control, while three groups were injected orally with the above mentioned treatments, blood parameters were measured every two weeks for 45 days, the variance was analyzed, then means were compared by least significant difference (LSD) test. The results showed that the levels of hemoglobin were ranged between 11.15g/dl and 12.53 g/dl. Cyperoheptadine and the combination decreased white blood cells with time, lowest value were reported by the combination (3.28). RBC count increased with time, cyperoheptadine recorded 7.23. Packed cell volume was increased with time up to the end of the experiment period. Mean cell volume increased to reach the highest value at 45 days (78.80mm3) by both cyperoheptadine and the combination followed by dexamethasone (78.43mm3), which were statistically the same. By the end of the trial, no significant differences were found between the drugs in their effect on the mean cell hemoglobin. Neutrophils decreased with time reached the lowest values of 38.90, 39.53 and 43.05 % for the combination, dexamethasone and cyperoheptadine, respectively. Dexamethasone showed the lowest lymphocyte (33.40 %) as compared with other treatments, as concluded remarks various trends found concerning the relationships between blood parameters influenced by treatments and their normal ranges.

Objectives: To investigate the frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus (T2DM). Methods : A cross-sectional study was conducted on a sample of 355 patients with T2DM, using multistage cluster sampling, attending the Najran University Hospital and Primary health care centres in Najran, Saudi Arabia, from January to May 2019. The assessment of self-care behaviors was conducted using the 16-item diabetes self-management questionnaire (DSMQ). Results: The majority (85.1%) of the patients with T2DM were uncontrolled, 42% were obese, and 5.9% were morbidly obese. Based on DSMQ criteria, the majority of patients (90.1%) had poor self-care behaviors. The mean sum of DSMQ was 5.04 out of 10. Among the DSMQ subscales, health care use had the highest mean score of 5.63, followed by glucose management with a score of 5.12, while dietary control had lower mean scores of 4.96 and physical activity had 4.46, all were inadequate. Being married (OR=2.178, p =0.035) and having DM for more than 5 years (OR=2.711, p less than 0.006) were the significant independent factors associated with poor self-care behavior. Conclusion : Inadequate self-care behavior is widely prevalent in Najran city, Saudi Arabia. All the DSMQ subscales were poorly managed by most of the diabetic patients. Furthermore, being married and having a longer DM duration are the significant independent factors associated with poor self-care behaviors. Saudi Med J 2020; Vol. 41 (9): 955-964 doi: 10.15537/smj.2020.9.25339 How to cite this article: Al-Qahtani AM. Frequency and factors associated with inadequate self-care behaviors in patients with type 2 diabetes mellitus in Najran, Saudi Arabia. Based on diabetes self-management questionnaire. Saudi Med J. 2020 Sep;41(9):955-964. doi: 10.15537/smj.2020.9.25339

Background Childhood cancer is a highly curable disease when timely diagnosis and appropriate therapy are provided. A negative impact of the coronavirus disease 2019 (COVID‐19) pandemic on access to care for children with cancer is likely but has not been evaluated. METHODS A 34‐item survey focusing on barriers to pediatric oncology management during the COVID‐19 pandemic was distributed to heads of pediatric oncology units within the Pediatric Oncology East and Mediterranean (POEM) collaborative group, from the Middle East, North Africa, and West Asia. Responses were collected on April 11 through 22, 2020. Corresponding rates of proven COVID‐19 cases and deaths were retrieved from the World Health Organization database. Results In total, 34 centers from 19 countries participated. Almost all centers applied guidelines to optimize resource utilization and safety, including delaying off‐treatment visits, rotating and reducing staff, and implementing social distancing, hand hygiene measures, and personal protective equipment use. Essential treatments, including chemotherapy, surgery, and radiation therapy, were delayed in 29% to 44% of centers, and 24% of centers restricted acceptance of new patients. Clinical care delivery was reported as negatively affected in 28% of centers. Greater than 70% of centers reported shortages in blood products, and 47% to 62% reported interruptions in surgery and radiation as well as medication shortages. However, bed availability was affected in, The response to the coronavirus disease 2019 (COVID‐19) pandemic has led to significant alterations in access to care for children with cancer. Interventions are needed to mitigate the effects on life‐threatening diseases requiring immediate and uninterrupted therapy, such as childhood cancer.

