Vol 3 Issue 2 October 2015-March 2016

Abstract: Euthanasia is the process of withholding medical treatment by a qualified health care provider. There are ranges of attitudes both for and against passive euthanasia, which have been controversial for many years. Euthanasia is the termination of a person with their consent to withhold medical care. Some raise a moral question about euthanasia. Passive euthanasia done with the patients’ consent avoids wasting treatment and resources and reserving them for people expected to benefit from them. The controversial point is that holding back treatment of a patient, knowing that the person will die no matter what you do is morally equivalent to administering a lethal injection. Both end in death of the patient. In the case of passive euthanasia, the provider takes an informed decision of not treating beings the best solution. Keywords: euthanasia, passive, lethal, ethics, morals, believes. Title: Ethical Issue: Passive Euthanasia Author: Carmen Sigley International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Brucellosis is an infectious disease, frequently encountered in some areas of our country. It may involve multiple organ system of human body. However, spondylitis, diskitis, paravertebral and epidural abscesses are rare complications of brucellosis in children, it is more prevalent in adult patients with prolonged illness prior to treatment. Case report: A Four year old boy presented with a history of prolonged fever, lower back pain and inability to walk. He was previously hospitalized for brucellosis after a history of animal contact one year back which had been treated with rifampin and co-trimoxazole for six weeks with good outcome. At this hospital presentation, the magnetic resonance imaging ( MRI) showed destructive lesion over L5-S1 with paravertebral abscess formation. Both blood culture and paravertebral pus collection were culture positive for Brucella. The patient was successfully treated by surgical drainage and combination antibiotic therapy which comprised gentamicin rifampicin and co-trimoxazole. Conclusion: Brucella spinal infection is a rare complication in children. A high index of suspicion is required with confirmation of the pathology by use of MRI and aspiration of abscess contents. Paravertebral abscess draining plus the administration of gentamicin, rifampicin and co-trimoxazole resulted in an excellent therapeutic outcome in our patient. Keywords: spinal abscess, Brucellosis. Title: Spinal Abscess: A Rare Complication of Brucellosis in Children Author: Ashwaq Altawil, Roaa Zailiae, Mohammed Alshehri, Abdulsalam Alawfi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The Ponseti technique is a well-known and technically easy way of managing paediatric clubfoot deformity with fantastic results. It doesn’t have foot stiffness and persistent pain which are common with surgical management. PATIENTS AND METHODS In our study we performed Ponseti casting on 34 CTEV patients and 2 lost in follow up and 4 are failures. Patients are followed up prospectively for 6months and correction of deformity compared with Pirani scoring. RESULTS The mean age at initiation of treatment for 32 patients (37 feet) was 192 days (range 4 days to 2 years). The mean initial Pirani severity score for 37 feet was 4.30 (out of maximum possible score of six). After full correction by Ponseti technique (with or without percutaneous tenotomy) the final mean score was found to be 0.17 and the mean change in score was found to be 4.13. This was analysed by the paired t- test and the p value was< 0.005 which is significant. CONCLUSIONS Early treatment of Idiopathic CTEV by Ponseti technique results in good correction of the deformity with minimal need for surgery and percutaneous tenotomy of tendo Achilles is required in considerable number of cases to achieve good correction. Parent compliance plays an important role in maintenance of the deformity correction and it is definitely an effective and affordable technique. Keywords: Clubfoot-Foot deformities -Ponseti technique-Results. Title: OUR EXPERIENCE WITH PONSETI TECHNIQUE IN IDIOPATHIC VIRGIN CLUBFOOT OF CHILDREN BELOW 2 YEARS OF AGE Author: Dr. Danduru Vasudeva Reddy International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: To quantify problem of DM-II, determine 10 years risk of DM-II occurrence (CANRISK) and to identify risk factors associated with it. Materials and Methods: A cross sectional community-based study was carried-out among peri-menopausal females in Bini-Hassan and Nazlet- Ebeed villages of El Minia district. A self-administered structured questionnaire was used, included socio-demographic data, family, gynecological and obstetric history. CANRISK, blood sugar, Body mass index and waist hip ratio were measured. Results: About one fourth of participants (25.4%) were diabetics by the blood sugar evaluation. Also, near half of participants had moderate risk of diabetes (46.8%) as evaluated by (CANRISK). A significant relation between blood sugar and special habits, anthropometric measurements and reproductive factors. Most important predictors of DM among participants were lack of physical activity, overweight and obesity. Conclusion: Sedentary life style, obesity, early menarche and early menopause were all factors contributing to diabetes occurrence. We need locally adapted diabetes screening risk questionnaire to be applied to female taking into account female reproductive factors. Keywords: Type II diabetes, Risk factors, Peri-menopausal females, El-Minia district. Title: Quantifying Diabetes Risk and Identifying Contributing Factors among Middle Aged Females in Minia District, Egypt Author: Eman M. Mahfouz, Nashwa N. Kamal, Eman S. Mohammed International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: A breast tumor examination can help to detect the tumor in the early stages, which is meaningful for the cure. The medical image examination in digital mammography is the most effective method of the breast cancer detection. Computer-aided diagnosis (CAD) on breast tumor detection will provide a confirmation for the radiologists in detecting the suspicious regions in images and also improve accuracy and efficiency. This paper builds on prior work looking at neo adjuvant response to query whether baseline pharmacokinetic (PK) imaging heterogeneity can be used to predict prognosis. The Entire process is carried out in two phases: Segmentation and Classification of the breast tumor. In segmentation process, the tumor pixels are partitioned into groups that act similarly based on PK heterogeneity measures. Wavelet kinetic features are then extracted within each partitioned sub region to obtain the spatiotemporal patterns of the wavelet coefficients and contrast agent uptake. We extract localized spatiotemporal features within the obtained tumor pixel partitions, based on specific heterogeneity properties. During Classification Process, The features of the tumor are extracted, and input into ELM, as well as the judgment of radiologists which acts as the standard indicative of the classification, then the training of ELM is finished. Keywords: Breast cancer recurrence prediction, breast dynamic contrast-enhanced magnetic resonance imaging (DCEMRI), feature extraction, gene expression, partitioning, ELM. Title: A Novel Framework for Breast Tumor Segmentation and Classification Using Extreme Machine Learning Author: A. Sahaya Archana, A. Anuja merlyn International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: There are many studies that have investigated the force decay associated with orthodontic synthetic elastomeric chains; however few have compared different colours from different suppliers. Aim: To compare the force loss of 3 different coloured elastomeric chains from 3 suppliers. Method: Three different coloured elastomeric chains; clear, grey, and blue from 3 suppliers; (3M, TP, and GAC (DENTSPLY)) were tested using Instron Tensile Testing Machine. Records of residual force taken; initially, 1 h, 24 h, 7 days, and 28 days. Findings: Blue had the highest force decay in all the three brands. TP was the only material in which all colours were significantly different. Clear in both 3M and GAC perform better than grey, but grey was superior to clear in TP. All brands have different force decay; TP (grey then clear) gave the highest and the most constant force for the tested period, followed by 3M, and lastly GAC. when comparing the force decay after 7 days, TP (grey and clear) lost 40%-50% of their force and continued to retain it until the end of 28 days, where as 3M, GAC, and TP blue had lost 50%-75% of their force after 7 days, and only retained 13%-32% of their initial force at the end of 28 days. Conclusions: Different colours have different force decay. The blue colour had the lowest residual force. TP E-chain (grey & clear) maintained the force required for tooth movement for the whole test period, while 3M and GAC fail to deliver the minimum required force after 24 h, and 1 h respectively. Keywords: Vivo Investigation, TP E-Chain, Different Force Decay. Title: Force Decay Associated With Coloured Elastomeric Chains; an Ex Vivo Investigation Author: Hussain alabduljabbar International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Recently honey therapy (HT) has been tried for the treatment of burn wounds in a few clinical trials and their results are promising. The medicinal properties of honey have been known since ages and recent studies have also shown that honey helps in acceleration of wound healing than conventional