Background Knowing customers’ level of satisfaction is relevant to improve and provide quality health care services. In the clinical laboratory, monitoring customers’ satisfaction is an important indicator of the quality management system and required by international laboratory standards. However, in Ethiopia, there has not been baseline data about the satisfaction level of patients’ with laboratory services at the national level. The aim of this national level survey was to assess patients’ satisfaction level with laboratory services at public hospitals in Ethiopia. Methods A national survey was conducted using an institutional based cross-sectional study design was employed from 01 to 30 November 2017. A total of 2399 patients were selected randomly from 60 public hospitals. Data was collected using structured questionnaire, entered in Epi Info and analyzed with SPSS software. Multiple logistic regression model was fitted to identify predictors of patients’ satisfaction with laboratory services. A p-value of less than 0.05 was taken as statistically significant. Result Overall, 78.6% of the patients were satisfied with the clinical laboratory services. Patients were dissatisfied with cleanness of latrine (47%), long waiting time (30%), clear and understandable advisory service during specimen collection (26%), adequacy of waiting area (25%), easy accessibility of laboratory (19%) and latrine location (20%), availability of requested service (18%), unfair payment of service (17%) and missing of result (12%). The educational status (P = 0.032), and distance (P = 0.000) were significantly associated with client overall satisfaction level. Conclusion Most laboratory patients’ were satisfied with the service provided by public hospital laboratories in public hospitals in Ethiopia. However, patients’ were dissatisfied with the accessibility of sites, adequacy of waiting area, cleanness of latrine, long TAT, communication, missing of results, availability of requested service and cost of service. Therefore, responsible bodies in each level should act on the identified gaps and improve the need of patients in each hospital laboratory. In addition, all hospital laboratories should conduct a satisfaction survey and meet the needs of laboratory patients.

Background: Vitamin D deficiency is widespread and coexisted with diabetes. However, the relation between Vitamin D level and glycemic control is not yet fully understood. This study examines the correlation between vitamin D level and glycemia indicators and diabetic microvascular complications.Methods: The study is a cross-sectional study, had been done at the outpatient department in Najran university hospital, Saudi Arabia from May 2019 to February 2020. 220 patients recruited by simple random sampling.Results: 60% of diabetes (n-130) had been using oral anti-glycemic medications, though most of them had uncontrolled glycemic status and had got microvascular complications. It is notable that among diabetes having a low vitamin D level; 55.5% had high FBS, 45.6% had high RBS and 65% had high HBA1C. Besides,17% have retinopathy, 16.6% have nephropathy, 26.2% have peripheral neuropathy and 1.9% have a diabetic foot.Conclusion: The clinical and laboratory assessments are essential to control the glycemic state in diabetes. The study noted that an inverse relationship between the level of vitamin D with blood sugar levels and diabetic microvascular complications. To assure the feasibility of the prediction of vitamin D level in assessing the progress of diabetes further studies are needed.

Background The COVID-19 pandemic contributed to a significant mental health crisis and caused a widening economic crisis, growing financial loss, and numerous uncertainties. This pandemic brought alarming implications and overall increased risk for psychiatric illness. This study explores the psychological impact experienced by patients who tested positive from coronavirus in the Najran region, Saudi Arabia. Design and methods This exploratory analysis included 210 COVID-19 positive patients. The study was conducted during a six-month period starting from March to September 2020, in two tertiary government hospitals in Najran, Saudi Arabia. Samples were selected using purposive sampling; survey questionnaire and face-to-face interview to collect the data. Statistical data were calculated using IBM SPSS v. 2.0 to compute the following statistical formulas: percentage distribution, mean, standard deviation, and Chi-square test of independence. Results The findings of this study revealed that the majority of COVID-19 positive patients were middle-aged adults (n=98 or 46.7%), male (n=178 or 84.8%), and were non-Saudi nationals (n=132 or 62.9%). It was found out that COVID-19 patients experienced bothersome behaviour at a very high level ([Formula: see text]=2.63±0.6734). Meanwhile, depression ([Formula: see text]=2.51±0.7070), worry ([Formula: see text]=2.23±0.8811), and anxiety ([Formula: see text]=2.21±0.8719) was only at a high level. Conclusions The study revealed that the majority of participants had high levels of depression, anxiety and bothersome behaviours. However, demographic characteristics like age, sex, and nationality were not significantly related to coronavirus patients’ psychological health problems. Assessments and interventions for psychosocial concerns, integration of mental health considerations, and treatment for severe psychosocial consequences must be administered in COVID-19 care facilities.

Hypertension is a typical example of long-term condition posing formidable challenges to health care. Among hypertensive patients, insufficient adherence to drug therapy is one of the common causes of poor control of blood pressure. The objective of our study was to estimate the prevalence of blood pressure control among hypertensive patients and their determinants in primary care centers in Najran area. We conducted a retrospective analysis of administrative data from adult patients with hypertension followed in primary care clinics in Najran area. A representative sample of patients was randomly selected among eligible hypertensive patients from primary care clinics in Najran area. A total of 382 patients completed the survey and had data available for a 1 year medical record review. Their mean age was 62.71±14.16 years, 51.8% were male. The majority of the studied populations were married (96.6%). More than 50% of them were analphabetic (56.2%). The prevalence of patients with controlled blood pressure was 51.3% among the studied population despite ongoing hypertension treatments. Older age more than 60 years was a significant predictor of non-controlled hypertension. We conclude that targeted intervention to improve management of hypertension in primary care setting could make a substantial difference in the improvement of hypertensive patient prognosis.

Objective: To investigate lifestyle and dietary habits associated with development of obesity among male primary school children in Al-Madinah City, Saudi Arabia.Methods: A cross sectional study was conducted in Al-Madinah City that included 201 male primary school students aged above 8 years. The researcher used a study questionnaire that comprised socio-demographic variables and the HABITS questionnaire. Anthropometric measurements were also re-corded to calculate the Body Mass Index (BMI).Results: The mean age of participants (SD) was 11.22 (±1.1) years. Prevalence of obesity among participants was 19.4%, 59.7% of male primary schoolchildren ate three meals daily. Only 16.9% ate fruits daily, 17.9% ate vegetables daily, while 88.1% ate snacks between meals and 20.4% consumed soft and energy drinks once daily, while 10.4% consumed soft and energy drinks twice or several times daily. One third of male primary schoolchildren watched TV for 3 hours or more, while during weekends, 66.2% watched TV for 3 hours or more. Regarding outdoor activity, 29.9% practiced it once a day, while 18.9% practiced it more than once a day.Consumption of soft and energy drinks was significantly higher among obese participants than non-obese ones (p= 0.035), and outdoor activity was significantly higher among non-obese participants than obese ones (p=0.027).Conclusions: Bad nutritional habits are common among male primary schoolchildren. Prevalence of obesity among male primary school children is high and increases with their age. Consumption of soft and energy drinks and lack of physical activity are associated with obesity among children. Therefore, there is a pressing need for the development of effective obesity prevention programs for schoolchildren.

Traffic accidents constitute the substantial cause of disability and mortality in the young Saudi individuals reaching horrible figures. The aim of this study was to review and identify the pattern of injury among road traffic accident (RTA) victims as well as the peak time of accidents and their implications. This retrospective hospital-based cross-sectional study was carried out in the period between April 2016 to March 2017 in King Khalid Hospital, Maternity and Children Hospital and Najran General Hospital, Najran, Saudi Arabia. All RTA victims admitted to the emergency departments of the pre-mentioned hospitals. Data collected from 435 Saudis and non-Saudis’ files were statistically analyzed with regard to age, gender, the timing of road traffic accidents, injury pattern, and neurological deficits incidence. Most of the RTAs’ cases (92%) were male victims with the highest peak in the age group 20 - 29 years. 58% of the RTAs happened in the evening (6:00 PM-9:00 PM) while 20% occurred in the morning. Head injury represented the most frequent pattern (36%) followed by the spinal injury (23%), lower limb injury (23%), upper limb injury (20%), thoracic injury (17%), pelvic injury and abdominal injury (8%). 4.4% of RTAs resulted in death whilst 9% of cases experienced neurological deficits. In conclusion, young male drivers in Najran recorded the highest frequency of RTAs. Initiation of road safety education and expansion of speed detectors (Saher) system deployment is highly recommended.

The essence of this topic is the conversation about (The Verses of Bahrain) mentioned in the Book of God Almighty, as these verses are mentioned five times in the Qur’an. The honorable one, and that is why this research was the subject of five investigations. The researcher spoke in those investigations about the verses in which the word (Bahrain) came in Deuteronomy, The researcher dealt with the many benefits and blessings of these seas, as their fresh and salty waters have many benefits, and countless and countless goodies, and there is the great divine wisdom in the isthmus and the interdicted stone, which was mentioned in those verses, and the differences of scholars in the past and present in that barrier, and how modern science has interpreted that. In the course of the research, the researcher mentioned the living creatures that live inside these seas, as well as extracting pearls and coral from the depths of these vast oceans, and seeing the large ships that pierce the water in an enormous way back and forth, all with the power of God Almighty. As for the method and nature of the study, it is represented in the inductive analytical method, by collecting the verses in question, explaining and interpreting them according to the pleasure of the Almighty God from ancient and modern sources, and this method is what researchers follow in such research. The most important results of this research can be summarized as follows: The seas have a great variety of importance and that is why they took a good space from the Holy Book. And that the Signs of the Sea include a scientific miracle that modern science recently discovered. That the Prophet, may God’s prayers and peace be upon him, did not explain such verses, because the time has not yet come for them. That such verses clearly indicate the greatness and enormous power of God.

Depression is a major health burden associated with poor quality of life and impaired functioning. Depression is a leading cause of disability worldwide and is associated with profound economic costs. Depression is usually treated with antidepressant medications and psychological therapy or combination of both. However, there are lot of limitations associated with these therapies and as a result, a number of alternative or adjunctive therapies have been sought for. Exercise is one such option with a lot of substantial supportive research. The objective of the article was to review the beneficial effects of exercise in depression. An electronic search of literature from inception till 06/2017 highlighting the effects of exercise on depression and the possible mechanistic pathways involved was conducted using PubMed/ Medline, Google scholar and Scopus and relevant articles were utilized for this review. The results of this review confirmed the beneficial role of exercise in depression as evidenced by the improvement in the outcomes and the various psychobiological parameters measured. Thus exercise can be considered as a treatment option for the management of depression.Keywords: Depression, Exercise, Physical activity, Mechanistic pathways, BDNF

Background: The need to collect serial sputum specimens over multiple patient visits for pulmonary tuberculosis results in a protected diagnostic process with rates of patients with high rates of patient dropout. Recent studies on Spot Morning Spot (SMS) method of examination PTB reported that the first two specimens have high smear positivity in line with this WHO changed its policy to minimize the number of sputum specimens from three to two. Methods and Materials: Across-sectional study was conducted in 16 conveniently selected private clinics, governmental health centers, public and private hospitals from September 2017-December 2018. Individuals attending the selected health institutions for the diagnosis of MTB submitted three sputum samples for routine diagnosis (the standard approach). One additional sample was collected 1 h after the first sputum (the same-day approach). One sputum sample was cultured. The diagnosis was performed using ZN sputum smear microscopy and Light-Emitting Diodes Fluorescent Microscopy (LED-FM) technique. Data were entered and analyzed using SPSS version 16. We used sensitivity, specificity and predictive values for the different methods. Result: A total of 209 participants enrolled, 43 (21%) were identified culture positive, 39 (18.7%) were detected by the same day approach and 40 (19.1%) by the standard approach. On the other hand, LED-FM and ZN microscopy detected 39 (18.1%) and 48 (23%) tuberculosis cases respectively. Sensitivity was 88.4% for ZN microscopy and 95.3% for LED-FM and the specificity was 99.4% and 95.9% for ZN and LED-FM microscopy respectively. Conclusion: Using the same day approach together with LED-FM would reduce workload, TAT, patient drop out and increase the smear detection rate. Therefore it is necessary to give in-service and off service training for health personnel towards the use of LED-FM, conventional approach and the same day approach in the diagnosis of TB.

Treatment of severe malaria with artemisinin derivatives in patients with comorbid conditions such as sickle cell anemia must be considered with precaution. We report here a case of possibly undocumented ventricular arrhythmia in a sickle cell anemia patient diagnosed with Plasmodium falciparum malaria and treated with intravenous artesunate. The patient suffered from wide complex tachycardia after treatment with artesunate 170 mg (2.4 mg/kg) i.v. bolus, tachycardia was managed with amiodarone (150 mg i.v. for 10 minutes). Electrocardiographic abnormalities, including QT prolongation, are common in patients with sickle cell anemia. The mortality rate in sickle cell anemia patients due to cardiovascular and pulmonary complications remains high. The probability of precipitation of ventricular arrhythmias may increase in patients with sickle cell anemia, diagnosed with malaria and treated with artemisinin derivatives.

Introduction. Obesity is becoming the most common health problem of the 21st century, as it will contribute significantly to the high prevalence of cardiovascular disease in developing countries. The main objective of our study was to estimate the prevalence of obesity and overweight among adults attending primary health care settings, southwestern region of the Kingdom of Saudi Arabia. Methods. The studied population was composed of adults visiting primary health care centres in the southwestern region of Saudi Arabia. A cross-sectional study was carried out on a representative sample of 1681 adult patients. Obesity and overweight were defined according to the WHO standards. Statistical analysis was conducted using the statistical package SPSS 17.0. Logistic regression analysis was used to identify independent predictors of obesity and overweight in the studied population. Results. Data on body mass index (BMI) measurement was recorded for 1649 out of 1681 participants (98.1%). The overall mean weight was 74.1 ± 15.81 kg; and that for men was 77.69 ± 16.14 kg vs. 69.37 ± 14.02 kg for women with significant statistical difference of p < 0.001. The overall prevalence of overweight and obesity was, respectively, 38.3% and 27.6%. Smoking was not significantly associated with obesity, whereas hypertension was significantly associated with obesity. The risk of overweight or obesity significantly increased from the highest to the lowest monthly income; it passed from 1.67 CI 95% = [1.24-2.25] within the category 5000-7000 SAR to 2.23 CI 95% = [1.71-2.90] within the category less than 5000 SAR. Conclusion. Our study showed high prevalence of overweight and obesity which should be considered as a public health concern to be followed by specific interventions at the community level with multidisciplinary activities starting from childhood as a primordial prevention program.

Deficiency of the 5-α-reductase enzyme has been found to affect male sexual development. We report an 18-year-old patient who was referred to an endocrinology clinic in Jizan, Saudi Arabia, in April 2014 with primary amenorrhoea, virilisation and a lack of secondary sex characteristics. As female external genitalia were present at birth, she had been raised as a female. Magnetic resonance imaging revealed no uterine or ovarian tissue in the pelvis and the presence of a scrotal sac. She was diagnosed with 5-α-reductase type 2 deficiency, a 46,XY disorder of sexual development. Typically, affected males have pseudovaginal perineoscrotal hypospadias and ambiguous genitalia at birth. Individuals who have been raised as female manifest characteristics of virilisation at puberty, including deepening of the vocal tone, phallus enlargement, scrotal hyperpigmentation and increased muscle mass.

Background: Maternal near miss is one of the related concepts to maternal mortality where women survive merely by chance, luck, or by good hospital care. The present study was aimed to fill the prevailing knowledge gap on maternal near miss ratio and events and identify factors associated with near miss in selected health facilities of berak woreda. To determine associated factors of maternal near miss in selected health facilities of Berak woreda, Oromia national regional state, Ethiopia. Methods: Institutional based case control study was conducted in selected health facilities of barek woreda to asses determinant factors of maternal near miss among delivered women. Data of 1272 (344 cases and 928 controls) women were included in the analysis registered from 11 September 2014 to 30 March 2018. Cases were women due to severe acute maternal morbidity while controls were women for normal labor. Simple random sampling technique was used in the delivery unit. The data were collected using WHO standard tool. Data were entered using epi data version 3.1 and exported to SPSSV.20 for data analysis. Results: Majority of cases were due to obstructed labor 270 (78.8%) followed by hemorrhage 33 (9.6%), preeclampsia 29 (8.14%), abortion 6 (1.74%), anemia 3 (0.87%), congenital heart disease 2 (0.58%) and gestational infection 1 (0.29%).Conclusions: Independent variables residence, duration of labor, ANC utilization, past obstetrics complication and number of live births were statistically significant with the outcome variable near miss. Maternal health policy needs to be concerned preventing major cause of near miss.

Background Respiratory tract infection is one of the most important infectious diseases worldwide, and it is the leading cause of morbidity and mortality in critically ill patients, especially in developing countries, and is usually contracted through air and by direct contact. Currently, antibiotic resistance among respiratory pathogens has seen a dramatic rise. In Ethiopia, there is limited information concerning lower respiratory tract infections (LRTI) burden and antimicrobial resistance pattern. Thus, the aim of this study was to assess bacteriological-confirmed burden, profile, and antibiotic susceptibility pattern of bacteria that leads LRTI. Patients and methods An institution-based cross-sectional study was performed in selected health centers of Kolfe Keraniyo Subcity, Addis Ababa, Ethiopia, from May to July, 2018, on 240 patients. Sputum samples were collected using convenient sampling technique and inoculated onto MacConkey, chocolate, and blood agar. In addition, biochemical and antimicrobial susceptibility testing was done. Data were entered and analyzed using Statistical Package for Social Sciences (SPSS), version 20. P values less than 0.05 were considered statistically significant. Results Of 240 samples processed, 77 (32.1%) showed growth of various species of bacteria. Among those, Klebsiella pneumoniae [32 (39.5%)] was a frequently isolated organism, followed by Streptococcus pneumoniae [15 (18.5%)], and Escherichia coli [13 (16%)]. Gram-negative bacilli were highly sensitive to meropenem (98%), tobramycin (94%), amikacin (94%), ceftazidime (84%), and cefuroxime (76%) and resistant to ampicillin (83%), tetracycline (52%), ciprofloxacin (35%), and trimethoprim-sulfamethoxazole (33%). Conclusion K. pneumoniae and S. pneumoniae are the most predominant pathogens that contribute to LRTI. In addition, most isolates showed a high level of antibiotic resistance. Therefore, culture and susceptibility tests have paramount importance for better management of LRTI and drug-resistant infections.

The objective of the present work was to study the effects of some drugs misused by Sudanese women as body weight gain drugs on some fertility hormones concentration of female rabbits. Sixteen female rabbits were procured from local markets of Elnuhod localality, West Kordofan state. A randomized complete block design with three replicates was used; the treatments consisted of two drugs i.e., dexamethasone, cyperoheptadine and their combination administered orally with doses of 0.9 mg/kg of body weight with drugs two times a day for 45 days. Follicle stimulating hormone, luteinizing hormone, and prolactin were measured. The results showed that the medication used affects the levels of fertility hormones. The results showed that the level of FSH due to drugs decreased with time and the lowest level of the hormone was shown by the combination and dexamethasone and the values were (2.32 and 2.51 IU/L, respectively), while cyperoheptadine recorded a level of (2.75 IU/L) as highest value with significant differences as compared to other two treatments. The results showed that prolactin hormone increased with time by all drugs used and their combinations at the end of the experiment period, and there was no significant difference between the drugs in their effect on hormone level, physician and pharmacist should be consultant before using these drugs to avoid the adverse effects is needed as recommended point of view, effects of drugs on serum total cholesterol, triglyceride, high-density lipo-protein, low density lipo- protein and very low density lipo- protein are also recommended for future work.