therapy. Objective: To investigate topical honey in superficial first degree burns though a systematic review of randomized controlled trials. Methodology: systemic review study was performed through MEDLINE, EMBASE, PubMed, studies discussing the treatment burns wounds with honey were included and the reference lists of these studies and databases were used to seek randomized controlled trials. Conclusion: In vitro and in vivo studies have highlighted a broad range of activities provided by honey in first degree burn treatment, most of studies approved that the honey has a positive outcome results in treating the first degree burns injuries. Keywords: Honey, few clinical trials and their results are promising. Title: The Use of Honey in First Degree Burns Treatment Author: Ahmed Hameed Altowairqi, Musab Mohammed Alnefaie, Ahmad Majed Aljoudi, Fahd Hamoud Alhazmi, Raad Hameed Altowairqi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Laser-assisted therapy is a modern and effective strategy. Laser technology has a wide application in paediatric dentistry for dental care and treatment of primary and permanent teeth.This review presents a overview of erbium lasers types, mechanism of action, applications in paediatric dentistry. Keywords: erbium lasers, applications, paediatric dentistry. Title: Erbium Lasers in Paediatric Dentistry Author: Dr. Divya Doneria, Dr. Seema Thakur, Dr. Parul Singhal, Dr. Deepak Chauhan, Dr. Cheeranjeevi Jayam, Dr. Anika Uppal International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Prospective Study Was Done in 40 Patients with Degenerative Cervical spinee disease during a 6 month period of which al patients had clinical features of cervical spine disease and underwent surgery for the same. The main objective of the study was to study the most common presenting clinical features and the effectiveness of the surgical procedure over the clinical features. The immeadte post op results with respect to patient satisfaction of the surgery, morbidity and mortality along with unexpected complications have been analysed. Materials and methods: all 40 cases were analyzed from single institution and done in a single unit. None of the traumatic spine injuries were taen into study.all patients of ASA GRADE 2 were taen into study. Most of our patients were in age group around 50.All patients were neupologically intact before surgery with respect to mobility and were able to perform their regular work except that few had increased spasticity who were unable to perform their work. Conclusion: All patients had relief of pain in immeadete post op period. some patients had postop complications and there was also a mortality due to post op haemotoma in neck. The advantages and disadvantages of this technique over the previous technique of iliac crest bone graft was analysed. Keywords: Degenerative cervical spine disease. Analysis of pre-op and post-op clinical features and patient satisfaction, effectiveness of surgical technique. Title: Study of 40 Cases of Anterior Cervical Discectomy with Cylindrical Titanium Cage Fusion Author: DR.R.SRINIVAS, PROF.SELVAKUMAR, DR. Y. RAVISHEKAR International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: To report spectral domain optical coherence tomography findings in acute Purtscher’s retinopathy. Methods: Case report and image analysis. Results: A 32-year-old man presented with decreased vision and cotton-wool spots in his right eye, which was hyperreflective on spectral domain optical coherence tomography. There were retinal and pre retinal haemorrhages. He was diagnosed with Purtscher’s retinopathy, after two months of observation the vision slightly improved but still poor, although the haemorrhages resolved with some remaining retinal opacification of papillomacular bundle. There was marked temporal optic nerve pallor Conclusion: The visual prognosis of Purtscher’s retinopathy could be very guarded if the infarction involves the papillomacular bundle. Keywords: Purtscher’s retinopathy, Trauma, retinal haemorrhages, optic nerve pallor. Title: Spectral Domain Optical Coherence Tomography Findings of Acute Purtscher’s Retinopathy Author: Majed Tale Alharbi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: To assess the cost and diagnostic value of back X-ray in patient with back pain. Methods: in form of retrospective cross section study, the self-made data collection instrument was designed with all needed information. The study cover all patient with back pain went for X-ray with CT scan or M.R.I in one year duration started from July 2012 to July 2013 in National Guard Hospital. The data is collected from medical files in the medical record for total 295 patients.The collected data were statistically analyzed. Results: Regarding radiology requests for assessment of back