Available data suggests that calcitriol has a role in controlling pulmonary inflammation by inducing the production of natural broad-spectrum antimicrobial peptides, the so-called cathelicidin. Randomized clinical studies reported that vitamin D supplements in a daily-wise manner caused a significant risk reduction in acute respiratory tract viral infections and participants who were given vitamin D supplementations were half less infected with flu than those who were not given the vitamin. Hence, vitamin D3 supplementation may be advantageous when compared with flu vaccine especially when we put in consideration morbidities and complications caused by this vaccine as well as the conditions in which influenza vaccine may be contraindicated like in patients who receive cancer immunotherapies targeting the programmed death-ligand 1 (PD-L1) or its receptor, programmed cell death protein 1 (PD-1).

Background: Breast cancer (BC) remains one of the leading causes of death in women worldwide. The BRCA1 deleterious mutation has a significant role in developing BC, and the risk has been estimated to be 46–87%. Many studies emphasize the need for mining BRCA1 gene mutations that might have a role in BC pathogenesis and could affect early disease onset. This study was conducted to screen for possible pathogenic single nucleotide polymorphisms (SNPs) in BRCA1, targeting three regions: two in exon 11 and the third in exon 20. Methods: 45 blood samples were collected from patients diagnosed with BC. DNA was extracted and selected regions were amplified by PCR using three sets of primers - two within exon 11 and one within exon 20 of BRCA1. Subsets of 10 samples were selected for each primer set (30 PCR products) and sequenced. Sequences were analyzed using various bioinformatics tools. Results: Two missense variations were found, Q356R (rs1799950) in one patient (27 years old) and a novel SNP, V1736D, in three premenopausal patients (≤45 years), which were located within exons 11 and 20, respectively. Both detected variants were heterozygous, a status found in all patients detected with such monoallelic variation. Both missense variants underwent in silico analysis. The well-known variation, rs1799950, was predicted to alter the protein activity, conferred by a mutant residue (R-Arg), owing to the position with a bigger size and positive charge. The novel SNP, V1736D, was predicted to play a role in the pathogenesis of BC. Conclusion: Both variants require further investigation, firstly to assess their contribution to BC and secondly to determine their potential diagnostic value when assessed in a larger population.

Background: This cross-sectional hospital based study aimed at determining the level of knowledge, attitude and practice of diabetes among local people of Najran, Saudi Arabia.Methods: We aimed to investigate the levels of knowledge, attitude and practice among diabetic people in Najran area.Results: 10% of the participants scored >7, 28% scored >5 and 62% scored 5 and less in Knowledge questionnaire. None [0.00%] of the participants scored 7 or more out of the attitude questionnaire. 100% of the participants scored 5 and less out of 12. 100% of the participants scored >6 and 0% scored 12 or more in the practice questionnaire.Conclusions: Our study revealed that the level of knowledge, attitude and practice of diabetes in the area of Najran is very poor. We suggest that a structured educational program to be adopted by the health authorities in Saudi Arabia.

Background: Childhood obesity is currently a major health problem in many countries of the world. Aims & Objective: This study aimed to determine the prevalence of obesity and describe the risk factors among primary school male children in Al-Madinah Al- Munawarah, Saudi Arabia. It is our intension that these data can be useful in planning appropriate intervention programs targeting school children. Material and Methods: This is a cross sectional descriptive study included 197 primary-school children aged 9 to 14 years living in Al-Madinah Al- Munawarah city. A structured questionnaire was constructed to collect information from the subjects. After an interview and a review of clinical examination records, height and weight were measured. Results: In this study, 49 (24.9%) of 197 children were obese and 30 (15.2%) were overweight. Food consuming behaviors were strongly associated with childhood obesity in the variables “eating too much” (p = 0.001), “arguing if say enough or stop eating” (p< 0.001), “demanding food while still eating (p = 0.001) and “demanding food between meals” (p = 0.021). Personality behavioral variables were strongly associated with childhood obesity in the variables “complaint being overweight” (p< 0.001), “complaint being unattractive” (p < 0.001), “complaint being not fitting in clothes” (p< 0.001), “complaint being teased” (p = 0.009). Conclusion: The prevalence of overweight and obesity among primary school children in Al-Madinah Al- Munawarah is high. Multiple strategies and interventions are warranted to prevent overweight and obesity related risk behavior in school-aged children.