pain, X-ray plus MRI was frequently requested in the majority of cases (90.2%). Most patients were had a single request, while those requiring repeated requests were 8.5% for two requests, 1.0% and 0.3% for three or four requests. Out of the total requested, back X-ray yielded 28.1% abnormalities in comparison with MRI and CT scan which yielded a positive diagnosis in 88.5% and 79.3% of cases; respectively. In this regards, in comparison with MRI, and CT scan back X-ray was able to detect 3 out of every 10 diagnosis for back pain while MRI and CT scan was able to detect diagnosis in 9 out of 10 and 8 out of 10; respectively in cases with back pain. Among those who had done the back X-ray for back pain together with CT scan; the proportion of back X-ray there a frequency of 78.6% mismatch with abnormal CT scan done for back pain. On the other hand regarding the back X-ray which was done together with M.R.I for back pain; the back X-ray mismatch frequency with abnormal M.R.I amounted to (96.8%). The cost of x-ray requested in addition to M.R.I was the highest amounting to almost SR 700,000. Conclusion: back X-ray fails to detect abnormality in most of cases in compare with CT scan and M.R.I. it is lead to more cost and more radiation exposure and work load.so, generally it is not recommended. The clinical assessment is mandatory to evaluate the patient and request the proper form of radiology. Lumbosacral X-ray shows to be costly with minimum diagnostic value and high radiation exposure. Patient satisfaction should be reached by proper communication and trust with patient with detailed education rather than non-clinically indication for X-ray referral. Keywords: Back pain, X-ray, CT MRI, Saudi Arabia. Title: The Cost and Diagnostic Value of Back X-Ray in Back Pain Author: Adel Nasser Al bargi, Abdulrahman Ahmed Al naim, Abdullah Khaled Al maqhawi, Ammar Abdulfattah Al kubaish, Suha Jafar Al Bahrani, Saleh Khaled Al Mogairen, Ibrahim Faris Al ruqi, Sayed Ibrahim Ali ,Essam AbdelBary International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: To study the pattern of utilization of Corticosteroids in Dermatology Department in a Tertiary care hospital. The study was conducted for a period of 30 days.A prospective study was conducted in Dermatology Department and all the prescriptions containing steroids were included in the study and the parameters evaluated were gender, age, types of steroids used according to route of administration , potency of topical steroids , number of fixed dose combinations. A total of 100 patients were analysed during this study and among them 60% were males and 40% were females. The male population included 5(8.33%) in 11-20 years, 10(16.66%) in 21-30 years, 45(75%) in 31-40 years of age. The female patients included 5(12.5%) in 11-20years, 5(12.5%) in 21-30years of age, 30(75%) in 31-40 years of age. The potency of topical steroids were Mild in 6% ,Moderate in 14% ,Potent in 44% Superpotent in 36%. Keywords: corticosteroids, topical steroids, potency, utilization pattern. Title: A Prospective Study of Pattern of Utilization of Corticosteroids in Dermatology Department in a Tertiary Care Hospital Author: DR. PURABIROY, DR. V. LEKSHMANAN International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Title: Awareness of Basic Health Practices in Private & Governmental Schools’ Students in Riyadh, Saudi Arabia Author: Nouf Al- Sadoun, Areej Al- Balkhi, Malak Al- Sharif, Hind Al- Manee, Deema Al- Hazmi, Maha Al- Otaibi, Rana Mohammed, Hanadi Al- Sadeeq, Marwah Banaeem, Ghada Al- Khaldi, Dr. Mona Hassan International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Title: Heparin Induced Thrombocytopenia Author: Dr. R. Srinivas, Dr. G. Aishwarya International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Branchial cleft cysts are the most common congenital neck masses. The other name for Branchial cleft cyst is benign cervical lymphoepithelial cyst, which occurs on the lateral aspect of the neck. These cysts originate from remnants of the branchial arches or branchial pouches. The lesions presents as an asymptomatic circumscribed movable mass on the anterior border of the sternocledomastoid muscle. Many cases have been reported at the angle of the mandible, in the submandibular area and even in the pre-auricular and parotid areas. A solitary swelling with discharging sinus on the left side of the neck, in a 21-year-old female, Since childhood caused diagnostic dilemma with clinical presentation. Diagnosis was done after all the investigations and treated accordingly. Keywords: Branchial cleft cysts, discharging sinus. Title: Brancial Cyst Type IV Author: Pranab Jain, Shashank Mishra, Sanjay Pandey, Akshay Batta, Syamantak Srivastav International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals